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  1. Article ; Online: Observational cohort study of 100 patients presenting with functional visual loss: clinical characteristics and comparison with other functional neurologic disorders.

    Lawlor, Mitchell / Huynh, Brandon / Humphreys, Kate / Ogunbowale, Lola / Kopelman, Michael D / Plant, Gordon Terence

    Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

    2024  

    Abstract: Objective: Recent research has helped to develop a more detailed understanding of many functional neurologic disorders. The aim of this study was to increase our knowledge of functional visual loss and to compare the findings with those of other ... ...

    Abstract Objective: Recent research has helped to develop a more detailed understanding of many functional neurologic disorders. The aim of this study was to increase our knowledge of functional visual loss and to compare the findings with those of other functional syndromes.
    Design: Prospective and retrospective observational cohort study.
    Methods: This study took place at neuro-ophthalmology clinics at 3 major hospitals in London, United Kingdom, over a 12-month period. The study population consisted of 157 participants, 100 with functional visual loss, 21 pathologic control subjects with organic visual loss, and 36 healthy nonpathologic control subjects. All participants had their diagnosis confirmed with a full neuro-ophthalmic examination, neuroimaging, and visual electrophysiology. A full assessment of all participants' medical history was obtained from their general practitioner, and all participants completed a series of questionnaires assessing relevant associations.
    Results: Data were obtained on 157 participants, 100 with functional visual loss, 21 pathologic control subjects with organic visual loss, and 36 healthy nonpathologic control subjects. Participants with functional visual loss were typically female (74%) with a mean age at vision loss of 40.0 ± 16 years. Sixty-four percent of participants had bilateral vision loss; the remainder, unilateral loss. Twenty-six percent of the total cohort had organic visual loss with functional overlay. Fifty percent of participants with functional visual loss had a preexisting psychiatric diagnosis, the most common being a depressive disorder. Sixty-two percent of participants had an ocular history, and 87% had a previously diagnosed medical illness, most commonly neurologic (45%). Thirty-five percent of participants self-reported at least 1 additional functional symptom.
    Conclusions: Our population of functional visual loss subjects shares many similarities with the majority of patients with other functional neurologic disorders. They are generally young and female and have a greater than expected rate of psychiatric, medical, and coexisting ocular conditions. We found increased rates of precipitating stressors, clinical depression, and organic eye problems in subjects with functional visual loss.
    Language English
    Publishing date 2024-04-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 80091-0
    ISSN 1715-3360 ; 0008-4182
    ISSN (online) 1715-3360
    ISSN 0008-4182
    DOI 10.1016/j.jcjo.2024.02.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Associations between cortical lesions, optic nerve damage, and disability at the onset of multiple sclerosis: insights into neurodegenerative processes.

    Varmpompiti, Kyriakoula / Chow, Geoffrey / Foster, Michael / Kodali, Srikirti / Prados, Ferran / Yiannakas, Marios C / Kanber, Baris / Burke, Ailbhe / Ogunbowale, Lola / Davagnanam, Indran / Toosy, Ahmed T / Collorone, Sara

    Multiple sclerosis and related disorders

    2023  Volume 83, Page(s) 105413

    Abstract: Background: Multiple sclerosis cortical lesions are areas of demyelination and neuroaxonal loss. Retinal layer thickness, measured with optical coherence tomography (OCT), is an emerging biomarker of neuroaxonal loss. Studies have reported correlations ... ...

    Abstract Background: Multiple sclerosis cortical lesions are areas of demyelination and neuroaxonal loss. Retinal layer thickness, measured with optical coherence tomography (OCT), is an emerging biomarker of neuroaxonal loss. Studies have reported correlations between cortical lesions and retinal layer thinning in established multiple sclerosis, suggesting a shared pathophysiological process. Here, we assessed the correlation between cortical lesions and OCT metrics at the onset of multiple sclerosis, examining, for the first time, associations with physical or cognitive disability.
    Objective: To examine the relationship between cortical lesions, optic nerve and retinal layer thicknesses, and physical and cognitive disability at the first demyelinating event.
    Methods: Thirty-nine patients and 22 controls underwent 3T-MRI, optical coherence tomography, and clinical tests. We identified cortical lesions on phase-sensitive inversion recovery sequences, including occipital cortex lesions. We measured the estimated total intracranial volume and the white matter lesion volume. OCT metrics included peripapillary retinal nerve fibre layer (pRNFL), ganglion cell and inner plexiform layer (GCIPL) and inner nuclear layer (INL) thicknesses.
    Results: Higher total cortical and leukocortical lesion volumes correlated with thinner pRNFL (B = -0.0005, 95 % CI -0.0008 to -0.0001, p = 0.01; B = -0.0005, 95 % CI -0.0008 to -0.0001, p = 0.01, respectively). Leukocortical lesion number correlated with colour vision deficits (B = 0.58, 95 %CI 0.039 to 1,11, p = 0.036). Thinner GCIPL correlated with a higher Expanded Disability Status Scale (B = -0.06, 95 % CI -1.1 to -0.008, p = 0.026). MS diagnosis (n = 18) correlated with higher cortical and leukocortical lesion numbers (p = 0.004 and p = 0.003), thinner GCIPL (p = 0.029) and INL (p = 0.041).
    Conclusion: The association between cortical lesions and axonal damage in the optic nerve reinforces the role of neurodegenerative processes in MS pathogenesis at onset.
    MeSH term(s) Humans ; Multiple Sclerosis/complications ; Multiple Sclerosis/diagnostic imaging ; Retinal Ganglion Cells/pathology ; Retina/pathology ; Optic Nerve/pathology ; Retinal Degeneration/etiology ; Tomography, Optical Coherence
    Language English
    Publishing date 2023-12-26
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2645330-7
    ISSN 2211-0356 ; 2211-0348
    ISSN (online) 2211-0356
    ISSN 2211-0348
    DOI 10.1016/j.msard.2023.105413
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  3. Article ; Online: Automated Pupillometry Using a Prototype Binocular Optical Coherence Tomography System.

    Chopra, Reena / Mulholland, Pádraig J / Petzold, Axel / Ogunbowale, Lola / Gazzard, Gus / Bremner, Fion D / Anderson, Roger S / Keane, Pearse A

    American journal of ophthalmology

    2020  Volume 214, Page(s) 21–31

    Abstract: Purpose: To determine the test-retest reliability and diagnostic accuracy of a binocular optical coherence tomography (OCT) prototype (Envision Diagnostics, El Segundo, California, USA) for pupillometry.: Design: Assessment of diagnostic reliability ... ...

    Abstract Purpose: To determine the test-retest reliability and diagnostic accuracy of a binocular optical coherence tomography (OCT) prototype (Envision Diagnostics, El Segundo, California, USA) for pupillometry.
    Design: Assessment of diagnostic reliability and accuracy.
    Methods: Fifty participants with relative afferent pupillary defects (RAPDs) confirmed using the swinging flashlight method (mean age 49.6 years) and 50 healthy control subjects (mean age 31.3 years) were examined. Participants twice underwent an automated pupillometry examination using a binocular OCT system that presents a stimulus and simultaneously captures OCT images of the iris-pupil plane of both eyes. Participants underwent a single examination on the RAPDx (Konan Medical, Irvine, California, USA), an automated infrared pupillometer. Pupil parameters including maximum and minimum diameter, and anisocoria were measured. The magnitude of RAPD was calculated using the log of the ratio of the constriction amplitude between the eyes. A pathological RAPD was above ±0.5 log units on both devices.
    Results: The intraclass correlation coefficient was >0.90 for OCT-derived maximum pupil diameter, minimum pupil diameter, and anisocoria. The RAPDx had a sensitivity of 82% and a specificity of 94% for detection of RAPD whereas the binocular OCT had a sensitivity of 74% and specificity of 86%. The diagnostic accuracy of the RAPDx and binocular OCT was 88% (95% confidence interval 80%-94%) and 80% (95% confidence interval 71%-87%) respectively.
    Conclusions: Binocular OCT-derived pupil parameters had excellent test-retest reliability. The diagnostic accuracy of RAPD was inferior to the RAPDx and is likely related to factors such as eye movement during OCT capture. As OCT becomes ubiquitous, OCT-derived measurements may provide an efficient method of objectively quantifying the pupil responses.
    MeSH term(s) Adult ; Diagnostic Techniques, Ophthalmological/instrumentation ; Female ; Healthy Volunteers ; Humans ; Male ; Middle Aged ; Pupil/physiology ; Pupil Disorders/diagnosis ; Pupil Disorders/physiopathology ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, Optical Coherence/instrumentation ; Vision, Binocular/physiology ; Visual Acuity/physiology
    Language English
    Publishing date 2020-02-28
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80030-2
    ISSN 1879-1891 ; 0002-9394
    ISSN (online) 1879-1891
    ISSN 0002-9394
    DOI 10.1016/j.ajo.2020.02.013
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  4. Article ; Online: Sensitivity and specificity of the AdenoPlus point-of-care system in detecting adenovirus in conjunctivitis patients at an ophthalmic emergency department: a diagnostic accuracy study.

    Kam, K Y Ronald / Ong, Hon Shing / Bunce, Catey / Ogunbowale, Lola / Verma, Seema

    The British journal of ophthalmology

    2015  Volume 99, Issue 9, Page(s) 1186–1189

    Abstract: Background: To estimate the diagnostic accuracy (sensitivity and specificity) of the AdenoPlus point-of-care adenoviral test compared to PCR in an ophthalmic accident and emergency service. These findings were compared with those of a previous study.: ...

    Abstract Background: To estimate the diagnostic accuracy (sensitivity and specificity) of the AdenoPlus point-of-care adenoviral test compared to PCR in an ophthalmic accident and emergency service. These findings were compared with those of a previous study.
    Methods: This was a prospective diagnostic accuracy study on 121 patients presenting to an emergency eye unit with a clinical picture of acute adenoviral conjunctivitis. AdenoPlus testing was carried out on one eye of each patient and a PCR analysis was also performed on a swab taken from the same eye. AdenoPlus and PCR results were interpreted by masked personnel. Sensitivity and specificity for the AdenoPlus test were calculated using PCR results as the reference standard.
    Results: 121 patients were enrolled and 109 met the inclusion criteria. 43 patients (39.4%) tested positive for adenovirus by PCR analysis. The sensitivity of the AdenoPlus swab in detecting adenovirus was 39.5% (17/43, 95% CI 26% to 54%) and specificity was 95.5% (63/66, 95% CI 87% to 98%) compared to PCR.
    Conclusions: The AdenoPlus test has a high specificity for diagnosing adenoviral conjunctivitis, but in this clinical setting, we could not reproduce the high sensitivity that has been previously published.
    MeSH term(s) Acute Disease ; Adenovirus Infections, Human/diagnosis ; Adenoviruses, Human/genetics ; Adenoviruses, Human/isolation & purification ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Conjunctivitis, Viral/diagnosis ; Conjunctivitis, Viral/virology ; DNA, Viral/analysis ; Diagnostic Techniques, Ophthalmological ; Emergency Service, Hospital/statistics & numerical data ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Point-of-Care Systems/standards ; Polymerase Chain Reaction/methods ; Prospective Studies ; Sensitivity and Specificity ; Young Adult
    Chemical Substances DNA, Viral
    Language English
    Publishing date 2015-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 80078-8
    ISSN 1468-2079 ; 0007-1161
    ISSN (online) 1468-2079
    ISSN 0007-1161
    DOI 10.1136/bjophthalmol-2014-306508
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  5. Article: Drops and falls.

    Spratt, Alexander / Ogunbowale, Lola / Khawaja, Anthony / Franks, Wendy

    Age and ageing

    2006  Volume 35, Issue 6, Page(s) 646

    MeSH term(s) Accidental Falls ; Adrenergic beta-Antagonists/administration & dosage ; Adrenergic beta-Antagonists/adverse effects ; Aged, 80 and over ; Humans ; Levobunolol/administration & dosage ; Levobunolol/adverse effects ; Male ; Ophthalmic Solutions/adverse effects
    Chemical Substances Adrenergic beta-Antagonists ; Ophthalmic Solutions ; Levobunolol (G6317AOI7K)
    Language English
    Publishing date 2006-11
    Publishing country England
    Document type Case Reports ; Comment ; Letter
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afl113
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  6. Article ; Online: Intravitreal bevacizumab in refractory neovascular glaucoma: a prospective, observational case series.

    Kotecha, Aachal / Spratt, Alexander / Ogunbowale, Lola / dell'Omo, Roberto / Kulkarni, Avinash / Bunce, Catey / Franks, Wendy A

    Archives of ophthalmology (Chicago, Ill. : 1960)

    2011  Volume 129, Issue 2, Page(s) 145–150

    Abstract: Objective: To examine the efficacy of intravitreal bevacizumab for pain relief in eyes with refractory neovascular glaucoma.: Methods: In this prospective case series, 52 eyes with neovascular glaucoma were administered intravitreal bevacizumab, 1.25 ...

    Abstract Objective: To examine the efficacy of intravitreal bevacizumab for pain relief in eyes with refractory neovascular glaucoma.
    Methods: In this prospective case series, 52 eyes with neovascular glaucoma were administered intravitreal bevacizumab, 1.25 mg, and monitored for 6 months. The primary outcome measure was change in subjective pain score. Intraocular pressure and iris neovascularization were evaluated at each visit. Surgical intervention for control of intraocular pressure was performed according to clinical need.
    Results: Forty-two patients (44 eyes) completed the 6-month follow-up. Subjective pain score was reduced significantly 1 week after intravitreal bevacizumab injection and lasted throughout the follow-up period (median [interquartile range]: baseline, 3 [0-6]; week 1, 1 [0-3]; month 1, 0 [0-1]; month 3, 0 [0-1]; and month 6, 0 [0-0]; Kruskal-Wallis χ(2) 31.03; P < .001). A rapid, yet relatively transient, reduction in iris neovascularization was also noted (iris neovascularization grade at baseline, 4.0 [3-4]; week 1, 2.5 [1-4]; month 1, 2.0 [1-4]; month 3, 3.0 [2-4]; and month 6, 3.0 [2-4], χ(2) 23.33; P < .001). Four eyes (8%) required more than 1 injection to facilitate further intraocular surgery.
    Conclusions: Intravitreal bevacizumab is a useful adjunct in the management of refractory neovascular glaucoma, producing rapid relief of pain. However, we found no evidence to suggest that intravitreal bevacizumab lowers intraocular pressure in eyes with angle closure; conventional medical, laser, and surgical treatment are still needed in these eyes.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/administration & dosage ; Angiogenesis Inhibitors/adverse effects ; Antibodies, Monoclonal/administration & dosage ; Antibodies, Monoclonal/adverse effects ; Antibodies, Monoclonal, Humanized ; Antihypertensive Agents/administration & dosage ; Bevacizumab ; Female ; Follow-Up Studies ; Glaucoma, Neovascular/drug therapy ; Glaucoma, Neovascular/physiopathology ; Humans ; Intraocular Pressure/drug effects ; Intraocular Pressure/physiology ; Intravitreal Injections ; Iris/blood supply ; Male ; Middle Aged ; Neovascularization, Pathologic/drug therapy ; Pain/drug therapy ; Pain Measurement ; Prospective Studies ; Recurrence ; Tonometry, Ocular ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology ; Young Adult
    Chemical Substances Angiogenesis Inhibitors ; Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Antihypertensive Agents ; VEGFA protein, human ; Vascular Endothelial Growth Factor A ; Bevacizumab (2S9ZZM9Q9V)
    Language English
    Publishing date 2011-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 211580-3
    ISSN 1538-3601 ; 0003-9950 ; 0093-0326
    ISSN (online) 1538-3601
    ISSN 0003-9950 ; 0093-0326
    DOI 10.1001/archophthalmol.2010.350
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