27 results on '"Humma Shahid"'
Search Results
2. Evaluating multidisciplinary glaucoma care: visual field progression and loss of sight year analysis in the community vs hospital setting
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Tasneem Z Khatib, Maryam Mushtaq, Keith R Martin, Humma Shahid, Jane Kean, Rupert R A Bourne, Sarah Farrell, Nikou Nassehzadeh-Tabriz, Yusuf Mushtaq, Binita Panchasara, and Hong Kai Lim
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Pediatrics ,medicine.medical_specialty ,genetic structures ,Hospital setting ,Vision Disorders ,MEDLINE ,Glaucoma ,Lower risk ,Article ,03 medical and health sciences ,0302 clinical medicine ,Multidisciplinary approach ,medicine ,Humans ,Intraocular Pressure ,Retrospective Studies ,Shared care ,business.industry ,medicine.disease ,Health services ,Hospitals ,eye diseases ,Visual field ,Ophthalmology ,Cohort ,Optic nerve diseases ,Disease Progression ,030221 ophthalmology & optometry ,Visual Field Tests ,Visual Fields ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND: A variety of shared care models have been developed, which aim to stratify glaucoma patients according to risk of disease progression. However, there is limited published data on the rate of glaucoma progression in the hospital vs community setting. Here we aimed to compare rates of glaucomatous visual field progression in the Cambridge Community Optometrist Glaucoma Scheme (COGS) and Addenbrooke's Hospital Glaucoma Clinic (AGC). METHODS: A retrospective comparative cohort review was performed. Patients with five or more visual field tests were included. Zeiss Forum software was used to calculate the MD progression rate (dB/year). Loss of sight years (LSY) were also calculated for both COGS and AGC. RESULTS: Overall, 8465 visual field tests from 854 patients were reviewed. In all, 362 eyes from the AGC group and 210 eyes from COGS were included. The MD deterioration rate was significantly lower in the COGS patients compared with the AGC group (-0.1 vs -0.3 dB/year; p
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- 2021
3. Association of Smoking, Alcohol Consumption, Blood Pressure, Body Mass Index, and Glycemic Risk Factors With Age-Related Macular Degeneration
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Itay Chowers, Stacy M Meuer, R. Theodore Smith, Bamini Gopinath, Brendan J Vote, Thierry Léveillard, David A Mackey, Dwight Stambolian, Jamie E Craig, José-Alain Sahel, David J Hunter, Michael L Klein, Jane Romm, Robyn H Guymer, Mingyao Li, J. L. Haines, Emily L. Moore, J Allie McGrath, Chloe M. Stanton, Danni Lin, Jessica N Cooke Bailey, Anton Orlin, Anita Agarwal, Frank G Holz, Debra A Schaumberg, Valerie Kuan, Christine A. Curcio, Ken Flagg, Sudha K Iyengar, Sebanti Sengupta, Bal Dhillon, Joanna E. Merriam, Janette Hall, Bernhard H F Weber, Caroline Brandl, Donald Zack, Eric Souied, Yara T. E. Lechanteur, Christina A Rennie, Mathias Gorski, Murray H Brilliant, Denise J. Morgan, Barbara Truitt, Daniel E Weeks, Thomas Langmann, Aroon D. Hingorani, Gerald Liew, Andrea J Richardson, Neal S Peachey, John Blangero, Alasdair Warwick, Humma Shahid, Eiko K de Jong, Kari E Branham, S. V. Goverdhan, Paul Mitchell, Angela J Cree, Margaux A. Morrison, Rebecca J Sardell, Ian J Constable, Michael A. Hauser, Zhenglin Yang, Reneé Laux, G. Rudolph, David Cho, Jie Jin Wang, Albert Caramoy, Jaclyn L Kovach, Alexander Brucker, Frédéric Blond, Hongrong Luo, Michael B Gorin, Robert P Igo, Caroline C W Klaver, Lebriz Ersoy, Timothy Isaacs, Adnan Tufail, Gabriëlle H.S. Buitendijk, Nicholas Katsanis, Stephen Burgess, Carel B Hoyng, Reecha Sofat, Ivana K Kim, Mohammad Othman, Ian L McAllister, Giuliana Silvestri, Helena Hai Liang, Margaret DeAngelis, Matthew P Johnson, Ava G Tan, Felix Grassmann, Lindsay A Farrer, Alex W Hewitt, Hong Ouyang, Cindy Wen, Henry Ferreyra, Milam A Brantley, Melinda Cain, Caroline Hayward, Kristine E. Lee, Linn Gieser, Isabelle Audo, Evangelia E Tsironi, Nicole T.M. Saksens, Hendrik P N Scholl, Stephen G Schwartz, Matthias Olden, Saddek Mohand-Said, Scott J Hebbring, Joshua D Hoffman, Shira Hagbi-Levi, Anthony T Moore, Mustapha Benchaboune, Lars G Fritsche, Margaret A Pericak-Vance, Iris M Heid, Kyu Hyung Park, Jennifer L Bragg-Gresham, Hélène Blanché, Alexis Boleda, Rando Allikmets, John R Heckenlively, Kathryn P Burdon, Elisa Bala, Rinki Ratnapriya, Kimberly F Doheny, Xiaowei Zhan, Sascha Fauser, Claudia N von Strachwitz, Ronald Klein, Johanna R. Foerster, Wilmar Igl, Andrew J Lotery, Klaus Stark, Matthew Brooks, Jane C Khan, Emily Y Chew, Paul N Baird, Cornelia M Van Duijn, Chelsea E. Myers, Anneke I den Hollander, Monique D Courtenay, Zhiguang Su, Yingda Jiang, William K Scott, Tammy M Martin, Armin Wolf, Jeeyun Ahn, John C. Merriam, Eric A Postel, Guanping Mao, Emmanuelle Souzeau, Barbara E K Klein, Terrie Kitchner, Stewart Lake, Anand Swaroop, Valentina Cipriani, Tina Schick, Stephanie A. Hagstrom, Alan M. Kwong, Daniel Chen, Gonçalo R. Abecasis, Matthew Schu, Michelle Grunin, John R.W. Yates, Peter Campochiaro, Kang Zhang, and Jean-François Deleuze
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Vascular Endothelial Growth Factor A ,medicine.medical_specialty ,Alcohol Drinking ,medicine.medical_treatment ,Visual Acuity ,Angiogenesis Inhibitors ,Blood Pressure ,Type 2 diabetes ,Blindness ,Lower risk ,Body Mass Index ,Risk Factors ,Internal medicine ,Mendelian randomization ,Humans ,Medicine ,Risk factor ,Glycemic ,business.industry ,Smoking ,Odds ratio ,Mendelian Randomization Analysis ,medicine.disease ,Ophthalmology ,Diabetes Mellitus, Type 2 ,Wet Macular Degeneration ,Smoking cessation ,business ,Body mass index ,Genome-Wide Association Study - Abstract
Importance Advanced age-related macular degeneration (AMD) is a leading cause of blindness in Western countries. Causal, modifiable risk factors need to be identified to develop preventive measures for advanced AMD. Objective To assess whether smoking, alcohol consumption, blood pressure, body mass index, and glycemic traits are associated with increased risk of advanced AMD. Design, Setting, Participants This study used 2-sample mendelian randomization. Genetic instruments composed of variants associated with risk factors at genome-wide significance (P
- Published
- 2021
4. Distribution and extent of electronic medical record utilisation in eye units across the United Kingdom: a cross-sectional study of the current landscape
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Humma Shahid and Shin Bin Lim
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Diagnostic Imaging ,Future studies ,020205 medical informatics ,National Health Programs ,Cross-sectional study ,health care facilities, manpower, and services ,02 engineering and technology ,digestive system ,behavioral disciplines and activities ,03 medical and health sciences ,0302 clinical medicine ,Secondary outcome ,patient records ,information technology ,System use ,Patient information ,health services administration ,Surveys and Questionnaires ,0202 electrical engineering, electronic engineering, information engineering ,electronic medical records ,Medicine ,Humans ,health care economics and organizations ,business.industry ,Medical record ,Research ,Electronic medical record ,General Medicine ,National health service ,medicine.disease ,United Kingdom ,Ophthalmology ,electronic health records ,Cross-Sectional Studies ,030221 ophthalmology & optometry ,Optometry ,Medical emergency ,business - Abstract
ObjectivesOphthalmology units across the UK vary widely in their adoption of electronic medical records (EMR). There is a lack of evidence to show the extent and progress of EMR adoption. The aim of this study was to capture a snapshot of the current landscape of EMR use, as a baseline for comparison in future studies.SettingAn electronic survey questionnaire was sent to all NHS ophthalmology Units in the UK.ParticipantsA total of 104 National Health Service (NHS) ophthalmology units participated in the survey, which was carried out over 6 months from December 2013 to June 2014.Primary and secondary outcome measuresRespondents were asked about technology usage pertaining to specific processes in the clinic workflow. This allowed us to determine the extent of EMR usage and details about current use or planned implementation by each unit.Results77.6% (n=104) of NHS ophthalmology units responded. 45.3% (n=48) of units were currently using an EMR and a further 26.4% (n=28) of units plan to implement EMR within 2 years. 70.8% of units with a current EMR system use Medisoft. EMR is used by all clinicians in 37.5% and by all subspecialties offered at the unit in 27.0%. In 56.3%, new clinical notes are entered into EMR only by clinicians. All imaging devices are networked to EMR in 28.3%. In 46.7%, EMR is accessible by other specialties within the same hospital. 71.1% would recommend EMR to a colleague.ConclusionsEMR has the potential to address current limitations of patient information transfer and sharing in ophthalmology. It is pleasing to see a significant proportion of units already engaging with EMR or having plans to do so in the near future. However, differing EMR systems and lack of remote access mean further optimisation of these record systems are needed to allow data transfer between units.
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- 2017
5. Cambridge community Optometry Glaucoma Scheme
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Jonathan Keenan, Humma Shahid, Keith R Martin, Andrew White, and Rupert R A Bourne
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Intraocular pressure ,genetic structures ,Shared care ,medicine.diagnostic_test ,Referral ,business.industry ,Optic disk ,Ocular hypertension ,Glaucoma ,Teleophthalmology ,medicine.disease ,eye diseases ,Ophthalmology ,Visual field test ,Optometry ,Medicine ,sense organs ,business - Abstract
Background With a higher life expectancy, there is an increased demand for hospital glaucoma services in the United Kingdom. Design The Cambridge community Optometry Glaucoma Scheme (COGS) was initiated in 2010, where new referrals for suspected glaucoma are evaluated by community optometrists with a special interest in glaucoma, with virtual electronic review and validation by a consultant ophthalmologist with special interest in glaucoma. Participants 1733 patients were evaluated by this scheme between 2010 and 2013. Methods Clinical assessment is performed by the optometrist at a remote site. Goldmann applanation tonometry, pachymetry, monoscopic colour optic disc photographs and automated Humphrey visual field testing are performed. A clinical decision is made as to whether a patient has glaucoma or is a suspect, and referred on or discharged as a false positive referral. The clinical findings, optic disc photographs and visual field test results are transmitted electronically for virtual review by a consultant ophthalmologist. Main Outcome Measures The number of false positive referrals from initial referral into the scheme. Results Of the patients, 46.6% were discharged at assessment and a further 5.7% were discharged following virtual review. Of the patients initially discharged, 2.8% were recalled following virtual review. Following assessment at the hospital, a further 10.5% were discharged after a single visit. Conclusions The COGS community-based glaucoma screening programme is a safe and effective way of evaluating glaucoma referrals in the community and reducing false-positive referrals for glaucoma into the hospital system.
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- 2014
6. Seven new loci associated with age-related macular degeneration
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Paul Mitchell, Lindsay A. Farrer, Ming Zhang, Mohammad Othman, Michiaki Kubo, André G. Uitterlinden, Anton Orlin, Kyu Hyung Park, Simon P. Harding, Yusuke Nakamura, Eric H Souied, William K. Scott, Gregory S. Hageman, Anita Agarwal, G. Rudolph, Henry Ferreyra, Yutaka Kiyohara, Humma Shahid, Yukinori Okada, Gregory Hannum, Hendrik P. N. Scholl, Christian Gieger, Clara Lee, H.-Erich Wichmann, Andrew R. Webster, Margaret A. Pericak-Vance, Brian L. Yaspan, Bernhard H. F. Weber, Gyungah Jun, Gabriëlle H.S. Buitendijk, Ching-Yu Cheng, Igor Kozak, Ana Maria Armbrecht, Gaetano R. Barile, Valentina Cipriani, Stephanie A. Hagstrom, Paul N. Baird, Margaret M. DeAngelis, Ronald Klein, Itay Chowers, Matthew Brooks, Mark J. Daly, Kimberly A Chin, Wei Chen, Thierry Léveillard, Cornelia M. van Duijn, Barbara E.K. Klein, Tien Yin Wong, Olivier Poch, Yi Yu, Peter Lichtner, Michael L. Klein, Lars G. Fritsche, Daniel E. Weeks, Radu Cojocaru, Gayle J.T. Pauer, Jaclyn L. Kovach, John R. Heckenlively, Jonathan L. Haines, Andrew J. Lotery, Nicholas Katsanis, Caroline C W Klaver, Stephan Ripke, Unnur Thorsteinsdottir, M. Carolina Ortube, Rando Allikmets, Nirubol Tosakulwong, Barbara Truitt, Robert P. Igo, Johanna M. Seddon, Kristine E. Lee, Emily Y. Chew, Kang Zhang, Debra A. Schaumberg, David Clayton, Frank G. Holz, Robyn Reynolds, Matthew Schu, Neal S. Peachey, Neel Gupta, Tatsuro Ishibashi, William Cade, Melinda Cain, Gwen M. Sturgill-Short, Jane C. Khan, Asbjorg Geirsdottir, Atsushi Takahashi, Thomas Meitinger, Belinda K. Cornes, Xueling Sim, Raymond Ripp, Evangelos Evangelou, Saddek Mohand-Said, Albert O. Edwards, Theru A. Sivakumaran, John P. A. Ioannidis, Kari Branham, Peronne Joseph, Jie Jin Wang, Chelsea E. Myers, Thomas W. Winkler, Johannes R. Vingerling, Robyn H. Guymer, Anthony T. Moore, Christos Haritoglou, Peter A. Campochiaro, Ronnie George, Chi-Chao Chan, Sudha K. Iyengar, Lucia Sobrin, Eranga N. Vithana, Haraldur Sigurdsson, James S. Friedman, Guy Hughes, Baljean Dhillon, Lingam Vijaya, Alan F. Wright, José-Alain Sahel, Rinki Ratna Priya, Tin Aung, R. Theodore Smith, Isabelle Audo, Satoshi Arakawa, Alexander J. Brucker, Gonçalo R. Abecasis, Evangelia E. Tsironi, Anand Swaroop, Mark Lathrop, Mustapha Benchaboune, Diana Zelenika, Joanna E. Merriam, Iris M. Heid, Denise J. Morgan, Michael B. Gorin, Donald J. Zack, Ling Zhao, Hreinn Stefansson, Andrea J. Richardson, Yvette P. Conley, Kari Stefansson, Giuliana Silvestri, Yoichiro Kamatani, Ivana K. Kim, Gudmar Thorleifsson, Stephen G. Schwartz, Alan C. Bird, Claudia N. Keilhauer, Euijung Ryu, Margaux A. Morrison, Chris Pappas, Dwight Stambolian, John R.W. Yates, Paul N. Bishop, Jesen Fagerness, Adam C. Naj, Peter J. Francis, Ophthalmology, Internal Medicine, Epidemiology, and Obstetrics & Gynecology
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Male ,Genome-wide association study ,Biology ,Bioinformatics ,Polymorphism, Single Nucleotide ,Article ,Macular Degeneration ,03 medical and health sciences ,0302 clinical medicine ,Meta-Analysis as Topic ,Risk Factors ,Polymorphism (computer science) ,Genotype ,Genetics ,medicine ,Humans ,SNP ,Genetic Predisposition to Disease ,030304 developmental biology ,0303 health sciences ,Haplotype ,Case-control study ,Macular degeneration ,medicine.disease ,eye diseases ,3. Good health ,Genetic Loci ,Case-Control Studies ,Factor H ,030221 ophthalmology & optometry ,Female ,Biomarkers ,Genome-Wide Association Study - Abstract
Age-related macular degeneration (AMD) is a common cause of blindness in older individuals. To accelerate the understanding of AMD biology and help design new therapies, we executed a collaborative genome-wide association study, including >17,100 advanced AMD cases and >60,000 controls of European and Asian ancestry. We identified 19 loci associated at P
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- 2013
7. Pre-operative intraocular pressure does not influence outcome of trabeculectomy surgery: a retrospective cohort study
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Humma Shahid, Nicholas Sarkies, Keith R Martin, Nisha Nesaratnam, Martin, Keith [0000-0002-9347-3661], and Apollo - University of Cambridge Repository
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Male ,medicine.medical_specialty ,Intraocular pressure ,Visual acuity ,Open angle glaucoma ,genetic structures ,medicine.medical_treatment ,Visual Acuity ,Glaucoma ,Trabeculectomy ,Tonometry, Ocular ,Postoperative Complications ,medicine ,Humans ,Antihypertensive Agents ,Intraocular Pressure ,Aged ,Retrospective Studies ,business.industry ,Retrospective cohort study ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Pre operative ,eye diseases ,Surgery ,Pre-operative intraocular pressure ,Ophthalmology ,Treatment Outcome ,Preoperative Period ,Visual Field Tests ,Female ,sense organs ,Visual Fields ,medicine.symptom ,business ,Glaucoma, Open-Angle ,Research Article ,Follow-Up Studies - Abstract
Background To investigate whether pre-operative intraocular pressure (IOP) predicts outcome of trabeculectomy surgery in patients with primary open angle glaucoma over a 3-year period of follow-up. Methods Retrospective cohort study, of a total of 61 patients (80 procedures) who had undergone trabeculectomy surgery after failed medical management at a single centre between 2000 and 2011. Patients were identified through surgical logbooks. A subsequent case note-review identified 61 patients (80 procedures) with primary open angle glaucoma (POAG). The primary outcome was success of trabeculectomy surgery, with failure defined as intraocular pressure (IOP) > 21 mmHg, ≤ 5 mmHg or not reduced by 20% at two consecutive follow-up visits 3-months post-operatively. Qualified success was defined as surgical success with the use of supplemental medical therapy. Secondary outcomes included visual acuity, Humphrey visual field MD, surgical complications and post-operative interventions. Results At 3 years, the odds ratio of failure was 0.93 per mmHg pre-operative IOP (95% C.I. 0.83-1.03, p = 0.15 Wald Χ2 test), and the odds ratio of failure or qualified success was 0.96 (95% C.I. 0.89-1.04, p = 0.35). The incidence of surgical complications showed an odds ratio of 1.02 per mmHg pre-operative IOP (95% C.I. 0.95-1.10, p = 0.55 Wald Χ2 test). The incidence of post-operative interventions showed an odds ratio of 1.01 per mmHg pre-operative IOP (95% C.I. 0.94-1.09, p = 0.80 Wald Χ2 test). Conclusions Pre-operative IOP does not predict success of trabeculectomy surgery in POAG patients during the first 3 years of follow-up. The incidence of surgical complications and post-operative interventions shows no association with pre-operative IOP.
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- 2016
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8. Complement factor H variant Y402H is a major risk determinant for geographic atrophy and choroidal neovascularization in smokers and nonsmokers
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Jane C. Khan, Alan C. Bird, Humma Shahid, T. Sepp, John R.W. Yates, D A Thurlby, David Clayton, and Anthony T. Moore
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Male ,medicine.medical_specialty ,Pathology ,Genotype ,genetic structures ,Population ,Polymerase Chain Reaction ,Polymorphism, Single Nucleotide ,Gastroenterology ,Macular Degeneration ,Gene Frequency ,Risk Factors ,Internal medicine ,medicine ,Humans ,Family history ,Pigment Epithelium of Eye ,education ,Allele frequency ,Alleles ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,Smoking ,Case-control study ,Genetic Variation ,Odds ratio ,Choroidal Neovascularization ,eye diseases ,Choroidal neovascularization ,Case-Control Studies ,Complement Factor H ,Female ,sense organs ,Gene polymorphism ,Atrophy ,medicine.symptom ,business ,Photoreceptor Cells, Vertebrate - Abstract
PURPOSE: The complement factor H (CFH) gene polymorphism Y402H (1277T-->C) has been associated with susceptibility to age-related macular degeneration (AMD). The purpose of this study was to confirm this association in a U.K. population, to determine whether the association holds for both geographic atrophy (GA) and choroidal neovascularization (CNV), and to investigate interactions with smoking. METHODS: A case-control study was undertaken in 443 cases of AMD, with 262 spouses as control subjects. All subjects completed a health and lifestyle questionnaire, had an ophthalmic assessment with fundus photography, and were genotyped. RESULTS: The frequencies of the C allele and CC genotype were significantly higher in cases than in controls. In comparison to the TT genotype, the odds ratios for AMD associated with the CT and CC genotypes were 3.1 (CI 2.0-4.6) and 6.3 (CI 3.8-10.4), respectively. The results were similar in subgroup analyses confined to cases with GA or CNV. The findings were also similar for subgroup analyses restricted to subjects who had never smoked, moderate smokers, or heavier smokers (>20 pack years of smoking). Heavier smokers with the CC genotype may be particularly at risk. The frequency of the CC genotype did not differ significantly between cases with and without a family history of AMD. There was no evidence that genotype had any influence on age at onset of disease. CONCLUSIONS: The CFH Y402H variant is strongly associated with both GA and CNV in the U.K. population. This association is similar in smokers and nonsmokers. Heavier smokers with the CC genotype may be at particular risk.
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- 2016
9. Analysis of copy number variation at DMBT1 and age-related macular degeneration
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Anthony T. Moore, John R.W. Yates, Humma Shahid, Jane C. Khan, Shamik Polley, Edward J. Hollox, and Valentina Cipriani
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0301 basic medicine ,Aging ,Linkage disequilibrium ,genetic structures ,Neurodegenerative ,Eye ,Linkage Disequilibrium ,Macular Degeneration ,Gene Frequency ,Receptors ,Odds Ratio ,2.1 Biological and endogenous factors ,Genetics(clinical) ,Pair 10 ,Copy-number variation ,Aetiology ,International HapMap Project ,Genetics (clinical) ,Genetics & Heredity ,Genetics ,Serine Endopeptidases ,Single Nucleotide ,High-Temperature Requirement A Serine Peptidase 1 ,DNA-Binding Proteins ,Factor H ,Cell Surface ,Human ,Research Article ,DNA Copy Number Variations ,Genotype ,Clinical Sciences ,Single-nucleotide polymorphism ,Receptors, Cell Surface ,Biology ,Polymorphism, Single Nucleotide ,Chromosomes ,Structural variation ,03 medical and health sciences ,Clinical Research ,medicine ,Humans ,Polymorphism ,Allele ,Eye Disease and Disorders of Vision ,Alleles ,Chromosomes, Human, Pair 10 ,Tumor Suppressor Proteins ,Calcium-Binding Proteins ,Proteins ,Macular degeneration ,medicine.disease ,eye diseases ,030104 developmental biology ,Case-Control Studies ,sense organs - Abstract
Background DMBT1 is a gene that shows extensive copy number variation (CNV) that alters the number of bacteria-binding domains in the protein and has been shown to activate the complement pathway. It lies next to the ARMS2/HTRA1 genes in a region of chromosome 10q26, where single nucleotide variants have been strongly associated with age-related macular degeneration (AMD), the commonest cause of blindness in Western populations. Complement activation is thought to be a key factor in the pathogenesis of this condition. We sought to investigate whether DMBT1 CNV plays any role in the susceptibility to AMD. Methods We analysed long-range linkage disequilibrium of DMBT1 CNV1 and CNV2 with flanking single nucleotide polymorphisms (SNPs) using our previously published CNV and HapMap Phase 3 SNP data in the CEPH Europeans from Utah (CEU). We then typed a large cohort of 860 AMD patients and 419 examined age-matched controls for copy number at DMBT1 CNV1 and CNV2 and combined these data with copy numbers from a further 480 unexamined controls. Results We found weak linkage disequilibrium between DMBT1 CNV1 and CNV2 with the SNPs rs1474526 and rs714816 in the HTRA1/ARMS2 region. By directly analysing copy number variation, we found no evidence of association of CNV1 or CNV2 with AMD. Conclusions We have shown that copy number variation at DMBT1 does not affect risk of developing age-related macular degeneration and can therefore be ruled out from future studies investigating the association of structural variation at 10q26 with AMD.
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- 2016
10. Genome-wide association study of age-related macular degeneration identifies associated variants in the TNXB–FKBPL–NOTCH4 region of chromosome 6p21.3
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Sharon Jenkins, Thierry Léveillard, Anthony T. Moore, Jane C. Khan, H. T. Leung, Eric H Souied, Alan F. Wright, Andrew J. Lotery, Humma Shahid, Catey Bunce, Harry Campbell, Diana Zelenika, Mark Lathrop, David Clayton, John R.W. Yates, Samantha Mann, Susan Campbell, Anna F. Dominiczak, Jane Gibson, Ian J. Deary, French Amd Investigators, Caroline Hayward, Baljean Dhillon, Paul N. Bishop, Ana Maria Armbrecht, José-Alain Sahel, Valentina Cipriani, Sarah Ennis, Simon P. Harding, Andrew R. Webster, Malcolm G. Dunlop, Vincent Plagnol, Alan C. Bird, and Angela J. Cree
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Male ,Population ,Single-nucleotide polymorphism ,Genome-wide association study ,Biology ,Polymorphism, Single Nucleotide ,Complement factor B ,Tacrolimus Binding Proteins ,Macular Degeneration ,FKBPL ,Proto-Oncogene Proteins ,Odds Ratio ,Genetics ,Humans ,Genetic Predisposition to Disease ,Immunophilins ,Receptor, Notch4 ,Association Studies Article ,education ,Molecular Biology ,Genetics (clinical) ,Aged ,Aged, 80 and over ,Principal Component Analysis ,education.field_of_study ,Complement component 3 ,Receptors, Notch ,Complement component 2 ,Tenascin ,Sequence Analysis, DNA ,General Medicine ,eye diseases ,Logistic Models ,Haplotypes ,Genetic Loci ,Case-Control Studies ,Factor H ,Linear Models ,Chromosomes, Human, Pair 6 ,Female ,Genome-Wide Association Study - Abstract
Age-related macular degeneration (AMD) is a leading cause of visual loss in Western populations. Susceptibility is influenced by age, environmental and genetic factors. Known genetic risk loci do not account for all the heritability. We therefore carried out a genome-wide association study of AMD in the UK population with 893 cases of advanced AMD and 2199 controls. This showed an association with the well-established AMD risk loci ARMS2 (age-related maculopathy susceptibility 2)-HTRA1 (HtrA serine peptidase 1) (P =2.7 × 10(-72)), CFH (complement factor H) (P =2.3 × 10(-47)), C2 (complement component 2)-CFB (complement factor B) (P =5.2 × 10(-9)), C3 (complement component 3) (P =2.2 × 10(-3)) and CFI (P =3.6 × 10(-3)) and with more recently reported risk loci at VEGFA (P =1.2 × 10(-3)) and LIPC (hepatic lipase) (P =0.04). Using a replication sample of 1411 advanced AMD cases and 1431 examined controls, we confirmed a novel association between AMD and single-nucleotide polymorphisms on chromosome 6p21.3 at TNXB (tenascin XB)-FKBPL (FK506 binding protein like) [rs12153855/rs9391734; discovery P =4.3 × 10(-7), replication P =3.0 × 10(-4), combined P =1.3 × 10(-9), odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.3-1.6] and the neighbouring gene NOTCH4 (Notch 4) (rs2071277; discovery P =3.2 × 10(-8), replication P =3.8 × 10(-5), combined P =2.0 × 10(-11), OR = 1.3, 95% CI = 1.2-1.4). These associations remained significant in conditional analyses which included the adjacent C2-CFB locus. TNXB, FKBPL and NOTCH4 are all plausible AMD susceptibility genes, but further research will be needed to identify the causal variants and determine whether any of these genes are involved in the pathogenesis of AMD.
- Published
- 2012
11. Genetic variation in complement regulators and susceptibility to age-related macular degeneration
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Alan F. Wright, Valentina Cipriani, David Clayton, Baljinder K Matharu, Humma Shahid, John R.W. Yates, Catey Bunce, Chloe M. Stanton, Caroline Hayward, Anthony T. Moore, and Jane C. Khan
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Male ,Aging ,genetic structures ,DAF, decay accelerating factor ,Macular Degeneration ,0302 clinical medicine ,DNA, deoxyribonucleic acid ,Immunology and Allergy ,AMD, age-related macular degeneration ,Complement regulators ,Genetics ,Aged, 80 and over ,0303 health sciences ,CNV, choroidal neovascularisation ,CD55 Antigens ,MCP, membrane cofactor protein ,Hematology ,SNP, single nucleotide polymorphism ,3. Good health ,Complement (complexity) ,MAC, membrane attack complex ,Female ,RPE, retinal pigment epithelium ,Genotype ,Immunology ,Complement ,CD59 Antigens ,Complement factor I ,Biology ,CFH, complement factor H ,MAF, minor allele frequency ,Polymorphism, Single Nucleotide ,Article ,Membrane Cofactor Protein ,03 medical and health sciences ,Genetic variation ,medicine ,Humans ,Genetic Predisposition to Disease ,Genetic Association Studies ,030304 developmental biology ,Genetic association ,Aged ,Properdin ,CD46 ,HWE, Hardy–Weinberg equilibrium ,Age-related macular degeneration ,CPI, complement factor I ,CFB, complement factor B ,Complement System Proteins ,Macular degeneration ,medicine.disease ,eye diseases ,Complement system ,Single nucleotide polymorphism ,CI, confidence interval ,OR, odds ratio ,GA, geographic atrophy ,Case-Control Studies ,030221 ophthalmology & optometry ,sense organs ,CFP, complement factor P ,ARM, age-related maculopathy - Abstract
ObjectivesAge-related macular degeneration (AMD) is the commonest cause of blindness in Western populations. Risk is influenced by age, genetic and environmental factors. Complement activation appears to be important in the pathogenesis and associations have been found between AMD and genetic variations in complement regulators such as complement factor H. We therefore investigated other complement regulators for association with AMD.MethodsWe carried out a case–control study to test for association between AMD and single nucleotide polymorphisms (SNPs) spanning the genes encoding complement factor P (CFP, properdin), CD46 (membrane cofactor protein, MCP), CD55 (decay accelerating factor, DAF) and CD59 (protectin). All cases and controls were examined by an ophthalmologist and had independent grading of fundus photographs to confirm their disease status.Results20 SNPs were genotyped in 446 cases and 262 controls. For two SNPs with p-values approaching significance additional subjects were genotyped to increase the numbers to 622 cases and 359 controls. There was no evidence of association between AMD and any of the SNPs typed in CFP, CD46, CD55 or CD59.ConclusionsIn a case–control sample that has shown the well established associations between AMD and variants in CFH, CFB and C3 there was absence of association with SNPs in CFP, CD46, CD55 and CD59. This suggests that these are not important susceptibility genes for AMD.
- Published
- 2012
12. Factors affecting outcome of punctoplasty surgery: a review of 205 cases
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Andrew Pearson, Humma Shahid, Amanjeet Sandhu, and Tiarnan D. L. Keenan
- Subjects
Male ,medicine.medical_specialty ,Treatment outcome ,Hospital records ,Cellular and Molecular Neuroscience ,Patient satisfaction ,Humans ,Medicine ,Retrospective Studies ,Lacrimal Apparatus Diseases ,business.industry ,Significant difference ,Eyelids ,Retrospective cohort study ,Consecutive case series ,Middle Aged ,Sensory Systems ,Topical medication ,Surgery ,Ophthalmology ,Treatment Outcome ,Patient Satisfaction ,Additional procedure ,Female ,Clinical Competence ,business ,Dacryocystorhinostomy - Abstract
Aim: We reviewed retrospectively the indications, surgical techniques and outcomes of punctoplasty surgery for 205 consecutive patients in order to identify factors that influence success. Methods: We identified all patients who underwent punctoplasty surgery from April 2002 to June 2006 within the Royal Berkshire NHS Trust, UK. No patient had an additional procedure simultaneously. Hospital records were used to ascertain the proportion of patients who were appropriately assessed preoperatively, the anatomical and functional success rates for surgery and the patient satisfaction rate. We assessed the influence of surgical technique, grade of operating surgeon and the use of postoperative topical medication on these outcomes. Results: Eighty-two per cent of patients had an appropriate preoperative assessment. Amongst these, the anatomical and functional success rates for punctoplasty surgery were 91% and 64%, respectively. The patient satisfaction rate was 71%. The grade of surgeon did not significantly affect outcome of punctoplasty (p = 0.4). The use of topical steroids postoperatively did not significantly improve surgical outcome (p = 0.7). There was no significant difference in anatomical success between a two-snip versus a three-snip punctoplasty technique (p = 0.7). However, in the presence of anatomical success the two-snip procedure gave significantly greater functional success (p = 0.03). Conclusions: This is the largest reported consecutive case series of isolated punctoplasty surgery. Overall anatomical success was high and the surgical technique, grade of surgeon and choice of postoperative medication did not significantly alter the outcome. Without adequate preoperative assessment a significant proportion of patients may undergo surgery inappropriately. Even with an adequate assessment anatomical success is not always followed by resolution of epiphora.
- Published
- 2008
13. Complement C3 Variant and the Risk of Age-Related Macular Degeneration
- Author
-
D A Thurlby, E Redmond, Humma Shahid, Baljean Dhillon, Anthony T. Moore, Caroline Hayward, Baljinder K Matharu, David Clayton, Ana Maria Armbrecht, Ian J. Deary, T. Sepp, Joanne E. Morgan, Jane C. Khan, John R.W. Yates, Alan C. Bird, and Alan F. Wright
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Genotype ,genetic structures ,Single-nucleotide polymorphism ,Polymorphism, Single Nucleotide ,Macular Degeneration ,Membranoproliferative glomerulonephritis ,Odds Ratio ,medicine ,Humans ,Genetic Predisposition to Disease ,Protein Structure, Quaternary ,Aged ,Complement component 5 ,business.industry ,Case-control study ,Complement C5 ,Complement C3 ,General Medicine ,Odds ratio ,Macular degeneration ,medicine.disease ,eye diseases ,Complement system ,Logistic Models ,Case-Control Studies ,Immunology ,Female ,business ,Retinopathy - Abstract
Age-related macular degeneration is the most common cause of blindness in Western populations. Susceptibility is influenced by age and by genetic and environmental factors. Complement activation is implicated in the pathogenesis.We tested for an association between age-related macular degeneration and 13 single-nucleotide polymorphisms (SNPs) spanning the complement genes C3 and C5 in case subjects and control subjects from the southeastern region of England. All subjects were examined by an ophthalmologist and had independent grading of fundus photographs to confirm their disease status. To test for replication of the most significant findings, we genotyped a set of Scottish cases and controls.The common functional polymorphism rs2230199 (Arg80Gly) in the C3 gene, corresponding to the electrophoretic variants C3S (slow) and C3F (fast), was strongly associated with age-related macular degeneration in both the English group (603 cases and 350 controls, P=5.9x10(-5)) and the Scottish group (244 cases and 351 controls, P=5.0x10(-5)). The odds ratio for age-related macular degeneration in C3 S/F heterozygotes as compared with S/S homozygotes was 1.7 (95% confidence interval [CI], 1.3 to 2.1); for F/F homozygotes, the odds ratio was 2.6 (95% CI, 1.6 to 4.1). The estimated population attributable risk for C3F was 22%.Complement C3 is important in the pathogenesis of age-related macular degeneration. This finding further underscores the influence of the complement pathway in the pathogenesis of this disease.
- Published
- 2007
14. Cambridge community Optometry Glaucoma Scheme
- Author
-
Jonathan, Keenan, Humma, Shahid, Rupert R, Bourne, Andrew J, White, and Keith R, Martin
- Subjects
National Health Programs ,Optic Disk ,Glaucoma ,Diagnostic Techniques, Ophthalmological ,Telemedicine ,United Kingdom ,Ophthalmology ,Tonometry, Ocular ,Community Medicine ,Predictive Value of Tests ,Optic Nerve Diseases ,Humans ,False Positive Reactions ,Ocular Hypertension ,Guideline Adherence ,Visual Fields ,Referral and Consultation ,Intraocular Pressure ,Optometry - Abstract
With a higher life expectancy, there is an increased demand for hospital glaucoma services in the United Kingdom.The Cambridge community Optometry Glaucoma Scheme (COGS) was initiated in 2010, where new referrals for suspected glaucoma are evaluated by community optometrists with a special interest in glaucoma, with virtual electronic review and validation by a consultant ophthalmologist with special interest in glaucoma.1733 patients were evaluated by this scheme between 2010 and 2013.Clinical assessment is performed by the optometrist at a remote site. Goldmann applanation tonometry, pachymetry, monoscopic colour optic disc photographs and automated Humphrey visual field testing are performed. A clinical decision is made as to whether a patient has glaucoma or is a suspect, and referred on or discharged as a false positive referral. The clinical findings, optic disc photographs and visual field test results are transmitted electronically for virtual review by a consultant ophthalmologist.The number of false positive referrals from initial referral into the scheme.Of the patients, 46.6% were discharged at assessment and a further 5.7% were discharged following virtual review. Of the patients initially discharged, 2.8% were recalled following virtual review. Following assessment at the hospital, a further 10.5% were discharged after a single visit.The COGS community-based glaucoma screening programme is a safe and effective way of evaluating glaucoma referrals in the community and reducing false-positive referrals for glaucoma into the hospital system.
- Published
- 2014
15. The changing geometry of angle closure
- Author
-
Humma, Shahid and John F, Salmon
- Subjects
Iridectomy ,Anterior Eye Segment ,Humans ,Iris ,Laser Therapy ,Glaucoma, Angle-Closure - Published
- 2012
16. Complement factor H genetic variant and age-related macular degeneration: effect size, modifiers and relationship to disease subtype
- Author
-
Arthur A.B. Bergen, Sharon Jenkins, Gisèle Soubrane, Ian S. Young, Daniel E. Weeks, Caroline C W Klaver, Mati Rahu, Aroon D. Hingorani, Andrew J. Lotery, Paulus T. V. M. de Jong, Li L Chen, Bernhard H. F. Weber, Maria Carolina Ortube, Andrew R. Webster, Johanna Jakobsdottir, Humma Shahid, Thierry Léveillard, Juan P. Casas, Gonçalo R. Abecasis, Johan H. Seland, Usha Chakravarthy, Fotis Topouzis, Astrid E. Fletcher, Helen Griffiths, Yuhong Chen, Lars G. Fritsche, Kari Branham, Reecha Sofat, T. Sepp, Kang Zhang, Jane C. Khan, Catey Bunce, Jesús Vioque, Samantha Mann, Angela J. Cree, Sepideh Zareparsi, Claudia N. Keilhauer, Robert E. Ferrell, John C. Whittaker, Michael B. Gorin, John R.W. Yates, Yvette P. Conley, Alan C. Bird, Shomi S. Bhattacharya, Anand Swaroop, Mark Lathrop, Laura Tomazzoli, Valentina Cipriani, Dominique C Baas, Daniel Gibbs, Liam Smeeth, Anthony T. Moore, Tunde Peto, ANS - Amsterdam Neuroscience, Human Genetics, Ophthalmology, Epidemiology, and Netherlands Institute for Neuroscience (NIN)
- Subjects
Oncology ,Male ,medicine.medical_specialty ,genetic structures ,Genotype ,Epidemiology ,Single-nucleotide polymorphism ,Polymorphism, Single Nucleotide ,White People ,Macular Degeneration ,Internal medicine ,medicine ,SNP ,Humans ,Genetic Predisposition to Disease ,Prospective Studies ,Allele ,Genetic association ,Aged ,Aged, 80 and over ,business.industry ,Smoking ,Case-control study ,General Medicine ,Odds ratio ,eye diseases ,Factor H ,Meta-analysis ,Case-Control Studies ,Complement Factor H ,Female ,sense organs ,business ,Genetic and Intergenerational Epidemiology - Abstract
Background: variation in the complement factor H gene (CFH) is associated with risk of late age-related macular degeneration (AMD). Previous studies have been case–control studies in populations of European ancestry with little differentiation in AMD subtype, and insufficient power to confirm or refute effect modification by smoking. Methods: to precisely quantify the association of the single nucleotide polymorphism (SNP rs1061170, ‘Y402H’) with risk of AMD among studies with differing study designs, participant ancestry and AMD grade and to investigate effect modification by smoking, we report two unpublished genetic association studies (n?=?2759) combined with data from 24 published studies (26 studies, 26?494 individuals, including 14?174 cases of AMD) of European ancestry, 10 of which provided individual-level data used to test gene–smoking interaction; and 16 published studies from non-European ancestry. Results: in individuals of European ancestry, there was a significant association between Y402H and late-AMD with a per-allele odds ratio (OR) of 2.27 [95% confidence interval (CI) 2.10–2.45; P?=?1.1?x?10?161]. There was no evidence of effect modification by smoking (P?=?0.75). The frequency of Y402H varied by ancestral origin and the association with AMD in non-Europeans was less clear, limited by paucity of studies. Conclusion: the Y402H variant confers a 2-fold higher risk of late-AMD per copy in individuals of European descent. This was stable to stratification by study design and AMD classification and not modified by smoking. The lack of association in non-Europeans requires further verification. These findings are of direct relevance for disease prediction. New research is needed to ascertain if differences in circulating levels, expression or activity of factor H protein explain the genetic association
- Published
- 2012
17. Age-related macular degeneration: the importance of family history as a risk factor
- Author
-
Humma, Shahid, Jane C, Khan, Valentina, Cipriani, Tiina, Sepp, Baljinder K, Matharu, Catey, Bunce, Simon P, Harding, David G, Clayton, Anthony T, Moore, John R W, Yates, and D A, Thurlby
- Subjects
Male ,medicine.medical_specialty ,Pediatrics ,genetic structures ,Genotype ,Vision Disorders ,Disease ,Polymorphism, Single Nucleotide ,Cellular and Molecular Neuroscience ,Macular Degeneration ,Risk Factors ,Ophthalmology ,Surveys and Questionnaires ,Epidemiology ,medicine ,Odds Ratio ,Prevalence ,Humans ,Sibling Relations ,Risk factor ,Family history ,Aged ,Family Health ,business.industry ,Case-control study ,Proteins ,Odds ratio ,Complement C3 ,Macular degeneration ,medicine.disease ,eye diseases ,Sensory Systems ,Case-Control Studies ,Complement Factor H ,Female ,sense organs ,business ,Risk assessment ,Complement Factor B - Abstract
Family history is considered a risk factor for age-related macular degeneration (AMD). With the advent of effective therapy for the disease, the importance of family history merits further investigation. This study quantifies the risk associated with family history, first, by a case-control study of reported family history and, second, by examining the siblings of AMD cases.The authors recruited cases with advanced AMD, spouses and siblings. All subjects were carefully phenotyped. Clinical findings in the siblings were compared with spouses. Information about family history was collected. The ORs for reported family history of AMD were calculated. Analyses were adjusted for age, smoking and genotype.495 AMD cases, 259 spouses and 171 siblings were recruited. The OR for AMD was 27.8 (CI 3.8 to 203.0; p=0.001) with a reported family history of an affected parent and 12.0 (CI 3.7 to 38.6; p0.0001) with a history of an affected sibling. ORs adjusted for age and smoking were higher. Examination of siblings confirmed their increased risk with 23% affected by AMD and an OR of 10.8 (4.5 to 25.8; p0.0001). Adjusting for age increased the OR to 16.1 (6.2 to 41.8).The risk of AMD is greatly increased by having an affected first-degree relative. Those at risk need to be made aware of this and AMD patients should advise siblings and children to seek prompt ophthalmological advice if they develop visual symptoms of distortion or reduced vision.
- Published
- 2011
18. Use of 5-Fluorouracil injections to reduce the risk of trabeculectomy bleb failure after cataract surgery
- Author
-
Humma Shahid and John F Salmon
- Subjects
Male ,medicine.medical_specialty ,Intraocular pressure ,genetic structures ,medicine.medical_treatment ,Eye disease ,Glaucoma ,Trabeculectomy ,Cataract Extraction ,Cataract ,Drug Administration Schedule ,Postoperative Complications ,Ophthalmology ,Medicine ,Humans ,Pharmacology (medical) ,Treatment Failure ,Survival rate ,Aged ,Pharmacology ,Aged, 80 and over ,Postoperative Care ,Phacoemulsification ,business.industry ,Cataract surgery ,Middle Aged ,medicine.disease ,eye diseases ,Surgery ,Female ,sense organs ,Fluorouracil ,Bleb (medicine) ,Injections, Intraocular ,business ,Conjunctiva ,Glaucoma, Open-Angle ,Follow-Up Studies - Abstract
To determine whether the use of postoperative subconjunctival 5-fluorouracil (5-FU) reduces the risk of trabeculectomy bleb failure after uncomplicated small incisional cataract surgery.Twenty-five consecutive patients with primary open-angle glaucoma and a functioning trabeculectomy bleb and who underwent uncomplicated phacoemulsification surgery were given subconjunctival injections of 5 mg 5-FU at 2, 4, and 12 weeks after cataract surgery (5-FU group). The mean postoperative intraocular pressure (IOP) over a 2-year period and the trabeculectomy survival rate, as determined by Kaplan-Meier survival analysis, was compared with a historical series of patients who had undergone cataract surgery in the presence of a filtering trabeculectomy bleb, but who had not received 5-FU (control group).After a 2-year follow-up period, there was no significant difference in the mean IOP between the 5-FU (15.1 mm Hg SD 3.1) and control (15.3 mm Hg SD 3.3) groups (P = 0.67). An IOP21 mm Hg at any time point after the first postoperative month after cataract surgery was found in 4.0% cases in the 5-FU group and 16.7% cases in the control group (P = 0.78). Using Kaplan-Meier survival analysis, the difference in the cumulative probability of survival between the 5-FU and control groups was not significant (P = 0.30).Cataract surgery is a significant risk factor for trabeculectomy bleb failure. The use of subconjunctival 5-FU injections at 2, 4, and 12 weeks after cataract surgery in elderly white patients with primary open-angle glaucoma does not reduce the risk of trabeculectomy failure.
- Published
- 2010
19. Anaphylactic response to topical fluorescein 2% eye drops: a case report
- Author
-
Humma Shahid and John F Salmon
- Subjects
Medicine(all) ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,lcsh:R ,Anaphylactic reaction ,lcsh:Medicine ,Eye drop ,Physical examination ,General Medicine ,medicine.disease ,Dermatology ,Brittle asthma ,eye diseases ,chemistry.chemical_compound ,Systemic reaction ,chemistry ,Ophthalmology ,Case report ,medicine ,Fluorescein ,Retinal angiography ,business ,Anaphylaxis - Abstract
Introduction The intravenous use of fluorescein 10% during retinal angiography can cause severe systemic reactions including, on rare occasions, anaphylaxis. Fluorescein 2% eye drops are used extensively for clinical examination and diagnosis, but to the best of our knowledge, they have only been reported as being responsible for a systemic anaphylactic response on two previous occasions. Case presentation We report the case of a 51-year-old woman who developed an anaphylactic reaction when she was administered fluorescein sodium 2% eye drops after cataract surgery. This was the second time she had been exposed to fluorescein. She had brittle asthma and a history of anaphylaxis following exposure to a variety of drug and food allergens. She was successfully resuscitated and recovered completely over a period of two days. Conclusions Fluorescein 2% drops are universally used in general practice, ophthalmology, optometry, and casualty departments. Our case report reveals the potential for this benign eye drop to cause a life-threatening systemic reaction and emphasises the importance of considering this consequence when administering topical fluorescein 2% to a patient with a history of anaphylaxis to other allergens.
- Published
- 2010
20. Charles Bonnet syndrome in age-related macular degeneration: the nature and frequency of images in subjects with end-stage disease
- Author
-
Humma Shahid, D A Thurlby, Anthony T. Moore, John R.W. Yates, and Jane C. Khan
- Subjects
Male ,medicine.medical_specialty ,Visual acuity ,genetic structures ,Hallucinations ,Epidemiology ,Ocular Pathology ,Population ,Visual Acuity ,Macular Degeneration ,Risk Factors ,Ophthalmology ,Charles Bonnet syndrome ,Prevalence ,Medicine ,Humans ,education ,Aged ,Aged, 80 and over ,education.field_of_study ,Vision, Binocular ,business.industry ,Case-control study ,Odds ratio ,Syndrome ,Macular degeneration ,medicine.disease ,eye diseases ,Visual Hallucination ,Case-Control Studies ,Disease Progression ,Female ,medicine.symptom ,business - Abstract
The term Charles Bonnet syndrome (CBS) is used to describe visual hallucinations resulting from ocular pathology. As part of a larger case-control study we assessed factors which may predispose to this phenomenon in Age-related macular degeneration (AMD).Three-hundred and sixty cases of late AMD underwent a detailed questionnaire about visual symptoms experienced. Potential ocular and environmental risk factors were compared in two groups; those experiencing symptoms of CBS (n = 97) and those not experiencing CBS symptoms (n = 263).Twenty-seven percent experienced CBS. Poor visual acuity was the only factor associated with the development of these images in AMD with an odds ratio of 3.50 (95% CI 1.64-7.48, p = 0.001) for those with best binocular visual acuity worse than 6/36. In those who experienced CBS, the images tended to be straight ahead (84.5%), colored (72.2%), have moving parts (62.9%), and occur on average once per day (34%). The most common visual image was of people (19.6%) followed by geometric patterns (15.8%). The majority (71.1%) felt the experience to be neither pleasant nor unpleasant. In 41% images were present throughout the course of their disease. There was no association between visual acuity and complexity of images.The prevalence of CBS in late AMD is high, the main risk factor being poor better eye visual acuity. The most commonly experienced hallucinations were of people. Although most patients were unperturbed by the images, reassurance of their benign nature was welcomed. Practitioners should be aware that resolution of symptoms over time does not always occur.
- Published
- 2008
21. Smoking and age related macular degeneration: the number of pack years of cigarette smoking is a major determinant of risk for both geographic atrophy and choroidal neovascularisation
- Author
-
David Clayton, John R.W. Yates, D A Thurlby, Jane C. Khan, A. T. Moore, Humma Shahid, M Bradley, and A C Bird
- Subjects
Male ,medicine.medical_specialty ,Passive smoking ,Time Factors ,genetic structures ,medicine.medical_treatment ,Population ,medicine.disease_cause ,Cellular and Molecular Neuroscience ,Macular Degeneration ,Risk Factors ,Internal medicine ,medicine ,Humans ,Risk factor ,education ,Pigment Epithelium of Eye ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,Clinical Science - Extended Report ,Smoking ,Case-control study ,Odds ratio ,Macular degeneration ,Former Smoker ,medicine.disease ,eye diseases ,Sensory Systems ,Choroidal Neovascularization ,Surgery ,Ophthalmology ,Case-Control Studies ,Smoking cessation ,Female ,Smoking Cessation ,Tobacco Smoke Pollution ,sense organs ,Atrophy ,business - Abstract
Background/aims: There is evidence that smoking is a risk factor for age related macular degeneration (AMD). However, not all studies have demonstrated this association and several key questions about the role of smoking in AMD have still to be determined. The aim of this study was to further investigate this relation for both choroidal neovascularisation (CNV) and geographic atrophy (GA). Methods: To investigate the relation between smoking and the risk of developing age related macular degeneration (AMD) in white people, 435 cases with end stage AMD were compared with 280 controls. All subjects had graded stereoscopic colour fundus photography and AMD was defined as the presence of GA or CNV. Smoking history was assessed using multiple parameters in a detailed questionnaire. Results: Comparison of current and former smokers with non-smokers was consistent with smoking being a risk factor for AMD but did not reach statistical significance. There was a strong association between AMD and pack years of cigarette smoking (p = 0.002), the odds ratio increasing with the amount smoked; for subjects with more than 40 pack years of smoking the odds ratio was 2.75 (95% CI 1.22 to 6.20) compared with non-smokers. Both types of AMD showed a similar relation; smoking more than 40 pack years of cigarettes was associated with an odds ratio of 3.43 (95% CI 1.28 to 9.20) for GA and 2.49 (95% CI 1.06 to 5.82) for CNV. Stopping smoking was associated with reduced odds of AMD and the risk in those who had not smoked for over 20 years was comparable to non-smokers. The risk profile was similar for males and females. Passive smoking exposure was associated with an increased risk of AMD (OR 1.87; 95% CI 1.03 to 3.40) in non-smokers. Conclusions: The authors have demonstrated a strong association between the risk of both GA and CNV and pack years of cigarette smoking. This provides support for a causal relation between smoking and AMD. They also show an increased risk for AMD in non-smokers exposed to passive smoking. Stopping smoking appears to reduce the risk of developing AMD.
- Published
- 2006
22. Age related macular degeneration and sun exposure, iris colour, and skin sensitivity to sunlight
- Author
-
A C Bird, David Clayton, John R.W. Yates, M Bradley, D A Thurlby, Jane C. Khan, A. T. Moore, and Humma Shahid
- Subjects
Male ,medicine.medical_specialty ,genetic structures ,Sunburn ,Skin Pigmentation ,Fundus (eye) ,Clinical Science - Scientific Report ,Cellular and Molecular Neuroscience ,Macular Degeneration ,Risk Factors ,Ophthalmology ,Eye color ,medicine ,Humans ,Risk factor ,skin and connective tissue diseases ,Hair Color ,Aged ,Skin ,Sunlight ,Aged, 80 and over ,integumentary system ,Eye Color ,business.industry ,Smoking ,Macular degeneration ,Middle Aged ,medicine.disease ,eye diseases ,Sensory Systems ,Surgery ,medicine.anatomical_structure ,Logistic Models ,Case-Control Studies ,Maculopathy ,Female ,sense organs ,Choroid ,Disease Susceptibility ,business - Abstract
Background/aim: It has been suggested that sun exposure may be a risk factor for age related macular degeneration (AMD) and that skin sensitivity to sunlight and iris colour could be confounding factors. The aim was to investigate this further in the white population. Methods: 446 cases with end stage AMD were compared with 283 spouse controls. Data on sun exposure, places of residence, iris colour, subjective assessment of change in iris colour, hair colour at age 20, and skin sensitivity were obtained using a questionnaire. Iris colour was graded clinically by comparison with standard photographs. AMD was graded using stereoscopic colour fundus photographs as well as clinical examination and was defined as the presence of geographic atrophy or choroidal neovascularisation. All variables were included in a multiple logistic regression model including age, sex, and smoking. Results: There was no association between AMD and sun exposure or related factors except for the suggestion of an association between sunburn prone skin type and geographic atrophy which reached borderline significance. Conclusions: No significant association between AMD and sun exposure, iris colour, change in iris colour, or hair colour was demonstrated.
- Published
- 2006
23. Fifteen-year mortality rate and visual outcome in newly diagnosed chronic open-angle glaucoma
- Author
-
John F Salmon and Humma Shahid
- Subjects
Pediatrics ,medicine.medical_specialty ,genetic structures ,Open angle glaucoma ,business.industry ,Mortality rate ,Glaucoma ,Newly diagnosed ,medicine.disease ,eye diseases ,Sensory Systems ,Surgery ,Natural history ,Cellular and Molecular Neuroscience ,Ophthalmology ,Cohort ,Medicine ,sense organs ,business - Abstract
The natural history of open-angle glaucoma has been comprehensively studied, but there is little known of the long-term mortality and visual outcome of patients with chronic open-angle glaucoma under active management.1 In a previous publication we found that 30% of a cohort of newly diagnosed glaucoma patients had died within a period of 10 years and that the survivors had good visual function.2 We reviewed the results of the same patients at 15 years and, in addition, we compared the demographic features of the group who died with those that survived. In summary, of 436 patients who were referred to a glaucoma case-finding clinic between July 1994 and December 1995, 68 patients were found to have chronic open-angle glaucoma.2 These patients were followed at regular intervals in a specialist-led glaucoma clinic. Over the next 15 years, …
- Published
- 2012
24. The changing geometry of angle closure
- Author
-
John F Salmon and Humma Shahid
- Subjects
Ophthalmology ,business.industry ,Closure (topology) ,Medicine ,Geometry ,business - Published
- 2012
25. No evidence of association between complement factor I genetic variant rs10033900 and age-related macular degeneration
- Author
-
Caroline Hayward, Simon P. Harding, Paul N. Bishop, Anthony T. Moore, John R.W. Yates, Humma Shahid, Jane C. Khan, Baljean Dhillon, Alan F. Wright, Ana Maria Armbrecht, Valentina Cipriani, Catey Bunce, David Clayton, and Baljinder K Matharu
- Subjects
Genetics ,Candidate gene ,Genetic variants ,Single-nucleotide polymorphism ,Genome-wide association study ,Complement factor I ,Biology ,Macular degeneration ,medicine.disease ,eye diseases ,medicine ,SNP ,sense organs ,Gene ,Genetics (clinical) - Abstract
In 2008, an association between age-related macular degeneration (AMD) and single nucleotide polymorphisms (SNPs) on chromosome 4q25 was reported in this journal by Fagerness et al1 studying a large US-based sample of around 1200 cases with advanced AMD and 800 controls. The association signal extended over a region of about 175 kb, the most associated variant (P
- Published
- 2011
26. The Effectiveness of Trans-scleral Cyclodiode Treatment
- Author
-
Humma Shahid and Emma Samia-Aly
- Subjects
medicine.medical_specialty ,genetic structures ,business.industry ,Trans-scleral ,Ophthalmology ,Medicine ,business - Abstract
Transcleral cyclodiode laser treatment is increasingly being used in the management of complex glaucoma. This review discusses the literature with reference to the effectiveness of this treatment modality as well as its potential limitations.
- Published
- 2013
27. Identification of a rare coding variant in complement 3 associated with age-related macular degeneration
- Author
-
John R. Heckenlively, Stuart Cantsilieris, Rinki Ratnapriya, Emily Y. Chew, Yvette P. Conley, Albert Hofman, Fred G. Pluthero, Lindsay A. Farrer, Gonçalo R. Abecasis, Jonathan L. Haines, Daniel C. Koboldt, Claudia N von Strachwitz, Richard K. Wilson, Mindy M. Zhang, Andrea J. Richardson, Yuri V. Sergeev, Goo Jun, Elaine R. Mardis, Felix Grassmann, Paul N. Baird, Lana M. Olson, Mohammad Othman, Catrina Fronick, Xiaowei Zhan, Hyun Min Kang, Matthew P. Johnson, Youna Hu, Matthew Brooks, Humma Shahid, Michael B. Gorin, Bernhard H. F. Weber, Michael L. Klein, Lucinda Fulton, Chaolong Wang, Alexis Boleda, David E. Larson, Valentina Cipriani, Dwight Stambolian, Christoph Licht, Hongrong Luo, Anthony T. Moore, Anand Swaroop, Ivana K. Kim, John R.W. Yates, Robert S. Fulton, Kang Zhang, Yingda Jiang, Denise J. Morgan, Margaret M. DeAngelis, Hong Ouyang, Kari Branham, Dajiang J. Liu, Daniel E. Weeks, Caroline C W Klaver, Gabriëlle H.S. Buitendijk, Cornelia M. van Duijn, Jennifer L. Bragg-Gresham, Margaret A. Pericak-Vance, Robyn H. Guymer, John Blangero, Ophthalmology, and Epidemiology
- Subjects
Aging ,Genotype ,Complement Pathway, Alternative ,Genome-wide association study ,Biology ,Polymorphism, Single Nucleotide ,Complement factor B ,Article ,Macular Degeneration ,03 medical and health sciences ,0302 clinical medicine ,Gene Frequency ,Genetics ,medicine ,Gene ,Allele frequency ,030304 developmental biology ,0303 health sciences ,Genetic Variation ,Complement C3 ,Macular degeneration ,medicine.disease ,3. Good health ,Complement system ,Complement Factor H ,Factor H ,030221 ophthalmology & optometry ,Alternative complement pathway - Abstract
Macular degeneration is a common cause of blindness in the elderly. To identify rare coding variants associated with a large increase in risk of age-related macular degeneration (AMD), we sequenced 2,335 cases and 789 controls in 10 candidate loci (57 genes). To increase power, we augmented our control set with ancestry-matched exome-sequenced controls. An analysis of coding variation in 2,268 AMD cases and 2,268 ancestry-matched controls identified 2 large-effect rare variants: previously described p. Arg1210Cys encoded in the CFH gene (case frequency (f(case)) = 0.51%; control frequency (f(control)) = 0.02%; odds ratio (OR) = 23.11) and newly identified p. Lys155Gln encoded in the C3 gene (f(case) = 1.06%; f(control) = 0.39%; OR = 2.68). The variants suggest decreased inhibition of C3 by complement factor H, resulting in increased activation of the alternative complement pathway, as a key component of disease biology.
- Published
- 2013
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