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Browsing by Author "Hussain, Rehan"
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Item Prediction of Anti-VEGF Response in Diabetic Macular Edema After 1 Injection(2017-05) Shah, Ankoor R.; Yonekawa, Yoshihiro; Todorich, Bozho; Van Laere, Lily; Hussain, Rehan; Woodward, Maria A.; Abbey, Ashkan M.; Wolfe, Jeremy D.; Ophthalmology, School of MedicinePurpose With multiple anti-vascular endothelial growth factor and steroid therapies available for diabetic macular edema (DME), there is a need for early determination of the best treatment for a particular patient to prevent irreversible vision loss from chronic DME. In this study, we classify patients as responders or non-responders to anti-vascular endothelial growth factor (VEGF) monotherapy in the treatment of DME after a single anti-VEGF injection. Methods The study was designed as a single center, retrospective, interventional case series. We included patients who received 3 consecutive monthly injections with the same anti-VEGF agent. We excluded patients who were treated for DME in the preceding 3 months with any form of anti-VEGF therapy. Visual acuity and central retinal thickness (CRT) data were followed for one year. Receiver operating characteristic (ROC) curve analysis was performed in order to identify cutoff values for identifying responders. Results 107 eyes were reviewed, with 40 eyes of 34 patients meeting all inclusion criteria. Based on ROC curve analysis, a reduction in CRT by > 15% at 1-month, identified eyes that responded to treatment and had a >25% reduction in CRT at 3-months (sensitivity 0.75, specificity 0.92). Conclusion DME eyes that have early response to anti-VEGF treatment by reduction in CRT will have significant response to treatment by 3 months.Item Reductions in retrobulbar and retinal capillary blood flow strongly correlate with changes in optic nerve head and retinal morphology over four years in open-angle glaucoma patients of African descent compared to patients of European descent(Wolters Kluwer, 2016-09) Siesky, Brent; Harris, Alon; Carr, Joseph; Vercellin, Alice Verticchio; Hussain, Rehan; Hembree, Priyanka Parekh; Wentz, Scott; Isaacs, Michael; Eckert, George; Moore, Nicholas A.; Ophthalmology, School of MedicinePurpose To investigate the relationship of changes in ocular blood flow with optic nerve head and retinal morphology in open-angle glaucoma patients of African versus European descent over four years. Materials and Methods In this study, 112 patients with open-angle glaucoma were examined at baseline, 79 (59 European descent, 20 African descent) of which were followed for four years. Retinal capillary blood flow was assessed with Heidelberg retinal flowmetry. Retrobulbar blood flow was measured by color Doppler imaging. Retinal structural changes were examined with optical coherence tomography and Heidelberg retinal tomography-III. Mixed-model analysis of covariance was used to test for the significance of change from baseline to four-year follow-up, and Pearson correlation coefficients were calculated to evaluate linear associations. Results In open-angle glaucoma patients of African descent, structural changes of the optic nerve head demonstrated a strong association with the end diastolic velocities and resistive indices of the short posterior ciliary arteries over four years. In addition, there was a significantly larger increase in the avascular area of the inferior retina in patients of African descent, and this reduction in retinal capillaries strongly correlated with a reduction in macular thickness. Conclusion Reductions in retinal capillary and retrobulbar blood flow strongly correlated with changes in the optic nerve head and macular thickness over four years in open-angle glaucoma patients of African descent compared to European descent. This data suggests that ocular vascular health may be a more influential contributing factor in the pathophysiology of open-angle glaucoma in patients of African descent compared to European descent.