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Articles by P. J Foster
Total Records ( 4 ) for P. J Foster
  V. S. E Jeganathan , T. Y Wong , P. J Foster , J. G Crowston , W. T Tay , S. C Lim , S. M Saw , E. S Tai and T. Aung

Objective  To examine the relationship between peripheral artery disease (PAD) and glaucoma.

Methods  As part of a population-based study of 3280 persons of Malay descent (78.7% response) aged 40 to 80 years examined between August 1, 2004, and June 30, 2006, the ankle-brachial index (ABI) was assessed in all persons with known diabetes mellitus and every fifth systematically sampled participant without diabetes. Peripheral artery disease was deemed present if the ABI was 0.9 or less. Glaucoma was diagnosed using International Society of Geographical and Epidemiological Ophthalmology criteria.

Results  Of the 922 participants who had ABI measured, 79 (8.6%) had PAD and 42 (4.6%) had glaucoma. Persons with PAD were more likely to have glaucoma (11.4% vs 3.9%; age- and sex-adjusted odds ratio [OR], 2.80; 95% confidence interval [CI], 1.26-6.24), higher intraocular pressure (age- and sex-adjusted mean, 16.4 vs 15.5; P = .05), and a larger vertical cup-disc ratio (age- and sex-adjusted mean, 0.45 vs 0.40; P = .02). The association of PAD with glaucoma persisted while controlling for hypertension, diabetes, body mass index, serum triglyceride levels, and β-blocker use (multivariable-adjusted OR, 2.55; 95% CI, 1.09-5.98) and was stronger in people with diabetes (multivariable-adjusted OR, 2.91; 95% CI, 1.14-7.44).

Conclusions  Peripheral artery disease was related to glaucoma, supporting an association between large-vessel atherosclerotic disease and glaucoma. However, because the study sample included a high proportion of persons with diabetes, further research is needed to determine the relevance of these results to the general population.

  A. C. S How , G. S. W Tan , Y. H Chan , T. T. L Wong , S. K Seah , P. J Foster and T. Aung

Objective  To determine the prevalence of tilted and torted optic discs and associated risk factors among Chinese adults in Singapore.

Methods  As part of a population-based survey, optic disc stereophotographs of both eyes were obtained, and left eyes were analyzed using imaging software. A tilted optic disc was defined as an index of tilt (ratio of minimum to maximum optic disc diameter) less than 0.75. The angle of tilt was defined as the angle between the maximum and vertical optic disc diameter, and optic discs were graded as torted if the angle of tilt exceeded 15°.

Results  Twenty-six of 739 subjects (3.5%) had tilted optic discs, and 478 (64.7%) had torted optic discs. Myopia was present in 23 of 26 eyes (88.5% [95% confidence interval, 69.9%-97.6%]) with tilted optic discs and in 211 of 661 eyes (31.9% [28.4%-35.6%]) without tilted optic discs (P < .001). On multivariate analysis, myopia (spherical equivalent) was a significant risk factor for tilted optic discs (P < .001). Index of tilt was not associated with corneal astigmatism or with cylindrical refractive error. Seventeen eyes (65.4%) with tilted optic discs had an optic disc morphologic abnormality, but none were glaucomatous.

Conclusions  The prevalence of tilted optic discs among this Chinese population was 3.5%. Tilted optic discs were associated with myopia but not with glaucoma.

  S Huang , Y Zheng , P. J Foster , W Huang and M. He

Objective  To assess the prevalence and causes of visual impairment and blindness in adults living in an urban area of southern China.

Methods  Random cluster sampling was used to identify the adults 50 years and older living in the Liwan district of Guangzhou, China. Presenting visual acuity (PVA) with habitual correction and best-corrected visual acuity (BCVA) based on autorefraction and subjective refraction were measured using the Early Treatment Diabetic Retinopathy Study visual chart. Blindness and low vision were defined according to World Health Organization criteria. Eyes with visual impairment were assigned 1 principal cause for the impairment.

Results  Visual acuity measurements were available for 1399 adults 50 years and older (75.3% participation rate). The prevalence of blindness and low vision based on the PVA was 0.6% (95% confidence interval, 0.2%-1.0%) and 10.1% (95% confidence interval, 8.5%-11.7%), respectively. These rates were reduced to 0.5% and 3.1% when the BCVA was considered. Based on the PVA, the principal causes for blindness were cataract (39.6%), glaucoma (11.0%), and myopic maculopathy (6.6%). The majority of low vision cases were attributable to cataract (45.3%) and uncorrected refractive error (43.9%).

Conclusion  The majority of eye diseases leading to visual impairment are potentially treatable in this population.

  A Narayanaswamy , L. M Sakata , M. G He , D. S Friedman , Y. H Chan , R Lavanya , M Baskaran , P. J Foster and T. Aung

Objective  To assess the diagnostic performance of angle measurements from anterior segment optical coherence tomography (AS-OCT) images for identifying eyes with narrow angles.

Methods  We conducted a community-based cross-sectional study of individuals 50 years or older who had phakic eyes and who underwent AS-OCT imaging in the dark by a single operator and gonioscopy by an ophthalmologist masked to AS-OCT findings. An eye was considered to have narrow angles if the posterior pigmented trabecular meshwork was not visible for at least 180° on gonioscopy. Horizontal AS-OCT images were analyzed for the following measurements using customized software: angle opening distance (AOD) at 250, 500, and 750 µm from the scleral spur; trabecular-iris space area (TISA) at 500 and 750 µm; and angle recess area (ARA) at 750 µm. Areas under the receiver operating characteristic curves (AUCs) were generated for AOD, TISA, and ARA to assess the performance of these measurements in detecting eyes with narrow angles.

Results  Of 2047 individuals examined, 582 were excluded mostly because of poor image quality or inability to locate the scleral spur. Of the remaining 1465 participants, 315 (21.5%) had narrow angles on gonioscopy. Mean (SD) age was 62.7 (7.7) years, 54.1% were women, and 90.0% were Chinese. The AUCs were highest for AOD750 in the nasal (0.90 [95% confidence interval, 0.89-0.92]) and temporal (0.91 [0.90-0.93]) quadrants.

Conclusions  The AOD750 is the most useful angle measurement for identifying individuals with gonioscopic narrow angles in gradable AS-OCT images. Poor definition of the scleral spur precludes quantitative analysis in approximately 25% of AS-OCT images.

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