Ashkan Abbey - Academia.edu (original) (raw)

Papers by Ashkan Abbey

Ocular Immunology and Inflammation, Jun 28, 2022

British Journal of Ophthalmology, Nov 25, 2009

Investigative Ophthalmology & Visual Science, Apr 28, 2009

Investigative Ophthalmology & Visual Science, Jun 21, 2021

Ophthalmology Retina, 2021

PURPOSE To describe the clinical features and surgical outcomes of patients experiencing a sponta... more PURPOSE To describe the clinical features and surgical outcomes of patients experiencing a spontaneous conversion of lamellar macular holes (LMH) to full-thickness macular holes (FTMH). DESIGN Retrospective, multicenter, observational case series. PARTICIPANTS Patients with LMH who experienced a spontaneous conversion to FTMH and underwent FTMH surgery. METHODS Clinical charts and optical coherence tomography features of 20 eyes of 20 patients were reviewed. MAIN OUTCOME MEASURES Optical coherence tomography features and surgical outcomes of FTMH derived from LMH. RESULTS The mean baseline visual acuity (VA) was 0.21 ± 0.19 LogMAR (20/32 Snellen equivalent [SE]). Epiretinal proliferation was noted in 18 (90%) eyes, and 14 (75%) eyes had an epiretinal membrane. At the diagnosis of FTMH, the mean VA decreased to 0.61 ± 0.50 LogMAR (20/81 SE) (P=0.001). The mean FTMH diameter was 224.4 ± 194.8 μm, with 15 (75%) small (≤250 μm), 2 (10%) medium (>250 - ≤400 μm) and 3 (15%) large (>400 μm) FTMH. Eighteen (90%) FTMH were sealed after one surgery, while two (10%) required an additional procedure. At the last follow-up, the mean VA was increased to 0.29 ± 0.23 LogMAR (20/38 SE) (P=0.003), but did not significantly differ from the baseline VA (P=0.071). CONCLUSION Patients with LMH may develop a FTMH with no evidence of vitreomacular traction. A tangential traction from an epiretinal membrane may contribute to its genesis, but a progressive loss of retinal tissue and an inherent weakness of the foveal architecture in LMH eyes could be sufficient. Most FTMH derived from LMH had a small diameter, showed epiretinal proliferation, limited retinal hydration, and were associated with relatively poor surgical outcomes compared to idiopathic FTMH.

Eye, May 12, 2023

BACKGROUND/OBJECTIVE: Investigate real-world patients receiving faricimab for the treatment of ne... more BACKGROUND/OBJECTIVE: Investigate real-world patients receiving faricimab for the treatment of neovascular age-related macular degeneration (nAMD). SUBJECTS/METHODS: Multicenter, retrospective chart review was conducted on patients treated with faricimab for nAMD from February 2022 to September 2022. Collected data includes background demographics, treatment history, best-corrected visual acuity (BCVA), anatomic changes, and adverse events as safety markers. The main outcome measures are changes in BCVA, changes in central subfield thickness (CST) and adverse events. Secondary outcome measures included treatment intervals and presence of retinal fluid. RESULTS: After one injection of faricimab, all eyes (n = 376), previously-treated (n = 337) and treatment-naïve (n = 39) eyes demonstrated a + 1.1 letter (p = 0.035), a + 0.7 letter (p = 0.196) and a + 4.9 letter (p = 0.076) improvement in BCVA, respectively, and a − 31.3 μM (p < 0.001), a − 25.3 μM (p < 0.001) and a − 84.5 μM (p < 0.001) reduction in CST, respectively. After three injections of faricimab, all eyes (n = 94), previously-treated (n = 81) and treatment-naïve (n = 13) eyes demonstrated a + 3.4 letter (p = 0.03), a + 2.7 letter (p = 0.045) and a + 8.1 letter (p = 0.437) improvement in BCVA, and a − 43.4 μM (p < 0.001), a − 38.1 μM (p < 0.001) and a − 80.1 μM (p < 0.204) reduction in CST, respectively. One case of intraocular inflammation was observed after four injections of faricimab and resolved with topical steroids. One case of infectious endophthalmitis was treated with intravitreal antibiotics and resolved. CONCLUSIONS: Faricimab has demonstrated improvement or maintenance of visual acuity for patients with nAMD, along with rapid improvement of anatomical parameters. It has been well-tolerated with low incidence of treatable intraocular inflammation. Future data will continue to investigate faricimab for real-world patients with nAMD.

$Research paper thumbnail of Refractive Outcomes after Sutureless Intrascleral Fixation of Secondary Intraocular Lens with Pars Plana Vitrectomy$

Investigative Ophthalmology & Visual Science, Jun 10, 2020

PURPOSE To evaluate the refractive outcomes of sutureless intrascleral fixation of intraocular le... more PURPOSE To evaluate the refractive outcomes of sutureless intrascleral fixation of intraocular lens with pars plana vitrectomy. METHOD A retrospective, consecutive cohort from multiple surgeons of a single center. Primary outcomes included spherical equivalent (SEQ) and change in SEQ (ΔSEQ) from preoperative intraocular lens power calculations. Secondary outcomes included refractive outcomes of fixation at 1.5 mm, 2 mm, and 2.5 mm posterior to the limbus. RESULTS In total, 84 eyes of 80 patients were included. Preoperative logarithm of the minimum angle of resolution visual acuity was 1.21 ± 0.68 (20/320). The mean follow-up time was 2.33 ± 1.36 years. At 3 months, SEQ was -0.50 ± 1.59 D and ΔSEQ was 0.58 ± 1.49 D. At 1 year, SEQ was -0.55 ± 1.32 D and ΔSEQ was 0.39 ± 1.42 D. At the last follow-up, logarithm of the minimum angle of resolution visual acuity was 0.34 ± 0.34 (20/40), SEQ was -0.51 ± 1.44 D, and ΔSEQ was 0.57 ± 1.27 D. There was no difference between SEQ or ΔSEQ throughout follow-up (P = 0.97 and P = 0.96, respectively). At fixation distances more posterior to the limbus, mean ΔSEQ was more hyperopic at 3 months, 1-year, and the last follow-up (P = 0.02, P = 0.01, and P = 0.006, respectively). CONCLUSION Refractive outcomes for sutureless intrascleral fixation of intraocular lens with pars plana vitrectomy were favorable and showed stability postoperatively. These results may aid surgeons achieve better desired refractive outcomes for this technique.

Ophthalmic surgery, lasers & imaging retina, Feb 1, 2015

To evaluate subfoveal choroidal thickness (CT) and the extent of outer retinal disruption in pati... more To evaluate subfoveal choroidal thickness (CT) and the extent of outer retinal disruption in patients with macular telangiectasia type 2 (MacTel2) compared with healthy eyes. In this prospective, observational, cohort study, 62 patients (62 eyes) with Mac-Tel2 and 130 healthy controls (130 eyes) underwent a complete ophthalmological examination, spectral-domain optical coherence tomography (SD-OCT) imaging, and axial length measurements. Patients in the study group also underwent color fundus photography, fundus autofluorescence, and fluorescein angiography. En face SD-OCT imaging was used to assess abnormalities involving the photoreceptor inner segment/outer segment/ellipsoid zone (IS/OS/EZ). After adjusting for age and axial length, the authors found that eyes with MacTel2 had a mean CT measurement that was greater than control eyes (P = .007). There was a negative correlation between the visual acuity and the area of IS/OS/EZ damage (P = .009), but no statistically significant correlation was seen between CT and the area of IS/OS/EZ damage. Eyes with MacTel2 were found to have thicker CT measurements than control eyes. While the extent of IS/OS/EZ disruption correlated with the loss of visual acuity, this damage did not correlate with CT measurements. [Ophthalmic Surg Lasers Imaging Retina. 2015;46:162-170.].

Ophthalmic surgery, lasers & imaging retina, 2015

Investigative Ophthalmology & Visual Science, Mar 26, 2012

Ophthalmology Retina, Mar 1, 2017

Purpose: To report the prevalence and surgical outcomes of macular holes (MHs) in eyes with age-r... more Purpose: To report the prevalence and surgical outcomes of macular holes (MHs) in eyes with age-related macular degeneration (AMD). Design: Interventional, retrospective, consecutive case series. Participants: Patients with MH and concurrent non-neovascular (NNV) or neovascular (NV) AMD. Methods: The records of 27 912 patients diagnosed with AMD between 2009 and 2014 at Associated Retinal Consultants were reviewed. Demographic data, visual acuity (VA), funduscopic examination, and optical coherence tomography were reviewed in those with a concurrent diagnosis of MH. Main Outcome Measures: The VA and MH closure status. Results: A total of 15 196 patients with NNV and 12 716 patients with NV AMD were identified. A total of 199 eyes (0.7%) had MHs (160 NNV [1.1%]; 39 NV [0.3%]). Mean time to diagnosis of MH after the initial visit was 11.2 months (7.1 NNV; 24.8 NV). A total of 127 eyes underwent surgical repair (106 NNV; 21 NV). The final closure rate in those who underwent vitrectomy was 89.8% (91.5% NNV; 81.0% NV) and 25.0% in those who were observed (18.5% NNV, P < 0.0001; 44.4% NV, P ¼ 0.02). Preoperative logarithm of the minimum angle of resolution VAs in NNV and NV AMD was 0.8AE0.4 and 0.8AE0.5, respectively, and final VA was 0.6AE0.5 (P < 0.001) and 0.9AE0.6 (P ¼ 0.52), respectively. Mean follow-up time was 5.0 years. Conclusions: The prevalence of MH was higher in eyes with NNV AMD than in those with NV AMD. The surgical closure rate was comparable in both groups, but VA improvement reached statistical significance only in the NNV AMD group. Ophthalmology Retina 2016;-:1e7 ª 2016 by the American Academy of Ophthalmology Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries and has an estimated worldwide prevalence of 8.7%. 1 Complications include geographic atrophy (GA), choroidal neovascularization, hemorrhage, exudation, retinal pigment epithelial (RPE) detachment or tear, and fibrosis with profound central vision loss. 2 Non-neovascular (NNV) AMD currently is managed with vitamin supplementation if certain characteristics are met. 3 Neovascular (NV) AMD is treated with intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents. 4 Macular hole (MH) also is a prevalent macular pathology. Full-thickness macular holes (FTMHs) are visually significant disruptions of foveal anatomy with an estimated incidence of 0.02% to 0.8% in those aged >40 years. 5,6 Originally described by Gass in 1988, the pathophysiologic mechanism of MH formation involves posterior hyaloid contraction, perifoveal vitreous detachment, and anterior-posterior vitreoretinal forces. 7,8 Current treatment options include observation, pharmacologic vitreolysis, and vitrectomy with or without internal limiting membrane (ILM) peeling. 9,10 Lamellar MHs are partial-thickness defects in the neurosensory retina, which are generally less visually significant. 11 Our understanding and treatment of AMD and MH as individual entities have significantly improved over the years. However, little is known regarding eyes that harbor both AMD and MH. 12e14 Many questions remain unanswered, such as the prevalence, treatment response, and visual outcomes. The purpose of this study was to determine the prevalence of MHs in both NV and NNV AMD and to present the long-term surgical outcomes. Methods This was a single-center, interventional, consecutive, comparative, retrospective review of all medical records that contained diagnostic codes of a "macular hole" and "age-related macular degeneration" from January 1, 2009, to November 30, 2014, at the Associated Retinal Consultants. Institutional review board approval was granted. The study complied with the Health Insurance Portability and Accountability Act of 1996 and conformed to the tenets of the Declaration of Helsinki. Eligibility Inclusion criteria included a diagnosis of an MH and concurrent AMD. Exclusion criteria were: patients who (1) developed AMD after MH diagnosis, (2) underwent MH surgery at an outside facility, (3) had prior vitreoretinal surgery for another pathology before or concurrently with the MH diagnosis, (4) had other concurrent macular or vaso-occlusive pathology that may confound the

Investigative Ophthalmology & Visual Science, Sep 26, 2016

Investigative Ophthalmology & Visual Science, Apr 30, 2014

Clinical and Experimental Ophthalmology, Mar 17, 2016

standardized by Moorfields Eye Hospital, which has lower doses of adrenaline and atropine than us... more standardized by Moorfields Eye Hospital, which has lower doses of adrenaline and atropine than used in this case (refer to the preceding texts). We believe that the high dose of adrenaline used, combined with the stress and discomfort of subconjunctival injection, is the most likely cause of takotsubo cardiomyopathy in this case. There are currently multiple hypotheses attempting to describe the pathophysiology of takotsubo cardiomyopathy, including theories that it is a protective adaptation to cardiac overstimulation, with experiments in rat models showing that elevated levels of serum adrenaline can induce the effect. The high concentration of vasculature in the conjunctiva further increases the risk of subconjunctival mydricaine injections resulting in systemic effects. A subconjunctival injection of 1.0ml is extremely uncomfortable, despite topical and local anaesthetic, and is sufficient to cause significant physical and emotional stress. As a result of this case, the use of subconjunctival mydricaine has been ceased in this hospital’s emergency department and limited elsewhere within the hospital. An alternative form of controlled topical adrenaline has been proposed. We would recommend that further use of subconjunctival mydricaine should not only be judicious but also only performed in a setting where tertiarymedical services can be easily accessed.

Investigative Ophthalmology & Visual Science, 2015

Investigative Ophthalmology & Visual Science, 2013

Investigative Ophthalmology & Visual Science, 2014

American Journal of Ophthalmology, 2010