Carroll Webers - Academia.edu (original) (raw)

Papers by Carroll Webers

Journal of Cataract and Refractive Surgery, Sep 30, 2008

Journal of ophthalmology, 2015

Purpose. Complement plays an important role in the pathogenesis of age related macular degenerati... more Purpose. Complement plays an important role in the pathogenesis of age related macular degeneration (AMD) and trials are currently being conducted to investigate the effect of complement inhibition on AMD progression. We previously found that the plasma level of factor D (FD), which is the rate limiting enzyme of the complement alternative pathway, was significantly decreased following lutein supplementation. FD is synthesized by adipose tissue, which is also the main storage site of lutein. In view of these findings we tested the hypothesis whether lutein could affect FD synthesis by adipocytes. Methods. A cell line of mature human adipocytes was incubated with 50 μg/mL lutein for 24 and 48 h, whereafter FD mRNA and protein expression were measured. Results. Lutein significantly inhibited adipocyte FD mRNA expression and FD protein release into adipocyte culture supernatants. Conclusions. Our earlier observations showing that a daily lutein supplement in individuals with early sign...

The lancet. Diabetes & endocrinology, 2015

Optical coherence tomography (OCT) of the retina and around the optic nerve head and corneal conf... more Optical coherence tomography (OCT) of the retina and around the optic nerve head and corneal confocal microscopy (CCM) are non-invasive and repeatable techniques that can quantify ocular neurodegenerative changes in individuals with diabetes. We systematically reviewed studies of ocular neurodegenerative changes in adults with type 1 or type 2 diabetes and noted changes in the retina, the optic nerve head, and the cornea. Of the 30 studies that met our inclusion criteria, 14 used OCT and 16 used CCM to assess ocular neurodegenerative changes. Even in the absence of diabetic retinopathy, several layers in the retina and the mean retinal nerve fibre layer around the optic nerve head were significantly thinner (-5·36 μm [95% CI -7·13 to -3·58]) in individuals with type 2 diabetes compared with individuals without diabetes. In individuals with type 1 diabetes without retinopathy none of the intraretinal layer thicknesses were significantly reduced compared with individuals without diabe...

Clinical ophthalmology (Auckland, N.Z.)

Brinzolamide 1%/timolol 0.5% is a new fixed-combination for the treatment of open-angle glaucoma ... more Brinzolamide 1%/timolol 0.5% is a new fixed-combination for the treatment of open-angle glaucoma or ocular hypertension. Brinzolamide/timolol has a favorable safety profile, with an incidence of ocular burning and stinging <5%. Published data show that brinzolamide 1%/timolol 0.5% and dorzolamide 2%/timolol 0.5% have similar efficacies for lowering intraocular pressure (IOP). There is some evidence that brinzolamide/timolol may be more comfortable. Although patients receiving brinzolamide/timolol may experience more blurred vision on instillation, some data show a preference for brinzolamide/timolol over dorzolamide/timolol. Although available data to assess the role of brinzolamide/timolol in daily clinical practice are still limited, these first results suggest the agent to be a reasonable alternative for patients who do not reach target IOP with monotherapy.

JAMA ophthalmology, 2014

Spectacle independence is becoming increasingly important in cataract surgery. Not correcting cor... more Spectacle independence is becoming increasingly important in cataract surgery. Not correcting corneal astigmatism at the time of cataract surgery will fail to achieve spectacle independency in 20% to 30% of patients. To compare bilateral aspherical toric with bilateral aspherical control intraocular lens (IOL) implantation in patients with cataract and corneal astigmatism. A multicenter, hospital-based, randomized clinical trial was conducted. The participants included 86 individuals with bilateral cataract and bilateral corneal astigmatism of at least 1.25 diopters (D) who were randomized to receive either bilateral toric (n = 41) or bilateral control (n = 45) IOL implantation. Bilateral implantation of an aspherical toric IOL or an aspherical control IOL. Spectacle independency for distance vision, uncorrected distance visual acuity, refractive astigmatism, contrast sensitivity, wavefront aberrations, and refractive error-related quality-of-life questionnaire. Preoperatively, mean...

Investigative ophthalmology & visual science, 2014

To assess the reproducibility of iridocorneal angle (ICA) analysis in young, healthy Caucasian su... more To assess the reproducibility of iridocorneal angle (ICA) analysis in young, healthy Caucasian subjects using swept-source optical coherence tomography (SS-OCT) by determining variability and interobserver agreement between expert and nonexpert observers. Thirty-one healthy volunteers (nonexperts) acquired three consecutive SS-OCT images of the right eyes of their peer nonexperts. Images were analyzed by 31 nonexperts and additionally by three experts, whereby the angle opening distance (AOD) and the trabecular iris space area (TISA) at 500 and 750 μm were calculated. A random intercept model was used to determine the amount of variation between observers. In addition, the intra-observer variability between nonexperts and experts was calculated by determining the coefficient of variation (CV). A significant difference was found in the expert analysis for the nasal and temporal angle in the AOD500 (P = 0.002), AOD750 (P < 0.01), and TISA750 (P < 0.01), and the values AOD500 (P ...

European journal of ophthalmology

To gather information regarding patient's understanding of glaucoma and the manner in which p... more To gather information regarding patient's understanding of glaucoma and the manner in which patients wish to learn about the disease with the intent of improving patient education. Forty-four of sixty randomly selected ophthalmologists (73%) asked four of their patients consecutively to complete a questionnaire about glaucoma. The selection of questions was based on focus group interviews and suggestions from several experts. Topics included knowledge about glaucoma and its treatment, the need for information, and preferred providers and methods of patient education. Fifty percent of the patients had 49% or less correct answers to questions about glaucoma or its treatment. Per item the correct answers ranged from 5% to 90%. Lack of knowledge was associated with low level of education, short duration of glaucoma, high age, and no preference for the Internet as method of supplying information. These variables, however, did not identify groups with a considerable lack of knowledge ...

Documenta ophthalmologica. Advances in ophthalmology, 2000

The outcome of combined same-site phacoemulsification, posterior chamber lens implantation and tr... more The outcome of combined same-site phacoemulsification, posterior chamber lens implantation and trabeculectomy was retrospectively studied in patients with cataract and moderately controlled glaucoma, with a follow-up of at least 6 months. Primary phacotrabeculectomy without antimetabolites was performed in 74 patients. Mean IOP decreased from 22.8 to 14.3 mm Hg (35.3%). A maximum IOP of 19 mm Hg without glaucoma medication was reached in 66.2%. Mean logMAR visual acuity increased from 0.58 to 0.30. Primary phacotrabeculectomy has been shown to be a safe and effective procedure with good IOP control and rapid visual rehabilitation.

Journal of glaucoma, Jan 26, 2014

To develop a prediction model for glaucomatous visual field progression using easily accessible b... more To develop a prediction model for glaucomatous visual field progression using easily accessible baseline clinical data. We collected baseline data of 613 consecutive patients with open-angle glaucoma from 2001 to 2003. The rate of visual field progression was calculated using the Visual Field Index (VFI) of routine follow-up examinations until 2010. Baseline data of 333 patients from 3 hospitals were used to develop a model to predict the rate of VFI progression using a linear regression analysis and univariate preselection (P<0.1) of 8 candidate predictors. The performance of the model was investigated using R, the area under the receiver-operating characteristic curve, and calibration plots. The prediction model was internally validated using bootstrapping and externally validated in 280 patients from 2 other hospitals. After a mean follow-up period of 5.8 years of all 613 eyes, the mean rate of VFI progression was -1.6% per year. The final model contained the following predict...

American Journal of Ophthalmology, 1993

In 19 patients who had retinal vein occlusion or retinal artery occlusion before the age of 50 ye... more In 19 patients who had retinal vein occlusion or retinal artery occlusion before the age of 50 years, the incidence of hyperhomocysteinemia, as observed in heterozygosity for homocystinuria, was studied by the performance of a standardized, oral methionine-loading test. In four of the 19 patients (21%), two with retinal artery occlusion and two with central retinal vein occlusion, the after-load peak levels of homocysteine exceeded the mean level, established in normal control subjects, by more than two standard deviations and were as well within the ranges established in obligate heterozygotes for homocystinuria. Because the frequency of heterozygosity for homocystinuria in the normal population is one in 70 (1.4%) at the most, we conclude that hyperhomocysteinemia predisposes to the development of premature retinal artery and retinal vein occlusion (P < .01; chi 2 test).

Archives of Biochemistry and Biophysics, 2015

Ophthalmology, 2007

To estimate the intraocular pressure (IOP)-lowering effect of 2% dorzolamide or 0.005% latanopros... more To estimate the intraocular pressure (IOP)-lowering effect of 2% dorzolamide or 0.005% latanoprost when added to 0.5% timolol. Meta-analysis of randomized clinical trials. Seventeen articles reporting on 19 study arms with 5 possible treatment combinations and 4 study arms serving as controls. Articles written in English, German, French, or Dutch and published up to December 2004 were identified in Medline, Embase, the Cochrane Controlled Trials Register, and references from relevant articles. For the article to be considered, over 85% of the patients had to have primary open-angle glaucoma or ocular hypertension. The pooled 1- to 3-month additional IOP-lowering effect after a run-in phase on timolol was calculated by performing meta-analysis using the random effects model. Absolute and relative changes in IOP after run-in on timolol for peak moment, trough moment, or mean diurnal curve. The pooled change from baseline [mean (95% confidence interval)] for 0.5% timolol varied from -0.7 mmHg (-1.2 to -0.2, for the mean diurnal curve) to -2.0 mmHg (-1.3 to -2.7, at peak). Pooled changes for 2% dorzolamide in concomitant use with 0.5% timolol were -4.1 mmHg (-4.4 to -3.8) at trough and -4.9 mmHg (-5.3 to -4.5) at peak. The fixed 2% dorzolamide and 0.5% timolol combination resulted in a pooled change of -3.8 mmHg (-4.2 to -3.4) at trough and -4.9 mmHg (-5.3 to -4.5) at peak. The concomitant use of 0.005% latanoprost and 0.5% timolol gave a pooled change from baseline of -6.0 mmHg (-6.8 to -5.2) at the mean diurnal curve. The fixed combination of 0.005% latanoprost and 0.5% timolol resulted in a mean change of -3.0 mmHg (-3.8 to -2.2) at the mean diurnal curve. In this meta-analysis of clinical trials, the addition of dorzolamide or latanoprost further lowers IOP in eyes on timolol. This result may not be generalizable because these trials may have included nonresponders to timolol.

Ophthalmology, 2005

To summarize the available scientific evidence to support clinical decisions on how to deal with ... more To summarize the available scientific evidence to support clinical decisions on how to deal with noncompliance in glaucoma patients. Insufficient reduction of intraocular pressure and progression of visual field (VF) loss in glaucoma patients due to noncompliance with topical treatment may result in unnecessary therapy, with additional risks and costs. We conducted a literature search in the databases MEDLINE, EMBASE, CINAHL, PsychInfo, and Cochrane and reference lists. Thirty-four articles describing 29 original quantitative studies, in English, German, French, or Dutch, were included. Studies on noncompliance in drug trials were excluded. Two investigators independently selected the articles and abstracted their content, before negotiating their inclusion or exclusion. The proportions of patients who deviate from their prescribed medication regimen ranged from 5% to 80%. The impact of noncompliance on clinical outcome has not yet been established. There are no determinants sensitive and specific enough to identify potential noncompliers accurately. Patient knowledge and dose frequency can be used as starting points to improve compliance. A combination of patient education and prevention of forgetting doses seems to be successful in enhancing patient compliance. Noncompliance with hypotensive treatment is common among glaucoma patients. However, there is no strong evidence supporting a relation between noncompliance and progression of VF loss. Only a few guidelines for clinicians can be derived from the currently available literature. Future research should be guided by clinically relevant questions.

Ophthalmology, 2010

To estimate the intraocular pressure (IOP)-lowering effect of prostaglandin analogs (PGAs) when a... more To estimate the intraocular pressure (IOP)-lowering effect of prostaglandin analogs (PGAs) when added to topical β-blocker (BB) therapy. Systematic review and meta-analyses of randomized clinical trials. Twenty-nine articles reporting on 33 study arms and 3 control arms. Articles published between January 1, 1990, and August 18, 2009, were identified in relevant databases. The pooled IOP-lowering effects at the 1- to 3-month follow-ups were calculated by performing random effects meta-analyses. Absolute and relative change in IOP for mean diurnal curve and highest and lowest IOP decrease on the diurnal IOP curve. Adding 0.005% latanoprost in the evening to 0.5% timolol twice daily resulted in a pooled change of -6.3 mmHg (95% CI, -7.1 to -5.5 mmHg, mean IOP curve); switching to the fixed combination of 0.5% timolol and 0.005% latanoprost in the morning resulted in a pooled change of -2.8 mmHg (95% CI, -3.3 to -2.3 mmHg, mean IOP curve). Starting with any fixed combination of 0.5% timolol and a PGA in the morning resulted in a pooled change of -8.4 mmHg (95% CI, -9.1 to -7.6 mmHg, mean IOP curve) and varied between -9.1 mmHg (95% CI, -9.9 to -8.2 mmHg, highest) and -7.9 mmHg (95% CI, -8.5 to -7.2 mmHg, lowest); starting with any fixed combination of 0.5% timolol and a PGA in the evening resulted in a pooled change of -8.6 (95% CI, -9.2 to -8.0 mmHg, mean IOP curve) and varied between -10.1 mmHg (95% CI, -11.0 to -9.2 mmHg, highest) and -7.3 mmHg (95% CI, -8.1 to -6.4 mmHg, lowest). The concomitant use of latanoprost and timolol leads to a larger additional IOP reduction when compared with the fixed combination. There is no difference in mean IOP-lowering effect between evening and morning dosing of a fixed combination of timolol and a PGA, although the largest IOP decreases are seen with evening dosing. These findings are explained by differences in study design. When time points of IOP measurements close to the peak or trough moment of a drug are included, the IOP-lowering effect will be overestimated or underestimated, respectively. Proprietary or commercial disclosure may be found after the references.