Lab Affiliations


All Publications


  • Alendronate induced chorioretinitis: The importance of meticulous assessments. American journal of ophthalmology case reports Hassan, M., Maleki, A., Ying, Q., Nguyen, N., Halim, M. S., Sepah, Y. J., Do, D. V., Nguyen, Q. D. 2019; 14: 21–25

    Abstract

    Purpose: To report a case of presumed bilateral chorioretinitis secondary to alendronate therapy.Observations: A 71-year-old female presented to the clinic in July 2017 with six months history of difficulty in reading along with floaters in both eyes which were more severe in the right eye. Past medical and surgical history revealed a history of hypertension, gout, hyperthyroidism, osteoporosis, and humerus fracture. She was started on alendronate three months before developing ocular symptoms. On ocular examination, best corrected visual acuity was 20/30 in the right and 20/25 in the left eye. Slit-lamp examination demonstrated normal anterior chamber examination in both eyes. Dilated fundus examination revealed geographic chorioretinal lesions around the optic nerve head in both eyes, more extensively in the right eye; and superior and temporal to the macula in the right eye. Past ocular records in February 2015 did not reveal any such findings. Fundus autofluorescence demonstrated hyper-autofluorescence in the peripapillary lesions in both eyes. The lesion adjacent to the macula in right eye displayed mixed hyper and hypo-autofluorescence. Fluorescein angiography showed combined hyper- and hypo-fluorescence compatible with window defect, staining and blockage. However, no leakage was appreciated in the macula, peripapillary, and peripheral lesions in both eyes. Optical coherence tomography scan showed septate hyporeflective intraretinal spaces in the right eye.Conclusion and importance: The index report underscore the importance of considering alendronate as an etiologic cause of chorioretinitis, especially in subjects with atypical lesions developing after alendronate therapy. We, therefore, recommend discontinuation of this medication in subjects who develop chorioretinitis after employing this medication.

    View details for PubMedID 30809598

  • Blue light versus green light fundus autofluorescence in normal subjects and in patients with retinochoroidopathy secondary to retinal and uveitic diseases. Journal of ophthalmic inflammation and infection Bittencourt, M. G., Hassan, M., Halim, M. S., Afridi, R., Nguyen, N. V., Plaza, C., Tran, A. N., Ahmed, M. I., Nguyen, Q. D., Sepah, Y. J. 2019; 9 (1): 1

    Abstract

    PURPOSE: The aim of this study is to evaluate the differences in the fundus autofluorescence (FAF) signal between the blue light autofluorescence (BAF) from Spectralis (Heidelberg, CA) and green light autofluorescence (GAF) 200TxTM (OPTOS, UK, in normal subjects and in patients with retinochoroidopathies (RC).METHODS: In this prospective study, FAF was performed using BL (lambda=488nm) and GL (lambda=532nm) on normal subjects and patients with RC. The corresponding pairs of BAF and GAF images from both groups were analyzed using Photoshop. The strength of the FAF signal was measured on a gray scale, where optic disc was a standard to indicate absence of AF. In addition, gray values obtained from three identical points (foveal center, and points of hypo and hyper autofluorescence) in the corresponding BAF and GAF images of normal and RC subjects were divided by the optic disc value to calculate autofluorescence signal ratio (R). The R values at fovea (R1), hypoautofluorescent point (R2), and hyperautofluorescent point (R3) were compared between BAF and GAF modalities, in normal and in RC subjects separately.RESULTS: One hundred six pairs (106 eyes) of FAF images analyzed (37 pairs: normal and 69 pairs: RC subjects). In normal subjects, the mean R1, R2, and R3 values for BAF were (1.5±0.88, 1.23±0.58, and 4.73±2.85, respectively) and for GAF were (0.78±0.20, 0.78±0.20, and 1.62±0.39, respectively). Similarly, in subjects with RC, the mean R1, R2, and R3 values for BAF were (1.68±1.02, 1.66±1.15, and 7.75±6.82, respectively) and for GAF were (0.95±0.59, 0.79±0.45, and 2.50±1.65, respectively). The mean difference in the R1, R2, and R3 ratios between BAF and GAF in normal and in RC subjects was statistically significant (p<0.001). The strength of the correlation (r) between ratios for BAF and GAF was weak or not statistically significant in both normal and RC subjects (p>0.05).CONCLUSION: The distribution and intensity of the AF signal differ in BAF and GAF and cannot be used interchangeably. In BAF, optic disc signal is always weaker than in other areas, which was not true for GAF where optic disc signal was stronger than fovea and hypoautofluorescent point in both groups.

    View details for PubMedID 30617430

  • Effects of Vitreomacular Adhesion on Treatment Outcomes in the Study of Safety and Bioactivity of TOcilizumab in Patients with Non-Infectious UVEITIS: The STOP-UVEITIS Study Nguyen, N. V., Hassan, M., Halim, M., Afridi, R., Baluyot, S., Sepah, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2018
  • Posterior Segment Inflammatory Outcomes (Month-6) in the STOP-Uveitis Study: Evaluating the Safety, Tolerability, and Efficacy of Tocilizumab in Patients with Non-Infectious Uveitis Sadiq, M., Hassan, M., Halim, M., Afridi, R., Do, D. V., Quan Dong Nguyen, Sepah, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2018
  • Scleral Vessel Density Using Novel Optical Coherence Tomography Angiography Methodology Halim, M., Hassan, M., Afridi, R., Nguyen, N. V., Maleki, A., Baluyot, S., Sepah, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2018
  • Can Fundus Photograph Montage Replace the Standard 7-Field Stereo Images for Diabetic Retinopathy Severity Scale Assessments? Baluyot, S., Hassan, M., Halim, M., Afridi, R., Nguyen, N. V., Sepah, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2018
  • Diurnal variation of choriocapillaris vessel flow density in normal subjects measured using optical coherence tomography angiography. International journal of retina and vitreous Sarwar, S., Hassan, M., Soliman, M. K., Halim, M. S., Sadiq, M. A., Afridi, R., Agarwal, A., Do, D. V., Nguyen, Q. D., Sepah, Y. J. 2018; 4: 37

    Abstract

    Background: Vessel flow density (VFD) may provide important information regarding perfusion status. Diurnal variation in VFD of choriocapillaris has not been reported in literature. In the index study, optical coherence tomography angiography (OCTA) was used to assess the diurnal variation of the VFD in the choriocapillaris of subjects with no known ocular disease.Methods: Fifty eyes with no known ocular disease (25 subjects) were included. OCTA images were acquired using AngioVue (Optovue, Fremont, CA, USA) at two different time points on a single day: 9:00 AM and 6:00 PM. Macular cube scan protocol (3*3mm) centered on the fovea was used. Automatic segmentation of the retinal layers and choriocapillaris was performed using ReVue software, which was also used to measure the choriocapillaris VFD. Horizontal line scan passing through fovea was obtained by the device at both time points to measure the subfoveal choroidal thickness (CT). Linear measurement tool of software was used to measure subfoveal CT according to a standardized reproducible method. Wilcoxon signed-rank test was used to assess the differences in choriocapillaris VFD and subfoveal CT at the two time points. Correlation between change in choriocapillaris VFD and subfoveal CT at the two time points was assessed using the Pearson correlation coefficient (r).Results: The mean age of the subjects was 31.96±11.23years. Choriocapillaris VFD was significantly higher at 9:00 AM compared to 6:00 PM (P<0.0001) with mean choriocapillaris VFD of 68.74±4.80% at 9:00 AM and 67.57±5.41% at 6:00 PM, with a mean diurnal amplitude of 1.17%. Mean subfoveal CT was 287.74±61.51m at 9:00 AM and 270.06±60.73m at 6:00 PM. Subfoveal CT was also significantly higher at 9:00 AM compared to 6:00 PM (P<0.0001) with a mean diurnal amplitude of 17.68m. Change in choriocapillaris VFD correlated with change in subfoveal CT (r=0.87, P<0.001).Conclusion: OCTA demonstrated significant diurnal change in choriocapillaris VFD in subjects without any ocular disease with VFD being higher in the morning and lower in the evening. Decrease in choriocapillaris VFD in the evening correlated with a reduction in subfoveal CT.

    View details for PubMedID 30338130

  • Fundus Autofluorescence Imaging in Posterior Uveitis Multimodal Imaging in Uveitis Afridi, R., Agarwal, A., Sadiq, M. A., Hassan, M., Do, D. V., Nguyen, Q. D. Springer International Publishing. 2018: 69–85
  • Multifocal Choroiditis The Uveitis Atlas Hassan, M., Nguyen, N., Sepah, Y. J., Nguyen, Q. D. Springer, New Delhi. 2018
  • Primary (Month-6) Outcomes of the STOP-Uveitis Study: Evaluating the Safety, Tolerability, and Efficacy of Tocilizumab in Patients With Noninfectious Uveitis AMERICAN JOURNAL OF OPHTHALMOLOGY Sepah, Y., Sadiq, M., Chu, D. S., Dacey, M., Gallemore, R., Dayani, P., Hanout, M., Hassan, M., Afridi, R., Agarwal, A., Halim, M., Do, D. V., Quan Dong Nguyen 2017; 183: 71–80

    Abstract

    To report the primary endpoint analyses of the safety and efficacy of 2 different doses of intravenous (IV) infusions of tocilizumab (TCZ), an IL-6 inhibitor, in eyes with noninfectious intermediate uveitis, posterior uveitis, or panuveitis.Randomized, controlled, multicenter clinical trial.STOP-Uveitis is a randomized, open-label safety, efficacy, and bioactivity clinical trial conducted at 5 clinical centers across the United States. The study evaluated the role of TCZ in patients with noninfectious uveitis (NIU). Thirty-seven patients with NIU were randomized into one of 2 treatment groups in a ratio of 1:1. Group 1 received IV infusions of 4 mg/kg TCZ and group 2 received IV infusions of 8 mg/kg TCZ. Infusions were given every 4 weeks in both groups until month 6 (primary endpoint). Primary outcome measure was incidence and severity of systemic and ocular adverse events through month 6. Secondary outcome measures included mean change in visual acuity (VA), vitreous haze (VH), and central macular thickness (CMT) at month 6.A total of 37 patients were randomized in the study. At month 6, 43.5% of patients who had the potential for a 2-step decrease in VH demonstrated a 2-step decrease (40% in Group 1 and 46.1% in Group 2). Mean change in CMT was -83.88 ± 136.1 μm at month 6 (-131.5 ± 41.56 μm in Group 1 and -38.92 ± 13.7 μm in Group 2). Mean change in VA was +8.22 ± 11.83 ETDRS letters at month 6 (10.9 ± 14.6 in Group 1 and 5.5 ± 7.8 in Group 2). Repeated infusions of TCZ were well tolerated.Repeated IV administrations of TCZ are well tolerated. TCZ (both 4 and 8 mg/kg) is effective in improving VA and reducing VH and CMT in eyes with noninfectious intermediate uveitis, posterior uveitis, and panuveitis.

    View details for PubMedID 28887113

  • Towards Automated Distortion and Health Correlation for Age-Related Macular Degeneration Chakravarthy, A. D., Subramaniam, M., Chundi, P., Hassan, M., Nguyen, Q., IEEE IEEE. 2017: 486–91
  • Effects of Two Different Doses of Ranibizumab on Diabetic Retinopathy Severity Ophthalmology Retina Sadiq, M. A., Hassan, M., Soliman, M. K., Afridi, R., Do, D. V., Nguyen, Q. D., Sepah, Y. J. 2017; 1 (6): 566-567
  • The Role of Sirolimus in the Management of Uveitis Evolution of intravitreal sirolimus through clinical trials Retinal Physician Hassan, M., Halim, M. S., Afridi, R., Sadiq, M. A., Sepah, Y. J., Dong Nguyen Quan 2017; 14 (September): 40-44
  • Evaluation of macular and peripapillary vessel flow density in eyes with no known pathology using optical coherence tomography angiography. International journal of retina and vitreous Hassan, M., Sadiq, M. A., Halim, M. S., Afridi, R., Soliman, M. K., Sarwar, S., Agarwal, A., Do, D. V., Nguyen, Q. D., Sepah, Y. J. 2017; 3: 27

    Abstract

    To assess normal vessel flow density (VFD) in macular and peripapillary regions of eyes with no known ocular pathology using optical coherence tomography angiography (OCTA).AngioVue (Optovue, Fremont, CA, USA) was used to capture OCTA images. A 3 × 3 mm grid and a 4.5 × 4.5 mm grid was used to scan parafoveal and peripapillary regions, respectively. ReVue software was utilized to measure VFD in five sectors within the inner two circles of ETDRS grid in macular region and correlated to retinal thickness of same sectors. At optic disc, VFD was calculated in six sectors based on Garway-Heath map. Area and morphology of foveal avascular zone (FAZ) was correlated with VFD in central 1 mm. The influence of myopia on mean VFD was also assessed.Twenty-four eyes (mean age: 30 years) were analyzed. Mean VFD in macular sectors was 43.5 (±4.5) and 45.8 (±5.0) % in superficial and deep retinal plexuses, respectively. Mean VFD was significantly higher in deep retinal plexus compared to superficial retinal plexus in all sectors except central 1 mm (p < 0.05). Mean VFD in central 1 mm increases with an increase in central retinal thickness in both superficial and deep retinal plexuses (p < 0.001). Mean parafoveal VFD at level of both superficial and deep retinal plexuses decrease with an increase in spherical equivalent in myopics (p < 0.05). Mean VFD in myopics was found to be significantly lower in parafoveal region of deep retinal plexus (p < 0.05). Mean area of FAZ was 0.33 (±0.15) and 0.47 mm2 (±0.15) in superficial and deep retinal plexuses, respectively. Area of FAZ decreases with an increase in central 1 mm thickness and foveal VFD (p < 0.001).OCTA may be used to measure VFD in macular and peripapillary regions. Vessels in the parafoveal region are more densely packed in the deep retinal plexus leading to higher VFD compared to superficial plexus. Thicker retina in fovea translates into higher foveal VFD due to more compact arrangement of retinal layers and continuity of inner nuclear layer (INL). Myopia is associated with lower VFD in parafoveal region at level of deep retinal plexuses which may explain thinning of INL in myopics.

    View details for PubMedID 28781889

    View details for PubMedCentralID PMC5535290

  • Twenty-four-Month Outcomes of the Ranibizumab for Edema of the Macula in Diabetes - Protocol 3 with High Dose (READ-3) Study OPHTHALMOLOGY Sepah, Y. J., Sadiq, M., Boyer, D., Callanan, D., Gallemore, R., Bennett, M., Marcus, D., Halperin, L., Hassan, M., Campochiaro, P. A., Nguyen, Q., Do, D. V. 2016; 123 (12): 2581–87

    Abstract

    To compare 2.0 mg ranibizumab (RBZ) injections with 0.5 mg RBZ for eyes with center-involved diabetic macular edema (DME).Randomized, controlled, double-masked (to the dose), interventional, multicenter clinical trial.A total of 152 patients (152 eyes) with DME.Eligible eyes were randomized in a 1:1 ratio to 0.5 mg (n = 77) or 2.0 mg (n = 75) RBZ. Study eyes received 6 monthly mandatory injections followed by as-needed injections until month 24.The primary efficacy end point of the study was mean change in best-corrected visual acuity (BCVA) and central foveal thickness (CFT) at month 6. Secondary outcomes included the mean change in BCVA and CFT at month 24, and incidence and severity of systemic and ocular adverse events through month 24.A total of 152 eyes were randomized in the study. At month 24, the mean improvement from baseline BCVA was +11.06 letters in the 0.5 mg RBZ group (n = 59) and +6.78 letters in the 2.0 mg RBZ group (n = 54) (P = 0.02). The mean numbers of RBZ injections through month 24 were 18.4 and 17.3 in the 0.5 mg and 2.0 mg RBZ groups, respectively (P = 0.08). The mean change in CFT was -192.53 μm in the 0.5 mg RBZ group and -170.64 μm in the 2.0 mg RBZ group (P = 0.41). By month 24, 3 deaths had occurred in the 0.5 mg RBZ group and 3 deaths had occurred in the 2.0 mg RBZ group; 5 of these 6 deaths occurred secondary to cardiovascular causes, and 1 death occurred as the result of severe pneumonia. All 5 patients with a cardiovascular cause of death had a history of coronary heart disease.At month 24, there were significant visual and anatomic improvements in both groups, with subjects in the 0.5 mg RBZ group gaining more vision. Visual and anatomic gains achieved at month 6 were largely maintained through month 24. No new safety events were identified. In this study population, 2.0 mg RBZ does not appear to provide additional benefit over 0.5 mg RBZ.

    View details for PubMedID 27707550

  • The Role of Optical Coherence Tomography Angiography in the Management of Uveitis. International ophthalmology clinics Hassan, M., Agarwal, A., Afridi, R., daSilva, M. J., Karaca, I., Sadiq, M. A., Nguyen, Q. D., Do, D. V. 2016; 56 (4): 1-24

    View details for DOI 10.1097/IIO.0000000000000130

    View details for PubMedID 27575755

  • Assessment of vitreous haze using ultra-wide field retinal imaging JOURNAL OF OPHTHALMIC INFLAMMATION AND INFECTION Dickson, D., Agarwal, A., Sadiq, M., Hassan, M., High, R., Quan Dong Nguyen, Sepah, Y. J. 2016; 6: 35

    Abstract

    Conventional fundus imaging has been used to assess vitreous haze (VH) in patients with uveitis. Ultra-wide field (UWF) retinal imaging that uses scanning laser technology has not been evaluated for the detection of VH. This pilot study evaluates the ability of UWF imaging in detecting VH. Patients with intermediate, posterior, or panuveitis were examined to assess the level of VH using slit-lamp biomicroscopy. Colored fundus images were acquired using a Carl Zeiss FF450 camera. The same photographer obtained fundus images of the same eyes during the same visit by Optos UWF P200Tx retinal camera. Two graders independently analyzed UWF fundus images for presence or absence of VH, without quantifying the degree of VH using any scale. The images were analyzed using the composite red plus red-free wavelengths utilized by the Optos UWF camera and by using each wavelength exclusively. These findings were compared to clinical detection of VH and detection of VH using conventional fundus photography.Ninety-two eyes were included in the study. For composite UWF images, sensitivity was 0.27, specificity was 0.88, PPV was 0.31, NPV was 0.86, positive LR was 2.25, and negative LR was 0.83. For the conventional Zeiss images, sensitivity was 0.5, specificity was 0.84, PPV was 0.33, NPV was 0.91, positive LR was 3.13, and negative LR was 0.6. Agreement between the composite UWF and Zeiss techniques was substantial with k = 0.64. Inter-observer agreement for composite UWF images was also substantial with k = 0.65. Inter-observer agreement for Zeiss images was moderate with k = 0.471. Intra-observer agreement for both imaging modalities was substantial with a composite UWF k = 0.76 and Zeiss k = 0.7.UWF fundus imaging using scanning laser technique may be used to assess VH and employed in the management of intermediate, posterior, and panuveitis.

    View details for DOI 10.1186/s12348-016-0105-0

    View details for Web of Science ID 000387947000001

    View details for PubMedID 27687961

    View details for PubMedCentralID PMC5042918

  • Evaluation of Macular and Peripapillary Vessel Flow Density in Eyes with no known Pathology Using Optical Coherence Tomography Angiography. Hassan, M., Sadiq, M., Agarwal, A., Soliman, M., Afridi, R., Sarwar, S., Jawed, M., Do, D. V., Quan Dong Nguyen, Sepah, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2016
  • Effects of Two Different Doses of Ranibizumab on Diabetic Retinopathy Severity and Progression in the Ranibizumab for Edema of the Macula in Diabetes (READ-3) Study Sadiq, M., Hassan, M., Soliman, M., Sarwar, S., Afridi, R., Agarwal, A., Do, D. V., Quan Dong Nguyen, Sepah, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2016
  • The role of Aflibercept in the management of age-related macular degeneration EXPERT OPINION ON BIOLOGICAL THERAPY Hassan, M., Afridi, R., Sadiq, M., Soliman, M., Agarwal, A., Sepah, Y., Do, D. V., Quan Dong Nguyen 2016; 16 (5): 699–709

    Abstract

    During the past decade, significant advances have occurred in the management of neovascular age-related macular degeneration (NV-AMD). The advent of anti-vascular endothelial growth factor (anti-VEGF) therapy has shifted the treatment goal of NV-AMD from merely salvaging vision to improving visual acuity and maintaining a good quality of life. Aflibercept (AFL) is a significant addition to the arsenal of anti-VEGF therapies against the NV-AMD. In the index review, pharmacology and efficacy of AFL has been reviewed.An extensive literature search was performed to identify preclinical and clinical studies performed to illustrate the role of AFL in NV-AMD. Randomized clinical trials evaluating other anti-VEGF agents were also included for comparison. Additionally, studies where AFL was employed to treat anti-VEGF-resistant cases agents have been reviewed.AFL is an effective agent in the management of NV-AMD and its efficacy has been found to be comparable to ranibizumab (RBZ). Additionally, AFL is a good alternative agent in patients with NV-AMD resistant to RBZ and bevacizumab (BVZ), and can potentially lessen the treatment burden. As more research is conducted, the role of AFL in varying dosing regimens, as monotherapy and in combination with other agents, will become further defined.

    View details for DOI 10.1517/14712598.2016.1167182

    View details for Web of Science ID 000374600700010

    View details for PubMedID 26982640

  • High-Resolution Imaging of Parafoveal Cones in Different Stages of Diabetic Retinopathy Using Adaptive Optics Fundus Camera PLOS ONE Soliman, M., Sadiq, M., Agarwal, A., Sarwar, S., Hassan, M., Hanout, M., Graf, F., High, R., Do, D. V., Quan Dong Nguyen, Sepah, Y. J. 2016; 11 (4): e0152788

    Abstract

    To assess cone density as a marker of early signs of retinopathy in patients with type II diabetes mellitus.An adaptive optics (AO) retinal camera (rtx1™; Imagine Eyes, Orsay, France) was used to acquire images of parafoveal cones from patients with type II diabetes mellitus with or without retinopathy and from healthy controls with no known systemic or ocular disease. Cone mosaic was captured at 0° and 2°eccentricities along the horizontal and vertical meridians. The density of the parafoveal cones was calculated within 100×100-μm squares located at 500-μm from the foveal center along the orthogonal meridians. Manual corrections of the automated counting were then performed by 2 masked graders. Cone density measurements were evaluated with ANOVA that consisted of one between-subjects factor, stage of retinopathy and the within-subject factors. The ANOVA model included a complex covariance structure to account for correlations between the levels of the within-subject factors.Ten healthy participants (20 eyes) and 25 patients (29 eyes) with type II diabetes mellitus were recruited in the study. The mean (± standard deviation [SD]) age of the healthy participants (Control group), patients with diabetes without retinopathy (No DR group), and patients with diabetic retinopathy (DR group) was 55 ± 8, 53 ± 8, and 52 ± 9 years, respectively. The cone density was significantly lower in the moderate nonproliferative diabetic retinopathy (NPDR) and severe NPDR/proliferative DR groups compared to the Control, No DR, and mild NPDR groups (P < 0.05). No correlation was found between cone density and the level of hemoglobin A1c (HbA1c) or the duration of diabetes.The extent of photoreceptor loss on AO imaging may correlate positively with severity of DR in patients with type II diabetes mellitus. Photoreceptor loss may be more pronounced among patients with advanced stages of DR due to higher risk of macular edema and its sequelae.

    View details for DOI 10.1371/journal.pone.0152788

    View details for Web of Science ID 000373604800011

    View details for PubMedID 27057752

    View details for PubMedCentralID PMC4825992

  • Subcutaneous repository corticotropin gel for non-infectious panuveitis: Reappraisal of an old pharmacologic agent. American journal of ophthalmology case reports Agarwal, A., Hassan, M., Sepah, Y. J., Do, D. V., Nguyen, Q. D. 2016; 4: 78–82

    Abstract

    To describe the clinical course of a patient with non-infectious idiopathic unilateral panuveitis and retinal vasculitis treated with subcutaneous repository adrenocorticotropic hormone (ACTH) gel.A 33-year-old male presented with blurry vision and floaters in the left eye (OS). The best-corrected visual acuity was 20/20 in the right eye (OD) and 20/50 in OS at the time of initial presentation. Slit-lamp examination revealed mild anterior segment inflammation in OS. There were 1 + vitreous haze and 2 + cells noted in OS. Clinical examination and ancillary imaging assessment including fluorescein angiography revealed retinal vasculitis and optic nerve head inflammation. After infectious etiologies were ruled out, the patient was started on oral corticosteroids and enrolled in a clinical trial employing intravenous tocilizumab therapy. Six months after completion of the tocilizumab trial, the patient demonstrated recurrence of disease. Twice weekly subcutaneous ACTH gel was initiated and the patient demonstrated improvement of retinal vascular inflammation.Repository subcutaneous ACTH gel formulation may be a safe and viable therapeutic option for patients with non-infectious uveitis and retinal vasculitis. Clinical trials using this formulation in a larger patient cohort with longer monitoring are indicated to evaluate its tolerability and bioactivity.

    View details for DOI 10.1016/j.ajoc.2016.09.004

    View details for PubMedID 29503933

    View details for PubMedCentralID PMC5757479

  • Sirolimus for Retinal and Uveitic Diseases RETINAL PHARMACOTHERAPEUTICS Agarwal, A., Rajagopalan, N., Hassan, M., Sadiq, M., Soliman, M. K., Afridi, R., Sepah, Y., Quan Dong Nguyen, Nguyen, Q. D., Rodrigues, E. B., Farah, M. E., Mieler, W. F., Do, D. V. 2016; 55: 276–81

    Abstract

    Chronic inflammation plays an important role in the pathogenesis of ocular diseases such as diabetic retinopathy, uveitis and age-related macular degeneration. Activation and proliferation of naïve T cells may result in pathological changes responsible for significant visual morbidity. Sirolimus (earlier termed rapamycin) is a novel drug that inhibits cellular kinases and, thereby, inhibits T-cell proliferation. Preclinical studies in experimental models have shown promising results with the use of this pharmacological agent in various ocular conditions. Subsequently, early phase I/II studies have provided encouraging safety and efficacy data. This chapter focuses on the mechanisms of action, preclinical study results and data from human clinical trials of sirolimus in human eye diseases. Key highlights from ongoing phase III clinical trials are also provided. Sirolimus, thus, appears to be an important addition to the armamentarium of steroid-sparing therapeutic agents that act on various steps in the inflammatory pathway.

    View details for DOI 10.1159/000438951

    View details for Web of Science ID 000413475300031

    View details for PubMedID 26501229

  • Platelet-Derived Growth Factor Inhibitors: A Potential Therapeutic Approach for Ocular Neovascularization RETINAL PHARMACOTHERAPEUTICS Sadiq, M., Hanout, M., Sarwar, S., Hassan, M., Agarwal, A., Sepah, Y., Do, D. V., Quan Dong Nguyen, Nguyen, Q. D., Rodrigues, E. B., Farah, M. E., Mieler, W. F., Do, D. V. 2016; 55: 310–16

    Abstract

    Retinochoroidal vascular diseases are the leading causes of blindness in the developed world. They include diabetic retinopathy, retinal vein occlusion, retinopathy of prematurity, age-related macular degeneration (AMD), and pathological myopia, among many others. Several different therapies are currently under consideration for the aforementioned disorders. In the following section, agents targeting platelet-derived growth factors (PDGF) are discussed as a potential therapeutic option for retinochoroidal vascular diseases. PDGF play an important role in the angiogenesis cascade that is activated in retinochoroidal vascular diseases. The mechanism of action, side effects, efficacy, and the potential synergistic role of these agents in combination with other treatment options is discussed. The future of treatment of retinochoroidal vascular diseases, particularly neovascular AMD, has become more exciting due to agents like PDGF antagonists.

    View details for DOI 10.1159/000438953

    View details for Web of Science ID 000413475300035

    View details for PubMedID 26501397

  • Endogenous endophthalmitis: diagnosis, management, and prognosis JOURNAL OF OPHTHALMIC INFLAMMATION AND INFECTION Sadiq, M., Hassan, M., Agarwal, A., Sarwar, S., Toufeeq, S., Soliman, M. K., Hanout, M., Sepah, Y., Do, D. V., Quan Dong Nguyen 2015; 5: 32

    Abstract

    Endogenous endophthalmitis is an ophthalmic emergency that can have severe sight-threatening complications. It is often a diagnostic challenge because it can manifest at any age and is associated with a number of underlying predisposing factors. Microorganisms associated with this condition vary along a broad spectrum. Depending upon the severity of the disease, both medical and surgical interventions may be employed. Due to rarity of the disease, there are no guidelines in literature for optimal management of these patients. In this review, treatment guidelines based on clinical data and microorganism profile have been proposed.

    View details for DOI 10.1186/s12348-015-0063-y

    View details for Web of Science ID 000379234900001

    View details for PubMedID 26525563

    View details for PubMedCentralID PMC4630262

  • Platelet derived growth factor inhibitors: A potential therapeutic approach for ocular neovascularization SAUDI JOURNAL OF OPHTHALMOLOGY Sadiq, M., Hanout, M., Sarwar, S., Hassan, M., Do, D. V., Quan Dong Nguyen, Sepah, Y. 2015; 29 (4): 287–91

    Abstract

    Retinochoroidal vascular diseases are the leading causes of blindness in the developed world. They include diabetic retinopathy (DR), retinal vein occlusion, retinopathy of prematurity, age-related macular degeneration (AMD), and pathological myopia, among many others. Several different therapies are currently under consideration for the aforementioned disorders. In the following section, agents targeting platelet-derived growth factor (PDGF) are discussed as a potential therapeutic option for retinochoroidal vascular diseases. PDGF plays an important role in the angiogenesis cascade that is activated in retinochoroidal vascular diseases. The mechanism of action, side effects, efficacy, and the potential synergistic role of these agents in combination with other treatment options is discussed. The future of treatment of retinochoroidal vascular diseases, particularly AMD, has become more exciting due to agents such as PDGF antagonists.

    View details for DOI 10.1016/j.sjopt.2015.05.005

    View details for Web of Science ID 000217146700009

    View details for PubMedID 26586980

    View details for PubMedCentralID PMC4625223

  • Novel Therapies in Development for Diabetic Macular Edema CURRENT DIABETES REPORTS Agarwal, A., Afridi, R., Hassan, M., Sadiq, M., Sepah, Y. J., Do, D. V., Nguyen, Q. 2015; 15 (10): 75

    Abstract

    Diabetic macular edema (DME) secondary to diabetic retinopathy (DR) is a major cause for functional visual loss in the developed world. Laser photocoagulation has been used for decades in the treatment of DME. However, the advent of anti-vascular endothelial growth factor (anti-VEGF) has revolutionized the treatment of DME. Three important anti-VEGF agents whose efficacy has been well established via phase III clinical trials include ranibizumab, bevacizumab, and aflibercept. However, even in the era of anti-VEGF therapies, there are some challenges that retina specialists have to confront in managing patients with DME. These include the need for frequent treatment and an unpredictable response to therapy. There is evidence to suggest that pathways other than the VEGF pathway may be playing a role in the development of DME. Thus, extensive research is focused on development of novel agents that target these pathways. This review focuses on novel therapeutic agents in development, which may be used as a monotherapy or in combination with anti-VEGF agents, for the management of DME in the future.

    View details for DOI 10.1007/s11892-015-0652-z

    View details for Web of Science ID 000361488100009

    View details for PubMedID 26294336

  • Assessment of Vitreous Haze using Ultra-Wide Field Retinal Imaging Dickson, D., Agarwal, A., Sadiq, M., High, R., Quan Dong Nguyen, Sepah, Y., Ocular Imaging Reading Res Ctr ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2015
  • Taxi drivers' attitudes toward road safety in Pakistan PUBLIC HEALTH Rehman, A., Imran, S., Hassan, M., Akhlaq, A., Iqbal, S., Beg, F., Zahid, G., Khalid, H., Qadir, F. S., Murad, H. F., Baloch, N. A., Awais, M., Saleem, S. 2015; 129 (6): 818–21

    View details for DOI 10.1016/j.puhe.2015.03.022

    View details for Web of Science ID 000356368100027

    View details for PubMedID 25936972

  • High Resolution Imaging of Parafoveal Cones in Different Stages of Diabetic Retinopathy using Adaptive Optics Fundus Camera Soliman, M., Sadiq, M., Agarwal, A., Sarwar, S., Hanout, M., Graf, F. E., High, R., Do, D. V., Quan Dong Nguyen, Sepah, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2015
  • Therapies in Development for Non-Infectious Uveitis CURRENT MOLECULAR MEDICINE Sadiq, M. A., Agarwal, A., Hassan, M., Afridi, R., Sarwar, S., Soliman, M. K., Do, D. V., Nguyen, Q. D. 2015; 15 (6): 565–77

    Abstract

    Uveitis represents a spectrum of diseases characterized by ocular inflammation that leads to significant visual loss if left untreated. Adequate, long-term control of inflammation with minimal systemic and local adverse effects is the preferred strategy for treating patients with uveitis. Pharmacotherapy for uveitis consists mainly of corticosteroids in various formulations such as topical, local, intraocular and systemic. However, monotherapy with corticosteroids is often unacceptable due to serious adverse effects on various organ systems. There exist limitations with the use of steroid-sparing systemic immunosuppressive agents, as these medications may have significant adverse events and a narrow therapeutic window. Thus, newer molecular targets that act on various steps of the inflammatory pathway appear to be promising emerging strategies for treating uveitis. Specially designed monoclonal antibodies in development can potentially halt the inflammatory processes resulting in remission of the disease. In the index review, novel molecular agents and biological therapies that have shown promising efficacy and safety data in preclinical and clinical studies have been summarized. In addition, new drug delivery systems that may ensure high intraocular therapeutic levels of pharmacologic agents have been highlighted.

    View details for DOI 10.2174/1566524015666150731103847

    View details for Web of Science ID 000359986900009

    View details for PubMedID 26238367

  • Assessment of Retinal Structural and Functional Characteristics in Eyes with Autoimmune Retinopathy CURRENT MOLECULAR MEDICINE Sepah, Y. J., Sadiq, M. A., Hassan, M., Hanout, M., Soliman, M., Agarwal, A., Afridi, R., Coupland, S. G., Nguyen, Q. D. 2015; 15 (6): 578–86

    Abstract

    To evaluate the thicknesses of individual retinal layers, and the correlation between structural changes and functional loss using spectral domain optical coherence tomography (SD-OCT) scans and electroretinograms (ERG), in eyes with autoimmune retinopathy (AIR).SD-OCT raster scans of 12 eyes from 6 patients serologically diagnosed with AIR were evaluated. Retinal layers were segmented along a 5 mm horizontal scan passing through the fovea. Retinal layers analyzed include full retinal thickness (FRT), retinal pigment epithelium and Bruch's membrane complex (RPE+BM complex), photoreceptor layer (PRL), inner nuclear layer (INL), combined ganglion cell and inner plexiform layers (GCL+), nerve fiber layer (NFL), and combined GCL+ and NFL layers (GCL+/NFL). Changes in the thicknesses of the layers were assessed in 0.5 mm increments along the B-scan in the central, nasal, and temporal regions. These recorded values were compared to corresponding values of 51 eyes from 51 subjects with no known ocular pathology. Full-field ERGs were obtained at corresponding visits and were interpreted by a grader masked to the diagnoses and OCT findings.The mean age of the patients was 59.5 years (range, 33-83), with 4 males (66.6%). Within the control population of 51 subjects, mean age was 51.5 years (range, 40-75), with 25 males (49%). Eyes with AIR showed a loss of retinal tissue compared to eyes with no known ocular pathology at the fovea. Specifically, the FRT, RPE+BM complex, and PRL exhibited thinning of statistically significance. ERG findings demonstrated a functional deficit which showed a good correlation with structural loss. Fifty (50) percent of eyes experienced central photoreceptor (rod and cone) dysfunction and 75% of eyes displayed peripheral photoreceptor (rod and cone) dysfunction.Eyes with AIR show a loss of retinal tissue compared to eyes with no known ocular pathology. The greatest loss appears to occur in the RPE and PRL. ERG findings correlate strongly with the loss of tissue seen in these layers. Thus, therapeutic options may be targeted to preserve these regions of the retina.

    View details for DOI 10.2174/1566524015666150731104626

    View details for Web of Science ID 000359986900010

    View details for PubMedID 26238366