Publications by authors named "Umar Mian"

7 Publications

  • Page 1 of 1

Elevated fetal haemoglobin levels are associated with decreased incidence of retinopathy in adults with sickle cell disease.

Br J Haematol 2018 12 12;183(5):807-811. Epub 2018 Nov 12.

Department of Hematology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.

Among the many vascular complications of sickle cell disease (SCD), retinopathy is the most prevalent and represents a leading cause of blindness. Hydroxycarbamide therapy ameliorates many symptoms of SCD, and high fetal haemoglobin (HbF) levels have been shown to protect against the development of retinopathy in children with HbSS. Its effect on adults with SCD, who are at a much higher risk of developing retinopathy, has not been studied. We aimed to investigate the effect of hydroxycarbamide use and HbF level on sickle cell retinopathy development in adults. We performed a retrospective cross-sectional study and collected demographics, comorbidities, and ocular and haematological data from 300 adult sickle cell subjects examined at the Henkind Eye Institute at Montefiore Medical Center during a 5-year period, from October 2012 to November 2017. The cohort was comprised mainly of Black and Hispanic subjects with all SCD genotypes, aged 18-71 years. Results show that in HbSS patients treated with hydroxycarbamide, those with retinopathy had significantly lower HbF levels compared to patients without retinopathy (P = 0·018). Our study identified the optimal HbF cut-off point for retinopathy protection to be 14·87%. Thus, a HbF level of 15% appears to be the threshold above which the odds for developing retinopathy in SS patients are reduced by 50%.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/bjh.15617DOI Listing
December 2018

Associations with retinal vascular occlusions in a diverse, urban population.

Ophthalmic Epidemiol 2018 06 30;25(3):220-226. Epub 2017 Nov 30.

b Department of Ophthalmology and Visual Science and Department of Epidemiology and Population Science , Montefiore Medical Center and the Albert Einstein College of Medicine , Bronx , NY.

Purpose: Retinal vascular occlusions can lead to sudden and permanent visual impairment or blindness. Few epidemiological studies on retinal vascular occlusions have been conducted, especially on diverse populations.

Methods: This is a retrospective case-control study of all incident retinal vascular occlusions occurring during a three and one-half year study period at Montefiore Medical Center, capturing all potential cases by diagnosis codes. Patients with retinal venous occlusions (RVO) and retinal arterial occlusions (RAO) were analyzed separately and compared to age-matched control groups.

Results: All potential charts (n = 700) were reviewed, confirming 214 RVO and 35 RAO incident cases. In multivariable analyses, RVO was associated with type 2 diabetes mellitus (OR 2.41, p < 0.001), history of cerebrovascular accident (OR 2.14, p = 0.011), hypertension (OR 1.83, p = 0.004), glaucoma (OR 6.91, p < 0.001), black race (OR 3.72, p < 0.001), and male gender (OR 2.19 p < 0.001). RAO was significantly associated with current and former smoking combined (OR 8.95, p = 0.021) and male gender (OR 2.56, p = 0.038).

Conclusion: Cardiovascular risk factors and glaucoma are reaffirmed as significant predictors of retinal vascular occlusions in a diverse patient population. Retinal vascular occlusions are more common in certain races and ethnicities, and further study into this may help identify high-risk individuals based on demographics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09286586.2017.1406530DOI Listing
June 2018

Trends in retinopathy of prematurity over a 5-year period in a racially diverse population.

Ophthalmic Surg Lasers Imaging Retina 2014 Mar-Apr;45(2):138-42

Background And Objective: Retinopathy of prematurity presents differently in developing versus developed countries, which may be due to environmental as well as racial differences.

Patients And Methods: Retrospective chart review of infants screened for ROP at a single neonatal intensive care unit. Risk factors were reviewed. Main outcome measures were rates of plus disease or treatment-requiring ROP by race.

Results: The study included 497 infants screened for ROP in an urban neonatal intensive care unit. Gestational age, birth weight, and bronchopulmonary dysplasia were independent risk factors for both plus disease and treatment-requiring ROP with type 3 multivariate analysis. Self-identified white race was also a risk factor for plus disease and treatment-requiring ROP. Race was significantly associated with maternal age, multiple births, and blood transfusions.

Conclusion: In the study population, white race was an independent risk factor for plus disease and ROP treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3928/23258160-20140306-07DOI Listing
September 2014

A typical bilateral Toxoplasma retinochoroiditis in a bone marrow transplant patient with negative serum titers.

J Ophthalmic Inflamm Infect 2013 Jan 28;3(1):23. Epub 2013 Jan 28.

Department of Ophthalmology and Visual Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA.

Background: Toxoplasma retinochoroiditis can have an atypical presentation and be difficult to diagnose in immunocompromised patients. Accurate diagnosis and appropriate treatment is important since the disease can be aggressive in these patients. This paper is a case report with literature review, emphasizing on the diagnosis and treatment of Toxoplasma retinochoroiditis.

Findings: A 27-year-old male with chronic myelogenous leukemia with history of bone marrow transplantation presented with floaters in his right eye. Fundus exam showed bilateral, multifocal retinochoroiditis with subsequent development of a mild vitritis. Serum cytomegalovirus and toxoplasmosis antibody titers and syphilis screen were negative. Aqueous polymerase chain reaction (PCR) analysis revealed the presence of Toxoplasma gondii DNA OU. Clindamycin (1.0 mg/0.1 mL) was injected bilateral intravitreal OU twice at 4 days apart with subsequent resolution of retinochoroiditis.

Conclusions: When evaluating retinochoroiditis in an immunocompromised patient, one must keep a high index of suspicion for atypical presentations of well-known disease entities. Aqueous and vitreous samples for PCR can be useful in obtaining an accurate diagnosis and therefore provide appropriate management for the patient. Intravitreal clindamycin is an option for treatment in these patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1869-5760-3-23DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3605077PMC
January 2013

Patent ductus arteriosus and indomethacin treatment as independent risk factors for plus disease in retinopathy of prematurity.

J Pediatr Ophthalmol Strabismus 2013 Mar-Apr;50(2):88-92. Epub 2013 Jan 15.

Department of Ophthalmology, Montefiore Medical Center; Albert Einstein College of Medicine, Bronx, NY, USA.

Purpose: To examine whether clinically significant patent ductus arteriosus (PDA) or indomethacin treatment are associated with plus disease or retinopathy of prematurity (ROP) requiring treatment.

Methods: Retrospective, cross-sectional study. Charts were reviewed for gestational age, birth weight, birth head circumference, birth length, maternal characteristics, gender, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, blood transfusions, and sepsis. Main outcome measures were increased rates of plus disease or ROP requiring treatment.

Results: A total of 450 premature infants screened for ROP in a mid-sized, urban neonatal intensive care unit were included. On univariate analysis, gestational age, birth weight, birth head circumference, birth length, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, and sepsis were significantly correlated to plus disease and ROP requiring treatment. PDA was significantly associated with bronchopulmonary dysplasia, neurologic comorbidities, sepsis, and blood transfusions (P < .0001). With type 3 multivariate analysis, only gestational age and bronchopulmonary dysplasia were independent risk factors for ROP.

Conclusion: PDA and indomethacin were associated with plus disease and ROP requiring treatment on univariate analysis but this was not significant after adjusting for other risk factors. PDA was also strongly related to bronchopulmonary dysplasia and blood transfusions, which may explain its effect on ROP.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3928/01913913-20130108-03DOI Listing
December 2013

Optical coherence tomography findings in idiopathic macular holes.

J Ophthalmol 2011 18;2011:928205. Epub 2011 Jul 18.

Retina Division, Department of Ophthalmology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, NY 10467, USA.

Purpose. To describe the characteristics of idiopathic macular holes (MH) on optical coherence tomography (OCT) and correlate OCT with clinical assessment. Design. Cross-sectional chart review and OCT assessment. Participants. Sixty-seven eyes with a clinically diagnosed idiopathic MH with available OCT data. Methods. A retrospective chart review and OCT assessment. Results. Based on OCT grading, 40 eyes had a full-thickness macular hole (FTMH) and 21 eyes had a lamellar macular hole (LMH). Clinical exam and OCT assessment agreed in 53 (87%) eyes when assessing the extent of MH. Six eyes (14.6%) in the FTMH group, and 3 eyes in the LMH group (14.3%) had persistent vitreomacular traction. Thirty-seven eyes (92.5%) in the FTMH group and 11 eyes (52.4%) in the LMH group had associated intraretinal cysts. Two eyes (5.0%) in the FTMH group and zero eyes in the LMH group had subretinal fluid. Intraretinal cysts were found to be more frequently associated with FTMH than with LMH (P < 0.001). Conclusion. This paper described OCT findings in a group of patients with clinically diagnosed MH. A high level of correlation between clinical assessment and OCT findings of LMH and FTMH was observed, and intraretinal cysts were often present in FTMH.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2011/928205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147006PMC
November 2011

Effect of partial posterior vitreous detachment on retinal nerve fiber layer thickness as measured by optical coherence tomography.

Arch Ophthalmol 2010 Jun;128(6):692-7

Henkind Eye Institute, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA.

Objective: To evaluate the effect of partially attached posterior vitreous detachments (pPVDs) at the optic disc on retinal nerve fiber layer (RNFL) thickness as measured by optical coherence tomography.

Methods: A retrospective study was conducted using stored Stratus optical coherence tomography III scans of patients with suspected glaucoma from January 2003 to September 2006 at the Montefiore Medical Center, Bronx, New York. All scans were evaluated for vitreous attachments at the disc and were divided into control (without pPVD) and pPVD groups. The RNFL thickness was compared using the fast RNFL protocol. Patients were defined as glaucoma suspects based on clinical findings of either glaucomatous-appearing optic discs or elevated intraocular pressure. All study patients had normal Humphrey visual fields.

Results: A total of 110 eyes from 110 patients were included; 59 were in the pPVD group and 51 were controls. Partial PVD was found in 40% of the glaucoma suspects. The mean RNFL thickness of eyes with pPVD was significantly broader than that of controls (101.6 microm vs 95.6 microm, respectively; P < .001). The average RNFL thickness of each quadrant was greater in the pPVD group than in the control group, with statistically significant differences in superior and inferior quadrants (P < .001 and P = .001, respectively).

Conclusions: More than one-third of this population of glaucoma suspects had a pPVD, indicating that this is a common phenomenon. The results suggest that RNFL thicknesses are greater in patients with pPVD than in controls. This may indicate a limitation of using RNFL thickness as a criterion for evaluating glaucomatous damage in patients with pPVD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/archophthalmol.2010.99DOI Listing
June 2010