Publications by authors named "Ramya Gnanaraj"

Aim: To determine the differences in levels of systemic C-reactive protein (CRP) in patients with geographic atrophy (GA) and sex-based differences in CRP levels.

Methods: Blood samples from patients with GA and controls were collected in a prospective age-related macular degeneration (AMD) registry from August 2014 to June 2021. AMD was confirmed using multimodal imaging and the Beckman and Consensus of Atrophy Meeting criteria for GA.

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Importance: Understanding the relationship between longitudinally measured systemic complement factors and intermediate AMD (iAMD) progression may enable the introduction of systemic therapeutics earlier in the disease course, before vision loss occurs.

Objective: To determine the contribution of longitudinal measures of systemic complement factors and ratios to time to progression to advanced AMD (geographic atrophy [GA] or neovascular AMD [NVAMD]).

Design, Setting, And Participants: This cohort study was conducted at Sue Anschutz Rodgers Eye Center, Aurora, Colorado, from 2014 to 2022.

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Purpose: To compare the computation of the choriocapillaris flow deficit obtained from three different optical coherence tomography angiography devices in healthy subjects.

Methods: Twenty-six healthy subjects were included in this post hoc analysis of data from a prospective healthy subject optical coherence tomography angiography study. Fovea-centered 6 × 6 optical coherence tomography angiography volume scans were obtained by all three devices: Heidelberg Spectralis spectral domain optical coherence tomography angiography (Heidelberg, Germany) using a full spectrum probabilistic algorithm (512 × 512 pixels); Zeiss Cirrus 5000 AngioPlex (Zeiss Meditec, Dublin, CA) (spectral domain-optical coherence tomography angiography) using the optical microangiography algorithm (350 × 350 pixels); Zeiss PLEX Elite 9000 swept source optical coherence tomography angiography (Zeiss Meditec, Dublin, CA) using the optical microangiography algorithm (500 × 500 pixels).

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Objective: To evaluate multimodal imaging (MMI) biomarkers for predicting progression from intermediate to advanced age-related macular degeneration (AMD).

Methods And Analysis: This prospective longitudinal cohort study included patients with intermediate AMD (iAMD) enrolled in the University of Colorado AMD registry between July 2014 and August 2023, with follow-up through February 2024. At enrolment, patients' medical histories and MMI were collected.

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The COVID-19 pandemic has had significant psychological effects on individuals and communities around the world. Studies have found that the prevalence of anxiety and depression symptoms increased significantly during the pandemic. The goal of the study is to understand how the emerging new virus variants keep the world in a state of fear and how mental health measures can be implemented and adopted to alleviate anxiety.

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Background And Objective: The utility of incomplete retinal pigment epithelium (RPE) and outer retinal atrophy (iRORA) in intermediate age-related macular degeneration (iAMD) as a clinical endpoint is not yet elucidated. We aim to understand the time to iRORA development in iAMD.

Patients And Methods: Eyes with iAMD without iRORA of subjects with fellow-eye neovascular AMD (nAMD) were identified from visits between 2010 and 2019 at a tertiary clinic.

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Introduction: The COVID-19 pandemic has significantly impacted global healthcare systems. Vaccination is an effective strategy to battle the disease. Policies and distribution frameworks have varied widely across countries.

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Background And Objective: Investigate associations between systemic vascular endothelial growth factor (VEGF) and optical coherence tomography (OCT) biomarkers in eyes with complete retinal pigment epithelium and outer retina atrophy (cRORA) secondary to non-neovascular age-related macular degeneration.

Patients And Methods: Cross-sectional study of patients with cRORA. OCT images and blood samples were collected at study enrollment.

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Introduction: Tumor necrosis factor alpha (TNF-α) is an inflammatory cytokine implicated in pathological changes to the retinal pigment epithelium that are similar to changes in geographic atrophy (GA), an advanced form of age related macular degeneration (AMD). TNF-α also modulates expression of other cytokines including vascular endothelial growth factor (VEGF), leading to choroidal atrophy in models of AMD. The purpose of this study was to investigate systemic TNF-α and VEGF in patients with GA and intermediate AMD (iAMD) compared to controls without AMD.

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Purpose: To quantify and compare the different prevalence rates of specific retinal imaging biomarkers in patients with intermediate AMD (iAMD) and advanced non-neovascular AMD (nnAMD).

Methods: Cross-sectional study of patients with iAMD and advanced nnAMD. Imaging studies were reviewed for qualitative imaging biomarkers.

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Purpose: Investigate associations between geographic atrophy (GA) growth rate and multimodal imaging biomarkers and patient demographics in patients with advanced non-neovascular age-related macular degeneration (nnAMD).

Design: Prospective cohort study.

Methods: One hundred twenty-one eyes of 66 patients with advanced nnAMD with GA enrolled in the University of Colorado AMD Registry from August 2014 to June 2021, with follow-up through June 2023.

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Purpose: To evaluate the alterations in the psycho-physical tests, contrast sensitivity (CS) and hue discrimination (total estimation score, TES) in COVID-19 patients.

Methods: A prospective case-control study was undertaken in 2021-22 to look at CS and TES among COVID-19 patients and RT-PCR negative normal subjects by a mobile app "smart optometry" and X-Rite's free online version of Farnsworth-Munsell 100 hue test. Strict visual acuity (minimum of 6/9 equivalent on Snellen) and other clinical parameters were used as exclusion criteria to filter potentially confounding pre-receptoral co-morbid conditions.

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Article Synopsis
  • The study aimed to analyze age-related changes in the choroid of healthy eyes using swept-source optical coherence tomography angiography (SS-OCTA), involving 222 eyes from 116 participants.
  • Key findings revealed that choroidal volume (CV) and thickness (CT) varied significantly with age and sex, exhibiting complex patterns; CV increased in women and generally peaked before declining with age, while flow deficits consistently rose.
  • The conclusion stressed the importance of having a normative database for healthy individuals to better understand choroidal changes related to diseases, as variations in choroidal parameters with age were not uniform or consistent.
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Purpose: Chronic local inflammation underlies the pathogenesis of age-related macular degeneration (AMD) causing damage to the neurosensory retina. However, there is minimal research on systemic cell-mediated inflammation in AMD. Interleukin-4 (IL-4) is an immunoregulatory cytokine with an important role in modulating inflammation in chronic immune mediated disease.

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We report a case of intermediate uveitis in the setting of both systemic sarcoidosis and multiple sclerosis. A 68-year-old female was diagnosed with bilateral granulomatous intermediate uveitis and cystoid macular edema. Initial systemic work-up was unrevealing.

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Purpose: To assess the relationship between qualitative diabetic retinopathy (DR) scales with the precise numbers and surface area of DR lesions within the Early Treatment Diabetic Retinopathy Study (ETDRS) standard seven field (S7F) region on ultrawide-field (UWF) color fundus images.

Methods: In this study, we collected UWF images from adult patients with diabetes. Poor-quality images and eyes with any pathology precluding assessment of DR severity were excluded.

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Article Synopsis
  • A study evaluated the connection between retinal vascular fractal dimension (FD) and age in healthy eyes using advanced imaging technology.
  • It involved 222 eyes from 116 participants without any ocular or systemic diseases, employing retinal imaging techniques to analyze vascular structures.
  • Findings revealed that FD values don't significantly change with age, indicating they remain consistent across different areas of the retina, implying minimal age adjustment is needed when assessing retinal health.
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Background: Long-term outcomes of acute pulmonary thromboembolism (PTE) have been reported. However, the immediate- and short-term outcomes have not been reported adequately.

Objectives: Primary objective was to determine the patient characteristics, and immediate- and short-term outcomes of intermediate-risk PTE, and the secondary objective was to evaluate the benefit of thrombolysis in normotensive PTE patients.

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Article Synopsis
  • * It involved 222 eyes of 116 healthy individuals, where researchers captured detailed images and analyzed vessel length density, perfusion density, and FAZ characteristics.
  • * The findings revealed that as age increases, there is a decrease in vessel density and perfusion in the macula, along with an increase in FAZ area and perimeter, indicating complex age-related changes that need to be considered when examining diseased eyes.
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