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Biomedical subjects

R S Newsom

Publications and source records attributed to R S Newsom.

3 recordsLinked to original sources

Retinal vessel measurement: comparison between observer and computer driven methods.

A method of semi-automated image analysis for the measurement of retinal vessel diameters is described. This was compared with an observer-driven method for reproducibility and accuracy. The coefficient of variation for the data from the semi-automated method was 1.5-7.5% (depending on the vessel diameter) compared to 6-34% with the observer-driven method. The mean vessel diameters using the observer-driven method tended to be higher; however, this did not reach significance. The speed and low inter- and intra-observer variability for the semi-automated method make it a useful technique for measuring retinal blood vessel diameters. A larger variability was found between photographs taken at different times. This may be due to changes in retinal vessel diameter with changes in retinal perfusion pressure during the cardiac cycle.

Diabetic Retinopathy

A simulated patient-physician encounter using a talking computer.

Computer-based clinical simulations provide a means for evaluating the information-gathering and patient-management competencies of physicians. The need for expensive computer terminals has restricted physician use of these simulations. This computer-based program permits physicians to complete computer-based encounters using a standard touch-tone telephone.

Clinical Competence

The effect of beta blockers on retinal blood flow in diabetic patients.

The effect of a single oral dose of propanolol 80 mg, dilevalol 200 mg, salbutamol 4 mg, and placebo on the systolic (BPs), diastolic blood (BPd), intraocular pressure (IOP), on retinal vessel diameter (D), blood velocity (Vmax) and volumetric retinal blood flow (RBF), was measured at baseline, 90 minutes and three hours after administration in normotensive diabetic volunteers. These drugs were chosen to demonstrate a range of beta receptor activity. Propanolol is a non-specific beta blocker, affecting beta 1 and beta 2 receptors, dilevalol has beta 1 antagonist and beta 2 agonist effects and salbutamol has beta 2 agonist effects. Retinal blood flow was measured by bidirectional laser Doppler velocimetry (BLDV) and red free photography. Dilevalol reduced the mean BPs by 10.4 mmHg (SD 4.2, P less than 0.05), the mean BPd by 7 mmHg (SD 3.8, P less than 0.05), whereas propanolol, salbutamol and placebo had no significant effect. Propanolol reduced the mean intraocular pressure by 4.88 mmHg (SD 1.8, P less than 0.01). No treatment had a significant effect on retinal perfusion pressure. In all treatments the vessel diameter and volumetric flow remained unchanged, and there was no significant difference between the treatments. The mechanisms of action of these drugs are analysed and the possible implications of their use in patients with retinal disease are discussed.

Administration, Oral