101
|
Lu Y, Wang JC, Zeng R, Nagata T, Katz R, Mukai S, Miller JB. Detection of retinal microvascular changes in von Hippel-Lindau disease using optical coherence tomography angiography. PLoS One 2020; 15:e0229213. [PMID: 32078656 PMCID: PMC7032707 DOI: 10.1371/journal.pone.0229213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/01/2020] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Von Hippel-Lindau (VHL) disease is a hereditary disorder that can lead to ophthalmic manifestations, including retinal capillary hemangioma (RCH). The diagnosis of RCH is often guided by wide-field fluorescein angiography. In some cases, optical coherence tomography angiography (OCT-A) serves as a non-invasive alternative to FA. Herein, we used OCT-A to examine the macular microvasculature in patients with VHL disease. SUBJECTS Subjects were selected from patients with a diagnosis of VHL. The control group included eyes without retinal diagnosis from patients with an episode of unilateral retinal detachment or trauma and age ≤ 50 years old. METHODS Subjects were scanned on the Optovue RTVue-XR device to acquire 3mm x 3mm OCT-A images of the superficial (SCP) and deep capillary plexus (DCP). SCP and DCP vessel density (VD) were calculated after the images were binarized. Furthermore, for subjects with RCH, each OCT-A image was divided equally into four quadrants. SCP and DCP VD of quadrants with RCH were compared to those without RCH. T-tests were performed for statistical analysis. RESULTS 67 eyes with a history of VHL disease were included as study subjects, while 16 eyes were included as controls. Significant increases in VD were found in patients with VHL disease for both the SCP (p = 0.0441) and DCP (p = 0.0344). When comparing quadrants with associated RCH development to those without, we found no significant difference in SCP VD (p = 0.160) or DCP VD (p = 0.484). CONCLUSIONS OCT-A can detect changes in the retinal microvasculature in the macula of patients with VHL disease. OCT-A imaging may be an additional tool for screening and early detection of patients at risk of developing ocular complications of VHL disease. Future studies should explore subtle progression on OCT-A associated with the pathogenesis and development of RCH, particularly with larger scan patterns.
Collapse
Affiliation(s)
- Yifan Lu
- Department of Ophthalmology, Harvard Medical School, Boston, MA, United States of America
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, United States of America
| | - Jay C. Wang
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, United States of America
- Retina Service, Massachusetts Eye and Ear, Boston, MA, United States of America
| | - Rebecca Zeng
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, United States of America
| | - Tatsuo Nagata
- Retina Service, Massachusetts Eye and Ear, Boston, MA, United States of America
| | - Raviv Katz
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, United States of America
| | - Shizuo Mukai
- Department of Ophthalmology, Harvard Medical School, Boston, MA, United States of America
- Retina Service, Massachusetts Eye and Ear, Boston, MA, United States of America
| | - John B. Miller
- Department of Ophthalmology, Harvard Medical School, Boston, MA, United States of America
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, United States of America
- Retina Service, Massachusetts Eye and Ear, Boston, MA, United States of America
- * E-mail:
| |
Collapse
|
102
|
Roh M, Shin HJ, Laíns I, Providência J, Caseiro-Alves M, Barreto P, Vavvas DG, Miller JB, Kim IK, Gaziano JM, Liang L, Silva R, Miller JW, Husain D. Higher Intake of Polyunsaturated Fatty Acid and Monounsaturated Fatty Acid is Inversely Associated With AMD. Invest Ophthalmol Vis Sci 2020; 61:20. [PMID: 32058563 PMCID: PMC7326508 DOI: 10.1167/iovs.61.2.20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 10/31/2019] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate the association between dietary fat intake and the presence of AMD. Methods Cross-sectional, observational study with cohorts prospectively recruited from the United States and Portugal. AMD was diagnosed based on color fundus photographs with the AREDS classification. A validated food frequency questionnaire was used to calculate the percent energy intake of trans fat, saturated fat, monounsaturated fatty acid (MUFA), and polyunsaturated fatty acid (PUFA). Odds ratio (OR) and 95% confidence intervals for quintile of amount of FA were calculated. Multiple logistic regression was used to estimate the OR. Results We included 483 participants, 386 patients with AMD and 97 controls. Higher intake of trans fat was associated with a 2.3-fold higher odds of presence of AMD (P for trend = 0.0156), whereas a higher intake of PUFA (OR, 0.25; P for trend = 0.006) and MUFA (OR, 0.24; P for trend < 0.0001) presented an inverse association. Subgroup analysis showed that higher quintile of trans fat was associated with increased odds of having intermediate AMD (OR, 2.26; P for trend = 0.02); and higher quintile of PUFA and MUFA were inversely associated with intermediate AMD (OR, 0.2 [P for trend = 0.0013]; OR, 0.17 [P for trend < 0.0001]) and advanced AMD (OR, 0.13 [P for trend = 0.02]; OR, 0.26 [P for trend = 0.004]). Additionally, a statistically significant effect modification by country was noted with inverse association between MUFA and AMD being significant (OR, 0.04; P for trend < 0.0001) for the Portugal population only. Conclusions Our study shows that higher dietary intake of trans fat is associated with the presence of AMD, and a higher intake of PUFA and MUFA is inversely associated with AMD.
Collapse
Affiliation(s)
- Miin Roh
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Beetham Eye Institute, Joslin Diabetes Center, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Hyun Joon Shin
- Division of General Internal Medicine, Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Department of Global Health and Social Medicine, Harvard Medical School, Boston Massachusetts, United States
| | - Inês Laíns
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Joana Providência
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | | | - Patrícia Barreto
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Demetrios G. Vavvas
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - John B. Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Ivana K. Kim
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - John Michael Gaziano
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
- VA Boston Healthcare System, Jamaica Plain, Massachusetts, United States
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Joan W. Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Deeba Husain
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| |
Collapse
|
103
|
|
104
|
Affiliation(s)
- Kareem Moussa
- Massachusetts Eye and Ear Infirmary, Retina Service, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Janice Kim
- Harvard Medical School, Boston, Massachusetts
| | - John B Miller
- Massachusetts Eye and Ear Infirmary, Retina Service, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
105
|
Cui Y, Zhu Y, Wang JC, Lu Y, Zeng R, Katz R, Wu DM, Vavvas DG, Husain D, Miller JW, Kim LA, Miller JB. Imaging Artifacts and Segmentation Errors With Wide-Field Swept-Source Optical Coherence Tomography Angiography in Diabetic Retinopathy. Transl Vis Sci Technol 2019; 8:18. [PMID: 31772829 PMCID: PMC6859832 DOI: 10.1167/tvst.8.6.18] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/19/2019] [Indexed: 12/31/2022] Open
Abstract
Purpose To analyze imaging artifacts and segmentation errors with wide-field swept-source optical coherence tomography angiography (SS-OCTA) in diabetic retinopathy (DR). Methods We conducted a prospective, observational study at Massachusetts Eye and Ear from December 2018 to March 2019. Proliferative diabetic retinopathy (PDR), nonproliferative diabetic retinopathy (NPDR), diabetic patients with no diabetic retinopathy (DR), and healthy control eyes were included. All patients were imaged with a SS-OCTA and the Montage Angio (15 × 9 mm) was used for analysis. Images were independently evaluated by two graders using the motion artifact score (MAS). All statistical analyses were performed using SPSS 25.0 and R software. Results One hundred thirty-six eyes in 98 participants with the montage image were included in the study. Patients with more severe stages of DR had higher MAS by trend test analysis (P < 0.05). The occurrence of segmentation error was 0% in the healthy group, 10.53% in the no DR group, 10.00% in the NPDR group, and 50% in the PDR group. Multivariate regression analysis showed that the severity of DR and dry eye were the major factors affecting MAS (P < 0.05). There were some modifiable artifacts that could be corrected to improve image quality. Conclusions Wide field SS-OCTA assesses retinal microvascular changes by noninvasive techniques, yet distinguishing real alterations from artifacts is paramount to accurate interpretations. DR severity and dry eye correlated with MAS. Translational Relevance Understanding contributing factors and methods to reduce artifacts is critical to routine use and clinical trial with wide-field SS-OCTA.
Collapse
Affiliation(s)
- Ying Cui
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.,Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying Zhu
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.,Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jay C Wang
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Yifan Lu
- Harvard Medical School, Boston, MA, USA
| | - Rebecca Zeng
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.,Boston University School of Medicine, Boston, MA, USA
| | - Raviv Katz
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - David M Wu
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Demetrios G Vavvas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Leo A Kim
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
106
|
Arboleda-Velasquez JF, Lopera F, O'Hare M, Delgado-Tirado S, Marino C, Chmielewska N, Saez-Torres KL, Amarnani D, Schultz AP, Sperling RA, Leyton-Cifuentes D, Chen K, Baena A, Aguillon D, Rios-Romenets S, Giraldo M, Guzmán-Vélez E, Norton DJ, Pardilla-Delgado E, Artola A, Sanchez JS, Acosta-Uribe J, Lalli M, Kosik KS, Huentelman MJ, Zetterberg H, Blennow K, Reiman RA, Luo J, Chen Y, Thiyyagura P, Su Y, Jun GR, Naymik M, Gai X, Bootwalla M, Ji J, Shen L, Miller JB, Kim LA, Tariot PN, Johnson KA, Reiman EM, Quiroz YT. Resistance to autosomal dominant Alzheimer's disease in an APOE3 Christchurch homozygote: a case report. Nat Med 2019; 25:1680-1683. [PMID: 31686034 PMCID: PMC6898984 DOI: 10.1038/s41591-019-0611-3] [Citation(s) in RCA: 279] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 09/12/2019] [Indexed: 02/07/2023]
Abstract
We identified a PSEN1 mutation carrier from the world’s largest autosomal dominant Alzheimer’s disease kindred who did not develop mild cognitive impairment until her seventies, three decades after the expected age of clinical onset. She had two copies of the APOE3 Christchurch (R136S) mutation, unusually high brain amyloid, and limited tau/tangle and neurodegenerative measurements. Our findings have implications for APOE’s role in the pathogenesis, treatment, and prevention of Alzheimer’s disease.
Collapse
Affiliation(s)
- Joseph F Arboleda-Velasquez
- Schepens Eye Research Institute of Mass Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia de la Universidad de Antioquia, Medellin, Colombia
| | - Michael O'Hare
- Schepens Eye Research Institute of Mass Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Santiago Delgado-Tirado
- Schepens Eye Research Institute of Mass Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Claudia Marino
- Schepens Eye Research Institute of Mass Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Natalia Chmielewska
- Schepens Eye Research Institute of Mass Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.,Boston College, Boston, MA, USA
| | - Kahira L Saez-Torres
- Schepens Eye Research Institute of Mass Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Dhanesh Amarnani
- Schepens Eye Research Institute of Mass Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Massachusetts General Hospital and Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Massachusetts General Hospital and Department of Neurology, Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital and the Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - David Leyton-Cifuentes
- Schepens Eye Research Institute of Mass Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.,Universidad Escuela de Ingenieria de Antioquia-EIA, Medellin, Colombia
| | - Kewei Chen
- The Banner Alzheimer's Institute, Phoenix, AZ, USA.,University of Arizona, Tucson, AZ, USA.,Arizona State University, Tempe, AZ, USA
| | - Ana Baena
- Grupo de Neurociencias de Antioquia de la Universidad de Antioquia, Medellin, Colombia
| | - David Aguillon
- Grupo de Neurociencias de Antioquia de la Universidad de Antioquia, Medellin, Colombia
| | - Silvia Rios-Romenets
- Grupo de Neurociencias de Antioquia de la Universidad de Antioquia, Medellin, Colombia
| | - Margarita Giraldo
- Grupo de Neurociencias de Antioquia de la Universidad de Antioquia, Medellin, Colombia
| | - Edmarie Guzmán-Vélez
- Massachusetts General Hospital and the Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Daniel J Norton
- Massachusetts General Hospital and the Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Department of Psychology, Gordon College, Wenham, MA, USA
| | | | - Arabiye Artola
- Massachusetts General Hospital and the Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Justin S Sanchez
- Massachusetts General Hospital and Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Juliana Acosta-Uribe
- Grupo de Neurociencias de Antioquia de la Universidad de Antioquia, Medellin, Colombia.,Neuroscience Research Institute, Department of Molecular Cellular Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Matthew Lalli
- Neuroscience Research Institute, Department of Molecular Cellular Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Kenneth S Kosik
- Neuroscience Research Institute, Department of Molecular Cellular Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Matthew J Huentelman
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - Rebecca A Reiman
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Ji Luo
- The Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Yinghua Chen
- The Banner Alzheimer's Institute, Phoenix, AZ, USA
| | | | - Yi Su
- The Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Gyungah R Jun
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Marcus Naymik
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Xiaowu Gai
- Center for Personalized Medicine, Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.,Department of Pathology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Moiz Bootwalla
- Center for Personalized Medicine, Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Jianling Ji
- Center for Personalized Medicine, Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.,Department of Pathology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Lishuang Shen
- Center for Personalized Medicine, Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - John B Miller
- Mass Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Leo A Kim
- Schepens Eye Research Institute of Mass Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Pierre N Tariot
- The Banner Alzheimer's Institute, Phoenix, AZ, USA.,University of Arizona, Tucson, AZ, USA
| | - Keith A Johnson
- Massachusetts General Hospital and Department of Neurology, Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital and the Department of Neurology, Harvard Medical School, Boston, MA, USA.,Massachusetts General Hospital and Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Eric M Reiman
- The Banner Alzheimer's Institute, Phoenix, AZ, USA. .,University of Arizona, Tucson, AZ, USA. .,Arizona State University, Tempe, AZ, USA. .,Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ, USA.
| | - Yakeel T Quiroz
- Grupo de Neurociencias de Antioquia de la Universidad de Antioquia, Medellin, Colombia. .,Massachusetts General Hospital and Department of Neurology, Harvard Medical School, Boston, MA, USA. .,Massachusetts General Hospital and the Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
107
|
Agranat JS, Miller JB, Douglas VP, Douglas KAA, Marmalidou A, Cunningham MA, Houston SK. The Scope Of Three-Dimensional Digital Visualization Systems In Vitreoretinal Surgery. Clin Ophthalmol 2019; 13:2093-2096. [PMID: 31749606 PMCID: PMC6818135 DOI: 10.2147/opth.s213834] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/10/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction Significant advances in three-dimensional (3D) imaging technology have allowed for the incorporation of 3D digital displays into medical and surgical devices. Despite initial adoption of the NGENUITY® 3D Visualization System in vitreoretinal surgery, there are limited publications regarding its use. The generally accepted main benefits include improved ergonomics, enhanced surgical team communication and education, reduced retinal phototoxicity, increased depth of field, and display image manipulation. Despite these potential benefits, many retina specialists have questioned its universal applicability to a wide variety of vitreoretinal surgeries. Objective To report on the variety of indications and surgical efficacy of the NGENUITY® 3D Visualization System in vitreoretinal surgery via a review of surgical experience at two vitreoretinal practices in both the academic and community settings. Methods A retrospective review was conducted of consecutive surgical cases performed on the NGENUITY® 3D Visualization System at Massachusetts Eye and Ear Infirmary and Florida Retina Institute from June 1st, 2017 to November 1st, 2018. Age, presenting diagnosis, surgical procedure, and intraoperative details were recorded. Results 272 vitreoretinal surgeries on the Alcon NGENUITY® 3D Visualization System were identified between June 1st, 2017 and November 1st, 2018 at the participating institutions. A detailed breakdown of the indications for surgery and related procedures is reported. During all 272 cases on the 3D digital system, there were no complications attributed to the visualization system. Conclusion This series illustrates the diversity of vitreoretinal surgeries that can be performed on this system without compromising surgical viewing or increasing surgical complications. The Alcon NGENUITY® 3D Visualization System possesses favorable ergonomics, illumination levels, depth of field, display filters, and trainee experience.
Collapse
Affiliation(s)
- Joshua S Agranat
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Vivian Paraskevi Douglas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Konstantinos A A Douglas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Anna Marmalidou
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | | | | |
Collapse
|
108
|
Lu Y, Wang JC, Zeng R, Katz R, Vavvas DG, Miller JW, Miller JB. Quantitative Comparison Of Microvascular Metrics On Three Optical Coherence Tomography Angiography Devices In Chorioretinal Disease. Clin Ophthalmol 2019; 13:2063-2069. [PMID: 31749603 PMCID: PMC6816077 DOI: 10.2147/opth.s215322] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/03/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Optical coherence tomography angiography (OCT-A) has emerged as a novel tool for the non-invasive imaging and evaluation of the retinal microvasculature. There is little existing literature that compares OCT-A microvasculature metrics across different OCT-A devices in chorioretinal diseases. Herein, we examined these metrics on three available OCT-A platforms. Patients and methods All subjects were scanned on each of three OCT-A devices: Optovue Avanti Angiovue, Topcon DRI-OCT Triton Swept-Source OCT, and Zeiss Cirrus 5000-HD-OCT Angioplex. Two investigators independently measured foveal avascular zone (FAZ) area. Superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel densities (VD) were calculated from binarized images with ImageJ software. Image quality across devices was qualitatively compared. Interclass correlation coefficient (ICC), Bland-Altman analysis, repeated measures ANOVA, and post-hoc tests were performed for statistical analysis. Results Thirteen eyes of seven patients with chorioretinal diagnoses were reviewed. ICC for FAZ measurement was 0.95. There was no significant difference in FAZ area across the three devices (p= 0.792). There was a significant difference in the SCP VD between the OCT-A devices (Triton 0.344 ± 0.013, Angiovue 0.323 ± 0.013, Angioplex 0.367 ± 0.014, p < 0.05). Significantly greater DCP VD was observed with Angioplex (0.385 ± 0.010) in comparison to both Triton (0.331 ± 0.009) and Angiovue (0.341 ± 0.020). A comparison of image quality revealed that Angiovue gives the highest quality, followed by Angioplex and Triton. Conclusion Core macular microvasculature metrics are now readily accessible on a variety of available OCT-A devices. While the FAZ can be reliably measured across all three devices in this study, there were significant differences for the vessel density in both the SCP and DCP. As a result, clinicians should be careful when comparing microvasculature metrics across different devices when using patient data in multicenter research investigations and clinical trials.
Collapse
Affiliation(s)
- Yifan Lu
- Department of Ophthalmology, Harvard Medical School, Boston, Ma, USA.,Harvard Retinal Imaging Laboratory, Massachusetts Eye and Ear, Boston, Ma, USA
| | - Jay C Wang
- Department of Ophthalmology, Harvard Medical School, Boston, Ma, USA.,Harvard Retinal Imaging Laboratory, Massachusetts Eye and Ear, Boston, Ma, USA.,Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Rebecca Zeng
- Harvard Retinal Imaging Laboratory, Massachusetts Eye and Ear, Boston, Ma, USA
| | - Raviv Katz
- Harvard Retinal Imaging Laboratory, Massachusetts Eye and Ear, Boston, Ma, USA
| | - Demetrios G Vavvas
- Harvard Retinal Imaging Laboratory, Massachusetts Eye and Ear, Boston, Ma, USA.,Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Joan W Miller
- Harvard Retinal Imaging Laboratory, Massachusetts Eye and Ear, Boston, Ma, USA.,Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Department of Ophthalmology, Harvard Medical School, Boston, Ma, USA.,Harvard Retinal Imaging Laboratory, Massachusetts Eye and Ear, Boston, Ma, USA.,Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
109
|
Quiroz YT, Sperling RA, Norton DJ, Baena A, Arboleda-Velasquez JF, Cosio D, Schultz A, Lapoint M, Guzman-Velez E, Miller JB, Kim LA, Chen K, Tariot PN, Lopera F, Reiman EM, Johnson KA. Association Between Amyloid and Tau Accumulation in Young Adults With Autosomal Dominant Alzheimer Disease. JAMA Neurol 2019; 75:548-556. [PMID: 29435558 DOI: 10.1001/jamaneurol.2017.4907] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Importance It is critically important to improve our ability to diagnose and track Alzheimer disease (AD) as early as possible. Individuals with autosomal dominant forms of AD can provide clues as to which and when biological changes are reliably present prior to the onset of clinical symptoms. Objective To characterize the associations between amyloid and tau deposits in the brains of cognitively unimpaired and impaired carriers of presenilin 1 (PSEN1) E280A mutation. Design, Setting, and Participants In this cross-sectional imaging study, we leveraged data from a homogeneous autosomal dominant AD kindred, which allowed us to examine measurable tau deposition as a function of individuals' proximity to the expected onset of dementia. Cross-sectional measures of carbon 11-labeled Pittsburgh Compound B positron emission tomography (PET) and flortaucipir F 18 (previously known as AV 1451, T807) PET imaging were assessed in 24 PSEN1 E280A kindred members (age range, 28-55 years), including 12 carriers, 9 of whom were cognitively unimpaired and 3 of whom had mild cognitive impairment, and 12 cognitively unimpaired noncarriers. Main Outcomes and Measures We compared carbon 11-labeled Pittsburgh Compound B PET cerebral with cerebellar distribution volume ratios as well as flortaucipir F 18 PET cerebral with cerebellar standardized uptake value ratios in mutation carriers and noncarriers. Spearman correlations characterized the associations between age and mean cortical Pittsburgh Compound B distribution volume ratio levels or regional flortaucipir standardized uptake value ratio levels in both groups. Results Of the 24 individuals, the mean (SD) age was 38.0 (7.4) years, or approximately 6 years younger than the expected onset of clinical symptoms in carriers. Compared with noncarriers, cognitively unimpaired mutation carriers had elevated mean cortical Pittsburgh Compound B distribution volume ratio levels in their late 20s, and 7 of 9 carriers older than 30 years reached the threshold for amyloidosis (distribution volume ratio level > 1.2). Elevated levels of tau deposition were seen within medial temporal lobe regions in amyloid-positive mutation carriers 6 years before clinical onset of AD in this kindred. Substantial tau deposition in the neocortex was only observed in 1 unimpaired carrier and in those with mild cognitive impairment. β-Amyloid uptake levels were diffusely elevated in unimpaired carriers approximately 15 years prior to expected onset of mild cognitive impairment. In carriers, higher levels of tau deposition were associated with worse performance on the Mini-Mental State Examination (entorhinal cortex: r = -0.60; P = .04; inferior temporal lobe: r = -0.54; P = .06) and the Consortium to Establish a Registry for Alzheimer Disease Word List Delayed Recall (entorhinal cortex: r = -0.86; P < .001; inferior temporal lobe: r = -0.70; P = .01). Conclusions and Relevance The present findings add to the growing evidence that molecular markers can characterize biological changes associated with AD in individuals who are still cognitively unimpaired. The findings also suggest that tau PET imaging may be useful as a biomarker to distinguish individuals at high risk to develop the clinical symptoms of AD and to track disease progression.
Collapse
Affiliation(s)
- Yakeel T Quiroz
- Massachusetts General Hospital, Harvard Medical School, Boston.,Grupo de Neurociencias, Universidad de Antioquia, Medellin, Antioquia, Colombia
| | - Reisa A Sperling
- Massachusetts General Hospital, Harvard Medical School, Boston.,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts.,Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel J Norton
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Ana Baena
- Grupo de Neurociencias, Universidad de Antioquia, Medellin, Antioquia, Colombia
| | | | - Danielle Cosio
- Massachusetts General Hospital, Harvard Medical School, Boston.,Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge
| | - Aaron Schultz
- Massachusetts General Hospital, Harvard Medical School, Boston.,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts
| | - Molly Lapoint
- Massachusetts General Hospital, Harvard Medical School, Boston.,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts
| | | | - John B Miller
- Massachusetts Eye and Ear, Harvard Medical School, Boston
| | - Leo A Kim
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston.,Massachusetts Eye and Ear, Harvard Medical School, Boston
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, Arizona
| | | | - Francisco Lopera
- Grupo de Neurociencias, Universidad de Antioquia, Medellin, Antioquia, Colombia
| | | | - Keith A Johnson
- Massachusetts General Hospital, Harvard Medical School, Boston.,Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
110
|
Laíns I, Chung W, Kelly RS, Gil J, Marques M, Barreto P, Murta JN, Kim IK, Vavvas DG, Miller JB, Silva R, Lasky-Su J, Liang L, Miller JW, Husain D. Human Plasma Metabolomics in Age-Related Macular Degeneration: Meta-Analysis of Two Cohorts. Metabolites 2019; 9:E127. [PMID: 31269701 PMCID: PMC6680405 DOI: 10.3390/metabo9070127] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/27/2019] [Accepted: 06/28/2019] [Indexed: 01/01/2023] Open
Abstract
The pathogenesis of age-related macular degeneration (AMD), a leading cause of blindness worldwide, remains only partially understood. This has led to the current lack of accessible and reliable biofluid biomarkers for diagnosis and prognosis, and absence of treatments for dry AMD. This study aimed to assess the plasma metabolomic profiles of AMD and its severity stages with the ultimate goal of contributing to addressing these needs. We recruited two cohorts: Boston, United States (n = 196) and Coimbra, Portugal (n = 295). Fasting blood samples were analyzed using ultra-high performance liquid chromatography mass spectrometry. For each cohort, we compared plasma metabolites of AMD patients versus controls (logistic regression), and across disease stages (permutation-based cumulative logistic regression considering both eyes). Meta-analyses were then used to combine results from the two cohorts. Our results revealed that 28 metabolites differed significantly between AMD patients versus controls (false discovery rate (FDR) q-value: 4.1 × 10-2-1.8 × 10-5), and 67 across disease stages (FDR q-value: 4.5 × 10-2-1.7 × 10-4). Pathway analysis showed significant enrichment of glycerophospholipid, purine, taurine and hypotaurine, and nitrogen metabolism (p-value ≤ 0.04). In conclusion, our findings support that AMD patients present distinct plasma metabolomic profiles, which vary with disease severity. This work contributes to the understanding of AMD pathophysiology, and can be the basis of future biomarkers and precision medicine for this blinding condition.
Collapse
Affiliation(s)
- Inês Laíns
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
- Faculty of Medicine, University of Coimbra, 3000 Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra, 3000 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image, 3000 Coimbra, Portugal
| | - Wonil Chung
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Rachel S Kelly
- Systems Genetics and Genomics Unit, Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - João Gil
- Faculty of Medicine, University of Coimbra, 3000 Coimbra, Portugal
| | - Marco Marques
- Faculty of Medicine, University of Coimbra, 3000 Coimbra, Portugal
| | - Patrícia Barreto
- Association for Innovation and Biomedical Research on Light and Image, 3000 Coimbra, Portugal
| | - Joaquim N Murta
- Faculty of Medicine, University of Coimbra, 3000 Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra, 3000 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image, 3000 Coimbra, Portugal
| | - Ivana K Kim
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Demetrios G Vavvas
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - John B Miller
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra, 3000 Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra, 3000 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image, 3000 Coimbra, Portugal
| | - Jessica Lasky-Su
- Systems Genetics and Genomics Unit, Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Liming Liang
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Joan W Miller
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Deeba Husain
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA.
| |
Collapse
|
111
|
Abstract
Intraoperative OCT (iOCT) is an emerging modality capable of displaying real-time OCT images to the surgeon during surgery. The use of iOCT during vitreoretinal surgery improves our understanding of the tissue alterations that occur during surgical manipulations, which may impact surgical decision-making. We review the current iOCT modalities and clinical applications of iOCT.
Collapse
Affiliation(s)
- Cindy Ung
- a Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
| | - John B Miller
- a Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
| |
Collapse
|
112
|
Hu L, Andrews AE, Thoning KW, Sweeney C, Miller JB, Michalak AM, Dlugokencky E, Tans PP, Shiga YP, Mountain M, Nehrkorn T, Montzka SA, McKain K, Kofler J, Trudeau M, Michel SE, Biraud SC, Fischer ML, Worthy DEJ, Vaughn BH, White JWC, Yadav V, Basu S, van der Velde IR. Enhanced North American carbon uptake associated with El Niño. Sci Adv 2019; 5:eaaw0076. [PMID: 31183402 PMCID: PMC6551193 DOI: 10.1126/sciadv.aaw0076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 04/29/2019] [Indexed: 05/29/2023]
Abstract
Long-term atmospheric CO2 mole fraction and δ13CO2 observations over North America document persistent responses to the El Niño-Southern Oscillation. We estimate these responses corresponded to 0.61 (0.45 to 0.79) PgC year-1 more North American carbon uptake during El Niño than during La Niña between 2007 and 2015, partially offsetting increases of net tropical biosphere-to-atmosphere carbon flux around El Niño. Anomalies in derived North American net ecosystem exchange (NEE) display strong but opposite correlations with surface air temperature between seasons, while their correlation with water availability was more constant throughout the year, such that water availability is the dominant control on annual NEE variability over North America. These results suggest that increased water availability and favorable temperature conditions (warmer spring and cooler summer) caused enhanced carbon uptake over North America near and during El Niño.
Collapse
Affiliation(s)
- Lei Hu
- Cooperative Institute for Research in Environmental Sciences, University of Colorado-Boulder, Boulder, CO, USA
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Arlyn E. Andrews
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Kirk W. Thoning
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Colm Sweeney
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - John B. Miller
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Anna M. Michalak
- Department of Global Ecology, Carnegie Institution for Science, Stanford, CA, USA
- Department of Earth System Science, Stanford University, Stanford, CA, USA
| | - Ed Dlugokencky
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Pieter P. Tans
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Yoichi P. Shiga
- Department of Global Ecology, Carnegie Institution for Science, Stanford, CA, USA
| | | | | | - Stephen A. Montzka
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Kathryn McKain
- Cooperative Institute for Research in Environmental Sciences, University of Colorado-Boulder, Boulder, CO, USA
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Jonathan Kofler
- Cooperative Institute for Research in Environmental Sciences, University of Colorado-Boulder, Boulder, CO, USA
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Michael Trudeau
- Cooperative Institute for Research in Environmental Sciences, University of Colorado-Boulder, Boulder, CO, USA
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Sylvia E. Michel
- Institute of Arctic and Alpine Research, University of Colorado-Boulder, Boulder, CO, USA
| | - Sébastien C. Biraud
- Earth and Environmental Sciences Area, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Marc L. Fischer
- Environmental Technologies Area, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | | | - Bruce H. Vaughn
- Institute of Arctic and Alpine Research, University of Colorado-Boulder, Boulder, CO, USA
| | - James W. C. White
- Institute of Arctic and Alpine Research, University of Colorado-Boulder, Boulder, CO, USA
| | - Vineet Yadav
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - Sourish Basu
- Cooperative Institute for Research in Environmental Sciences, University of Colorado-Boulder, Boulder, CO, USA
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
| | - Ivar R. van der Velde
- Cooperative Institute for Research in Environmental Sciences, University of Colorado-Boulder, Boulder, CO, USA
- Global Monitoring Division, Earth System Research Laboratory, NOAA, Boulder, CO, USA
- Faculty of Science, VU University Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
113
|
Abstract
Optical coherence tomography angiography (OCT-A) has enabled fast, non-invasive, high-resolution visualization of vasculature within the eye. In the past few years, it has become increasingly utilized for a range of disorders including age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, and uveitis among others. This article reviews technical aspects of OCT-A, its applications in chorioretinal disease, and known limitations of the technology.
Collapse
Affiliation(s)
- Jay C Wang
- a Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
| | - John B Miller
- a Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
| |
Collapse
|
114
|
Laíns I, Duarte D, Barros AS, Martins AS, Carneiro TJ, Gil JQ, Miller JB, Marques M, Mesquita TS, Barreto P, Kim IK, da Luz Cachulo M, Vavvas DG, Carreira IM, Murta JN, Silva R, Miller JW, Husain D, Gil AM. Urine Nuclear Magnetic Resonance (NMR) Metabolomics in Age-Related Macular Degeneration. J Proteome Res 2019; 18:1278-1288. [PMID: 30672297 PMCID: PMC7838731 DOI: 10.1021/acs.jproteome.8b00877] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Biofluid biomarkers of age-related macular degeneration (AMD) are still lacking, and their identification is challenging. Metabolomics is well-suited to address this need, and urine is a valuable accessible biofluid. This study aimed to characterize the urinary metabolomic signatures of patients with different stages of AMD and a control group (>50 years). It was a prospective, cross-sectional study, where subjects from two cohorts were included: 305 from Coimbra, Portugal (AMD patients n = 252; controls n = 53) and 194 from Boston, United States (AMD patients n = 147; controls n = 47). For all participants, we obtained color fundus photographs (for AMD staging) and fasting urine samples, which were analyzed using 1H nuclear magnetic resonance (NMR) spectroscopy. Our results revealed that in both cohorts, urinary metabolomic profiles differed mostly between controls and late AMD patients, but important differences were also found between controls and subjects with early AMD. Analysis of the metabolites responsible for these separations revealed that, even though distinct features were observed for each cohort, AMD was in general associated with depletion of excreted citrate and selected amino acids at some stage of the disease, suggesting enhanced energy requirements. In conclusion, NMR metabolomics enabled the identification of urinary signals of AMD and its severity stages, which might represent potential metabolomic biomarkers of the disease.
Collapse
Affiliation(s)
- Inês Laíns
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - Daniela Duarte
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - António S. Barros
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Ana Sofia Martins
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Tatiana J. Carneiro
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - João Q. Gil
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - John B. Miller
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Marco Marques
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - Tânia S. Mesquita
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
| | - Patrícia Barreto
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
| | - Ivana K. Kim
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Maria da Luz Cachulo
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - Demetrios G. Vavvas
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Isabel M. Carreira
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
| | - Joaquim Neto Murta
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - Joan W. Miller
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Deeba Husain
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Ana M. Gil
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| |
Collapse
|
115
|
Miller JB, Danoff SK, Bingham CO, Paik JJ, Mecoli CA, Tiniakou E, Christopher-Stine L, Albayda J. Sonographic findings from inflammatory arthritis due to antisynthetase syndrome. Clin Rheumatol 2019; 38:1477-1483. [PMID: 30810913 DOI: 10.1007/s10067-019-04471-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 01/29/2019] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Abstract
Inflammatory arthritis is a common feature of antisynthetase syndrome. Ultrasonography is able to characterize important features of bone and tendon pathology but has not been evaluated in this setting. We review the sonographic findings in a series of patients with antisynthetase syndrome and inflammatory arthritis. A retrospective chart review was performed of patients with antisynthetase syndrome-associated inflammatory arthritis who had undergone ultrasound imaging for joint pathology. Seventeen sonographic assessments of eight patients were included. Synovial hypertrophy was seen in all eight patients, with active Doppler signal present in six patients (13 of 17 ultrasound locations). Tendon involvement was common, with tenosynovitis in seven patients (11 of 17 ultrasound locations). Erosions were present in five patients. Musculoskeletal ultrasound showed significant joint pathology including proliferative synovitis and tenosynovitis. This may be severe and associated with erosive disease. Further systematic studies are needed to better understand the articular involvement of antisynthetase syndrome. Key points • Marked inflammatory change-with proliferative synovitis, tenosynovitis, and erosions-can be seen in selected patients with antisynthetase syndrome (ASyS). • Inflammatory arthritis from ASyS can be severe and erosive in the absence of RF and ACPA and can be refractory to immunosuppressive therapy used to manage the myositis and interstitial lung disease. • Systematic sonographic evaluation of patients with ASyS is needed to further evaluate pathology and treatment response of inflammatory arthritis.
Collapse
Affiliation(s)
- John B Miller
- Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Mason F Lord Building Center Tower, Suite 4100, Baltimore, MD, 21224, USA.
| | - Sonye K Danoff
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Mason F Lord Building Center Tower, Suite 4100, Baltimore, MD, 21224, USA
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Mason F Lord Building Center Tower, Suite 4100, Baltimore, MD, 21224, USA
| | - Julie J Paik
- Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Mason F Lord Building Center Tower, Suite 4100, Baltimore, MD, 21224, USA
| | - Christopher A Mecoli
- Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Mason F Lord Building Center Tower, Suite 4100, Baltimore, MD, 21224, USA
| | - Eleni Tiniakou
- Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Mason F Lord Building Center Tower, Suite 4100, Baltimore, MD, 21224, USA
| | - Lisa Christopher-Stine
- Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Mason F Lord Building Center Tower, Suite 4100, Baltimore, MD, 21224, USA.,Department of Neurology, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Mason F Lord Building Center Tower, Suite 4100, Baltimore, MD, 21224, USA
| | - Jemima Albayda
- Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Mason F Lord Building Center Tower, Suite 4100, Baltimore, MD, 21224, USA
| |
Collapse
|
116
|
Roh M, Laíns I, Shin HJ, Park DH, Mach S, Vavvas DG, Kim IK, Miller JW, Husain D, Miller JB. Microperimetry in age-related macular degeneration: association with macular morphology assessed by optical coherence tomography. Br J Ophthalmol 2019; 103:1769-1776. [PMID: 30709810 DOI: 10.1136/bjophthalmol-2018-313316] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/26/2018] [Accepted: 01/04/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS Microperimetry is a technique that is increasingly used to assess visual function in age-related macular degeneration (AMD). In this study, we aimed to evaluate the relationship between retinal sensitivity measured with macular integrity assessment (MAIA) microperimetry and optical coherence tomography (OCT)-based macular morphology in AMD. METHODS Prospective, cross-sectional study. All participants were imaged with colour fundus photographs used for AMD staging (Age-Related Eye Disease Study scale), spectral-domain OCT (Spectralis, Heidelberg, Germany) and swept-source OCT (Topcon, Japan). Threshold retinal sensitivity of the central 10° diameter circle was assessed with the full-threshold, 37-point protocol of the MAIA microperimetry device (Centervue, Italy). Univariable and multivariable multilevel mixed-effect linear regression models were used for analysis. RESULTS We included 102 eyes with AMD and 46 control eyes. Multivariable analysis revealed that older age (p<0.0001), advanced AMD stage (p<0.0001) and reduced retinal thickness (p<0.0001) were associated with decreased mean retinal sensitivity. No associations were found between choroidal thickness and retinal sensitivity within the macula. Within the 10° diameter circle of the macula, the presence of ellipsoid disruption, subretinal fluid, atrophy and fibrosis, and outer retinal tubulation on OCT images was also associated with decreased retinal sensitivity (all p<0.05). CONCLUSIONS There is an association between TRS as determined by MAIA microperimetry and several OCT structural parameters across various stages of AMD. This study highlights the relevance of microperimetry as a functional outcome measure for AMD.
Collapse
Affiliation(s)
- Miin Roh
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.,Department of Ophthalmology, Beetham Eye Institute, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Inês Laíns
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.,Department of Ophthalmology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Association for Innovation and Biomedical Research on Light (AIBILI), Coimbra, Portugal.,Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Hyun Joon Shin
- Division of Global Health Equity, Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Dong Ho Park
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.,Department of Ophthalmology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Steven Mach
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Demetrios G Vavvas
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Ivana K Kim
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Joan W Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Deeba Husain
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - John B Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
117
|
Miller JB, Gelber AC. Profound Neutropenia with Concomitant Hepatitis During Oxacillin Therapy. Cureus 2019; 11:e3823. [PMID: 30868036 PMCID: PMC6402867 DOI: 10.7759/cureus.3823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Beta-lactam antibiotics are widely used and generally well-tolerated. Neutropenia and hepatitis are two adverse drug reactions associated with beta-lactam therapy that are typically benign and reversible, yet have seldom been reported as simultaneous occurrences. This narrative describes these adverse drug reactions during oxacillin therapy.
Collapse
|
118
|
Wang JC, Laíns I, Oellers P, Kim IK, Miller JW, Miller JB. Choroidal thickness and vascular density in macular telangiectasia type 2 using enface swept-source optical coherence tomography. Br J Ophthalmol 2019; 103:1584-1589. [DOI: 10.1136/bjophthalmol-2018-313414] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/05/2018] [Accepted: 12/14/2018] [Indexed: 11/03/2022]
Abstract
PurposeTo investigate the choroidal thickness (CT) and choroidal vascular densities (CVD) of patients with macular telangiectasia type 2 (MacTel2) and their association with other multimodal imaging features, using swept-source optical coherence tomography (SS-OCT).MethodsProspective, cross-sectional study. Consecutive patients with MacTel2 along with controls without any macular disease were included. Fundus photography, confocal blue reflectance, near-infrared reflectance, autofluorescence, fluorescein angiography, spectral domain OCT and SS-OCT were performed. Images were independently analysed by two graders, and CVD was calculated from binarised en face SS-OCT images. CT was obtained from the SS-OCT platform via built-in automated segmentation. Multilevel mixed-effects models were used for statistical analysis.ResultsThirty-nine eyes of 20 patients with MacTel2 and 29 eyes of 15 control patients were included. Average CT and perifoveal temporal CT did not differ significantly between eyes with MacTel2 and control eyes (p≥0.350), when accounting for confounding factors. Overall and temporal CVD also did not significantly differ between the two groups (p≥0.490).ConclusionCT and CVD did not significantly differ between MacTel2 and control eyes in this study using SS-OCT. Even though MacTel2 may include abnormalities involving the choroid, these are likely minor in comparison to the predominant retinal changes.
Collapse
|
119
|
Wang JC, McKay KM, Sood AB, Laíns I, Sobrin L, Miller JB. Comparison of choroidal neovascularization secondary to white dot syndromes and age-related macular degeneration by using optical coherence tomography angiography. Clin Ophthalmol 2018; 13:95-105. [PMID: 30643383 PMCID: PMC6318713 DOI: 10.2147/opth.s185468] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose To characterize and compare choroidal neovascularization (CNV) secondary to white dot syndromes (WDS) and age-related macular degeneration (AMD) using optical coherence tomography angiography (OCT-A). Methods This is a cross-sectional study in which we imaged patients with CNV secondary to WDS and AMD with either the Zeiss Angioplex OCT-A or Optovue AngioVue OCT-A. Relevant demographic and clinical characteristics were collected and analyzed. CNV area and vessel density (VD) were measured by three independent graders, and linear regression analysis was subsequently performed. Results Three patients with multifocal choroiditis and panuveitis, one patient each with birdshot chorioretinopathy, presumed ocular histoplasmosis syndrome, and persistent placoid maculopathy, and eleven patients with AMD with sufficient image quality were included. CNV associated with WDS was significantly smaller than that secondary to AMD (0.56±0.32 vs 2.79±1.80 mm2, β=-2.22, P=0.01), while no difference in VD was detected (0.46±0.09 vs 0.44±0.09, β=0.02, P=0.71). Conclusion CNV networks secondary to WDS appear to be smaller than those secondary to AMD but have similar VD. OCT-A is a powerful tool to investigate properties of CNV from various etiologies. Larger studies are needed for further characterization and understanding of CNV pathogenesis in inflammatory conditions.
Collapse
Affiliation(s)
- Jay C Wang
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA,
| | - Kenneth M McKay
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA,
| | - Arjun B Sood
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA,
| | - Inês Laíns
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA,
| | - Lucia Sobrin
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA,
| | - John B Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA,
| |
Collapse
|
120
|
Wang JC, Laíns I, Silverman RF, Sobrin L, Vavvas DG, Miller JW, Miller JB. Visualization of Choriocapillaris and Choroidal Vasculature in Healthy Eyes With En Face Swept-Source Optical Coherence Tomography Versus Angiography. Transl Vis Sci Technol 2018; 7:25. [PMID: 30598856 PMCID: PMC6306077 DOI: 10.1167/tvst.7.6.25] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/07/2018] [Indexed: 12/12/2022] Open
Abstract
Purpose To compare the visualization of the choriocapillaris and deeper choroidal vessels in healthy eyes in en face swept-source optical coherence tomography (SS-OCT) versus SS-OCT angiography (SS-OCTA). Methods This is a cross-sectional study of consecutive eyes without chorioretinal disease. En face SS-OCT and SS-OCTA images of the choriocapillaris and choroid were assessed for visualization of the vasculature. Choroidal vessel densities (CVD) of the choriocapillaris, inner choroid, midchoroid, and outer choroid were calculated from binarized en face SS-OCT and SS-OCTA images. Paired t-tests and linear regression were used for statistical analysis. Results Twenty-seven eyes of 27 patients were included. There was no statistically significant difference between the CVDs of the midchoroid assessed with en face SS-OCT versus SS-OCTA (P = 0.21). However, there were statistically significant differences between the CVDs for the choriocapillaris (P < 0.001), inner choroid (P < 0.001), and outer choroid (P = 0.006). Qualitative analysis revealed incomplete visualization of vessels in the inner choroid and exaggeration of vessel lumens in the outer choroid with SS-OCTA. Conclusions Visualization of the choriocapillaris is superior with SS-OCTA, but it has numerous limitations that make visualization of deeper choroidal vessels less reliable when compared with en face SS-OCT. It is important to understand such limitations when using these technologies to study the choroidal vasculature in chorioretinal disease. Translational Relevance The presented study of optimal imaging techniques for the choroidal vessels of healthy eyes provides an important foundation for future investigations into the role of the choroidal vasculature in chorioretinal diseases.
Collapse
Affiliation(s)
- Jay C Wang
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Rebecca F Silverman
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Lucia Sobrin
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Demetrios G Vavvas
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
121
|
Affiliation(s)
- John B. Miller
- Johns Hopkins University School of Medicine; Baltimore MD
| | - Alan N. Baer
- Johns Hopkins University School of Medicine; Baltimore MD
| |
Collapse
|
122
|
Peters W, van der Velde IR, van Schaik E, Miller JB, Ciais P, Duarte HF, van der Laan-Luijkx IT, van der Molen MK, Scholze M, Schaefer K, Vidale PL, Verhoef A, Wårlind D, Zhu D, Tans PP, Vaughn B, White JW. Increased water-use efficiency and reduced CO 2 uptake by plants during droughts at a continental-scale. Nat Geosci 2018; 11:744-748. [PMID: 30319710 PMCID: PMC6179136 DOI: 10.1038/s41561-018-0212-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/17/2018] [Indexed: 05/06/2023]
Abstract
Severe droughts in the Northern Hemisphere cause widespread decline of agricultural yield, reduction of forest carbon uptake, and increased CO2 growth rates in the atmosphere. Plants respond to droughts by partially closing their stomata to limit their evaporative water loss, at the expense of carbon uptake by photosynthesis. This trade-off maximizes their water-use efficiency, as measured for many individual plants under laboratory conditions and field experiments. Here we analyze the 13C/12C stable isotope ratio in atmospheric CO2 (reported as δ13C) to provide new observational evidence of the impact of droughts on the water-use efficiency across areas of millions of km2 and spanning one decade of recent climate variability. We find strong and spatially coherent increases in water-use efficiency along with widespread reductions of net carbon uptake over the Northern Hemisphere during severe droughts that affected Europe, Russia, and the United States in 2001-2011. The impact of those droughts on water-use efficiency and carbon uptake by vegetation is substantially larger than simulated by the land-surface schemes of six state-of-the-art climate models. This suggests that drought induced carbon-climate feedbacks may be too small in these models and improvements to their vegetation dynamics using stable isotope observations can help to improve their drought response.
Collapse
Affiliation(s)
- Wouter Peters
- Environmental Sciences Group, Wageningen University, Wageningen, The Netherlands
- University of Groningen, Centre for Isotope Research, Groningen, The Netherlands
| | - Ivar R. van der Velde
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, United States
- Global Monitoring Division, NOAA Earth System Research Laboratory, Boulder, CO, United States
| | - Erik van Schaik
- Environmental Sciences Group, Wageningen University, Wageningen, The Netherlands
| | - John B. Miller
- Global Monitoring Division, NOAA Earth System Research Laboratory, Boulder, CO, United States
| | - Philippe Ciais
- Laboratoire des Sciences du Climat et de l’Environnement, LSCE/IPSL, CEA-CNRS-UVSQ, Gif sur Yvette, France
| | - Henrique F. Duarte
- Dept. of Atm. Sciences, University of Utah, Salt Lake City, Utah, United States
| | | | | | - Marko Scholze
- Dept. of Physical Geography and Ecosystem Science, Lund University, Lund, Sweden
| | - Kevin Schaefer
- National Snow and Ice Data Center, University of Colorado, Boulder, CO, United States
| | | | - Anne Verhoef
- Dept. of Geography and Environmental Science, University of Reading, Reading, UK
| | - David Wårlind
- Dept. of Physical Geography and Ecosystem Science, Lund University, Lund, Sweden
| | - Dan Zhu
- Laboratoire des Sciences du Climat et de l’Environnement, LSCE/IPSL, CEA-CNRS-UVSQ, Gif sur Yvette, France
| | - Pieter P. Tans
- Global Monitoring Division, NOAA Earth System Research Laboratory, Boulder, CO, United States
| | - Bruce Vaughn
- Institute for Arctic and Alpine Research, University of Colorado, Boulder, CO, United States
| | - James W.C. White
- Institute for Arctic and Alpine Research, University of Colorado, Boulder, CO, United States
| |
Collapse
|
123
|
Gaier ED, Gittinger JW, Cestari DM, Miller JB. Peripapillary Capillary Dilation in Leber Hereditary Optic Neuropathy Revealed by Optical Coherence Tomographic Angiography. JAMA Ophthalmol 2018; 134:1332-1334. [PMID: 27711925 DOI: 10.1001/jamaophthalmol.2016.3593] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Eric D Gaier
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - John W Gittinger
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - Dean M Cestari
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - John B Miller
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| |
Collapse
|
124
|
Abstract
We describe the benefits of perfluoro-N-octane (PFO), a perfluorocarbon liquid, in the removal of nonmagnetic intraocular foreign bodies (IOFBs) from the macula and posterior segment. Two consecutive cases of posterior segment IOFB were reviewed. An 18-year-old male presented to the emergency room after a motor vehicle accident with a zone 1 open globe injury and large glass IOFB in the left eye. A 53-year-old male presented to the emergency room with a history of a 3-week delayed presentation of a zone 1 open globe injury from a nail to the right eye. He was found to have a metallic IOFB. In both cases, PFO was used to slide the nonmagnetic IOFBs outside of the macula for safer retrieval. PFO was also able to protect the posterior pole from IOFB drops during early attempts at removal. PFO can be a useful surgical adjunct to pars plana vitrectomy in the removal of certain nonmagnetic IOFBs.
Collapse
Affiliation(s)
- Cindy Ung
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Thanos D Papakostas
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Safa Rahmani
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
125
|
Gaier ED, Wang M, Gilbert AL, Rizzo JF, Cestari DM, Miller JB. Quantitative analysis of optical coherence tomographic angiography (OCT-A) in patients with non-arteritic anterior ischemic optic neuropathy (NAION) corresponds to visual function. PLoS One 2018; 13:e0199793. [PMID: 29953490 PMCID: PMC6023180 DOI: 10.1371/journal.pone.0199793] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 06/13/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common cause of non-glaucomatous optic neuropathy in older adults. Optical coherence tomographic angiography (OCT-A) is an emerging, non-invasive method to study the microvasculature of the posterior pole, including the optic nerve head. The goal of this study was to assess the vascular changes in the optic nerve head and peripapillary area associated with NAION using OCT-A. Design Retrospective comparative case series. Methods We performed OCT-A in 25 eyes (7 acute and 18 non-acute) in 19 patients with NAION. Fellow, unaffected eyes were analyzed for comparison. Patent macro- and microvascular densities were quantified in the papillary and peripapillary regions of unaffected, acutely affected, and non-acutely affected eyes and compared across these groups according to laminar segment and capillary sampling region, and with respect to performance on automated visual field testing. Results In acutely affected eyes, OCT-A revealed a reduction in the signal from the major retinal vessels and dilation of patent superficial capillaries in the peripapillary area. By contrast, non-acutely affected eyes showed attenuation of patent capillaries. The peripapillary choriocapillaris was obscured by edema in acute cases, but was similar between non-acute and unaffected eyes. The degree of dilation of the superficial microvasculature in the acute phase and attenuation in the non-acute phase each correlated inversely with visual field performance. The region of reduced patent capillary density correlated with the location of visual field defects in 80% of acute cases and 80% of non-acute cases. Conclusions OCT-A reveals a dynamic shift in the superficial capillary network of the optic nerve head with strong functional correlates in both the acute and non-acute phases of NAION. Further study may validate OCT-A as a useful adjunctive diagnostic tool in the evaluation of ischemic optic neuropathy.
Collapse
Affiliation(s)
- Eric D. Gaier
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States of America
| | - Mengyu Wang
- Schepens Eye Research Institute, Harvard Medical School, Boston, MA, United States of America
| | - Aubrey L. Gilbert
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States of America
| | - Joseph F. Rizzo
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States of America
| | - Dean M. Cestari
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States of America
| | - John B. Miller
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States of America
- * E-mail:
| |
Collapse
|
126
|
Laíns I, Park DH, Mukai R, Silverman R, Oellers P, Mach S, Kim IK, Vavvas DG, Miller JW, Miller JB, Husain D. Peripheral Changes Associated With Delayed Dark Adaptation in Age-related Macular Degeneration. Am J Ophthalmol 2018; 190:113-124. [PMID: 29621510 DOI: 10.1016/j.ajo.2018.03.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/14/2018] [Accepted: 03/22/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE To study the association between peripheral changes in age-related macular degeneration (AMD) and dark adaptation (DA). DESIGN Prospective, cross-sectional study. METHODS We recruited patients with AMD and a control group (>50 years) without any vitreoretinal disease. Ultra-widefield (UWF) pseudocolor and fundus autofluorescence (FAF) were obtained, and were assessed by 2 graders for the presence of several peripheral changes in perimacular, midperipheral, and far-peripheral zones. All participants were also imaged with 7-field color fundus photographs used for AMD staging (Age-Related Eye Disease Study classification system). Both eyes of study participants were tested with a dark adaptation (DA) extended protocol (20 minutes). Multilevel mixed-effect models (accounting for correlated outcomes between 2 eyes) were used for analyses. RESULTS We included 128 eyes (n = 72 patients), 75% with AMD and the remainder controls. The presence of reticular pigmentary changes in the midperipheral (ß = 4.3, P = .012) and far-peripheral zones (ß = 8.4, P < .001) was associated with delayed rod-intercept times (RITs), even after adjusting for confounding factors. The presence, number, and extent of peripheral classic drusen did not show a similar association (P ≥ .148). The presence of a mottled decreased FAF pattern in the midperipheral zone was also associated with prolonged RITs (β = 4.4, P = .031). CONCLUSION Our results suggest an association between DA and the presence of peripheral reticular pigmentary changes, as well as the presence of a peripheral mottled decreased FAF pattern. This provides new insights on the clinical significance of peripheral changes in AMD, and their contribution to impairments on DA.
Collapse
Affiliation(s)
- Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Dong Ho Park
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Ryo Mukai
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Rebecca Silverman
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Patrick Oellers
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Steven Mach
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Ivana K Kim
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Demetrios G Vavvas
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States.
| |
Collapse
|
127
|
Laíns I, Miller JB, Mukai R, Mach S, Vavvas D, Kim IK, Miller JW, Husain D. HEALTH CONDITIONS LINKED TO AGE-RELATED MACULAR DEGENERATION ASSOCIATED WITH DARK ADAPTATION. Retina 2018; 38:1145-1155. [PMID: 28452839 DOI: 10.1097/iae.0000000000001659] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE To determine the association between dark adaption (DA) and different health conditions linked with age-related macular degeneration (AMD). METHODS Cross-sectional study, including patients with AMD and a control group. Age-related macular degeneration was graded according to the Age-Related Eye Disease Study (AREDS) classification. We obtained data on medical history, medications, and lifestyle. Dark adaption was assessed with the extended protocol (20 minutes) of AdaptDx (MacuLogix). For analyses, the right eye or the eye with more advanced AMD was selected. Multivariate linear and logistic regressions were performed, accounting for age and AMD stage. RESULTS Seventy-eight subjects (75.6% AMD; 24.4% controls) were included. Multivariate assessments revealed that body mass index (BMI; β = 0.30, P = 0.045), taking AREDS vitamins (β = 5.51, P < 0.001), and family history of AMD (β = 2.68, P = 0.039) were significantly associated with worse rod intercept times. Abnormal DA (rod intercept time ≥ 6.5 minutes) was significantly associated with family history of AMD (β = 1.84, P = 0.006), taking AREDS supplements (β = 1.67, P = 0.021) and alcohol intake (β = 0.07, P = 0.017). CONCLUSION Besides age and AMD stage, a higher body mass index, higher alcohol intake, and a family history of AMD seem to impair DA. In this cohort, the use of AREDS vitamins was also statistically linked with impaired DA, most likely because of an increased severity of disease in subjects taking them.
Collapse
Affiliation(s)
- Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
- Department of Ophthalmology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Ryo Mukai
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Steven Mach
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Demetrios Vavvas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Ivana K Kim
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
128
|
Diaz JD, Wang JC, Oellers P, Lains I, Sobrin L, Husain D, Miller JW, Vavvas DG, Miller JB. Imaging the Deep Choroidal Vasculature Using Spectral Domain and Swept Source Optical Coherence Tomography Angiography. ACTA ACUST UNITED AC 2018; 2:146-154. [PMID: 29930992 DOI: 10.1177/2474126418771805] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Purpose To evaluate the deeper choroidal vasculature in eyes with various ocular disorders using spectral domain (SD) optical coherence tomography angiography (OCTA) and swept source (SS) OCTA. Methods Patients underwent OCTA imaging with either SD-OCTA (Zeiss Cirrus Angioplex or Optovue AngioVue) or SS-OCTA (Topcon Triton). Retinal pigment epithelium (RPE) integrity, structural visualization of deep choroidal vessels on en face imaging, and OCTA of deep choroidal blood flow signal were analyzed. Choroidal blood flow was deemed present if deeper choroidal vessels appeared bright after appropriate segmentation. Results Structural visualization of choroidal vessels was feasible in all eyes by en face imaging. In both SD-OCTA and SS-OCTA, choroidal blood flow signal was present in all eyes with overlying RPE atrophy (100% of eyes with RPE atrophy, 28.6% of all imaged eyes, P < .001). Conclusions While choroidal vessels can be visualized anatomically in all eyes by en face imaging, choroidal blood flow detection in deep choroidal vessel is largely restricted to areas with overlying RPE atrophy. Intact RPE acts as a barrier for reliable detection of choroidal flow using current OCTA technology, inhibiting evaluation of flow in deeper choroidal vessels in most eyes.
Collapse
Affiliation(s)
- J Daniel Diaz
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Jay C Wang
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Patrick Oellers
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Inês Lains
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Lucia Sobrin
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Demetrios G Vavvas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
129
|
Ung C, Laíns I, Silverman RF, Woods R, Lane AM, Papakostas TD, Husain D, Miller JW, Gragoudas ES, Kim IK, Miller JB. Evaluation of choroidal lesions with swept-source optical coherence tomography. Br J Ophthalmol 2018; 103:88-93. [PMID: 29605814 DOI: 10.1136/bjophthalmol-2017-311586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/11/2018] [Indexed: 12/18/2022]
Abstract
AIMS The aim of our study was to image choroidal lesions with swept-source optical coherence tomography (SS-OCT) and to identify the morphological characteristics associated with optimal visualisation. METHODS This was a prospective, cross-sectional study. Patients with choroidal melanocytic lesions <3 mm in thickness on B-scan ultrasonography were recruited. All participants underwent SS-OCT. On SS-OCT we evaluated qualitative (eg, lesion outline, detection of scleral-choroidal interface and quality of the image) and quantitative (measurement of maximum lesion thickness and the largest basal diameter) parameters. Probability of optimal image quality was examined using ordered logistic regression models. The main outcome measure was quality of the choroidal lesion images on SS-OCT, defined as: optimal, suboptimal or poor. RESULTS We included 85 choroidal lesions of 82 patients. There were 24 choroidal lesions (29%) for which image quality was classified as optimal, 31 lesions (37%) as suboptimal and 30 lesions (36%) as poor. The factors associated with optimal image quality were distance closer to the fovea (OR 0.76, p<0.001), posterior pole location (OR 3.87, p=0.05), lower ultrasonography thickness (OR 0.44, p=0.04), lighter lesion pigmentation (OR 0.12, p=0.003) and smaller lesion diameter (OR 0.73, p<0.001). In the multivariable analysis, closer distance to the fovea (OR 0.81, p=0.005), lighter lesion pigmentation (OR 0.11, p=0.01) and smaller lesion diameter (OR 0.76, p=0.006) remained statistically significant. CONCLUSION SS-OCT is useful in imaging most choroidal melanocytic lesions. Image quality is best when the choroidal lesion is closer to the fovea, has a smaller diameter and a lighter choroidal pigmentation.
Collapse
Affiliation(s)
- Cindy Ung
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rebecca F Silverman
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Russell Woods
- Department of Ophthalmology, Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
| | - Anne Marie Lane
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Thanos D Papakostas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Evangelos S Gragoudas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Ivana K Kim
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
130
|
Chou JC, Cousins CC, Miller JB, Song BJ, Shen LQ, Kass MA, Wiggs JL, Pasquale LR. Fundus Densitometry Findings Suggest Optic Disc Hemorrhages in Primary Open-Angle Glaucoma Have an Arterial Origin. Am J Ophthalmol 2018; 187:108-116. [PMID: 29330062 DOI: 10.1016/j.ajo.2017.12.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/11/2017] [Accepted: 12/27/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To analyze optic disc hemorrhages (DH) associated with primary open-angle glaucoma by quantifying their geometric profile and comparing their densitometry with hemorrhages from retinal vein occlusions (RVO) and retinal macroaneurysms (MA), which have venous and arterial sources of bleeding, respectively. DESIGN Retrospective cross-sectional study. METHODS Setting: Massachusetts Eye & Ear. POPULATION Fundus images of DH (n = 40), MA (n = 14), and RVO (n = 25) were identified. Patient clinical backgrounds and demographics were obtained. MAIN OUTCOME MEASURES Grayscale pixel intensity units of hemorrhages and adjacent arteriole and venule over the same background tissue were measured. Densitometry differentials (arteriole or venule minus hemorrhage [ΔA and ΔV, respectively]) were calculated. The ratios of length (radial) to midpoint width for DH were calculated. Mean ΔA and ΔV between groups were compared with t tests. Multiple linear regression assessed the relation of retinal hemorrhage diagnosis to ΔA and ΔV and of DH shape to ΔA and ΔV. RESULTS Mean (± standard deviation) ΔA and ΔV for DH (6.9 ± 7.1 and -4.7 ± 8.0 pixel intensity units, respectively) and MA (5.3 ± 5.9 and -6.0 ± 4.6, respectively) were comparable (P ≥ .43). Mean ΔA (14.6 ± 7.7) and ΔV (6.4 ± 6.3) for RVO were significantly higher compared to DH and MA (P < .0001) and remained significant in multivariable analyses. A unit increase in DH length-to-width ratio was associated with 1.2 (0.5) and 1.3 (0.5) pixel intensity unit (standard error) decrease in ΔA and ΔV, respectively (P ≤ .014). CONCLUSIONS DH have densitometry profiles comparable to MA and different from RVO, suggesting that DH in glaucoma have an arterial origin.
Collapse
|
131
|
Laíns I, Kelly RS, Miller JB, Silva R, Vavvas DG, Kim IK, Murta JN, Lasky-Su J, Miller JW, Husain D. Human Plasma Metabolomics Study across All Stages of Age-Related Macular Degeneration Identifies Potential Lipid Biomarkers. Ophthalmology 2018; 125:245-254. [PMID: 28916333 PMCID: PMC8077680 DOI: 10.1016/j.ophtha.2017.08.008] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/01/2017] [Accepted: 08/07/2017] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To characterize the plasma metabolomic profile of patients with age-related macular degeneration (AMD) using mass spectrometry (MS). DESIGN Cross-sectional observational study. PARTICIPANTS We prospectively recruited participants with a diagnosis of AMD and a control group (>50 years of age) without any vitreoretinal disease. METHODS All participants underwent color fundus photography, used for AMD diagnosis and staging, according to the Age-Related Eye Disease Study classification scheme. Fasting blood samples were collected and plasma was analyzed by Metabolon, Inc. (Durham, NC), using ultrahigh-performance liquid chromatography (UPLC) and high-resolution MS. Metabolon's hardware and software were used to identify peaks and control quality. Principal component analysis and multivariate regression were performed to assess differences in the metabolomic profiles of AMD patients versus controls, while controlling for potential confounders. For biological interpretation, pathway enrichment analysis of significant metabolites was performed using MetaboAnalyst. MAIN OUTCOME MEASURES The primary outcome measures were levels of plasma metabolites in participants with AMD compared with controls and among different AMD severity stages. RESULTS We included 90 participants with AMD (30 with early AMD, 30 with intermediate AMD, and 30 with late AMD) and 30 controls. Using UPLC and MS, 878 biochemicals were identified. Multivariate logistic regression identified 87 metabolites with levels that differed significantly between AMD patients and controls. Most of these metabolites (82.8%; n = 72), including the most significant metabolites, belonged to the lipid pathways. Analysis of variance revealed that of the 87 metabolites, 48 (55.2%) also were significantly different across the different stages of AMD. A significant enrichment of the glycerophospholipids pathway was identified (P = 4.7 × 10-9) among these metabolites. CONCLUSIONS Participants with AMD have altered plasma metabolomic profiles compared with controls. Our data suggest that the most significant metabolites map to the glycerophospholipid pathway. These findings have the potential to improve our understanding of AMD pathogenesis, to support the development of plasma-based metabolomics biomarkers of AMD, and to identify novel targets for treatment of this blinding disease.
Collapse
Affiliation(s)
- Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Rachel S Kelly
- Systems Genetics and Genomics Unit, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Demetrios G Vavvas
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Ivana K Kim
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Joaquim N Murta
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Jessica Lasky-Su
- Systems Genetics and Genomics Unit, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
132
|
Laíns I, Talcott KE, Santos AR, Marques JH, Gil P, Gil J, Figueira J, Husain D, Kim IK, Miller JW, Silva R, Miller JB. CHOROIDAL THICKNESS IN DIABETIC RETINOPATHY ASSESSED WITH SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY. Retina 2018; 38:173-182. [PMID: 28196053 DOI: 10.1097/iae.0000000000001516] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the choroidal thickness (CT) of diabetic eyes (different stages of disease) with controls, using swept-source optical coherence tomography. METHODS A multicenter, prospective, cross-sectional study of diabetic and nondiabetic subjects using swept-source optical coherence tomography imaging. Choroidal thickness maps, according to the nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields, were obtained using automated software. Mean CT was calculated as the mean value within the ETDRS grid, and central CT as the mean in the central 1 mm. Diabetic eyes were divided into four groups: no diabetic retinopathy (No DR), nonproliferative DR (NPDR), NPDR with diabetic macular edema (NPDR + DME), and proliferative DR (PDR). Multilevel mixed linear models were performed for analyses. RESULTS The authors included 50 control and 160 diabetic eyes (n = 27 No DR, n = 51 NPDR, n = 61 NPDR + DME, and n = 21 PDR). Mean CT (ß = -42.9, P = 0.022) and central CT (ß = -50.2, P = 0.013) were statistically significantly thinner in PDR eyes compared with controls, even after adjusting for confounding factors. Controlling for age, DR eyes presented a significantly decreased central CT than diabetic eyes without retinopathy (β = -36.2, P = 0.009). CONCLUSION Swept-source optical coherence tomography demonstrates a significant reduction of CT in PDR compared with controls. In the foveal region, the choroid appears to be thinner in DR eyes than in diabetic eyes without retinopathy.
Collapse
Affiliation(s)
- Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Ophthalmology, Coimbra University Hospital, Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Katherine E Talcott
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Ana R Santos
- Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
- School of Allied Health Technologies, Polytechnic Institute of Porto, Porto, Portugal
| | - João H Marques
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Pedro Gil
- Department of Ophthalmology, Coimbra University Hospital, Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - João Gil
- Department of Ophthalmology, Coimbra University Hospital, Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - João Figueira
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Ophthalmology, Coimbra University Hospital, Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Ivana K Kim
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Ophthalmology, Coimbra University Hospital, Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
133
|
Sparrow KJ, Kessler JD, Southon JR, Garcia-Tigreros F, Schreiner KM, Ruppel CD, Miller JB, Lehman SJ, Xu X. Limited contribution of ancient methane to surface waters of the U.S. Beaufort Sea shelf. Sci Adv 2018; 4:eaao4842. [PMID: 29349299 PMCID: PMC5771695 DOI: 10.1126/sciadv.aao4842] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/13/2017] [Indexed: 05/29/2023]
Abstract
In response to warming climate, methane can be released to Arctic Ocean sediment and waters from thawing subsea permafrost and decomposing methane hydrates. However, it is unknown whether methane derived from this sediment storehouse of frozen ancient carbon reaches the atmosphere. We quantified the fraction of methane derived from ancient sources in shelf waters of the U.S. Beaufort Sea, a region that has both permafrost and methane hydrates and is experiencing significant warming. Although the radiocarbon-methane analyses indicate that ancient carbon is being mobilized and emitted as methane into shelf bottom waters, surprisingly, we find that methane in surface waters is principally derived from modern-aged carbon. We report that at and beyond approximately the 30-m isobath, ancient sources that dominate in deep waters contribute, at most, 10 ± 3% of the surface water methane. These results suggest that even if there is a heightened liberation of ancient carbon-sourced methane as climate change proceeds, oceanic oxidation and dispersion processes can strongly limit its emission to the atmosphere.
Collapse
Affiliation(s)
- Katy J. Sparrow
- Department of Earth and Environmental Sciences, University of Rochester, Rochester, NY 14627, USA
- Department of Environmental Science and Analytical Chemistry, Bolin Centre for Climate Research, Stockholm University, Stockholm, Sweden
| | - John D. Kessler
- Department of Earth and Environmental Sciences, University of Rochester, Rochester, NY 14627, USA
| | - John R. Southon
- Keck Carbon Cycle Accelerator Mass Spectrometry Laboratory, Department of Earth System Science, University of California, Irvine, Irvine, CA 92697, USA
| | - Fenix Garcia-Tigreros
- Department of Earth and Environmental Sciences, University of Rochester, Rochester, NY 14627, USA
| | - Kathryn M. Schreiner
- Large Lakes Observatory, University of Minnesota Duluth, Duluth, MN 55812, USA
- Department of Chemistry and Biochemistry, University of Minnesota Duluth, Duluth, MN 55812, USA
| | | | - John B. Miller
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO 80309, USA
- Global Monitoring Division, Earth System Research Laboratory, National Oceanic and Atmospheric Administration, Boulder, CO 80305, USA
| | - Scott J. Lehman
- Institute of Arctic and Alpine Research, University of Colorado Boulder, Boulder, CO 80309, USA
| | - Xiaomei Xu
- Keck Carbon Cycle Accelerator Mass Spectrometry Laboratory, Department of Earth System Science, University of California, Irvine, Irvine, CA 92697, USA
| |
Collapse
|
134
|
Wang JC, Laíns I, Providência J, Armstrong GW, Santos AR, Gil P, Gil J, Talcott KE, Marques JH, Figueira J, Vavvas DG, Kim IK, Miller JW, Husain D, Silva R, Miller JB. Diabetic Choroidopathy: Choroidal Vascular Density and Volume in Diabetic Retinopathy With Swept-Source Optical Coherence Tomography. Am J Ophthalmol 2017; 184:75-83. [PMID: 28988899 DOI: 10.1016/j.ajo.2017.09.030] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/27/2017] [Accepted: 09/27/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE To compare choroidal vascular density (CVD) and volume (CVV) in diabetic eyes and controls, using en face swept-source optical coherence tomography (SS-OCT). DESIGN Prospective cross-sectional study. METHODS Setting: Multicenter. PATIENT POPULATION Total of 143 diabetic eyes-27 with no diabetic retinopathy (DR), 47 with nonproliferative DR (NPDR), 51 with NPDR and diabetic macular edema (DME), and 18 with proliferative DR (PDR)-and 64 age-matched nondiabetic control eyes. OBSERVATION PROCEDURES Complete ophthalmologic examination and SS-OCT imaging. En face SS-OCT images of the choroidal vasculature were binarized. MAIN OUTCOME MEASURES CVD, calculated as the percent area occupied by choroidal vessels in the central macular region (6-mm-diameter circle centered on the fovea), and throughout the posterior pole (12 × 9 mm). The central macular CVV was calculated by multiplying the average CVD by macular area and choroidal thickness (obtained with SS-OCT automated software). Multilevel mixed linear models were performed for analyses. RESULTS Compared to controls (0.31 ± 0.07), central macular CVD was significantly decreased by 9% in eyes with NPDR + DME (0.28 ± 0.06; ß = -0.03, P = .02) and by 15% in PDR (0.26 ± 0.05; ß = -0.04, P = .01). The central macular CVV was significantly decreased by 19% in eyes with PDR (0.020 ± 0.005 mm3, ß = -0.01, P = .01) compared to controls (0.025 ± 0.01 mm3). CONCLUSIONS Choroidal vascular density and volume are significantly reduced in more advanced stages of diabetic retinopathy. New imaging modalities should allow further exploration of the contributions of choroidal vessel disease to diabetic eye disease pathogenesis, prognosis, and treatment response.
Collapse
Affiliation(s)
- Jay C Wang
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Inês Laíns
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra University Hospital, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Joana Providência
- Coimbra University Hospital, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Grayson W Armstrong
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Ana R Santos
- Association for Innovation and Biomedical Research on Light, Coimbra, Portugal; School of Allied Health Technologies, Polytechnic Institute of Porto, Porto, Portugal
| | - Pedro Gil
- Coimbra University Hospital, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - João Gil
- Coimbra University Hospital, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Katherine E Talcott
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - João H Marques
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Figueira
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra University Hospital, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Demetrios G Vavvas
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Ivana K Kim
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra University Hospital, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
135
|
Moreira DS, Longo KM, Freitas SR, Yamasoe MA, Mercado LM, Rosário NE, Gloor E, Viana RSM, Miller JB, Gatti LV, Wiedemann KT, Domingues LKG, Correia CCS. Modeling the radiative effects of biomass burning aerosols on carbon fluxes in the Amazon region. Atmos Chem Phys 2017; 17:14785-14810. [PMID: 32647529 PMCID: PMC7346277 DOI: 10.5194/acp-17-14785-2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Every year, a dense smoke haze covers a large portion of South America originating from fires in the Amazon Basin and central parts of Brazil during the dry biomass burning season between August and October. Over a large portion of South America, the average aerosol optical depth at 550 nm exceeds 1.0 during the fire season, while the background value during the rainy season is below 0.2. Biomass burning aerosol particles increase scattering and absorption of the incident solar radiation. The regional-scale aerosol layer reduces the amount of solar energy reaching the surface, cools the near-surface air, and increases the diffuse radiation fraction over a large disturbed area of the Amazon rainforest. These factors affect the energy and CO2 fluxes at the surface. In this work, we applied a fully integrated atmospheric model to assess the impact of biomass burning aerosols in CO2 fluxes in the Amazon region during 2010. We address the effects of the attenuation of global solar radiation and the enhancement of the diffuse solar radiation flux inside the vegetation canopy. Our results indicate that biomass burning aerosols led to increases of about 27% in the gross primary productivity of Amazonia and 10% in plant respiration as well as a decline in soil respiration of 3%. Consequently, in our model Amazonia became a net carbon sink; net ecosystem exchange during September 2010 dropped from +101 to -104 TgC when the aerosol effects are considered, mainly due to the aerosol diffuse radiation effect. For the forest biome, our results point to a dominance of the diffuse radiation effect on CO2 fluxes, reaching a balance of 50-50% between the diffuse and direct aerosol effects for high aerosol loads. For C3 grasses and savanna (cerrado), as expected, the contribution of the diffuse radiation effect is much lower, tending to zero with the increase in aerosol load. Taking all biomes together, our model shows the Amazon during the dry season, in the presence of high biomass burning aerosol loads, changing from being a source to being a sink of CO2 to the atmosphere.
Collapse
Affiliation(s)
- Demerval S. Moreira
- Universidade Estadual Paulista (UNESP), Faculdade de Ciências, Bauru, SP, Brazil
- Centro de Meteorologia de Bauru (IPMet), Bauru, SP, Brazil
| | - Karla M. Longo
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais (INPE), Cachoeira Paulista, SP, Brazil
| | - Saulo R. Freitas
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais (INPE), Cachoeira Paulista, SP, Brazil
| | - Marcia A. Yamasoe
- Departamento de Ciências Atmosféricas do Institudo de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Lina M. Mercado
- Geography, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
- Centre for Ecology and Hydrology (CEH), Wallingford, UK
| | - Nilton E. Rosário
- Universidade Federal de São Paulo (UNIFESP), Campus Diadema, Diadema, SP, Brazil
| | - Emauel Gloor
- School of Geography, University of Leeds, Woodhouse Lane, Leeds, UK
| | - Rosane S. M. Viana
- Departamento de Matemática, Universidade Federal de Viçosa (UFV), Viçosa, MG, Brazil
| | - John B. Miller
- Global Monitoring Division, Earth System Research Laboratory, National Oceanic and Atmospheric Administration (NOAA), Boulder, Colorado 80305, USA
| | - Luciana V. Gatti
- Centro de Ciências do Sistema Terrestre, Instituto Nacional de Pesquisas Espaciais (INPE), São José dos Campos, SP, Brazil
- Instituto de Pesquisas Energéticas e Nucleares (IPEN), Comissão Nacional de Energia Nuclear (CNEN), São Paulo, Brazil
| | - Kenia T. Wiedemann
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, USA
| | - Lucas K. G. Domingues
- Centro de Ciências do Sistema Terrestre, Instituto Nacional de Pesquisas Espaciais (INPE), São José dos Campos, SP, Brazil
- Instituto de Pesquisas Energéticas e Nucleares (IPEN), Comissão Nacional de Energia Nuclear (CNEN), São Paulo, Brazil
| | - Caio C. S. Correia
- Centro de Ciências do Sistema Terrestre, Instituto Nacional de Pesquisas Espaciais (INPE), São José dos Campos, SP, Brazil
- Instituto de Pesquisas Energéticas e Nucleares (IPEN), Comissão Nacional de Energia Nuclear (CNEN), São Paulo, Brazil
| |
Collapse
|
136
|
Affiliation(s)
- Miin Roh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston MA, USA
| | - Nahyoung Grace Lee
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston MA, USA
| | - John B. Miller
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston MA, USA
| |
Collapse
|
137
|
Gaier ED, Gilbert AL, Cestari DM, Miller JB. Optical coherence tomographic angiography identifies peripapillary microvascular dilation and focal non-perfusion in giant cell arteritis. Br J Ophthalmol 2017; 102:1141-1146. [PMID: 29122818 DOI: 10.1136/bjophthalmol-2017-310718] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/28/2017] [Accepted: 10/20/2017] [Indexed: 11/03/2022]
Abstract
AIMS We set out to determine the optical coherence tomographic angiography (OCT-A) characteristics of arteritic anterior ischaemic optic neuropathy (AAION) in the context of giant cell arteritis (GCA). METHODS This is an observational case series of four patients with AAION secondary to GCA, three with unilateral AAION and one with bilateral AAION. We reviewed the charts, fundus photography, visual fields, fluorescein angiography (FA) and OCT-A images for all patients to identify a unifying theme in a range of AAION clinical severity. Imaging of two healthy control eyes from two patients of similar age to the patients in our series were used for comparison. RESULTS Superficial peripapillary capillary dilation was seen in eyes with acute AAION. It was also noted in the fellow eyes of two patients. Retinal capillary perfusion defects corresponded to visual field loss. Dense optic disc oedema and cotton-wool spots imparted blockage effects. OCT-A laminar analysis did not highlight the choroidal/choriocapillaris perfusion defects seen on FA in two patients. Follow-up OCT-A was obtained in two patients and revealed progression to superficial peripapillary capillary attenuation that corresponded with visual field loss. CONCLUSIONS There are acute and chronic vascular changes in AAION that are detectable by OCT-A that correspond with visual function. Though the microvascular changes seen in GCA and AAION are not specific, the nearly ubiquitous findings among preclinical and clinically affected eyes in this series of patients with GCA support OCT-A as a potentially useful adjunctive diagnostic test in the work-up of ambiguous cases of suspected ischaemic optic neuropathy.
Collapse
Affiliation(s)
- Eric D Gaier
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Aubrey L Gilbert
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Dean M Cestari
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - John B Miller
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
138
|
Oellers P, Laíns I, Mach S, Garas S, Kim IK, Vavvas DG, Miller JW, Husain D, Miller JB. Novel grid combined with peripheral distortion correction for ultra-widefield image grading of age-related macular degeneration. Clin Ophthalmol 2017; 11:1967-1974. [PMID: 29184386 PMCID: PMC5687493 DOI: 10.2147/opth.s143246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Eyes with age-related macular degeneration (AMD) often harbor pathological changes in the retinal periphery and perimacular region. These extramacular changes have not been well classified, but may be phenotypically and functionally relevant. The purpose of this study was to demonstrate a novel grid to systematically study peripheral retinal abnormalities in AMD using geometric distortion-corrected ultra-widefield (UWF) imaging. Methods This is a cross-sectional observational case series. Consecutive patients with AMD without any other coexisting vitreoretinal disease and control patients over age 50 without AMD or any other vitreoretinal disease were imaged using Optos 200 Tx. Captured 200° UWF images were corrected for peripheral geometric distortion using Optos transformation software. A newly developed grid to study perimacular and peripheral abnormalities in AMD was then projected onto the images. Results Peripheral and perimacular changes such as drusen, retinal pigment epithelium changes and atrophy were found in patients with AMD. The presented grid in conjunction with geometric distortion-corrected UWF images allowed for systematic study of these peripheral changes in AMD. Conclusion We present a novel grid to study peripheral and posterior pole changes in AMD. The grid is unique in that it adds a perimacular zone, which may be important in characterizing certain phenotypes in AMD. Our UWF images were corrected for geometric peripheral distortion to accurately reflect the anatomical dimensions of the retina. This grid offers a reliable and reproducible foundation for the exploration of peripheral retinal pathology associated with AMD.
Collapse
Affiliation(s)
- Patrick Oellers
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Inês Laíns
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Steven Mach
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Shady Garas
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Ivana K Kim
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Demetrios G Vavvas
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Joan W Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Deeba Husain
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
139
|
Roohipoor R, Yaseri M, Teymourpour A, Kloek C, Miller JB, Loewenstein JI. Early Performance on an Eye Surgery Simulator Predicts Subsequent Resident Surgical Performance. J Surg Educ 2017; 74:1105-1115. [PMID: 28434885 DOI: 10.1016/j.jsurg.2017.04.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 03/20/2017] [Accepted: 04/03/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To examine early performance on an eye surgery simulator and its relationship to subsequent live surgical performance in a single large residency program. DESIGN Retrospective study. SETTING Massachusetts Eye and Ear, Harvard Medical School, Department of Ophthalmology. METHODS In a retrospective study, we compared performance of 30 first-year ophthalmology residents on an eye surgery simulator to their surgical skills as third-year residents. Variables collected from the eye surgery simulator included scores on the following modules of the simulator (Eyesi, VRmagic, Mannheim, Germany): antitremor training level 1, bimanual training level 1, capsulorhexis level 1 (configured), forceps training level 1, and navigation training level 1. Subsequent surgical performance was assessed using the total number of phacoemulsification cataract surgery cases for each resident, as well as the number performed as surgeon during residency and scores on global rating assessment of skills in intraocular surgery (GRASIS) scales during the third year of residency. Spearman correlation coefficients were calculated between each of the simulator performance and subsequent surgical performance variables. We also compared variables in a small group of residents who needed extra help in learning cataract surgery to the other residents in the study. MAIN OUTCOME MEASURES Relationships between Eyesi scores early in residency and surgical performance measures in the final year of residency. RESULTS A total of 30 residents had Eyesi data from their first year of residency and had already graduated so that all subsequent surgical performance data were available. There was a significant correlation between capsulorhexis task score on the simulator and total surgeries (r = 0.745, p = 0.008). There was a significant correlation between antitremor training level 1 (r = 0.554, p = 0.040), and forceps training level 1 (r = 0.622, p = 0.023) with primary surgery numbers. There was a significant correlation between forceps training level 1 (r = 0.811, p = 0.002), and navigation training level 1 (r = 0.692, p = 0.013) with total GRASIS score. There was a significant inverse correlation between total GRASIS score and residents in need of extra help (r = -0.358, p = 0.003). CONCLUSION Module scores on an eye surgery simulator early in residency may predict a resident׳s future performance in the operating room. These scores may allow early identification of residents in need of supplemental training in cataract surgery.
Collapse
Affiliation(s)
- Ramak Roohipoor
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; Biostatistic Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Teymourpour
- Biostatistic Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Carolyn Kloek
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - John B Miller
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - John I Loewenstein
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
140
|
Miller JB, Paik JJ. Overlap Syndromes in Inflammatory Myopathies. Curr Treat Options in Rheum 2017. [DOI: 10.1007/s40674-017-0074-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
141
|
Wolkow N, Oellers P, Miller JB. Retinal Whitening After Uncomplicated Cataract Surgery. JAMA Ophthalmol 2017; 135:1117-1118. [PMID: 28750111 DOI: 10.1001/jamaophthalmol.2017.1445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Natalie Wolkow
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - Patrick Oellers
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - John B Miller
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| |
Collapse
|
142
|
Miller JB, Miller TE, Hoffert MJ, Dingle LA, Harwell R, Hayes E. Astronomical time-of-flight photon speedometer. Rev Sci Instrum 2017; 88:094501. [PMID: 28964243 DOI: 10.1063/1.4986226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A dual-band, fiber-optic, photon time-of-flight instrument was developed. Its design was optimized for measuring the velocity of visible photons emanating from relatively dim astronomical sources (apparent magnitude m>12), such as distant galaxies and quasars. We report the first direct photon group velocity measurements for extragalactic objects. The photon group velocity is found to be 3.00±0.03×108 ms-1 and is invariant, within experimental error, over the range of redshifts measured (0≤z≤1.33). This measurement provides additional validation of general relativity and is consistent with the Friedmann-Lemaître-Robertson-Walker and hyperbolic anti-de Sitter metrics but not with the elliptical de Sitter metric.
Collapse
Affiliation(s)
- J B Miller
- Chemistry Department-MS5413, Western Michigan University, Kalamazoo, Michigan 49008, USA
| | - T E Miller
- BlueRad, 108 Titleist Drive, Bluefield, Virginia 24605, USA
| | - M J Hoffert
- Tierra Astronomical Institute, 2364 S. Annadel, Rowland Heights, California 91748, USA
| | - L A Dingle
- Tierra Astronomical Institute, 2364 S. Annadel, Rowland Heights, California 91748, USA
| | - R Harwell
- Tierra Astronomical Institute, 2364 S. Annadel, Rowland Heights, California 91748, USA
| | - E Hayes
- Tierra Astronomical Institute, 2364 S. Annadel, Rowland Heights, California 91748, USA
| |
Collapse
|
143
|
Laíns I, Miller JB, Park DH, Tsikata E, Davoudi S, Rahmani S, Pierce J, Silva R, Chen TC, Kim IK, Vavvas D, Miller JW, Husain D. Structural Changes Associated with Delayed Dark Adaptation in Age-Related Macular Degeneration. Ophthalmology 2017; 124:1340-1352. [PMID: 28501377 DOI: 10.1016/j.ophtha.2017.03.061] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/27/2017] [Accepted: 03/31/2017] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To examine the relationship between dark adaptation (DA) and optical coherence tomography (OCT)-based macular morphology in age-related macular degeneration (AMD). DESIGN Prospective, cross-sectional study. PARTICIPANTS Patients with AMD and a comparison group (>50 years) without any vitreoretinal disease. METHODS All participants were imaged with spectral-domain OCT and color fundus photographs, and then staged for AMD (Age-related Eye Disease Study system). Both eyes were tested with the AdaptDx (MacuLogix, Middletown, PA) DA extended protocol (20 minutes). A software program was developed to map the DA testing spot (2° circle, 5° superior to the fovea) to the OCT B-scans. Two independent graders evaluated the B-scans within this testing spot, as well as the entire macula, recording the presence of several AMD-associated abnormalities. Multilevel mixed-effects models (accounting for correlated outcomes between 2 eyes) were used for analyses. MAIN OUTCOME MEASURES The primary outcome was rod-intercept time (RIT), defined in minutes, as a continuous variable. For subjects unable to reach RIT within the 20 minutes of testing, the value of 20 was assigned. RESULTS We included 137 eyes (n = 77 subjects), 72.3% (n = 99 eyes) with AMD and the remainder belonging to the comparison group. Multivariable analysis revealed that even after adjusting for age and AMD stage, the presence of any abnormalities within the DA testing spot (ß = 4.8, P < 0.001), as well as any abnormalities in the macula (ß = 2.4, P = 0.047), were significantly associated with delayed RITs and therefore impaired DA. In eyes with no structural changes within the DA testing spot (n = 76, 55.5%), the presence of any abnormalities in the remaining macula was still associated with delayed RITs (ß = 2.00, P = 0.046). Presence of subretinal drusenoid deposits and ellipsoid zone disruption were a consistent predictor of RIT, whether located within the DA testing spot (P = 0.001 for both) or anywhere in the macula (P < 0.001 for both). Within the testing spot, the presence of classic drusen or serous pigment epithelium detachment was also significantly associated with impairments in DA (P ≤ 0.018). CONCLUSIONS Our results suggest a significant association between macular morphology evaluated by OCT and time to dark-adapt. Subretinal drusenoid deposits and ellipsoid zone changes seem to be strongly associated with impaired dark adaptation.
Collapse
Affiliation(s)
- Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, AIBILI, Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Dong H Park
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, School of Medicine, Kyungpook National University, South Korea
| | - Edem Tsikata
- Glaucoma Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Samaneh Davoudi
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Safa Rahmani
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Jonathan Pierce
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, AIBILI, Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Teresa C Chen
- Glaucoma Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Ivana K Kim
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Demetrios Vavvas
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
144
|
Laíns I, Wang J, Providência J, Mach S, Gil P, Gil J, Marques M, Armstrong G, Garas S, Barreto P, Kim IK, Vavvas DG, Miller JW, Husain D, Silva R, Miller JB. Choroidal Changes Associated With Subretinal Drusenoid Deposits in Age-related Macular Degeneration Using Swept-source Optical Coherence Tomography. Am J Ophthalmol 2017; 180:55-63. [PMID: 28579063 DOI: 10.1016/j.ajo.2017.05.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 05/23/2017] [Accepted: 05/25/2017] [Indexed: 01/11/2023]
Abstract
PURPOSE To compare choroidal vascular features of eyes with and without subretinal drusenoid deposits (SDD), using swept-source optical coherence tomography (SS OCT). DESIGN Multicenter, cross-sectional study. METHODS We prospectively recruited patients with intermediate age-related macular degeneration (AMD), without other vitreoretinal pathology. All participants underwent complete ophthalmic examination, color fundus photography (used for AMD staging), and spectral-domain OCT (to evaluate the presence of SDD). SS OCT was used to obtain automatic macular choroidal thickness (CT) maps, according to the Early Treatment Diabetic Retinopathy Study (ETDRS) sectors. For data analysis, we considered mean choroidal thickness as the arithmetic mean value of the 9 ETDRS sectors. SS OCT en face images of choroidal vasculature were also captured and converted to binary images. Choroidal vascular density (CVD) was calculated as a percent area occupied by choroidal vessels in a 6-mm-diameter submacular circular. Choroidal vessel volume was calculated by multiplying the average CVD by macular area and CT. Multilevel mixed linear models (to account for the inclusion of 2 eyes of same subject) were performed for analysis. RESULTS We included 186 eyes (n = 118 subjects), 94 (50.5%) presenting SDD. Multiple regression analysis revealed that, controlling for age, eyes with SDD presented a statistically thinner mean CT (ß = -21.9, P = .006) and CT in all the individual ETDRS fields (ß ≤ -18.79, P ≤ .026). Mean choroidal vessel volume was also significantly reduced in eyes with SDD (ß = -0.003, P = .007). No significant associations were observed with mean CVD. CONCLUSION In subjects with intermediate AMD, choroidal thickness and vessel volume are reduced in the presence of subretinal drusenoid deposits.
Collapse
Affiliation(s)
- Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Jay Wang
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Joana Providência
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Steven Mach
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Pedro Gil
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - João Gil
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Marco Marques
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Grayson Armstrong
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Shady Garas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Patrícia Barreto
- Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - Ivana K Kim
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Demetrios G Vavvas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
145
|
Wang JC, Laíns I, Sobrin L, Miller JB. Distinguishing White Dot Syndromes With Patterns of Choroidal Hypoperfusion on Optical Coherence Tomography Angiography. Ophthalmic Surg Lasers Imaging Retina 2017; 48:638-646. [DOI: 10.3928/23258160-20170802-06] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/28/2017] [Indexed: 11/20/2022]
|
146
|
Gaier ED, Miller JB. Retinal Loop Vessel Captured with Optical Coherence Tomography-Angiography. Ophthalmology 2017; 124:1174. [DOI: 10.1016/j.ophtha.2017.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/19/2017] [Indexed: 11/25/2022] Open
|
147
|
Finn AP, Eliott D, Kim LA, Husain D, Wu DM, Young LHY, Kim IK, Andreoli C, Skondra D, Vavvas DG, Miller JB. Characteristics and Outcomes of Simultaneous Bilateral Rhegmatogenous Retinal Detachments. Ophthalmic Surg Lasers Imaging Retina 2017; 47:840-5. [PMID: 27631480 DOI: 10.3928/23258160-20160901-07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 07/19/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To better understand the clinical course and outcomes of simultaneous bilateral retinal detachments managed by modern vitreoretinal surgical techniques. PATIENTS AND METHODS A retrospective review of 21 patients (42 eyes) presenting between April 2000 and June 2015 with simultaneous bilateral rhegmatogenous retinal detachments. RESULTS Mean visual acuity (VA) improved from 20/100 at presentation to 20/40 at last follow-up (P = .01). The mean final VA for patients undergoing scleral buckle (SB) alone was 20/30 (log MAR 0.17), pars plana vitrectomy (PPV) alone was 20/40 (logMAR 0.33), and combined PPV/SB was 20/80 (logMAR 0.59) (P = .019). Primary reattachment rate in this series was 98%. CONCLUSION In contrast to prior studies, which investigated the management of simultaneous bilateral retinal detachments primarily by SB alone, multiple treatment modalities were utilized in this study, including vitrectomy alone, and overall success of retinal detachment repair was high regardless of treatment modality chosen. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:840-845.].
Collapse
|
148
|
Laíns I, Duarte D, Barros AS, Martins AS, Gil J, Miller JB, Marques M, Mesquita T, Kim IK, Cachulo MDL, Vavvas D, Carreira IM, Murta JN, Silva R, Miller JW, Husain D, Gil AM. Human plasma metabolomics in age-related macular degeneration (AMD) using nuclear magnetic resonance spectroscopy. PLoS One 2017; 12:e0177749. [PMID: 28542375 PMCID: PMC5436712 DOI: 10.1371/journal.pone.0177749] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/02/2017] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To differentiate the plasma metabolomic profile of patients with age related macular degeneration (AMD) from that of controls, by Nuclear Magnetic Resonance (NMR) spectroscopy. METHODS Two cohorts (total of 396 subjects) representative of central Portugal and Boston, USA phenotypes were studied. For each cohort, subjects were grouped according to AMD stage (early, intermediate and late). Multivariate analysis of plasma NMR spectra was performed, followed by signal integration and univariate analysis. RESULTS Small changes were detected in the levels of some amino acids, organic acids, dimethyl sulfone and specific lipid moieties, thus providing some biochemical information on the disease. The possible confounding effects of gender, smoking history and age were assessed in each cohort and found to be minimal when compared to that of the disease. A similar observation was noted in relation to age-related comorbidities. Furthermore, partially distinct putative AMD metabolite fingerprints were noted for the two cohorts studied, reflecting the importance of nutritional and other lifestyle habits in determining AMD metabolic response and potential biomarker fingerprints. Notably, some of the metabolite changes detected were noted as potentially differentiating controls from patients diagnosed with early AMD. CONCLUSION For the first time, this study showed metabolite changes in the plasma of patients with AMD as compared to controls, using NMR. Geographical origins were seen to affect AMD patients´ metabolic profile and some metabolites were found to be valuable in potentially differentiating controls from early stage AMD patients. Metabolomics has the potential of identifying biomarkers for AMD, and further work in this area is warranted.
Collapse
Affiliation(s)
- Inês Laíns
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, United States
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Daniela Duarte
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - António S. Barros
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Ana Sofia Martins
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - João Gil
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - John B. Miller
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, United States
| | - Marco Marques
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Tânia Mesquita
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Ivana K. Kim
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, United States
| | - Maria da Luz Cachulo
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Demetrios Vavvas
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, United States
| | | | - Joaquim N. Murta
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Joan W. Miller
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, United States
| | - Deeba Husain
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, United States
| | - Ana M. Gil
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, Aveiro, Portugal
- * E-mail:
| |
Collapse
|
149
|
Chen X, Miller JB, Eliott D. Recurrent Macular Detachment Due to Occult Retinal Break in a Patient With Optic Disc Pit. Ophthalmic Surg Lasers Imaging Retina 2017; 48:432-434. [PMID: 28499056 DOI: 10.3928/23258160-20170428-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 01/25/2017] [Indexed: 11/20/2022]
Abstract
Serous macular detachment occurs in nearly 50% of eyes with optic disc pit. These macular detachments have been historically difficult to treat. The authors report a case of macular retinal detachment due to an occult juxtapapillary retinal break in a patient with optic disc pit refractory to prior treatments. This case demonstrates that a presumed serous detachment associated with an optic disc pit may have a rhegmatogenous etiology. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:432-434.].
Collapse
|
150
|
Gaier ED, Miller JB, Loewenstein JI. Combined Central Retinal Vein Occlusion and Central Retinal Arterial Obstruction with Cilioretinal Artery Sparing. Ophthalmology 2017; 124:576. [DOI: 10.1016/j.ophtha.2016.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 10/20/2016] [Indexed: 11/29/2022] Open
|