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Glacet-Bernard A, Miere A, Houmane B, Tilleul J, Souied E. NONPERFUSION ASSESSMENT IN RETINAL VEIN OCCLUSION: Comparison Between Ultra-widefield Fluorescein Angiography and Widefield Optical Coherence Tomography Angiography. Retina 2021; 41:1202-1209. [PMID: 33105298 DOI: 10.1097/iae.0000000000002993] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare widefield optical coherence tomography angiography (OCTA) to ultra-widefield fluorescein angiography (UWFA) in the assessment of nonperfusion in retinal vein occlusion (RVO). METHODS A cross-sectional study of 43 eyes of 43 patients with RVO examined using both widefield OCTA (PLEX Elite, Carl Zeiss Meditec, Dublin, CA) with a panoramic montage of five 12 × 12-mm images and UWFA (Optos, 200°). Qualitative analysis was performed according to nonperfusion areas (cutoff: three disk areas) on widefield OCTA. The quantitative analysis assessed the vascular density on the widefield OCTA and ischemic index on UWFA. RESULTS The ischemic index on UWFA and vascular density in the superficial and deep plexus correlated significantly (P = 0.019, r = 0.357 and P < 0.013, r = 0.375, respectively). The qualitative classification on widefield OCTA and ischemic index on UWFA correlated significantly (P < 0.001, r = 0.618). For the detection of marked nonperfusion (ischemic index ≥ 25%), widefield OCTA had a sensitivity of 100% and a specificity of 64.9%. CONCLUSION The presence of nonperfusion on UWFA correlated with widefield OCTA. Optical coherence tomography angiography could help to identify high-risk RVO patients who might benefit from a further evaluation using fluorescein angiography.
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Affiliation(s)
- Agnès Glacet-Bernard
- Department of Ophthalmology, Intercommunal Hospital Center and Henri Mondor Hospital, Paris-Est Créteil University (UPEC, Paris XII University), Créteil, France
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Arslan GD, Guven D, Demir M, Alkan AA, Ozcan D. Microvascular and functional changes according to the fundus location of the affected arteriovenous crossing in patients with branch retinal vein occlusion. Indian J Ophthalmol 2021; 69:1189-1196. [PMID: 33913857 PMCID: PMC8186628 DOI: 10.4103/ijo.ijo_1018_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the structural and functional changes occurring in patients with branch retinal vein occlusion (BRVO) according to the distance of the affected arteriovenous (AV) crossing to the centers of the fovea and optic disc by optic coherence tomography angiography (OCTA). Methods: Forty-five patients with unilateral BRVO and 45 age- and sex-matched healthy controls were included in this retrospective observational study. Images of the macula (3 mm × 3 mm) and affected AV crossing sites were obtained by OCTA. The fovea-AV crossing distance (FAVD), optic disc-AV crossing distance (DAVD), and optic disc-fovea distance (DFD) were measured. Results: The FAVD/DFD ratio was positively correlated with the vessel density in the superficial and deep affected hemifields (r = 0.430, P < 0.05 and r = 0.308, P < 0.05, respectively) and negatively correlated with the superficial foveal avascular zone and logarithm of the minimum angle of resolution (logMAR) visual acuity (r = –0.412, P < 0.05 and r = –0.356, P < 0.05, respectively). The DAVD/DFD ratio was not correlated with the logMAR visual acuity, superficial FAZ area or vessel densities in the affected hemifield (all P > 0.05). Conclusion: The affected AV crossing site that was further away from the fovea had better visual acuity and quantitative microvascular parameters in the affected hemifields. However, this correlation was not observed for the distance between the affected AV crossing site and the optic disc.
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Affiliation(s)
| | - Dilek Guven
- Department of Ophthalmology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Demir
- Department of Ophthalmology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | | | - Delil Ozcan
- Department of Ophthalmology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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153
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Wang Q, Yang J, Jonas JB, Shi X, Wu S, Chen S, Yan Y, Zhou W, Dong L, Wei W, Wang YX. Prevalence of Retinal Vein Occlusions and Estimated Cerebrospinal Fluid Pressure: The Kailuan Eye Study. Eye Brain 2021; 13:147-156. [PMID: 34045911 PMCID: PMC8149277 DOI: 10.2147/eb.s290107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/23/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the prevalence of retinal vein occlusions (RVOs) and associated factors in a Chinese population. Patients and Methods The cross-sectional community-based Kailuan Eye Study included individuals who participated in the Kailuan Study. RVOs were diagnosed on the fundus photographs. Estimated cerebrospinal fluid pressure (eCSFP) was calculated as “eCSFP=0.44*Body Mass Index+0.16*Diastolic Blood Pressure-0.18*Age”. Results The study included 12,499 participants with a mean age of 52.9±13.1 years. The overall prevalence of RVO was 120/12,499 or 0.96%, with branch RVOs observed in 116/12,499 individuals and central RVOs in 4/12,499 individuals. RVOs started at the optic disc in 19 participants (15.8% of all RVOs), and in 101 (84.2%) individuals arterio-venous crossings outside the optic disc. In multivariable analysis, a higher RVO prevalence was associated with older age (P<0.001), higher eCSFP (P<0.001), and higher fasting serum glucose concentration (P<0.001). Differentiating between RVOs at arterio-venous crossings and RVOs at the optic disc revealed that the prevalence of both RVO types was associated with higher eCSFP (P<0.001 and P=0.004, respectively) after adjusting for age and fasting serum glucose concentration. Conclusion In this adult Chinese population recruited on a community basis, the prevalence of any RVO (mean: 0.96) was associated with older age, higher eCSFP and higher fasting serum glucose concentration. Higher eCSFP may play an etiologic role in RVOs.
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Affiliation(s)
- Qian Wang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jingyan Yang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karis-University, Mannheim, Germany
| | - Xuehui Shi
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Shouling Wu
- Cardiology Department, Kailuan General Hospital, Tangshan, People's Republic of China
| | - Shuohua Chen
- Health Care Center, Kailuan Group, Tangshan, People's Republic of China
| | - Yanni Yan
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Wenjia Zhou
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Li Dong
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology and Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
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Kazantzis D, Theodossiadis P, Kroupis C, Theodossiadis G, Chatziralli I. Vitamin B12 and Folate as Risk Factors for Retinal Vein Occlusion: A Meta-Analysis. Klin Monbl Augenheilkd 2021; 239:709-716. [PMID: 34000749 DOI: 10.1055/a-1473-5897] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate the association between serum vitamin B12/folate and retinal vein occlusion (RVO). METHODS A comprehensive search of the PubMed database was performed, which identified 271 abstracts to be screened. Ten studies met our inclusion criteria and a meta-analysis of these comparative case-control studies was performed on the mean ± standard deviation serum vitamin B12 and folate levels, without language restrictions. Nine studies with 720 patients with RVO and 613 controls were included in the meta-analysis for vitamin B12, and 10 studies with 784 patients with RVO and 677 controls in the meta-analysis for folate. RESULTS There was no statistically significant difference between patients with RVO and controls in serum vitamin B12 levels (mean difference: - 40.25 pg/mL, p = 0.28), either central RVO (mean difference: - 18.24 pg/mL, p = 0.71) or branch RVO (mean difference: - 23.56 pg/mL, p = 0.48). On the contrary, the plasma folate level was significantly lower in RVO patients than in controls (mean difference: - 1.34 ng/mL, p = 0.001), as well as in patients with CRVO compared to controls (mean difference: - 1.48 ng/mL, p = 0.006), but not in BRVO patients (mean difference: - 0.72 ng/mL, p = 0.11). CONCLUSIONS RVO is associated with low serum folate levels, but not with serum vitamin B12 levels.
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Affiliation(s)
- Dimitrios Kazantzis
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Christos Kroupis
- Department of Clinical Biochemistry, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - George Theodossiadis
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Irini Chatziralli
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
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155
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Li Y, Hall NE, Pershing S, Hyman L, Haller JA, Lee AY, Lee CS, Chiang M, Lum F, Miller JW, Lorch A, Elze T. Age, Gender, and Laterality of Retinal Vascular Occlusion: A Retrospective Study from the IRIS® Registry. Ophthalmol Retina 2021; 6:161-171. [PMID: 33991710 DOI: 10.1016/j.oret.2021.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/17/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Retinal vascular occlusion is a leading cause of profound irreversible visual loss, but the understanding of the disease is insufficient. We systematically investigated the age, gender, and laterality at the onset of retinal artery occlusion (RAO) and retinal vein occlusion (RVO) in the Intelligent Research in Sight (IRIS®) Registry. DESIGN Retrospective registry cohort. PARTICIPANTS Patients with retinal vascular occlusion participating in the IRIS® Registry. METHODS Patients who received a diagnosis of retinal vascular occlusion between 2013 and 2017 were included. Those with unspecified gender or laterality were excluded when conducting the relevant analyses. Patients were categorized into RAO, with subtypes transient retinal artery occlusion (TRAO), partial retinal artery occlusion (PRAO), branch retinal artery occlusion (BRAO), and central retinal artery occlusion (CRAO), and into RVO, with subtypes venous engorgement (VE), branch retinal vein occlusion (BRVO), and central retinal vein occlusion (CRVO). Age was evaluated as a categorical variable (5-year increments). We investigated the association of age, gender, and laterality with the onset frequency of retinal vascular occlusion subtypes. MAIN OUTCOME MEASURES The frequency of onset of RAO and RVO subtypes by age, gender and laterality. RESULTS A total of 1 251 476 patients with retinal vascular occlusion were included, 23.8% of whom had RAO, whereas 76.2% had RVO. Of these, 1 248 656 and 798 089 patients were selected for analyses relevant to gender and laterality, respectively. The onset frequency of all subtypes increased with age. PRAO, BRAO, CRAO, and CRVO presented more frequently in men (53.5%, 51.3%, 52.6%, and 50.4%, respectively), whereas TRAO, VE, and BRVO presented more frequently in women (54.9%, 56.0%, and 54.5% respectively). All RAO subtypes and BRVO showed a right-eye onset preference (TRAO, 51.7%; PRAO, 54.4%; BRAO, 53.5%; CRAO, 53.4%; and BRVO, 51.0%), whereas VE and CRVO exhibited a left-eye onset preference (53.3% and 50.9%, respectively). CONCLUSIONS Although retinal vascular occlusion incidence increases with age regardless of subtypes, we found various subtype-specific disease-onset differences related to gender and, in particular, ocular laterality. These findings may improve understanding of the specific cause of retinal vascular occlusions of different subtypes and their relationships with structural and anatomic asymmetries of the vascular system.
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Affiliation(s)
- Yangjiani Li
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Nathan E Hall
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Suzann Pershing
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, USA; Department of Ophthalmology, VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Leslie Hyman
- Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | | | - Aaron Y Lee
- eScience Institute, University of Washington, Seattle, Washington, USA; Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | - Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | - Michael Chiang
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Flora Lum
- American Academy of Ophthalmology, San Francisco, California, USA
| | - Joan W Miller
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Alice Lorch
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Tobias Elze
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
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156
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Lee CS, Lee ML, Gibbons LE, Yanagihara RT, Blazes M, Kam JP, McCurry SM, Bowen JD, McCormick WC, Lee AY, Larson EB, Crane PK. Associations Between Retinal Artery/Vein Occlusions and Risk of Vascular Dementia. J Alzheimers Dis 2021; 81:245-253. [PMID: 33749651 DOI: 10.3233/jad-201492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Vascular disease is a risk factor for Alzheimer's disease (AD) and related dementia in older adults. Retinal artery/vein occlusion (RAVO) is an ophthalmic complication of systemic vascular pathology. Whether there are associations between RAVO and dementia risk is unknown. OBJECTIVE To determine whether RAVOs are associated with an increased risk of developing vascular dementia or AD. METHODS Data from Adult Changes in Thought (ACT) study participants were analyzed. This prospective, population-based cohort study followed older adults (age ≥65 years) who were dementia-free at enrollment for development of vascular dementia or AD based on research criteria. RAVO diagnoses were extracted from electronic medical records. Cox-regression survival analyses were stratified by APOEɛ4 genotype and adjusted for demographic and clinical factors. RESULTS On review of 41,216 person-years (4,743 participants), 266 (5.6%) experienced RAVO. APOEɛ4 carriers who developed RAVO had greater than four-fold higher risk for developing vascular dementia (Hazard Ratio [HR] 4.54, 95% Confidence Interval [CI] 1.86, 11.10, p = 0.001). When including other cerebrovascular disease (history of carotid endarterectomy or transient ischemic attack) in the model, the risk was three-fold higher (HR 3.06, 95% CI 1.23, 7.62). No other conditions evaluated in the secondary analyses were found to confound this relationship. There was no effect in non-APOEɛ4 carriers (HR 1.03, 95% CI 0.37, 2.80). There were no significant associations between RAVO and AD in either APOE group. CONCLUSION Older dementia-free patients who present with RAVO and carry the APOEɛ4 allele appear to be at higher risk for vascular dementia.
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Affiliation(s)
- Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Michael L Lee
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Laura E Gibbons
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ryan T Yanagihara
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Marian Blazes
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Jason P Kam
- Kaiser Permanente Washington, Seattle, WA, USA
| | - Susan M McCurry
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, USA
| | - James D Bowen
- Department of Neurology, Swedish Medical Center, Seattle, WA, USA
| | | | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
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157
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Chatzirallis A, Varaklioti A, Sergentanis TN, Theodossiadis P, Chatziralli I. Quality of Life among Patients with Retinal Vein Occlusion: A Case-Control Study. Semin Ophthalmol 2021; 36:658-664. [PMID: 33684018 DOI: 10.1080/08820538.2021.1896750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: The purpose of this study was to evaluate health-related quality of life in patients with retinal vein occlusion (RVO) and investigate the possible risk factors for poor quality of life in patients with RVO.Methods: Participants in the study were 67 patients with RVO, 42 male and 25 female, mean-aged 73.1 ± 10.9 years, and 70 sex- and age-matched controls. Demographic data, lifestyle factors and medical history were recorded. All patients underwent best-corrected visual acuity measurement, dilated fundoscopy and optical coherence tomography. All participants completed two questionnaires assessing quality of life (EQ-5D, NEI VFQ-25). Risk factors for health-related quality of life in RVO patients were investigated.Results: Patients with RVO exhibited significantly lower composite score for VFQ-25 compared to controls (74.1 ± 3.8 vs. 91.7 ± 3.9 for patients and controls, respectively, p < .001). In addition, RVO patients had significantly lower EQ-5D Index score compared to controls (0.88 ± 0.15 vs. 0.92 ± 0.12 for patients and controls, respectively, p = .043). Risk factors associated with quality of life in patients with RVO were found the alcohol consumption, the presence of thyroidopathy, coagulation disorders, visual acuity in the eye with RVO, central retinal thickness, the type of edema, the presence of ischemia and the condition of external limiting membrane. In multivariate analysis, only alcohol consumption and visual acuity in the eye with RVO were found to be independent risk factors, affecting quality of life in RVO patients.Conclusions: Patients with RVO presented lower quality of life in comparison with controls. Potential risk factors should be taken into account and their early detection may improve quality of life in such patients and lead to targeted health policies.
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Affiliation(s)
- Alexandros Chatzirallis
- Faculty of Social Sciences, Department of Health Management, Hellenic Open University, Patras, Greece
| | - Agoritsa Varaklioti
- Faculty of Social Sciences, Department of Health Management, Hellenic Open University, Patras, Greece
| | - Theodoros N Sergentanis
- Faculty of Social Sciences, Department of Health Management, Hellenic Open University, Patras, Greece
| | | | - Irini Chatziralli
- 2 Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
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158
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Koch R, Seto B, Yamada K, Atreay P, Lemire CA, Hazra N, Arroyo JG. Relative Retinal Blood Flow: A Novel and Informative Measure of Unilateral Retinal Vein Occlusion Severity. Transl Vis Sci Technol 2021; 10:15. [PMID: 34003949 PMCID: PMC7961123 DOI: 10.1167/tvst.10.3.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose This study quantifies retinal vascular blood flow affected by unilateral central or branch retinal vein occlusion (CRVO or BRVO). We created a new, unitless metric for the severity of these diseases—relative blood flow (RBF)—and contextualized it with subject demographics, ocular presentation, and systemic conditions. Finally, we explored its efficacy as a predictor of future outcomes. Methods Data were collected from 20 control subjects and 32 clinically diagnosed CRVO (n = 15) or BRVO (n = 17) patients. We used laser speckle flowgraphy to quantify blood flow as mean blur rate and present RBF as the ratio between the blood flow in a subject's diseased and undiseased eyes. Because of our demonstration that blood flow has high intrapatient (between eyes and over time) but low interpatient correlation in eyes of healthy subjects, any differences between eyes can be attributed to the disease. These data were correlated with subject demographics and disease characteristics. Results In CRVO and BRVO eyes, average blood flow decreased by 26% and 7%, respectively. In CRVO, occlusion duration, central macular thickness, intraocular pressure, diabetes, previous laser and injection treatments, and injection within three months after measurement were significantly associated with RBF. In BRVO, no significant associations with RBF were found. Conclusions Blood flow in CRVO and BRVO was reduced compared to the unaffected fellow eye in most patients. RBF was useful in determining the severity of RVOs and predicting future treatment needs. Translational Relevance RBF is a promising new and informative metric for quantifying the severity of unilateral RVOs.
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Affiliation(s)
- Rachelle Koch
- Division of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Brendan Seto
- Division of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Keiko Yamada
- Division of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Purva Atreay
- Division of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Colin A Lemire
- Division of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Nina Hazra
- Division of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Jorge G Arroyo
- Division of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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159
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Laíns I, Wang JC, Cui Y, Katz R, Vingopoulos F, Staurenghi G, Vavvas DG, Miller JW, Miller JB. Retinal applications of swept source optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Prog Retin Eye Res 2021; 84:100951. [PMID: 33516833 DOI: 10.1016/j.preteyeres.2021.100951] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 02/08/2023]
Abstract
The advent of optical coherence tomography (OCT) revolutionized both clinical assessment and research of vitreoretinal conditions. Since then, extraordinary advances have been made in this imaging technology, including the relatively recent development of swept-source OCT (SS-OCT). SS-OCT enables a fast scan rate and utilizes a tunable swept laser, thus enabling the incorporation of longer wavelengths than conventional spectral-domain devices. These features enable imaging of larger areas with reduced motion artifact, and a better visualization of the choroidal vasculature, respectively. Building on the principles of OCT, swept-source OCT has also been applied to OCT angiography (SS-OCTA), thus enabling a non-invasive in depth-resolved imaging of the retinal and choroidal microvasculature. Despite their advantages, the widespread use of SS-OCT and SS-OCTA remains relatively limited. In this review, we summarize the technical details, advantages and limitations of SS-OCT and SS-OCTA, with a particular emphasis on their relevance for the study of retinal conditions. Additionally, we comprehensively review relevant studies performed to date to the study of retinal health and disease, and highlight current gaps in knowledge and opportunities to take advantage of swept source technology to improve our current understanding of many medical and surgical chorioretinal conditions. We anticipate that SS-OCT and SS-OCTA will continue to evolve rapidly, contributing to a paradigm shift to more widespread adoption of new imaging technology to clinical practice.
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Affiliation(s)
- Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Jay C Wang
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Ying Cui
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA; Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Raviv Katz
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Filippos Vingopoulos
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", University of Milan, Italy
| | - Demetrios G Vavvas
- 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
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA.
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160
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Hikage F, Furuhashi M, Ida Y, Ohguro H, Watanabe M, Suzuki S, Itoh K. Fatty acid-binding protein 4 is an independent factor in the pathogenesis of retinal vein occlusion. PLoS One 2021; 16:e0245763. [PMID: 33503066 PMCID: PMC7840053 DOI: 10.1371/journal.pone.0245763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/07/2021] [Indexed: 01/11/2023] Open
Abstract
The main objective of current study was to identify the fatty acid-binding protein 4 (FABP4) expressed in both adipocytes and macrophages in vitreous fluid from patients with retinal vein occlusion (RVO). Patients with RVO (n = 14, CRVO; central RVO n = 5, BRVO; branch RVO n = 9) and non-RVO (macular hole or epiretinal membrane, n = 18) were surgically treated by a 25 or 27G vitrectomy. Undiluted vitreous fluid samples obtained as the result of surgery were subjected to enzyme-linked immunosorbent assays to measure the levels of FABP4 and vascular endothelial growth factor A (VEGFA).Data including ocular blood flow by laser speckle flow graphy (LSFG), height and weight, systemic blood pressures and several blood biochemistry values were collected. Among the LSFG mean blur rate (MBR) values of the optic nerve head (ONH) at baseline, MA (MBR of all area), MV (MBR of the vascular area), and MV-MT (MBR of the tissue area) were significantly decreased in patients with CRVO. The levels of V-FABP4 and V-VEGFA were relatively or significantly (P< 0.05) higher in the BRVO or CRVO patients compared to the non-RVO patients, respectively. A positive correlation (r = 0.36, P = 0.045) or a negative correlation (r = -0.51, P = 0.006) was observed between Log V-FABP4 and Log V-VEGF, or Log V-FABP4 and MV-MT at post-operative 1-week, respectively. Furthermore, neither of these factors were affected with respect to sex, body mass index and several clinical parameters that were collected, except that a positive correlation was observed for Log V-FABP4 with blood urea nitrogen. Stepwise multivariable regression analyses indicated that MV-MT at post-operative 1week was independently associated with Log V-FABP4 after adjustment for age and gender, and gender and Log V-FABP4 were independently associated with Log V-VEGFA after adjustment for age. The findings reported herein suggest that an independent factor, FABP4 may be synergistically involved in the pathogenesis of RVO with VEGFA.
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Affiliation(s)
- Fumihito Hikage
- Departments of Ophthalmology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masato Furuhashi
- Departments of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yosuke Ida
- Departments of Ophthalmology, Sapporo Medical University School of Medicine, Sapporo, Japan
- * E-mail:
| | - Hiroshi Ohguro
- Departments of Ophthalmology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Megumi Watanabe
- Departments of Ophthalmology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Soma Suzuki
- Departments of Ophthalmology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kaku Itoh
- Departments of Ophthalmology, Sapporo Medical University School of Medicine, Sapporo, Japan
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161
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Turczyńska MJ, Krajewski P, Brydak-Godowska JE. Wide-Field Fluorescein Angiography in the Diagnosis and Management of Retinal Vein Occlusion: A Retrospective Single-Center Study. Med Sci Monit 2021; 27:e927782. [PMID: 33449920 PMCID: PMC7814513 DOI: 10.12659/msm.927782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this retrospective study was to evaluate the role of wide-field fluorescein angiography (WF-FA) in the diagnosis and management of retinal vein occlusion (RVO) at a single center in Poland. Material/Methods This study included 106 patients (112 eyes) diagnosed with RVO (102 eyes) or impending RVO (10 eyes) (54% women and 46% men, aged 26 to 86 years). The medical records of the participants were reviewed in search of documentation on ocular and systemic diseases. Results of FA of central and peripheral retina and optical coherence tomography (OCT) scans, which had been used to establish treatment indications, were analyzed. WF-FA was performed with Spectralis HRA+OCT or Optos Tx200. Results Actual RVO was found in 102 eyes. Of those cases, 46.1% were CRVO (central retinal vein occlusion), 40.2% branch retinal vein occlusion, 11.8% small tributary vein occlusion, and 1.9% hemispheric retinal vein occlusion. Neovascularization on an optic disc, neovascularization elsewhere, and veno-venous collateral vessels were observed in 32.3%, 17.4%, and 41.2% of the eyes, respectively. Peripheral ischemic zones were present in 59.8% of the eyes, in 20.6% of which, ischemia was not observed in the posterior pole. Dye leaks limited to peripheral vessels, peripheral vascular amputations, and central macular edema in OCT were observed in 17.6%, 43.1%, and 63.7% of the eyes, respectively. Retinal laser photocoagulation was conducted on 73.5% of the eyes. Conclusions Decision-making about management of patients with RVO should be done after physical examination and analysis of central and peripheral retina FA. In 20.6% of patients, assessment of the peripheral retina resulted in a change in treatment. The first changes suggestive of progression of thrombotic disease to the ischemic form appeared on the periphery in images from WF-FA.
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Affiliation(s)
- Monika J Turczyńska
- Department of Ophthalmology, Infant Jesus Clinical Hospital, University Clinical Center, Medical University of Warsaw, Warsaw, Poland
| | - Przemysław Krajewski
- Department of Ophthalmology, Infant Jesus Clinical Hospital, University Clinical Center, Medical University of Warsaw, Warsaw, Poland
| | - Joanna E Brydak-Godowska
- Department of Ophthalmology, Infant Jesus Clinical Hospital, University Clinical Center, Medical University of Warsaw, Warsaw, Poland
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Dourado LFN, Oliveira LG, da Silva CN, Toledo CR, Fialho SL, Jorge R, Silva-Cunha A. Intravitreal ketamine promotes neuroprotection in rat eyes after experimental ischemia. Biomed Pharmacother 2021; 133:110948. [PMID: 33249278 DOI: 10.1016/j.biopha.2020.110948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/13/2020] [Accepted: 10/26/2020] [Indexed: 12/21/2022] Open
Abstract
Retinal ischemia, one of the most common cause of visual loss, is associated with blood flow inadequacy and subsequent tissue injury. In this setting, some treatments that can counteract glutamate increase, arouse interest in ischemic pathogenesis. Ketamine, a potent N-methyl-d-aspartate (NMDA) receptor antagonist, provides a neuroprotective pathway via decreasing the excitotoxicity triggered by excess glutamatergic. Thus, the goal of this study was to evaluate the safety of intravitreal use of ketamine and their potential protective effects on retinal cells in retinal ischemia/reperfusion model. Initially, ketamine toxicity was evaluated by cytotoxicity assay and Hen's egg chorioallantoic membrane (HET-CAM) method. Afterward, some ketamine concentrations were tested in rat's eyes to verify the safety of the intravitreal use. To investigate the neuroprotective effect on retinal, a single intravitreal injection of ketamine in concentrations of 0.059 mmol.L-1 and 0.118 mmol.L-1 was performed one day before the retinal injury by ischemia/reperfusion model. After 7 and 15 days, the retina activity was evaluated by electroretinogram (ERG) records and, lastly, by morphological analyzes. Cytotoxicity assay reveals that the maximum ketamine concentration that could reach retinal pigmented epithelium cells is 0.353 mmol.L-1. HET-CAM assay showed that concentrations above 0.237 mmol.L-1 are irritants to the eye. Thus, Ketamine in concentrations of 0.0237 mmol.L-1, 0.118 mmol.L-1, and 0.059 mmol.L-1 were selected for in vivo toxicity test. ERG records reveal a tendency of b-wave amplitude to decrease as the luminous intensity increased, in the group receiving ketamine at 0.237 mmol.L-1. Therefore, ketamine in concentrations at 0.059 mmol.L-1 and 0.118 mmol.L-1 were chosen for the following tests. In the ischemia retinal degeneration model, pretreatment with ketamine was capable to promote a recovery of retinal electrophysiological function minimizing the ischemic effects. In histological analysis, the groups that received intravitreal ketamine showed a number of retinal cells significantly higher than the vehicle group. In TUNEL assay a reduction on TUNEL-positive cells was observed in all the layers for both concentrations which allow to affirm that ketamine contributes to reducing cell death in the retina. Transmission electron microscopy (TEM) reaffirms this finding. Ketamine intravitreal pretreatment showed reduced ultrastructural changes. Our findings demonstrate that ketamine is safe for intravitreal use in doses up to 0.118 mmol.L-1. They seem to be particularly efficient to protect the retina from ischemic injury.
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Affiliation(s)
- Lays Fernanda Nunes Dourado
- Faculty of Pharmacy, Federal University of Minas Gerais, Pampulha, Av. Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
| | - Lucas Gomes Oliveira
- Faculty of Pharmacy, Federal University of Minas Gerais, Pampulha, Av. Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
| | - Carolina Nunes da Silva
- Faculty of Pharmacy, Federal University of Minas Gerais, Pampulha, Av. Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
| | - Cibele Rodrigues Toledo
- Faculty of Pharmacy, Federal University of Minas Gerais, Pampulha, Av. Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
| | - Silvia Ligório Fialho
- Pharmaceutical Research and Development, Ezequiel Dias Foundation, Rua Conde Pereira Carneiro, 80, Gameleira, Belo Horizonte, Minas Gerais, 30510-010, Brazil.
| | - Rodrigo Jorge
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Ribeirão Preto School of Medicine, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.
| | - Armando Silva-Cunha
- Faculty of Pharmacy, Federal University of Minas Gerais, Pampulha, Av. Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
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Shah SM, Bakri SJ. Obstructive sleep apnea evaluation in retinal vein occlusion patients: an opportunity for multidisciplinary care? Can J Ophthalmol 2020; 55:284-285. [PMID: 32771116 DOI: 10.1016/j.jcjo.2020.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Saumya M Shah
- Mayo Clinic, Department of Ophthalmology, Rochester, MN
| | - Sophie J Bakri
- Mayo Clinic, Department of Ophthalmology, Rochester, MN; Canadian Journal of Ophthalmology (CJO) Section Editor, Retina & Vitreous.
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164
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Romiti GF, Corica B, Borgi M, Visioli G, Pacella E, Cangemi R, Proietti M, Basili S, Raparelli V. Inherited and acquired thrombophilia in adults with retinal vascular occlusion: A systematic review and meta-analysis. J Thromb Haemost 2020; 18:3249-3266. [PMID: 32805772 DOI: 10.1111/jth.15068] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/19/2020] [Accepted: 08/12/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Retinal vascular occlusion is a leading cause of sight loss. Both retinal artery occlusion (RAO) and retinal vein occlusion (RVO) have been associated with hypercoagulable states; however, the burden of thrombophilia in these patients is unclear. OBJECTIVES This study aims at estimating the prevalence of inherited and acquired thrombophilias in adults with RAO or RVO through a systematic review and meta-analysis of the literature. PATIENTS/METHODS PubMed and EMBASE were systematically searched from inception to 29 February 2020. All studies reporting prevalences of factor V Leiden (FVL) and prothrombin (F-II) G20210A mutations, methylenetetrahydrofolate reductase (MTHFR) C677T and plasminogen activator inhibitor (PAI) 4G polymorphisms, antithrombin III (AT-III), protein C (PC) and protein S (PS) activity deficiencies, hyperhomocysteinemia, and antiphospholipid (APL) antibodies in adults with RAO or RVO were included. Pooled prevalences and 95% confidence intervals (CI) were calculated. RESULTS Ninety-five studies were included; FVL and F-II mutations were found in 6% (95% CI: 5-8) and 3% (95% CI: 2-4) of individuals with RVO, respectively, whereas AT-III, PC, and PS activity deficiencies were found in <2%. The MTHFR C677T and PAI 4G homozygous polymorphism were observed in 13% (95% CI: 10-17) and 23% (95% CI: 16-31) of RVO, respectively; 8% presented APL antibodies. Similar findings were observed in individuals with RAO. CONCLUSIONS Compared with healthy subjects, patients with retinal vascular occlusion showed similar prevalences of inherited and acquired thrombophilias. These findings do not support routine thrombophilia screening in individuals with RAO or RVO.
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Affiliation(s)
- Giulio Francesco Romiti
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Bernadette Corica
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Marco Borgi
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Giacomo Visioli
- Department of Sense Organs, Sapienza - University of Rome, Rome, Italy
| | - Elena Pacella
- Department of Sense Organs, Sapienza - University of Rome, Rome, Italy
| | - Roberto Cangemi
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Marco Proietti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Valeria Raparelli
- Department of Experimental Medicine, Sapienza - University of Rome, Rome, Italy
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165
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Jang M, Lee H, Kim HC, Chung H. Two-dimensional Quantitative Effects of Anti-vascular Endothelial Growth Factor and Dexamethasone Implants on Retinal Vein Occlusion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.11.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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166
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Dewan KS, Hentati F, Greenlee TE, Conti TF, Chen AX, Hom GL, Singh RP. Age-related differences in presentation and outcomes of anti-VEGF treatment of retinal vein occlusion. Can J Ophthalmol 2020; 56:96-104. [PMID: 33039322 DOI: 10.1016/j.jcjo.2020.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/03/2020] [Accepted: 09/09/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess age-related differences at baseline and treatment outcomes in patients with retinal vein occlusion (RVO) and macular edema treated with anti-vascular endothelial growth factor (VEGF) therapy DESIGN: Single-centre retrospective chart review. PARTICIPANTS 295 treatment-naïve RVO patients. METHODS 295 RVO patients included were separated into age quartiles: group A (22-61 years), group B (62-70 years), group C (71-79 years), and group D (80-95 years). Outcomes including central subfield thickness (CST), cubic volume, cubic average thickness, and visual acuity (VA) were collected at baseline and at 6 and 12 months after treatment. The primary outcome of the study was the CST at 12 months after anti-VEGF therapy. RESULTS Mean baseline CST for groups A, B, C, and D was 406.3 ± 161.2 μm, 463.4 ± 165.5 μm, 470.6 ± 187 μm, and 427.3 ± 187.2 μm, respectively. No significant differences in CST were observed between groups at baseline, 6 months, or 12 months (p ≥ 0.08). Mean baseline VA for groups A, B, C, and D was 55.8 ± 19.5, 54.4 ± 19.8, 54.7 ± 19, and 51.4 ± 20.4 Early Treatment Diabetic Retinopathy letters, respectively. VA did not differ significantly between age groups at baseline, 6 months, or 12 months (p ≥ 0.06). CONCLUSIONS The presentation of RVO and the visual outcomes of anti-VEGF therapy do not vary based on age.
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Affiliation(s)
- Karan S Dewan
- Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Firas Hentati
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Tyler E Greenlee
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH
| | - Thais F Conti
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH
| | - Andrew X Chen
- Case Western Reserve University School of Medicine, Cleveland, OH; Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH
| | - Grant L Hom
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Rishi P Singh
- Case Western Reserve University School of Medicine, Cleveland, OH; Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH.
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167
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Choi SU, Oh JY, Kim JT. Correlations between choroidal thickness and renal function in patients with retinal vein occlusion. Sci Rep 2020; 10:16865. [PMID: 33033387 PMCID: PMC7545166 DOI: 10.1038/s41598-020-74058-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/03/2020] [Indexed: 12/30/2022] Open
Abstract
The purpose of this study was to analyze the correlation of renal function indices with sub-foveal choroidal thickness (SFChT) in treatment-naïve (naïve) eyes with retinal vein occlusion (RVO) using swept-source optical coherence tomography (SS-OCT) and systemic workup. Retrospective chart review was performed from Dec 2016 to Sep 2019 in patients newly diagnosed with treatment-naïve unilateral RVO. Ocular parameters, including SFChT, and systemic profiles, including renal function indices, were reviewed. Simple and multiple linear regression analyses were performed to check if there was a correlation between renal profiles and SFChT. A total of 56 patients were included in the study; 34 of them were branch RVO and 22 were central RVO patients. Multiple linear regression analysis revealed that SFChT was positively correlated with estimated glomerular filtration rate (eGFR) (P < 0.001). SFChT showed significant correlation with renal function indices. In addition, choroidal thickness may be considered as systemic biomarkers for renal function.
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Affiliation(s)
- Sang Uk Choi
- Department of Ophthalmology, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - Ja Young Oh
- Department of Ophthalmology, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - Jee Taek Kim
- Department of Ophthalmology, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea.
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168
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Park JY, Park SJ, Byun SJ, Woo SJ, Park KH. Twelve-year incidence of retinal vein occlusion and its trend in Korea. Graefes Arch Clin Exp Ophthalmol 2020; 258:2095-2104. [DOI: 10.1007/s00417-020-04811-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 10/24/2022] Open
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Fang LJ, Dong L, Li YF, Wei WB. Retinal vein occlusion and chronic kidney disease: A meta-analysis. Eur J Ophthalmol 2020; 31:1945-1952. [PMID: 32578456 DOI: 10.1177/1120672120937669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We performed this meta-analysis to assess the correlation of retinal vein occlusion (RVO) and chronic kidney disease (CKD). METHODS We searched PubMed, Embase, Web of Science and Cochrane Library for population-based studies reporting the CKD as associated factor to RVO, central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). Then we pooled the data for analysis. RESULTS After screening potential literature, 12 eligible studies with 23,656,214 individuals were finally included in quantitative synthesis. The pooled prevalence (95% confidence interval [CI]) of CKD in RVO group was 10.9% (95% CI: 6.6%, 15.1%). The pooled prevalence of any RVO in end stage renal disease (ESRD) group was 1.8% (95% CI: 1.6%, 2.1%). The prevalence of CKD was significantly higher in subjects diagnosed with RVO than non-RVO participants (odds ratio [OR]: 3.30; 95% CI: 2.28, 4.76; p < 0.001). CRVO subjects had a higher prevalence of CKD than BRVO patients (OR: 2.17; 95% CI: 1.28, 4.66; p = 0.004). In a similar manner, compared to non-ESRD subjects, ESRD patients had significantly higher prevalence of RVO (OR: 2.19; 95% CI: 1.97, 2.43; p < 0.001), CRVO (OR: 2.61; 95% CI: 2.17, 3.15; p < 0.001) and BRVO (OR: 2.01; 95% CI: 1.76, 2.30; p < 0.001). CONCLUSION The prevalence of CKD increases in RVO patients, especially in CRVO. And in turn, the prevalence of RVO also increases in ESRD patients. The data support a correlation of RVO and CKD.
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Affiliation(s)
- Li Jian Fang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Department of Ophthalmology, Beijing Liangxiang Hospital, Capital Medical University, Beijing, China
| | - Li Dong
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yi Fan Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wen Bin Wei
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Pearce I, Clemens A, Brent MH, Lu L, Gallego-Pinazo R, Minnella AM, Creuzot-Garcher C, Spital G, Sakamoto T, Dunger-Baldauf C, McAllister IL. Real-world outcomes with ranibizumab in branch retinal vein occlusion: The prospective, global, LUMINOUS study. PLoS One 2020; 15:e0234739. [PMID: 32555630 PMCID: PMC7302470 DOI: 10.1371/journal.pone.0234739] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/01/2020] [Indexed: 11/19/2022] Open
Abstract
Objective To evaluate the effectiveness, safety, and treatment patterns of ranibizumab 0.5 mg in treatment-naïve patients with branch retinal vein occlusion (BRVO) enrolled in the LUMINOUS™ study. Study design A 5-year, global, prospective, multicenter, observational, open-label study conducted in a clinical practice (real-world) setting at outpatient ophthalmology clinics that recruited 30,138 consenting adult patients from all approved indications for ranibizumab across 42 countries. Patients with BRVO were treated according to the local ranibizumab label of the participating countries. Mean change in visual acuity (VA) in Early Treatment Diabetic Retinopathy Study letters from baseline to Year 1, treatment exposure during Year 1, and adverse events (AEs) over 5 years were assessed. Results Of the 1366 recruited BRVO patients, 405 were treatment-naïve at baseline with a mean (standard deviation [SD]) age of 67.9 (12.5) years, 57.5% were female, and 71.8% were White. At Year 1 (n = 189), the mean (SD) VA gain was 11.9 (17.66) letters from a baseline of 49.2 (±20.32) letters with a mean (SD) of 5.0 (2.34) injections. VA gains were higher in patients (n = 83) who received 6–9 injections (13.6 [20.16] letters) than in those who received 2–5 injections (n = 92, 11.7 [15.43] letters), or 1 injection (n = 14, 3.6 [13.72] letters). Patients with baseline VA <23 letters had numerically highest VA gains (n = 20, 31.1 [24.48] letters). Over 5 years, the rate of ocular/non-ocular AEs was 7.4%/9.1% and serious AEs was 0.3%/4.4% in treatment-naïve BRVO patients (n = 405). Conclusions One year results from the LUMINOUS real-world study showed a clinically meaningful VA improvement with ranibizumab in treatment-naïve patients with BRVO; numerically higher VA gains were achieved in patients who received more injections and those with poor baseline VA. No new safety signals were observed.
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Affiliation(s)
- Ian Pearce
- St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, England, United Kingdom
- Department of Eye and Vision Science, University of Liverpool, Liverpool, England, United Kingdom
| | - Andreas Clemens
- Novartis Pharma AG, Basel, Switzerland
- Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- * E-mail:
| | - Michael H. Brent
- Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Lin Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | - Angelo Maria Minnella
- Department of Ophthalmology, Catholic University of Sacred Heart - Foundation "Policlinico Universitario A. Gemelli"- IRCCS, Rome, Italy
| | | | - Georg Spital
- Department of Ophthalmology at St. Franziskus Hospital, Münster, Germany
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University, Kagoshima, Japan
| | | | - Ian L. McAllister
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, The University of Western Australia, Perth, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Australia
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171
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Zhang X, Lai TYY. Impact of the LEAVO Study in Asia. Eye (Lond) 2020; 34:211-212. [DOI: 10.1038/s41433-019-0710-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 10/22/2019] [Indexed: 11/09/2022] Open
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172
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Wei P, He M, Teng H, Han G. Quantitative analysis of metabolites in glucose metabolism in the aqueous humor of patients with central retinal vein occlusion. Exp Eye Res 2020; 191:107919. [PMID: 31923416 DOI: 10.1016/j.exer.2020.107919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/18/2019] [Accepted: 01/04/2020] [Indexed: 01/30/2023]
Abstract
Quantitative analysis of aqueous humor (AH) was performed to investigate glucose metabolism in patients with central retinal vein occlusion (CRVO), and to explore metabolic changes after anti-vascular endothelial growth factor (VEGF) treatment. AH samples were collected from 35 patients. Participants diagnosed with CRVO (n = 15) were compared to participants who underwent cataract surgery (n = 20). Thirteen of the participants with CRVO received second-round anti-VEGF treatments. Ultra-high performance liquid chromatography tandem-mass spectrometry (UHPLC-MS/MS) was used to quantify metabolites of the AH. Central macular thickness (CMT) and retinal ganglion cell layer (RGC) thickness were measured using spectral-domain optical coherence tomography. Thirteen metabolites involved in glucose metabolism were identified. Among these metabolites, succinate, glutamate, and glutamine were significantly decreased for the CRVO group (p = 0.028, 0.009, and 0.017, respectively). The α-ketoglutarate/citrate (K/C) ratio had a significant positive correlation with glutamine levels for both control (r = 0.922, p < 0.001) and CRVO groups (r = 0.674, p = 0.006). A significant increase in lactate was observed after intravitreal anti-VEGF administration (t = 2.273, p = 0.045); the change in CMT was negatively correlated with this increase (r = -0.745, p = 0.003). The alteration of RGC thickness was negatively correlated with increases in both glutamine (r = -0.619, p = 0.024) and glucose (r = -0.754, p = 0.003). These results indicate that, compared to glucose metabolism, glutamine was significantly decreased in the AH of patients with CRVO, and may therefore serve as a potential target for CRVO therapy. The glycolytic pathway might be enhanced after intravitreal anti-VEGF injection, which is an important insight into CRVO pathophysiology.
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Affiliation(s)
- Pinghui Wei
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, PR China; Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University, Tianjin, PR China
| | - Meiqin He
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, PR China
| | - He Teng
- Eye Institute and School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, PR China
| | - Guoge Han
- Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University, Tianjin, PR China.
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Zhang HW, Lin CW, Kok VC, Tseng CH, Lin YP, Li TC, Sung FC, Wen CP, Hsiung CA, Hsu CY. Incidence of retinal vein occlusion with long-term exposure to ambient air pollution. PLoS One 2019; 14:e0222895. [PMID: 31550294 PMCID: PMC6759191 DOI: 10.1371/journal.pone.0222895] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/08/2019] [Indexed: 02/07/2023] Open
Abstract
This study aimed to investigate whether long-term exposure to airborne hydrocarbons, including volatile organic compounds, increases the risk of developing retinal vein occlusion (RVO) among the population of Taiwan. A retrospective cohort study involving 855,297 people was conducted. Cox proportional hazards regression analysis fitted the multiple pollutant models for two targeted pollutants, including total hydrocarbons (THC), nonmethane hydrocarbons (NMHC) were used, and the risk of RVO was estimated. The chi-squared test and one-way analysis of variance were used to test differences in demographics and comorbidity distribution among tertiles of the targeted pollutants. Before controlling for multiple pollutants, hazard ratios for the overall population were 19.88 (95% CI: 17.56-22.50) at 0.51-ppm increases in THC and 4.33 (95% CI: 3.97-4.73) at 0.27-ppm increases in NMHC. The highest adjusted hazard ratios for different multiple pollutant models of each targeted pollutant were statistically significant (all p values were ≤0.05) for all patients at 29.67 (95% CI: 25.57-34.42) for THC and 16.24 (95% CI: 14.14-18.65) for NMHC. Our findings suggest that long-term exposure to THC and NMHC contribute to RVO development.
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Affiliation(s)
- Han-Wei Zhang
- PhD Program for Aging, China Medical University, Taichung, Taiwan
- Institute of Electrical Control Engineering, Department of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
- * E-mail:
| | - Chao-Wen Lin
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Victor C. Kok
- Disease Informatics Research Group, Asia University Taiwan, Taichung, Taiwan
- Department of Internal Medicine, Kuang Tien General Hospital, Taichung, Taiwan
| | - Chun-Hung Tseng
- Department of Neurology, China Medical University Hospital, and School of Medicine, China Medical University, Taichung, Taiwan
| | - Yuan-Pei Lin
- Institute of Electrical Control Engineering, Department of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan
| | - Fung-Chang Sung
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chi Pang Wen
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Chao A. Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Chung Y. Hsu
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan
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