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Cehofski LJ, Kruse A, Mæng MO, Kjaergaard B, Grauslund J, Honoré B, Vorum H. Proteome Analysis of Bevacizumab Intervention in Experimental Central Retinal Vein Occlusion. J Pers Med 2023; 13:1580. [PMID: 38003895 PMCID: PMC10672637 DOI: 10.3390/jpm13111580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/17/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Bevacizumab is a frequently used inhibitor of vascular endothelial growth factor (VEGF) in the management of macular edema in central retinal vein occlusion (CRVO). Studying retinal protein changes in bevacizumab intervention may provide insights into mechanisms of action. In nine Danish Landrace pigs, experimental CRVO was induced in both eyes with argon laser. The right eyes received an intravitreal injection of 0.05 mL bevacizumab (n = 9), while the left control eyes received 0.05 mL saline water (NaCl). Retinal samples were collected 15 days after induced CRVO. Label-free quantification nano-liquid chromatography-tandem mass spectrometry identified 59 proteins that were regulated following bevacizumab treatment. Following bevacizumab intervention, altered levels of bevacizumab components, including the Ig gamma-1 chain C region and the Ig kappa chain C region, were observed. Changes in other significantly regulated proteins ranged between 0.58-1.73, including for the NADH-ubiquinone oxidoreductase chain (fold change = 1.73), protein-transport protein Sec24B (fold change = 1.71), glycerol kinase (fold change = 1.61), guanine-nucleotide-binding protein G(T) subunit-gamma-T1 (fold change = 0.67), and prefoldin subunit 6 (fold change = 0.58). A high retinal concentration of bevacizumab was achieved within 15 days. Changes in the additional proteins were limited, suggesting a narrow mechanism of action.
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Affiliation(s)
- Lasse Jørgensen Cehofski
- Department of Ophthalmology, Odense University Hospital, 5000 Odense, Denmark;
- Biomedical Research Laboratory, Aalborg University Hospital, 9000 Aalborg, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Anders Kruse
- Department of Ophthalmology, Aalborg University Hospital, 9000 Aalborg, Denmark; (A.K.); (M.O.M.)
| | - Mads Odgaard Mæng
- Department of Ophthalmology, Aalborg University Hospital, 9000 Aalborg, Denmark; (A.K.); (M.O.M.)
| | - Benedict Kjaergaard
- Biomedical Research Laboratory, Aalborg University Hospital, 9000 Aalborg, Denmark;
| | - Jakob Grauslund
- Department of Ophthalmology, Odense University Hospital, 5000 Odense, Denmark;
| | - Bent Honoré
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark;
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
| | - Henrik Vorum
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark;
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
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Romanitan MO, Popa-Cherecheanu M, Vasile VA, Stanca S, Iancu G, Zemba M, Branisteanu D, Iancu R, Pirvulescu RA. Highlights on Genetic Polymorphism Associated with Thromboembolic Risk; Implications in Ophthalmic and Autoimmune Disorders—A Review. Diagnostics (Basel) 2023; 13:diagnostics13071267. [PMID: 37046485 PMCID: PMC10093669 DOI: 10.3390/diagnostics13071267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/15/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023] Open
Abstract
The present paper explores genetic polymorphism and its association with thromboembolic retinal venous disorders, such as central/hemi-retinal vein occlusion, as well as possible correlations with other ocular findings, such as closed angle glaucoma, but also with autoimmune general disorders. In this review, we are highlighting the importance of establishing a correspondence between all of the above, since they all have complex etiopathogeneses; sometimes, when all coexist together, they could generate effects that may be very difficult to manage. There are studies supporting that genetic polymorphism, such as the variant MTHFR A1298C, may increase the risk for developing glaucoma, especially in the heterozygote model. Being aware of all these aspects may prove to be useful in patients with several associated diseases, as a combined effort between several medical specialties may prove to the benefit of these patients. Our review, completed with an exemplifying clinical case, shows that it is necessary to raise awareness of all aspects of a complex medical situation, including the genetic one, of a patient being at risk for thromboembolic episodes, for preventing them or managing them promptly and properly in the future.
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Bakhoum CY, Madala S, Long CK, Adabifirouzjaei F, Freeman WR, Goldbaum MH, DeMaria AN, Bakhoum MF. Retinal vein occlusion is associated with stroke independent of underlying cardiovascular disease. Eye (Lond) 2023; 37:764-767. [PMID: 35411111 PMCID: PMC9998396 DOI: 10.1038/s41433-022-02038-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 03/03/2022] [Accepted: 03/15/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Stroke is a leading cause of mortality and morbidity. Thus, identifying associated risk factors may lead to earlier interventions aimed at reducing the risk of stroke development. Since cardiovascular disease simultaneously increases the risk of stroke and retinal vein occlusion (RVO), we sought to determine whether RVO is associated with the risk of stroke independent of underlying cardiovascular co-morbidities. METHODS In this cross-sectional study, we reviewed the records of 80,754 individuals who were evaluated by an ophthalmologist over a 6-year period. We identified individuals with RVO, stroke and cardiovascular diseases including hypertension, diabetes mellitus, carotid disease, coronary artery disease and atrial fibrillation. Multivariable logistic regression models were used to analyze odds ratios for RVO and stroke. RESULTS After adjusting for age, sex, cardiovascular disease and other risk factors, we found that the presence of RVO was associated with an odds ratio for stroke of 1.73 (CI, 1.40-2.12, p < 0.001). The association between RVO and stroke, after adjusting for sex and cardiovascular co-morbidities, was significantly stronger in individuals younger than 50 years of age, with an odds ratio of having a stroke of 3.06 (1.34-6.25, p < 0.001), while the presence of RVO in individuals older than 85 years was not significantly associated with stroke 1.19 (0.77-1.79, p = 0.41). CONCLUSIONS Our findings demonstrate that RVO is significantly associated with stroke, even after adjusting for underlying cardiovascular co-morbidities. This association was highly significant in younger subjects, while not significant in older individuals.
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Affiliation(s)
- Christine Y Bakhoum
- Department of Pediatrics, Section of Nephrology, Yale University School of Medicine, New Haven, CT, USA
| | - Samantha Madala
- School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Christopher K Long
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
| | - Fatemeh Adabifirouzjaei
- Department of Medicine, Sulpizio Cardiovascular Center, University of California San Diego, La Jolla, CA, USA
| | - William R Freeman
- Department of Ophthalmology, Shiley Eye Center, University of California San Diego, La Jolla, CA, USA
| | - Michael H Goldbaum
- Department of Ophthalmology, Shiley Eye Center, University of California San Diego, La Jolla, CA, USA
| | - Anthony N DeMaria
- Department of Medicine, Sulpizio Cardiovascular Center, University of California San Diego, La Jolla, CA, USA
| | - Mathieu F Bakhoum
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA.
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
- Yale Cancer Center, Yale University, New Haven, CT, USA.
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Rueda-Camino JA, Gimena-Rodríguez FJ, Domínguez-Sepúlveda MA, Bolzoni M, Pastor-Vivas AI, Angelina-García M, Joya-Seijo MD, Trujillo-Luque D, Losada-Bayo D, Barba-Martín R. Retinal vein occlusion. Audit of a specialized care program. Rev Clin Esp 2023; 223:84-89. [PMID: 36646420 DOI: 10.1016/j.rceng.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/11/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Retinal vein occlusion (RVO) is the second most frequent cause of retinal vascular disease and is related to classic cardiovascular risk factors. A specific program was designed to detect and treat risk factors in patients with RVO. The aim of this study is to audit the results of this program. PATIENTS AND METHODS The program consisted of a multidisciplinary clinical evaluation by the Ophthalmology and Internal Medicine Departments. All patients with RVO were screened, at minimum, for hypertension, diabetes, dyslipidemia, smoking, overweight, and antiphospholipid syndrome. New risk factors or poor control of known risk factors were expected to be found in at least one-third of the patients. Among them, therapeutic measures were expected to be taken in at least two-thirds. A dissociated automated search of the data of all patients who entered the program between April 2021 and April 2022 was performed. RESULTS Fifty-six patients were included for analysis. Of these, 39 (69.6%) had at least one new or poorly controlled risk factor and 43 (76.8%) had their treatment modified in some way. Antiphospholipid syndrome was detected in five (8.9%). Only one patient had low-risk hereditary thrombophilia. After an exhaustive examination, no risk factors were found in 11 patients. CONCLUSION This specific program has been effective in detecting new or poorly controlled risk factors and improving their treatment.
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Affiliation(s)
- J A Rueda-Camino
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain.
| | - F J Gimena-Rodríguez
- Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M A Domínguez-Sepúlveda
- Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M Bolzoni
- Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - A I Pastor-Vivas
- Servicio de Oftalmología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M Angelina-García
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M D Joya-Seijo
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - D Trujillo-Luque
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - D Losada-Bayo
- Servicio de Oftalmología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - R Barba-Martín
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
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Dărăbuș DM, Pac CP, Munteanu M. Retinal vein occlusions associated or complicated with glaucoma. Aspects of prediction and paths of progression. Rom J Ophthalmol 2023; 67:97-103. [PMID: 37089806 PMCID: PMC10117181 DOI: 10.22336/rjo.2023.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
Background and Objectives: The aim of the study is to evaluate prediction factors and progression paths when retinal vein occlusions are associated with preexisting glaucoma or complicated with neovascular glaucoma. Materials and Methods: The study included 111 patients diagnosed with retinal vein occlusions, of whom 21 with preexisting open angle glaucoma and 12 with neovascular glaucoma as complication. The study was conducted from September 2020 to September 2022 in Timişoara, Romania. We assessed intraocular pressure, cup-disc ratio and retinal nerve fiber layer from the moment of retinal vein occlusion diagnosis until at least one year of follow-up, considering these aspects as values of prediction concerning the paths of progression when glaucoma and retinal vein occlusions come together. Results: The mean initial IOP for the affected eyes was higher (15.89 ± 2.73) than for fellow eyes (15.20 ± 3.11), with an increase of the IOP after one year, but with no statistically significant differences for the affected eyes (p=0.116) or for the other eyes (p=0.684), neither for the affected eyes associated with glaucoma in comparison with affected eyes without glaucoma association. The mean cup-disc ratio was higher for the affected eyes in comparison with the fellow eyes (0.4812 ± 0.219 for the affected eyes and 0.4738 ± 0.229 for the fellow ones in cases without associated glaucoma and 0.681 ± 0.157 for the affected eyes and 0.600 ± 0.241 for the fellow eyes in cases with associated glaucoma), with statistical significant differences in the evolution for both groups in comparison with the unaffected eyes (p=0.0056 for the first group and p=0.0003 for the second group). Comparing the evolution of the affected eyes with the preexisting glaucoma and the affected eyes without preexisting glaucoma, no statistical difference has been found (p=0.1104). The mean retinal nerve fiber layer decreased significantly in affected eyes without glaucoma (from 96 ± 14.71 to 89.16 ± 13.07) and in affected eyes with associated glaucoma (from 78.50 ± 4.23 to 75.50 ± 5.83), but with no significant differences (p=0.182). The level of decreasing was significantly more consistent in association with a venous occlusion (p= 0.0001). Conclusions: The findings of the current study fortify the correlation between glaucoma as a risk factor for retinal venous occlusion development, the intraocular pressure and optic nerve cupping as prediction factors in retinal venous occlusions, the association of a well-controlled preexisting glaucoma with no effect on the progression of the retinal venous occlusions and the development of a neovascular glaucoma with a much aggressive and different path of disease progression.
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Affiliation(s)
- Diana-Maria Dărăbuș
- Department of Ophthalmology, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania
| | - Cristina-Patricia Pac
- Department of Ophthalmology, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania
| | - Mihnea Munteanu
- Department of Ophthalmology, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania
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Rueda-Camino J, Gimena-Rodríguez F, Domínguez-Sepúlveda M, Bolzoni M, Pastor-Vivas A, Angelina-García M, Joya-Seijo M, Trujillo-Luque D, Losada-Bayo D, Barba-Martín R. Trombosis venosa de retina. Auditoría de un programa de atención especializada. REVISTA CLÍNICA ESPAÑOLA 2022. [DOI: 10.1016/j.rce.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Jabbehdari S, Yazdanpanah G, Cantor LB, Hajrasouliha AR. A narrative review on the association of high intraocular pressure and glaucoma in patients with retinal vein occlusion. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1072. [PMID: 36330401 PMCID: PMC9622479 DOI: 10.21037/atm-22-2730] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/14/2022] [Indexed: 09/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Retinal vein occlusion (RVO) is a major cause of vision loss and elevated intraocular pressure (IOP), high ocular perfusion pressure, and glaucoma are known ophthalmic risk factors for RVO. The aim of this paper is to provide the update on the association and management of high IOP/glaucoma and RVO. METHODS A literature review was performed in PubMed and Medline until May 2022 utilizing specific keywords and cross-matched reference lists. KEY CONTENT AND FINDINGS The association of RVO with high IOP/glaucoma may be attributed to retinal ganglion cell loss due to retinal ischemia in high IOP and glaucoma. As new modalities showed, decreased optic disc perfusion, reduced density of blood vessels in the optic nerve head of glaucoma patients, changes in the peripapillary microvascular parameters, and decreased retinal nerve fiber layer (RNFL) thickness of the optic nerve head of eyes with RVO suggest a common pathway between RVO and glaucoma. Literature suggests the close follow up for glaucoma development among patients with non-arteriovenous (AV) crossing (optic cup or optic nerve sited) RVO in fellow eye and management of elevated IOP among RVO cases treated with anti-vascular endothelial growth factor (VEGF) antibodies/corticosteroids and those with preexisting primary open angle glaucoma (POAG). CONCLUSIONS Determining potential patient responses to treatment and considering therapeutic options are challenging among patients with RVO and glaucoma. However, IOP lowering managements in preventing IOP spikes in patients with preexisting glaucoma and early treatment of macular edema in eyes with RVO is recommended.
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Affiliation(s)
- Sayena Jabbehdari
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ghasem Yazdanpanah
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Louis B. Cantor
- Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Amir Reza Hajrasouliha
- Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
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The clinical relevance of ultra-widefield angiography findings in patients with central retinal vein occlusion and macular oedema receiving anti-VEGF therapy. Eye (Lond) 2022; 36:1086-1093. [PMID: 34035490 PMCID: PMC9046393 DOI: 10.1038/s41433-021-01553-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/28/2021] [Accepted: 04/13/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS To report, using ultra-widefield angiography (UWFA) the area, distribution, and change in retinal capillary nonperfusion (RCNP) at baseline and 100 weeks in eyes with central retinal vein occlusion (CRVO) receiving anti-VEGF for macula oedema. METHODS Prospective longitudinal multi-centre cohort study. Adults with CRVO treated with anti-VEGF therapy for macular oedema underwent UWFA at baseline and week-100. The area, distribution, and change in total, peripheral and posterior pole RCNP were determined. RESULTS Of 153 eyes at baseline, mean area of RCNP was 34.3DA and 12 (7.8%) had ≥75DA RCNP. More than 10DA RCNP was present in the temporal periphery in 75.8% of eyes vs. 10.5% in the nasal periphery. At week-100, mean RCNP was 42.1DA with a median change from baseline of 3.3DA 95% CI [0.4, 7.3]; p < 0.01. Of 146 eyes with ≤10DA of posterior pole RCNP at baseline, 16/146 (11.0%) progressed to >10DA at week-100. These eyes had a median increase in total RCNP of 69.7DA [95% CI 27.2-85.4] vs 0DA [0.0-1.4]; p < 0.001 for those who did not, and two developed neovascular glaucoma. Larger baseline area of RCNP and history of glaucoma were risk factors for posterior pole RCNP developing. CONCLUSIONS With UWFA, significant baseline RCNP was identified in the majority of CRVO patients, notably in the temporal periphery, but large increases over 100 weeks were uncommon. Development of >10DA posterior pole RCNP is a marker for widespread RCNP and in such cases the risk of anterior segment neovascularisation is not abolished by concomitant anti-VEGF therapy.
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Baek J, Park HYL, Kim SA, Hong KE, Jeon SJ, Shin DY, Jung Y, Park CK. Parapapillary Choroidal Microvasculature Dropout in Branched Retinal Vein Occlusion and Glaucoma. Invest Ophthalmol Vis Sci 2022; 63:27. [PMID: 35348587 PMCID: PMC8976936 DOI: 10.1167/iovs.63.3.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate parapapillary choroidal microvasculature dropout (MvD) in branch retinal vein occlusion (BRVO) patients and compare them with open-angle glaucoma (OAG) patients using optical coherence tomography angiography (OCT-A). Methods In total, 85 eyes of BRVO patients and 85 eyes of OAG patients, matched by age, spherical equivalent, and baseline mean deviation (MD) of the visual field (VF), were assessed. MvD was defined as complete loss of microvasculature within the choroidal layer on OCT-A. Linear regression analysis was used to obtain the slope of the MD change of the VF. Results The presence of MvD on OCT-A was significantly more frequent in OAG eyes (63.1%) compared to BRVO eyes (31.8%). BRVO eyes with MvD showed worse baseline MD of the VF than BRVO eyes without MvD (−10.19 ± 8.50 and −7.77 ± 6.46 dB, respectively; P = 0.045). The presence of MvD was the only factor significantly associated with MD change of the VF in OAG eyes. Lower baseline average RNFL thickness, greater MvD angle, and lower macular superficial vessel density were significantly associated with MD change of the VF in BRVO eyes. Conclusions OCT-A of the parapapillary area showed choroidal microvasculature impairment in both BRVO and OAG patients. However, the frequency was higher in glaucoma patients with similar degrees of VF damage, which suggests that the glaucomatous process contributes to MvD development. The effect of MvD on VF change was different between BRVO and OAG, suggesting that the underlying pathogenesis may also be different.
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Affiliation(s)
- Jiwon Baek
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Bucheon St. Mary's Hospital, Gyeonggi-do, South Korea
| | - Hae-Young Lopilly Park
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Seoul St. Mary's Hospital, Seoul, South Korea
| | - Seong Ah Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Seoul St. Mary's Hospital, Seoul, South Korea
| | - Kyung Euy Hong
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Seoul St. Mary's Hospital, Seoul, South Korea
| | - Soo Ji Jeon
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Bucheon St. Mary's Hospital, Gyeonggi-do, South Korea
| | - Da Young Shin
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Eunpyeong St. Mary's Hospital, Seoul, South Korea
| | - Younhea Jung
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Yeouido St. Mary's Hospital, Seoul, South Korea
| | - Chan Kee Park
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Seoul St. Mary's Hospital, Seoul, South Korea
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Optic disc microvascularity in patients with intravitreal dexamethasone implantation for branch retinal vein occlusion. J Fr Ophtalmol 2021; 44:1491-1498. [PMID: 34785067 DOI: 10.1016/j.jfo.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To compare changes in optic disc microvascular parameters before and after treatment of patients who received IVD for macular edema secondary to BRVO, using optical coherence tomography angiography (OCT-A). METHODS Eighteen BRVO patients who received only IVD treatment and 20 healthy controls were retrospectively reviewed. Patients with moderate or severe IOP spikes (>6mmHg) after implantation were excluded from the study. Whole, peripapillary, inside disc capillary density and retinal nerve fiber layer thickness (RNFLT) were recorded at the 2nd and 6th months after implantation. RESULTS Whole, peripapillary and inside disc capillary densities were significantly lower in BRVO patients before implantation than in the control group (P<0.001 for all comparisons). Despite a mild mean IOP increase after IVD, no significant change was observed in whole, peripapillary and inside disc capillary vascular densities in the 2nd and 6th months (P>0.05 for all comparisons). The mean RNFLT of BRVO patients before IVD was lower than the control group, but this difference was not statistically significant (110.1±12.3μm and 115.6±10.7μm, P=0.131). The mean RNFLT at the 2nd and 6th months did not show a statistically significant difference after implantation (P=0.239, P=0.459). CONCLUSIONS OCT-A shows the decrease in whole, peripapillary and inside disc microvascular parameters in BRVO patients compared to healthy subjects. No significant change in optic nerve head microvascular parameters was observed in patients without moderate or severe IOP spikes after treatment with IVD.
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11
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Optic Disc Vascular Density in Normal-Tension Glaucoma Eyes with or without Branch Retinal Vessel Occlusion. J Clin Med 2021; 10:jcm10122574. [PMID: 34200846 PMCID: PMC8230548 DOI: 10.3390/jcm10122574] [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] [Received: 03/26/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/17/2022] Open
Abstract
We analyzed the vascular densities (VDs) of the optic disc areas in eyes with normal-tension glaucoma (NTG) according to their branch retinal vessel occlusion (BRVO) status. The VDs of the optic discs and peripapillary areas of 68 NTG patients with BRVO (BRVO group; BRVO eyes and fellow eyes) and 37 patients with NTG alone (control eyes) were measured on angiographic images obtained via swept-source optical coherence tomography angiography. VDs were compared among groups and correlations were assessed. The VD of the optic disc large vessel was the highest in BRVO eyes, followed by the fellow eyes and controls (all P < 0.05). Conversely, small and medium vessel VD was in the opposite order (all P < 0.05). Large vessel VD was negatively correlated with small and medium vessel VD (r = −0.697, P < 0.001). Peripapillary VD was lower in the BRVO eyes than in the control and fellow eyes (P < 0.001 and P = 0.861, respectively). In conclusion, significant changes in the distribution of VDs for optic disc larger vessel and small and medium vessels were observed in both eyes of NTG patients with BRVO, compared to NTG patients without BRVO.
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Lyu M, Lee Y, Kim BS, Kim HJ, Hong R, Shin YU, Cho H, Shin JH. Clinical significance of subclinical atherosclerosis in retinal vein occlusion. Sci Rep 2021; 11:11905. [PMID: 34099806 PMCID: PMC8184809 DOI: 10.1038/s41598-021-91401-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/26/2021] [Indexed: 11/17/2022] Open
Abstract
Retinal vein occlusion (RVO) is associated with atherosclerotic cardiovascular risk factors; however, its association with the specific markers of subclinical atherosclerosis has not yet been established. To investigate this association, we compared 70 patients with RVO to 70 age- and sex-matched patients without RVO. Low-density lipoprotein cholesterol (LDL-C) levels and brachial-ankle pulse wave velocity (baPWV) were significantly higher in the RVO group than in the control group. Carotid plaques (54.3% vs. 28.6%, p = 0.004) were more frequent in the RVO group. Multivariate logistic regression analysis showed that the presence of carotid plaques (odds ratio [OR]: 3.15, 95% confidence interval [CI] 1.38–7.16, p = 0.006), as well as smoking, LDL-C level, and baPWV were associated with RVO. Additionally, a multinomial logistic regression model showed that the presence of carotid plaques (OR: 3.94, 95% CI 1.65–9.41, p = 0.002) and LDL-C level were associated with branch RVO, whereas smoking and baPWV were associated with central RVO. In conclusion, RVO was associated with subclinical atherosclerosis markers, including carotid plaques and baPWV. These results support the hypothesis that atherosclerosis contributes to the etiology of RVO and suggest the evaluation of subclinical atherosclerosis in patients with RVO.
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Affiliation(s)
- Minhyung Lyu
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, Gyeonggi-do, 11923, Republic of Korea
| | - Yonggu Lee
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, Gyeonggi-do, 11923, Republic of Korea
| | - Byung Sik Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, Gyeonggi-do, 11923, Republic of Korea
| | - Hyun-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, Gyeonggi-do, 11923, Republic of Korea
| | - Rimkyung Hong
- Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, Gyeonggi-do, 11923, Republic of Korea
| | - Yong Un Shin
- Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, Gyeonggi-do, 11923, Republic of Korea.
| | - Heeyoon Cho
- Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, Gyeonggi-do, 11923, Republic of Korea
| | - Jeong-Hun Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, Gyeonggi-do, 11923, Republic of Korea.
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Scott IU, Campochiaro PA, Newman NJ, Biousse V. Retinal vascular occlusions. Lancet 2020; 396:1927-1940. [PMID: 33308475 PMCID: PMC9546635 DOI: 10.1016/s0140-6736(20)31559-2] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 05/29/2020] [Accepted: 07/03/2020] [Indexed: 12/11/2022]
Abstract
Acute retinal vascular occlusions are common causes of visual impairment. Although both retinal artery occlusions and retinal vein occlusions are associated with increased age and cardiovascular risk factors, their pathophysiology, systemic implications, and management differ substantially. Acute management of retinal artery occlusions involves a multidisciplinary approach including neurologists with stroke expertise, whereas treatment of retinal vein occlusions is provided by ophthalmologists. Optimisation of systemic risk factors by patients' primary care providers is an important component of the management of these two disorders.
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Affiliation(s)
- Ingrid U Scott
- Department of Ophthalmology and Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Peter A Campochiaro
- Department of Ophthalmology and Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Nancy J Newman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurological Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Valérie Biousse
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
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Hypertension and multiple cardiovascular risk factors increase the risk for retinal vein occlusions: results from the Gutenberg Retinal Vein Occlusion Study. J Hypertens 2020; 37:1372-1383. [PMID: 31145709 DOI: 10.1097/hjh.0000000000002057] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Although several risk factors for retinal vein occlusion (RVO) are known, what triggers RVO is unclear in many cases. We aimed to evaluate the relevance of multiple risk factors in patients with RVO. METHODS The Gutenberg RVO Study is an observational case-control study that assessed thrombophilic, cardiovascular, ophthalmic, and drug-related risk factors in participants with RVO and the same number of matched controls. Conditional logistic regression analysis was chosen to estimate the risk of RVO due to several risk factors. RESULTS Of 92 patients with RVO, 46 (50%) had central RVO, 31 (33.7%) had branch RVO, and 15 (16.3) had hemi-RVO. Systemic hypertension was associated with RVO [any RVO: odds ratio (OR): 1.81; 95% confidence interval (CI): 1.14-2.88; branch RVO: OR: 2.56; 95% CI: 1.08-6.10]. The most frequent combinations of risk factors were hypertension with dyslipidemia (33 of 92, 35.9%) and hyperhomocysteinemia and high levels of factor VIII (10 of 92, 10.9%). An increase in the risk sum score by one additional risk factor corresponded to ORs of 1.74 (95% CI: 1.31-2.32) for cardiovascular risk factors, 1.38 (95% CI: 1.04-1.82) for thrombophilic risk factors, and 1.43 (95% CI: 1.20-1.70) for the total number of risk factors for RVO. CONCLUSION Cardiovascular risk factors are more important than other risk factors for the presence of RVO. The risk of RVO increased by approximately 40% with any additional risk factor and by 70% with any additional cardiovascular risk factor.
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Longitudinal changes in the peripapillary retinal nerve fiber layer thickness in the fellow eyes of unilateral retinal vein occlusion. Sci Rep 2020; 10:7708. [PMID: 32382106 PMCID: PMC7206108 DOI: 10.1038/s41598-020-64484-5] [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: 01/17/2020] [Accepted: 04/16/2020] [Indexed: 11/09/2022] Open
Abstract
To analyze longitudinal changes in peripapillary retinal nerve fiber layer (pRNFL) thicknesses over time in the fellow eyes of patients with unilateral retinal vein occlusion (RVO). A total of 47 patients with unilateral RVO and 47 healthy controls were enrolled. The mean and sectoral pRNFL thicknesses were measured using spectral domain-optical coherence tomography at 1 year intervals, and followed for 3 years. Linear mixed models were performed to calculate and compare the reduction rates of pRNFL thicknesses over time. The mean pRNFL thickness decreased significantly during the 3-year follow-up, with a significant decrease over time in both groups. The reduction rate in mean pRNFL thicknesses was -0.41 μm/year in the control group and -0.68 μm/year in the fellow eyes of RVO group, and the decrease was significantly higher in the fellow eyes of RVO group than in the control group (p < 0.001). Using a multivariate linear mixed model, age (estimate: -0.41, p = 0.011) and hypertension (HTN) (estimate: -6.51, p = 0.014) were significantly associated with the reduction in mean pRNFL thicknesses in fellow eyes of RVO group. The fellow eyes of RVO patients showed a greater reduction in pRNFL thickness over time than normal controls. Age and HTN should be considered as factors to decrease the pRNFL thickness over time in fellow eyes of RVO group.
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Incidence of Open-angle Glaucoma in Newly Diagnosed Retinal Vein Occlusion: A Nationwide Population-based Study. J Glaucoma 2020; 28:111-118. [PMID: 30689606 DOI: 10.1097/ijg.0000000000001134] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to compare the incidence of open-angle glaucoma (OAG) in patients with newly diagnosed retinal vein occlusion (RVO) with that in the general population in order to determine the association between OAG and RVO. METHODS The Korean Health Insurance Review and Assessment (HIRA) data from 2011 through 2015 was analyzed in order to determine the incidence rates of OAG in the general population and in patients with newly diagnosed RVO based on the diagnostic code. The standardized incidence ratios (SIRs) of OAG in patients with RVO were determined with respect to the age- and sex-matched general population. RESULTS The incidence rate of OAG in the general population during the 3 years (2013 to 2015) was 233.98 per 100,000 person-years (95% CI, 233.21-234.76). A total of 31,722 patients with newly diagnosed RVO were identified in 2012 as the population at risk. The incidence rate of OAG in patients with RVO during the 3-year follow-up period was 1829.43 per 100,000 person-years (95% CI, 1745.49-1917.42). The expected incidence of OAG in patients with RVO was 433.69 during the 3-year follow-up period. On the other hand, the observed incidence of OAG was 1,741. The SIR of OAG in patients with RVO with reference to the general population was 4.01 (95% CI, 3.83-4.20). CONCLUSIONS The incidence rate of OAG in patients with RVO is significantly higher than that in the general population.
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Yin X, Li J, Zhang B, Lu P. Association of glaucoma with risk of retinal vein occlusion: A meta-analysis. Acta Ophthalmol 2019; 97:652-659. [PMID: 31125174 DOI: 10.1111/aos.14141] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Abstract
To summarize epidemiological evidences on the association between glaucoma and the risk of retinal vein occlusion (RVO). Relevant studies were identified by searching in PubMed, EMBASE and Cochrane until February 2018. Fifteen eligible observational studies were aggregated in this analysis. All results were analysed and pooled using random effects models with 95% confidence intervals (CI). In all studies, the odds ratio (OR) of glaucoma as a risk factor for RVO was 4.01 (95% CI: 3.28-4.91). In RVO subtype-differentiated subgroup analyses (six studies), the pooled OR showed that glaucoma was associated with central retinal vein occlusion (CRVO) (OR: 6.21; 95% CI: 4.64-8.31), branch retinal vein occlusion (BRVO) (OR: 2.38; 95% CI: 1.77-3.19) and hemiretinal vein occlusion (HRVO) (OR: 4.60; 95% CI: 2.26-9.35). In glaucoma-classified subgroup analyses (five studies), primary open-angle glaucoma (POAG) (OR: 5.03; 95% CI: 3.97-6.37) and chronic open-angle glaucoma (COAG) (OR: 2.36; 95% CI: 1.39-4.02) were significant risk factors for RVO development. There was a plausible relationship between primary angle closure glaucoma (PACG) and RVO risk (OR: 1.85; 95% CI: 0.41-8.35); to be precise, the OR was 5.3 in PACG and CRVO risk (95% CI: 1.04-26.95; p = 0.045), while the OR was 0.65 in PACG and BRVO risk (95% CI: 0.07-6.27; p = 0.707). To sum up, this meta-analysis shows that glaucoma is associated with the risk of RVO. Glaucoma should be kept in mind when investigating patients with RVO in the clinic.
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Affiliation(s)
- Xue Yin
- Department of Ophthalmology The First Affiliated Hospital of Soochow University Suzhou China
| | - Jianqin Li
- Department of Ophthalmology The First Affiliated Hospital of Soochow University Suzhou China
| | - Bingyu Zhang
- Department of Ophthalmology The First Affiliated Hospital of Soochow University Suzhou China
| | - Peirong Lu
- Department of Ophthalmology The First Affiliated Hospital of Soochow University Suzhou China
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Shin YI, Nam KY, Lee SE, Lim HB, Lee MW, Jo YJ, Kim JY. Changes in Peripapillary Microvasculature and Retinal Thickness in the Fellow Eyes of Patients With Unilateral Retinal Vein Occlusion: An OCTA Study. Invest Ophthalmol Vis Sci 2019; 60:823-829. [PMID: 30807638 DOI: 10.1167/iovs.18-26288] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate changes in peripapillary microvascular parameters in the fellow eyes of patients with unilateral retinal vein occlusion (RVO) using optical coherence tomography angiography (OCTA) and to determine the relationships between peripapillary microvasculature and retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness. Methods Eighty-three patients with unilateral RVO (50 patients with branch RVO and 33 with central RVO) and 83 normal controls were enrolled. OCTA (Cirrus HD-OCT 5000 with AngioPlex) 6 × 6-mm scans centered on the optic disc were acquired. Peripapillary vessel density (VD) and perfusion density (PD) were automatically calculated. Results The average RNFL and GC-IPL thicknesses in the fellow eyes of RVO patients were significantly thinner than in normal controls (93.5 vs. 96.6 μm, P = 0.013 and 81.3 vs. 84.1 μm, P = 0.003, respectively). In the fellow eyes of patients with unilateral RVO, the peripapillary VD of the inner ring, outer ring, and full area (17.47, 18.50, and 17.89, respectively) were significantly lower than those of controls (17.87, 18.87, and 18.27, respectively). The peripapillary PD of the inner ring, outer ring, and full area (0.456, 0.467, and 0.456, respectively) were also significantly lower than those of controls (0.468, 0.476, and 0.466, respectively). RNFL and GC-IPL thicknesses were correlated with both peripapillary VD and PD. Conclusions OCTA revealed that peripapillary microvascular parameters in the fellow eyes of patients with unilateral RVO were decreased, and GC-IPL and RNFL thinning were also observed. The RNFL and GC-IPL thicknesses were positively correlated with both peripapillary VD and PD.
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Affiliation(s)
- Yong-Il Shin
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Ki Yup Nam
- Department of Ophthalmology, Kosin University College of Medicine, Busan, Republic of Korea
| | - Seong Eun Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Hyung-Bin Lim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Min Woo Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Young-Joon Jo
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Jung-Yeul Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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Călugăru D, Călugăru M, Ţălu Ş. Ocular hypertension in patients with central/hemicentral retinal vein occlusions: cumulative prevalence and management. Int J Ophthalmol 2018; 11:1173-1178. [PMID: 30046535 PMCID: PMC6048337 DOI: 10.18240/ijo.2018.07.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 11/26/2017] [Indexed: 02/07/2023] Open
Abstract
AIM To prospectively evaluate the cumulative prevalence and the management of ocular hypertension (OH) in patients with unilateral acute central/hemicentral retinal vein occlusions (C/HCRVOs) over the course of 3y. METHODS The study included 57 patients with unilateral acute C/HCRVOs. All patients underwent a comprehensive ophthalmological examination of both eyes. OH associated with C/HCRVO in patients showing a score >5% for the risk of conversion to primary open angle glaucoma (POAG) was treated with OH medication. The treatment aimed for a decrease in intraocular pressure (IOP) to <21 mm Hg with a >22% reduction from the initial values. The cumulative prevalence of OH and the effectiveness of treatment assessed by the cumulative prevalence of conversion from OH to POAG, were estimated. RESULTS Fifteen patients had OH associated with C/HCRVOs, the cumulative prevalence of OH was 29.4% (95% confidence interval, 16.9-41.9). The mean value of the risk score of OH conversion to POAG for the 5 subsequent years was 11.7%±5.4%. The IOP significantly decreased from 25.67±2.16 mm Hg to 18.73±2.96 mm Hg. None of the OH patients converted to POAG during the follow-up period. CONCLUSION The increased cumulative prevalence of OH in C/HCRVO patients indicates that OH is a risk factor for the appearance of venous occlusion. Patients with OH associated with C/HCRVO must be considered to be at high risk for conversion to POAG. Treatment with OH medications prevented conversion to POAG during the 3-year follow-up.
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Affiliation(s)
- Dan Călugăru
- Department of Ophthalmology, University of Medicine, Cluj-Napoca 400467, Romania
| | - Mihai Călugăru
- Department of Ophthalmology, University of Medicine, Cluj-Napoca 400467, Romania
| | - Ştefan Ţălu
- Department of AET Discipline of Descriptive Geometry and Engineering Graphics, Faculty of Mechanical Engineering, Technical University of Cluj-Napoca, Cluj-Napoca 400012, Romania
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Park HYL, Jung Y, Han K, Lee MY, Park CK. Health care claims for primary open-angle glaucoma and retinal vein occlusion from an 11-year nationwide dataset. Sci Rep 2017; 7:8038. [PMID: 28808282 PMCID: PMC5556030 DOI: 10.1038/s41598-017-07890-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 07/05/2017] [Indexed: 11/16/2022] Open
Abstract
To evaluate the risk of retinal vein occlusion (RVO) development after primary open-angle glaucoma (POAG) and the risk of POAG development after RVO, we conducted a nationwide, population-based 11-year longitudinal study. National registry data were collected from the Korean National Health Insurance Research Database, comparing 1 025 340 (~2.2%) subjects who were selected from 46 605 433 Korean residents in 2002. Each sampled patients was tracked until 2013. POAG developed in 0.92% of the RVO group (n = 6 826) and in 0.22% of the comparison group. RVO developed in 0.99% of the POAG group (n = 4 138) and in 0.37% of the comparison group. RVO was associated with an increased risk of POAG development (hazard ratio [HR], 3.25; 95% confidence interval [CI], 2.39–4.42) and POAG was associated with an increased risk of RVO development (HR, 5.05; 95% CI, 3.94–6.47). Comorbidity of systemic hypertension and diabetes mellitus further increased the risk of POAG development in the RVO group (HR, 3.58 and HR, 5.98, respectively). Patients with RVO exhibit a significantly higher risk of POAG development and patients with POAG exhibit a significantly higher risk of RVO development, based on an 11-year follow-up period.
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Affiliation(s)
- Hae-Young Lopilly Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Younhea Jung
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kyungdo Han
- Department of Biostatistics, The Catholic University of Korea, Seoul, South Korea
| | - Mee Yon Lee
- Department of Ophthalmology and Visual Science, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chan Kee Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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Wittström E. Central Retinal Vein Occlusion in Younger Swedish Adults: Case Reports and Review of the Literature. Open Ophthalmol J 2017; 11:89-102. [PMID: 28603574 PMCID: PMC5447937 DOI: 10.2174/1874364101711010089] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 03/06/2017] [Accepted: 03/07/2017] [Indexed: 12/19/2022] Open
Abstract
Purpose: To investigate associated systemic diseases, other conditions, visual outcome, ocular complications and treatment in Swedish patients younger than 50 years with central retinal vein occlusion (CRVO) and reviewing the literature. Methods: Twenty-two patients with CRVO, younger than 50 years, were examined with full-field electroretinography (ERG) within 3 months after a thrombotic event, or were periodically examined and were observed for at least 6 months. In 18 of these patients, the initial retinal ischemia was studied using the cone b-wave implicit time in the 30 Hz flicker ERG. Fifteen patients also underwent fluorescein angiography. Optical coherence tomography (OCT) was performed in 14 patients. The patients studied were divided into two groups, non-ischemic and ischemic, which were compared. All patients underwent ocular and systemic examination, as well as complete screening for thrombophilic risk factors. Results: Of the 22 patients, 15 had non-ischemic type of CRVO and 7 the ischemic type. Patients with non-ischemic CRVO showed significantly improved visual acuity (VA) at the final examination (p=0.006). Patients with ischemic CRVO showed no significant reduction in VA at the final examination (p=0.225). Systemic hypertension (27% in non-ischemic CRVO and 29% in ischemic CRVO) was the most prevalent systemic risk factor for CRVO. The mean central foveal thickness (CFT) decreased significantly from 402.3±136.2 (µm) at the initial examination to 243.8±48.1 (µm) at the final examination in the non-ischemic group (p=0.005). The mean initial CFT was 444.5±186.1 (µm) in the ischemic CRVO group, which decreased to 211.5±20.2 (µm) at the final visit (p=0.068). Pigment dispersion syndrome (PDS)/pigmentary glaucoma (PG), ocular hypertension and dehydration were equally frequent; four patients each (18%) out of 22. The clinical course of 4 younger patients with PDS/PG are described. Conclusion: The patients with non-ischemic CRVO showed significantly improved VA and significantly decreased CFT at the final examination. Systemic hypertension was the most prevalent risk factor for CRVO. Younger adults with CRVO also had a high prevalence of PDS/PG, ocular hypertension and dehydration. This study highlights the importance of careful IOP monitoring, and the need to investigate possible PDS/PG and to obtain an accurate history of the patient including alcohol intake and intense exercise.
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Glaucoma Progression in the Unaffected Fellow Eye of Glaucoma Patients Who Developed Unilateral Branch Retinal Vein Occlusion. Am J Ophthalmol 2017; 175:194-200. [PMID: 27793602 DOI: 10.1016/j.ajo.2016.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/19/2016] [Accepted: 10/19/2016] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate glaucoma progression in eyes with glaucoma that developed unilateral branch retinal vein occlusion (BRVO) in the contralateral eye. DESIGN Retrospective, case-control study. METHODS Participants: Forty glaucoma patients with unilateral BRVO and 40 age- and baseline mean deviation (MD) of the visual field (VF)-matched glaucoma patients were evaluated during at least 4 years of follow-up. OBSERVATION PROCEDURES Glaucoma progression was defined as VF progression using the modified Anderson criteria of the MD of the VF. Kaplan-Meier life table analyses were performed to compare times to confirmed VF progression, and related risk factors were evaluated using the Cox proportional hazards model. MAIN OUTCOME MEASURES VF progression. RESULTS Comparison of the baseline characteristics between the glaucomatous eyes that developed BRVO and the contralateral glaucomatous eyes that did not develop BRVO showed that BRVO occurred in the more advanced-stage eyes. Patients with glaucoma with BRVO in the fellow eyes had significant and frequent detection of disc hemorrhage (35.0%), which was 7.5% in patients with glaucoma without BRVO (P = .003). Four (10%) patients from the glaucoma group without BRVO and 22 (55.0%) patients from the glaucoma group with BRVO in the fellow eye showed progression according to the modified Anderson criteria (P < .001). Disc hemorrhage and the presence of BRVO in the fellow eye were found to be significantly predictive of VF progression using the Cox proportional hazards model. CONCLUSIONS More advanced glaucomatous eyes develop BRVO. Patients who developed BRVO showed more rapid glaucoma progression in the contralateral eyes without BRVO compared with glaucoma patients who did not develop BRVO.
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Garcia-Horton A, Al-Ani F, Lazo-Langner A. Retinal vein thrombosis: The Internist's role in the etiologic and therapeutic management. Thromb Res 2016; 148:118-124. [PMID: 27838473 DOI: 10.1016/j.thromres.2016.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/29/2016] [Accepted: 11/03/2016] [Indexed: 02/04/2023]
Abstract
Retinal vein occlusion is a common and important cause of vision loss. In general, knowledge about this condition is scant within an internist's practice but the condition is relevant because of its association with other chronic ailments. A diagnosis of RVO should prompt the investigation of conditions needing chronic management in these patients. In this review we summarize the clinical presentation of RVO, its classification, associated risk factors, and treatment focused in the internist's scope of practice.
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Affiliation(s)
- Alejandro Garcia-Horton
- Department of Medicine, Division of Hematology, University of Western Ontario, London, ON, Canada
| | - Fatimah Al-Ani
- Department of Medicine, Division of Hematology, University of Western Ontario, London, ON, Canada
| | - Alejandro Lazo-Langner
- Department of Medicine, Division of Hematology, University of Western Ontario, London, ON, Canada; Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada.
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Ponto KA, Elbaz H, Peto T, Laubert-Reh D, Binder H, Wild PS, Lackner K, Pfeiffer N, Mirshahi A. Prevalence and risk factors of retinal vein occlusion: the Gutenberg Health Study. J Thromb Haemost 2015; 13:1254-63. [PMID: 25894549 DOI: 10.1111/jth.12982] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 03/22/2015] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To determine the age- and sex-specific prevalence and determinants of retinal vein occlusions (RVOs) in a large population-based German cohort. METHODS The investigation included 15,010 participants (aged 35-74 years) from the Gutenberg Health Study. We determined the prevalence of RVO (central retinal vein occlusion [CRVO] and branch retinal vein occlusion [BRVO]) for the local population by assessing fundus photographs of 12 954 (86.3%; 49.8% women and 50.2% men) participants. Further, we analyzed the associations of RVO with cardiovascular, anthropometric, and ophthalmic parameters. RESULTS The weighted prevalences of RVO, CRVO, and BRVO were 0.40%, 0.08%, and 0.32%, respectively. Men were 1.7 times more frequently affected by RVO than were women. Prevalence of RVO was 0.2% in participants aged 35-44 and 45-54 years, respectively, 0.48% in those aged 55-64 years, and 0.92% in those aged 65-74 years. Of persons with RVO, 91.5% had one or more cardiovascular risk factor or disease vs. 75.9% of persons without RVO. BRVO was associated with arterial hypertension (odds ratio 2.69, 95% confidence interval 1.27-5.70) and atrial fibrillation (3.37, 1.24-9.12) and CRVO with higher age (7.02, 1.63-30.19) and a family history of stroke (4.64, 1.18-18.25). Median visual acuity (base 10 logarithm of minimum angle of resolution) was 0.2 in persons with RVO vs. 0.05 in those without. CONCLUSION The prevalence of RVO in this German population was 0.4%, and men were 1.7 times more frequently affected than women. CRVO was associated with higher age and a family history of stroke, and BRVO was associated with arterial hypertension and atrial fibrillation.
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Affiliation(s)
- K A Ponto
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - H Elbaz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
- Department of Ophthalmology, University of Marburg, Marburg, Germany
| | - T Peto
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - D Laubert-Reh
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Department of Medicine 2, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - H Binder
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P S Wild
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Department of Medicine 2, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site RhineMain, Mainz, Germany
| | - K Lackner
- Institute for Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - N Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - A Mirshahi
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Dardenne Eye Hospital, Bonn-Bad Godesberg, Mainz, Germany
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25
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Tsuda S, Kunikata H, Shimura M, Aizawa N, Omodaka K, Shiga Y, Yasuda M, Yokoyama Y, Nakazawa T. Pulse-waveform analysis of normal population using laser speckle flowgraphy. Curr Eye Res 2014; 39:1207-15. [PMID: 24749668 DOI: 10.3109/02713683.2014.905608] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Laser speckle flowgraphy (LSFG), a new, non-invasive method of measuring the mean blur rate (MBR) of ocular blood flow, allows for the analysis of the pulse waveform of a heartbeat as it changes dynamically. Here, we investigated the relationship between the pulse waveform and clinical parameters, particularly age. MATERIALS AND METHODS Sixty eyes of 60 healthy subjects without diabetes were enrolled from among patients undergoing annual health examinations. LSFG, and its analysis software, were used to determine pulse waveform parameters including MBR, skew, blowout score (BOS), blowout time (BOT), rising rate and falling rate in the optic nerve head (ONH), both specifically in the tissue area and in the ONH overall. Fifteen clinical parameters were also recorded, including age and blood pressure, as well as triglyceride and creatinine levels. RESULTS Skew, BOT and falling rate had a strong correlation (|r| > 0.60) with age, but not with the other clinical parameters. This correlation with age was stronger in the tissue area (BOT: p < 0.0001, r = - 0.68; skew: p < 0.0001, r = 0.65; falling rate: p < 0.0001, r = 0.61) than in the ONH overall (BOT: p < 0.0001, r = -0.67; skew: p < 0.0001, r = 0.60; falling rate: p < 0.0001, r = 0.59). Stepwise multiple regression analysis revealed that tissue area falling rate was an independent factor indicating age, and conversely that age was an independent factor indicating tissue area falling rate. CONCLUSIONS The significant correlation of LSFG-measured tissue area falling rate with age suggests that it may be a new candidate biomarker for age-dependent microcirculation.
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Affiliation(s)
- Satoru Tsuda
- Department of Ophthalmology, Tohoku University Graduate School of Medicine , Sendai, Miyagi , Japan and
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26
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Park CH, Park HY, Yoon JY, Park CK. Diurnal Fluctuation of Ocular Perfusion Pressure in the Fellow Eyes of Branch Retinal Vein Occlusion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.2.237] [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]
Affiliation(s)
- Chang Hyun Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hae Young Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jae Yoon Yoon
- Department of Ophthalmology, Saevit Eye Hospital, Goyang, Korea
| | - Chan Kee Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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27
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Bello-Rodriguez BM, Sanchez-Cruz G, Delgado-Bustillo F, Asiama G. The relationship between metabolic syndrome and target organ damage in Ghanaian with stage-2 hypertension. Ghana Med J 2013; 47:189-196. [PMID: 24669025 PMCID: PMC3961852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES To determine the frequency of Metabolic syndrome (MetS) in stage-2 hypertension and to assess the influence of MetS components over target organ damage (TOD) in Ghanaian patients. METHODS Forty adult patients with stage-2 hypertension were enrolled in a cross-sectional study developed at the Police Hospital, Accra, between 1st February 2009 and 31st January 2010. Diagnosis of MetS was based on The National Cholesterol Education Program in Adult Treatment Panel Revised in 2005 criteria. The alterations on the heart, aortic and carotid arteries, retina, and kidneys were evaluated through the clinical examination including retinal funduscopy, chest X-Ray, ECG, and serum creatinine quantification. The Brain CT-scan was performed on the patients with clinical cerebrovascular disease manifestations. RESULTS MetS was diagnosed in 25 cases (62.5%); female sex revealed significant association with MetS (OR, 4.88; 95% CI, 1.19-19.94; P=0.027). Ninety-five percent of patients had TOD. Coronary disease was associated with MetS (OR, 4.43; 95% CI, 1.026-19,27; P=0.047) and diabetes mellitus as single MetS component (OR, 14.00; 95% CI, 1.56-125.61; P=0.018). A positive significant correlation was shown of age with cerebrovascular disease (r=0.381; P=0.015) and coronary disease (r=0.623; P=0.000). Non-significant correlation or association (P>0.05) was shown between number of MetS components and number of TOD. CONCLUSIONS In stage-2 hypertension patients a high frequency of MetS with a risk increase in female sex was observed. This stage hypertension is for itself an individual risk to develop cardiovascular disease with high frequency none related with MetS, although coronary disease risk was increased in diabetic patients.
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Affiliation(s)
- B M Bello-Rodriguez
- Cuban Medical Brigade, Ministry of Health, Accra, Ghana and Centre of Epidemiology and Public Health, Matanzas, Cuba
| | - G Sanchez-Cruz
- Police Hospital, Accra, Ghana and Hospital Universitario "Comandante Faustino Pérez", Matanzas, Cuba
| | - F Delgado-Bustillo
- Cuban Medical Brigade, Ministry of Health, Accra, Ghana and Collaboration Unit of Cuban Medical Brigade, MINSAP, La Habana, Cuba
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28
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Actis AG, Belli L, Dall'orto L, Penna R, Brogliatti B, Rolle T. Morphology of optic disc through heidelberg retina tomograph in retinal vein occlusions alone or in combination with primary open angle glaucoma. Open Ophthalmol J 2013; 7:34-41. [PMID: 23961303 PMCID: PMC3744860 DOI: 10.2174/1874364101307010034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 07/08/2013] [Accepted: 07/08/2013] [Indexed: 11/26/2022] Open
Abstract
Purpose: To evaluate the morphology of optic discs in eyes suffering from retinal vein occlusion (RVO) alone or in combination with primary open-angle glaucoma (POAG). Methods: Prospective, observational study. 48 consecutive patients were enrolled, 30 with unilateral RVO diagnosis, 18 with unilateral retinal vein occlusion (RVO) associated with POAG. We divided RVOs on the basis of occlusion site: arterio-venous crossing (AV-RVO), optic cup (OC-RVO), optic nerve (ON-RVO) with head nerve swelling (ONHS-RVO) or without it (NONHS-RVO). A control group of 25 patients who were sex and age matched was selected. Results: Comparing the fellow eyes of the patients with RVO and control healthy eyes, no differences emerged in cup/disc ratio but they came out for the HRT values in Rim Area, cup shape measure and height variation contour (p<0.05). The most frequent occlusion site was at the level of an arteriovenous crossing in patients not suffering from POAG (36.7%) and at the level of the optic cup in patients with RVO and POAG (50%). In the RVO group without POAG, the OC-RVO subgroup has shown an higher cup area (0.366±0.094) and cup/disc area ratio (0.184±0.063), a lower rim volume (0.374±0.021) and a different cup shape measure (-0.221±0.066) (p<0.05) compared with the AV and NONHS sites. Compared with NONHS group differences emerged also for the fibres parameters and in the height variation contour (0.346±0.081). Also in the RVO group with POAG significant differences (p<0.05) have been surveyed between OC-RVO and other occlusion sites in cup area (0.119±0.029), cup/disc area ratio (0.532±0.09), rim volume (0.374±0.07), cup/shape measure (-0.079±0.013). Conclusions: Classification of the analyzed parameters on the basis of the occlusion site provides a basis for which clinical decisions and research on causal factors in future studies can be based on.
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Affiliation(s)
- Alessandro Guido Actis
- Department of Surgical Sciences, Eye Clinic and Doctoral School in Life and Health Sciences. University of Turin. Italy
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29
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Chen SJ, Lu P, Zhang WF, Lu JH. High myopia as a risk factor in primary open angle glaucoma. Int J Ophthalmol 2012; 5:750-3. [PMID: 23275912 DOI: 10.3980/j.issn.2222-3959.2012.06.18] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 11/25/2012] [Indexed: 12/20/2022] Open
Abstract
Glaucoma, one of the leading causes of irreversible blindness in the adult population worldwide, is a progressive optic neuropathy. Primary open angle glaucoma (POAG) is the most commonly reported type of glaucoma in population based prevalence studies worldwide. Elevated intraocular pressure is a well-known major risk factor for POAG. In addition, there is growing evidence that other risk factors like age, gender, race, refractive error, heredity and systemic factors may play a role in glaucoma pathogenesis. Many studies found that high myopia has been associated with POAG, however, direct and convincing evidences are still lacking. The aim of this review is to summarize the evidences implicating high myopia as a risk factor in the pathogenesis of POAG.
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Affiliation(s)
- Sheng-Ju Chen
- Department of Ophthalmology, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu Province, China
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