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Tian H, Xu W, Wen L, Song T, Tian Y, Tang L, Guo N, Chen Q, Wang H, Zhang K, Zhang X, Peng Y. Relationship between CCL2 gene 2518A/G (rs1024611) polymorphism and age-related macular degeneration susceptibility: meta-analysis and trial sequential analysis. Int Ophthalmol 2024; 44:348. [PMID: 39141020 DOI: 10.1007/s10792-024-03266-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/29/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE This study aimed to investigate the association between the CC-cytokine ligand-2 (CCL2) 2518A/G (rs1024611) single nucleotide polymorphism (SNP) and susceptibility to age-related macular degeneration (AMD). METHODS PubMed, Embase, Web of Science, and other databases were searched for articles published before August 24, 2023. After searching, data extraction, and quality assessment, meta-analysis and trial sequential analysis were conducted using RevMan 5.4, Stata 17.0, and TSA 0.9.5.10 Beta software. Combined OR, P values, and 95% confidence intervals (CIs) were calculated. Sensitivity analysis, subgroup analysis and publication bias assessment were also performed. RESULTS Six articles, comprising 1186 cases and 1124 controls, were included. No significant statistical difference was found in six main outcomes. However, due to observed heterogeneity and high sensitivity, subgroup analysis was performed, revealing statistically significant differences across different regions. No significant publication bias was observed. Trial sequential analysis suggested the need for additional follow-up case-control studies to further validate the findings. CONCLUSION The CCL2 gene 2518A/G (rs1024611) polymorphism is associated with AMD susceptibility. Among Caucasian populations in West Asia and Europe, the G allele is protective against AMD, whereas in East and South Asia, it poses a risk factor.
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Affiliation(s)
- Haokun Tian
- Joint Programme of Nanchang University and Queen Mary University of London, Nanchang University, Nanchang, China
- Queen Mary School, Nanchang University, Nanchang, China
- Nanchang Joint Programme, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Weikai Xu
- Joint Programme of Nanchang University and Queen Mary University of London, Nanchang University, Nanchang, China
- Queen Mary School, Nanchang University, Nanchang, China
- Nanchang Joint Programme, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Lequan Wen
- Joint Programme of Nanchang University and Queen Mary University of London, Nanchang University, Nanchang, China
- Queen Mary School, Nanchang University, Nanchang, China
- Nanchang Joint Programme, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Tiangang Song
- Joint Programme of Nanchang University and Queen Mary University of London, Nanchang University, Nanchang, China
- Queen Mary School, Nanchang University, Nanchang, China
- Nanchang Joint Programme, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Ye Tian
- Joint Programme of Nanchang University and Queen Mary University of London, Nanchang University, Nanchang, China
- Queen Mary School, Nanchang University, Nanchang, China
- Nanchang Joint Programme, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Lirui Tang
- Joint Programme of Nanchang University and Queen Mary University of London, Nanchang University, Nanchang, China
- Queen Mary School, Nanchang University, Nanchang, China
- Nanchang Joint Programme, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Nan Guo
- The Third Affiliated Hospital of Nanchang University, Nanchang, China
- The Third Clinical Medical College, Nanchang University, Nanchang, China
| | - Qianxi Chen
- Joint Programme of Nanchang University and Queen Mary University of London, Nanchang University, Nanchang, China
- Queen Mary School, Nanchang University, Nanchang, China
- Nanchang Joint Programme, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Haoran Wang
- Joint Programme of Nanchang University and Queen Mary University of London, Nanchang University, Nanchang, China
- Queen Mary School, Nanchang University, Nanchang, China
- Nanchang Joint Programme, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Kaiyuan Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xinyuan Zhang
- Joint Programme of Nanchang University and Queen Mary University of London, Nanchang University, Nanchang, China
- Queen Mary School, Nanchang University, Nanchang, China
- Nanchang Joint Programme, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Yu Peng
- Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Nanchang, China.
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Vujosevic S, Alovisi C, Chakravarthy U. Epidemiology of geographic atrophy and its precursor features of intermediate age-related macular degeneration. Acta Ophthalmol 2023; 101:839-856. [PMID: 37933608 DOI: 10.1111/aos.15767] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 11/08/2023]
Abstract
Globally age-related macular degeneration (AMD) is a leading cause of blindness with a significant impact on quality of life. Geographic atrophy (GA) is the atrophic late form of AMD and its prevalence increases markedly with age with around 1 in 5 persons aged 85 and above having GA in at least one eye. Bilateral GA leads to severe visual impairment thus posing a significant burden on patients, careers and health providers. The incidence and prevalence of GA varies across different geographic regions, with the highest rates in those of European ancestry. Although heterogeneity in definitions of GA and reporting strategy can explain some of the discrepancies, the data overall are consistent in showing a lower prevalence in other ethnicities such as those of Asian heritage. This is at present unexplained but thought to be due to the existence of protective factors such as differences in eye pigmentation, diet, environmental exposures and genetic variability. This review covers key aspects of the prevalence and incidence of the ocular precursor features of GA (large drusen, pigmentary abnormalities and reticular pseudo-drusen), the late stage of GA and factors that have been known to be associated with modifying risk including systemic, demographic, environment, genetic and ocular. Understanding the global epidemiology scenario is crucial for the prevention of and management of patients with GA.
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Affiliation(s)
- Stela Vujosevic
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Eye Clinic, IRCCS MultiMedica, Milan, Italy
| | | | - Usha Chakravarthy
- Center for Public Health, Queen's University of Belfast, Belfast, Northern Ireland
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Tan AC, Chee ML, Fenner BJ, Mitchell P, Tham YC, Rim T, Teo K, Sim SS, Cheng CY, Wong TY, Chakravarthy U, Cheung CMG. Six-year incidence of age-related macular degeneration and correlation to OCT-derived drusen volume measurements in a Chinese population. Br J Ophthalmol 2023; 107:392-398. [PMID: 34607789 DOI: 10.1136/bjophthalmol-2021-319290] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/18/2021] [Indexed: 11/03/2022]
Abstract
AIMS To report the 6-year incidence of optical coherence tomography (OCT)-derived age-related changes in drusen volume and related systemic and ocular associations. METHODS Chinese adults aged 40 years and older were assessed at baseline and 6 years with colour fundus photography (CFP) and spectral domain (SD) OCT. CFPs were graded for age-related macular degeneration (AMD) features and drusen volume was generated using commercially available automated software. RESULTS A total of 4172 eyes of 2580 participants (mean age 58.12±9.03 years; 51.12% women) had baseline and 6-year follow-up CFP for grading, of these, 2130 eyes of 1305 participants had gradable SD-OCT images, available for analysis. Based on CFP grading, 136 (3.39%) participants developed incident early AMD and 10 (0.25%) late AMD. Concurrently, retinal pigment epithelial-Bruch's membrane (RPE-BrC) volumes decreased, remained stable and increased in 6.8%, 78.5% and 14.7%, respectively, over 6 years. In eyes where RPE-BrC volumes were >0 mm3 at baseline, this was associated with two-fold higher prevalence rate of any AMD at baseline (p<0.001). Multivariable analysis showed that when compared with eyes where RPE-BrC volume was unchanged, volume decrease was significantly associated with older age (OR=1.30; p<0.001), smoking (OR=2.21; p=0.001) and chronic kidney disease (OR=3.4, p=0.008), while increase was associated with older age (OR=1.36; p<0.001) and hypertension (OR=1.43; p=0.016). CONCLUSION AMD incidence detected at 6 years on CFP and correlated OCT-derived drusen volume measurement change is low. Older age and some systemic risk factors are associated with drusen volume change, and our data provide new insights into relationship between systemic risk factors and outer retinal morphology in Asian eyes.
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Affiliation(s)
- Anna Cs Tan
- Singapore National Eye Centre, Singapore.,Duke-NUS, Singapore.,Singapore Eye Research Institute, Singapore
| | | | - Beau J Fenner
- Singapore National Eye Centre, Singapore.,Duke-NUS, Singapore.,Singapore Eye Research Institute, Singapore
| | - Paul Mitchell
- Centre for Vision Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Yih Chung Tham
- Singapore National Eye Centre, Singapore.,Duke-NUS, Singapore.,Singapore Eye Research Institute, Singapore
| | - Tyler Rim
- Singapore National Eye Centre, Singapore.,Duke-NUS, Singapore.,Singapore Eye Research Institute, Singapore
| | - Kelvin Teo
- Singapore National Eye Centre, Singapore.,Duke-NUS, Singapore.,Singapore Eye Research Institute, Singapore.,Save Sight Institute, Sydney, New South Wales, Australia
| | - Shaun S Sim
- Singapore National Eye Centre, Singapore.,Duke-NUS, Singapore.,Singapore Eye Research Institute, Singapore
| | - Ching Yu Cheng
- Singapore National Eye Centre, Singapore.,Duke-NUS, Singapore.,Singapore Eye Research Institute, Singapore
| | - Tien Yin Wong
- Singapore National Eye Centre, Singapore.,Duke-NUS, Singapore.,Singapore Eye Research Institute, Singapore
| | | | - Chui Ming Gemmy Cheung
- Singapore National Eye Centre, Singapore .,Duke-NUS, Singapore.,Singapore Eye Research Institute, Singapore
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4
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Li C, Zhu B, Zhang J, Guan P, Zhang G, Yu H, Yang X, Liu L. Epidemiology, health policy and public health implications of visual impairment and age-related eye diseases in mainland China. Front Public Health 2022; 10:966006. [PMID: 36438305 PMCID: PMC9682104 DOI: 10.3389/fpubh.2022.966006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/26/2022] [Indexed: 11/10/2022] Open
Abstract
The prevalence of visual impairment (VI) and age-related eye diseases has increased dramatically with the growing aging population in mainland China. However, there is limited comprehensive evidence on the progress of ophthalmic epidemiological research in mainland China to enhance our awareness of the prevention of eye diseases to inform public health policy. Here, we conducted a literature review of the population-based epidemiology of VI and age-related eye diseases in mainland China from the 1st of January 1946 to the 20th of October 2021. No language restrictions were applied. There was significant demographic and geographic variation in the epidemic of VI and age-related eye diseases. There are several factors known to be correlated to VI and age-related eye diseases, including age, gender, family history, lifestyle, biological factors, and environmental exposures; however, evidence relating to genetic predisposition remains unclear. In addition, posterior segment eye diseases, including age-related macular degeneration and diabetic retinopathy, are amongst the major causes of irreversible visual impairments in the senile Chinese population. There remains a significant prevention gap, with only a few individuals showing awareness and achieving optimal medical care with regards to age-related eye diseases. Multiple challenges and obstacles need to be overcome, including the accelerated aging of the Chinese population, the lack of structured care delivery in many underdeveloped regions, and unequal access to care. Despite the progress to date, there are few well-conducted multi-center population-based studies following a single protocol in mainland China, which findings can hopefully provide valuable cues for governmental decision-making and assist in addressing and halting the incidence of VI and age-related eye diseases in China.
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Affiliation(s)
- Cong Li
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,School of Medicine, South China University of Technology, Guangzhou, China
| | - Bo Zhu
- Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Jie Zhang
- Department of Retina, Weifang Eye Hospital, Weifang, China
| | - Peng Guan
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Guisen Zhang
- Department of Retina, Inner Mongolia Chaoju Eye Hospital, Hohhot, China
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,*Correspondence: Honghua Yu
| | - Xiaohong Yang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,Xiaohong Yang
| | - Lei Liu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,Lei Liu
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5
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Hwang S, Kang SW, Choi J, Son KY, Lim DH, Shin DW, Kim K, Kim SJ. Lipid profile and future risk of exudative age-related macular degeneration development: a nationwide cohort study from South Korea. Sci Rep 2022; 12:18777. [PMID: 36335257 PMCID: PMC9637211 DOI: 10.1038/s41598-022-23607-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022] Open
Abstract
This nationwide population-based cohort study evaluated the association between lipid profiles and the future risk of exudative age-related macular degeneration (AMD) using authorized clinical data provided by the Korean National Health Insurance Service. A total of 6,129,616 subjects over 50 years of age who participated in the Korean National Health Screening Program in 2013 or 2014 were included. Data on risk factors, including age, sex, comorbidities, behavioral factors, and baseline lipid profiles, including total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride (TG) levels were collected. Patients were followed-up patients until December 2018, and incident cases of exudative AMD were identified using registered diagnostic codes. During an average follow-up period of 4.91 years, 18,803 patients were newly diagnosed with exudative AMD. Compared to the lowest HDL cholesterol quartile group, the highest HDL cholesterol quartile group had a greater risk of future exudative AMD development with a hazard ratio (95% confidence interval) of 1.13 (1.08-1.18) in the fully adjusted model. The highest TG quartile group had a lower risk of exudative AMD than the lowest TG quartile group, with a hazard ratio (95% confidence interval) of 0.84 (0.81-0.88). High HDL cholesterol and low TG levels were prospectively associated with exudative AMD incidence.
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Affiliation(s)
- Sungsoon Hwang
- grid.414964.a0000 0001 0640 5613Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea ,grid.264381.a0000 0001 2181 989XDepartment of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Se Woong Kang
- grid.414964.a0000 0001 0640 5613Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea
| | - Jaehwan Choi
- grid.414964.a0000 0001 0640 5613Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea
| | - Ki Young Son
- grid.414964.a0000 0001 0640 5613Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea
| | - Dong Hui Lim
- grid.414964.a0000 0001 0640 5613Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea ,grid.264381.a0000 0001 2181 989XDepartment of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Dong Wook Shin
- grid.264381.a0000 0001 2181 989XDepartment of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea ,grid.414964.a0000 0001 0640 5613Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ,grid.264381.a0000 0001 2181 989XDepartment of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Kyunga Kim
- grid.264381.a0000 0001 2181 989XDepartment of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea ,grid.414964.a0000 0001 0640 5613Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sang Jin Kim
- grid.414964.a0000 0001 0640 5613Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea
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Liang CL, Wang CM, Jung CR, Chang YC, Lin CJ, Lin YT, Hwang BF. Fine particulate matter measured by satellites predicts the risk of age-related macular degeneration in a longitudinal cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:51942-51950. [PMID: 35257331 DOI: 10.1007/s11356-022-19278-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
Although studies have revealed that ambient particulate matter (PM) has detrimental effects on the ocular surface, there have been limited reports detailing the effect of ambient PM on the posterior segment of the eye. A large-scale longitudinal cohort study evaluating the association between fine PM, especially PM2.5, and the retina could elucidate the risk of ambient pollutants for retinal diseases. We investigated the association between PM2.5 and the development of age-related macular degeneration (AMD). We conducted a population-based cohort study of 4,284,128 participants in Taiwan between 2001 and 2011. PM2.5 was continuously measured by satellites and subsequently assigned to each geographic district along with its postcode. A time-dependent Cox proportional-hazard model was used to assess the overall effects of average PM2.5. We used distributed lag non-linear models to evaluate the dose-response relationship between PM2.5 and AMD development. The annual mean of PM2.5 exposure was 34.23 ± 7.17 μg/m3. The PM2.5 concentrations were highest in spring, followed by those in winter, autumn, and summer. Twelve thousand ninety-five new AMD cases were reported during the study period. After adjusting for covariates, the AMD risk increased by 19% (95% confidence interval 1.13-1.25) for a 10 μg/m3 PM2.5 increase. The present study demonstrated that chronic exposure to PM2.5 increases the risk of AMD. Almost half of the Taiwanese live in a polluted area where the PM2.5 levels are higher than the World Health Organization recommended air quality guideline of 10 μg/m3 had a 1.4-fold risk, which significantly increases concern about their visual health and social burden.
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Affiliation(s)
- Chung-Ling Liang
- Center for Myopia and Eye Disease, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Bright Eyes Clinic, Kaohsiung, Taiwan
| | - Chi-Min Wang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chau-Ren Jung
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Ya-Chu Chang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
| | - Yu-Ting Lin
- Big Data Center, China Medical University Hospital, China Medical University, North District, No. 2, Yude Road, Taichung, 40447, Taiwan
| | - Bing-Fang Hwang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan.
- Department of Occupational Therapy, College of Medical and Health Science, Asia UniversityJingmao RdBeitun Dist, No. 100, Sec. 1, Taichung, 406040, Taiwan.
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Kido A, Miyake M, Tamura H, Hiragi S, Kimura T, Yoshida S, Takeuchi M, Ohtera S, Takahashi A, Ooto S, Kawakami K, Kuroda T, Tsujikawa A. Incidence and Clinical Practice of Exudative Age-related Macular Degeneration. OPHTHALMOLOGY SCIENCE 2022; 2:100125. [PMID: 36249688 PMCID: PMC9559904 DOI: 10.1016/j.xops.2022.100125] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/05/2022] [Accepted: 02/07/2022] [Indexed: 11/26/2022]
Abstract
Purpose To elucidate the incidence and treatment pattern of active exudative age-related macular degeneration (AMD). Design A population-based cohort study conducted using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), a national claims database managed by the Japanese Ministry of Health, Labour, and Welfare (MHLW). Participants The entire Japanese population aged 40 years or older (76 million people). Methods With the permission of the MHLW, we accessed the complete NDB dataset and identified patients with newly diagnosed active exudative AMD between 2011 and 2018. The incidence of active exudative AMD was categorized by age and sex per year between 2011 and 2018; moreover, details regarding first-line therapy and number of anti-vascular endothelial growth factor (VEGF) injections per elapsed year since initial treatment were obtained and changes in treatment pattern were investigated. Main Outcome Measures Incidence rate of active exudative AMD. Results During the specified 8-year period, 246 064 incident cases of active exudative AMD were identified; 61.4% of these patients were men. The overall incidence rate was 40.66 per 100 000 person-years (95% confidence interval [CI], 40.49–40.82) in the general population aged 40 years or older, 53.22 (95% CI, 52.95–53.49) in men, and 29.78 (95% CI, 29.60–29.98) in women. Mean age of onset was lower in men than in women (72.51 ± 10.50 years vs. 73.90 ± 10.46 years). Among patients with newly diagnosed active exudative AMD, 92.9% received anti-VEGF injections for initial treatments, whereas 1.8% underwent combination therapy with photodynamic therapy. The number of anti-VEGF injections in the first year (0–12 months), second year (13–24 months), and third year (25–36 months) after the initial injection was 3.66 ± 2.30, 1.39 ± 2.20, and 1.23 ± 2.19, respectively. Patients who received fewer injections in the first year received fewer injections in subsequent years and vice versa. Conclusions This is a relatively large population-based study on the detailed epidemiology and actual treatment patterns of active exudative AMD in clinical practice. Our results can be a fundamental information source to ensure healthy eyes and promote well-being for all at all ages.
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Evaluation of vascular endothelial growth factor (VEGF) level in the tears and serum of age-related macular degeneration patients. Sci Rep 2022; 12:4423. [PMID: 35292705 PMCID: PMC8924159 DOI: 10.1038/s41598-022-08492-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 03/08/2022] [Indexed: 11/09/2022] Open
Abstract
Age-related macular degeneration (AMD) is an important cause of irreversible central blindness worldwide. Clinical manifestations range from asymptomatic in early and intermediate AMD to significant vision loss in late AMD. Approximately 10% of cases of early AMD eventually progress to the late advanced stage, influenced by the upregulation of vascular endothelial growth factor (VEGF). In this study, we evaluated VEGF concentration in the tears and serum of AMD patients. Our study revealed a significantly higher level of VEGF in the tears of patients with AMD compared with controls. The tear VEGF level has high sensitivity and specificity, and is significantly related to the severity of AMD, whilst serum VEGF level is non-specific and non-predictive of AMD severity. Thus, VEGF level in the tears may be used as a non-invasive biomarker for AMD progression. A large cohort study is needed for further verification.
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Zhang Y, Bai W, Li R, Du Y, Sun R, Li T, Kang H, Yang Z, Tang J, Wang N, Liu H. Cost-Utility Analysis of Screening for Diabetic Retinopathy in China. HEALTH DATA SCIENCE 2022; 2022:9832185. [PMID: 38487485 PMCID: PMC10904067 DOI: 10.34133/2022/9832185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/01/2022] [Indexed: 03/17/2024]
Abstract
Background. Diabetic retinopathy (DR) has been primarily indicated to cause vision impairment and blindness, while no studies have focused on the cost-utility of telemedicine-based and community screening programs for DR in China, especially in rural and urban areas, respectively.Methods. We developed a Markov model to calculate the cost-utility of screening programs for DR in DM patients in rural and urban settings from the societal perspective. The incremental cost-utility ratio (ICUR) was calculated for the assessment.Results. In the rural setting, the community screening program obtained 1 QALY with a cost of $4179 (95% CI 3859 to 5343), and the telemedicine screening program had an ICUR of $2323 (95% CI 1023 to 3903) compared with no screening, both of which satisfied the criterion of a significantly cost-effective health intervention. Likewise, community screening programs in urban areas generated an ICUR of $3812 (95% CI 2906 to 4167) per QALY gained, with telemedicine screening at an ICUR of $2437 (95% CI 1242 to 3520) compared with no screening, and both were also cost-effective. By further comparison, compared to community screening programs, telemedicine screening yielded an ICUR of 1212 (95% CI 896 to 1590) per incremental QALY gained in rural setting and 1141 (95% CI 859 to 1403) in urban setting, which both meet the criterion for a significantly cost-effective health intervention.Conclusions. Both telemedicine and community screening for DR in rural and urban settings were cost-effective in China, and telemedicine screening programs were more cost-effective.
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Affiliation(s)
- Yue Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing, China
| | - Weiling Bai
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing, China
| | - Ruyue Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing, China
| | - Yifan Du
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing, China
| | - Runzhou Sun
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing, China
| | - Tao Li
- College of Computer Science, Nankai University, Tianjin, China
| | - Hong Kang
- College of Computer Science, Nankai University, Tianjin, China
| | - Ziwei Yang
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Jianjun Tang
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing, China
- National Institute of Health Data Science at Peking University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Hanruo Liu
- National Institute of Health Data Science at Peking University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
- School of Information and Electronics, Beijing Institute of Technology, Beijing, China
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10
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Wang Y, Zhong Y, Zhang L, Wu Q, Tham Y, Rim TH, Kithinji DM, Wu J, Cheng C, Liang H, Yu H, Yang X, Liu L. Global Incidence, Progression, and Risk Factors of Age-Related Macular Degeneration and Projection of Disease Statistics in 30 Years: A Modeling Study. Gerontology 2021; 68:721-735. [PMID: 34569526 DOI: 10.1159/000518822] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/29/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Age-related macular degeneration(AMD) has become a major cause of visual impairment worldwide, especially in the elderly. Estimates of incidence, progression rates, and risk factors of AMD vary among studies, complicating the understanding of its epidemiology. METHODS For this systematic review and meta-analysis, literature published up to March 1, 2021, was searched in both English and Chinese databases. Hierarchical Bayesian approaches were used to estimate pooled incidence, progression, and 95% credible intervals (CrIs). RESULTS Thirty studies were included. The pooled annual early and late AMD incidence rates were 1.59 (95% CrI: 1.18-2.11) and 0.23 (95% CrI: 0.14-0.34) per 100 person-years, respectively. The annual progression rate of AMD was 5.5 (95% CrI: 2.3-8.8) per 100 person-years. Smoking was an independent risk factor for both early and late AMD, whereas age, high-density lipoprotein cholesterol, and alcohol consumption were risk factors for early AMD incidence only. The projected number of new cases of early and late AMD in 2050 would be 39.05 million (95% CrI: 23.12-63.57) and 6.41 million (95% CrI: 3.37-13.22), respectively. CONCLUSION The prediction the number of new cases of AMD is not equal across the globe. Our findings indicate the need for more rigorous control and prevention measures in AMD focus on its risk factors for early intervention. The epidemiological estimates reported in this study could inform to identify effective strategies for preventing AMD worldwide.
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Affiliation(s)
- Yuye Wang
- Department of Neurology, The First affiliated Hospital of China Medical University, Shenyang, China
| | - Yifan Zhong
- Department of Ophthalmology, The First affiliated Hospital of China Medical University, Shenyang, China
| | - Liang Zhang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore City, Singapore
| | - Qijun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yihchung Tham
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore City, Singapore
| | - Tyler Hyungtaek Rim
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore City, Singapore
| | | | - Jingyang Wu
- Department of Ophthalmology, The First affiliated Hospital of China Medical University, Shenyang, China
| | - Chingyu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore City, Singapore.,Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore City, Singapore
| | - Huiying Liang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Xiaohong Yang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Lei Liu
- Department of Ophthalmology, The First affiliated Hospital of China Medical University, Shenyang, China.,Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
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11
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Ng Yin Ling C, Lim SC, Jonas JB, Sabanayagam C. Obesity and risk of age-related eye diseases: a systematic review of prospective population-based studies. Int J Obes (Lond) 2021; 45:1863-1885. [PMID: 33963292 DOI: 10.1038/s41366-021-00829-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/18/2021] [Accepted: 04/21/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Obesity is a public health challenge worldwide. The relationship between obesity and age-related eye diseases including cataract, glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy (DR) have remained elusive. DESIGN AND METHODS We conducted a systematic review of three electronic databases for longitudinal population-based studies that described associations between measures of obesity including body mass index (BMI), waist-circumference (WC), and waist-to-hip ratio (WHR), and age-related eye diseases. RESULTS Our search yielded 1731 articles, of which 14, 10, 16 and 8 articles met our eligibility criteria for cataract, glaucoma, AMD and DR, respectively. BMI-defined obesity was positively associated with incident cataract, incident AMD and incident DR in Western populations, but in Asian populations associations for incident AMD were not significant and associations for incident DR were inverse. WC-defined obesity was associated with incident glaucoma in non-Western populations. WHR-defined obesity but not BMI-defined obesity was associated with the incidence or progression of AMD in two Western studies. CONCLUSIONS Overall, we found strong evidence supporting associations between obesity and age-related eye diseases. Further research on the association of abdominal obesity and effect of weight loss and physical activity on age-related eye diseases is warranted to support clinical and public health recommendations.
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Affiliation(s)
| | - Su Chi Lim
- Khoo Tech Puat Hospital, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. .,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
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12
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Teo KYC, Cheong KX, Ong R, Hamzah H, Yanagi Y, Wong TY, Chakravarthy U, Cheung CMG. Macular neovascularization in eyes with pachydrusen. Sci Rep 2021; 11:7495. [PMID: 33820941 PMCID: PMC8021555 DOI: 10.1038/s41598-021-87083-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/16/2021] [Indexed: 12/14/2022] Open
Abstract
The natural history and clinical significance of pachydrusen is unclear. This study aims to compare the longitudinal changes of eyes with pachydrusen and soft drusen and progression to exudative macular neovascularisation (MNV). Patients with a diagnosis of MNV in one eye only and the fellow eye was selected as the study eye. Study eyes were required to have pachydrusen or soft drusen on fundus photographs and follow up of at least 2 years or until exudative MNV occurred. Systematic grading was performed at baseline and change in drusen area and onset of exudative MNV recorded over the period of follow up. A total of 75 eyes from 75 patients (29 with pachydrusen and 46 with soft drusen) were included. There was no difference in the rate of progression to exudative MNV in the soft and pachydrusen groups (13.3% versus 24.1%, p = 0.38). Pachydrusen, as compared to soft drusen, was associated with polypoidal choroidal vasculopathy subtype (85.7% versus 16.7%, p < 0.01) and the location of exudation was co-localised with soft drusen but not with pachydrusen. There was a higher rate of increase in soft drusen area compared to pachydrusen area (27.7 ± 31.9%/year versus 8.7 ± 12.4%/year respectively, p < 0.01). We found no difference in the proportion of eyes that developed exudative MNV in this study however characterisation of drusen evolution patterns revealed a strong association with exudative MNV subtype.
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Affiliation(s)
- Kelvin Yi Chong Teo
- Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
- Singapore Eye Research Institute, Singapore 20 College Road Discovery Tower, Level 6 The Academia, Singapore, 169856, Singapore
- University of Sydney, Camperdown, NSW, 2006, Australia
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 1E Kent Ridge, NUHS Tower Block, Level 7, Singapore, 119228, Singapore
- Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Kai Xiong Cheong
- Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
- Singapore Eye Research Institute, Singapore 20 College Road Discovery Tower, Level 6 The Academia, Singapore, 169856, Singapore
| | - Ricardo Ong
- Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Haslina Hamzah
- Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Yasuo Yanagi
- Singapore Eye Research Institute, Singapore 20 College Road Discovery Tower, Level 6 The Academia, Singapore, 169856, Singapore
- Department of Ophthalmology, Asahikawa Medical University, Hokkaido, Japan
| | - Tien Yin Wong
- Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
- Singapore Eye Research Institute, Singapore 20 College Road Discovery Tower, Level 6 The Academia, Singapore, 169856, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 1E Kent Ridge, NUHS Tower Block, Level 7, Singapore, 119228, Singapore
- Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Usha Chakravarthy
- School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, 97 Lisburn Rd, Belfast, BT9 7BL, UK
| | - Chui Ming Gemmy Cheung
- Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore.
- Singapore Eye Research Institute, Singapore 20 College Road Discovery Tower, Level 6 The Academia, Singapore, 169856, Singapore.
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 1E Kent Ridge, NUHS Tower Block, Level 7, Singapore, 119228, Singapore.
- Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore.
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13
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Joo K, Mun YS, Park SJ, Park KH, Woo SJ. Ten-Year Progression From Intermediate to Exudative Age-Related Macular Degeneration and Risk Factors: Bundang AMD Cohort Study Report 1. Am J Ophthalmol 2021; 224:228-237. [PMID: 33279454 DOI: 10.1016/j.ajo.2020.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/08/2020] [Accepted: 11/20/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE This study investigated the 10-year incidence of progression from intermediate to exudative age-related macular degeneration (AMD) and identified genetic and environmental factors influencing that progression in the Korean population. DESIGN Retrospective, observational cohort study. METHODS In total, 632 eyes of 418 patients (age: ≥50 years) with intermediate AMD were enrolled. The incidence of exudative AMD was assessed from color fundus photographs and optical coherence tomography images obtained at baseline and during annual visits. Data regarding lifestyle variables and dietary habits were acquired through comprehensive questionnaires. Genotyping data concerning 3 single nucleotide polymorphisms (SNPs), rs800292 and rs1061170 in the CFH gene and rs10490924 in ARMS2 were also analyzed. The cumulative incidence of exudative changes was estimated using Kaplan-Meier analysis. Associated influential factors were evaluated using univariate and multivariate Cox regression models. RESULTS The mean follow-up period was 3.99 ± 2.85 years. The cumulative incidence of progression to exudative AMD was 5.6%, 14.8%, and 28.4% at 2, 5, and 10 years, respectively. Multivariate Cox analysis showed that age (hazard ratio [HR]: 1.041; P = .0393), family history of AMD (HR: 3.175; P = .0184), and pre-existing exudative AMD in the fellow eye (HR: 3.186; P = 5.31 × 10-5) were positively associated with exudative changes. Regular intake of green tea (HR: 0.632; P = .0475) was associated with a decrease in exudative changes. The ARMS2 SNP rs10490924 (HR: 1.482; P = .0185) showed a significant association with AMD progression. CONCLUSIONS The annual progression rate from intermediate to exudative AMD in the Korean population is approximately 2.8%, which is comparable with that for whites. Intake of green tea may be a modifiable protective factor against exudative changes.
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14
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Hadziahmetovic M, Malek G. Age-Related Macular Degeneration Revisited: From Pathology and Cellular Stress to Potential Therapies. Front Cell Dev Biol 2021; 8:612812. [PMID: 33569380 PMCID: PMC7868387 DOI: 10.3389/fcell.2020.612812] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/23/2020] [Indexed: 12/12/2022] Open
Abstract
Age-related macular degeneration (AMD) is a neurodegenerative disease of the aging retina, in which patients experience severe vision loss. Therapies available to patients are limited and are only effective in a sub-population of patients. Future comprehensive clinical care depends on identifying new therapeutic targets and adopting a multi-therapeutic approach. With this goal in mind, this review examines the fundamental concepts underlying the development and progression of AMD and re-evaluates the pathogenic pathways associated with the disease, focusing on the impact of injury at the cellular level, with the understanding that critical assessment of the literature may help pave the way to identifying disease-relevant targets. During this process, we elaborate on responses of AMD vulnerable cells, including photoreceptors, retinal pigment epithelial cells, microglia, and choroidal endothelial cells, based on in vitro and in vivo studies, to select stressful agents, and discuss current therapeutic developments in the field, targeting different aspects of AMD pathobiology.
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Affiliation(s)
- Majda Hadziahmetovic
- Duke Eye Center, Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States
| | - Goldis Malek
- Duke Eye Center, Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States.,Department of Pathology, Duke University School of Medicine, Durham, NC, United States
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15
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Zhou M, Duan PC, Liang JH, Zhang XF, Pan CW. Geographic distributions of age-related macular degeneration incidence: a systematic review and meta-analysis. Br J Ophthalmol 2020; 105:1427-1434. [PMID: 32907810 DOI: 10.1136/bjophthalmol-2020-316820] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/16/2020] [Accepted: 08/18/2020] [Indexed: 01/17/2023]
Abstract
PURPOSE We performed a systematic review and meta-analysis to summarise the geographic distribution of age-related macular degeneration (AMD) incidence. METHODS Databases including PubMed, Embase and Web of Science were searched for publications of early and late AMD before September 2019. Studies were included if they applied a standardised photographic assessment and classification system. The proportion of participants with AMD in each eligible study was combined to obtain a pooled incidence from all studies using a random effects model. We also assessed sources of potential heterogeneity in the incidence of AMD using meta-regression analyses for both late and early AMD. RESULTS Twenty-four population-based studies (70 123 individuals aged 55 years or older) were included in the meta-analysis. The pooled global annual incidences of early and late AMD were 1.59% (95% CI 1.12% to 2.10%) and 0.19% (95% CI: 0.13% to 0.28%), respectively. Individuals of European descent had the highest annual incidence of both early (2.73%, 95% CI 1.63% to 4.57%) and late (0.36%, 95% CI 0.17% to 0.75%) AMD than other ethnic groups. Average age (p=0.001) at baseline, ethnicity (p=0.001), region (p=0.043) and gender (p=0.011) were predictors for incident late AMD, while only average age (p=0.01) at baseline and ethnicity (p=0.025) was associated with incidence of early AMD. CONCLUSIONS This meta-analysis offers an up-to-date overview of AMD globally, which may provide scientific guidance for the design and implementation of public health strategies such as screening programmes for AMD in both specific geographic locations and ethnic groups, as well as worldwide.
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Affiliation(s)
- Miao Zhou
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Pei-Chen Duan
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jing-Hong Liang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xiao-Feng Zhang
- Department of Ophthalmology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
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16
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Hu A, Gu SZ, Friedman DS, Cao K, Wang N. Six-Year Incidence and Causes of Low Vision and Blindness in a Rural Chinese Adult Population: The Handan Eye Study. Ophthalmic Epidemiol 2020; 28:160-168. [PMID: 32744100 DOI: 10.1080/09286586.2020.1795886] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To determine the six-year incidence, risk factors, and causes of visual impairment in a Chinese population. METHODS This was a population-based study of eye disease in Chinese adults in a rural district of Handan in China. 6,830 individuals were invited to participate in 2006 and 5,394 returned for follow-up in 2012. All participants underwent standardized eye examinations. Visual impairment was defined according to WHO criteria. The incidence of visual impairment was age- and gender-standardized to the 2010 China Census. Multivariable logistic regression analysis was used to determine risk factors for visual impairment. RESULTS The leading causes of visual impairment were cataract and refractive error. Based on presenting visual acuity (PVA), the six-year incidence rates of low vision and blindness were 5.2% and 0.5%, respectively. Incidence of low vision was associated with older age (p < .001), less education (p < .001), diabetes (p < .05), and lower BMI (p < .001). The incidence of blindness was associated with diabetes (p < .05). Based on best-corrected visual acuity (BCVA), the six-year incidence rates of low vision and blindness were 0.8% and 0.1%, respectively. Incidence of low vision was associated with older age (p < .001) and lower BMI (p < .05). None of these factors were associated with the incidence of blindness. CONCLUSION In Handan, the incidence of visual impairment was high and associated with older age, less education, diabetes, and lower BMI. The majority of cases were due to unoperated cataract and uncorrected refractive error, reflecting the need for improved eye care in this region.
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Affiliation(s)
- Ailian Hu
- Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing
| | - Sophie Z Gu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David S Friedman
- Glaucoma Center of Excellence, Massachusetts Eye and Ear Glaucoma Center of Excellence, Harvard Medical School, Boston, Massachusetts, USA
| | - Kai Cao
- Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing
| | - Ningli Wang
- Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing
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17
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Wong TY, Cheung CMG, Lai TYY, Chen SJ, Lee WK, Yoon YH, Iida T, Tueckmantel C, Sowade O, Ogura Y. EFFICACY AND SAFETY OF INTRAVITREAL AFLIBERCEPT AND RANIBIZUMAB IN ASIAN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: Subgroup Analyses From the VIEW Trials. Retina 2020; 39:537-547. [PMID: 29280937 PMCID: PMC6410967 DOI: 10.1097/iae.0000000000001986] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the treatment effect of intravitreal aflibercept and ranibizumab in Asian patients with neovascular age-related macular degeneration. METHODS We evaluated data from VIEW 1 and VIEW 2, comparing functional and morphologic outcomes at Week 96 between intravitreal aflibercept 2 mg monthly (2q4) or 2 mg bimonthly after 3 initial monthly doses (2q8) versus ranibizumab 0.5 mg monthly among Asian patients (n = 269) and between Asian and white patients (n = 2044). RESULTS In Asian patients, there were no significant differences between intravitreal aflibercept 2q4 and 2q8 compared with ranibizumab in mean gain in best-corrected visual acuity (10.23 and 8.35 vs. 8.51 letters). Reduction in central retinal thickness was greater for intravitreal aflibercept 2q4 (150.43 μm, P = 0.0075) and 2q8 (148.15 μm, P = 0.0126) than ranibizumab (119.46 μm). The proportion of dry retinas was greater for intravitreal aflibercept 2q4 (65.7%, P < 0.01) than ranibizumab (41.7%). There were no differences in outcomes between Asian and white patients. Serious treatment-emergent ocular adverse events occurred in <8% of treated eyes, evenly distributed across subgroups. CONCLUSION In Asian patients with neovascular age-related macular degeneration, functional and morphologic outcomes were largely similar between intravitreal aflibercept and ranibizumab groups, and to results seen in white patients.
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Affiliation(s)
- Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, The Academia, Singapore.,Duke-NUS Graduate Medical School, National University of Singapore, Singapore
| | - Chui Ming Gemmy Cheung
- Singapore Eye Research Institute, Singapore National Eye Center, The Academia, Singapore.,Duke-NUS Graduate Medical School, National University of Singapore, Singapore
| | - Timothy Y Y Lai
- Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Shih-Jen Chen
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, People's Republic of China.,National Yang-Ming University School of Medicine, Taipei, Taiwan, People's Republic of China
| | - Won Ki Lee
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Young Hee Yoon
- Department of Ophthalmology, University of Ulsan, College of Medicine, Ulsan, South Korea.,Asan Medical Center, Seoul, South Korea
| | - Tomohiro Iida
- Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan
| | | | | | - Yuichiro Ogura
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
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18
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Mao F, Yang X, Yang K, Cao X, Cao K, Hao J, Zhang Y, Wang N. Six-Year Incidence and Risk Factors for Age-Related Macular Degeneration in a Rural Chinese Population: The Handan Eye Study. ACTA ACUST UNITED AC 2019; 60:4966-4971. [PMID: 31790559 DOI: 10.1167/iovs.19-27325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Feifei Mao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Capital Medical University, Beijing, China
- Beijing DiTan Hospital, Capital Medical University, Beijing, China
| | - Xiaohui Yang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ke Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Xusheng Cao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jie Hao
- Clinical Research Center, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ye Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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19
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Talks J, Daien V, Finger RP, Eldem B, Sakamoto T, Cardillo JA, Mitchell P, Wong TY, Korobelnik JF. The use of real-world evidence for evaluating anti–vascular endothelial growth factor treatment of neovascular age-related macular degeneration. Surv Ophthalmol 2019; 64:707-719. [DOI: 10.1016/j.survophthal.2019.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 12/15/2022]
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20
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Genetic risk score has added value over initial clinical grading stage in predicting disease progression in age-related macular degeneration. Sci Rep 2019; 9:6611. [PMID: 31036867 PMCID: PMC6488669 DOI: 10.1038/s41598-019-43144-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/17/2019] [Indexed: 11/23/2022] Open
Abstract
Several prediction models for progression of age-related macular degeneration (AMD) have been developed, but the added value of using genetic information in those models in addition to clinical characteristics is ambiguous. In this prospective cohort study, we explored the added value of genetics using a genetic risk score (GRS) based on 52 AMD-associated variants, in addition to the clinical severity grading at baseline as quantified by validated drusen detection software, to predict disease progression in 177 AMD patients after 6.5 years follow-up. The GRS was strongly associated with the drusen coverage at baseline (P < 0.001) and both the GRS and drusen coverage were associated with disease progression. When the GRS was added as predictor in addition to the drusen coverage, R2 increased from 0.46 to 0.56. This improvement by the GRS was predominantly seen in patients with a drusen coverage <15%. In patients with a larger drusen coverage, the GRS had less added value to predict progression. Thus, genetic information has added value over clinical characteristics in predicting disease progression in AMD, but only in patients with a less severe disease stage. Patients with a high GRS should be made aware of their risk and could be selected for clinical trials for arresting progression.
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21
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Farinha CVL, Cachulo ML, Alves D, Pires I, Marques JP, Barreto P, Nunes S, Costa J, Martins A, Sobral I, Laíns I, Figueira J, Ribeiro L, Cunha-Vaz J, Silva R. Incidence of Age-Related Macular Degeneration in the Central Region of Portugal: The Coimbra Eye Study - Report 5. Ophthalmic Res 2019; 61:226-235. [PMID: 30820012 DOI: 10.1159/000496393] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 12/17/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE To describe the 6.5-year incidence and progression of age-related macular degeneration (AMD) in a coastal town of central Portugal. METHODS Population-based cohort study. Participants underwent standardized interviews and ophthalmological examination. Color fundus photographs were graded according to the International Classification and Grading System for AMD and ARM. The crude and age-standardized incidence of early and late AMD was calculated, and progression was analyzed. RESULTS The 6.5-year cumulative incidence of early AMD was 10.7%, and of late AMD it was 0.8%. The incidence of early AMD was 7.2, 13.1 and 17.7% for participants aged 55-64, 65-74 and 75-84 years (p < 0.001). The late AMD incidence was 0.3, 0.9 and 2.8% for the corresponding age groups (p = 0.003). The age-standardized incidence was 10.8% (95% CI, 10.74-10.80%) for early and 1.0% (95% CI, 1.00-1.02%) for late AMD. The incidence of both neovascular AMD and geographic atrophy was 0.4%. Progression occurred in 17.2% of patients. CONCLUSION The early AMD incidence in a coastal town of central Portugal was found to be similar to that of major epidemiological studies of European-descent populations; however, the incidence of late AMD was lower, and further analysis on risk factors will be conducted.
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Affiliation(s)
- Cláudia Virgínia Louro Farinha
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal, .,Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal, .,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal,
| | - Maria Luz Cachulo
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Dalila Alves
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Isabel Pires
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - João Pedro Marques
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Patrícia Barreto
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Sandrina Nunes
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - José Costa
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Amélia Martins
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Isa Sobral
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Inês Laíns
- Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal.,Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - João Figueira
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Luísa Ribeiro
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Rufino Silva
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra (iCBR-FMUC), Coimbra, Portugal
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22
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Sabanayagam C, Banu R, Chee ML, Lee R, Wang YX, Tan G, Jonas JB, Lamoureux EL, Cheng CY, Klein BEK, Mitchell P, Klein R, Cheung CMG, Wong TY. Incidence and progression of diabetic retinopathy: a systematic review. Lancet Diabetes Endocrinol 2019; 7:140-149. [PMID: 30005958 DOI: 10.1016/s2213-8587(18)30128-1] [Citation(s) in RCA: 243] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/06/2018] [Accepted: 04/06/2018] [Indexed: 12/23/2022]
Abstract
Diabetic retinopathy is a leading cause of vision impairment and blindness. We systematically reviewed studies published from Jan 1, 1980, to Jan 7, 2018, assessed the methodological quality, and described variations in incidence of diabetic retinopathy by region with a focus on population-based studies that were conducted after 2000 (n=8, including two unpublished studies). Of these eight studies, five were from Asia, and one each from the North America, Caribbean, and sub-Saharan Africa. The annual incidence of diabetic retinopathy ranged from 2·2% to 12·7% and progression from 3·4% to 12·3%. Progression to proliferative diabetic retinopathy was higher in individuals with mild disease compared with those with no disease at baseline. Our Review suggests that more high-quality population-based studies capturing data on the incidence and progression of diabetic retinopathy with stratification by age and sex are needed to consolidate the evidence base. Our data is useful for conceptualisation and development of major public health strategies such as screening programmes for diabetic retinopathy.
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Affiliation(s)
- Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Riswana Banu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Miao Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Ryan Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Gavin Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Jost B Jonas
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China; Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Paul Mitchell
- Centre for Vision Research, University of Sydney, Sydney, NSW, Australia
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - C M Gemmy Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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23
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Rim TH, Yoo TK, Kim SH, Kim DW, Kim SS. Incidence of exudative age-related macular degeneration and treatment load under the Korean national health insurance system in 2010-2015. Br J Ophthalmol 2018; 103:1361-1366. [PMID: 30573498 DOI: 10.1136/bjophthalmol-2018-312693] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/21/2018] [Accepted: 11/27/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIM The aim of this study was to estimate the nationwide incidence of clinically diagnosed exudative age-related macular degeneration (AMD) and associated use of ranibizumab and aflibercept in South Korea. METHODS In this retrospective, population-based cohort study, claims data for 2010-2015 were analysed in a randomly selected sample of 519 661 adults aged ≥40 years. The incidence per 10 000 person-years was estimated, along with the 95% CI. Incident exudative AMD was defined based on the registration code for rare intractable diseases. Use of ranibizumab and aflibercept and the incidence of exudative AMD were recorded. RESULTS Nine hundred and twelve patients were newly diagnosed with exudative AMD in 2010-2015. The 6-year incidence in the general population aged ≥40 years was 2.9 (95% CI 2.8 to 3.0) per 10 000 person-years. The incidence was highest in individuals aged 75-79 years (12.0, 95% CI 10.3 to 13.8). The incidence was higher in men than in women in all age groups. Six hundred and twenty-five (69%) of the 912 newly diagnosed patients started ranibizumab or aflibercept as a first-line treatment. The average number of injections administered was 6.1 (SD 3.9; minimum of 1 injection and maximum government-supported limit of 14) during 2010-2015; the number increased with increasing government funding support (from 5 to 10 and from 10 to 14 in 2013 and 2014, respectively). CONCLUSIONS This study describes the incidence of exudative AMD in South Korea and its treatment under the national health insurance system in this country. Its findings could be used for reference purposes and be useful when planning treatment for exudative AMD.
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Affiliation(s)
- Tyler Hyungtaek Rim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Keun Yoo
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Seo Hee Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Wook Kim
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
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24
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Cheung CMG, Gan A, Yanagi Y, Wong TY, Spaide R. Association between Choroidal Thickness and Drusen Subtypes in Age-Related Macular Degeneration. ACTA ACUST UNITED AC 2018; 2:1196-1205. [DOI: 10.1016/j.oret.2018.06.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 06/14/2018] [Accepted: 06/25/2018] [Indexed: 01/11/2023]
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25
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Gürbüz Yurtseven Ö, Aksoy S, Karatay Arsan A, Buyru Özkurt Y, Kökçen HK. Evaluation of the Relationship Between Age-related Macular Degeneration and Refractive Error, Socio-demographic Features, and Biochemical Variables in a Turkish Population. Turk J Ophthalmol 2018; 48:238-244. [PMID: 30405945 PMCID: PMC6216530 DOI: 10.4274/tjo.97254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 04/09/2018] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To investigate the relationship between age-related macular degeneration (AMD) and refractive error and axial length, as well as the socio-demographic characteristics and biochemical variables that may affect this relationship. MATERIALS AND METHODS A total of 196 eyes of 98 patients over 50 years of age who were diagnosed with AMD at our clinic were included in this cross-sectional study. Early and late AMD findings were categorized according to the age-related eye disease study grading scale. Objective refractive error was measured by autorefractometer, confirmed by subjective examination, and spherical equivalent was calculated. Refractive errors of -0.50 D to 0.50 D were classified as emmetropia, <-0.50 D as myopia, and >0.50 D as hyperopia. Axial length was measured by ultrasonic biometry and values ≤23.00 mm were classified as short, >23.00 and <24.00 mm as normal, and ≥24.00 mm as long axial length. Demographic, systemic, and biochemical parameters of all patients were also investigated. RESULTS Hypermetropic refractive error and shorter axial length were significantly more common than the other groups (p<0.01). No differences were observed between early and late stage groups in terms of refractive error and axial length. Patients with myopia had significantly lower values for total cholesterol, triglyceride, fasting blood glucose, and proportion of smokers. Rates of oral nutritional supplement use and fish consumption were significantly higher in the early AMD group. The most common comorbidity among the AMD patients in our study was essential hypertension. CONCLUSION Hyperopic refractive error and shorter axial length were found to be associated with AMD. Longitudinal studies including larger patient numbers are needed to elucidate the causal and temporal relationship between hyperopic refractive error and AMD.
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Affiliation(s)
| | - Sibel Aksoy
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey
| | - Aysu Karatay Arsan
- University of Health Sciences, Kartal Dr. Lütfi Kırdar Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey
| | - Yelda Buyru Özkurt
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey
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26
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Correlation of Color Fundus Photograph Grading with Risks of Early Age-related Macular Degeneration by using Automated OCT-derived Drusen Measurements. Sci Rep 2018; 8:12937. [PMID: 30154521 PMCID: PMC6113205 DOI: 10.1038/s41598-018-31109-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/28/2018] [Indexed: 01/17/2023] Open
Abstract
We evaluated automated OCT-derived drusen volume measures in a population-based study (n = 4,512) aged ≥40 years, and its correlation with conventional color fundus photographs (CFP)-derived early AMD features. Participants had protocol-based assessment to capture medical and ocular history, genotyping for SNPs in CFH, ARMS2, and CETP, CFP-based AMD grading and automated drusen volume based on SD-OCT using built-in software (Cirrus OCT advanced RPE analysis software). Significantly fewer eyes with early AMD features (drusen, hyperpigmentation, soft or reticular drusen) had drusen volume = 0 mm3 (p < 0.001). In eyes with drusen volume > 0 mm3, increasing AMD severity was associated with increase in drusen volume (correlation coefficient 0.17, p < 0.001). However 220 (59.14%) of 372 participants with AMD based on CFP grading had drusen volume = 0 mm3. Factors associated with drusen volume included age (OR 1.42 per 5 years, 95% confidence interval [CI] 2.76, 4.48), systolic blood pressure (OR1.00, 95% CI 1.00, 1.01), ethnic Malay (OR 1.54, 95% CI 1.29, 1.83) and Chinese (OR 1.66, 95% CI 1.37, 2.01) compared to Indian. The ARMS2 rs10490924 T allele was associated with increased drusen volume in subjects with AMD (multivariable adjusted OR1.54, 95% CI 1.08, 2.19). Automated OCT-derived drusen volume is correlated with CFP-based AMD grading in many, but not all subjects. However the agreement is not good. These two modalities provide complementary information and should be incorporated into future studies.
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27
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Six-Year Incidence and Risk Factors of Age-Related Macular Degeneration in Singaporean Indians: The Singapore Indian Eye Study. Sci Rep 2018; 8:8869. [PMID: 29891972 PMCID: PMC5995892 DOI: 10.1038/s41598-018-27202-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/21/2018] [Indexed: 02/07/2023] Open
Abstract
We aimed to determine the 6-year incidence and risk factors of age-related macular degeneration (AMD) in first and second generations of Singaporean Indians. Baseline examination was conducted in 2007-9 and 6-year propsective follow-up examination of this Indian population in 2013-5. All participants underwent interviews with questionnaires and comprehensive medical and eye examinations. Incidence was age-standardized to Singaporean 2010 census. Risk factors associated with AMD incidence were assessed and compared between first and second generations of immigrants. Among 2200 persons who participated in the follow-up examination (75.5% response rate), gradable fundus photographs were available in 2105. The 6-year age-standardized incidences of early and late AMD were 5.26% and 0.51% respectively. Incident early AMD was associated with cardiovascular disease history (HR 1.59, 95% CI 1.04-2.45), underweight body mass index (BMI) (HR 3.12, 95% CI 1.37-7.14) (BMI of <18.5 vs 18.51-25 kg/m2), heavy alcohol drinking (HR 3.14 95% CI 1.25-7.89) and ARMS2 rs3750847 homozygous genetic loci carrier (HR 2.52, 95% CI 1.59-3.99). We found a relatively low incidence of early AMD in this Singaporean Indian population compared to Caucasian populations. Both first and second-generation Indian immigrants have similar incidence and risk factor patterns for early AMD.
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28
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Tan NYQ, Chew M, Tham YC, Nguyen QD, Yasuda M, Cheng CY, Wong TY, Sabanayagam C. Associations between sleep duration, sleep quality and diabetic retinopathy. PLoS One 2018; 13:e0196399. [PMID: 29795569 PMCID: PMC5968411 DOI: 10.1371/journal.pone.0196399] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 04/10/2018] [Indexed: 01/09/2023] Open
Abstract
Background Abnormal durations of sleep have been associated with risk of diabetes. However, it is not clear if sleep duration is associated with diabetic retinopathy (DR). Methods In a cross-sectional study, we included 1,231 (Malay, n = 395; Indian, n = 836) adults (mean age 64.4 ± 9.0 years, 50.4% female) with diabetes from the second visit of two independent population-based cohort studies (2011–15) in Singapore. Self-reported habitual sleep duration was categorized as short (<6 h), normal (6≤ h <8), and long (≥8 h). Questionnaires were administered to detect risk of obstructive sleep apnea (OSA), excessive daytime sleepiness, and insomnia, all of which may indicate poor quality of sleep. The associations between sleep-related characteristics with moderate DR and vision-threatening DR (VTDR) were analysed using logistic regression models adjusted for potential confounders. Results Prevalence of moderate DR and VTDR in the study population were 10.5% and 6.3% respectively. The mean duration of sleep was 6.4 ± 1.5 h. Compared to normal sleep duration, both short and long sleep durations were associated with moderate DR with multivariable odds ratio (95% confidence interval) of 1.73 (1.03–2.89) and 2.17 (1.28–3.66) respectively. Long sleep duration (2.37 [1.16–4.89]), high risk of OSA (2.24 [1.09–4.75]), and excessive daytime sleepiness (3.27 [1.02–10.30]) were separately associated with VTDR. Conclusion Sleep duration had a U-shaped association with moderate DR; long sleep duration, excessive daytime sleepiness and high risk of OSA were positively associated with VTDR.
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Affiliation(s)
- Nicholas Y. Q. Tan
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore
- Department of Ophthalmology, National University Hospital, Singapore
| | - Merwyn Chew
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore
- Department of Ophthalmology, National University Hospital, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore
| | - Quang Duc Nguyen
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore
| | - Masayuki Yasuda
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- * E-mail:
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29
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Differential effect of body mass index on the incidence of diabetes and diabetic retinopathy in two Asian populations. Nutr Diabetes 2018; 8:16. [PMID: 29549238 PMCID: PMC5856769 DOI: 10.1038/s41387-018-0018-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/08/2018] [Accepted: 01/12/2018] [Indexed: 01/24/2023] Open
Abstract
AIMS To examine the association of body mass index (BMI) with the incidence of diabetes mellitus (DM) and diabetic retinopathy (DR) in Asians. METHODS We analysed data from 4101 adults (Malay, n = 1901 and Indian, n = 2200) who participated in the baseline (2004-2009) and 6-year follow-up (2011-2015) of two independent population-based studies with similar methodology in Singapore. BMI was categorised into normal (<25 kg/m2), overweight (25-29.9 kg/m2) and obese (≥30 kg/m2). DM was diagnosed as random plasma glucose ≥200 mg/dL, HbA1c ≥6.5% or self-reported physician diagnosed DM. DR was assessed from retinal photographs graded using a standard protocol. The associations of baseline BMI with incident DM and DR was examined using multivariable poisson regression models adjusting for potential confounders including duration of DM, family history of DM and HbA1c. RESULTS The incidence of DM was 12.8% and among 1586 participants with DM, the incidence of DR was 17.6% over a median follow-up period of 6.2 years. Compared to those with BMI < 25, the relative risk (95% confidence interval) of incident DM was 1.77 (1.36-2.29) for overweight and 2.01 (1.50-2.71) for obese (p trend < 0.001). Relative risk of DR was 0.80 (0.59-1.09) for overweight and 0.60 (0.39-0.92) for obese (p trend = 0.02). In analyses stratified by ethnicity, similar pattern of associations with DM and DR were observed in both ethnicities. CONCLUSION Our results suggest that, overweight and obesity increased the 6-year risk of DM but decreased the 6-year risk of DR in these Asian populations.
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30
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Tan NYQ, Chan J, Cheng CY, Wong TY, Sabanayagam C. Sleep Duration and Diabetic Kidney Disease. Front Endocrinol (Lausanne) 2018; 9:808. [PMID: 30692966 PMCID: PMC6340267 DOI: 10.3389/fendo.2018.00808] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/21/2018] [Indexed: 12/22/2022] Open
Abstract
Aims: Abnormally short or long durations of sleep have been proposed as a risk factors for diabetes and its micro- and macro-vascular complications. However, the relationship between sleep duration and diabetic kidney disease (DKD) has not been well-characterized. Thus, we aimed to examine the association of sleep duration with DKD in two Asian populations. Methods: We included 1,258 persons (Malay, n = 403; Indian, n = 855) aged 40-80 years with diabetes from a population-based cross-sectional sample from Singapore. DKD was defined by low estimated glomerular filtration rate (eGFR <60 mL/min/1.73 m2) and albuminuria (urinary albumin-to-creatinine ratio ≥30 mg/g, only measured in Indian participants). Self-reported habitual sleep duration was categorized into 4 categories: very short (<5 h), short (5-6.9 h), normal (7-8 h) and long (>8 h). The associations of sleep duration with low eGFR and albuminuria were analyzed using multivariable logistic regression models adjusted for multiple potential confounders (including classic risk factors such as HbA1c and hypertension). Results: In total, 268 (21.3%) participants had low eGFR, and 271 (34.7% in Indians) had albuminuria. The number (%) of individuals with very short, short, normal, and long durations of sleep were 117 (9.3%), 629 (50.0%), 429 (34.1%), and 83 (6.6%), respectively. Long sleep duration was associated with a higher odds of renal insufficiency compared to normal sleep duration (OR [95% CI]: 2.31 [1.27-4.19]) on multivariable analysis. Similarly, both long and very short durations of sleep were associated with higher odds of albuminuria (OR [95%]: 2.44 [1.36, 4.38] and 2.37 [1.25, 4.50], respectively) in Indian participants (where data on albuminuria were available). Conclusions: Our study suggests that abnormally short or long durations of sleep were associated with DKD, manifesting as either a reduced eGFR or increased albuminuria. However, further longitudinal data would be required for confirmation.
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Affiliation(s)
- Nicholas Y. Q. Tan
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | - Joel Chan
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Tien Yin Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- *Correspondence: Charumathi Sabanayagam
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