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Mathis T, Baudin F, Mariet AS, Augustin S, Bricout M, Przegralek L, Roubeix C, Benzenine É, Blot G, Nous C, Kodjikian L, Mauget-Faÿsse M, Sahel JA, Plevin R, Zeitz C, Delarasse C, Guillonneau X, Creuzot-Garcher C, Quantin C, Hunot S, Sennlaub F. DRD2 activation inhibits choroidal neovascularization in patients with Parkinson's disease and age-related macular degeneration. J Clin Invest 2024:e174199. [PMID: 39012703 DOI: 10.1172/jci174199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024] Open
Abstract
Neovascular age-related macular degeneration (nAMD) remains a major cause of visual impairment and puts considerable burden on patients and health care systems. L-DOPA-treated Parkinson Disease (PD) patients have been shown to be partially protected from nAMD, but the mechanism remains unknown. Using murine models, combining 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD and laser-induced nAMD, standard PD treatment of L-DOPA/DOPA-decarboxylase inhibitor, or specific dopamine receptor inhibitors, we here demonstrate that L-DOPA treatment-induced increase of dopamine mediated dopamine receptor D2 (DRD2) signaling inhibits choroidal neovascularization independently of MPTP-associated nigrostriatal pathway lesion. Analyzing a retrospective cohort of more than two hundred thousand nAMD patients receiving anti-VEGF treatment from the French nationwide insurance database, we show that DRD2-agonist treated (PD) patients have a significantly delayed age of onset for nAMD (81.4 (±7.0) vs 79.4 (±8.1) years old, respectively, p<0.0001) and reduced need for anti-VEGF therapies (-0.6 injections per 100 mg/day daily dose of DRD2 agonists the second year of treatment), similar to the L-DOPA treatment. While providing a mechanistic explanation for an intriguing epidemiological observation, our findings suggest that systemic DRD2 agonists might constitute an adjuvant therapy to delay and reduce the need for anti-VEGF therapy in nAMD patients.
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Affiliation(s)
- Thibaud Mathis
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Florian Baudin
- Ophthalmology, CHU de Dijon (University Hospital of Dijon), Dijon, France
| | | | | | - Marion Bricout
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | | | - Éric Benzenine
- Epidemiology, CHU de Dijon, Université de Bourgogne, Dijon, France
| | - Guillaume Blot
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Caroline Nous
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | | | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Robin Plevin
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Christina Zeitz
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Cécile Delarasse
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | | | | | - Stéphane Hunot
- Paris Brain Institute, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Florian Sennlaub
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
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Uzzan J, Haddad M, Salamé N. [Quality of life survey of 3,738 patients treated with intravitreal injections for age-related macular degeneration]. J Fr Ophtalmol 2024; 47:104075. [PMID: 38368762 DOI: 10.1016/j.jfo.2024.104075] [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: 05/01/2023] [Accepted: 07/03/2023] [Indexed: 02/20/2024]
Abstract
PURPOSE To evaluate the peri- and post-intravitreal injection (IVI) symptoms reported by patients who have been repeatedly injected for age-related macular degeneration (AMD) and to analyze these according to the protocols of the injector. MATERIALS AND METHODS Multi-center, cross-sectional, consecutive, analytical survey. RESULTS The IVI protocols of 106 injectors differed in terms of the number of instillations of povidone-iodine, its contact time, and rinsing of the ocular surface post-injection. In total, 3,738 patients responded to the survey, 60.1% of whom were women; 36.4% had received more than 20 IVIs; 50.7% of patients reported irritation upon application of povidone-iodine. Post-IVI, depending on the symptom in question, between 44.8% and 57.4% of patients reported symptoms of ocular surface change. The number of instillations of povidone-iodine, its contact time with the ocular surface, and abundant rinsing post-IVI increased the immediate symptoms. Patients who received more IVIs were more prone to experiencing gritty eyes, and the incidence of acute pain increased in patients who had previously received over 20 IVIs. Women and patients previously treated for dry eye or glaucoma were at greater risk of worse symptoms. CONCLUSION Comparing injecting centers' practices with patients' self-assessments showed an aggravation of symptoms of ocular surface changes related to povidone-iodine. This survey contributes to providing data for the implementation of a protocol to improve the quality of life of patients injected repeatedly for AMD.
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Affiliation(s)
- J Uzzan
- Clinique Mathilde Gpe Vivalto, 4, rue de Lessard, 76100 Rouen, France
| | - M Haddad
- Hôpital privé de la Baie, avenue du Quesnoy, 50300 Avranches, France
| | - N Salamé
- CHP Saint-Martin, 18, rue des Roquemonts, 14000 Caen, France.
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Rozanowska M, Edge R, Land EJ, Navaratnam S, Sarna T, Truscott TG. Scavenging of Cation Radicals of the Visual Cycle Retinoids by Lutein, Zeaxanthin, Taurine, and Melanin. Int J Mol Sci 2023; 25:506. [PMID: 38203675 PMCID: PMC10779001 DOI: 10.3390/ijms25010506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
In the retina, retinoids involved in vision are under constant threat of oxidation, and their oxidation products exhibit deleterious properties. Using pulse radiolysis, this study determined that the bimolecular rate constants of scavenging cation radicals of retinoids by taurine are smaller than 2 × 107 M-1s-1 whereas lutein scavenges cation radicals of all three retinoids with the bimolecular rate constants approach the diffusion-controlled limits, while zeaxanthin is only 1.4-1.6-fold less effective. Despite that lutein exhibits greater scavenging rate constants of retinoid cation radicals than other antioxidants, the greater concentrations of ascorbate in the retina suggest that ascorbate may be the main protectant of all visual cycle retinoids from oxidative degradation, while α-tocopherol may play a substantial role in the protection of retinaldehyde but is relatively inefficient in the protection of retinol or retinyl palmitate. While the protection of retinoids by lutein and zeaxanthin appears inefficient in the retinal periphery, it can be quite substantial in the macula. Although the determined rate constants of scavenging the cation radicals of retinol and retinaldehyde by dopa-melanin are relatively small, the high concentration of melanin in the RPE melanosomes suggests they can be scavenged if they are in proximity to melanin-containing pigment granules.
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Affiliation(s)
- Malgorzata Rozanowska
- Cardiff Institute of Tissue Engineering and Repair, Cardiff University, Cardiff CF10 3AX, UK
- School of Optometry and Vision Sciences, Cardiff University, Cardiff CF24 4HQ, UK
| | - Ruth Edge
- Dalton Cumbrian Facility, The University of Manchester, Westlakes Science Park, Moor Row, Cumbria CA24 3HA, UK;
| | - Edward J. Land
- The Paterson Institute, The University of Manchester, Wilmslow Road, Manchester M20 4BX, UK;
| | - Suppiah Navaratnam
- Biomedical Sciences Research Institute, University of Salford, Manchester M5 4WT, UK;
| | - Tadeusz Sarna
- Department of Biophysics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland;
| | - T. George Truscott
- School of Chemical and Physical Sciences, Lennard-Jones Building, Keele University, Staffordshire ST5 5BG, UK;
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Różanowska MB. Lipofuscin, Its Origin, Properties, and Contribution to Retinal Fluorescence as a Potential Biomarker of Oxidative Damage to the Retina. Antioxidants (Basel) 2023; 12:2111. [PMID: 38136230 PMCID: PMC10740933 DOI: 10.3390/antiox12122111] [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: 10/12/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
Lipofuscin accumulates with age as intracellular fluorescent granules originating from incomplete lysosomal digestion of phagocytosed and autophagocytosed material. The purpose of this review is to provide an update on the current understanding of the role of oxidative stress and/or lysosomal dysfunction in lipofuscin accumulation and its consequences, particularly for retinal pigment epithelium (RPE). Next, the fluorescence of lipofuscin, spectral changes induced by oxidation, and its contribution to retinal fluorescence are discussed. This is followed by reviewing recent developments in fluorescence imaging of the retina and the current evidence on the prognostic value of retinal fluorescence for the progression of age-related macular degeneration (AMD), the major blinding disease affecting elderly people in developed countries. The evidence of lipofuscin oxidation in vivo and the evidence of increased oxidative damage in AMD retina ex vivo lead to the conclusion that imaging of spectral characteristics of lipofuscin fluorescence may serve as a useful biomarker of oxidative damage, which can be helpful in assessing the efficacy of potential antioxidant therapies in retinal degenerations associated with accumulation of lipofuscin and increased oxidative stress. Finally, amendments to currently used fluorescence imaging instruments are suggested to be more sensitive and specific for imaging spectral characteristics of lipofuscin fluorescence.
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Affiliation(s)
- Małgorzata B. Różanowska
- School of Optometry and Vision Sciences, College of Biomedical and Life Sciences, Cardiff University, Maindy Road, Cardiff CF24 4HQ, Wales, UK;
- Cardiff Institute for Tissue Engineering and Repair (CITER), Redwood Building, King Edward VII Avenue, Cardiff CF10 3NB, Wales, UK
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Khanna S, Shaw L, Hyman MJ, Zhang J, Hariprasad S, Soo J, Flores A, Skondra D. Association of metformin use with risk of newly onset neovascular age-related macular degeneration development. Retina 2023; 44:00006982-990000000-00499. [PMID: 38408173 DOI: 10.1097/iae.0000000000003968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 10/03/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE To investigate if metformin use reduces the odds of developing new neovascular AMD (nAMD). METHODS This is a case-control study of 86,930 subjects with new diagnoses of nAMD and 86,918 matched controls using the Merative™ Marketscan® Research Databases. Subjects were analyzed using multivariable conditional logistic regression to identify the risks of various exposures on developing nAMD. A subgroup analysis of 22,117 diabetic cases and 21,616 diabetic controls was also performed. RESULTS Metformin use was associated with reduced odds ratio (OR) of developing nAMD (OR 0.95, 95% confidence interval 0.91-0.98) in full sample and diabetic cohort particularly in patients without any diabetic retinopathy (DR) -an effect that persisted after Bonferroni correction. In the diabetic cohort without DR, reduced OR was observed at 24-month cumulative doses of 1 to 300g, 301 to 630g, and 631 to 1080g. CONCLUSIONS Metformin use was associated with reduced OR of nAMD, particularly in patients without DR. The protective effect was noted for 24-month cumulative doses below 1080g. Metformin may be a novel preventive strategy for nAMD.
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Affiliation(s)
- Saira Khanna
- Department of Ophthalmology & Visual Science, University of Chicago Pritzker, School of Medicine, Chicago, IL, United States
- The Retina Institute, St. Louis, MO
| | - Lincoln Shaw
- Department of Ophthalmology & Visual Science, University of Chicago Pritzker, School of Medicine, Chicago, IL, United States
| | - Max J Hyman
- University of Chicago Division of the Biological Sciences, Chicago, IL, United States
| | - Jason Zhang
- Department of Ophthalmology & Visual Science, University of Chicago Pritzker, School of Medicine, Chicago, IL, United States
| | - Seenu Hariprasad
- Department of Ophthalmology & Visual Science, University of Chicago Pritzker, School of Medicine, Chicago, IL, United States
| | - Jackie Soo
- University of Chicago Division of the Biological Sciences, Chicago, IL, United States
| | - Andrea Flores
- University of Chicago Division of the Biological Sciences, Chicago, IL, United States
| | - Dimitra Skondra
- Department of Ophthalmology & Visual Science, University of Chicago Pritzker, School of Medicine, Chicago, IL, United States
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Brézin AP, Labbe A, Schweitzer C, Lignereux F, Rozot P, Goguillot M, Bugnard F, Dot C. Incidence of Nd:YAG laser capsulotomy following cataract surgery: a population-based nation-wide study - FreYAG1 study. BMC Ophthalmol 2023; 23:417. [PMID: 37845645 PMCID: PMC10578013 DOI: 10.1186/s12886-023-03134-6] [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: 04/20/2023] [Accepted: 09/12/2023] [Indexed: 10/18/2023] Open
Abstract
RATIONALE Nd:YAG (neodymium:yttrium-aluminum-garnet) capsulotomy (Nd:YAG-caps) is the gold standard for the treatment of PCO (Posterior Capsule Opacification). There is a lack of real-world data about Nd:YAG-caps use. PURPOSE This study's objectives were to estimate Nd:YAG-caps incidence in France, to describe the patient characteristics, and to analyze the time between surgeries and capsulotomies. SETTING The study was based on data extracted from the EGB database, a 1/97th sample representative of the French population. DESIGN observational, retrospective, cohort study using national claims data. METHODS French adult patients who underwent Nd:YAG-caps between 2014 and 2017 were selected. Main outcomes were the number of patients and procedures performed and the risk factors associated with early Nd:YAG-caps. RESULTS During the study period, Nd:YAG-caps were performed in 8,425 patients accounting for 10,774 procedures. The extrapolation to the French population led to estimate that 253.103 patients had Nd:YAG-caps, representing 312.103 procedures in 2017. The mean age at Nd:YAG-caps was 75.1 (± 10.2) years. About 36% of patients presented at least one ocular comorbidity. Nd:YAG-caps was performed within 2 years after surgery in 33.0% of patients and within one year in 9.8% of patients. Patients with Nd:YAG-caps within the first year (OR CI95 0.721 [0.673-0.772]) or in the first two years (OR CI95 0.721 [0.673-0.772]) were younger than patients with later Nd:YAG-caps and had a more frequent history of treated ocular diseases (OR 1.516 and 1.178, respectively). CONCLUSIONS This study brought new real-world and large-scale data regarding Nd:YAG-caps use and gave an updated insight into the patients' characteristics.
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Affiliation(s)
- Antoine P Brézin
- Department of Ophthalmology, Université Paris Cité, Cochin Hospital, APHP, 27 rue du faubourg Saint-Jacques, Paris, 75014, France.
| | - Antoine Labbe
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - Cédric Schweitzer
- Department of Ophthalmology, CHU Bordeaux, Univ. Bordeaux, ISPED, INSERM, U1219 - Bordeaux Population Health Research Centre, Bordeaux, F-33000, France
| | | | - Pascal Rozot
- Department of Ophthalmology, Juge Clinic, Marseille, France
| | | | | | - Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
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Creuzot Garcher CP, Srour M, Baudin F, Dot C, Nghiem-Buffet S, Girmens JF, Collin C, Ponthieux A, Delcourt C. Management of Neovascular Age-Related Macular Degeneration Treatment in France from 2008-2018: The Nationwide LANDSCAPE Study. Ophthalmol Ther 2023; 12:2687-2701. [PMID: 37531029 PMCID: PMC10441869 DOI: 10.1007/s40123-023-00772-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/10/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION The aim of this study was to describe the management of neovascular age-related macular degeneration (nAMD) in French patients between 2008 and 2018. METHODS This was a retrospective longitudinal cohort study using exhaustive nationwide health records from the French National Health Information database. Enrollment criteria were adults aged ≥ 50 years, nAMD diagnosis, or reimbursement for nAMD treatments (anti-vascular epithelial growth factor [VEGF] injection or dynamic phototherapy with verteporfin). Exclusion criteria were high myopia, diagnosis of other retinal diseases, and treatments for other macular diseases (dexamethasone implant, laser). Main outcome measures were consumption of medical care and nAMD treatments per calendar year and number of years of follow-up. RESULTS Between 2008 and 2018, we identified 342,961 patients who have been treated for nAMD. Median duration of ophthalmological follow-up exceeded 7 years (90 months). The median annual number of ophthalmology consultations decreased from nine visits in year 1 after treatment initiation to four visits from year 7 onwards. The median duration of nAMD treatment was 10.1 months for all patients, with 48.5% of patients undergoing treatment for < 1 year. Only 24.4% of patients had maintained treatment at year 11. Patients remaining under treatment had a median of four anti-VEGF treatments per year throughout the 10-year study period. Ranibizumab was the more common first-line treatment (67.5% of patients) compared to aflibercept (32.4%). About 20% of patients who initiated treatment switched treatment at least once. CONCLUSIONS LANDSCAPE provides exhaustive nationwide data on the real-world management of nAMD in France over a 10-year period. Further investigation into short treatment duration is required, especially in terms of understanding its relation to visual outcomes.
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Affiliation(s)
| | - Mayer Srour
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Université de Paris Est Créteil, Créteil, France
| | - Florian Baudin
- Department of Ophthalmology, University Hospital, Dijon, France
| | - Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | | | - Jean-Francois Girmens
- Department of Ophthalmology, INSERM-DGOS CIC 1423 , Centre Hospitalier National d'Ophtalmologie (CHNO) des Quinze-Vingts, Paris, France
| | | | - Anne Ponthieux
- Novartis Pharma SAS, 8/10 rue Henri Sainte Claire Deville, CS 40150, 92563, Rueil-Malmaison CEDEX, France.
| | - Cécile Delcourt
- Team LEHA, Bordeaux Population Health Research Center, UMR INSERM 1219, Université de Bordeaux, Bordeaux, France
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Pirinen I, Leinonen S, Helminen M, Hujanen P, Vaajanen A, Tuulonen A, Uusitalo‐Järvinen H. Glaucoma progression in patients receiving intravitreal
anti‐VEGF
treatment for neovascular age‐related macular degeneration. Acta Ophthalmol 2022; 101:261-265. [PMID: 36398433 DOI: 10.1111/aos.15288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 10/24/2022] [Accepted: 10/29/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this study was to investigate how often glaucoma and neovascular age-related macular degeneration (nAMD) occur in the same patient and to evaluate whether glaucoma progression is faster in eyes treated with intravitreal anti-VEGF medications for nAMD. METHODS This single-centre retrospective real-world data (RWD) consists of medical records of 6314 glaucoma and 2166 nAMD patients treated in 2008-2017 in Tays Eye Centre, Finland. To study glaucoma progression, changes in visual fields (mean deviation [MD], dB/year), IOP (mmHg/year) and fundus photographs (progression, yes/no) were compared in glaucoma eyes with and without anti-VEGF treatment for nAMD and ≥1 year follow-up. RESULTS During the 10-year period, 147 patients with glaucoma received intravitreal anti-VEGF treatment for nAMD corresponding to 2% of glaucoma and 7% of nAMD patients. The mean change in MD was -0.70 dB/year (SD 1.8) vs. -0.27 dB/year (SD 1.7) (p = 0.027) in glaucoma eyes with (n = 37) and without (n = 4304) anti-VEGF injections, respectively. In patients with bilateral glaucoma and unilateral nAMD treated with anti-VEGF injections (n = 20), MD declined at -0.62 dB/year (SD 1.9) vs 0.33 dB/year (SD 1.5) (p = 0.654), and glaucoma progression was detected in 14/20 vs 10/20 (p = 0.219) fundus photographs in eyes with anti-VEGF treatment compared with their untreated fellow eyes. CONCLUSION nAMD and glaucoma were found co-existing in the same eye at rates that were similar to the age-corrected prevalence of the two diseases in the general population. Our results suggest that intravitreal anti-VEGF treatment for nAMD may accelerate glaucoma progression.
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Affiliation(s)
- Inka Pirinen
- Tays Eye Centre, Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology, Tampere University Tampere Finland
| | - Sanna Leinonen
- Tays Eye Centre, Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology, Tampere University Tampere Finland
| | - Mika Helminen
- Faculty of Social Sciences, Health Sciences, Tampere University Tampere Finland
- Tays Research Services, Tampere University Hospital Tampere Finland
| | - Pekko Hujanen
- Tays Eye Centre, Tampere University Hospital Tampere Finland
| | - Anu Vaajanen
- Faculty of Medicine and Health Technology, Tampere University Tampere Finland
- Health Center Mehilainen Helsinki Finland
- Health Center Terveystalo Tampere Finland
| | - Anja Tuulonen
- Tays Eye Centre, Tampere University Hospital Tampere Finland
| | - Hannele Uusitalo‐Järvinen
- Tays Eye Centre, Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology, Tampere University Tampere Finland
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