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Inada Y, Sakurada Y, Shijo T, Kikushima W, Kashiwagi K. Familial Occurrence of a Severe Phenotype of Central Serous Chorioretinopathy in Two Brothers. Cureus 2024; 16:e63557. [PMID: 39087179 PMCID: PMC11289704 DOI: 10.7759/cureus.63557] [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] [Accepted: 06/28/2024] [Indexed: 08/02/2024] Open
Abstract
We report the familial occurrence of a severe phenotype of central serous chorioretinopathy (CSC). A 62-year-old man was referred to our institute to treat a macular lesion in his right eye. Best-corrected visual acuity (BCVA) in his right eye was 0.05 (decimal format). On the initial visit, swept-source optical coherence tomography (SS-OCT) demonstrated subretinal hyperreflective material (SHRM) and subretinal fluid involving the central macula in the right eye and a descending tract on fundus autofluorescence (FAF) in the left eye, and fluorescein angiography revealed focal leakage corresponding to choroidal vascular hyperpermeability (CVH) on indocyanine green angiography (ICGA) of the right eye. He received photodynamic therapy (PDT) for the right eye and exudation disappeared. His 66-year-old elder brother had a medical history of CSC in both eyes and had received treatment at our hospital at 61 years old. On the initial presentation, ICGA showed multiple CVH in both eyes, and FAF showed hypofluorescence corresponding to retinal pigment epithelium (RPE) tears and RPE atrophy in both eyes. Bullous retinal detachment (RD) developed inferiorly in both eyes, and a vitrectomy was performed for the right eye to repair RD. The baseline BCVA was 0.3 in both eyes. Two years after the initial visit, recurrent serous RD developed in his left eye, and multiple PDT sessions were performed during the six-year follow-up. A severe phenotype of CSC may be associated with a genetic background.
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Affiliation(s)
- Yuta Inada
- Department of Ophthalmology, University of Yamanashi, Chuo, JPN
| | - Yoichi Sakurada
- Department of Ophthalmology, University of Yamanashi, Chuo, JPN
| | - Taiyo Shijo
- Department of Ophthalmology, University of Yamanashi, Chuo, JPN
| | | | - Kenji Kashiwagi
- Department of Ophthalmology, University of Yamanashi, Chuo, JPN
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Feenstra HMA, van Dijk EHC, Cheung CMG, Ohno-Matsui K, Lai TYY, Koizumi H, Larsen M, Querques G, Downes SM, Yzer S, Breazzano MP, Subhi Y, Tadayoni R, Priglinger SG, Pauleikhoff LJB, Lange CAK, Loewenstein A, Diederen RMH, Schlingemann RO, Hoyng CB, Chhablani JK, Holz FG, Sivaprasad S, Lotery AJ, Yannuzzi LA, Freund KB, Boon CJF. Central serous chorioretinopathy: An evidence-based treatment guideline. Prog Retin Eye Res 2024; 101:101236. [PMID: 38301969 DOI: 10.1016/j.preteyeres.2024.101236] [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: 09/12/2023] [Revised: 12/30/2023] [Accepted: 01/02/2024] [Indexed: 02/03/2024]
Abstract
Central serous chorioretinopathy (CSC) is a relatively common disease that causes vision loss due to macular subretinal fluid leakage and it is often associated with reduced vision-related quality of life. In CSC, the leakage of subretinal fluid through defects in the retinal pigment epithelial layer's outer blood-retina barrier appears to occur secondary to choroidal abnormalities and dysfunction. The treatment of CSC is currently the subject of controversy, although recent data obtained from several large randomized controlled trials provide a wealth of new information that can be used to establish a treatment algorithm. Here, we provide a comprehensive overview of our current understanding regarding the pathogenesis of CSC, current therapeutic strategies, and an evidence-based treatment guideline for CSC. In acute CSC, treatment can often be deferred for up to 3-4 months after diagnosis; however, early treatment with either half-dose or half-fluence photodynamic therapy (PDT) with the photosensitive dye verteporfin may be beneficial in selected cases. In chronic CSC, half-dose or half-fluence PDT, which targets the abnormal choroid, should be considered the preferred treatment. If PDT is unavailable, chronic CSC with focal, non-central leakage on angiography may be treated using conventional laser photocoagulation. CSC with concurrent macular neovascularization should be treated with half-dose/half-fluence PDT and/or intravitreal injections of an anti-vascular endothelial growth factor compound. Given the current shortage of verteporfin and the paucity of evidence supporting the efficacy of other treatment options, future studies-ideally, well-designed randomized controlled trials-are needed in order to evaluate new treatment options for CSC.
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Affiliation(s)
- Helena M A Feenstra
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Chui Ming Gemmy Cheung
- Singapore Eye Research Institution, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Timothy Y Y Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong
| | - Hideki Koizumi
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Michael Larsen
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark; Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Giuseppe Querques
- Department of Ophthalmology, University Vita-Salute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Susan M Downes
- Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Suzanne Yzer
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mark P Breazzano
- Retina-Vitreous Surgeons of Central New York, Liverpool, NY, USA; Department of Ophthalmology & Visual Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Yousif Subhi
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ramin Tadayoni
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université de Paris, Paris, France
| | - Siegfried G Priglinger
- Department of Ophthalmology, Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | - Laurenz J B Pauleikhoff
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands; Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Clemens A K Lange
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
| | - Anat Loewenstein
- Division of Ophthalmology, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Roselie M H Diederen
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Reinier O Schlingemann
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands; Ocular Angiogenesis Group, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - Carel B Hoyng
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jay K Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Sobha Sivaprasad
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Andrew J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lawrence A Yannuzzi
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA; Department of Ophthalmology, New York University Grossman School of Medicine, New York, USA; Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
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Kaye RA, Peto T, Hogg R, Griffiths H, Sivaprasad S, Lotery AJ. CHOROIDAL VASCULARITY IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY AND ITS ASSOCIATION WITH RISK SINGLE-NUCLEOTIDE POLYMORPHISMS. Retina 2024; 44:837-843. [PMID: 38109714 PMCID: PMC11027981 DOI: 10.1097/iae.0000000000004024] [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] [Indexed: 12/20/2023]
Abstract
PURPOSE To analyze the choroidal parameters of patients with chronic central serous chorioretinopathy (cCSC) and the association with central serous chorioretinopathy susceptibility genes. METHODS The choroidal vascular index (CVI) was obtained by binarizing spectral domain optical coherence tomography enhanced depth images of patients with cCSC and healthy age-matched controls. Patients with cCSC were genotyped for three central serous chorioretinopathy susceptibility single-nucleotide polymorphisms: rs4844392 ( mir-29b-2/CD46 ), rs1329428 ( CFH ), and rs2379120 (upstream GATA5 ). RESULTS One hundred three eyes with cCSC and 53 control eyes were included. There was a significant increase in the subfoveal choroidal area in both the affected (2.4 ± 0.6 mm 2 ) and fellow (2.2 ± 0.6 mm 2 ) eyes of patients with cCSC compared with controls (1.8 ± 0.5 mm 2 , P < 0.0001 and P < 0.0001). The CVI was reduced in patients with cCSC 63.5% ± 3.1% compared with controls 65.4% ± 2.3% ( P < 0.001) and also in the affected compared with the fellow eyes 64.6% ± 2.9% ( P < 0.01). There was a significant association between CVI in the cCSC group and presence of the risk single-nucleotide polymorphisms rs2379120 at GATA5 ( P < 0.01). CONCLUSION The relative reduction of CVI in patients with cCSC may suggest a persistence of vessel hyperpermeability over dilation in chronic disease. GATA5 is associated with CVI in patients with cCSC and therefore may have a role in choroidal vascularity.
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Affiliation(s)
- Rebecca A. Kaye
- Department of Ophthalmology, University Hospital Southampton, Southampton, United Kingdom
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Tunde Peto
- School of Medicine, Dentistry and Biomedical Science, Queens University Belfast, Belfast, United Kingdom
- The VICI Trial, ISRCTN92746680
| | - Ruth Hogg
- School of Medicine, Dentistry and Biomedical Science, Queens University Belfast, Belfast, United Kingdom
| | - Helen Griffiths
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Sobha Sivaprasad
- University College London Institute of Ophthalmology, London, United Kingdom; and
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Andrew J. Lotery
- Department of Ophthalmology, University Hospital Southampton, Southampton, United Kingdom
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- The VICI Trial, ISRCTN92746680
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Yoneyama S, Fukui A, Sakurada Y, Terao N, Kusada N, Kikushima W, Kotoda Y, Mabuchi F, Sotozono C, Kashiwagi K. Genetic and Clinical Characteristics of Central Serous Chorioretinopathy With Steroid Use. Cureus 2024; 16:e58631. [PMID: 38770465 PMCID: PMC11103902 DOI: 10.7759/cureus.58631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2024] [Indexed: 05/22/2024] Open
Abstract
PURPOSE To compare the genetic and clinical characteristics of central serous chorioretinopathy (CSC) in patients with and without steroid use. METHODS A total of 407 consecutive patients with CSC were included. Demographic data and clinical factors, including subfoveal choroidal thickness, bilateral involvement, descending tracts, pachydrusen, fibrin, and dome-shaped pigment epithelial detachment, were obtained. Variants of complement factor H (CFH) I62V (rs800292) and rs1329428 were genotyped in all cases using TaqMan technology. RESULTS Of the total patients, 48 (11.8%) were steroid users. The majority of males were non-steroid users (82.5%) than steroid users (58.3%) (p = 9.8 × 10-5). Demographic data and the prevalence of clinical factors were comparable between the two groups (all p-values > 0.10). Risk allele frequencies of CFH rs800292 and rs1329428 were also comparable between the two groups (p = 0.76, rs800292: steroid users = 52.1% vs. non-steroid users = 50.4%; p = 0.62, rs1329428: steroid users = 47.9% vs. non-steroid users = 45.3%). CONCLUSIONS Except for the male/female ratio, there were no significant differences in the clinical presentation or genetic characteristics, including variants of the CFH gene, between the two groups.
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Affiliation(s)
- Seigo Yoneyama
- Department of Ophthalmology, University of Yamanashi, Yamanashi, JPN
| | - Ayumi Fukui
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, JPN
| | - Yoichi Sakurada
- Department of Ophthalmology, University of Yamanashi, Yamanashi, JPN
| | - Nobuhiro Terao
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, JPN
| | - Natsuki Kusada
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, JPN
| | - Wataru Kikushima
- Department of Ophthalmology, University of Yamanashi, Yamanashi, JPN
| | - Yumi Kotoda
- Department of Ophthalmology, University of Yamanashi, Yamanashi, JPN
| | - Fumihiko Mabuchi
- Department of Ophthalmology, University of Yamanashi, Yamanashi, JPN
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, JPN
| | - Kenji Kashiwagi
- Department of Ophthalmology, University of Yamanashi, Yamanashi, JPN
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Honda S, Misawa N, Sato Y, Oikawa D, Tokunaga F. The hypothetical molecular mechanism of the ethnic variations in the manifestation of age-related macular degeneration; focuses on the functions of the most significant susceptibility genes. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06442-9. [PMID: 38507046 DOI: 10.1007/s00417-024-06442-9] [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: 08/26/2023] [Revised: 02/27/2024] [Accepted: 03/08/2024] [Indexed: 03/22/2024] Open
Abstract
Age-related macular degeneration (AMD) is the leading sight-threatening disease in developed countries. On the other hand, recent studies indicated an ethnic variation in the phenotype of AMD. For example, several reports demonstrated that the incidence of drusen in AMD patients is less in Asians compared to Caucasians though the reason has not been clarified yet. In the last decades, several genome association studies have disclosed many susceptible genes of AMD and revealed that the association strength of some genes was different among races and AMD phenotypes. In this review article, the essential findings of the clinical studies and genome association studies for the most significant genes CFH and ARMS2/HTRA1 in AMD of different races are summarized, and theoretical hypotheses about the molecular mechanisms underlying the ethnic variation in the AMD manifestation mainly focused on those genes between Caucasians and Asians are discussed.
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Affiliation(s)
- Shigeru Honda
- Department of Ophthalmology and Visual Sciences, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, Japan.
| | - Norihiko Misawa
- Department of Ophthalmology and Visual Sciences, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, Japan
| | - Yusuke Sato
- Center for Research On Green Sustainable Chemistry, Graduate School of Engineering, Tottori University, Tottori, Japan
- Department of Chemistry and Biotechnology, Graduate School of Engineering, Tottori University, Tottori, Japan
| | - Daisuke Oikawa
- Department of Medical Biochemistry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Fuminori Tokunaga
- Department of Medical Biochemistry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Liu P, Fang H, An G, Jin B, Lu C, Li S, Yang F, Du L, Jin X. Chronic Central Serous Chorioretinopathy in Elderly Subjects: Structure and Blood Flow Characteristics of Retina and Choroid. Ophthalmol Ther 2024; 13:321-335. [PMID: 37966697 PMCID: PMC10776535 DOI: 10.1007/s40123-023-00849-z] [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: 09/25/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION With advancements in imaging technology, researchers have been able to identify more distinctive imaging features of central serous chorioretinopathy (CSC). However, existing research primarily concentrates on young patients aged 50 years and below, leaving a dearth of studies on elderly CSC patients. Previous studies indicate that elderly CSC patients may exhibit unique imaging characteristics and have a clinical prognosis that significantly differs from younger patients. This study aimed to evaluate the characteristics of retina, choroid structure, and blood flow in elderly patients with chronic CSC (cCSC) examined multimode imaging and try to find new pathogenesis information of it. METHODS Using a cut-off age of 50 years, patients with chronic central serous chorioretinopathy were divided into two groups: older and younger. The control group consisted of 40 healthy individuals, with their right eyes assigned. Various clinical features were recorded, including the incidence of ellipsoid zone rupture (EZ-), fibrin in the subretinal fluid (SRF), pachydrusen, subretinal drusenoid deposits (SDD), pigment epithelial detachment (PED), double-layer sign (DLS), and choroidal lipid globule cavern. Measurements were taken for the thickness of the outer nuclear layer (ONL), the length of the extended outer photoreceptor segment (POS), the height and width of SRF, the vascular density of each layer of the retinal capillary plexus, the central macular thickness (CMT), and the subfoveal choroidal thickness (SFCT). RESULTS The proportion of females in the elderly group (43.75%) was significantly higher than that in the youth group (22.41%) (p = 0.034). The degree of hyperopia in the elderly group (1.03 ± 0.73) was higher than that in the youth group (0.26 ± 1.06), with a significant difference in BCVA (p = 0.05). The thickness of SFCT, CMT, ONL in the elderly group, and the length of photoreceptor outer segment in the elderly group were thinner than those in the youth group (p < 0.05). Choroidal capillary perfusion area (CCPA), macular area, and paramacular area were lower in the elderly group than those in the youth group in the full scan range (p < 0.05). The blood flow densities of deep capillary plexus (DCP), intermediate capillary plexus (ICP), and superficial capillary plexus (SCP) in the whole scan range, macular area, and paramacular area were lower in the elderly group than in the youth group, but the differences were not statistically significant. CONCLUSIONS In conclusion, our data suggest that elderly patients with cCSC may experience different disease outcomes. Elderly cCSC patients exhibit less gender bias, poorer vision, more severe structural damage and ischemia in the choroid and retina, and have a higher risk of developing choroidal neovascularization.
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Affiliation(s)
- Pei Liu
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Haixin Fang
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Guangqi An
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Bo Jin
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
- Fundus Disease Institute of Zhengzhou University, Zhengzhou, 450000, China
| | - Chenyu Lu
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Shu Li
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Fan Yang
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Liping Du
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China.
- Henan Eye Hospital, Zhengzhou, 450000, China.
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China.
- Fundus Disease Institute of Zhengzhou University, Zhengzhou, 450000, China.
| | - Xuemin Jin
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China.
- Henan Eye Hospital, Zhengzhou, 450000, China.
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China.
- Fundus Disease Institute of Zhengzhou University, Zhengzhou, 450000, China.
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Funatsu R, Sonoda S, Terasaki H, Shiihara H, Hirokawa M, Yuanting J, Tanabe Y, Sakamoto T. Vortex Veins in Eyes With Pachychoroid Spectrum Disorders Evaluated by the Adjusted Reverse 3-Dimensional Projection Model. OPHTHALMOLOGY SCIENCE 2023; 3:100320. [PMID: 37274011 PMCID: PMC10238580 DOI: 10.1016/j.xops.2023.100320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 06/06/2023]
Abstract
Purpose To compare the distribution of vortex vein ampulla (VVA) between pachychoroid spectrum disorder (PSD) and controls. Design A single-center, case-control study. Participants This study included 75 PSD, 35 fellow, and 65 control eyes. Methods We quantified VVA distribution using a 3-dimensional reverse projection model corrected for image distortion. We investigated the distribution of major drainage veins (MDV), in which macular Haller's vessels directly influx. Main Outcome Measures The mean distances from the optic disc to VVAs and the mean angles between VVAs and the fovea-disc line. Results The PSD group had significantly fewer VVA in infranasal sector (PSD, fellow, control; 1.6 ± 0.6, 1.8 ± 0.6, 1.9 ± 0.6, respectively, P = 0.026). In supralateral sector, for PSD, fellows, and controls, the mean distances from the optic disc to VVAs were 14.1 ± 1.0 mm, 14.1 ± 1.1 mm, and 13.6 ± 1.4 mm, respectively, and were significantly farther in PSD than in controls (P = 0.023). The mean angles between VVAs and the fovea-disc line were 64.8 ± 5.9°, 66.4 ± 6.4°, and 61.7 ± 6.4°, respectively, and were significantly higher in PSD and fellows than in controls (P = 0.008). The mean distances from the optic disc to MDV in supratemporal sector were 14.1 ± 1.2 and 13.7 ± 1.2 in eyes whose Haller's vessels extended beyond the fovea-disc line (asymmetry), and those that did not, respectively, with the asymmetric eyes significantly farther (P = 0.016). Conclusions The VVA position in supralateral sector was farther and higher in PSD than in controls, suggesting that the distribution of VVA may be associated with the development of PSD. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Ryoh Funatsu
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shozo Sonoda
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hideki Shiihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Mariko Hirokawa
- System Development Department, Nikon Corporation, Yokohama, Japan
| | - Ji Yuanting
- System Development Department, Nikon Corporation, Yokohama, Japan
| | - Yasushi Tanabe
- System Development Department, Nikon Corporation, Yokohama, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Leclercq B, Weiner A, Zola M, Mejlacowicz D, Lassiaz P, Jonet L, Gélizé E, Perrot J, Viengchareun S, Zhao M, Behar-Cohen F. The choroidal nervous system: a link between mineralocorticoid receptor and pachychoroid. Acta Neuropathol 2023; 146:747-766. [PMID: 37682293 PMCID: PMC10564818 DOI: 10.1007/s00401-023-02628-3] [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: 06/01/2023] [Revised: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
Central serous chorioretinopathy (CSCR) belongs to the pachychoroid spectrum, a pathological phenotype of the choroidal vasculature, in which blood flow is under the choroidal nervous system (ChNS) regulation. The pathogenesis of CSCR is multifactorial, with the most recognised risk factor being intake of glucocorticoids, which activate both the gluco- and the mineralocorticoid (MR) receptors. As MR over-activation is pathogenic in the retina and choroid, it could mediate the pathogenic effects of glucocorticoids in CSCR. But the role of MR signalling in pachychoroid is unknown and whether it affects the ChNS has not been explored. Using anatomo-neurochemical characterisation of the ChNS in rodents and humans, we discovered that beside innervation of arteries, choroidal veins and choriocapillaris are also innervated, suggesting that the entire choroidal vasculature is under neural control. The numerous synapses together with calcitonin gene-related peptide (CGRP) vesicles juxtaposed to choroidal macrophages indicate a neuro-immune crosstalk. Using ultrastructural approaches, we show that transgenic mice overexpressing human MR, display a pachychoroid-like phenotype, with signs of choroidal neuropathy including myelin abnormalities, accumulation and enlargement of mitochondria and nerves vacuolization. Transcriptomic analysis of the RPE/choroid complex in the transgenic mice reveals regulation of corticoids target genes, known to intervene in nerve pathophysiology, such as Lcn2, rdas1/dexras1, S100a8 and S100a9, rabphilin 3a (Rph3a), secretogranin (Scg2) and Kinesin Family Member 5A (Kif5a). Genes belonging to pathways related to vasculature development, hypoxia, epithelial cell apoptosis, epithelial mesenchymal transition, and inflammation, support the pachychoroid phenotype and highlight downstream molecular targets. Hypotheses on the imaging phenotype of pachychoroid in humans are put forward in the light of these new data. Our results provide evidence that MR overactivation causes a choroidal neuropathy that could explain the pachychoroid phenotype found in transgenic mice overexpressing human MR. In patients with pachychoroid and CSCR in which systemic dysautonomia has been demonstrated, MR-induced choroidal neuropathy could be the missing link between corticoids and pachychoroid.
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Affiliation(s)
- Bastien Leclercq
- Centre de Recherche des Cordeliers, Inserm, Université Paris Cité, Sorbonne Université, Physiopathology of Ocular Diseases: Therapeutic Innovations, 15 rue de l'Ecole de Médecine, 75006, Paris, France
| | - Allon Weiner
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France
| | - Marta Zola
- Centre de Recherche des Cordeliers, Inserm, Université Paris Cité, Sorbonne Université, Physiopathology of Ocular Diseases: Therapeutic Innovations, 15 rue de l'Ecole de Médecine, 75006, Paris, France
- Ophthalmopole Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Hopital Foch, Suresnes, France
| | - Dan Mejlacowicz
- Centre de Recherche des Cordeliers, Inserm, Université Paris Cité, Sorbonne Université, Physiopathology of Ocular Diseases: Therapeutic Innovations, 15 rue de l'Ecole de Médecine, 75006, Paris, France
| | - Patricia Lassiaz
- Centre de Recherche des Cordeliers, Inserm, Université Paris Cité, Sorbonne Université, Physiopathology of Ocular Diseases: Therapeutic Innovations, 15 rue de l'Ecole de Médecine, 75006, Paris, France
| | - Laurent Jonet
- Centre de Recherche des Cordeliers, Inserm, Université Paris Cité, Sorbonne Université, Physiopathology of Ocular Diseases: Therapeutic Innovations, 15 rue de l'Ecole de Médecine, 75006, Paris, France
| | - Emmanuelle Gélizé
- Centre de Recherche des Cordeliers, Inserm, Université Paris Cité, Sorbonne Université, Physiopathology of Ocular Diseases: Therapeutic Innovations, 15 rue de l'Ecole de Médecine, 75006, Paris, France
| | - Julie Perrot
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, 94276, Le Kremlin-Bicêtre, France
| | - Say Viengchareun
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, 94276, Le Kremlin-Bicêtre, France
| | - Min Zhao
- Centre de Recherche des Cordeliers, Inserm, Université Paris Cité, Sorbonne Université, Physiopathology of Ocular Diseases: Therapeutic Innovations, 15 rue de l'Ecole de Médecine, 75006, Paris, France
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, Inserm, Université Paris Cité, Sorbonne Université, Physiopathology of Ocular Diseases: Therapeutic Innovations, 15 rue de l'Ecole de Médecine, 75006, Paris, France.
- Ophthalmopole Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
- Hopital Foch, Suresnes, France.
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Fan Q, Li H, Wang X, Tham YC, Teo KYC, Yasuda M, Lim WK, Kwan YP, Teo JX, Chen CJ, Chen LJ, Ahn J, Davila S, Miyake M, Tan P, Park KH, Pang CP, Khor CC, Wong TY, Yanagi Y, Cheung CMG, Cheng CY. Contribution of common and rare variants to Asian neovascular age-related macular degeneration subtypes. Nat Commun 2023; 14:5574. [PMID: 37696869 PMCID: PMC10495468 DOI: 10.1038/s41467-023-41256-z] [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: 05/29/2022] [Accepted: 08/28/2023] [Indexed: 09/13/2023] Open
Abstract
Neovascular age-related macular degeneration (nAMD), along with its clinical subtype known as polypoidal choroidal vasculopathy (PCV), are among the leading causes of vision loss in elderly Asians. In a genome-wide association study (GWAS) comprising 3,128 nAMD (1,555 PCV and 1,573 typical nAMD), and 5,493 controls of East Asian ancestry, we identify twelve loci, of which four are novel ([Formula: see text]). Substantial genetic sharing between PCV and typical nAMD is noted (rg = 0.666), whereas collagen extracellular matrix and fibrosis-related pathways are more pronounced for PCV. Whole-exome sequencing in 259 PCV patients revealed functional rare variants burden in collagen type I alpha 1 chain gene (COL1A1; [Formula: see text]) and potential enrichment of functional rare mutations at AMD-associated loci. At the GATA binding protein 5 (GATA5) locus, the most significant GWAS novel loci, the expressions of genes including laminin subunit alpha 5 (Lama5), mitochondrial ribosome associated GTPase 2 (Mtg2), and collagen type IX alpha 3 chain (Col9A3), are significantly induced during retinal angiogenesis and subretinal fibrosis in murine models. Furthermore, retinoic acid increased the expression of LAMA5 and MTG2 in vitro. Taken together, our data provide insights into the genetic basis of AMD pathogenesis in the Asian population.
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Affiliation(s)
- Qiao Fan
- Center for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore.
| | - Hengtong Li
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Innovation and Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xiaomeng Wang
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
- Center for Vision Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Yih-Chung Tham
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Innovation and Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kelvin Yi Chong Teo
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Masayuki Yasuda
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Weng Khong Lim
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore, Singapore
- SingHealth Duke-NUS Genomic Medicine Centre, Singapore, Singapore
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore, Singapore
- Laboratory of Genome Variation Analytics, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Yuet Ping Kwan
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
| | - Jing Xian Teo
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore, Singapore
| | - Ching-Jou Chen
- Center for Vision Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Jeeyun Ahn
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sonia Davila
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore, Singapore
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Patrick Tan
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore, Singapore
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore, Singapore
- Human Genetics, Genome Institute of Singapore, Singapore, Singapore
| | - Kyu Hyung Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Chiea Chuan Khor
- Human Genetics, Genome Institute of Singapore, Singapore, Singapore
| | - Tien Yin Wong
- Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Yasuo Yanagi
- Department of Ophthalmology and Microtechnology, Yokohama City University, Yokohama, Japan
| | - Chui Ming Gemmy Cheung
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Ching-Yu Cheng
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore.
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Centre for Innovation and Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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Sazhnyev Y, Sin TN, Ma A, Chang E, Huynh L, Roszak K, Park S, Choy K, Farsiu S, Moshiri A, Thomasy SM, Yiu G. Choroidal Changes in Rhesus Macaques in Aging and Age-Related Drusen. Invest Ophthalmol Vis Sci 2023; 64:44. [PMID: 37773500 PMCID: PMC10547013 DOI: 10.1167/iovs.64.12.44] [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: 04/13/2023] [Accepted: 09/07/2023] [Indexed: 10/01/2023] Open
Abstract
Purpose Choroidal vascular changes occur with normal aging and age-related macular degeneration (AMD). Here, we evaluate choroidal thickness and vascularity in aged rhesus macaques to better understand the choroid's role in this nonhuman primate model of AMD. Methods We analyzed optical coherence tomography (OCT) images of 244 eyes from 122 rhesus macaques (aged 4-32 years) to measure choroidal thickness (CT) and choroidal vascularity index (CVI). Drusen number, size, and volume were measured by semiautomated annotation and segmentation of OCT images. We performed regression analyses to determine any association of CT or CVI with age, sex, and axial length and to determine if the presence and volume of soft drusen impacted these choroidal parameters. Results In rhesus macaques, subfoveal CT decreased with age at 3.2 µm/y (R2 = 0.481, P < 0.001), while CVI decreased at 0.66% per year (R2 = 0.257, P < 0.001). Eyes with soft drusen exhibited thicker choroid (179.9 ± 17.5 µm vs. 162.0 ± 27.9 µm, P < 0.001) and higher CVI (0.612 ± 0.051 vs. 0.577 ± 0.093, P = 0.005) than age-matched control animals. Neither CT or CVI appeared to be associated with drusen number, size, or volume in this cohort. However, some drusen in macaques were associated with underlying choroidal vessel enlargement resembling pachydrusen in human patients with AMD. Conclusions Changes in the choroidal vasculature in rhesus macaques resemble choroidal changes in human aging, but eyes with drusen exhibit choroidal thickening, increased vascularity, and phenotypic characteristics of pachydrusen observed in some patients with AMD.
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Affiliation(s)
- Yevgeniy Sazhnyev
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
- Department of Ophthalmology, California Northstate University, College of Medicine, Elk Grove, California, United States
| | - Tzu-Ni Sin
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Anthony Ma
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
- Department of Ophthalmology, California Northstate University, College of Medicine, Elk Grove, California, United States
| | - Ellie Chang
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Leon Huynh
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Karolina Roszak
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Sangwan Park
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Kevin Choy
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
| | - Sina Farsiu
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, United States
| | - Ala Moshiri
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Sara M. Thomasy
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Glenn Yiu
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
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11
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Oribio-Quinto C, Alarcón-García AD, Fuentes JE, Fernández-Vigo JI. Evaluation of the changes in choroidal macular anastomoses after photodynamic therapy and in the follow-up of central serous chorioretinopathy by en face optical coherence tomography. Photodiagnosis Photodyn Ther 2023; 43:103719. [PMID: 37487812 DOI: 10.1016/j.pdpdt.2023.103719] [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: 06/26/2023] [Revised: 07/15/2023] [Accepted: 07/21/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE To evaluate the changes in the choroidal macular anastomoses after photodynamic therapy (PDT) and in the follow-up of patients with central serous chorioretinopathy (CSCR) by en face optical coherence tomography (EF-OCT). METHODS Prospective study using EF-OCT images of patients with chronic CSCR treated by PDT with a minimum follow-up of 12 months and with the presence of at least two prominent anastomoses in the macula. Scans of 6 × 6 mm and 12 × 12 mm were made to assess the changes in choroidal macular anastomoses (defined as a diameter ≥150 µm) crossing the medial raphe. EF-OCT was performed before PDT and 3 days, 3 months and at the end of the follow-up after PDT. RESULTS The mean follow-up time was 23.6 ± 12.1 months. The mean number of anastomoses was 2.5 ± 1.1 in the baseline examination, being 2.3 ± 1.2 in the final examination, with no differences being observed (p = 0.110). A sub-analysis was performed to assess differences in the evolution of the anastomoses between active chronic CSCR and those in which the subretinal fluid (SRF) had been resolved, with no differences being observed in the number or caliber of anastomoses (p = 0.642 and p = 0.306). A significant decrease in the size of anastomoses was found at the 3-day (p<0.01) and 3-month (p = 0.032) visits, but not at the last follow-up visit (p = 0.156). CONCLUSIONS There was an early decrease in the size of the major macular choroidal anastomotic vessels after PDT treatment. Long-term studies are required to assess its evolution and its possible role in the etiopathogenesis of this disease.
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Affiliation(s)
- Carlos Oribio-Quinto
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), Profesor Martin Lagos s/n, Madrid 28040, Spain.
| | - Antonio Domingo Alarcón-García
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), Profesor Martin Lagos s/n, Madrid 28040, Spain
| | - Jacobo Enríquez Fuentes
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), Profesor Martin Lagos s/n, Madrid 28040, Spain
| | - José Ignacio Fernández-Vigo
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), Profesor Martin Lagos s/n, Madrid 28040, Spain; Centro Internacional de Oftalmología Avanzada, Madrid 28010, Spain
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12
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Chuang HK, Hsieh AR, Ang TY, Chen SW, Yang YP, Huang HJ, Chiou SH, Lin TC, Chen SJ, Hsu CC, Hwang DK. TMEM132D and VIPR2 Polymorphisms as Genetic Risk Loci for Retinal Detachment: A Genome-Wide Association Study and Polygenic Risk Score Analysis. Invest Ophthalmol Vis Sci 2023; 64:17. [PMID: 37695605 PMCID: PMC10501492 DOI: 10.1167/iovs.64.12.17] [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: 02/14/2023] [Accepted: 07/12/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose Retinal detachment (RD) is a sight-threatening ocular disease caused by separation of the neurosensory retina from the underlying retinal pigment epithelium layer. Its genetic basis is unclear because of a limited amount of data. In this study, we aimed to identify genetic risk loci associated with RD in participants without diabetes mellitus and to construct a polygenic risk score (PRS) to predict the risk of RD. Methods A genome-wide association study was conducted using data from the Taiwan Biobank to identify RD risk loci. A total of 1533 RD cases and 106,270 controls were recruited, all of whom were Han Chinese. Replication studies were performed using data from the UK Biobank and Biobank Japan. To construct the PRS, a traditional clumping and thresholding method was performed and validated by fivefold cross-validation. Results Two novel loci with significant associations were identified. These two genes were TMEM132D (lead single nucleotide polymorphism [SNP]: rs264498, adjusted-P = 7.18 × 10-9) and VIPR2 (lead SNP: rs3812305, adjusted-P = 8.38 × 10-9). The developed PRS was effective in discriminating individuals at high risk of RD with a dose-response relationship. The quartile with the highest risk had an odds ratio of 1244.748 compared to the lowest risk group (95% confidence interval, 175.174-8844.892). Conclusions TMEM132D and VIPR2 polymorphisms are genetic candidates linked to RD in Han Chinese populations. Our proposed PRS was effective at discriminating high-risk from low-risk individuals.
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Affiliation(s)
- Hao-Kai Chuang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ai-Ru Hsieh
- Department of Statistics, Tamkang University, New Taipei City, Taiwan
| | - Tien-Yap Ang
- Department of Statistics, Tamkang University, New Taipei City, Taiwan
| | - Szu-Wen Chen
- Department of Statistics, Tamkang University, New Taipei City, Taiwan
| | - Yi-Ping Yang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hung-Juei Huang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of General Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shih-Hwa Chiou
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tai-Chi Lin
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Jen Chen
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Chien Hsu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - De-Kuang Hwang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
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13
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Fukuda Y, Notomi S, Shiose S, Kano K, Hashimoto S, Fujiwara K, Akiyama M, Ishikawa K, Hisatomi T, Sonoda KH. Differences in Central and Peripheral Choroidal Thickness among the Subtypes of Age-Related Macular Degeneration in an Asian Population. J Clin Med 2023; 12:5364. [PMID: 37629406 PMCID: PMC10455582 DOI: 10.3390/jcm12165364] [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: 08/03/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Age-related macular degeneration (AMD) causes visual impairment in individuals who are >50 years of age. However, no study has investigated AMD when using ultra-wide-field swept-source optical coherence tomography (UWF SS-OCT). We aimed to evaluate central and peripheral choroidal thicknesses using UWF SS-OCT, and to compare these across the AMD subtypes. We included 75 eyes of patients with typical AMD (tAMD), 56 with polypoidal choroidal vasculopathy (PCV), 29 with pachychoroid neovasculopathy (PNV), and 12 with retinal angiomatous proliferation (RAP). To compare choroidal thicknesses in the central and peripheral choroids, we established subfields of <3 mm, <9 mm, and 9-18 mm from the fovea. PNV patients were significantly younger than those with tAMD (p = 0.01). The choroidal thicknesses of PNV were significantly greater than that of tAMD in all subfields (p < 0.01), and choroidal thickness significantly correlated with age and axial length in all subfields (p < 0.05). Even after adjusting for age and axial length, the choroidal thickness in PNV was significantly greater than that in tAMD (p < 0.05). In addition, the ratio of the posterior <9 mm to a peripheral 9-18 mm choroidal thickness in PNV was significantly greater than that in tAMD (p < 0.01). A thickened choroid in PNV was more pronounced in the posterior choroid than in the periphery.
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Affiliation(s)
- Yosuke Fukuda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Fukuoka, Japan
| | - Shoji Notomi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Fukuoka, Japan
| | - Satomi Shiose
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Fukuoka, Japan
| | - Kumiko Kano
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Fukuoka, Japan
| | - Sawako Hashimoto
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Fukuoka, Japan
| | - Kohta Fujiwara
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Fukuoka, Japan
| | - Masato Akiyama
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Fukuoka, Japan
| | - Keijiro Ishikawa
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Fukuoka, Japan
| | - Toshio Hisatomi
- Department of Ophthalmology, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyouin, Chikushino 818-8502, Fukuoka, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Fukuoka, Japan
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14
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Rossin EJ, Sobrin L. The Pleiotropy of Complement Factor H. JAMA Ophthalmol 2023; 141:745-746. [PMID: 37410484 DOI: 10.1001/jamaophthalmol.2023.2756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Affiliation(s)
- Elizabeth J Rossin
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
| | - Lucia Sobrin
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
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15
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Fernández-Vigo JI, Rego-Lorca D, Moreno-Morillo FJ, Burgos-Blasco B, Valverde-Megías A, Méndez-Hernández C, López-Guajardo L, Donate-López J. Intervortex Venous Anastomosis in the Macula in Central Serous Chorioretinopathy Imaged by En Face Optical Coherence Tomography. J Clin Med 2023; 12:2088. [PMID: 36983092 PMCID: PMC10052017 DOI: 10.3390/jcm12062088] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/22/2023] [Accepted: 03/04/2023] [Indexed: 03/09/2023] Open
Abstract
PURPOSE To assess the presence of macular intervortex venous anastomosis in central serous chorioretinopathy (CSCR) patients using en face optical coherence tomography (EF-OCT). METHODS A cross-sectional study where EF-OCT 6 × 6 and 12 × 12 mm macular scans of patients with unilateral chronic CSCR were evaluated for anastomosis between vortex vein systems in the central macula. The presence of prominent anastomoses was defined as a connection with a diameter ≥150 µm between the inferotemporal and superotemporal vortex vein systems which crossed the temporal raphe. Three groups were studied: CSCR eyes (with an active disease with the presence of neurosensorial detachment; n = 135), fellow unaffected eyes (n = 135), and healthy eyes as controls (n = 110). Asymmetries, abrupt termination, sausaging, bulbosities and corkscrew appearance were also assessed. RESULTS In 79.2% of the CSCR eyes there were prominent anastomoses in the central macula between the inferotemporal and superotemporal vortex vein systems, being more frequent than in fellow eyes and controls (51.8% and 58.2% respectively). The number of anastomotic connections was higher in the affected eye group (2.9 ± 1.8) than in the unaffected fellow eye group (2.1 ± 1.7) and the controls (1.5 ± 1.6) (p < 0.001). Asymmetry, abrupt terminations and the corkscrew appearance of the choroidal vessels were more frequent in the affected eyes, although no differences in sausaging or bulbosities were observed. CONCLUSIONS Intervortex venous anastomoses in the macula were common in CSCR, being more frequently observed in affected eyes than in fellow unaffected eyes and healthy controls. This anatomical variation could have important implications concerning the pathogenesis and classification of the disease.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), 28040 Madrid, Spain
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
| | - Daniela Rego-Lorca
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), 28040 Madrid, Spain
| | - Francisco Javier Moreno-Morillo
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), 28040 Madrid, Spain
- Ophthalmology Department, Hospital Infanta Sofía, San Sebastián de los Reyes, 19171 Madrid, Spain
| | - Bárbara Burgos-Blasco
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), 28040 Madrid, Spain
| | - Alicia Valverde-Megías
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), 28040 Madrid, Spain
| | - Carmen Méndez-Hernández
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), 28040 Madrid, Spain
| | - Lorenzo López-Guajardo
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), 28040 Madrid, Spain
| | - Juan Donate-López
- Ophthalmology Department, Hospital Clínico San Carlos, Institute of Health Research (IdISSC), 28040 Madrid, Spain
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16
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Yoneyama S, Fukui A, Sakurada Y, Terao N, Shijo T, Kusada N, Sugiyama A, Matsubara M, Fukuda Y, Kikushima W, Mabuchi F, Sotozono C, Kashiwagi K. DISTINCT CHARACTERISTICS OF SIMPLE VERSUS COMPLEX CENTRAL SEROUS CHORIORETINOPATHY. Retina 2023; 43:389-395. [PMID: 36729824 DOI: 10.1097/iae.0000000000003692] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To compare the clinical and genetic characteristics of simple and complex central serous chorioretinopathy using central serous chorioretinopathy international group criteria. METHODS Patients with idiopathic central serous chorioretinopathy were included. Depending on the presence or absence of retinal pigment alterations greater than 2-disc areas in either eye, patients were classified into complex or simple types. Demographic factors and clinical findings were compared between groups. CFH variants, including rs800292 and rs1329428, were genotyped using TaqMan technology. RESULTS A total of 319 consecutive patients were evaluated at the initial presentation. Of them, 53 (16.6%) had the complex type. The complex type was exclusively seen in men (100% vs. 79.0%, P = 2.0 × 10 -4 ) and demonstrated a significantly higher proportion of bilateral involvement (75.5% vs. 17.7%, P = 6.2 × 10 -18 ) and descending tract(s) (83.0% vs. 0%, P = 1.2 × 10 -57 ) than the simple type. Increased choroidal thickness (425 ± 131 vs. 382 ± 110, P = 0.02) and decreased central retinal thickness (274 ± 151 vs. 337 ± 136, P = 2.9 × 10 -4 ) were observed for the complex versus simple type. The risk allele frequencies of both variants were significantly higher in the complex versus simple type (rs800292: 61.3% vs. 48.7%, P = 0.018; rs1329428: 65.1% vs. 54.3%, P = 0.04). CONCLUSION In this new classification system, the complex type has distinct genetic and clinical characteristics compared with the simple type.
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Affiliation(s)
- Seigo Yoneyama
- Department of Ophthalmology, University of Yamanashi, Chuo Yamanashi, Japan; and
| | - Ayumi Fukui
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto Kyoto, Japan
| | - Yoichi Sakurada
- Department of Ophthalmology, University of Yamanashi, Chuo Yamanashi, Japan; and
| | - Nobuhiro Terao
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto Kyoto, Japan
| | - Taiyo Shijo
- Department of Ophthalmology, University of Yamanashi, Chuo Yamanashi, Japan; and
| | - Natsuki Kusada
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto Kyoto, Japan
| | - Atsushi Sugiyama
- Department of Ophthalmology, University of Yamanashi, Chuo Yamanashi, Japan; and
| | - Mio Matsubara
- Department of Ophthalmology, University of Yamanashi, Chuo Yamanashi, Japan; and
| | - Yoshiko Fukuda
- Department of Ophthalmology, University of Yamanashi, Chuo Yamanashi, Japan; and
| | - Wataru Kikushima
- Department of Ophthalmology, University of Yamanashi, Chuo Yamanashi, Japan; and
| | - Fumihiko Mabuchi
- Department of Ophthalmology, University of Yamanashi, Chuo Yamanashi, Japan; and
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto Kyoto, Japan
| | - Kenji Kashiwagi
- Department of Ophthalmology, University of Yamanashi, Chuo Yamanashi, Japan; and
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17
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Chen LJ, Chen ZJ, Pang CP. Latest Development on Genetics of Common Retinal Diseases. Asia Pac J Ophthalmol (Phila) 2023; 12:228-251. [PMID: 36971708 DOI: 10.1097/apo.0000000000000592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/15/2022] [Indexed: 03/29/2023] Open
Abstract
Many complex forms of retinal diseases are common and pan-ethnic in occurrence. Among them, neovascular age-related macular degeneration, polypoidal choroidal vasculopathy, and central serous choroid retinopathy involve both choroidopathy and neovascularization with multifactorial etiology. They are sight-threatening and potentially blinding. Early treatment is crucial to prevent disease progression. To understand their genetic basis, candidate gene mutational and association analyses, linkage analysis, genome-wide association studies, transcriptome analysis, next-generation sequencing, which includes targeted deep sequencing, whole-exome sequencing, and whole genome sequencing have been conducted. Advanced genomic technologies have led to the identification of many associated genes. But their etiologies are attributed to complicated interactions of multiple genetic and environmental risk factors. Onset and progression of neovascular age-related macular degeneration and polypoidal choroidal vasculopathy are affected by aging, smoking, lifestyle, and variants in over 30 genes. Although some genetic associations have been confirmed and validated, individual genes or polygenic risk markers of clinical value have not been established. The genetic architectures of all these complex retinal diseases that involve sequence variant quantitative trait loci have not been fully delineated. Recently artificial intelligence is making an impact in the collection and advanced analysis of genetic, investigative, and lifestyle data for the establishment of predictive factors for the risk of disease onset, progression, and prognosis. This will contribute to individualized precision medicine for the management of complex retinal diseases.
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Affiliation(s)
- Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital Eye Centre, Hong Kong, China
- Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhen Ji Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
- Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
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18
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Fenner BJ, Li H, Gan ATL, Song YS, Tham YC, Jonas JB, Wang YX, Cheng CY, Wong TY, Teo KYC, Tan ACS, Fan Q, Cheung CMG. Genetic Variability of Complement Factor H Has Ethnicity-Specific Associations With Choroidal Thickness. Invest Ophthalmol Vis Sci 2023; 64:10. [PMID: 36749597 PMCID: PMC9919691 DOI: 10.1167/iovs.64.2.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Purpose To identify genetic alleles associated with differences in choroidal thickness (CT) in a population-based multiethnic Asian cohort. Methods A population-based multiethnic Asian cohort without retinal pathology was subjected to spectral-domain OCT (SD-OCT) and genotyping of risk alleles in CFH, VIPR2, ARMS2, and CETP. Subfoveal choroidal thickness (SFCT) values were assessed from SD-OCT, and associations with the risk alleles were determined for each cohort. Results A total of 1045 healthy Asian individuals (550 Chinese, 147 Indians, 348 Malays) were prospectively enrolled in the study. Several CFH alleles (rs800292, rs1061170, and rs1329428) were associated with increased SFCT in Indians (+18.7 to +31.7 µm; P = 0.001-0.038) and marginally associated with decreased SFCT in Malays (-12.7 to -20.6 µm; P = 0.014-0.022). Haplotype analysis of CFH revealed variable associations with SFCT among races, with the H6 haplotype being associated with a 29.08-µm reduction in SFCT in the Chinese cohort (P = 0.02) but a 35.2-µm increase in SFCT in the Indian cohort (P < 0.001). Finally, subfield analysis of the Chinese cohort identified associations between the CFH risk allele rs1061170 and reduced CT in the nasal and superior sectors (-20.2 to -25.8 µm; P = 0.003-0.027). Conclusions CFH variants are variably associated with CT among Asian ethnic groups. This has broad implications for the pathogenesis of common diseases such as age-related macular degeneration and central serous choroidopathy, the pathogenesis of which is associated with CT.
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Affiliation(s)
- Beau J Fenner
- Singapore National Eye Centre, Singapore.,Singapore Eye Research Institute, Singapore
| | | | | | - Young Seok Song
- Singapore Eye Research Institute, Singapore.,Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore.,Centre for Innovation & Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Jost B Jonas
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ching Yu Cheng
- Singapore Eye Research Institute, Singapore.,Centre for Innovation & Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Tien Yin Wong
- School of Medicine, Tsinghua University, Beijing, China
| | - Kelvin Y C Teo
- Singapore National Eye Centre, Singapore.,Singapore Eye Research Institute, Singapore
| | - Anna C S Tan
- Singapore National Eye Centre, Singapore.,Singapore Eye Research Institute, Singapore
| | - Qiao Fan
- Singapore Eye Research Institute, Singapore.,Center for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore
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19
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Imanaga N, Terao N, Sonoda S, Sawaguchi S, Yamauchi Y, Sakamoto T, Koizumi H. Relationship Between Scleral Thickness and Choroidal Structure in Central Serous Chorioretinopathy. Invest Ophthalmol Vis Sci 2023; 64:16. [PMID: 36662534 PMCID: PMC9872835 DOI: 10.1167/iovs.64.1.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Purpose Central serous chorioretinopathy (CSC) is a retinal disorder characterized by serous retinal detachment with or without pigment epithelial detachment in the posterior pole of the eye. We aimed to elucidate the relationship between scleral thickness and choroidal structure in CSC eyes. Methods This single-center retrospective study included 111 eyes of 111 CSC patients. Using swept-source optical coherence tomography, the horizontal cross-sectional images of the posterior choroid were converted to binary images by semiautomated software. The luminal and stromal areas of the choroid were measured, and the luminal/stromal (L/S) ratios of the whole choroid (WC), inner choroid, and outer choroid (OC) at 1500 µm, 3000 µm, and 7500 µm ranges centered on the fovea were calculated. Correlations of L/S ratio and age, spherical equivalent, axial length, subfoveal choroidal thickness (SCT), and scleral thickness were determined. Scleral thickness was measured vertically, 6 mm posterior to the scleral spur in four directions. Results SCT and mean scleral thickness were significantly positively correlated with the L/S ratio in all ranges of WC and OC. Multiple regression analysis found that SCT and mean scleral thickness were significantly correlated with the L/S ratio, and the strength of correlation of mean scleral thickness (WC: 0.386, P < 0.001; OC: 0.391, P < 0.001) was greater than that of SCT (WC: 0.368, P < 0.001; OC: 0.383, P < 0.001) in 7500 µm range. Conclusions Thick sclera appeared to play a role in an increase in the luminal component of the posterior choroid in CSC eyes.
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Affiliation(s)
- Naoya Imanaga
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Nobuhiro Terao
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Shozo Sonoda
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shota Sawaguchi
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yukihide Yamauchi
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hideki Koizumi
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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20
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Fung AT, Yang Y, Kam AW. Central serous chorioretinopathy: A review. Clin Exp Ophthalmol 2023; 51:243-270. [PMID: 36597282 DOI: 10.1111/ceo.14201] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/18/2022] [Accepted: 12/18/2022] [Indexed: 01/05/2023]
Abstract
Central serous chorioretinopathy (CSC) is the fourth most common non-surgical retinopathy associated with fluid leakage. The pathogenesis is not yet completely understood, but changes in the choroid, sclera and RPE have been described associated with venous congestion of choroidal outflow. CSC can be categorised into acute, chronic, and recurrent subtypes with recent classifications of simple and complex based on the area of RPE change seen on fundus autofluorescence. A multimodal imaging approach is helpful in the diagnosis and management of CSC and secondary complications such as type 1 neovascularisation. Although spontaneous resolution with relatively good visual outcomes is common, treatment should be considered in patients with persistent or recurrent SRF. Treatment options include laser, systemic medications, intravitreal therapy, and surgery. Of these, argon laser for focal extramacular fluid leaks and photodynamic therapy of leakage identified by indocyanine-green angiography currently have the greatest supportive evidence.
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Affiliation(s)
- Adrian T Fung
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University, New South Wales, Australia.,Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Yi Yang
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Eye Hospital, Sydney, New South Wales, Australia
| | - Andrew W Kam
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Eye Hospital, Sydney, New South Wales, Australia
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21
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Jain M, Mohan S, van Dijk EHC. Central serous chorioretinopathy: Pathophysiology, systemic associations, and a novel etiological classification. Taiwan J Ophthalmol 2022; 12:381-393. [PMID: 36660127 PMCID: PMC9843580 DOI: 10.4103/2211-5056.362601] [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: 09/15/2022] [Accepted: 10/04/2022] [Indexed: 12/08/2022] Open
Abstract
Central serous chorioretinopathy (CSC) has remained an enigmatic disease since its initial description by Von Graefe. Over the years, multiple risk factors have been recognized: these include psychological stress, behavioral traits, and corticosteroids. The basic pathophysiology of CSC involves choroidal thickening, vascular congestion, altered choroidal blood flow (ChBF), and choroidal hyperpermeability, leading to retinal pigment epithelium decompensation and subsequent neurosensory detachment. Multiple organ systems, mainly the nervous, cardiovascular, endocrinal, and renal systems participate in the control of the vascular tone and the ChBF via hypothalamus-pituitary-adrenal axis and renin-angiotensin-aldosterone system, while others such as the hepatic system regulate the enzymatic degradation of corticosteroids. Many vasoactive and psychotropic drugs also modulate the ocular perfusion. In addition, there are anatomical and genetic predispositions that determine its progression to the chronic or recurrent form, through cellular response and angiogenesis. We herein review the basic pathophysiology and immunogenetics in CSC along with the role of multiple organ systems. With this background, we propose an etiological classification that should provide a framework for customized therapeutic interventions.
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Affiliation(s)
- Manish Jain
- Department of Ophthalmology, Al Dhannah Hospital, Abu Dhabi, United Arab Emirates,Address for correspondence: Dr. Manish Jain, Department of Ophthalmology, Al Dhannah Hospital, Abu Dhabi, United Arab Emirates. E-mail:
| | - Sashwanthi Mohan
- Department of Vitreous and Retina, Rajan Eye Care Hospital, Chennai, Tamil Nadu, India
| | - Elon H. C. van Dijk
- Department of Ophthalmology, Leiden University Medical Centre, Leiden, The Netherlands
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22
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Yagi M, Miyake M, Mori Y, Hosoda Y, Takahashi A, Muraoka Y, Ueda-Arakawa N, Miyata M, Yamashiro K, Tamura H, Ooto S, Tsujikawa A. Natural Course of Pachychoroid Pigment Epitheliopathy. OPHTHALMOLOGY SCIENCE 2022; 2:100201. [PMID: 36531587 PMCID: PMC9754975 DOI: 10.1016/j.xops.2022.100201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/24/2022] [Accepted: 07/07/2022] [Indexed: 05/28/2023]
Abstract
PURPOSE To investigate the natural course of pachychoroid pigment epitheliopathy (PPE). DESIGN A retrospective cohort study. SUBJECTS From the Kyoto central serous chorioretinopathy (CSC) cohort consisting of 548 patients with CSC as of September 2020, we included consecutive unilateral patients with acute or chronic CSC between January 2013 and December 2016. METHODS All patients underwent complete ophthalmic examination, including multimodal imaging such as fundus autofluorescence, spectral-domain optical coherence tomography, and fluorescein angiography/indocyanine green angiography and/or optimal coherence tomography angiography. The fellow eyes of eyes diagnosed with CSC were screened for PPE, and their natural course was evaluated. We also evaluated the association of ARMS2 rs10490924, CFH rs800292, TNFRSF10A rs13278062, and GATA5 rs6061548 genotypes with the natural course. MAIN OUTCOME MEASURES Incidence of CSC, pachychoroid neovasculopathy, and pachychoroid geographic atrophy (GA). RESULTS In total, 165 patients with unilateral CSC (mean age, 55.7 ± 12.6 years; female, 22.4%) were included from the Kyoto CSC cohort. Among them, 148 (89.7%) were diagnosed as having PPE in their non-CSC eye. Survival analysis revealed that 16.8% of PPE eyes developed CSC during the 6-year follow up, whereas non-PPE eyes did not. Although genetic factors did not have significant association with CSC development (P > 0.05, log-rank test), choroidal vascular hyperpermeability (CVH) and subfoveal choroidal thickness (SFCT) were significantly associated with CSC incidence (P = 0.001, log-rank test). Survival analysis showed that eyes without CVH and eyes with SFCT < 300 μm did not develop CSC during the 6-year follow-up. Pachychoroid neovasculopathy developed in only 1 eye with PPE during a follow-up of 46.4 months. Pachychoroid GA did not develop in any of the studied eyes. CONCLUSIONS This study revealed a natural history of PPE in a relatively large Japanese cohort. Choroidal vascular hyperpermeability and SFCT were significant risk factors for the development of CSC in PPE eyes. Although the current results cannot be generalized for all eyes with PPE, these findings present an important clinical implication.
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Key Words
- BCVA, best-corrected visual acuity
- CI, confidence interval
- CSC, central serous chorioretinopathy
- CVH, choroidal vascular hyperpermeability
- FA, fluorescein angiography
- GA, geographic atrophy
- ICGA, indocyanine green angiography
- MNV, macular neovascularization
- PNV, pachychoroid neovasculopathy
- PPE, pachychoroid pigment epitheliopathy
- SD, standard deviation
- SFCT, Subfoveal choroidal thickness
- SNPs, single nucleotide polymorphisms
- central serous chorioretinopathy
- pachychoroid
- pachychoroid pigment epitheliopathy
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Affiliation(s)
- Mariko Yagi
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Ophthalmology, Kansai Electric Power Hospital, Osaka, Japan
| | - Masahiro Miyake
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Mori
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Ayako Takahashi
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Muraoka
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naoko Ueda-Arakawa
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Manabu Miyata
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Yamashiro
- Department of Ophthalmology, Kochi University Graduate School of Medicine, Kochi, Japan
| | - Hiroshi Tamura
- Center for Innovative Research and Education in Data Science, Institute for Liberal Arts and Sciences, Kyoto University, Kyoto, Japan
| | - Sotaro Ooto
- Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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23
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Morino K, Miyake M, Kamei T, Kawaguchi T, Mori Y, Hosoda Y, Uji A, Yamashiro K, Matsuda F, Tsujikawa A. Association between central serous chorioretinopathy susceptibility genes and choroidal parameters. Jpn J Ophthalmol 2022; 66:504-510. [PMID: 36181643 DOI: 10.1007/s10384-022-00945-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/06/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the association between central serous chorioretinopathy (CSC) susceptibility genes and choroidal parameters in a large Japanese cohort. STUDY DESIGN Retrospective cohort study. METHODS Of the 9850 individuals in the Nagahama study whose second visit was between 2013 and 2016, those with optical coherence tomography (OCT) images with enhanced depth imaging (EDI), axial length, and genome-wide single nucleotide polymorphism (SNP) genotyping data were included. We calculated subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), normalized choroidal intensity (NCI), and vertical asymmetry of choroidal thickness. Genome-wide quantitative trait locus (QTL) analyses were performed for each parameter. We screened for four CSC susceptibility SNPs: CFH rs800292, TNFRSF10A rs13278062, GATA5 rs6061548, and VIPR2 rs3793217. Whenever an SNP was not included in the genotyping data after quality control, its proxy SNP was selected. RESULTS In total, 4586 participants were evaluated. CFH rs800292 was significantly associated with SFCT (P < 0.001) and CVI (P < 0.001). VIPR2 rs3793217 was significantly associated with SFCT (P < 0.001) but not with CVI. Whereas, TNFRSF10A rs13254617 and GATA5 rs6061548 were not significantly associated with SFCT or CVI. None of these SNPs was associated with NCIEDI and asymmetry of choroidal thickness. CONCLUSION CFH, VIPR2, TNFRSF10A, and GATA5 showed different association patterns with choroidal parameters. Although the mechanism of CSC pathogenesis by choroidal changes is not fully understood, this finding suggests that each gene may be involved in different mechanisms of CSC development. Our genetic study provides a basis for understanding the role of CSC susceptibility genes.
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Affiliation(s)
- Kazuya Morino
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara, Shogoin, Sakyo, Kyoto, 606-8507, Japan.,Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara, Shogoin, Sakyo, Kyoto, 606-8507, Japan. .,Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Takuro Kamei
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara, Shogoin, Sakyo, Kyoto, 606-8507, Japan.,Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Mori
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara, Shogoin, Sakyo, Kyoto, 606-8507, Japan.,Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Akihito Uji
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara, Shogoin, Sakyo, Kyoto, 606-8507, Japan
| | - Kenji Yamashiro
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Kochi, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara, Shogoin, Sakyo, Kyoto, 606-8507, Japan
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Ishikura M, Muraoka Y, Nishigori N, Takahashi A, Miyake M, Ueda-Arakawa N, Miyata M, Ooto S, Tsujikawa A. Widefield Choroidal Thickness of Eyes with Central Serous Chorioretinopathy Examined by Swept-Source OCT. Ophthalmol Retina 2022; 6:949-956. [PMID: 35436598 DOI: 10.1016/j.oret.2022.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/31/2022] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE To examine widefield (WF) changes in the choroidal thickness of eyes with central serous chorioretinopathy (CSC). DESIGN An observational study. PARTICIPANTS Twenty-two patients (20 men and 2 women) with treatment-naïve unilateral CSC and 28 normal eyes of 28 age-matched, healthy participants (21 men and 7 women). METHODS We performed enhanced depth imaging of swept-source (SS) OCT with a viewing angle of vertical 20 mm × horizontal 23 mm. Moreover, we developed a grid consisting of 9 subfields, with diameters of 3, 9, and 18 mm; the inner and outer rings were enclosed by circles with diameters of 3 and 9 mm and 9 and 18 mm, respectively, which were divided into 4 subfields-superotemporal, inferotemporal, superonasal, and inferonasal. MAIN OUTCOME MEASURES Widefield changes in choroidal thickness. RESULTS The mean duration from the presumed onset of CSC was 6.8 ± 3.1 months during the examination. Compared with that in normal eyes, the choroidal thickness in eyes of patients with CSC was significantly greater in all subfields (P < 0.020 for fellow eyes; P < 0.001 for eyes with CSC). Compared with that in fellow eyes, the choroidal thicknesses in eyes of patients with CSC were significantly greater, except for the outer superotemporal and inferonasal subfields (P < 0.001 for all inner subfields; P < 0.001 for the outer superonasal and inferotemporal subfields). In areas with dilated vortex veins, choroidal thickening was observed from the vicinity of the vortex vein ampulla to the macula along the course of the veins. Choroidal thickening on the dominant side was significantly greater than that on the nondominant side (P = 0.015 for the nasal subfield of the inner ring; P = 0.003 and P < 0.001 for the temporal subfields of the inner and outer rings, respectively). CONCLUSIONS Enhanced depth imaging of SS-OCT facilitated the analysis of WF changes in choroidal thickness in both healthy patients and patients with CSC. The local factors of the affected vortex vein and systemic risk factors may be involved in the pathogenesis of CSC.
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Affiliation(s)
- Masaharu Ishikura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Muraoka
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Naomi Nishigori
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ayako Takahashi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naoko Ueda-Arakawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Manabu Miyata
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sotaro Ooto
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Gouda HR, Talaat IM, Bouzid A, El-Assi H, Nabil A, Venkatachalam T, Manasa Bhamidimarri P, Wohlers I, Mahdami A, EL-Gendi S, ElKoraie A, Busch H, Saber-Ayad M, Hamoudi R, Baddour N. Genetic analysis of CFH and MCP in Egyptian patients with immune-complex proliferative glomerulonephritis. Front Immunol 2022; 13:960068. [PMID: 36211394 PMCID: PMC9539770 DOI: 10.3389/fimmu.2022.960068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/30/2022] [Indexed: 11/19/2022] Open
Abstract
Glomerulonephritis (GN) is a complex disease with intricate underlying pathogenic mechanisms. The possible role of underlying complement dysregulation is not fully elucidated in some GN subsets, especially in the setting of autoimmunity or infection. In the current study, diagnosed cases of lupus nephritis (LN) and post-infectious GN (PIGN) were recruited for molecular genetic analysis and targeted next-generation DNA sequencing was performed for two main complement regulating genes: in the fluid phase; CFH, and on tissue surfaces; MCP. Three heterozygous pathogenic variants in CFH (Q172*, W701*, and W1096*) and one likely pathogenic heterozygous variant in MCP (C223R) have been identified in four of the studied LN cases. Additionally, among the several detected variants of uncertain significance, one novel variant (CFH:F614S) was identified in 74% of the studied LN cases and in 65% of the studied PIGN cases. This variant was detected for the first time in the Egyptian population. These findings suggest that subtle mutations may be present in complement regulating genes in patients with immune-complex mediated category of GN that may add to the disease pathogenesis. These findings also call for further studies to delineate the impact of these gene variants on the protein function, the disease course, and outcome.
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Affiliation(s)
- Heba R. Gouda
- Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Iman M. Talaat
- Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- *Correspondence: Iman M. Talaat, ; Rifat Hamoudi,
| | - Amal Bouzid
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Hoda El-Assi
- Human Genetics Unit, Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Amira Nabil
- Human Genetics Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Thenmozhi Venkatachalam
- Department of Physiology and Immunology, College of Medicine, Khalifa University, Abu Dhabi, United Arab Emirates
| | | | - Inken Wohlers
- Medical Systems Biology Division, Lübeck Institute of Experimental Dermatology and Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - Amena Mahdami
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Saba EL-Gendi
- Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed ElKoraie
- Nephrology Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hauke Busch
- Medical Systems Biology Division, Lübeck Institute of Experimental Dermatology and Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - Maha Saber-Ayad
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Pharmacology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rifat Hamoudi
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
- *Correspondence: Iman M. Talaat, ; Rifat Hamoudi,
| | - Nahed Baddour
- Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Yamashiro K, Yanagi Y, Koizumi H, Matsumoto H, Cheung CMG, Gomi F, Iida T, Tsujikawa A. Relationship between Pachychoroid and Polypoidal Choroidal Vasculopathy. J Clin Med 2022; 11:jcm11154614. [PMID: 35956229 PMCID: PMC9369798 DOI: 10.3390/jcm11154614] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/14/2022] [Accepted: 08/05/2022] [Indexed: 11/20/2022] Open
Abstract
Previous clinical studies have suggested that pachychoroid can induce macular neovascularization (MNV) to develop pachychoroid neovasculopathy (PNV) and that PNV can progress to polypoidal choroidal vasculopathy (PCV). Recent studies based on the pachychoroid concept are now gradually revealing the true nature of, at least some part of, PCV. However, previous studies on PNV and/or PCV have used different frameworks for the classification of PNV, PCV, and neovascular age-related macular degeneration (nAMD). These have hampered the rapid overhaul of the understanding of PCV. Some investigators have assumed that all PCV is pachychoroid-driven whereas other investigators have classified PCV into “pachychoroid PCV” and “non-pachychoroid PCV”. Furthermore, since there is no consensus as to whether PNV includes PCV, some studies have included PCV with PNV, while other studies have excluded PCV from PNV. To address these gaps, we summarize previous studies on PCV and pachychoroid. Even before the proposal of the pachychoroid concept, previous studies had suggested that PCV could be divided into two subtypes, of which one was characterized by pachychoroid features. Previous studies had also provided keys to understand relationship between PCV and PNV. We here recommend a refined conceptual framework for future studies on PNV, PCV, and nAMD. Considering the current inconsistent understanding of PCV, we should be cautious about using the term PCV until we understand the true nature of PCV.
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Affiliation(s)
- Kenji Yamashiro
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Nankoku 7838505, Japan
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto 6068507, Japan
- Correspondence: ; Tel.: +81-88-880-2391
| | - Yasuo Yanagi
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Yokohama 2320024, Japan
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 168751, Singapore
- The Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
| | - Hideki Koizumi
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Nishihara 9030215, Japan
| | - Hidetaka Matsumoto
- Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi 3718511, Japan
| | - Chui Ming Gemmy Cheung
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 168751, Singapore
- The Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
| | - Fumi Gomi
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya 6638501, Japan
| | - Tomohiro Iida
- Department of Ophthalmology, Tokyo Women’s Medical University, Tokyo 1628666, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto 6068507, Japan
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Yoneyama S, Fukui A, Sakurada Y, Terao N, Shijo T, Kusada N, Sugiyama A, Matsubara M, Fukuda Y, Kikushima W, Parikh R, Mabuchi F, Sotozono C, Kashiwagi K. Distinct characteristics of central serous chorioretinopathy according to gender. Sci Rep 2022; 12:10565. [PMID: 35732691 PMCID: PMC9217960 DOI: 10.1038/s41598-022-14777-8] [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: 02/17/2022] [Accepted: 06/13/2022] [Indexed: 12/02/2022] Open
Abstract
To investigate the differences in clinical and genetic characteristics between males and females with central serous chorioretinopathy (CSC). Consecutive 302 patients (mean age; 56.3 ± 11.7, male/female: 249/53) with CSC were evaluated on the initial presentation. All CSC patients underwent fluorescein angiography and indocyanine green angiography (FA/ICGA), swept-source or spectral-domain optical coherence tomography (OCT), and fundus autofluorescence (FAF) to confirm a diagnosis. All patients were genotyped for rs800292 and rs1329428 variants of CFH using TaqMan technology. On the initial presentation, female patients were significantly older (p = 2.1 × 10–4, female 61.6 ± 12.4 vs male 55.1 ± 11.3) and had thinner subfoveal choroidal thickness (p = 3.8 × 10–5) and higher central retinal thickness (p = 3.0 × 10–3) compared to males. A descending tract was more frequently seen in males than in females (p = 8.0 × 10–4, 18.1% vs 0%). Other clinical characteristics were comparable between the sexes. The risk allele frequency of both variants including CFH rs800292 and CFH rs1329428 was comparable between males and females (CFH rs800292 A allele male 51.2% vs female 47.2%, CFH rs1329428 T allele male 56.2% vs 52.8%). On the initial presentation, age, subfoveal choroidal thickness and central retinal thickness differ between males and females in eyes with CSC. A descending tract may be a strong male finding in CSC.
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Affiliation(s)
- Seigo Yoneyama
- Department of Ophthalmology, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan
| | - Ayumi Fukui
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoichi Sakurada
- Department of Ophthalmology, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
| | - Nobuhiro Terao
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Taiyo Shijo
- Department of Ophthalmology, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan
| | - Natsuki Kusada
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Sugiyama
- Department of Ophthalmology, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan
| | - Mio Matsubara
- Department of Ophthalmology, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan
| | - Yoshiko Fukuda
- Department of Ophthalmology, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan
| | - Wataru Kikushima
- Department of Ophthalmology, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan
| | - Ravi Parikh
- New York University School of Medicine, New York, NY, USA.,Manhattan Retina and Eye Consultants, New York, NY, USA
| | - Fumihiko Mabuchi
- Department of Ophthalmology, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kenji Kashiwagi
- Department of Ophthalmology, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan
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Karkhaneh R, Toufighi M, Amirfiroozy A, Ahmad-Raji A, Ahmadzadeh O, Mahdavi A, Naderan M. Association of central serous chorioretinopathy with single nucleotide polymorphisms in complement factor H gene in Iranian population. Eye (Lond) 2022; 36:1061-1065. [PMID: 33976403 PMCID: PMC9046259 DOI: 10.1038/s41433-021-01579-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 04/07/2021] [Accepted: 04/23/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To investigate the association of two different single nucleotide polymorphisms (SNPs) in the complement factor H (CFH) gene with central serous chorioretinopathy (CSCR) in the Iranian population. METHODS This is a case-control study with 95 participants in each group who were stratified according to their various ethnical variations. Primers for rs1329428 and rs3753394 polymorphisms were synthesized. DNA was extracted from peripheral blood leukocytes and underwent PCR and high-resolution melt analysis. RESULTS The frequency of tt, ct, and cc genotypes for rs1329428 polymorphism was 22 (26.5%), 46 (55.4%), and 15 (18.1%) in acute CSCR and 5 (41.7%), 5 (41.7%), and 2 (16.7%) in chronic CSCR respectively with no significant difference between case and control groups. The frequency of tt, ct, and cc genotypes for rs3753394 polymorphism was 31 (37.3%), 14 (16.9%), and 38 (45.8%) in acute CSCR and 4 (33.3%), 3 (25%), and 5 (41.7%) in chronic CSCR respectively. There was a significant difference between patients of Persian descent and controls in rs3753394 polymorphism (P = 0.00, chi-square test). There was no statistical difference in the frequency of polymorphism between acute and chronic patients (P = 0.64 and P = 0.79 respectively, chi-square test). CONCLUSIONS The rs3753394 polymorphism is probably associated with CSCR in Persian ethnicity. Further studies are required to validate the implications of this finding in clinical practice.
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Affiliation(s)
- Reza Karkhaneh
- grid.411705.60000 0001 0166 0922Department of Vitreoretinal Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Toufighi
- grid.411705.60000 0001 0166 0922Department of Vitreoretinal Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Amirfiroozy
- grid.411705.60000 0001 0166 0922Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliasghar Ahmad-Raji
- grid.411705.60000 0001 0166 0922Department of Ocular Emergency and Trauma, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Oveis Ahmadzadeh
- grid.411705.60000 0001 0166 0922Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alborz Mahdavi
- grid.411705.60000 0001 0166 0922Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Naderan
- grid.411705.60000 0001 0166 0922Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Mori Y, Miyake M, Hosoda Y, Miki A, Takahashi A, Muraoka Y, Miyata M, Sato T, Tamura H, Ooto S, Yamada R, Yamashiro K, Nakamura M, Tajima A, Nagasaki M, Honda S, Tsujikawa A. Genome-wide Survival Analysis for Macular Neovascularization Development in Central Serous Chorioretinopathy Revealed Shared Genetic Susceptibility with Polypoidal Choroidal Vasculopathy. Ophthalmology 2022; 129:1034-1042. [PMID: 35490733 DOI: 10.1016/j.ophtha.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/04/2022] [Accepted: 04/22/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To identify susceptibility genes for macular neovascularization (MNV) development in central serous chorioretinopathy (CSC). DESIGN Genome-wide survival analysis using a longitudinal cohort study. PARTICIPANTS We included 402 and 137 patients with CSC but without MNV at their first visit from the Kyoto CSC Cohort and Kobe CSC dataset, respectively. All patients underwent detailed ophthalmologic examinations, including multimodal imaging, such as fundus autofluorescence, spectral-domain optical coherence tomography, and fluorescein angiography/indocyanine green angiography and/or optimal coherence tomography angiography. METHODS We conducted a genome-wide survival analysis using the Kyoto CSC Cohort. We applied the Cox proportional hazard model to adjust for age, sex, and the first principal component. Single nucleotide polymorphisms (SNPs) with P-values <1.0×10-5 were carried forward to the replication in the Kobe CSC dataset. Moreover, we evaluated the contribution of previously-reported age-related macular degeneration (AMD) susceptibility loci. We used FUMA and ToppFun for the functional enrichment analysis. MAIN OUTCOME MEASURES The association between SNPs and MNV development in patients with CSC. RESULTS Rs370974631 near ARMS2 displayed a genome-wide significant association in the meta-analysis of discovery and replication result (hazard ratio [HR]meta = 3.63; Pmeta = 5.76×10-9). Among previously-reported AMD susceptibility loci, we additionally identified CFH rs800292 (HR = 0.39, P = 2.55×10-4), COL4A3 rs4276018 (HR = 0.26, P = 1.56×10-3), and B3GALTL rs9564692 (HR = 0.56, P = 8.30×10-3) as susceptibility loci for MNV development in CSC. The functional enrichment analysis revealed significant enrichment of eight pathways (GO:0051561, GO:0036444, GO:0008282, GO:1990246, GO:0015272, GO:0030955, GO:0031420, and GO:0005242) related to ion transport. CONCLUSIONS ARMS2, CFH, COL4A3, and B3GALTL were identified as susceptibility genes for MNV development in CSC. The aforementioned four genes are known as susceptibility genes for AMD, whereas COL4A3 and B3GALTL were previously reported to be polypoidal choroidal vasculopathy (PCV)-specific susceptibility genes. Our findings revealed the shared genetic susceptibility between PCV and MNV secondary to CSC.
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Affiliation(s)
- Yuki Mori
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Miyake
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | | | - Akiko Miki
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ayako Takahashi
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Muraoka
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Manabu Miyata
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takehiro Sato
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Ishikawa Japan
| | - Hiroshi Tamura
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sotaro Ooto
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryo Yamada
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Yamashiro
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Nankoku City, Kochi, Japan
| | - Makoto Nakamura
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Atsushi Tajima
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Ishikawa Japan
| | - Masao Nagasaki
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shigeru Honda
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Associations of Single-Nucleotide Polymorphisms in Slovenian Patients with Acute Central Serous Chorioretinopathy. Genes (Basel) 2021; 13:genes13010055. [PMID: 35052395 PMCID: PMC8774639 DOI: 10.3390/genes13010055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 11/17/2022] Open
Abstract
Central serous chorioretinopathy (CSC) is a chorioretinal disease that usually affects the middle-aged population and is characterised by a thickened choroid, retinal pigment epithelium detachment, and subretinal fluid with a tendency towards spontaneous resolution. We investigated 13 single-nucleotide polymorphisms (SNPs) in 50 Slovenian acute CSC patients and 71 healthy controls in Complement Factor H (CFH), Nuclear Receptor Subfamily 3 Group C Member 2 (NR3C2), Cadherin 5 (CDH5) Age-Related Maculopathy Susceptibility 2 (ARMS2), TNF Receptor Superfamily Member 10a (TNFRSF10A), collagen IV alpha 3 (COL4A3) and collagen IV alpha 4 (COL4A4) genes using high-resolution melt analysis. Statistical calculations revealed significant differences in genotype frequencies for CFH rs1329428 (p = 0.042) between investigated groups and an increased risk for CSC in patients with TC (p = 0.040) and TT (p = 0.034) genotype. Genotype–phenotype correlation analysis revealed that CSC patients with CC genotype in CFH rs3753394 showed a higher tendency for spontaneous CSC episode resolution at 3 months from the disease onset (p = 0.0078), which could indicate clinical significance of SNP testing in CSC patients. Bioinformatics analysis of the non-coding polymorphisms showed alterations in transcription factor binding motifs for CFH rs3753394, CDH5 rs7499886 and TNFRSF10A rs13278062. No association of collagen IV polymorphisms with CSC was found in this study.
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Terao N, Imanaga N, Wakugawa S, Sawaguchi S, Tamashiro T, Yamauchi Y, Koizumi H. Short Axial Length Is Related to Asymmetric Vortex Veins in Central Serous Chorioretinopathy. OPHTHALMOLOGY SCIENCE 2021; 1:100071. [PMID: 36246946 PMCID: PMC9560636 DOI: 10.1016/j.xops.2021.100071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/16/2021] [Accepted: 10/19/2021] [Indexed: 02/05/2023]
Abstract
Purpose To investigate the clinical and morphologic factors related to asymmetric dilated vortex veins in central serous chorioretinopathy (CSC). Design Retrospective, comparative study. Participants One hundred fifty-eight eyes of 158 patients with CSC. Methods All patients with CSC underwent ophthalmic examination and multimodal imaging, including measurements of axial length (AL), fluorescein angiography, indocyanine green angiography, swept-source OCT, and anterior segment OCT. Using en face OCT images at the level of the outer choroid, the eyes were divided into 2 groups: eyes with symmetric vortex veins (symmetry group) and those with asymmetric vortex veins (asymmetry group). Main Outcome Measures Clinical and morphologic factors related to asymmetric vortex veins in CSC. Results Of the 158 eyes, 120 eyes (75.9%) were classified into the asymmetry group and 38 eyes (24.1%) were classified into the symmetry group. The asymmetry group showed significantly greater spherical equivalent (–0.32 ± 1.78 diopters [D] vs. –1.35 ± 2.64 D; P = 0.033), shorter AL (23.52 ± 0.86 mm vs. 24.10 ± 1.06 mm; P = 0.005), and greater subfoveal choroidal thickness (414.6 ± 105.3 μm vs. 360.4 ± 91.8 μm; P = 0.005) than the symmetry group. No significant differences existed between the 2 groups regarding age, sex, or all scleral thicknesses at the superior, temporal, inferior, and nasal points. In the multivariate analyses, shorter AL (odds ratio, 0.56; 95% confidence interval, 0.36–0.88; P = 0.011) was found to be significantly associated with the presence of asymmetric vortex veins. Conclusions The asymmetric dilated vortex vein is a common finding in patients with CSC. Our results suggest that certain biometric factors, such as short AL, may be associated with asymmetric dilated vortex veins developing in patients with CSC.
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Affiliation(s)
| | | | | | | | | | | | - Hideki Koizumi
- Correspondence: Hideki Koizumi, MD, PhD, Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa 903-0215, Japan.
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Kinoshita T, Mori J, Hatanaka A, Shimizu M, Imaizumi H. Visual Outcome and Treatment Frequency of Anti-VEGF Therapy Using the Treat-and-Extend and Treatment Cessation Regimen for Exudative Age-Related Macular Degeneration and Pachychoroid Neovasculopathy. Clin Ophthalmol 2021; 15:4405-4418. [PMID: 34795473 PMCID: PMC8593600 DOI: 10.2147/opth.s334641] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/27/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose To report the results of anti-vascular endothelial growth factor (VEGF) therapy using treat-and-extend (TAE) and treatment cessation regimens for exudative age-related macular degeneration (AMD) and pachychoroid neovasculopathy (PN). Methods We retrospectively studied 101 treatment-naïve eyes of 101 patients with exudative AMD and PN that underwent anti-VEGF therapy using TAE and treatment cessation regimen with a follow-up period of ≥12 months. Best-corrected visual acuity (BCVA), treatment frequency, and number of eyes with successful treatment cessation were measured. Successful treatment cessation was defined as dry macula retention without treatment for >16 weeks after the last injections. Factors related to the successful treatment cessation were evaluated. Results BCVA was maintained at the last visit with a mean follow-up period of 49.9 ± 26.9 months. The injection number decreased from 6.8 ± 2.31 at the first year to 3.7 ± 3.64 at the fifth year. At the last visit, 48 (47.5%) eyes were being treated at an interval of ≥12 weeks or were under treatment cessation. Successful treatment cessation during the follow-up period and at the last visit were achieved in 56 (55.4%) and 27 (26.7%) eyes, with a median treatment-free period of 66 and 126 weeks, respectively. Good early treatment response and a small recurrence number were associated with successful treatment cessation at the last visit. Conclusion Patients with good early response to treatment and fewer recurrences may achieve treatment cessation. This information could help physicians predict the achievement of treatment cessation for a considerable period.
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Affiliation(s)
- Takamasa Kinoshita
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Junya Mori
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Akira Hatanaka
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Miho Shimizu
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Hiroko Imaizumi
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
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Lee LC, Wu TJ, Huang KH, Chen YH, Chen JT, Chung CH, Chien WC, Chen CL. Increased risk for central serous chorioretinopathy in nephrotic syndrome patients: A population-based cohort study. J Chin Med Assoc 2021; 84:1060-1069. [PMID: 34320516 DOI: 10.1097/jcma.0000000000000591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Nephrotic syndrome (NS) is characterized by various etiologies that damage the glomerulus. Central serous chorioretinopathy (CSCR) is a retinal disease characterized by neurosensory detachment of the retina. Several case reports have described the relationship between both. Therefore, we try to analyze the epidemiological associations between NS and CSCR using the National Health Insurance Research Database in Taiwan. METHODS Data spanning 14 years were extracted from the National Health Insurance Research Database and sub-grouped. The variables were analyzed using Pearson's chi-squared test and Fisher's exact test. The risk factors for disease development with or without comorbidities were examined using an adjusted hazard ratio (aHR). Kaplan-Meier analysis was performed to evaluate the cumulative incidence of CSCR with or without NS. RESULTS A total of 14 794 patients with NS and 14 794 matched controls without NS were enrolled in this cohort study. The incidence rate of CSCR was higher in the study cohort than in the control cohort (aHR = 3.349, p < 0.001). The overall incidence of CSCR was 44.51 per 100 000 person-years in the study cohort and 33.39 per 100 000 person-years in the control cohort. In both groups, CSCR occurred more frequently in males than in females. Patients aged 40-49, 50-59, and ≥60 years in the study cohort had a significantly higher risk of developing CSCR than those in the control cohort (aHR = 3.445, 5.421, and 4.957, all p < 0.001). NS patient with a 4-week history of steroid usage has a higher risk of developing CSCR (aHR = 2.010, p < 0.001). CONCLUSION Our data showed that patients with NS have an increased risk of developing subsequent CSCR. Physician should routinely refer their NS patients to ophthalmologist for ophthalmic evaluation. This is the first nationwide epidemiological study reporting the association between these two diseases. Further studies are needed to clarify this relationship.
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Affiliation(s)
- Lung-Chi Lee
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Tai-Jung Wu
- Department of Nephrology, Department of Internal Medicine, Fu Jen Catholic University Hospital, Taipei, Taiwan, ROC
| | - Ke-Hao Huang
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
- Department of Ophthalmology, Songshan Branch of Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Jiann-Torng Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, ROC
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Ching-Long Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
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Hirai H, Yamashita M, Matsumoto M, Hayakawa M, Sakai K, Ueda T, Ogata N. Analysis focusing on plasma von Willebrand factor in pachychoroid neovasculopathy and age-related macular degeneration. Sci Rep 2021; 11:19987. [PMID: 34620972 PMCID: PMC8497477 DOI: 10.1038/s41598-021-99557-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/28/2021] [Indexed: 12/31/2022] Open
Abstract
Pachychoroid neovasculopathy (PNV) is a new concept of macular disorder. Some cases diagnosed as age-related macular degeneration (AMD) have been re-diagnosed as PNV. However, the biological features of PNV are still uncertain. The purpose of this study was to compare PNV and AMD by analyses focusing on von Willebrand factor (VWF) and complement factor H (CFH). Ninety-seven patients who were previously diagnosed with treatment naïve AMD were enrolled in this study. They were re-classified as either PNV or AMD based on the clinical criteria and 33 patients were classified as PNV and 64 patients as AMD. We examined the clinical data, analyzed VWF multimer and two genetic polymorphisms (I62V and Y402H) in the CFH. PNV group was significantly younger than AMD group (P = 0.001). In both I62V and Y402H, there were no significant differences between PNV and AMD while the recessive homozygous (AA) was found only in PNV group in I62V. The presence of unusually large VWF multimers (UL-VWFMs) and subretinal hemorrhages were significantly higher in PNV than in AMD (P = 0.045, P = 0.020, respectively). Thus, the residual UL-VWFMs may result in platelet thrombosis and hemorrhages in the choriocapillaris of PNV. In conclusion, our results suggest the biological differences between PNV and AMD.
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Affiliation(s)
- Hiromasa Hirai
- Department of Ophthalmology, Nara Medical University, 840 Shijo-Cho, Kashihara, Japan
| | - Mariko Yamashita
- Department of Ophthalmology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Japan
| | - Masanori Matsumoto
- Department of Blood Transfusion Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Japan
| | - Masaki Hayakawa
- Department of Blood Transfusion Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Japan
| | - Kazuya Sakai
- Department of Blood Transfusion Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Japan
| | - Tetsuo Ueda
- Department of Ophthalmology, Nara Medical University, 840 Shijo-Cho, Kashihara, Japan
| | - Nahoko Ogata
- Department of Ophthalmology, Nara Medical University, 840 Shijo-Cho, Kashihara, Japan.
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QUANTIFICATION OF VESSELS OF HALLER'S LAYER BASED ON EN-FACE OPTICAL COHERENCE TOMOGRAPHY IMAGES. Retina 2021; 41:2148-2156. [PMID: 33734190 DOI: 10.1097/iae.0000000000003166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To quantify the vessels of Haller's layer of normal subjects in en-face optical coherence tomographic images. METHODS One hundred and seventy-two normal eyes were studied. En-face images of the top 25% slab of Haller's layer was analyzed. The vessel area, vessel length, and mean vessel diameter were calculated. The vessel running pattern was quantified for the degree of symmetry and designated as the "symmetry index." The coefficient of correlation between each choroidal parameter and the age, sex, axial length, and central choroidal thickness was determined. RESULTS The vessel area was 23.4 ± 3.6 mm2, vessel length was 164.6 ± 24.1 mm, mean vessel diameter was 0.143 ± 0.019 mm, and the symmetry index was 58.6 ± 6.1%. Multiple regression analysis showed that the vessel area was significantly correlated with the age (R = -0.421, P < 0.001) and central choroidal thickness (R = 0.315, P < 0.001). The vessel length was significantly correlated with the age (R = -0.391, P = 0.024) and central choroidal thickness (R = -0.410, P < 0.001). The mean vessel diameter was significantly correlated with the age (R = -0.107, P = 0.024) and central choroidal thickness (R = 0.775, P < 0.001). The correlation between the symmetry index and any clinical findings was not significant. CONCLUSION Quantification of en-face images of Haller's layer provide new biomarkers of the choroid.
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Feng L, Chen S, Dai H, Dorajoo R, Liu J, Kong J, Yin X, Ren Y. Discovery of Novel Genetic Risk Loci for Acute Central Serous Chorioretinopathy and Genetic Pleiotropic Effect With Age-Related Macular Degeneration. Front Cell Dev Biol 2021; 9:696885. [PMID: 34490249 PMCID: PMC8417822 DOI: 10.3389/fcell.2021.696885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/29/2021] [Indexed: 12/27/2022] Open
Abstract
Background Central serous chorioretinopathy (CSC) is a severe and heterogeneous chorioretinal disorder. Shared clinical manifestations between CSC and age-related macular degeneration (AMD) and the confirmation of CFH as genetic risk locus for both CSC and AMD suggest possible common pathophysiologic mechanisms between two diseases. Methods To advance the understanding of genetic susceptibility of CSC and further investigate genetic pleiotropy between CSC and AMD, we performed genetic association analysis of 38 AMD-associated single nucleotide polymorphisms (SNPs) in a Chinese CSC cohort, consisting of 464 patients and 548 matched healthy controls. Results Twelve SNPs were found to be associated with CSC at nominal significance (p < 0.05), and four SNPs on chromosomes 1, 4, and 15 showed strong associations whose evidences surpassed Bonferroni (BF)-corrected significance [rs1410996, odds ratios (OR) = 1.47, p = 2.37 × 10-5; rs1329428, OR = 1.40, p = 3.32 × 10-4; rs4698775, OR = 1.45, p = 2.20 × 10-4; and rs2043085, OR = 1.44, p = 1.91 × 10-4]. While the genetic risk effects of rs1410996 and rs1329428 (within the well-established locus CFH) are correlated (due to high LD), rs4698775 on chromosome 4 and rs2043085 on chromosome 15 are novel risk loci for CSC. Polygenetic risk score (PRS) constructed by using three independent SNPs (rs1410996, rs4698775, and rs2043085) showed highly significant association with CSC (p = 2.10 × 10-7), with the top 10% of subjects with high PRS showing 6.39 times higher risk than the bottom 10% of subjects with lowest PRS. Three SNPs were also found to be associated with clinic manifestations of CSC patients. In addition, by comparing the genetic effects (ORs) of these 38 SNPs between CSC and AMD, our study revealed significant, but complex genetic pleiotropic effect between the two diseases. Conclusion By discovering two novel genetic risk loci and revealing significant genetic pleiotropic effect between CSC and AMD, the current study has provided novel insights into the role of genetic composition in the pathogenesis of CSC.
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Affiliation(s)
- Lei Feng
- Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Si Chen
- Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.,Department of Ophthalmology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Huatuo Dai
- Department of Dermatology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.,Department of Dermatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jinfeng Kong
- Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xianyong Yin
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Yunqing Ren
- Department of Dermatology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.,Department of Dermatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Kitagawa Y, Shimada H, Kawamura A, Tanaka K, Mori R, Onoe H, Nakashizuka H. A case of bilateral pachychoroid disease: polypoidal choroidal vasculopathy in one eye and peripheral exudative hemorrhagic chorioretinopathy in contralateral eye. BMC Ophthalmol 2021; 21:320. [PMID: 34481477 PMCID: PMC8418046 DOI: 10.1186/s12886-021-02067-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/10/2021] [Indexed: 12/04/2022] Open
Abstract
Background We report a case of bilateral pachychoroid disease manifesting polypoidal choroidal vasculopathy (PCV) with punctate hyperfluorescent spot (PHS) in one eye, and peripheral exudative hemorrhagic choroidal retinopathy (PEHCR) with central serous chorioretinopathy (CSC) and PHS in the contralateral eye. Case presentation : A 51-year-old healthy woman presented with complaint of blurred vision in her right eye. Corrected visual acuity was 20/20 in the right and 24/20 in the left eye. Fundus examination was normal in the left eye. In the right eye, fundus finding of an orange-red nodular lesion and optical coherence tomography (OCT) finding of polypoidal lesions led to a diagnosis of PCV. Four aflibercept intravitreal injections were performed in her right eye. After treatment, indocyanine green angiography (ICGA) confirmed residual polypoidal lesions with branching vascular networks and PHS with choroidal vascular hyperpermeability. OCT showed PHS associated with small sharp-peaked retinal pigment epithelium (RPE) elevation in peripheral fundus and small RPE elevation in posterior fundus. Based on the above findings, PCV with PHS was finally diagnosed in the right eye. Posttreatment corrected visual acuity in the right eye was 20/20. She presented again 32 months later, with complaint of vision loss in her left eye. Left corrected visual acuity was 20/20, and fundus examination showed mild vitreous hemorrhage. Vitrectomy was performed. In temporal midperipheral fundus, fluorescein angiography revealed CSC, and OCT showed pachychoroid. ICGA depicted abnormal choroidal networks and PHS in peripheral fundus. Furthermore, polypoidal lesions were confirmed by OCT. Based on the above findings, PEHCR and CSC with PHS was finally diagnosed in the left eye. Postoperative corrected visual acuity in the left eye was 20/20, and aflibercept intravitreal injection was performed for prevention of recurrence of vitreous hemorrhage. Conclusions This is the first case report of PCV with PHS in one eye, and PEHCR with CSC and PHS in the contralateral eye. This case suggests that PCV, PEHCR, and CSC may be linked pathologies of pachychoroid spectrum disease.
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Affiliation(s)
- Yorihisa Kitagawa
- Department of Ophthalmology, School of Medicine, Nihon University, 1-6 Surugadai, Kanda, Chiyodaku, 101-8309, Tokyo, Japan
| | - Hiroyuki Shimada
- Department of Ophthalmology, School of Medicine, Nihon University, 1-6 Surugadai, Kanda, Chiyodaku, 101-8309, Tokyo, Japan.
| | - Akiyuki Kawamura
- Department of Ophthalmology, School of Medicine, Nihon University, 1-6 Surugadai, Kanda, Chiyodaku, 101-8309, Tokyo, Japan
| | - Koji Tanaka
- Department of Ophthalmology, School of Medicine, Nihon University, 1-6 Surugadai, Kanda, Chiyodaku, 101-8309, Tokyo, Japan
| | - Ryusaburo Mori
- Department of Ophthalmology, School of Medicine, Nihon University, 1-6 Surugadai, Kanda, Chiyodaku, 101-8309, Tokyo, Japan
| | - Hajime Onoe
- Department of Ophthalmology, School of Medicine, Nihon University, 1-6 Surugadai, Kanda, Chiyodaku, 101-8309, Tokyo, Japan
| | - Hiroyuki Nakashizuka
- Department of Ophthalmology, School of Medicine, Nihon University, 1-6 Surugadai, Kanda, Chiyodaku, 101-8309, Tokyo, Japan
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Hua R, Duan J, Zhang M. Pachychoroid Spectrum Disease: Underlying Pathology, Classification, and Phenotypes. Curr Eye Res 2021; 46:1437-1448. [PMID: 34114902 DOI: 10.1080/02713683.2021.1942073] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Pachychoroid spectrum disease encompasses a set of macular disorders secondary to an abnormally thick choroid. However, the pathological process underlying pachychoroid spectrum disease and its overlap with age-related macular degeneration (AMD) remain unclear. This review aimed to understand the underlying pathology, classification, and phenotypes of pachychoroid spectrum disease. METHODS This comprehensive literature review was performed based on a search of peer-reviewed published papers relevant to the current knowledge of pachychoroid disease spectrum. RESULTS Pachychoroid is primarily a bilateral phenomenon; the main pathological lesions include choriocapillaris attenuation and abnormally dilated pachyvessels. Chronic central serous chorioretinopathy (CSC) and pachychoroid neovasculopathy (PNV) show similar morphological changes and angiogenic cytokine levels. The subretinal fluid in PNV may not accurately indicate PNV activity. Besides, types 1 and 2 of choroidal neovascularization (CNV) may be involved in primary pachychoroidal disease. Both choroidal arteriosclerosis and higher hydrostatic pressure contribute to hyalinized choroidal arteries and aneurysmal dilatations, resulting in PNV progression to polypoidal choroidal vasculopathy (PCV). Thus, pachychoroid-related type 2 CNV and chronic CSC could be considered as PNV (IIIc) and as a precursor of PNV (IIIa), respectively. Tangled PCV on optical coherence tomography angiography that fails to develop aneurysms should be classified as a subtype of PNV or a forme fruste of PCV. CONCLUSIONS Multiple disorders of the pachychoroid spectrum are considered as a continuous disease process, ultimately stimulated by choroidal malfunction. PCV overlaps both AMD and pachychoroid disease, especially for thin-choroid and bilateral types. The terminology and classification of pachychoroid spectrum disease should be used cautiously.
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Affiliation(s)
- Rui Hua
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.,Department of Ophthalmology, First Hospital of China Medical University, Shenyang, China.,Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Jianan Duan
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.,Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Meixia Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.,Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
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Sagar P, Sodhi PS, Roy S, Takkar B, Azad SV. Pachychoroid neovasculopathy: A comparative review on pathology, clinical features, and therapy. Eur J Ophthalmol 2021; 32:11206721211036290. [PMID: 34325545 DOI: 10.1177/11206721211036290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There have been major changes in our understanding of choroidal diseases in the last decade owing to multiple retinal and choroidal imaging related advances. A major conceptual pivot is establishment of pachychoroid and its spectrum of clinical disorders: pachychoroid pigment epitheliopathy, central serous chorioretinopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy/aneurysmal type 1 neovascularization, peripapillary pachychoroid syndrome, and focal choroidal excavation. However, considerable overlaps in manifestations and therapeutics of these disorders make differentiation amongst them difficult. This review is focused on pathogenesis and clinical aspects of pachychoroid neovasculopathy (PNV). Since PNV was defined as a separate entity around 5 years ago, there have been numerous contrasting observations surrounding it. We review and summarize these studies, and also compare PNV with other disorders of the pachychoroid spectrum in detail. There are important differences between etiologies of neovascular age related macular degeneration and PNV. Yet the current treatment strategies for PNV have been extrapolated from the trials for the former. Future research needs to validate this assumption with long-term results.
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Affiliation(s)
- Pradeep Sagar
- Department of Vitreo-Retina, Sankara Eye Hospital, Shivamogga, India
| | | | - Sangeeta Roy
- Department of Vitreo Retina, Susrut Eye Foundation and Research Centre, Kolkata, West Bengal, India
| | - Brijesh Takkar
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
- Indian Health Outcomes, Public Health and Economics Research (IHOPE) Centre, Hyderabad, Telangana, India
| | - Shorya Vardhan Azad
- Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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40
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Brinks J, van Dijk EHC, Klaassen I, Schlingemann RO, Kielbasa SM, Emri E, Quax PHA, Bergen AA, Meijer OC, Boon CJF. Exploring the choroidal vascular labyrinth and its molecular and structural roles in health and disease. Prog Retin Eye Res 2021; 87:100994. [PMID: 34280556 DOI: 10.1016/j.preteyeres.2021.100994] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/04/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022]
Abstract
The choroid is a key player in maintaining ocular homeostasis and plays a role in a variety of chorioretinal diseases, many of which are poorly understood. Recent advances in the field of single-cell RNA sequencing have yielded valuable insights into the properties of choroidal endothelial cells (CECs). Here, we review the role of the choroid in various physiological and pathophysiological mechanisms, focusing on the role of CECs. We also discuss new insights regarding the phenotypic properties of CECs, CEC subpopulations, and the value of measuring transcriptomics in primary CEC cultures derived from post-mortem eyes. In addition, we discuss key phenotypic, structural, and functional differences that distinguish CECs from other endothelial cells such as retinal vascular endothelial cells. Understanding the specific clinical and molecular properties of the choroid will shed new light on the pathogenesis of the broad clinical range of chorioretinal diseases such as age-related macular degeneration, central serous chorioretinopathy and other diseases within the pachychoroid spectrum, uveitis, and diabetic choroidopathy. Although our knowledge is still relatively limited with respect to the clinical features and molecular pathways that underlie these chorioretinal diseases, we summarise new approaches and discuss future directions for gaining new insights into these sight-threatening diseases and highlight new therapeutic strategies such as pluripotent stem cell‒based technologies and gene therapy.
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Affiliation(s)
- J Brinks
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - E H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - I Klaassen
- Ocular Angiogenesis Group, Departments of Ophthalmology and Medical Biology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - R O Schlingemann
- Ocular Angiogenesis Group, Departments of Ophthalmology and Medical Biology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands; Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - S M Kielbasa
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands
| | - E Emri
- Department of Clinical Genetics, Section of Ophthalmogenetics, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - P H A Quax
- Department of Vascular Surgery, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - A A Bergen
- Department of Clinical Genetics, Section of Ophthalmogenetics, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - O C Meijer
- Department of Medicine, Division of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, the Netherlands
| | - C J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
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Mori Y, Miyake M, Hosoda Y, Uji A, Nakano E, Takahashi A, Muraoka Y, Miyata M, Tamura H, Ooto S, Tabara Y, Yamashiro K, Matsuda F, Tsujikawa A. Distribution of Choroidal Thickness and Choroidal Vessel Dilation in Healthy Japanese Individuals. OPHTHALMOLOGY SCIENCE 2021; 1:100033. [PMID: 36249300 PMCID: PMC9562294 DOI: 10.1016/j.xops.2021.100033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/26/2022]
Abstract
Purpose To report fundamental epidemiologic data for choroidal parameters such as choroidal thickness and index of choroidal vascularity in Japanese individuals and to evaluate their correlations with age, sex, systemic parameters, and other ocular parameters. Design Population-based cohort study. Participants A total of 9850 individuals participated in the first follow-up of the Nagahama Prospective Cohort for Comprehensive Human Bioscience (the Nagahama Study) conducted between 2013 and 2016. Methods All participants underwent standardized ophthalmic examinations, including OCT with enhanced depth imaging (EDI; RS-3000 Advance; Nidek). We manually segmented the choroidoscleral interface to measure subfoveal choroidal thickness (SFCT) and calculated the normalized choroidal intensity obtained with EDI (NCIEDI) and choroidal vascularity index (CVI). These are indices of choroidal brightness in OCT and reportedly represent the dilation of choroidal vessels. After summarizing the age-sex stratified distributions of SFCT, NCIEDI, and CVI, their associations with age, sex, axial length (AL), and spherical equivalent (SE) were evaluated using linear regression analysis with adjustments for possible confounders. Main Outcome Measures Distribution of SFCT, NCIEDI, and CVI in the healthy Japanese population and their characteristics. Results Age-sex standardized SFCT, NCIEDI, and CVI were 291.2 μm, 0.653, and 66.88%, respectively. In both men and women, SFCT was associated negatively with age (P < 0.001) and NCIEDI was associated positively with age (P < 0.001). Although both SFCT and NCIEDI did not differ significantly between men and women overall (P = 0.87 and P = 0.21, respectively), among younger participants (35–50 years of age), men showed significantly greater SFCT than women (P < 0.001). Only in men was CVI associated positively with age (P < 0.001). In the multivariable analysis, SFCT was associated significantly with age, sex, AL, SE, and the interaction term of age and sex (P < 0.001). Independent of SFCT, NCIEDI and CVI were associated significantly with age (P < 0.001). Conclusions We report normative Japanese SFCT, NCIEDI, and CVI data using a large general Japanese cohort. The association analysis of SFCT with NCIEDI and CVI suggested that younger individuals have a more lumen-rich choroid for their choroidal thickness than older individuals.
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Affiliation(s)
- Yuki Mori
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Miyake
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Correspondence: Masahiro Miyake, MD, PhD, MPH, Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara, Sakyo, Kyoto 606-8507, Japan.
| | | | - Akihito Uji
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Eri Nakano
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ayako Takahashi
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Muraoka
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Manabu Miyata
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Tamura
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Center for Innovative Research and Education in Data Science, Institute for Liberal Arts and Sciences, Kyoto University, Kyoto, Japan
| | - Sotaro Ooto
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Kenji Yamashiro
- Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Chen ZJ, Lu SY, Rong SS, Ho M, Ng DSC, Chen H, Gong B, Yam JC, Young AL, Brelen M, Tham CC, Pang CP, Chen LJ. Genetic associations of central serous chorioretinopathy: a systematic review and meta-analysis. Br J Ophthalmol 2021; 106:1542-1548. [PMID: 34039561 DOI: 10.1136/bjophthalmol-2021-318953] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/08/2021] [Indexed: 11/04/2022]
Abstract
AIMS To identify single-nucleotide polymorphisms (SNPs) associated with central serous chorioretinopathy (CSCR) by a systematic review and meta-analysis, and to compare the association profiles between CSCR, neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV). METHODS We searched the EMBASE, PubMed and Web of Science for genetic studies of CSCR from the starting dates of the databases to 12 September 2020. We then performed meta-analyses on all SNPs reported by more than two studies and calculated the pooled OR and 95% CIs. We also conducted sensitivity analysis and adopted the funnel plot to assess potential publication bias. RESULTS Totally 415 publications were reviewed, among them 10 were eligible for meta-analysis. We found 10 SNPs that have been reported at least twice. Meta-analysis and sensitivity analysis confirmed significant associations between CSCR and six SNPs in three genes, namely age-related maculopathy susceptibility 2 (ARMS2) (rs10490924, OR=1.37; p=0.00064), complement factor H (CFH) (rs800292, OR=1.44; p=7.80×10-5; rs1061170, OR=1.34; p=0.0028; rs1329428, OR=1.40; p=0.012; and rs2284664, OR=1.36; p=0.0089) and tumour necrosis factor receptor superfamily, member 10a (TNFRSF10A) (rs13278062, OR=1.34; p=1.44×10-15). Among them, only TNFRSF10A rs13278062 showed the same trend of effect on CSCR, nAMD and PCV, while the SNPs in ARMS2 and CFH showed opposite trends in the SNP associations. CONCLUSIONS This study confirmed the associations of ARMS2, CFH and TNFRSF10A with CSCR, and revealed that ARMS2, CFH and TNFRSF10A may affect different phenotypic expressions of CSCR, nAMD and PCV.
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Affiliation(s)
- Zhen Ji Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Shi Yao Lu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Shi Song Rong
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Mary Ho
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Danny Siu-Chun Ng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Haoyu Chen
- Joint Shantou International Eye Center, Shantou University, Shantou, China
| | - Bo Gong
- Sichuan Key Laboratory for Disease Gene Study, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Alvin L Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Marten Brelen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Joint Shantou International Eye Center, Shantou University, Shantou, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China .,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
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43
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Funatsu R, Terasaki H, Shiihara H, Kawano S, Hirokawa M, Tanabe Y, Fujiwara T, Mitamura Y, Sakamoto T, Sonoda S. Quantitative evaluations of vortex vein ampullae by adjusted 3D reverse projection model of ultra-widefield fundus images. Sci Rep 2021; 11:8916. [PMID: 33903616 PMCID: PMC8076294 DOI: 10.1038/s41598-021-88265-w] [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: 12/02/2020] [Accepted: 04/05/2021] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to determine the number and location of vortex vein ampullae (VVA) in normal eyes. This was an observational retrospective study. Montage images of one on-axis and two off-axis ultra-widefield images of 74 healthy eyes were enhanced, and reverse projected onto a 3D model eye. The number and distance between the optic disc to each VVA in the four sectors were compared. The significance of correlations between these values and age, sex, visual acuity, refractive error, and axial length was determined. The mean number of VVA was 8.10/eye with 1.84, 2.12, 2.19 and 1.95 in upper lateral, lower lateral, upper nasal, and lower nasal sectors, respectively. The mean number of VVA/eye was significantly greater in men at 8.43 than women at 7.76 (P = 0.025). The mean distance between the optic disc and VVA was 14.15 mm, and it was 14.04, 15.55, 13.29 and 13.66 mm in the upper lateral, lower lateral, upper nasal and lower nasal sectors, respectively (all P < 0.05). The number and location of VVA can be obtained non-invasively, and the number was significantly higher in men than women. This technique can be used to determine whether these values are altered in a retinochoroidal disease.
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Affiliation(s)
- Ryoh Funatsu
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Japan-Clinical Retina Study (J-CREST) Group, Kagoshima, Japan
| | - Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Japan-Clinical Retina Study (J-CREST) Group, Kagoshima, Japan
| | - Hideki Shiihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Japan-Clinical Retina Study (J-CREST) Group, Kagoshima, Japan
| | - Sumihiro Kawano
- Department of Ophthalmology, Kurashiki Chuo Hospital, Kurashiki, Japan
| | | | | | | | - Yoshinori Mitamura
- Japan-Clinical Retina Study (J-CREST) Group, Kagoshima, Japan.,Department of Ophthalmology, Tokushima University Graduate School, Tokushima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. .,Japan-Clinical Retina Study (J-CREST) Group, Kagoshima, Japan.
| | - Shozo Sonoda
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Japan-Clinical Retina Study (J-CREST) Group, Kagoshima, Japan
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44
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Hwang S, Kang M, Ham DI, Kong M. Genetic Influence on Choroidal Volume. Am J Ophthalmol 2021; 224:143-149. [PMID: 33340507 DOI: 10.1016/j.ajo.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/03/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the degree of genetic influence on macular choroidal volume. DESIGN A cross-sectional twin and family study. METHODS In total, 353 Korean adults with healthy eyes from 78 households with 2 or more family members were included in the study. Macular choroidal volume was measured using spectral-domain optical coherence tomography with enhanced depth imaging at 9 macular subfields defined by the ETDRS. Demographics and clinical characteristics were investigated, including age, sex, axial length, hypertension, diabetes, drinking habits, and smoking status. The associations of these factors with macular choroidal volume were assessed using univariate and subsequent multivariate regression analyses while accounting for family structure. The heritability estimates of macular choroidal volume in total and at each of the 9 macular subfields were calculated after adjusting the covariates. RESULTS Patients who were younger, male, and had a shorter axial length showed associations with greater choroidal volume (P < .001 for all 3 independent variables). The covariates-adjusted heritability (±standard error) of the total macular choroidal volume was 0.76 ± 0.06, and the heritabilities of choroidal volume at each subfield ranged from 0.55 ± 0.09 (inner temporal subfield) to 0.77 ± 0.08 (inner superior subfield). CONCLUSION The macular choroidal volume is highly heritable.
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45
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Tamiya R, Miyake M, Kido A, Hiragi S, Tamura H, Kuroda T, Tsujikawa A. Validation study of the claims-based definition for age-related macular degeneration at a single university hospital in Japan. Jpn J Ophthalmol 2021; 65:388-394. [PMID: 33735404 DOI: 10.1007/s10384-021-00816-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 12/03/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE To evaluate the efficacy of the claims'-based definition of age-related macular degeneration (AMD) in detecting clinically-diagnosed AMD. STUDY DESIGN A validation study using cross-sectional data. METHODS Seven hundred clinically-diagnosed AMD patients and seven hundred non-AMD individuals were randomly selected from patients at the Kyoto University Hospital's ophthalmology outpatient clinic between January 2011 and December 2017. We evaluated the sensitivity, specificity, and positive/negative likelihood ratio of eight different claims'-based definitions of AMD for detecting clinically-diagnosed AMD. These definitions consist of the diagnosis name (AMD) in combination with (1) fluorescent fundus angiography, and/or (2) treatment of AMD, and (3) the exclusion of patients who had a diagnosis of central serous chorioretinopathy (CSC) or myopic choroidal neovascularization. RESULTS Defining by the diagnosis name AMD in the claims' data showed the highest accuracy (sensitivity 94.9%, specificity 92.6%, accuracy 93.7%). Combining the diagnosis name AMD with fluorescence fundus angiography and/or anti-vascular endothelial growth factor (anti VEGF) treatment increased the specificity at the expense of sensitivity. Notably, the combination with AMD treatment achieved a specificity of 98.3%. CONCLUSION The current validation study elucidated the high accuracy of the disease name (AMD) in the claims' data for identifying clinically-diagnosed AMD at a single university hospital. Although drawing wider conclusions may be limited, the results of this study contribute to creating real-world evidence in ophthalmology, based on the National Database of Health Insurance Claims in Japan.
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Affiliation(s)
- Ryosuke Tamiya
- Department of Ophthalmology, Osaka Red Cross Hospital, Osaka, Japan.,Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin, Kawahara, Sakyo, Kyoto, 606-8507, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin, Kawahara, Sakyo, Kyoto, 606-8507, Japan.
| | - Ai Kido
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin, Kawahara, Sakyo, Kyoto, 606-8507, Japan
| | - Shusuke Hiragi
- Division of Medical Informatics and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Hiroshi Tamura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin, Kawahara, Sakyo, Kyoto, 606-8507, Japan.,Division of Medical Informatics and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Tomohiro Kuroda
- Division of Medical Informatics and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin, Kawahara, Sakyo, Kyoto, 606-8507, Japan
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van Dijk EHC, Boon CJF. Serous business: Delineating the broad spectrum of diseases with subretinal fluid in the macula. Prog Retin Eye Res 2021; 84:100955. [PMID: 33716160 DOI: 10.1016/j.preteyeres.2021.100955] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/14/2021] [Accepted: 02/19/2021] [Indexed: 02/08/2023]
Abstract
A wide range of ocular diseases can present with serous subretinal fluid in the macula and therefore clinically mimic central serous chorioretinopathy (CSC). In this manuscript, we categorise the diseases and conditions that are part of the differential diagnosis into 12 main pathogenic subgroups: neovascular diseases, vitelliform lesions, inflammatory diseases, ocular tumours, haematological malignancies, paraneoplastic syndromes, genetic diseases, ocular developmental anomalies, medication-related conditions and toxicity-related diseases, rhegmatogenous retinal detachment and tractional retinal detachment, retinal vascular diseases, and miscellaneous diseases. In addition, we describe 2 new clinical pictures associated with macular subretinal fluid accumulation, namely serous maculopathy with absence of retinal pigment epithelium (SMARPE) and serous maculopathy due to aspecific choroidopathy (SMACH). Differentiating between these various diseases and CSC can be challenging, and obtaining the correct diagnosis can have immediate therapeutic and prognostic consequences. Here, we describe the key differential diagnostic features of each disease within this clinical spectrum, including representative case examples. Moreover, we discuss the pathogenesis of each disease in order to facilitate the differentiation from typical CSC.
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Affiliation(s)
- Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
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Karska-Basta I, Pociej-Marciak W, Chrząszcz M, Kubicka-Trząska A, Dębicka-Kumela M, Gawęcki M, Romanowska-Dixon B, Sanak M. Imbalance in the Levels of Angiogenic Factors in Patients with Acute and Chronic Central Serous Chorioretinopathy. J Clin Med 2021; 10:1087. [PMID: 33807809 PMCID: PMC7961803 DOI: 10.3390/jcm10051087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/19/2021] [Accepted: 02/26/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The pathogenesis of central serous chorioretinopathy (CSC) remains a subject of intensive research. We aimed to determine correlations between plasma levels of selected angiogenic factors and different forms of CSC. METHODS Eighty patients were enrolled in the study including 30 with a chronic form of CSC, 30 with acute CSC, and 20 controls. Presence of active CSC was determined by fluorescein angiography (FA), indocyanine green angiography (ICGA), and swept-source optical coherence tomography (SS-OCT). Plasma concentrations of angiopoietin-1, endostatin, fibroblast growth factor, placental growth factor (PlGF), platelet-derived growth factor (PDGF-AA), thrombospondin-2, vascular endothelial growth factor (VEGF), VEGF-D, and pigment epithelium-derived factor were measured, and the results were compared between groups. Additionally, mean choroidal thickness (CT) was measured in all patients. RESULTS Levels of angiopoietin-1 (p = 0.008), PlGF (p = 0.045), and PDGF-AA (p = 0.033) differed significantly between the three groups. Compared with the controls, VEGF (p = 0.024), PlGF (p = 0.013), and PDGF-AA (p = 0.012) were downregulated in the whole CSC group, specifically PDGF-AA (p = 0.002) in acute CSC and angiopoietin-1 (p = 0.007) in chronic CSC. An inverse correlation between mean CT and VEGF levels was noted in CSC patients (rho = -0.27, p = 0.044). CONCLUSIONS Downregulated angiopoietin-1, VEGF, PDGF-AA, and PlGF levels may highlight the previously unknown role of the imbalanced levels of proangiogenic and antiangiogenic factors in the pathogenesis of CSC. Moreover, downregulated VEGF levels may suggest that choroidal neovascularization in CSC is associated with arteriogenesis rather than angiogenesis.
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Affiliation(s)
- Izabella Karska-Basta
- Department of Ophthalmology, Faculty of Medicine, Clinic of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, 31-070 Krakow, Poland; (W.P.-M.); (M.C.); (A.K.-T.); (M.D.-K.); (B.R.-D.)
| | - Weronika Pociej-Marciak
- Department of Ophthalmology, Faculty of Medicine, Clinic of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, 31-070 Krakow, Poland; (W.P.-M.); (M.C.); (A.K.-T.); (M.D.-K.); (B.R.-D.)
| | - Michał Chrząszcz
- Department of Ophthalmology, Faculty of Medicine, Clinic of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, 31-070 Krakow, Poland; (W.P.-M.); (M.C.); (A.K.-T.); (M.D.-K.); (B.R.-D.)
| | - Agnieszka Kubicka-Trząska
- Department of Ophthalmology, Faculty of Medicine, Clinic of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, 31-070 Krakow, Poland; (W.P.-M.); (M.C.); (A.K.-T.); (M.D.-K.); (B.R.-D.)
| | - Magdalena Dębicka-Kumela
- Department of Ophthalmology, Faculty of Medicine, Clinic of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, 31-070 Krakow, Poland; (W.P.-M.); (M.C.); (A.K.-T.); (M.D.-K.); (B.R.-D.)
| | - Maciej Gawęcki
- Dobry Wzrok Ophthalmological Clinic, 80-402 Gdansk, Poland;
| | - Bożena Romanowska-Dixon
- Department of Ophthalmology, Faculty of Medicine, Clinic of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, 31-070 Krakow, Poland; (W.P.-M.); (M.C.); (A.K.-T.); (M.D.-K.); (B.R.-D.)
| | - Marek Sanak
- Molecular Biology and Clinical Genetics Unit, Department of Internal Medicine, Jagiellonian University Medical College Faculty of Medicine, 31-066 Krakow, Poland;
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Higgins BE, Taylor DJ, Binns AM, Crabb DP. Are Current Methods of Measuring Dark Adaptation Effective in Detecting the Onset and Progression of Age-Related Macular Degeneration? A Systematic Literature Review. Ophthalmol Ther 2021; 10:21-38. [PMID: 33565038 PMCID: PMC7887145 DOI: 10.1007/s40123-020-00323-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 12/09/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Dark adaptation (DA) has been proposed as a possible functional biomarker for age-related macular degeneration (AMD). In this systematic review we aim to evaluate current methodology used to assess DA in people with AMD, the evidence of precision in detecting the onset and progression of AMD, and the relationship between DA and other functional and structural measures. METHODS MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, PsycARTICLES were searched for studies published between January 2006 and January 2020 that assessed DA in people with AMD. Details of eligible studies including study design, characteristics of study population and outcomes were recorded. All included studies underwent quality appraisal using approved critical appraisal tools. This systematic review follows PRISMA guidelines (PROSPERO registration number: CRD42019129486). RESULTS Forty-eight studies were eligible for inclusion, reporting a variety of instruments and protocols to assess different DA parameters. Twenty of these studies used the AdaptDx (MacuLogix, Hummelstown, PA, USA) instrument and assessed rod-intercept time (RIT). Most of these reported that RIT was delayed in people with AMD and this delay worsened with AMD severity. Four studies, involving 533 participants, reported estimates of diagnostic performance of AdaptDx to separate people with AMD from visually healthy controls. DA has been compared to other measures of visual function, patient-reported outcome measures (PROMs) and structural measures. Ten studies specifically considered evidence that the presence of certain structural abnormalities was associated with impaired DA in AMD. CONCLUSIONS This systematic review indicates overwhelming evidence of reasonable quality for an association between impaired DA and AMD. Data on the repeatability and reproducibility of DA measurement are sparse. There is evidence that structural abnormalities such as reticular drusen are associated with prolongation of DA time. Fewer studies have explored an association between DA and other measures of visual function or PROMs. We found no studies that had compared DA with performance-based measures.
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Affiliation(s)
- Bethany E Higgins
- Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Deanna J Taylor
- Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Alison M Binns
- Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - David P Crabb
- Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK.
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Nakano E, Miyake M, Hosoda Y, Mori Y, Suda K, Kameda T, Ikeda-Ohashi H, Tabara Y, Yamashiro K, Tamura H, Akagi T, Matsuda F, Tsujikawa A. Relationship between Intraocular Pressure and Coffee Consumption in a Japanese Population without Glaucoma: The Nagahama Study. Ophthalmol Glaucoma 2021; 4:268-276. [PMID: 33518504 DOI: 10.1016/j.ogla.2020.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the association between daily coffee consumption and intraocular pressure (IOP) in healthy persons without glaucoma and the association between daily coffee consumption and history of glaucoma. DESIGN Cross-sectional study. PARTICIPANTS A total of 9850 individuals participated in the first follow-up of the Nagahama Prospective Cohort for Comprehensive Human Bioscience (the Nagahama Study) conducted between 2013 and 2016. METHODS All participants underwent a standardized ophthalmic examination. Self-reporting questionnaires were completed by all participants. First, the association between habitual coffee consumption and IOP among nonglaucoma individuals was evaluated by a multivariate linear regression analysis, adjusting for possible confounders. Second, the association between habitual coffee consumption and history of glaucoma also was evaluated using a multivariate logistic regression analysis. MAIN OUTCOME MEASURES The association between habitual coffee consumption and IOP among nonglaucoma individuals. RESULTS Of 9850 participants, 9418 did not have history of glaucoma. Among these participants, the mean ± standard deviation IOP of both eyes was 14.7 ± 2.9 mmHg. The multivariate regression analysis revealed that habitual coffee consumption was associated significantly with IOP (P < 0.001): the higher the consumption of coffee, the lower the IOP of an individual. The IOP of the group who consumed coffee most frequently (3 times daily or more) was 0.4 mmHg lower (95% confidence interval, 0.2-0.5 mmHg lower) than that of the group that consumed coffee least frequently (less than once daily). However, the logistic regression analysis showed that habitual coffee consumption was not associated significantly with history of glaucoma (P = 0.53). CONCLUSIONS Frequent coffee consumption was associated with a slightly lower IOP in people without glaucoma but was not associated with a decreased risk of glaucoma developing. Additional experimental studies are needed to examine the effects of coffee on IOP and glaucoma risk.
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Affiliation(s)
- Eri Nakano
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Miyake
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Yoshikatsu Hosoda
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Mori
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Suda
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takanori Kameda
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hanako Ikeda-Ohashi
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Yamashiro
- Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, Japan
| | - Hiroshi Tamura
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tadamichi Akagi
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Jung KS, Hong KW, Jo HY, Choi J, Ban HJ, Cho SB, Chung M. KRGDB: the large-scale variant database of 1722 Koreans based on whole genome sequencing. DATABASE-THE JOURNAL OF BIOLOGICAL DATABASES AND CURATION 2021; 2020:5775747. [PMID: 32133509 PMCID: PMC7056612 DOI: 10.1093/database/baz146] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/07/2019] [Accepted: 12/09/2019] [Indexed: 12/16/2022]
Abstract
Since 2012, the Center for Genome Science of the Korea National Institute of Health (KNIH) has been sequencing complete genomes of 1722 Korean individuals. As a result, more than 32 million variant sites have been identified, and a large proportion of the variant sites have been detected for the first time. In this article, we describe the Korean Reference Genome Database (KRGDB) and its genome browser. The current version of our database contains both single nucleotide and short insertion/deletion variants. The DNA samples were obtained from four different origins and sequenced in different sequencing depths (10× coverage of 63 individuals, 20× coverage of 194 individuals, combined 10× and 20× coverage of 135 individuals, 30× coverage of 230 individuals and 30× coverage of 1100 individuals). The major features of the KRGDB are that it contains information on the Korean genomic variant frequency, frequency difference between the Korean and other populations and the variant functional annotation (such as regulatory elements in ENCODE regions and coding variant functions) of the variant sites. Additionally, we performed the genome-wide association study (GWAS) between Korean genome variant sites for the 30×230 individuals and three major common diseases (diabetes, hypertension and metabolic syndrome). The association results are displayed on our browser. The KRGDB uses the MySQL database and Apache-Tomcat web server adopted with Java Server Page (JSP) and is freely available at http://coda.nih.go.kr/coda/KRGDB/index.jsp. Availability: http://coda.nih.go.kr/coda/KRGDB/index.jsp
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Affiliation(s)
- Kwang Su Jung
- Division of Biomedical Informatics, Center for Genome Science, National Institute of Health, KCDC, Cheongju 28159, Republic of Korea
| | - Kyung-Won Hong
- Division of Biomedical Informatics, Center for Genome Science, National Institute of Health, KCDC, Cheongju 28159, Republic of Korea
| | - Hyun Youn Jo
- Division of Biomedical Informatics, Center for Genome Science, National Institute of Health, KCDC, Cheongju 28159, Republic of Korea
| | - Jongpill Choi
- Division of Biomedical Informatics, Center for Genome Science, National Institute of Health, KCDC, Cheongju 28159, Republic of Korea
| | - Hyo-Jeong Ban
- Healthcare R&D Division, Theragen Etex Bio Institute Co. LTD., Suwon 16229, Republic of Korea; Thermo Fisher Scientific Solutions, Seoul 06349, Republic of Korea and Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Seong Beom Cho
- Division of Biomedical Informatics, Center for Genome Science, National Institute of Health, KCDC, Cheongju 28159, Republic of Korea
| | - Myungguen Chung
- Division of Biomedical Informatics, Center for Genome Science, National Institute of Health, KCDC, Cheongju 28159, Republic of Korea
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