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Jung J, Han J, Han JM, Ko J, Yoon J, Hwang JS, Park JI, Hwang G, Jung JH, Hwang DDJ. Prediction of neovascular age-related macular degeneration recurrence using optical coherence tomography images with a deep neural network. Sci Rep 2024; 14:5854. [PMID: 38462646 PMCID: PMC10925587 DOI: 10.1038/s41598-024-56309-6] [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: 05/27/2023] [Accepted: 03/05/2024] [Indexed: 03/12/2024] Open
Abstract
Neovascular age-related macular degeneration (nAMD) can result in blindness if left untreated, and patients often require repeated anti-vascular endothelial growth factor injections. Although, the treat-and-extend method is becoming popular to reduce vision loss attributed to recurrence, it may pose a risk of overtreatment. This study aimed to develop a deep learning model based on DenseNet201 to predict nAMD recurrence within 3 months after confirming dry-up 1 month following three loading injections in treatment-naïve patients. A dataset of 1076 spectral domain optical coherence tomography (OCT) images from 269 patients diagnosed with nAMD was used. The performance of the model was compared with that of 6 ophthalmologists, using 100 randomly selected samples. The DenseNet201-based model achieved 53.0% accuracy in predicting nAMD recurrence using a single pre-injection image and 60.2% accuracy after viewing all the images immediately after the 1st, 2nd, and 3rd injections. The model outperformed experienced ophthalmologists, with an average accuracy of 52.17% using a single pre-injection image and 53.3% after examining four images before and after three loading injections. In conclusion, the artificial intelligence model demonstrated a promising ability to predict nAMD recurrence using OCT images and outperformed experienced ophthalmologists. These findings suggest that deep learning models can assist in nAMD recurrence prediction, thus improving patient outcomes and optimizing treatment strategies.
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Affiliation(s)
- Juho Jung
- Department of Applied Artificial Intelligence, Sungkyunkwan University, Seoul, Korea
| | - Jinyoung Han
- Department of Applied Artificial Intelligence, Sungkyunkwan University, Seoul, Korea
- Department of Human-Artificial Intelligence Interaction, Sungkyunkwan University, Seoul, Korea
| | - Jeong Mo Han
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Kong Eye Center, Seoul, Korea
| | | | | | | | - Ji In Park
- Department of Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Gangwon-do, Korea
| | - Gyudeok Hwang
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-Daero, Bupyeong-gu, Incheon, 21388, Korea
| | - Jae Ho Jung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Daniel Duck-Jin Hwang
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-Daero, Bupyeong-gu, Incheon, 21388, Korea.
- Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, Korea.
- Lux Mind, Incheon, Korea.
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Xu S, Cui K, Long K, Li J, Fan N, Lam W, Liang X, Wang W. Red Light-Triggered Anti-Angiogenic and Photodynamic Combination Therapy of Age-Related Macular Degeneration. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2301985. [PMID: 37705491 PMCID: PMC10625062 DOI: 10.1002/advs.202301985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/18/2023] [Indexed: 09/15/2023]
Abstract
Choroidal neovascularization (CNV) is the key pathological event of wet age-related macular degeneration (wAMD) leading to irreversible vision loss. Currently, anti-angiogenic therapy with anti-vascular endothelial growth factor (VEGF) agents has become the standard treatment for wAMD, while it is still subject to several limitations, including the safety concerns of monthly intravitreal administration and insufficient efficacy for neovascular occlusion. Combined therapy with photodynamic therapy (PDT) and anti-angiogenic agents has emerged as a novel treatment paradigm. Herein, a novel and less-invasive approach is reported to achieve anti-angiogenic and photodynamic combination therapy of wAMD by intravenous administration of a photoactivatable nanosystem (Di-DAS-VER NPs). The nanosystem is self-assembled by reactive oxygen species (ROS)-sensitive dasatinib (DAS) prodrug and photosensitizer verteporfin (VER). After red-light irradiation to the diseased eyes, intraocular release of anti-angiogenic DAS is observed, together with selective neo-vessels occlusion by VER-generated ROS. Notably, Di-DAS-VER NPs demonstrates promising therapeutic efficacy against CNV with minimized systemic toxicity. The study enables an efficient intravenous wAMD therapy by integrating a photoactivation process with combinational therapeutics into one simple nanosystem.
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Affiliation(s)
- Shuting Xu
- State Key Laboratory of Pharmaceutical BiotechnologyDepartment of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineLaboratory of Molecular Engineering and NanomedicineDr. Li Dak‐Sum Research CentreThe University of Hong KongHong KongSARChina
| | - Kaixuan Cui
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterGuangdong Provincial Key Laboratory of Ophthalmology and Visual ScienceSun Yat‐sen UniversityGuangzhou510060China
| | - Kaiqi Long
- State Key Laboratory of Pharmaceutical BiotechnologyDepartment of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineLaboratory of Molecular Engineering and NanomedicineDr. Li Dak‐Sum Research CentreThe University of Hong KongHong KongSARChina
| | - Jia Li
- State Key Laboratory of Pharmaceutical BiotechnologyDepartment of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineLaboratory of Molecular Engineering and NanomedicineDr. Li Dak‐Sum Research CentreThe University of Hong KongHong KongSARChina
| | - Ni Fan
- State Key Laboratory of Pharmaceutical BiotechnologyDepartment of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineLaboratory of Molecular Engineering and NanomedicineDr. Li Dak‐Sum Research CentreThe University of Hong KongHong KongSARChina
| | - Wai‐Ching Lam
- Department of OphthalmologyVancouver General HospitalVancouverBCV5Z 0A6Canada
| | - Xiaoling Liang
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterGuangdong Provincial Key Laboratory of Ophthalmology and Visual ScienceSun Yat‐sen UniversityGuangzhou510060China
| | - Weiping Wang
- State Key Laboratory of Pharmaceutical BiotechnologyDepartment of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineLaboratory of Molecular Engineering and NanomedicineDr. Li Dak‐Sum Research CentreThe University of Hong KongHong KongSARChina
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Korhonen E, Piippo N, Hytti M, Kaarniranta K, Kauppinen A. Cis-urocanic acid improves cell viability and suppresses inflammasome activation in human retinal pigment epithelial cells. Biochem Pharmacol 2023; 216:115790. [PMID: 37683842 DOI: 10.1016/j.bcp.2023.115790] [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: 08/23/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
Age-related macular degeneration (AMD) is a common eye disease among the elderly, which can result in impaired vision and irreversible loss of vision. The majority of patients suffer from the dry (also known as the atrophic) form of the disease, which is completely lacking an effective treatment. In the present study, we evaluated the potential of cis-urocanic acid (cis-UCA) to protect human ARPE-19 cells from cell damage and inflammasome activation induced by UVB light. Urocanic acid is a molecule normally present in human epidermis. Its cis-form has recently been found to alleviate UVB-induced inflammasome activation in human corneal epithelial cells. Here, we observed that cis-UCA is well-tolerated also by human retinal pigment epithelial (RPE) cells at a concentration of 100 μg/ml. Moreover, cis-UCA was cytoprotective and efficiently diminished the levels of mature IL-1β, IL-18, and cleaved caspase-1 in UVB-irradiated ARPE-19 cells. Interestingly, cis-UCA also reduced DNA damage, whereas its effect against ROS production was negligible. Collectively, cis-UCA protected ARPE-19 cells from UVB-induced phototoxicity and inflammasome activation. This study indicates that due to its beneficial properties of preserving cell viability and preventing inflammation, cis-UCA has potential in drug development of chronic ocular diseases, such as AMD.
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Affiliation(s)
- Eveliina Korhonen
- Immuno-Ophthalmology, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O.Box 1627, FI-70211 Kuopio, Finland.
| | - Niina Piippo
- Immuno-Ophthalmology, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O.Box 1627, FI-70211 Kuopio, Finland
| | - Maria Hytti
- Immuno-Ophthalmology, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O.Box 1627, FI-70211 Kuopio, Finland; Department of Ophthalmology, Kuopio University Hospital, P.O.Box 100, FI-70029 Kuopio, Finland
| | - Kai Kaarniranta
- Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, P.O.Box 1627, FI-70211 Kuopio, Finland; Department of Ophthalmology, Kuopio University Hospital, P.O.Box 100, FI-70029 Kuopio, Finland
| | - Anu Kauppinen
- Immuno-Ophthalmology, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O.Box 1627, FI-70211 Kuopio, Finland.
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Narnaware SH, Bansal A, Bawankule PK, Raje D, Chakraborty M. Vessel density changes in choroid, chorio-capillaries, deep and superficial retinal plexues on OCTA in normal ageing and various stages of age-related macular degeneration. Int Ophthalmol 2023; 43:3523-3532. [PMID: 37340155 DOI: 10.1007/s10792-023-02758-3] [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: 09/09/2022] [Accepted: 05/21/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE To study vessel density (VD) on optical coherence tomography angiography at choroid, chorio-capillaries (CC) and various retinal levels in normal population and various stages of dry AMD and how these changes progress with increase in severity of the disease. METHODS Prospective, observational, cross-sectional study was done on 252 eyes of 132 patients (males: 61, females: 71) presenting to tertiary-care centre in Central India between February 2021 and January 2022. For study purpose, eyes were divided into five groups according to the size and number of the drusen, viz, Group 1: No AMD (< 50 years), Group 2: No AMD (> 50 years), Group 3: Early AMD, Group 4: Intermediate AMD and Group 5: Advanced AMD. In all eyes, VD was measured at choroid, CC, deep capillary plexus (DCP) of retina and superficial capillary plexus (SCP) of retina. RESULTS The mean age in case cohort is 61.90 ± 7.97 years. The mean vascular density differed significantly across diagnosis types in all the quadrants (p < 0.05) at choroid, CC and DCP level. At SCP level, the differences were significant across the groups except at the central quadrant. Vessel density was found to be more in early AMD cohort when compared to No AMD (> 50 years) cohort at SCP and DCP level, while it showed continuous reduction later in intermediate and advanced AMD cohort. CONCLUSION With increase in the severity of disease, significant reduction in VD is also seen in retinal plexuses, along with the changes in choroid and CC. These VD maps may play a role as non-invasive biomarkers for healthy and diseased ageing.
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Affiliation(s)
- Shilpi H Narnaware
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India.
| | - Anju Bansal
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India
| | - Prashant K Bawankule
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India
| | - Dhananjay Raje
- MDS Bio-Analytics Pvt. Ltd, Plot No: 127, Sakar Enclave, Shankar Nagar, Nagpur, Maharashtra, 440010, India
| | - Moumita Chakraborty
- MDS Bio-Analytics Pvt. Ltd, Plot No: 127, Sakar Enclave, Shankar Nagar, Nagpur, Maharashtra, 440010, India
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Naif S, Majed R, Mohieldin E, Hanan A, Lamis A, Maha A. Neutrophil-Lymphocyte Ratios in Dry Age-Related Macular Degeneration. Ocul Immunol Inflamm 2023; 31:1647-1652. [PMID: 35830215 DOI: 10.1080/09273948.2022.2092752] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/17/2022] [Indexed: 10/17/2022]
Abstract
Inflammation plays a role in the etiopathogenesis of age-related macular degeneration (AMD). A retrospective case-control study was conducted to assess the significance of the neutrophil-lymphocyte ratio (NLR) as a systemic inflammatory indicator in dry AMD. Clinical diagnosis and complete blood count (CBC) results were extracted from medical records for patients with dry AMD and age/sex-matched controls. This study included 90 patients diagnosed with dry AMD and 270 controls without AMD. There were no significant differences in the CBC results between the cases and controls. Patients with dry AMD had a slightly higher mean NLR than controls; however, this increase was not significant (P = .13). In the NLR model, age and sex were significant factors affecting the NLR values in the dry AMD group (P = .03 and 0.01, respectively). The NLR alone cannot predict dry AMD. Therefore, exploring other routine laboratory measurements may shed light on early disease prediction and prevention.
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Affiliation(s)
- Sannan Naif
- Department of Clinical Laboratory Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Department of Biomedical Research, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Pathology and Laboratory Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Ramadan Majed
- Department of Biomedical Research, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Pathology and Laboratory Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Elsayid Mohieldin
- Department of Clinical Laboratory Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Department of Biomedical Research, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Alghamdi Hanan
- Department of Clinical Laboratory Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Alghamdi Lamis
- Department of Clinical Laboratory Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Alqahtani Maha
- Department of Clinical Laboratory Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Pathology and Laboratory Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
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Bansal A, Narnaware SH, Bawankule PK, Gupta R, Nagdeve R. Retro-mode: a newer insight into dry age-related macular degeneration (AMD). Lasers Med Sci 2023; 38:178. [PMID: 37552467 DOI: 10.1007/s10103-023-03845-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023]
Abstract
The purpose of this study is to study the role of retro-mode (RM) in early detection and to compare it with other preexisting available modalities on multimodal imaging system in dry AMD. A prospective observational cross-sectional study was done between November 2020 and October 2021 which included 409 eyes of 207 patients. For study purpose, eyes were divided into 3 groups according to the size and number of the drusen, viz, group 1: No AMD, group 2: early AMD and group 3: intermediate AMD which was further divided into 2 subgroups, viz, subgroup A: eyes with drusen size 63-125 μm and subgroup B: eyes with drusen size 125-250 μm. Patients with active or treated wet AMD, scarred choroidal neovascular membrane (CNVM), other maculopathies, other retinopathies, high myopia, trauma and glaucoma were excluded from the study. In cases of No AMD and early AMD, a number of drusens detected on RM were statistically not significant compared to fundus autofluorescence (FAF) and color photo (CF), but in intermediate AMD cases, it was statistically significant. While the area involved by drusens calculated by RM was statistically significant compared to both other modalities. When all modalities were compared with enhanced depth imaging-optical coherence tomography (EDI-OCT) at the choroid and chorio-capillary (CC) level and vessel density (VD) on optical coherence tomography angiography (OCTA) at the choroid, capillaries, deep retinal and superficial retinal plexus level; it was only RM which was found to be in sync with these proven modalities in terms of pattern and trend. In the present scenario, RM is found to be a better diagnostic modality in detecting early and a greater number of drusens with area of involvement than other existing modalities. Though superior, as found in this study, this mode cannot replace other modalities at present but only acts as a complementary investigation in early detection of this disease.
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Affiliation(s)
- Anju Bansal
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India.
| | - Shilpi H Narnaware
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India
| | - Prashant K Bawankule
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India
| | - Richa Gupta
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India
| | - Rakesh Nagdeve
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India
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Sanabria MR, Calles-Monar PS, Alonso-Tarancón AM, Coco-Martín RM, Mayo-Iscar A. Impact of COVID-19 Confinement on Quality of Life of Patients with Age-Related Macular Degeneration: A Two-Wave Panel Study. J Clin Med 2023; 12:jcm12062394. [PMID: 36983394 PMCID: PMC10058256 DOI: 10.3390/jcm12062394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 03/22/2023] Open
Abstract
Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. Intravitreal injections of antiangiogenic agents (anti-VEGF) can stop vision loss in the neovascular form of the disease (nAMD). The aim of this study was to assess the general health-related quality of life (HRQoL) in a cohort of patients with nAMD treated with intravitreal anti-VEGF injections and to detesrmine to what extent their HRQoL was affected by COVID-19. This was an observational, analytical, and longitudinal study performed with a two-wave panel survey. Clinical outcomes, HRQoL, and tangible support were evaluated. In the final survey, changes in living conditions and medical visits due to the COVID-19 pandemic were also examined. Of the 102 patients initially interviewed in the before-COVID survey, 24 were lost after 30 months of follow-up. In the initial assessment, the mean health index was 0.73 ± 0.2. The EQ VAS score worsened at the final survey (p = 0.048). Patients needing treatment in both eyes (p = 0.007) and with lower levels of bilateral visual acuity (p = 0.018) reported an increase in social support at the final survey. In conclusion, patients perceived a worsening in HRQoL after confinement. However, patients enjoyed good social support that improved in the after-COVID survey.
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Affiliation(s)
- María R. Sanabria
- Palencia University Hospital Complex, Sanidad Castilla y Leon (SACYL), 34004 Palencia, Spain
- Instituto de Oftalmobiología Aplicada (IOBA), Facultad de Medicina, Universidad de Valladolid, 47011 Valladolid, Spain
- RICORS de Enfermedades Inflamatorias, Carlos III Health Institute, 28220 Madrid, Spain
| | - Paola S. Calles-Monar
- Palencia University Hospital Complex, Sanidad Castilla y Leon (SACYL), 34004 Palencia, Spain
| | - Ana M. Alonso-Tarancón
- Palencia University Hospital Complex, Sanidad Castilla y Leon (SACYL), 34004 Palencia, Spain
| | - Rosa M. Coco-Martín
- Instituto de Oftalmobiología Aplicada (IOBA), Facultad de Medicina, Universidad de Valladolid, 47011 Valladolid, Spain
- RICORS de Enfermedades Inflamatorias, Carlos III Health Institute, 28220 Madrid, Spain
- Correspondence: ; Tel.: +34-983-184-738
| | - Agustín Mayo-Iscar
- Department of Statistics and Operations Research, Instituto de Investigación en Matemáticas (IMUVa), Universidad de Valladolid, 47011 Valladolid, Spain
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Network Pharmacology-Based Identification of Key Targets of Ziyin Mingmu Pills Acting on Age-Related Macular Degeneration. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2023; 2023:5933125. [PMID: 36777624 PMCID: PMC9911245 DOI: 10.1155/2023/5933125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 02/05/2023]
Abstract
Objective This study is designed to find out the molecular targets of effective Chinese medicine Ziyin Mingmu pills (ZMPs) in treating age-related macular degeneration (AMD) based on network pharmacology and experimental data. Methods A comprehensive network pharmacology strategy that consists of three sequential modules (drug-disease target molecular docking, enrichment analysis, and external verification) was carried out to identify potential targets of ZMPs acting on AMD. Results The active ingredients of ZMPs targeting 66 genes have effects on the process of AMD. GO and KEGG pathway enrichment analyses suggested that response to oxidative stress, regulation of angiogenesis, and lipid and atherosclerosis might serve as the most important signaling pathways in ZMPs for AMD treatment. Combined with the GSE29801 dataset for further analysis, two key genes, EGFR and VEGFA, were identified. Immune infiltration analysis showed that there was a strong association between EGFR and immune cell content. In addition, images were acquired following 24 h in the scratch experiment showed that ZMPs can reduce the percentage of wound healing distance. The Western blot assay found that ZMPs increased the expression of EGFR and decreased the expression of VEGFA. Conclusion This study sheds light on some mechanisms of ZMP therapy for AMD, particularly the effect of ZMP on the oxidative stress in RPE and cell survival and angiogenesis in AMD. We propound ZMPs as a promising strategy to intervene in the process of AMD.
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Yang W, Song C, Gao M, Wang S, Yu H, Li Y. Effects of smoking on the retina of patients with dry age-related macular degeneration by optical coherence tomography angiography. BMC Ophthalmol 2022; 22:315. [PMID: 35869464 PMCID: PMC9308247 DOI: 10.1186/s12886-022-02525-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background The macula of the retina is analysed using optical coherence tomography angiography (OCTA) to provide clinical basis and explain the mechanism of smoking as a risk factor in dry age-related macular degeneration (AMD). Methods This cross-sectional study included 49 normal control nonsmokers, 12 normal control smokers, 38 dry AMD nonsmokers and 35 dry AMD smokers. The foveal avascular zone (FAZ), foveal density (FD) in a 300 μm region around FAZ, vessel densities of the superficial (SCP) and deep (DCP) capillary plexuses and central fovea retinal thickness (FRT) were compared using OCTA. The bivariate correlation analysis was used to evaluate the effect of pack–year history on retina-related indices. Results The vessel densities of whole, foveal and parafoveal of SCP and whole and parafoveal of DCP in the control nonsmoking group were all significantly higher than those in the dry AMD nonsmoking group (all P < 0.05), whereas the whole vessel density of SCP in the normal smoking group was higher than that in the dry AMD smoking group (P = 0.04). The thickness values of the inner and full-layer FRT in the normal nonsmoking group were significantly thicker than those in the dry AMD nonsmoking group (all P < 0.01). The pack–year history was negatively correlated with the parafoveal vessel density of DCP (r = − 0.224, P < 0.01). Conclusions FD, SCP, DCP and FRT are sensitive indices for the detection of early and intermediate dry AMD. DCP is a sensitive indicator that reflects the effects of smoking on the retina. Considerable changes are observed in retinal vessels, suggesting that dry AMD may affect the retinal tissue to a certain extent.
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miR-140-5p and miR-140-3p: Key Actors in Aging-Related Diseases? Int J Mol Sci 2022; 23:ijms231911439. [PMID: 36232738 PMCID: PMC9570089 DOI: 10.3390/ijms231911439] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 12/02/2022] Open
Abstract
microRNAs (miRNAs) are small single strand non-coding RNAs and powerful gene expression regulators. They mainly bind to the 3′UTR sequence of targeted mRNA, leading to their degradation or translation inhibition. miR-140 gene encodes the pre-miR-140 that generates the two mature miRNAs miR-140-5p and miR-140-3p. miR-140-5p/-3p have been associated with the development and progression of cancers, but also non-neoplastic diseases. In aging-related diseases, miR-140-5p and miR-140-3p expressions are modulated. The seric levels of these two miRNAs are used as circulating biomarkers and may represent predictive tools. They are also considered key actors in the pathophysiology of aging-related diseases. miR-140-5p/-3p repress targets regulating cell proliferation, apoptosis, senescence, and inflammation. This work focuses on the roles of miR-140-3p and miR-140-5p in aging-related diseases, details their regulation (i.e., by long non-coding RNA), and reviews the molecular targets of theses miRNAs involved in aging pathophysiology.
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D’Aloisio R, Di Antonio L, Toto L, Rispoli M, Di Iorio A, Delvecchio G, Mastropasqua R. Choroidal Changes in Blood Flow in Patients with Intermediate AMD after Oral Dietary Supplement Based on Astaxanthin, Bromelain, Vitamin D3, Folic Acid, Lutein, and Antioxidants. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081092. [PMID: 36013559 PMCID: PMC9412262 DOI: 10.3390/medicina58081092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/04/2022] [Accepted: 08/09/2022] [Indexed: 11/18/2022]
Abstract
Background and Objectives: The aim of this study was to investigate the impact of oral administration of the combination of astaxanthin (AXT), lutein, folic acid, vitamin D3, and bromelain with antioxidants on choroidal blood flow in patients with age-related intermediate macular degeneration (AMD). Materials and Methods: Patients affected by intermediate AMD and treated with daily oral nutritional supplement with AXT, bromelain, vitamin D3, folic acid, lutein, and antioxidants for a period of at least 6 months were included in this retrospective study. A control group homogenous for age and sex was also included in the analysis. All participants underwent a complete ophthalmologic examination, spectral domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA) evaluation. Outcome measures were choroidal thickness (CHT) and choriocapillary vessel density (CCVD) after six months of AXT assumption. Results: CCVD values showed statistically significant difference between cases and controls at baseline (p < 0.001) and in the cases during follow-up (p < 0.001). The CHT measurements showed statistically significant difference between cases and controls (p = 0.002) and in the cases during follow-up (p < 0.001). Conclusions: The combined use of structural OCT and OCTA allows for a detailed analysis in vivo of perfusion parameters of the choriocapillaris and choroid and evaluation of changes of choroidal blood flow after oral nutritional supplements that affect blood flow velocity.
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Affiliation(s)
- Rossella D’Aloisio
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, Chieti-Pescara, 66100 Chieti, Italy
- Correspondence:
| | - Luca Di Antonio
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, Chieti-Pescara, 66100 Chieti, Italy
| | - Lisa Toto
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, Chieti-Pescara, 66100 Chieti, Italy
| | - Marco Rispoli
- Ophthalmology Department UOSD Medical Retina, Eye Hospital, 00193 Rome, Italy
| | - Angelo Di Iorio
- Department of Innovative Technologies in Medicine & Dentistry, University “G. d’Annunzio”; Chieti-Pescara, 66100 Chieti, Italy
| | - Giancarlo Delvecchio
- Department of Ophthalmology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Rodolfo Mastropasqua
- Department of Ophthalmology, University of Modena and Reggio Emilia, 41121 Modena, Italy
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12
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Red blood cell fatty acids and age-related macular degeneration in postmenopausal women. Eur J Nutr 2022; 61:1585-1594. [PMID: 34988653 DOI: 10.1007/s00394-021-02746-2] [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: 08/05/2021] [Accepted: 11/16/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To evaluate the relationship between red blood cell (RBC) polyunsaturated fatty acid (PUFA) levels, and dietary PUFA and fish intake, with prevalent and incident age-related macular degeneration (AMD) in a US cohort of postmenopausal women. METHODS This analysis included 1456 postmenopausal women from the Women's Health Initiative (WHI) Clinical Trials. RBC PUFAs were measured from fasting serum samples collected at WHI baseline. Dietary PUFAs and fish intake were assessed via food frequency questionnaires at baseline. There were 240 women who had prevalent AMD and 138 who self-reported AMD development over 9.5 years. Adjusted odds ratios and 95% confidence intervals were estimated for prevalent AMD by RBC PUFA levels, dietary PUFA intake, and frequency of fish consumption. Adjusted hazard ratios and 95% confidence intervals were estimated for incident AMD. A p-for-trend was estimated for continuous measures of dietary PUFA and fish intake. RESULTS No significant association was found between prevalent or incident AMD and RBC docosahexaenoic acid (DHA) + eicosapentaenoic acid (EPA), EPA, DHA, alpha-linolenic acid (ALA), linoleic acid (LA), or arachidonic acid (AA). A positive association was found between dietary intake of AA and odds of prevalent AMD (p-for-trend for continuous AA intake = 0.02) and between intake of LA/ALA and incident AMD (p-for-trend for continuous ratio of LA/ALA intake = 0.03). No statistically significant associations were found between AMD and dietary intake of PUFAs or fish. CONCLUSIONS RBC PUFAs were not associated with AMD in this cohort. Overall, dietary analyses of PUFAs supported this, excepting dietary AA intake and intake of LA in proportion to ALA of which there were trends of increased risk.
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Hilal A, Bazarah M, Kapoula Z. Benefits of Implementing Eye-Movement Training in the Rehabilitation of Patients with Age-Related Macular Degeneration: A Review. Brain Sci 2021; 12:36. [PMID: 35053780 PMCID: PMC8774007 DOI: 10.3390/brainsci12010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/18/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Abstract
Age-related macular degeneration (ARMD) is one of the most debilitating eye-related illnesses worldwide. Eye-movement training is evolving to be a non-invasive, rapid, and effective method that is positively impacting vision and QoL (quality of life) in patients suffering from ARMD. This review aims to highlight why a greater adoption of eye-movement training in the clinical and research setting is of importance. A PubMed and ResearchGate search was performed for articles published between 1982 and 2020. Patients with advanced ARMD tend to experience a diminished QoL. Studies regarding eye-movement training for patients with central vision loss revealed overall significant improvements in reading speeds, fixation, and saccade performance. They also experienced less fatigue. In select studies, eye-movement training revealed an improvement in binocular vision, fixation, reading speed, and diminished reading exhaustion. The process of eye-movement training used in some of the studies was rather empirical. The latter requires standardization so that a uniform and applicable methodology can be adopted overall.
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Affiliation(s)
- Anis Hilal
- Department of Ophthalmology, Skåne University Hospital, Kioskgatan 1, 22285 Lund, Sweden
- Laboratoire IRIS, Physiopathologie de la Vision et Motricité Binoculaire, CNRS FR2022 UFR Biomédicale Université de Paris 45, rue des Saints-Pères, 75006 Paris, France
| | - Mazen Bazarah
- Department of Ophthalmology, Skåne University Hospital, Kioskgatan 1, 22285 Lund, Sweden
| | - Zoï Kapoula
- Laboratoire IRIS, Physiopathologie de la Vision et Motricité Binoculaire, CNRS FR2022 UFR Biomédicale Université de Paris 45, rue des Saints-Pères, 75006 Paris, France
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14
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Sanabria MR, Alonso‐Tarancón AM, Calles‐Monar PS, Ibañez P, García de Arriba S, Alvarez N, Piñuel JA, Coco RM, Fernández I. Silicone microbubbles after anti-vascular endothelial growth factor injections in patients with wet age-related macular degeneration: incidence, quantification and secondary optical coherence tomography artfacts. Acta Ophthalmol 2021; 99:e1051-e1055. [PMID: 33421336 DOI: 10.1111/aos.14743] [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] [Received: 07/28/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To report the incidence and quantity of silicone oil microbubbles and the relationship with the number of intravitreal anti-vascular endothelial growth factor (VEGF) injections and evaluate if microbubbles induce artefacts on optical coherence tomography (OCT) images. METHODS Observational, descriptive, cross-sectional study. Patients with wet age-related macular degeneration were included who had been treated for 1 year minimally with anti-VEGF injections repackaged in the hospital pharmacy. Detection and quantification of silicone microbubbles by mydriatic biomicroscopic examination were conducted 1 month after the last injection. The numbers of microbubbles were quantified on a scale of 0-3: 0, none; 1 scarce (1-10 microbubbles); 2 moderate (10-30); or 3 numerous (>30). Shadowing on OCT images was classified as 0-3: 0, none; 1 obscuring some retinal layers; 2 obscuring all retinal layers; or 3 obscuring the retinal thickness. RESULTS The study included 142 eyes of 98 patients (mean age, 82.4 years + 7.3; range, 65-97) treated with 2377 injections. Microbubbles were detected in 127 (89.4%) eyes, 62 (43.6%) with numerous microbubbles and 36 (25.4%) and 29 (20.4%), respectively, with scarce and moderate numbers. A positive correlation was found between the numbers of injections and intravitreal silicone (rho, 0.7). Optical coherence tomography (OCT) artefacts were detected in 11 eyes; the artefacts obscured all retinal layers in three eyes. No significant relationship could be established between the appearance of floaters and the microbubbles. CONCLUSION The presence and number of silicone microbubbles were correlated with the number of intravitreal injections. Microbubbles can produce OCT artefacts, which can hinder the treatment decision.
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Affiliation(s)
- Maria R. Sanabria
- Palencia University Hospital Complex Palencia Spain
- Institute of Applied Ophthalmobiology University of Valladolid Valladolid Spain
| | | | | | | | | | | | | | - Rosa M. Coco
- Institute of Applied Ophthalmobiology University of Valladolid Valladolid Spain
- OFTARED Health Research Thematic Network Carlos III Health Institute Madrid Spain
| | - Itziar Fernández
- Institute of Applied Ophthalmobiology University of Valladolid Valladolid Spain
- Department of Statistics University of Valladolid Valladolid Spain
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15
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Risk of Posterior Capsular Rupture during Phacoemulsification in Patients with the History of Anti-VEGF Intravitreal Injections: Results from the Pan-American Collaborative Retina Study (PACORES) Group. J Ophthalmol 2021; 2021:5591865. [PMID: 34671489 PMCID: PMC8523249 DOI: 10.1155/2021/5591865] [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: 01/25/2021] [Revised: 09/03/2021] [Accepted: 09/11/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To assess the risk for capsular rupture during routine phacoemulsification in patients with a history of anti-VEGF injections and other possible risk modifiers such as treatment patterns, type of anti-VEGF agent, and experience of the surgeon, among others. Methods This study reviewed the medical records of 11,129 patients from 7 different hospitals in 5 countries. The study included 939 patients that underwent routine phacoemulsification and had a history of anti-VEGF therapy. We excluded patients with known risk factors for capsular rupture, as well as patients with a history of other retinal procedures. The study extracted data regarding general demographics, the number of previous injections, type of anti-VEGF agent, details of cataract surgery, and anti-VEGF treatment patterns. Results Overall prevalence of posterior capsular rupture: 7.45% (95% CI: 5.9–9.32%). The mean number of injections per patient was 3.37 ± 2.8. More than 50% of the patients received their last anti-VEGF injection within three months before cataract surgery. The complication rate during intravitreal injections was 1.07%. In the univariate analysis, the experience of the cataract surgeon (inexperience surgeons; OR: 2.93) and the history of prior anti-VEGF therapy (OR: 1.77) were significant risk indicators for PCR (p < 0.05). However, after controlling for age in the multivariate analysis, the trend did not reach a statistical significance. Conclusion The risk for capsular rupture is higher in patients with a history of intravitreal anti-VEGF injections.
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16
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MACULAR HOLE ASSOCIATED WITH AGE-RELATED MACULAR DEGENERATION: Pathogenesis and Surgical Outcomes. Retina 2021; 41:2079-2087. [PMID: 34543242 DOI: 10.1097/iae.0000000000003148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To ascertain the pathogenesis of macular hole (MH) associated with age-related macular degeneration (AMD) and its surgical outcomes. METHODS Patients with full-thickness MH associated with AMD (higher grades than intermediate) were enrolled. The mechanism of MH formation and closure rate after vitrectomy (surgical outcome) were determined using optical coherence tomography imaging. RESULTS The mechanism of MH formation (35 eyes) associated with AMD was classified into four types: vitreomacular traction (42.9%), gradual retinal thinning caused by subretinal drusen or pigment epithelial detachment (22.9%), massive subretinal hemorrhage (20.0%), and combined (14.3%). In the 41 eyes that underwent vitrectomy, the logarithm of the minimum angle of resolution best-corrected visual acuity improved from 0.82 (0.10-2.30) preoperative to 0.69 (0.10-2.30) postoperative (P = 0.001). Successful closure of the MH was achieved in 33 eyes (80.5%) after vitrectomy. No significant association was observed between the closure rate of MH after vitrectomy and mechanism of MH formation (P = 0.083). CONCLUSION The mechanism of MH formation associated with AMD was classified into four types and was not related to its surgical outcome. Considering visual improvement and surgical outcome after vitrectomy in our study, active surgical treatment can be considered for MH associated with AMD.
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Macnamara A, Chen C, Schinazi VR, Saredakis D, Loetscher T. Simulating Macular Degeneration to Investigate Activities of Daily Living: A Systematic Review. Front Neurosci 2021; 15:663062. [PMID: 34483815 PMCID: PMC8414246 DOI: 10.3389/fnins.2021.663062] [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: 02/02/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Investigating difficulties during activities of daily living is a fundamental first step for the development of vision-related intervention and rehabilitation strategies. One way to do this is through visual impairment simulations. The aim of this review is to synthesize and assess the types of simulation methods that have been used to simulate age-related macular degeneration (AMD) in normally sighted participants, during activities of daily living (e.g., reading, cleaning, and cooking). Methods: We conducted a systematic literature search in five databases and a critical analysis of the advantages and disadvantages of various AMD simulation methods (following PRISMA guidelines). The review focuses on the suitability of each method for investigating activities of daily living, an assessment of clinical validation procedures, and an evaluation of the adaptation periods for participants. Results: Nineteen studies met the criteria for inclusion. Contact lenses, computer manipulations, gaze contingent displays, and simulation glasses were the main forms of AMD simulation identified. The use of validation and adaptation procedures were reported in approximately two-thirds and half of studies, respectively. Conclusions: Synthesis of the methodology demonstrated that the choice of simulation has been, and should continue to be, guided by the nature of the study. While simulations may never completely replicate vision loss experienced during AMD, consistency in simulation methodology is critical for generating realistic behavioral responses under vision impairment simulation and limiting the influence of confounding factors. Researchers could also come to a consensus regarding the length and form of adaptation by exploring what is an adequate amount of time and type of training required to acclimatize participants to vision impairment simulations.
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Affiliation(s)
- Anne Macnamara
- Cognitive Ageing and Impairment Neurosciences Laboratory, UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
| | - Celia Chen
- College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Adelaide, SA, Australia
| | - Victor R Schinazi
- Department of Psychology, Faculty of Society & Design, Bond University, Gold Coast, QLD, Australia.,Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Dimitrios Saredakis
- Cognitive Ageing and Impairment Neurosciences Laboratory, UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
| | - Tobias Loetscher
- Cognitive Ageing and Impairment Neurosciences Laboratory, UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
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18
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Causes and Five-Year Proportion of New Irreversible Visual Impairment in Jinshan District, Shanghai, from 2009-2018. J Ophthalmol 2021; 2021:8873283. [PMID: 34367689 PMCID: PMC8337108 DOI: 10.1155/2021/8873283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 07/23/2021] [Indexed: 02/03/2023] Open
Abstract
Purpose To describe the age distribution and main causes of new registered irreversible visual impairment (VI) and to compare the five-year proportion of VI in Jinshan district, Shanghai, from 2009 to 2018. Methods The new irreversible VI data were collected in the registry system from the Disabled Persons' Federation in Jinshan district from January 1, 2009, to December 31, 2018. Age, gender, and causes of VI were included, and the 5-year proportion of VI was calculated. Results The peak occurrence of blindness occurred in the 50–59 yrs group in 2009–2013 and in the ≥70 yrs group in 2014–2018. The peak occurrence of low vision occurred in the 40–49 yrs group in 2009–2013 and in the 50–59 yrs group in 2014–2018. Myopic macular degeneration (MMD, 15.5%), diabetic retinopathy (DR, 14.3%), and other optic nerve atrophy (ONA, 14.3%) were the three leading causes of blindness in 2009-2013, whereas MMD (21.3%), age-related macular degeneration (AMD, 19.6%), ONA (14.9%) were the three leading causes of blindness in 2014–2018. MMD (39.2%), DR (9.6%), ONA (8.8%) were the three leading causes of low vision in 2009–2013, whereas MMD (38.7%), AMD (23.3%), ONA (7.4%) were the three leading causes of low vision in 2014–2018. The proportions of blindness and low vision caused by AMD were higher in 2014–2018 than those in 2009–2013 (P=0.034 and P < 0.001, respectively). Conclusion The present study demonstrated an increasing trend in the number of irreversibly visually impaired individuals from 2009 to 2018. More attention should be paid to people with high myopia and old age.
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Non-steroidal Anti-inflammatory Drug Use and Risk of Age-Related Macular Degeneration in the California Teachers Study. Drugs Aging 2021; 38:817-828. [PMID: 34309807 PMCID: PMC8419134 DOI: 10.1007/s40266-021-00885-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 11/28/2022]
Abstract
Purpose The aim of this study was to examine whether use of regular aspirin and/or other non-steroidal anti-inflammatory drugs (NSAIDs) is associated with the development of age-related macular degeneration (AMD). Methods In the California Teachers Study cohort (N = 88,481) we identified diagnoses of AMD up to December 31, 2012 by linkage to statewide hospital discharge records. Aspirin, ibuprofen, other NSAIDs, and acetaminophen use and comprehensive risk factor information were collected via self-administered questionnaires at baseline in 1995–1996 and a follow-up questionnaire in 2005–2006. We employed Cox proportional hazard regression to model AMD risk. Results We did not find any associations between AMD and frequency and duration of aspirin or ibuprofen use reported at baseline. In the subsample with more specific information on medication use, we observed a 20% decrease in risk of AMD among low-dose aspirin users (HR 0.81, 95% CI 0.70–0.95) and a 55% decrease among cyclooxygenase-2 (COX-2) inhibitor users (HR 0.45, 95% CI 0.26–0.78) during 6.3 years of average follow-up. Conclusion The decrease in risk of intermediate- or late-stage AMD among women who reported regular use of low-dose aspirin or specific COX-2 inhibitors suggests a possible protective role for medications with COX-2 inhibitory properties or aspirin at doses used for cardiovascular disease prevention.
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20
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Feng KM, Chien WC, Chen JT, Chen YH, Chung CH, Sun CA, Chen CL. The impact of glucosamine on age-related macular degeneration in patients: A nationwide, population-based cohort study. PLoS One 2021; 16:e0251925. [PMID: 34010361 PMCID: PMC8133402 DOI: 10.1371/journal.pone.0251925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/05/2021] [Indexed: 01/25/2023] Open
Abstract
Purpose To analyze the association between glucosamine (GlcN) use and the risk of age-related macular degeneration (AMD) using claims data from the National Health Insurance Research Database (NHIRD). Methods A retrospective, population-based study was conducted with NHIRD data from a 14-year period (2000–2013). Chi-squared and Student’s t-tests were used to evaluate differences between the study and comparison cohorts for categorical and continuous variables, respectively. Risk factors for disease development were examined by the adjusted hazard ratio (aHR) with 95% confidence interval. Kaplan-Meier analysis was performed to compare the cumulative risk of AMD between the two cohorts. Results In total, 1,344 patients with GlcN treatment were enrolled in the study cohort and 5,376 patients without GlcN use were enrolled in the comparison cohort. The incidence rate of AMD was lower with GlcN use (3.65%) than without GlcN use (5.26%) (P = 0.014). GlcN use was associated with a lower risk of developing AMD among patients with hyperlipidemia, coronary artery disease, chronic obstructive pulmonary disease, stroke, other neurological disorders, or degenerative arthritis. Although the incidence of wet type AMD did not significantly differ (P = 0.91), the incidence of dry type AMD was lower in patients with GlcN use (2.9%) than those without GlcN use (4.84%) (P = 0.003). Kaplan-Meier analysis similarly revealed a lower rate of dry type AMD in patients with GlcN use compared to those without GlcN use (log-rank P = 0.004). Conclusions GlcN treatment can decrease the risk of developing dry type AMD. Further prospective controlled studies are needed to determine the effectiveness of GlcN treatment in patients with AMD and the associated mechanism.
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Affiliation(s)
- Kathy Ming Feng
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Jiann-Torng Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Ching-Long Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
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Hwang DDJ, Choi S, Ko J, Yoon J, Park JI, Hwang JS, Han JM, Lee HJ, Sohn J, Park KH, Han J. Distinguishing retinal angiomatous proliferation from polypoidal choroidal vasculopathy with a deep neural network based on optical coherence tomography. Sci Rep 2021; 11:9275. [PMID: 33927240 PMCID: PMC8085229 DOI: 10.1038/s41598-021-88543-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/05/2021] [Indexed: 11/26/2022] Open
Abstract
This cross-sectional study aimed to build a deep learning model for detecting neovascular age-related macular degeneration (AMD) and to distinguish retinal angiomatous proliferation (RAP) from polypoidal choroidal vasculopathy (PCV) using a convolutional neural network (CNN). Patients from a single tertiary center were enrolled from January 2014 to January 2020. Spectral-domain optical coherence tomography (SD-OCT) images of patients with RAP or PCV and a control group were analyzed with a deep CNN. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUROC) were used to evaluate the model's ability to distinguish RAP from PCV. The performances of the new model, the VGG-16, Resnet-50, Inception, and eight ophthalmologists were compared. A total of 3951 SD-OCT images from 314 participants (229 AMD, 85 normal controls) were analyzed. In distinguishing the PCV and RAP cases, the proposed model showed an accuracy, sensitivity, and specificity of 89.1%, 89.4%, and 88.8%, respectively, with an AUROC of 95.3% (95% CI 0.727-0.852). The proposed model showed better diagnostic performance than VGG-16, Resnet-50, and Inception-V3 and comparable performance with the eight ophthalmologists. The novel model performed well when distinguishing between PCV and RAP. Thus, automated deep learning systems may support ophthalmologists in distinguishing RAP from PCV.
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Affiliation(s)
- Daniel Duck-Jin Hwang
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, South Korea.
- Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, South Korea.
| | - Seong Choi
- Department of Applied Artificial Intelligence, Sungkyunkwan University, 25-2, Sungkyunkwan-ro, Jongno-gu, Seoul, 03063, South Korea
- RAON DATA, Seoul, South Korea
| | - Junseo Ko
- Department of Applied Artificial Intelligence, Sungkyunkwan University, 25-2, Sungkyunkwan-ro, Jongno-gu, Seoul, 03063, South Korea
| | - Jeewoo Yoon
- Department of Applied Artificial Intelligence, Sungkyunkwan University, 25-2, Sungkyunkwan-ro, Jongno-gu, Seoul, 03063, South Korea
- RAON DATA, Seoul, South Korea
| | - Ji In Park
- Department of Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Gangwon-do, South Korea
| | | | | | - Hak Jun Lee
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, South Korea
| | - Joonhong Sohn
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, South Korea
| | - Kyu Hyung Park
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jinyoung Han
- Department of Applied Artificial Intelligence, Sungkyunkwan University, 25-2, Sungkyunkwan-ro, Jongno-gu, Seoul, 03063, South Korea.
- RAON DATA, Seoul, South Korea.
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22
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Shayan M, Safi S, Karimi S, Yaseri M. Patient Satisfaction of Intravitreal Bevacizumab Injection Services at a Referral Center. J Curr Ophthalmol 2021; 33:41-47. [PMID: 34084956 PMCID: PMC8102940 DOI: 10.4103/joco.joco_116_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/19/2020] [Accepted: 07/11/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose: To evaluate the patient satisfaction of intravitreal bevacizumab (IVB) injection services for ocular complications of diabetes mellitus (DM) at a referral center. Methods: Patients with diabetic macular edema (DME) and diabetic retinopathy (DR) who had undergone IVB injections between March and September 2018 were interviewed by telephone using two questionnaires. First, demographic information, medical history, and the Patient Satisfaction Questionnaire Short Form (PSQ-18) 5-point scale were collected. Then, the Retinopathy Treatment Satisfaction Questionnaire (RetTSQ) 7-point scale was completed. Total scores are presented on a 100-point scale, with 100 indicating complete satisfaction. Results: Two hundred and fifty patients (145 with DME and 105 with DR) were interviewed (mean age: 61 ± 10 years; male-to-female ratio: 1:1.5). The response rate was 96%. Twenty-one patients had only one injection. Two hundred and forty-eight (99.2%) patients had insurance. The mean number of total injections was 12.2 ± 11.5. Seventy (28%), forty-seven (18.8%), sixty-one (24.4%), and seventy-two (28.8%) patients underwent IVB treatment for <6 months, between 7 and 12 months, between 13 and 24 months, and >25 months, respectively. The mean total and overall scores were 90.8 ± 22.5 (completely satisfied) and 88.7 ± 16.6 (completely satisfied) based on PSQ-18 and RetTSQ, respectively. Financial problems and appointment scheduling systems were the highest cases of dissatisfaction. Conclusion: The majority of patients were highly satisfied with IVB injections for the management of ocular complications of DM. The appointment taking procedure, waiting times, out-of-pocket expenses, and access to the hospital should be improved.
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Affiliation(s)
- Maryam Shayan
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sare Safi
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Karimi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medicine Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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23
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Xu Z, Zhang M, Zhang Q, Xu T, Tao L. Thyroid disease is associated with higher age-related macular degeneration risk: results from a meta-analysis of epidemiologic studies. Ophthalmic Res 2021; 64:696-703. [PMID: 33596562 DOI: 10.1159/000515273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although epidemiologic studies have suggested that thyroid disease may be a risk factor for age-related macular degeneration (AMD), this finding is still controversial. OBJECTIVES The aim of this meta-analysis was to investigate whether an association exists between thyroid disease and medication and AMD in epidemiologic studies. METHODS We searched PubMed, EMBASE, and Google Scholar from their inception to March 2020 for cross-sectional, case-control and cohort studies that assessed thyroid function and AMD risk. Data from selected studies were extracted, and a meta-analysis was performed using fixed-effect or random-effect models. The statistical heterogeneity (I2) among studies and the possibility of publication bias were evaluated. If I2 > 50%, a significant heterogeneity existed among studies and a random effects model was used to calculate the pooled RR. Otherwise, a fixed-effects model was performed. RESULTS A total of 13 epidemiologic studies that consisted of 7 thyroid disease and 7 thyroid medication studies were included. Statistically significant heterogeneity was observed in the study results (I2 thyroid disease = 80.1%, I2 thyroid medication = 69.0%). A significant positive association was found between thyroid disease and AMD, with an overall relative risk (RR) of 1.25 (95% CI: 1.02, 1.54). However, there was no statistical association between thyroid medication and AMD risk (pooled RR 1.26 [95% CI 0.92-1.72]). Egger's test indicated that there was no significant publication bias for thyroid disease (P=0.889) or thyroid medication (P = 0.226). CONCLUSIONS Our findings indicate that thyroid disease is associated with higher AMD risk. Thyroid disease prevention strategies may have a significant effect on the prevention of AMD and warrant further evaluation.
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Affiliation(s)
- Ziming Xu
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mei Zhang
- School of Life Science, University of Science and Technology of China, Hefei, China
| | - Qing Zhang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tingjuan Xu
- Gerontology Institute, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Anhui Provincial Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei, China
| | - Liming Tao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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24
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Nguyen T, Urrutia-Cabrera D, Liou RHC, Luu CD, Guymer R, Wong RCB. New Technologies to Study Functional Genomics of Age-Related Macular Degeneration. Front Cell Dev Biol 2021; 8:604220. [PMID: 33505962 PMCID: PMC7829507 DOI: 10.3389/fcell.2020.604220] [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: 09/09/2020] [Accepted: 12/07/2020] [Indexed: 12/18/2022] Open
Abstract
Age-related macular degeneration (AMD) is the most common cause of irreversible vision loss in people over 50 years old in developed countries. Currently, we still lack a comprehensive understanding of the genetic factors contributing to AMD, which is critical to identify effective therapeutic targets to improve treatment outcomes for AMD patients. Here we discuss the latest technologies that can facilitate the identification and functional study of putative genes in AMD pathology. We review improved genomic methods to identify novel AMD genes, advances in single cell transcriptomics to profile gene expression in specific retinal cell types, and summarize recent development of in vitro models for studying AMD using induced pluripotent stem cells, organoids and biomaterials, as well as new molecular technologies using CRISPR/Cas that could facilitate functional studies of AMD-associated genes.
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Affiliation(s)
- Tu Nguyen
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Daniel Urrutia-Cabrera
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Roxanne Hsiang-Chi Liou
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Chi D Luu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Robyn Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Raymond Ching-Bong Wong
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
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25
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Wang K, Hsieh MJ, Chien HW, Lee CY, Yeh CB, Huang JY, Yang SF. Medical Compliance of Fibrate and the Decreased Risk of Age-Related Macular Degeneration in Dyslipidemia-Related Diseases: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18010301. [PMID: 33401577 PMCID: PMC7796116 DOI: 10.3390/ijerph18010301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/15/2022]
Abstract
The purpose of the current study is to evaluate the incidence of age-related macular degeneration (AMD) in dyslipidemia-related diseases with or without the use of fibrate. Patients were defined as dyslipidemia-related diseases according to the diagnostic code and lab exam arrangement, then the population was divided into those with fibrate application and those without via 1:2 ratios of propensity-score matching. The primary outcome is the development of AMD after dyslipidemia-related diseases by the Cox proportional hazard regression. Besides, the relationship between the medical compliance of fibrate, presented as medical possession ratio (MPR), and the AMD development was also analyzed. A total of 22,917 patients and 45,834 individuals were enrolled in the study and control groups. There were 572 and 1181 events of any AMD development in the study and control groups which showed identical risk of AMD (aHR: 0.94, 95% CI: 0.85–1.04). However, a reduced risk of any AMD was found in those patients reached a baseline MPR more than 20% (aHR: 0.729, 95% CI: 0.599–0.887, p = 0.0016) and overall MPR more than 5% three years after the diagnosis of dyslipidemia-related diseases (aHR: 0.712, 95% CI: 0.557–0.909, p = 0.0065). Besides, a lower risk of dry-AMD was also found in those patients with the above conditions (aHR: 0.736, 95% CI: 0.599–0.906, p = 0.0038 and aHR: 0.721, 95% CI: 0.557–0.934, p = 0.0133, respectively). In conclusion, the use of fibrate with fair initial medical compliance will decrease the incidence of AMD in patients with dyslipidemia-related diseases, especially for the development of dry-AMD.
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Affiliation(s)
- Kai Wang
- Department of Ophthalmology, Cathay General Hospital, Taipei 106, Taiwan; (K.W.); (H.-W.C.)
- Department of Ophthalmology, Sijhih Cathay General Hospital, New Taipei City 211, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei 242, Taiwan
| | - Ming-Ju Hsieh
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (M.-J.H.); (J.-Y.H.)
- Oral Cancer Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
| | - Hsiang-Wen Chien
- Department of Ophthalmology, Cathay General Hospital, Taipei 106, Taiwan; (K.W.); (H.-W.C.)
- Department of Ophthalmology, Sijhih Cathay General Hospital, New Taipei City 211, Taiwan
| | - Chia-Yi Lee
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 500, Taiwan;
| | - Chao-Bin Yeh
- Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan;
- Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (M.-J.H.); (J.-Y.H.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (M.-J.H.); (J.-Y.H.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Correspondence:
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26
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Cimaglia G, Votruba M, Morgan JE, André H, Williams PA. Potential Therapeutic Benefit of NAD + Supplementation for Glaucoma and Age-Related Macular Degeneration. Nutrients 2020; 12:nu12092871. [PMID: 32961812 PMCID: PMC7551676 DOI: 10.3390/nu12092871] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
Glaucoma and age-related macular degeneration are leading causes of irreversible blindness worldwide with significant health and societal burdens. To date, no clinical cures are available and treatments target only the manageable symptoms and risk factors (but do not remediate the underlying pathology of the disease). Both diseases are neurodegenerative in their pathology of the retina and as such many of the events that trigger cell dysfunction, degeneration, and eventual loss are due to mitochondrial dysfunction, inflammation, and oxidative stress. Here, we critically review how a decreased bioavailability of nicotinamide adenine dinucleotide (NAD; a crucial metabolite in healthy and disease states) may underpin many of these aberrant mechanisms. We propose how exogenous sources of NAD may become a therapeutic standard for the treatment of these conditions.
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Affiliation(s)
- Gloria Cimaglia
- Department of Clinical Neuroscience, Division of Eye and Vision, St. Erik Eye Hospital, Karolinska Institutet, 112 82 Stockholm, Sweden;
- School of Optometry and Vision Sciences, Cardiff University, Cardiff CF24 4HQ, Wales, UK; (M.V.); (J.E.M.)
| | - Marcela Votruba
- School of Optometry and Vision Sciences, Cardiff University, Cardiff CF24 4HQ, Wales, UK; (M.V.); (J.E.M.)
- Cardiff Eye Unit, University Hospital Wales, Cardiff CF14 4XW, Wales, UK
| | - James E. Morgan
- School of Optometry and Vision Sciences, Cardiff University, Cardiff CF24 4HQ, Wales, UK; (M.V.); (J.E.M.)
- School of Medicine, Cardiff University, Cardiff CF14 4YS, Wales, UK
| | - Helder André
- Department of Clinical Neuroscience, Division of Eye and Vision, St. Erik Eye Hospital, Karolinska Institutet, 112 82 Stockholm, Sweden;
- Correspondence: (H.A.); (P.A.W.)
| | - Pete A. Williams
- Department of Clinical Neuroscience, Division of Eye and Vision, St. Erik Eye Hospital, Karolinska Institutet, 112 82 Stockholm, Sweden;
- Correspondence: (H.A.); (P.A.W.)
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27
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Central geographic atrophy vs. neovascular age–related macular degeneration: differences in longitudinal vision-related quality of life. Graefes Arch Clin Exp Ophthalmol 2020; 259:307-316. [DOI: 10.1007/s00417-020-04892-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/28/2020] [Accepted: 08/10/2020] [Indexed: 12/13/2022] Open
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28
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Vitreous protein binding with nanopore dialysis membrane device. Biomed Microdevices 2020; 22:46. [PMID: 32623529 DOI: 10.1007/s10544-020-00500-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Age-related macular degeneration (AMD) is one of the leading causes of blindness in the industrialized world, affecting over 8 million patients in the United State alone. While the wet (exudative) form of the disease is treated with intraocular injections, there are currently no approved therapies available for the dry (non-exudative) form of the disease which often affects both eyes in patients with AMD. Current research has focused on developing drugs that can be injected into the eye, but the treatment burden associated with monthly injections limits the effectiveness of this approach. Hence, there is a pressing need for a long-term therapeutic solution for patients suffering from this blinding disease. We detail a novel implantable intraocular device, which adsorbs and traps complement factors associated with AMD. In this study, we tested a novel approach by dialyzing proteins from the vitreous using biocompatible implants composed of a nanopore polyacrylonitrile polymer membrane. Preliminary in vitro and in vivo studies demonstrate a high affinity and capacity for complement protein absorption. After a three-month implantation in New Zealand White Cross rabbits, the implant demonstrated good biocompatibility with no inflammation and normal retinal physiology and histology. These studies demonstrate that prolonged CF suppression intraocularly may be accomplished with a nanopore polymer membrane.
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Battaglia Parodi M, Brunoro A, Tomasso L, Scuderi G. Benefits of micronutrient supplementation for reducing the risk of wet age-related macular disease and diabetic retinopathy. Eur J Ophthalmol 2020; 30:780-794. [DOI: 10.1177/1120672120920537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Age-related macular disease and diabetic retinopathy are chronic degenerative diseases characterised by progressive visual impairment. In Europe, age-related macular disease accounts for over 15% of blindness in adults over 50 years of age, and although the burden of diabetic retinopathy in terms of vision impairment is lower, vision loss associated with diabetic retinopathy is increasing with the rising prevalence of diabetes mellitus and the ageing of the population. Late-stage age-related macular disease can be subdivided into dry (non-neovascular) or wet (neovascular or exudative) forms. The large Age-Related Eye Disease Study 2 showed that supplementation with antioxidant nutrients reduces choroids neovascularisation and reduces the risk of progression of neovascular age-related macular disease. Antioxidant micronutrient supplements have also shown promising results in preventing the pathogenesis of retinopathy in animal models of diabetes. Age-related macular disease and diabetic retinopathy are understood to share some common pathophysiological characteristics, suggesting that micronutrients have an important role in ocular health in both conditions. This article will review the current evidence for the utility of micronutrients in preventing the development and progression of neovascular age-related macular disease and diabetic retinopathy.
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Affiliation(s)
| | | | | | - Gianluca Scuderi
- Ophthalmology Unit, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), St. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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30
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Plyukhova AA, Budzinskaya MV, Starostin KM, Rejdak R, Bucolo C, Reibaldi M, Toro MD. Comparative Safety of Bevacizumab, Ranibizumab, and Aflibercept for Treatment of Neovascular Age-Related Macular Degeneration (AMD): A Systematic Review and Network Meta-Analysis of Direct Comparative Studies. J Clin Med 2020; 9:jcm9051522. [PMID: 32443612 PMCID: PMC7291235 DOI: 10.3390/jcm9051522] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/07/2020] [Accepted: 05/14/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Since the efficacy of ranibizumab (RBZ), bevacizumab (BVZ) and aflibercept (AFB) is comparable in neovascular age-related macular degeneration (AMD), we conducted a systematic review and meta-analysis to evaluate the long-term safety profiles of these agents, including ocular safety. Methods: Systematic review identifying randomized controlled trials (RCTs) comparing RBZ, BVZ and AFB directly published before March 2019. Serious ocular adverse events (SOAE) of special interest were endophthalmitis, pseudo-endophthalmitis, retinal pigment epithelium tear and newly identified macular atrophy. Results: Thirteen RCTs selected for meta-analysis (4952 patients, 8723 people-years follow-up): 10 compared RBZ vs. BVZ and three RBZ vs. AFB. There were no significant differences in almost all adverse events (systemic and ocular) between BVZ, RBZ and AFB in up to two years’ follow-up. Macular atrophy was reported heterogeneously and not reported as SOAE in most trials. Conclusions: Direct comparison of RBZ, BVZ and AFB safety profiles in the RCT network meta-analytical setting have not revealed a consistent benefit of these three commonly used anti-vascular endothelial growth factor (anti-VEGF) agents in AMD. Network model ranking highlighted potential benefits of RBZ in terms of a systemic safety profile; however, this appears a hypothesis rather than a conclusion. Newly identified macular atrophy is underestimated in RCTs—future real-world data should be focused on SOAE.
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Affiliation(s)
- Anna A. Plyukhova
- Federal State Budget Scientific Research Institute “Scientific Research Institute of Eye Diseases”, 119021 Moscow, Russia;
- Correspondence: (A.A.P.); (M.R.); Tel.: +7-9036128695 (A.A.P.)
| | - Maria V. Budzinskaya
- Federal State Budget Scientific Research Institute “Scientific Research Institute of Eye Diseases”, 119021 Moscow, Russia;
| | | | - Robert Rejdak
- Department of General Ophthalmology with Pediatric Service, Medical University of Lublin, 20079 Lublin, Poland; (R.R.); (M.D.T.)
| | - Claudio Bucolo
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy;
| | - Michele Reibaldi
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy
- Correspondence: (A.A.P.); (M.R.); Tel.: +7-9036128695 (A.A.P.)
| | - Mario D. Toro
- Department of General Ophthalmology with Pediatric Service, Medical University of Lublin, 20079 Lublin, Poland; (R.R.); (M.D.T.)
- Faculty of Medicine, Collegium Medicum Cardinal Stefan Wyszyński University, 01815 Warsaw, Poland
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31
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Korhonen E, Piippo N, Hytti M, Hyttinen JMT, Kaarniranta K, Kauppinen A. Only IL‐1β release is inflammasome‐dependent upon ultraviolet B irradiation although IL‐18 is also secreted. FASEB J 2020; 34:6437-6448. [DOI: 10.1096/fj.201902355rr] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 02/20/2020] [Accepted: 03/03/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Eveliina Korhonen
- School of Pharmacy Faculty of Health Sciences University of Eastern Finland Kuopio Finland
- HUSLAB University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Niina Piippo
- School of Pharmacy Faculty of Health Sciences University of Eastern Finland Kuopio Finland
| | - Maria Hytti
- School of Pharmacy Faculty of Health Sciences University of Eastern Finland Kuopio Finland
| | - Juha M. T. Hyttinen
- Department of Ophthalmology Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
| | - Kai Kaarniranta
- Department of Ophthalmology Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
- Department of Ophthalmology Kuopio University Hospital Kuopio Finland
| | - Anu Kauppinen
- School of Pharmacy Faculty of Health Sciences University of Eastern Finland Kuopio Finland
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32
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Affiliation(s)
- Claudiu T Supuran
- NEUROFARBA Department, Sezione di Scienze Farmaceutiche e Nutraceutiche, Università degli Studi di Firenze , Firenze , Italy
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33
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Huang J, Chen M, Xu K, Zhou R, Zhang S, Zhao C. Microarray expression profile and functional analysis of circular RNAs in choroidal neovascularization. J Biomed Res 2019; 34:67-74. [PMID: 35081684 DOI: 10.7555/jbr.33.20190063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Choroidal neovascularization (CNV) is a leading cause of visual loss in age-related macular degeneration (AMD). However, the molecular mechanism for CNV progression is still unclear. This study aimed to identify CNV-related circular RNAs (circRNAs), a novel class of non-coding RNAs with diverse functions. A total of 117 circRNAs were differentially expressed in the murine CNV model by microarrays. Gene ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed to identify the functions of selected circRNAs. The host genes of these circRNAs were predicted to be targeted to neurogenesis (ontology: biological process), proteinaceous extracellular matrix (ECM) (ontology: cellular component), and binding (ontology: molecular function). Differentially expressed circRNAs-mediated regulatory networks were enriched in ECM receptor interaction. Most of the dysregulated circRNAs could potentially bind to five different miRNAs by TargetScan and miRanda. Specifically, circ_15752 was identified in this circRNAs pool which may facilitate vascular endothelial cell proliferation, migration, and tube formation, suggesting a critical role in endothelial angiogenesis. Our work suggests that dysregulated circRNAs may be involved in CNV pathogenesis and serve as potential biomarkers for CNV.
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Affiliation(s)
- Jiancheng Huang
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, State Key Laboratory of Reproductive Medicine, Nanjing, Jiangsu 210029, China.,Eye Institute, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - Meng Chen
- Eye Institute, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai 200032, China
| | - Kai Xu
- Eye Institute, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai 200032, China
| | - Rongmei Zhou
- Eye Institute, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai 200032, China
| | - Shujie Zhang
- Eye Institute, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai 200032, China
| | - Chen Zhao
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, State Key Laboratory of Reproductive Medicine, Nanjing, Jiangsu 210029, China.,Eye Institute, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai 200032, China
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Burlina PM, Joshi N, Pacheco KD, Liu TYA, Bressler NM. Assessment of Deep Generative Models for High-Resolution Synthetic Retinal Image Generation of Age-Related Macular Degeneration. JAMA Ophthalmol 2019; 137:258-264. [PMID: 30629091 DOI: 10.1001/jamaophthalmol.2018.6156] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Importance Deep learning (DL) used for discriminative tasks in ophthalmology, such as diagnosing diabetic retinopathy or age-related macular degeneration (AMD), requires large image data sets graded by human experts to train deep convolutional neural networks (DCNNs). In contrast, generative DL techniques could synthesize large new data sets of artificial retina images with different stages of AMD. Such images could enhance existing data sets of common and rare ophthalmic diseases without concern for personally identifying information to assist medical education of students, residents, and retinal specialists, as well as for training new DL diagnostic models for which extensive data sets from large clinical trials of expertly graded images may not exist. Objective To develop DL techniques for synthesizing high-resolution realistic fundus images serving as proxy data sets for use by retinal specialists and DL machines. Design, Setting, and Participants Generative adversarial networks were trained on 133 821 color fundus images from 4613 study participants from the Age-Related Eye Disease Study (AREDS), generating synthetic fundus images with and without AMD. We compared retinal specialists' ability to diagnose AMD on both real and synthetic images, asking them to assess image gradability and testing their ability to discern real from synthetic images. The performance of AMD diagnostic DCNNs (referable vs not referable AMD) trained on either all-real vs all-synthetic data sets was compared. Main Outcomes and Measures Accuracy of 2 retinal specialists (T.Y.A.L. and K.D.P.) for diagnosing and distinguishing AMD on real vs synthetic images and diagnostic performance (area under the curve) of DL algorithms trained on synthetic vs real images. Results The diagnostic accuracy of 2 retinal specialists on real vs synthetic images was similar. The accuracy of diagnosis as referable vs nonreferable AMD compared with certified human graders for retinal specialist 1 was 84.54% (error margin, 4.06%) on real images vs 84.12% (error margin, 4.16%) on synthetic images and for retinal specialist 2 was 89.47% (error margin, 3.45%) on real images vs 89.19% (error margin, 3.54%) on synthetic images. Retinal specialists could not distinguish real from synthetic images, with an accuracy of 59.50% (error margin, 3.93%) for retinal specialist 1 and 53.67% (error margin, 3.99%) for retinal specialist 2. The DCNNs trained on real data showed an area under the curve of 0.9706 (error margin, 0.0029), and those trained on synthetic data showed an area under the curve of 0.9235 (error margin, 0.0045). Conclusions and Relevance Deep learning-synthesized images appeared to be realistic to retinal specialists, and DCNNs achieved diagnostic performance on synthetic data close to that for real images, suggesting that DL generative techniques hold promise for training humans and machines.
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Affiliation(s)
- Philippe M Burlina
- Johns Hopkins University Applied Physics Laboratory, Baltimore, Maryland.,Malone Center for Engineering in Healthcare, Baltimore, Maryland.,Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Neil Joshi
- Johns Hopkins University Applied Physics Laboratory, Baltimore, Maryland
| | - Katia D Pacheco
- Brasilian Center of Vision Eye Hospital, Brasilia, Distrito Federal, Brazil
| | - T Y Alvin Liu
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Neil M Bressler
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Editor
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35
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Shoshany N, Weiner C, Safir M, Einan-Lifshitz A, Pokroy R, Kol A, Modai S, Shomron N, Pras E. Rare Genetic Variants in Jewish Patients Suffering from Age-Related Macular Degeneration. Genes (Basel) 2019; 10:genes10100825. [PMID: 31635417 PMCID: PMC6826738 DOI: 10.3390/genes10100825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/1970] [Revised: 10/02/2019] [Accepted: 10/15/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose: To identify rare genetic variants in early age-related macular degeneration (AMD) utilizing whole-exome sequencing (WES). Methods: Eight non-related early-AMD families of different Jewish ethnicities were ascertained. Initial mutation screening (phase-1) included common complement factor-H (CFH) p.Y402H; and age related maculopathy susceptibility 2 (ARMS2) p.A69S; and rare variants complement factor-I (CFI) p.V412M; and hemicentin1 (HMCN1) c.4163delC identified previously in our population. Four families, whose initial screening for the aforementioned variants was negative, underwent WES (phase-2). Bioinformatics filtering was based on functionality (from a panel of 234 genes with proven or presumed association to AMD); predicted severity; and frequency (rare variants with minor allele frequency <1%). When applicable, further screening for specific rare variants was carried out on additional cases of similar ethnicities and phenotypes (phase-3). Results: Phase-1 identified three families carrying CFI p.V412M mutation. WES analysis detected probable disease-related variants in three out of the remaining families. These included: a family with a variant in PLEKHA1 gene p.S177N; a family with previously reported variant p.R1210C in CFH gene; and two families with the C3 p.R735W variant. Conclusions: Rare, high-penetrance variants have a profound contribution to early-AMD pathogenesis. Utilization of WES in genetic research of multifactorial diseases as AMD, allows a thorough comprehensive analysis with the identification of previously unreported rare variants.
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Affiliation(s)
- Nadav Shoshany
- The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir (formerly Assaf-Harofeh) Medical Center, Zerifin 70300, Israel.
| | - Chen Weiner
- The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir (formerly Assaf-Harofeh) Medical Center, Zerifin 70300, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
| | - Margarita Safir
- The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir (formerly Assaf-Harofeh) Medical Center, Zerifin 70300, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
| | - Adi Einan-Lifshitz
- The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir (formerly Assaf-Harofeh) Medical Center, Zerifin 70300, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
| | - Russell Pokroy
- The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir (formerly Assaf-Harofeh) Medical Center, Zerifin 70300, Israel.
| | - Ayala Kol
- The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir (formerly Assaf-Harofeh) Medical Center, Zerifin 70300, Israel.
| | | | - Noam Shomron
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
- Variantyx Inc, MA 01701, USA.
| | - Eran Pras
- The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir (formerly Assaf-Harofeh) Medical Center, Zerifin 70300, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
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Burlina PM, Joshi N, Pacheco KD, Freund DE, Kong J, Bressler NM. Use of Deep Learning for Detailed Severity Characterization and Estimation of 5-Year Risk Among Patients With Age-Related Macular Degeneration. JAMA Ophthalmol 2019; 136:1359-1366. [PMID: 30242349 DOI: 10.1001/jamaophthalmol.2018.4118] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Importance Although deep learning (DL) can identify the intermediate or advanced stages of age-related macular degeneration (AMD) as a binary yes or no, stratified gradings using the more granular Age-Related Eye Disease Study (AREDS) 9-step detailed severity scale for AMD provide more precise estimation of 5-year progression to advanced stages. The AREDS 9-step detailed scale's complexity and implementation solely with highly trained fundus photograph graders potentially hampered its clinical use, warranting development and use of an alternate AREDS simple scale, which although valuable, has less predictive ability. Objective To describe DL techniques for the AREDS 9-step detailed severity scale for AMD to estimate 5-year risk probability with reasonable accuracy. Design, Setting, and Participants This study used data collected from November 13, 1992, to November 30, 2005, from 4613 study participants of the AREDS data set to develop deep convolutional neural networks that were trained to provide detailed automated AMD grading on several AMD severity classification scales, using a multiclass classification setting. Two AMD severity classification problems using criteria based on 4-step (AMD-1, AMD-2, AMD-3, and AMD-4 from classifications developed for AREDS eligibility criteria) and 9-step (from AREDS detailed severity scale) AMD severity scales were investigated. The performance of these algorithms was compared with a contemporary human grader and against a criterion standard (fundus photograph reading center graders) used at the time of AREDS enrollment and follow-up. Three methods for estimating 5-year risk were developed, including one based on DL regression. Data were analyzed from December 1, 2017, through April 15, 2018. Main Outcomes and Measures Weighted κ scores and mean unsigned errors for estimating 5-year risk probability of progression to advanced AMD. Results This study used 67 401 color fundus images from the 4613 study participants. The weighted κ scores were 0.77 for the 4-step and 0.74 for the 9-step AMD severity scales. The overall mean estimation error for the 5-year risk ranged from 3.5% to 5.3%. Conclusions and Relevance These findings suggest that DL AMD grading has, for the 4-step classification evaluation, performance comparable with that of humans and achieves promising results for providing AMD detailed severity grading (9-step classification), which normally requires highly trained graders, and for estimating 5-year risk of progression to advanced AMD. Use of DL has the potential to assist physicians in longitudinal care for individualized, detailed risk assessment as well as clinical studies of disease progression during treatment or as public screening or monitoring worldwide.
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Affiliation(s)
- Philippe M Burlina
- Applied Physics Laboratory, The Johns Hopkins University, Baltimore, Maryland
| | - Neil Joshi
- Applied Physics Laboratory, The Johns Hopkins University, Baltimore, Maryland
| | | | - David E Freund
- Applied Physics Laboratory, The Johns Hopkins University, Baltimore, Maryland
| | - Jun Kong
- The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang
| | - Neil M Bressler
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Editor
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Burlina P, Joshi N, Pacheco KD, Freund DE, Kong J, Bressler NM. Utility of Deep Learning Methods for Referability Classification of Age-Related Macular Degeneration. JAMA Ophthalmol 2019; 136:1305-1307. [PMID: 30193354 DOI: 10.1001/jamaophthalmol.2018.3799] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Phillippe Burlina
- Applied Physics Laboratory, Johns Hopkins University, Baltimore, Maryland.,Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Computer Science, Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore, Maryland
| | - Neil Joshi
- Applied Physics Laboratory, Johns Hopkins University, Baltimore, Maryland
| | - Katia D Pacheco
- Retina Division, Department of Ophthalmology, Brazilian Center of Vision Eye Hospital, Brasilia, Brazil
| | - David E Freund
- Applied Physics Laboratory, Johns Hopkins University, Baltimore, Maryland
| | - Jun Kong
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, China
| | - Neil M Bressler
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Editor
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Xu X, Ritz B, Coleman A, Liew Z, Deapen D, Lee E, Bernstein L, Pinder R, Marshall S, Heck JE. Hypertension, antihypertensive medications use and risk of age-related macular degeneration in California Teachers Cohort. J Hum Hypertens 2019; 34:568-576. [PMID: 31595025 DOI: 10.1038/s41371-019-0269-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/19/2019] [Accepted: 09/25/2019] [Indexed: 01/02/2023]
Abstract
Sustained and inadequately controlled hypertension can promote the development of age-related macular degeneration (AMD) through multiple biologic pathways. Epidemiologic studies of high blood pressure, antihypertensive therapies, and the risk of AMD thus far have been inconclusive. However, few studies evaluated risks according to the use of different classes of antihypertensive drugs or took combinations of use into account. We performed a prospective cohort study by linking the California Teachers Study (CTS) cohort (N = 88 481) to statewide hospital discharge records up to December 31, 2012. History of high blood pressure, regular use of antihypertensive medications, and comprehensive risk factor information was collected via self-administered questionnaires at baseline in 1995-1996, and information on specific classes of antihypertensive drugs was provided by a subsample of CTS participants who completed a follow-up questionnaire in 2000. We identified 1762 female teachers with AMD during 14.8 years of follow-up on average. Applying Cox proportional hazard regression, we estimated increased risks of AMD among women treated for hypertension at baseline (HR = 1.15, 95% CI: 1.03, 1.30); the magnitude of the association increased with longer duration of antihypertensive treatment. In the subsample with more specific information on type of medication use, we estimated a 45% increased risk of AMD among women receiving diuretics as monotherapy compared to women with medications more potent than diuretics (HR = 1.45, 95% CI 1.10, 1.90). In women treated with a combination of antihypertensive drugs, we observed no increased risk of AMD for any individual class of drugs.
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Affiliation(s)
- Xiaoqing Xu
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Anne Coleman
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA.,Jules Stein Eye Institute, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Zeyan Liew
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Dennis Deapen
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Eunjung Lee
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Leslie Bernstein
- Division of Cancer Etiology, Department of Population Sciences, City of Hope National Medical Center and Comprehensive Cancer Center, Duarte, CA, USA
| | - Rich Pinder
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Sarah Marshall
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA.
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Supuran CT. Agents for the prevention and treatment of age-related macular degeneration and macular edema: a literature and patent review. Expert Opin Ther Pat 2019; 29:761-767. [PMID: 31540558 DOI: 10.1080/13543776.2019.1671353] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Introduction: Macular degeneration (MD) and macular edema (ME) are ophthalmologic diseases affecting an increasing number of the aging population. Until recently, there were few therapeutic options for both conditions but the last two decades saw important advances. Areas covered: This review summarizes the agents used for the treatment of age-related MD (AMD), which include verteporfin, for photodynamic therapy, and anti-VEGF agents, the aptamer pegaptanib, the monoclonal antibodies (MAbs) ranibizumab (Lucentis®) and bevacizumab (Avastin®) and the fusion protein aflibercept (Eylea®). All these drugs are effective only for the wet form of AMD, whereas for the dry form there is no treatment available. ME is, on the other hand, treated with nonsteroidal anti-inflammatory drugs and carbonic anhydrase (CA) inhibitors. Recently, MAbs such as ranibizumab and bevacizumab were also shown to be effective for the management of the cystoid and diabetic ME. Expert opinion: There are important advances made in the field in the last years but longer-acting anti-VEGF agents or drugs with less ocular side effects are needed. Many such agents are in clinical development.
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Affiliation(s)
- Claudiu T Supuran
- NEUROFARBA Department, Sezione di Scienze Farmaceutiche e Nutraceutiche, Università degli Studi di Firenze , Firenze , Italy
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Reiter GS, Told R, Baratsits M, Hecht A, Schlanitz FG, Sacu S, Schmidt‐Erfurth U. Repeatability and reliability of quantitative fundus autofluorescence imaging in patients with early and intermediate age-related macular degeneration. Acta Ophthalmol 2019; 97:e526-e532. [PMID: 30549203 DOI: 10.1111/aos.13987] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 11/09/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Quantification of fundus autofluorescence has only recently become available. We report our findings on the evaluation of the repeatability and reliability of quantitative fundus autofluorescence (qAF) measurements in patients with early and intermediate age-related macular degeneration (AMD), using the first approved and commercially available instrument. METHODS A total of 43 eyes of 22 patients (aged between 52 and 84 years) diagnosed with early and intermediate AMD were included. All eyes were imaged at day 1, 3 months and 6 months using a modified scanning laser ophthalmoscope, equipped with an internal fluorescent reference. Mean qAF values were calculated for the fovea and for each concentric ring of the Delori pattern. Repeatability and reliability were calculated using Bland-Altman analysis and intraclass correlation (ICC). RESULTS The mean patient age was 73.5 ± 7.9 years. Sixteen patients (73%) were female. qAF repeatability of the eight segments in the middle ring of the Delori pattern (qAFM 8 ) for between sessions was ±8.2%. Agreement at 3- and 6-month follow-up in eyes without retinal changes was ±8.3% and ±9.8%, respectively. Reliability of qAFM 8 was high for all images acquired [ICC = 0.98 (CI: 0.96-0.99), 0.97 (0.93-0.99) and 0.98 (0.92-0.99)]. Agreement at 3- and 6-month follow-up in eyes with retinal changes was ±18.1% and ±20.2%, respectively. Intraclass correlation (ICC) was slightly lower in eyes with retinal changes at 0.93 (0.84-0.97) and 0.96 (0.91-0.98), respectively. CONCLUSIONS Quantitative autofluorescence shows excellent repeatability and reliability as well as follow-up agreement in patients with early and intermediate AMD without retinal changes. This is relevant when conducting longitudinal studies using qAF.
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Affiliation(s)
- Gregor Sebastian Reiter
- Department of Ophthalmology and Optometry Vienna Trial Center (VTC) Medical University of Vienna Vienna Austria
| | - Reinhard Told
- Department of Ophthalmology and Optometry Vienna Trial Center (VTC) Medical University of Vienna Vienna Austria
| | - Magdalena Baratsits
- Department of Ophthalmology and Optometry Vienna Trial Center (VTC) Medical University of Vienna Vienna Austria
| | - Alexander Hecht
- Department of Ophthalmology and Optometry Vienna Trial Center (VTC) Medical University of Vienna Vienna Austria
| | - Ferdinand Georg Schlanitz
- Department of Ophthalmology and Optometry Vienna Trial Center (VTC) Medical University of Vienna Vienna Austria
| | - Stefan Sacu
- Department of Ophthalmology and Optometry Vienna Trial Center (VTC) Medical University of Vienna Vienna Austria
| | - Ursula Schmidt‐Erfurth
- Department of Ophthalmology and Optometry Vienna Trial Center (VTC) Medical University of Vienna Vienna Austria
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Napo A, Guirou N, Boro A, Dougnon A, Keita F, Simaga A, Sylla F, Théra J, Traore L, Bamani S. [Evaluation of the quality of life of adult patients treated in low vision at the CHU-IOTA]. J Fr Ophtalmol 2019; 42:492-498. [PMID: 30987760 DOI: 10.1016/j.jfo.2019.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/28/2018] [Accepted: 01/22/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Visual impairment is a handicap defined as any alteration of visual function responsible for a partial or total limitation of the activities of daily living (OMS, 2004). The objective of this study is to assess quality of life in patients before and after management of low vision. PATIENTS AND METHODS This was a mono-centric, transverse, analytical study over a period of 6 months. Our study population included all adult patients seen in ophthalmologic consultation and followed in the low vision unit with visual acuity less than 3/10 and greater than or equal to 1/20 in the best eye with best optical correction. The National Eye Institute's quality of life questionnaire, the NEF VFQ 25, was administered to patients on site prior to management and then a month later. RESULTS Low-vision management improved overall the dimensions of the quality of life questionnaire. Following the end-of-care assessment, the score for ocular pain was lowest (38.20), followed by the overall vision score (44.95) and near vision difficulty score (45.33). DISCUSSION Our sample population was distinguished by a cultural mix, with diversity of beliefs and lifestyles, and also by the relatively advanced age of the subjects constituting it. This can influence the individual's perception of him- or herself within his or her environment, modifying the patient's estimation of his or her condition and therefore his or her behavior. CONCLUSION Low-vision rehabilitation can improve the quality of life of visually impaired patients, particularly for near vision, activities of daily living and psychological health.
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Affiliation(s)
- A Napo
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali.
| | - N Guirou
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - A Boro
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - A Dougnon
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - F Keita
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - A Simaga
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - F Sylla
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - J Théra
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - L Traore
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
| | - S Bamani
- Institut d'ophtalmologie tropicale de l'Afrique, BP 248, Bamako, Mali
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Korhonen E, Piippo N, Hytti M, Hyttinen JM, Kaarniranta K, Kauppinen A. SQSTM1/p62 regulates the production of IL-8 and MCP-1 in IL-1β-stimulated human retinal pigment epithelial cells. Cytokine 2019; 116:70-77. [DOI: 10.1016/j.cyto.2018.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 02/07/2023]
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Piatti A, Croce A, Mazzacane D, Traina G, Ambrosino L, Boni L, Lisi L, Cascella MC, Grunberger A. Effect of 2-year nutritional supplementation on progression of age-related macular degeneration. Eur J Ophthalmol 2019; 30:376-381. [DOI: 10.1177/1120672119836007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To examine the effect of a long-term nutritional supplementation on age-related macular degeneration progression. Methods: In this prospective, double-blind, placebo-controlled study, 80 patients with intermediate age-related macular degeneration were randomized (2:1) to receive 1 tablet/day of a nutritional supplement containing a mixture of carotenoids, vitamins and omega-3 fatty acids or placebo. Age-related macular degeneration progression assessed by digital fundus photography (primary outcome) and best-corrected visual acuity were evaluated. Differences between arms were tested using chi-square test or Fisher’s exact test. Results: Seventy-four patients completed the follow-up at 24 months (48 in the treated arm and 26 in the placebo arm). An age-related macular degeneration progression was observed in the 2.1% of patients of the treated arm and in the 15.4% of patients in the placebo arm (p = 0.05, Fisher’s exact test). Best-corrected visual acuity data alone were not statistically significant among groups. Conclusion: A clinically meaningful stabilization of intermediate age-related macular degeneration over a period of 2 years may be obtained by treating patients with a mixture of carotenoids, vitamins and omega-3 fatty acids.
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Parmeggiani F, Gallenga CE, Costagliola C, Semeraro F, Romano MR, Dell'Omo R, Russo A, De Nadai K, Gemmati D, D'Angelo S, Bolletta E, Sorrentino FS. Impact of methylenetetrahydrofolate reductase C677T polymorphism on the efficacy of photodynamic therapy in patients with neovascular age-related macular degeneration. Sci Rep 2019; 9:2614. [PMID: 30796269 PMCID: PMC6385217 DOI: 10.1038/s41598-019-38919-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/02/2019] [Indexed: 02/07/2023] Open
Abstract
The most severe visual impairments due to age-related macular degeneration (AMD) are frequently caused by the occurrence of choroidal neovascularization (CNV). Although photodynamic therapy with verteporfin (PDT-V) is currently a second-line treatment for neovascular AMD, it can be conveniently combined with drugs acting against vascular endothelial growth factor (anti-VEGF) to reduce the healthcare burden associated with the growing necessity of anti-VEGF intravitreal re-injection. Because the common 677 C > T polymorphism of the methylenetetrahydrofolate reductase gene (MTHFR-C677T; rs1801133) has been described as predictor of satisfactory short-term responsiveness of AMD-related CNV to PDT-V, we retrospectively examined the outcomes of 371 Caucasian patients treated with standardized, pro-re-nata, photodynamic regimen for 24 months. Responder (R) and non-responder (NR) patients were distinguished on the basis of the total number of scheduled PDT-V (TN-PDT-V) and change of best-corrected visual acuity (∆-BCVA). The risk for both TN-PDT-V and ∆-BCVA to pass from R to NR group was strongly correlated with CT and TT genotypes of MTHFR-C677T variant resulting, respectively, in odd ratios of 0.19 [95% CI, 0.12-0.32] and 0.09 [95% CI, 0.04-0.21] (P < 0.001), and odd ratios of 0.24 [95% CI, 0.15-0.39] and 0.03 [95% CI, 0.01-0.11] (P < 0.001). These pharmacogenetic findings indicate a rational basis to optimize the future clinical application of PDT-V during the combined treatments of AMD-related CNV, highlighting the role of thrombophilia to be aware of the efficacy profile of photodynamic therapy.
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Affiliation(s)
- Francesco Parmeggiani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, 44121, Italy. .,Center for the Study of Inflammation of the University of Ferrara, Ferrara, 44121, Italy.
| | - Carla Enrica Gallenga
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, 44121, Italy
| | - Ciro Costagliola
- Department of Medicine and Health Sciences, University of Molise, Campobasso, 86100, Italy
| | - Francesco Semeraro
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, 25121, Italy
| | - Mario R Romano
- Department of Biomedical Sciences, Humanitas University, Milan, 20090, Italy
| | - Roberto Dell'Omo
- Department of Medicine and Health Sciences, University of Molise, Campobasso, 86100, Italy
| | - Andrea Russo
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, 25121, Italy
| | - Katia De Nadai
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, 44121, Italy.,Center for Retinitis Pigmentosa of Veneto Region, Camposampiero Hospital, Azienda ULSS 6 Euganea, Padova, 35131, Italy
| | - Donato Gemmati
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, 44121, Italy
| | - Sergio D'Angelo
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, 44121, Italy
| | - Elena Bolletta
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, 44121, Italy
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Melatonin as the Possible Link Between Age-Related Retinal Regeneration and the Disrupted Circadian Rhythm in Elderly. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1185:45-49. [PMID: 31884587 DOI: 10.1007/978-3-030-27378-1_8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The association between age-related macular degeneration (AMD) and biological rhythms has been insufficiently studied; however there are several reasons to believe that impairment in circadian rhythm may affect incidence and pathogenesis of AMD. The current understanding of AMD pathology is based on age-related, cumulative oxidative damage to the retinal pigmented epithelium (RPE) partially due to impaired clearance of phagocytosed photoreceptor outer segments. In higher vertebrates, phagocytosis of the outer segments is synchronized by circadian rhythms and occurs shortly after dawn, followed by lysosomal-mediated clearance. Aging has been shown to be associated with the changes in circadian rhythmicity of melatonin production, which can be a major factor contributing to the impaired balance between phagocytosis and clearance and increased levels of reactive oxygen species resulting in degenerative changes in the retina. This minireview summarizes studies linking AMD with melatonin production and discusses challenges and perspectives of this area of research.
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Views of ophthalmologists on the genetics of age-related macular degeneration: Results of a qualitative study. PLoS One 2018; 13:e0209328. [PMID: 30571778 PMCID: PMC6301605 DOI: 10.1371/journal.pone.0209328] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 12/04/2018] [Indexed: 02/06/2023] Open
Abstract
Background Age-related macular degeneration (AMD) is the leading cause of blindness in industrialized countries. It is a multifactorial disease of the retina modified by environmental/individual (e.g. smoking) and genetic factors. 34 independent genomic loci are associated with the risk to develop AMD; an interaction between smoking and genetics is currently investigated. It is unclear how the knowledge on the strong genetic component has entered the knowledge base of practicing ophthalmologists, and how they inform and counsel their (AMD) patients about it. In this study, we explore the ophthalmologists’ view on AMD genetics, and their inclination towards communicating genetic risks to patients. Methods We recruited a purposive sample of thirty German ophthalmologists (office based: n = 15, hospital employees: n = 15, f:8/30), who took part in a recorded semi-standardized interview. Transcripts were analyzed using content analysis. Results The majority of office-based ophthalmologists claimed to be unfamiliar with genetics of AMD, in contrast to hospital-affiliated ophthalmologists. Both office and hospital ophthalmologists were convinced that genetics lacks practical relevance in everyday patient care. Many withhold information on heritability or genetic background of AMD from patients and their relatives, for fear of unsettling those individuals. The relevance of the genetic component of AMD or an individuals’ high genetic risk for prevention, e.g. screening or lifestyle modifications in persons with adverse genetic profile, was rated low. Conclusion Developing genetic educational programs tailored to the routine care of ophthalmologists may be indicated, as well as a better two-way communication between research and practice. Exploring patient views about their expectations to being informed about genetic disease etiology, or about their individual risk, would help inform communication strategies.
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Roizenblatt M, Naranjit N, Maia M, Gehlbach PL. The Question of a Role for Statins in Age-Related Macular Degeneration. Int J Mol Sci 2018; 19:ijms19113688. [PMID: 30469381 PMCID: PMC6274767 DOI: 10.3390/ijms19113688] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 01/22/2023] Open
Abstract
Age-related macular degeneration (AMD) is the leading cause of irreversible central vision loss in patients over the age of 65 years in industrialized countries. Epidemiologic studies suggest that high dietary fat intake is a risk factor for the development and progression of both vascular and retinal disease. These, and other associations, suggest a hypothesis linking elevated cholesterol and AMD progression. It follows, therefore, that cholesterol-lowering medications, such as statins, may influence the onset and progression of AMD. However, the findings have been inconclusive as to whether statins play a role in AMD. Due to the significant public health implications of a potential inhibitory effect of statins on the onset and progression of AMD, it is important to continually evaluate emerging findings germane to this question.
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Affiliation(s)
- Marina Roizenblatt
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
- Department of Ophthalmology, Federal University of São Paulo, São Paulo 04023-062, Brazil.
- Vision Institute, IPEPO, Department of Ophthalmology, Paulista Medical School, Federal University of São Paulo, São Paulo 04038-032, Brazil.
| | - Nara Naranjit
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
| | - Mauricio Maia
- Department of Ophthalmology, Federal University of São Paulo, São Paulo 04023-062, Brazil.
- Vision Institute, IPEPO, Department of Ophthalmology, Paulista Medical School, Federal University of São Paulo, São Paulo 04038-032, Brazil.
| | - Peter L Gehlbach
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Arya M, Sabrosa AS, Duker JS, Waheed NK. Choriocapillaris changes in dry age-related macular degeneration and geographic atrophy: a review. EYE AND VISION 2018; 5:22. [PMID: 30238015 PMCID: PMC6138930 DOI: 10.1186/s40662-018-0118-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/29/2018] [Indexed: 01/16/2023]
Abstract
Age-related macular degeneration (AMD) is a leading cause of central vision loss worldwide. The progression of dry AMD from early to intermediate stages is primarily characterized by increasing drusen formation and adverse impact on outer retinal cells. Late stage AMD consists of either geographic atrophy (GA), the non-exudative (dry) AMD subtype, or choroidal neovascularization, the exudative (wet) AMD subtype. GA is characterized by outer retinal and choroidal atrophy, specifically the photoreceptor layer, RPE, and choriocapillaris. Much remains to be discovered regarding the pathogenesis of AMD progression and subsequent development of GA. As the functionality of all three layers is closely linked, the temporal sequence of events that end up in atrophy is important in the understanding of the pathogenic pathway of the disease. The advent of OCTA, and particularly of swept-source technology, has allowed for depth-resolved imaging of retinal vasculature and the choriocapillaris. With the use of OCTA, recent studies demonstrate that choriocapillaris flow alterations are closely associated with the development and progression of AMD. Such changes may even possibly offer predictive value in determining progression of GA. This article reviews studies demonstrating choriocapillaris changes in dry AMD and summarizes the existing literature on the potential role of the choriocapillaris as a key factor in the pathogenesis of AMD.
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Affiliation(s)
- Malvika Arya
- 1New England Eye Center, Tufts Medical Center, Boston, MA USA.,Institude of Ophthalmology, Rio de Janeiro, Brazil
| | - Almyr S Sabrosa
- 1New England Eye Center, Tufts Medical Center, Boston, MA USA.,Institude of Ophthalmology, Rio de Janeiro, Brazil
| | - Jay S Duker
- 1New England Eye Center, Tufts Medical Center, Boston, MA USA
| | - Nadia K Waheed
- 1New England Eye Center, Tufts Medical Center, Boston, MA USA
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Hodge R, Narayanavari SA, Izsvák Z, Ivics Z. Wide Awake and Ready to Move: 20 Years of Non-Viral Therapeutic Genome Engineering with the Sleeping Beauty Transposon System. Hum Gene Ther 2018; 28:842-855. [PMID: 28870121 DOI: 10.1089/hum.2017.130] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gene therapies will only become a widespread tool in the clinical treatment of human diseases with the advent of gene transfer vectors that integrate genetic information stably, safely, effectively, and economically. Two decades after the discovery of the Sleeping Beauty (SB) transposon, it has been transformed into a vector system that is fulfilling these requirements. SB may well overcome some of the limitations associated with viral gene transfer vectors and transient non-viral gene delivery approaches that are being used in the majority of ongoing clinical trials. The SB system has achieved a high level of stable gene transfer and sustained transgene expression in multiple primary human somatic cell types, representing crucial steps that may permit its clinical use in the near future. This article reviews the most important aspects of SB as a tool for gene therapy, including aspects of its vectorization and genomic integration. As an illustration, the clinical development of the SB system toward gene therapy of age-related macular degeneration and cancer immunotherapy is highlighted.
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Affiliation(s)
- Russ Hodge
- 1 Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) , Berlin, Germany
| | - Suneel A Narayanavari
- 1 Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) , Berlin, Germany
| | - Zsuzsanna Izsvák
- 1 Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) , Berlin, Germany
| | - Zoltán Ivics
- 2 Division of Medical Biotechnology, Paul Ehrlich Institute , Langen, Germany
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Automated Segmentation of Lesions Including Subretinal Hyperreflective Material in Neovascular Age-related Macular Degeneration. Am J Ophthalmol 2018; 191:64-75. [PMID: 29655643 DOI: 10.1016/j.ajo.2018.04.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/31/2018] [Accepted: 04/04/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate an automated segmentation algorithm with a convolutional neural network (CNN) to quantify and detect intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelial detachment (PED), and subretinal hyperreflective material (SHRM) through analyses of spectral-domain optical coherence tomography (SD-OCT) images from patients with neovascular age-related macular degeneration (nAMD). DESIGN Reliability and validity analysis of a diagnostic tool. METHODS We constructed a dataset including 930 B-scans from 93 eyes of 93 patients with nAMD. A CNN-based deep neural network was trained using 11 550 augmented images derived from 550 B-scans. The performance of the trained network was evaluated using a validation set including 140 B-scans and a test set of 240 B-scans. The Dice coefficient, positive predictive value (PPV), sensitivity, relative area difference (RAD), and intraclass correlation coefficient (ICC) were used to evaluate segmentation and detection performance. RESULTS Good agreement was observed for both segmentation and detection of lesions between the trained network and clinicians. The Dice coefficients for segmentation of IRF, SRF, SHRM, and PED were 0.78, 0.82, 0.75, and 0.80, respectively; the PPVs were 0.79, 0.80, 0.75, and 0.80, respectively; and the sensitivities were 0.77, 0.84, 0.73, and 0.81, respectively. The RADs were -4.32%, -10.29%, 4.13%, and 0.34%, respectively, and the ICCs were 0.98, 0.98, 0.97, and 0.98, respectively. All lesions were detected with high PPVs (range 0.94-0.99) and sensitivities (range 0.97-0.99). CONCLUSIONS A CNN-based network provides clinicians with quantitative data regarding nAMD through automatic segmentation and detection of pathologic lesions, including IRF, SRF, PED, and SHRM.
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