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Larrousse Morellón M, López Loureiro Y, Ruiz Bilbao S. [Retinal venous occlusion and its association with atherosclerotic vascular disease]. Med Clin (Barc) 2024; 163:199-207. [PMID: 38714470 DOI: 10.1016/j.medcli.2024.01.048] [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: 11/08/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 05/10/2024]
Abstract
Retinal venous occlusion (RVO) is the second most frequent cause of decreased visual acuity due to retinal vascular, after diabetic retinopathy. Its etiology is not completely clear. Current scientific evidence suggests that it is related to the atherosclerotic process given the high number of cardiovascular risk factors and the higher incidence of cardiovascular events in these patients. In fact, RVO implies a 45% higher risk of stroke, 26% of acute myocardial infarction and peripheral vascular disease, 53% of heart failure and 36% of overall mortality, compared to the general population adjusted for age, sex and the different cardiovascular risk factors. However, no increase in cardiovascular mortality has been detected. Therefore, a multidisciplinary clinical approach to this pathology is essential.
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Affiliation(s)
- María Larrousse Morellón
- Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
| | - Yéssica López Loureiro
- Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - Susana Ruiz Bilbao
- Servicio de Oftalmología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
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Si S, Lin J, Guo R, Chen A, Ji Y. Impact of high-risk optic disc on central retinal vein occlusion in patients with metabolic disorders. Front Physiol 2024; 15:1424144. [PMID: 39210970 PMCID: PMC11358100 DOI: 10.3389/fphys.2024.1424144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 08/06/2024] [Indexed: 09/04/2024] Open
Abstract
Purpose To evaluate the impact of high-risk optic disc (HROD) on central retinal vein occlusion (CRVO) in patients with metabolic disorder(s). Design Retrospective case-control study. Methods A case-control study involving CRVO patients with metabolic disorder(s) was performed. PART I. All eligible patients with CRVO were included in CRVO group, and a similar number of patients with metabolic disorder(s) without CRVO were matched by sex, age and blood glucose level in the non-CRVO group. Various parameters were compared between groups. The impact of risk factors associated with CRVO was presented as odds ratios (ORs) and 95% confidence interval (95% CI). PART II. All eyes with CRVO that underwent intravitreal treatment (IVT) with a follow-up duration of ≥1 year were divided into non-HROD and HROD groups, and the differences between the two groups were compared. Results In PART I, a total of 45 and 63 eyes were enrolled in the CRVO and non-CRVO groups, respectively, with a significant statistical difference in HROD (51.16% vs 26.98%, p = 0.010) between them. In further multivariate regression analysis, HROD was the independent risk factor for CRVO (OR = 5.036, 95% CI 1.847-13.729, p = 0.002). In PART II, demographic, follow-up information, treatment, and prognosis showed no significant statistical difference between the two groups (all p > 0.05). Conclusion HROD was likely to be an independent risk factor for CRVO occurrence in patients with metabolic disorder(s), but it did not affect the treatment and prognosis of CRVO eyes with HROD.
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Affiliation(s)
- Shancheng Si
- Eye Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jiateng Lin
- Department of Ophthalmology, Rongcheng Eye Hospital, Rongcheng, China
| | - Rong Guo
- Endocrine Department, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Anming Chen
- Eye Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yicong Ji
- Eye Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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3
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Daneshvar K, Akhlaghi M, Iranpour S, Irajpour M, Pourazizi M. Vitamin D deficiency in patients with retinal vein occlusion: a systematic review and meta-analysis. Int J Retina Vitreous 2024; 10:52. [PMID: 39068491 PMCID: PMC11282712 DOI: 10.1186/s40942-024-00571-3] [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: 06/03/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND This review aims to substantiate the correlation between vitamin D and retinal vein occlusion (RVO) within the medical literature. METHOD A systematic review and meta-analysis were conducted in PubMed, SCOPUS, Web of Science, and Embase until December 10th, 2023. A meticulous literature search was undertaken to identify and analyze all observational-analytical papers reporting vitamin D levels in RVO patients. The principal outcome measures centered on the comparative assessment of vitamin D levels between patients with RVO (cases) and those devoid of RVO (controls). The protocol was registered in PROSPERO (code: CRD42024499853). RESULTS A total of six relevant studies consisting of 589 participants were included in this meta-analysis. The results indicated a significant association between vitamin D deficiency and increased risk of RVO (Odds ratio = 14.51; 95% CI: [1.71, 122.59], P = 0.014); and patients with RVO exhibited a significant decrease in serum vitamin D levels by 1.91ng/mL (95% CI: [-2.29, -1.54], P < 0.001). Moreover, there was no significant difference observed in vitamin D levels between central RVO (CRVO) and branch RVO (BRVO) subtypes (P = 0.63). CONCLUSION RVO patients have more vitamin D deficiency than healthy controls. These results contribute to the growing body of evidence highlighting the intricate role of vitamin D supplementation as both a prophylactic and a treatment strategy in RVO. PROSPERO REGISTRATION IDENTIFIER CRD42024499853.
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Affiliation(s)
- Kimia Daneshvar
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Akhlaghi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shila Iranpour
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Matin Irajpour
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Ophthalmology, Feiz Hospital, Modares St, Isfahan, Iran.
| | - Mohsen Pourazizi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Ophthalmology, Feiz Hospital, Modares St, Isfahan, Iran.
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Aslan Sirakaya H, Sirakaya E. Association of triglyceride‑glucose index in branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 2024; 262:2067-2072. [PMID: 38300335 PMCID: PMC11222183 DOI: 10.1007/s00417-024-06376-2] [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: 10/22/2023] [Revised: 12/09/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND To investigate the association between the triglyceride-glucose (TyG) index and newly diagnosed branch retinal vein occlusion (BRVO) in patients. METHODS The study included 57 individuals with BRVO and a control group comprising 50 healthy volunteers matched for age and gender. Detailed eye examinations were conducted, and various blood biochemistry and hematological parameters were recorded. The TyG index was calculated using fasting plasma glucose and triglyceride values. RESULTS The mean age was 61.4 ± 9.6 years for the BRVO group and 60.6 ± 10.3 years for the control group. The TyG values were significantly higher in the BRVO group when compared to the control group (8.84 ± 0.41 vs. 8.52 ± 0.29, p < 0.001). Multivariate analysis revealed that the TyG index independently predicted BRVO (odds ratio = 2.58, 95% confidence interval = 1.69-3.93; p < 0.001). In receiver operating characteristics analysis, the TyG index had an area under the curve of 0.749, and a TyG index higher than 8.52 predicted BRVO with 83% sensitivity and 70% specificity. CONCLUSIONS This study establishes a significant association between an elevated TyG index and BRVO. Consequently, the TyG index could serve as a valuable predictive tool for identifying individuals at risk for BRVO.
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Affiliation(s)
- Hatice Aslan Sirakaya
- Department of Internal Medicine, Health Science University, The Kayseri City Hospital, Kayseri, Turkey.
| | - Ender Sirakaya
- Department of Ophthalmology, Health Science University, The Kayseri City Hospital, Kayseri, Turkey
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Yao Y, Wang Q, Yang J, Yan Y, Wei W. Prevalence and risk factors of retinal vein occlusion in individuals with diabetes: The kailuan eye study. Diab Vasc Dis Res 2024; 21:14791641241271899. [PMID: 39105547 PMCID: PMC11304485 DOI: 10.1177/14791641241271899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024] Open
Abstract
PURPOSE The aim of this study was to analyze the incidence of retinal vein occlusion (RVO) in patients with and without diabetes in the population and compare the influencing factors. METHOD The community-based Kailuan Eye Study included 14,440 participants (9835 male, 4605 female) with a mean age of 54.0 ± 13.3 years (range, 20-110 years). They underwent a systemic and ophthalmologic examination. RVO were diagnosed on fundus photographs. RESULT By matching for age and gender, we included a total of 2767 patients each with diabetes and non-diabetes. The prevalence of RVO among patients with and without diabetes was 1.5% and 0.8%, respectively. The prevalence of RVO was higher in patients with diabetes than in patients without diabetes in all age groups. Multifactorial regression analysis showed that only fasting blood glucose levels were significantly different between patients with RVO with or without DM. The occurrence of RVO in the group with diabetes was mainly associated with higher fasting glucose and systolic blood pressure; in the group without diabetes, RVO was mainly associated with higher diastolic blood pressure, Body Mass Index, and lower low-density lipoprotein cholesterol levels. CONCLUSION We found that patients with diabetes have increased risks of RVO. In addition to blood pressure control, we recommend educating patients with diabetes about RVO, to prevent its subsequent occurrence.
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Affiliation(s)
- Yao Yao
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Qian Wang
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Jingyan Yang
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Yanni Yan
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing Tongren Hospital, Beijing, China
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Galvez-Olortegui J, Bouchikh-El Jarroudi R, Silva-Ocas I, Palacios-Herrera H, Cubillas-Martin M, Zavaleta-Mercado M, Burgueño-Montañes C, Galvez-Olortegui T. Systematic review of clinical practice guidelines for the diagnosis and management of retinal vein occlusion. Eye (Lond) 2024; 38:1722-1733. [PMID: 38467863 PMCID: PMC11156943 DOI: 10.1038/s41433-024-03008-1] [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: 09/13/2023] [Revised: 02/08/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND/OBJECTIVES To assess the methodological quality of Clinical Practice Guidelines (CPG) for the diagnosis and management of Retinal Vein Occlusion (RVO). METHODS A systematic review of CPGs for the diagnosis and management of RVO was carried out with a search in databases, metasearch engines, CPG development institutions, ophthalmology associations and CPG repositories until April 2022. Search update was performed on April 2023, with no new record available. Five CPGs published in the last 10 years in English/Spanish were selected, and 5 authors evaluated them independently, using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument. An individual assessment of each CPG by domain (AGREE-II), an overall assessment of the guide, and its use with or without modifications were performed. Additionally, a meta-synthesis of the recommendations for the most relevant outcomes was carried out. RESULTS The lowest score (mean 18.8%) was for domain 5 'applicability', and the highest score (mean 62%) was for domain 4 'clarity of presentation'. The 2019 American guideline (PPP) presented the best score (40.4%) in domain 3 'rigour of development'. When evaluating the overall quality of the CPGs analysed, all CPGs could be recommended with modifications. In the meta-synthesis, anti-VEGF therapy is the first-choice therapy for macular oedema associated with RVO, but there is no clear recommendation about the type of anti-VEGF therapy to choose. Recommendations for diagnosis and follow-up are similar among the CPGs appraised. CONCLUSION Most CPGs for the diagnosis and management of RVO have a low methodological quality assessed according to the AGREE-II. PPP has the higher score in the domain 'rigour of development'. Among the CPGs appraised, there is no clear recommendation on the type of anti-VEGF therapy to choose.
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Affiliation(s)
- Jose Galvez-Olortegui
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru.
- Service of Ophthalmology, Hospital Universitario Central de Asturias, Oviedo, Spain.
- Universidad Nacional de Tumbes, Tumbes, Peru.
| | - Rachid Bouchikh-El Jarroudi
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Service of Ophthalmology, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
- Department of Surgery, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - Isabel Silva-Ocas
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Centro de Excelencia en Glaucoma, Clinica GO-Vision, Lima, Peru
| | - Hector Palacios-Herrera
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Servicio de Retina y Vitreo, EP Oftalmólogos asociados, Lima, Peru
| | | | - Miguel Zavaleta-Mercado
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Instituto de Investigaciones Oftalmológicas y Ciencias Visuales Avanzadas Zavaleta Mercado (Innovaz), Oruro, Bolivia
| | - Carmen Burgueño-Montañes
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Service of Ophthalmology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Tomas Galvez-Olortegui
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Centro de Excelencia en Glaucoma, Clinica GO-Vision, Lima, Peru
- Department of Ophthalmology, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru
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Malvasi M, Compagno S, Segnalini A, Malvasi VM, Pacella F, Turchetti P, Pacella E. Effectiveness of Mp-3 Microperimetric Biofeedback Fixation Training For Low Vision Rehabilitation in Patients Treated With Corticosteroid Ivt in Retinal Vein Occlusions. CLINICAL OPTOMETRY 2024; 16:131-142. [PMID: 38798785 PMCID: PMC11128221 DOI: 10.2147/opto.s460999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024]
Abstract
Background The success of fixation training using microperimetric biofeedback (MP-3 MBFT) in the realm of visual rehabilitation for patients with central vision loss caused by macular pathologies is well established. This study aimed to assess the effectiveness and safety of visual rehabilitation with microperimetric biofeedback in consolidating the benefits obtained, with the goal of reducing the need for repeated intravitreal injections (IVT). Specifically, the focus is on the eyes of patients with central vision loss treated with slow-release corticosteroid IVT following retinal venous thrombosis (RVO), aiming to enhance and maintain postoperative efficacy. Methods This retrospective review involved the examination of 44 eyes affected by macular edema due to RVO associated with central vision loss. Patients were divided into two groups, with only one undergoing ten sessions of 10-minute visual rehabilitation with a microperimeter (MP-3 MBFT) after IVT over a period of 20 weeks. Results All the treated patients demonstrated good tolerance to the procedure, with no reported complications. A comparison of best-corrected visual acuity (BCVA), retinal sensitivity recorded with a microperimeter, and pre-IVT fixation stability revealed statistically significant improvements at the end of the first month after IVT. However, the treatment group continued to exhibit superior and more enduring results at four months post-IV. Conclusion The synergistic use of MP-3 MBFT rehabilitation after IVT with slow-release corticosteroids has proven particularly effective in improving BCVA and long-term fixation stability. This led to a significant reduction in the number of required IVTs, with no related adverse events. The authors argue that biofeedback utilization represents a noninvasive therapeutic option devoid of contraindications and easy to implement and that it positively contributes to the overall patient experience regarding quality of life in advanced stages of macular diseases.
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Affiliation(s)
- Mariaelena Malvasi
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Sabrina Compagno
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Alessandro Segnalini
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Vito Maurizio Malvasi
- Department of Odontostomatological and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Paolo Turchetti
- National Institute for Health, Migration and Poverty (INMP/NIHMP), Rome, Italy
| | - Elena Pacella
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
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Lee JH, Kim SH, Kim E. Influence of Smoking and Controlled Medical Conditions on the Risks of Branch Retinal Vein Occlusion in South Korea: A Population-Based Study. Ophthalmic Epidemiol 2024:1-8. [PMID: 38507597 DOI: 10.1080/09286586.2024.2321902] [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: 11/06/2023] [Accepted: 02/18/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE To evaluate the effect of controlled medical conditions and risk of lifetime smoking history on the prevalence of branch retinal vein occlusion (BRVO) based on the Korea National Health and Nutrition Survey (KNHANES) database from 2017-2021. METHODS The study population consisted of individuals aged ≥ 40 years who had completed ophthalmological questionnaires, underwent comprehensive ophthalmological examinations, and had at least one good-quality readable fundus photograph. Age, sex, hypertension status, diabetes status, dyslipidemia status, body mass index status, a history of chronic kidney disease (CKD), a lifetime smoking history of ≥ 100 cigarettes, and glaucoma were subjected to univariate and multivariate logistic regression analyses. RESULTS The estimated prevalence (± standard error) of RVO was 0.5% (±0.1%). Significant risk factors were one-year increase in age, female sex, hypertension (stage 1, controlled, uncontrolled, and undiagnosed hypertension), underweight, pre-obesity, history of CKD, lifetime smoking history of ≥ 100 cigarettes, and glaucoma. Controlled diabetes decreased the risk of BRVO by 55% (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.22-0.89, p = 0.022) and controlled hyper-high-density-lipoprotein (HDL)-cholesterolemia decreased the risk by 69% (OR = 0.31, 95% CI = 0.13-0.76, p = 0.010). CONCLUSION This study, for the first time, reported the association between lifetime smoking history of ≥ 100 cigarettes and BRVO in Korea. The risk of BRVO was lower in participants with controlled diabetes and hypo-HDL-cholesterolemia.
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Affiliation(s)
- Jung Hoo Lee
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Seong Ho Kim
- Kim's Eye Hospital of Konyang University, Seoul, South Korea
| | - EunAh Kim
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
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Díaz DE Terán T, González P, González M, Cerveró A, Nicolini A, Banfi P, Solidoro P, Napal JJ, Valero C. Risk factors in developing retinal vein occlusion in subject with obstructive sleep apnea. Minerva Med 2023; 114:825-831. [PMID: 35315633 DOI: 10.23736/s0026-4806.22.07989-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Patients with obstructive sleep apnea (OSA) have a higher risk of developing vascular diseases. In this study, we evaluated the clinical profile of patients with OSA who develop retinal vein occlusion (RVO) compared with a population of OSA patients without RVO. METHODS We analyzed patients with OSA diagnosed with RVO (21 cases; mean of age 61 years. range 44-87 years. 67% men), belonging to a large cohort of people with long-term follow-up for RVO (up to 12 years). We compared them with 21 patients with OSA, without RVO, matched by age and gender, selected from the Sleep Unit Registry (control group). RESULTS There were no differences in the prevalence of arterial hypertension (AHT) or Diabetes mellitus (DM), but the RVO patients presented a higher diastolic blood pressure compared to controls (87.6±12.6 mmHg vs. 77.9±10.1 mmHg respectively). The polygraphic parameters were similar in both groups. The Apnea-Hypopnea Index (IHA) similar in both groups (30.4±20.9 RVO vs. 33.7±22.1 controls). In addition, RVO patients had a less favorable lipid profile, with higher total cholesterol (218±52 mg/dL vs. 179±41 mg/dL), higher LDL cholesterol (139±47 mg/dL vs. 107±32 mg/dL) and higher atherogenic indices: LDL/HDL (2.78±0.95 RVO vs. 2.03±0.67 controls) and total cholesterol/HDL (4.37±1.08 vs. 3.45±0.84). Among the cases, 81% had peripheral RVO (superior temporal branch in 20 out of 21 cases) and 19% had central RVO. A percentage of 62% of the cases received intravitreal antiangiogenic therapy and dexamethasone implants and 33% received argon laser photocoagulation. CONCLUSIONS Poor control of cardiovascular risk factors, particularly dyslipidemias, in patients with OSA may lead to the development of this ocular complication.
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Affiliation(s)
- Teresa Díaz DE Terán
- Department of Internal Medicine, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Cantabria University, Santander, Spain
| | - Paula González
- Department of Internal Medicine, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Cantabria University, Santander, Spain
| | - Mónica González
- Department of Internal Medicine, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Cantabria University, Santander, Spain
| | - Andrea Cerveró
- Department of Ophthalmology, Marqués de Valdecilla University Hospital, Santander, Spain
| | | | | | - Paolo Solidoro
- Division of Respiratory Diseases, Department of Cardiovascular and Thoracic Medicine, Città della Salute e della Scienza, Turin, Italy
| | - José J Napal
- Department of Internal Medicine, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Cantabria University, Santander, Spain
| | - Carmen Valero
- Department of Internal Medicine, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Cantabria University, Santander, Spain -
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Zhang JT, Cui S, Li Q, Li JR, Zhang YF, Zheng YH. Sleep-disordered breathing is related to retinal vein occlusion: A meta-analysis. Medicine (Baltimore) 2023; 102:e35411. [PMID: 37832067 PMCID: PMC10578690 DOI: 10.1097/md.0000000000035411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/05/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Previous studies suggest that sleep-disordered breathing (SDB) may be a potential risk factor of retinal vein occlusion (RVO). We conducted a meta-analysis to systematically explore the relationship between RVO and SDB. METHODS Observational studies assessing the relationship between SDB and RVO were retrieved by searches of electronic databases including the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wan Fang databases from database inception to August 9, 2023. In consideration of intra-study heterogeneity, a random-effects model was adopted to combine the results. RESULTS Seven studies (1 retrospective cohort and 6 case-control studies) were included in this meta-analysis, and among 36,628 adults included in those studies, 6452 (17.6%) had SDB. The combined results indicated that SDB was associated with RVO [risk ratio (RR): 1.92, 95% confidence interval (CI): 1.60-2.30, P < .001] with no significant heterogeneity (I2 = 0%). Subgroup analyses showed consistent relationships between SDB and any RVO (RR: 1.73, 95% CI: 1.13-2.28, P < .001), central RVO (RR: 2.20, 95% CI: 1.57-3.08, P < .001), and branch RVO (RR: 1.85, 95% CI: 1.15-2.99, P = .01). Moreover, the relationship was consistent among patients with mild (RR: 1.82, 95% CI: 1.32-2.53, P < .001), moderate (RR: 2.17, 95% CI: 1.65-2.85, P < .001), and severe SDB (RR: 2.66, 95% CI: 1.96-3.62, P < .001). The association was consistent in studies that adjusted for age and sex (RR: 2.17, 95% CI: 1.50-3.13, P < .001), and in studies with additional adjustment for comorbidities (RR: 1.78, 95% CI: 1.42-2.25, P < .001). CONCLUSION SDB is associated with RVO in adults.
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Affiliation(s)
- Jun-Tao Zhang
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Sha Cui
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Qin Li
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Jin-Rong Li
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Yan-Fang Zhang
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Yan-Huang Zheng
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
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Wang H, Wang C, Zhang S, Liu J, Bi X. Impact of anti-VEGF therapy on distinctive retina layers in patients with macular edema secondary to branch retinal vein occlusion. BMC Ophthalmol 2023; 23:235. [PMID: 37231357 DOI: 10.1186/s12886-023-02981-7] [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: 10/08/2022] [Accepted: 05/18/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND To explore the impact of anti-vascular epithelial growth factor (ant-VEGF) on the thickness of each retinal layer in patients with macular edema (ME) secondary to the branch retinal vein occlusion (BRVO). METHODS This retrospective study included patients with ME secondary to monocular BRVO who received anti-VEGF therapy in Ningxia Eye Hospital between January-December 2020. RESULTS Forty-three patients (25 males) were included, with 31 showed > 25% reduction in central retinal thickness (CRT) after anti-VEGF therapy (response group), and the others showed a ≤25% reduction in CRT (no-response group). The response group showed significantly smaller mean changes in the ganglion cell layer (GCL) (after 2 months) and inner plexiform layer (IPL) (after 1, 2, and 3 months) and significantly greater mean changes in the inner nuclear layer (INL) (after 2 and 3 months), outer plexiform layer (OPL) (after 3 months), outer nuclear layer (ONL) (after 2 and 3 months), and CRT (after 1 and 2 months) (all P < 0.05) as compared to the no-response group. The mean change in the thickness of each retinal layer IPL (P = 0.006) between the two groups was significantly different after controlling for a time and with a significant time trend (P < 0.001). Additionally, patients in the response group were more likely to have an improvement in IPL (43.68 ± 6.01 at 1 month and 41.52 ± 5.45 at 2 months vs. 39.9 ± 6.86 at baseline) after anti-VEGF therapy, while those in no response group might show improvement in GCL (45.75 ± 8.24 at 1 month, 40.00 ± 8.92 at 2 months, and 38.83 ± 9.93 at 3 months vs. 49.67 ± 6.83 at baseline). CONCLUSIONS Anti-VEGF therapy might help restore the retinal structure and function in patients with ME secondary to BRVO, and those who have a response after anti-VEGF therapy are more likely to improve IPL, while those having no response might show improvement in GCL.
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Affiliation(s)
- Hui Wang
- Ophthalmology Center of Changzhi People's Hospital affiliated to Changzhi Medical College, Changzhi City, China
| | - Chanjuan Wang
- Ningxia Eye Hospital, People Hospital of Ningxia Hui Autonomous Region (First Affiliated Hospital of Northwest University for Nationalities), Yinchuan, 750000, China
| | - Shaochi Zhang
- Ningxia Eye Hospital, People Hospital of Ningxia Hui Autonomous Region (First Affiliated Hospital of Northwest University for Nationalities), Yinchuan, 750000, China
| | - Jun Liu
- Ophthalmology Center of Changzhi People's Hospital affiliated to Changzhi Medical College, Changzhi City, China
| | - Xiaojun Bi
- Ningxia Eye Hospital, People Hospital of Ningxia Hui Autonomous Region (First Affiliated Hospital of Northwest University for Nationalities), Yinchuan, 750000, China.
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12
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Huang J. Mendelian randomization indicates a causal contribution of type 2 diabetes to retinal vein occlusion. Front Endocrinol (Lausanne) 2023; 14:1146185. [PMID: 37223029 PMCID: PMC10200935 DOI: 10.3389/fendo.2023.1146185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/05/2023] [Indexed: 05/25/2023] Open
Abstract
Background Retinal vein occlusion (RVO) is a common retinal vascular disease that can cause severe visual impairment. Many observational studies have shown that type 2 diabetes (T2DM) is associated with RVO, but it remains unknown if the association is causal. The present study aimed to perform Mendelian randomization (MR) analyses to evaluate the causal contribution of genetically predicted T2DM to RVO. Methods We obtained summary-level data from a genome-wide association study meta-analysis including 48,286 cases and 250,671 controls for T2DM and from a genome wide association study of 372 cases and 182,573 controls in the FinnGen project for RVO. To verify the robustness of the results, an independent validation dataset for T2DM (12,931 cases and 57,196 controls) was used. In addition to the main MR analysis using the inverse variance weighted (fixed effect) approach, sensitivity analyses and multivariable MR adjusting for common risk factors of RVO were conducted. Results Genetically predicted T2DM was found to be causally associated with RVO risk (odds ratio (OR)=2.823, 95% confidence interval (CI): 2.072-3.847, P=4.868×10-11). This association was supported by sensitivity analyses using the weighted median (OR=2.415, 95% CI: 1.411-4.132, P=1.294×10-3), weighted mode (OR=2.370, 95% CI: 1.321-4.252, P=5.159×10-3), maximum likelihood (OR=2.871, 95% CI: 2.100-3.924, P=3.719×10-11), MR-PRESSO (OR=2.823, 95% CI: 2.135-3.733, P=5.150×10-10), and MR-Egger (OR=2.441, 95% CI: 1.149-5.184, P=2.335×10-2) methods. In addition, this association persisted in multivariable MR after accounting for common RVO risk factors (OR=1.748, 95% CI: 1.238-2.467, P=1.490×10-3). The MR analyses using the validation dataset obtained consistent results. Conclusion This study indicates that genetically predicted T2DM may have a causal contribution to RVO. Future studies are required to elucidate the underlying mechanisms.
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Mariadoss AVA, Park S, Saravanakumar K, Sathiyaseelan A, Wang MH. Phytochemical profiling, in vitro antioxidants, and antidiabetic efficacy of ethyl acetate fraction of Lespedeza cuneata on streptozotocin-induced diabetic rats. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:60976-60993. [PMID: 37042914 DOI: 10.1007/s11356-023-26412-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/08/2023] [Indexed: 05/10/2023]
Abstract
In the recent past, phytomolecules are exponentially applied in discovering the antidiabetic drug due to less adverse effects. This work screened the active solvent fraction of Lespedeza cuneata based on the phytochemical, enzyme inhibition, and antioxidant properties. The antioxidant efficacy of the different fractions of the L. cuneata was assessed by 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), ferric reducing power, hydrogen peroxide, and hydroxyl radical scavenging assays. The digestive enzyme (α-amylase and α-glucosidase) inhibitory activity was also evaluated. The phytochemical composition of ethyl acetate fraction of L. cuneata (Lc-EAF) was studied by UHPLC-QTOF-MS/MS. The effect of Lc-EAF treatments on glucose uptake was studied in insulin resistance HepG2 cells (IR-HepG2). Further, the antidiabetic effect of Lc-EAF in streptozotocin (STZ)-induced diabetic mice were demonstrated. Ethyl acetate, hexane, and methanol fractions of the L. cuneata showed notable antioxidant, α-amylase, and α-glucosidase inhibitory properties. Among the fractions, Lc-EAF was found to be the most potent. The Lc-EAF exhibited an IC50 of 205.32 ± 23.47 µg/mL and 105.32 ± 13.93 µg/mL for α-amylase and α-glucosidase inhibition, respectively. In addition, 75 µg/mL of Lc-EAF exposure enhanced glucose uptake (68.23%) in IR-HepG2 cells. In vivo study indicated that treatment of Lc-EAF (100 mg/kg b.wt) maintained the blood glucose level through reduced insulin level while improving the lipid profile, hepatic, and renal markers. These findings suggest that Lc-EAF could be considered a prominent source for antidiabetic, anti-hyperlipidemic, and anti-ROS potentials.
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Affiliation(s)
- Arokia Vijaya Anand Mariadoss
- Department of Bio-Health Convergence, Kangwon National University, Chuncheon, 200-701, Republic of Korea
- Department of Orthopaedic Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, 18450, Republic of Korea
| | - SeonJu Park
- Chuncheon Center, Korea Basic Science Institute (KBSI), Chuncheon, 24341, Republic of Korea
| | - Kandasamy Saravanakumar
- Department of Bio-Health Convergence, Kangwon National University, Chuncheon, 200-701, Republic of Korea
| | - Anbazhagan Sathiyaseelan
- Department of Bio-Health Convergence, Kangwon National University, Chuncheon, 200-701, Republic of Korea
| | - Myeong-Hyeon Wang
- Department of Bio-Health Convergence, Kangwon National University, Chuncheon, 200-701, Republic of Korea.
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14
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Zhao Y, Ma C, Qiu Q, Huang X, Qiaolongbatu X, Qu H, Wu J, Fan G, Wu Z. Exploring the components and mechanisms of Shen-qi-wang-mo granule in the treatment of retinal vein occlusion by UPLC-Triple TOF MS/MS and network pharmacology. Sci Rep 2023; 13:5330. [PMID: 37005436 PMCID: PMC10066998 DOI: 10.1038/s41598-023-32472-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/28/2023] [Indexed: 04/04/2023] Open
Abstract
This study aimed to explore the substance basis and mechanisms of Shen-qi-wang-mo Granule (SQWMG), a traditional Chinese medicine prescription that had been clinically utilized to treat retinal vein occlusion (RVO) for 38 years. Components in SQWMG were analyzed by UPLC-Triple-TOF/MS and a total of 63 components were identified with ganoderic acids (GA) being the largest proportion. Potential targets of active components were retrieved from SwissTargetPrediction. RVO-related targets were acquired from related disease databases. Core targets of SQWMG against RVO were acquired by overlapping the above targets. The 66 components (including 5 isomers) and 169 targets were obtained and concluded into a component-target network. Together with biological enrichment analysis of targets, it revealed the crucial role of the "PI3K-Akt signaling pathway", "MAPK signaling pathway" and their downstream factor iNOS and TNF-α. The 20 key targets of SQWMG in treating RVO were acquired from the network and pathway analysis. The effects of SQWMG on targets and pathways were validated by molecular docking based on AutoDock Vina and qPCR experiment. The molecular docking showed great affinity for these components and targets, especially on ganoderic acids (GA) and alisols (AS), which were both triterpenoids and qPCR exhibited remarkably reduced inflammatory factor gene expression through regulation of these two pathways. Finally, the key components were also identified from rat serum after treatment of SQWMG.
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Affiliation(s)
- Yi Zhao
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People's Republic of China
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, 200240, People's Republic of China
| | - Cui Ma
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People's Republic of China
| | - Qinghua Qiu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People's Republic of China
| | - Xucong Huang
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People's Republic of China
- School of Pharmacy, Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Xijier Qiaolongbatu
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, 200240, People's Republic of China
| | - Han Qu
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, 200240, People's Republic of China
| | - Jiaqi Wu
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People's Republic of China
| | - Guorong Fan
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People's Republic of China.
| | - Zhenghua Wu
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People's Republic of China.
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15
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Parmeggiani F. Are visual disturbances (excluding diabetic retinopathy) more common in geriatric DM patients? Are they risks factor for the progression of disability? JOURNAL OF GERONTOLOGY AND GERIATRICS 2021. [DOI: 10.36150/2499-6564-n452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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16
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Feldman-Billard S, Dupas B. Eye disorders other than diabetic retinopathy in patients with diabetes. DIABETES & METABOLISM 2021; 47:101279. [PMID: 34534696 DOI: 10.1016/j.diabet.2021.101279] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/18/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
AIM While diabetic retinopathy is the most specific complication of chronic hyperglycaemia, numerous other ocular conditions also can involve the eyes of people with diabetes. Cataract, glaucoma, age-related macular degeneration, retinal vascular occlusion, and acute ischaemic optic neuropathy combine to impair vision in people with diabetes, especially when they are old. This report provides a critical analysis and an overview of the current knowledge of the main ocular disorders (excluding diabetic retinopathy) and their association in patients with diabetes. METHODS A literature search strategy was conducted for all English-language literature with a systematic review of key references until 2021. RESULTS Patients with diabetes have a high-to-moderate increased risk for most of the usual ocular disorders we reviewed with the exception of age-related macular degeneration. Exposure to chronic hyperglycaemia promotes the development of many eye disorders while acute glucose changes are involved in refractive disorders, diabetic papillopathy and acute cataract. CONCLUSION Diabetes, beyond diabetic retinopathy, increases the risk of numerous eye disorders leading to low vision with implications for daily diabetes management. Even in the absence of clearly demonstrated benefit from glucose control in all eye conditions, achieving good glycaemic control and adherence to diabetes treatment will likely help avoid an additional risk of visual impairment in people with diabetes. In perspective, interesting findings suggesting a preventive effect of metformin use on age-related macular degeneration occurrence justify further studies.
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Affiliation(s)
- Sylvie Feldman-Billard
- Service de Médecine Interne, CHNO des Quinze-Vingts, 28 rue de Charenton, 75571 Paris Cedex 12, France.
| | - Bénédicte Dupas
- Centre Ophtalmologique Sorbonne Saint-Michel, Paris, France; Service d'Ophtalmologie, Hôpital Lariboisière, Paris, France
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Lee MK, Kim B, Han K, Lee JH, Kim M, Kim MK, Baek KH, Song KH, Kwon HS, Roh YJ. Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Retinal Vein Occlusion Among Patients With Type 2 Diabetes: A Propensity Score-Matched Cohort Study. Diabetes Care 2021; 44:dc203133. [PMID: 34301735 DOI: 10.2337/dc20-3133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/21/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess the association between use of sodium-glucose cotransporter 2 (SGLT2) inhibitors and retinal vein occlusion (RVO) using data from the National Health Insurance Service in South Korea. RESEARCH DESIGN AND METHODS We used an active comparator, new user design, and nationwide data from 2014 to 2017. Based on a 1:1 propensity score match, we included 47,369 new users of SGLT2 inhibitors and 47,369 users of other glucose-lowering drugs (oGLDs). In the matched sample, we used the Cox proportional hazards model to estimate hazard ratios (HRs) with 95% CIs for developing RVO. Based on the main outcome, exploratory subgroup analyses were undertaken. RESULTS During a follow-up of 2.57 years, the incidence rate of RVO was 2.19 and 1.79 per 1,000 person-years in patients treated with SGLT2 inhibitors and oGLDs, respectively. The new use of SGLT2 inhibitors was associated with an increased risk of RVO compared with oGLD use (HR 1.264 [95% CI 1.056, 1.513]). In the subgroup analyses, a significant interaction with SGLT2 inhibitors was observed for age and estimated glomerular filtration rate (eGFR); the HR for RVO was higher in patients aged ≥60 years and those with eGFR <60 mL/min/1.73 m2 than in others. CONCLUSIONS In a matched cohort study, we found that SGLT2 inhibitors were associated with a significantly increased risk of RVO. Older patients and those with chronic kidney disease were at higher risk for RVO.
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Affiliation(s)
- Min-Kyung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University Medical Center, Gyeonggi-do, Republic of Korea
| | - Bongsung Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jae-Hyuk Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University Medical Center, Gyeonggi-do, Republic of Korea
| | - Minhee Kim
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Ho Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Jung Roh
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Turczyńska MJ, Krajewski P, Brydak-Godowska JE. Wide-Field Fluorescein Angiography in the Diagnosis and Management of Retinal Vein Occlusion: A Retrospective Single-Center Study. Med Sci Monit 2021; 27:e927782. [PMID: 33449920 PMCID: PMC7814513 DOI: 10.12659/msm.927782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this retrospective study was to evaluate the role of wide-field fluorescein angiography (WF-FA) in the diagnosis and management of retinal vein occlusion (RVO) at a single center in Poland. Material/Methods This study included 106 patients (112 eyes) diagnosed with RVO (102 eyes) or impending RVO (10 eyes) (54% women and 46% men, aged 26 to 86 years). The medical records of the participants were reviewed in search of documentation on ocular and systemic diseases. Results of FA of central and peripheral retina and optical coherence tomography (OCT) scans, which had been used to establish treatment indications, were analyzed. WF-FA was performed with Spectralis HRA+OCT or Optos Tx200. Results Actual RVO was found in 102 eyes. Of those cases, 46.1% were CRVO (central retinal vein occlusion), 40.2% branch retinal vein occlusion, 11.8% small tributary vein occlusion, and 1.9% hemispheric retinal vein occlusion. Neovascularization on an optic disc, neovascularization elsewhere, and veno-venous collateral vessels were observed in 32.3%, 17.4%, and 41.2% of the eyes, respectively. Peripheral ischemic zones were present in 59.8% of the eyes, in 20.6% of which, ischemia was not observed in the posterior pole. Dye leaks limited to peripheral vessels, peripheral vascular amputations, and central macular edema in OCT were observed in 17.6%, 43.1%, and 63.7% of the eyes, respectively. Retinal laser photocoagulation was conducted on 73.5% of the eyes. Conclusions Decision-making about management of patients with RVO should be done after physical examination and analysis of central and peripheral retina FA. In 20.6% of patients, assessment of the peripheral retina resulted in a change in treatment. The first changes suggestive of progression of thrombotic disease to the ischemic form appeared on the periphery in images from WF-FA.
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Affiliation(s)
- Monika J Turczyńska
- Department of Ophthalmology, Infant Jesus Clinical Hospital, University Clinical Center, Medical University of Warsaw, Warsaw, Poland
| | - Przemysław Krajewski
- Department of Ophthalmology, Infant Jesus Clinical Hospital, University Clinical Center, Medical University of Warsaw, Warsaw, Poland
| | - Joanna E Brydak-Godowska
- Department of Ophthalmology, Infant Jesus Clinical Hospital, University Clinical Center, Medical University of Warsaw, Warsaw, Poland
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Araujo DB, Dantas JR, Silva KR, Souto DL, Pereira MDFC, Moreira JP, Luiz RR, Claudio-Da-Silva CS, Gabbay MAL, Dib SA, Couri CEB, Maiolino A, Rebelatto CLK, Daga DR, Senegaglia AC, Brofman PRS, Baptista LS, Oliveira JEP, Zajdenverg L, Rodacki M. Allogenic Adipose Tissue-Derived Stromal/Stem Cells and Vitamin D Supplementation in Patients With Recent-Onset Type 1 Diabetes Mellitus: A 3-Month Follow-Up Pilot Study. Front Immunol 2020; 11:993. [PMID: 32582156 PMCID: PMC7280537 DOI: 10.3389/fimmu.2020.00993] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/27/2020] [Indexed: 01/06/2023] Open
Abstract
Objective: To evaluate the short term safety and potential therapeutic effect of allogenic adipose tissue-derived stromal/stem cells (ASCs) + cholecalciferol in patients with recent-onset T1D. Methods: Prospective, phase II, open trial, pilot study in which patients with recent onset T1D received ASCs (1 × 106 cells/kg) and cholecalciferol 2000 UI/day for 3 months (group 1) and were compared to controls with standard insulin therapy (group 2). Adverse events, C-peptide (CP), insulin dose, HbA1c, time in range (TIR), glucose variability (continuous glucose monitoring) and frequency of CD4+FoxP3+ T-cells (flow cytometry) were evaluated at baseline (T0) and after 3 months (T3). Results: 13 patients were included (8: group 1; 5: group 2). Their mean age and disease duration were 26.7 ± 6.1 years and 2.9 ± 1.05 months. Adverse events were transient headache (n = 8), mild local reactions (n = 7), tachycardia (n = 4), abdominal cramps (n = 1), thrombophlebitis (n = 4), mild floaters (n = 2), central retinal vein occlusion (n = 1, complete resolution). At T3, group 1 had lower insulin requirement (0.22 ± 0.17 vs. 0.61±0.26IU/Kg; p = 0.01) and HbA1c (6.47 ± 0.86 vs. 7.48 ± 0.52%; p = 0.03) than group 2. In group 1, 2 patients became insulin free (for 4 and 8 weeks) and all were in honeymoon at T3 (vs. none in group 2; p = 0.01). CP variations did not differ between groups (−4.6 ± 29.1% vs. +2.3 ± 59.65%; p = 0.83). Conclusions: Allogenic ASCs + cholecalciferol without immunosuppression was associated with stability of CP and unanticipated mild transient adverse events in patients with recent onset T1D. ClinicalTrials.gov registration: NCT03920397.
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Affiliation(s)
- Debora B Araujo
- Federal University of Rio de Janeiro, Nutrology and Diabetes Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Joana R Dantas
- Federal University of Rio de Janeiro, Nutrology and Diabetes Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Karina R Silva
- Laboratory of Tissue Bioengineering, National Institute of Metrology, Quality and Technology (Inmetro), Rio de Janeiro, Brazil
| | - Débora L Souto
- Nutrology and Diabetes Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Jessica P Moreira
- Biostatistics Department, Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ronir R Luiz
- Biostatistics Department, Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Monica A L Gabbay
- Department of Stem Cell Therapy, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Sergio A Dib
- Department of Stem Cell Therapy, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Angelo Maiolino
- Hematology Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carmen L K Rebelatto
- Core Cell Technology, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | - Debora R Daga
- Core Cell Technology, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | | | - Paulo R S Brofman
- Surgical Clinic D at University of Sao Paulo, Core Cell Technology, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | - Leandra Santos Baptista
- Laboratory of Tissue Bioengineering, National Institute of Metrology, Quality and Technology (Inmetro), Rio de Janeiro, Brazil.,Multidisciplinary Center for Biological Research (Numpex-Bio), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - José E P Oliveira
- Nutrology and Diabetes Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lenita Zajdenverg
- Nutrology and Diabetes Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Melanie Rodacki
- Nutrology and Diabetes Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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