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Muhtaseb RE, Huther A, Alwreikat AM, Ramsey DJ. Optimizing open-angle glaucoma risk assessment in patients with retinal vein occlusions. Eye (Lond) 2024:10.1038/s41433-024-03205-y. [PMID: 38982301 DOI: 10.1038/s41433-024-03205-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 05/23/2024] [Accepted: 06/21/2024] [Indexed: 07/11/2024] Open
Abstract
PURPOSE To evaluate factors associated with the diagnosis of open-angle glaucoma (OAG) after a retinal vein occlusion (RVO). DESIGN Retrospective, cross-sectional study. METHODS Patients diagnosed with OAG after RVO were matched 2:1 with RVO patients without prior glaucoma. Logistic regression identified factors linked to OAG diagnosis. RESULTS Of 1178 RVO patients without initial OAG, 51 (4.5%) were later diagnosed with OAG after an average of 5.5 ± 6.1 years. Screening tests for OAG were performed at a higher frequency in patients diagnosed with OAG compared with patients who never received this diagnosis (visual field [VF] testing 21.6% versus 10.8% (P = 0.073) and retinal nerve fiber layer [RNFL] imaging 52.9% versus 27.4% (P = 0.002), respectively). At the time of the first VF obtained after RVO, mean deviation averaged -10.3 dB in the affected eyes, compared with -5.0 dB in the fellow eyes (P < 0.001); in contrast, RNFL thickness was similar between eyes at the time of OAG diagnosis (72 µm versus 74 µm, P = 0.290). Predictive factors for OAG diagnosis included higher intraocular pressure (IOP) and cup-to-disc ratio (CDR) in the unaffected eye, and the absence of macular edema in the RVO-affected eye (R2 = 0.375, P < 0.001). CONCLUSIONS OAG is a significant risk factor for RVO. Our study reveals a reciprocal relationship between RVO and the development of OAG, highlighting the need for glaucoma risk assessment in all patients with RVOs to avoid delays in diagnosis and vision loss from glaucoma.
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Affiliation(s)
- Ruba E Muhtaseb
- Lahey Department of Surgery, Division of Ophthalmology, UMass Chan Medical School, University of Massachusetts, Burlington, MA, 01805, USA
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, 02111, USA
| | - Alexander Huther
- Lahey Department of Surgery, Division of Ophthalmology, UMass Chan Medical School, University of Massachusetts, Burlington, MA, 01805, USA
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, 02111, USA
| | - Amer M Alwreikat
- Lahey Department of Surgery, Division of Ophthalmology, UMass Chan Medical School, University of Massachusetts, Burlington, MA, 01805, USA
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, 02111, USA
| | - David J Ramsey
- Lahey Department of Surgery, Division of Ophthalmology, UMass Chan Medical School, University of Massachusetts, Burlington, MA, 01805, USA.
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, 02111, USA.
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Cheng Y, Ren T, Wang N. Biomechanical homeostasis in ocular diseases: A mini-review. Front Public Health 2023; 11:1106728. [PMID: 36733902 PMCID: PMC9886686 DOI: 10.3389/fpubh.2023.1106728] [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: 11/24/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
Diabetes mellitus-induced hyperglycemia is responsible for multiple pathological ocular alternations from vasculopathy to biomechanical dyshomeostasis. Biomechanical homeostasis is crucial to maintain the normal physiological condition of the eyes. Biomechanical features vary in eye tissues regarding different anatomical positions, tissue components, and cellular functions. The disturbance in biomechanical homeostasis may result in different ocular diseases. In this review, we provide a preliminary sketch of the latest evidence on the mechano-environment of the eyeball and its possible influencing factors, thereby underscoring the relationship between the dyshomeostasis of ocular biomechanics and common eye diseases (e.g., diabetic retinopathy, keratoconus, glaucoma, spaceflight-associated neuro-ocular syndrome, retinal vein occlusion and myopia, etc.). Together with the reported evidence, we further discuss and postulate the potential role of biomechanical homeostasis in ophthalmic pathology. Some latest strategies to investigate the biomechanical properties in ocular diseases help unveil the pathological changes at multiple scales, offering references for making new diagnostic and treatment strategies targeting mechanobiology.
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Affiliation(s)
- Ying Cheng
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Tianmin Ren
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China,Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China,*Correspondence: Ningli Wang ✉
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Song MY, Kim JW, Kim CG, Kim JH. The Long-term Outcomes of Central Retinal Vein Occlusion and Factors Associated with Resolution of Macular Edema. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.8.682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To report the long-term outcomes of patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO) and to explore the ME incidence and factors associated with ME resolution.Methods: We retrospectively studied patients with ME secondary to CRVO. The visual acuity at baseline was compared to that at the final visit. The incidence and timing of ME resolution during treatment were evaluated and the visual outcomes of patients who did and did not experience ME resolution were compared. We also identified factors predictive of ME resolution.Results: We included 79 patients; the mean follow-up time was 50.1 ± 14.3 months. The mean logarithm of the minimal angle of resolution (logMAR) of visual acuity was 0.94 ± 0.75 at diagnosis and 1.00 ± 0.84 at the final visit (p = 1.000). A logMAR visual loss of 0.3 or greater was noted in 28 patients (35.4%). During follow-up, ME resolution was evident in 40 eyes (50.6%) at a mean of 16.9 ± 17.4 months. Visual improvement was greater in patients who evidenced ME resolution than in those who did not (p < 0.001). The ME resolution rate was higher in patients younger than 60 years (p = 0.039) and in those who lacked subretinal fluid at diagnosis (p < 0.001).Conclusions: In patients with ME secondary to CRVO, the risk of long-term recurrent ME was higher in older patients and those evidencing subretinal fluid at diagnosis indicating that such patients require close follow-up and aggressive treatment.
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