Age-related macular degeneration among the elderly: The 5th National Health and Nutrition Examination Survey, 2010 through 2012

Voluntary Exercise Suppresses Choroidal Neovascularization in Mice

Purpose

To determine the effect of voluntary exercise on choroidal neovascularization (CNV) in mice.

Methods

Age-matched wild-type C57BL/6J mice were housed in cages equipped with or without running wheels. After four weeks of voluntary running or sedentariness, mice were subjected to laser injury to induce CNV. After surgical recovery, mice were placed back in cages with or without exercise wheels for seven days. CNV lesion volumes were measured by confocal microscopy. The effect of wheel running only in the seven days after injury was also evaluated. Macrophage abundance and cytokine expression were quantified.

Results

In the first study, exercise-trained mice exhibited a 45% reduction in CNV volume compared to sedentary mice. In the replication study, a 32% reduction in CNV volume in exercise-trained mice was observed (P = 0.029). Combining these two studies, voluntary exercise was found to reduce CNV by 41% (P = 0.0005). Exercise-trained male and female mice had similar CNV volumes (P = 0.99). The daily running distance did not correlate with CNV lesion size. Exercise only after the laser injury without a preconditioning period did not reduce CNV size (P = 0.41). CNV lesions of exercise-trained mice also exhibited significantly lower F4/80+ macrophage staining and Vegfa and Ccl2 mRNA expression.

Conclusions

These findings provide the first experimental evidence that voluntary exercise improves CNV outcomes. These studies indicate that exercise before laser treatment is required to improve CNV outcomes.

OCT Angiography Features of Neovascularization as Predictive Factors for Frequent Recurrence in Age-Related Macular Degeneration

PURPOSE

To investigate the features of neovascularization (NV) in eyes with neovascular age-related macular degeneration using optical coherence tomography angiography (OCTA) according to the treatment interval of intravitreal aflibercept injection (IVI).

DESIGN

Retrospective, interventional, comparative case series.

METHODS

Patients with type 1 NV treated with the "pro re nata" regimen after 3 loading IVI were classified into 2 groups based on the numbers of treatments during 12 months, specifically a stable group who required fewer than 2 injections and an unstable group who required more than 3 injections. Quantitative features of OCTA including NV area, NV length, NV density, endpoint density (open-ended vessels per unit length), junction density (vessel junction per unit length), lacunarity, and largest vessel caliber were compared between the 2 groups.

RESULTS

Among 71 eyes, 38 and 33 eyes were classified into the stable and unstable groups, respectively. The unstable group had higher endpoint densities (stable vs unstable: 2.72 vs 3.18; P = .03) and higher levels of lacunarity (0.177 vs 0.211; P = .028). The area, density, length of NV, junction density, and largest vessel caliber were not different between the 2 groups (P = .057, P = .184, P = .062, P = .160, and P = .473, respectively). Endpoint density was correlated with the unstable group in both univariate and multivariate analyses (P = .004, P = .002, respectively). A predictive model with an endpoint index demonstrated a sensitivity of 93.75% and a negative predictive value of 89.47% for the unstable group.

CONCLUSIONS

The characteristics of NV in eyes of exudative age-related macular degeneration with type 1 NV were different according to treatment requirements. Identifying the features of NV on OCTA might be helpful for predicting clinical outcomes and optimal treatment intervals.