Seasonal variations of acute massive submacular haemorrhage associated with age-related macular degeneration

Submacular Hemorrhages Show No Significant Seasonal Variations in a European Cohort

The aim of the article is to investigate the seasonality of acute submacular hemorrhages (SMHs) in a European population and analyze the influence of the seasons, arterial hypertension, and intake of anticoagulatory/antiplatelet (AC/AP) medication on hemorrhage size. This retrospective, monocentric study included 164 eyes of 164 patients treated for acute SMH at the University Hospital Münster, Germany, between 1 January 2016 and 31 December 2021. Data on the day of occurrence, hemorrhage size, and general patient characteristics were recorded. "Test for cyclic trends in incidence data" and the Chi-Square Test were applied to investigate seasonal variations in SMH incidence. Fisher's exact test was used to investigate the influence of the seasons, arterial hypertension, and intake of AC/AP medication on hemorrhage size. A statistical analysis did not reveal significant seasonal variations in the occurrence of SMHs (p = 0.81). While the seasons and the presence of systemic arterial hypertension did not exert a significant influence, the intake of AC/AP medication significantly affected the size of SMH (p = 0.03). In this European cohort, no significant seasonal variations of SMHs were observed. However, in patients with risk factors, such as neovascular age-related macular degeneration (nAMD), the chance of an increase in hemorrhage size should be considered when initiating AC/AP therapy.

Seasonal variation in submacular hemorrhages in retinal macroaneurysms and its disappearance in age-related macular degeneration

PURPOSE

To investigate whether previously reported seasonal variation and winter-dominant prevalence of acute massive submacular hemorrhages (SMHs) caused by age-related macular degeneration (AMD) disappeared, and those caused by retinal microaneurysms (RMAs) emerged.

METHOD

The medical charts of 95 patients (95 eyes) with SMH caused by AMD and 76 patients (76 eyes) with SMH caused by RMAs in 2012-2019 were retrospectively reviewed. For each subject, the month of onset, the mean ambient temperature of that month were recorded.

RESULTS

The monthly numbers of cases of SMHs caused by AMD from January to December were 6, 8, 4, 9, 7, 10, 9, 11, 7, 11, 3, and 10. No significant seasonal variation in the monthly incidence was identified (Roger's R = 1.89, p = 0.39). The monthly numbers of SMHs caused by RMAs from January to December were 3, 11, 11, 8, 7, 8, 5, 5, 2, 4, 7, and 5. There was significant seasonal variation in the monthly incidence (Roger's R = 7.67, p = 0.02). There was no significant correlation between the monthly incidence of SMHs caused by RMAs and mean ambient temperature.

CONCLUSION

Our previous study conducted for cases obtained in 1998-2005 showed seasonal cyclic trend in the number of SMHs caused by AMD, with the peak in winter. However, that significant seasonal variation disappeared in 2012-2019 in the present study. Common usage of OCT devices and anti-VEGF drugs might be the reason for the lack of seasonal variation in the cases of SMH caused by AMD.

Climate and season: the effects on ophthalmic diseases

Seasonal changes and climate have a significant impact on human health. Diseases influenced by temperature and climate conditions are likely to undergo dynamic pattern shifts with consequent impact on human health. A number of infectious and non-infectious ophthalmic diseases are influenced by temperature and seasonality. Awareness of this is important from public and global health perspective in addition to resource allocation strategies. We examine the evidence for a seasonal pattern to ophthalmic diseases and assess the possible impact of climate change.

Subretinal recombinant tissue plasminogen activator and pneumatic displacement for the management of subretinal hemorrhage occurring after anti-VEGF injections for wet AMD

We describe three cases of submacular hemorrhage that occurred two to four days after anti-VEGF intravitreal injection for occult choroidal neovascularisation in age-related macular degeneration and their management with 25 gauge pars plana vitrectomy with injection of subretinal recombinant tissue plasminogen activator (rTPA) followed by fluid-air exchange and postoperative prone position. Vitrectomy, subretinal rTPA injection and fluid-gas exchange apply as a safe and effective treatment in these cases. Functional results seem to be positive especially if surgical treatment is promptly performed.

Frequency and seasonal variation of ophthalmology-related internet searches

OBJECTIVE

To use internet search activity to reveal the intensity of public interest and seasonal variation in ophthalmology-related diseases, symptoms, and treatments.

DESIGN

Time-series analysis of internet search data.

METHODS

Google trend data for ophthalmology terms for the United States, the United Kingdom, Canada, and Australia from 2004 through 2008 were studied. Mean population-weighted temperature and fraction of schools in session were estimated from databases, and relative potential sunlight intensity was calculated. Multivariable linear regression was used to predict search term frequency based on environmental variables.

RESULTS

Relative to diabetes searches (100%), common US eye-related searches were: "glasses" (44%), "Lasik" (16%), "contact lenses" (12.4%), "pink eye" (9.5%), "glaucoma" (5.9%), "cataract" (4.1%), "dry eyes" (2.1%), "eye twitching" (1.9%), and "eye pain" (1.9%). Seasonal nature was high for "conjunctivitis" (r(2) = 0.37), "pink eye" (r(2) = 0.32), "eye floaters" (r2 = 0.26), and "stye" (r(2) = 0.19), moderate for "glaucoma" (r(2) = 0.09) and "eye twitching" (r(2) = 0.06), and low for "uveitis" (r(2) = 0.02) and "macular degeneration" (r(2) < 0.01). Heat was associated with "stye" and cold was associated with "pink eye," "conjunctivitis," and "glaucoma" (all p < 0.002). Sunlight intensity was associated with "dry eyes" and "eye floaters" (p < 0.01). School sessions were associated positively with "eye twitching" (p >= 0.001) and negatively with "eyeglasses." "Eye allergy," "itchy eyes," and "watery eyes" were highly seasonal (r(2) = 0.75-0.38) and associated with "pollen" searches.

CONCLUSIONS

Internet ophthalmology searches relate (in decreasing order) to refractive correction, eye diseases, and eye symptoms. Search study reveals the seasonality and environmental associations of interest in health terms.