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Umetsu A, Tanaka M, Sato T, Akiyama Y, Endo K, Mori K, Ohnishi H, Watanabe M, Ohguro H, Hanawa N, Furuhashi M. High Intraocular Pressure Is Independently Associated With New-Onset Systemic Hypertension Over a 10-Year Period. Circ J 2024; 88:1689-1696. [PMID: 39048347 DOI: 10.1253/circj.cj-24-0241] [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] [Indexed: 07/27/2024]
Abstract
BACKGROUND Systemic hypertension (HT) is associated with the development of increased intraocular pressure (IOP), a risk factor for glaucoma. However, it remains unclear whether high IOP is a risk factor for HT.Methods and Results: We investigated 7,487 Japanese individuals (4,714 men, 2,773 women; mean [±SD] age 49±9 years) who underwent annual health checkups in 2006. Over the 10-year follow-up period, 1,232 (24.3%) men and 370 (11.5%) women developed new-onset HT, defined as initiation of antihypertensive drug treatment or blood pressure ≥140/90 mmHg. After dividing IOP into tertiles (T1-T3), Cox proportional hazards analysis (adjusted for age, sex, systolic blood pressure, obesity, current smoking, alcohol consumption, family history of HT, estimated glomerular filtration rate, and diabetes and dyslipidemia diagnoses at baseline) revealed a significantly higher risk of newly developed HT in T3 (IOP ≥14 mmHg; hazard ratio 1.14; 95% confidence interval 1.01-1.29; P=0.038) using T1 (IOP ≤11 mmHg) as the reference group. There was no significant interaction between sex and IOP tertile (P=0.153). A restricted cubic spline model showed a gradual but robust increase in the hazard ratio for new-onset HT with increasing IOP. CONCLUSIONS High IOP is an independent risk factor for the development of HT over a 10-year period.
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Affiliation(s)
- Araya Umetsu
- Department of Ophthalmology, School of Medicine, Sapporo Medical University
| | - Marenao Tanaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
- Tanaka Medical Clinic
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine
| | - Yukinori Akiyama
- Department of Neurosurgery, Sapporo Medical University School of Medicine
| | - Keisuke Endo
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Kazuma Mori
- Department of Immunology and Microbiology, National Defense Medical College
| | - Hirofumi Ohnishi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
- Department of Public Health, Sapporo Medical University School of Medicine
| | - Megumi Watanabe
- Department of Ophthalmology, School of Medicine, Sapporo Medical University
| | - Hiroshi Ohguro
- Department of Ophthalmology, School of Medicine, Sapporo Medical University
| | - Nagisa Hanawa
- Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
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Choudhari NS, Khanna RC, Marmamula S, Mettla AL, Giridhar P, Banerjee S, Shekhar K, Chakrabarti S, Murthy GVS, Gilbert C, Rao GN. Incidence of primary open angle glaucoma in the Andhra Pradesh Eye Disease Study (APEDS). Eye (Lond) 2024; 38:2179-2186. [PMID: 37968514 PMCID: PMC11269674 DOI: 10.1038/s41433-023-02799-z] [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: 07/16/2023] [Revised: 10/04/2023] [Accepted: 10/17/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND To report 15-year incidence rate of primary open angle glaucoma (POAG) in the Andhra Pradesh Eye Disease Study (APEDS). METHODS A population-based longitudinal study was carried out at three rural study sites. Phakic participants aged ≥40 years who participated at baseline (APEDS I) and the mean 15-year follow-up visit (APEDS III) were included. A comprehensive ophthalmic examination was performed on all participants. Mean intraocular pressure (IOP) was average of IOPs of right and left eyes. The definition of glaucoma was based on the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) classification. The main outcome measure was incidence of POAG during the follow-up period in participants without glaucoma or suspicion of glaucoma at baseline. RESULTS Data from the available and eligible participants from the original cohort (1241/2790; 44.4%) were analysed. The mean age (standard deviation) of participants at baseline was 50.2 (8.1) years; 580 (46.7%) were men. Thirty-six participants developed POAG [bilateral in 17 (47.2%)] over 15 years. The incidence rate of POAG per 100-person years (95% confidence interval) was 2.83 (2.6, 3.08). Compared to baseline, the reduction in mean IOP [median (range) mm Hg] was -0.75 (-7.5, 9) in participants with incident POAG and -2.5 (-14.5, 14.5) in those without. The inter-visit difference in mean IOP was a significant risk factor on logistic regression analysis. CONCLUSION We report the long-term incidence of POAG in rural India. A longitudinal change in IOP, specifically a less pronounced reduction in IOP with increasing age, was a novel risk factor.
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Affiliation(s)
- Nikhil S Choudhari
- VST Glaucoma Centre, Dr. Kallam Anji Reddy Campus, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India.
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India.
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia.
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
- Department of Biotechnology/ Wellcome Trust India Alliance, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Asha Latha Mettla
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Pyda Giridhar
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Seema Banerjee
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Konegari Shekhar
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Subhabrata Chakrabarti
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Gudlavalleti V S Murthy
- Indian Institute of Public Health, Madhapur, Hyderabad, India
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Clare Gilbert
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Gullapalli N Rao
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
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Ho C, Tseng VL, Grassi L, Morales E, Yu F, Coleman AL, Caprioli J. Predictors of Glaucomatous Progression in Individuals with Small and Large Optic Discs. Ophthalmol Glaucoma 2024; 7:177-189. [PMID: 37944752 DOI: 10.1016/j.ogla.2023.11.002] [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: 08/07/2023] [Revised: 10/16/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE To identify factors associated with glaucomatous progression in individuals with small and large optic discs. DESIGN Retrospective review. SUBJECTS 4505 individuals with glaucoma at UCLA; 233 (59.7%) with small discs, 157 (40.3%) with large discs. METHODS Small and large disc sizes were defined by OCT or Heidelberg Retinal Tomography as disc area ≤ 5% (≤ 1.3 mm2) and ≥ 95% (≥ 2.9 mm2), respectively. Medical records were reviewed for demographics, systemic comorbidities, glaucoma type, ocular comorbidities, and ocular surgery. Logistic regression was used to identify predictors of visual field (VF) progression in individuals with small and large discs and predictors of large versus small discs. MAIN OUTCOME MEASURES The VF deterioration with mean deviation, pointwise linear regression, and glaucoma rate index (GRI); large vs. small disc. RESULTS In individuals with small discs, Asian versus non-Hispanic White ethnicity was associated with increased progression (adjusted odds ratio [aOR] = 4.05; 95% confidence interval [CI] = 1.12-14.59 for GRI). Higher intraocular pressure (IOP) range and peak were associated with increased progression in individuals with both small discs (aOR = 1.12; 95% CI = 1.00-1.27 and aOR = 1.05; 95% CI = 1.00-1.10 per 1 mmHg for range and peak with GRI) and large discs (aOR = 1.35; 95% CI = 1.12-1.66 and aOR = 1.11; 95% CI = 1.03-1.20 per 1 mmHg for range and peak with GRI). Multivariable predictors of having large vs. small discs included vasospastic phenotype (aOR = 2.58; 95% CI = 1.35-5.19) and Black (aOR = 20.46; 95% CI = 8.33-61.84), Hispanic/Latino (aOR = 9.65; 95% CI = 4.14-25.39), Asian (aOR = 4.87; 95% CI = 2.96-8.1), and other (aOR = 2.79; 95% CI = 1.69-4.63) versus non-Hispanic White ethnicity. CONCLUSIONS Increased odds of glaucomatous progression were associated with Asian vs. non-Hispanic White ethnicity in glaucoma patients with small optic discs, as well as with increased IOP range and peak in those with small and large discs. Individuals with a vasospastic phenotype and those from racial and ethnic minority backgrounds had increased odds of having large vs. small optic discs. Further characterization of discernible phenotypes would improve disease prognostication and help individualize glaucoma treatment. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Connie Ho
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Victoria L Tseng
- Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Lourdes Grassi
- Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Esteban Morales
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California
| | - Fei Yu
- Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California; Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California
| | - Anne L Coleman
- Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California
| | - Joseph Caprioli
- Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California.
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Sun MT, Pershing S, Goldberg JL, Wang SY. Impact of Type 2 diabetes mellitus and insulin use on progression to glaucoma surgery in primary open angle glaucoma. Eye (Lond) 2024; 38:558-564. [PMID: 37740048 PMCID: PMC10858255 DOI: 10.1038/s41433-023-02734-2] [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: 02/09/2023] [Revised: 08/07/2023] [Accepted: 09/07/2023] [Indexed: 09/24/2023] Open
Abstract
PURPOSE To investigate outcomes of primary open-angle glaucoma (POAG) patients with and without type 2 diabetes mellitus (T2DM). METHODS Retrospective observational study using U.S. nationwide healthcare insurance claims database. Patients ≥40 years old with at least one HbA1c within one year of POAG diagnosis were included. Diabetic factors associated with POAG progression requiring glaucoma surgery were evaluated using multivariable Cox proportional hazards regression models adjusted for demographic, diabetic and glaucoma factors. T2DM diagnosis and use of either oral hypoglycaemic agents or insulin therapy were assessed in association with POAG progression requiring glaucoma surgery. RESULTS 104,515 POAG patients were included, of which 70,315 (67%) had T2DM. The mean age was 68.9 years (Standard deviation 9.2) and 55% were female. Of those with T2DM, 93% were taking medication (65,468); 95% (62,412) taking oral hypoglycaemic agents, and 34% (22,028) were on insulin. In multivariable analyses, patients with T2DM had a higher hazard of requiring glaucoma surgery (Hazard ratio, HR 1.15, 95% CI 1.09-1.21, p < 0.001). Higher mean HbA1c was also a significant predictor of progression requiring glaucoma surgery (HR 1.02, 95% CI 1.01-1.03, p < 0.001). When evaluating only patients who were taking antidiabetic medication, after adjusting for confounders, insulin use was associated with a 1.20 higher hazard of requiring glaucoma surgery compared to oral hypoglycaemic agents (95% CI 1.14-1.27, p < 0.001), but when stratified by HbA1c, this effect was only significant for those with HbA1c > 7.5%. CONCLUSIONS Higher baseline HbA1c, particularly in patients taking insulin may be associated with higher rates of glaucoma surgery in POAG.
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Affiliation(s)
- Michelle T Sun
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Suzann Pershing
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Jeffrey L Goldberg
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Sophia Y Wang
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
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Sano K, Terauchi R, Fukai K, Furuya Y, Nakazawa S, Kojimahara N, Hoshi K, Nakano T, Toyota A, Tatemichi M. Association Between Alcohol Consumption Patterns and Glaucoma in Japan. J Glaucoma 2023; 32:968-975. [PMID: 37748099 PMCID: PMC10621645 DOI: 10.1097/ijg.0000000000002308] [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: 12/26/2022] [Accepted: 08/25/2023] [Indexed: 09/27/2023]
Abstract
PRCIS In this case-control study of the Japanese population, including 3207 glaucoma cases, alcohol consumption patterns such as frequency and quantity showed a positive association with glaucoma prevalence. PURPOSE To examine the association between alcohol consumption patterns and glaucoma. SUBJECTS AND METHODS This case-control study evaluated 3207 cases with glaucoma and 3207 matched controls. Patients over 40 years of age were included from 1,693,611 patients admitted to 34 hospitals in Japan. Detailed alcohol consumption patterns (drinking frequency, average daily drinks, and total lifetime drinks) were obtained, as well as various confounding factors, including smoking history and lifestyle-related comorbidities. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% CIs for glaucoma prevalence. RESULTS Drinking frequency showed an association with glaucoma for "a few days/week" (OR, 1.19; 95% CI, 1.03-1.38) and "almost every day/week" (OR, 1.40; 95% CI, 1.18-1.66). Average daily drinks showed an association for ">0-2 drinks/day" (OR, 1.16; 95% CI, 1.03-1.32). Total lifetime drinks showed an association for ">60-90 drink-year" (OR, 1.23; 95% CI, 1.01-1.49) and ">90 drink-year" (OR, 1.23; 95% CI, 1.05-1.44). As alcohol consumption levels differed considerably between men and women, additional analyses were conducted separately for men and women. Among men, drinking frequency of "a few days/week" and "almost every day/week," average daily drinks of ">0-2 drinks/day" and ">2-4 drinks/day," and total lifetime drinks of ">60-90 drink-year" and ">90 drink-year" had an association with glaucoma. Conversely, among women, neither drinking frequency, average daily drinks, nor total lifetime drinks were associated. CONCLUSIONS Both the frequency and quantity of alcohol consumption were associated with glaucoma. Further research on gender differences is warranted.
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Affiliation(s)
- Kei Sano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo
| | - Ryo Terauchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo
| | - Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Yuko Furuya
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Shoko Nakazawa
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Noriko Kojimahara
- Department of Public Health, Shizuoka Graduate University of Public Health, Shizuoka
| | - Keika Hoshi
- Center for Health Informatics Policy, National Institute of Public Health, Wako
- Department of Hygiene, School of Medicine, Kitasato University, Sagamihara
| | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo
| | - Akihiro Toyota
- Chugoku Rosai Hospital Research Center for the Promotion of Health and Employment Support, Japan Organization of Occupational Health and Safety, Hiroshima, Japan
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
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Sharfuddin Ahmed M, Ullah AY, Barman N, Ratan ZA, Mostafa S, Khaleque A, Kabir S, Khan MH, Haque MA. Risk factors associated with elevated intraocular pressure: a population-based study in a rural community of Bangladesh. BMJ Open Ophthalmol 2023; 8:e001386. [PMID: 37844969 PMCID: PMC10582991 DOI: 10.1136/bmjophth-2023-001386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/25/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE High intraocular pressure (IOP) is one of the major modifiable risk factors for glaucoma. The objective was to examine socio-demographic and clinical factors related to IOP. METHODS AND ANALYSIS This study was conducted among 3097 adults residing in a rural area of Bangladesh, with all participants undergoing clinical and ophthalmological evaluations. The measurement of IOP was carried out using of a rebound Tonometer called Icare pro. Multiple logistic regression analysis was employed to identify variables associated to IOP levels of 21 mm Hg or above. Adjusted OR (aOR) and 95% CI were reported. RESULTS This study found that, in total, 9% of the study population had high IOP in one or both eyes. Elevated IOP was significantly associated with respondents who were service holders (aOR 2.52; 95% CI 1.48 to 4.31), had a lower education level (aOR 1.55, 95% CI 1.07 to 2.23), used biomass fuel (aOR 2.00; 95% CI 1.09 to 3.67), belonged to a higher socioeconomic position (aOR 1.55, 95% CI 1.07 to 2.23) and had obesity (aOR 2.00; 95% CI 1.07 to 3.73), hypertension (aOR 1.32; 95% CI 1.01 to 1.73) or history of diabetes (aOR 2.44; 95% CI 1.67 to 3.55), after adjusting for covariates including age, sex, marital status, light source and tobacco consumption, in a multiple regression analysis. CONCLUSION Chronic diseases, such as hypertension and diabetes, obesity and sociodemographic characteristics such as high socioeconomic status and use of biomass fuels, have all been linked to elevated IOP. Patients with chronic diseases should undergo for IOP testing regularly.
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Affiliation(s)
- Md Sharfuddin Ahmed
- Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Abm Yasin Ullah
- Department of Vitreo-Retina, National Institute of Ophthalmology and Hospital, Dhaka, Bangladesh
| | - Nilima Barman
- Department of Laboratory Medicine, Bangladesh Institute of Research and Rehabilitation of Diabetes Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Zubair Ahmed Ratan
- Department of Biomedical Engineering, Khulna University of Engineering and Technology, Khulna, Bangladesh
| | | | - Abdul Khaleque
- Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Showkat Kabir
- Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Maruf Haque Khan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - M Atiqul Haque
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Tiambeng C, Batur A, Dikmetas Ö, Aksu NM. The acute effect of systemic blood pressure reduction on intraocular pressure in hypertensive patients. Turk J Emerg Med 2022; 22:131-136. [PMID: 35936951 PMCID: PMC9355068 DOI: 10.4103/2452-2473.348441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES: Previous studies have shown an association between systemic hypertension and intraocular pressure (IOP). We analyzed the relationship between the decreases of the blood pressure (BP) and IOP in hypertensive patients. METHODS: The study includes a total of 214 patients: 158 hypertensive and 56 normotensive patients as study and control groups, respectively. The IOP of each eye in both the groups was measured once with a noncontact tonometer at presentation and an hour after BP reduction to normal in the study group. We analyzed the reduction in IOP with decreasing BP. RESULTS: In the study group, the mean IOP was 15.29 ± 4.05 mmHg in the right and 15.11 ± 3.78 mmHg in the left eyes. The mean IOP measured an hour after the patients became normotensive was 13.78 ± 4.06 mmHg in the right and 13.51 ± 3.82 in the left eyes. There was a statistically significant decrease in the IOPs (P < 0.001). The mean IOP in the control group was 13.54 ± 3.51 mmHg in the right and 13.20 ± 3.33 mmHg in the left eyes. The mean IOP at presentation in the study and control groups was found to be significantly different (P < 0.001). CONCLUSIONS: Patients in the study group showed a significantly higher IOP compared to patients in the normotensive group. Furthermore, patients in the study group showed a significant reduction in IOP after BP reduction. This may indicate that uncontrolled hypertension poses a risk for prolonged higher IOP. Prolonged higher IOP can be considered a risk factor for the glaucoma.
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Affiliation(s)
- Canan Tiambeng
- Department of Emergency Medicine, Faculty of Medicine, Hacettepe University, Altindag, Ankara, Turkey
| | - Ali Batur
- Department of Emergency Medicine, Faculty of Medicine, Hacettepe University, Altindag, Ankara, Turkey
| | - Özlem Dikmetas
- Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Altindag, Ankara, Turkey
| | - Nalan Metin Aksu
- Department of Emergency Medicine, Faculty of Medicine, Hacettepe University, Altindag, Ankara, Turkey
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Hu Z, Zhou F, Kaminga AC, Xu H. Type 2 Diabetes, Fasting Glucose, Hemoglobin A1c Levels and Risk of Primary Open-Angle Glaucoma: A Mendelian Randomization Study. Invest Ophthalmol Vis Sci 2022; 63:37. [PMID: 35622353 PMCID: PMC9150838 DOI: 10.1167/iovs.63.5.37] [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] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the potential causal associations between type 2 diabetes and fasting glucose and HbA1c levels and the risk of primary open-angle glaucoma (POAG) in European and East Asian populations. Methods We selected genetic variants (P < 5 × 10−8) for type 2 diabetes (898,130 Europeans; 433,540 East Asians), fasting glucose, and HbA1c (196,991 Europeans; 36,584 East Asians) from three meta-analyses of genome-wide association studies (GWAS). The GWAS for POAG provided summary statistics (192,702 Europeans; 46,523 East Asians). Mendelian randomization (MR) analysis was accomplished using the inverse variance–weighted method, weighted-median method, MR Egger method, and MR-Pleiotropy RESidual Sum and Outlier test. Results Genetically predicted type 2 diabetes was potentially positively associated with POAG in the European ancestry (body mass index [BMI]–unadjusted: odds ratio [OR] = 1.07, 95% confidence interval [CI], 1.01–1.14, P = 0.028; BMI-adjusted: OR = 1.07, 95% CI, 1.01–1.15, P = 0.035), but not in the East Asian ancestry (BMI-unadjusted: OR = 1.01, 95% CI, 0.95–1.06, P = 0.866; BMI-adjusted: OR = 1.00, 95% CI, 0.94–1.05, P = 0.882). There was no evidence to support a causal association of fasting glucose (European: OR = 1.19, P = 0.157; East Asian: OR = 0.94, P = 0.715) and HbA1c (European: OR = 1.27, P = 0.178; East Asian: OR = 0.85, P = 0.508) levels with POAG. Conclusions The causal effect of type 2 diabetes on the risk of POAG is different in European and East Asian populations. The point estimates of fasting glucose and Hb1Ac with POAG are large but not statistically significant, which prompts the question of statistical power.
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Affiliation(s)
- Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Feixiang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Atipatsa Chiwanda Kaminga
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
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Asian Race and Primary Open-Angle Glaucoma: Where Do We Stand? J Clin Med 2022; 11:jcm11092486. [PMID: 35566612 PMCID: PMC9099679 DOI: 10.3390/jcm11092486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 01/27/2023] Open
Abstract
Primary open-angle glaucoma (POAG) is an optic neuropathy characterized by irreversible retinal ganglion cell damage and visual field loss. The global POAG prevalence is estimated to be 3.05%, and near term is expected to significantly rise, especially within aging Asian populations. Primary angle-closure glaucoma disproportionately affects Asians, with up to four times greater prevalence of normal-tension glaucoma reported compared with high-tension glaucoma. Estimates for overall POAG prevalence in Asian populations vary, with Chinese and Indian populations representing the majority of future cases. Structural characteristics associated with glaucoma progression including the optic nerve head, retina, and cornea are distinct in Asians, serving as intermediates between African and European descent populations. Patterns in IOP suggest some similarities between races, with a significant inverse relationship between age and IOP only in Asian populations. Genetic differences have been suggested to play a role in these differences, however, a clear genetic pattern is yet to be established. POAG pathogenesis differs between Asians and other ethnicities, and it may differ within the broad classification of the Asian race. Greater awareness and further research are needed to improve treatment plans and outcomes for the increasingly high prevalence of normal tension glaucoma within aging Asian populations.
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Abusharha A, El-Hiti GA, Alharbi A, Fagehi R, Alanazi MA, Alsaqar A, Masmali AM, Almubrad T. Evaluation of Tear Evaporation Rate in Subjects with a High Body Mass Index. Klin Monbl Augenheilkd 2022; 240:283-287. [PMID: 35426102 DOI: 10.1055/a-1778-4435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Aim This study evaluated the tear evaporation rate (TER) in subjects with a high body mass index (BMI) and tested the correlation between BMI and dry eye.
Methods Thirty male subjects aged 18 – 38 years (26.4 ± 4.0 years) with a high BMI (26.4 – 47.0 kg/m2) were enrolled in the study. In addition, a control group of 30 males
aged 20 – 36 years (24.0 ± 3.6 years) with a normal BMI (< 25 kg/m2) participated in the study for comparison. Each subject completed the ocular surface disease index (OSDI),
followed by the TER measurement using a handheld VapoMeter.
Results Significant differences (Wilcoxon test; p = 0.002 and 0.001) were found between the median scores of the OSDI (10.3 [3.7] vs. 5.9 [7.2]) and TER (35.5 [13.1] vs. 15.5 [12.8]
g/m2 h) in the study and control groups, respectively. The OSDI indicated dry eye in 60.0% of subjects in the study group (n = 18). The TER measurements showed that 76.7% of
subjects in the study group (n = 23) had dry eyes. A medium correlation (r = 0.569; p = 0.001) was found between the OSDI scores and TER measurements.
Conclusions The means of the tear evaporation rate and the ocular surface disease index scores are significantly higher in subjects with a high BMI compared with the control group.
Therefore, a high BMI is considered a risk factor for dry eye. The measurement of the tear evaporation rate using a handheld VapoMeter is a simple and rapid method to detect dry eyes in
combination with other tools.
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Affiliation(s)
- Ali Abusharha
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Gamal A. El-Hiti
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdulhadi Alharbi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Raied Fagehi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mana A. Alanazi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alsaqar
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ali M. Masmali
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Turki Almubrad
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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11
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Yang Y, Zhang X, Chen Z, Wei Y, Ye Q, Fan Y, Nathwani N, Gazzard G, Yu M. Intraocular pressure and diurnal fluctuation of open-angle glaucoma and ocular hypertension: a baseline report from the LiGHT China trial cohort. Br J Ophthalmol 2022; 107:823-827. [PMID: 35086806 DOI: 10.1136/bjophthalmol-2021-320128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/17/2021] [Indexed: 01/07/2023]
Abstract
AIMS To report the baseline intraocular pressure (IOP) characteristics and its diurnal fluctuation in the Laser in Glaucoma and Ocular Hypertension China cohort. METHODS 622 primary open-angle glaucoma (POAG) patients and 149 ocular hypertension (OHT) patients were recruited at Zhongshan Ophthalmic Center from 2015 to 2019. Standardised ocular examinations were performed including IOP measurement using the Goldmann applanation tonometer. Daytime phasing IOP was recorded at 8:00, 10:00, 11:30, 14:30, 17:00 hour. RESULTS The mean baseline IOP was 20.2 mm Hg for POAG patients and 24.4 mm Hg for OHT. Multiple regression analysis revealed that thicker central corneal thickness (CCT) was correlated with higher IOP in both POAG and OHT. Male gender and younger age were correlated with higher IOP only for POAG. As for diurnal IOP fluctuation, mean IOP fluctuation was 3.4 mm Hg in POAG eyes and 4.4 mm Hg in OHT. The peak and trough IOP occurred at 8:00 and 14:30 hour in both POAG and OHT eyes. CONCLUSIONS Younger age, male gender and thicker CCT are correlated to higher IOP in POAG patients while only thicker CCT is related to higher IOP in OHT patients. Peak IOP appears mostly at early morning or late afternoon and trough value occurs mostly at early afternoon.
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Affiliation(s)
- Yangfan Yang
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong, China
| | - Xinyi Zhang
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong, China
| | - Zidong Chen
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong, China
| | - Yifan Wei
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong, China
| | - Qiaona Ye
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong, China
| | - Yanmei Fan
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong, China
| | - Neil Nathwani
- National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Gus Gazzard
- NIHR Moorfields Biomedical Research Centre, London, UK.,University College London, London, UK
| | - Minbin Yu
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong, China
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12
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Liu X, Pan X, Ma Y, Jin C, Wang B, Ning Y. Variation in intraocular pressure by sex, age, and geographic location in China: A nationwide study of 284,937 adults. Front Endocrinol (Lausanne) 2022; 13:949827. [PMID: 36093102 PMCID: PMC9453811 DOI: 10.3389/fendo.2022.949827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To investigate the distribution characteristics of intraocular pressure (IOP) by sex, age, and geographic location in China and to build the corresponding reference intervals (RIs). MATERIAL AND METHODS A cross-sectional, multi-centered, population-based study was conducted. All data were collected from participants without eye diseases who underwent ophthalmological examinations in 170 Health Screening Centers in mainland China in 2018. The non-contact tonometer was used to measure IOP. The age-, sex-, and province-specific RIs of IOP were investigated. The IOP of different age-sex groups was further explored by stratifying according to height, body mass index (BMI), blood pressure, altitude, and geographic area. RESULTS During the study, a population-based sample of 284,937 participants was included. The distribution of measured IOP followed an approximately Gaussian distribution, with a higher mean value in men than in women. The IOP showed a general trend of decline with age for both men and women and varied across geographical locations. The mean IOP was 15.4 (95% CI: 9.1-21.6) mmHg for men and 14.9 (95% CI: 9.0-20.8) mmHg for women. For men, it decreased from 11.0-23.5 mmHg at age 18-24 years to 10.5-20.5 mmHg at age ≥70 years. For women, it decreased from 10.5-22.0 to mmHg at age 18-24 years to 10.0-21.0 mm Hg at age ≥70 years. CONCLUSIONS The IOP varied with age, sex, metabolic disorders and geographic location. These RIs should be considered in the clinical process of glaucoma diagnosis and treatment.
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Affiliation(s)
- Xuan Liu
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xue Pan
- Department of Ophthalmology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yuan Ma
- Peking University Health Science Center, Meinian Public Health Research Institute, Beijing, China
| | - Cheng Jin
- Peking University Health Science Center, Meinian Public Health Research Institute, Beijing, China
| | - Bo Wang
- Peking University Health Science Center, Meinian Public Health Research Institute, Beijing, China
| | - Yi Ning
- School of Public Health, Hainan Medical University, Haikou, China
- *Correspondence: Yi Ning,
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Shehab A, Bhagavathula AS, AlHajri N. Sex differences in the antihypertensive treatment and risk of uncontrolled hypertension in 5308 hypertensive patients in the United Arab Emirates. Blood Press Monit 2021; 26:333-340. [PMID: 34001757 DOI: 10.1097/mbp.0000000000000539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sex differences in the antihypertensive medications used to control blood pressure and risk factor control in hypertensive patients is poorly understood. METHODS We conducted a retrospective review of the patients newly diagnosed with hypertension registered for treatment in 52 outpatient settings across Abu Dhabi province between 1 January and 31 December 2017. We explored sex differences in risk factors and treatment management over 6 months of the follow-up period of each patient. Multiple logistic regression models were used to identify factors associated with poor BP control. RESULTS A total of 5308 patients (2559 men and 2849 women) were identified. We observed an increase in SBP and DBP levels in men (1.72/1.13 mmHg) and only SBP in women (0.87/-0.021 mmHg) with increased incidence of comorbidities overtime. The overall BP control was suboptimal (65%) (<140/90 mmHg) with no significant difference between women (65.3%) and men (64.2%). In men with dyslipidemia, use of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker with diuretics and in women, only calcium channel blockers showed higher for BP control. Factors significantly associated with poor BP control in men are being overweight and obese, and dyslipidemia in men. After the age of 50, women in contrast to men, with dyslipidemia and heart rate >80 beats per minute are less likely to maintain hypertension control. CONCLUSION Sex-specific analysis indicated that BP control among United Arab Emirates men and women was suboptimal (65%). Interventions aiming to achieve better control of BP in hypertensive patients with metabolic syndrome should be emphasized.
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Affiliation(s)
| | - Akshaya Srikanth Bhagavathula
- Institute of Public Health, College of Medicine and Health Sciences, College of Medicine and Health Sciences, UAE University, Al Ain
| | - Noora AlHajri
- Department of Epidemiology and Population Health, Khalifa University, Abu Dhabi, UAE
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14
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Choriocapillaris microvasculature dysfunction in systemic hypertension. Sci Rep 2021; 11:4603. [PMID: 33633311 PMCID: PMC7907127 DOI: 10.1038/s41598-021-84136-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/11/2021] [Indexed: 12/13/2022] Open
Abstract
We examined the choriocapillaris microvasculature using a non-invasive swept-source optical coherence tomography angiography (SS-OCTA) in 41 healthy controls and 71 hypertensive patients and determined possible correlations with BP and renal parameters. BP levels, serum creatinine and urine microalbumin/creatinine ratio (MCR) specimens were collected. The estimated glomerular filtration rate (eGFR) was calculated based on CKD-EPI Creatinine Equation. The main outcome was choriocapillaris flow deficits (CFD) metrics (density, size and numbers). The CFD occupied a larger area and were fewer in number in the hypertensive patients with poor BP control (407 ± 10 µm2; 3260 ± 61) compared to the hypertensives with good BP control (369 ± 5 µm2; 3551 ± 41) and healthy controls (365 ± 11 µm2; 3581 ± 84). Higher systolic BP (β = 9.90, 95% CI, 2.86–16.93), lower eGFR (β = − 0.85; 95% CI, − 1.58 to − 0.13) and higher urine MCR (β = 1.53, 95% CI, 0.32–2.78) were associated with larger areas of CFD. Similar significant associations with systolic BP, eGFR and urine MCR were found with number of CFD. These findings highlight the potential role of choriocapillaris imaging using SS-OCTA as an indicator of systemic microvascular abnormalities secondary to hypertensive disease.
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Hou H, Moghimi S, Baxter SL, Weinreb RN. Is Diabetes Mellitus a Blessing in Disguise for Primary Open-angle Glaucoma? J Glaucoma 2021; 30:1-4. [PMID: 33074964 PMCID: PMC7755751 DOI: 10.1097/ijg.0000000000001719] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/04/2020] [Indexed: 11/26/2022]
Abstract
Although numbers of studies have addressed this question, the relationship between diabetes mellitus and primary open-angle glaucoma is still unclear. This article discusses progress in understanding the complex relationship between these 2 entities and recent shifts in perspective that challenge the traditional dogma regarding diabetes mellitus and primary open-angle glaucoma. There are still many unanswered questions.
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Affiliation(s)
- Huiyuan Hou
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
| | - Sally L. Baxter
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
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16
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Kaplan M, Abacýoglu OO, Yavuz F, Kaplan GI, Düzen B, Bursa N, Zorlu F. Intraocular pressure predicts premature coronary atherosclerosis. ACTA ACUST UNITED AC 2020; 66:1707-1711. [PMID: 33331581 DOI: 10.1590/1806-9282.66.12.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 07/27/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between intraocular pressure (IOP) and premature atherosclerotic coronary artery disease (PACAD) by comparing central corneal thicknesses (CCTs) measurements. METHODS One hundred-eighty-six subjects were enrolled in this cross-sectional study, 100 in the PACAD group and 86 in the control group. All participants underwent a physical examination and routine biochemical tests. Ophthalmological examinations, including IOP and CCTs measurements, were performed for each subject. Additionally, pulse wave velocity measurements were obtained and recorded. RESULTS Participants with PACAD showed significantly higher IOP values than those without atherosclerosis (p = 0.001), and there was no statistically significant difference between the groups in terms of CCT (p = 0.343). Also, pulse wave velocity (PWV) values were statistically significantly higher in the PACAD group (p = 0.001). High IOP was not significantly associated with metabolic syndrome parameters (p > 0.05). CONCLUSIONS A relationship was found between PACAD and IOP, but CCTs were not associated with PACAD. The IOP measurement is affected by CCT; therefore, CCT is used to correct IOP values. To our knowledge, this is the first study to report a positive relationship between PACAD and IOP based on CCTs measurements.
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Affiliation(s)
- Mehmet Kaplan
- Gaziantep University School of Medicine, Department of Cardiology. 27100, Gaziantep, Turkey
| | - Ozge Ozcan Abacýoglu
- Adana City Training & Research Hospital, Department of Cardiology, Adana, Turkey
| | - Fethi Yavuz
- Adana City Training & Research Hospital, Department of Cardiology, Adana, Turkey
| | - Gizem Ilgýn Kaplan
- Ersin Arslan Training & Research Hospital, Department of Internal Medicine, Gaziantep, Turkey
| | - Betül Düzen
- Ersin Arslan Training & Research Hospital, Department of Ophthalmology, Gaziantep, Turkey
| | - Nurbanu Bursa
- Hacettepe University, Department of Statistics, Ankara, Turkey
| | - Ferhat Zorlu
- Adana City Training & Research Hospital, Department of Ophthalmology, Adana, Turkey
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17
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Liu Q, Liu D, Yan D, Huang W, Ji X, Hui J, Tang Z. Gender-Specific Association Between Serum Uric Acid and Incident High Intraocular Pressure in Chinese Population: A Cross-Sectional Study. Invest Ophthalmol Vis Sci 2020; 61:10. [PMID: 32897376 PMCID: PMC7488210 DOI: 10.1167/iovs.61.11.10] [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] [Indexed: 12/22/2022] Open
Abstract
Purpose The purpose of this study was to investigate the relationship between high intraocular pressure (IOP) and uric acid. Methods In a retrospective cross-sectional study, 19,147 participants were included in 2018. Serum uric acid (SUA) was cut to four groups as Q1 to Q4, according to the quartiles. The odds ratio (OR) and 95% confidence interval (CI) of different SUA levels were estimated by a binomial logistic regression model in men and women. A restrictive cubic spline method was used to estimate the dose-response relationship between uric acid and high IOP. Subgroup analysis was performed to find the gender-specific association between uric acid and high IOP. Results In women, after adjusting for confounding factors, the Q3 and Q4 of SUA levels were significantly associated with the risk of high IOP. The OR with 95% CI for Q3 and Q4 were 1.77 (1.22, 2.57) and 1.51 (1.01, 2.26), respectively, Q1 as a reference. For men, SUA levels were not associated with the incidence of high IOP. Moreover, the spline analysis found an inverted U‐shaped relationship between uric acid and high IOP in women (P = 0.0171). Conclusions Elevated levels of SUAwere independently associated with an increased risk of high IOP in women, but not in men. In addition, uric acid had an inverse U-shaped nonlinear dose-response relationship with high IOP in women.
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Affiliation(s)
- Qianqian Liu
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Dan Liu
- Health Management Center, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Derui Yan
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Weicun Huang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Xiaodong Ji
- Health Management Center, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Hui
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zaixiang Tang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
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Hong J, Tan B, Quang ND, Gupta P, Lin E, Wong D, Ang M, Lamoureux E, Schmetterer L, Chua J. Intra-session repeatability of quantitative metrics using widefield optical coherence tomography angiography (OCTA) in elderly subjects. Acta Ophthalmol 2020; 98:e570-e578. [PMID: 31833241 PMCID: PMC7496426 DOI: 10.1111/aos.14327] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 11/17/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To assess the repeatability of retinal vascular metrics using different postprocessing methods as obtained from the swept-source optical coherence tomography angiography (SS-OCTA). METHODS Thirty-two participants (63% males; mean [SD] age, 70 [7] years) underwent SS-OCTA imaging (PLEX® Elite 9000, Carl Zeiss Meditec, Inc., Dublin, USA). Each participant underwent 2 repeated scans of 2 scan protocols: a macular-centred 3 × 3-mm2 and a widefield 12 × 12-mm2 for a total of 4 acquisitions. Images of superficial vascular plexuses (SVP) and deep vascular plexuses (DVP) were processed using different filters to generate the perfusion density (PD) and vessel density (VD). Vessel enhancement filters ranged from vessel targeted (Hessian and Gabor filters), classical denoising (Gaussian filter), to a scale-selective adaption (modified Bayesian residual transform [MBRT]). Intra-session repeatability of the different filters and their correlation with the original data set were calculated with the intraclass correlation coefficient (ICC) and Pearson's r. RESULTS Of the 32 eyes, 17 and 15 were right and left eyes, respectively. For 3 × 3-mm2 scans, both MBRT and Gabor filters yielded very good repeatable PD and VD (both ICCs > 0.87) values. Gabor filter was the most correlated with the original data set for the OCTA metrics (r = 0.95-0.97). For 12 × 12-mm2 scans, MBRT filter produced good-to-moderate ICC values for SVP (ICC>0.89) and DVP (ICC>0.73) metrics. Both the MBRT and Gabor filters were highly correlated with the original 12 × 12-mm2 scan data set (r = 0.96-0.98). The ICCs for the agreement between 3 × 3-mm2 and cropped 12 × 12-mm2 were high only for the PD values at the SVP layer and were poor for the VD at SVP and DVP measurements (ICC < 0.50). CONCLUSION Our findings show that with the proper choice of postimaging processing methods, SS-OCTA metrics can be obtained with high repeatability, which supports its use in various clinical settings.
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Affiliation(s)
- Jimmy Hong
- Singapore Eye Research InstituteSingapore National Eye CentreSingapore CitySingapore
- Department of OphthalmologyLee Kong Chian School of MedicineNanyang Technological UniversitySingapore CitySingapore
| | - Bingyao Tan
- Singapore Eye Research InstituteSingapore National Eye CentreSingapore CitySingapore
| | - Nguyen Duc Quang
- Singapore Eye Research InstituteSingapore National Eye CentreSingapore CitySingapore
| | - Preeti Gupta
- Singapore Eye Research InstituteSingapore National Eye CentreSingapore CitySingapore
| | - Emily Lin
- Singapore Eye Research InstituteSingapore National Eye CentreSingapore CitySingapore
| | - Damon Wong
- Singapore Eye Research InstituteSingapore National Eye CentreSingapore CitySingapore
- School of Chemical and Biomedical EngineeringNanyang Technological UniversitySingapore CitySingapore
| | - Marcus Ang
- Singapore Eye Research InstituteSingapore National Eye CentreSingapore CitySingapore
- Academic Clinical ProgramDuke‐NUS Medical SchoolSingapore CitySingapore
| | - Ecosse Lamoureux
- Singapore Eye Research InstituteSingapore National Eye CentreSingapore CitySingapore
- Academic Clinical ProgramDuke‐NUS Medical SchoolSingapore CitySingapore
| | - Leopold Schmetterer
- Singapore Eye Research InstituteSingapore National Eye CentreSingapore CitySingapore
- Department of OphthalmologyLee Kong Chian School of MedicineNanyang Technological UniversitySingapore CitySingapore
- School of Chemical and Biomedical EngineeringNanyang Technological UniversitySingapore CitySingapore
- Academic Clinical ProgramDuke‐NUS Medical SchoolSingapore CitySingapore
- Department of Clinical PharmacologyMedical University of ViennaViennaAustria
- Center for Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
| | - Jacqueline Chua
- Singapore Eye Research InstituteSingapore National Eye CentreSingapore CitySingapore
- Academic Clinical ProgramDuke‐NUS Medical SchoolSingapore CitySingapore
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19
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Lin E, Ke M, Tan B, Yao X, Wong D, Ong L, Schmetterer L, Chua J. Are choriocapillaris flow void features robust to diurnal variations? A swept-source optical coherence tomography angiography (OCTA) study. Sci Rep 2020; 10:11249. [PMID: 32647298 PMCID: PMC7347889 DOI: 10.1038/s41598-020-68204-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 06/02/2020] [Indexed: 12/17/2022] Open
Abstract
We evaluated the impact of diurnal variation on choroidal and retinal microvasculature and structural measurements using a swept-source optical coherence tomography angiography machine (SS-OCTA; PLEX Elite 9,000, Carl Zeiss Meditec, Inc., Dublin, USA). Fourteen participants who were without ocular diseases underwent SS-OCTA imaging using 3 × 3-mm2 macular scan pattern on two separate days at five time points. Choriocapillaris flow voids were generated to determine its density (percentage), size (μm) and numbers. Perfusion densities of the large superficial vessels, as well as capillaries on superficial and deep vascular plexuses were generated from retinal angiograms. Subfoveal choroidal and retinal thicknesses were manually measured. Repeated-measures ANOVA was used to investigate the impact of diurnal variation on choroidal and retinal measurements. There was no observable diurnal pattern for any of the flow void features, in terms of the density, size and numbers. There was a significant diurnal pattern observed in the choroidal thickness, where it decreased progressively during the day (P < 0.005). As opposed to sub-foveal choroidal thickness, there does not appear to be significant diurnal variation in choriocapillaris flow voids in normal individuals. This suggests that alterations of choriocapillaris flow deficit seen in pathological eyes will not be confounded by the diurnal fluctuation.
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Affiliation(s)
- Emily Lin
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Road, The Academia, Level 6, Discovery Tower, Singapore, 169856, Singapore
| | - Mengyuan Ke
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Road, The Academia, Level 6, Discovery Tower, Singapore, 169856, Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Road, The Academia, Level 6, Discovery Tower, Singapore, 169856, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore.,Institute for Health Technologies, Nanyang Technological University, Singapore, Singapore
| | - Xinwen Yao
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Road, The Academia, Level 6, Discovery Tower, Singapore, 169856, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore.,Institute for Health Technologies, Nanyang Technological University, Singapore, Singapore
| | - Damon Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Road, The Academia, Level 6, Discovery Tower, Singapore, 169856, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore.,Institute for Health Technologies, Nanyang Technological University, Singapore, Singapore
| | - Lirong Ong
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Road, The Academia, Level 6, Discovery Tower, Singapore, 169856, Singapore
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Road, The Academia, Level 6, Discovery Tower, Singapore, 169856, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore.,Institute for Health Technologies, Nanyang Technological University, Singapore, Singapore.,Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Road, The Academia, Level 6, Discovery Tower, Singapore, 169856, Singapore. .,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore. .,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
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20
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Yao X, Ke M, Ho Y, Lin E, Wong DWK, Tan B, Schmetterer L, Chua J. Comparison of retinal vessel diameter measurements from swept-source OCT angiography and adaptive optics ophthalmoscope. Br J Ophthalmol 2020; 105:426-431. [PMID: 32461263 PMCID: PMC7907556 DOI: 10.1136/bjophthalmol-2020-316111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/14/2020] [Accepted: 05/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND/IMS To compare the retinal vessel diameter measurements obtained from the swept-source optical coherence tomography angiography (OCTA; Plex Elite 9000, Carl Zeiss Meditec, USA) and adaptive optics ophthalmoscope (AOO; RTX1, Imagine Eyes, France). METHODS Fifteen healthy subjects, 67% women, mean age (SD) 30.87 (6.19) years, were imaged using OCTA and AOO by a single experienced operator on the same day. Each eye was scanned using two OCTA protocols (3×3 mm2 and 9×9 mm2) and two to five AOO scans (1.2×1.2 mm2). The OCTA and AOO scans were scaled to the same pixel resolution. Two independent graders measured the vessel diameter at the same location on the region-of-interest in the three coregistered scans. Differences in vessel diameter measurements between the scans were assessed. RESULTS The inter-rater agreement was excellent for vessel diameter measurement in both OCTA protocols (ICC=0.92) and AOO (ICC=0.98). The measured vessel diameter was widest from the OCTA 3×3 mm2 (55.2±16.3 µm), followed by OCTA 9×9 mm2 (54.7±14.3 µm) and narrowest by the AOO (50.5±15.6 µm; p<0.001). Measurements obtained from both OCTA protocols were significantly wider than the AOO scan (OCTA 3×3 mm2: mean difference Δ=4.7 µm, p<0.001; OCTA 9×9 mm2: Δ=4.2 µm, p<0.001). For vessels >45 µm, it appeared to be larger in OCTA 3×3 mm2 scan than the 9×9 mm2 scan (Δ=1.9 µm; p=0.005), while vessels <45 µm appeared smaller in OCTA 3×3 mm2 scan (Δ=-1.3 µm; p=0.009) CONCLUSIONS: The diameter of retinal vessels measured from OCTA scans were generally wider than that obtained from AOO scans. Different OCTA scan protocols may affect the vessel diameter measurements. This needs to be considered when OCTA measures such as vessel density are calculated.
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Affiliation(s)
- Xinwen Yao
- Institute of Health Technologies, Nanyang Technological University, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore.,Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Mengyuan Ke
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Yijie Ho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Emily Lin
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Damon W K Wong
- Institute of Health Technologies, Nanyang Technological University, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore.,Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Bingyao Tan
- Institute of Health Technologies, Nanyang Technological University, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore.,Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Leopold Schmetterer
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore.,Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore.,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.,Academic Clinical Program, Duke-NUS Medical School, Singapore.,Institute of Ophthalmology, Basel, Switzerland
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore .,Academic Clinical Program, Duke-NUS Medical School, Singapore
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21
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Impact of hypertension on retinal capillary microvasculature using optical coherence tomographic angiography. J Hypertens 2020; 37:572-580. [PMID: 30113530 PMCID: PMC6365272 DOI: 10.1097/hjh.0000000000001916] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: Reduction in capillary density or rarefaction is a hallmark of essential hypertension. We measured the retinal capillary density using noninvasive optical coherence tomographic angiography (OCT-A) in adults with treated systemic hypertension and determined possible correlations with ambulatory blood pressure (BP) and renal parameters. Methods: This observational cross-sectional study consisted of 153 normal eyes from 77 nondiabetic hypertensive adults [mean (SD) age, 58 (9) years; 49% women; 23% poorly controlled BP]. Data on 24-h ambulatory BP monitoring, serum creatinine, and urine microalbumin/creatinine ratio (MCR) were collected. Estimated glomerular filtration rate (eGFR) was calculated based on CKD-EPI Creatinine Equation. Retinal capillary density measured with the OCT-A (AngioVue) at superficial (SVP) and deep vascular plexuses (DVP). Linear regression was used to investigate the association of risk factors with capillary density. Results: Retinal capillary density (percentage) at DVP was reduced in patients with poorly controlled BP (SBP = 148 ± 8 mmHg; 27.2 ± 13.0) compared with those with well controlled BP (SBP = 125 ± 9 mmHg; 34.7 ± 11.3). In the multivariable analysis, poorly controlled BP [β = −6.49, 95% confidence interval (CI), −12.39 to −0.59], higher SBP (β = −0.23, 95% CI −0.44 to −0.02) and lower eGFR (β = 6.42, 95% CI 1.25–11.60) were associated with sparser retinal capillary density. Systemic factors were not associated with capillary density at SVP (all P > 0.05). Conclusion: In adults with treated systemic hypertension, retinal capillary density reduced with higher BP and poorer eGFR. These findings highlight the potential role of OCT-A to study early microvascular changes because of systemic hypertension.
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22
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Chua J, Tham YC, Tan B, Devarajan K, Schwarzhans F, Gan A, Wong D, Cheung CY, Majithia S, Thakur S, Fischer G, Vass C, Cheng CY, Schmetterer L. Age-related changes of individual macular retinal layers among Asians. Sci Rep 2019; 9:20352. [PMID: 31889143 PMCID: PMC6937292 DOI: 10.1038/s41598-019-56996-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/19/2019] [Indexed: 02/08/2023] Open
Abstract
We characterized the age-related changes of the intra-retinal layers measured with spectral-domain optical coherence tomography (SD-OCT; Cirrus high-definition OCT [Carl Zeiss Meditec]. The Singapore Epidemiology of Eye Diseases is a population-based, cross-sectional study of Chinese, Malays and Indians living in Singapore. Iowa Reference Algorithms (Iowa Institute for Biomedical Imaging) were used for intra-retinal layer segmentation and mean thickness of 10 intra-retinal layers rescaled with magnification correction using axial length value. Linear regression models were performed to investigate the association of retinal layers with risk factors. After excluding participants with history of diabetes or ocular diseases, high-quality macular SD-OCT images were available for 2,047 participants (44–89 years old). Most of the retinal layers decreased with age except for foveal retinal nerve fiber layer (RNFL) and the inner/outer segments of photoreceptors where they increased with age. Men generally had thicker retinal layers than women. Chinese have the thickest RNFL and retinal pigment epithelium amongst the ethnic groups. Axial length and refractive error remained correlated with retinal layers in spite of magnification correction. Our data show pronounced age-related changes in retinal morphology. Age, gender, ethnicity and axial length need be considered when establishing OCT imaging biomarkers for ocular or systemic disease.
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Affiliation(s)
- Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
| | - Kavya Devarajan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
| | - Florian Schwarzhans
- Center for Medical Statistics Informatics and Intelligent Systems, Section for Medical Information Management and Imaging, Medical University Vienna, Vienna, Austria
| | - Alfred Gan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Damon Wong
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore.,Department of Ophthalmology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Georg Fischer
- Center for Medical Statistics Informatics and Intelligent Systems, Section for Medical Information Management and Imaging, Medical University Vienna, Vienna, Austria
| | - Clemens Vass
- Department of Ophthalmology and Optometry, Medical University Vienna, Vienna, Austria
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. .,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore. .,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore. .,Department of Ophthalmology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. .,Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria. .,Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria.
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23
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Wang Y, Wang G, Jing R, Hu T, Likhodii S, Sun G, Randell E, Jia G, Yu T, Zhang W. Metabolomics analysis of human plasma metabolites reveals the age- and sex-specific associations. J LIQ CHROMATOGR R T 2019. [DOI: 10.1080/10826076.2019.1701016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yixiao Wang
- School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, P. R. China
| | - Guangshu Wang
- School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, P. R. China
| | - Ru’nan Jing
- School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, P. R. China
| | - Ting Hu
- Department of Computer Science, Memorial University, St John’s, Canada
| | - Sergei Likhodii
- Provincial Toxicology Centre, Provincial Health Services Authority, Vancouver, Canada
| | - Guang Sun
- Faculty of Medicine, Discipline of Medicine, Memorial University, St. John’s, Canada
| | - Edward Randell
- Faculty of Medicine, Department of Laboratory Medicine, Memorial University, St. John’s, Canada
| | - Guihua Jia
- School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, P. R. China
| | - Tianmiao Yu
- School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, P. R. China
| | - Weidong Zhang
- School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin, P. R. China
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24
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Affiliation(s)
- Marc Leeman
- From the Hypertension Clinic, Erasme University Hospital, Université Libre de Bruxelles, Belgium; on behalf of the Belgian Society of Hypertension (M.L.)
| | - Philippe Kestelyn
- Department of Ophthalmology, Ghent University, Belgium; on behalf of the Belgian Glaucoma Society (P.K.)
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25
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Laville V, Kang JH, Cousins CC, Iglesias AI, Nagy R, Cooke Bailey JN, Igo RP, Song YE, Chasman DI, Christen WG, Kraft P, Rosner BA, Hu F, Wilson JF, Gharahkhani P, Hewitt AW, Mackey DA, Hysi PG, Hammond CJ, vanDuijn CM, Haines JL, Vitart V, Fingert JH, Hauser MA, Aschard H, Wiggs JL, Khawaja AP, MacGregor S, Pasquale LR. Genetic Correlations Between Diabetes and Glaucoma: An Analysis of Continuous and Dichotomous Phenotypes. Am J Ophthalmol 2019; 206:245-255. [PMID: 31121135 PMCID: PMC6864262 DOI: 10.1016/j.ajo.2019.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 05/03/2019] [Accepted: 05/09/2019] [Indexed: 01/05/2023]
Abstract
PURPOSE A genetic correlation is the proportion of phenotypic variance between traits that is shared on a genetic basis. Here we explore genetic correlations between diabetes- and glaucoma-related traits. DESIGN Cross-sectional study. METHODS We assembled genome-wide association study summary statistics from European-derived participants regarding diabetes-related traits like fasting blood sugar (FBS) and type 2 diabetes (T2D) and glaucoma-related traits (intraocular pressure [IOP], central corneal thickness [CCT], corneal hysteresis [CH], corneal resistance factor [CRF], cup-to-disc ratio [CDR], and primary open-angle glaucoma [POAG]). We included data from the National Eye Institute Glaucoma Human Genetics Collaboration Heritable Overall Operational Database, the UK Biobank, and the International Glaucoma Genetics Consortium. We calculated genetic correlation (rg) between traits using linkage disequilibrium score regression. We also calculated genetic correlations between IOP, CCT, and select diabetes-related traits based on individual level phenotype data in 2 Northern European population-based samples using pedigree information and Sequential Oligogenic Linkage Analysis Routines. RESULTS Overall, there was little rg between diabetes- and glaucoma-related traits. Specifically, we found a nonsignificant negative correlation between T2D and POAG (rg = -0.14; P = .16). Using Sequential Oligogenic Linkage Analysis Routines, the genetic correlations between measured IOP, CCT, FBS, fasting insulin, and hemoglobin A1c were null. In contrast, genetic correlations between IOP and POAG (rg ≥ 0.45; P ≤ 3.0 × 10-4) and between CDR and POAG were high (rg = 0.57; P = 2.8 × 10-10). However, genetic correlations between corneal properties (CCT, CRF, and CH) and POAG were low (rg range -0.18 to 0.11) and nonsignificant (P ≥ .07). CONCLUSION These analyses suggest that there is limited genetic correlation between diabetes- and glaucoma-related traits.
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Affiliation(s)
- Vincent Laville
- Department of Computational Biology, Institut Pasteur, Paris, France
| | - Jae H Kang
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Clara C Cousins
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Adriana I Iglesias
- Departments of Ophthalmology and Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Réka Nagy
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Jessica N Cooke Bailey
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA; Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Robert P Igo
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Yeunjoo E Song
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA; Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Daniel I Chasman
- Division of Preventive Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - William G Christen
- Division of Preventive Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA
| | - Frank Hu
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA; Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA
| | - James F Wilson
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Puya Gharahkhani
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; School of Medicine, Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - David A Mackey
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - Pirro G Hysi
- Department of Twin Research and Genetic Epidemiology, King's College London, United Kingdom
| | - Christopher J Hammond
- Department of Twin Research and Genetic Epidemiology, King's College London, United Kingdom
| | - Cornelia M vanDuijn
- Departments of Ophthalmology and Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jonathan L Haines
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA; Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Veronique Vitart
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - John H Fingert
- Department of Ophthalmology and Visual Science, University of Iowa, Iowa City, Iowa, USA
| | - Michael A Hauser
- Departments of Ophthalmology and Medicine, Duke University, Durham, North Carolina, USA
| | - Hugues Aschard
- Department of Computational Biology, Institut Pasteur, Paris, France; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Anthony P Khawaja
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Louis R Pasquale
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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26
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Chua J, Schwarzhans F, Nguyen DQ, Tham YC, Sia JT, Lim C, Mathijia S, Cheung C, Tin A, Fischer G, Cheng CY, Vass C, Schmetterer L. Compensation of retinal nerve fibre layer thickness as assessed using optical coherence tomography based on anatomical confounders. Br J Ophthalmol 2019; 104:282-290. [PMID: 31118184 PMCID: PMC7025730 DOI: 10.1136/bjophthalmol-2019-314086] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/04/2019] [Accepted: 04/27/2019] [Indexed: 01/07/2023]
Abstract
Background/Aims To compensate the retinal nerve fibre layer (RNFL) thickness assessed by spectral-domain optical coherence tomography (SD-OCT) for anatomical confounders. Methods The Singapore Epidemiology of Eye Diseases is a population-based study, where 2698 eyes (1076 Chinese, 704 Malays and 918 Indians) with high-quality SD-OCT images from individuals without eye diseases were identified. Optic disc and macular cube scans were registered to determine the distance between fovea and optic disc centres (fovea distance) and their respective angle (fovea angle). Retinal vessels were segmented in the projection images and used to calculate the circumpapillary retinal vessel density profile. Compensated RNFL thickness was generated based on optic disc (ratio, orientation and area), fovea (distance and angle), retinal vessel density, refractive error and age. Linear regression models were used to investigate the effects of clinical factors on RNFL thickness. Results Retinal vessel density reduced significantly with increasing age (1487±214 µm in 40–49, 1458±208 µm in 50–59, 1429±223 µm in 60–69 and 1415±233 µm in ≥70). Compensation reduced the variability of RNFL thickness, where the effect was greatest for Chinese (10.9%; p<0.001), followed by Malays (6.6%; p=0.075) and then Indians (4.3%; p=0.192). Compensation reduced the age-related RNFL decline by 55% in all participants (β=−3.32 µm vs β=−1.50 µm/10 years; p<0.001). Nearly 62% of the individuals who were initially classified as having abnormally thin RNFL (outside the 99% normal limits) were later reclassified as having normal RNFL. Conclusions RNFL thickness compensated for anatomical parameters reduced the variability of measurements and may improve glaucoma detection, which needs to be confirmed in future studies.
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Affiliation(s)
- Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Florian Schwarzhans
- Section for Medical Information Management and Imaging, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Duc Quang Nguyen
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Josh Tjunrong Sia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Claire Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Shivani Mathijia
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Carol Cheung
- Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong
| | - Aung Tin
- Singapore National Eye Centre, Singapore, Singapore
| | - Georg Fischer
- Section for Medical Information Management and Imaging, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Ching-Yu Cheng
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Clemens Vass
- Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Leopold Schmetterer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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27
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Chua J, Chin CWL, Tan B, Wong SH, Devarajan K, Le TT, Ang M, Wong TY, Schmetterer L. Impact of systemic vascular risk factors on the choriocapillaris using optical coherence tomography angiography in patients with systemic hypertension. Sci Rep 2019; 9:5819. [PMID: 30967575 PMCID: PMC6456612 DOI: 10.1038/s41598-019-41917-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/20/2019] [Indexed: 12/29/2022] Open
Abstract
We investigated the characteristics of the choriocapillaris flow voids using optical coherence tomography angiography (OCTA) in 85 patients (164 eyes) with hypertension (mean ± SD age, 56 ± 11 years; 45% women; 20% poorly controlled BP; 16% diabetes) who are without ocular diseases and determined possible correlations with systemic vascular risk factors. Data on 24-hour ambulatory blood pressure (BP), serum creatinine, and urine microalbumin/creatinine ratio (MCR) were collected. Estimated glomerular filtration rate (eGFR) was calculated based on CKD-EPI Creatinine Equation. OCTA imaging (6 × 6 mm scans; AngioVue) with quantitative microvascular analysis of the choriocapillaris was performed. Linear regression was used to investigate the association of systemic risk factors with area (percentage), size (pixels) and number of choriocapillaris flow voids. Diabetes (β = 0.33; 95% CI, 0.02 to 0.63) and daytime systolic BP (β = -0.13; 95% CI, -0.24 to -0.02) were associated with areas of flow voids. Age (β = 0.21; 95% CI, 0.06 to 0.36) and daytime diastolic BP (β = -0.18; 95% CI, -0.34 to -0.02) were associated with size of flow voids. Age (β = -21.21; 95% CI, -31.79 to -10.63) and nighttime diastolic BP (β = 13.89; 95% CI, 0.61 to 27.17) were associated with number of flow voids. Kidney parameters were not associated with any features of flow voids. In patients with hypertension, a higher BP appeared to increase blood flow in the choriocapillaris which needs to be considered when using the OCTA to study eye diseases in hypertensives.
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Affiliation(s)
- Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Calvin Woon Loong Chin
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.,National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Si Han Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Kavya Devarajan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Thu-Thao Le
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. .,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore. .,Department of Ophthalmology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. .,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria. .,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
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