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Reste-Ferreira D, Santos T, Marques IP, Ribeiro ML, Santos AR, Martinho ACV, Lobo C, Cunha-Vaz J. Characterization of central-involved diabetic macular edema using OCT and OCTA. Eur J Ophthalmol 2024:11206721241248478. [PMID: 38644796 DOI: 10.1177/11206721241248478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
PURPOSE To characterize the occurrence of diabetic macular edema and the presence of abnormal retinal fluid accumulation in nonproliferative diabetic retinopathy (NPDR). METHODS In this two-year prospective study, a total of 122 eyes with diabetes type 2 underwent optical coherence tomography (OCT) and OCT-Angiography in association with OCT-Fluid imaging, a novel algorithm of OCT analysis allowing quantification of abnormal accumulation of fluid in the retina through low optical reflectivity ratios (LOR). Early Treatment Diabetic Retinopathy Study (ETDRS) grading for diabetic retinopathy (DR) severity assessment was performed using 7-field color fundus photography. Best corrected visual acuity was also recorded. RESULTS During the 2-year follow-up, 23 eyes (19%) developed central-involved diabetic macular edema (CI-DME) and 2 eyes (2%) developed clinically significant macular edema (CSME). In the two-year period of the study, eyes that developed CI-DME showed a progressive increase in central retinal thickness (CRT) (β = 7.7 ± 2.1 µm/year, p < 0.001) and in LOR values (β = 0.009 ± 0.004 ratio/year, p = 0.027). The increase in CRT and abnormal retinal fluid, represented by increased LOR ratios, are associated with increased retinal perfusion in the deep capillary plexus (DCP) (skeletonized vessel density, p = 0.039). In contrast, the eyes with CSME showed decreased retinal perfusion and abnormal fluid located in the outer layers of the retina. CONCLUSIONS CI-DME and CSME appear to represent different entities. Eyes with CI-DME show increases in abnormal retinal fluid associated with increased retinal vascular perfusion in the DCP. Eyes with CSME are apparently associated with decreased retinal vascular perfusion in the DCP and abnormal fluid in the outer retina.
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Affiliation(s)
- Débora Reste-Ferreira
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Torcato Santos
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Inês Pereira Marques
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- CORC - Coimbra Ophthalmology Reading Centre, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Maria Luísa Ribeiro
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Ana Rita Santos
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- CORC - Coimbra Ophthalmology Reading Centre, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | | | - Conceição Lobo
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- CORC - Coimbra Ophthalmology Reading Centre, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Centro de Responsabilidade Integrado de Oftalmologia (CRIO), Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
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Pinheiro RL, Raimundo M, Gil JQ, Henriques J, Rosa AM, Quadrado MJ, Lobo C, Murta JN. The influence of personality on the quality of vision after multifocal intraocular lens implantation. Eur J Ophthalmol 2024; 34:154-160. [PMID: 37218212 DOI: 10.1177/11206721231176313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To assess the possible correlation between patients' personality traits and subjective perception of quality of vision (QoV), after multifocal intraocular lens (mIOL) implantation. METHODS patients who had bilateral implantation of a non-diffractive X-WAVE or a trifocal lens were assessed 6 months postoperatively. Patients answered the NEO-Five Factor Inventory (NEO-FFI-20) questionnaire ("Big Five five-factor personality model") to examine their personality. Six months following surgery, patients were asked to fill a QoV questionnaire where they graded the frequency of 10 common visual symptoms. Primary outcomes were to evaluate the correlation between personality scores and the reported frequency of visual disturbances. RESULTS The study comprised 20 patients submitted to bilateral cataract surgery, 10 with a non-diffractive X-WAVE lens (AcrySof® IQ Vivity) and 10 with a trifocal lens (AcrySof® IQ PanOptix). Mean age was 60.23 (7.06) years. Six months following surgery, patients with lower scores of conscientiousness and extroversion reported a higher frequency of visual disturbances (blurred vision, P = .015 and P = .009, seeing double images P = .018 and P = .006, and having difficulties focusing, P = .027 and P = .022, respectively). In addition, patients with high neuroticism scores had more difficulty focusing (P = .033). CONCLUSIONS In this study, personality traits such as low conscientiousness and extroversion and high neuroticism significantly influenced QoV perception 6 months after bilateral multifocal lens implantation. Patients' personality questionnaires could be a useful preoperative assessment test to a mIOL.
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Affiliation(s)
- Rosa L Pinheiro
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Miguel Raimundo
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - João Q Gil
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Jorge Henriques
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Andreia M Rosa
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Maria João Quadrado
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Conceição Lobo
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Joaquim N Murta
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
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Reste-Ferreira D, Marques IP, Santos T, Ribeiro ML, Mendes L, Santos AR, Lobo C, Cunha-Vaz J. Retinal neurodegeneration in eyes with NPDR risk phenotypes: A two-year longitudinal study. Acta Ophthalmol 2023. [PMID: 37798863 DOI: 10.1111/aos.15787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Diabetic retinopathy (DR) is both a microangiopathy and a neurodegenerative disease. However, the connections between both changes are not well known. PURPOSE To characterise the longitudinal retinal ganglion cell layer + inner plexiform layer (GCL + IPL) changes and their association with microvascular changes in type-2 diabetes (T2D) patients with nonproliferative diabetic retinopathy (NPDR). METHODS This two-year prospective study (CORDIS, NCT03696810) included 122 T2D individuals with NPDR identified as risk phenotypes B and C, which present a more rapid progression. Phenotype C was identified by decreased VD ≥ 2SD in healthy controls, and phenotype B, identified by subclinical macular oedema with only minimal vascular closure. The GCL + IPL thickness, vessel density, perfusion density and area of intercapillary spaces (AIS) were assessed by optical coherence tomography (OCT) and OCT angiography (OCTA). Linear mixed effects models were employed to evaluate the retinal GCL + IPL progression and its associations. RESULTS Regarding GCL + IPL thickness, T2D individuals presented on average 80.1 ± 7.49 μm, statistically significantly lower than the healthy control group, 82.5 ± 5.71 (p = 0.022), with only phenotype C differing significantly from controls (p = 0.006). GCL + IPL thickness steadily decreased during the two-year period in both risk phenotypes, with an annual decline rate of -0.372 μm/year (p < 0.001). Indeed, phenotype C showed a higher rate of progression (-0.459 μm/year, p < 0.001) when compared to phenotype B (-0.296 μm/year, p = 0.036). Eyes with ETDRS grade 20 showed GCL + IPL thickness values comparable to those of healthy control group (83.3 ± 5.80 and 82.7 ± 5.50 μm, respectively, p = 0.880), whereas there was a progressive decrease in GCL + IPL thickness in ETDRS grades 35 and 43-47 associated with the increase in severity of the retinopathy (-0.276 μm/year, p = 0.004; -0.585 μm/year, p = 0.013, respectively). Furthermore, the study showed statistically significant associations between the progressive thinning of GCL + IPL and the progressive increase in retinal capillary non-perfusion, with particular relevance for AIS (p < 0.001). CONCLUSIONS Our findings showed that, in eyes with NPDR and at risk for progression, retinal neurodegeneration occurs at different rates in different risk phenotypes, and it is associated with retinal microvascular non-perfusion.
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Affiliation(s)
- Débora Reste-Ferreira
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Inês Pereira Marques
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- CORC - Coimbra Ophthalmology Reading Center, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Torcato Santos
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Maria Luísa Ribeiro
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Luís Mendes
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Ana Rita Santos
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- CORC - Coimbra Ophthalmology Reading Center, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Conceição Lobo
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- CORC - Coimbra Ophthalmology Reading Center, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Centro de Responsabilidade Integrado de Oftalmologia (CRIO), Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
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Lobo C, Santos T, Marques IP, Madeira MH, Santos AR, Figueira J, Cunha-Vaz J. Characterisation of progression of macular oedema in the initial stages of diabetic retinopathy: a 3-year longitudinal study. Eye (Lond) 2023; 37:313-319. [PMID: 35066579 PMCID: PMC9873671 DOI: 10.1038/s41433-022-01937-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/14/2021] [Accepted: 01/13/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND/OBJECTIVES To characterise the prevalence and three-year progression of centre-involving diabetic macular oedema (CI-DMO) in minimal to moderate non-proliferative diabetic retinopathy, using optical coherence tomography (OCT) and measurements of retinal fluid using tissue optical reflectivity ratios (OCT-Leakage). METHODS/METHODS Seventy-four eyes from 74 patients were followed in a 3-year prospective longitudinal observational cohort of type 2 diabetes (T2D) patients using spectral-domain optical coherence tomography (SD-OCT), OCT-Angiography (OCT-A) and OCT-Leakage (OCT-L). Eyes were examined four times with 1-year intervals. Sixteen eyes (17.8%) were excluded from the analysis due to quality control standards. Retinal oedema was measured by central retinal thickness and retinal fluid by using optical reflectivity ratios obtained with the OCT-L algorithm. Vessel density was measured by OCT-A. Thinning of the ganglion cell and inner plexiform layers (GCL + IPL) was examined to identify retinal neurodegenerative changes. Diabetic retinopathy ETDRS classification was performed using the seven-field ETDRS protocol. RESULTS CI-DMO was identified in the first visit in 9% of eyes in ETDRS groups 10-20, 10% of eyes in ETDRS group 35 and 15% of eyes in ETDRS groups 43-47. The eyes with CI-DMO and subclinical CI-DMO showed a progressive increase in retinal extracellular fluid during the 3-year period of follow-up. The eyes with CI-DMO and increased retinal extracellular fluid accumulation were associated with vision loss. CONCLUSIONS The prevalence of subclinical CI-DMO and CI-DMO in the initial stages of NPDR occurs independently of severity grading of the retinopathy, showing progressive increase in retinal extracellular fluid and this increase is associated with vision loss (82% 9 out of 11 cases).
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Affiliation(s)
- Conceição Lobo
- grid.422199.50000 0004 6364 7450AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal ,grid.28911.330000000106861985Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3000-548 Coimbra, Portugal
| | - Torcato Santos
- grid.422199.50000 0004 6364 7450AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal
| | - Inês P. Marques
- grid.422199.50000 0004 6364 7450AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Maria H. Madeira
- grid.422199.50000 0004 6364 7450AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana Rita Santos
- grid.422199.50000 0004 6364 7450AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal ,Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - João Figueira
- grid.422199.50000 0004 6364 7450AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal ,grid.28911.330000000106861985Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3000-548 Coimbra, Portugal
| | - José Cunha-Vaz
- grid.422199.50000 0004 6364 7450AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
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Ribeiro L, Marques IP, Santos T, Carvalho S, Santos AR, Mendes L, Lobo C, Cunha-Vaz J. Characterization of 2-Year Progression of Different Phenotypes of Nonproliferative Diabetic Retinopathy. Ophthalmic Res 2022; 66:228-237. [PMID: 36170808 DOI: 10.1159/000526370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/28/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of the study was to characterize the 2-year progression of risk phenotypes of nonproliferative diabetic retinopathy (NPDR) in type 2 diabetes (T2D) phenotype C, or ischemic phenotype, identified by decreased skeletonized retinal vessel density (VD), ≥2 SD over normal values, and phenotype B, or edema phenotype, identified by increased retinal thickness, i.e., subclinical macular edema, and no significant decrease in VD. METHODS A prospective longitudinal cohort study (CORDIS, NCT03696810) was conducted with 4 visits (baseline, 6 months, 1 year, and 2 years). Ophthalmological examinations included best-corrected visual acuity, color fundus photography (CFP), and optical coherence tomography (OCT) and OCT angiography. Early Treatment Diabetic Retinopathy Study grading was performed at the baseline and last visits based on 7-field CFP. RESULTS One hundred and twenty-two eyes from T2D individuals with NPDR fitted in the categories of phenotypes B and C and completed the 2-year follow-up. Sixty-five (53%) of the eyes were classified as phenotype B and 57 (47%) eyes as phenotype C. Neurodegeneration represented by thinning of the ganglion cell layer and inner plexiform layer was present in both phenotypes and showed significant progression over the 2-year period (p < 0.001). In phenotype C, significant progression in the 2-year period was identified in decreased skeletonized VD (p = 0.01), whereas in phenotype B microvascular changes involved preferentially decrease in perfusion density (PD, p = 0.012). Phenotype B with changes in VD and PD (flow) and preferential involvement of the deep capillary plexus (p < 0.001) is associated with development of center-involved macular edema. DISCUSSION In the 2-year period of follow-up, both phenotypes B and C showed progression in retinal neurodegeneration, with changes at the microvascular level characterized by decreases in PD in phenotype B and decreases in VD in phenotype C.
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Affiliation(s)
- Luísa Ribeiro
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Inês P Marques
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Torcato Santos
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Sara Carvalho
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Ana R Santos
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Luís Mendes
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Conceição Lobo
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
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Marques IP, Ferreira S, Santos T, Madeira MH, Santos AR, Mendes L, Lobo C, Cunha-Vaz J. Association between neurodegeneration and macular perfusion in the progression of diabetic retinopathy. A 3-year longitudinal study. Ophthalmologica 2022; 245:335-341. [PMID: 35158351 PMCID: PMC9393829 DOI: 10.1159/000522527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/07/2022] [Indexed: 11/19/2022]
Abstract
Objective and purpose: To explore the relation between retinal neurodegenerative changes and vessel closure (VC) in individuals with non-proliferative diabetic retinopathy (NPDR) in a follow-up period of 3 years. DESIGN 3-year prospective longitudinal study with four annual visits. PARTICIPANTS 74 individuals with type 2 diabetes, NPDR and ETDRS grades from 10 to 47, one eye/person. An age-matched healthy control population of 84 eyes was used as control group. METHODS Participants were annually examined by color fundus photography (CFP), spectral domain-optical coherence tomography (SD-OCT) and OCT-Angiography (OCTA). Vessel closure was assessed by OCTA vessel density maps. SD-OCT segmentations was performed to access central retinal thickness (CRT) and retinal neurodegeneration considered as thinning of the ganglion cell plus inner plexiform layer (GCL+IPL). RESULTS Type 2 diabetic individuals presented significantly higher CRT (p=0.001), GCL+IPL thinning (p=0.042), and decreased vessel density at the superficial capillary plexus (p<0.001) and full retina (p=0.001). When looking at changes occurring over the 3-year period of follow up (Table 2), there were statistically significant decreases in GCL+IPL thickness (-0.438 µm/year; p=0.038), foveal avascular zone circularity (-0.009; p=0.047), and vessel density, in superficial capillary plexus (-0.172 mm-1/year; p<0.001), deep capillary plexus (-0.350 mm-1/year; p<0.001) and full retina (-0.182 mm-1/year; p<0.001). A statistically significant association was identified between GCL+IPL thinning and decrease in deep capillary plexus vessel density (β = 0.196 [95% CI 0.037, 0.355], z = 2.410, p = 0.016), after controlling for age, gender, diabetes duration, hemoglobin A1c level, and CRT. CONCLUSIONS Retinal neurodegenerative changes show a steady progression during a 3-year period of follow-up in eyes with NPDR and appear to be directly associated with progression in decreased vessel density including vascular closure through preferential involvement of the deep capillary plexus. Our findings provide evidence that retinal neuropathy is linked with microvascular changes occurring in diabetic patients.
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Affiliation(s)
- Inês P Marques
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal,
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal,
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal,
| | - Sónia Ferreira
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Torcato Santos
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Maria H Madeira
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Ana Rita Santos
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Luís Mendes
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Conceição Lobo
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
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Madeira MH, Marques IP, Ferreira S, Tavares D, Santos T, Santos AR, Figueira J, Lobo C, Cunha-Vaz J. Retinal Neurodegeneration in Different Risk Phenotypes of Diabetic Retinal Disease. Front Neurosci 2021; 15:800004. [PMID: 35757010 PMCID: PMC9231566 DOI: 10.3389/fnins.2021.800004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/15/2021] [Indexed: 12/02/2022] Open
Abstract
Diabetic retinopathy (DR) has been considered a microvascular disease, but it has become evident that neurodegeneration also plays a key role in this complex pathology. Indeed, this complexity is reflected in its progression which occurs at different rates in different type 2 diabetic (T2D) individuals. Based on this concept, our group has identified three DR progression phenotypes that might reflect the interindividual differences: phenotype A, characterized by low microaneurysm turnover (MAT <6), phenotype B, low MAT (<6) and increased central retinal thickness (CRT); and phenotype C, with high MAT (≥6). In this study, we evaluated the progression of DR neurodegeneration, considering ganglion cell+inner plexiform layers (GCL+IPL) thinning, in 170 T2D individuals followed for a period of 5 years, to explore associations with disease progression or risk phenotypes. Ophthalmological examinations were performed at baseline, first 6 months, and annually. GCL+IPL average thickness was evaluated by optical coherence tomography (OCT). Microaneurysm turnover (MAT) was evaluated using the RetMarkerDR. ETDRS level and severity progression were assessed in seven-field color fundus photography. In the overall population there was a significant loss in GCL+IPL (−0.147 μm/year), independently of glycated hemoglobin, age, sex, and duration of diabetes. Interestingly, this progressive thinning in GCL + IPL reached higher values in phenotypes B and C (−0.249 and −0.238 μm/year, respectively), whereas phenotype A remained relatively stable. The presence of neurodegeneration in all phenotypes suggests that it is the retinal vascular response to the early neurodegenerative changes that determines the course of the retinopathy in each individual. Therefore, classification of different DR phenotypes appears to offer relevant clarification of DR disease progression and an opportunity for improved management of each T2D individual with DR, thus playing a valuable role for the implementation of personalized medicine in DR.
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Affiliation(s)
- Maria H. Madeira
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Inês P. Marques
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Sónia Ferreira
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Diana Tavares
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Torcato Santos
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Ana Rita Santos
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - João Figueira
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Conceição Lobo
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- *Correspondence: José Cunha-Vaz,
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Ribeiro L, Marques IP, Coimbra R, Santos T, Madeira MH, Santos AR, Barreto P, Lobo C, Cunha-Vaz J. Characterization of One-Year Progression of Risk Phenotypes of Diabetic Retinopathy. Ophthalmol Ther 2021; 11:333-345. [PMID: 34865186 PMCID: PMC8770718 DOI: 10.1007/s40123-021-00437-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction We characterized the progression of different diabetic retinopathy (DR) phenotypes in type 2 diabetes (T2D). Methods A prospective longitudinal cohort study (CORDIS, NCT03696810) was conducted with three visits (baseline, 6 months, and 1 year). Demographic and systemic data included age, sex, diabetes duration, lipid profile, and hemoglobin A1c (HbA1c). Ophthalmological examinations included best-corrected visual acuity (BCVA), color fundus photography (CFP), and optical coherence tomography (OCT and OCTA). Phenotype classification was performed at the 6-month visit based on microaneurysm turnover (MAT, on CFP) and central retinal thickness (CRT, on OCT). Only risk phenotypes B (MAT < 6 and increased CRT) and C (MAT ≥ 6 with or without increased CRT) were included. ETDRS grading was performed at the baseline visit based on seven-field CFP. Results A total of 133 T2D individuals were included in the study; 81 (60%) eyes were classified as phenotype B and 52 (40%) eyes as phenotype C. Of these, 128 completed the 1-year follow-up. At baseline, eyes with phenotype C showed greater capillary closure (superior capillary plexus, deep capillary plexus, and full retina, p < 0.001) and increased foveal avascular zone (FAZ) area (p < 0.001), indicating more advanced microvascular disease. Neurodegeneration represented by thinning of the ganglion cell layer + inner plexiform layer (GCL + IPL) was present in both phenotypes. When analyzing the 1-year progression of each phenotype, only phenotype C revealed a significant decrease in BCVA (p = 0.02) and enlargement of the FAZ (p = 0.03). A significant progressive decrease in the vessel density of the deep capillary layer and in MAT occurred in both phenotypes, but these changes were particularly relevant in phenotype C and ETDRS grades 43–47. During the 1-year period, both phenotypes B and C showed progression in GCL + IPL thinning (p < 0.001). Conclusions In the 1-year period of follow-up, both phenotypes B and C showed progression in retinal neurodegeneration, whereas phenotype C showed more marked disease progression at the microvascular level.
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Affiliation(s)
- Luísa Ribeiro
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal. .,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal. .,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal.
| | - Inês P Marques
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal
| | - Rita Coimbra
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Torcato Santos
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Maria H Madeira
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal
| | - Ana Rita Santos
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal.,Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Patrícia Barreto
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Conceição Lobo
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal.,Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal. .,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal. .,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal.
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Santos AR, Mendes L, Madeira MH, Marques IP, Tavares D, Figueira J, Lobo C, Cunha-Vaz J. Microaneurysm Turnover in Mild Non-Proliferative Diabetic Retinopathy is Associated with Progression and Development of Vision-Threatening Complications: A 5-Year Longitudinal Study. J Clin Med 2021; 10:jcm10102142. [PMID: 34063514 PMCID: PMC8156148 DOI: 10.3390/jcm10102142] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/04/2021] [Accepted: 05/12/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Analysis of retinal microaneurysm turnover (MAT) has been previously shown to contribute to the identification of eyes at risk of developing clinically significant complications associated with diabetic retinopathy (DR). We propose to further characterize MAT as a predictive biomarker of DR progression and development of vision-threatening complications. Methods: 212 individuals with type 2 diabetes (T2D; ETDRS grades 20 and 35) were evaluated annually in a 5-year prospective, longitudinal study, by color fundus photography and optical coherence tomography. Endpoints were diabetic macular edema (DME) or proliferative retinopathy (PDR). MAT analysis included determination of MA formation and disappearance rates, automatically assessed using the RetMarkerDR®. Retinopathy severity progression was evaluated using step increases in ETDRS severity levels. Results: Of the 212 individuals, 172 completed the 5-year follow-up study or developed an endpoint (n = 27). MAT calculated at 1 year showed a significant difference between groups of endpoint developments (p = 0.018), particularly MA disappearance rate (p = 0.007). MAT also showed a significant difference between eyes with different ETDRS severity progression in the 5-year period (p = 0.035). Conclusions: MAT is an indicator of the development of DME and/or PDR as well as of DR severity progression in T2D individuals with mild retinopathy.
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Affiliation(s)
- Ana Rita Santos
- AIBILI—Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal; (A.R.S.); (L.M.); (M.H.M.); (I.P.M.); (D.T.); (J.F.); (C.L.)
- Department of Orthoptics, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Luis Mendes
- AIBILI—Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal; (A.R.S.); (L.M.); (M.H.M.); (I.P.M.); (D.T.); (J.F.); (C.L.)
| | - Maria Helena Madeira
- AIBILI—Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal; (A.R.S.); (L.M.); (M.H.M.); (I.P.M.); (D.T.); (J.F.); (C.L.)
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ines P. Marques
- AIBILI—Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal; (A.R.S.); (L.M.); (M.H.M.); (I.P.M.); (D.T.); (J.F.); (C.L.)
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Diana Tavares
- AIBILI—Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal; (A.R.S.); (L.M.); (M.H.M.); (I.P.M.); (D.T.); (J.F.); (C.L.)
| | - João Figueira
- AIBILI—Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal; (A.R.S.); (L.M.); (M.H.M.); (I.P.M.); (D.T.); (J.F.); (C.L.)
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3000-075 Coimbra, Portugal
| | - Conceição Lobo
- AIBILI—Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal; (A.R.S.); (L.M.); (M.H.M.); (I.P.M.); (D.T.); (J.F.); (C.L.)
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3000-075 Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI—Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal; (A.R.S.); (L.M.); (M.H.M.); (I.P.M.); (D.T.); (J.F.); (C.L.)
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Correspondence: ; Tel.: +351-239-480-136
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Abstract
PURPOSE To comparatively evaluate the accuracy of newer intraocular lens (IOL) calculation formulas and common third-generation formulas after Wang-Koch adjustment in the prediction of postoperative refraction in highly myopic eyes. METHODS This was a retrospective study including eyes with high myopia that had uncomplicated cataract surgery with implantation of an AcrySof MA60MA IOL (power range: -5.00 to +5.00 diopters [D]) (Alcon Laboratories, Inc). All patients underwent optical biometry (Carl Zeiss IOLMaster 500 and IOLMaster 700, and Allegro Biograph) and the postoperative spherical equivalent for the implanted IOL was estimated using SRK/T, Holladay 1 (both Wang-Koch adjusted), Haigis, Barrett Universal II, Kane, Ladas, and Hill-RBF v2.0 formulas. Outcomes included the median absolute prediction error (MedAE) and the proportion of eyes within ±0.25, ±0.50, and ±1.00 D of the preoperative prediction. RESULTS Eighty-two eyes with a mean axial length of 30.89 ± 1.85 mm were included. The MedAE in ascending order was Hill-RBF v2.0 0.31 D, Kane 0.33 D, Barrett 0.36 D, Holladay Iwk 0.37 D, SRK/Twk 0.37 D, Holladay Iwk 0.43 D, HaigisULIB 0.54 D, and Ladas 0.61 D. The formula with the lowest MedAE (Hill-RBF v2.0) yielded a prediction error within ±0.25, ±0.50, and ±1.00 D in 43.1%, 70.6%, and 94.1% of cases, respectively. CONCLUSIONS Recent formulas such as Barrett Universal II, Kane, and Hill-RBF v2.0 and Wang-Koch adjusted formulas perform well in this subset of patients with high myopia. The Hill-RBF v2.0 formula had the lowest MedAE and highest proportion of eyes within ±0.25, ±0.50, and ±1.00 D of the predicted target. [J Refract Surg. 2021;37(3):207-211.].
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Martinho ACV, Marques IP, Messias AL, Santos T, Madeira MH, Sousa DC, Lobo C, Cunha-Vaz J. Ocular and Systemic Risk Markers for Development of Macular Edema and Proliferative Retinopathy in Type 2 Diabetes: A 5-Year Longitudinal Study. Diabetes Care 2021; 44:e12-e14. [PMID: 33158947 PMCID: PMC7783945 DOI: 10.2337/dc20-1125] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/10/2020] [Indexed: 02/03/2023]
Affiliation(s)
- António C-V Martinho
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Inês P Marques
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Ana L Messias
- Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Torcato Santos
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Maria H Madeira
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - David C Sousa
- Vision Sciences Study Center, CECV, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Ophthalmology Department, Hospital de Santa Maria, Lisbon, Portugal
| | - Conceição Lobo
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal .,Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Lobo C, Klemm E. CHEM|ampere: Sustainable chemical production with electricity. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- C. Lobo
- Universität Stuttgart Institut für Technische Chemie Pfaffenwaldring 55 70569 Stuttgart Germany
| | - E. Klemm
- Universität Stuttgart Institut für Technische Chemie Pfaffenwaldring 55 70569 Stuttgart Germany
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13
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Marques IP, Alves D, Santos T, Mendes L, Lobo C, Santos AR, Durbin M, Cunha-Vaz J. Characterization of Disease Progression in the Initial Stages of Retinopathy in Type 2 Diabetes: A 2-Year Longitudinal Study. Invest Ophthalmol Vis Sci 2020; 61:20. [PMID: 32181799 PMCID: PMC7401457 DOI: 10.1167/iovs.61.3.20] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To characterize 2-year changes occurring in neurodegeneration, edema, and capillary dropout in nonproliferative diabetic retinopathy. Methods Two-year prospective longitudinal observational cohort of eyes/patients with type 2 diabetes using spectral domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA). Eyes were examined three times with intervals of 1 year. Thickness of the full retina and layer-by-layer measurements were used to identify edema or neurodegeneration. OCTA vessel density maps of the retina were used to identify capillary dropout. Early Treatment Diabetic Retinopathy Study (ETDRS) classification was performed using the seven-field ETDRS protocol. Results A total of 62 eyes from 62 patients with diabetes were followed for 2 years. After verification for image quality, a total of 44 eyes from 44 patients (30% women) aged 52 to 80 years were retained for data analysis. There were 18 eyes with ETDRS grades 10 to 20, 17 eyes with ETDRS grade 35, and 9 eyes with ETDRS grades 43 to 47. During the 2-year follow-up period, there was a progressive increase in capillary dropout, whereas edema and neurodegeneration remained stable. In multivariate analysis, considering a model adjusted for age, sex, hemoglobin A1C, visual acuity, and diabetes duration, vessel density remained significantly different between Diabetic Retinopathy Severity Scale groups (Wilks' λ = 0.707; P = 0.015) showing association with disease progression. Conclusions Capillary dropout increased in a period of 2 years in eyes with minimal, mild, and moderate diabetic retinopathy, whereas the presence of edema and neurodegeneration remained stable.
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Knight MT, Newman MC, Benzinger MJ, Neufang KL, Agin JR, McAllister JS, Ramos M, Carter M, Duran B, Hagan K, Hansen R, Rudolph C, Quinley S, Updaw A, Neufang K, Brook L, Lucia L, Koeritzer B, Tomer J, Smith T, Brown D, Lobo C, Tobin P, O’Brien-Gammon L, Boleszcczuk P. Comparison of the Petrifilm Dry Rehydratable Film and Conventional Culture Methods for Enumeration of Yeasts and Molds in Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.806] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A collaborative study was performed involving 18 laboratories and 6 food types to compare 3M Petrifilm yeast and mold count plates with the method described in the U.S. Food and Drug Administration’s Bacteriological Analytical Manual. Four species of mold and 2 species of yeast were used to inoculate the following foods: hot dogs, corn meal, ketchup, orange juice, yogurt, and cake mix. Each collaborator received 15 samples of each food type: 5 low-level inoculations, 5 high- level inoculations, and 5 uninoculated samples. There was no significant difference between the means of the 2 methods for any product or inoculation level. The Petrifilm yeast and mold count plate method for enumeration of yeasts and molds in foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | | | | | - Karen L Neufang
- Q Laboratories, Inc., 2014 Harrison Ave, Cincinnati, OH 45214
| | - James R Agin
- Q Laboratories, Inc., 2014 Harrison Ave, Cincinnati, OH 45214
| | - J Sue McAllister
- 3M Microbiology Products, 3M Center Bldg. 270-3N-04, St. Paul, MN 55144
| | - Mary Ramos
- 3M Microbiology Products, 3M Center Bldg. 270-3N-04, St. Paul, MN 55144
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Santos AR, Santos T, Alves D, Marques IP, Lobo C, Cunha-Vaz J. Characterization of Initial Stages of Diabetic Macular Edema. Ophthalmic Res 2019; 62:203-210. [PMID: 31013506 DOI: 10.1159/000499117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 02/22/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE This study is aimed at characterizing the type of retinal edema in the initial stages of retinopathy in type 2 diabetes. METHODS In this retrospective cross-sectional study, spectral domain optical coherence tomography (OCT) layer by layer analysis of the retina in association with OCT-Leakage, an algorithm to detect sites of low optical reflectivity, were used to examine eyes with minimal, mild, and moderate diabetic retinopathy (DR). RESULTS A total of 142 eyes from 142 patients (28% women) aged 52-88 years were imaged. Macular edema, either subclinical (SCME) or central-involved macular edema (CIME), was present in 43% of eyes in group 10-20, 41% of eyes in group 35, and 38% of eyes in group 43-47. The inner nuclear layer (INL) was the layer showing higher and most frequent increases in retinal thickness (79%). The edema was predominantly intracellular in group 10-20 (65%) and extracellular in groups 35 (77%) and 43-47 (69%). CONCLUSIONS Eyes from diabetic patients in the initial stages of DR with different Early Treatment Diabetic Retinopathy Study gradings show similar prevalence of SCME and CIME, independent of the severity of the retinopathy. Retinal edema is located mainly in the INL and appears to be mostly extracellular except in the earliest stages of diabetic retinal disease where intracellular edema predominates.
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Affiliation(s)
- Ana Rita Santos
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Department of Orthoptics, Superior School of Health, Polytechnic of Porto, Porto, Portugal
| | - Torcato Santos
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Dalila Alves
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Inês P Marques
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Conceição Lobo
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,University of Coimbra, Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal, .,University of Coimbra, Coimbra, Portugal,
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Marques IP, Alves D, Santos T, Mendes L, Santos AR, Lobo C, Durbin M, Cunha-Vaz J. Multimodal Imaging of the Initial Stages of Diabetic Retinopathy: Different Disease Pathways in Different Patients. Diabetes 2019; 68:648-653. [PMID: 30523027 DOI: 10.2337/db18-1077] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 11/27/2018] [Indexed: 11/13/2022]
Abstract
The objective of this study was to evaluate the prevalence of different disease pathways (ischemia, neurodegeneration, and edema) in the initial stages of diabetic retinopathy. In this retrospective cross-sectional study, eyes were grouped by diabetic retinopathy severity using the 7-field Early Treatment Diabetic Retinopathy Study (ETDRS) protocol (levels 10-20, 35, and 43-47). Neurodegeneration was identified by thinning of the retinal nerve fiber layer and/or ganglion cell layer. Edema was identified by thickening of the inner nuclear layer, outer plexiform layer, or full retina. Ischemia was identified by metrics of retinal vessel density. Imaging was performed in 142 eyes from 142 patients (28% women) aged 52-88 years. Vessel density (ischemia) was significantly different between the ETDRS groups (P < 0.020). On multivariate regression analysis, it remained significantly different between stages of the disease and showed associations with age (P < 0.001), sex (P = 0.028), and metabolic control (P = 0.034). No significant differences between ETDRS groups were found in retinal thinning (neurodegeneration) or retinal thickness (edema). Eyes with the same ETDRS retinopathy grading from different patients with diabetes showed that the prevalence of different disease pathways varies between patients, even within the same severity group. Ischemia (capillary dropout) is the only disease pathway that shows correlation with retinopathy severity and metabolic control.
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Affiliation(s)
- Inês P Marques
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Dalila Alves
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Torcato Santos
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Luís Mendes
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Ana Rita Santos
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Conceição Lobo
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- University of Coimbra, Coimbra, Portugal
| | - Mary Durbin
- Advanced Development, Carl Zeiss Meditec, Inc., Dublin, CA
| | - José Cunha-Vaz
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- University of Coimbra, Coimbra, Portugal
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17
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Costa JF, Bompastor-Ramos P, Marques M, Henriques J, Póvoa J, Lobo C, Alió JL, Werner L, Murta J. Large-scale opacification of a hydrophilic/hydrophobic intraocular lens. Eur J Ophthalmol 2019; 30:307-314. [PMID: 30782006 DOI: 10.1177/1120672119830581] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine the prevalence and risk factors related to the opacification of the LS-502-1 intraocular lens. METHODS Cross-sectional study including patients submitted to cataract surgery between January 2010 and March 2012, with implantation of the LS-502-1 intraocular lens. Past medical history was registered and a complete ophthalmologic evaluation, that included best-corrected visual acuity, slit-lamp examination and fundoscopy, was performed. Anterior segment photographs were taken whenever intraocular lens opacification was present. RESULTS One hundred and sixty-nine eyes of 154 patients were included, mean age 78.5 ± 7.9 years. The average follow-up after intraocular lens implantation was 65.6 ± 10.0 months. Intraocular lens opacification was seen in 53.3% (n = 90) and presented as one of four different patterns: peripheral (15.6%, n = 14), central (4.4%, n = 4), diffuse (71.1%, n = 64) and superficial white deposits (8.9%, n = 8). There was no statistically significant association with systemic or ophthalmic conditions. In patients with bilateral implantation, intraocular lens opacification in one eye was significantly related to intraocular lens opacification in the fellow eye. A significant variability in opacification was found across intraocular lens serial numbers: the odds ratio for opacification in intraocular lens with serial number beginning with 200003 was 6.0 when comparing with the remaining lenses. CONCLUSION The opacification prevalence of the LS-502-1 intraocular lens was 53.3%, which is the highest ever described for any intraocular lens model. Our results suggest that this occurrence is secondary to an interaction between unknown patient variables and problems related to intraocular lens manufacturing and storage procedures.
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Affiliation(s)
- José F Costa
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Paula Bompastor-Ramos
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Marco Marques
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Jorge Henriques
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - João Póvoa
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Conceição Lobo
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Jorge L Alió
- Research & Development Department, Ophthalmic Explants Biobank, VISSUM Alicante, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
| | - Liliana Werner
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Joaquim Murta
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
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18
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Simó R, Hernández C, Porta M, Bandello F, Grauslund J, Harding SP, Aldington SJ, Egan C, Frydkjaer-Olsen U, García-Arumí J, Gibson J, Lang GE, Lattanzio R, Massin P, Midena E, Ponsati B, Ribeiro L, Scanlon P, Lobo C, Costa MÂ, Cunha-Vaz J. Effects of Topically Administered Neuroprotective Drugs in Early Stages of Diabetic Retinopathy: Results of the EUROCONDOR Clinical Trial. Diabetes 2019; 68:457-463. [PMID: 30389750 DOI: 10.2337/db18-0682] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/21/2018] [Indexed: 12/25/2022]
Abstract
The primary objective of this study was to assess whether the topical administration of two neuroprotective drugs (brimonidine and somatostatin) could prevent or arrest retinal neurodysfunction in patients with type 2 diabetes. For this purpose, adults aged between 45 and 75 years with a diabetes duration ≥5 years and an Early Treatment of Diabetic Retinopathy Study (ETDRS) level of ≤35 were randomly assigned to one of three arms: placebo, somatostatin, or brimonidine. The primary outcome was the change in implicit time (IT) assessed by multifocal electroretinography between baseline and at the end of follow-up (96 weeks). There were 449 eligible patients allocated to brimonidine (n = 152), somatostatin (n = 145), or placebo (n = 152). When the primary end point was evaluated in the whole population, we did not find any neuroprotective effect of brimonidine or somatostatin. However, in the subset of patients (34.7%) with preexisting retinal neurodysfunction, IT worsened in the placebo group (P < 0.001) but remained unchanged in the brimonidine and somatostatin groups. In conclusion, the topical administration of the selected neuroprotective agents appears useful in preventing the worsening of preexisting retinal neurodysfunction. This finding points to screening retinal neurodysfunction as a critical issue to identify a subset of patients in whom neuroprotective treatment might be of benefit.
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Affiliation(s)
- Rafael Simó
- Diabetes and Metabolism Research Unit and CIBERDEM, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Cristina Hernández
- Diabetes and Metabolism Research Unit and CIBERDEM, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Massimo Porta
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Francesco Bandello
- Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milano, Italy
| | - Jakob Grauslund
- Research Unit of Ophthalmology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Simon P Harding
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, U.K
| | - Stephen J Aldington
- Gloucestershire Hospitals National Health Service Foundation Trust, Cheltenham, U.K
| | - Catherine Egan
- Moorfields Eye Hospital National Health Service Foundation Trust, Institute of Ophthalmology/University College London, London, U.K
| | - Ulrik Frydkjaer-Olsen
- Research Unit of Ophthalmology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - José García-Arumí
- Department of Ophthalmology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Jonathan Gibson
- Department of Vision Sciences, Aston University, Birmingham, U.K
| | - Gabriele E Lang
- Department of Ophthalmology, University of Ulm, Ulm, Germany
| | - Rosangela Lattanzio
- Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milano, Italy
| | - Pascale Massin
- Department of Ophthalmology, Lariboisière Hospital, Paris, France
| | - Edoardo Midena
- Department of Ophthalmology, University of Padova, Padova, Italy
| | | | - Luísa Ribeiro
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal, and Faculty of Medicine, University of Coimbra, Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Peter Scanlon
- Gloucestershire Hospitals National Health Service Foundation Trust, Cheltenham, U.K
| | - Conceição Lobo
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal, and Faculty of Medicine, University of Coimbra, Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Miguel Ângelo Costa
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal, and Faculty of Medicine, University of Coimbra, Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
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19
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Bompastor-Ramos P, Póvoa J, Lobo C, Rodriguez AE, Alió JL, Werner L, Murta JN. Late postoperative opacification of a hydrophilic-hydrophobic acrylic intraocular lens. J Cataract Refract Surg 2018; 42:1324-1331. [PMID: 27697251 DOI: 10.1016/j.jcrs.2016.06.032] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE To report late postoperative opacification of a model of hydrophilic-hydrophobic acrylic intraocular lens (IOL) as well as the clinical consequences and laboratory characteristics. SETTING Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. DESIGN Retrospective case series. METHODS Medical records were reviewed of patients with Lentis LS-502-1 IOL opacification reporting visual loss who had IOL explantation between November 2013 and March 2015. Patients were identified in the emergency room or during regular follow-up visits. Explanted IOLs were analyzed at the Ophthalmic Explants Biobank, Vissum, Spain, or at the John A. Moran Eye Center, University of Utah, USA. RESULTS Twenty opacified IOLs were explanted from 19 patients. The mean interval between cataract surgery and diagnosis of opacification was 29.15 months ± 9.57 (SD) (range 6 to 45 months). Opacification led to a statistically significant reduction in corrected distance visual acuity (mean 0.86 ± 0.76 logMAR; P < .001) and occurred in 5.1% of the hydrophilic-hydrophobic acrylic IOLs implanted at the department. The most frequently associated medical conditions were arterial hypertension, diabetes, and glaucoma. All IOLs but 1 had a similar pattern of opacification, with yellowish diffuse opacification uniformly distributed and calcium deposits on the surface and/or subsurface of the optic and haptics and within the IOL material. CONCLUSIONS Opacification of the hydrophilic-hydrophobic acrylic IOL was found in a significant number of patients and had a significant effect on their vision. The opacification was attributed to primary calcification. FINANCIAL DISCLOSURE None of the authors has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Paula Bompastor-Ramos
- From the Department of Ophthalmology (Bompastor-Ramos, Póvoa, Lobo, Murta), Centro Hospitalar e Universitário de Coimbra, and the Faculty of Medicine (Lobo, Murta), University of Coimbra, Coimbra, Portugal; the Research and Development Department (Rodriguez, Alió), Ophthalmic Explants Biobank, Vissum Alicante, and the Division of Ophthalmology (Alió), Universidad Miguel Hernández, Alicante, Spain; the John A. Moran Eye Center (Werner), University of Utah, Salt Lake City, Utah, USA
| | - João Póvoa
- From the Department of Ophthalmology (Bompastor-Ramos, Póvoa, Lobo, Murta), Centro Hospitalar e Universitário de Coimbra, and the Faculty of Medicine (Lobo, Murta), University of Coimbra, Coimbra, Portugal; the Research and Development Department (Rodriguez, Alió), Ophthalmic Explants Biobank, Vissum Alicante, and the Division of Ophthalmology (Alió), Universidad Miguel Hernández, Alicante, Spain; the John A. Moran Eye Center (Werner), University of Utah, Salt Lake City, Utah, USA
| | - Conceição Lobo
- From the Department of Ophthalmology (Bompastor-Ramos, Póvoa, Lobo, Murta), Centro Hospitalar e Universitário de Coimbra, and the Faculty of Medicine (Lobo, Murta), University of Coimbra, Coimbra, Portugal; the Research and Development Department (Rodriguez, Alió), Ophthalmic Explants Biobank, Vissum Alicante, and the Division of Ophthalmology (Alió), Universidad Miguel Hernández, Alicante, Spain; the John A. Moran Eye Center (Werner), University of Utah, Salt Lake City, Utah, USA
| | - Alejandra E Rodriguez
- From the Department of Ophthalmology (Bompastor-Ramos, Póvoa, Lobo, Murta), Centro Hospitalar e Universitário de Coimbra, and the Faculty of Medicine (Lobo, Murta), University of Coimbra, Coimbra, Portugal; the Research and Development Department (Rodriguez, Alió), Ophthalmic Explants Biobank, Vissum Alicante, and the Division of Ophthalmology (Alió), Universidad Miguel Hernández, Alicante, Spain; the John A. Moran Eye Center (Werner), University of Utah, Salt Lake City, Utah, USA
| | - Jorge L Alió
- From the Department of Ophthalmology (Bompastor-Ramos, Póvoa, Lobo, Murta), Centro Hospitalar e Universitário de Coimbra, and the Faculty of Medicine (Lobo, Murta), University of Coimbra, Coimbra, Portugal; the Research and Development Department (Rodriguez, Alió), Ophthalmic Explants Biobank, Vissum Alicante, and the Division of Ophthalmology (Alió), Universidad Miguel Hernández, Alicante, Spain; the John A. Moran Eye Center (Werner), University of Utah, Salt Lake City, Utah, USA
| | - Liliana Werner
- From the Department of Ophthalmology (Bompastor-Ramos, Póvoa, Lobo, Murta), Centro Hospitalar e Universitário de Coimbra, and the Faculty of Medicine (Lobo, Murta), University of Coimbra, Coimbra, Portugal; the Research and Development Department (Rodriguez, Alió), Ophthalmic Explants Biobank, Vissum Alicante, and the Division of Ophthalmology (Alió), Universidad Miguel Hernández, Alicante, Spain; the John A. Moran Eye Center (Werner), University of Utah, Salt Lake City, Utah, USA
| | - Joaquim N Murta
- From the Department of Ophthalmology (Bompastor-Ramos, Póvoa, Lobo, Murta), Centro Hospitalar e Universitário de Coimbra, and the Faculty of Medicine (Lobo, Murta), University of Coimbra, Coimbra, Portugal; the Research and Development Department (Rodriguez, Alió), Ophthalmic Explants Biobank, Vissum Alicante, and the Division of Ophthalmology (Alió), Universidad Miguel Hernández, Alicante, Spain; the John A. Moran Eye Center (Werner), University of Utah, Salt Lake City, Utah, USA.
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20
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Pappuru RKR, Ribeiro L, Lobo C, Alves D, Cunha-Vaz J. Microaneurysm turnover is a predictor of diabetic retinopathy progression. Br J Ophthalmol 2018; 103:222-226. [PMID: 29699981 PMCID: PMC6362804 DOI: 10.1136/bjophthalmol-2018-311887] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/20/2018] [Accepted: 04/05/2018] [Indexed: 11/05/2022]
Abstract
Aim To analyse retinopathy phenotypes and microaneurysm (MA) turnover in mild non-proliferative diabetic retinopathy (NPDR) as predictors of progression to diabetic central-involved macular oedema (CIMO) in patients with type 2 diabetes mellitus (DM) in two different ethnic populations. Methods 205 patients with type 2 DM and mild NPDR were followed in a prospective observational study for 2 years or until development of CIMO, in two centres from different regions of the world. Ophthalmological examinations, including best-corrected visual acuity (BCVA), fundus photography with RetmarkerDR analysis, and optical coherence tomography (OCT), were performed at baseline and 6 12 and 24 months. Results 158 eyes/patients reached either the study endpoint, CIMO (24) or performed the last study visit (24-month visit) without developing CIMO (134). From the eyes/patients in analysis, 27 eyes (17.1%) progressed to more advanced ETDRS (Early Treatment Diabetic Retinopathy Study) levels: 6 progressed to mild NPDR (level 35), 15 progressed to moderate NPDR (level 43), 5 progressed to moderately severe NPDR (level 47) and 1 progressed to high risk PDR (level 71). Worsening in ETDRS level is associated with phenotype C (p=0.005). From the 130 eyes/patients with a low MA turnover, 18 (13.8%) eyes/patients had an increase in ETDRS level, and from the 19 eyes/patients with a high MA turnover, 9 (47.4%) had an increase in ETDRS level (p<0.001). Conclusion Eyes in the initial stages of diabetic retinopathy show different phenotypes with different risks for progression to CIMO. In phenotype C, MA turnover correlates with ETDRS grading worsening and development of CIMO.
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Affiliation(s)
| | - Luísa Ribeiro
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Conceição Lobo
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Dalila Alves
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - José Cunha-Vaz
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
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21
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Lobo C, Pires I, Alves D, Pappuru R, Ribeiro L, Cunha-Vaz J. Subclinical Macular Edema as a Predictor of Progression to Central-Involved Macular Edema in Type 2 Diabetes. Ophthalmic Res 2018; 60:18-22. [PMID: 29510401 DOI: 10.1159/000486792] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 01/10/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of this study was to examine the relationship between subclinical diabetic macular edema (SCME) and the development of central-involved macular edema (CIME) in patients with diabetes mellitus type-2 and mild nonproliferative diabetic retinopathy (NPDR), from 2 populations of different ethnicities. METHODS Two hundred and five patients with diabetes mellitus type-2 and mild NPDR with no prior laser or intravitreal treatment were followed for 2 years or until the development of CIME. Ophthalmological examinations, including BCVA, fundus photography with RetmarkerDR analysis, and optical coherence tomography were performed at baseline and months 6, 12, and 24. RESULTS One hundred and fifty eight eyes/patients reached either the study endpoint, CIME (n = 24), or performed the 24-month visit without developing CIME (n = 134). Fifty eyes/patients had SCME at baseline (31.6%). Of these 50 eyes, 16 (32.0%) developed CIME, whereas of the 108 eyes with normal retinal thickness (RT) at baseline, only 8 (7.4%) developed CIME (p < 0.001). Patients with increased RT in the central subfield at baseline showed a 12-fold risk of progression to CIME compared with patients without SCME. CONCLUSIONS In patients with mild NPDR, the presence of SCME is a good predictor of progression to CIME.
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Affiliation(s)
- Conceição Lobo
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Isabel Pires
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.,Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Dalila Alves
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | | | - Luísa Ribeiro
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - José Cunha-Vaz
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
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22
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Figueira J, Fletcher E, Massin P, Silva R, Bandello F, Midena E, Varano M, Sivaprasad S, Eleftheriadis H, Menon G, Amaro M, Ayello Scheer S, Creuzot-Garcher C, Nascimento J, Alves D, Nunes S, Lobo C, Cunha-Vaz J. Ranibizumab Plus Panretinal Photocoagulation versus Panretinal Photocoagulation Alone for High-Risk Proliferative Diabetic Retinopathy (PROTEUS Study). Ophthalmology 2018; 125:691-700. [PMID: 29395119 DOI: 10.1016/j.ophtha.2017.12.008] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 11/10/2017] [Accepted: 12/04/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE Comparison of the efficacy of ranibizumab (RBZ) 0.5 mg intravitreal injections plus panretinal photocoagulation (PRP) versus PRP alone in the regression of the neovascularization (NV) area in subjects with high-risk proliferative diabetic retinopathy (HR-PDR) over a 12-month period. DESIGN Prospective, randomized, multicenter, open-label, phase II/III study. PARTICIPANTS Eighty-seven participants (aged ≥18 years) with type 1/2 diabetes and HR-PDR (mean age, 55.2 years; 37% were female). METHODS Participants were randomized (1:1) to receive RBZ+PRP (n = 41) or PRP monotherapy (n = 46). The RBZ+PRP group received 3 monthly RBZ injections along with standard PRP. The PRP monotherapy group received standard PRP between day 1 and month 2; thereafter, re-treatments in both groups were at the investigators' discretion. MAIN OUTCOME MEASURES The primary outcome was regression of NV total, on the disc (NVD) plus elsewhere (NVE), defined as any decrease in the area of NV from the baseline to month 12. Secondary outcomes included best-corrected visual acuity (BCVA) changes from baseline to month 12, time to complete NV regression, recurrence of NV, macular retinal thickness changes from baseline to month 12, need for treatment for diabetic macular edema, need for vitrectomy because of occurrence of vitreous hemorrhage, tractional retinal detachment or other complications of DR, and adverse events (AEs) related to treatments. RESULTS Seventy-seven participants (88.5%) completed the study. Overall baseline demographics were similar for both groups, except for age. At month 12, 92.7% of participants in the RBZ+PRP group presented NV total reduction versus 70.5% of the PRP monotherapy participants (P = 0.009). The number of participants with NVD and NVE reductions was higher with RBZ+PRP (93.3% and 91.4%, respectively) versus PRP (68.8% and 73.7%, respectively), significant only for NVE (P = 0.048). Complete NV total regression was observed in 43.9% in the RBZ+PRP group versus 25.0% in the PRP monotherapy group (P = 0.066). At month 12, the mean BCVA was 75.2 letters (20/32) in the RBZ+PRP group versus 69.2 letters (20/40) in the PRP monotherapy group (P = 0.104). In the RBZ+PRP group, the mean number of PRP treatments over month 12 was 3.5±1.3, whereas in the PRP monotherapy group, it was 4.6±1.5 (P = 0.001). No deaths or unexpected AEs were reported. CONCLUSIONS Treatment with RBZ+PRP was more effective than PRP monotherapy for NV regression in HR-PDR participants over 12 months.
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Affiliation(s)
- João Figueira
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.
| | - Emily Fletcher
- Department of Ophthalmology, Gloucestershire Hospitals, Gloucestershire, United Kingdom
| | - Pascale Massin
- Department of Ophthalmology, Lariboisière Hospital, Paris, France
| | - Rufino Silva
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal; Coimbra Medical Space, Coimbra, Portugal
| | - Francesco Bandello
- Department of Ophthalmology University Vita-Salute, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Edoardo Midena
- Centre for Clinical Trials, Department of Ophthalmology University of Padova, Padova, Italy
| | | | - Sobha Sivaprasad
- Laser Retinal Research Unit, King's Health Partners, London, United Kingdom
| | | | - Geeta Menon
- Ophthalmology Clinical Trials Unit Frimley, Frimley, United Kingdom
| | - Miguel Amaro
- Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Sarah Ayello Scheer
- Centre d'Investigation Clinique, Centre National d'Ophthalmologie des Quinze-Vingts, Paris, France
| | | | - João Nascimento
- Instituto de Retina e Diabetes Oculares de Lisboa, Lisbon, Portugal
| | - Dalila Alves
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Sandrina Nunes
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Conceição Lobo
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - José Cunha-Vaz
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
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Ribeiro L, Pappuru R, Lobo C, Alves D, Cunha-Vaz J. Different Phenotypes of Mild Nonproliferative Diabetic Retinopathy with Different Risks for Development of Macular Edema (C-TRACER Study). Ophthalmic Res 2017; 59:59-67. [PMID: 29268280 DOI: 10.1159/000484666] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 10/27/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate diabetic retinopathy (DR) progression in patients with diabetes mellitus type 2 in 2 populations of different ethnicity. METHODS A prospective observational study was designed to follow eyes/patients with mild nonproliferative DR, for 2 years or until the development of central-involved macular edema (CIME), in 2 centers from different regions of the world. A total of 205 eyes/patients fulfilled the inclusion/exclusion criteria and were included in this study. Ophthalmological examinations, fundus photography with RetmarkerDR analysis, and optical coherence tomography were performed at baseline and at 6, 12 and 24 months. RESULTS Of the 158 eyes/patients that completed this study, 24 eyes developed CIME and 134 eyes were present at the last study visit. Eighty-eight eyes (56.4%) were classified as phenotype A, 49 (31.4%) as phenotype B, and 19 (12.2%) as phenotype C. Phenotype A is associated with a very low risk for development of CIME in comparison with phenotypes B and C. The OR for development of CIME was 19.0 for phenotype B and 25.1 for phenotype C. CONCLUSION Eyes in the initial stages of DR show different phenotypes with different risks of progression to ME. The phenotypes associated with increased risks of progression show different distributions in patients of different ethnicities.
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Affiliation(s)
- Luísa Ribeiro
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
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Núñez-Díaz JA, García de la Banda I, Lobo C, Moriñigo MA, Balebona MC. Transcription of immune related genes in Solea senegalensis vaccinated against Photobacterium damselae subsp. piscicida. Identification of surrogates of protection. Fish Shellfish Immunol 2017; 66:455-465. [PMID: 28532666 DOI: 10.1016/j.fsi.2017.05.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 05/17/2017] [Accepted: 05/18/2017] [Indexed: 06/07/2023]
Abstract
Solea senegalensis is a flatfish with a great potential for aquaculture, but infectious diseases restrict its production, being this fish species highly susceptible to Photobacterium damselae subsp. piscicida (Phdp) infections. A better understanding of the mechanisms related to fish immune response is crucial for the development of effective approaches in disease management. In the present work, transcriptional changes of immune related genes have been evaluated in farmed S. senegalensis specimens vaccinated against Phdp by intraperitoneal injection (IP) and immersion (IM). IP fish showed higher antibody levels and increased transcription of genes encoding lysozyme C1, complement factors involved in the classical pathway and components involved in the opsonization and the limitation of free iron availability, all of them facilitating the faster elimination of the pathogen and promoting higher RPS after the infection with Phdp. The results of this study seem to support a different intensity of the specimens immune response in the head kidney. Analysis of the immune response in 15 day post-challenged fish showed up-regulation of genes involved in all stages of S. senegalensis immune response, but especially those genes encoding proteins related to the innate response such as complement, lysozyme and iron homeostasis in the head kidney. On the other hand, liver transcription was higher for genes related to inflammation, apoptosis and cell mediated cytotoxicity (CMC). Furthermore, comparison of the differential response of S. senegalensis genes in vaccinated and unvaccinated fish to Phdp infection allowed the identification of a potential biosignature, consisting in 10 genes, as a surrogate of protection and therefore, as indicator of vaccine success against fotobacteriosis after IP vaccination. These results provide important insights into the S. senegalensis protection against Phdp induced by vaccination.
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Affiliation(s)
- J A Núñez-Díaz
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - I García de la Banda
- Spanish Institute of Oceanography, Oceanographic Center of Santander, 39080 Santander, Spain
| | - C Lobo
- Spanish Institute of Oceanography, Oceanographic Center of Santander, 39080 Santander, Spain
| | - M A Moriñigo
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - M C Balebona
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain.
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Cunha-Vaz J, Santos T, Alves D, Marques I, Neves C, Soares M, Lobo C. Agreement between OCT Leakage and Fluorescein Angiography to Identify Sites of Alteration of the Blood-Retinal Barrier in Diabetes. Ophthalmol Retina 2017; 1:395-403. [PMID: 31047568 DOI: 10.1016/j.oret.2017.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 02/03/2017] [Accepted: 02/06/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare the location of the sites of lower reflectivity, as determined by OCT leakage using spectral domain (SD)-OCT, with sites of fluorescein leakage identified by fluorescein angiography (FA) in eyes with diabetic retinopathy. DESIGN Prospective consecutive case series. PARTICIPANTS Fifty-two eyes from 28 patients with type 2 diabetes and presence of nonproliferative diabetic retinopathy. METHODS All patients were imaged with FA and SD-OCT (Angioplex, Carl Zeiss Meditec, Inc). All FA images were analyzed by 2 experienced graders, and the area surrounding well-defined sites of leakage was outlined by the graders. The SD-OCT scans were processed using OCT leakage proprietary software and semiautomated segmentation. Both procedures were performed without access to the clinical data. MAIN OUTCOME MEASURES Agreement of OCT leakage with FA findings. RESULTS In eyes that were classified as having well-defined sites of leakage on FA, OCT leakage showed a sensitivity of 95.9% and a specificity of 75.4% regarding agreement between these sites of alteration of the blood-retinal barrier. The areas of abnormal extracellular fluid increase were larger than the areas of fluorescein leakage and included the well-defined leakage sites identified by FA. On OCT leakage, localized increases in extracellular space were identified, mainly in the inner nuclear, outer plexiform, or outer nuclear layers, even in eyes without leakage on FA. CONCLUSIONS Using SD-OCT, OCT leakage was found to better identify abnormal retinal fluid than did FA and showed good sensitivity and specificity in comparison with FA for identification of sites of alterations of the blood-retinal barrier.
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Affiliation(s)
- José Cunha-Vaz
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - Torcato Santos
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Dalila Alves
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Inês Marques
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Catarina Neves
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Mário Soares
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal; Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Conceição Lobo
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
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Guerra MG, Silva AM, Marques SH, Melo SH, Póvoa JA, Lobo C, Murta JN. Phakic Intraocular Lens Implantation: Refractive Outcome and Safety in Patients with Anterior Chamber Depth between 2.8 and 3.0 versus ≥3.0 mm. Ophthalmic Res 2017; 57:239-246. [DOI: 10.1159/000453528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 11/19/2022]
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Cachulo MDL, Laíns I, Lobo C, Figueira J, Ribeiro L, Marques JP, Costa J, Vieira A, Rodrigues J, Alves D, Nunes S, Costa M, Rodrigues V, Cunha-Vaz J, Delcourt C, Silva R. Age-related macular degeneration in Portugal: prevalence and risk factors in a coastal and an inland town. The Coimbra Eye Study - Report 2. Acta Ophthalmol 2016; 94:e442-53. [PMID: 26806024 DOI: 10.1111/aos.12950] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/05/2015] [Indexed: 01/22/2023]
Abstract
PURPOSE To determine the age- and sex-specific prevalence of early and late age-related macular degeneration (AMD) in two Portuguese population-based samples and to identify its risk factors. POPULATION A population of 6023 adults aged ≥55 years was recruited from two Portuguese primary healthcare units in the central region of Portugal - one from a coastal (n = 3000) and another from an inland town (n = 3023). METHODS Cross-sectional population-based study. Participants were enrolled in the two locations between August 2009 and October 2013. Responders underwent standardized interviews and ophthalmologic examination, including digital fundus imaging. All fundus photographs were graded according to an International Classification and Grading System. The main outcome measures consisted of age- and sex-adjusted prevalence of early and late AMD. Potential epidemiologic risk factors were also evaluated using logistic regression analysis. RESULTS Of the 6023 subjects enrolled, 5996 had gradable fundus images and were included in the analysis. The crude prevalence of early and late AMD was 6.99 and 0.67%, respectively, for the coastal town and 15.39 and 1.29% for the inland town. Age- and sex-adjusted prevalence of any AMD for the Portuguese population was 12.48% (95% CI: 11.61-13.33) with late AMD accounting for 1.16% (95% CI: 0.85-1.46). Neovascular AMD (NV-AMD) and geographic atrophy (GA) accounted for 0.55% (95% CI: 0.36-0.75) and 0.61% (95% CI: 0.37-0.84) of individuals, respectively. After adjusting for possible confounding factors, prevalence of early and late AMD increased with increasing age (OR = 1.35; 95% CI: 1.23-1.49 for early and OR = 3.01; 95% CI: 2.22-4.08 for late AMD, per each decade of age increase, p < 0.001). After adjustment for age, sex, family history, smoking history, hypertension, diabetes and BMI, subjects from the inland town presented a significantly higher OR of early and late AMD than subjects from the coastal town (OR = 2.57, 95% CI: 2.12-3.12, p < 0.001 for early and OR = 2.06, 95% CI: 1.07-3.95, p = 0.029 for late AMD). CONCLUSIONS The prevalence of early and late AMD in this Portuguese population was similar to other large-scale population-based cohorts. After controlling for confounders, age and study site of inclusion were significant independent predictors for both early and late forms of the disease. Further analysis will be needed to completely unravel the underlying reasons for this difference regarding geographic location.
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Affiliation(s)
- Maria da Luz Cachulo
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - Inês Laíns
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - Conceição Lobo
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - João Figueira
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - Luísa Ribeiro
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - João P. Marques
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
| | - José Costa
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
| | | | - João Rodrigues
- Primary Health Care Unit of Lousã; Unidade de Saúde Familiar da Serra da Lousã e Trevim Sol; Coimbra Portugal
| | - Dalila Alves
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Sandrina Nunes
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Miguel Costa
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Victor Rodrigues
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
- Instituto de Higiene e Medicina Social of the Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - José Cunha-Vaz
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | | | - Rufino Silva
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
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Silva JL, Póvoa J, Lobo C, Murta J. New technique for iridodialysis correction: Single-knot sewing-machine suture. J Cataract Refract Surg 2016; 42:520-3. [DOI: 10.1016/j.jcrs.2016.03.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 02/25/2016] [Accepted: 03/06/2016] [Indexed: 10/21/2022]
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Labetoulle M, Findl O, Malecaze F, Alió J, Cochener B, Lobo C, Lazreg S, Hartani D, Colin J, Tassignon MJ, Behndig A. Evaluation of the efficacy and safety of a standardised intracameral combination of mydriatics and anaesthetics for cataract surgery. Br J Ophthalmol 2015; 100:976-985. [PMID: 26531052 PMCID: PMC4941138 DOI: 10.1136/bjophthalmol-2015-307587] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/24/2015] [Accepted: 10/10/2015] [Indexed: 11/12/2022]
Abstract
Background/aims To compare the efficacy and safety of intracameral (IC) administration at the beginning of cataract surgery, of Mydrane, a standardised ophthalmic combination of tropicamide 0.02%, phenylephrine 0.31% and lidocaine 1%, to a standard topical regimen. Methods In this international phase III, prospective, randomised study, the selected eye of 555 patients undergoing phacoemulsification with intraocular lens (IOL) implantation received 200 μL of Mydrane (Mydrane group) just after the first incision or a topical regimen of one drop each of tropicamide 0.5% and phenylephrine 10% repeated three times (reference group). The primary efficacy variable was achievement of capsulorhexis without additional mydriatics. The non-inferiority of Mydrane to the topical regimen was tested. The main outcome measures were pupil size, patient perception of ocular discomfort and safety. Results Capsulorhexis without additional mydriatics was performed in 98.9% of patients and 94.7% in the Mydrane and reference groups, respectively. Both groups achieved adequate mydriasis (>7 mm) during capsulorhexis, phacoemulsification and IOL insertion. IOL insertion was classified as ‘routine’ in a statistically greater number of eyes in the Mydrane group compared with the reference group (p=0.047). Patients in the Mydrane group reported statistically greater comfort than the reference group before IOL insertion (p=0.034). Safety data were similar between groups. Conclusions Mydrane is an effective and safe alternative to standard eye drops for initiating and maintaining intraoperative mydriasis and analgesia. Patients who received IC Mydrane were significantly more comfortable before IOL insertion than the reference group. Surgeons found IOL insertion less technically challenging with IC Mydrane. Trial registration number NCT02101359; Results.
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Affiliation(s)
- Marc Labetoulle
- Hôpital Bicêtre, APHP, South Paris University, Ophtalmology, Le Kremlin-Bicêtre, France.,Institute for Integrative Biology of the Cell (I2BC), Département de Virologie, CNRS, Gif/Yvette, France
| | - Oliver Findl
- Vienna Institute for Research in Ocular Surgery (VIROS), Hanusch Hospital, Vienna, Austria
| | | | - Jorge Alió
- Instituto Oftalmologico de Alicante, Alicante, Spain
| | | | - Conceição Lobo
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Tapia-Paniagua ST, Vidal S, Lobo C, García de la Banda I, Esteban MA, Balebona MC, Moriñigo MA. Dietary administration of the probiotic SpPdp11: Effects on the intestinal microbiota and immune-related gene expression of farmed Solea senegalensis treated with oxytetracycline. Fish Shellfish Immunol 2015; 46:449-458. [PMID: 26190256 DOI: 10.1016/j.fsi.2015.07.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/08/2015] [Accepted: 07/14/2015] [Indexed: 06/04/2023]
Abstract
Few antimicrobials are currently authorised in the aquaculture industry to treat infectious diseases. Among them, oxytetracycline (OTC) is one of the first-choice drugs for nearly all bacterial diseases. The objective of this study was to evaluate the effect of the dietary administration of OTC both alone and jointly with the probiotic Shewanella putrefaciens Pdp11 (SpPdp11) on the intestinal microbiota and hepatic expression of genes related to immunity in Senegalese sole (Solea senegalensis) juveniles. The results demonstrated that the richness and diversity of the intestinal microbiota of fish treated with OTC decreased compared with those of the control group but that these effects were lessened by the simultaneous administration of SpPdp11. In addition, specimens that received OTC and SpPdp11 jointly showed a decreased intensity of the Denaturing Gradient Gel Electrophoresis (DGGE) bands related to Vibrio genus and the presence of DGGE bands related to Lactobacillus and Shewanella genera. The relationship among the intestinal microbiota of fish fed with control and OTC diets and the expression of the NADPH oxidase and CASPASE-6 genes was demonstrated by a Principal Components Analysis (PCA) carried out in this study. In contrast, a close relationship between the transcription of genes, such as NKEF, IGF-β, HSP70 and GP96, and the DGGE bands of fish treated jointly with OTC and SpPdp11 was observed in the PCA study. In summary, the results obtained in this study demonstrate that the administration of OTC results in the up-regulation of genes related to apoptosis but that the joint administration of OTC and S. putrefaciens Pdp11 increases the transcription of genes related to antiapoptotic effects and oxidative stress regulation. Further, a clear relationship between these changes and those detected in the intestinal microbiota is established.
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Affiliation(s)
- S T Tapia-Paniagua
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - S Vidal
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - C Lobo
- Spanish Institute of Oceanography, Oceanographic Center of Santander, 39080 Santander, Spain
| | - I García de la Banda
- Spanish Institute of Oceanography, Oceanographic Center of Santander, 39080 Santander, Spain
| | - M A Esteban
- Innate Immune System Group, Department of Cell Biology and Histology, Faculty of Biology, Campus Regional de Excelencia Internacional "Campus Mare Nostrum", University of Murcia, 30100 Murcia, Spain
| | - M C Balebona
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - M A Moriñigo
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain.
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Jaka A, Gutiérrez-Rivera A, López-Pestaña A, del Alcázar E, Zubizarreta J, Vildosola S, Arregui M, Sarasqueta C, Lobo C, Tuneu A. Predictors of Tumor Response to Cetuximab and Panitumumab in 116 Patients and a Review of Approaches to Managing Skin Toxicity. Actas Dermo-Sifiliográficas (English Edition) 2015. [DOI: 10.1016/j.adengl.2015.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Cachulo MDL, Lobo C, Figueira J, Ribeiro L, Laíns I, Vieira A, Nunes S, Costa M, Simão S, Rodrigues V, Vilhena N, Cunha-Vaz J, Silva R. Prevalence of Age-Related Macular Degeneration in Portugal: The Coimbra Eye Study - Report 1. Ophthalmologica 2015; 233:119-27. [PMID: 25677077 DOI: 10.1159/000371584] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/27/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the age- and gender-specific prevalence of early and late age-related macular degeneration (AMD) in a Portuguese population-based sample. METHODS All patients aged ≥55 years of a Portuguese primary health-care unit were recruited for a cross-sectional population-based study. Responders underwent complete ophthalmological examination and digital fundus imaging. Early and late AMD was defined according to the International Age-Related Macular Epidemiological Study Group Classification, and the adopted staging for AMD was the same as that used in the Rotterdam study. The age- and gender-adjusted prevalence of early and late forms of AMD was calculated. RESULTS Of the 4,370 eligible subjects, 3,000 underwent study procedures (68.6% response rate) and 2,975 were included in the analysis; they had a mean age of 68.9 ± 8.6 years. The overall prevalence of early and late AMD was 15.53% (95% CI 14.25-16.88) and 0.67% (95% CI 0.41-1.04), respectively. Neovascular AMD (NV-AMD) and geographic atrophy (GA) accounted for 0.44% (95% CI 0.23-0.75) and 0.27% (95% CI 0.12-0.53) of individuals, respectively. The highest prevalence of advanced AMD was among those aged ≥75 years (1.13% for NV-AMD; 0.63% for GA). CONCLUSIONS To our knowledge, this is the first AMD epidemiological study in a Portuguese population. The early forms of the disease had a similar prevalence to that of other large-scale population-based cohorts, but late AMD was less frequent than previously reported.
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Affiliation(s)
- Maria da Luz Cachulo
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Tapia-Paniagua ST, Vidal S, Lobo C, Prieto-Álamo MJ, Jurado J, Cordero H, Cerezuela R, García de la Banda I, Esteban MA, Balebona MC, Moriñigo MA. The treatment with the probiotic Shewanella putrefaciens Pdp11 of specimens of Solea senegalensis exposed to high stocking densities to enhance their resistance to disease. Fish Shellfish Immunol 2014; 41:209-221. [PMID: 25149590 DOI: 10.1016/j.fsi.2014.08.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/30/2014] [Accepted: 08/07/2014] [Indexed: 06/03/2023]
Abstract
Aquaculture industry exposes fish to acute stress events, such as high stocking density, and a link between stress and higher susceptibility to diseases has been concluded. Several studies have demonstrated increased stress tolerance of fish treated with probiotics, but the mechanisms involved have not been elucidated. Shewanella putrefaciens Pdp11 is a strain isolated from healthy gilthead seabream (Sparus aurata L.) and it is considered as probiotics. The aim of this study was to evaluate the effect of the dietary administration of this probiotics on the stress tolerance of Solea senegalensis specimens farmed under high stocking density (PHD) compared to a group fed a commercial diet and farmed under the same conditions (CHD). In addition, during the experiment, a natural infectious outbreak due to Vibrio species affected fish farmed under crowding conditions. Changes in the microbiota and histology of intestine and in the transcription of immune response genes were evaluated at 19 and 30 days of the experiment. Mortality was observed after 9 days of the beginning of the experiment in CHD and PHD groups, it being higher in the CHD group. Fish farmed under crowding stress showed reduced expression of genes at 19 day probiotic feeding. On the contrary, a significant increase in immune related gene expression was detected in CHD fish at 30 day, whereas the gene expression in fish from PHD group was very similar to that showed in specimens fed and farmed with the conventional conditions. In addition, the dietary administration of S. putrefaciens Pdp11 produced an important modulation of the intestinal microbiota, which was significantly correlated with the high number of goblet cells detected in fish fed the probiotic diet.
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Affiliation(s)
- S T Tapia-Paniagua
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - S Vidal
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - C Lobo
- Instituto Español de Oceanografía, Centro Oceanográfico de Santander, 39080 Santander, Spain
| | - M J Prieto-Álamo
- Universidad de Córdoba, Departamento de Bioquímica y Biología Molecular, Campus de Rabanales, Ctra. Madrid, Km. 396, 14071 Córdoba, Spain
| | - J Jurado
- Universidad de Córdoba, Departamento de Bioquímica y Biología Molecular, Campus de Rabanales, Ctra. Madrid, Km. 396, 14071 Córdoba, Spain
| | - H Cordero
- Universidad de Murcia, Departamento de Biología Celular e Histología, Campus de Espinardo s/n, 30100 Murcia, Spain
| | - R Cerezuela
- Universidad de Murcia, Departamento de Biología Celular e Histología, Campus de Espinardo s/n, 30100 Murcia, Spain
| | - I García de la Banda
- Instituto Español de Oceanografía, Centro Oceanográfico de Santander, 39080 Santander, Spain
| | - M A Esteban
- Universidad de Murcia, Departamento de Biología Celular e Histología, Campus de Espinardo s/n, 30100 Murcia, Spain
| | - M C Balebona
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - M A Moriñigo
- Universidad de Málaga, Departamento de Microbiología, Campus de Teatinos s/n, 29071 Málaga, Spain.
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Simões MJ, Lobo C, Egas C, Nunes S, Carmona S, Costa MÂ, Duarte T, Ribeiro L, Faro C, Cunha-Vaz JG. Genetic Variants in ICAM1, PPARGC1A and MTHFR Are Potentially Associated with Different Phenotypes of Diabetic Retinopathy. Ophthalmologica 2014; 232:156-62. [DOI: 10.1159/000365229] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 06/11/2014] [Indexed: 11/19/2022]
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Guimarães P, Rodrigues P, Lobo C, Leal S, Figueira J, Serranho P, Bernardes R. Ocular fundus reference images from optical coherence tomography. Comput Med Imaging Graph 2014; 38:381-9. [PMID: 24631317 DOI: 10.1016/j.compmedimag.2014.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 02/04/2014] [Accepted: 02/11/2014] [Indexed: 10/25/2022]
Abstract
Two-dimensional images computed from three-dimensional optical coherence tomography (OCT) data are intrinsically aligned with it, allowing to accurately position a retinal OCT scan within the ocular fundus. In this work, we aim to compute an OCT fundus reference image with improved retinal vasculature extension and contrast over traditional approaches. Based on the shadow casted by hemoglobin on the outer layers of the retina, we compute three independent images from the OCT volumetric data (including the traditional fundus reference image). Combining these images, a fourth one is created that is able to outperform the other three, both quantitatively and qualitatively (as evaluated by retina specialists). The vascular network extension provided by this method was also compared with widely used fundus imaging modalities, showing that it is similar to that achieved with color fundus photography. In this way, the proposed method is an important starting point to the segmentation of the vascular tree and provides users with a detailed fundus reference image.
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Affiliation(s)
- Pedro Guimarães
- IBILI - Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal.
| | - Pedro Rodrigues
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal.
| | - Conceição Lobo
- IBILI - Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal; AIBILI - Association for Innovation and Biomedical Research on Light and Image, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal; Coimbra University Hospitals, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal.
| | - Sérgio Leal
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal; Coimbra University Hospitals, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal.
| | - João Figueira
- IBILI - Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal; AIBILI - Association for Innovation and Biomedical Research on Light and Image, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal; Coimbra University Hospitals, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal.
| | - Pedro Serranho
- IBILI - Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal; Mathematics Section, Department of Science and Technology, Universidade Aberta, Campus TagusPark, Av. Dr. Jacques Delors, 2740-122 Porto Salvo, Oeiras, Portugal.
| | - Rui Bernardes
- IBILI - Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal; AIBILI - Association for Innovation and Biomedical Research on Light and Image, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal.
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Goulko O, Chevy F, Lobo C. Spin drag of a Fermi gas in a harmonic trap. Phys Rev Lett 2013; 111:190402. [PMID: 24266462 DOI: 10.1103/physrevlett.111.190402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Indexed: 06/02/2023]
Abstract
Using a Boltzmann equation approach, we analyze how the spin drag of a trapped interacting fermionic mixture is influenced by the nonhomogeneity of the system in a classical regime where the temperature is much larger than the Fermi temperature. We show that for very elongated geometries, the spin damping rate can be related to the spin conductance of an infinitely long cylinder. We characterize analytically the spin conductance both in the hydrodynamic and collisionless limits and discuss the influence of the velocity profile. Our results are in good agreement with recent experiments and provide a quantitative benchmark for further studies of spin drag in ultracold gases.
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Affiliation(s)
- O Goulko
- Physics Department, Arnold Sommerfeld Center for Theoretical Physics, and Center for NanoScience, Ludwig-Maximilians-Universität, Theresienstraße 37, 80333 Munich, Germany
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Nunes S, Ribeiro L, Lobo C, Cunha-Vaz J. Three different phenotypes of mild nonproliferative diabetic retinopathy with different risks for development of clinically significant macular edema. Invest Ophthalmol Vis Sci 2013; 54:4595-604. [PMID: 23745006 DOI: 10.1167/iovs.13-11895] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To identify different phenotypes of nonproliferative diabetic retinopathy (NPDR) and their progression to clinically significant macular edema (CSME). METHODS A prospective observational study was designed to follow eyes/patients with diabetes type 2 and NPDR with no prior laser treatment for 2 years or until development of CSME. A total of 410 patients, one eye per patient, fulfilled the inclusion/exclusion criteria and were included in the study. Ophthalmological examinations, including BCVA, fundus photography with Retmarker analysis, and optical coherence tomography (OCT), were performed at baseline, month 6 and month 24, or before laser treatment. Hierarchical cluster analysis was used to identify homogeneous subgroups and clinically significant thresholds of the data collected. RESULTS A total of 376 eyes/patients performed the 6-month visit and were considered for cluster analysis. This mathematical method identified three different phenotypes based on statistically significant differences for the microaneurysm (MA) turnover and for the central retinal thickness (RT): phenotype A (low MA turnover and normal RT, 48.1%); phenotype B (low MA turnover and increased central RT, 23.2%); and phenotype C (high MA turnover, 28.7%). From the 348 eyes/patients that reached the study end point or completed the 24-month visit, 26 developed CSME: 3 from phenotype A (1.8%), 7 from phenotype B (8.5%), and 16 from phenotype C (16.2%). Eyes/patients from phenotype C showed a higher risk for CSME development (OR = 3.536; P < 0.001). CONCLUSIONS Hierarchical cluster analysis identifies three different phenotypes of NPDR based on MA turnover and central macular thickness. Eyes/patients from phenotype C show a higher risk for the development of CSME. (ClinicalTrials.gov number, NCT00763802.)
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Affiliation(s)
- Sandrina Nunes
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
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Gonçalves-Pereira J, Povoa P, Lobo C, Carneiro A. Bloodstream infections as a marker of community-acquired sepsis severity. Results from the Portuguese community-acquired sepsis study (SACiUCI study). Clin Microbiol Infect 2013; 19:242-8. [DOI: 10.1111/j.1469-0691.2012.03776.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pires I, Santos AR, Nunes S, Lobo C. Macular Thickness Measured by Stratus Optical Coherence Tomography in Patients with Diabetes Type 2 and Mild Nonproliferative Retinopathy without Clinical Evidence of Macular Edema. Ophthalmologica 2013; 229:181-6. [DOI: 10.1159/000350593] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 03/08/2013] [Indexed: 11/19/2022]
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Pires I, Santos AR, Nunes S, Lobo C, Cunha-Vaz J. Subclinical Macular Edema as a Predictor of Progression to Clinically Significant Macular Edema in Type 2 Diabetes. Ophthalmologica 2013; 230:201-6. [DOI: 10.1159/000354550] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 07/03/2013] [Indexed: 11/19/2022]
Abstract
<b><i>Objective:</i></b> To examine the relationship between subclinical diabetic macular edema (DME) and the development of clinically significant macular edema (CSME) in nonproliferative diabetic retinopathy (NPDR) in patients with type 2 diabetes. <b><i>Methods:</i></b> A prospective, monocenter, observational study was designed to follow patients/eyes with type 2 diabetes and NPDR (Early Treatment Diabetic Retinopathy Study levels 20 and 35) with no prior laser treatment for 2 years or until development of CSME. Ophthalmologic examinations, including best-corrected visual acuity, fundus photography and optical coherence tomography (OCT), were performed at baseline, 6 months and a final visit. <b><i>Results:</i></b> A total of 348 patients completed study follow-up; 26 eyes developed CSME. Six out of 32 eyes/patients presenting subclinical DME at baseline developed CSME (18.7%), while 20 out of 316 eyes without subclinical DME developed CSME (6.3%). Eyes/patients with subclinical DME presented a risk for DME progression 3.686 times higher than that of eyes/patients without subclinical DME (95% confidence interval 1.221-7.988). <b><i>Conclusions:</i></b> Subclinical DME in eyes with NPDR identified by center point thickness measured on a Stratus OCT is a good predictor of CSME development.
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Lopez A, Tuneu A, Ormaechea N, Lobo C, Vildósola S, Zubizarreta J. Alopécie frontale fibrosante : série de 55 cas, huit avec papules du visage. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Aguinagalde B, Zabaleta J, Fuentes M, Lobo C, Mendoza M, Aldama L, Izquierdo J. Enfermedad de Castleman y embarazo. ¿Casualidad o causalidad? Clínica e Investigación en Ginecología y Obstetricia 2012. [DOI: 10.1016/j.gine.2011.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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López-Pestaña A, Tuneu A, Lobo C, Zubizarreta J. [Sarcoid granulomas in facial cosmetic filler material: induction by interferon-α and ribavirin in a patient with hepatitis C]. Actas Dermosifiliogr 2012; 102:746-7. [PMID: 21640959 DOI: 10.1016/j.ad.2011.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Revised: 01/17/2011] [Accepted: 01/23/2011] [Indexed: 11/28/2022] Open
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Tzias D, George S, Wilkinson L, Mehta R, Lobo C, Hainsworth A, Sharma A. Correlation of ethnicity with breast density as assessed by Quantra™. Breast Cancer Res 2011. [PMCID: PMC3238236 DOI: 10.1186/bcr2951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
Ocular fundus imaging plays a key role in monitoring the health status of the human eye. Currently, a large number of imaging modalities allow the assessment and/or quantification of ocular changes from a healthy status. This review focuses on the main digital fundus imaging modality, color fundus photography, with a brief overview of complementary techniques, such as fluorescein angiography. While focusing on two-dimensional color fundus photography, the authors address the evolution from nondigital to digital imaging and its impact on diagnosis. They also compare several studies performed along the transitional path of this technology. Retinal image processing and analysis, automated disease detection and identification of the stage of diabetic retinopathy (DR) are addressed as well. The authors emphasize the problems of image segmentation, focusing on the major landmark structures of the ocular fundus: the vascular network, optic disk and the fovea. Several proposed approaches for the automatic detection of signs of disease onset and progression, such as microaneurysms, are surveyed. A thorough comparison is conducted among different studies with regard to the number of eyes/subjects, imaging modality, fundus camera used, field of view and image resolution to identify the large variation in characteristics from one study to another. Similarly, the main features of the proposed classifications and algorithms for the automatic detection of DR are compared, thereby addressing computer-aided diagnosis and computer-aided detection for use in screening programs.
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Affiliation(s)
- Rui Bernardes
- Institute of Biomedical Research on Light and Image, Faculty of Medicine, University of Coimbra, and Coimbra University Hospital, Coimbra, Portugal.
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Lobo C, Amin S, Ramsay A, Diss T, Kocjan G. Serous fluid cytology of multicentric Castleman’s disease and other lymphoproliferative disorders associated with Kaposi sarcoma-associated herpes virus: a review with case reports. Cytopathology 2011; 23:76-85. [DOI: 10.1111/j.1365-2303.2011.00868.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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López-Obregón C, Arregui-Murua M, Eguino P, Lobo C. Angiohistiocitoma de células multinucleadas generalizado. Actas Dermo-Sifiliográficas 2011; 102:231-3. [DOI: 10.1016/j.ad.2010.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 07/19/2010] [Accepted: 08/04/2010] [Indexed: 11/16/2022] Open
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López-Obregón C, Arregui-Murua M, Eguino P, Lobo C. Generalized Multinucleated Cell Angiohistiocytoma. Actas Dermo-Sifiliográficas (English Edition) 2011. [DOI: 10.1016/s1578-2190(11)70795-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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50
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Bernardes R, Santos T, Serranho P, Lobo C, Cunha-Vaz J. Noninvasive Evaluation of Retinal Leakage Using Optical Coherence Tomography. Ophthalmologica 2011; 226:29-36. [DOI: 10.1159/000326268] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 02/18/2011] [Indexed: 11/19/2022]
Abstract
<i>Purpose:</i> To demonstrate the association between changes in the blood-retinal barrier (BRB) identified by fluorescein leakage and those in the optical properties of the human retina determined by optical coherence tomography (OCT) and show how these changes can be quantified and their location identified within the retina. <i>Methods:</i> Two imaging techniques were applied: the retinal leakage analyzer, to map BRB function into intact or disrupted regions, and OCT, to measure refractive index changes along the light path within the human ocular fundus. <i>Results:</i> A total of 140 comparisons were made, 77 between areas of regions receiving the same classification (intact or disrupted BRB) and 63 between areas of regions receiving distinct classifications, from 4 pathological cases: 2 eyes with nonproliferative diabetic retinopathy and 2 eyes with wet age-related macular degeneration. In all cases, the distribution of OCT data between regions of intact and regions of disrupted BRB, identified by the retinal leakage analyzer, was quantified and was statistically significantly different (p < 0.001). In addition, it was found that the differences could be localized in the retina to specific structural sequences. <i>Conclusions:</i> Using a novel method to analyze OCT data, we showed that it may be possible to quantify differences in the extracellular compartment in eyes with retinal disease and alterations of the BRB. Based on quantitative techniques, our findings demonstrate the presence of indirect information on the BRB status within noninvasive OCT data.
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