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Cho J, Lee NK, Kim JY, Lee CS, Byeon SH, Kim SS, Lee SW, Kim YJ. Trends in the Incidence of Retinal Artery and Vein Occlusion Before and After COVID-19: A National Study in South Korea (2017-2022). Am J Ophthalmol 2025; 274:101-111. [PMID: 40058535 DOI: 10.1016/j.ajo.2025.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Revised: 11/17/2024] [Accepted: 03/03/2025] [Indexed: 03/29/2025]
Abstract
PURPOSE This study investigated the incidence of new retinal artery occlusion (RAO) and retinal vein occlusion (RVO) during the coronavirus disease-19 (COVID-19) pandemic compared to pre-outbreak periods in South Korea. DESIGN Nationwide population-based retrospective cohort study. PARTICIPANTS Individuals diagnosed with RAO or RVO. METHODS We evaluated data from 326 154 patients diagnosed with RAO (n = 32 028), RVO (n = 304 405), or both (n = 10 279) from January 1, 2017 to December 31, 2022. We calculated the incidence rate ratios (IRR) of RAO and RVO using 2019 as the reference year, making comparisons across the total population and within age and sex subgroups. We examined correlations between the number of new RVO patients and COVID-19 infected or vaccinated persons. Additionally, we compared the systemic characteristics of individuals with RAO and RVO, adjusting for multiple comparisons with Bonferroni correction. MAIN OUTCOME MEASURES Annual IRRs of RAO and RVO. RESULTS The IRR for RAO showed no significant increase across all age and sex subgroups. Contrastingly, RVO exhibited a consistent IRR in 2020; however, significant increases were observed in 2021 and 2022 among those aged 20-39 years (adjusted IRR in 2021, 1.22, 95% CI, 1.15-1.29; adjusted IRR in 2022, 1.12, 95% CI, 1.06-1.18) as well as those aged 40-64 years (adjusted IRR in 2021, 1.11; 95% CI, 1.09-1.13; adjusted IRR in 2022, 1.11, 95% CI, 1.08-1.12). No correlations were found between the monthly number of patients with RVO and the number of individuals infected with or vaccinated against COVID-19. Additionally, a higher proportion of patients with RVO having hypertension, diabetes, dyslipidemia, and chronic liver disease were seen in 2021 and 2022, as analyzed by ANOVA with Bonferroni correction. CONCLUSIONS The incidence of RAO did not increase during the COVID-19 outbreak. However, the incidence of RVO increased during the pandemic, especially in 2021 and 2022, with the highest rates observed in the 40-64 years age group, likely linked to increases in metabolic diseases rather than COVID-19 infection and vaccination. Further research is warranted to confirm these findings.
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Affiliation(s)
- Jin Cho
- From the Department of Ophthalmology (J.C., J.Y.K., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Nang Kyeong Lee
- Department of Precision Medicine (N.K.L., S.W.L.), School of Medicine, Sungkyunkwan University, Suwon, Republic of Korea
| | - Jin Yeong Kim
- From the Department of Ophthalmology (J.C., J.Y.K., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Christopher Seungkyu Lee
- From the Department of Ophthalmology (J.C., J.Y.K., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk Ho Byeon
- From the Department of Ophthalmology (J.C., J.Y.K., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Soo Kim
- From the Department of Ophthalmology (J.C., J.Y.K., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Won Lee
- Department of Precision Medicine (N.K.L., S.W.L.), School of Medicine, Sungkyunkwan University, Suwon, Republic of Korea.
| | - Yong Joon Kim
- From the Department of Ophthalmology (J.C., J.Y.K., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Menean M, Bianco L, Perna L, L'Abbate G, Lattanzio R, Bandello F, Pierro L. Lamina cribrosa perfusion density is reduced in eyes with central retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 2025:10.1007/s00417-025-06853-2. [PMID: 40450105 DOI: 10.1007/s00417-025-06853-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Revised: 04/17/2025] [Accepted: 05/05/2025] [Indexed: 06/03/2025] Open
Abstract
PURPOSE Central retinal vein occlusion (CRVO) etiology remains still not fully understood. This study explores in-vivo lamina cribrosa structural and vascular changes in eyes with CRVO through OCT and OCT-Angiography. METHODS Retrospective, cross-sectional study of 37 eyes of 37 patients with CRVO. Lamina cribrosa thickness, curvature depth (CD) and curvature index (CI) were quantified at structural OCT. Lamina cribrosa perfusion density (PD) was quantified at en-face OCTA. Healthy fellow eyes were included as control group. RESULTS Thirty-seven CRVO eyes and 37 control fellow eyes were included in the study. Patient's mean age was 57 ± 16 years. BCVA in the study group was 0.46 ± 0.39 LogMAR. Intraocular pressure (IOP) did not show any significant different distribution among study and control group (14.7 ± 3.1 mmHg vs 15.1 ± 2.9 mmHg, p = 0.591). Study and control groups did not show any statistically significant difference in thickness (258 ± 75 μm vs 272 ± 73 μm, p = 0.208) and depth (463 ± 111 μm vs 464 ± 144 μm, p = 0.955). The CI and CD were higher in CRVO eyes, compared to fellow eyes (11.47 ± 3.60 vs 9.79 ± 3.99, p = 0.058; 170 ± 45 μm vs 150 ± 58 μm, p = 0.084, respectively), while PD was significantly decreased (46.13 ± 19.21% vs 63.78 ± 22.58%, p < 0.001). PD did not exhibit any significant association with thickness (r = 0.12, p = 0.552), CD (r = -0.07, p = 0.605), CI (r = -0.12, p = 0.340) and IOP (r = 0.19, p = 0.192-9. CONCLUSIONS In vivo assessment of lamina cribrosa depicted peculiar structural and vascular changes occurring after onset of CRVO. Structural changes in the curvature may imply a stiffer and more compressed microarchitecture of the lamina itself, justifying lower intrinsic perfusion metrics.
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Affiliation(s)
- Matteo Menean
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
| | - Lorenzo Bianco
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Lida Perna
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Gaia L'Abbate
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Rosangela Lattanzio
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Luisa Pierro
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
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Jiang B, Wei X, Cao X, Zheng C. Insights into modifiable risk factors of retinal vascular occlusion: A Mendelian randomization study. Medicine (Baltimore) 2025; 104:e41752. [PMID: 40324241 PMCID: PMC12055163 DOI: 10.1097/md.0000000000041752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 01/11/2025] [Accepted: 02/14/2025] [Indexed: 05/07/2025] Open
Abstract
Understanding the etiological risk factors for retinal vascular occlusion (RVO) is critical for prevention and treatment. While the effects of cardiovascular events, hypertension, glaucoma, obesity and glycemic risk factors on RVO are still controversial. This study employed two-sample Mendelian randomization (MR) analysis to investigate these causal risk factors. Single-nucleotide polymorphisms (SNPs) were used as instrumental variables (IVs). Genetic instruments for hypertension, glaucoma, obesity, cardiovascular events and glycemic risk factors were obtained from published genome-wide association studies (GWASs). Summary-level data for RVO and hypertension were obtained from the FinnGen consortium. MR analysis primarily utilized the inverse variance weighted (IVW) method, with MR-Egger and weighted median as supplementary approaches. Multivariable MR (MVMR) adjusting for hypertension or glaucoma of RVO were conducted. Heterogeneity was assessed using Cochrane's Q test and I2, while MR-Egger intercept and MR-PRESSO tested horizontal pleiotropy. All MR analyses were performed within R software (4.1.3) using the R packages "TwoSampleMR" and "MR-PRESSO." Genetic instruments for hypertension and glaucoma were significantly associated with RVO risk. A one-standard deviation (SD) increase in hypertension was associated with a higher risk of RVO [OR = 1.577, 95% CI = (1.342, 1.854), P < .001], while a one-SD increase in the log odds of genetically predicted glaucoma was associated with a higher risk of RVO [OR = 1.24, 95% CI = (1.115, 1.379), P < .001]. Meanwhile, hypertension and glaucoma were still significant in multivariable MR. There was not sufficient evidence to suggest cardiovascular events and obesity were associated with RVO risk. This MR study provided genetic evidence supporting that hypertension and glaucoma were causally associated with the risk of RVO. It may help guide clinical decisions in the management of RVO patients with hypertension and glaucoma.
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Affiliation(s)
- Bingcai Jiang
- Department of Ophthalmology, Guizhou Provincial People’s Hospital, Guizhou, China
| | - Xin Wei
- Department of Ophthalmology, The People’s Hospital of Tongliang District, Chongqing, China
| | - Xiaochuan Cao
- Department of Ophthalmology, The People’s Hospital of Tongliang District, Chongqing, China
| | - Changwei Zheng
- Department of Ophthalmology, The People’s Hospital of Tongliang District, Chongqing, China
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Gálvez-Sánchez R, Salmón González Z, Fernández-García M, Cerveró Varona A, González-Mesones B, López-Hoyos M, Martínez-Taboada V, Luis Hernández J. Impact of the 2023 ACR/EULAR Antiphospholipid Syndrome Criteria on Retinal Vein Occlusion Patients. J Clin Med 2025; 14:2826. [PMID: 40283661 PMCID: PMC12028246 DOI: 10.3390/jcm14082826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2025] [Revised: 04/12/2025] [Accepted: 04/16/2025] [Indexed: 04/29/2025] Open
Abstract
Background/Objectives: Retinal vein occlusion (RVO) represents a common ophthalmological disorder that, if untreated, often leads to severely impaired vision. The classic vascular risk factors, aging and glaucoma, represent the core pathogenic factors for RVO. However, antiphospholipid syndrome (APS) has been involved in a non-negligible number of patients with RVO. The main objective of the present study was to assess the performance of the new 2023 ACR/EULAR classification criteria for APS in a cohort of patients with RVO fulfilling the Sydney classification criteria. Methods: A prospective study of consecutive patients with RVO diagnosed with APS in a third-level university hospital. The new 2023 ACR/EULAR classification criteria for APS were applied to all patients. Vascular risk factors, the antiphospholipid antibody (aPL) profile, clinical management, and clinical outcomes were assessed and compared between those fulfilling the Sydney and the 2023 ACR/EULAR criteria. Results: Sixty-nine RVO-APS patients were included in the study. After applying the new classification criteria, 18 patients (26.1%) did not fulfill the new criteria for APS. Specifically, 17 (24.6%) were excluded due to the new Domain 8 (p < 0.001) as they presented only aPL IgM serology, and 1 patient (1.4%) was excluded due to having high venous thromboembolic risk (VTE) with a clinical domain score < 3. Interestingly enough, the presence of high arterial risk (45.1% vs. 50%; p = 0.72) was greater than the presence of high VTE (3.9% vs. 5.6%; p = 0.99); in both cases, the 51 RVO-APS patients were classified with the 2023 ACR/EULAR criteria, and the 18 cases were excluded according to the new classification criteria. Except for the expected differences in serological domains (Domain 7, p < 0.001, and Domain 8, p < 0.001), we did not find other significant differences in terms of prognosis or risk of recurrence between both groups of patients. Conclusions: The implementation of the new ACR/EULAR 2023 classification criteria for APS resulted in the exclusion of about one out of four previously diagnosed RVO-APS patients. The higher prevalence of manifestations of high arterial risk compared with high VTE among both newly classified and excluded APS patients highlights the importance of monitoring cardiovascular risk factors for both the prevention and the management of potential retinal and cardiovascular events.
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Affiliation(s)
- Rafael Gálvez-Sánchez
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, 39008 Santander, Spain; (R.G.-S.); (V.M.-T.)
| | - Zaida Salmón González
- Division of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, 39008 Santander, Spain; (Z.S.G.); (M.F.-G.)
| | - Magdalena Fernández-García
- Division of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, 39008 Santander, Spain; (Z.S.G.); (M.F.-G.)
| | - Andrea Cerveró Varona
- Division of Ophtalmology, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, 39008 Santander, Spain;
| | - Belén González-Mesones
- Division of Hematology, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, 39008 Santander, Spain;
| | - Marcos López-Hoyos
- Division of Inmunology, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, 39008 Santander, Spain;
| | - Víctor Martínez-Taboada
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, 39008 Santander, Spain; (R.G.-S.); (V.M.-T.)
- Departamento de Medicina y Psiquiatría, Universidad de Cantabria, 39005 Santander, Spain
| | - José Luis Hernández
- Division of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, 39008 Santander, Spain; (Z.S.G.); (M.F.-G.)
- Departamento de Medicina y Psiquiatría, Universidad de Cantabria, 39005 Santander, Spain
- Department of Internal Medicine, Hospital Marqués de Valdecilla-IDIVAL, Avda. Valdecilla s/n, 39008 Santander, Spain
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Lee JH, Kim SH, Kim E. Influence of Smoking and Controlled Medical Conditions on the Risks of Branch Retinal Vein Occlusion in South Korea: A Population-Based Study. Ophthalmic Epidemiol 2025; 32:44-51. [PMID: 38507597 DOI: 10.1080/09286586.2024.2321902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/10/2024] [Accepted: 02/18/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE To evaluate the effect of controlled medical conditions and risk of lifetime smoking history on the prevalence of branch retinal vein occlusion (BRVO) based on the Korea National Health and Nutrition Survey (KNHANES) database from 2017-2021. METHODS The study population consisted of individuals aged ≥ 40 years who had completed ophthalmological questionnaires, underwent comprehensive ophthalmological examinations, and had at least one good-quality readable fundus photograph. Age, sex, hypertension status, diabetes status, dyslipidemia status, body mass index status, a history of chronic kidney disease (CKD), a lifetime smoking history of ≥ 100 cigarettes, and glaucoma were subjected to univariate and multivariate logistic regression analyses. RESULTS The estimated prevalence (± standard error) of RVO was 0.5% (±0.1%). Significant risk factors were one-year increase in age, female sex, hypertension (stage 1, controlled, uncontrolled, and undiagnosed hypertension), underweight, pre-obesity, history of CKD, lifetime smoking history of ≥ 100 cigarettes, and glaucoma. Controlled diabetes decreased the risk of BRVO by 55% (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.22-0.89, p = 0.022) and controlled hyper-high-density-lipoprotein (HDL)-cholesterolemia decreased the risk by 69% (OR = 0.31, 95% CI = 0.13-0.76, p = 0.010). CONCLUSION This study, for the first time, reported the association between lifetime smoking history of ≥ 100 cigarettes and BRVO in Korea. The risk of BRVO was lower in participants with controlled diabetes and hypo-HDL-cholesterolemia.
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Affiliation(s)
- Jung Hoo Lee
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Seong Ho Kim
- Kim's Eye Hospital of Konyang University, Seoul, South Korea
| | - EunAh Kim
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
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Yuan C, He C, Zuo L, Liu B, Qi H. The effect of coagulation traits on the risk of retinal vein occlusion: a mendelian randomization study. Sci Rep 2025; 15:3052. [PMID: 39856373 PMCID: PMC11761461 DOI: 10.1038/s41598-025-87648-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 01/21/2025] [Indexed: 01/27/2025] Open
Abstract
Retinal vein occlusion (RVO) is the leading cause of vision loss due to an obstruction in the retinal venous system. While RVO is often linked to thrombotic tendencies and coagulation abnormalities, the exact role of coagulation traits in its development is not fully understood. This study aims to investigate the potential causal relationship between coagulation traits and the risk of RVO by analyzing publicly available genome-wide association study (GWAS) summary statistics. A two-sample Mendelian randomization (MR) analysis framework was employed to investigate the causal relationship between coagulation traits and the risk of RVO. Stringent quality control measures were applied to select appropriate instrumental variables strongly linked to exposure, such as coagulation factor III (FIII), coagulation factor V (FV), coagulation factor VIII (FVIII), coagulation factor XI (FXI), coagulation factor VII (FVII) and coagulation factor X (FX), as well as plasmin, platelet count, platelet crit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW). The study utilized the FinnGen project RVO GWAS summary statistics cohort, consisting of 372 RVO cases and 182,573 controls. The analysis focused on 11 coagulation traits. The research suggests that genetically predicted plasma levels of FIII, FVII, MPV, and PCT may be potentially causative for reducing the risk of RVO, and that levels of FVIII may be potentially causative for increasing the risk of RVO. Our MR analysis, utilizing GWAS data from a comprehensive population-based study, revealed a causal association between plasma levels of FIII, FVII, FVIII, MPV, and PCT with the risk of RVO.
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Affiliation(s)
- Chaoyi Yuan
- Department of Ophthalmology, The Second Hospital of Jilin University, #218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Chao He
- Weihai Municipal Hospital, Weihai, 264200, Shandong Province, China
| | - Ling Zuo
- Department of Ophthalmology, The Second Hospital of Jilin University, #218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Baoxing Liu
- Department of Ophthalmology, The Second Hospital of Jilin University, #218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Hui Qi
- Department of Ophthalmology, The Second Hospital of Jilin University, #218 Ziqiang Street, Changchun, 130041, Jilin, China.
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Dursun E, Derhem B, Çobanoğlu S, Oğurel T. Investigation of choroidal structure changes after intravitreal anti-VEGF therapy for retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 2024; 262:3837-3845. [PMID: 39037469 PMCID: PMC11608387 DOI: 10.1007/s00417-024-06562-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/05/2024] [Accepted: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND We aimed to investigate the effect of retinal vein occlusion (RVO) on the posterior segment structures of the eye and its changes with intravitreal anti-Vascular Endothelial Growth Factor (VEGF) treatment. METHODS This prospective longitudinal study included 29 eyes of 29 patients with RVO (17 males and 12 females) followed for 6 months. The best corrected visual acuity (BCVA), macula, choroid ticknesses and choroidal vascularity index (CVI) obtained by spectral-domain optical coherence tomography were recorded at baseline and the first, third, and sixth months after the first injection. Results were compared with fellow eyes (non-affected eyes) and age- and sex-matched controls. RESULTS BCVA increased significantly in the 6th month, more in the first month of injection (p < 0.05 for each). Central macular tickness, subfoveal choroid tickness, stromal and total area of choroid decreased significantly after injection (p < 0.05 for each). CVI values increased significantly, especially in the 1st month after injection (p < 0.05 for each). In eyes with Branch RVO, there was a significant decrease in the macular thickness of the occlusive areas with treatment, while there was no statistically significant change in the non-occlusive macular thickness. CONCLUSION Observation of changes in choroidal structure may be useful to assess the activity of RVO and predict the efficacy of anti-VEGF therapy.
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Affiliation(s)
- Erdem Dursun
- Faculty of Medicine, Ophthalmology Department, Kırıkkale University, Seyrantepe Mh. Asude Kent Sitesi C Blok no:22 Yahsihan, Kırıkkale, Turkey.
| | - Baki Derhem
- Faculty of Medicine, Family Medicine Department, Kırıkkale University, Kırıkkale, Turkey
| | - Seval Çobanoğlu
- Faculty of Medicine, Ophthalmology Department, Kırıkkale University, Seyrantepe Mh. Asude Kent Sitesi C Blok no:22 Yahsihan, Kırıkkale, Turkey
| | - Tevfik Oğurel
- Faculty of Medicine, Ophthalmology Department, Kırıkkale University, Seyrantepe Mh. Asude Kent Sitesi C Blok no:22 Yahsihan, Kırıkkale, Turkey
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Katsimpris A, Baumeister SE, Voulgari N, Baurecht H, Kandarakis S, Nolde M. Intraocular pressure, primary open-angle glaucoma and the risk of retinal vein occlusion: A Mendelian randomization mediation analysis. Eye (Lond) 2024; 38:3347-3351. [PMID: 39147865 PMCID: PMC11584727 DOI: 10.1038/s41433-024-03303-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 07/15/2024] [Accepted: 08/08/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND The etiological connection between intraocular pressure (IOP) and the risk of retinal vein occlusion (RVO) remains elusive, particularly regarding whether this risk emanates from the direct influence of elevated intraocular pressure (IOP), irrespective of the presence of primary open-angle glaucoma (POAG), or if it arises as a consequence of the sequelae of POAG. Therefore, we conducted a Mendelian Randomization (MR) mediation analysis to elucidate the mediating role of POAG in the association between IOP and RVO. METHODS We identified 47 single-nucleotide polymorphisms (SNPs) associated with IOP (P-value < 5 × 10-8) leveraging data from a genome-wide association study (GWAS) (N = 97,653) obtained from the UK Biobank and 50 SNPs associated with POAG (P-value < 5 × 10-8) from a GWAS meta-analysis (16,677 cases and 199,580 controls). We related these SNPs with RVO using a GWAS of 775 RVO cases and 376,502 controls from FinnGen. By utilizing univariable and multivariable MR analyses we calculated the total effect of IOP on RVO and estimated the degree to which POAG mediates this association. RESULTS MR analyses showed that higher IOP is associated with higher RVO risk (odds ratio of RVO per 1 mmHg increase in IOP: 1.53; 95% confidence interval: 1.04 to 2.26; p-value = 0.03). Moreover, our MR mediation analysis suggested that 91.6% of the total effect of IOP on RVO risk was mediated through POAG. The primary results were consistent with estimates of pleiotropy-robust MR methods. CONCLUSION Our findings suggest that higher IOP increases the risk of RVO and that the majority of this effect is mediated through POAG.
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Affiliation(s)
- Andreas Katsimpris
- Princess Alexandra Eye Pavilion, University of Edinburgh, Edinburgh, UK.
| | | | - Nafsika Voulgari
- Princess Alexandra Eye Pavilion, University of Edinburgh, Edinburgh, UK
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Stylianos Kandarakis
- First Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Nolde
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany.
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Wang LA, Yang ASH, Su YC, Hsu SM, Huang YH, Lee CN, Shao SC, Lin SJ, Hung JH, Lai ECC. Cataract Surgery and Incidence of Retinal Vascular Occlusion: Population-Based Cohort Study Using a Target Trial Emulation Framework. Am J Ophthalmol 2024; 268:143-154. [PMID: 39097255 DOI: 10.1016/j.ajo.2024.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 07/18/2024] [Accepted: 07/21/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Previous studies suggested an association between cataract surgery and retinal vascular occlusion. However, the association may be attributable to detection bias because postoperative monitoring may be more frequent for those who receive cataract surgery than for those who do not. DESIGN Population-based cohort study using target trial emulation framework. METHODS We included patients with cataract aged 50 years and older receiving cataract surgery or nonsurgical interventions identified from the Taiwan National Health Insurance Research Database between 2003 and 2018, matched by propensity score. The primary outcome was retinal vascular occlusion. Cox proportional hazards models were used to compare surgery and control groups. Additional analyses were restricted to patients who had undergone fundoscopic examination within 6 months prior to cataract surgery to address the issue of detection bias. RESULTS We included 577,129 cataract surgery and control pairs. We found the hazard ratio (HR) for retinal vascular occlusion after cataract surgery was 1.23 (95% confidence interval (CI): 1.17-1.29), compared with the control group. Secondary outcome analyses yielded similar results for retinal artery occlusion (HR: 1.13, 95% CI: 1.02-1.26) and retinal vein occlusion (HR: 1.26, 95% CI: 1.20-1.33). However, no risk of retinal vascular occlusion was observed among patients who had received fundoscopic examinations (HR: 1.06, 95% CI: 0.98-1.15) at baseline. CONCLUSIONS Our study underscored the importance of conducting complete baseline fundoscopic examinations before cataract surgery to clarify whether postoperative conditions are due to patients' underlying diseases or unintended complications of cataract surgery.
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Affiliation(s)
- Li-An Wang
- From the Department of Ophthalmology (L.W., Y.S., S.H., Y.H., J.H.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Avery Shuei-He Yang
- Population Health Data Center (A.Y., C.L., S.S., J.H., E.L.), National Cheng Kung University, Tainan, Taiwan; School of Pharmacy (A.Y., C.L., S.S., E.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Chen Su
- From the Department of Ophthalmology (L.W., Y.S., S.H., Y.H., J.H.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Min Hsu
- From the Department of Ophthalmology (L.W., Y.S., S.H., Y.H., J.H.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Hsun Huang
- From the Department of Ophthalmology (L.W., Y.S., S.H., Y.H., J.H.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chaw-Ning Lee
- Population Health Data Center (A.Y., C.L., S.S., J.H., E.L.), National Cheng Kung University, Tainan, Taiwan; School of Pharmacy (A.Y., C.L., S.S., E.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Dermatology (C.L.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Chieh Shao
- Population Health Data Center (A.Y., C.L., S.S., J.H., E.L.), National Cheng Kung University, Tainan, Taiwan; School of Pharmacy (A.Y., C.L., S.S., E.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacy (S.S.), Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Swu-Jane Lin
- Department of Pharmacy Systems (S.L.), Outcomes and Policy College of Pharmacy, University of Illinois, Chicago, Illinois, USA
| | - Jia-Horung Hung
- From the Department of Ophthalmology (L.W., Y.S., S.H., Y.H., J.H.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Population Health Data Center (A.Y., C.L., S.S., J.H., E.L.), National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine (J.H.), College of Medicine, National Cheng Kung University, Tainan, Taiwan..
| | - Edward Chia-Cheng Lai
- Population Health Data Center (A.Y., C.L., S.S., J.H., E.L.), National Cheng Kung University, Tainan, Taiwan; School of Pharmacy (A.Y., C.L., S.S., E.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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10
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Hashemi E, Looha MA, Mazaherinia H, Samadaeian N, Panahi NM, Bonilla-Escobar FJ, Arevalo JF. Risk of stroke development following retinal vein occlusion: A systematic review and meta-analysis. Surv Ophthalmol 2024; 69:924-936. [PMID: 38969210 DOI: 10.1016/j.survophthal.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/07/2024]
Abstract
Retinal vein occlusion (RVO) and cerebrovascular disease share common risk factors and may be independently associated; however, the strength and nature of this association remain unclear. We conducted a systematic review and meta-analysis, informed by studies from PubMed, Scopus, EMBASE, Web of Science, and Google Scholar until January 6, 2024, aimed to clarify this relationship. Eligible studies included cohorts observing stroke incidence in RVO patients for over a year. Pooled effect estimates were calculated using random-effects models, with subgroup analyses evaluating associations between RVO types (central and branch) and stroke subtypes (ischemic and hemorrhagic). Ten cohort studies with a total of 428,650 participants (86,299 RVO patients) were included. Compared to controls, RVO patients exhibited a significantly increased risk of stroke (pooled risk ratio [RR]=1.38, 95 % confidence interval (95 %CI)=1.34-1.41). Subgroup analyses indicated elevated risk for both ischemic (RR=1.37, 95 %CI=1.32-1.42) and hemorrhagic (RR=1.55, 95 %CI=1.08-2.22) strokes in RVO patients. Additionally, both central (RR=1.50, 95 %CI=1.27-1.78) and branch (RR=1.41, 95 %CI=1.32-1.50) RVO were associated with stroke risk. Sensitivity analyses confirmed consistent results across various criteria, and funnel plots indicated no publication bias. RVO significantly increases the risk of both ischemic and hemorrhagic stroke, regardless of RVO type, suggesting a strong independent association between these conditions.
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Affiliation(s)
- Erfan Hashemi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mehdi Azizmohammad Looha
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homa Mazaherinia
- Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nariman Samadaeian
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | | | - Francisco J Bonilla-Escobar
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia; Vision y Salud Ocular, VISOC, Ophthalmology Department, Universidad del Valle, Cali, Colombia; Ophthalmology Department, Institute for Clinical Research Education, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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11
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Yang T, Lu Y, Zeng F, Yu R, Zou C, Hu R, Jin G, Liu J. Prognosis and factors related to anti-VEGF therapy in patients with retinal vein occlusion and concomitant carotid artery disease. Sci Rep 2024; 14:24634. [PMID: 39428411 PMCID: PMC11491442 DOI: 10.1038/s41598-024-75604-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Accepted: 10/07/2024] [Indexed: 10/22/2024] Open
Abstract
To evaluate the prognosis and influencing factors of retinal vein occlusion (RVO) in patients with concomitant carotid artery disease receiving anti-vascular endothelial growth factor (VEGF) treatment. Patients diagnosed with RVO and receiving anti-VEGF treatment were included. Eye and clinical data were collected. The patients were divided into a group with concomitant carotid artery disease (Group A) and a group without concomitant carotid artery disease (Group B). The risk factors affecting the visual prognosis of RVO patients with concomitant carotid artery disease were analyzed. Among 177 eligible patients with RVO, 101 had concomitant carotid artery disease (Group A), while 76 did not (Group B). Group A had a significantly lower treatment effectiveness rate than Group B (P < 0.001). The age and platelet distribution width of Group A were significantly higher than Group B (P < 0.001). Multivariate logistic regression analysis showed that baseline best-corrected visual acuity (BCVA), disorganization of retinal inner layers (DRIL), external limiting membrane (ELM) disruption, and red blood cell distribution width (RDW) were significantly associated with the posttreatment visual prognosis of RVO patients with concomitant carotid artery disease(P < 0.05). RVO patients with concomitant carotid artery disease had a significantly lower treatment effectiveness rate than RVO patients without carotid artery disease. The poor baseline BCVA, DRIL, ELM disruption, and a greater RDW are risk factors for low anti-VEGF treatment efficacy among RVO patients with concomitant carotid artery disease.
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Affiliation(s)
- Tingting Yang
- Department of Ophthalmology, The Affiliated Qingyuan Hospital (Qingyuan People's Hospital), Guangzhou Medical University, Qingyuan, 511518, China
| | - Yamei Lu
- Department of Ophthalmology, The Affiliated Qingyuan Hospital (Qingyuan People's Hospital), Guangzhou Medical University, Qingyuan, 511518, China
| | - Feng Zeng
- Department of Ophthalmology, The Affiliated Qingyuan Hospital (Qingyuan People's Hospital), Guangzhou Medical University, Qingyuan, 511518, China
| | - Ruixia Yu
- Department of Ophthalmology, The Affiliated Qingyuan Hospital (Qingyuan People's Hospital), Guangzhou Medical University, Qingyuan, 511518, China
| | - Chunhui Zou
- Department of Ophthalmology, The Affiliated Qingyuan Hospital (Qingyuan People's Hospital), Guangzhou Medical University, Qingyuan, 511518, China
| | - Rongsheng Hu
- Department of Urology, The Affiliated Qingyuan Hospital (Qingyuan People's Hospital), Guangzhou Medical University, Qingyuan, 511518, China
| | - Guangming Jin
- Department of Ophthalmology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China.
| | - Jiayan Liu
- Department of Ophthalmology, The Affiliated Qingyuan Hospital (Qingyuan People's Hospital), Guangzhou Medical University, Qingyuan, 511518, China.
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12
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Jaggi D, Nagamany T, Wolf S, Zinkernagel MS, Heussen FM. Aflibercept for central retinal vein occlusions: long-term outcomes of a 'Treat-and-Extend' regimen. BMJ Open Ophthalmol 2024; 9:e001659. [PMID: 39181546 PMCID: PMC11344529 DOI: 10.1136/bmjophth-2024-001659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 08/12/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND/AIMS This study reports on the long-term functional and anatomical outcomes of patients with central retinal vein occlusion (CRVO) treated under the Bern treat-and-extend (T&E) protocol. METHODS Observational study. Treatment-naive patients with CRVO and consecutive macular oedema treated with aflibercept were included. The T&E protocol involved 2 monthly injections followed by an extension based on individual assessments. At each visit, best-corrected visual acuity (BCVA), optical coherence tomography imaging and a 2 mg aflibercept injection were administered. Changes in BCVA, proportion of patients gaining ≥15 letters, central subfield thickness (CST) and treatment intervals were analysed. RESULTS Out of 173 patients, 64 had a follow-up of at least 2 years. BCVA improved from 46.7±25.3 at baseline to 78.3±0.5 at year 9. The proportion of patients with ≥15 letters gained was 56%, 53%, 56%, 62%, 52%, 52%, 43%, 50% and 33% at years 1-9, respectively. CST decreased significantly from 660±242 µm at baseline to 359±63 µm at year 9. Treatment intervals extended from 4 weeks initially to an average of 13.0±4.1 weeks by year 8. CONCLUSIONS The T&E regimen for CRVO shows sustained visual improvements and reduced CST over time. Patients maintained stable visual gains for many years, demonstrating the effectiveness of this treatment approach. However, no control group was available to compare our T&E regimen with other strategies.
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Affiliation(s)
- Damian Jaggi
- Department of Ophthalmology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Thanoosha Nagamany
- Department of Ophthalmology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Sebastian Wolf
- Department of Ophthalmology, Inselspital University Hospital Bern, Bern, Switzerland
- Bern Photographic Reading Center, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Martin S. Zinkernagel
- Department of Ophthalmology, Inselspital University Hospital Bern, Bern, Switzerland
- Bern Photographic Reading Center, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Florian M. Heussen
- Department of Ophthalmology, Inselspital University Hospital Bern, Bern, Switzerland
- Bern Photographic Reading Center, Inselspital, University Hospital Bern, Bern, Switzerland
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Vitiello L, Lixi F, Coppola A, Abbinante G, Gagliardi V, Salerno G, De Pascale I, Pellegrino A, Giannaccare G. Intravitreal Dexamethasone Implant Switch after Anti-VEGF Treatment in Patients Affected by Retinal Vein Occlusion: A Review of the Literature. J Clin Med 2024; 13:5006. [PMID: 39274219 PMCID: PMC11395781 DOI: 10.3390/jcm13175006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 08/20/2024] [Accepted: 08/22/2024] [Indexed: 09/16/2024] Open
Abstract
Nowadays, retinal vein occlusion (RVO) is the second most prevalent cause of vision loss associated with retinal vascular disease. Intravitreal injections are currently known as a major advancement in ophthalmology, particularly in the treatment of RVO and other retinal disorders. Particularly, the first line of therapy is usually anti-vascular endothelial growth factor (VEGF) drugs. Notably, for RVO eyes that have not responded to anti-VEGF therapy, an intravitreal dexamethasone (DEX) implant 0.7 mg (Ozurdex®, AbbVie Inc., North Chicago, IL, USA) is considered a suitable therapeutical substitute. Actually, investigations carried out in the real world and clinical trials have shown the safety and the efficacy of intravitreal DEX implants for treating this retinal disease. For this reason, choosing patients carefully may thus be essential to reduce the number of injections that clinics and hospitals have to do to manage RVO and its complications. The primary aim of this review is to summarize the pathophysiology of this retinal vascular disease, as well as the clinical and ocular imaging features that may support a switch from prior anti-VEGF treatment to intravitreal DEX implant, to provide the RVO patients with the best possible treatment to ensure maximum visual recovery.
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Affiliation(s)
- Livio Vitiello
- Eye Unit, "Luigi Curto" Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy
| | - Filippo Lixi
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, CA, Italy
| | - Alessia Coppola
- Eye Unit, "Luigi Curto" Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy
| | - Giulia Abbinante
- Eye Unit, "Luigi Curto" Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy
| | - Vincenzo Gagliardi
- Eye Unit, "Luigi Curto" Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy
| | - Giulio Salerno
- Eye Unit, "Luigi Curto" Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy
| | - Ilaria De Pascale
- Eye Unit, "Luigi Curto" Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy
| | - Alfonso Pellegrino
- Eye Unit, "Luigi Curto" Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy
| | - Giuseppe Giannaccare
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, CA, Italy
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14
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Lin W, Li D, Wen L, Wang Y, Lin Z, Wang F, Liang Y. Prevalence and Risk Factors of Fundus Pathology in Patients with Type 2 Diabetes in a Northeastern Chinese Cohort. Ophthalmic Epidemiol 2024; 31:356-363. [PMID: 37727019 DOI: 10.1080/09286586.2023.2260855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 09/04/2023] [Accepted: 09/15/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE To assess the prevalence of and risk factors for fundus pathology in patients with type 2 diabetes mellitus (T2DM) in a cohort from northeastern China. METHODS Patients were included from the Fushun Diabetic Retinopathy Cohort Study. Patients aged ≥ 30 years with T2DM were recruited between July 2012 and May 2013. Fundus pathology included retinal vascular occlusion (RVO), age-related macular degeneration (AMD), macular pathology, pathologic myopia (PM) and glaucomatous optic atrophy (GOA). RESULTS A Total of 1998 patients with gradable fundus photographs were included in this study, of whom 388 (19.42%) had fundus pathology regardless of whether they had diabetic retinopathy (DR). There were 187 (9.36%) patients with AMD, 97 (4.85%) with GOA, 67 (3.35%) with macular pathology, 35 (1.75%) with PM and 23 (1.15%) with RVO. Advanced age was significantly associated with AMD (odds ratio (OR), 95% confidence interval (CI): 1.03, 1.01-1.05), macular pathology (OR, 95% CI: 1.06, 1.03-1.09) and GOA (OR, 95% CI: 1.06, 1.04-1.09). A wider central retinal arteriolar equivalent was protective against PM (OR, 95% CI: 0.78, 0.66-0.92). Wider central retinal venular equivalent was a protective factor for PM (OR, 95% CI: 0.75, 0.68-0.82) and GOA (OR, 95% CI: 0.93, 0.87-0.99). CONCLUSIONS One-fifth of these patients in northeast China with T2DM had fundus pathology regardless of whether they had DR, indicating the importance of early screening and long-term follow-up.
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Affiliation(s)
- Wei Lin
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Dong Li
- Fushun Eye Hospital, Fushun, Liaoning, China
| | - Liang Wen
- Fushun Eye Hospital, Fushun, Liaoning, China
| | - Yu Wang
- Fushun Eye Hospital, Fushun, Liaoning, China
| | - Zhong Lin
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fenghua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Yuanbo Liang
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
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15
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Kim S, Kim BH, Han K, Kong M, Song SJ. Association Between Three Atopic Triad and Retinal Vein Occlusion Risk: A Nationwide Population-Based Study. Ophthalmic Epidemiol 2024; 31:301-310. [PMID: 37899646 DOI: 10.1080/09286586.2023.2276193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/23/2023] [Indexed: 10/31/2023]
Abstract
PURPOSE To evaluate the association between three allergic diseases (allergic dermatitis, allergic rhinitis, and asthma) and the development of retinal vein occlusion (RVO), a major retinal disease that causes visual impairment. METHOD This study used data obtained from the Korean National Health Insurance Claims database between 2009 and 2018. The association between the three atopic triads (allergic dermatitis, allergic rhinitis, and asthma) and the occurrence of sight-threatening RVO, as determined by diagnostic and treatment codes, were analyzed. Multivariate adjusted Cox regression analysis was used to determine the hazard ratios (HRs) and 95% confidence intervals for RVO development in the presence of allergic disease. RESULTS In this population-based study, 2,160,195 (54.6%) individuals were male, 1,794,968 (45.4%) were female, and 620,938 (15.7%) were diagnosed with allergic diseases. Patients with either asthma or allergic rhinitis had a greater risk of RVO (adjusted hazard ratio (aHR) = 1.101, 95% confidence interval [CI] = 1.029-1.178 for asthma; aHR = 1.181, 95% CI = 1.147-1.215 for allergic rhinitis) compared to those without asthma or allergic rhinitis; however, patients with atopic dermatitis did not show a significant association with RVO (aHR = 1.071, 95% CI = 0.889-1.290), after adjusting for other risk factors. CONCLUSION Our study revealed that allergic rhinitis, asthma, and coexisting multiple allergic conditions were associated with an increased risk of RVO. Thus, it may be advisable to suggest an ophthalmological examination for patients with allergies due to the increased possibility of the occurrence of retinal vascular disease.
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Affiliation(s)
- Seongho Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Bo Hee Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Mingui Kong
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Su Jeong Song
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Biomedical Institute for Convergence (BICS), Sungkyunkwan University, Suwon, Republic of Korea
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16
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Yao Y, Wang Q, Yang J, Yan Y, Wei W. Prevalence and risk factors of retinal vein occlusion in individuals with diabetes: The kailuan eye study. Diab Vasc Dis Res 2024; 21:14791641241271899. [PMID: 39105547 PMCID: PMC11304485 DOI: 10.1177/14791641241271899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024] Open
Abstract
PURPOSE The aim of this study was to analyze the incidence of retinal vein occlusion (RVO) in patients with and without diabetes in the population and compare the influencing factors. METHOD The community-based Kailuan Eye Study included 14,440 participants (9835 male, 4605 female) with a mean age of 54.0 ± 13.3 years (range, 20-110 years). They underwent a systemic and ophthalmologic examination. RVO were diagnosed on fundus photographs. RESULT By matching for age and gender, we included a total of 2767 patients each with diabetes and non-diabetes. The prevalence of RVO among patients with and without diabetes was 1.5% and 0.8%, respectively. The prevalence of RVO was higher in patients with diabetes than in patients without diabetes in all age groups. Multifactorial regression analysis showed that only fasting blood glucose levels were significantly different between patients with RVO with or without DM. The occurrence of RVO in the group with diabetes was mainly associated with higher fasting glucose and systolic blood pressure; in the group without diabetes, RVO was mainly associated with higher diastolic blood pressure, Body Mass Index, and lower low-density lipoprotein cholesterol levels. CONCLUSION We found that patients with diabetes have increased risks of RVO. In addition to blood pressure control, we recommend educating patients with diabetes about RVO, to prevent its subsequent occurrence.
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Affiliation(s)
- Yao Yao
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Qian Wang
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Jingyan Yang
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Yanni Yan
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing Tongren Hospital, Beijing, China
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17
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Luo M, Sun L, Dai R, Chen Y, Wu C. Central retinal vein occlusion in patients with metastatic solid tumors on tyrosine kinase inhibitors: a report of case series and literature review. Front Med (Lausanne) 2024; 11:1362108. [PMID: 38966527 PMCID: PMC11222329 DOI: 10.3389/fmed.2024.1362108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 06/05/2024] [Indexed: 07/06/2024] Open
Abstract
Background Central retinal vein occlusion (CRVO) is a rare adverse effect related to the use of tyrosine kinase inhibitors (TKIs) in patients with metastatic malignancies, which has only been reported in several case reports. Case presentation We reported the case series of three CRVO patients on regular regimens of TKIs as part of targeted therapies for metastatic malignancies, all of whom were otherwise healthy with no or well-controlled systemic conditions. All these patients received injections of intravitreal dexamethasone implant (IDI) and achieved a fluid-free macula at the end of the visit. In addition, we reviewed the existing literature on this subject and present here an updated analysis of the related TKIs, ocular presentation, treatment, and prognosis. Conclusion All patients diagnosed with CRVO on TKIs received dexamethasone implant treatment and obtained a fluid-free macula. We would like to raise awareness among our colleague oncologists about the possibility of CRVO related to TKI use and the necessity for patients to be screened regularly by a retinal specialist.
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Affiliation(s)
- Mingyue Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Lu Sun
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Rongping Dai
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Chan Wu
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
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18
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Ye Y, Huang Z, Yan M, Yu J. Clinical evaluation of ranibizumab and conbercept for the treatment of macular edema secondary to central retinal-vein occlusion. Asian J Surg 2024; 47:2963-2964. [PMID: 38448288 DOI: 10.1016/j.asjsur.2024.02.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
- Ya Ye
- Department of Ophthalmology, General Hospital of Central Theater Command, Wuhan, 430061, Hubei Province, China
| | - Zhen Huang
- Department of Ophthalmology, General Hospital of Central Theater Command, Wuhan, 430061, Hubei Province, China
| | - Ming Yan
- Department of Ophthalmology, General Hospital of Central Theater Command, Wuhan, 430061, Hubei Province, China.
| | - Juan Yu
- Department of Ophthalmology, General Hospital of Central Theater Command, Wuhan, 430061, Hubei Province, China.
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Singh G, Pillai S. Demographic profile, prevalence, pattern, and risk factors for retinal vein occlusion in Liberia: A retrospective study. Oman J Ophthalmol 2024; 17:205-209. [PMID: 39132113 PMCID: PMC11309524 DOI: 10.4103/ojo.ojo_343_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 11/15/2023] [Accepted: 02/27/2024] [Indexed: 08/13/2024] Open
Abstract
PURPOSE This study aims to describe the demographic profile, prevalence, pattern, and risk factors for retinal vein occlusion (RVO) in patients over 40 years of age presenting to the Liberia Eye Centre, John F Kennedy Memorial Medical Centre, Monrovia, Liberia. SUBJECTS AND METHODS A retrospective study was conducted on patients presenting to Liberia Eye Centre from July 2017 to February 2021. A total of 17506 new patients were examined during this period out of which 10813 patients were over 40 years of age. Data were collected from the electronic medical record system database. The variables in the collected data included age, gender, location, laterality of eye affected, uncorrected visual acuity, best-corrected visual acuity, intraocular pressure, ocular diagnosis, systemic risk factors, and associated complications. RESULTS Of the 10813 patients, RVO was found in 111 patients with an overall prevalence rate of 1.03% (95% confidence interval 0.80-1.2). Central RVO (CRVO) was more common than branch RVO (BRVO) in the defined population with similar proportions of both genders. The mean age for any RVO was 64.45 ± 12.27 standard deviation (SD) years (P = 0.734). Majority of the cases of RVO were from Lofa (n = 20; 18%). Fifty-five (61.1%) patients had hypertension, 5 (5.6%) had diabetes mellitus, and 6 (6.7%) had dyslipidemia. More than one systemic risk factor was present in 24 (26.7%) patients. However, none of the systemic risk factors were statistically significant. Visual acuity was most affected in patients with CRVO, with a visual acuity of <3/60 in 45 (63.4%) patients compared to 12 (30.0%) in BRVO patients. Glaucoma was present in 34 (30.6%) patients. The most common ocular complication was macular edema (n = 62, 55.8%) followed by vitreous hemorrhage (n = 8, 7.2%). CONCLUSIONS RVO was detected in 1.03% of the study population over the age of 40 years in Liberia, CRVO being more common than BRVO. The clinical presentation of RVO in the Liberian population for the first time provides insight into the burden of the disease and opportunity for further research.
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Affiliation(s)
- Gurcharan Singh
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eyecare, LV Prasad Eye Institute, Hyderabad, Telangana, India
- Liberia Eye Centre, John F. Kennedy Memorial Medical Centre, Monrovia, Liberia, West Africa
| | - Shayri Pillai
- Liberia Eye Centre, John F. Kennedy Memorial Medical Centre, Monrovia, Liberia, West Africa
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20
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Zheng Y, Woodward R, Feng HL, Lee T, Zhang X, Pant P, Thomas AS, Fekrat S. IMPLICATIONS OF COMPLETE POSTERIOR VITREOUS DETACHMENT IN EYES WITH CENTRAL RETINAL VEIN OCCLUSION. Retina 2024; 44:159-165. [PMID: 37683266 DOI: 10.1097/iae.0000000000003932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
BACKGROUND/PURPOSE To evaluate the status of the posterior vitreous hyaloid on presenting optical coherence tomography images of the macula and its relationship to clinical characteristics, treatment patterns, and outcomes in eyes with central retinal vein occlusion. METHODS This is a retrospective longitudinal cohort study of consecutive patients with acute, treatment-naive central retinal vein occlusion diagnosed between 2009 and 2021 who had at least 12 months of follow-up. Clinical characteristics, treatment patterns, and outcomes were analyzed between eyes stratified based on the presence or absence of a complete posterior vitreous detachment (PVD) on optical coherence tomography at presentation. RESULTS Of 102 acute, treatment-naive central retinal vein occlusions identified, 52 (51%) had complete PVD at presentation and 50 (49%) did not. Central subfield thickness was significantly lower in those with complete PVD (12 months: 284.9 ± 122.9 µ m vs. 426.8 ± 286.4 µ m, P < 0.001; last follow-up: 278 ± 127.9 vs. 372.8 ± 191.0 µ m, P = 0.022). One-year intravitreal injection burden was significantly less for those with a complete PVD than those without (5.1 ± 3.6 injections vs. 6.7 ± 3.3 injections, P = 0.013). CONCLUSION Central retinal vein occlusion with complete PVD on presentation had significantly lower central subfield thickness and 1-year injection burden. Assessment of the vitreomacular interface in central retinal vein occlusion may serve as a prognostic imaging biomarker.
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Affiliation(s)
- Yuxi Zheng
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Richmond Woodward
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Henry L Feng
- Illinois Retina Associates, Rush University Medical Center, Chicago, Illinois ; and
| | - Terry Lee
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Xinxin Zhang
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Praruj Pant
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | | | - Sharon Fekrat
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
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21
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Pickel L, Ji PX, Abdelazim A, Sivachandran N. From Hair Loss to Vision Loss: Minoxidil-Associated CRVO in a Young Female. Case Rep Ophthalmol 2024; 15:220-224. [PMID: 38500541 PMCID: PMC10948167 DOI: 10.1159/000537911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/13/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction Central retinal vein occlusion (CRVO) is a common retinal vascular disorder that is most often seen in older adults and individuals with vascular risk factors. Case Presentation We report a case of CRVO with cystoid macular edema (CME) in a young, otherwise healthy patient taking minoxidil for hair loss. The patient had no known vascular risk factors, and a comprehensive coagulability workup was negative. The CRVO with CME resolved without intervention upon cessation of minoxidil. Conclusion Possible mechanisms for minoxidil-associated retinal vascular disorders are explored. Thorough medication histories and the consideration of possible adverse drug events in patients without traditional risk factors are recommended.
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Affiliation(s)
- Lauren Pickel
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Amr Abdelazim
- Life Sciences, Faculty of Science, Master University, Hamilton, ON, Canada
| | - Nirojini Sivachandran
- Toronto Retina Institute, Toronto, ON, Canada
- Department of Chemistry and Biology, Toronto Metropolitan University, Toronto, ON, Canada
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22
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Zhou C, Li S, Ye L, Chen C, Liu S, Yang H, Zhuang P, Liu Z, Jiang H, Han J, Jiang Y, Zhou L, Zhou X, Xiao J, Zhang C, Wen L, Lan C, Wang Y, Sun T, Jiang L, Xie P, Chen F, Liang G, Fu D, Zhang T, Shi X, Song Z, Liu X, Li S, Li P, Xu X, Wei Q, Wang W, Huang X, De Z, Deng A, Ding L, Pan X, Wen H, Zhang Z, Lv H, Zhang J, Tian X, Deng Z, Wang H, Wang F, Wang Y, Zhao H, Fang Y, Wu Y, Wu Y, Shen N, Li B, Li X, Dai H, Zhao N, Sun X, Zheng Z, Liu K, Xu X. Visual impairment and blindness caused by retinal diseases: A nationwide register-based study. J Glob Health 2023; 13:04126. [PMID: 37921040 PMCID: PMC10623496 DOI: 10.7189/jogh.13.04126] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
Background Retinal disorders cause substantial visual burden globally. Accurate estimates of the vision loss due to retinal diseases are pivotal to inform optimal eye health care planning and allocation of medical resources. The purpose of this study is to describe the proportion of visual impairment and blindness caused by major retinal diseases in China. Methods A nationwide register-based study of vitreoretinal disease covering all 31 provinces (51 treating centres) of mainland China. A total of 28 320 adults diagnosed with retinal diseases were included. Participants underwent standardised ocular examinations, which included best-corrected visual acuity (BCVA), dilated-fundus assessments, and optical coherence tomography. Visual impairment and blindness are defined using BCVA according to the World Health Organization (WHO) (visual impairment: <20/63-≥20/400; blindness: <20/400) and the United States (visual impairment: <20/40-≥20/200; blindness: <20/200) definitions. The risk factors of vision loss were explored by logistic regression analyses. Results Based on the WHO definitions, the proportions for unilateral visual impairment and blindness were 46% and 18%, respectively, whereas those for bilateral visual impairment and blindness were 31% and 3.3%, respectively. Diabetic retinopathy (DR) accounts for the largest proportion of patients with visual impairment (unilateral visual impairment: 32%, bilateral visual impairment: 60%) and blindness (unilateral blindness: 35%; bilateral blindness: 64%). Other retinal diseases that contributed significantly to vision loss included age-related macular degeneration, myopic maculopathy, retinal vein occlusion, and rhegmatogenous retinal detachment and other macular diseases. Women (bilateral vision loss: P = 0.011), aged patients (unilateral vision loss: 45-64 years: P < 0.001, ≥65 years: P < 0.001; bilateral vision loss: 45-64 years: P = 0.003, ≥65 years: P < 0.001 (reference: 18-44 years)) and those from Midwest China (unilateral and bilateral vision loss: both P < 0.001) were more likely to suffer from vision loss. Conclusions Retinal disorders cause substantial visual burden among patients with retinal diseases in China. DR, the predominant retinal disease, is accountable for the most prevalent visual disabilities. Better control of diabetes and scaled-up screenings are warranted to prevent DR. Specific attention should be paid to women, aged patients, and less developed regions.
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Affiliation(s)
- Chuandi Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Shu Li
- Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luyao Ye
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Chong Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Shu Liu
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong Province, China
| | - Hongxia Yang
- Department of Ophthalmology, The First People's Hospital of Jinzhong, Jinzhong, Liaoning Province, China
| | - Peng Zhuang
- Department of Ophthalmology, Zhangzhou Municipal Hospital of Fujian Province, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, China
| | - Zengye Liu
- Department of Ophthalmology, Tianjin First Central Hospital, Tianjin, China
| | - Hongwen Jiang
- Department of Ophthalmology, The First People's Hospital of Kashgar, Kashgar, Xinjiang Uighur Autonomous Region, China
| | - Jing Han
- Department of Ophthalmology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shanxi Province, China
| | - Yiping Jiang
- Department of Ophthalmology, The First Affiliated Hospital of Gannan Medical University, Gannan, Jiangxi Province, China
| | - Liqin Zhou
- Department of Ophthalmology, The First Hospital of Jiaxing, Affiliatd Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China
| | - Xiyuan Zhou
- Department of Ophthalmology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Xiao
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Cangxia Zhang
- Department of Ophthalmology, Cangzhou Hospital of Integrated TCM-WM of Hebei, Cangzhou, Hebei Province, China
| | - Lihui Wen
- Department of Ophthalmology, The Second People's Hospital of Guilin, Guilin, Guangxi Province, China
| | - Changjun Lan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Yuqing Wang
- Department of Ophthalmology, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang Province, China
| | - Tao Sun
- Department of Ophthalmology, Yancheng City No. 1 People's Hospital, Yancheng, Jiangsu Province, China
| | - Li Jiang
- Department of Ophthalmology, Benxi Central Hospital, Benxi, Liaoning Province, China
| | - Peipei Xie
- Department of Ophthalmology, The 152th Central Hospital of the People's Liberation Army, Pingdingshan, Henan Province, China
| | - Fan Chen
- Department of Ophthalmology, Anqing Municipal Hospital, Anqing, Anhui Province, China
| | - Ge Liang
- Department of Ophthalmology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Dongdong Fu
- Department of Ophthalmology, People's Hospital of Zunyi City Bo Zhou District, Zunyi, Guzhou Province, China
| | - Tianzi Zhang
- Department of Ophthalmology, Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia Autonomous Region, China
| | - Xuetao Shi
- Department of Ophthalmology, Pu’er City People's Hospital, Pu’er, Yunnan Province, China
| | - Zhengyu Song
- Department of Ophthalmology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xinghong Liu
- Department of Ophthalmology, The Central Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Shanshan Li
- Department of Ophthalmology, Workers' Hospital of Jinchuan Group Co., Ltd, Jinchang, Gansu Province, China
| | - Pengcheng Li
- Department of Ophthalmology, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiangzhou Xu
- Department of Ophthalmology, Huizhou First Hospital, Huizhou, Guangdong Province, China
| | - Qinfeng Wei
- Department of Ophthalmology, The Second People's Hospital of Xining, Xining, Qinghai Province, China
| | - Weibang Wang
- Department of Ophthalmology, The First People's Hospital of Yinchuan, The Second Affiliated Hospital of Ningxia Medical School, Yinchuan, Ningxia Hui autonomous region, China
| | - Xionggao Huang
- Department of Ophthalmology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
| | - Zhen De
- Department of Ophthalmology, Shigatse People's Hospital, Shigatse, Tibet Autonomous Region, China
| | - Aijun Deng
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical School, Weifang, Shandong Province, China
| | - Lin Ding
- Department of Ophthalmology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Xiuhong Pan
- Yuncheng Eye Hospital, Yuncheng, Shanxi Province, China
| | - Haiyan Wen
- Department of Ophthalmology, People's Hospital of Jilin City, Jilin, Jilin Province, China
| | - Zhongchen Zhang
- Department of Ophthalmology, Hebei Yanda Hospital, Langfang, Hebei Province, China
| | - Hongbin Lv
- Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Jian Zhang
- Department of Ophthalmology, Shaanxi Provincial People's Hospital, Xi’an, Shanxi Province, China
| | - Xuemin Tian
- Department of Ophthalmology, The 988th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army, Kaifeng, Henan Province, China
| | - Zhen Deng
- Department of Ophthalmology, The First People's Hospital of Linping District, Hangzhou, Zhejiang Province, China
| | - Hua Wang
- Department of Ophthalmology, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu Province, China
| | - Fang Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Yu Wang
- Fushun Ophthalmopathy Hospital, Fushun, Liaoning Province, China
| | - Hongchao Zhao
- Department of Ophthalmology, People's Hospital of Yuxi City, Yuxi, Yunnan Province, China
| | - Yanhong Fang
- Department of Ophthalmology, Jiangjin Central Hospital, Chongqing, China
| | - Yuyu Wu
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China
| | - Yufeng Wu
- Department of Ophthalmology, Qingyang People's Hospital, Qingyang, Gansu Province, China
| | - Nian Shen
- Department of Ophthalmology, Liuzhou People's Hospital, Liuzhou, Guangxi Zhuang Autonomous Region, China
| | - Bo Li
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Xiaorong Li
- Department of Ophthalmology, Tianjin Medical University Eye Hospital, School of Optometry & Eye Institute, Tianjin, China
| | - Hong Dai
- Department of Ophthalmology, Beijing Hospital, Beijing, China
| | - Naiqing Zhao
- Department of Biostatistics, Fudan University School of Public Health, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Zhi Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Kun Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
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23
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Tomita R, Goto K, Ueno Y, Yamaguchi K, Takeuchi J, Akahori T, Kaneko H, Iwase T. Narrowing Ratio of Retinal Veins at Arteriovenous Crossing in Patients With Branch Retinal Vein Occlusion Versus That in Healthy Individuals. Invest Ophthalmol Vis Sci 2023; 64:22. [PMID: 37971732 PMCID: PMC10664725 DOI: 10.1167/iovs.64.14.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/22/2023] [Indexed: 11/19/2023] Open
Abstract
Purpose This cross-sectional study aimed to clarify the differences in the retinal venous narrowing ratio (VNR) at retinal arteriovenous crossing by optical coherence tomography (OCT) among the eyes with branch retinal vein occlusion (BRVO), fellow eyes of patients with BRVO, and eyes of individuals without BRVO and to determine factors that influence the VNR. Methods We studied 31 eyes of young participants, 54 eyes of an older control group, 56 fellow eyes of patients with BRVO, and 48 eyes with BRVO. Cross-sectional OCT images were used to determine the VNR at two arteriovenous crossings per eye. Results Overall, 378 arteriovenous crossings were analyzed. The VNR of arterial overcrossings of fellow eyes (27.7% ± 11.1%) and BRVO eyes (27.3% ± 9.76%) were significantly higher than those in the young (16.0% ± 7.9%, all P < 0.001) and control (22.0% ± 8.81%, P < 0.001, P = 0.003, respectively) groups. The VNR of arterial overcrossings was significantly larger than that of venous overcrossings (24.0% ± 10.5% vs. 20.6% ± 13.0%, P = 0.021). A linear mixed-effects model showed that the VNR was significantly higher in arterial overcrossings, crossings with larger arterial internal diameters, smaller venous internal diameters, and participants with older age and a BRVO history. Conclusions The VNR in arterial overcrossings was higher in BRVO eyes and even in the fellow eyes. Thus, a higher VNR in arterial overcrossings may contribute to BRVO development, and crossings with factors contributing to higher VNR might be associated with a risk of BRVO.
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Affiliation(s)
- Ryo Tomita
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Kensuke Goto
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Yoshitaka Ueno
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Katsuya Yamaguchi
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Jun Takeuchi
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Tomohiko Akahori
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Hiroki Kaneko
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
- Department of Ophthalmology, Akita University Graduate School of Medicine, Akita, Japan
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24
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Arepalli S, Wykoff CC, Abraham JR, Lunasco L, Yu H, Hu M, Srivastava SK, Reese JL, Brown D, Ehlers JP. Longitudinal analysis of aqueous humour cytokine expression and OCT-based imaging biomarkers in retinal vein occlusions treated with anti-vascular endothelial growth factor therapy in the IMAGINE study. Eye (Lond) 2023; 37:1928-1935. [PMID: 36220884 PMCID: PMC10275974 DOI: 10.1038/s41433-022-02265-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 08/14/2022] [Accepted: 09/15/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES Retinal vein occlusion (RVO) is the second most common retinal vascular disorder. Despite promising advances with anti-VEGF therapy, select patients are unresponsive to therapy. A precision medicine-based approach for therapeutic decision-making based on underlying biomarkers may facilitate treatment based on the underlying pathway. This study aims to identify the baseline and longitudinal cytokine profiles of RVO-related macular oedema and correlating these expression profiles with higher order OCT features using a novel retinal segmentation and feature extraction platform. SUBJECTS/METHODS The IMAGINE study is a post-hoc assessment of aqueous humour cytokines with correlation to higher level analysis of imaging studies. OCT scans underwent machine learning enhanced segmentation of the internal limiting membrane (ILM), ellipsoid zone (EZ) and retinal pigment epithelium (RPE), as well as evaluating volumetric fluid metrics. Samples of aqueous humour were obtained at baseline, as well as months 4 and 9 prior to treatment. These samples were analysed for the expression of multiple cytokines. Patients were divided into Responders and Non-Responders based on OCT profiles. Additionally, patients were categorised as a Rebounder if their CST increased by 50% after initial improvement. RESULTS Twenty-six eyes were included. The OCT-based response schema identified 21 Responders (81%) and 5 Non-Responders (19%). VEGF levels directly correlated with intraretinal fluid volume and angiogenin was inversely correlated with fluid indices. Multiple cytokines, including ANGPTL4, were directly correlated with ellipsoid zone disruption. The baseline VEGF levels were significantly higher in all responders compared to Non-Responders (p = 0.02). Rebounders tended to have significantly decreased levels of angiogenin and TIMP-1 (p = 0.019, p = 0.015). CONCLUSIONS Cytokine expression was linked to specific OCT features and treatment response in RVO. Identification of an imaging phenotype that could serve as a surrogate for underlying active disease pathways could enhance treatment decision-making and precision medicine.
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Affiliation(s)
- Sruthi Arepalli
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Charles C Wykoff
- Retinal Consultants of Texas, Retina Consultants of America, Houston, TX, USA
| | - Joseph R Abraham
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Leina Lunasco
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Hannah Yu
- Retinal Consultants of Texas, Retina Consultants of America, Houston, TX, USA
| | - Ming Hu
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Sunil K Srivastava
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jamie L Reese
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - David Brown
- Retinal Consultants of Texas, Retina Consultants of America, Houston, TX, USA
| | - Justis P Ehlers
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
- Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
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25
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Hashimoto Y, Kaneko H, Aso S, Okada A, Matsui H, Yasunaga H, Aihara M, Obata R. Association between retinal vein occlusion and early-stage hypertension: A propensity score analysis using a large claims database. Eye (Lond) 2023; 37:1741-1747. [PMID: 36104524 PMCID: PMC10219958 DOI: 10.1038/s41433-022-02241-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 07/27/2022] [Accepted: 09/05/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUNDS/OBJECTIVES The threshold of hypertension was lowered from systolic blood pressure (SBP)/diastolic blood pressure (DBP) 140/90 mmHg to 130/80 mmHg by the 2017 American College of Cardiology/American Heart Association blood pressure (BP) guideline. Thus, we investigated the association between retinal vein occlusion (RVO) occurrence and early-stage hypertension. SUBJECTS/METHODS This retrospective cohort study used the JMDC Claims Database (JMDC Inc., Tokyo, Japan) between 2005 and 2020. Individuals undergoing health checkups who had data on BP and did not take antihypertensive medications were included. They were classified into four BP groups: normal BP (SBP < 120 mmHg and DBP < 80 mmHg), elevated BP (SBP 120-129 mmHg and DBP < 80 mmHg), stage 1 hypertension (SBP 130-139 mmHg or DBP 80-89 mmHg), and stage 2 hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg). Date of RVO occurrence was defined as the first date of diagnosis. We estimated adjusted hazard ratios for RVO and central RVO using weighted Cox regression to adjust for potential confounders. RESULTS A total of 2,703,264 individuals were eligible. During a mean follow-up of 1,091 days, 3,526 RVO and 828 central RVO events occurred. The adjusted hazard ratios (95% confidence intervals) were 1.37 (1.19-1.57), 1.95 (1.75-2.18), and 3.33 (2.95-3.76) for RVO and 1.44 (1.07-1.93), 2.17 (1.72-2.73), and 3.76 (2.91-4.86) for central RVO in the elevated BP, stage 1 hypertension, and stage 2 hypertension groups, respectively, compared with the normal BP group. CONCLUSIONS Even individuals with early-stage hypertension showed higher risks for RVO and central RVO than individuals with normal BP.
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Affiliation(s)
- Yohei Hashimoto
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Shotaro Aso
- Department of Biostatistics & Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Makoto Aihara
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Obata
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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26
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Mehta N, Patil S, Modi V, Vardi R, Liu K, Singh RP, Sarraf D, Oden NL, VanVeldhuisen PC, Scott IU, Ip MS, Blodi BA, Modi Y. High Variation in Inner Retinal Reflectivity Predicts Poor Visual Outcome in Patients With Central Retinal Vein Occlusion: SCORE2 Report 21. Transl Vis Sci Technol 2023; 12:21. [PMID: 37367722 DOI: 10.1167/tvst.12.6.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
Purpose To assess the association of a novel spectral domain optical coherence tomography biomarker with 6-month visual acuity in in the Study of COmparative Treatments for REtinal Vein Occlusion 2. Methods Spectral domain optical coherence tomography volume scans were evaluated for inner retinal hyperreflectivity, quantified by optical intensity ratio (OIR) and OIR variation. Baseline visual acuity letter score (VALS), baseline OCT biomarkers, and month 1 OIR were correlated with VALS at month 6. Regression trees, a machine learning technique yielding readily interpretable models, were used to assess for variable interaction. Results Only baseline VALS correlated positively with month 6 VALS in multivariate regression. Regression trees detected a novel functional and anatomical interaction in a subgroup. Among patients with a baseline VALS worse than 43, those with an OIR variation at month 1 of more than 0.09 had a mean of 13 fewer letters of vision at 6 months compared with patients with an OIR variation of 0.09 or less. Conclusions Baseline VALS was the strongest predictor of month 6 VALS. Regression tree analysis detected an interaction effect, in which higher OIR variation at month 1 predicted worse 6-month VALS in patients with low VALS at baseline. OIR variation may serve as a predictor for poor visual outcome despite treatment of macular edema secondary to retinal vein occlusion in patients with poor vision at baseline. Translational Relevance Pixel heterogeneity in three-dimensional OCT data may serve as measure of disruption of the retinal laminations, and this factor may carry visually prognostic value.
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Affiliation(s)
- Nitish Mehta
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Sachi Patil
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Vikram Modi
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Rachel Vardi
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Kevin Liu
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Rishi P Singh
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, The Cleveland Clinic, Cleveland, OH, USA
| | - David Sarraf
- Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA
- Jules Stein Eye Institute, Los Angeles, CA, USA
| | | | | | - Ingrid U Scott
- Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Michael S Ip
- Doheny Eye Institute, University of California, Los Angeles, CA, USA
| | - Barbara A Blodi
- University of Wisconsin Fundus Photograph Reading Center, Madison, WI, USA
| | - Yasha Modi
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
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Osaka R, Muraoka Y, Nagasato D, Mitamura Y, Nishigori N, Murakami T, Suzuma K, Tabuchi H, Tsujikawa A. Binocular metamorphopsia in patients with branch retinal vein occlusion: a multi-center study. Int Ophthalmol 2023:10.1007/s10792-023-02731-0. [PMID: 37227617 PMCID: PMC10400688 DOI: 10.1007/s10792-023-02731-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 04/22/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE The pathology of branch retinal vein occlusion (BRVO), a retinal circulatory disease, is related to monocular metamorphopsia-related vision impairment of the affected eyes, but the association of binocular metamorphopsia in such patients is unclear. This study aimed to examine the frequency of binocular metamorphopsia and its association with the clinical characteristics of patients with BRVO. METHODS A total of 87 patients who were treated for BRVO-associated macular edema (ME) were included in this study. At baseline and 1 and 3 months after the initiation of anti-vascular endothelial growth factor (VEGF) treatment, we quantified metamorphopsia in the affected eyes and binocular metamorphopsia using the M-CHARTS® diagnostic tool. RESULTS At baseline, 53 and 7 patients had metamorphopsia in the affected eyes and binocular metamorphopsia, respectively. Although the visual acuity improved significantly after the initiation of anti-VEGF treatment, the mean M-CHARTS score in the affected eyes did not change from the baseline score. At 3 months, 9 patients showed binocular metamorphopsia; it was significantly associated with metamorphopsia in the affected eyes with a 95% confidence interval of 0.021-0.122 (β = 0.306, p = 0.006). CONCLUSION Metamorphopsia in the affected eyes can cause binocular metamorphopsia in patients with BRVO-ME.
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Affiliation(s)
- Rie Osaka
- Department of Ophthalmology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yuki Muraoka
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Daisuke Nagasato
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
- Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School, Hiroshima, Japan
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yoshinori Mitamura
- Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School, Hiroshima, Japan
| | - Naomi Nishigori
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomoaki Murakami
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kiyoshi Suzuma
- Department of Ophthalmology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
- Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School, Hiroshima, Japan
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Huang J. Mendelian randomization indicates a causal contribution of type 2 diabetes to retinal vein occlusion. Front Endocrinol (Lausanne) 2023; 14:1146185. [PMID: 37223029 PMCID: PMC10200935 DOI: 10.3389/fendo.2023.1146185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/05/2023] [Indexed: 05/25/2023] Open
Abstract
Background Retinal vein occlusion (RVO) is a common retinal vascular disease that can cause severe visual impairment. Many observational studies have shown that type 2 diabetes (T2DM) is associated with RVO, but it remains unknown if the association is causal. The present study aimed to perform Mendelian randomization (MR) analyses to evaluate the causal contribution of genetically predicted T2DM to RVO. Methods We obtained summary-level data from a genome-wide association study meta-analysis including 48,286 cases and 250,671 controls for T2DM and from a genome wide association study of 372 cases and 182,573 controls in the FinnGen project for RVO. To verify the robustness of the results, an independent validation dataset for T2DM (12,931 cases and 57,196 controls) was used. In addition to the main MR analysis using the inverse variance weighted (fixed effect) approach, sensitivity analyses and multivariable MR adjusting for common risk factors of RVO were conducted. Results Genetically predicted T2DM was found to be causally associated with RVO risk (odds ratio (OR)=2.823, 95% confidence interval (CI): 2.072-3.847, P=4.868×10-11). This association was supported by sensitivity analyses using the weighted median (OR=2.415, 95% CI: 1.411-4.132, P=1.294×10-3), weighted mode (OR=2.370, 95% CI: 1.321-4.252, P=5.159×10-3), maximum likelihood (OR=2.871, 95% CI: 2.100-3.924, P=3.719×10-11), MR-PRESSO (OR=2.823, 95% CI: 2.135-3.733, P=5.150×10-10), and MR-Egger (OR=2.441, 95% CI: 1.149-5.184, P=2.335×10-2) methods. In addition, this association persisted in multivariable MR after accounting for common RVO risk factors (OR=1.748, 95% CI: 1.238-2.467, P=1.490×10-3). The MR analyses using the validation dataset obtained consistent results. Conclusion This study indicates that genetically predicted T2DM may have a causal contribution to RVO. Future studies are required to elucidate the underlying mechanisms.
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Romano F, Lamanna F, Gabrielle PH, Teo KYC, Battaglia Parodi M, Iacono P, Fraser-Bell S, Cornish EE, Nassisi M, Viola F, Agarwal A, Samanta A, Chhablani J, Staurenghi G, Invernizzi A. Update on Retinal Vein Occlusion. Asia Pac J Ophthalmol (Phila) 2023; 12:196-210. [PMID: 36912792 DOI: 10.1097/apo.0000000000000598] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/11/2022] [Indexed: 03/14/2023] Open
Abstract
Retinal vein occlusion represents the second leading cause of retinal vascular disorders, with a uniform sex distribution worldwide. A thorough evaluation of cardiovascular risk factors is required to correct possible comorbidities. The diagnosis and management of retinal vein occlusion have changed tremendously in the last 30 years, but the assessment of retinal ischemia at baseline and during follow-up examinations remains crucial. New imaging techniques have shed light on the pathophysiology of the disease and laser treatment, once the only therapeutic option, is now only one of the possible approaches with antivascular endothelial growth factors and steroid injections being preferred in most cases. Nowadays long-term outcomes are better than those achievable 20 years ago and yet, many new therapeutic options are under development, including new intravitreal drugs and gene therapy. Despite this, some cases still develop sight-threatening complications deserving a more aggressive (sometimes surgical) approach. The purpose of this comprehensive review is to reappraise some old but still valid concepts and to integrate them with new research and clinical data. The work will provide an overview of the disease's pathophysiology, natural history, and clinical features along with a detailed discussion on the advantages of multimodal imaging and of the different treatment strategies with the aim of providing retina specialists with the most updated knowledge in the field.
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Affiliation(s)
- Francesco Romano
- Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Francesca Lamanna
- Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | | | - Kelvin Y C Teo
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, NSW, Australia
| | - Maurizio Battaglia Parodi
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Pierluigi Iacono
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Samantha Fraser-Bell
- Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, NSW, Australia
| | - Elisa E Cornish
- Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, NSW, Australia
| | - Marco Nassisi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Ophthalmological Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Viola
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Ophthalmological Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Aniruddha Agarwal
- Eye Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, US
- Department of Ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Anindya Samanta
- Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, US
| | - Jay Chhablani
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
- Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, NSW, Australia
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30
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McAllister IL, Vijayasekaran S, Bhikoo R, Chen FK, Zhang D, Kanagalingam E, McLenachan S, Yu DY. Inner Retinal Changes in Acute Experimental BRVO Treated With Bevacizumab or Triamcinolone Acetonide. Transl Vis Sci Technol 2023; 12:11. [PMID: 36753186 PMCID: PMC9919627 DOI: 10.1167/tvst.12.2.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Purpose Apoptosis is a key process in neural degeneration associated with retinal vascular diseases. Vascular endothelial growth factor (VEGF) antagonists, including bevacizumab, are used to treat macular edema in these diseases. As VEGF has a critical role in the preservation of retinal neuronal cells, this study investigates the effects of bevacizumab on neural damage in a pig model of branch retinal vein occlusion (BRVO) and compares it with triamcinolone acetonide (TA) which is reported to possess neuroprotective properties. Methods Thirty-six pigs had a photothrombotic BRVO in both eyes. Six pigs were injected with bevacizumab in one eye and TA in the fellow eye, then they were sacrificed, the eyes enucleated, and retinas processed at 2, 6, 10, and 20 days, respectively, together with three pigs (six eyes) BRVO only and three normal pigs (six eyes). Neuronal degeneration (apoptosis) and associated inner retinal changes were determined by terminal deoxyynuclotidyl transferase dUTP nick-end labeling (TUNEL), histology, and immunohistochemistry for macrophages. Results TUNEL labeling showed significantly higher apoptosis rates in the ganglion cell layer (GCL) and the inner nuclear layer (INL) in the bevacizumab-treated compared with the TA-treated retinas at 2, 10, and 20 day time points after occlusion (P < 0.05). Pyknotic cells were significantly higher in the GCL in bevacizumab-treated eyes at 6, 10, and 20 days and in the INL at 2 days compared to TA-treated retinas (P < 0.05). Macrophage infiltration was seen at all time points in both untreated and treated retinas with an absence of significance between bevacizumab- and TA-treated retinas (P > 0.05). Conclusions Neurodegeneration in the BRVO acute phase is exacerbated by current standard treatments for BRVO. These results may have implications for the timing and treatment type. Translational Relevance In the acute phase of BRVO, VEGF suppression with bevacizumab and to a lesser extent with triamcinolone exacerbates apoptosis in the inner retinal layers, which has implications for both the timing and choice of treatment.
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Affiliation(s)
- Ian L. McAllister
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia,Lions Eye Institute, The University of Western Australia, Perth, Australia,Department of Ophthalmology, Royal Perth Hospital, Perth, Australia
| | - Sarojini Vijayasekaran
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia,Lions Eye Institute, The University of Western Australia, Perth, Australia
| | - Riyaz Bhikoo
- Lions Eye Institute, The University of Western Australia, Perth, Australia,Department of Ophthalmology, Royal Perth Hospital, Perth, Australia
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia,Lions Eye Institute, The University of Western Australia, Perth, Australia,Department of Ophthalmology, Royal Perth Hospital, Perth, Australia,Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, Australia
| | - Dan Zhang
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia,Lions Eye Institute, The University of Western Australia, Perth, Australia
| | - Emily Kanagalingam
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia,Lions Eye Institute, The University of Western Australia, Perth, Australia
| | - Samuel McLenachan
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia,Lions Eye Institute, The University of Western Australia, Perth, Australia
| | - Dao-Yi Yu
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia,Lions Eye Institute, The University of Western Australia, Perth, Australia
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Rueda-Camino JA, Gimena-Rodríguez FJ, Domínguez-Sepúlveda MA, Bolzoni M, Pastor-Vivas AI, Angelina-García M, Joya-Seijo MD, Trujillo-Luque D, Losada-Bayo D, Barba-Martín R. Retinal vein occlusion. Audit of a specialized care program. Rev Clin Esp 2023; 223:84-89. [PMID: 36646420 DOI: 10.1016/j.rceng.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/11/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Retinal vein occlusion (RVO) is the second most frequent cause of retinal vascular disease and is related to classic cardiovascular risk factors. A specific program was designed to detect and treat risk factors in patients with RVO. The aim of this study is to audit the results of this program. PATIENTS AND METHODS The program consisted of a multidisciplinary clinical evaluation by the Ophthalmology and Internal Medicine Departments. All patients with RVO were screened, at minimum, for hypertension, diabetes, dyslipidemia, smoking, overweight, and antiphospholipid syndrome. New risk factors or poor control of known risk factors were expected to be found in at least one-third of the patients. Among them, therapeutic measures were expected to be taken in at least two-thirds. A dissociated automated search of the data of all patients who entered the program between April 2021 and April 2022 was performed. RESULTS Fifty-six patients were included for analysis. Of these, 39 (69.6%) had at least one new or poorly controlled risk factor and 43 (76.8%) had their treatment modified in some way. Antiphospholipid syndrome was detected in five (8.9%). Only one patient had low-risk hereditary thrombophilia. After an exhaustive examination, no risk factors were found in 11 patients. CONCLUSION This specific program has been effective in detecting new or poorly controlled risk factors and improving their treatment.
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Affiliation(s)
- J A Rueda-Camino
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain.
| | - F J Gimena-Rodríguez
- Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M A Domínguez-Sepúlveda
- Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M Bolzoni
- Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - A I Pastor-Vivas
- Servicio de Oftalmología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M Angelina-García
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M D Joya-Seijo
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - D Trujillo-Luque
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - D Losada-Bayo
- Servicio de Oftalmología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - R Barba-Martín
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
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Choroidal thickness as a possible predictor of non-response to intravitreal bevacizumab for macular edema after retinal vein occlusion. Sci Rep 2023; 13:451. [PMID: 36624124 PMCID: PMC9829912 DOI: 10.1038/s41598-023-27753-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
To evaluate outcomes of intravitreal bevacizumab (IVB) treating macular edema (ME) after retinal vein occlusion (RVO) following pro re nata (PRN) regimen and investigate potential predictors of non-response. Retrospective analysis of 126 treatment-naive eyes with ME after RVO. Eyes were treated initially with IVB of 1.25 mg/ml. Therapy was switched in case of non-response. Outcome measures included best-corrected visual acuity (BCVA) and central macular thickness (CMT), which were recorded over 4 years of treatment. BCVA improved significantly during first 2 years. CMT decreased significantly during the 4-year follow-up period. Switching was required in 42 eyes (33%). 34 eyes (26.9%) were switched to steroids, while 8 eyes (6.3%) were switched to other anti-VEGF due to diagnosed glaucoma. Switching occurred after 12.4 ± 8.3 months and an average of 8 ± 4.1 IVBs. Compared with the treatment-responsive group, the treatment-unresponsive group had significantly worse BCVA, higher CMT and subfoveal choroidal thickness (SFCT) at baseline. Treatment IVB following PRN regimen showed significant functional and anatomic improvement in patients with ME after RVO. Switching was required in more than one third of eyes. Higher baseline SFCT could be considered as predictor for non-response to such therapy and thus an indicator of early switching.
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33
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Rueda-Camino J, Gimena-Rodríguez F, Domínguez-Sepúlveda M, Bolzoni M, Pastor-Vivas A, Angelina-García M, Joya-Seijo M, Trujillo-Luque D, Losada-Bayo D, Barba-Martín R. Trombosis venosa de retina. Auditoría de un programa de atención especializada. REVISTA CLÍNICA ESPAÑOLA 2022. [DOI: 10.1016/j.rce.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Horozoglu F, Sener H, Polat OA, Temizyurek O, Evereklioglu C. Predictive impact of optical coherence tomography biomarkers in anti-vascular endothelial growth factor resistant macular edema treated with dexamethasone implant. Photodiagnosis Photodyn Ther 2022; 42:103167. [PMID: 36261095 DOI: 10.1016/j.pdpdt.2022.103167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/16/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To perform a longitudinal analysis of the effect of optic coherence tomography (OCT) biomarkers on macular thickness in patients with persistent macular edema secondary to diabetes mellitus and retinal vein occlusion who recieved intravitreal dexamethasone (DEX) implant. METHODS Eighty-nine patients were included in the retrospective study. Patients with anti-VEGF-resistant macular edema were included in the study. The effect of the presence or absence of OCT biomarkers before intravitreal DEX implant therapy on central foveal thickness (CFT) was evaluated. In addition, the change in biomarkers from the baseline visit to the final visit was evaluated. The evaluated OCT biomarkers were as follows: ellipsoid zone and external limiting membrane (ELM) integrity, hyperreflective foci (HRF), disorganization of inner retinal layers (DRIL), hard exudates, serous macular detachment (SMD), pearl necklace, posterior vitreous detachment and the epiretinal membrane (ERM). RESULTS The mean age of the overall sample in the study was 64.4 ± 9.6. CFT decreased significantly from 625.3 ± 22.3 μm at baseline to 365.0 ± 21.7 μm in the 1st month but increased significantly to 430.2 ± 22.6 μm in the 3rd month. In the presence of HRF and SMD, recurrence of macular edema was significant in the 3rd month. The percentage of ELM disruption, DRIL, and ERM deteriorated significantly and the percentage of SMD improved significantly at the final visit. CONCLUSIONS DEX implant therapy resulted in a satisfactory reduction in CFT in patients with DME and RVO. The presence of HRF and SMD is a negative predictor of recurrence in CFT in short term. DEX implant therapy resulted in satisfactory improvement in SMD.
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Affiliation(s)
- Fatih Horozoglu
- Department of Ophthalmology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Hidayet Sener
- Department of Ophthalmology, Erciyes University School of Medicine, Kayseri, Turkey.
| | - Osman Ahmet Polat
- Department of Ophthalmology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Ozge Temizyurek
- Department of Ophthalmology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Cem Evereklioglu
- Department of Ophthalmology, Erciyes University School of Medicine, Kayseri, Turkey
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Vural GS, Karahan E. Central corneal thickness, axial length, anterior chamber and optic disc structure in patients with central and branch retinal vein occlusion. Eur J Ophthalmol 2022; 33:11206721221131705. [PMID: 36217753 DOI: 10.1177/11206721221131705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To compare the central corneal thickness (CCT), the structural properties of the anterior chamber and optic disc in patients with central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), and controls. MATERIAL AND METHODS In this prospective study, 31 eyes of 31 CRVO patients (group 1) (mean age: 65.7 ± 10.2 male/female:16/15), 42 eyes of 42 BRVO patients (group 2) (mean age: 61.5 ± 9.9, male/female: 21/21), and 41 controls (mean age: 61.2 ± 15.3, male/female:15/26) were enrolled. Intraocular pressure (IOP), corrected IOP (IOPcorr), central corneal thickness (CCT), anterior chamber depth & volume (ACD & ACV), iridocorneal angle (ICA), axial length (AL), retinal nerve fiber layer (RNFL) thickness, ganglion cell layer (GCL) thickness, cup to disc ratio (C/D), cup & rim volume, the scleral canal diameter (SCD), and mean & pattern deviation in visual field of the eyes with CRVO/BRVO, their fellow eyes and control eyes were evaluated. RESULTS There was no significant difference in IOP among groups (p:0.239), while IOPcorr was significantly higher in eyes with CRVO compared with eyes with BRVO (p:0.003). Central corneal thickness was significantly thinner in CRVO than both BRVO and controls (p:0.005, p:0.002 respectively). The difference in the RNFL thickness was significant among groups (p:0.019), and it was detected significant between CRVO eyes and controls (p:0.05). Anterior chamber volume was lower in eyes with BRVO than in normal eyes (p:0.009). There was no significant difference in AL, ACD, rim volume, cup volume, GCL thickness, C/D ratio, ICA, and PSD among groups. CONCLUSION The patients with CRVO tend to have thinner corneas, and the evaluation of IOP and CCT can be overlooked during retinal follow-up. Intraocular pressure values corrected with CCT should always be take into account to prevent possible optic nerve damage.
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Affiliation(s)
- Gozde Sahin Vural
- Department of Ophthalmology, Balıkesir University Medicine Faculty, Balıkesir, Turkey
| | - Eyyup Karahan
- Department of Ophthalmology, Balıkesir University Medicine Faculty, Balıkesir, Turkey
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Real-Life Efficacy of Bevacizumab Treatment for Macular Edema Secondary to Central Retinal Vein Occlusion according to Pro Re Nata or Treat-and-Extend Regimen in Eyes with or without Epiretinal Membrane. J Ophthalmol 2022; 2022:6288582. [PMID: 36225608 PMCID: PMC9550471 DOI: 10.1155/2022/6288582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 09/14/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose. To present real-life data of patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO) treated with bevacizumab (BVZ); determine the possible influence of epiretinal membrane (ERM) on treatment efficacy; and compare treatment outcomes in a treat-and-extend regimen (TER) versus pro re nata (PRN). Methods. We carried out a retrospective analysis of 58 eyes (56 patients) with new-onset CRVO treated only with intravitreal bevacizumab according to TER or PRN. Outcome measures were best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at baseline and 12 months after the first treatment, number of visits and injections, and presence of ERM confirmed by optical coherence tomography in the first 6 months. Results. At 12 months, the mean number of injections was 6.3 across all eyes, with significantly more injections given in TER (
). Mean CRT improved from 627 μm to 359 μm (
) in all eyes, with improvement noted in TER (
), PRN (
), ERM (
), and non-ERM (
) subgroups. The mean BCVA gain was +13.6 letters, and the mean BCVA improved from 0.81 to 0.54 LogMAR (
) in all eyes. BCVA improvement from baseline was significant in TER (
) and non-ERM (
) but not in PRN (
) or ERM (
) subgroups. Seven eyes, all receiving PRN treatment, developed neovascularization. Conclusions. Intravitreal bevacizumab according to either PRN or TER resolved edema and stabilized vision in the first 12 months, with TER yielding significant visual improvement and avoiding neovascular complications. ERM had no influence on bevacizumab efficacy in reducing ME in CRVO during 12 months of treatment.
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Ørskov M, Vorum H, Bjerregaard Larsen T, Vestergaard N, Lip GYH, Bek T, Skjøth F. A review of risk factors for retinal vein occlusions. Expert Rev Cardiovasc Ther 2022; 20:761-772. [PMID: 35972726 DOI: 10.1080/14779072.2022.2112667] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Risk factors for retinal vein occlusion have been extensively studied, with varying population sizes. Smaller populations result in less certain measures of associations. The present review included studies with a relevant population size to identify clinically relevant risk factors for retinal vein occlusion. Understanding the risk factors of retinal vein occlusion is important for the management of these patients. AREAS COVERED A comprehensive literature review was conducted through a systematic literature search in PubMed and Embase. Additional studies were selected from cross references in the assessed studies. Weighted effect measures were calculated for all included risk factors.Risk factors associated with retinal vein occlusion included cardiovascular diseases, eye diseases, systemic diseases, medical interventions, and sociodemographic factors. EXPERT OPINION This review provided an extensive overview of a wide variety of risk factors increasing the risk of developing retinal vein occlusion. The severity of the identified risk factors indicated that these patients have been in contact with the health care system before their retinal vein occlusion event. Therefore, the clinical course for patients with retinal vein occlusion may benefit from a multidisciplinary collaboration between ophthalmologists and especially cardiologists.
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Affiliation(s)
- Marie Ørskov
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark
| | - Henrik Vorum
- Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark
| | - Torben Bjerregaard Larsen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark
| | - Nanna Vestergaard
- Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark
| | - Gregory Y H Lip
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark.,Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, Aarhus N, Denmark
| | - Flemming Skjøth
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark.,Unit for Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
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Scott IU, VanVeldhuisen PC, Oden NL, Ip MS, Blodi BA. Month 60 Outcomes After Treatment Initiation With Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema Due to Central Retinal or Hemiretinal Vein Occlusion. Am J Ophthalmol 2022; 240:330-341. [PMID: 35461831 PMCID: PMC11064059 DOI: 10.1016/j.ajo.2022.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate 5-year outcomes in eyes initially treated with aflibercept or bevacizumab for macular edema due to central retinal or hemiretinal vein occlusion. METHODS Long-term follow-up (LTF) after a randomized clinical trial from 64 centers in the United States. Participants were followed up to 60 months and treated at investigator discretion after completing the 12-month treatment protocol. Main outcomes were visual acuity letter score (VALS) and central subfield thickness (CST) on optical coherence tomography. RESULTS Seventy-five percent (248/330) of eligible participants completed at least 1 visit between months 24 and 60, and 45% completed the month 60 visit. Among participants completing month 60, overall mean VALS improvement over baseline was 13.5 (95% CI: 9.6, 17.5), less than the mean improvement of 20.6 (95% CI: 18.7, 22.4) observed at month 12, with no significant differences between originally assigned study groups. Further, 66% (99/150) had at least 1 treatment between months 48 and 60 with a mean (SD) of 3.41 (3.69) treatments over this period. Mean CST was 671 μm at baseline and 261 μm (95% CI: 241.2, 280.9) at month 60. CONCLUSIONS Although VALS improved substantially when patients were treated per protocol through month 12, improvement lessened when treatment was at investigator discretion and fewer treatments were received although VALS remained markedly improved over baseline through year 5. Most patients continued to receive treatment in year 5. This suggests that continued monitoring and, if warranted, treatment with anti-VEGF therapy benefits patients with macular edema associated with central retinal or hemiretinal vein occlusion. Publication of this article is sponsored by the American Ophthalmological Society.
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Affiliation(s)
- Ingrid U Scott
- From the Departments of Ophthalmology and Public Health Sciences (I.U.C.), Penn State College of Medicine, Hershey, Pennsylvania.
| | | | - Neal L Oden
- The Emmes Company, LLC (P.C.V., N.L.O.), Rockville, Maryland
| | - Michael S Ip
- Doheny Eye Institute (M.S.I.), University of California, Los Angeles, California
| | - Barbara A Blodi
- University of Wisconsin Fundus Photograph Reading Center (B.A.B.), Madison, Wisconsin, USA
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Retinal non-perfusion in the ETDRS seven fields compared with widefield fluorescein angiography: correlation and use of extrapolation factor. Retina 2022; 42:1592-1598. [PMID: 35389969 DOI: 10.1097/iae.0000000000003498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION In previous landmark studies on central retinal vein occlusion (CRVO), retinal non-perfusion assessments were obtained using 7-field (7F) angiography. The widespread current use of widefield (WF) imaging allows better visualization of the peripheral retina and more comprehensive estimation of the total area of non-perfusion. The relationship between non-perfusion measurement of 7F and WF angiography (WFA) in CRVO has not been studied. We aim to identify the correlation of retinal non-perfusion measured within the 7F and on WFA in eyes with central retinal vein occlusion. METHODS Retinal non-perfusion in participants with CRVO was determined using a 7F ETDRS template and the concentric rings method. RESULTS A total of 153 eyes were included. Pearson correlation test showed a near-perfect positive, linear correlation between the non-perfusion found in the 7F and total retinal non-perfusion on WFA (0.985 95% CI [0.793, 0.999]) The regression line equation for non-perfusion on 7F and WFA was y = 37 + 3.2x. Eyes with 0 disc areas (DA), >0DA - 10DA and >10DA of non-perfusion on 7-fields had on average 23DA 95%CI [19.20, 27.06], 45DA 95% CI [35.75, 55.18], and 115DA 95%CI [88.89, 142.05] on WF respectively. CONCLUSIONS There is a positive and linear relationship between non-perfusion measured by 7F and WFA in CRVO with more than 3-times the amount of non-perfusion identified on WFA. Despite <10DA no areas of non-perfusion on 7F, there is typically at least 35DA of non-perfusion on WFA while eyes with >10DA of non-perfusion on 7F had at least 88DA on WFA.
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Kishore K, Bhat PV, Venkatesh P, Canizela CC. Dexamethasone Intravitreal Implant for the Treatment of Macular Edema and Uveitis: A Comprehensive Narrative Review. Clin Ophthalmol 2022; 16:1019-1045. [PMID: 35418744 PMCID: PMC8995179 DOI: 10.2147/opth.s209395] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/10/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose The purpose of this review article is to provide a comprehensive review of the current applications of intravitreal DEX implant (Ozurdex®, Allergan Inc, Irvine, CA) for a variety of ophthalmic conditions – ranging from FDA approved indications to off-label uses. We have attempted to provide relevant evidence from the literature to help a reader develop an understanding of the biological and pharmacokinetic properties of DEX implant, its uses, and potential side effects. Methods PubMed searches were performed using the terms “Ozurdex”, or “intravitreal DEX implant”, AND “retinal vein occlusion”, or “diabetic macular edema”, or “uveitis”. The search was performed in July of 2021, with an additional search in October 2021. All original English language articles were considered for this review. Results DEX implant has evidence of efficacy in a variety of clinical situations including macular edema associated with retinal vein occlusion, diabetes, uveitis, and others. Safety concerns include cataract formation and progression, intraocular pressure elevation, complications related to intravitreal injection, and opportunistic infections secondary to steroid-induced immune suppression. Conclusion DEX implant is a useful tool in the management of several retinal disorders. Further studies are needed for head-to-head comparison with other treatment modalities and to determine its precise place in clinical practice.
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Affiliation(s)
- Kamal Kishore
- Illinois Retina and Eye Associates, Peoria, IL, USA
- Department of Surgery, University of Illinois College of Medicine, Peoria, IL, USA
- Correspondence: Kamal Kishore, Illinois Retina and Eye Associates, 4505 N Rockwood Drive, Suite 1, Peoria, IL, 61615, USA, Tel +1 3095891880, Fax +1 3095891885, Email
| | - Pooja V Bhat
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Pradeep Venkatesh
- Department of Ophthalmology, Dr. Rajendra Prasad Center for Ophthalmic Sciences, AIIMS, Ansari Nagar, New Delhi, 110029, India
| | - Cecilia C Canizela
- Department of Surgery, University of Illinois College of Medicine, Peoria, IL, USA
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Baek J, Park HYL, Kim SA, Hong KE, Jeon SJ, Shin DY, Jung Y, Park CK. Parapapillary Choroidal Microvasculature Dropout in Branched Retinal Vein Occlusion and Glaucoma. Invest Ophthalmol Vis Sci 2022; 63:27. [PMID: 35348587 PMCID: PMC8976936 DOI: 10.1167/iovs.63.3.27] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate parapapillary choroidal microvasculature dropout (MvD) in branch retinal vein occlusion (BRVO) patients and compare them with open-angle glaucoma (OAG) patients using optical coherence tomography angiography (OCT-A). Methods In total, 85 eyes of BRVO patients and 85 eyes of OAG patients, matched by age, spherical equivalent, and baseline mean deviation (MD) of the visual field (VF), were assessed. MvD was defined as complete loss of microvasculature within the choroidal layer on OCT-A. Linear regression analysis was used to obtain the slope of the MD change of the VF. Results The presence of MvD on OCT-A was significantly more frequent in OAG eyes (63.1%) compared to BRVO eyes (31.8%). BRVO eyes with MvD showed worse baseline MD of the VF than BRVO eyes without MvD (−10.19 ± 8.50 and −7.77 ± 6.46 dB, respectively; P = 0.045). The presence of MvD was the only factor significantly associated with MD change of the VF in OAG eyes. Lower baseline average RNFL thickness, greater MvD angle, and lower macular superficial vessel density were significantly associated with MD change of the VF in BRVO eyes. Conclusions OCT-A of the parapapillary area showed choroidal microvasculature impairment in both BRVO and OAG patients. However, the frequency was higher in glaucoma patients with similar degrees of VF damage, which suggests that the glaucomatous process contributes to MvD development. The effect of MvD on VF change was different between BRVO and OAG, suggesting that the underlying pathogenesis may also be different.
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Affiliation(s)
- Jiwon Baek
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Bucheon St. Mary's Hospital, Gyeonggi-do, South Korea
| | - Hae-Young Lopilly Park
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Seoul St. Mary's Hospital, Seoul, South Korea
| | - Seong Ah Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Seoul St. Mary's Hospital, Seoul, South Korea
| | - Kyung Euy Hong
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Seoul St. Mary's Hospital, Seoul, South Korea
| | - Soo Ji Jeon
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Bucheon St. Mary's Hospital, Gyeonggi-do, South Korea
| | - Da Young Shin
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Eunpyeong St. Mary's Hospital, Seoul, South Korea
| | - Younhea Jung
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Yeouido St. Mary's Hospital, Seoul, South Korea
| | - Chan Kee Park
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Seoul St. Mary's Hospital, Seoul, South Korea
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McDermott JJ, Lee TC, Chan AX, Ye GY, Shahrvini B, Saseendrakumar BR, Ferreyra H, Nudleman E, Baxter SL. Novel Association between Opioid Use and Increased Risk of Retinal Vein Occlusion Using the National Institutes of Health All of Us Research Program. OPHTHALMOLOGY SCIENCE 2022; 2:100099. [PMID: 35721456 PMCID: PMC9205363 DOI: 10.1016/j.xops.2021.100099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 12/19/2022]
Abstract
Purpose To assess for risk factors for retinal vein occlusion (RVO) among participants in the National Institutes of Health All of Us database, particularly social risk factors that have not been well studied, including substance use. Design Retrospective, case-control study. Participants Data were extracted for 380 adult participants with branch retinal vein occlusion (BRVO), 311 adult participants with central retinal vein occlusion (CRVO), and 1520 controls sampled among 311 640 adult participants in the All of Us database. Methods Data were extracted regarding demographics, comorbidities, income, housing, insurance, and substance use. Opioid use was defined by relevant diagnosis and prescription codes, with prescription use > 30 days. Controls were sampled at a 4:1 control to case ratio from a pool of individuals aged > 18 years without a diagnosis of RVO and proportionally matched to the demographic distribution of the 2019 U.S. census. Multivariable logistic regression identified medical and social determinants significantly associated with BRVO or CRVO. Statistical significance was defined as P < 0.05. Main Outcome Measure Development of BRVO or CRVO based on diagnosis codes. Results Among patients with BRVO, the mean (standard deviation) age was 70.1 (10.5) years. The majority (53.7%) were female. Cases were diverse; 23.7% identified as Black, and 18.4% identified as Hispanic or Latino. Medical risk factors including glaucoma (odds ratio [OR], 3.29; 95% confidence interval [CI], 2.22-4.90; P < 0.001), hypertension (OR, 2.15; 95% CI, 1.49-3.11; P < 0.001), and diabetes mellitus (OR, 1.68; 95% CI, 1.18-2.38; P = 0.004) were re-demonstrated to be associated with BRVO. Black race (OR, 2.64; 95% CI, 1.22-6.05; P = 0.017) was found to be associated with increased risk of BRVO. Past marijuana use (OR, 0.68; 95% CI, 0.50-0.92; P = 0.013) was associated with decreased risk of BRVO; however, opioid use (OR, 1.98; 95% CI, 1.41-2.78; P < 0.001) was associated with a significantly increased risk of BRVO. Similar associations were found for CRVO. Conclusions Understanding RVO risk factors is important for primary prevention and improvement in visual outcomes. This study capitalizes on the diversity and scale of a novel nationwide database to elucidate a previously uncharacterized association between RVO and opioid use.
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Affiliation(s)
- John J. McDermott
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Terrence C. Lee
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Alison X. Chan
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Gordon Y. Ye
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Bita Shahrvini
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Bharanidharan Radha Saseendrakumar
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Henry Ferreyra
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Eric Nudleman
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Sally L. Baxter
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
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Thomas GN, Kiew SY, Singh P, Dmitriev P, Thomas AS, Fekrat S. Central Retinal Vein Occlusion: The Effect of Antiplatelet and Anticoagulant Agents. JOURNAL OF VITREORETINAL DISEASES 2022; 6:97-103. [PMID: 37008668 PMCID: PMC9976011 DOI: 10.1177/24741264211028508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose This work evaluates the effect of antiplatelet and anticoagulant agents on clinical outcomes, optical coherence tomography (OCT) parameters, and macular ischemia in eyes with central retinal vein occlusion (CRVO). Methods A retrospective longitudinal cohort study was performed to evaluate patients with CRVO. Demographics, OCT parameters before and after treatment, macular ischemia on fluorescein angiography, and clinical outcomes including the number of injections received were analyzed. Results A total of 365 patients with CRVO were identified. The average follow-up was 36 months. Antiplatelet or anticoagulant agent use was not associated with a significant difference in visual acuity (VA), prevalence of macular edema, or central subfield thickness on OCT at presentation or final visit. The use of 81-mg aspirin alone was associated with an increased prevalence of foveal hemorrhage at presentation. Patients who were taking an antiplatelet agent, an anticoagulation agent, or both and had an ischemic CRVO with logMAR VA of less than 1.0 experienced improved VA at the final study visit. Patients given antiplatelet or anticoagulant agents had a similar incidence of neovascular sequelae compared with patients not administered these agents. Conclusions In eyes with CRVO, the use of antiplatelet or anticoagulant agents at CRVO onset was not associated with significantly different functional outcomes, except in ischemic CRVO eyes with VA of less than 20/200. The use of 81-mg aspirin was associated with foveal hemorrhage at CRVO presentation. Otherwise, the use of any antiplatelet agent or anticoagulation was not associated with any CRVO structural outcomes.
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Affiliation(s)
- George N. Thomas
- Department of Ophthalmology, National University Health System, Singapore
| | | | - Pali Singh
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Pauline Dmitriev
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Akshay S. Thomas
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
- Tennessee Retina, Nashville, Tennessee, USA
| | - Sharon Fekrat
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
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Evaluation of augmentation index and pulse wave velocity measurements in central retinal vein occlusion patients with and without hypertension. Int Ophthalmol 2022; 42:1347-1354. [PMID: 35083600 DOI: 10.1007/s10792-022-02237-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate arterial stiffness using the pulse wave velocity (PWV) and augmentation index (AI) in central retinal vein occlusion (CRVO) patients. METHODS Forty-two CRVO patients (i.e., CRVO group) and 54 healthy controls (i.e., control group) were included in this comparative and cross-sectional study. The PWV, AI and augmentation pressure were measured with a noninvasive, oscillometric method. RESULTS The mean PWV, AI and augmentation pressure values were significantly higher in CRVO patients than in controls (p = 0.024, p < 0.001 and p = 0.001, respectively). The mean augmentation pressure, AI and PWV measurements were not statistically significant between CRVO patients with and without hypertension (p = 0.856 and p < 0.526, p = 0.432, respectively). Age, presence of hypertension, AI and PWV were found to be as independent risk factors of CRVO development (OR = 2.21, 95% CI [1.44, 3.38] and OR = 2.40, 95% CI [1.50, 3.86], OR = 3.2, 95% CI [1.70, 5.60] and OR = 5.70, 95% CI [2.00, 18.50], respectively). CONCLUSION The AI and PWV values were significantly higher in CRVO patients than in controls. These results indicate that similar abnormalities in the arterial wall structure may play an important role in the pathogenesis of the CRVO and cardiovascular diseases. In addition, our findings show that each patient with RVO should be examined in terms of systemic vascular pathologies.
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Rodríguez-Fernández CA, Campo-Gesto A, López-López A, Gayoso-Rey M. Real-World Evidence for Treat-and-Extend Regimen of Ranibizumab Therapy for Macular Oedema Secondary to Branch Retinal Vein Occlusion. Pharmaceuticals (Basel) 2022; 15:ph15010059. [PMID: 35056116 PMCID: PMC8778817 DOI: 10.3390/ph15010059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/23/2021] [Accepted: 12/30/2021] [Indexed: 01/27/2023] Open
Abstract
The aim of this study was to evaluate the efficacy of a treat-and-extend (T&E) regimen of ranibizumab as the first-choice treatment in macular oedema (MO) secondary to branch retinal vein occlusion (BRVO). We conducted a retrospective study of 20 patients who developed MO due to BRVO treated with intravitreal ranibizumab in a T&E regimen between 2016 and 2017 with a minimum follow-up of two years. Patients were classified as complete responders if treated with ranibizumab alone or incomplete responders if salvage treatment with other medications or laser was needed. Data on best corrected visual acuity (BCVA) and central macular thickness (CMT) every 6 months were recorded. The mean BCVA (logMAR) improved from 0.60 ± 0.36 to 0.29 ± 0.44 and the CMT decreased from 559.85 ± 198.61 to 305.85 ± 11.78 μm. We found statistically significant differences between complete and incomplete responders on the average number of injections during the second year (2.46 ± 2.18 compared to 5.43 ± 1.27; p = 0.007) and change of the BCVA and CMT between both groups (p < 0.001) at 6, 12, 18 and 24 months. T&E seems to be effective in MO secondary to BRVO, improving visual function and decreasing CMT, with less need for injections.
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Affiliation(s)
- Carmen Antía Rodríguez-Fernández
- Ophthalmology Service, Complejo Hospitalario Universitario de Vigo, Estrada do Meixoeiro, s/n, 36213 Vigo, Spain;
- Correspondence:
| | - Ana Campo-Gesto
- Ophthalmology Service, Complejo Hospitalario Universitario de Vigo, Estrada do Meixoeiro, s/n, 36213 Vigo, Spain;
| | - Aida López-López
- Pharmacy Service, Complejo Hospitalario Universitario de Vigo, Camiño Dos Cañotais n 44, 36204 Vigo, Spain; (A.L.-L.); (M.G.-R.)
| | - Mónica Gayoso-Rey
- Pharmacy Service, Complejo Hospitalario Universitario de Vigo, Camiño Dos Cañotais n 44, 36204 Vigo, Spain; (A.L.-L.); (M.G.-R.)
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Camiño Dos Cañotais n 44, 36204 Vigo, Spain
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Multani EK, Bajwa D, Multani PK, Nobakht E, Raj D, Paul RS, Paul RS. EYE DISEASE IN KIDNEY TRANSPLANTATION: CLINICAL CHALLENGES IN A UNIQUE PATIENT POPULATION. Surv Ophthalmol 2021; 67:1252-1269. [PMID: 34954092 DOI: 10.1016/j.survophthal.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
Eye disease is common among kidney transplant recipients and their management is challenging. Chronic kidney disease is associated with ocular complications, both independently and in the context of various systemic disorders. In addition, chronic immunosuppression predisposes kidney transplant recipients to an array of long-term ocular issues. This may be broadly categorized into infections, malignancies, and other immunosuppression-specific side effects. The interdependence of kidney disease, transplant pharmacotherapy and ocular health therefore requires a multispecialty approach. Although the kidney transplant population has grown along with the burden of associated oculopathies, systematic guidelines targeting this patient group are lacking. This evidenced-based narrative review summarizes the pertinent issues that may present in the ophthalmic and optometric clinical settings, with emphasis on collaborative management and directions for future research.
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Affiliation(s)
- Eisha K Multani
- MY EYE DR OPTOMETRISTS LLC, 1330 CONNECTICUT AVE NW, WASHINGTON DC, 20037, UNITED STATES
| | - Dalvir Bajwa
- THE NEWCASTLE UPON TYNE HOSPITALS, NHS FOUNDATION TRUST, ROYAL VICTORIA INFIRMARY, QUEEN VICTORIA ROAD, NEWCASTLE UPON TYNE NE1 4LP, UNITED KINGDOM
| | - Priyanika K Multani
- INLAND VISION CENTER OPTOMETRY, 473 E CARNEGIE DR, SUITE 100, SAN BERNADINO, CA 92408
| | - Ehsan Nobakht
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES
| | - Dominic Raj
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES
| | - Rohan S Paul
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES
| | - Rohan S Paul
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES.
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Ramachandran N, Schmiedel O, Vaghefi E, Hill S, Wilson G, Squirrell D. Evaluation of the prevalence of non-diabetic eye disease detected at first screen from a single region diabetic retinopathy screening program: a cross-sectional cohort study in Auckland, New Zealand. BMJ Open 2021; 11:e054225. [PMID: 34907067 PMCID: PMC8672006 DOI: 10.1136/bmjopen-2021-054225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To evaluate the prevalence of incidental non-diabetic ocular comorbidities detected at first screen in a large diabetic retinopathy (DR) screening programme. DESIGN Cross-sectional cohort study. SETTING Single large metropolitan diabetic eye screening programme in Auckland, New Zealand. PARTICIPANTS Twenty-two thousand seven hundred and seventy-one participants who attended screening from September 2008 to August 2018. RESULTS Hypertensive retinopathy (HTR) was observed in 14.2% (3236/22 771) participants. Drusen were present in 14.0% participants under the age of 55 years, increasing to 20.5% in those 55 years and older. The prevalence of neovascular age-related macular degeneration (AMD) was 0.5% in participants aged<55 years, 2.4% in participants aged 55-75 years and 16% in participants aged>75 years. Retinal vein occlusion and retinal arterial embolus were prevalent in 0.7% and 0.02%, respectively, in participants aged<55 years, increasing to 2.2% and 0.4%, respectively, in those >75 years. Cataracts were common being present in 37.1% of participants over the age of 75 years. Only 386 individuals (1.7%) were labelled as glaucoma suspects. Geographic atrophy, epiretinal membrane, choroidal nevi and posterior capsular opacification had an increased prevalence in older individuals. CONCLUSIONS Our data suggest that AMD, HTR and cataracts are routinely detected during DR screening. The incorporation of the detection of these ocular comorbidities during DR screening provide opportunities for patients to modify risk factors (smoking cessation and diet for AMD, blood pressure for HTR) and allow access to cataract surgery.
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Affiliation(s)
- Nishanthan Ramachandran
- Department of Ophthalmology, Auckland District Health Board Ophthalmology, Auckland, New Zealand
| | - Ole Schmiedel
- Department of Ophthalmology, Auckland District Health Board Ophthalmology, Auckland, New Zealand
| | - Ehsan Vaghefi
- Optometry and Vision Sciences, The University of Auckland, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Sophie Hill
- Department of Ophthalmology, Auckland District Health Board Ophthalmology, Auckland, New Zealand
| | - Graham Wilson
- Ophthalmology, Gisborne Hospital, Gisborne, New Zealand
| | - David Squirrell
- Department of Ophthalmology, Auckland District Health Board Ophthalmology, Auckland, New Zealand
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Topographic patterns of retinal edema in eyes with branch retinal vein occlusion and their association with macular edema recurrence. Sci Rep 2021; 11:23249. [PMID: 34853402 PMCID: PMC8636476 DOI: 10.1038/s41598-021-02726-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
In this study, we evaluated the topographic pattern of retinal edema in eyes with macular edema (ME) secondary to branch retinal vein occlusion (BRVO) using a widefield retinal thickness map of optical coherence tomography and its association with ME recurrence. In 87 eyes with ME secondary to BRVO who were treated with anti-vascular endothelial growth factor (VEGF) injections and followed up for ≥ 1 years, 12 × 9 mm macular volume scans of swept-source optical coherence tomography (DRI-OCT Triton; Topcon Inc, Japan) were performed and retinal thickness maps were automatically generated at baseline and follow-up visits. Topographic patterns of retinal edema on the maps at baseline and 1 month after the first anti-vascular endothelial growth factor (VEGF) treatment were classified as extramacular (outside the ETDRS grid), macular (within the grid), and combined pattern and correlated with ME recurrences. Seventy-five of 87 (86.2%) eyes with BRVO ME showed combined edema at baseline. There were 4 topographic patterns of edema at 1 month following anti-VEGF injection as follows: no residual edema, extramacular only, macular only, and combined edema. In contrast to the baseline pattern, the pattern of retinal edema 1 month following anti-VEGF therapy showed significant association with 6-month recurrence, number of ME recurrences during a 1-year period, and time to first recurrence. (all P < 0.05) An automatically generated widefield retinal thickness map could be used to effectively visualize the topographic patterns of retinal edema in eyes with BRVO. The map can be used as a valuable tool for detection of retinal edema on widefield retinal areas and prediction of ME recurrence in eyes with BRVO.
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49
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Belamkar AV, Jabbehdari S, Harris A, Hajrasouliha AR. Clinical implications of retinal oximetry in retinal vein occlusion: a review. Acta Ophthalmol 2021; 100:624-631. [PMID: 34845846 DOI: 10.1111/aos.15066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/28/2021] [Accepted: 11/19/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To review retinal vein occlusion (RVO) and its relationship with retinal oxygen saturation via automated retinal oximetry in eyes with RVO. METHODS A literature review was performed in PubMed and Medline until October 2021 utilizing specific keywords and cross-matched reference lists. RESULTS This review found RVO to be associated with risk factors including age, hypertension, cardiovascular and metabolic conditions, male gender, and glaucoma. These may be attributed to a breakdown of regulatory processes in the retina. Retinal venous oxygen saturation (SvO2 ) and arteriovenous difference in eyes with central RVO have been found to be reduced and elevated, respectively. The literature indicates variable and contradictory findings in regard to branch RVO and retinal oxygenation. Additionally, ischaemic eyes have been found to have elevated retinal arterial oxygen saturation; however, the literature reports variable results regarding SvO2 levels. Medications have been suggested to increase SvO2 in RVO eyes, which may represent an important mechanism for disease management. Ranibizumab is currently the most studied drug for retinal oxygenation in RVO and has been suggested to increase SvO2 in RVO eyes. In comparison, dexamethasone was found to decrease SvO2 . CONCLUSION The current literature on retinal oxygenation in ischaemic subtypes of RVO and in drug therapies is minimal, and further work is required to expand upon our understanding of how ischaemia and drugs influence retinal oxygenation and clinical outcomes.
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Affiliation(s)
- Aditya V. Belamkar
- Glick Eye Institute Department of Ophthalmology Indiana University School of Medicine Indianapolis Indiana USA
| | - Sayena Jabbehdari
- Jones Eye Institute University of Arkansas for Medical Sciences Little Rock Arkansas USA
| | - Alon Harris
- Icahn School of Medicine at Mount Sinai Ophthalmic Vascular Diagnostic and Research Program at Mount Sinai Hospital New York New York USA
| | - Amir R. Hajrasouliha
- Glick Eye Institute Department of Ophthalmology Indiana University School of Medicine Indianapolis Indiana USA
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50
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Dong WJ, Su T, Li CQ, Shu YQ, Shi WQ, Min YL, Yuan Q, Zhu PW, Liu KC, Yi JL, Shao Y. Altered brain network centrality in patients with retinal vein occlusion: a resting-state fMRI study. Int J Ophthalmol 2021; 14:1741-1747. [PMID: 34804865 DOI: 10.18240/ijo.2021.11.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 01/12/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the intrinsic brain activity variations in retinal vein occlusion (RVO) subjects by using the voxel-wise degree centrality (DC) technique. METHODS Twenty-one subjects with RVO and twenty-one healthy controls (HCs) were enlisted and underwent the resting-state functional magnetic resonance imaging (rs-fMRI) examination. The spontaneous cerebrum activity variations were inspected using the DC technology. The receiver operating characteristic (ROC) curve was implemented to distinguish the DC values of RVOs from HCs. The relationships between DC signal of definite regions of interest and the clinical characteristics in RVO group were evaluated by Pearson's correlation analysis. RESULTS RVOs showed notably higher DC signals in right superior parietal lobule, middle frontal gyrus and left precuneus, but decreased DC signals in left middle temporal gyrus and bilateral anterior cingulated (BAC) when comparing with HCs. The mean DC value of RVOs in the BAC were negatively correlated with the anxiety and depression scale. CONCLUSION RVO is associated aberrant intrinsic brain activity patterns in several brain areas including pain-related as well as visual-related regions, which might assist to reveal the latent neural mechanisms.
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Affiliation(s)
- Wen-Jia Dong
- Affiliated Eye Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Ting Su
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, Fujian Province, China
| | - Chu-Qi Li
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Yong-Qiang Shu
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Wen-Qing Shi
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - You-Lan Min
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Qing Yuan
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Pei-Wen Zhu
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Kang-Cheng Liu
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Jing-Lin Yi
- Affiliated Eye Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Yi Shao
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
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