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Affiliation(s)
- Michael Larsen
- Department of Ophthalmology, Rigshospitalet-Glostrup and University of Copenhagen, Glostrup, Denmark
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Klefter ON, Hommel E, Munch IC, Nørgaard K, Madsbad S, Larsen M. Retinal characteristics during 1 year of insulin pump therapy in type 1 diabetes: a prospective, controlled, observational study. Acta Ophthalmol 2016; 94:540-7. [PMID: 27126300 DOI: 10.1111/aos.13066] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 02/16/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE To investigate changes in retinal metabolism, function, structure and morphology in relation to initiation of insulin pump therapy (continuous subcutaneous insulin infusion, CSII). METHODS Visual acuity, retinopathy level, dark adaptation kinetics, retinal and subfoveal choroidal thickness, macular perfusion velocities, retinal vessel diameters and blood oxygen saturations were measured at baseline and after 1, 4, 16, 32 and 52 weeks in 31 patients with type 1 diabetes who started CSII and 20 patients who continued multiple daily insulin injections (MDI). RESULTS One year of CSII reduced haemoglobin A1c (HbA1c ) by 1.6% (17.8 mmol/mol) compared with 0.3% (3.1 mmol/mol) in the MDI group (p < 0.0001). Central retinal thickness increased by 1.5% in the CSII group (within-group p = 0.0098; between-group p = 0.063) without producing macular oedema. No detectable change was found in any other primary outcome measure. The proportion of patients with retinopathy worsening did not differ between groups. At baseline, longer disease duration was associated with higher retinal artery oxygen saturation (p = 0.014) and lower macular venous perfusion velocity (p = 0.045). CONCLUSION One year of CSII led to an HbA1c reduction relative to continued MDI and a small increase in retinal thickness but not to early retinopathy worsening or to changes in retinal vascular, structural or functional characteristics. Longer duration of type 1 diabetes appears to be associated with lower macular venous perfusion velocity and higher retinal artery oxygen saturation. The latter could potentially reflect cumulative glycaemia.
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Affiliation(s)
- Oliver Niels Klefter
- Department of Ophthalmology; Rigshospitalet; University of Copenhagen; Glostrup Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | | | - Inger Christine Munch
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
- Department of Ophthalmology; Roskilde Hospital; Roskilde Denmark
| | - Kirsten Nørgaard
- Department of Endocrinology; Hvidovre Hospital; University of Copenhagen; Hvidovre Denmark
| | - Sten Madsbad
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
- Department of Endocrinology; Hvidovre Hospital; University of Copenhagen; Hvidovre Denmark
| | - Michael Larsen
- Department of Ophthalmology; Rigshospitalet; University of Copenhagen; Glostrup Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
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Abstract
There are few long-term follow-up reports concerning the treatment of thumb duplication. We reviewed the treatment of 19 of 74 patients treated at our institution between 1956 and 2002. The average follow-up was 22 (range, 7 years to 35 years) years. Satisfactory function was achieved in 18 thumbs and cosmesis in 12 thumbs. Six thumbs were cold-intolerant at this late follow-up. Pinch strength was similar to the contralateral normal thumbs. Collateral ligament repair did not significantly contribute to joint stability. An objective method of postoperative evaluation showed good results in five, fair results in 12 and poor results in two thumbs.
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Affiliation(s)
- M Larsen
- Department of Plastic Surgery, University Hospital, Groningen, The Netherlands
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154
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Abstract
OPINION STATEMENT A disconnected pancreatic duct most commonly follows an episode of severe pancreatitis and walled-off necrosis (WON). When the latter is drained percutaneously, a pancreatic fistula connected to an upstream and disconnected duct is commonly seen. Transgastric drainage of WON with or without concomitant percutaneous drainage (dual drainage) will allow placement of two pigtail stents to drain the upstream duct and ultimately allows removal of percutaneous tubes and avoids the need for distal pancreatectomy. These stents should be left in place indefinitely. In patients referred with percutaneous drains and a disconnected pancreatic duct but without a concomitant fluid collection, a combined procedure, in which an interventional radiologist places a TIPS needle into the drain tract to puncture the stomach, allows the endoscopist access to dilate and stent the tract in a manner comparable to pseudocyst drainage. These stents should be left indefinitely, unless subsequent imaging demonstrates atrophy of the disconnected pancreatic tail.
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Affiliation(s)
- Michael Larsen
- Gastroenterology Division, Digestive Disease Institute, Virginia Mason Medical Center, 1100 Ninth Avenue, C3-GAS, Seattle, WA, 98101, USA. .,Virginia Mason Medical Center, 1100 Ninth Avenue, C3-GAS, Seattle, WA, 98101, USA.
| | - Richard A Kozarek
- Gastroenterology Division, Digestive Disease Institute, Virginia Mason Medical Center, 1100 Ninth Avenue, C3-GAS, Seattle, WA, 98101, USA
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155
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Li XQ, Heegaard S, Kiilgaard JF, Munch IC, Larsen M. Enhanced-Depth Imaging Optical Coherence Tomography of the Human Choroid In Vivo Compared With Histology After Enucleation. ACTA ACUST UNITED AC 2016; 57:OCT371-6. [DOI: 10.1167/iovs.15-18884] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Xiao Qiang Li
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark 2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark 2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Folke Kiilgaard
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark 2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Inger Christine Munch
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark 3Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark
| | - Michael Larsen
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark 2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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156
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Munch IC, Altuntas C, Li XQ, Jackson GR, Klefter ON, Larsen M. Dark adaptation in relation to choroidal thickness in healthy young subjects: a cross-sectional, observational study. BMC Ophthalmol 2016; 16:105. [PMID: 27401722 PMCID: PMC4940899 DOI: 10.1186/s12886-016-0273-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 06/20/2016] [Indexed: 11/17/2022] Open
Abstract
Background Dark adaptation is an energy-requiring process in the outer retina nourished by the profusely perfused choroid. We hypothesized that variations in choroidal thickness might affect the rate of dark adaptation. Method Cross-sectional, observational study of 42 healthy university students (mean age 25 ± 2.0 years, 29 % men) who were examined using an abbreviated automated dark adaptometry protocol with a 2° diameter stimulus centered 5° above the point of fixation. The early, linear part of the rod-mediated dark adaptation curve was analyzed to extract the time required to reach a sensitivity of 5.0 × 10−3 cd/m2 (time to rod intercept) and the slope (rod adaptation rate). The choroid was imaged using enhanced-depth imaging spectral-domain optical coherence tomography (EDI-OCT). Results The time to the rod intercept was 7.3 ± 0.94 (range 5.1 - 10.2) min. Choroidal thickness 2.5° above the fovea was 348 ± 104 (range 153–534) μm. There was no significant correlation between any of the two measures of rod-mediated dark adaptation and choroidal thickness (time to rod intercept versus choroidal thickness 0.072 (CI95 -0.23 to 0.38) min/100 μm, P = 0.64, adjusted for age and sex). There was no association between the time-to–rod-intercept or the dark adaptation rate and axial length, refraction, gender or age. Conclusion Choroidal thickness, refraction and ocular axial length had no detectable effect on rod-mediated dark adaptation in healthy young subjects. Our results do not support that variations in dark adaptation can be attributed to variations in choroidal thickness. Electronic supplementary material The online version of this article (doi:10.1186/s12886-016-0273-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Inger Christine Munch
- Department of Ophthalmology, Zealand University Hospital, Sygehusvej 10, DK-4000, Roskilde, Denmark. .,Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200, København N, Denmark.
| | - Cigdem Altuntas
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200, København N, Denmark
| | - Xiao Qiang Li
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200, København N, Denmark.,Department of Ophthalmology, Rigshospitalet, Nordre Ringvej 57, DK-2600, Glostrup, Denmark
| | | | - Oliver Niels Klefter
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200, København N, Denmark.,Department of Ophthalmology, Rigshospitalet, Nordre Ringvej 57, DK-2600, Glostrup, Denmark
| | - Michael Larsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200, København N, Denmark.,Department of Ophthalmology, Rigshospitalet, Nordre Ringvej 57, DK-2600, Glostrup, Denmark
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Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, Wapner RJ, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Varner M, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Leveno K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spangler T, Lozitska A, Spong C, Tolivaisa S, VanDorsten J. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstet Gynecol 2016; 215:103.e1-103.e14. [PMID: 26772790 DOI: 10.1016/j.ajog.2016.01.004] [Citation(s) in RCA: 290] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/28/2015] [Accepted: 01/02/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although preterm birth <37 weeks' gestation is the leading cause of neonatal morbidity and mortality in the United States, the majority of data regarding preterm neonatal outcomes come from older studies, and many reports have been limited to only very preterm neonates. Delineation of neonatal outcomes by delivery gestational age is needed to further clarify the continuum of mortality and morbidity frequencies among preterm neonates. OBJECTIVE We sought to describe the contemporary frequencies of neonatal death, neonatal morbidities, and neonatal length of stay across the spectrum of preterm gestational ages. STUDY DESIGN This was a secondary analysis of an obstetric cohort of 115,502 women and their neonates who were born in 25 hospitals nationwide, 2008 through 2011. All liveborn nonanomalous singleton preterm (23.0-36.9 weeks of gestation) neonates were included in this analysis. The frequency of neonatal death, major neonatal morbidity (intraventricular hemorrhage grade III/IV, seizures, hypoxic-ischemic encephalopathy, necrotizing enterocolitis stage II/III, bronchopulmonary dysplasia, persistent pulmonary hypertension), and minor neonatal morbidity (hypotension requiring treatment, intraventricular hemorrhage grade I/II, necrotizing enterocolitis stage I, respiratory distress syndrome, hyperbilirubinemia requiring treatment) were calculated by delivery gestational age; each neonate was classified once by the worst outcome for which criteria was met. RESULTS In all, 8334 deliveries met inclusion criteria. There were 119 (1.4%) neonatal deaths. In all, 657 (7.9%) neonates had major morbidity, 3136 (37.6%) had minor morbidity, and 4422 (53.1%) survived without any of the studied morbidities. Deaths declined rapidly with each advancing week of gestation. This decline in death was accompanied by an increase in major neonatal morbidity, which peaked at 54.8% at 25 weeks of gestation. As frequencies of death and major neonatal morbidity fell, minor neonatal morbidity increased, peaking at 81.7% at 31 weeks of gestation. The frequency of all morbidities fell >32 weeks. After 25 weeks, neonatal length of hospital stay decreased significantly with each additional completed week of pregnancy; among babies delivered from 26-32 weeks of gestation, each additional week in utero reduced the subsequent length of neonatal hospitalization by a minimum of 8 days. The median postmenstrual age at discharge nadired around 36 weeks' postmenstrual age for babies born at 31-35 weeks of gestation. CONCLUSION Our data show that there is a continuum of outcomes, with each additional week of gestation conferring survival benefit while reducing the length of initial hospitalization. These contemporary data can be useful for patient counseling regarding preterm outcomes.
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158
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Tabatabaeifar S, Thomassen M, Larsen M, Larsen SR, Kruse T, Sørensen JA. Ultra-deep sequencing reveals the subclonal structure and genomic evolution of oral squamous cell carcinoma. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61148-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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159
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Sarzi E, Seveno M, Angebault C, Milea D, Rönnbäck C, Quilès M, Adrian M, Grenier J, Caignard A, Lacroux A, Lavergne C, Reynier P, Larsen M, Hamel CP, Delettre C, Lenaers G, Müller A. Increased steroidogenesis promotes early-onset and severe vision loss in females with OPA1 dominant optic atrophy. Hum Mol Genet 2016; 25:2539-2551. [PMID: 27260406 DOI: 10.1093/hmg/ddw117] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/26/2016] [Accepted: 04/12/2016] [Indexed: 11/13/2022] Open
Abstract
OPA1 mutations are responsible for autosomal dominant optic atrophy (ADOA), a progressive blinding disease characterized by retinal ganglion cell (RGC) degeneration and large phenotypic variations, the underlying mechanisms of which are poorly understood. OPA1 encodes a mitochondrial protein with essential biological functions, its main roles residing in the control of mitochondrial membrane dynamics as a pro-fusion protein and prevention of apoptosis. Considering recent findings showing the importance of the mitochondrial fusion process and the involvement of OPA1 in controlling steroidogenesis, we tested the hypothesis of deregulated steroid production in retina due to a disease-causing OPA1 mutation and its contribution to the visual phenotypic variations. Using the mouse model carrying the human recurrent OPA1 mutation, we disclosed that Opa1 haploinsufficiency leads to very high circulating levels of steroid precursor pregnenolone in females, causing an early-onset vision loss, abolished by ovariectomy. In addition, steroid production in retina is also increased which, in conjunction with high circulating levels, impairs estrogen receptor expression and mitochondrial respiratory complex IV activity, promoting RGC apoptosis in females. We further demonstrate the involvement of Muller glial cells as increased pregnenolone production in female cells is noxious and compromises their role in supporting RGC survival. In parallel, we analyzed ophthalmological data of a multicentre OPA1 patient cohort and found that women undergo more severe visual loss at adolescence and greater progressive thinning of the retinal nerve fibres than males. Thus, we disclosed a gender-dependent effect on ADOA severity, involving for the first time steroids and Müller glial cells, responsible for RGC degeneration.
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Affiliation(s)
- Emmanuelle Sarzi
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France,
| | - Marie Seveno
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France
| | - Claire Angebault
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France
| | - Dan Milea
- Département de Biochimie et Génétique, UMR CNRS 6214-INSERM 1083, Centre Hospitalier Universitaire, Angers, France.,Singapore National Eye Centre, Singapore.,Singapore Eye Research Institute, Singapore.,Duke-NUS, Singapore
| | - Cecilia Rönnbäck
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Melanie Quilès
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,Université de Montpellier - Faculté de Pharmacie-Montpellier, France
| | - Mathias Adrian
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France
| | - Joanna Grenier
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,Centre de référence des affections sensorielles d'origine génétique, Hôpital Gui de Chauliac, Montpellier, France
| | - Angélique Caignard
- Département de Biochimie et Génétique, UMR CNRS 6214-INSERM 1083, Centre Hospitalier Universitaire, Angers, France
| | - Annie Lacroux
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,Centre de référence des affections sensorielles d'origine génétique, Hôpital Gui de Chauliac, Montpellier, France
| | - Christian Lavergne
- Institut Montpelliérain Alexander Grothendieck. Université Montpellier 3, France and
| | - Pascal Reynier
- Département de Biochimie et Génétique, UMR CNRS 6214-INSERM 1083, Centre Hospitalier Universitaire, Angers, France
| | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian P Hamel
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,Centre de référence des affections sensorielles d'origine génétique, Hôpital Gui de Chauliac, Montpellier, France
| | - Cécile Delettre
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France,
| | - Guy Lenaers
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,PREMMI, UMR CNRS 6214-INSERM 1083, Université d'Angers, France
| | - Agnès Müller
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,Université de Montpellier - Faculté de Pharmacie-Montpellier, France
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160
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Munk MR, Beck M, Kolb S, Larsen M, Hamann S, Valmaggia C, Zinkernagel MS. Quantification of retinal layer thickness changes in acute macular neuroretinopathy. Br J Ophthalmol 2016; 101:160-165. [PMID: 27170518 PMCID: PMC5293849 DOI: 10.1136/bjophthalmol-2016-308367] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/08/2016] [Accepted: 04/16/2016] [Indexed: 11/26/2022]
Abstract
Purpose To quantitatively evaluate retinal layer thickness changes in acute macular neuroretinopathy (AMN). Methods AMN areas were identified using near-infrared reflectance (NIR) images. Intraretinal layer segmentation using Heidelberg software was performed. The inbuilt ETDRS -grid was moved onto the AMN lesion and the mean retinal layer thicknesses of the central grid were recorded and compared with the corresponding area of the fellow eye at initial presentation and during follow-up. Results Eleven patients were included (mean age 26±6 years). AMN lesions at baseline had a significantly thinner outer nuclear layer (ONL) (51±21 µm vs 73±17 µm, p=0.002). The other layers, including inner nuclear layer (37±8 µm vs 38±6 µm, p=0.9) and outer plexiform layer (OPL) (45±19 µm vs 33±16 µm, p=0.1) did not show significant differences between the study eyes and fellow eyes. Adjacent to NIR image lesions, areas of OPL thickening were identified (study eye: 50±14 µm vs fellow eye: 39±16 µm, p=0.005) with corresponding thinning of ONL (study eye: 52±16 µm vs fellow eye: 69±16 µm, p=0.002). Conclusions AMN presents with characteristic quantitative retinal changes and the extent of the lesion may be more extensive than initially presumed from NIR image lesions.
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Affiliation(s)
- Marion R Munk
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.,Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Marco Beck
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Simone Kolb
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Michael Larsen
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Steffen Hamann
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark
| | | | - Martin S Zinkernagel
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Department of Clinical Research, Inselspital, Bern University Hospital, University of Bern, Switzerland
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161
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Concillado M, Lund-Andersen H, Mathiesen ER, Larsen M. Dexamethasone Intravitreal Implant for Diabetic Macular Edema During Pregnancy. Am J Ophthalmol 2016; 165:7-15. [PMID: 26896557 DOI: 10.1016/j.ajo.2016.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 02/04/2016] [Accepted: 02/09/2016] [Indexed: 01/17/2023]
Abstract
PURPOSE To describe the management of diabetic macular edema during pregnancy with the use of a dexamethasone slow-release intravitreal implant. DESIGN Retrospective, observational, consecutive case series. METHODS The study included 5 pregnant women who presented with diabetic macular edema during pregnancy in the period from 2011 to 2014. Review of charts and photographs comprised best-corrected visual acuity (BCVA), foveal center field thickness assessed by optical coherence tomography, blood pressure, glycated hemoglobin, medications, and changes in such parameters after implant injection. RESULTS Diabetic macular edema involving the foveal center was observed between gestational weeks 9 and 23 in 10 eyes of 5 patients. Dexamethasone intravitreal implant injection was given 10 times in 9 eyes with a mean preinjection center field retinal thickness of 535 μm (range, 239-727 μm) and a mean preinjection best-corrected visual acuity (BCVA) of 63 approximated Early Treatment Diabetic Retinopathy Study (approxETDRS) letters (range, 50-77 letters). One eye was unavailable for follow-up. In 7 of 8 eyes injection was followed, within 3 weeks, by a greater than 145 μm reduction in foveal center field thickness and in 6 of 8 eyes by an increase in BCVA of 5 or more approxETDRS letters. A mild transient rise in intraocular pressure occurred in 3 out of 8 eyes. CONCLUSION Diabetic macular edema involving the foveal center that presented during pregnancy responded promptly to intravitreal dexamethasone therapy by foveal thickness reduction and visual acuity improvement without clinically significant intraocular pressure increases.
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Evans L, Larsen M, James A, Watts J. 45NOVEL METHODS IN TEACHING OF MULTIDISCIPLINARY GERIATRIC MEDICINE. Age Ageing 2016. [DOI: 10.1093/ageing/afw029.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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163
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O’Dea B, Larsen M, Batterham P, Calear A, Christensen H. Talking suicide on Twitter: Linguistic style and language processes of suicide-related posts. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IntroductionSuicide is a leading cause of death worldwide and is largely preventable. The social media site Twitter is used by individuals to express suicidal intentions. It is not yet feasible to contact each Twitter user to confirm risk. Instead, it may be possible to validate risk by linguistic analysis. Psychological linguistic theory suggests that language is a reliable way of measuring people's internal thoughts and emotions; however, the linguistics of suicidality on Twitter is yet to be fully explored.Objectives & aimThe aim of this study is to characterise the linguistic styles of suicide-related posts on Twitter for the purposes of predicting suicide risk.MethodsThe Linguistic Inquiry and Word Count (LIWC) program was used to compare the linguistic features of suicide-related tweets previously coded for suicide risk by humans with a set of matched controls. Logistic regression was then used for predictive modelling.ResultsThe suicide-related tweets had significantly different linguistic profiles to the control tweets. The “strongly concerning” suicide tweets were found to have fewer words than all other tweets and not surprisingly, references to ‘death’ were significantly higher in this group. A number of other results were found. The final model which distinguished “strongly concerning” suicide risk from the controls was found to have 97.7% sensitivity and 99.8% specificity.ConclusionsThis study confirms that the linguistic features of suicide-related Twitter posts are different from general Twitter posts and that these linguistic profiles may be used to predict suicide risk in Twitter users.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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164
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Razzaghi A, Larsen M, Lund P, Weisbjerg M. Effect of conventional and extrusion pelleting on in situ ruminal degradability of starch, protein, and fibre in cattle. Livest Sci 2016. [DOI: 10.1016/j.livsci.2016.01.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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165
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Klefter ON, Vilsbøll T, Knop FK, Larsen M. Retinal vascular and structural dynamics during acute hyperglycaemia. Acta Ophthalmol 2015; 93:697-705. [PMID: 26146858 DOI: 10.1111/aos.12797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 06/01/2015] [Indexed: 12/24/2022]
Abstract
PURPOSE To compare retinal vascular dynamics during acute hyperglycaemia in patients with type 2 diabetes and healthy volunteers. METHODS Twenty-one patients with type 2 diabetes and 27 healthy controls were examined with fundus photographic measurement of retinal vessel diameters, retinal oximetry, macular perfusion velocities and optical coherence tomographic measurement of subfoveal choroidal thickness every 30 min during a 3-hr 75 g oral glucose tolerance test (OGTT). Patients paused antidiabetic therapy for 1 week prior to the OGTT. RESULTS Plasma glucose (PG) and fluctuations in PG were larger in patients with diabetes (p < 0.0001). PG increased significantly 30 min after ingestion of glucose (p < 0.0001 in both groups). With a delay of 0-120 min, the PG increase was followed by increased retinal arterial oxygen saturations and arteriovenous oxygen saturation differences, narrowed retinal veins and increased arteriovenous diameter ratios. No effect of age, gender or diabetes status was observed. Choroidal thickness was transiently reduced in controls and unchanged in patients with diabetes (p = 0.021). Macular perfusion velocities increased after 150 min in patients with diabetes but not in controls (arterial p = 0.059; venous p = 0.16). Higher age and diabetes tended to be associated with higher retinal arterial oxygen saturation. CONCLUSION The transition from fasting to acute hyperglycaemia is followed, with a delay of up to 2 hr, by retinal vascular changes, notably increased oxygen extraction, suggesting an effect of secondary metabolic changes. Retinal responses were similar in patients with type 2 diabetes and controls despite differences in glucose levels. It is necessary to standardize measurement conditions in studies of retinal physiology.
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Affiliation(s)
- Oliver N. Klefter
- Department of Ophthalmology; Glostrup Hospital; University of Copenhagen; Glostrup Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - Tina Vilsbøll
- Center for Diabetes Research; Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - Filip K. Knop
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
- Center for Diabetes Research; Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - Michael Larsen
- Department of Ophthalmology; Glostrup Hospital; University of Copenhagen; Glostrup Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
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166
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Rönnbäck C, Nissen C, Almind GJ, Grønskov K, Milea D, Larsen M. Genotype-phenotype heterogeneity of ganglion cell and inner plexiform layer deficit in autosomal-dominant optic atrophy. Acta Ophthalmol 2015; 93:762-6. [PMID: 26385429 DOI: 10.1111/aos.12835] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 07/22/2015] [Indexed: 12/01/2022]
Abstract
PURPOSE To describe the thickness of the combined ganglion cell and inner plexiform layers (GC-IPL) and the peripapillary retinal nerve fibre layer (RNFL) in patients with OPA1 c.983A>G or c.2708_2711delTTAG autosomal-dominant optic atrophy (ADOA). METHODS The study included 20 individuals with c.983A>G and nine individuals with c.2708_2711delTTAG. Data for comparison were drawn from 49, previously published, individuals with OPA1 c.2826_2836delinsGGATGCTCCA and 51 individuals with no OPA1 mutation. Subjects underwent refraction, best-corrected visual acuity assessment, axial length measurement and high-definition optical coherence tomography. RESULTS There was overlap in GC-IPL thickness in subjects younger than 20-30 years between the two new groups of ADOA patients and controls. Numerical decreases in GC-IPL thickness with age did not reach statistical significance in individuals with c.983A>G (p = 0.18) or in healthy controls (p = 0.22), but it did in individuals with c.2708_2711delTTAG (p = 0.02). Visual acuity decreased with decreasing GC-IPL thickness (p = 0.0006 in c.983A>G and p = 0.0084 in c.2708_2711delTTAG). Unlike c.2826_2836delinsGGATGCTCCA, individuals with c.983A>G or c.2708_2711delTTAG did not show a pattern of maximum GC-IPL deficit inferonasal of the fovea. CONCLUSION Genotype-phenotype heterogeneity in OPA1 ADOA is evident when inner retinal atrophy is examined as a function of age. Thus, a pronounced decline with age in GC-IPL thickness is observed in c.2708_2711delTTAG ADOA, an intermediate decline with age is observed in c.983A>G ADOA, whereas little or no change with age is observed in c.2826_2836delinsGGATGCTCCA ADOA. This genotype-phenotype heterogeneity may explain why some patients have progressive visual loss while others have a relatively stable prognosis.
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Affiliation(s)
- Cecilia Rönnbäck
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Claus Nissen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Gitte J. Almind
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- Kennedy Center; Clinical Genetic Clinic; Copenhagen Denmark
| | - Karen Grønskov
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- Kennedy Center; Clinical Genetic Clinic; Copenhagen Denmark
| | - Dan Milea
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Singapore Eye Research Institute; Singapore National Eye Centre and Duke-NUS; Singapore Singapore
| | - Michael Larsen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- Kennedy Center; National Eye Clinic; Copenhagen Denmark
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167
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Rasmussen A, Brandi S, Fuchs J, Hansen LH, Lund-Andersen H, Sander B, Larsen M. Visual outcomes in relation to time to treatment in neovascular age-related macular degeneration. Acta Ophthalmol 2015; 93:616-20. [PMID: 26073051 DOI: 10.1111/aos.12781] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 05/03/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To study the relation between the interval from diagnosis to initiation of intravitreal injection therapy and visual outcome in neovascular age-related macular degeneration (nAMD) and to report changes over time in fellow-eye status. METHODS Retrospective chart review. The study included 1185 eyes in 1099 patients who began vascular endothelial growth factor inhibitor treatment for nAMD during four separate periods in 2007, 2009, 2011 and 2012 using a fixed loading-dose regimen of three ranibizumab injections. RESULTS Mean best-corrected visual acuity (BCVA) at presentation remained within the range 0.23-0.24 Snellen and the median patient age within 79-80 years, whereas BCVA at first visit after the third injection increased from 0.24 to 0.31 (p < 0.0001) in concert with a shift in preferred practice from separate-day injection to same-day injection. This led to a reduction in the median time to treatment from 16 days to 1 day. The proportion of patients with fellow-eye BCVA 0.05 or worse at presentation with newly diagnosed wet AMD in the incident eye decreased from 38% to 22% (p < 0.0018). The proportion of bilaterally treated patients increased during the study period. CONCLUSION In this study, 2-week-earlier injection was associated with the equivalent of a 5-Early Treatment Diabetic Retinopathy Study letter-gain in mean visual acuity at 3 months after presentation. The difference is larger than expected from the 2-week-longer duration of disease at the study end-point. The study supports that early diagnosis and treatment of nAMD is of value for functional outcomes.
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Affiliation(s)
- Annette Rasmussen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- University of Copenhagen; Copenhagen Denmark
| | - Sara Brandi
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
| | - Josefine Fuchs
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- University of Copenhagen; Copenhagen Denmark
| | - Louise H Hansen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
| | - Henrik Lund-Andersen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- University of Copenhagen; Copenhagen Denmark
| | - Birgit Sander
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- University of Copenhagen; Copenhagen Denmark
| | - Michael Larsen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- University of Copenhagen; Copenhagen Denmark
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168
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Larsen M, Galindo C, Ouellet D, Maxin G, Kristensen N, Lapierre H. Abomasal amino acid infusion in postpartum dairy cows: Effect on whole-body, splanchnic, and mammary amino acid metabolism. J Dairy Sci 2015; 98:7944-61. [DOI: 10.3168/jds.2015-9439] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/19/2015] [Indexed: 11/19/2022]
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169
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Sullivan S, Kumar N, Edmundowicz SA, Abu Dayyeh BK, Jonnalagadda SS, Larsen M, Thompson CC. ASGE position statement on endoscopic bariatric therapies in clinical practice. Gastrointest Endosc 2015; 82:767-72. [PMID: 26282949 DOI: 10.1016/j.gie.2015.06.038] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 06/22/2015] [Indexed: 12/13/2022]
Affiliation(s)
| | - Shelby Sullivan
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Nitin Kumar
- Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Steven A Edmundowicz
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Barham K Abu Dayyeh
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Michael Larsen
- Division of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, Washington, USA
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170
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Bjerre-Harpøth V, Storm AC, Eslamizad M, Kuhla B, Larsen M. Effect of propylene glycol on adipose tissue mobilization in postpartum over-conditioned Holstein cows. J Dairy Sci 2015; 98:8581-96. [PMID: 26454303 DOI: 10.3168/jds.2014-8606] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 08/18/2015] [Indexed: 11/19/2022]
Abstract
Our objective was to investigate the quantitative and qualitative effects of propylene glycol (PG) allocation on postpartum adipose tissue mobilization in over-conditioned Holstein cows. Nine ruminally cannulated and arterially catheterized cows were, at parturition, randomly assigned to a ruminal pulse dose of either 500g of tap water (n=4) or 500g of PG (n=5) once a day. The PG was given with the morning feeding for 4 wk postpartum (treatment period), followed by a 4-wk follow-up period. All cows were fed the same prepartum and postpartum diets. At -16 (±3), 4 (±0), 15 (±1) and 29 (±2) days in milk (DIM), body composition was determined using the deuterium oxide dilution technique, liver and subcutaneous adipose tissue biopsies were collected, and mammary gland nutrient uptake was measured. Weekly blood samples were obtained during the experiment and daily blood samples were taken from -7 to 7 DIM. Postpartum feed intake and milk yield was not affected by PG allocation. The body content of lipid was not affected by treatment, but tended to decrease from 4 to 29 DIM with both treatments. Except for the first week postpartum, no difference in plasma nonesterified fatty acids concentration was noted between treatments in the treatment period. Yet, PG allocation resulted in decreased plasma concentrations of β-hydroxybutyrate (BHB) and increased plasma concentrations of glucose. In the follow-up period, plasma concentrations of nonesterified fatty acids, glucose, and BHB did not differ between treatments. Additionally, the change in abundance of proteins in adipose tissue biopsies from prepartum to 4 DIM was not affected by treatment. In conclusion, the different variables to assess body fat mobilization were concurrent and showed that a 4-wk postpartum PG allocation had limited effect on adipose tissue mobilization. The main effect was an enhanced glucogenic status with PG. No carry-over effect of PG allocation was recorded for production or plasma metabolites, and, hence, a new period of metabolic adaption to lactation seemed to occur with PG treatment after ceasing PG allocation. Thus, PG seemed to induce a 2-step adaption to lactation, reducing the immediate postpartum nadir and peak of plasma concentration of glucose and BHB, respectively; which is beneficial for postpartum cows at high risk of lipid-related metabolic diseases.
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Affiliation(s)
- V Bjerre-Harpøth
- Department of Animal Science, Aarhus University, Foulum, Blichers Allé 20, DK-8830 Tjele, Denmark
| | - A C Storm
- Department of Animal Science, Aarhus University, Foulum, Blichers Allé 20, DK-8830 Tjele, Denmark
| | - M Eslamizad
- Institute of Nutritional Physiology "Oskar Kellner," Leibniz Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
| | - B Kuhla
- Institute of Nutritional Physiology "Oskar Kellner," Leibniz Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
| | - M Larsen
- Department of Animal Science, Aarhus University, Foulum, Blichers Allé 20, DK-8830 Tjele, Denmark.
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171
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Harder S, Paulsen RR, Larsen M, Laugesen S, Mihocic M, Majdak P. Reliability in Measuring Head Related Transfer Functions of Hearing Aids. ACTA ACUST UNITED AC 2015; 101:1064-1066. [PMID: 28239328 DOI: 10.3813/aaa.918900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S Harder
- Technical University of Denmark, DTU Compute, Department of Applied Mathematics and Computer Science, 2800 Lyngby, Denmark
| | - R R Paulsen
- Technical University of Denmark, DTU Compute, Department of Applied Mathematics and Computer Science, 2800 Lyngby, Denmark
| | - M Larsen
- Oticon A/S, DK-2765 Smørum, Denmark
| | - S Laugesen
- Eriksholm Research Centre, DK-3070 Snekkersten, Denmark
| | - M Mihocic
- Acoustics Research Institute, Austrian Academy of Sciences, Vienna, Austria
| | - P Majdak
- Acoustics Research Institute, Austrian Academy of Sciences, Vienna, Austria
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172
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Potyrailo RA, Bonam RK, Hartley JG, Starkey TA, Vukusic P, Vasudev M, Bunning T, Naik RR, Tang Z, Palacios MA, Larsen M, Le Tarte LA, Grande JC, Zhong S, Deng T. Towards outperforming conventional sensor arrays with fabricated individual photonic vapour sensors inspired by Morpho butterflies. Nat Commun 2015; 6:7959. [PMID: 26324320 PMCID: PMC4569698 DOI: 10.1038/ncomms8959] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 07/01/2015] [Indexed: 12/18/2022] Open
Abstract
Combining vapour sensors into arrays is an accepted compromise to mitigate poor selectivity of conventional sensors. Here we show individual nanofabricated sensors that not only selectively detect separate vapours in pristine conditions but also quantify these vapours in mixtures, and when blended with a variable moisture background. Our sensor design is inspired by the iridescent nanostructure and gradient surface chemistry of Morpho butterflies and involves physical and chemical design criteria. The physical design involves optical interference and diffraction on the fabricated periodic nanostructures and uses optical loss in the nanostructure to enhance the spectral diversity of reflectance. The chemical design uses spatially controlled nanostructure functionalization. Thus, while quantitation of analytes in the presence of variable backgrounds is challenging for most sensor arrays, we achieve this goal using individual multivariable sensors. These colorimetric sensors can be tuned for numerous vapour sensing scenarios in confined areas or as individual nodes for distributed monitoring. Individual vapour sensors often suffer from poor selectivity, which hinders their broad applicability. Here, Potyrailo et al. fabricate individual sensors inspired by the Morpho butterfly capable of selectively detecting vapours in mixtures and with a variable moisture background.
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Affiliation(s)
| | - Ravi K Bonam
- College of Nanoscale Science and Engineering, State University of New York, Albany, New York 12203, USA
| | - John G Hartley
- College of Nanoscale Science and Engineering, State University of New York, Albany, New York 12203, USA
| | | | - Peter Vukusic
- School of Physics, University of Exeter, Exeter, EX4 4QL, UK
| | - Milana Vasudev
- Materials and Manufacturing Directorate, Air Force Research Laboratory, Wright-Patterson AFB, Ohio 45433, USA.,Department of Bioengineering, University of Massachusetts Dartmouth, Dartmouth, MA 02747, USA
| | - Timothy Bunning
- Materials and Manufacturing Directorate, Air Force Research Laboratory, Wright-Patterson AFB, Ohio 45433, USA
| | - Rajesh R Naik
- Materials and Manufacturing Directorate, Air Force Research Laboratory, Wright-Patterson AFB, Ohio 45433, USA
| | - Zhexiong Tang
- General Electric Global Research Center, Niskayuna, New York 12309, USA
| | - Manuel A Palacios
- General Electric Global Research Center, Niskayuna, New York 12309, USA
| | - Michael Larsen
- General Electric Global Research Center, Niskayuna, New York 12309, USA
| | - Laurie A Le Tarte
- General Electric Global Research Center, Niskayuna, New York 12309, USA
| | - James C Grande
- General Electric Global Research Center, Niskayuna, New York 12309, USA
| | - Sheng Zhong
- General Electric Global Research Center, Niskayuna, New York 12309, USA
| | - Tao Deng
- General Electric Global Research Center, Niskayuna, New York 12309, USA.,State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, People's Republic of China
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Galindo C, Larsen M, Ouellet DR, Maxin G, Pellerin D, Lapierre H. Abomasal amino acid infusion in postpartum dairy cows: Effect on whole-body, splanchnic, and mammary glucose metabolism. J Dairy Sci 2015; 98:7962-74. [PMID: 26319765 DOI: 10.3168/jds.2014-9013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/19/2015] [Indexed: 11/19/2022]
Abstract
Nine Holstein cows fitted with rumen cannulas and indwelling catheters in splanchnic blood vessels were used to study the effects of supplementing AA on milk lactose secretion, whole-body rate of appearance (WB-Ra) of glucose, and tissue metabolism of glucose, lactate, glycerol, and β-OH-butyrate (BHBA) in postpartum dairy cows according to a generalized randomized incomplete block design with repeated measures in time. At calving, cows were blocked according to parity (second and third or greater) and were allocated to 2 treatments: abomasal infusion of water (n=4) or abomasal infusion of free AA with casein profile (AA-CN; n=5) in addition to the same basal diet. The AA-CN infusion started with half the maximal dose at 1 d in milk (DIM) and then steadily decreased from 791 to 226 g/d from DIM 2 to 29 to cover the estimated essential AA deficit. On DIM 5, 15, and 29, D[6,6-(2)H2]-glucose (23.7 mmol/h) was infused into a jugular vein for 5h, and 6 blood samples were taken from arterial, portal, hepatic, and mammary sources at 45-min intervals, starting 1h after the initiation of the D[6,6-(2)H2]glucose infusion. Trans-organ fluxes were calculated as veno-arterial differences times plasma flow (splanchnic: downstream dilution of deacetylated para-aminohippurate; mammary: Fick principle using Phe+Tyr). Energy-corrected milk and lactose yields increased on average with AA-CN by 6.4 kg/d and 353 g/d, respectively, with no DIM × treatment interaction. Despite increased AA supply and increased demand for lactose secretion with AA-CN, net hepatic release of glucose remained unchanged, but WB-Ra of glucose tended to increase with AA-CN. Portal true flux of glucose increased with AA-CN and represented, on average, 17% of WB-Ra. Splanchnic true flux of glucose was unaltered by treatments and was numerically equivalent to WB-Ra, averaging 729 and 741 mmol/h, respectively. Mammary glucose utilization increased with AA-CN infusion, averaging 78% of WB-Ra, and increased gradually as lactation advanced. Net portal, hepatic, splanchnic, and mammary fluxes of lactate, glycerol, and BHBA were not affected by AA infusion. Increasing the supply of AA in postpartum dairy cows elevated the WB-Ra of glucose without affecting the true liver glucose release. The greater WB-Ra of glucose with abomasal AA infusion seemed to originate mainly from greater true portal-drained viscera release of glucose. Glucose utilization by the portal-drained viscera was unaffected by abomasal AA infusion, but the exact mechanism behind the greater true portal glucose release could not be assessed in the current study. The increased mammary glucose uptake was in line with the increased milk lactose yield. In early postpartum lactation, the demand for AA seems to be so high that even with increased AA supply, cows have metabolic priorities for AA other than hepatic gluconeogenesis.
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Affiliation(s)
- C Galindo
- Département de Sciences Animales, Université Laval, Québec, QC, Canada, G1V 0A6
| | - M Larsen
- Department of Animal Science, Aarhus University, Foulum, DK-8830 Tjele, Denmark
| | - D R Ouellet
- Dairy and Swine Research and Development Centre, Agriculture and Agri-Food Canada, Sherbrooke, QC, Canada J1M 0C8
| | - G Maxin
- Dairy and Swine Research and Development Centre, Agriculture and Agri-Food Canada, Sherbrooke, QC, Canada J1M 0C8
| | - D Pellerin
- Département de Sciences Animales, Université Laval, Québec, QC, Canada, G1V 0A6
| | - H Lapierre
- Dairy and Swine Research and Development Centre, Agriculture and Agri-Food Canada, Sherbrooke, QC, Canada J1M 0C8.
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Larsen M, Friis M, Karlsen CV, Poulsen SS, Lund SP, Qvortrup K. Auto-inflammatory challenge of the endolymphatic sac--Cochlear damage measured by distortion product oto-acoustic emissions. Acta Otolaryngol 2015; 135:758-64. [PMID: 25858709 DOI: 10.3109/00016489.2015.1032433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Twenty-five rats were challenged by an immunologic attack of the endolymphatic sac. After 6 months, distortion product oto-acoustic emissions (DPOAE) revealed a dysfunction of the outer hair cells and immunological active cells were observed in the endolymphatic sac. This information could contribute to the understanding of Ménière's disease. OBJECTIVES This study investigated if an autoimmune challenge of the endolymphatic sac could affect DPOAE output measurements in rats. Also, a potential autoimmune cell infiltration of the endolymphatic sac was investigated. METHODS Eighteen Lewis rats were immunized with a crude endolymphatic sac extract in complete Freund's adjuvant. Seven control animals were injected with Freund's adjuvant in saline. Cochlear damage was estimated by DPOAE dynamics 3 weeks and 6 months after the immunization. Infiltrative cells in the endolymphatic sac were investigated with transmission electron microscopy. RESULTS The hearing assessment 6 months after immunization revealed a reduction of the DPOAE, on the full range of frequencies (2-63 kHz) in an average of the mean, of 2 dB ± 1.1 in the immunized group compared to the controls (p < 0.05). The same test showed a 2.5 dB decrease from 2 to 5 kHz (p < 0.01). Immunological active cells were observed in the endolymphatic sac in most of the immunized rats.
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175
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Klefter ON, Holfort SK, Larsen M. Baseline haemoglobin A1c influences retinal function after long-term insulin pump therapy. Graefes Arch Clin Exp Ophthalmol 2015; 254:467-73. [PMID: 26108526 DOI: 10.1007/s00417-015-3083-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 05/14/2015] [Accepted: 06/03/2015] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The purpose of the study was to characterize the long-term effect of insulin pump therapy (CSII) on electroretinography and dark adaptometry and to examine the influence of baseline glycaemic control on retinal function in patients with type 1 diabetes mellitus. METHODS This prospective observational extension study enrolled 13 patients out of 17 who completed a primary 1-year study of the effect of CSII on retinal function. Twelve patients were still on CSII at follow-up. The extension study included a single examination 3.5 years (range 3.0-4.0 years) after initiation of CSII of one study eye per patient. Procedures included full-field electroretinography (ERG), dark adaptometry, optical coherence tomography, and fundus photography. RESULTS Mean ERG amplitudes 3.5 years after initiation of CSII were 15-43 % lower than at baseline (all p < 0.05) and 21-45 % lower than after 1 year on CSII. The mean rate of dark adaptation had returned to baseline after a transient 13 % (p = 0.0024) acceleration at the 1-year visit. Reduction of ERG amplitudes between 1 and 3.5 years was statistically associated predominantly with baseline haemoglobin A1c (HbA1c) ≥ 8.7 % and, to a smaller extent, with HbA1c reductions larger than 1.9 % after initiation of CSII. No significant changes in ERG amplitudes were found in patients with baseline HbA1c < 8.7 % and HbA1c reductions smaller than 1.9 %. CONCLUSIONS Deterioration of subclinical retinal function from 1 to 3.5 years after initiation of CSII was associated predominantly with poorer metabolic control before initiation of CSII. Analyses of retinal function may supplement structural and morphological characteristics in the study of diabetic complications.
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Affiliation(s)
- Oliver N Klefter
- Department of Ophthalmology, Glostrup Hospital, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark.
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Stig K Holfort
- Department of Ophthalmology, Glostrup Hospital, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark
| | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Klokkerud M, Dagfinrud H, Uhlig T, Nylenna S, Larsen M, Øie L, Klokkeide Å, Dager T, Furunes K, Nygaard S, Kjeken I. OP0229-HPR Developing a National Core Set of Outcome Measures for Rehabilitation in Rheumatic and Musculoskeletal Diseases. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
OBJECTIVE To compare the efficacy and safety of approved treatments for macular oedema secondary to branch retinal vein occlusion (BRVO). DESIGN Randomised controlled trials (RCTs) evaluating the efficacy and safety of approved treatments for macular oedema secondary to BRVO were identified from an updated systematic review. SETTING A Bayesian network meta-analysis of RCTs of treatments for macular oedema secondary to BRVO. INTERVENTIONS Ranibizumab 0.5 mg pro re nata, aflibercept 2 mg monthly (2q4), dexamethasone 0.7 mg implant, laser photocoagulation, ranibizumab+laser, or sham intervention. Bevacizumab and triamcinolone were excluded. OUTCOME MEASURES Efficacy outcomes were mean change in best corrected visual acuity (Early Treatment Diabetic Retinopathy Study scale) and the percentage of patients gaining ≥ 15 letters. Safety outcome was the percentage of patients with increased intraocular pressure (IOP)/ocular hypertension (OH). RESULTS 8 RCTs were identified for inclusion with 1743 adult patients. The probability of being the most efficacious treatment at month 6 or 12 based on letters gained was 54% for ranibizumab monotherapy, 30% for aflibercept, 16% for ranibizumab plus laser (adjunctive or prompt), and 0% for dexamethasone implant, laser or sham. The probability of being the most efficacious treatment for patients gaining ≥ 15 letters was 39% for aflibercept, 35% for ranibizumab monotherapy, 24% for ranibizumab plus laser, 2% for dexamethasone implant, and less than 1% for laser or sham. There was no statistical difference between ranibizumab monotherapy and aflibercept for letters gained (+1.4 letters for ranibizumab vs aflibercept with 95% credible interval (CrI) of -5.2 to +8.5 letters) or the OR for gaining ≥ 15 letters: 1.06 (95% CrI 0.16 to 8.94)). Dexamethasone implant was associated with significantly higher IOP/OH than antivascular endothelial growth factor agents (OR 13.1 (95% CrI 1.7 to 116.9)). CONCLUSIONS There was no statistically significant difference between ranibizumab and aflibercept.
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Affiliation(s)
| | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
| | | | - Felicity Allen
- Novartis Pharmaceuticals UK Ltd., Frimley, Camberley, Surrey, UK
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178
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Schatz P, Sharon D, Al-Hamdani S, Andréasson S, Larsen M. Retinal structure in young patients aged 10 years or less with Best vitelliform macular dystrophy. Graefes Arch Clin Exp Ophthalmol 2015; 254:215-21. [DOI: 10.1007/s00417-015-3025-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/08/2015] [Accepted: 04/20/2015] [Indexed: 11/30/2022] Open
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Klefter ON, Lauritsen AØ, Larsen M. Retinal hemodynamic oxygen reactivity assessed by perfusion velocity, blood oximetry and vessel diameter measurements. Acta Ophthalmol 2015; 93:232-41. [PMID: 25270587 DOI: 10.1111/aos.12553] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 08/05/2014] [Indexed: 01/02/2023]
Abstract
PURPOSE To test the oxygen reactivity of a fundus photographic method of measuring macular perfusion velocity and to integrate macular perfusion velocities with measurements of retinal vessel diameters and blood oxygen saturation. METHODS Sixteen eyes in 16 healthy volunteers were studied at two examination sessions using motion-contrast velocimetry and retinal oximetry with vessel diameter corrections. To test oxygen reactivity, participants were examined during normoxia, after 15 min of hyperoxia and finally after 45 min of normoxia. Repeatability was assessed by intraclass correlation coefficients (ICC) and limits of agreement. RESULTS Fifteen minutes of hyperoxia was accompanied by mean reductions in arterial and venous perfusion velocities of 14% and 16%, respectively (p = 0.0080; p = 0.0019), constriction of major arteries and veins by 5.5% and 8.2%, respectively (p < 0.0001), increased retinal arterial oxygen saturation from 95.1 ± 5.0% to 96.6 ± 6.4% (p = 0.038) and increased retinal venous oxygen saturation from 62.9 ± 6.7% to 70.3 ± 7.8% (p = 0.0010). Parameters returned to baseline levels after subsequent normoxia. Saturation and vessel diameter ICCs were 0.88-0.98 (range). For perfusion velocities, short-term ICCs were 0.79-0.82 and long-term ICCs were 0.06-0.11. Intersession increases in blood glucose were associated with reductions in perfusion velocities (arterial p = 0.0067; venous p = 0.018). CONCLUSION Oxygen reactivity testing supported that motion-contrast velocimetry is a valid method for assessing macular perfusion. Results were consistent with previous observations of hyperoxic blood flow reduction using blue field entoptic and laser Doppler velocimetry. Retinal perfusion seemed to be regulated around individual set points according to blood glucose levels. Multimodal measurements may provide comprehensive information about retinal metabolism.
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Affiliation(s)
- Oliver Niels Klefter
- Department of Ophthalmology Glostrup Hospital Glostrup Denmark
- Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | | | - Michael Larsen
- Department of Ophthalmology Glostrup Hospital Glostrup Denmark
- Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
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180
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Kessel L, Larsen M. Action spectrum for photobleaching of human lenses by short wavelength visible irradiation. PLoS One 2015; 10:e0123732. [PMID: 25884924 PMCID: PMC4401553 DOI: 10.1371/journal.pone.0123732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 02/25/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose Cataract is the world-leading cause of blindness. In search for a new treatment of cataract we have found that the yellow discolouration of aged human lenses can be photobleached using a non-invasive, infra-red, femtosecond laser treatment. These results were presented in an earlier PlosOne publication. The objective of the study was to characterize the single-photon photobleaching action spectrum of the aged human lens in vitro. Methods Ninety-one human donor lenses were irradiated with continuous wave laser light at 375, 405, 420, 445, 457 or 473 nm. Photobleaching was monitored by photography and transmission measurements. Results The action spectrum peaked at 420 nm followed by, in order of decreasing effect, 445, 457, 473, 405 and 375 nm. Younger and less absorbent lenses showed smaller changes than older and more absorbent lenses. There was a dose-dependent increase in lens transmission with increasing laser irradiation. Conclusions For a 75 year old lens an effect corresponding to elimination of 15 years or more of optical ageing was obtained. This study of the spectral characteristics and intensity needed to bleach the human lens with single-photon laser effects found an action-spectrum peak at 420 nm tailing gradually off toward longer wavelengths and more steeply toward shorter wavelengths. The results may be used to guide experiments with two-photon bleaching.
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Affiliation(s)
- Line Kessel
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark
- * E-mail:
| | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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181
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Hasler PW, Brandi Bloch S, Villumsen J, Fuchs J, Lund-Andersen H, Larsen M. Safety study of 38,503 intravitreal ranibizumab injections performed mainly by physicians in training and nurses in a hospital setting. Acta Ophthalmol 2015; 93:122-5. [PMID: 25403735 DOI: 10.1111/aos.12589] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 10/06/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate and to compare the safety of intravitreal ranibizumab injections performed by physicians and nurses at a single large hospital clinic in Denmark during 5 years. DESIGN Retrospective, interventional, non-comparative study. METHODS SETTING All eyes that underwent a protocolized ranibizumab injection procedure performed in an operating room mainly by nurses and physicians in their first year of ophthalmology training. STUDY POPULATION A total of 4623 eyes in 3679 patients with subretinal neovascularization secondary to a variety of retinal diseases, mainly neovascular AMD treated with intravitreal therapy (IVT) at the Glostrup Hospital from January 1, 2007 to December 31, 2011 with a mean follow-up of 12.2 months (95% confidence interval: 11.9-12.6). MAIN OUTCOME MEASURES Frequency of endophthalmitis, traumatic cataract, intraocular haemorrhage and retinal detachment from 2007 to 2012. RESULTS Overall, 38,503 intravitreal ranibizumab injections were performed in 4623 eyes. Injections were performed by nurses (32.5%), ophthalmology residents (61.3%) and vitreoretinal surgeons (6.2%). Severe complications to treatment were observed in 17 eyes: Endophthalmitis (14 eyes, 0.36 ‰ of injections whereof seven cases were culture-positive), anterior uveitis (one eye, 0.026 ‰), traumatic cataract (one eye, 0.026 ‰) and rhegmatogenous retinal detachment (one eye, 0.026 ‰). Retinal pigment epithelial tears were registered in 14 eyes in 14 subjects within the first year of treatment with ranibizumab. Of the 14 cases of endophthalmitis, seven occurred within a period of 5 weeks in 2010 when occasionally abnormal needle outflow resistance prompted the needle replacement in the operating room. No drug-related adverse events were recorded. CONCLUSIONS Intravitreal ranibizumab injection performed by nurses and physicians without preinjection topical antibiotics was associated with a rate of injection-related adverse events of 0.44 ‰.
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Affiliation(s)
- Pascal W. Hasler
- Department of Ophthalmology; University Hospital Basel; Basel Switzerland
| | - Sara Brandi Bloch
- Department of Ophthalmology; Glostrup Hospital; University of Copenhagen; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Jørgen Villumsen
- Department of Ophthalmology; Glostrup Hospital; University of Copenhagen; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Josefine Fuchs
- Department of Ophthalmology; Glostrup Hospital; University of Copenhagen; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- National Eye Clinic; Kennedy Center; Glostrup Denmark
| | - Henrik Lund-Andersen
- Department of Ophthalmology; Glostrup Hospital; University of Copenhagen; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Michael Larsen
- Department of Ophthalmology; Glostrup Hospital; University of Copenhagen; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- National Eye Clinic; Kennedy Center; Glostrup Denmark
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182
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Bloch SB, Larsen M. Translational public health care perspective: intravitreal treatment of neovascular age-related macular degeneration has revolutionized clinical ophthalmology. Acta Ophthalmol 2015; 93:103-4. [PMID: 25688486 DOI: 10.1111/aos.12680] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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183
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Nissen C, Rönnbäck C, Sander B, Herbst K, Milea D, Larsen M, Lund-Andersen H. Dissociation of Pupillary Post-Illumination Responses from Visual Function in Confirmed OPA1 c.983A > G and c.2708_2711delTTAG Autosomal Dominant Optic Atrophy. Front Neurol 2015; 6:5. [PMID: 25699009 PMCID: PMC4316714 DOI: 10.3389/fneur.2015.00005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 01/09/2015] [Indexed: 12/03/2022] Open
Abstract
Purpose: To test whether the melanopsin-containing, intrinsically photosensitive retinal ganglion cells (ipRGCs), as evaluated by examination of the pupillary light reflex (PLR), are preserved in genetically confirmed autosomal dominant optic atrophy (ADOA). Method: Twenty-nine patients with either the c.983A > G (n = 14) or the c.2708_ 2711delTTAG mutation (n = 15) were examined with monochromatic pupillometry, using isoluminant (300 cd/m2), red (660 nm) or blue (470 nm) light, optical coherence tomography, automated visual field analysis, and with determination of best corrected visual acuity (BCVA). Since we examined two different mutations, initially we compared all outcome variables between the two, and finding no statistically significant difference, pooled them. Results: Despite a poor BCVA (56 letters, ETDRS) in the ADOA patients, their post-illuminatory pupil responses did not differ significantly from those of healthy controls (blue, p = 0.45, red, p = 0.49, t-test), and no statistically significant effect was noted of peripapillary retinal nerve fiber layer thickness, ganglion cell-inner plexiform layer thickness, or age. Conclusion: The PLR to blue light of high luminance (300 cd/m2) was preserved in both c.983A > G and c.2708_2711delTTAG ADOA despite severe visual loss and optic nerve atrophy. The study confirms, in a large sample of two genetically homogenous groups, that the ipRGCs are spared in ADOA.
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Affiliation(s)
- Claus Nissen
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Cecilia Rönnbäck
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Birgit Sander
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Kristina Herbst
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Dan Milea
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen , Copenhagen , Denmark ; Singapore National Eye Centre, Singapore Eye Research Institute, Duke-NUS Graduate Medical School Singapore , Singapore , Singapore ; Angers University Hospital , Angers , France
| | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Henrik Lund-Andersen
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen , Copenhagen , Denmark
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184
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Ahmed HJ, Klefter ON, Willerslev A, Munch IC, Larsen M. Embolus characterization in branch retinal artery occlusion by optical coherence tomography. Acta Ophthalmol 2015; 93:95-6. [PMID: 25125213 DOI: 10.1111/aos.12526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 07/10/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Hassan J. Ahmed
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
| | - Oliver N. Klefter
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - Anne Willerslev
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - Inger C. Munch
- Department of Ophthalmology; Copenhagen University Hospital Roskilde; Roskilde Denmark
| | - Michael Larsen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
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185
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Schubert C, Pryds A, Zeng S, Xie Y, Freund KB, Spaide RF, Merriam JC, Barbazetto I, Slakter JS, Chang S, Munch IC, Drack AV, Hernandez J, Yzer S, Merriam JE, Linneberg A, Larsen M, Yannuzzi LA, Mullins RF, Allikmets R. Cadherin 5 is regulated by corticosteroids and associated with central serous chorioretinopathy. Hum Mutat 2015; 35:859-67. [PMID: 24665005 PMCID: PMC4215937 DOI: 10.1002/humu.22551] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 03/10/2014] [Indexed: 11/18/2022]
Abstract
Central serous chorioretinopathy (CSC) is characterized by leakage of fluid from the choroid into the subretinal space and, consequently, loss of central vision. The disease is triggered by endogenous and exogenous corticosteroid imbalance and psychosocial stress and is much more prevalent in men. We studied the association of genetic variation in 44 genes from stress response and corticosteroid metabolism pathways with the CSC phenotype in two independent cohorts of 400 CSC cases and 1,400 matched controls. The expression of cadherin 5 (CDH5), the major cell–cell adhesion molecule in vascular endothelium, was downregulated by corticosteroids which may increase permeability of choroidal vasculature, leading to fluid leakage under the retina. We found a significant association of four common CDH5 SNPs with CSC in male patients in both cohorts. Two common intronic variants, rs7499886:A>G and rs1073584:C>T, exhibit strongly significant associations with CSC; P = 0.00012; odds ratio (OR) = 1.5; 95%CI [1.2;1.8], and P = 0.0014; OR = 0.70; 95%CI [0.57;0.87], respectively. A common haplotype was present in 25.4% male CSC cases and in 35.8% controls (P = 0.0002; OR = 0.61, 95% CI [0.47–0.79]). We propose that genetically predetermined variation in CDH5, when combined with triggering events such as corticosteroid treatment or severe hormonal imbalance, underlie a substantial proportion of CSC in the male population.
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Affiliation(s)
- Carl Schubert
- Department of Ophthalmology, Columbia University, New York City, New York
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Li XQ, Pryds A, Carlsen J, Larsen M. Multifocal central serous chorioretinopathy with photoreceptor-retinal pigment epithelium diastasis in heritable pulmonary arterial hypertension. Retin Cases Brief Rep 2015; 9:83-87. [PMID: 25383848 DOI: 10.1097/icb.0000000000000090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE To report atypical central serous chorioretinopathy and choroidal thickening in a patient with heritable pulmonary arterial hypertension. METHODS A 40-year-old man with heritable pulmonary arterial hypertension presented with blurred vision in his left eye and was followed up for 1 year with clinical examination, enhanced depth optical coherence tomography, fluorescein and indocyanine green angiography, and fundus photography. RESULTS At presentation, atypical central serous chorioretinopathy with multiple retinal pigment epithelial detachments, a thick subfoveal choroid, and dilated choroidal vessels were seen in the patient's symptomatic left eye. After treatment for pulmonary hypertension, the serous detachments disappeared and choroidal thickness gradually decreased over a period of 4 weeks and remained unchanged at 13 months of follow-up. CONCLUSION Central serous chorioretinopathy and choroidal thickening that responded to treatment of pulmonary arterial hypertension suggest a pathophysiological link between pulmonary arterial hypertension and central serous chorioretinopathy, perhaps mediated by choroidal venous stasis.
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Affiliation(s)
- Xiao Qiang Li
- *Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark; †Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; and ‡Department of Cardiology, Pulmonary Vascular Program, Rigshospitalet, Copenhagen, Denmark
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187
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Bailit JL, Grobman W, Zhao Y, Wapner RJ, Reddy UM, Varner MW, Leveno KJ, Caritis SN, Iams JD, Tita AT, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, VanDorsten JP, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Thorp J, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Shubert P, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spong C, Tolivaisa S. Nonmedically indicated induction vs expectant treatment in term nulliparous women. Am J Obstet Gynecol 2015; 212:103.e1-7. [PMID: 24983681 DOI: 10.1016/j.ajog.2014.06.054] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/27/2014] [Accepted: 06/23/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to compare maternal and neonatal outcomes in nulliparous women with nonmedically indicated inductions at term vs those expectantly treated. STUDY DESIGN Data were obtained from maternal and neonatal charts for all deliveries on randomly selected days across 25 US hospitals over a 3-year period. A low-risk subset of nulliparous women with vertex nonanomalous singleton gestations who delivered 38 0/7 to 41 6/7 weeks were selected. Maternal and neonatal outcomes for nonmedically indicated induction within each week were compared with women who did not undergo nonmedically indicated induction during that week. Multivariable analysis was used to adjust for hospital, maternal age, race/ethnicity, body mass index, cigarette use, and insurance status. RESULTS We found 31,169 women who met our criteria. Neonatal complications were either less frequent with nonmedically indicated induction or no different between groups. Nonmedically indicated induction was associated with less frequent peripartum infections (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.16-0.98) at 38 weeks of gestation and less frequent third- and fourth-degree lacerations (OR, 0.60; 95% CI, 0.42-0.86) and less frequent peripartum infections (OR, 0.66; 95% CI, 0.49-0.90) at 39 weeks of gestation. Nonmedically indicated induction was associated with a longer admission-to-delivery time by approximately 3-4 hours and increased odds of cesarean delivery at 38 (OR, 1.50; 95% CI, 1.08-2.08) and 40 weeks (OR, 1.30; 95% CI, 1.15-1.46) of gestation. CONCLUSION At 39 weeks of gestation, nonmedically indicated induction is associated with lower maternal and neonatal morbidity than women who are expectantly treated.
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188
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Rönnbäck C, Grønskov K, Larsen M. Retinal vessel diameters decrease with macular ganglion cell layer thickness in autosomal dominant optic atrophy and in healthy subjects. Acta Ophthalmol 2014; 92:670-4. [PMID: 24612963 DOI: 10.1111/aos.12378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 01/29/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate retinal trunk vessel diameters in subjects with autosomal dominant optic atrophy (ADOA) and mutation-free healthy relatives. METHODS This cross-sectional study included 52 ADOA patients with the optic atrophy 1 (OPA1) exon 28 (c.2826_2836delinsGGATGCTCCA) mutation (age 8.6-83.5 years) (best-corrected visual acuity (BCVA) 8-94 Early Treatment Diabetic Retinopathy Study (ETDRS) letters) and 55 mutation-free first-degree healthy relatives (age 8.9-68.7 years, BCVA 80-99). Analysis of fundus photographs provided integrated magnification-corrected measures of retinal vessel diameters (central retinal artery equivalent, CRAE, and central retinal vein equivalent, CRVE). Statistical analysis was corrected for age, gender, spherical equivalent refraction, axial length and mean arterial blood pressure (MABP) in a mixed model analysis. RESULTS Retinal arteries and veins were thinner in ADOA than in healthy controls (CRAE (mean ± 2 standard deviations (SD)) 153.9 ± 41.0 μm and CRVE 236.1 ± 42.0 μm in ADOA, CRAE 172.5 ± 25.0 μm (p = 0.0004) and CRVE 254.2 ± 37.6 μm (p = 0.0019) in healthy controls). MABP was comparable in the two groups (p = 0.18), and in both groups, CRAE decreased with increasing MABP (p = 0.01 and p < 0.0001, respectively). In ADOA, CRAE and CRVE decreased with age (p = 0.011 and p = 0.020, respectively) and CRAE decreased with decreasing BCVA (p = 0.011). In patients with ADOA and in healthy controls, CRAE decreased with decreasing average macular ganglion cell-inner plexiform layer (GC-IPL) thickness (p = 0.0017 and p = 0.0057, respectively). CONCLUSION Narrow retinal arteries and veins were associated not only with the severity of ADOA but with ganglion cell volume in patients with ADOA and in healthy subjects. This suggests that narrow vessels are a consequence rather than the cause of inner retinal hypoplasia or atrophy, although longitudinal studies are needed to confirm this hypothesis.
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Affiliation(s)
- Cecilia Rönnbäck
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Karen Grønskov
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- Applied Human Molecular Genetics; Kennedy Center; Rigshospitalet; Copenhagen Denmark
| | - Michael Larsen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- National Eye Clinic; Kennedy Center; Rigshospitalet; Copenhagen Denmark
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189
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Li XQ, Munkholm A, Larsen M, Munch IC. Choroidal thickness in relation to birth parameters in 11- to 12-year-old children: the Copenhagen Child Cohort 2000 Eye Study. Invest Ophthalmol Vis Sci 2014; 56:617-24. [PMID: 25358736 DOI: 10.1167/iovs.14-15016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To examine choroidal thickness in a population-based child cohort in relation to birth parameters. METHODS The Copenhagen Child Cohort 2000 Eye Study examined 1406 children aged 11 to 12 years using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT), ocular biometry and measurement of height, weight, refraction, and self-reported pubertal development status. Birth parameters were obtained from the Danish Medical Birth Registry. RESULTS The subfoveal choroid in low birth weight children (<2500 g, n = 51, mean 324 ± 76 μm) was thinner than in normal birth weight children (2500-4500 g, n = 1194, mean 361 ± 78 μm), the difference being -37 (CI95 -60 to -15) μm, P = 0.001 after adjusting for age, sex, height, Tanner stage by sex, axial length, anterior chamber depth, and spherical equivalent refractive error. The subfoveal choroid in high birth weight children (>4500 g, n = 48, mean 351 ± 63 μm) was comparable with normal birth weight children, P = 0.44. The subfoveal choroid was thinner in preterm children, however the difference was not significant (-18 [-37 to 2] μm, P = 0.08). Small for gestation children had thinner subfoveal choroid (-19 [-37 to -1] μm, P = 0.04) compared with appropriate for gestation children. Longer birth length was associated with a thicker subfoveal choroid (2 [1-4] μm/cm, P = 0.005). Macular choroidal thickness at 16 extrafoveal locations was measured in a subset of children and found to have the same associations with birth weight as the subfoveal choroidal thickness. CONCLUSIONS In 11- to 12-year-old children, thinner choroids were associated with lower birth weight, lower birth length, and being small for the gestational age.
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Affiliation(s)
- Xiao Q Li
- Department of Ophthalmology, Glostrup Hospital, Copenhagen, Denmark Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anja Munkholm
- Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark Child and Adolescent Psychiatric Center, Capital Region, Department Glostrup, Denmark
| | | | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital, Copenhagen, Denmark Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Inger C Munch
- Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark Department of Ophthalmology, Roskilde Hospital, Roskilde, Denmark
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Rufa M, Antonitsis P, Winkler B, Kiessling AH, Ulrich C, Bennett MJ, Kehara H, Asopa S, Alexopoulos C, Zavaropoulos P, Alexopoulos C, Ganushchak YM, McLean LA, Borrelli U, Antonitsis P, Gifford D, Reineke D, Antonitsis P, Bennett M, Schubel J, Schubel J, Ulrich C, Schaarschmidt J, Tiliscan C, Bauer A, Hausmann H, Asteriou C, Argiriadou H, Deliopoulos A, Gatzos S, Anastasiadis K, Zenklusen U, Döbele T, Kohler B, Grapow M, Eckstein F, May M, Keller H, Diefenbach M, Reyher C, Moritz A, Bauer A, Eberle T, Schaarschmidt J, Lucy J, Hausmann H, Larsen M, Asopa S, Webb G, Wright A, Lloyd C, Takano T, Fujii T, Gomibuchi T, Nakahara K, Ohhashi N, Komatsu K, Ohtsu Y, Terasaki T, Wada Y, Seto T, Fukui D, Amano J, Bennett M, Webb G, Lloyd C, Hakim N, Zografos P, Protopapas E, Zavaropoulos P, Kirvassilis G, Sarris G, Alexopoulos C, Hakim N, Zografos P, Protopapas E, Kirvassilis G, Sarris G, Hakim N, Zografos P, Protopapas E, Zavaropoulos P, Kirvassilis G, Sarris G, Körver E, Yamamoto Y, Weerwind P, Medlam W, Bell J, Bennett R, Bennett R, Turner E, Jagannadham K, Westwood E, Silvestri A, Detroux M, Nottin R, Al-Attar N, Pappalardo A, Gabrielli M, Gripari C, Scala A, Mercurio S, Gustin G, Fasolo D, Deliopoulos A, Gatzos S, Mimikos S, Kleontas A, Grosomanidis V, Kyparissa M, Tossios P, Anastasiadis K, Colah S, Farid S, Irons J, Gilhouly M, Moorjani N, König T, Meszaros K, Sodeck G, Erdoes G, Englberger L, Czerny M, Carrel T, Mimikos S, Kostarelou G, Kleontas A, Deliopoulos A, Gatzos S, Foroulis C, Tossios P, Anastasiadis K, Asopa S, Webb G, Gomez-Cano M, Lloyd C, Xhymshiti A, Ulrich C, Schaarschmidt J, Eberle T, Rufa M, Bauer A, Hausmann H. 1st International Symposium on Minimal Invasive Extracorporeal Circulation Technologies, Thessaloniki, Greece, 13–14 June 2014001EMERGENCY CORONARY ARTERY BYPASS GRAFT SURGERY IN PATIENTS WITH OR WITHOUT ACUTE MYOCARDIAL INFARCTION USING THE MINIMAL INVASIVE EXTRACORPOREAL CIRCULATION002IS THERE A LEARNING CURVE WHEN USING MINIMAL INVASIVE EXTRACORPOREAL CIRCULATION IN CORONARY REVASCULARIZATION PROCEDURES?003MINIMAL EXTRACORPOREAL CIRCULATION ASSURES PERFORMANCE OUTCOME004CORONARY ARTERY REVASCULARIZATION WITH A MINIMAL EXTRACORPOREAL CIRCULATION TECHNIQUE: SHOTGUN ANALYSIS IN A PROSPECTIVE, RANDOMIZED TRIAL WITH THREE DIFFERENT PERFUSION TECHNIQUES005EFFECTS OF CELL SALVAGED AND DIRECTLY RETRANSFUSED MEDIASTINAL SHED BLOOD ON THE POSTOPERATIVE COMPETENCY OF THE COAGULATION SYSTEM AFTER CORONARY ARTERY BYPASS GRAFT SURGERY006THE RELATIVE INFLUENCE OF MINIATURIZED CARDIOPULMONARY BYPASS AND OTHER PERIOPERATIVE FACTORS ON BLOOD TRANSFUSION REQUIREMENT AFTER HEART SURGERY007LOWER PLATELET AGGREGATION MIGHT REDUCE PERIOPERATIVE BLEEDING IN MINI-CIRCUIT CARDIOPULMONARY BYPASS COMPARED TO CONVENTIONAL CARDIOPULMONARY BYPASS0085-YEAR EXPERIENCE OF BLOOD TRANSFUSION IN CORONARY ARTERY BYPASS GRAFT SURGERY PATIENTS USING MINIATURIZED EXTRACORPOREAL CIRCULATION009PAEDIATRIC CARDIAC EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT: IMPROVED OUTCOME WITH EVOLVING TECHNOLOGY AND PRACTICE REFINEMENTS OVER 16 YEARS010THE USE OF ARTERIOVENOUS PCO 2DIFFERENCE (Delta PCO 2) AS AN INDEX OF THE DENSITY OF CAPILLARY PERFUSION DURING PAEDIATRIC CARDIOPULMONARY BYPASS AND EXTRACORPOREAL MEMBRANE OXYGENATION011‘ETERNAL ECMO’: THE CHALLENGE OF PROLONGED POST-CARDIOTOMY EXTRACORPOREAL MEMBRANE OXYGENATION012A VERSATILE MINIMIZED SYSTEM: THE STEP TOWARDS SAFE PERFUSION013HOW WE DEVELOPED A SAFER MINI BYPASS SYSTEM WITH THE USE OF A STOCKERT HEART LUNG BYPASS MACHINE AND MEDTRONIC FUSION OXYGENATOR014MINIMALIZING THE CARDIOPULMONARY BYPASS CIRCUIT AND THE CONSOLE015IS THREE-STAGE VENOUS CANNULA SUPERIOR TO DUAL-STAGE DURING SURGERY WITH MINIMAL INVASIVE EXTRACORPOREAL CIRCULATION?016BENEFITS OF CLOSED MINIATURIZED CARDIOPULMONARY BYPASS017COGNITIVE BRAIN FUNCTION AFTER CORONARY BYPASS GRAFTING WITH MINIMIMAL INVASIVE EXTRACORPOREAL CIRCULATION018MINIMAL INVASIVE EXTRACORPOREAL CIRCULATION REDUCES GASEOUS MICROEMBOLI AND PRESERVES NEUROCOGNITIVE FUNCTION: A SINGLE-CENTRE PROSPECTIVE RANDOMIZED STUDY019THE INFLUENCE OF PERIOPERATIVE FACTORS TO GENERATE ‘OUTLIERS’ IN CARDIAC SURGERY ASSOCIATED ACUTE KIDNEY INJURY: A PRELIMINARY INVESTIGATION INCLUDING DIABETES AND METHOD OF CARDIOPULMONARY BYPASS020MINIMAL INVASIVE EXTRACORPOREAL CIRCULATION IN 64 COMPLEX CARDIAC PROCEDURES: IS IT FEASIBLE AND SAFE? Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schmidt-Erfurth U, Chong V, Loewenstein A, Larsen M, Souied E, Schlingemann R, Eldem B, Monés J, Richard G, Bandello F. Guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA). Br J Ophthalmol 2014; 98:1144-67. [PMID: 25136079 PMCID: PMC4145443 DOI: 10.1136/bjophthalmol-2014-305702] [Citation(s) in RCA: 400] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 06/23/2014] [Indexed: 02/06/2023]
Abstract
UNLABELLED Age-related macular degeneration (AMD) is still referred to as the leading cause of severe and irreversible visual loss world-wide. The disease has a profound effect on quality of life of affected individuals and represents a major socioeconomic challenge for societies due to the exponential increase in life expectancy and environmental risks. Advances in medical research have identified vascular endothelial growth factor (VEGF) as an important pathophysiological player in neovascular AMD and intraocular inhibition of VEGF as one of the most efficient therapies in medicine. The wide introduction of anti-VEGF therapy has led to an overwhelming improvement in the prognosis of patients affected by neovascular AMD, allowing recovery and maintenance of visual function in the vast majority of patients. However, the therapeutic benefit is accompanied by significant economic investments, unresolved medicolegal debates about the use of off-label substances and overwhelming problems in large population management. The burden of disease has turned into a burden of care with a dissociation of scientific advances and real-world clinical performance. Simultaneously, ground-breaking innovations in diagnostic technologies, such as optical coherence tomography, allows unprecedented high-resolution visualisation of disease morphology and provides a promising horizon for early disease detection and efficient therapeutic follow-up. However, definite conclusions from morphologic parameters are still lacking, and valid biomarkers have yet to be identified to provide a practical base for disease management. The European Society of Retina Specialists offers expert guidance for diagnostic and therapeutic management of neovascular AMD supporting healthcare givers and doctors in providing the best state-of-the-art care to their patients. TRIAL REGISTRATION NUMBER NCT01318941.
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Affiliation(s)
| | - Victor Chong
- Oxford Eye Hospital, Oxford University Hospitals, Oxford, UK
| | - Anat Loewenstein
- Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital and University of Copenhagen, Copenhagen, Denmark
| | - Eric Souied
- Hôpital Intercommunal de Créteil, Paris, France
| | - Reinier Schlingemann
- Medical Retina Unit and Ocular Angiogenesis Group, Department Of Ophthalmology, Academic Medical Center, Amsterdam, The Netherlands
| | - Bora Eldem
- Department of Ophthalmology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Jordi Monés
- Centro Médico TEKNON, Director Institut de la Màcula i de la Retina, Barcelona, Spain
| | - Gisbert Richard
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Francesco Bandello
- Department of Ophthalmology, University Vita-Salute; Scientific Institute San Raffaele, Milano, Italy
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Larsen M, Lapierre H, Kristensen N. Abomasal protein infusion in postpartum transition dairy cows: Effect on performance and mammary metabolism. J Dairy Sci 2014; 97:5608-22. [DOI: 10.3168/jds.2013-7247] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 05/11/2014] [Indexed: 11/19/2022]
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Rönnbäck C, Larsen M. Macular sensitivity and fixation patterns in patients with autosomal dominant optic atrophy. Dan Med J 2014; 61:A4888. [PMID: 25186535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION The objective of this study was to test macular sensitivity, fixation stability and fixation location using microperimetry in patients with autosomal dominant optic atrophy (ADOA) and mutation-free relatives. MATERIAL AND METHODS This was a cross-sectional study of 43 patients with exon 28 (2826 delT) mutation in OPA1 (age 11.7-71.5 years, best-corrected visual acuity (BCVA) 20/24-20/13). The patients and 49 mutation-free first-degree relatives (BCVA 20/25-20/10) underwent ophthalmic examination including macular microperimetry out to 12° eccentricity with registration of fixation stability and fixation location. RESULTS The average (± standard deviation) sensitivity was significantly reduced in ADOA patients compared with controls, 14.9 (± 4.4) dB versus 19.7 (± 0.4) dB (p < 0.0001). In a retinotopic projection, the largest relative sensitivity deficits in ADOA were seen in the nasal macula (13.6 (± 5.7) dB versus 19.7 (± 0.7) dB) and in the central macula (14.2 (± 5.1) dB versus 19.9 (± 0.3) dB). The average sensitivity decreased with decreasing BCVA in ADOA (p < 0.0001). Stable fixation was found in 58% of ADOA patients versus 86% of controls, and relatively unstable fixation was observed in 35% of ADOA patients versus 14% of controls. Unstable fixation was found only in ADOA, where its prevalence was 7%. CONCLUSION ADOA was associated with unstable fixation and subnormal microperimetric sensitivity, especially in the central and nasal macula where the ganglion cell deficit is most pronounced. FUNDING The study was supported by Øjenfonden, Øjenforeningen, and Synoptikfonden. TRIAL REGISTRATION NCT01522638.
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Affiliation(s)
- Cecilia Rönnbäck
- Øjenafdelingen, Glostrup Hospital, Nordre Ringvej 57, 2600 Glostrup, Denmark.
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Malmström E, Davidova A, Mörgelin M, Linder A, Larsen M, Qvortrup K, Nordenfelt P, Shannon O, Dzupova O, Holub M, Malmström J, Herwald H. Targeted mass spectrometry analysis of neutrophil-derived proteins released during sepsis progression. Thromb Haemost 2014; 112:1230-43. [PMID: 25104417 DOI: 10.1160/th14-04-0312] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/16/2014] [Indexed: 12/22/2022]
Abstract
Early diagnosis of severe infectious diseases is essential for timely implementation of lifesaving therapies. In a search for novel biomarkers in sepsis diagnosis we focused on polymorphonuclear neutrophils (PMNs). Notably, PMNs have their protein cargo readily stored in granules and following systemic stimulation, an immediate increase of neutrophil-borne proteins can be observed into the circulation of sepsis patients. We applied a combination of mass spectrometry (MS) based approaches, LC-MS/MS and selected reaction monitoring (SRM), to characterise and quantify the neutrophil proteome in healthy or disease conditions. With this approach we identified a neutrophil-derived protein abundance pattern in blood plasma consisting of 20 proteins that can be used as a protein signature for severe infectious diseases. Our results also show that SRM is highly sensitive, specific, and reproducible and, thus, a promising technology to study a complex, dynamic and multifactorial disease such as sepsis.
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Affiliation(s)
- E Malmström
- Erik Malmström, Department of Clinical Sciences, Division of Infection Medicine, BMC B14, Lund University, Tornavägen 10, SE-221 84 Lund, Sweden, Tel.: +46 46 73 243 14 16, Fax: +46 46 157756, E-mail:
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Willerslev A, Li XQ, Munch IC, Larsen M. Flow patterns on spectral-domain optical coherence tomography reveal flow directions at retinal vessel bifurcations. Acta Ophthalmol 2014; 92:461-4. [PMID: 23819809 DOI: 10.1111/aos.12233] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To study intravascular characteristics of flowing blood in retinal vessels using spectral-domain optical coherence tomography (SD-OCT). METHODS Examination of selected arterial bifurcations and venous sites of confluence in 25 healthy 11-year-old children recruited as an ad hoc subsample from the population-based, observational Copenhagen Child Cohort 2000 study. RESULTS The blood stream in retinal arteries maintains a figure-of-8 SD-OCT profile consistent with a laminar flow in concentric sheets and a parabolic velocity distribution up to the point of divergence at arterial bifurcations. In contrast, the blood stream at the site of confluence of two retinal veins remains divided into two parallel sets of sheets with separate velocity distribution for a downstream distance of at least four trunk vessel diameters. Consequently, retinal trunk vessels near bifurcations/confluences have distinctly different internal SD-OCT profiles, a figure-of-8 pattern in arteries and a figure figure-of-88 in veins that can be used to distinguish between the two vessel types. CONCLUSION This study verified the hypothesis that directions of blood flow at dichotomous vascular branchings can be determined using SD-OCT. This feature may assist the identification of flow reversal near sites of vascular occlusion, the analysis of blood flow near vascular malformations and the segmentation of retinal SD-OCT images.
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Affiliation(s)
- Anne Willerslev
- Department of Ophthalmology, Glostrup Hospital, Glostrup, DenmarkFaculty of Health Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Ophthalmology, Roskilde Hospital, Roskilde, Denmark
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Scott IU, Jackson GR, Quillen DA, Larsen M, Klein R, Liao J, Holfort S, Munch IC, Gardner TW. Effect of doxycycline vs placebo on retinal function and diabetic retinopathy progression in patients with severe nonproliferative or non-high-risk proliferative diabetic retinopathy: a randomized clinical trial. JAMA Ophthalmol 2014; 132:535-43. [PMID: 24604308 DOI: 10.1001/jamaophthalmol.2014.93] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
IMPORTANCE Inflammation may contribute to the pathogenesis of diabetic retinopathy (DR). OBJECTIVES To investigate, in a proof-of-concept clinical trial, whether low-dose oral doxycycline monohydrate can (1) slow the deterioration of, or improve, retinal function or (2) induce regression or slow the progression of DR in patients with severe nonproliferative DR (NPDR) or non-high-risk proliferative (PDR), and to determine the potential usefulness of visual function end points to expedite the feasibility of conducting proof-of-concept clinical trials in patients with DR. DESIGN, SETTING, AND PARTICIPANTS We conducted a randomized, double-masked, 24-month proof-of-concept clinical trial. Thirty patients (from hospital-based retina practices) with 1 or more eyes with severe NPDR or PDR less than Early Treatment Diabetic Retinopathy Study-defined high-risk PDR. INTERVENTIONS Patients were randomized to receive 50 mg of doxycycline monohydrate or placebo daily for 24 months. MAIN OUTCOMES AND MEASURES Change at 24 months compared with baseline in functional factors (frequency doubling perimetry [FDP], Humphrey photopic Swedish Interactive Thresholding Algorithm 24-2 testing, contrast sensitivity, dark adaptation, visual acuity, and quality of life) and anatomic factors (Early Treatment Diabetic Retinopathy Study DR severity level, area of retinal thickening, central macular thickness, macular volume, and retinal vessel diameters). RESULTS From baseline to month 24, mean FDP foveal sensitivity decreased in the placebo group (-1.9 dB) and increased in the doxycycline group (+1.8 dB) (P = .02). A higher mean FDP foveal sensitivity in the doxycycline group compared with the placebo group was detected at 6 months (P = .04), and this significant difference persisted at 12 and 24 months. A difference between the groups was not detected with respect to the other visual function outcomes and all anatomic outcomes assessed. CONCLUSIONS AND RELEVANCE To our knowledge, this is the first observation suggesting a link between a low-dose oral anti-inflammatory agent and subclinical improvement in inner retinal function. Oral doxycycline may be a promising therapeutic strategy targeting the inflammatory component of DR. Furthermore, study results suggest that FDP, which primarily measures inner retinal function, is responsive to intervention and may be a useful clinical trial end point for proof-of-concept studies in patients with DR. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00511875.
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Abstract
Pancreatic duct leaks can occur as a result of both acute and chronic pancreatitis or in the setting of pancreatic trauma. Manifestations of leaks include pseudocysts, pancreatic ascites, high amylase pleural effusions, disconnected duct syndrome, and internal and external pancreatic fistulas. Patient presentations are highly variable and range from asymptomatic pancreatic cysts to patients with severe abdominal pain and sepsis from infected fluid collections. The diagnosis can often be made by high-quality cross-sectional imaging or during endoscopic retrograde cholangiopancreatography (ERCP). Because of their complexity, pancreatic leak patients are best managed by a multidisciplinary team comprised of therapeutic endoscopists, interventional radiologists, and surgeons in the field of pancreatic interventions. Minor leaks will often resolve with conservative management while severe leaks will frequently require interventions. Endoscopic treatments for pancreatic duct leaks have replaced surgical interventions in many situations. Interventional radiologists also have the ability to offer therapeutic interventions for many leak patients. The mainstay of endotherapy for pancreatic leaks is transpapillary pancreatic duct stenting with a stent that bridges the leak if possible, but varies based on the manifestation and clinical presentation. Fluid collections that result from leaks, such as pseudocysts, can often be treated by endoscopic transluminal drainage with or without endoscopic ultrasound or by percutaneous drainage. Endoscopic interventions have been shown to be effective and have an acceptable complication rate.
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Affiliation(s)
- Michael Larsen
- Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington, USA
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Bregnhøj J, Al-Hamdani S, Sander B, Larsen M, Schatz P. Reappearance of the tapetal-like reflex after prolonged dark adaptation in a female carrier of RPGR ORF15 X-linked retinitis pigmentosa. Mol Vis 2014; 20:852-63. [PMID: 24959064 PMCID: PMC4063355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 06/17/2014] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To report changes in the tapetal-like reflex in a female carrier of RPGR ORF15 c.3395delA X-linked retinitis pigmentosa (XLRP) between examinations at 16 and 22 years of age, and to report the observation that the tapetal-like reflex faded due to exposure to daylight and reappeared with prolonged dark adaptation at 22 years of age. METHODS Clinical examination, kinetic Goldmann perimetry, dark adaptometry, fundus autofluorescence photography, spectral domain optical coherence tomography (SD-OCT), full-field electroretinography (ffERG), and multifocal electroretinography (mfERG) were performed. RESULTS A female carrier of RPGR XLRP presented with a tapetal-like reflex at age 16. At age 22, the tapetal-like reflex was absent upon examination in daylight; however, the reflex reappeared after 12 h of dark adaptation. Fundus autofluorescence was unremarkable and did not change after prolonged dark adaptation. Full-field electroretinography and dark adaptometry at age 22 demonstrated reduced rod and cone function compared to at age 16. CONCLUSIONS Dark adaptation before fundus photography may enable the detection of a tapetal-like reflex where it is otherwise invisible. The light-dependent fluctuation of a disease-related substance in the photoreceptors should prompt further study of the potential role of light as a modulator of the progression of RPGR XLRP.
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Affiliation(s)
- Jesper Bregnhøj
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark,National Eye Clinic for the Visually Impaired and Kennedy Center, Glostrup, Denmark
| | - Sermed Al-Hamdani
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark,National Eye Clinic for the Visually Impaired and Kennedy Center, Glostrup, Denmark
| | - Birgit Sander
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark,Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark,National Eye Clinic for the Visually Impaired and Kennedy Center, Glostrup, Denmark,Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Patrik Schatz
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark,National Eye Clinic for the Visually Impaired and Kennedy Center, Glostrup, Denmark,Department of Ophthalmology, Clinical Sciences, Scane County University Hospital, Lund, Sweden
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Munk MR, Kiss CG, Huf W, Montuoro A, Sulzbacher F, Kroh M, Larsen M, Schmidt-Erfurth U. Visual acuity and microperimetric mapping of lesion area in eyes with inflammatory cystoid macular oedema. Acta Ophthalmol 2014; 92:332-8. [PMID: 23802743 DOI: 10.1111/aos.12201] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate the effect of fluid accumulation on local visual function in inflammatory cystoid-macular-edema (ICME). METHODS This cross-sectional study applied optical-coherence-tomography over a 12×12 fovea-centered field in 50 patients with ICME and mapped the extent of fluid-filled spaces in various retinal layers, of subretinal-fluid and of diffuse-edema. Regression analysis examined effect of planimetric fluid-distribution on best-corrected-visual-acuity (BCVA) and mean microperimetric-sensitivity. RESULTS BCVA decreased with increasing central-neuroretinal-thickness (r= 0.52, p= 0.001), total central-retinal-thickness, including subneuroretinal-fluid (r= 0.41, p= 0.006), total cystoid-and-diffuse edema-area (r= 0.35, p= 0.036) and cystoid inner-nuclear-layer area (r= 0.39, p= 0.02). Mean retinal-sensitivity decreased with increasing diffuse edema-area (r= -0.86, p<0.0001), total cystoid-and-diffuse edema-area (r= -0.54, p= 0.001), cystoid inner-nuclear-layer area (r= -0.46, p= 0.008) and cystoid ganglion-cell-layer area (r= -0.6, p=0.049), central-neuroretinal-thickness (r= -0.42, p= 0.028) and total central-retinal-thickness (r= -0.34, p= 0.039). In multivariate-analyses BCVA was best described by central-neuroretinal-thickness, duration of edema, total cystoid-and-diffuse edema-area and cystoid inner-nuclear-layer area (R(2) = 0.5, p= 0.002). Mean retinal-sensitivity was best described by diffuse edema-area, total cystoid-and-diffuse edema-area and central-neuroretinal-thickness (R(2) = 0.75, p< 0.0001). Subretinal-fluid area and cystoid outer-nuclear/Henle's layer area had no effect on either BCVA or microperimetry. CONCLUSIONS Thickening of the neurosensory-fovea, not subfoveal-fluid, had major impact on both BCVA and retinal-sensitivity. The extent of edema in inner retinal layers also had major impact on both of these two functional parameters. Visual-impairment seems to differ depending on the layers involved, thus different types of fluid accumulation may potentially be given varying treatment priorities.
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Affiliation(s)
- Marion R Munk
- Department of Ophthalmology, Medical University of Vienna, Vienna, AustriaCenter for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, AustriaDepartment of Ophthalmology, Glostrup Hospital, Glostrup, DenmarkFaculty of Health and Medicine, University of Copenhagen, Copenhagen, Denmark
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