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Abdelaal A, Eltaras MM, Katamesh BE, Serhan HA, Farahat RA, Badr H, Abdelazeem B. The prevalence and presentation patterns of microcystic macular oedema: a systematic review and meta-analysis of 2128 glaucomatous eyes. Eye (Lond) 2023; 37:3322-3333. [PMID: 37072471 PMCID: PMC10630304 DOI: 10.1038/s41433-023-02524-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 03/06/2023] [Accepted: 04/04/2023] [Indexed: 04/20/2023] Open
Abstract
We conducted this research to determine the prevalence rate and presentation patterns with microcystic macular oedema (MMO) in glaucoma patients. The protocol was pre-registered on PROSPERO ( CRD42022316367 ). PubMed, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, CENTRAL, clinicaltrials.gov, and Google Scholar were searched for articles reporting MMO in glaucoma patients. The primary outcome was the prevalence of MMO, while secondary outcomes included the comparison between MMO and non-MMO in terms of patients' characteristics (age, gender), glaucoma stage, and ocular parameters (axial length (AL), intraocular pressure, mean deviation, spherical equivalent). Data are reported as mean difference (MD) or log odds ratio (logOR) along with their corresponding 95% confidence intervals (CI) for continuous and dichotomous outcomes, respectively. The quality of included studies was assessed using the NIH tool, and the certainty of evidence was assessed using GRADE framework. Ten studies (2128 eyes) were included, revealing an overall prevalence rate of MMO of 8% (95%CI: 5-12%). When compared to non-MMO group, MMO was associated with lower age (MD = -5.91; 95%CI: -6.02: -5.20), greater risk of advanced glaucoma stage (LogOR=1.41; 95%CI: 0.72: 2.09), and lower mean deviation of the visual field (MD = -5.00; 95%CI: -7.01: -2.99). No significant difference was noted between both groups in terms of gender, axial length, or spherical equivalent. Three studies had good quality while seven had poor quality. MMO is a prevalent observation in glaucoma patients and is associated with patients' age and stage of the disease. However, the certainty of evidence remains very low.
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Affiliation(s)
- Abdelaziz Abdelaal
- Tanta Research Team, Tanta, El-Gharbia, Egypt.
- Harvard Medical School, Boston, MA, USA.
- Master of Medical Sciences in Clinical Investigation (MMSCI), Harvard Medical School, Boston, MA, USA.
- Tanta University Hospitals, Tanta, Gharbia Governorate, Egypt.
| | - Mennatullah Mohamed Eltaras
- Tanta Research Team, Tanta, El-Gharbia, Egypt
- Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Basant E Katamesh
- Tanta Research Team, Tanta, El-Gharbia, Egypt
- Tanta University Hospitals, Tanta, Gharbia Governorate, Egypt
- Research Scholar, Mayo Clinic, Rochester, USA
| | - Hashem Abu Serhan
- Tanta Research Team, Tanta, El-Gharbia, Egypt
- Department of Ophthalmology, Hamad Medical Corporations, Doha, Qatar
| | - Ramadan Abdelmoez Farahat
- Tanta Research Team, Tanta, El-Gharbia, Egypt
- Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Helmy Badr
- Tanta Research Team, Tanta, El-Gharbia, Egypt
- Tanta University Hospitals, Tanta, Gharbia Governorate, Egypt
| | - Basel Abdelazeem
- Tanta Research Team, Tanta, El-Gharbia, Egypt
- McLaren Health Care, Flint, MI, 48532, USA
- Michigan State University, East Lansing, MI, 48824, USA
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Chapelle AC, Rakic JM, Plant GT. Nonarteritic Anterior Ischemic Optic Neuropathy. OPHTHALMOLOGY SCIENCE 2023; 3:100230. [PMID: 36439696 PMCID: PMC9692034 DOI: 10.1016/j.xops.2022.100230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022]
Abstract
Purpose Microcystic macular edema (MME), also known as retrograde maculopathy (RM), is associated with severe optic atrophy because of a range of causes. However, similar changes have also been described in primary retinal pathology and the pathogenesis of MME is debated. Design A retrospective observational case series. Participants Patients with nonarteritic ischemic optic neuropathy. Methods A retrospective observational case series was performed at the University Hospital of Liège, Belgium. The medical records of patients who were referred to our Neuro-ophthalmology department with a diagnosis of nonarteritic anterior ischemic optic neuropathy (NA-AION), between 2014 and 2021, were reviewed. Main Outcome Measures Ganglion cell complex thickness, acute and chronic inner nuclear change. Results In a cohort of 34 patients (mean age: 60 ± 12.5 years; 65.6% men) with NA-AION, we identified a transient microcystic change in the inner nuclear layer (INL) associated with optic disc swelling in 19 eyes at presentation. This early change was associated with a transudate of intraretinal and subretinal fluid originating from the optic disc. Among patients who had shown this transient change 3 subsequently developed MME, which remained fixed during the period of observation (range, 12–34 months). No MME was observed in patients without an early INL transient change. Microcystic macular edema was observed in patients with severe ganglion cell complex thinning at 6 months: mean (± SD) loss in superior hemimacula (−28.2 ± 5.2 μm [−33.3%, range, −22.3 to −30.3 μm]) and in inferior hemimacula (−30.7 ± 5.6 μm [−31.0%, range, −24.3 to 34.8 μm]). Conclusions Our study has revealed 2 causes of INL cystic change in the same patients experiencing NA-AION, 1 reversible and the other likely permanent. This finding highlights the distinction between genuine edema related to transudation of fluid (in this case secondary to ischemic optic disc swelling) and the phenomenon observed in RM that is related to the degree of retinal nerve fiber layer/ganglion cell complex thinning. Cystic change in the INL is associated with severe optic atrophy (MME). However, similar changes have been described in retinal pathology and the pathogenesis of MME is debated.
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Liu H, Chen Y, Qin X, Jin Z, Jiang Y, Wang Y. Epidemiology and Survival of Patients With Optic Pathway Gliomas: A Population-Based Analysis. Front Oncol 2022; 12:789856. [PMID: 35223473 PMCID: PMC8874351 DOI: 10.3389/fonc.2022.789856] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/24/2022] [Indexed: 11/20/2022] Open
Abstract
Background We aimed to analyze the epidemiology and outcomes of pediatric patients and adult patients with optic pathway gliomas in the United States using a population-based method. Methods Data for patients with optic pathway gliomas diagnosed between 2000 and 2018 were extracted from the SEER database. We divided the patients into a pediatric group and an adult group. Descriptive analyses were conducted to analyze demographic and clinical characteristics and treatment. We used the chi-square test to evaluate differences between pediatric and adult patients with optic pathway gliomas. The possible prognostic indicators were analyzed by Kaplan–Meier curves and Cox proportional hazards models. Results Optic pathway gliomas represented 86.6% of all lesions originating from the optic pathway. In total, 1257 cases of optic pathway gliomas were included in our study. Pediatric patients accounted for 83.7% in this cohort, and most of the patients were diagnosed at 1-4 years old. Chemotherapy was chosen most often for pediatric patients, but radiation therapy was chosen most often for adult patients. Pilocytic astrocytoma accounted for 59.1% of pediatric patients and 37.5% of adult patients. The overall survival (OS) rates were 94.8% 5 years after diagnosis and 93.0% 10 years after diagnosis. Survival analysis showed that surgery, radiation and chemotherapy did not help patients obtain a better prognosis. Overall, pediatric patients had a better prognosis. Conclusion Optic pathway gliomas are relatively rare lesions with good prognosis. They mostly affect children, and pilocytic astrocytoma is the most common histological diagnosis. Highly individualized treatment is essential for such patients.
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Mahroo OA, Shalchi Z, Williamson TH, Plant GT. Re: Bhatti et al.: Microcystic macular edema in optic nerve glioma (Ophthalmology. 2020;127:930). Ophthalmology 2020; 128:e9. [PMID: 32896389 DOI: 10.1016/j.ophtha.2020.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
- Omar A Mahroo
- Institute of Ophthalmology, University College London, UK; Moorfields Eye Hospital, London, UK; Section of Ophthalmology, King's College London, UK; Department of Ophthalmology, St Thomas' Hospital, London, UK.
| | | | - Tom H Williamson
- Section of Ophthalmology, King's College London, UK; Department of Ophthalmology, St Thomas' Hospital, London, UK
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