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Woltsche N, Valentin K, Hoeflechner L, Guttmann A, Horwath-Winter J, Schneider MR, Ivastinovic D, Lindner M, Schmetterer L, Singh N, Riedl R, Buchmann A, Khalil M, Lindner E. Neurofilament light chain: a new marker for neuronal decay in the anterior chamber fluid of patients with glaucoma. Br J Ophthalmol 2023; 107:1432-1437. [PMID: 35750478 DOI: 10.1136/bjo-2021-320828] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 11/22/2021] [Accepted: 06/10/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Neurofilament light chain (NfL) levels in cerebrospinal fluid and serum are reliable indicators for neuroaxonal damage in a broad spectrum of neurodegenerative diseases. Herein, we investigate NfL levels in serum and anterior chamber fluid of patients with glaucoma. METHODS Patients scheduled for routine glaucoma or cataract surgery were recruited for this study. Retinal nerve fibre layer thickness was measured by optical coherence tomography (OCT, Heidelberg Spectralis). NfL levels in serum and in anterior chamber fluid were analysed with Simoa SR-X Analyzer (Quanterix; NFLIGHT, Lexington, Massachusetts, USA). T-test was used for parametric data and Mann-Whitney-U test for nonparametric data. Spearman's rank-order correlation was used to investigate correlations. P values<0.05 were considered as statistically significant. RESULTS Sixty patients with glaucoma and 58 controls were enrolled. Serum NfL concentration of patients with glaucoma was similar to serum NfL concentration in controls (median (IQR); 22.7 (18.9) pg/mL vs 22.5 (24.0) pg/mL; p=0.763). A positive correlation of serum NfL with age was observed in both patients with glaucoma (r=0.77; p<0.001) and in the control group (r=0.82, p<0.001). In the anterior chamber fluid, the NfL concentration was substantially increased in patients with glaucoma compared with controls (20.7 (101.3) pg/mL vs 3.1 (2.9) pg/mL; p<0.001). Furthermore, we found a positive correlation of anterior chamber fluid NfL with preoperative intraocular pressure (r=0.39, p=0.003) and with retinal nerve fibre layer thickness (r=0.58, p<0.001). CONCLUSION NfL levels in anterior chamber fluid are elevated in patients with glaucoma and correlate with intraocular pressure and retinal nerve fibre layer thickness. The presented data strongly support anterior chamber fluid NfL as a new marker for glaucoma.
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Affiliation(s)
- Nora Woltsche
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | | | - Lukas Hoeflechner
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | - Andreas Guttmann
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | | | | | | | - Marlene Lindner
- Department of Dentistry, Medical University of Graz, Graz, Steiermark, Austria
| | - Leopold Schmetterer
- Ocular Imaging, Singapore Eye Research Institute, Singapore
- Department of Clinical Pharmacology, Medical University of Vienna, Wien, Austria
| | - Neena Singh
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Graz, Austria
| | - Arabella Buchmann
- Department of Neurology, Medical University of Graz, Graz, Steiermark, Austria
| | - Michael Khalil
- Department of Neurology, Medical University of Graz, Graz, Steiermark, Austria
| | - Ewald Lindner
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
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Yuzbasioglu S, Icoz M. Evaluation of effect of covıd-19 pandemic on anatomical and functional changes and vision-related quality of life in patients with glaucoma. Photodiagnosis Photodyn Ther 2023; 43:103705. [PMID: 37451656 DOI: 10.1016/j.pdpdt.2023.103705] [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: 05/06/2023] [Revised: 06/23/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND To evaluate anatomical and functional changes and vision-related quality of life in patients whose glaucoma follow-up was disrupted by the COVID-19 restrictions. METHODS This retrospective observational study included 100 patients who were followed up at the glaucoma unit. For the patients whose follow-up evaluations were postponed due to COVID-19 restrictions, visual acuity (VA), intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness, visual field parameters [mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI)], and the National Institute of Ophthalmology Visual Function Scale-25 (NEI-VFQ-25) score were evaluated based on the measurements performed at the last visit before COVID-19 (V1) and at the first visit after the removal of COVID-19 restrictions (V2). RESULTS The mean age of the patients was 61.1 ± 13.4 years, the mean follow-up time was 11.4 ± 4.2 months, and the mean interval between the last two visits was 7.2 ± 2.7 months. In the evaluation of the last two visits, VA was lower and IOP was higher at V2, and there was progression in the MD, PSD, and VFI values (p<0.05, for all). RNFL thickness progression was seen in 13-23% of the patients. According to the NEI-VFQ-25 evaluation, except for peripheral vision and near vision, all the remaining subscale scores and the total score were lower at V2 (p<0.05, for all). CONCLUSIONS This study demonstrates the devastating impact of the COVID-19 pandemic on the anatomical and functional changes and vision-related quality of life together in patients with glaucoma.
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Affiliation(s)
- Sema Yuzbasioglu
- Ophthalmology Clinic, Department of Ophthalmology, Yıldırım Beyazıt University Faculty of Medicine, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Mehmet Icoz
- Department of Ophthalmology, Yozgat City Hospital, Erdoğan Akdağ Mah., Viyana Cad., Merkez, Yozgat 66100, Turkey.
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Falb T, Heidinger A, Wallisch F, Tomasic H, Ivastinovic D, Lindner M, Tiefenthaller F, Keintzel L, Hoeflechner L, Riedl R, Hommer A, Lindner E. Postoperative Pain after Different Transscleral Laser Cyclophotocoagulation Procedures. Int J Environ Res Public Health 2023; 20:2666. [PMID: 36768032 PMCID: PMC9915327 DOI: 10.3390/ijerph20032666] [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] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND As the number of surgical options in glaucoma treatment is continuously rising, evidence regarding distinctive features of these surgeries is becoming more and more important for clinicians to choose the right surgical treatment for each individual patient. METHODS For this retrospective data analysis, we included glaucoma patients treated with either continuous wave (CW-TSCPC) or micropulse transscleral cyclophotocoagulation (MP-TSCPC) in an inpatient setting. Pain intensity was assessed using a numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst imaginable pain) during hospitalization. CW-TSCPC was performed using OcuLight® Six (IRIDEX Corporation, Mountain View, CA, USA) and MP-TSCPC was performed using the IRIDEX® Cyclo-G6 System (IRIDEX Corporation, Mountain View, CA, USA). RESULTS A total of 243 consecutive cases of TSCPC were included. Of these, 144 (59.26%) were treated with CW-TSCPC and 99 (40.74%) with MP-TSCPC. Using the univariable model, the risk for postoperative pain was observed to be lower in MP-TSCPC compared with CW-TSCPC (unadjusted: OR 0.46, 95% CI 0.24-0.84, p = 0.017), but this did not hold using the multivariable model (adjusted: OR 0.52, 95% CI 0.27-1.02, p = 0.056). Simultaneously conducted anterior retinal cryotherapy was associated with a higher risk for postoperative pain (OR 4.41, 95% CI 2.01-9.69, p < 0.001). CONCLUSIONS We found that the occurrence of postoperative pain was not different in CW-TSCPC compared with MP-TSCPC in a multivariable model. In cases of simultaneous anterior retinal cryotherapy, the risk for postoperative pain was significantly higher.
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Affiliation(s)
- Thomas Falb
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | - Astrid Heidinger
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | - Fabian Wallisch
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | - Hrvoje Tomasic
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | | | - Marlene Lindner
- Department of Dentistry and Oral Health, Medical University Graz, 8036 Graz, Austria
| | | | - Lukas Keintzel
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | - Lukas Hoeflechner
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, 8036 Graz, Austria
| | - Anton Hommer
- Department of Ophthalmology, Sanatorium Hera, 1090 Vienna, Austria
| | - Ewald Lindner
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
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Anton A, Nolivos K, Pazos M, Fatti G, Ayala ME, Martínez-Prats E, Peral O, Poposki V, Tsiroukis E, Morilla-Grasa A, Comas M, Castells X. Diagnostic Accuracy and Detection Rate of Glaucoma Screening with Optic Disk Photos, Optical Coherence Tomography Images, and Telemedicine. J Clin Med 2021; 11:jcm11010216. [PMID: 35011957 PMCID: PMC8746039 DOI: 10.3390/jcm11010216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the diagnostic accuracy of optical coherence tomography (OCT) and retinography in the detection of glaucoma through a telemedicine program. Methods: A population-based sample of 4113 persons was randomly selected. The screening examination included a fundus photograph and OCT images. Images were evaluated on a deferred basis. All participants were then invited to a complete glaucoma examination, including gonioscopy, visual field, and dilated fundus examination. The detection rate, sensitivity, specificity, and positive and negative predictive values were calculated. Results: We screened 1006 persons. Of these, 201 (19.9%) were classified as glaucoma suspects; 20.4% were identified only by retinographs, 11.9% only by OCT images, and 46.3% by both. On ophthalmic examination at the hospital (n = 481), confirmed glaucoma was found in 58 (12.1%), probable glaucoma in 76 (15.8%), and ocular hypertension in 10 (2.1%), and no evidence of glaucoma was found in 337 (70.0%). The detection rate for confirmed or probable glaucoma was 9.2%. Sensitivity ranged from 69.4% to 86.2% and specificity from 82.1% to 97.4%, depending on the definition applied. Conclusions: The combination of OCT images and fundus photographs yielded a detection rate of 9.2% in a population-based screening program with moderate sensitivity, high specificity, and predictive values of 84–96%.
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Affiliation(s)
- Alfonso Anton
- Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain; (M.E.A.); (V.P.); (E.T.); (A.M.-G.)
- Medical School, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
- Ophthalmology Service, Parc de Salut Mar, 08005 Barcelona, Spain;
- Correspondence: ; Tel.: +34-93-254-0565 (ext. 4000-4002); Fax: +34-93-254-0567
| | - Karen Nolivos
- Department of Medicine, Institut Mar d’Investigacions Mèdiques (IMIM), 08005 Barcelona, Spain;
- Epidemiology and Evaluation Department, Parc Salut Mar, 08005 Barcelona, Spain; (M.C.); (X.C.)
| | - Marta Pazos
- Institut Clínic d’Oftalmologia (ICOF), Hospital Clínic de Barcelona, Institut d’Investigacions Mèdiques, 08036 Barcelona, Spain;
| | - Gianluca Fatti
- Ophthalmology Service, Parc de Salut Mar, 08005 Barcelona, Spain;
| | - Miriam Eleonora Ayala
- Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain; (M.E.A.); (V.P.); (E.T.); (A.M.-G.)
| | | | | | - Vladimir Poposki
- Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain; (M.E.A.); (V.P.); (E.T.); (A.M.-G.)
- Ophthalmology Service, Parc de Salut Mar, 08005 Barcelona, Spain;
| | - Evangelos Tsiroukis
- Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain; (M.E.A.); (V.P.); (E.T.); (A.M.-G.)
| | - Antonio Morilla-Grasa
- Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain; (M.E.A.); (V.P.); (E.T.); (A.M.-G.)
| | - Merce Comas
- Epidemiology and Evaluation Department, Parc Salut Mar, 08005 Barcelona, Spain; (M.C.); (X.C.)
- Health Services Research on Chronic Patients Network (REDISSEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Xavier Castells
- Epidemiology and Evaluation Department, Parc Salut Mar, 08005 Barcelona, Spain; (M.C.); (X.C.)
- Health Services Research on Chronic Patients Network (REDISSEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
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