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Strzalkowska A, Rennert L, Strzalkowski P, Stingl JV, Hoffmann EM, Pfeiffer N, Schuster AK. Characteristics and Treatment Outcomes of Hypotony Maculopathy Post-Glaucoma Filtering Surgery: An Optical Coherence Tomography-Based Study. J Glaucoma 2024:00061198-990000000-00389. [PMID: 38709193 DOI: 10.1097/ijg.0000000000002413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/13/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE This study assesses morphological characteristics using SD-OCT in patients with hypotony maculopathy (HM) following glaucoma filtering surgery and evaluates the results of its treatment. MATERIAL AND METHODS Retrospective analysis of all HM patients between January 2019 and March 2023. Inclusion criteria consisted of both pre-operative and post-revision SD-OCT images of the macula and the presence of HM as observed on OCT images preoperatively. HM was graded according to its appearance in OCT both pre- and post-revision surgery. Change in visual acuity and IOP were assessed. RESULTS 45 eyes of 45 patients were included. 21 eyes had HM limited to retinal pigment epithelium (RPE), 18 eyes had involvement of RPE and photoreceptor layers and 6 eyes had additional intra- or subretinal edema. After revision surgery with IOP elevation, 64% of eyes had complete HM regression with no HM signs in OCT imaging. 80% of patients achieved at least one grade improvement in HM. Preoperative visual acuity increased from 0.7±0.4 (logMAR) to 0.4±0.4 at 2 weeks postoperatively, over the course of an increase of IOP from 3.5±1.8 mmHg to 17.1±10.6 mmHg at day one. Eyes with complete HM regression had higher IOP at day 1 compared to those without improvement (P=0.04). The median time between HM onset and revision was 10.0 days for those with complete regression and 27 days for those without improvement (P=0.04). CONCLUSIONS Bleb revision procedures for HM following glaucoma filtering surgery show promising outcomes, including notable improvements in visual acuity and IOP. The timing of revision surgery appears to influence outcome. In our study earlier intervention was associated with better results. Even delayed surgeries can lead to an improvement, although complete morphological restoration may not be achieved in advanced grades of HM.
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Affiliation(s)
- Alicja Strzalkowska
- Department of Ophthalmology, Mainz University Medical Centre of the Johannes Gutenberg, University of Mainz, Mainz, Germany
- Department of Ophthalmology, Heinrich-Heine-University, University Hospital Düsseldorf, Germany
| | - Lisa Rennert
- Department of Ophthalmology, Mainz University Medical Centre of the Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - Piotr Strzalkowski
- Department of Ophthalmology, Heinrich-Heine-University, University Hospital Düsseldorf, Germany
| | - Julia V Stingl
- Department of Ophthalmology, Mainz University Medical Centre of the Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - Esther M Hoffmann
- Department of Ophthalmology, Mainz University Medical Centre of the Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, Mainz University Medical Centre of the Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, Mainz University Medical Centre of the Johannes Gutenberg, University of Mainz, Mainz, Germany
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O'Brien K, Hackenberg B, Döge J, Bohnert A, Rader T, Lackner KJ, Beutel ME, Münzel T, Wild PS, Chalabi J, Schuster AK, Schmidtmann I, Matthias C, Bahr-Hamm K. Age standardization and time-of-day performance for the Oldenburg Sentence Test (OLSA): results from the population-based Gutenberg Health Study. Eur Arch Otorhinolaryngol 2024; 281:2341-2351. [PMID: 38110748 PMCID: PMC11023958 DOI: 10.1007/s00405-023-08358-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/15/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE The Oldenburg Sentence Test (OLSA) is a German matrix test designed to determine speech recognition thresholds (SRT). It is widely used for hearing-aids and cochlear implant fitting, but an age-adjusted standard is still lacking. In addition, knowing that the ability to concentrate is an important factor in OLSA performance, we hypothesized that OLSA performance would depend on the time of day it was administered. The aim of this study was to propose an age standardization for the OLSA and to determine its diurnal performance. METHODS The Gutenberg Health Study is an ongoing population-based study and designed as a single-centre observational, prospective cohort study. Participants were interviewed about common otologic symptoms and tested with pure-tone audiometry and OLSA. Two groups-subjects with and without hearing loss-were established. The OLSA was performed in two runs. The SRT was evaluated for each participant. Results were characterized by age in 5-year cohorts, gender and speech recognition threshold (SRT). A time stamp with an hourly interval was also implemented. RESULTS The mean OLSA SRT was - 6.9 ± 1.0 dB (group 1 male) and - 7.1 ± 0.8 dB (group 1 female) showing an inverse relationship with age in the whole cohort, whereas a linear increase was observed in those without hearing loss. OLSA-SRT values increased more in males than in females with increasing age. No statistical significance was found for the diurnal performance. CONCLUSIONS A study with 2900 evaluable Oldenburg Sentence Tests is a novelty and representative for the population of Mainz and its surroundings. We postulate an age- and gender-standardized scale for the evaluation of the OLSA. In fact, with an intergroup standard deviation (of about 1.5 dB) compared to the age dependence of 0.7 dB/10 years, this age normalization should be considered as clinically relevant.
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Affiliation(s)
- Karoline O'Brien
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Berit Hackenberg
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Julia Döge
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Andrea Bohnert
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Tobias Rader
- Division of Audiology, Department of Otolaryngology, University Hospital, Ludwig-Maximillian-University, Munich, Germany
| | - Karl J Lackner
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology-Cardiology I, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site RhineMine, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site RhineMine, Mainz, Germany
| | - Julian Chalabi
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center Mainz, Mainz, Germany
| | | | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany
| | - Christoph Matthias
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Katharina Bahr-Hamm
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
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Fieß A, Gißler S, Mildenberger E, Urschitz MS, Laspas P, Stoffelns B, Pfeiffer N, Schuster AK. A short report on: Postnatal environmental factors associated with corneal shaping: Results from the Gutenberg Prematurity Eye Study. Acta Ophthalmol 2024; 102:e405-e407. [PMID: 37909757 DOI: 10.1111/aos.15804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/15/2023] [Indexed: 11/03/2023]
Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sandra Gißler
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Panagiotis Laspas
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Hahad O, Döge J, Bahr-Hamm K, Beutel ME, Kontohow-Beckers K, Schuster AK, Keller K, Hobohm L, Schmitt VH, Gianicolo E, Lackner KJ, Daiber A, Wild PS, Hackenberg B, Münzel T. Noise annoyance due to different sources is associated with tinnitus presence and distress in the general population. J Expo Sci Environ Epidemiol 2024:10.1038/s41370-024-00668-9. [PMID: 38570612 DOI: 10.1038/s41370-024-00668-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND The pathophysiology of tinnitus is not yet fully understood. Although there is a large amount of evidence associating traffic noise exposure with non-auditory health outcomes, there is no evidence regarding the impact of noise annoyance on auditory disorders such as tinnitus. OBJECTIVE Thus, we aimed to investigate the association between noise annoyance due to different sources and tinnitus presence and distress in the general population. METHODS Data of 6813 participants from a large German population-based cohort were used (Gutenberg Health Study). Participants were asked about the presence of tinnitus and how much they were bothered by it. In addition, information on annoyance from road traffic, aircraft, railways, industrial, and neighborhood noise during the day and sleep was collected through validated questionnaires. RESULTS The prevalence of tinnitus was 27.3%, and the predominant sources of noise annoyance in these subjects were aircraft, neighborhood, and road traffic noise. Overall, logistic regression results demonstrated consistent positive associations between annoyance due to different noise sources and prevalent risk of tinnitus with increases in odds ratios ranging from 4 to 11% after adjustment for sex, age, and socioeconomic status. Likewise, consistent increases in odds ratios were observed for tinnitus distress in subjects with prevalent tinnitus. For instance, neighborhood noise annoyance during the sleep was associated with a 26% increase in tinnitus distress (OR 1.26, 95% CI 1.13; 1.39). IMPACT This is the first study investigating the association between noise annoyance and tinnitus presence and distress in a large cohort of the general population. Our results indicate consistent and positive associations between various sources of noise annoyance and tinnitus. These unprecedented findings are highly relevant as noise annoyance and tinnitus are widespread. The precise etiology and locus of tinnitus remain unknown, but excessive noise exposure is thought to be among the major causes. This study suggests that transportation and neighborhood noise levels thought merely to contribute to annoyance and non-auditory health effects may be sufficient to cause or exacerbate tinnitus.
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Affiliation(s)
- Omar Hahad
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany.
| | - Julia Döge
- Department of Otorhinolaryngology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Katharina Bahr-Hamm
- Department of Otorhinolaryngology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Konstantin Kontohow-Beckers
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karsten Keller
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Lukas Hobohm
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Volker H Schmitt
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Emilio Gianicolo
- Institute of Medical Biostatistics, Epidemiology & Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Philipp S Wild
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute for Molecular Biology, Mainz, Germany
| | - Berit Hackenberg
- Department of Otorhinolaryngology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
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Schuster AK, Leisle L, Picker N, Bubendorfer-Vorwerk H, Lewis P, Hahn P, Wasem J, Finger RP. Epidemiology of Diagnosed Age-related Macular Degeneration in Germany: An Evaluation of the Prevalence Using AOK PLUS Claims Data. Ophthalmol Ther 2024; 13:1025-1039. [PMID: 38386186 PMCID: PMC10912065 DOI: 10.1007/s40123-024-00901-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/26/2024] [Indexed: 02/23/2024] Open
Abstract
INTRODUCTION Epidemiologic data on age-related macular degeneration (AMD) are mainly based on cohort studies, including both diagnosed and undiagnosed cases. Using health claims data allows estimating epidemiological data of diagnosed subjects with AMD within the health care system using diagnosis codes from a regional claims database (AOK PLUS) to estimate the prevalence and incidence of non-exudative and exudative AMD in Germany. METHODS Patients with AMD were identified among AOK PLUS insured patients based on at least two outpatient, ophthalmologic or one inpatient H35.3 diagnoses for the years 2012 to 2021. Patients without continuous observation in a calendar year were excluded. Prevalence was assessed, and 1-year cumulative incidence was determined by the number of newly diagnosed patients divided by the number of individuals at risk. For 2020 and 2021, the AMD stage was assessed by diagnostic subcodes for non-exudative and exudative AMD, respectively. For 2012 to 2019, patient numbers were estimated based on the average proportions of non-exudative AMD and exudative AMD, respectively, in 2020 and 2021. Incidence and prevalence numbers were then extrapolated to Germany. RESULTS Between 2012 to 2021, the prevalence of diagnosed AMD cases remained relatively stable among approximately 3.27 million AOK PLUS insured persons, ranging from 0.96% (minimum in 2021) to 1.31% (maximum in 2014) for non-exudative AMD, about twice as high as for exudative AMD (min-max: 0.53-0.72%). The age- and sex-adjusted projections amounted to 644,153 diagnosed non-exudative and 367,086 diagnosed German patients with exudative AMDs in 2021. The 1-year cumulative incidence for non-exudative and exudative AMD, respectively, ranged from 122,427-142,932 to 46,092-86,785 newly diagnosed cases. CONCLUSION The number of diagnosed cases with AMD in Germany has increased slightly over the past decade. For the first time, patient counts with non-exudative and exudative AMD were approximated for Germany based on a representative, large-scale database study.
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Affiliation(s)
- Alexander K Schuster
- Department of Ophthalmology, University Medical Center Mainz, Geb. 101, Langenbeckstr. 1, 55131, Mainz, Germany.
| | - Lilia Leisle
- Real World and Advanced Analytics, Ingress-Health HWM GmbH, A Cytel Company, Wismar/Berlin, Germany
| | - Nils Picker
- Real World and Advanced Analytics, Ingress-Health HWM GmbH, A Cytel Company, Wismar/Berlin, Germany
| | | | - Philip Lewis
- Value, Access and Policy DACH, Apellis Germany GmbH, München, Germany
| | - Philipp Hahn
- Institut für Pharmakoökonomie und Arzneimittellogistik e.V, Wismar, Germany
| | - Jürgen Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Robert P Finger
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
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Fieß A, Zange M, Gißler S, Mildenberger E, Urschitz MS, Laspas P, Stoffelns B, Pfeiffer N, Schuster AK. Foveal avascular zone in adults born preterm with and without retinopathy of prematurity - results from the Gutenberg Prematurity Eye Study. Retina 2024:00006982-990000000-00640. [PMID: 38564800 DOI: 10.1097/iae.0000000000004113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
PURPOSE To examine potential changes in the foveal avascular zone (FAZ) during adulthood due to prematurity and retinopathy of prematurity (ROP), as assessed by measurements of FAZ area and circularity. METHODS The Gutenberg Prematurity Eye Study (GPES) is a retrospective German cohort study with a prospective ophthalmologic examination of adults aged 18 to 52 years, born either preterm or full-term, utilizing spectral-domain optical coherence tomography angiography. Participants were categorized into groups based on gestational age and postnatal ROP status. The study employed multivariable linear regression analyses to explore associations with the FAZ. RESULTS The study cohort comprised 380 right eyes from individuals born both preterm and full-term, with an average age of 28.4 +/- 8.6 years, including 214 females. The FAZ area decreased as gestational age decreased: FAZ was 0.28 ± 0.12 mm2 (control group), 0.21 ± 0.10 mm2 at GA 33-36 weeks, 0.18 ± 0.10 mm2 at GA 29-32 weeks, 0.11 ± 0.10 mm2 at GA ≤28 weeks, 0.11 ± 0.10 mm2 in ROP without treatment, and 0.11 ± 0.10 mm2 in those requiring ROP treatment. In the multivariable analyses, smaller FAZ was independently associated with gestational age (p<0.05), increased foveal retinal thickness (<0.05), and foveal hypoplasia (p<0.05).Moreover, no association was seen between visual acuity and FAZ. CONCLUSION The main perinatal factor associated with a smaller FAZ in this German cohort is preterm birth, while ROP, ROP treatment, or other perinatal factors do not affect FAZ observed in adulthood. A smaller FAZ shape in preterm individuals might be an indicator of foveal hypoplasia.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Maria Zange
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sandra Gißler
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Panagiotis Laspas
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Fieß A, Dautzenberg K, Gißler S, Mildenberger E, Urschitz MS, Elflein HM, Laspas P, Stoffelns BM, Pfeiffer N, Schuster AK. Prevalence of strabismus and risk factors in adults born preterm with and without retinopathy of prematurity: results from the Gutenberg Prematurity Eye study. Br J Ophthalmol 2024:bjo-2023-324698. [PMID: 38503479 DOI: 10.1136/bjo-2023-324698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/29/2024] [Indexed: 03/21/2024]
Abstract
AIM The purpose of this study was to assess the prevalence of strabismus and nystagmus and to analyse associated factors in preterm and full-term infants in adulthood. METHODS The Gutenberg Prematurity Eye Study is a retrospective cohort study with a prospective ophthalmological examination of participants born preterm and full-term (aged 18-52 years). Perinatal data were carefully assessed for risk factors and comprehensive ophthalmological examinations were conducted. The association between strabismus and nystagmus was assessed by analysing 16 different perinatal and actual risk factors in multivariable analysis. Participants were grouped into full-term controls (gestational age (GA) at birth ≥37 weeks), preterm participants without retinopathy of prematurity (ROP) and GA 33-36 weeks (group 2), GA 29-32 weeks (group 3), GA ≤28 weeks (group 4), non-treated ROP (group 5) and treated ROP (group 6). RESULTS In total, 892 eyes of 450 preterm and full-term individuals (mean age: 28.6 years, SD: ± 8.6 years, 251 females) were included. Strabismus was observed in 2.1% (3/140), 6.6% (9/137), 17.4% (16/92), 11.1% (2/18), 27.1% (13/48) and 60% (9/15) of participants and nystagmus in 0.7% (1/140), 1.5% (2/137), 4.3% (4/92), 5.6% (1/18), 10.4% (5/48) and 26.7% (4/15) of participants in the respective groups. In the multivariable regression model, strabismus was associated with GA (OR=0.90; p=0.046), anisometropia ≥1.5 diopter (OR=3.87; p=0.003), hypermetropia ≥2 diopter (OR=9.89; p<0.001) and astigmatism ≥1.5 diopter (OR=2.73; p=0.017). Esotropia was more frequent than exotropia and hypermetropia/hypometropia. Most strabismus cases occurred within the first 10 years of life. The strongest predictor associated with nystagmus was perinatal adverse events (OR=15.8; p=0.002). CONCLUSION Low GA and refraction of the eye are independent risk factors for strabismus, which typically occurs in the first 10 years of life. Perinatal adverse events are the most important factors for the presence of nystagmus in adulthood.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Kim Dautzenberg
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sandra Gißler
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Department of Pediatrics, Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Germany, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany, Mainz, Germany
| | - Heike M Elflein
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Panagiotis Laspas
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard M Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Hahad O, Gilan D, Michal M, Tüscher O, Chalabi J, Schuster AK, Keller K, Hobohm L, Schmitt VH, König J, Lackner KJ, Wild P, Schattenberg JM, Daiber A, Münzel T. Noise annoyance and cardiovascular disease risk: results from a 10-year follow-up study. Sci Rep 2024; 14:5619. [PMID: 38454061 PMCID: PMC10920781 DOI: 10.1038/s41598-024-56250-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
The relationship between noise annoyance and risk of cardiovascular disease (CVD) still needs to be fully elucidated. Thus, we examined the relationship between noise annoyance and CVD risk in a large population-based cohort study. Cross-sectional (N = 15,010, aged 35-74 years, baseline investigation period 2007-2012) and prospective data (5- and 10-year follow-up from 2012 to 2022) from the Gutenberg Health Study were used to examine the relationship between noise annoyance due to different sources and risk of prevalent and incident CVD comprising atrial fibrillation, coronary artery disease, myocardial infarction, stroke, chronic heart failure, peripheral artery disease, and venous thromboembolism. In cross-sectional analyses, noise annoyance was an independent risk factor for prevalent CVD, with the strongest associations seen for noise annoyance during sleep (e.g., neighborhood noise annoyance: odds ratio 1.20, 95% confidence interval 1.13-1.27, p < 0.0001). While in the 10-year follow-up, mostly positive associations (although not significant) between noise annoyance and incident CVD were observed, no indication of increased CVD risk was observed after 5 years of follow-up. Noise annoyance due to different sources was associated with prevalent CVD, whereas only weak associations with incident CVD were found. Further large-scale studies are needed to establish the relationship between noise annoyance and risk of CVD.
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Affiliation(s)
- Omar Hahad
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
| | - Donya Gilan
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Matthias Michal
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute for Molecular Biology, Mainz, Germany
| | - Julian Chalabi
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karsten Keller
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany
- Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Lukas Hobohm
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany
| | - Volker H Schmitt
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp Wild
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Institute for Molecular Biology, Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany
| | - Jörn M Schattenberg
- Metabolic Liver Research Program, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Internal Medicine II, Saarland University Medical Center, Homburg, Germany
| | - Andreas Daiber
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany
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Fieß A, Gißler S, Mildenberger E, Urschitz MS, Laspas P, Stoffelns B, Pfeiffer N, Hartmann A, Schuster AK. Macular morphology is not affected by low or high birthweight in individuals born at term-Results from the Gutenberg Prematurity Eye Study. Acta Ophthalmol 2024. [PMID: 38450902 DOI: 10.1111/aos.16666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/19/2024] [Accepted: 02/24/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sandra Gißler
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Panagotios Laspas
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alica Hartmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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10
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Fieß A, Volmering C, Gißler S, Mildenberger E, Urschitz MS, Laspas P, Stoffelns B, Pfeiffer N, Schuster AK. Macular Curvature in Adults Born Preterm With and Without ROP: Results from the Gutenberg Prematurity Eye Study. Invest Ophthalmol Vis Sci 2024; 65:39. [PMID: 38551582 PMCID: PMC10981436 DOI: 10.1167/iovs.65.3.39] [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: 10/05/2023] [Accepted: 02/19/2024] [Indexed: 04/01/2024] Open
Abstract
Purpose This study investigated the effects of prematurity and retinopathy of prematurity (ROP) as well as the associations of the ocular geometry with macular curvature in adults. Methods The Gutenberg Prematurity Eye Study is a retrospective cohort study of preterm and full-term participants aged 18 to 52 years with a prospective ophthalmologic examination. The main outcome measure was the macular curvature in the central foveal optical coherence tomography (OCT) scan and its associations with gestational age (GA), birth weight and birth weight percentile, ROP occurrence, ROP treatment, and other perinatal factors were evaluated in univariable and multivariable linear regression analyses. Furthermore, a second model assessed the association of ocular geometry with macular curvature. Results In the present study, 550 eyes of 284 adults born preterm and 277 eyes of 139 adults born full-term were examined (aged = 28.7 ± 8.7 years, 240 female subjects). In multivariable analyses for perinatal parameters, ROP treatment (B = -52.44, P = 0.023) and maternal smoking during pregnancy (B = 26.41, P = 0.019) showed an association with macular curvature. Regarding ocular geometric parameters, posterior segment length (B = 9.07, P < 0.001) and subfoveal choroidal thickness (B = -0.26, P < 0.001) were associated with macular curvature, central corneal thickness, anterior chamber depth, lens thickness, and foveal retinal thickness were not associated. Conclusions Adults treated for ROP had relatively more negative curvature values compared to the full-term group, indicating a macular protrusion toward the vitreous cave. A thicker subfoveal choroidal thickness was associated with a flatter macular curvature, whereas a longer posterior segment length was associated with a steeper macular curvature indicating the characteristics of the myopic elongation of the eye.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Christin Volmering
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sandra Gißler
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S. Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Panagiotis Laspas
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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11
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Fieß A, Gißler S, Mildenberger E, Hoffmann EM, Laspas P, Stoffelns B, Pfeiffer N, Hartmann A, Schuster AK. Fetal Growth Restriction Leads to an Enlarged Cup-to-Disc Ratio in Adults Born at Full Term. Am J Ophthalmol 2024; 262:170-177. [PMID: 38360336 DOI: 10.1016/j.ajo.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE This study explores associations between fetal growth restriction or excessive fetal growth, along with perinatal factors on the optic nerve head morphology in adulthood. DESIGN Retrospective cohort study. METHODS This retrospective cohort study involved a prospective ophthalmological examination of individuals born at full term (with a gestational age of ≥37 weeks) from 1969 to 2002. Each participant underwent nonmydriatic fundus camera photography to capture images of the optic discs, followed by manual measurements. The vertical cup-to-disc ratio (VCDR) and optic disc area were examined and analyzed in relation to the baby's birth weight relative to the gestational age. These categories included those with former moderate (birth weight percentile between the 3rd and <10th), severe SGA (below the third percentile), normal (AGA, 10th-90th percentile), and moderately (birth weight >90th-97th percentile) and severely (birth weight >97th percentile) large for gestational age (LGA) adults within the age range of 18 to 52 years. RESULTS Overall, 535 eyes of 280 individuals (age 29.7 ± 9.2 years, 144 females) born at full term were included. Multivariable analysis showed a significant association between a larger VCDR and the severe SGA group (B = 0.05, 95% CI 0.01-0.10; P = .02). In the univariable model, placental insufficiency was associated with VCDR (B = 0.10, 95% CI 0.01-0.19; P = .03). Other perinatal factors did not demonstrate an association with VCDR. Furthermore, there was an indication of an association suggesting a smaller optic disc area in individuals born moderately SGA at full term (B = -0.17, 95% CI -0.33 to -0.001; P = .05). CONCLUSIONS This study provides evidence that individuals born at-term with severe SGA have an increased VCDR, suggesting that fetal growth restriction has a lasting impact on optic disc morphology independent of prematurity throughout adulthood.
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Affiliation(s)
- Achim Fieß
- From the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz (A.F., S.G., E.M.H., P.L., B.S., N.P., A.H., A.K.S.), Mainz, Germany.
| | - Sandra Gißler
- From the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz (A.F., S.G., E.M.H., P.L., B.S., N.P., A.H., A.K.S.), Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University (E.M.), Mainz, Germany
| | - Esther M Hoffmann
- From the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz (A.F., S.G., E.M.H., P.L., B.S., N.P., A.H., A.K.S.), Mainz, Germany
| | - Panagiotis Laspas
- From the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz (A.F., S.G., E.M.H., P.L., B.S., N.P., A.H., A.K.S.), Mainz, Germany
| | - Bernhard Stoffelns
- From the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz (A.F., S.G., E.M.H., P.L., B.S., N.P., A.H., A.K.S.), Mainz, Germany
| | - Norbert Pfeiffer
- From the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz (A.F., S.G., E.M.H., P.L., B.S., N.P., A.H., A.K.S.), Mainz, Germany
| | - Alica Hartmann
- From the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz (A.F., S.G., E.M.H., P.L., B.S., N.P., A.H., A.K.S.), Mainz, Germany
| | - Alexander K Schuster
- From the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz (A.F., S.G., E.M.H., P.L., B.S., N.P., A.H., A.K.S.), Mainz, Germany
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12
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Hopf S, Tüscher O, Schuster AK. [Retinal OCT biomarkers and neurodegenerative diseases of the central nervous system beyond Alzheimer's disease]. Ophthalmologie 2024; 121:93-104. [PMID: 38263475 DOI: 10.1007/s00347-023-01974-7] [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] [Accepted: 12/18/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Optical coherence tomography (OCT) biomarkers are increasingly used by neurologists, psychiatrists, and ophthalmologists for the diagnosis, prognosis, and follow-up of neurodegenerative diseases. Long-term data on OCT biomarkers of selected primary and secondary neurodegenerative diseases of the central nervous system (CNS), such as multiple sclerosis (MS) or Parkinson's disease, are already available in part. In addition, there are rare neurodegenerative diseases with early disease onset that may show OCT abnormalities. METHODS A literature review on the association of OCT biomarkers with neurodegenerative diseases of the CNS beyond Alzheimer's disease is presented. Parkinson's disease, MS, Friedreich's ataxia, Huntington's disease, spinocerebellar ataxia, and lysosomal storage diseases are addressed. RESULTS Relevant OCT biomarkers of neurodegenerative diseases are the macular ganglion cell inner plexiform layer (GCIPL) and the peripapillary retinal nerve fiber layer (pRNFL) thickness. Different sectors may be affected depending on the disease entity in addition to global pRFNL reduction. OCT‑angiography (OCT-A) is also increasingly used as a biomarker in neurodegenerative diseases. CONCLUSION Optical coherence tomography biomarkers are used in an interdisciplinary context. Retinal pathologies should be excluded by an ophthalmologist. While OCT biomarkers are increasingly used clinically in MS, the benefit in other neurodegenerative diseases, especially the rare ones, is less well documented. Further longitudinal studies are required.
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Affiliation(s)
- Susanne Hopf
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
| | - Oliver Tüscher
- Zentrum für seltene Erkrankungen des Nervensystems (ZSEN) Mainz und Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Alexander K Schuster
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland
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13
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Fieß A, Schultheis A, Mildenberger E, Urschitz MS, Stoffelns B, Pfeiffer N, Schuster AK. Ocular geometry in adults born small, appropriate or large for gestational age at term. Acta Ophthalmol 2024; 102:e86-e93. [PMID: 37070484 DOI: 10.1111/aos.15672] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/07/2023] [Accepted: 03/27/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE Intrauterine growth restriction leading to a birth weight (BW) which is too low for gestational age (GA) is a known risk factor for various altered organ morphologies and dysfunction in later life. This study aimed to determine for the first time the effects of being small (SGA) or large for gestational age (LGA) on the ocular geometry of adults born at term. METHODS All participants were examined with optical biometry (LenStar 900, Haag Streit) to compare the corneal curvature, white-to-white distance, anterior chamber depth, lens thickness and axial length between former moderate (BW percentile 3rd to <10th) and severe (BW <3rd percentile) SGA, controls (BW 10th-90th percentile) and former moderate (BW >90th to 97th percentile) and severe (BW >97th percentile) LGA. Multivariable linear regression was used to analyse associations with GA, BW percentile categories, placental insufficiency, preeclampsia and breastfeeding after adjustment for age and sex. RESULTS In total, 589 eyes of 296 individuals born at term (aged 30.0 ± 9.4 years, 156 females) were examined, including 40 severe SGA, 38 moderate SGA, 140 with normal BW, 38 moderate LGA and 40 severe LGA. There was an association between a steeper corneal curvature with moderate (B = -0.201; p < 0.001) and severe SGA (B = -0.199; p < 0.001), with extreme SGA associated with smaller white-to-white (B = -0.263; p = 0.001) and a shorter axial length (B = -0.524; p = 0.031). CONCLUSIONS Severe and moderate prenatal growth restriction in adults born at term leads to an altered ocular geometry, namely a steepening of the cornea and a smaller corneal diameter.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anna Schultheis
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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14
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Voigt AM, Grabitz S, Hoffmann EM, Schuster AK. Systemic Diseases in Primary Open-Angle Glaucoma. Klin Monbl Augenheilkd 2024; 241:170-176. [PMID: 38412981 DOI: 10.1055/a-2239-0123] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Primary open-angle glaucoma is a neurodegenerative disease with progressive chronic optic neuropathy and corresponding visual field defects. In this literature review, we discuss systemic diseases and their mechanism for developing glaucoma, including systemic hypertension and hypotension, diabetes, dyslipidemia, obstructive sleep apnoea syndrome, chronic kidney disease, migraine, and polypharmacy.
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Affiliation(s)
- Anna Maria Voigt
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Deutschland
| | - Stephanie Grabitz
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Deutschland
| | - Esther Maria Hoffmann
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Deutschland
| | - Alexander K Schuster
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Deutschland
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15
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Hahad O, Gilan DA, Chalabi J, Al-Kindi S, Schuster AK, Wicke F, Büttner M, Tüscher O, Lackner KJ, Galle PR, Konstantinides S, Daiber A, Wild PS, Münzel T. Cumulative social disadvantage and cardiovascular disease burden and mortality. Eur J Prev Cardiol 2024; 31:40-48. [PMID: 37721449 DOI: 10.1093/eurjpc/zwad264] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 09/19/2023]
Abstract
AIMS To investigate the association between cumulative social disadvantage and cardiovascular burden and mortality in a large cohort of the general population. METHODS AND RESULTS Cross-sectional (n = 15 010, aged 35 to 74 years, baseline investigation period 2007 to 2012) and longitudinal data (5- and 10-year follow-ups from 2012 to 2022) from the Gutenberg Health Study were used to investigate the association between individual socioeconomic status (SES, measured via a validated questionnaire) and cardiovascular disease (CVD, composite of atrial fibrillation, coronary artery disease, myocardial infarction, stroke, chronic heart failure, peripheral artery disease, and/or venous thromboembolism) risk and mortality. Subjects with prevalent CVD had a lower SES sum score, as well as lower education, occupation, and household net-income scores (all P < 0.0001). Logistic regression analysis showed that a low SES (vs. high, defined by validated cut-offs) was associated with 19% higher odds of prevalent CVD [odds ratio (OR) 1.19, 95% CI 1.01; 1.40] in the fully adjusted model. At 5-year follow-up, low SES was associated with both increased cardiovascular [hazard ratio (HR) 5.36, 2.24; 12.82] and all-cause mortality (HR 2.23, 1.51; 3.31). At 10-year follow-up, low SES was associated with a 68% higher risk of incident CVD (OR 1.68, 1.12; 2.47) as well as 86% higher all-cause mortality (HR 1.86, 1.55; 2.24). In general, the education and occupation scores were stronger related to risk of CVD and death than the household net-income score. Low SES was estimated to account for 451.45 disability-adjusted life years per 1000 people (years lived with disability 373.41/1000 and years of life lost 78.03/1000) and an incidence rate of 11 CVD cases and 3.47 CVD deaths per 1000 people per year. The population attributable fraction for CVD incidence after 5 years was 4% due to low SES. CONCLUSION Despite universal healthcare access, cumulative social disadvantage remains associated with higher risk of CVD and mortality. Dimensions of education and occupation, but not household net income, are associated with outcomes of interest.
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Affiliation(s)
- Omar Hahad
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Donya A Gilan
- Leibniz Institute for Resilience Research (LIR), Wallstraße 7, 55122 Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
| | - Julian Chalabi
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Sadeer Al-Kindi
- Department of Medicine, University Hospitals, Harrington Heart & Vascular Institute, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106, USA
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Felix Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
| | - Matthias Büttner
- Institute of Medical Biostatistics, Epidemiology & Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Rhabanusstraße 3/Tower A, 55118 Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR), Wallstraße 7, 55122 Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Peter R Galle
- Department of Internal Medicine, Gastroenterology and Hepatology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Stavros Konstantinides
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Philipp S Wild
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstraße 1, 55131 Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Institute for Molecular Biology, Ackermannweg 4, 55128 Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
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16
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Hartmann A, Scholz I, Hoffmann EM, Strzalkowska A, Lackner KJ, Münzel T, Wicke FS, Schmidtmann I, Tüscher O, Schattenberg JM, Konstantinides S, Wild PS, Pfeiffer N, Schuster AK. Change of Intraocular Pressure Over 5 Years and its Relationship to Cardiovascular Parameters: Results From the Gutenberg Health Study. Invest Ophthalmol Vis Sci 2024; 65:12. [PMID: 38175640 PMCID: PMC10774695 DOI: 10.1167/iovs.65.1.12] [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: 05/15/2023] [Accepted: 11/12/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose To investigate the longitudinal change in intraocular pressure (IOP) over 5 years and its relationship with cardiovascular parameters in a population-based sample in Germany. Methods The Gutenberg Health Study is a prospective, observational, single-center cohort study. The sample was equally stratified for sex, residence, and age decade. IOP was measured with noncontact tonometry at baseline and at 5-year follow-up. Cardiovascular parameters, including body mass index (BMI), systolic blood pressure, and diabetes status, were assessed. Participants without IOP measurement at one time point, who were taking IOP-lowering medications, or who had ophthalmic surgery during the 5-year follow-up interval were excluded, as well as those with glaucoma diagnosis. Univariable and multivariable linear regression analyses were conducted. Results This analysis included 9633 participants (48.9% female). The mean IOP increased from 14.04 ± 2.78 mmHg at baseline to 14.77 ± 2.92 mmHg at 5-year follow-up (P < 0.001). In multivariable linear regression analyses, an increase in BMI was associated with an increase in IOP over time (P < 0.001), whereas a higher baseline BMI was associated with a lower IOP change (P < 0.001). Higher age and male sex were associated with higher IOP change (P < 0.001). A change in systolic blood pressure was associated with IOP change, whereas baseline systolic blood pressure and diabetes status were not associated. Conclusions This population-based study found a relationship between IOP change over 5 years and BMI and systolic blood pressure change, respectively. These findings suggest the importance of monitoring cardiovascular risk factors in IOP management.
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Affiliation(s)
- Alica Hartmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ida Scholz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Esther M. Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alicja Strzalkowska
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology–Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Felix S. Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biometry, Epidemiology and Informatics, Mainz, Germany
| | - Oliver Tüscher
- Institute of Molecular Biology, Mainz, Germany
- Clinic for Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Jörn M. Schattenberg
- Metabolic Liver Research Center and Medicine, University Medical Center, Mainz, Germany
| | | | - Philipp S. Wild
- Institute of Molecular Biology, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Strzalkowska A, Hoffmann EM, Strzalkowski P, Stingl JV, Pfeiffer N, Schuster AK. Publisher Erratum: Real-world-Ergebnisse von glaukomchirurgischen Verfahren beim Offenwinkelglaukom. Ophthalmologie 2024; 121:61. [PMID: 38277056 DOI: 10.1007/s00347-023-01973-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Affiliation(s)
- Alicja Strzalkowska
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - Esther M Hoffmann
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | | | - Julia V Stingl
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Norbert Pfeiffer
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Alexander K Schuster
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
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18
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Tesarz J, Schuster AK, Mildenberger E, Urschitz MS, Ernst M, Beutel M, Hermes M, Stoffelns B, Zepp F, Pfeiffer N, Fieß A. Impact of preterm birth on the onset of panic disorder in later life - Results from the Gutenberg Prematurity Study (GPS). J Psychiatr Res 2024; 169:201-208. [PMID: 38043256 DOI: 10.1016/j.jpsychires.2023.11.017] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/30/2023] [Accepted: 11/15/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The present study aimed to investigate whether prematurity and perinatal stress exert long-term effects on the onset of panic disorder in later life. METHODS From 40,189 adults born in Germany between 1969 and 2002, a study cohort (n = 427) stratified by gestational age (GA) (extremely preterm: GA < 29 weeks; very preterm: GA 29-32 weeks; moderately preterm: GA 33-36 weeks; and full-term GA ≥ 37 weeks) was selected (age 28.5 ± 8.7 years). Multivariable logistic regression analyses were conducted to investigate associations between gestational age at birth and panic disorder adjusting for age, gender, socioeconomic status, and perinatal factors. RESULTS The prevalence of panic disorder was roughly equal in moderate to very preterm and full-term birth groups at 1.9%-3.8%. However, this rate significantly increased to 14.3% in the extreme preterm category (GA <2 9: 14.3 %, p = 0.002). In multivariable analyses, female gender and GA were independently associated with panic disorder. Adjusting for age, gender and socioeconomic status, panic disorder was associated with lower GA at birth (OR = 1.12 per week (CI95%: 1.01-1.26, p = 0.037). Whereas adjustment for nutrition status or indicators of perinatal stress had no effect, correction for the length of postnatal ICU-stay eliminated the association between preterm birth and later panic disorder. LIMITATIONS Limitations include the small number of cases and the reliance on questionnaires to assess mental status. CONCLUSIONS Prematurity likely increases the risk of panic disorder later in life, and the subsequent postnatal ICU-stay appears to be of critical importance. However, due to strong collinearity and other associated factors with preterm births, it remains unclear which is the primary determinant.
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Affiliation(s)
- Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michelle Hermes
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Fred Zepp
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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19
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Görig T, Schuster AK, Breitbart EW, Diehl K. [Use of sunglasses in everyday life, at work, and during outdoor sports: current results from nationwide surveys]. Ophthalmologie 2024; 121:11-17. [PMID: 37755498 DOI: 10.1007/s00347-023-01924-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Ultraviolet (UV) radiation can increase the risk of eye damage. Therefore, wearing sunglasses is recommended to protect the eyes from UV rays. OBJECTIVE To report the latest data on the use of sunglasses in everyday life in adults, children, at work, and during outdoor sports. MATERIAL AND METHODS We used data from waves 2020 and 2021 from the representative National Cancer Aid Monitoring (NCAM). The use of sunglasses in everyday life was assessed in 4000 participants aged 16-65 years. Data on use during outdoor work were obtained from 486 outdoor workers and the use of sunglasses during outdoor sports from 2081 participants. Additionally, 554 adults living in a household with at least 1 child aged 1-10 years reported the use of sunglasses by children. Descriptive results and associations with demographic characteristics are reported. RESULTS Overall, 50.6% of the general population, 31.0% of outdoor workers, 44.3% of those who reported being engaged in outdoor sports and 12.5% of children wore sunglasses always or often while being outside for more than 10 min in summer. The infrequent use of sunglasses was associated with a younger age, male sex, and lower school education. CONCLUSION Because of the relatively low use of sunglasses further education in various settings (e.g., at the workplace, kindergartens, and schools) seems necessary. The general public should also be made aware of the risks of UV radiation for the eyes, especially against the background of climate change.
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Affiliation(s)
- Tatiana Görig
- Professur für Epidemiologie und Public Health, Institut für Medizininformatik, Biometrie und Epidemiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Waldstr. 6, 91054, Erlangen, Deutschland.
| | | | - Eckhard W Breitbart
- Arbeitsgemeinschaft Dermatologische Prävention e. V., Buxtehude, Deutschland
| | - Katharina Diehl
- Professur für Epidemiologie und Public Health, Institut für Medizininformatik, Biometrie und Epidemiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Waldstr. 6, 91054, Erlangen, Deutschland
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20
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Baumkötter R, Yilmaz S, Zahn D, Schulz A, Prochaska JH, Hettich-Damm N, Schmidtmann I, Schuster AK, Lackner KJ, Münzel T, Beutel ME, Wild PS. Predictors for COVID-19 Vaccine Hesitancy in a Population-Based Cohort Study. Dtsch Arztebl Int 2023; 120:886-887. [PMID: 38315654 PMCID: PMC10859747 DOI: 10.3238/arztebl.m2023.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 02/07/2024]
Affiliation(s)
- Rieke Baumkötter
- Preventive Cardiology and Medical Prevention, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz;
- German Center for Cardiovascular Research, partner site Rhine Main, Mainz
| | - Simge Yilmaz
- Preventive Cardiology and Medical Prevention, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz;
- German Center for Cardiovascular Research, partner site Rhine Main, Mainz
| | - Daniela Zahn
- Preventive Cardiology and Medical Prevention, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz;
- German Center for Cardiovascular Research, partner site Rhine Main, Mainz
| | - Andreas Schulz
- Preventive Cardiology and Medical Prevention, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz;
| | - Jürgen H. Prochaska
- Preventive Cardiology and Medical Prevention, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz;
- German Center for Cardiovascular Research, partner site Rhine Main, Mainz
- Center for Thrombosis and Hemostasis, JUniversity Medical Center of the Johannes Gutenberg University Mainz
| | - Nora Hettich-Damm
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center, University Medical Center of the Johannes Gutenberg University Mainz
| | - Karl J. Lackner
- German Center for Cardiovascular Research, partner site Rhine Main, Mainz
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz
| | - Thomas Münzel
- German Center for Cardiovascular Research, partner site Rhine Main, Mainz
- Cardiology 1, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz
| | - Philipp S. Wild
- Preventive Cardiology and Medical Prevention, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz;
- German Center for Cardiovascular Research, partner site Rhine Main, Mainz
- Center for Thrombosis and Hemostasis, JUniversity Medical Center of the Johannes Gutenberg University Mainz
- Institute of Molecular Biology, Mainz
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21
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Mauschitz MM, Verzijden T, Schuster AK, Elbaz H, Pfeiffer N, Khawaja A, Luben RN, Foster PJ, Rauscher FG, Wirkner K, Kirsten T, Jonas JB, Bikbov MM, Hogg R, Peto T, Cougnard-Grégoire A, Bertelsen G, Erke MG, Topouzis F, Giannoulis DA, Brandl C, Heid IM, Creuzot-Garcher CP, Gabrielle PH, Hense HW, Pauleikhoff D, Barreto P, Coimbra R, Piermarocchi S, Daien V, Holz FG, Delcourt C, Finger RP. Association of lipid-lowering drugs and antidiabetic drugs with age-related macular degeneration: a meta-analysis in Europeans. Br J Ophthalmol 2023; 107:1880-1886. [PMID: 36344262 DOI: 10.1136/bjo-2022-321985] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/27/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/AIMS To investigate the association of commonly used systemic medications with prevalent age-related macular degeneration (AMD) in the general population. METHODS We included 38 694 adults from 14 population-based and hospital-based studies from the European Eye Epidemiology consortium. We examined associations between the use of systemic medications and any prevalent AMD as well as any late AMD using multivariable logistic regression modelling per study and pooled results using random effects meta-analysis. RESULTS Between studies, mean age ranged from 61.5±7.1 to 82.6±3.8 years and prevalence ranged from 12.1% to 64.5% and from 0.5% to 35.5% for any and late AMD, respectively. In the meta-analysis of fully adjusted multivariable models, lipid-lowering drugs (LLD) and antidiabetic drugs were associated with lower prevalent any AMD (OR 0.85, 95% CI=0.79 to 0.91 and OR 0.78, 95% CI=0.66 to 0.91). We found no association with late AMD or with any other medication. CONCLUSION Our study indicates a potential beneficial effect of LLD and antidiabetic drug use on prevalence of AMD across multiple European cohorts. Our findings support the importance of metabolic processes in the multifactorial aetiology of AMD.
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Affiliation(s)
| | - Timo Verzijden
- Department of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Hisham Elbaz
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Anthony Khawaja
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Robert N Luben
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Paul J Foster
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK
| | - Franziska G Rauscher
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, 04107 Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany
| | - Kerstin Wirkner
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, 04107 Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany
| | - Toralf Kirsten
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, 04107 Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany
- Leipzig University Medical Center, Medical Informatics Center - Dept. of Medical Data Science, 04107 Leipzig, Germany
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | | | - Ruth Hogg
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Tunde Peto
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Audrey Cougnard-Grégoire
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Team LEHA, F-33000 Bordeaux, France
| | - Geir Bertelsen
- Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
- Department of Ophthalmology, University Hospital of North Norway, Tromsø, Norway
| | - Maja Gran Erke
- Directorate of eHealth, Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Fotis Topouzis
- Department of Ophthalmology, Aristotle University of Thessaloniki, School of Medicine, AHEPA Hospital, Thessaloniki, Greece
| | - Dimitrios A Giannoulis
- Department of Ophthalmology, Aristotle University of Thessaloniki, School of Medicine, AHEPA Hospital, Thessaloniki, Greece
| | - Caroline Brandl
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
- Department of Ophthalmology, University Hospital Regensburg, Regensburg, Germany
| | - Iris M Heid
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | | | | | - Hans-Werner Hense
- University of Münster, Faculty of Medicine, Institute of Epidemiology, Münster, Germany
| | | | - Patricia Barreto
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, Coimbra, Portugal
- Univ Coimbra, Centre for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
| | - Rita Coimbra
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Stefano Piermarocchi
- Padova-Camposampiero Hospital, Padova, Italy
- University of Padova, Department of Neuroscience, Padova, Italy
| | - Vincent Daien
- Department of Ophthalmology, Gui de Chauliac Hospital, F-34000 Montpellier, France
- Institute for Neurosciences of Montpellier INM, Univ. Montpellier, INSERM, F-34091 Montpellier, France
- The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Frank G Holz
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Cecile Delcourt
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Team LEHA, F-33000 Bordeaux, France
| | - Robert P Finger
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
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22
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Schuster AK. [Healthcare research in glaucoma]. Ophthalmologie 2023; 120:1086-1087. [PMID: 37921909 DOI: 10.1007/s00347-023-01944-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 11/05/2023]
Affiliation(s)
- Alexander K Schuster
- Augenklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
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23
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Stingl JV, Greslechner R, Brandl C, Heid IM, Hoffmann EM, Pfeiffer N, Schuster AK. [Awareness for glaucoma in the general population]. Ophthalmologie 2023; 120:1088-1097. [PMID: 37847376 DOI: 10.1007/s00347-023-01943-0] [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] [Accepted: 09/18/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Glaucoma is not a rare entity but because very few symptoms occur and visual field defects are frequently first recognized at a late stage, a large proportion of glaucoma diseases remain undetected. The aim of this study was to identify the proportion of undiagnosed glaucoma in German population-based cohort studies and to contextualize them in the context of the literature. MATERIAL AND METHODS The prevalence of glaucoma in the Gutenberg Health Study (GHS) and the age-related investigations on health of the University of Regensburg (AugUR) was evaluated based on visual field examinations and optic disc color photography according to the ISGEO criteria. Furthermore, the self-reported glaucoma diagnoses were collected and the proportion of undiagnosed glaucoma was determined. RESULTS The proportion of undiagnosed glaucoma was 55% in the GHS, and 53% in the AugUR study. The results correlate with results from previous studies from other countries in which the proportion of unrecognized glaucoma ranged from 33% to 78%. In the GHS and the AugUR study the proportion of undiagnosed glaucoma was higher in younger age groups and in women. DISCUSSION Roughly every second case of glaucoma is undetected. As the symptoms are often nonspecific or take a long time to appear, there is a risk of advanced glaucomatous visual field defects or blindness due to a lack of glaucoma awareness. Studies have shown that a systematic screening can halve this risk.
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Affiliation(s)
- Julia V Stingl
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - R Greslechner
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Caroline Brandl
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland
- Lehrstuhl für Genetische Epidemiologie, Universität Regensburg, Regensburg, Deutschland
| | - Iris M Heid
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Esther M Hoffmann
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Norbert Pfeiffer
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Alexander K Schuster
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
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24
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Strzalkowska A, Hoffmann EM, Strzalkowski P, Stingl JV, Pfeiffer N, Schuster AK. [Real-world outcomes of glaucoma surgical procedures for open-angle glaucoma]. Ophthalmologie 2023; 120:1107-1116. [PMID: 37880486 DOI: 10.1007/s00347-023-01941-2] [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] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/27/2023]
Abstract
This article provides an overview of real-world outcomes in glaucoma surgical procedures. While randomized clinical trials provide valuable insights, they do not fully reflect real-world clinical practice. Real-world studies enable the evaluation of outcomes in uncontrolled settings and play a crucial role in counselling and decision-making for glaucoma treatment. By examining real-world data the article aims to identify rare adverse events that may go unnoticed in controlled clinical trials. The focus is on assessing the effectiveness and safety of glaucoma surgical procedures beyond the controlled trial setting.
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Affiliation(s)
- Alicja Strzalkowska
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - Esther M Hoffmann
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | | | - Julia V Stingl
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Norbert Pfeiffer
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Alexander K Schuster
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
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Korb CA, Lackner KJ, Wolters D, Schuster AK, Nickels S, Beutgen VM, Münzel T, Wild PS, Beutel ME, Schmidtmann I, Pfeiffer N, Grus FH. Association of autoantibody levels with different stages of age-related macular degeneration (AMD): Results from the population-based Gutenberg Health Study (GHS). Graefes Arch Clin Exp Ophthalmol 2023; 261:2763-2773. [PMID: 37160502 PMCID: PMC10543519 DOI: 10.1007/s00417-023-06085-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/17/2023] [Accepted: 04/21/2023] [Indexed: 05/11/2023] Open
Abstract
PURPOSE Anti-retinal autoantibodies are assumed to be associated with age-related macular degeneration (AMD). To our knowledge, this is the first evaluation of autoantibodies in human sera of participants with different stages of AMD in a large population-based, observational cohort study in Germany. METHODS The Gutenberg Health Study (GHS) is a population-based, observational cohort study in Germany, including 15,010 participants aged between 35 and 74. Amongst others, non-mydriatic fundus photography (Visucam PRO NM™, Carl Zeiss Meditec AG, Jena, Germany) was performed. Fundus images of the first 5000 participants were graded based on the Rotterdam Eye Study classification. Sera of participants with AMD (n=541) and sera of age-matched participants without AMD (n=490) were analyzed by antigen-microarrays. Besides descriptive statistics, autoantibody-levels were compared by Mann-Whitney-U test and the associations of level of autoantibodies with AMD were calculated by logistic regression analysis. Likewise, possible associations of the autoantibodies and both clinical and laboratory parameters on AMD subjects were analyzed. RESULTS Autoantibodies against transferrin (p<0.001) were significantly downregulated in participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only compared to Controls. Mitogen-activated protein kinase 3 (p=0.041), glutathione peroxidase 4 (p=0.048), clusterin (p=0.045), lysozyme (p=0.19), protein kinase C substrate 80K-H (p=0.02), heat shock 70 kDa protein 1A (p=0.04) and insulin (p=0.018) show a trend between Control and participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only. CONCLUSIONS This study contributes to a growing knowledge of autoantibodies in association with different AMD stages compared to controls in the context of a large population-based study in Germany. Especially autoantibodies against inflammatory proteins were downregulated in participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only.
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Affiliation(s)
- Christina A Korb
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
| | - Karl J Lackner
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Dominik Wolters
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Stefan Nickels
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Vanessa M Beutgen
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine Main, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Franz H Grus
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
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Ten Cate V, Rapp S, Schulz A, Pallares Robles A, Jurk K, Koeck T, Espinola-Klein C, Halank M, Seyfarth HJ, Beutel ME, Schuster AK, Marini F, Hobohm L, Lankeit M, Lackner KJ, Ruf W, Münzel T, Andrade-Navarro MA, Prochaska JH, Konstantinides SV, Wild PS. Circulating microRNAs predict recurrence and death following venous thromboembolism. J Thromb Haemost 2023; 21:2797-2810. [PMID: 37481073 DOI: 10.1016/j.jtha.2023.07.010] [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: 01/25/2023] [Revised: 06/10/2023] [Accepted: 07/07/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Recurrent events frequently occur after venous thromboembolism (VTE) and remain difficult to predict based on established genetic, clinical, and proteomic contributors. The role of circulating microRNAs (miRNAs) has yet to be explored in detail. OBJECTIVES To identify circulating miRNAs predictive of recurrent VTE or death, and to interpret their mechanistic involvement. METHODS Data from 181 participants of a cohort study of acute VTE and 302 individuals with a history of VTE from a population-based cohort were investigated. Next-generation sequencing was performed on EDTA plasma samples to detect circulating miRNAs. The endpoint of interest was recurrent VTE or death. Penalized regression was applied to identify an outcome-relevant miRNA signature, and results were validated in the population-based cohort. The involvement of miRNAs in coregulatory networks was assessed using principal component analysis, and the associated clinical and molecular phenotypes were investigated. Mechanistic insights were obtained from target gene and pathway enrichment analyses. RESULTS A total of 1950 miRNAs were detected across cohorts after postprocessing. In the discovery cohort, 50 miRNAs were associated with recurrent VTE or death (cross-validated C-index, 0.65). A weighted miRNA score predicted outcome over an 8-year follow-up period (HRSD, 2.39; 95% CI, 1.98-2.88; P < .0001). The independent validation cohort validated 20 miRNAs (ORSD for score, 3.47; 95% CI, 2.37-5.07; P < .0001; cross-validated-area under the curve, 0.61). Principal component analysis revealed 5 miRNA networks with distinct relationships to clinical phenotype and outcome. Mapping of target genes indicated regulation via transcription factors and kinases involved in signaling pathways associated with fibrinolysis. CONCLUSION Circulating miRNAs predicted the risk of recurrence or death after VTE over several years, both in the acute and chronic phases.
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Affiliation(s)
- Vincent Ten Cate
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Partner Site Rhine-Main, German Centre for Cardiovascular Research (DZHK), Mainz, Germany. https://twitter.com/cesm_mainz
| | - Steffen Rapp
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alejandro Pallares Robles
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Kerstin Jurk
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Partner Site Rhine-Main, German Centre for Cardiovascular Research (DZHK), Mainz, Germany
| | - Thomas Koeck
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Christine Espinola-Klein
- Department of Angiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael Halank
- Department of Internal Medicine I and Pulmonology, Carl Gustav Carus Hospital, University of Dresden, Dresden, Germany
| | | | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Federico Marini
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Lukas Hobohm
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mareike Lankeit
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Internal Medicine and Cardiology, Campus Virchow Klinikum (CVK), Charité - University Medicine Berlin, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Wolfram Ruf
- Partner Site Rhine-Main, German Centre for Cardiovascular Research (DZHK), Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Immunology and Microbiology, Scripps Research, La Jolla, California, USA
| | - Thomas Münzel
- Partner Site Rhine-Main, German Centre for Cardiovascular Research (DZHK), Mainz, Germany; Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Miguel A Andrade-Navarro
- Institute of Organismic and Molecular Evolution, Faculty of Biology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jürgen H Prochaska
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Partner Site Rhine-Main, German Centre for Cardiovascular Research (DZHK), Mainz, Germany
| | - Stavros V Konstantinides
- Department of Internal Medicine and Cardiology, Campus Virchow Klinikum (CVK), Charité - University Medicine Berlin, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Partner Site Rhine-Main, German Centre for Cardiovascular Research (DZHK), Mainz, Germany; Institute of Molecular Biology (IMB), Mainz, Germany.
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Vergroesen JE, Schuster AK, Stuart KV, Asefa NG, Cougnard-Grégoire A, Delcourt C, Schweitzer C, Barreto P, Coimbra R, Foster PJ, Luben RN, Pfeiffer N, Stingl JV, Kirsten T, Rauscher FG, Wirkner K, Jansonius NM, Arnould L, Creuzot-Garcher CP, Stricker BH, Keskini C, Topouzis F, Bertelsen G, Eggen AE, Bikbov MM, Jonas JB, Klaver CCW, Ramdas WD, Khawaja AP. Association of Systemic Medication Use with Glaucoma and Intraocular Pressure: The European Eye Epidemiology Consortium. Ophthalmology 2023; 130:893-906. [PMID: 37150298 DOI: 10.1016/j.ophtha.2023.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 04/17/2023] [Accepted: 05/01/2023] [Indexed: 05/09/2023] Open
Abstract
PURPOSE To investigate the association of commonly used systemic medications with glaucoma and intraocular pressure (IOP) in the European population. DESIGN Meta-analysis of 11 population-based cohort studies of the European Eye Epidemiology Consortium. PARTICIPANTS The glaucoma analyses included 143 240 participants and the IOP analyses included 47 177 participants. METHODS We examined associations of 4 categories of systemic medications-antihypertensive medications (β-blockers, diuretics, calcium channel blockers [CCBs], α-agonists, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers), lipid-lowering medications, antidepressants, and antidiabetic medications-with glaucoma prevalence and IOP. Glaucoma ascertainment and IOP measurement method were according to individual study protocols. Results of multivariable regression analyses of each study were pooled using random effects meta-analyses. Associations with antidiabetic medications were examined in participants with diabetes only. MAIN OUTCOME MEASURES Glaucoma prevalence and IOP. RESULTS In the meta-analyses of our maximally adjusted multivariable models, use of CCBs was associated with a higher prevalence of glaucoma (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.08 to 1.39). This association was stronger for monotherapy of CCBs with direct cardiac effects (OR, 1.96; 95% CI, 1.23 to 3.12). No other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were associated with glaucoma. Use of systemic β-blockers was associated with a lower IOP (β coefficient, -0.33 mmHg; 95% CI, -0.57 to -0.08 mmHg). Monotherapy of both selective systemic β-blockers (β coefficient, -0.45 mmHg; 95% CI -0.74 to -0.16 mmHg) and nonselective systemic β-blockers (β coefficient, -0.54 mmHg; 95% CI, -0.94 to -0.15 mmHg) was associated with lower IOP. A suggestive association was found between use of high-ceiling diuretics and lower IOP (β coefficient, -0.30 mmHg; 95% CI, -0.47 to -0.14 mmHg) but not when used as monotherapy. No other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were associated with IOP. CONCLUSIONS We identified a potentially harmful association between use of CCBs and glaucoma prevalence. Additionally, we observed and quantified the association of lower IOP with systemic β-blocker use. Both findings potentially are important, given that patients with glaucoma frequently use systemic antihypertensive medications. Determining causality of the CCB association should be a research priority. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Joëlle E Vergroesen
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Kelsey V Stuart
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
| | - Nigus G Asefa
- Department of Ophthalmology, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Cécile Delcourt
- INSERM, BPH, U1219, Université de Bordeaux, Bordeaux, France
| | - Cédric Schweitzer
- INSERM, BPH, U1219, Université de Bordeaux, Bordeaux, France; Department of Ophthalmology, CHU de Bordeaux, Bordeaux, France
| | - Patrícia Barreto
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; University of Coimbra, Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine (iCBR- FMUC), Coimbra, Portugal
| | - Rita Coimbra
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Paul J Foster
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
| | - Robert N Luben
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Julia V Stingl
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Toralf Kirsten
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany; Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany; Medical Informatics Center, Department of Medical Data Science, Leipzig University Medical Center, Leipzig, Germany
| | - Franziska G Rauscher
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany; Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Kerstin Wirkner
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany; Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Nomdo M Jansonius
- Department of Ophthalmology, University Medical Center Groningen, Groningen, The Netherlands
| | - Louis Arnould
- Department of Ophthalmology, University Hospital, Dijon, France
| | | | - Bruno H Stricker
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Christina Keskini
- First Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fotis Topouzis
- First Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Geir Bertelsen
- Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Anne E Eggen
- Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | | | - Jost B Jonas
- Ufa Eye Research Institute, Ufa, Russia; Institute of Molecular and Clinical Ophthalmology, University of Basel, Basel, Switzerland; Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Institute of Molecular and Clinical Ophthalmology, University of Basel, Basel, Switzerland; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wishal D Ramdas
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
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Riedl JC, Pfeffer N, Giers BC, Schuster AK, Vossmerbaeumer U. Postoperative results after iris reconstruction with an Artificialiris ® implant with consideration of the cause of the iris defects. Eur J Ophthalmol 2023; 33:1946-1951. [PMID: 36788137 DOI: 10.1177/11206721231156204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
PURPOSE To test the hypothesis that severely damaged eyes are more likely to experience postoperative complications after an ArtificialIris® (AI) implantation than other iris defects. METHODS Patients after iris reconstruction with an AI were included in this consecutive case series of the Department of Ophthalmology, University of Mainz, Germany. Best-corrected visual acuity (BCVA), objective refraction (KR 8900 Topcon, Tokyo, Japan) and Scheimpflug imaging of the anterior segment with Pentacam® (Oculus, Wetzlar, Germany)and postoperative complications were evaluated. RESULTS Thirty-two eyes of 32 patients after AI implantation were included, separated in partial or total aniridia in a closed globe (group 1, n = 16) and after perforating globe injury (group 2, n = 16). Two or more previous surgeries in the corresponding eye were found in two patients (12.5%) in group 1 and eleven patients (69%) in group 2 (p = 0.001). The time span between initial trauma or iris defect and AI implantation was not significantly related to the occurrence and severity of postoperative complications (p = 0.89). Postoperative complications were classified into mild and severe and showed no differences between group 1 and group 2 (mild: 1 vs. 0; p = 0.52; severe: 5 vs. 6 p = 0.8). CONCLUSION AI implantation is a treatment option for various iris defects. An individual, case-based decision should be made with strict indication also considering other possible methods for pupil reconstruction. The postoperative outcome is not affected by the time point of AI implantation. So, an implantation is already possible as early as six weeks after the previous trauma.
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Affiliation(s)
- Jana C Riedl
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Nora Pfeffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Bert C Giers
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Urs Vossmerbaeumer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
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29
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Ernst M, Schuster AK, Mildenberger E, Otten D, Brähler E, Tesarz J, Urschitz MS, Pfeiffer N, Beutel ME, Fieß A. Recalled parental rearing behavior shapes mental health after preterm birth: Evidence from the Gutenberg Prematurity Study. Psychiatry Res 2023; 327:115374. [PMID: 37574598 DOI: 10.1016/j.psychres.2023.115374] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 07/14/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023]
Abstract
Associations of preterm birth with later-life mental distress are well-established. A research gap concerns the role of psychosocial factors such as the family context. This study investigated associations of recalled parental rearing behavior with both preterm birth characteristics and psychological symptom burden later in life. Based on birth registry data of the Mainz University Hospital in Germany (infants born between 1969 and 2002) and using a selection algorithm, a cohort study comprising four gestational age (GA) strata was conducted (≥ 37 weeks: n = 138; 33-36 weeks: n = 132; 29-32 weeks: n = 106; ≤ 28 weeks: n = 132). Participants underwent a medical examination and completed standardized questionnaires. We investigated differences in dimensions of recalled parental rearing behavior according to GA and tested pre-/perinatal stress indicators and recalled parental rearing behavior as statistical predictors of depression and anxiety symptoms later in life. Lower GA was associated with more recalled emotional warmth and overprotection. Recalled emotional warmth was associated with fewer depression and anxiety symptoms, while recalled overprotection co-occurred with more depression symptoms. The findings indicate the relevance of parental rearing behavior for the offspring's mental health. As preterm birth implicates stress for the whole family requiring adaptive parental behavior, the latter could be an important modifiable risk factor.
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Affiliation(s)
- Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria.
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Child and Adolescent Psychiatry-Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Strzalkowska A, Strzalkowski P, Hoffmann EM, Pfeiffer N, Schuster AK. Outcomes of Open Bleb Revision After PreserFlo MicroShunt Failure in Patients With Glaucoma. J Glaucoma 2023; 32:681-685. [PMID: 37327469 PMCID: PMC10414154 DOI: 10.1097/ijg.0000000000002246] [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: 02/18/2023] [Accepted: 05/13/2023] [Indexed: 06/18/2023]
Abstract
PRCIS After the open bleb revision following PreserFlo, the mean postoperative intraocular pressure (IOP) was lowered from 26.4 ± 9.9 mm Hg to 12.9 ± 5.6 mm Hg at 1 month and 15.9 ± 4.1 mm Hg at 12 months. PURPOSE The purpose of this study was to evaluate the effectiveness and safety of an open bleb revision with mitomycin- C (MMC) for bleb fibrosis after PreserFlo MicroShunt implantation. PATIENTS AND METHODS We performed a retrospective analysis of 27 consecutive patients with bleb fibrosis after PreserFlo MicroShunt Implantation that underwent an open revision with MMC 0.2 mg/mL applied for 3 minutes at the Department of Ophthalmology of the Mainz, University Medical Center, Mainz, Germany. Demographic data, such as age, sex, glaucoma type, number of glaucoma medications, IOP before and after PreserFlo implantation and revision, complications, and reoperations within 12 months, were analyzed. RESULTS Twenty-seven patients (27 eyes) received an open revision after previous PreserFlo Microshunt implantation and consecutive bleb fibrosis. The mean preoperative IOP was 26.4 ± 9.9 mm Hg before revision, 7.0 ± 2.7 mm Hg ( P < 0.001) in the first week after the revision, and 15.9 ± 4.1 mm Hg at 12 months ( P = 0.02). Four patients needed IOP-lowering medication after 12 months. One patient had a positive Seidel test and needed a conjunctival suture. Four patients required a second procedure due to recurring bleb fibrosis. CONCLUSIONS At 12 months, open revision with MMC for bleb fibrosis after failed PreserFlo implantation effectively and safely reduced IOP with a similar medication burden.
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Affiliation(s)
- Alicja Strzalkowska
- Department of Ophthalmology, Mainz University Medical Centre of the Johannes Gutenberg, University of Mainz, Mainz
| | | | - Esther M. Hoffmann
- Department of Ophthalmology, Mainz University Medical Centre of the Johannes Gutenberg, University of Mainz, Mainz
| | - Norbert Pfeiffer
- Department of Ophthalmology, Mainz University Medical Centre of the Johannes Gutenberg, University of Mainz, Mainz
| | - Alexander K. Schuster
- Department of Ophthalmology, Mainz University Medical Centre of the Johannes Gutenberg, University of Mainz, Mainz
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Strzalkowski P, Schuster AK, Strzalkowska A, Steinberg JS, Dithmar S. Semi-automated quantification of vitreal hyperreflective foci in SD-OCT and their relevance in patients with peripheral retinal breaks. BMC Ophthalmol 2023; 23:324. [PMID: 37460946 DOI: 10.1186/s12886-023-03060-7] [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: 05/08/2023] [Accepted: 06/25/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Retinal breaks (RB) are emergencies that require treatment to prevent progression of rhegmatogenous retinal detachment. Vitreal hyperreflective foci (VHF) representing migration of RPE cell clusters or interphotoreceptor matrix from the RB are potential biomarkers. The aim of this study is to investigate VHF in RB-patients using SD-OCT. METHODS The retrospective cross-sectional study included RB patients from our Department of Ophthalmology, HSK Wiesbaden who underwent macular SD-OCT (SPECTRALIS®, Heidelberg Engineering, Germany) on both eyes. VHF, defined and quantified as foci that differ markedly in size and reflectivity from the background speckle pattern, were assessed for presence and frequency. The RB-affected eyes were the study group (G1), the partner eyes the control group (G2). RESULTS 160 consecutive patients with RB were included. Age was 60 ± 10.2 years (52% female). 89.4% of G1 and 87.5% of G2 were phakic (p = 0.73). 94.4% (n = 151) were symptomatic. Symptom duration was 8.0 ± 10.1 days in G1, 94.4% (n = 151) showed VHF versus 5.6% (p < 0.0001) in G2, of which 75% (n = 6) showed asymptomatic lattice degenerations. Detectable VHF showed a strong association of OR = 320 (95% CI, 110-788, p < 0.0001)) with respect to symptomatic RB. Sensitivity and specificity were 94.7% and 94.7%, respectively. CONCLUSIONS Most eyes with symptomatic RB show vitreal VHF in SD-OCT. Detected VHF are strongly associated with RB, and our semi-automated greyscale reflectivity analysis indicates that VHF likely originate from photoreceptor complexes torn out of the RB area that migrate into the vitreous cavity. The presence of VHF may indicate RB and should lead to a thorough fundus examination in both symptomatic and asymptomatic cases.
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Affiliation(s)
- P Strzalkowski
- Department of Ophthalmology, Helios HSK Wiesbaden, Wiesbaden, Germany.
- Department of Ophthalmology, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany.
| | - A K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - A Strzalkowska
- Department of Ophthalmology, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - J S Steinberg
- Department of Ophthalmology, Helios HSK Wiesbaden, Wiesbaden, Germany
| | - S Dithmar
- Department of Ophthalmology, Helios HSK Wiesbaden, Wiesbaden, Germany
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Strzalkowska A, Strzalkowski P, Stingl JV, Pfeiffer N, Schuster AK, Hoffmann EM. Influence of different primary surgical techniques on long-term intraocular pressure and medication in glaucoma after congenital cataract surgery. PLoS One 2023; 18:e0286318. [PMID: 37406023 DOI: 10.1371/journal.pone.0286318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/13/2023] [Indexed: 07/07/2023] Open
Abstract
PURPOSE To assess long-time results of primary surgical treatment in children with glaucoma after congenital cataract surgery. METHODS A retrospective study of 37 eyes from 35 children with glaucoma after congenital cataract surgery, who underwent surgery between 2011 and 2021 at the Childhood Glaucoma Center, University Medical Center Mainz, Germany. Only children, who received a primary glaucoma surgery in our clinic within the given time (n = 25) and had at least one-year follow-up (n = 21), were included in the further analysis. The mean follow-up time was 40.4±35.1 months. The primary outcome was the mean reduction in IOP (in mmHg) from baseline to follow-up visits after the surgery, measured with Perkins tonometry. RESULTS 8 patients (38%) were treated with probe trabeculotomy (probe TO), 6 (29%) with 360° catheter-assisted trabeculotomy (360° TO) and 7 (33%) with cyclodestructive procedures. IOP was significantly reduced after probe TO and 360° TO after 2 years, from 26.9 mmHg to 17.4 mmHg (p<0.01) and 25.2 mmHg to 14.1 mmHg (p<0.02), respectively. There was no significant IOP reduction after cyclodestructive procedures after 2 years. Both, probe TO and 360° TO led descriptively to eye drops reduction after 2 years, from 2.0 to 0.7 and 3.2 to 1.1. The reduction was not significant. CONCLUSIONS In glaucoma after congenital cataract surgery, both trabeculotomy techniques, lead to good reduction of IOP after 2 years. There is a need for a prospective study with comparison to the use of glaucoma drainage implants.
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Affiliation(s)
- Alicja Strzalkowska
- Childhood Glaucoma Center, Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | | | - Julia V Stingl
- Childhood Glaucoma Center, Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Childhood Glaucoma Center, Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Alexander K Schuster
- Childhood Glaucoma Center, Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Esther M Hoffmann
- Childhood Glaucoma Center, Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
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Hartmann A, Bertram B, Siebelmann S, Böhm M, Faber H, Zhour A, Schuster AK. [Career prospects for ophthalmologists under 49 years old : A survey in Germany from 2022]. Ophthalmologie 2023; 120:726-733. [PMID: 36729123 DOI: 10.1007/s00347-022-01806-0] [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: 11/07/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The need for care in ophthalmology is constantly increasing due to demographic changes. The study analyzed the current professional situation and future prospects of ophthalmologists under 49 years old. METHODS The survey of members of the German Association of Ophthalmologists (Berufsverband der Augenärzte Deutschlands) and the German Ophthalmologic Society (Deutsche Ophthalmologische Gesellschaft) was conducted in 2022. All members under the age of 49 years received an online questionnaire on the current professional situation as well as future perspectives (desired working hours, form of organization). The results of the survey were additionally compared with the 2016 survey of the German Association of Ophthalmologists. A similar questionnaire was used at that time. RESULTS A total of 1014 people participated in the survey (62.7% women, mean age 39.3 ± 8 years, 75.6% specialists). The response rate to the survey was 25%. Specialist practice from 0 to 5 years showed a higher number of employed ophthalmologists (21% self-employed vs. 32% employed); over time the number of self-employed ophthalmologists increased (6-10 years: 40%, > 10 years: 59.3%). Overall, 46% of women were employed in a practice compared with 33% of men. Of the self-employed specialists, 95.9% said they planned to work in the same type of employment in 10 years as currently. Regarding ophthalmologists' career future, the other employment types showed a desire to move to independent practice. Compared to the 2016 survey, gender differences related to the current type of employment were evident. The number of self-employed women decreased from 43% to 26% and self-employed men decreased from 63% to 39%. The number of ophthalmologists in ambulatory healthcare centers was doubled compared to 2016. Ophthalmologists reported similar future perspectives at both survey times. CONCLUSION The results of the survey of ophthalmologists under 49 years in Germany showed similar perceptions as in 2016. It became clear that the desire to be self-employed in 10 years is very high; however, ophthalmologists expected large practices or medical care centers to prevail in the market. The number of self-employed doctors is decreasing and the desire for self-employment is difficult to realize.
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Affiliation(s)
- A Hartmann
- Augenklinik und Poliklinik, Fachbereich Ophthalmologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - B Bertram
- Augenarztpraxis Prof. Bertram & Dr. Helg, Löhergraben 30, 52064, Aachen, Deutschland
| | - S Siebelmann
- Augenärzte Solingen, Zentrum für Augenheilkunde, Uniklinik Köln, Köln, Deutschland
- Bergisches Kompetenzzentrum für Gesundheitsökonomik und Versorgungsforschung, Bergische Universität Wuppertal, Wuppertal, Deutschland
| | - M Böhm
- Augenklinik, Universitätsklinikum Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Deutschland
| | - H Faber
- Departement für Augenheilkunde, Universitätsklinikum Tübingen, Tübingen, Deutschland
- Moorfields Eye Hospital NHS Foundation Trust, London, Großbritannien
| | - A Zhour
- Berufsverband der Augenärzte Deutschlands e. V., Düsseldorf, Deutschland
| | - A K Schuster
- Augenklinik und Poliklinik, Fachbereich Ophthalmologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
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Hemelings R, Elen B, Schuster AK, Blaschko MB, Barbosa-Breda J, Hujanen P, Junglas A, Nickels S, White A, Pfeiffer N, Mitchell P, De Boever P, Tuulonen A, Stalmans I. A generalizable deep learning regression model for automated glaucoma screening from fundus images. NPJ Digit Med 2023; 6:112. [PMID: 37311940 DOI: 10.1038/s41746-023-00857-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 06/01/2023] [Indexed: 06/15/2023] Open
Abstract
A plethora of classification models for the detection of glaucoma from fundus images have been proposed in recent years. Often trained with data from a single glaucoma clinic, they report impressive performance on internal test sets, but tend to struggle in generalizing to external sets. This performance drop can be attributed to data shifts in glaucoma prevalence, fundus camera, and the definition of glaucoma ground truth. In this study, we confirm that a previously described regression network for glaucoma referral (G-RISK) obtains excellent results in a variety of challenging settings. Thirteen different data sources of labeled fundus images were utilized. The data sources include two large population cohorts (Australian Blue Mountains Eye Study, BMES and German Gutenberg Health Study, GHS) and 11 publicly available datasets (AIROGS, ORIGA, REFUGE1, LAG, ODIR, REFUGE2, GAMMA, RIM-ONEr3, RIM-ONE DL, ACRIMA, PAPILA). To minimize data shifts in input data, a standardized image processing strategy was developed to obtain 30° disc-centered images from the original data. A total of 149,455 images were included for model testing. Area under the receiver operating characteristic curve (AUC) for BMES and GHS population cohorts were at 0.976 [95% CI: 0.967-0.986] and 0.984 [95% CI: 0.980-0.991] on participant level, respectively. At a fixed specificity of 95%, sensitivities were at 87.3% and 90.3%, respectively, surpassing the minimum criteria of 85% sensitivity recommended by Prevent Blindness America. AUC values on the eleven publicly available data sets ranged from 0.854 to 0.988. These results confirm the excellent generalizability of a glaucoma risk regression model trained with homogeneous data from a single tertiary referral center. Further validation using prospective cohort studies is warranted.
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Affiliation(s)
- Ruben Hemelings
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
- Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium.
| | - Bart Elen
- Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | | | - João Barbosa-Breda
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
- Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Pekko Hujanen
- Tays Eye Centre, Tampere University Hospital, Tampere, Finland
| | - Annika Junglas
- Department of Ophthalmology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Stefan Nickels
- Department of Ophthalmology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Andrew White
- Department of Ophthalmology, The University of Sydney, Sydney, NSW, Australia
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Paul Mitchell
- Department of Ophthalmology, The University of Sydney, Sydney, NSW, Australia
| | - Patrick De Boever
- Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590, Diepenbeek, Belgium
- University of Antwerp, Department of Biology, 2610, Wilrijk, Belgium
| | - Anja Tuulonen
- Tays Eye Centre, Tampere University Hospital, Tampere, Finland
| | - Ingeborg Stalmans
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
- Ophthalmology Department, UZ Leuven, Herestraat 49, 3000, Leuven, Belgium
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Schuster AK, Wolfram C, Hudde T, Klatt A, Schnegelsberg B, Midani-Oezkan H, Ross M, Ziemssen F, Pfeiffer N. Impact of Routinely Performed Optical Coherence Tomography Examinations on Quality of Life in Patients with Retinal Diseases-Results from the ALBATROS Data Collection. J Clin Med 2023; 12:3881. [PMID: 37373576 DOI: 10.3390/jcm12123881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/16/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
The use of OCT to monitor intravitreal treatment varies in clinical practice and is not always mandatory. The ALBATROS data collection aimed to clarify the impact of routinely implemented OCT on clinical outcomes and its impact on vision-related quality of life (VRQoL). METHODS An observational cohort study included patients with retinal diseases starting an intravitreal anti-vascular endothelial growth factor treatment in Germany. Treatment followed clinical practice except mandatory OCT examination during the 12-month observation period. VRQoL was assessed by NEI VFQ-25 and compared with respect to OCT examinations and number of intravitreal injections in the different diseases (nAMD, DME, BRVO, CRVO). RESULTS 1478 patients (74.5 ± 10.9 years, 54.9% female) were included in the analysis. Patients had neovascular AMD (65.2%), DME (18.4%), BRVO (9.5%), or CRVO (6.9%). 8.8 ± 2.6 OCT examinations and 6.1 ± 3.2 intravitreal injections were performed within 12 months. VRQoL differed between indications at baseline, with substantially lower values for neovascular AMD and CRVO. After twelve months, an increase in visual acuity and visual functional scale was observed for nAMD, DME, and BRVO, while in DME only, there was an association between number of OCT examinations and VRQoL. CONCLUSION Intravitreal treatment was able to maintain VRQoL over twelve months in a real-world setting. Regular OCT examinations were associated with higher gain in VRQoL in DME patients after 12 months.
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Affiliation(s)
- Alexander K Schuster
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Christian Wolfram
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Tobias Hudde
- Eye Hospital Wolfsburg-Fallersleben, Am Spieker 10, 38440 Wolfsburg, Germany
| | - Alexander Klatt
- Eye Center Klatt, Henry-Wetjen-Platz 3, 28844 Weyhe, Germany
| | | | | | - Mike Ross
- Novartis Pharma GmbH, Roonstr. 25, 90429 Nuremberg, Germany
| | - Focke Ziemssen
- Department of Ophthalmology, Leipzig University Hospital, University of Leipzig, Liebigstraße 12, Haus 1, 04109 Leipzig, Germany
- Center for Ophthalmology, Eberhard-Karls-Universität Tübingen, Elfriede-Aulhorn-Str. 7, 72076 Tübingen, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
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Marx-Gross S, Kroell A, Wollschlaeger D, Schuster AK, Riedl JC, Wasielica-Poslednik J, Pfeiffer N. Impact of Cross-Linking Procedure on Perioperative Quality of Life in Keratoconus Patients. J Clin Med 2023; 12:jcm12113833. [PMID: 37298028 DOI: 10.3390/jcm12113833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND To evaluate the effect of crosslinking (CXL) with riboflavin for keratoconus (KC) therapy on quality of life (QoL): comparison of keratoconus patients with and without treatment. METHODS Prospective monocentric study. We recruited patients with progressive KC and with stable disease. Patients with progressive disease received cross-linking treatment; patients with stable disease were monitored. We compared QoL in both groups over 6 months and detected the influence of cross-linking treatment on QoL. QoL was assessed by NEI-VFQ-25, EQ-5D 5L, and EQ-Visual analog scale (VAS). In the evaluation of the Nei VFQ, the subgroups LFVFS and LFSES were calculated. RESULTS We enrolled 31 eyes of 31 patients in the intervention group and 37 eyes of 37 patients in the control group. Medians with standard deviations (SD) were calculated. All QoL-tests showed equal scores at baseline in both groups. At V2, one day after the treatment, EQ-VAS (56.4), LFVFS (57.4), and EQ5D5L (0.59) were significantly reduced. At V3 (one week after treatment), all results returned to baseline level. LFSES was not affected by the treatment. It remained stable (V2 85.4, V3 84.3). Comparing the baseline scores with the follow-up scores at month 6, we found a significant increase in QoL in all tests in the intervention group. Otherwise, the quality of life in the control group did not change over time. CONCLUSIONS Cross-linking led only to a short-term reduction in QoL. Although the treatment is painful for a few days, no effect on general quality of life LVSES has been demonstrated. QoL already returned to baseline after one week and the patients were not limited anymore.
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Affiliation(s)
- Susanne Marx-Gross
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
- Artemis MVZ Wiesbaden, 65189 Wiesbaden, Germany
| | - Angelina Kroell
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Daniel Wollschlaeger
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Jana C Riedl
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Joanna Wasielica-Poslednik
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
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Fieß A, Mildenberger E, Pfeiffer N, Schuster AK. [Ophthalmological long-term sequelae of premature birth-Persisting into adulthood : Eye development and premature birth anamnesis]. Ophthalmologie 2023:10.1007/s00347-023-01875-9. [PMID: 37266673 DOI: 10.1007/s00347-023-01875-9] [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] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Premature birth and the postnatal occurrence of retinopathy of prematurity (ROP) are the main risk factors for reduced visual acuity and blindness in childhood and adolescence accompanied by numerous morphological ocular changes. OBJECTIVE It can be assumed that these alterations persist throughout life and could represent a potential risk factor for ocular diseases, although little is known to date about the long-term effects of prematurity on ocular function and morphology in adulthood. METHODS The aim of the present study is to review the literature on the long-term effects of prematurity and associated factors. RESULTS Individuals born preterm exhibit reduced visual acuity, lower visual quality of life, and steeper corneal configuration in adulthood. Furthermore, individuals with advanced ROP and need for ROP treatment are at particularly high risk for myopic refractive error, the occurrence of strabismus, and increased lens opacities with thicker lenses. Low gestational age is associated with thinner peripapillary retinal nerve fiber layer thickness as well as thicker foveal retinal thickness and more frequent occurrence of foveal hypoplasia. In addition, data from the Gutenberg Health Study showed that low birth weight as a surrogate marker for prematurity and fetal growth restriction are associated with an increased prevalence of age-related macular degeneration as well as more frequently with diabetes and consequently diabetic retinopathy. DISCUSSION Premature birth and associated factors lead to life-long functional and morphological ocular changes. There is evidence that this can lead to retinal diseases later in life and thus, there appear to be fetal origins for adult eye disease. This may have implications for ophthalmic controls and its intervals in adulthood.
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Affiliation(s)
- Achim Fieß
- Augenklinik und Poliklinik, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - Eva Mildenberger
- Abteilung für Neonatologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Norbert Pfeiffer
- Augenklinik und Poliklinik, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Alexander K Schuster
- Augenklinik und Poliklinik, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
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Fieß A, Wacker A, Gißler S, Fauer A, Mildenberger E, Urschitz MS, Elflein H, Stoffelns B, Pfeiffer N, Schuster AK. [Ophthalmic care of adults born preterm and full-term-results from the Gutenberg Prematurity Eye Study (GPES) : Premature birth and ophthalmological care]. Ophthalmologie 2023; 120:608-619. [PMID: 36416921 DOI: 10.1007/s00347-022-01746-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 06/13/2023]
Abstract
BACKGROUND Prematurity and the presence of retinopathy of prematurity (ROP) increase the risk for the occurrence of amblyogenic risk factors in childhood and adolescence. AIM The aim of the present study was to evaluate ocular morbidities and the ophthalmological care of former preterm and full-term persons in adulthood. MATERIAL AND METHODS The Gutenberg prematurity eye study (GPES) is a retrospective cohort study with a prospective ophthalmological examination of individuals formerly born preterm and full term between 1969 and 2002 (now aged 18-52 years). All participants underwent a detailed ophthalmological examination and were asked about the frequency of ophthalmological care. Participants were grouped into those with normal gestational age (GA) ≥ 37 weeks (control group), preterm individuals without ROP and GA 33-36 weeks (group 2), GA 29-32 weeks (group 3), GA ≤ 28 weeks (group 4), and those with ROP without treatment (group 5) and with ROP with treatment (group 6). All participants were asked if they had an ophthalmological examination within the last 12 months. RESULTS In total, data from 140 term and 310 preterm adults were included in the present study. Strabismus was present in 2.1 % (3/140), 6.6 % (9/137), 17.4 % (16/92), 11.1 % (2/18), 27.1 % (13/48) and 60 % (9/15) in groups 1-6, respectively. The proportion of subjects with an ophthalmological examination within the last 12 months was highest in the groups of extremely preterm persons with and without ROP compared with the control group. Overall, 33.3 % (1/3) of the term and 57.1 % (28/49) of the preterm subjects with strabismus and 0 % (0/3) of the term and 46.9 % (15/32) of the preterm individuals with amblyopia had an ophthalmological examination within the past 12 months. DISCUSSION Extremely preterm adults with and without postnatal ROP showed the highest rate of eye diseases as well as the highest rate of ophthalmological check-ups within the last 12 months. This suggests that extremely preterm adults particularly with the occurrence of postnatal ROP perceive more frequent ophthalmological check-ups throughout their lives.
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Affiliation(s)
- Achim Fieß
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - Annika Wacker
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Sandra Gißler
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Agnes Fauer
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Eva Mildenberger
- Abteilung für Neonatologie, Klinik für Kinderheilkunde, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Michael S Urschitz
- Abteilung für Pädiatrische Epidemiologie, Institut für Medizinische Biostatistik, Epidemiologie und Informatik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Heike Elflein
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Bernhard Stoffelns
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Norbert Pfeiffer
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Alexander K Schuster
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
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Hartmann A, Grabitz SD, Hoffmann EM, Wild PS, Schmidtmann I, Lackner KJ, Beutel ME, Münzel T, Tüscher O, Schattenberg JM, Pfeiffer N, Schuster AK. Intraocular Pressure and Its Relation to Climate Parameters-Results From the Gutenberg Health Study. Invest Ophthalmol Vis Sci 2023; 64:15. [PMID: 37289170 DOI: 10.1167/iovs.64.7.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
Purpose To investigate the association between intraocular pressure (IOP) and climate parameters. Methods The Gutenberg Health Study (GHS) is a population-based cohort study in Mainz, Germany. Participants underwent two comprehensive ophthalmologic examinations (baseline visit and five-year follow up) including non-contact tonometry, objective refraction, pachymetry, perimetry, and fundus imaging in the time frame of 2007 to 2017. The respective climate parameters were assessed at the University Mainz including temperature, air humidity, and air pressure. Associations of IOP and climatic parameters were computed using component models and cross-correlation plots. Multivariable regression analysis was performed to adjust for age, sex, body mass index, diabetes, central corneal thickness, and systolic blood pressure. To further explore the link between systolic blood pressure, temperature, and IOP, an effect mediation analysis was conducted. Results A total of 14,632 participants (age 55 ± 11 years at baseline, 49.1% female) were included in this analysis. Mean IOP was 14.24 ± 2.8 mm Hg at baseline. There was a similar periodic change in IOP and in temperature, as shown in the component models. IOP was not associated with air humidity. In univariable and multivariable regression analyses we found a significant association between lower IOP during the summer months with higher air temperature (B = -0.011, P < 0.001). This could be partially explained in mediation analysis by lower systolic blood pressure at higher air temperature. Furthermore, IOP was associated with air pressure in univariable (B = 0.005, P = 0.04.) and multivariable models (B = 0.006, P = 0.03). Conclusions There is a periodic annual change of IOP with higher values in winter and lower values in summer supporting the hypothesis of an impact of environmental temperature on IOP, which is partly mediated by lower systolic blood pressure in summer.
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Affiliation(s)
- Alica Hartmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Stephanie D Grabitz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Esther M Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S Wild
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
- Preventive Cardiology and Preventive Medicine-Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biometry, Epidemiology and Informatics (IMBEI), Mainz, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Clinic for Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Jörn M Schattenberg
- Metabolic Liver Research Center and Medicine, University Medical Center, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Mildenberger E, Wackernagel D, Schuster AK, Fieß A, Winter J. [Changes in neonatal care : Implications for ophthalmological care]. Ophthalmologie 2023:10.1007/s00347-023-01874-w. [PMID: 37233804 DOI: 10.1007/s00347-023-01874-w] [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] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Preterm infants are at risk of characteristic, sometimes life-threatening diseases and development of deficits related to immaturity. In the field of ophthalmology, retinopathy of prematurity (ROP) and vision impairment reflect structural and functional disturbances in this large group of patients. In high income countries, more and more very immature preterm infants survive into adolescence and adulthood. OBJECTIVE To characterize the impact of an increasing number of surviving individuals born preterm on the provision of ophthalmological care in Germany. MATERIAL AND METHODS A literature search and analysis of key figures and quality indicators published in national health registers were carried out. RESULTS Currently, about 60,000 preterm infants are born in Germany every year. Of these, approximately 3600 extremely immature preterm infants with a gestational age < 28 weeks are treated with a curative approach on neonatal units. The survival rate is around 80%. A rise in the proportion of infants suffering from severe ROP has not been observed in recent years in Germany. The incidences of other structural and functional visual impairments vary between 3% and 25% in high income countries. CONCLUSION The incidence of ROP apparently has not increased in Germany. However, specific peculiarities of the structure and function of the visual system of individuals born preterm have to be taken into account. Approximately 70,000 outpatient check-ups of infants and toddlers, who require both, ophthalmological and developmental neurological expertise, are estimated for Germany each year.
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Affiliation(s)
- Eva Mildenberger
- Sektion Neonatologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - Dirk Wackernagel
- Sektion Neonatologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Alexander K Schuster
- Zentrum für ophthalmologische Epidemiologie und Versorgungsforschung, Augenklinik und Poliklinik, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Achim Fieß
- Zentrum für ophthalmologische Epidemiologie und Versorgungsforschung, Augenklinik und Poliklinik, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Julia Winter
- Sektion Neonatologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
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Fieß A, Grabitz SD, Mildenberger E, Urschitz MS, Fauer A, Hampel U, Wasielica-Poslednik J, Zepp F, Pfeiffer N, Schuster AK. A lower birth weight percentile is associated with central corneal thickness thinning: Results from the Gutenberg Prematurity Eye Study (GPES). J Optom 2023; 16:143-150. [PMID: 36182657 PMCID: PMC10104790 DOI: 10.1016/j.optom.2022.07.001] [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: 01/27/2022] [Revised: 06/17/2022] [Accepted: 07/03/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Prematurity, prenatal growth restriction, and retinopathy of prematurity (ROP) are associated with altered ocular geometry, such as a steeper corneal shape in childhood, but it is unclear whether perinatal history affects corneal thickness development, so this study investigated whether corneal thickness in adulthood is affected by perinatal history. MARTERIALS AND METHODS The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination in Germany. The corneal thickness was measured by Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany), and the relationship between perinatal parameters respective birth weight percentile and corneal thickness at different locations was assessed using uni- and multivariable linear regression models. Covariates included age, sex, mean corneal radius, white-to-white distance, gestational age, birth weight percentile, ROP occurrence, and treatment. The main outcome measures were corneal thickness at the apex, the pupil center, and the corneal periphery. RESULTS The corneal thickness was measured in 390 participants (754 eyes, mean age 29.7+/-8.7 years, 224 females). In multivariable analyses, a lower birth weight percentile was associated with a lower corneal thickness at the apex (B = 0.20, p = 0.003) and the pupil (B = 0.19, p = 0.007). These effects diminished towards the corneal periphery and were not observed beyond the 4-mm diameter circle around the thinnest corneal position. Neither gestational age, ROP occurrence, or ROP treatment affected the corneal thickness. CONCLUSION A lower birth weight percentile in subjects born preterm as a proxy for restricted fetal growth is associated with corneal thickness thinning in adults aged 18 to 52 years, indicating that corneal thickness development, particularly in the corneal center, may originate in the fetal stage.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Stephanie D Grabitz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Agnes Fauer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ulrike Hampel
- Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany
| | - Joanna Wasielica-Poslednik
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Fred Zepp
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Stingl JV, Wagner FM, Liebezeit S, Baumgartner R, Spät H, Schuster AK, Prokosch V, Grehn F, Hoffmann EM. Long-Term Efficacy and Safety of Modified Canaloplasty Versus Trabeculectomy in Open-Angle Glaucoma. Life (Basel) 2023; 13:life13020516. [PMID: 36836873 PMCID: PMC9963969 DOI: 10.3390/life13020516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/27/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND To evaluate the long-term efficacy and safety of modified canaloplasty versus trabeculectomy in open-angle glaucoma. METHODS In total, 210 subjects with open-angle glaucoma were included. 70 were treated with Mitomycin C-augmented modified canaloplasty with enhanced subconjunctival filtration and 140 with Mitomycin C-augmented trabeculectomy. Cases were matched 1:2 by sex and age. RESULTS In canaloplasty and trabeculectomy groups, 61.4% and 57.9% of participants were female. Mean age was 60.0 ± 13.9 and 63.0 ± 12.2 years, median follow-up time was 4.6 [IQR 4.3, 5.05] years and 5.8 [IQR 5.4, 6.3]. Strict success was achieved in 20.0% and 56.4%, complete success in 24.3% and 66.4%, and qualified success in 34.3% and 73.6% (each p < 0.001). Kaplan-Meier survival analysis showed a better survival probability for trabeculectomy than for canaloplasty (p < 0.001) and Cox regression analysis revealed an HR of 6.03 (95%-CI 3.66, 9.93, p < 0.001) after canaloplasty. Trabeculectomy showed superiority in terms of IOP decrease (9.2 ± 7.9 mmHg vs. 13.7 ± 10.4 mmHg, p = 0.002), use of AGM (50.0% vs. 10.7%, p < 0.001), and the number of revision surgeries (41.4% vs. 21.4%, p = 0.004). Occurrence of complications was similar in both groups (14.5% vs. 7.5%, p = 0.19). CONCLUSIONS Trabeculectomy showed superiority in efficacy and equality in safety compared to modified canaloplasty.
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Affiliation(s)
- Julia V. Stingl
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Felix M. Wagner
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | | | | | - Helene Spät
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Verena Prokosch
- Department of Ophthalmology, University of Cologne, 50937 Cologne, Germany
| | - Franz Grehn
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Esther M. Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Correspondence:
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Wagner FM, Schuster AK, Kianusch K, Stingl J, Pfeiffer N, Hoffmann EM. Long-term success after trabeculectomy in open-angle glaucoma: results of a retrospective cohort study. BMJ Open 2023; 13:e068403. [PMID: 36737088 PMCID: PMC9900049 DOI: 10.1136/bmjopen-2022-068403] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To evaluate the long-term outcomes of trabeculectomy (TE) surgery in a large cohort with a minimum follow-up of 3 years. DESIGN Retrospective cohort study. SETTING University Eye Hospital, Germany. PARTICIPANTS Three hundred and seventy-nine patients with open-angle glaucoma underwent TE with mitomycin C (MMC) between January 2013 and February 2017 with a minimal follow-up of 3 years. Eligible patients were identified via an electronic surgical case register. INTERVENTIONS All patients had undergone TE with MMC following a set surgical protocol. To assess the influence of cataract surgery following TE, eyes which underwent cataract surgery at least 6 months after TE were matched 1:3 by sex and age to eyes who did not undergo cataract surgery during the follow-up period. MAIN OUTCOME MEASURES Primary outcome was the proportion of surgical success based on intraocular pressure (IOP), surgical complications, the need for revision surgery, loss of light perception and the need for additional pressure-lowering medication. RESULTS The mean follow-up time was 6 (±0.8, IQR: 5.4-6.5) years. Seventy-three per cent of eyes achieved qualified surgical success at the last follow-up (IOP≥5 mm Hg and ≤18 mm Hg, without surgical complications or complete loss of vision) but necessitated additional medical therapy, complete surgical success with no additional medical therapy was achieved in 69% of eyes. There was no significant difference in the success probability between eyes that had undergone cataract surgery after TE and those that had not (p=0.45). CONCLUSIONS The results demonstrate a high and stable success rate of TE after a mean follow-up time of approximately 6 years, that is, not affected by later cataract surgery.
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Affiliation(s)
- Felix Mathias Wagner
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Keywan Kianusch
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Julia Stingl
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Esther M Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Michal M, Schulz A, Wild PS, Koeck T, Münzel T, Schuster AK, Strauch K, Lackner K, Süssmuth SD, Niessen HG, Borta A, Allers KA, Zahn D, Beutel ME. Tryptophan catabolites and depression in the general population: results from the Gutenberg Health Study. BMC Psychiatry 2023; 23:27. [PMID: 36631760 PMCID: PMC9835277 DOI: 10.1186/s12888-023-04520-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023] Open
Abstract
Previous studies reported significantly altered tryptophan catabolite concentrations in major depression. Thus, tryptophan catabolites were considered as potential biomarkers of depression and their modulators as potential targets for psychopharmacotherapy. However, the results were based mainly on studies with small sample sizes limiting their generalizability. Against this background, we investigated the relationship of peripheral tryptophan catabolites with depression in a population-based sample with n = 3,389 participants (with fasting status ≥ 8 h and C-reactive protein < 10 mg/L). N = 248 had clinically significant depression according to a PHQ-9 score of ≥ 10, n = 1,101 subjects had mild depressive symptoms with PHQ-9 scores between 5 and 9, and n = 2,040 had no depression. After multivariable adjustment, clinically significant depression was associated with lower kynurenine and kynurenic acid. Spearman correlation coefficients of the tryptophan catabolites with the severity of depression were very small (rho ≤ 0.080, p ≤ 0.015). None of the tryptophan catabolites could diagnostically separate depressed from not depressed persons. Concerning linear associations, kynurenine and kynurenic acid were associated only with the severity and the cognitive dimension of depression but not its somatic dimension. Tryptophan catabolites were not associated with persistence or recurrence of depression at the 5 year follow-up. The results replicated the association between kynurenine and kynurenic acid with depression. However, the associations were small raising doubts about their clinical utility. Findings underline the complexity of the relationships between depression and tryptophan catabolites. The search for subgroups of depression with a potentially higher impact of depression might be warranted.
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Affiliation(s)
- Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany. .,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, University Medical Center of the Johannes Gutenberg University, 55131, Langenbeckstr. 1, Mainz, Germany.
| | - Andreas Schulz
- grid.410607.4Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp S. Wild
- grid.410607.4German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, University Medical Center of the Johannes Gutenberg University, 55131, Langenbeckstr. 1, Mainz, Germany ,grid.410607.4Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Koeck
- grid.410607.4German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, University Medical Center of the Johannes Gutenberg University, 55131, Langenbeckstr. 1, Mainz, Germany ,grid.410607.4Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- grid.410607.4Center for Cardiology – Cardiology I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Alexander K. Schuster
- grid.410607.4Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Konstantin Strauch
- grid.5802.f0000 0001 1941 7111Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Karl Lackner
- grid.410607.4Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sigurd D. Süssmuth
- Clinical Development, uniQure NV, Allschwil, Switzerland ,grid.410712.10000 0004 0473 882XDepartment of Neurology, Univeristy Hospital of Ulm University, Ulm, Germany
| | - Heiko G. Niessen
- grid.420061.10000 0001 2171 7500Department of Translational Medicine & Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, 88397 Biberach an Der Riss, Germany
| | - Andreas Borta
- Clinical Development, uniQure NV, Allschwil, Switzerland
| | - Kelly A. Allers
- grid.420061.10000 0001 2171 7500CNS Diseases Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, 88397 Biberach an Der Riss, Germany
| | - Daniela Zahn
- grid.410607.4Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred E. Beutel
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
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Fieß A, Urschitz MS, Nagler M, Nickels S, Marx-Groß S, Münzel T, Wild PS, Beutel ME, Lackner KJ, Pfeiffer N, Schuster AK. Association of birth weight with corneal aberrations in adulthood - Results from a population-based study. J Optom 2023; 16:42-52. [PMID: 35764478 PMCID: PMC9811361 DOI: 10.1016/j.optom.2021.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 02/18/2021] [Revised: 05/21/2021] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE Low birth weight (BW) is associated with increased corneal aberrations in childhood and alterations of corneal geometry in adulthood. Increased corneal aberrations may be a factor contributing to decreased visual function in former low BW newborns in later life. Hence, the aim of this study was to analyze the long-term effect of low BW on corneal aberrations in adulthood. METHODS In the German population-based Gutenberg Health Study (GHS) participants (age: 40-80 years) were examined with Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany). The relationship between self-reported BW and the different types of corneal aberrations was analyzed using linear regression analysis as uni- and multivariable analysis with adjustment for potential confounders. The main outcome measures were corneal aberrations defined as astigmatism (Z2-2; Z22), coma (Z3-1; Z31), trefoil (Z3-3; Z33), spherical aberration (Z40) and root-mean square of higher order aberrations (HOA; 3rd up to 8th order; aperture size: 6 mm). RESULTS Overall, 5,628 participants were included in this analysis (3,004 women, aged 56.0 +/- 10.3 years). In a multivariable analysis lower BW was associated with decreased horizontal trefoil (B = 0.004 [0.001; 0.006] µm/500 g; p=.008); higher spherical aberrations (B=-0.006 [-0.008;-0.003] µm/500 g; p<.001), higher RMS (B=-0.028 [-0.042;-0.014] µm/500 g; p<.001), increased HOA (B=-0.007 [-0.010;-0.003] µm/500 g; p<.001) and increased LOA (B=-0.027 [-0.041;-0.013] µm/500 g; p<.001). No association was observed between birth weight and the other types of corneal aberrations in multivariable model. CONCLUSION Our results indicate an association between BW and spherical aberration in adults aged 40 to 80 years. This indicates that low BW may have an association with an altered corneal shape development which may affect optical image quality and, hence, visual function.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine / Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stefan Nickels
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Susanne Marx-Groß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine / Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Stingl JV, Ban SA, Nagler M, Schmidtmann I, Wild PS, Lackner KJ, Münzel T, Beutel ME, Pfeiffer N, Schuster AK. Five-year change in refractive error and its risk factors: results from the Gutenberg Health Study. Br J Ophthalmol 2023; 107:140-146. [PMID: 34362774 PMCID: PMC9763219 DOI: 10.1136/bjophthalmol-2021-318828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 07/23/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To examine the 5-year change in refractive error in phakic eyes and its risk factors in the general population. METHODS The Gutenberg Health Study (GHS) is a population-based cohort study including 15 010 participants from Germany aged 35-74 years at baseline examination (2007-2012). After 5 years, a follow-up examination was carried out (83% participation). 5-year change of spherical equivalent (SE) was computed as difference between follow-up and baseline objective refraction. Linear and logistic regression analysis were conducted analysing potential risk factors. Only phakic eyes at follow-up examination were included. RESULTS Right eyes of 10 175 subjects were included. An age-related shift of refractive error was identified, namely -0.12 D for age 35-44 years, 0.25 D for age 45-54 years, 0.25 D for age 55-64 years and 0.12 D for age 65-74 years during the 5-year follow-up. Smokers had a hyperopic shift (OR=1.31; p<0.001), while baseline SE (OR=0.89 per dioptre; p<0.001) and female sex (OR=1.49; p<0.001) were linked with a myopic shift. Education, occupation and other cardiovascular parameters were not associated with change in refractive error. CONCLUSIONS The GHS demonstrates a parabolic shift in refractive error with a myopic shift at age 35-44 years, followed by a hyperopic shift at age 45-64 years which decreases at higher age. Smoking is associated with a hyperopic shift whereas female sex and myopic baseline SE is associated with a myopic shift. Educational level and occupation were not linked to a change in refractive error at age 35-74 years.
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Affiliation(s)
- Julia V. Stingl
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sol A Ban
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Karl J. Lackner
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology – Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred E. Beutel
- Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Hahad O, Beutel ME, Gilan DA, Chalabi J, Schuster AK, Gianicolo E, Lackner KJ, Lieb K, Galle PR, Wild PS, Daiber A, Münzel T. Noise annoyance and risk of prevalent and incident atrial fibrillation-A sex-specific analysis. Front Public Health 2022; 10:1061328. [PMID: 36536776 PMCID: PMC9758722 DOI: 10.3389/fpubh.2022.1061328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/15/2022] [Indexed: 12/07/2022] Open
Abstract
Background While chronic exposure to high levels of noise was demonstrated to increase the risk of various cardiovascular diseases, the association between noise annoyance and risk of cardiovascular disease remains still inconsistent. Recently, we showed that noise annoyance is associated with prevalent atrial fibrillation in the general population. However, the association between noise annoyance and risk of incident atrial fibrillation as well as potential sex-differences remain still elusive. Methods and results 15,010 subjects from a German population-based cohort were examined at baseline (2007 to 2012) and follow-up five years later (2012 to 2017) to investigative the association between noise annoyance due to multiple sources and prevalent and incident atrial fibrillation. After multivariable adjustment, the results from logistic regression analyses revealed overall consistent and positive associations between noise annoyance and prevalent and incident atrial fibrillation in men, whereas this association was weaker in women, in particular with respect to incident atrial fibrillation. For instance, industrial noise annoyance was associated with 21% (95% confidence interval (CI) 9-34%) and 18% (8-29%) higher odds of prevalent atrial fibrillation in men and women, respectively. In prospective analysis, this association remained stable in men (odds ratio (OR) 1.25, 1.07-1.44), while in women no association was observed (OR 1.03, 0.89-1.18). Conclusions The findings suggest that noise annoyance can increase the risk of incident atrial fibrillation in a large population-based cohort and that men may be more sensitive to the adverse effects of noise annoyance with regard to the risk of atrial fibrillation.
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Affiliation(s)
- Omar Hahad
- Department of Cardiology–Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany,Leibniz Institute for Resilience Research (LIR), Mainz, Germany,*Correspondence: Omar Hahad
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Donya A. Gilan
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany,Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Julian Chalabi
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Emilio Gianicolo
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany,Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany,Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Peter R. Galle
- Department of Internal Medicine, Gastroenterology and Hepatology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S. Wild
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany,Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany,Institute of Molecular Biology (IMB), Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology–Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology–Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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48
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Fieß A, Schäffler A, Mildenberger E, Urschitz MS, Wagner FM, Hoffmann EM, Zepp F, Pfeiffer N, Schuster AK. Peripapillary Retinal Nerve Fiber Layer Thickness in Adults Born Extremely, Very, and Moderately Preterm With and Without Retinopathy of Prematurity: Results From the Gutenberg Prematurity Eye Study (GPES). Am J Ophthalmol 2022; 244:88-97. [PMID: 35932823 DOI: 10.1016/j.ajo.2022.07.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE This study investigated whether prematurity and associated factors or prenatal growth restriction have long-term effects on the peripapillary retinal nerve fiber layer (pRNFL) in adulthood. DESIGN Retrospective cohort study. METHODS The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination in Germany. Selected individuals born term and preterm (age 18-52 years) were examined with spectral-domain optical coherence tomography (SD-OCT) in adulthood, and perinatal medical charts were reviewed. The pRNFL thickness was measured using SD-OCT. Univariate and multivariable linear regression analyses were conducted to investigate associations between pRNFL and gestational age (GA; categorical), birth weight percentile (categorical), retinopathy of prematurity (ROP) occurrence, and treatment and other perinatal parameters with adjustment for age, sex, and spherical equivalent. RESULTS In total, 766 eyes of 406 preterm and full-term individuals were included (mean age 28.4 ± 8.6 years, 228 females). After adjustment for age, sex, and spherical equivalent, global pRNFL thinning was associated with moderate (GA = 33-36 wk, β = -4.68, P < .001), very (GA = 29-32 wk, β = -5.72, P < .001), and extreme (GA ≤ 28 wk, β = -8.69, P < .001) prematurity but not with low birth weight percentile (<25th percentile, P = .9) and ROP occurrence (P = .9) in multivariable analysis. ROP treatment was associated with increased pRNFL in the temporal sector (P = .002). Maternal smoking during pregnancy showed an association with pRNFL thinning (P = .07). CONCLUSION Our data indicate that the more preterm individuals are born the more pRNFL thinning occurs, whereas prenatal growth restriction and postnatal occurrence of ROP show less effects on pRNFL thickness. Furthermore, individuals with severe ROP with treatment but not lower ROP stages without treatment showed an increased temporal pRNFL thickness.
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Affiliation(s)
- Achim Fieß
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Alina Schäffler
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics (E.M., F.Z.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics (M.S.U.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Felix M Wagner
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Esther M Hoffmann
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Fred Zepp
- Division of Neonatology, Department of Pediatrics (E.M., F.Z.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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49
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Wolfram C, Schuster AK. [Glaucoma care in Germany-results of a survey among German ophthalmologists-part 2: treatment]. Ophthalmologie 2022; 119:1140-1148. [PMID: 35925336 DOI: 10.1007/s00347-022-01667-7] [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: 02/08/2022] [Revised: 03/23/2022] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The options for glaucoma treatment are quite diverse. The question therefore arises what is considered beneficial and feasible in daily practice. Our anonymized survey among members of the German Ophthalmological Society (DOG) and the Professional Association of Ophthalmologists in Germany (BVA) intends to explore treatment patterns and strategies in routine glaucoma care in Germany. OBJECTIVE The current article reflects current opinions of German ophthalmologists regarding glaucoma care, therapeutic strategies, and the role of glaucoma surgery. MATERIALS AND METHODS The survey was conducted using an online questionnaire with 26 questions (107 items) regarding care practice for glaucoma diagnosis and treatment. Complete responses were available from 1361 participants. RESULTS A total of 84.8% of responders define a target pressure regularly. A systemic therapeutic approach is followed by 44.9%. Two thirds consider side effects of eye drops to impair quality of life. Most common are conjunctival hyperemia and burning. Non-adherence to treatment is estimated to occur in 32% of patients. Approximately 5-10% of glaucoma patients are treated surgically. Among interventional treatment options, 90% consider trabeculectomy beneficial, followed by minimally invasive glaucoma surgery (MIGS) and selective laser trabeculoplasty (SLT), which are, however, the most commonly performed procedures. CONCLUSION The choice of treatment should intend a long-lasting reduction of intraocular pressure and yet to be reasonable and manageable. There is a demand for more overview and structured care.
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Affiliation(s)
- Christian Wolfram
- Augenklinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Alexander K Schuster
- Augenklinik und Poliklinik, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
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50
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Baumkötter R, Yilmaz S, Zahn D, Fenzl K, Prochaska JH, Rossmann H, Schmidtmann I, Schuster AK, Beutel ME, Lackner KJ, Münzel T, Wild PS. Protective behavior and SARS-CoV-2 infection risk in the population - Results from the Gutenberg COVID-19 study. BMC Public Health 2022; 22:1993. [PMID: 36316662 PMCID: PMC9623959 DOI: 10.1186/s12889-022-14310-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/26/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND During the SARS-CoV-2 pandemic, preventive measures like physical distancing, wearing face masks, and hand hygiene have been widely applied to mitigate viral transmission. Beyond increasing vaccination coverage, preventive measures remain urgently needed. The aim of the present project was to assess the effect of protective behavior on SARS-CoV-2 infection risk in the population. METHODS Data of the Gutenberg COVID-19 Study (GCS), a prospective cohort study with a representative population-based sample, were analyzed. SARS-CoV-2 infections were identified by sequential sampling of biomaterial, which was analyzed by RT-qPCR and two antibody immunoassays. Self-reported COVID-19 test results were additionally considered. Information on protective behavior including physical distancing, wearing face masks, and hand hygiene was collected via serial questionnaire-based assessments. To estimate adjusted prevalence ratios and hazard ratios, robust Poisson regression and Cox regression were applied. RESULTS In total, 10,250 participants were enrolled (median age 56.9 [43.3/68.6] years, 50.8% females). Adherence to preventive measures was moderate for physical distancing (48.3%), while the use of face masks (91.5%) and the frequency of handwashing (75.0%) were high. Physical distancing appeared to be a protective factor with respect to SARS-CoV-2 infection risk independent of sociodemographic characteristics and individual pandemic-related behavior (prevalence ratio [PR] = 0.77, 95% confidence interval [CI] 0.62-0.96). A protective association between wearing face masks and SARS-CoV-2 transmission was identified (PR = 0.73, 95% CI 0.55-0.96). However, the protective effect declined after controlling for potential confounding factors (PR = 0.96, 95% CI 0.68-1.36). For handwashing, this investigation did not find a beneficial impact. The adherence to protective behavior was not affected by previous SARS-CoV-2 infection or immunization against COVID-19. CONCLUSION The present study suggests primarily a preventive impact of physical distancing of 1.5 m, but also of wearing face masks on SARS-CoV-2 infections, supporting their widespread implementation. The proper fit and use of face masks are crucial for effectively mitigating the spread of SARS-CoV-2 in the population.
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Affiliation(s)
- Rieke Baumkötter
- grid.410607.4Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany ,grid.452396.f0000 0004 5937 5237German Center for Cardiovascular Research (DZHK), partner site Rhine Main, Mainz, Germany
| | - Simge Yilmaz
- grid.410607.4Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany ,grid.452396.f0000 0004 5937 5237German Center for Cardiovascular Research (DZHK), partner site Rhine Main, Mainz, Germany
| | - Daniela Zahn
- grid.410607.4Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Katharina Fenzl
- grid.410607.4Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Jürgen H. Prochaska
- grid.410607.4Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany ,grid.452396.f0000 0004 5937 5237German Center for Cardiovascular Research (DZHK), partner site Rhine Main, Mainz, Germany ,grid.410607.4Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Heidi Rossmann
- grid.410607.4Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- grid.410607.4Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- grid.410607.4Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred E. Beutel
- grid.410607.4Department of Psychosomatic Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl J. Lackner
- grid.452396.f0000 0004 5937 5237German Center for Cardiovascular Research (DZHK), partner site Rhine Main, Mainz, Germany ,grid.410607.4Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- grid.452396.f0000 0004 5937 5237German Center for Cardiovascular Research (DZHK), partner site Rhine Main, Mainz, Germany ,grid.410607.4Cardiology I, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp S. Wild
- grid.410607.4Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany ,grid.452396.f0000 0004 5937 5237German Center for Cardiovascular Research (DZHK), partner site Rhine Main, Mainz, Germany ,grid.410607.4Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany ,grid.424631.60000 0004 1794 1771Institute of Molecular Biology (IMB), Mainz, Germany
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