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Youssif AA, Onyekaba NA, Naithani R, Abdelazeem K, Fathalla AM, Abdel-Rhaman MS, Jammal AA, Medeiros FA. Social history and glaucoma progression: the effect of body mass index, tobacco and alcohol consumption on the rates of structural change in patients with glaucoma. Br J Ophthalmol 2024:bjo-2023-323186. [PMID: 38621956 DOI: 10.1136/bjo-2023-323186] [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: 01/05/2023] [Accepted: 03/31/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND/AIMS Although obesity, tobacco and alcohol consumption were linked to the progression of numerous chronic diseases, an association of these social history aspects with glaucoma progression is not yet determined. This study aims to investigate the effect of body mass index (BMI) and history of tobacco and alcohol use on the rates of retinal nerve fibre layer (RNFL) change over time in glaucoma patients. METHODS 2839 eyes of 1584 patients with glaucoma from the Duke Ophthalmic Registry were included. Patients had at least two spectral-domain optical coherency tomography (SD-OCT) tests over a minimum 6-month follow-up. Self-reported history of alcohol and tobacco consumption was extracted from electronic health records and mean BMI was calculated. Univariable and multivariable linear mixed models were used to determine the effect of each parameter on RNFL change over time. RESULTS Mean follow-up time was 4.7±2.1 years, with 5.1±2.2 SD-OCT tests per eye. 43% and 54% of eyes had tobacco or alcohol consumption history, respectively, and 34% were classified as obese. Higher BMI had a protective effect on glaucoma progression (0.014 µm/year slower per each 1 kg/m2 higher; p=0.011). Tobacco and alcohol consumption were not significantly associated with RNFL change rates (p=0.473 and p=0.471, respectively). Underweight subjects presented significantly faster rates of structural loss (-0.768 µm/year; p=0.002) compared with normal weight. CONCLUSIONS In a large clinical population with glaucoma, habits of tobacco and alcohol consumption showed no significant effect on the rates of RNFL change. Higher BMI was significantly associated with slower rates of RNFL loss.
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Affiliation(s)
- Asmaa A Youssif
- Duke Eye Center, Duke University, Durham, North Carolina, USA
- Ophthalmology, Assiut University Faculty of Medicine, Assiut, Egypt
| | | | - Rizul Naithani
- Duke Eye Center, Duke University, Durham, North Carolina, USA
| | | | - Ahmed M Fathalla
- Ophthalmology, Assiut University Faculty of Medicine, Assiut, Egypt
| | | | - Alessandro A Jammal
- Duke Eye Center, Duke University, Durham, North Carolina, USA
- Bascom Palmer Eye Institute, University of Miami Health System, Miami, Florida, USA
| | - Felipe A Medeiros
- Duke Eye Center, Duke University, Durham, North Carolina, USA
- Bascom Palmer Eye Institute, University of Miami Health System, Miami, Florida, USA
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Li D, Sun S, Liang J, Yue Y, Yang J, Zhi Y, Zhang X, Yu R, Li X. Papillary vitreous detachment as a possible accomplice in non-arteritic anterior ischaemic optic neuropathy. Br J Ophthalmol 2024; 108:607-612. [PMID: 37055157 PMCID: PMC10958297 DOI: 10.1136/bjo-2022-322726] [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: 10/13/2022] [Accepted: 03/15/2023] [Indexed: 04/15/2023]
Abstract
AIM To evaluate the role of papillary vitreous detachment in the pathogenesis of non-arteritic anterior ischaemic optic neuropathy (NAION) by comparing the features of vitreopapillary interface between NAION patients and normal individuals. METHODS This study included 22 acute NAION patients (25 eyes), 21 non-acute NAION patients (23 eyes) and 23 normal individuals (34 eyes). All study participants underwent swept-source optical coherence tomography to assess the vitreopapillary interface, peripapillary wrinkles and peripapillary superficial vessel protrusion. The statistical correlations between peripapillary superficial vessel protrusion measurements and NAION were analysed. Two NAION patients underwent standard pars plana vitrectomy. RESULTS Incomplete papillary vitreous detachment was noted in all acute NAION patients. The prevalence of peripapillary wrinkles was 68% (17/25), 30% (7/23) and 0% (0/34), and the prevalence of peripapillary superficial vessel protrusion was 44% (11/25), 91% (21/23) and 0% (0/34) in the acute, non-acute NAION and control groups, respectively. The prevalence of peripapillary superficial vessel protrusion was 88.9% in the eyes without retinal nerve fibre layer thinning. Furthermore, the number of peripapillary superficial vessel protrusions in the superior quadrant was significantly higher than that in the other quadrants in eyes with NAION, consistent with the more damaged visual field defect regions. Peripapillary wrinkles and visual field defects in two patients with NAION were significantly attenuated within 1 week and 1 month after the release of vitreous connections, respectively. CONCLUSION Peripapillary wrinkles and superficial vessel protrusion may be signs of papillary vitreous detachment-related traction in NAION. Papillary vitreous detachment may play an important role in NAION pathogenesis.
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Affiliation(s)
- Dong Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
- Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, China
| | - Shuo Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jingli Liang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yi Yue
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jihong Yang
- Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, China
| | - Yuntao Zhi
- Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, China
| | - Xiaomin Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Rongguo Yu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaorong Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
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Chuangsuwanich T, Tun TA, Braeu FA, Wang X, Chin ZY, Panda SK, Buist M, Milea D, Strouthidis N, Perera S, Nongpiur ME, Aung T, Girard MJA. Adduction induces large optic nerve head deformations in subjects with normal-tension glaucoma. Br J Ophthalmol 2024; 108:522-529. [PMID: 37011991 DOI: 10.1136/bjo-2022-322461] [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: 08/23/2022] [Accepted: 03/15/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE To assess intraocular pressure (IOP)-induced and gaze-induced optic nerve head (ONH) strains in subjects with high-tension glaucoma (HTG) and normal-tension glaucoma (NTG). DESIGN Clinic-based cross-sectional study. METHODS The ONH from one eye of 228 subjects (114 subjects with HTG (pre-treatment IOP≥21 mm Hg) and 114 with NTG (pre-treatment IOP<21 mm Hg)) was imaged with optical coherence tomography (OCT) under the following conditions: (1) OCT primary gaze, (2) 20° adduction from OCT primary gaze, (3) 20° abduction from OCT primary gaze and (4) OCT primary gaze with acute IOP elevation (to approximately 33 mm Hg). We then performed digital volume correlation analysis to quantify IOP-induced and gaze-induced ONH tissue deformations and strains. RESULTS Across all subjects, adduction generated high effective strain (4.4%±2.3%) in the LC tissue with no significant difference (p>0.05) with those induced by IOP elevation (4.5%±2.4%); while abduction generated significantly lower (p=0.01) effective strain (3.1%±1.9%). The lamina cribrosa (LC) of HTG subjects exhibited significantly higher effective strain than those of NTG subjects under IOP elevation (HTG: 4.6%±1.7% vs NTG: 4.1%±1.5%, p<0.05). Conversely, the LC of NTG subjects exhibited significantly higher effective strain than those of HTG subjects under adduction (NTG: 4.9%±1.9% vs HTG: 4.0%±1.4%, p<0.05). CONCLUSION We found that NTG subjects experienced higher strains due to adduction than HTG subjects, while HTG subjects experienced higher strain due to IOP elevation than NTG subjects-and that these differences were most pronounced in the LC tissue.
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Affiliation(s)
- Thanadet Chuangsuwanich
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tin A Tun
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Duke-NUS Medical School, Singapore
| | - Fabian A Braeu
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Singapore-MIT Alliance for Research and Technology, Singapore
| | - Xiaofei Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zhi Yun Chin
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Satish K Panda
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Martin Buist
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Dan Milea
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Duke-NUS Medical School, Singapore
| | | | - Shamira Perera
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Duke-NUS Medical School, Singapore
| | - Monisha Esther Nongpiur
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Duke-NUS Medical School, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
| | - Michael J A Girard
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Duke-NUS Medical School, Singapore
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Quigley C, Stephenson KAJ, Kenna PF, Cassidy L. Peripapillary retinal nerve fibre layer thinning, perfusion changes and optic neuropathy in carriers of Leber hereditary optic neuropathy-associated mitochondrial variants. BMJ Open Ophthalmol 2024; 9:e001295. [PMID: 38471715 DOI: 10.1136/bmjophth-2023-001295] [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: 03/21/2023] [Accepted: 02/18/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND We investigated Leber hereditary optic neuropathy (LHON) families for variation in peripapillary retinal nerve fibre layer thickness and perfusion, and associated optic nerve dysfunction. METHOD A group of LHON-affected patients (n=12) and their asymptomatic maternal relatives (n=16) underwent examination including visual acuity (VA), visual-evoked-potential and optic nerve imaging including optical coherence tomography (OCT) and OCT angiography of the peripapillary retinal nerve fibre layer (RNFL). A control sample was also examined (n=10). The software imageJ was used to measure perfusion by assessing vessel density (VD), and statistical software 'R' was used to analyse data. RESULTS The LHON-affected group (n=12) had significantly reduced peripapillary VD (median 7.9%, p=0.046). Overall, the LHON asymptomatic relatives (n=16) had no significant change in peripapillary VD (p=0.166), though three eyes had VD which fell below the derived normal range at 6% each, with variable VA from normal to blindness; LogMAR median 0, range 0-2.4. In contrast, RNFL thickness was significantly reduced in the LHON-affected group (median 51 µm, p=0.003), and in asymptomatic relatives (median 90 µm, p=0.01), compared with controls (median 101 µm). RNFL thinning had greater specificity compared with reduced perfusion for optic nerve dysfunction in asymptomatic carriers (92% vs 66%). CONCLUSION Overall, reduced peripapillary retinal nerve fibre layer perfusion was observed in those affected by LHON but was not reduced in their asymptomatic relatives, unlike RNFL thinning which was significantly reduced in both groups versus controls. The presence of RNFL changes was associated with signs of optic neuropathy in asymptomatic relatives.
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Affiliation(s)
- Clare Quigley
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital Dublin, Dublin, Ireland
| | - Kirk A J Stephenson
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital Dublin, Dublin, Ireland
| | - Paul F Kenna
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital Dublin, Dublin, Ireland
| | - Lorraine Cassidy
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital Dublin, Dublin, Ireland
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Micheletti E, El-Nimri N, Nishida T, Moghimi S, Rezapour J, Fazio MA, Suh MH, Bowd C, Belghith A, Christopher M, Jonas JB, Weinreb RN, Zangwill LM. Central visual field damage in glaucoma eyes with choroidal microvasculature dropout with and without high axial myopia. Br J Ophthalmol 2024; 108:372-379. [PMID: 36805846 DOI: 10.1136/bjo-2022-322234] [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: 07/15/2022] [Accepted: 02/09/2023] [Indexed: 02/22/2023]
Abstract
PURPOSE To characterise the relationship between a deep-layer microvasculature dropout (MvD) and central visual field (VF) damage in primary open-angle glaucoma (POAG) patients with and without high axial myopia. DESIGN Cross-sectional study. METHODS Seventy-one eyes (49 patients) with high axial myopia and POAG and 125 non-highly myopic POAG eyes (97 patients) were enrolled. Presence, area and angular circumference of juxtapapillary MvD were evaluated on optical coherence tomography angiography B-scans and en-face choroidal images. RESULTS Juxtapapillary MvD was detected more often in the highly myopic POAG eyes (43 eyes, 86%) than in the non-highly myopic eyes (73 eyes, 61.9%; p=0.002). In eyes with MvD, MvD area and angular circumference (95% CI) were significantly larger in the highly myopic eyes compared with the non-highly myopic eyes (area: (0.69 (0.40, 0.98) mm2 vs 0.31 (0.19, 0.42) mm2, p=0.011) and (angular circumference: 84.3 (62.9, 105.8) vs 74.5 (58.3, 90.9) degrees, p<0.001), respectively. 24-2 VF mean deviation (MD) was significantly worse in eyes with MvD compared with eyes without MvD in both groups (p<0.001). After adjusting for 24-2 MD VF, central VF defects were more frequently found in eyes with MvD compared with eyes without MvD (82.7% vs 60.9%, p<0.001). In multivariable analysis, higher intraocular pressure, worse 24-2 VF MD, longer axial length and greater MvD area and angular circumference were associated with worse 10-2 VF MD. CONCLUSIONS MvD was more prevalent and larger in POAG eyes with high myopia than in non-highly myopic POAG eyes. In both groups, eyes with MvD showed worse glaucoma severity and more central VF defects.
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Affiliation(s)
- Eleonora Micheletti
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
| | - Nevin El-Nimri
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
| | - Takashi Nishida
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
| | - Jasmin Rezapour
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Massimo A Fazio
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Min Hee Suh
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
- Department of Ophthalmology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of)
| | - Christopher Bowd
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
| | - Akram Belghith
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
| | - Mark Christopher
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
| | - Jost B Jonas
- Department of Ophthalmology, University of Heidelberg Faculty of Medicine Mannheim Institute of Public Health, Mannheim, Germany
| | - Robert N Weinreb
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
| | - Linda M Zangwill
- Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA
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Yang N, Zhu H, Ma J, Shao Q. OCT and OCTA in dysthyroid optic neuropathy: a systematic review and meta-analysis. BMJ Open Ophthalmol 2023; 8:e001379. [PMID: 37996119 PMCID: PMC10668299 DOI: 10.1136/bmjophth-2023-001379] [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: 07/03/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
PURPOSE To explore the current research about the role of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in dysthyroid optic neuropathy (DON). METHODS Studies in the literature that focused on OCT, OCTA and DON were retrieved by searching PubMed, EMBASE, Cochrane databases and Clinical Trial before 20 June 2023. The methodological quality was assessed using the Newcastle-Ottawa scale. The quantitative calculation was performed using Review Manager V.5.3. RESULTS Twelve studies met the eligibility criteria and were included. DON group presented lower macular ganglion cell complex in the overall, superior and inferior hemifields compared with the non-DON group. Furthermore, the ganglion cell layer and inner plexiform layer in DON group was thinner in contrast to the non-DON group. The optic nerve head vessel density was lower in the DON group than that in the non-DON group. A reduction of radial peripapillary capillary vessel density could be seen in the DON group than the non-DON group in overall, inside disc, peripapillary, superior-hemifield, temporal and nasal. Besides, the macular superficial retinal capillary layer of non-DON and DON is lower than the healthy control group. CONCLUSIONS This study supported the potential value of OCT and OCTA metrics as novel biomarkers of DON. Ophthalmologists should comprehensively consider the retinal structure and microvasculature in dealing with DON. ETHICS AND DISSEMINATION This systematic review included data from published literature and was exempt from ethics approval. Results would be disseminated through peer-reviewed publication and presented at academic conferences engaging clinicians. PROSPERO REGISTRATION NUMBER CRD42023414907.
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Affiliation(s)
- Nan Yang
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hui Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Junxin Ma
- Department of Ophthalmology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qing Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Zhang Y, Cao K, Pang R, Wang N, Qu X, Kang J, Wang N, Liu H. Non-invasive intracranial pressure estimation using ultrasonographic measurement of area of optic nerve subarachnoid space. Br J Ophthalmol 2023; 107:1716-1721. [PMID: 36002239 DOI: 10.1136/bjo-2022-321065] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/31/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To verify whether the area of the ONSAS (ONSASA) obtained by transorbital ultrasonography can be used to accurately evaluate the intracranial pressure (ICP). METHODS The recorded indexes included the optic nerve diameter, the optic nerve sheath diameter (ONSD), the width of both sides of the ONSAS (ONSASW) at 3 mm from the optic nerve head and the entire ONSASA outlined between 3 and 7 mm. After exploring and comparing five models to describe the relationship between body mass index (BMI), mean arterial blood pressure (MABP), ONSASA and ICP, the best model was determined. RESULTS In all, 90 patients with neurological diseases undergoing continuous invasive ICP monitoring were included in the study. In the training group, the correlation coefficient for the association between the ICP and ONSASA (Pearson's correlation r=0.953) was higher than that for the association of the ICP with the ONSD (r=0.672; p<0.0001) and ONSASW at 3 mm behind the globe (r=0.691; p<0.0001). In the training group, the weighting function for prediction of the ICP was as follows: non-invasive ICP=2.050×ONSASA-0.051×BMI +0.036*MABP-5.837. With 20 mm Hg as the cut-off point for a high or low ICP, the sensitivity and specificity of ONSASA predicting ICP was 1.00 and 0.92. Receiver operator curve analysis revealed that the calculated cut-off value for predicting elevated ICP was 19.96 (area under curve= 0.960, 95% CI 0.865 to 1.00). CONCLUSION Measurement of the ONSASA using ultrasonography can serve as a practical method for rapid and non-invasive quantification for evaluating ICP through an accurate mathematical formula with the BMI and MABP considered as contributing parameters. TRIAL REGISTRATION NUMBER The study was registered in the Chinese Clinical Trial Registry (Study no ChiCTR2100045274).
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Affiliation(s)
- Yue Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ruiqi Pang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ning Wang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Xin Qu
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Jun Kang
- Department of Neurosurgery, Beijing Tongren Hospital, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- School of Information and Electronics, Beijing Institute of Technology, Beijing, China
| | - Hanruo Liu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- School of Information and Electronics, Beijing Institute of Technology, Beijing, China
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Attia R, Fitoussi R, Mairot K, Demortiere S, Stellman JP, Tilsley P, Audoin B, David T, Stolowy N. Risk factors associated with progression from papilloedema to optic atrophy: results from a cohort of 113 patients. BMJ Open Ophthalmol 2023; 8:e001375. [PMID: 37935563 PMCID: PMC10632874 DOI: 10.1136/bmjophth-2023-001375] [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: 06/27/2023] [Accepted: 10/15/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND The aim of this study was to assess the risk factors for atrophic progression of patients with papilloedema secondary to intracranial hypertension, using optical coherence tomography parameters. METHODS A retrospective study was conducted at Marseille University Hospitals' Ophthalmology departments between December 2015 and December 2021. All patients with papilloedema resulting from elevated intracranial hypertension at the initial presentation were included. Ophthalmological evaluations included analysing retinal nerve fibre layer (RNFL), ganglion cell layer (GCL) and total peripapillary retinal thickness (RT). RESULTS The study included 222 eyes from 113 patients. The main aetiologies of intracranial hypertension were idiopathic intracranial hypertension (49/113), intracranial tumours (33/113) and cerebral venous thrombosis (15/113). The initial RNFL and RT showed significant correlations with optic atrophy. The mean RNFL was 199.63 µm in the 'no atrophy' group and 365.28 µm in the 'atrophy' group (p<0.001). Similarly, the mean RT was 483.72 µm in the 'non-atrophy' group and 796.69 µm in the 'atrophy' group (p<0.001). The presence of peripapillary haemorrhages showed a strong correlated with optic atrophy with an OR=19.12 (p<0.001). Impaired initial visual acuity was also associated with final optic atrophy with an OR=7.76 (p=0.020). Furthermore, impaired initial GCL was a major predictor of optic atrophy (OR=18.25 (p=0.021)). CONCLUSION Our study highlights the risk factors for optic atrophy in papilloedema, aiming to facilitate the early detection of patients at a high risk of vision loss and enable more aggressive medical or surgical management.
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Affiliation(s)
- Ruben Attia
- Ophthalmology, Hospital Timone, Marseille, France
| | | | - Kevin Mairot
- Ophthalmology, Hospital Timone, Marseille, France
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Verticchio Vercellin AC, Harris A, Oddone F, Siesky B, Eckert G, Belamkar A, Antman G, Segev F. Ocular blood flow biomarkers may predict long-term glaucoma progression. Br J Ophthalmol 2023:bjo-2022-322644. [PMID: 37852742 DOI: 10.1136/bjo-2022-322644] [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: 09/30/2022] [Accepted: 07/29/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND/AIM To examine the relationship between baseline blood flow biomarkers and long-term open-angle glaucoma (OAG) progression. METHODS 112 patients with early to moderate OAG (mean age 64.9±11.0 years; 68 female) were evaluated at baseline and every 6 months from 2008 to 2013. Biomarkers of retinal capillary blood flow were assessed by Heidelberg retinal flowmetry. Functional disease progression was monitored via Humphrey visual field examinations, defined as two consecutive visits with a mean deviation decrease ≥2 decibels and/or Advanced Glaucoma Intervention Study score increase ≥2 compared with baseline. Structural progression was monitored with optical coherence tomography and Heidelberg retinal tomograph, defined as two consecutive visits with retinal nerve fibre layer thickness decrease ≥8% and/or horizontal or vertical cup/disk ratio increase ≥0.2 compared with baseline. Mixed-model analysis of covariance was used to test for significant change from baseline to 5-year follow-up. Times to functional and structural progression were analysed using Cox proportional hazards models. RESULTS Lower HRF retinal capillary blood flow in the superior retina was significantly associated with structural progression (p=0.0009). CONCLUSION In our OAG sample, baseline lower retinal capillary perfusion in the superior retina was predictive of structural progression after 5 years. TRIAL REGISTRATION NUMBER NCT01145911.
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Affiliation(s)
| | - Alon Harris
- Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Brent Siesky
- Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - George Eckert
- Department of Biostatistics abd Health Data Science, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA
| | - Aditya Belamkar
- Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Gal Antman
- Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
| | - Fani Segev
- Ophthalmology, Assuta Ashdod Medical Center, Goldman Medical School, Ben-Gurion University, Be'er Sheva, Israel
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Mohammadzadeh V, Wu S, Davis T, Vepa A, Morales E, Besharati S, Edalati K, Martinyan J, Rafiee M, Martynian A, Scalzo F, Caprioli J, Nouri-Mahdavi K. Prediction of visual field progression with serial optic disc photographs using deep learning. Br J Ophthalmol 2023:bjo-2023-324277. [PMID: 37833037 PMCID: PMC11014894 DOI: 10.1136/bjo-2023-324277] [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: 07/19/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023]
Abstract
AIM We tested the hypothesis that visual field (VF) progression can be predicted with a deep learning model based on longitudinal pairs of optic disc photographs (ODP) acquired at earlier time points during follow-up. METHODS 3919 eyes (2259 patients) with ≥2 ODPs at least 2 years apart, and ≥5 24-2 VF exams spanning ≥3 years of follow-up were included. Serial VF mean deviation (MD) rates of change were estimated starting at the fifth visit and subsequently by adding visits until final visit. VF progression was defined as a statistically significant negative slope at two consecutive visits and final visit. We built a twin-neural network with ResNet50-backbone. A pair of ODPs acquired up to a year before the VF progression date or the last VF in non-progressing eyes were included as input. Primary outcome measures were area under the receiver operating characteristic curve (AUC) and model accuracy. RESULTS The average (SD) follow-up time and baseline VF MD were 8.1 (4.8) years and -3.3 (4.9) dB, respectively. VF progression was identified in 761 eyes (19%). The median (IQR) time to progression in progressing eyes was 7.3 (4.5-11.1) years. The AUC and accuracy for predicting VF progression were 0.862 (0.812-0.913) and 80.0% (73.9%-84.6%). When only fast-progressing eyes were considered (MD rate < -1.0 dB/year), AUC increased to 0.926 (0.857-0.994). CONCLUSIONS A deep learning model can predict subsequent glaucoma progression from longitudinal ODPs with clinically relevant accuracy. This model may be implemented, after validation, for predicting glaucoma progression in the clinical setting.
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Affiliation(s)
- Vahid Mohammadzadeh
- Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
| | - Sean Wu
- Department of Computer Science, Pepperdine University, Malibu, California, USA
| | - Tyler Davis
- Department of Computer Science, University of California Los Angeles, Los Angeles, California, USA
| | - Arvind Vepa
- Department of Computer Science, University of California Los Angeles, Los Angeles, California, USA
| | - Esteban Morales
- Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
| | - Sajad Besharati
- Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
| | - Kiumars Edalati
- Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
- Department of Ophthalmology, Jules Stien Eye Institute, UCLA, Los Angeles, California, USA
| | - Jack Martinyan
- Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
- University of California Los Angeles, Sherman Oaks, California, USA
| | - Mahshad Rafiee
- Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
| | - Arthur Martynian
- Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
| | - Fabien Scalzo
- Department of Computer Science, University of California Los Angeles, Los Angeles, California, USA
| | - Joseph Caprioli
- Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
| | - Kouros Nouri-Mahdavi
- Department of Ophthalmology, Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
- Ophthalmology, UCLA Jules Stein Eye Institute, Los Angeles, California, USA
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11
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Suwan Y, Aghsaei Fard M, Vilainerun N, Petpiroon P, Tantraworasin A, Teekhasaenee C, Ritch R, Kafieh R, Hojati S, Supakontanasan W. Parapapillary choroidal microvascular density in acute primary angle-closure and primary open-angle glaucoma: an optical coherence tomography angiography study. Br J Ophthalmol 2023; 107:1438-1443. [PMID: 35831203 PMCID: PMC10579173 DOI: 10.1136/bjo-2021-321022] [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: 01/03/2022] [Accepted: 06/21/2022] [Indexed: 11/04/2022]
Abstract
BACK GROUND/AIMS To determine whether parapapillary choroidal microvasculature (PPCMv) density, measured by optical coherence tomography angiography, differed between acute primary angle-closure (APAC), primary open-angle glaucoma (POAG) and controls. METHODS This is a prospective, cross-sectional, observational study. Data from 149 eyes from two academic referral centres were analysed. Automated PPCMv density was calculated in inner and outer annuli around the optic nerve region in addition to the peripapillary superficial vasculature, using customised software. A generalised estimating equation was used to compare vessel densities among groups, adjusted for confounders. RESULTS Data from 40 eyes with APAC, 65 eyes with POAG and 44 eyes in healthy controls were gathered and analysed. Global radial peripapillary capillary densities were reduced in eyes with APAC and POAG compared with controls (p=0.027 and 0.136, respectively). Mean outer annular PPCMv density in the POAG group was lower vs the APAC group by 3.6% (95% CI 0.6% to 6.5%) (p=0.018) in the multivariable model adjusted for confounders. The mean difference in inner and outer superior PPCMv between the POAG and APAC groups was 5.9% and 4.4% (95% CI 1.9% to 9.9% and 1.0% to 7.7%, respectively; both p<0.010). Furthermore, POAG and APAC groups both had significantly lower PPCMv compared with controls (both, p<0.001). CONCLUSIONS While superficial peripapillary vessels were affected to similar degrees in POAG and APAC, PPCMv drop-out was greater with POAG versus APAC, suggesting that choroidal vessel density may be affected to a lesser extent following an acute increase in intraocular pressure before glaucoma develops.
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Affiliation(s)
- Yanin Suwan
- Ophthalmology, Ramathibodi Hospital, Bangkok, Thailand
| | | | - Nantinee Vilainerun
- Ophthalmology, Chulabhorn hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | | | - Apichat Tantraworasin
- Surgery and Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical Surgical Research Center, Chiang Mai University, Chiang Mai, Thailand
| | | | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York City, New York, USA
| | - Rahele Kafieh
- Medical Image and Signal Processing Research Center, School of Advanced Technologies in Medicine, University of Medical Sciences, Isfahan, Iran
| | - Sahar Hojati
- Medical Image and Signal Processing Research Center, School of Advanced Technologies in Medicine, University of Medical Sciences, Isfahan, Iran
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12
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Konstantakopoulou E, Kastner A, Gazzard G, Jayaram H. Validation of the RCOphth and UKEGS glaucoma risk stratification tool 'GLAUC-STRAT-fast'. Br J Ophthalmol 2023; 107:1258-1263. [PMID: 35534178 DOI: 10.1136/bjophthalmol-2021-320968] [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: 12/22/2021] [Accepted: 04/11/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS The aim of this study was to validate the Glaucoma Risk Stratification Tool (GLAUC-STRAT-fast) currently recommended by the Royal College of Ophthalmologists for the risk stratification of patients with glaucoma in the UK National Health Service Hospital Eye Service. METHODS GLAUC-STRAT fast was applied to the LiGHT trial participants by risk-stratifying the worse eye of each patient at baseline and after 3 years of treatment. Metrics of disease severity or treatment intensity used for the validation were: increased number of monitoring visits or treatment escalations; needing a trabeculectomy; a reduction of >2 dB in visual field mean deviation (VF MD) during the monitoring period; identification of rapid VF loss on total (TD) and/or pattern deviation (PD). The proportion of eyes within each baseline stratum for each of the above markers was compared against the other strata, using a χ2 test for proportions. RESULTS There was an association between the baseline stratification and the number of treatment escalations needed to maintain the eye-specific target intraocular pressure (p=0.001), the number of visits needed throughout the 3-year follow-up period (p=0.001), the need for trabeculectomy (p<0.001) and absolute loss of MD over the course of the monitoring period (p<0.001). The rate of VF progression was not associated with baseline risk stratification for TD or PD progression (p≥0.007, with Bonferroni correction). CONCLUSION The GLAUC-STRAT fast tool is a useful tool for risk stratifying eyes with ocular hypertension or open angle glaucoma. Further research is needed to confirm and validate its applicability to more advanced glaucomas and generalisability to clinical use. TRIAL REGISTRATION NUMBER The LiGHT trial is registered at controlled-trials.com (ISRCTN32038223).
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Affiliation(s)
- Evgenia Konstantakopoulou
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Optics & Optometry, University of West Attica, Egaleo, Greece
| | - Alan Kastner
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gus Gazzard
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Institute of Ophthalmology, University College London, London, UK
| | - Hari Jayaram
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Institute of Ophthalmology, University College London, London, UK
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13
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Zhang XJ, Tang SM, Wang YM, Zhang Y, Chan HN, Lau YH, Kam KW, Chan PP, Ip P, Young AL, Tham CC, Chen LJ, Pang CP, Yam JC. Increase in Bruch's membrane opening minimum rim width with age in healthy children: the Hong Kong Children Eye Study. Br J Ophthalmol 2023; 107:1344-1349. [PMID: 35649695 DOI: 10.1136/bjophthalmol-2021-320524] [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: 09/28/2021] [Accepted: 05/18/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To identify normative values and determinants for Bruch's membrane opening (BMO) and the minimum rim width of BMO (BMO-MRW) among healthy children. METHODS A population-based cross-sectional study from the Hong Kong Children Eye Study, recruiting 1, 226 children aged 6-8 years. Spherical refractive error, axial length (AL), body mass index and intraocular pressure (IOP) were measured. The optic nerve head and the peripapillary retinal nerve fibre layer (p-RNFL) were imaged through spectral domain-optical coherence tomography, using 24 equally spaced radial B-scans. Global and sectoral BMO-MRW values, BMO area and fovea-to-BMO (FoBMO) angle were calculated. Multiple regression analysis was performed to define the determinants of BMO area and BMO-MRW in relation to demographic and ocular parameters. RESULTS The mean values for global BMO-MRW, BMO area and FoBMO angle among children were 345.76±54.08 µm, 2.34±0.49 mm2 and -5.45±4.36°, respectively. Global and sectoral values for BMO-MRW correlated with p-RNFL thickness (r=0.11-0.35, p<0.001). After adjusting for demographic and ocular parameters, global BMO-MRW increased with age (β=6.4, p<0.001) and greater global p-RNFL thickness (β=1.41, p<0.001), but decreased with larger BMO area (β=-47.46, p<0.001) and higher IOP (β=-1.73, p<0.001). Global BMO-MRW did not associate with AL, whereas both BMO area and FoBMO angle associated with AL (β=0.04, p=0.02 and β=0.31, p=0.03, respectively), but not with age. CONCLUSION We observed that BMO-MRW increases with age among children. Our results provide normative values and the determinants of BMO parameters among Chinese children.
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Affiliation(s)
- Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shu Min Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Yu Meng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuzhou Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hei-Nga Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yi Han Lau
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ka Wai Kam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Poemen P Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Alvin L Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR
- Department of Ophthalmology, Hong Kong Children Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR
- Department of Ophthalmology, Hong Kong Children Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
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Tavakoli M, Jafari-Pozve N, Aryanezhad SS. Sphenoid Sinus Pneumatization Types and Correlation with Adjacent Neurovascular Structures Using Cone-Beam Computed Tomography. Indian J Otolaryngol Head Neck Surg 2023; 75:2245-2250. [PMID: 37636739 PMCID: PMC10447682 DOI: 10.1007/s12070-023-03796-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/10/2023] [Indexed: 08/29/2023] Open
Abstract
Aims: This study aimed to assess the sphenoid sinus pneumatization types and their correlation with adjacent neurovascular structures using cone-beam computed tomography (CBCT). Materials and methods: This cross-sectional study was conducted on 97 CBCT scans of patients over 18 years of age that were retrieved from the archives of the Oral & Maxillofacial Radiology Department of School of Dentistry. Type of sphenoid sinus pneumatization based on its relationship with sella turcica (conchal, presellar, sellar, and postsellar), the correlation of internal carotid artery (ICA) and optic nerve (ON) with the sinus cavity in the axial and coronal planes (smooth or prolonged type), and presence of Onodi cells and their correlation with the sphenoid sinus (lateral, superior, and superolateral) were all evaluated on CBCT sections. Data were analyzed by the Chi-square and Fisher's exact tests (alpha = 0.05). Results: Postsellar type was the most common sphenoid sinus pneumatization type (82.5%). The Smooth type was the most common form of correlation of ON and ICA with the sphenoid sinus. Onodi cells were noted in 28.9% of the cases; among which, the lateral type had the highest prevalence. Conclusion: Considering the high prevalence of sphenoid sinus pneumatization, Onodi cells, and ON and ICA protrusion in our study population, CBCT should be requested prior to trans-sphenoidal surgical procedures to prevent perioperative and postoperative complications. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03796-0.
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Affiliation(s)
- Mohadese Tavakoli
- Faculty of Dentistry, Isfahan (khorasgan) Branch, Islamic Azad university, Isfahan, Iran
| | - Nasim Jafari-Pozve
- Department of oral and maxillofacial radiology, Faculty of Dentistry, Isfahan (khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Seyed Sasan Aryanezhad
- Department of oral and maxillofacial radiology, Faculty of Dentistry, Isfahan (khorasgan) Branch, Islamic Azad University, Isfahan, Iran
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Finkelstein MT, Nongpiur ME, Husain R, Perera S, Baskaran M, Wong TT, Aung T, Milea D, Najjar RP. Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia. Br J Ophthalmol 2023:bjo-2023-323878. [PMID: 37524446 DOI: 10.1136/bjo-2023-323878] [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: 05/04/2023] [Accepted: 07/12/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND/AIMS To assess pupillary light responses (PLRs) in eyes with high myopia (HM) and evaluate the ability of handheld chromatic pupillometry (HCP) to identify glaucomatous functional loss in eyes with HM. METHODS This prospective, cross-sectional study included 28 emmetropes (EM), 24 high myopes without glaucoma (HM) and 17 high myopes with confirmed glaucoma (HMG), recruited at the Singapore National Eye Center. Monocular PLRs were evaluated using a custom-built handheld pupillometer that recorded changes in horizontal pupil radius in response to 9 s of exponentially increasing blue (469.1 nm) and red (640.1 nm) lights. Fifteen pupillometric features were compared between groups. A logistic regression model (LRM) was used to distinguish HMG eyes from non-glaucomatous eyes (EM and HM). RESULTS All pupillometric features were similar between EM and HM groups. Phasic constriction to blue (p<0.001) and red (p=0.006) lights, and maximum constriction to blue light (p<0.001) were reduced in HMG compared with EM and HM. Pupillometric features of melanopsin function (postillumination pupillary response, PIPR area under the curve (AUC) 0-12 s (p<0.001) and PIPR 6 s (p=0.01) to blue light) were reduced in HMG. Using only three pupillometric features, the LRM could classify glaucomatous from non-glaucomatous eyes with an AUC of 0.89 (95% CI 0.77 to 1.00), sensitivity 94.1% (95% CI 82.4% to 100.0%) and specificity 78.8% (95% CI 67.3% to 90.4%). CONCLUSION PLRs to ramping-up light stimuli are unaltered in highly myopic eyes without other diagnosed ocular conditions. Conversely, HCP can distinguish glaucomatous functional loss in eyes with HM and can be a useful tool to detect/confirm the presence of glaucoma in patients with HM.
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Affiliation(s)
| | - Monisha Esther Nongpiur
- Glaucoma, Singapore Eye Research Institute, Singapore
- Glaucoma, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences, Duke-NUS Medical School, Singapore
| | - Rahat Husain
- Glaucoma, Singapore Eye Research Institute, Singapore
- Glaucoma, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences, Duke-NUS Medical School, Singapore
| | - Shamira Perera
- Glaucoma, Singapore Eye Research Institute, Singapore
- Glaucoma, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences, Duke-NUS Medical School, Singapore
| | - Mani Baskaran
- Glaucoma, Singapore Eye Research Institute, Singapore
- Glaucoma, Singapore National Eye Centre, Singapore
| | - Tina T Wong
- Glaucoma, Singapore Eye Research Institute, Singapore
- Glaucoma, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences, Duke-NUS Medical School, Singapore
- Ocular Therapeutics & Drug Delivery, Singapore Eye Research Institute, Singapore
| | - Tin Aung
- Glaucoma, Singapore Eye Research Institute, Singapore
- Glaucoma, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences, Duke-NUS Medical School, Singapore
| | - Dan Milea
- Visual Neurosciences, Singapore Eye Research Institute, Singapore
- Ophthalmology & Visual Sciences, Duke-NUS Medical School, Singapore
- Neuro-ophthalmology, Singapore National Eye Centre, Singapore
| | - Raymond P Najjar
- Visual Neurosciences, Singapore Eye Research Institute, Singapore
- Ophthalmology & Visual Sciences, Duke-NUS Medical School, Singapore
- Ophthalmology, National University of Singapore, Singapore
- Biomedical Engineering, National University of Singapore, Singapore
- Center for Innovation & Precision Eye Health, National University of Singapore, Singapore
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Bhattacharjee K, Soni D, Venkatraman V, Grewal AM, Rehman O, Bhattacharjee P, Bhattacharjee H. Navigation-guided transcaruncular orbital optic canal decompression in indirect traumatic optic neuropathy: long-term outcomes. Br J Ophthalmol 2023:bjo-2023-323282. [PMID: 37414533 DOI: 10.1136/bjo-2023-323282] [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: 01/29/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE To determine the surgical outcomes using navigation-guided transcaruncular orbital optic canal decompression (NGTcOCD) and investigate the relationship between visual prognosis. visual evoked potential (VEP), association with DeLano type of optic canal and Onodi cells in patients with indirect traumatic optic neuropathy (TON). DESIGN Prospective observational. METHODS Fifty-two consecutive patients with indirect TON unresponsive to steroid therapy were divided into three groups where Group I comprised of cases with optic canal fracture who underwent NGTcOCD, Group II without optic canal fracture who underwent NGTcOCD and Group III, no-decompression group who chose not to undergo NGTcOCD. An improvement in visual acuity (VA) at 1 week, 3 months and 1 year and amplitude and latency of VEP at 1 year were considered as primary and secondary outcomes, respectively. RESULTS The mean VA improved from 2.55±0.67 and 2.62±0.56 LogMAR at presentation to 2.03±0.96 and 2.33±0.72 LogMAR at final follow-up among Group I and Group II patients, respectively (p<0.001 and p=0.01). Statistically significant improvement observed among both the Groups in VEP amplitude (p=<0.01) and among Group II in VEP latency (p<0.01). Both Group I and Group II patients have better outcomes than patients in no-decompression group. VA at presentation and Type 1 DeLano optic canal were observed as significant prognostic factors. CONCLUSIONS NGTcOCD serves as a minimally invasive transcaruncular route to the optic canal which enables ophthalmologists to perform decompression from the anterior-most orbital end under direct visualisation. Patients with indirect TON with or without optic canal fracture and unresponsive to steroid therapy when managed with NGTcOCD have shown comparable and superior outcomes.
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Affiliation(s)
- Kasturi Bhattacharjee
- Ophthalmic Plastic and Reconstructive Surgery, Ocular Oncology and Facial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Deepak Soni
- Ophthalmic Plastic and Reconstructive Surgery, Ocular Oncology and Facial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Vatsalya Venkatraman
- Ophthalmic Plastic and Reconstructive Surgery, Ocular Oncology and Facial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Aditi Mehta Grewal
- Ophthalmic Plastic and Reconstructive Surgery, Ocular Oncology and Facial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Obaidur Rehman
- Ophthalmic Plastic and Reconstructive Surgery, Ocular Oncology and Facial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
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Vélez Cevallos A, Vásquez AM. Alterations in the optic nerve and retina in patients with COVID-19. A theoretical review. Arch Soc Esp Oftalmol (Engl Ed) 2023:S2173-5794(23)00110-X. [PMID: 37369321 PMCID: PMC10290763 DOI: 10.1016/j.oftale.2023.06.015] [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: 05/06/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023]
Abstract
The objective of this research is to identify and systematize the medical conditions generated by SARS-CoV-2 on the optic nerve and retina of young, adult, and elderly adults who suffered from COVID-19 in the period 2019-2022. A theoretical documentary review (TDR) was conducted within the framework of an investigation to determine the current state of knowledge of the subject under study. The TDR includes the analysis of publications in the scientific databases PubMed/Medline, Ebsco, Scielo and Google. A total of 167 articles were found, of which 56 were studied in depth, and these evidence the impact of COVID-19 infection on the retina and optic nerve of infected patients, both during the acute phase and in subsequent recovery. Among the reported findings, the following stand out: anterior and posterior non-arteritic ischemic optic neuropathy, optic neuritis, central or branch vascular occlusion, paracentral acute medial maculopathy, neuroretinitis, as well as concomitant diagnoses such as possible Vogt-Koyanagi-Harada disease, multiple evanescent white dot syndrome (MEWDS), Purtscher-like retinopathy, among others.
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Affiliation(s)
| | - A M Vásquez
- Instituto de Oftalmología y Glaucoma Vásquez
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18
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Horton JC, Dilbeck MD, Economides JR. Decussating axons segregate within the anterior core of the primate optic chiasm. Br J Ophthalmol 2023; 107:447-452. [PMID: 36575620 PMCID: PMC10038861 DOI: 10.1136/bjo-2022-322235] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The axons of ganglion cells in the nasal retina decussate at the optic chiasm. It is unclear why tumours cause more injury to crossing nasal fibres, thereby giving rise to temporal visual field loss in each eye. To address this issue, the course of fibres through the optic chiasm was examined following injection of a different fluorescent tracer into each eye of a monkey. METHODS Under general anaesthesia, cholera toxin subunit B-Alexa Fluor 488 was injected into the right eye and cholera toxin subunit B-Alexa Fluor 594 was injected into the left eye of a single normal adult male rhesus monkey. After a week's survival for anterograde transport, serial coronal sections through the primary optic pathway were examined. RESULTS A zone within the core of the anterior and mid portions of the optic chiasm was comprised entirely of crossing fibres. This zone of decussation was delineated by segregated, interwoven sheets of green (right eye) and red (left eye) fibres. It expanded steadily to fill more of the optic chiasm as fibres coursed posteriorly towards the optic tracts. Eventually, crossed fibres became completely intermingled with uncrossed fibres, so that ocular separation was lost. CONCLUSIONS A distinct, central compartment located within the anterior two-thirds of the optic chiasm contains only crossing fibres. Sellar tumours focus their compressive force on this portion of the structure, explaining why they so often produce visual field loss in the temporal fields.
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Affiliation(s)
- Jonathan C Horton
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - Mikayla D Dilbeck
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - John R Economides
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
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19
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Shemesh R, Yakirevitch A, Abergel A, Leibovitch I, Ben Simon GJ, Ben Cnaan R. Endoscopic approach for orbital apex lesions: case series and review of the literature. J Laryngol Otol 2023; 137:419-425. [PMID: 35678382 DOI: 10.1017/s0022215122001323] [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] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The transnasal endoscopic approach may provide better visualisation and a safer approach to the orbital apex. This study presents a case series of orbital apex lesions managed by this approach. METHOD This study was an eight-year retrospective analysis of seven patients who were operated on for orbital apex lesions in two tertiary medical centres. RESULTS Complete tumour removal was performed in three patients and partial removal was performed in four patients. Visual acuity improved in three patients, remained stable in one patient and decreased in the other two patients. The visual field improved in four patients and did not change in two patients. Complications included worse vision and visual fields in 28.6 per cent of patients and late enophthalmos (of -1.25 ± 4.6 mm) in 2 patients. CONCLUSION The transnasal approach to orbital apex lesions in selected cases may provide a rational alternative to transorbital surgery. Complete tumour removal should be weighed against the risk of damage to the optic nerve.
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Affiliation(s)
- R Shemesh
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Goldschleger Eye Institute, Ramat Gan, Israel
| | - A Yakirevitch
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Otolaryngology - Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel
| | - A Abergel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Otolaryngology - Head and Neck Surgery, Tel Aviv, Israel
| | - I Leibovitch
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - G J Ben Simon
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Goldschleger Eye Institute, Ramat Gan, Israel
| | - R Ben Cnaan
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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20
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Salowe RJ, Chen Y, Zenebe-Gete S, Lee R, Gudiseva HV, Di Rosa I, Ross AG, Cui QN, Miller-Ellis E, Addis V, Sankar PS, Daniel E, Ying GS, O'Brien JM. Risk factors for structural and functional progression of primary open-angle glaucoma in an African ancestry cohort. BMJ Open Ophthalmol 2023; 8:e001120. [PMID: 37278425 PMCID: PMC9990679 DOI: 10.1136/bmjophth-2022-001120] [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: 07/19/2022] [Accepted: 08/10/2022] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND/AIMS To investigate the rates of structural and functional progression of primary open-angle glaucoma in an African ancestry cohort and identify risk factors for progression. METHODS This retrospective study included 1424 eyes from glaucoma cases in the Primary Open-Angle African American Glaucoma Genetics cohort, with ≥2 visits for retinal nerve fibre layer (RNFL) thickness and mean deviation (MD) measurements over ≥6-month follow-up. The rates of structural progression (change in RNFL thickness/year) and functional progression (change in MD/year) were calculated from linear mixed effects models, accounting for intereye correlation and longitudinal correlation. Eyes were categorised as slow, moderate or fast progressors. Risk factors for progression rates were assessed using univariable and multivariable regression models. RESULTS The median (interquartile) rates of progression were -1.60 (-2.05 to -1.15) µm/year for RNFL thickness and -0.40 (-0.44 to -0.34) decibels/year for MD. Eyes were categorised as slow (structural: 19%, functional: 88%), moderate (structural: 54%, functional: 11%) and fast (structural: 27%, functional: 1%) progressors. In multivariable analysis, faster RNFL progression was independently associated with thicker baseline RNFL (p<0.0001), lower baseline MD (p=0.003) and beta peripapillary atrophy (p=0.03). Faster MD progression was independently associated with higher baseline MD (p<0.0001), larger cup-to-disc ratios (p=0.02) and lower body mass index (p=0.0004). CONCLUSION The median rates of structural and functional progression in this African ancestry cohort were faster than the rates reported from previously published studies in other ethnic groups. Higher baseline RNFL thickness and MD values were associated with faster progression rates. Results highlight the importance of monitoring structural and functional glaucoma progression to provide timely treatment in early disease.
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Affiliation(s)
- Rebecca J Salowe
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yineng Chen
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Selam Zenebe-Gete
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Roy Lee
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Harini V Gudiseva
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Isabel Di Rosa
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ahmara G Ross
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Qi N Cui
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eydie Miller-Ellis
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Victoria Addis
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Prithvi S Sankar
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ebenezer Daniel
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gui-Shuang Ying
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Joan M O'Brien
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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21
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Treviño-Gonzalez JL, Santos-Santillana KM, Maldonado-Chapa F, Morales-Del Angel JA, Becerra-Jimenez JA. Anatomical configurations of the optic canal in the sphenoid sinus in a Hispanic population: computed tomography based study. J Laryngol Otol 2023; 137:279-84. [PMID: 35125122 DOI: 10.1017/S0022215122000305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The prevalence of the optic canal anatomical variants across the sphenoid sinus varies widely among different ethnic groups. This study aimed to analyse the anatomical variants of the optic canal and their relationship to sphenoid sinus pneumatisation in a Hispanic population. METHOD A review of 320 sphenoid sinuses by high-resolution computed tomography was performed. DeLano's classification of the optic canal, presence of dehiscence, septa insertion, sphenoid sinus pneumatisation and presence of Onodi cells were established. RESULTS Dehiscence of the optic canal was observed in 4.7 per cent (n = 15) of the analysed sinuses. Type 4 and 3 optic canals were significantly more frequent among postsellar sphenoid sinuses than other patterns of sphenoid sinus pneumatisation (p = 0.002 and p = 0.018). A type 4 optic canal has a higher tendency to present inserted septum than other optic canal types (p = 0.014). CONCLUSION This study described the optic canal variants in a Hispanic population, which complements existing literature addressing other ethnicities.
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22
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Krasińska-Płachta A, Brązert A, Mamczur-Załęcka J, Gabriel M, Suchodolski M, Begier-Krasińska B, Kocięcki J. Visual outcomes in carotid stenosis patients treated using endarterectomy. Pol Przegl Chir 2023; 95:1-5. [PMID: 36808052 DOI: 10.5604/01.3001.0016.2123] [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] [Indexed: 01/27/2023]
Abstract
IntroductionCarotid arthrosclerosis can be a cause of visual impairment. It has been observed that carotid endarterectomy has a positive effect on ophthalmic parameters. The aim of this study was to evaluate the impact of endarterectomy on the optic nerve function.Materials and methods54 asymptomatic patients (19 women and 35 men - 108 eyes) with unilateral carotid stenosis >70% of internal carotid artery, were recruited to the study. All of them were qualified for the endarterectomy procedure. The whole study group underwent Doppler ultrasonography of internal carotid arteries and ophthalmic examination before the surgery, with 22 of them (11 women and 11 men) were examined after the endarterectomy. The ophthalmic examination included; distant best-corrected visual acuity, measurement of the intraocular pressure, electrophysiology (pattern visual evoked potentials), perimetry, and optical coherent tomography (the retinal nerve fiber layer thickness).DiscussionCarotid arteries supply brain and face with blood. Extensive research has observed a concomitant improvement in eyesight after enduring carotid endarterectomy in patients with artery stenosis. This effect was associated with a better blood flow in the ophthalmic artery and its branches, the central retinal artery and the ciliary artery; the major blood supply of the eye.ResultsThe present study proved that carotid endarterectomy has a positive impact on the function of the optic nerve. The visual field parameters and amplitude of pattern visual evoked potentials significantly improved. Preoperative and postoperative values of intraocular pressure and the retinal nerve fiber layer thickness remained stable.
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Affiliation(s)
| | - Agata Brązert
- Department of Ophthalmology, Poznan University of Medical Sciences, MD
| | | | - Marcin Gabriel
- University of Medical Sciences, Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznań, Poland, Professor
| | | | - Beata Begier-Krasińska
- Department of Hypertensiology, Angiology and Internal Diseases, Poznań, Poland, Professor
| | - Jarosław Kocięcki
- Department of Ophthalmology, Poznan University of Medical Sciences, Professor
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23
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Arnold A. Vascular supply of the optic nerve head: implications for optic disc ischaemia. Br J Ophthalmol 2022; 107:595-599. [PMID: 36261258 DOI: 10.1136/bjo-2022-322254] [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: 07/22/2022] [Accepted: 09/02/2022] [Indexed: 11/04/2022]
Abstract
The vascular supply of the optic nerve head is complex and remains incompletely delineated. Over the past 50 years, various investigators have attempted to clarify the relative contributions of the choroid, the short posterior ciliary arteries and the central retinal artery to the vascular beds of the inner retinal, prelaminar, laminar and retrolaminar segments of the nerve head. Conflicting theories have evolved, in no small part due to differing techniques of study, involving both flow parameters and anatomical constructs. These have included studies, both in normal subjects and in those with optic nerve ischaemia, of histopathology, electron microscopic corrosion casting, orbital colour Doppler flow studies, fluorescein angiography, indocyanine green angiography, laser Doppler flow studies, laser speckle flowgraphy, microperfusion and labelling studies and optical coherence tomography angiography. The nature of the optic disc, peripapillary retina and choroid microvasculature has implications for the pathophysiology of ischaemic optic neuropathy.
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Affiliation(s)
- Anthony Arnold
- Ophthalmology, University of California Los Angeles, Los Angeles, California, USA
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24
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Kohli D, Wu KY, White LJ, Hodge DO, Chen JJ, Roddy GW. Metabolic syndrome and its components are associated with non-arteritic anterior ischaemic optic neuropathy. BMJ Open Ophthalmol 2022; 7:bmjophth-2022-001111. [PMID: 36437528 PMCID: PMC9535188 DOI: 10.1136/bmjophth-2022-001111] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/13/2022] [Indexed: 11/05/2022] Open
Abstract
PURPOSE To determine whether metabolic syndrome (MetS) is a risk factor for various forms of optic neuropathy including non-arteritic anterior ischaemic optic neuropathy (NAION). METHODS This population-based analysis identified patients ≥40 years of age in Olmsted County, Minnesota, USA using the Rochester Epidemiology Project 2005-2018. Patients with MetS were identified if three or more of the five standard criteria for diagnosing MetS were present: systemic hypertension, hyperglycaemia, hypertriglyceridaemia, reduced high-density lipoprotein cholesterol (hypoalphalipoproteinaemia) and central adiposity defined by increased body mass index. Charts of patients identified as having an optic neuropathy were reviewed to record specific diagnoses and compared with patients without ocular pathology other than cataract. The odds ratio (OR) of association with MetS was calculated and adjusted for age, sex and race with multivariate analysis for the various optic neuropathies. RESULTS Patients with MetS were more likely to have an optic neuropathy than those without (OR 2.2, p<0.001). After adjusting for age, sex and race, the only optic neuropathy found to be significantly associated with MetS was NAION (OR 6.17, p=0.002). For patients with NAION, though each individual component of MetS was individually significantly associated with MetS, further analysis suggested that hypertriglyceridaemia, hypoalphalipoproteinaemia and hyperglycaemia were likely the key drivers in the overall significance between NAION and MetS. CONCLUSION Patients with MetS were more likely to have NAION. Further studies are needed to determine whether MetS is a modifiable risk factor for NAION.
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Affiliation(s)
| | | | - Launia J White
- Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - David O Hodge
- Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - John J Chen
- Mayo Clinic, Rochester, Minnesota, USA,Department of Neurology, Mayo Clinic, Rochester, MN, USA
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25
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Eswaran S, Djeamoorthy U, Saravanam PK. Endoscopic Transnasal Management of Giant Paediatric Sinonasal Ossifying Fibroma. Indian J Otolaryngol Head Neck Surg 2022; 74:1479-1482. [PMID: 36452801 PMCID: PMC9702491 DOI: 10.1007/s12070-021-02607-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022] Open
Abstract
The ossifying fibroma is a rare fibro-osseous benign lesion of bone in the head and neck region. The mandible is the most common site reported followed by maxilla and other bones of the skull. A paediatric male presented with protrusion of the right eyeball for one-month duration. Further evaluation by diagnostic nasal endoscopy revealed a smooth mass confined to the superior and middle meatus on the right side. Computed tomography of paranasal sinus showed a large heterogenous bony lesion involving the ethmoid and sphenoid sinus and extending laterally into the orbit and superiorly into anterior skull base. Endoscopic biopsy was suggestive of ossifying fibroma. Transnasal endoscopic excision of the lesion was done and the patient is currently on follow-up. This case is reported for the rarity of presentation and the difficulties in management.
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Affiliation(s)
- Sudhagar Eswaran
- Department of ENT, Head and Neck Surgery, Sri Ramchandra Institute of Higher Education and Research, Chennai, India
| | - Usha Djeamoorthy
- Department of ENT, Head and Neck Surgery, Sri Ramchandra Institute of Higher Education and Research, Chennai, India
| | - Prasanna Kumar Saravanam
- Department of ENT, Head and Neck Surgery, Sri Ramchandra Institute of Higher Education and Research, Chennai, India
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26
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Fraenkl SA, Simon Q, Yucel Y, Gupta N, Wittwer VV, Frueh BE, Tschanz SA. Impact of cerebral hypoperfusion-reperfusion on optic nerve integrity and visual function in the DBA/2J mouse model of glaucoma. BMJ Open Ophthalmol 2022; 7:bmjophth-2022-001078. [PMID: 36161839 PMCID: PMC9476133 DOI: 10.1136/bmjophth-2022-001078] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/30/2022] [Indexed: 11/28/2022] Open
Abstract
Objective One of the most important risk factors for developing a glaucomatous optic neuropathy is elevated intraocular pressure. Moreover, mechanisms such as altered perfusion have been postulated to injure the optical path. In a mouse model, we compare first negative effects of cerebral perfusion/reperfusion on the optic nerve structure versus alterations by elevated intraocular pressure. Second, we compare the alterations by isolated hypoperfusion-reperfusion and isolated intraocular pressure to the combination of both. Methods and analysis Mice were divided in four groups: (1) controls; (2) perfusion altered mice that underwent transient bi-common carotid artery occlusion (BCCAO) for 40 min; (3) glaucoma group (DBA/2J mice); (4) combined glaucoma and altered perfusion (DBA/2J mice with transient BCCAO). Optic nerve sections were stereologically examined 10–12 weeks after intervention. Results All experimental groups showed a decreased total axon number per optic nerve compared with controls. In DBA/2J and combined DBA/2J & BCCAO mice the significant decrease was roughly 50%, while BCCAO leaded to a 23% reduction of axon number, however reaching significance only in the direct t-test. The difference in axon number between BCCAO and both DBA/2J mice was almost 30%, lacking statistical significance due to a remarkably high variation in both DBA/2J groups. Conclusion Elevated intraocular pressure in the DBA/2J mouse model of glaucoma leads to a much more pronounced optic nerve atrophy compared with transient forebrain hypoperfusion and reperfusion by BCCAO. A supposed worsening effect of an altered perfusion added to the pressure-related damage could not be detected.
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Affiliation(s)
| | - Quentin Simon
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | - Yeni Yucel
- Keenan Research Centre, St Michael's Hospital Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Neeru Gupta
- Keenan Research Centre, St Michael's Hospital Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Valéry V Wittwer
- Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland.,Ophthalmologic Network Organization (ONO), Geneva, Switzerland
| | - Beatrice E Frueh
- Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland
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27
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Wong-Kee-You AMB, Loveridge-Easther C, Mueller C, Simon N, Good WV. The impact of early exposure to general anesthesia on visual and neurocognitive development. Surv Ophthalmol 2022; 68:539-555. [PMID: 35970232 DOI: 10.1016/j.survophthal.2022.08.006] [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: 02/09/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/19/2022]
Abstract
Every year millions of children are exposed to general anesthesia while undergoing surgical and diagnostic procedures. In the field of ophthalmology, 44,000 children are exposed to general anesthesia annually for strabismus surgery alone. While it is clear that general anesthesia is necessary for sedation and pain minimization during surgical procedures, the possibility of neurotoxic impairments from its exposure is of concern. In animals there is strong evidence linking early anesthesia exposure to abnormal neural development. but in humans the effects of anesthesia are debated. In humans many aspects of vision develop within the first year of life, making the visual system vulnerable to early adverse experiences and potentially vulnerable to early exposure to general anesthesia. We attempt to address whether the visual system is affected by early postnatal exposure to general anesthesia. We first summarize key mechanisms that could account for the neurotoxic effects of general anesthesia on the developing brain and review existing literature on the effects of early anesthesia exposure on the visual system in both animals and humans and on neurocognitive development in humans. Finally, we conclude by proposing future directions for research that could address unanswered questions regarding the impact of general anesthesia on visual development.
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Affiliation(s)
| | - Cam Loveridge-Easther
- Smith-Kettlewell Eye Research Institute, San Francisco, CA, USA; University of Auckland, Auckland, New Zealand
| | - Claudia Mueller
- Sutter Health, San Francisco, CA, USA; Stanford Children's Health, Palo Alto, CA, USA
| | | | - William V Good
- Smith-Kettlewell Eye Research Institute, San Francisco, CA, USA.
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28
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Kim M, Lee KM, Choung HK, Oh S, Kim SH. Change of peripapillary retinal nerve fiber layer and choroidal thickness during 4-year myopic progress: Boramae Myopia Cohort Study Report 4. Br J Ophthalmol 2022:bjophthalmol-2021-320596. [PMID: 35383050 DOI: 10.1136/bjophthalmol-2021-320596] [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: 10/11/2021] [Accepted: 03/18/2022] [Indexed: 11/03/2022]
Abstract
AIMS To investigate the longitudinal changes of peripapillary retinal nerve fibre layer (RNFL) and choroidal thickness during myopic axial elongation. METHODS Peripapillary RNFL and choroidal thickness were prospectively evaluated by spectral-domain optical coherence tomography (SD-OCT) in 46 eyes of 23 myopic children over the course of 4 years. Using serial OCT images acquired based on a fixed scan circle in the glaucoma progression analysis mode, general and sectoral RNFL thicknesses were acquired at the same position and the angular location of the peak was measured. The peripapillary choroidal thickness likewise was measured at eight positions in serial OCT images. RESULTS The mean age at the baseline was 9.6±1.7 years. The mean axial length increased from 24.80±1.28 mm to 25.64±1.35 mm. The global peripapillary RNFL thickness was 98.54±12.06 µm at baseline. The global and sectoral RNFL thicknesses did not change during the 4 years. The angular location of RNFL peaks was also stable and was located in the superotemporal (64.18±10.85°) and inferotemporal (293.98±11.62°) sectors. The global peripapillary choroidal thickness was 145.40±28.67 µm at the baseline. The global and sectoral choroidal thicknesses did not change during the 4 years. CONCLUSIONS The peripapillary RNFL and choroidal thicknesses as well as the locations of the RNFL peaks had been preserved, during the 4-year follow-up on myopic children, when traced and measured from the same location.
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Affiliation(s)
- Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, the Republic of Korea.,Sensory Organ Research Institute, Dongguk University Ilsan Hospital, Goyang, the Republic of Korea
| | - Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, the Republic of Korea.,Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul, the Republic of Korea
| | - Ho-Kyung Choung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, the Republic of Korea.,Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul, the Republic of Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Hospital, Seoul, the Republic of Korea
| | - Seok Hwan Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, the Republic of Korea .,Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul, the Republic of Korea
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29
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Safizadeh M, Shaabani A, Kamalipour A, Fard MA, Yeh K, Yaseri M, Hamzeh N, Khatibi N, Rao HL, Weinreb R, Moghimi S. Optic nerve head vessel density in different stages of pseudoexfoliation disease. Br J Ophthalmol 2022; 106:223-228. [PMID: 33246938 PMCID: PMC10042174 DOI: 10.1136/bjophthalmol-2020-317605] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/01/2020] [Accepted: 10/22/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE To evaluate the superficial vascular density of the optic nerve head in different stages of pseudoexfoliation disease using optical coherence tomography angiography (OCTA). METHODS In this cross-sectional study, 57 normal eyes, 41 eyes with pseudoexfoliation syndrome (PXS), 82 eyes with pseudoexfoliation glaucoma (PXG) and 27 non-glaucomatous fellow eyes of PXG (NL-PXG) that had OCTA were included. Circumpapillary RNFL (cpRNFL) thickness and circumpapillary capillary density (cpCD) were compared among the groups after adjusting for confounders using linear-mixed model. RESULTS PXG eyes had thinner global RNFL and lower cpCD (74.2±14.3 µm and 36.7±10.0%) than control (103.3±8.6 µm and 52.5±2.3%), PXS (96.8±8.8 µm and 51.5±2.3%), and NL-PXG eyes (96.3±11.1 µm and 50.1±3.9%) (p<0.001). After adjustment for age, gender and signal strength index, global cpRNFL thickness was comparable among control, PXS and NL-PXG. NL-PXG had the lowest cpCD (p=0.045) and sectoral cpCD compared to PXS and control eyes. Although cpCD was comparable between control and PXS (p=0.425) eyes, sectoral differences (p=0.009 and 0.004, for inferonasal and temporal-inferior cpCD, respectively) were detectable between the two groups. AUROC for differentiating NL-PXG eyes from normal were better for cpCD (0.78) compared to cpRNLF (0.69). CONCLUSIONS OCTA can detect reduced capillary density before significant changes in cpRNFL in fellow eyes of PXG patients. This can enable earlier detection of glaucomatous loss in pseudoexfoliation disease and enhance management of the disease.
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Affiliation(s)
- Mona Safizadeh
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Amirreza Shaabani
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Alireza Kamalipour
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Masoud Aghsaei Fard
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Kaileen Yeh
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Mehdi Yaseri
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Nikoo Hamzeh
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Nassim Khatibi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | | | - Robert Weinreb
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
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30
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Yang M, Wu Y, Lai M, Song H, Li H, Sun M, Xie L, Zhou H, Xu Q, Wei S, Wu W. Clinical predictive factors for diagnosis of MOG-IgG and AQP4-IgG related paediatric optic neuritis: a Chinese cohort study. Br J Ophthalmol 2022; 106:262-266. [PMID: 33199301 DOI: 10.1136/bjophthalmol-2020-317524] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/26/2020] [Accepted: 10/19/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Different glial-autoantibodies-related paediatric optic neuritis (ON) are associated with different clinical characteristics and prognosis that require different treatments. Because glial autoantibody detection is not available in some parts of the world and there is often a delay in obtaining results, clinical factors that can be used to predict the subtype of paediatric ON are needed. METHODS This was a single-centre retrospective cohort study. Children who presented with their first ON attack and with complete clinical data were included in the analysis. Single and multiple parameters for predicting paediatric myelin oligodendrocyte glycoprotein immunoglobin-associated ON (MOG-ON) and aquaporin-4 immunoglobin-related ON (AQP4-ON) were calculated. RESULTS 78 paediatric patients had their first ON attack from January 2016 to December 2019, of whom 69 were included in the final analysis, including 33 MOG-ON cases, 17 AQP4-ON cases and 19 Seronegative-ON cases. For predicting paediatric MOG-ON, the most sensitive predictors were 'male or optic disc swelling (ODS) or bilateral' (sensitivity 0.97 (95% CI 0.82 to 1.00)) and 'follow-up visual acuity (VA) ≤0.1 logMAR or ODS' (sensitivity 0.97 (95% CI 0.82 to 1.00)), and the most specific factor was 'Age ≤11 y and simultaneous CNS involvement' (specificity 0.97 (95% CI 0.84 to 1.00)). For predicting paediatric AQP4-ON, the most sensitive predictor was 'Female or without ODS' (sensitivity 1.00 (95% CI 0.77 to 1.00)), and the most specific factors were Neurological history (sensitivity 0.94 (95% CI 0.83 to 0.98)) and follow-up VA >1.0 logMAR (sensitivity 0.96 (95% CI 0.86 to 0.99)). CONCLUSION According to our data from a Chinese paediatric cohort, using multiple parameters increases the sensitivity and specificity of diagnosing paediatric MOG-ON and AQP4-ON. These can assist clinicians in diagnosing and treating paediatric ON when glial autoantibody status is not available.
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Affiliation(s)
- Mo Yang
- Department of Ophthalmology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.,Department of Neurology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yiqun Wu
- Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Mengying Lai
- Department of Ophthalmology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.,Shantou University Medical College, Shantou, China
| | - Honglu Song
- Department of Ophthalmology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.,Department of Ophthalmology, Bethune International Peace Hospital, Shijiazhuang, China
| | - Hongen Li
- Department of Ophthalmology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Mingming Sun
- Department of Ophthalmology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Lindan Xie
- Department of Ophthalmology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Huanfen Zhou
- Department of Ophthalmology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Quangang Xu
- Department of Ophthalmology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Shihui Wei
- Department of Ophthalmology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Weiping Wu
- Department of Neurology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
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Fahmideh F, Marchesi N, Barbieri A, Govoni S, Pascale A. Non-drug interventions in glaucoma: Putative roles for lifestyle, diet and nutritional supplements. Surv Ophthalmol 2021:S0039-6257(21)00185-5. [PMID: 34563531 DOI: 10.1016/j.survophthal.2021.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 02/06/2023]
Abstract
Glaucoma is a major ocular neurodegenerative disease characterized by progressive retinal ganglion cells degeneration and sight loss. Current treatment options have been limited to reducing intraocular pressure (IOP), known as the leading risk factor for this disease; however, glaucoma can develop even with low or normal IOP and progress despite controlling IOP values. Lifestyle, dietary habits, and supplementation may influence some of the risk factors and pathophysiological mechanisms underlying glaucoma development and progression; thus, the role of this complementary and alternative medicine in glaucoma has received great interest from both patients and ophthalmologists. We provide a summary of the current evidence concerning the relationship between lifestyle, dietary habits, and effects of supplements on the incidence and progression of glaucoma and their targets and associated mechanisms. The data suggest the existence of a therapeutic potential that needs to be further explored with both preclinical and rigorous clinical studies.
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32
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Arcuri J, Veldman MB, Bhattacharya SK. Lipidomics dataset of Danio rerio optic nerve regeneration model. Data Brief 2021; 37:107260. [PMID: 34377754 PMCID: PMC8327136 DOI: 10.1016/j.dib.2021.107260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/21/2021] [Accepted: 07/01/2021] [Indexed: 11/23/2022] Open
Abstract
The right optic nerve of adult, 6 month to 1 year old, female and male Danio rerio were crushed and collected three days after. Matching controls of uninjured left optic nerves were also collected. The tissue was dissected from euthanized fish and frozen on dry ice. Samples were pooled for each category (female crush, female control, male crush, male control) n = 24 to obtain sufficient tissue for analysis. The brain from one male fish was also collected for control/calibration. Lipid extraction was done with the Bligh and Dyer [1] method, followed by untargeted liquid chromatography-mass spectrometry (LC MS-MS) lipid profiling using a Q-Exactive Orbitrap instrument coupled with Vanquish Horizon Binary UHPLC LC-MS system. The lipids were identified and quantified with LipidSearch 4.2.21 and the statistical analysis was conducted through Metaboanalyst 5.0. This data is available at Metabolomics Workbench, Study ID ST001725.
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Affiliation(s)
- Jennifer Arcuri
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, 33136, USA.,Miami Integrative Metabolomics Research Center, Miami, FL, 33136, USA.,Molecular Cellular Pharmacology Graduate Program, University of Miami, Miami, FL, 33136, USA
| | - Matthew B Veldman
- Department of Cell Biology, Neurobiology, and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Sanjoy K Bhattacharya
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, 33136, USA.,Miami Integrative Metabolomics Research Center, Miami, FL, 33136, USA.,Molecular Cellular Pharmacology Graduate Program, University of Miami, Miami, FL, 33136, USA
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33
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Arcuri J, Hegarty S, He Z, Bhattacharya SK. Lipidomics dataset of PTEN deletion-induced optic nerve regeneration mouse model. Data Brief 2021; 34:106699. [PMID: 33457476 DOI: 10.1016/j.dib.2020.106699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 11/21/2022] Open
Abstract
The optic nerve is part of the mammalian adult central nervous system (CNS) and has limited capability to regenerate after injury. Deletion of phosphatase and tensin homolog (PTEN), a negative regulator of the PI3 kinase/Akt pathway, has been shown to promote regeneration in retinal ganglion cells (RGCs) after optic nerve injury [1]. We present the lipidome of adult PTENloxP/loxP mice subjected to intravitreal injection of adeno-associated viruses expressing Cre (AAV-Cre) as a model of CNS neuroregeneration. At 4 weeks old, PTENloxP/loxP mice were intravitreally-injected with 2–3 μl of either AAV-Cre (KO) or AAV-PLAP (control), and two weeks later optic nerve crush was performed. At indicated time-points after crush (0 days, 7 days, 14 days), mice were euthanized and optic nerves were immediately dissected out, and then flash frozen on dry ice. A modified Bligh and Dyer [2] method was used for lipid extraction from the optic nerves, followed by liquid chromatography-mass spectrometry (LC MS-MS) lipid profiling using a Q-Exactive Orbitrap instrument coupled with Accela 600 HPLC. The raw scans were analysed with LipidSearch 4.2 and the statistical analysis was conducted through Metaboanalyst 4.0. This data is available at Metabolomics Workbench, study ID ST001477.
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Kim JS, Kim YK, Kim YW, Baek SU, Ha A, Lee J, Lee HJ, Kim DW, Jeoung JW, Kim SJ, Park KH. Association between esodeviation and primary open-angle glaucoma: the 2010-2011 Korea National Health and Nutrition Examination Survey. Br J Ophthalmol 2020; 105:1672-1677. [PMID: 32998906 DOI: 10.1136/bjophthalmol-2020-316901] [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: 05/14/2020] [Revised: 08/12/2020] [Accepted: 09/15/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To evaluate the association between strabismus and primary open-angle glaucoma (POAG) in a representative Korean population. METHODS A total of 11 114 participants aged 20 years or older in the Korea National Health and Nutrition Examination Survey database for the years 2010 through 2011 were reviewed. A standardised protocol was used to interview every participant and to perform comprehensive ophthalmic examinations. Glaucoma diagnosis was based on fundus photography and frequency-doubling technology perimetry results, according to the International Society of Geographical and Epidemiological Ophthalmology criteria. Ocular alignment was evaluated using the alternate prism and cover test, and clinically significant horizontal strabismus was defined as exodeviation of ≥15 prism dioptres (PD) and esodeviation of ≥10 PD. Univariate and multivariate regression analyses were used to evaluate the potential risk factors for POAG. RESULTS In the Korean population, subjects with clinically significant esodeviation had a much higher prevalence of POAG (12.32%) than those without clinically significant esodeviation (3.14%, p=0.016). After adjusting for age and intraocular pressure, clinically significant esodeviation was independently associated with POAG (OR 7.61, p=0.002). CONCLUSION Esodeviation was independently associated with POAG in the Korean population. This could be the result of, at least in part, ocular-adduction-induced greater strain on the temporal optic nerve head and peripapillary tissues, which makes eyes with esodeviation more vulnerable to POAG.
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Affiliation(s)
- Jin-Soo Kim
- Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Ophthalmology, Chungnam National University Sejong Hospital, Sejong, Korea (the Republic of)
| | - Young Kook Kim
- Seoul National University College of Medicine, Seoul, Korea (the Republic of) .,Division of Glaucoma, Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Yong Woo Kim
- Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Division of Glaucoma, Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Sung Uk Baek
- Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, Korea (the Republic of)
| | - Ahnul Ha
- Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Ophthalmology, Jeju National University College of Medicine, Jeju, Korea (the Republic of)
| | - Jinho Lee
- Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Chuncheon, Korea (the Republic of)
| | - Haeng-Jin Lee
- Department of Ophthalmology, Chonbuk National University Hospital, Jeonju, Korea (the Republic of)
| | - Dai Woo Kim
- Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
| | - Jin Wook Jeoung
- Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Division of Glaucoma, Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Seong-Joon Kim
- Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Division of Neuro-ophthalmology and Strabismus, Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Ki Ho Park
- Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Division of Glaucoma, Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea (the Republic of)
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Frizziero L, Parrozzani R, Londei D, Pilotto E, Midena E. Quantification of vascular and neuronal changes in the peripapillary retinal area secondary to diabetic retinopathy. Br J Ophthalmol 2020; 105:1577-1583. [PMID: 32933938 DOI: 10.1136/bjophthalmol-2020-316468] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/22/2020] [Accepted: 08/31/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE To investigate and quantify peripapillary vascular and neuronal changes secondary to diabetic retinopathy, using spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA). DESIGN This was a cross-sectional study. METHODS 51 eyes of 51 patients affected by non-proliferative diabetic retinopathy (NPDR) and 19 age-matched healthy control eyes underwent full ophthalmic examination, including OCT and OCTA in the peripapillary area. Vessel area density (VAD), vessel length fraction (VLF) and vessel diameter index (VDI) were quantified in a ring-shaped region of interest of each OCTA image. Capillaries and larger vessels were separately analysed. The thickness of the peripapillary retinal nerve fibre layer (pRNFL) and macular ganglion cell complex (GCC) was also analysed. RESULTS VAD and VLF of peripapillary capillaries were significantly reduced in NPDR eyes, along with the progression of NPDR (p<0.05). VDI was significantly reduced in mild (p=0.0093) and moderate (p=0.0190) NPDR eyes, but not in severe NPDR (p=0.0841). Larger peripapillary vessels showed a significant increase of both VAD and VDI in NPDR eyes. pRNFL and GCC thickness decreased in NPDR eyes, reaching statistical significance only for GCC. No statistically significant correlation was found between perfusion parameters and pRNFL and GCC thickness. CONCLUSIONS Retinal capillary remodelling in NPDR involves the peripapillary vascularisation too, as confirmed by OCTA quantitative parameters. The peripapillary macrovasculature and microvasculature need to be separately evaluated. The lack of direct correlation between peripapillary capillaries changes and the loss of retinal nerve fibres suggests that neuronal damage cannot be simply considered secondary to the microvascular one.
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Affiliation(s)
| | | | - Davide Londei
- Department of Ophthalmology, University of Padova, Padova, Italy
| | | | - Edoardo Midena
- IRCCS - Fondazione Bietti, Rome, Italy .,Department of Ophthalmology, University of Padova, Padova, Italy
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36
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Sun S, Ha A, Kim YK, Yoo BW, Kim HC, Park KH. Dual-input convolutional neural network for glaucoma diagnosis using spectral-domain optical coherence tomography. Br J Ophthalmol 2020; 105:1555-1560. [PMID: 32920530 DOI: 10.1136/bjophthalmol-2020-316274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 07/15/2020] [Accepted: 08/25/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND/AIMS To evaluate, with spectral-domain optical coherence tomography (SD-OCT), the glaucoma-diagnostic ability of a deep-learning classifier. METHODS A total of 777 Cirrus high-definition SD-OCT image sets of the retinal nerve fibre layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) of 315 normal subjects, 219 patients with early-stage primary open-angle glaucoma (POAG) and 243 patients with moderate-to-severe-stage POAG were aggregated. The image sets were divided into a training data set (252 normal, 174 early POAG and 195 moderate-to-severe POAG) and a test data set (63 normal, 45 early POAG and 48 moderate-to-severe POAG). The visual geometry group (VGG16)-based dual-input convolutional neural network (DICNN) was adopted for the glaucoma diagnoses. Unlike other networks, the DICNN structure takes two images (both RNFL and GCIPL) as inputs. The glaucoma-diagnostic ability was computed according to both accuracy and area under the receiver operating characteristic curve (AUC). RESULTS For the test data set, DICNN could distinguish between patients with glaucoma and normal subjects accurately (accuracy=92.793%, AUC=0.957 (95% CI 0.943 to 0.966), sensitivity=0.896 (95% CI 0.896 to 0.917), specificity=0.952 (95% CI 0.921 to 0.952)). For distinguishing between patients with early-stage glaucoma and normal subjects, DICNN's diagnostic ability (accuracy=85.185%, AUC=0.869 (95% CI 0.825 to 0.879), sensitivity=0.921 (95% CI 0.813 to 0.905), specificity=0.756 (95% CI 0.610 to 0.790)]) was higher than convolutional neural network algorithms that trained with RNFL or GCIPL separately. CONCLUSION The deep-learning algorithm using SD-OCT can distinguish normal subjects not only from established patients with glaucoma but also from patients with early-stage glaucoma. The deep-learning model with DICNN, as trained by both RNFL and GCIPL thickness map data, showed a high diagnostic ability for discriminatingpatients with early-stage glaucoma from normal subjects.
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Affiliation(s)
- Sukkyu Sun
- Interdisciplinary Program in Bioengineering, Graduate school, Seoul National University, Seoul, South Korea
| | - Ahnul Ha
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.,Department of Ophthalmology, Jeju National University Hospital, Jeju-si, South Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.,Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea
| | | | - Hee Chan Kim
- Interdisciplinary Program in Bioengineering, Graduate school, Seoul National University, Seoul, South Korea .,Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, South Korea.,Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, South Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.,Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea
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Lee JC, Grisafe DJ, Burkemper B, Chang BR, Zhou X, Chu Z, Fard A, Durbin M, Wong BJ, Song BJ, Xu BY, Wang R, Richter GM. Intrasession repeatability and intersession reproducibility of peripapillary OCTA vessel parameters in non-glaucomatous and glaucomatous eyes. Br J Ophthalmol 2020; 105:1534-1541. [PMID: 32917629 DOI: 10.1136/bjophthalmol-2020-317181] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 06/10/2020] [Revised: 08/04/2020] [Accepted: 08/21/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To compare intrasession repeatability versus intersession reproducibility of the peripapillary vessel parameters using optical microangiography-based optical coherence tomography angiography (OCTA) in non-glaucomatous and glaucomatous eyes. METHODS In an observational, longitudinal study, peripapillary OCTA scans were collected to evaluate intrasession repeatability and intersession reproducibility using within-eye coefficient of variation (CVW) and intraclass correlation coefficient (ICC). Images were quantified using a custom research-oriented quantification software calculating vessel area density (VAD) and flux and a commercially developed, clinic-oriented quantification software (Cirrus 11.0, Carl Zeiss Meditec) calculating perfusion density (PD) and flux index (FI). Effect of signal strength on the reliability of OCTA parameters was also evaluated. RESULTS Among 120 non-glaucomatous eyes, intrasession CVW were 4.2% for VAD, 5.3% for flux, 1.5% for PD and 2.0% for FI. The intersession CVW were 6.5% for VAD, 8.0% for flux, 2.0% for PD and 3.2% for FI. The intrasession ICC ranged from 0.928 to 0.945, and intersession ICC ranged from 0.811 to 0.866. From 118 glaucomatous eyes, intrasession CVW was 9.0% for VAD, 10.3% for flux, 1.7% for PD and 2.3% for FI. The intersession CVW was 12.1% for VAD, 14.2% for flux, 2.3% for PD and 3.5% for FI. The intrasession ICC ranged from 0.904 to 0.972, and intersession ICC ranged from 0.855 to 0.955. Signal strength was significantly positively associated with OCTA vessel parameters (p<0.0001) for both groups. CONCLUSION Peripapillary OCTA vessel parameters had greater intrasession repeatability compared to intersession reproducibility in both non-glaucomatous and glaucomatous eyes. The built-in commercially developed quantification software demonstrated greater agreement than the custom research-oriented quantification software.
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Affiliation(s)
- Jae Chang Lee
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Dominic J Grisafe
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Bruce Burkemper
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Brenda R Chang
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Xiao Zhou
- Bioengineering, University of Washington, Seattle, Washington, USA
| | - Zhongdi Chu
- Bioengineering, University of Washington, Seattle, Washington, USA
| | - Ali Fard
- Carl Zeiss Meditec Inc, Dublin, California, USA
| | - Mary Durbin
- Carl Zeiss Meditec Inc, Dublin, California, USA
| | - Brandon J Wong
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Brian J Song
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Benjamin Y Xu
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Ruikang Wang
- Bioengineering, University of Washington, Seattle, Washington, USA
| | - Grace M Richter
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
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Wang D, Liu HL, Du YY, Yuan J, Li X, Tian Z, Zhou H, Wang S, Song L, Sun J, Xiao X, Wang ZT, Li B. Characterisation of thickness changes in the peripapillary retinal nerve fibre layer in patients with Leber's hereditary optic neuropathy. Br J Ophthalmol 2020; 105:1166-1171. [PMID: 32862131 PMCID: PMC8311077 DOI: 10.1136/bjophthalmol-2020-316573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/23/2020] [Accepted: 08/01/2020] [Indexed: 11/11/2022]
Abstract
Background Limited studies have identified the changes in peripapillary retinal nerve fibre layer (pRNFL) thickness in patients with chronic Leber’s hereditary optic neuropathy (LHON) at different stages of the disease. We aimed to characterise the pRNFL thickness changes in patients with LHON having m.11778G>A (MT-ND4) mutation. Methods This retrospective cross-sectional study included 221 eyes from patients with LHON (n=145)—classified into seven groups according to disease duration—and 52 eyes from healthy controls (n=26). All subjects underwent pRNFL examinations. pRNFL thickness of the superior, nasal and inferior, and temporal quadrants, and the 360° average were measured. Results Within 3 months of onset, the temporal pRNFL thickness decreased significantly, whereas the remaining quadrants and the average pRNFL thickness initially increased. The temporal quadrant (p<0.01) and average pRNFL thickness (p=0.02) significantly decreased at 3–6 months. Excluding that in the nasal quadrant (p=0.93), pRNFL thickness significantly decreased in all other quadrants at 6–9 months. At 9–12 months, the average and individual quadrant pRNFL thicknesses continued to decrease. Compared with 12–24 months, the pRNFL thickness was thinner at 24–60 months and >60 months. Conclusions The papillomacular bundle was affected first and preferentially in LHON. pRNFL thickness initially increased and then decreased, corresponding to the retinal ganglion cell swelling and apoptosis. pRNFL thinning first occurred in the temporal quadrant, followed by the inferior and superior quadrants, and finally, the nasal quadrant. pRNFL continued to thin slowly in some quadrants even after 60 months.
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Affiliation(s)
- Dan Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong-Li Liu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang-Yang Du
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiajia Yuan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Li
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Zhen Tian
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Haiqiang Zhou
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuang Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lin Song
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian Sun
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao Xiao
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi-Tao Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Li
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China .,Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, China.,Wuhan Neurophth Biological Technology Limited Company, Wuhan, China
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Chen T, Jin L, Zhu W, Wang C, Zhang G, Wang X, Wang J, Yang K, Cochrane GM, Lamoureux EL, Friedman DS, Gilbert S, Lansingh VC, Resnikoff S, Zhao J, Xiao B, He M, Congdon N. Knowledge, attitudes and eye health-seeking behaviours in a population-based sample of people with diabetes in rural China. Br J Ophthalmol 2020; 105:806-811. [PMID: 32737033 DOI: 10.1136/bjophthalmol-2020-316105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/19/2020] [Revised: 05/05/2020] [Accepted: 06/12/2020] [Indexed: 12/23/2022]
Abstract
AIMS To assess knowledge of diabetes and acceptance of eye care among people with diabetes in rural China, to improve service uptake. METHODS Population-based study of people in Guangdong, China, with glycosylated haemoglobin A1c≥6.5% and/or known history of diabetes. Between August and November 2014, participants answered a questionnaire (based on Delphi process/previous focus groups) on medical history, demographic characteristics, self-rated health and vision, knowledge about diabetes and diabetic retinopathy, quality of local healthcare, barriers to treatment, likely acceptance of eye exams and treatment, and interventions rated most likely to improve service uptake. Presenting visual acuity was assessed, fundus photography performed and images graded by trained graders. Potential predictors of accepting care were evaluated and confounders adjusted for using logistic regression. RESULTS A total of 562 people (9.6% (256/5825), mean age 66.2±9.84 years, 207 (36.8%) men) had diabetes, 118 (22.3%) previously diagnosed. 'Very likely' or 'likely' acceptance of laser treatment (140/530=26.4%) was lower than for eye exams (317/530=59.8%, p<0.001). Predictors of accepting both exams and laser included younger age (p<.001) and prior awareness of diabetes diagnosis (p=0.004 and p=0.035, respectively). The leading barrier to receiving diabetes treatment was unawareness of diagnosis (409/454, 97.2%), while interventions rated most likely to improve acceptance of eye exams included reimbursement of travel costs (387/562, 73.0%), video or other health education (359/562, 67.7%) and phone call reminders (346/562, 65.3%). CONCLUSIONS Improving diagnosis of diabetes, along with incentives, education and communication strategies, is most likely to enhance poor acceptance of diabetic eye care in this setting.
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Affiliation(s)
- Tingting Chen
- The Ophthalmology Department, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China.,State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Wenhui Zhu
- The Ophthalmology Department, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China.,State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Congyao Wang
- The Ophthalmology Department, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China.,State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Guoshan Zhang
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Xiuqin Wang
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Jun Wang
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Ke Yang
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Gillian M Cochrane
- Faculty of Health, School of Medicine (Optometry), Deakin University, Burwood, Australia
| | - Ecosse Luc Lamoureux
- Health Services Research Unit, Singapore Eye Research Institute, Singapore, Singapore
| | - David S Friedman
- Glaucoma Center of Excellence, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Suzanne Gilbert
- Innovation & Sight Programs, Seva Foundation, Berkeley, California, USA
| | | | | | - Jialiang Zhao
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Dongcheng-qu,China
| | - Baixiang Xiao
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China.,Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Nathan Congdon
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China .,Centre for Public Health, Queen's University Belfast, Belfast, UK
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Khanna RC, Marmamula S, Cicinelli MV, Mettla AL, Giridhar P, Banerjee S, Shekhar K, Chakrabarti S, Murthy GVS, Gilbert CE, Rao GN. Fifteen-year incidence rate and risk factors of pterygium in the Southern Indian state of Andhra Pradesh. Br J Ophthalmol 2020; 105:619-624. [PMID: 32732344 DOI: 10.1136/bjophthalmol-2020-316359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/20/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To report 15-year incidence rate and associated risk factors of pterygium among people aged 30 years and above at baseline in the rural clusters of longitudinal Andhra Pradesh Eye Disease Study (APEDS III). METHODS The baseline APEDS I included 7771 participants of which 6447 (83%) were traced and 5395 (83.7%) were re-examined in APEDS III. To estimate the incidence of pterygium, we selected participants who were 30 years and above at baseline (4188), of which 2976 were traced and 2627 (88.3%) were examined, and based on inclusion criteria, 2290 participants were included in the study. The incidence rate of pterygium was defined as the proportion of people free of pterygium at baseline who had developed the condition at 15-year follow-up (range 13-17 years). Univariate and multivariable analyses for risk factors were undertaken. RESULTS The sex-adjusted incidence rate of pterygium was 25.2 per 100 person-years (95% CI 24.8 to 25.7) which was significantly higher for men than women (26.3 per 100 person-years (95% CI 25.6 to 27.0) and 24.7 (95% CI 24.1 to 25.3) respectively). At the multivariable analysis, male gender (RR: 1.35, 95% CI 1.0 to 1.83), no formal education (RR: 2.46, 95% CI 1.22 to 4.93), outdoor occupation (RR: 1.47, 95% CI 1.14 to 1.9) and lower body mass index (BMI) (<18.5) (RR: 1.25, 95% CI 1.02 to 1.55) were associated with increased risk of pterygium. CONCLUSIONS The overall incidence rate of pterygium was high in this rural population, especially in men and those engaged in outdoor activities, lack of formal education and with lower BMI. It is likely that greater exposure to ultraviolet light is a major contributing factor, thus warranting preventive strategies.
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Affiliation(s)
- Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Wellcome Trust/Department of Biotechnology India Alliance Research Fellow, LV Prasad Eye Institute, Hyderabad, India
| | - Maria Vittoria Cicinelli
- Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, via Olgettina 60, 20132, Milan, Italy
| | - Asha Latha Mettla
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Pyda Giridhar
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Seema Banerjee
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Konegari Shekhar
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Subhabrata Chakrabarti
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Gudlavalleti V S Murthy
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Indian Institute of Public Health, Hyderabad, India
| | - Clare E Gilbert
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Gullapalli Nageswara Rao
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
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Mandal S, Saxena R, Dhiman R, Mohan A, Padhy SK, Phuljhele S, Sharma P, Guleria R. Prospective study to evaluate incidence and indicators for early detection of ethambutol toxicity. Br J Ophthalmol 2020; 105:1024-1028. [PMID: 32713840 DOI: 10.1136/bjophthalmol-2020-316897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/29/2020] [Indexed: 11/04/2022]
Abstract
AIMS To evaluate incidence of toxic optic neuropathy in patients receiving ethambutol (EMB) for 6 months and to identify its early indicators. METHODS We included 50 patients on anti-tubercular therapy (ATT) including EMB (HRE regimen) based on total body weight for 6 months. Best-corrected visual acuity (ETDRS), colour vision (Ishihara pseudo-isochromatic plates), contrast sensitivity (Pelli-Robson chart), Humphrey visual field analysis (HVF 30-2 SITA FAST), pattern visual evoked response (VER) and spectral-domain optical coherence tomography (SDOCT) for ganglion cell inner plexiform layer (GCIPL) and retinal nerve fibre layer (RNFL) analysis were assessed at baseline and at 2, 4 and 6 months after starting ATT. RESULTS Mean age of the patients was 36.5±14.7 years with male:female ratio of 2.5:1. Mean daily dosage of EMB was 17.5±1.3 mg/kg/day. No significant change was observed in visual acuity, contrast sensitivity, color vision and mean or pattern SD on HVF at 6 months. Significant increase in VER latency of >2 SD (>125 ms) was observed in 46% eyes on follow-up indicating subclinical toxicity. Significant loss of mean RNFL (from 100.79±16.05 μm to 89.96±13.79 μm) and GCIPL thickness (from 83.1±5.60 μm to 79.85±6.45 μm) was observed at 6 months (p=0.001 for both). Patients with subclinical toxicity had significantly greater damage in temporal RNFL quadrant, supero-nasal and infero-nasal GCIPL sectors compared with others. CONCLUSION The incidence of clinical EMB optic neuropathy was <2%, though subclinical damage in the form of increase in VER latency, and decrease in RNFL and GCIPL on OCT was seen in 46% eyes.
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Affiliation(s)
- Sohini Mandal
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Rohit Saxena
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Rebika Dhiman
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Anant Mohan
- Department of Pulmonary Critical Care and Sleep Medicine, AIIMS, New Delhi, India
| | - Srikanta Kumar Padhy
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Swati Phuljhele
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Pradeep Sharma
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary Critical Care and Sleep Medicine, AIIMS, New Delhi, India
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42
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Mendez-Hernandez C, Wang S, Arribas-Pardo P, Salazar-Quiñones L, Güemes-Villahoz N, Fernandez-Perez C, Garcia-Feijoo J. Diagnostic validity of optic nerve head colorimetric assessment and optical coherence tomography angiography in patients with glaucoma. Br J Ophthalmol 2020; 105:957-963. [PMID: 32703781 PMCID: PMC8237198 DOI: 10.1136/bjophthalmol-2020-316455] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 04/02/2020] [Revised: 06/07/2020] [Accepted: 06/25/2020] [Indexed: 12/17/2022]
Abstract
Background/Aims The aim of this study was to assess the optic nerve head (ONH) and macular vessel density with optical coherence tomography angiography (OCT-A) and the ONH haemoglobin (ONH Hb) amount with Laguna ONhE program in open-angle glaucoma (OAG) patients. Methods In this prospective observational cross-sectional study, 67 OAG patients and 41 healthy age-sex frequency matched subjects were examined with OCT-A and retinal photos. The circumpapillary (wcpVD), optic nerve head (iVD) and macular (wmVD) capillary vessel density of OCT-A and ONH colorimetric assessment to determine the ONH Hb amount using the Laguna ONhE program were evaluated. Results Significant differences between normal subjects and glaucoma patients in the wcpVD (22.18±3.42 vs 16.03±2.89%; p<0.001), iVD (18.31±5.56 vs 12.52±4.67%; p<0.001), wmVD (15.60±2.34 vs 13.34±2.32%; p<0.001) and amount of ONH Hb (71.10±1.67 vs 68.86±2.46%; p<0.001) and in the papillary cup (68.14±5.25 vs 64.77±5.08%; p=0.001) were found. The Laguna ONhE glaucoma discriminant function (GDF) index had a negative value in the OAG patients and normal values in healthy subjects (−18.76±13.31 vs 7.98±14.09; p<0.001). The area under the receiver operating characteristic (ROC) curve (AUROC) for discriminating between healthy and glaucomatous eyes was highest for wcpVD (0.93; 95% CI 0.86 to 0.97, p<0.0001), followed by GDF (0.92; 95% CI 0.86 to 0.97, p<0.0001), iVD (0.79; 95% CI 0.70 to 0.86; p<0.0001) and ONH Hb (0.78; 95% CI 0.69 to 0.85, p<0.0001). Pair wise comparisons showed that the AUROC of wcpVD (0.93) was not significantly different than GDF (0.92) (p=0.855). Conclusion Laguna ONhE program and OCT-A have similar diagnostic validity in open-angle glaucoma patients.
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Affiliation(s)
- Carmen Mendez-Hernandez
- Ophthalmology, Hospital Universitario Clinico San Carlos, Madrid, Spain .,Inmunología, Oftalmología y ORL, Facultad de Medicina., Universidad Complutense, Madrid, Spain.,OFTARED, Madrid, Spain
| | - Surina Wang
- Ophthalmology, Hospital Universitario Clinico San Carlos, Madrid, Spain.,Inmunología, Oftalmología y ORL, Facultad de Medicina., Universidad Complutense, Madrid, Spain
| | | | - Liseth Salazar-Quiñones
- Ophthalmology, Hospital Universitario Clinico San Carlos, Madrid, Spain.,Inmunología, Oftalmología y ORL, Facultad de Medicina., Universidad Complutense, Madrid, Spain
| | - Noemi Güemes-Villahoz
- Ophthalmology, Hospital Universitario Clinico San Carlos, Madrid, Spain.,Inmunología, Oftalmología y ORL, Facultad de Medicina., Universidad Complutense, Madrid, Spain
| | - Cristina Fernandez-Perez
- Medicina Preventiva, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Julian Garcia-Feijoo
- Ophthalmology, Hospital Universitario Clinico San Carlos, Madrid, Spain.,Inmunología, Oftalmología y ORL, Facultad de Medicina., Universidad Complutense, Madrid, Spain.,OFTARED, Madrid, Spain
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Iyer JV, Boland MV, Jefferys J, Quigley H. Defining glaucomatous optic neuropathy using objective criteria from structural and functional testing. Br J Ophthalmol 2020; 105:789-793. [PMID: 32699052 DOI: 10.1136/bjophthalmol-2020-316237] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 03/04/2020] [Revised: 04/25/2020] [Accepted: 06/15/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To identify objective criteria from optical coherence tomography (OCT) and perimetry that denote a useful, specific definition of glaucomatous optic neuropathy (GON) in eyes with open-angle glaucoma for comparisons among glaucoma research studies. METHODS A cross-sectional study of adult patients with glaucoma from nine centres on five continents evaluated de-identified physician diagnosis, OCT and perimetry results for 2580 eyes (1531 patients) in an online database. Each eye was graded by their glaucoma specialist as either definite, probable or not GON. Objective measures from OCT and perimetry, derived from an online consensus panel comprising 176 glaucoma specialists globally, were compared against the three diagnostic levels. RESULTS Diagnoses were 54% 'definite', 22% 'probable' and 24% 'not GON'. Using only OCT data or only field data had inadequate specificity (<90%). The best definitional choice for data from either the most recent or the preceding OCT/field pair had 77% sensitivity at 98% specificity and consisted of abnormal OCT superior or inferior nerve fibre layer quadrant with matching, opposite, abnormal Glaucoma Hemifield Test. CONCLUSIONS Objective criteria to define GON are practical and may be useful for comparisons among clinical studies to supplement subjective clinical assessment.
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Affiliation(s)
| | - Michael V Boland
- Wilmer Eye Institute, Johns Hopkins University Department of Ophthalmology, Baltimore, Maryland, USA
| | - Joan Jefferys
- Wilmer Eye Institute, Johns Hopkins University Department of Ophthalmology, Baltimore, Maryland, USA
| | - Harry Quigley
- Department of Ophthalmology, Johns Hopkins University, Baltimore, Maryland, USA
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Lim ZW, Chee ML, Thakur S, Fang X, Soh ZD, Majithia S, Teo ZL, Sabanayagam C, Wong TY, Cheng CY, Tham YC. Albuminuria and Primary Open-Angle Glaucoma: the Singapore Chinese Eye Study (SCES). Br J Ophthalmol 2020; 105:669-673. [PMID: 32675061 DOI: 10.1136/bjophthalmol-2020-315920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/06/2020] [Accepted: 06/03/2020] [Indexed: 11/03/2022]
Abstract
AIMS To determine the association between albuminuria and primary open-angle glaucoma (POAG). METHODS Participants of the Singapore Chinese Eye study were recruited and underwent standardised ocular and systemic examinations. Albuminuria was determined using urinary albumin-to-creatinine ratio (UACR, mg/g) based on random spot urinary albumin and creatinine measurements. POAG was defined using the International Society of Geographic and Epidemiological Ophthalmology classification. Multivariable logistic regression with generalised estimating equation model was used to evaluate the association between albuminuria and POAG, while accounting for correlation between eyes. RESULTS A total of 3009 Chinese adults (5963 eyes), aged 40-80 years, were included in this study, of which, 52 subjects (75 eyes) had POAG. Higher UACR (per 50 mg/g increase) was independently associated with POAG (OR=1.04, 95% CI 1.01 to 1.07, p=0.003) following adjustment for age, gender, intraocular pressure, diabetes mellitus, hyperlipidaemia, hypertension, anti-hypertensive medication, history of cardiovascular disease, current smoking status, alcohol intake, body mass index and estimated glomerular filtration rate. Further stratification revealed that individuals with macroalbuminuria were 8.00 times likely to have POAG (95% CI 2.97 to 21.54, p<0.001), compared with those with normoalbuminuria. Microalbuminuria was not significantly associated with POAG (OR=0.49, 95% CI 0.19 to 1.29, p=0.150). The association between macroalbuminuria and POAG remained significant among individuals who were diabetic (OR=9.89, 95% CI 2.49 to 39.30, p=0.001) and hypertensive (OR=8.39, 95% CI 3.07 to 22.94, p<0.001). CONCLUSION In this population-based study of Chinese adults, albuminuria was independently associated with POAG. Our findings provide further understanding on the pathogenesis of POAG and may potentially help to better identify individuals at risk of POAG.
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Affiliation(s)
- Zhi Wei Lim
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Miao-Li Chee
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Sahil Thakur
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Xiaoling Fang
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Shanghai Eye Diseases Prevention and Treatment Center, Department of Ophthalmology, Shanghai Jiao Tong University, Shanghai, China
| | - Zhi Da Soh
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Shivani Majithia
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Zhen Ling Teo
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Charumathi Sabanayagam
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Tien Yin Wong
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Ching-Yu Cheng
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Yih-Chung Tham
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore .,Duke-NUS Medical School, Singapore, Singapore
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Gyllencreutz E, Aring E, Landgren V, Landgren M, Gronlund MA. Thinner retinal nerve fibre layer in young adults with foetal alcohol spectrum disorders. Br J Ophthalmol 2020; 105:850-855. [PMID: 32620687 DOI: 10.1136/bjophthalmol-2020-316506] [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: 04/06/2020] [Revised: 05/26/2020] [Accepted: 06/09/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Ophthalmological abnormalities such as ptosis, strabismus, refractive errors and optic nerve hypoplasia have been reported in foetal alcohol spectrum disorders (FASD). The purpose of this study was to investigate whether retinal thickness, retinal nerve fibre layer (RNFL) and optic disc area (ODA) differ between individuals with FASD and healthy controls. METHODS Best-corrected visual acuity (BCVA) in terms of logarithm of the minimum angle of resolution (logMAR), refraction, and fundus variables measured by optical coherence tomography were obtained from 26 young adults with FASD (12 women, median age 23 years) and 27 controls (18 women, median age 25 years). RESULTS The total thickness of the peripapillary RNFL was significantly lower in the FASD group than in controls; median (range) in the right/left eye was 96.5 (60-109)/96 (59-107) µm in the FASD group and 105 (95-117)/103 (91-120) µm among controls (p=0.001 and p=0.0001). Macular RNFL and retinal thickness measurements from the FASD group were also lower in most of the nine ETDRS areas, except for the central parts. Median (range) BCVA in the best eye was 0.00 (-0.1-0.3) logMAR in the FASD group and 0.00 (-0.2-0.0) logMAR in controls (p=0.001). No significant differences between the groups were found regarding ODA or refraction. CONCLUSION Significant differences in peripapillary and macular RNFL, retinal thickness and BCVA were found in this group of young adults with FASD compared with healthy controls. However, there were no differences in the size of the optic disc.
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Affiliation(s)
- Emelie Gyllencreutz
- Clinical Neuroscience, University of Gothenburg Institute of Neuroscience and Physiology, Skövde, Sweden
| | - Eva Aring
- Clinical Neuroscience, University of Gothenburg Institute of Neuroscience and Physiology, Skövde, Sweden
| | - Valdemar Landgren
- Gillberg Neuropsychiatry Centre, University of Gothenburg Institute of Neuroscience and Physiology, Goteborg, Sweden
| | - Magnus Landgren
- Gillberg Neuropsychiatry Centre, University of Gothenburg Institute of Neuroscience and Physiology, Goteborg, Sweden
| | - Marita Andersson Gronlund
- Clinical Neuroscience, University of Gothenburg Institute of Neuroscience and Physiology, Skövde, Sweden
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Huynh B, Shah P, Sii F, Hunter D, Carnt N, White A. Low systemic vitamin D as a potential risk factor in primary open-angle glaucoma: a review of current evidence. Br J Ophthalmol 2020; 105:595-601. [PMID: 32606080 DOI: 10.1136/bjophthalmol-2020-316331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/04/2020] [Accepted: 06/12/2020] [Indexed: 11/03/2022]
Abstract
Currently, intraocular pressure is the only modifiable risk factor for glaucoma; thus, identifying other modifiable determinants may have far-reaching outcomes. There has been increasing interest in vitamin D status and glaucoma pathogenesis as low vitamin D has been identified by some studies as an independent risk factor for glaucoma. Although the exact mechanism of vitamin D in glaucoma remains uncertain, there is sufficient evidence to continue research in this area. There is a potential physiological role for vitamin D as an anti-inflammatory agent in the oxidative stress-driven pathogenesis of primary open-angle glaucoma, and further studies are required to evaluate the temporal and causal relationship. Ocular vitamin D status in the tear, aqueous and vitreous fluid is a prospective gap in research.
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Affiliation(s)
| | - Peter Shah
- Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK.,University College London, London, UK.,Centre for Health and Social Care Improvement, University of Wolverhampton, Wolverhampton, UK
| | - Freda Sii
- Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK
| | - Damien Hunter
- Centre for Vision Research, Westmead Institute for Medical Research, Westmead, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Nicole Carnt
- Centre for Vision Research, Westmead Institute for Medical Research, Westmead, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Andrew White
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.,Cambridge NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK.,Department of Ophthalmology, Westmead Hospital, Westmead, Australia.,Community Eye Care Centre, Western Sydney, Australia.,Sydney Medical School, Westmead Institute, Sydney, Australia.,Sydney Medical School, Save Sight Institute, Sydney, Australia
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Kim CY, Lee EJ, Kim JA, Kim H, Kim TW. Progressive retinal nerve fibre layer thinning and choroidal microvasculature dropout at the location of disc haemorrhage in glaucoma. Br J Ophthalmol 2020; 105:674-680. [PMID: 32611606 DOI: 10.1136/bjophthalmol-2020-316169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/12/2020] [Accepted: 06/03/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To investigate whether parapapillary choroidal microvasculature dropout (MvD) is associated with progressive retinal nerve fibre layer (RNFL) thinning in eyes with primary open-angle glaucoma (POAG) and disc haemorrhage (DH). METHODS Parapapillary microvasculature was evaluated by swept-source optical coherence tomography (OCT) angiography (OCTA) in 50 eyes with POAG and DH, 1 year before, at the time of and 1 year after the detection of DH. MvD was defined as an area in the parapapillary deep layer of focal sectoral dropout with no visible microvascular network. Progressive changes in OCT RNFL thickness were compared in groups of eyes with and without MvD. RESULTS Cumulative prevalence of MvD was 76.0% (38 eyes) at 1 year after detection of DH. All MvDs were detected in the same sectoral locations as DH. In eyes with MvD, global RNFL thickness and sectoral RNFL thickness at the location of DH were significantly reduced, both from 1 year before to the time of DH detection (both p<0.001) and from DH detection to 1 year later (both p<0.001). In eyes without MvD, however, the reductions in global (p=0.011) and sectoral (p=0.007) RNFL thickness were significant only from DH detection to 1 year later. CONCLUSION In eyes with POAG, RNFL thinning was spatially consistent and progressive at the location of MvD accompanied by subsequent DH and continued to progress after the occurrence of DH. When DH was not accompanied by MvD, progressive RNFL thinning was more likely to occur after the detection of DH.
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Affiliation(s)
- Chung Young Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun Ji Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji-Ah Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyunjoong Kim
- Department of Applied Statistics, Yonsei University, Seoul, Korea
| | - Tae-Woo Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Huang H, Kaur S, Hu Y. Lab review: Molecular dissection of the signal transduction pathways associated with PTEN deletion-induced optic nerve regeneration. Restor Neurol Neurosci 2020; 37:545-552. [PMID: 31839616 DOI: 10.3233/rnn-190949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Permanent loss of vital functions after central nervous system (CNS) injury occurs in part because axons in the adult mammalian CNS do not regenerate after injury. PTEN was identified as a prominent intrinsic inhibitor of CNS axon regeneration about 10 years ago. The PTEN negatively regulated PI3K-AKT-mTOR pathway, which has been intensively explored in diverse models of axon injury and diseases and its mechanism for axon regeneration is becoming clearer. OBJECTIVE It is timely to summarize current knowledge about the PTEN/AKT/mTOR pathway and discuss future directions of translational regenerative research for neural injury and neurodegenerative diseases. METHODS Using mouse optic nerve crush as an in vivo retinal ganglion cell axon injury model, we have conducted an extensive molecular dissection of the PI3K-AKT-mTORC1/mTORC2 pathway to illuminate the cross-regulating mechanisms in axon regeneration. RESULTS AKT is the nodal point that coordinates both positive (PI3K-PDK1-pAKT-T308) and negative (PI3K-mTORC2-pAKT-S473) signals to regulate adult CNS axon regeneration through two parallel pathways, activating mTORC1 and inhibiting GSK3β. However, mTORC1/S6K1-mediated feedback inhibition after PTEN deletion prevents potent AKT activation. CONCLUSIONS A key permissive signal from an unidentified AKT-independent pathway is required for stimulating the neuron-intrinsic growth machinery. Future studies into this complex neuron-intrinsic balancing mechanism involving necessary and permissive signals for axon regeneration is likely to lead to safe and effective regenerative strategies for CNS repair.
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Affiliation(s)
- Haoliang Huang
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Simran Kaur
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Yang Hu
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA
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Kang DH, Hwang YH. Effect of baseline test selection on glaucoma progression detection by optical coherence tomography-guided progression analysis. Br J Ophthalmol 2020; 105:783-788. [PMID: 32586934 DOI: 10.1136/bjophthalmol-2019-315715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/16/2020] [Accepted: 06/06/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE To evaluate the effect of baseline test selection on progression detection of circumpapillary retinal nerve fibre layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) in glaucomatous eyes by optical coherence tomography (OCT)-guided progression analysis (GPA). METHODS A total of 53 eyes with either RNFL or GCIPL progression determined using OCT-GPA were included. Three different baseline conditions were created by dividing eight serial OCT tests from each eye into three sets. Specifically, these sets presented baseline tests at exams 1-2 (1st set), 2-3 (2nd set) and 3-4 (3rd set), respectively. Agreement on progression detection was defined as the presence of 'Possible Loss' or 'Likely Loss' in the 2nd or 3rd sets at the same location in the 1st set. RESULTS The proportion of eyes with agreement on progression detection was 47.1%, 20.0% and 31.0% for RNFL 'thickness map progression', 'thickness profiles progression' and 'average thickness progression', respectively. In GCIPL 'thickness map progression' and 'average thickness progression', 53.8% and 62.8% of eyes showed agreement, respectively. Eyes with disagreement showed a greater change in thickness (slope of change in the 3rd set-1st set) compared to the eyes with agreement (p<0.05), with the exception of RNFL 'thickness profiles progression' (p=0.064). CONCLUSION Glaucoma progression detection by OCT-GPA was affected by baseline test selection, especially in eyes with a greater reduction in progression. GCIPL thickness was less influenced by baseline test selection compared to RNFL thickness.
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Affiliation(s)
- Dong Hyun Kang
- Department of Ophthalmology, Kim's Eye Hospital, Seoul, Korea (the Republic of)
| | - Young Hoon Hwang
- Department of Ophthalmology, Kim's Eye Hospital, Seoul, Korea (the Republic of)
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Pando-Cifuentes A, Cortés-González V, Berrones-Medina D, Villanueva-Mendoza C. [Extension of TORCH spectrum in ophthalmology: congenital Zika, case report]. Rev Med Inst Mex Seguro Soc 2019; 57:395-399. [PMID: 33001616] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Zika is a flavivirus that can be transmitted transplacentally. Eye abnormalities have been reported in 70% of Zika cases, and 41.7% of them can occur in the absence of microcephaly. The most common ocular abnormalities are macular atrophy, optic atrophy and chorioretinal coloboma. The objective was to report the case of eye disorders associated with Zika, acquired transplacentally, despite negative results for TORCH, and serology and PCR analyses for Zika. CLINICAL CASE 9-month-old female patient, born in Chiapas, Mexico, brought to an ophthalmologic evaluation because she did not follow objects. As family background patient's mother had Zika, confirmed serologically at 9 weeks gestation. Physical examination revealed microcephaly, redundant skin on neck, joint stiffness and delayed psychomotor development. Ophthalmological examination revealed in right eye atrophy of the optic nerve, and left eye with exotropia, macular scar and optic nerve aplasia. TORCH profile and serology and PCR for Zika were negative. CONCLUSIONS Despite the negative serology for Zika, given the history of pregnancy and the pre and post-natal clinical manifestations, diagnosis of embryopathy secondary to Zika infection with optic nerve aplasia, chorioretinal atrophy, macular scar, microcephaly and global neurodevelopmental delay was made.
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Affiliation(s)
| | | | - David Berrones-Medina
- Asociación para Evitar la Ceguera en México, Servicio de Retina, Ciudad de México, México
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