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Subhi Y, Potapenko I, Hajari JN, la Cour M. Prognostic modelling of number of patients with retinal vein occlusion in anti-VEGF therapy. Acta Ophthalmol 2024; 102:318-325. [PMID: 37278225 DOI: 10.1111/aos.15721] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/21/2023] [Accepted: 05/28/2023] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of the study was to evaluate temporal changes in age- and sex-stratified incidence rates of retinal vein occlusion (RVO) commenced in anti-vascular endothelial growth factor (anti-VEGF) treatment, proportion of patients remaining in active anti-VEGF therapy over time, and to develop a forecasting model for future number of patients with RVO in active anti-VEGF therapy. METHODS This was a registry-based study of patients with RVO in the Capital Region of Denmark from commenced in anti-VEGF therapy from 1 January 2007 to 30 June 2022. Census data were extracted from Statistics Denmark for incidence rate analyses and forecasting data of future demographics. RESULTS A total of 2641 patients with RVO were commenced in anti-VEGF therapy, of which 2192 were later discontinued. Number of patients rose dramatically during the first years of introduction of anti-VEGF therapy, after which growth was slower and followed the demographic changes. Trend analyses revealed that the COVID-19 epidemics impacted with fewer referrals and more aggressive discontinuation practices. Annual incidence of RVO in 2012-2021 was 13.1 per 100 000 (95% CI: 12.6-13.6 per 100 000). Proportion of patients with RVO remaining in active anti-VEGF treatment was 55.0%, 40.1%, 30.8% and 12.1% after Years 1, 2, 3 and 8, respectively. According to our forecast, number of patients with RVO in active anti-VEGF therapy will grow slowly but continually at least until year 2035. CONCLUSION Our study reports incidence rates and provides prognostic modelling of number of patients with RVO in anti-VEGF therapy.
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Affiliation(s)
- Yousif Subhi
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ivan Potapenko
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
| | - Javad N Hajari
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
| | - Morten la Cour
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Moon JY, Garg I, Miller JB, Ludwig CA. SUDDEN MONOCULAR VISION LOSS AFTER SNEEZING AS CAPTURED ON WIDEFIELD SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY-ANGIOGRAPHY. Retin Cases Brief Rep 2024; 18:407-410. [PMID: 36729527 PMCID: PMC11027971 DOI: 10.1097/icb.0000000000001395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE We report an unusual case of likely combined retinal artery occlusion and retinal vein occlusion after a sneeze. Widefield swept-source optical coherence tomography-angiography was used to analyze retinal changes at one-month follow-up. METHODS The patient reported visual symptoms in his left eye immediately after sneezing five times in a row. Fundus examination showed an embolus along the superior arcade. Stroke workup revealed moderate carotid artery stenosis and a subtherapeutic INR. At one-month follow-up, fundus photography and swept-source optical coherence tomography-angiography were obtained. RESULTS Fundus photography showed superior retinal whitening and arteriole attenuation, an inferior perifoveal cotton wool spot, and inferotemporal intraretinal hemorrhages. Swept-source optical coherence tomography-angiography showed loss of the deep capillary plexus superiorly and inferotemporally, most consistent with combined retinal artery and retinal vein occlusion. CONCLUSION We report the first case of sneeze-induced combined retinal artery and retinal vein occlusion. The retina is a uniquely accessible window that provides insight into human physiology, and swept-source optical coherence tomography-angiography is a powerful tool that can give further insight into the pathophysiology of an occlusion.
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Affiliation(s)
- Jade Y. Moon
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Itika Garg
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, Massachusetts
- Department of Ophthalmology, Tulane University, New Orleans, Louisiana
| | - John B. Miller
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, Massachusetts
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; and
| | - Cassie A. Ludwig
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, Massachusetts
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; and
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Cai X, Zhao J, Dang Y. Combination Therapy with Anti-VEGF and Intravitreal Dexamethasone Implant for Macular Edema Secondary to Retinal Vein Occlusion. Curr Eye Res 2024:1-7. [PMID: 38639040 DOI: 10.1080/02713683.2024.2343055] [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: 03/11/2024] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE To compare the safety and efficacy of intravitreal injection of ranibizumab alone or ranibizumab combined with dexamethasone intravitreal implant in the treatment of macular edema secondary to retinal vein occlusion. STUDY DESIGN A single center, case-controlled, prospective cohort study (Clinical Trail Registration Number: ChiCTR2400080048). METHODS A total of 44 patients were enrolled and randomized into the ranibizumab group (n = 23) and the combination group (ranibizumab combined with dexamethasone intravitreal implant) (n = 21). All patients received ranibizumab intravitreal injections in the first three months as the initial treatment. For the ranibizumab group, patients might receive repeat injections in case of the recurrence of macular edema; For the combination group, patients received an intravitreal injection of dexamethasone implant after the first injection of ranibizumab at the day 15. The main outcome was best-corrected visual acuity (BCVA) and reduction of central macular thickness. The secondary outcome were the numbers of recurrence, the average injection interval, and the numbers of injection. Adverse events were also recorded. RESULTS The BCVAs in both groups were significantly improved compared with the baselines (all p < 0.001), but more increment in BCVA was noticed at the 3-month in the combination group (p = 0.022). Both groups showed a reduction of central macular thickness at all time points (p < 0.05). However, the combination group did not exhibit higher central macular thickness-reducing effects than the ranibizumab group (p > 0.05). Compared with the combination group, the ranibizumab group suffered a higher number of recurrences of macular edema (p < 0.001), a lower interval of injection (p = 0.050), and a higher number of injection (p < 0.011). The incidence of adverse events was not significant between the two groups (p = 0.944). CONCLUSIONS Ranibizumab combined with dexamethasone injection sustainably improved the BCVA of retinal vein occlusion patients with a good safety profile.
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Affiliation(s)
- Xiaohui Cai
- Department of Ophthalmology, Sanmenxia Eye Hospital/Sanmenxia Central Hospital Affiliated to Henan University of Science and Technology, Sanmenxia, China
- Henan International Joint Laboratory of Outflow Engineering, Sanmenxia Central Hospital, School of Medicine, Henan University of Science and Technology, Sanmenxia, China
| | - Jing Zhao
- Department of Ophthalmology, Sanmenxia Eye Hospital/Sanmenxia Central Hospital Affiliated to Henan University of Science and Technology, Sanmenxia, China
- Henan International Joint Laboratory of Outflow Engineering, Sanmenxia Central Hospital, School of Medicine, Henan University of Science and Technology, Sanmenxia, China
| | - Yalong Dang
- Department of Ophthalmology, Sanmenxia Eye Hospital/Sanmenxia Central Hospital Affiliated to Henan University of Science and Technology, Sanmenxia, China
- Henan International Joint Laboratory of Outflow Engineering, Sanmenxia Central Hospital, School of Medicine, Henan University of Science and Technology, Sanmenxia, China
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4
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Lu B, Li Y, Xie L, Chiu K, Hao X, Xu J, Luo J, Sham PC. Computational Retinal Microvascular Biomarkers from an OCTA Image in Clinical Investigation. Biomedicines 2024; 12:868. [PMID: 38672222 DOI: 10.3390/biomedicines12040868] [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: 12/25/2023] [Revised: 03/24/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Retinal structural and functional changes in humans can be manifestations of different physiological or pathological conditions. Retinal imaging is the only way to directly inspect blood vessels and their pathological changes throughout the whole body non-invasively. Various quantitative analysis metrics have been used to measure the abnormalities of retinal microvasculature in the context of different retinal, cerebral and systemic disorders. Recently developed optical coherence tomography angiography (OCTA) is a non-invasive imaging tool that allows high-resolution three-dimensional mapping of the retinal microvasculature. The identification of retinal biomarkers from OCTA images could facilitate clinical investigation in various scenarios. We provide a framework for extracting computational retinal microvasculature biomarkers (CRMBs) from OCTA images through a knowledge-driven computerized automatic analytical system. Our method allows for improved identification of the foveal avascular zone (FAZ) and introduces a novel definition of vessel dispersion in the macular region. Furthermore, retinal large vessels and capillaries of the superficial and deep plexus can be differentiated, correlating with retinal pathology. The diagnostic value of OCTA CRMBs was demonstrated by a cross-sectional study with 30 healthy subjects and 43 retinal vein occlusion (RVO) patients, which identified strong correlations between OCTA CRMBs and retinal function in RVO patients. These OCTA CRMBs generated through this "all-in-one" pipeline may provide clinicians with insights about disease severity, treatment response and prognosis, aiding in the management and early detection of various disorders.
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Affiliation(s)
- Bingwen Lu
- Department of Ophthalmology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Yiming Li
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Centre for PanorOmic Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Like Xie
- Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Kin Chiu
- Department of Ophthalmology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Xiaofeng Hao
- Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Jing Xu
- Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Jie Luo
- Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Pak-Chung Sham
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Centre for PanorOmic Sciences, The University of Hong Kong, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
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Garmo V, Zhao X, Ng CD, Near A, Banerji T, Wada K, Oderda G, Brixner D, Biskupiak J, Ali FS, Khanani AM, Menezes A, Abbass IM. The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare Patients. J Health Econ Outcomes Res 2024; 11:94-102. [PMID: 38560652 PMCID: PMC10981881 DOI: 10.36469/001c.93022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024]
Abstract
Background: The association of neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) with functional status in the general Medicare population are not well established. Objectives: This study examined patient-reported survey data linked with Medicare claims to describe the burden of these vision-threatening retinal diseases (VTRDs) among Medicare beneficiaries. Methods: Medicare Current Beneficiary Survey data linked with Medicare Fee-for-Service claims data from 2006 to 2018 were used in a nationally representative retrospective pooled cross-sectional population-based comparison study. Outcomes between community-dwelling beneficiaries with nAMD (n = 1228), DME (n = 101), or RVO (n = 251) were compared with community-dwelling beneficiaries without any VTRDs (n = 104 088), controlling for baseline demographic and clinical differences. Beneficiaries with a diagnosis of nAMD, DME, or RVO during the data year were included; those with other VTRDs were excluded. Outcomes included vision function and loss, overall functioning as assessed by difficulties with activities of daily living (ADLs) and instrumental ADLs (iADLs), anxiety/depression, falls, and fractures. Results: In patient cohorts with nAMD, DME, and RVO, approximately one-third (34.2%-38.3%) reported "a little trouble seeing" (vs 28.3% for controls), and 26%, 17%, and 9%, respectively, reported "a lot of trouble seeing/blindness" (vs 5% of controls). Difficulty walking and doing heavy housework were the most reported ADLs and iADLs, respectively. Compared with those without VTRDs, beneficiaries with nAMD had higher odds of diagnosed vision loss (odds ratio [OR], 5.39; 95% confidence interval, 4.06-7.16; P < .001) and difficulties with iADLs (odds ratio, 1.41; 95% confidence interval, 1.11-1.80; P = .005); no differences were observed for DME or RVO vs control. After adjusting for age, sex, race/ethnicity, poverty status, comorbidities, and other relevant covariates, nAMD, DME, and RVO were not significantly associated with anxiety/depression, falls, or fractures. Discussion: Patients with nAMD or DME were more likely to report severe visual impairment than those without VTRDs, although only those with nAMD were more likely to be diagnosed with vision loss. Conclusions: Patients with nAMD continue to experience more vision impairment and worse functional status compared with a similar population of Medicare beneficiaries despite availability of therapies like antivascular endothelial growth factor to treat retinal disease.
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Affiliation(s)
- Vincent Garmo
- Genentech, Inc., South San Francisco, California, USA
| | | | - Carmen D Ng
- Genentech, Inc., South San Francisco, California, USA
| | | | | | | | - Gary Oderda
- University of Utah, Salt Lake City, Utah, USA
| | | | | | | | - Archad M Khanani
- Sierra Eye Associates, Reno, Nevada
- School of Medicine University of Nevada, Reno
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Lee JH, Kim SH, Kim E. Influence of Smoking and Controlled Medical Conditions on the Risks of Branch Retinal Vein Occlusion in South Korea: A Population-Based Study. Ophthalmic Epidemiol 2024:1-8. [PMID: 38507597 DOI: 10.1080/09286586.2024.2321902] [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: 11/06/2023] [Accepted: 02/18/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE To evaluate the effect of controlled medical conditions and risk of lifetime smoking history on the prevalence of branch retinal vein occlusion (BRVO) based on the Korea National Health and Nutrition Survey (KNHANES) database from 2017-2021. METHODS The study population consisted of individuals aged ≥ 40 years who had completed ophthalmological questionnaires, underwent comprehensive ophthalmological examinations, and had at least one good-quality readable fundus photograph. Age, sex, hypertension status, diabetes status, dyslipidemia status, body mass index status, a history of chronic kidney disease (CKD), a lifetime smoking history of ≥ 100 cigarettes, and glaucoma were subjected to univariate and multivariate logistic regression analyses. RESULTS The estimated prevalence (± standard error) of RVO was 0.5% (±0.1%). Significant risk factors were one-year increase in age, female sex, hypertension (stage 1, controlled, uncontrolled, and undiagnosed hypertension), underweight, pre-obesity, history of CKD, lifetime smoking history of ≥ 100 cigarettes, and glaucoma. Controlled diabetes decreased the risk of BRVO by 55% (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.22-0.89, p = 0.022) and controlled hyper-high-density-lipoprotein (HDL)-cholesterolemia decreased the risk by 69% (OR = 0.31, 95% CI = 0.13-0.76, p = 0.010). CONCLUSION This study, for the first time, reported the association between lifetime smoking history of ≥ 100 cigarettes and BRVO in Korea. The risk of BRVO was lower in participants with controlled diabetes and hypo-HDL-cholesterolemia.
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Affiliation(s)
- Jung Hoo Lee
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Seong Ho Kim
- Kim's Eye Hospital of Konyang University, Seoul, South Korea
| | - EunAh Kim
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
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Schreiberova Z, Rehak J, Babkova B, Sin M, Rybarikova M, Paskova B, Sinova I, Hubnerova P, Maluskova M, Maresova K, Karhanova M. Hypertension, hyperlipidaemia and thrombophilia as the most common risk factors for retinal vein occlusion in patients under 50 years. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024; 168:44-49. [PMID: 36036564 DOI: 10.5507/bp.2022.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIMS Cardiovascular (CV) diseases are the most common risk factors (RFs) for retinal vein occlusion (RVO) development in general. The aim of this study was to identify the most frequent causes of RVO in patients under 50. METHODS We retrospectively evaluated a group of patients with RVO under 50 years. The parameters of interest included age and sex, RVO type, presence of arterial hypertension (HT), hyperlipidaemia (HLD), diabetes mellitus (DM), congenital thrombophilic disorder (TD), obstructive sleep apnoea syndrome (OSAS), thyroid eye disease (TED), use of hormone contraception (HC) or hormone replacement therapy (HRT), glaucoma and other potential RFs. Patients with central RVO (CRVO), hemi-central RVO (HRVO), branch RVO (BRVO), impending CRVO and combined arterial-venous (AV) occlusion were included. RESULTS The group consisted of 110 eyes of 103 patients. CV disease was the most common systemic abnormality. 55.3% patients had HT, 17.5% had HLD. TD was the third most frequent RF (12.6%). The cohort also included patients with DM (6.8%), glaucoma (6.8%) and women using HC/HRT (26.2% of female patients). There were isolated cases of RVO due to retinal vasculitis, intense exercise, antiphospholipid syndrome and COVID-19 pneumonia. None of the patients had OSAS, TED or a haemato-oncological disease. The etiology remained unexplained in 20.4% patients. No difference was observed in RF occurrence between patients with CRVO and HRVO and those with BRVO. CONCLUSION The most common systemic abnormality in our cohort was CV disease, especially HT and HLD. The risk factors for central, hemi-central and branch RVOs were similar.
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Affiliation(s)
- Zuzana Schreiberova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Jiri Rehak
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Barbora Babkova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Martin Sin
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and Military University Hospital Prague, Czech Republic
| | - Martina Rybarikova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Barbora Paskova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Irena Sinova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Petra Hubnerova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Miroslava Maluskova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Klara Maresova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Marta Karhanova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
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Chatzimichail E, Pfau K, Gatzioufas Z, Panos GD. Ranibizumab Biosimilars in Treating Retinal Disorders: A Cost-Effective Revolution? Drug Des Devel Ther 2024; 18:365-374. [PMID: 38347957 PMCID: PMC10860804 DOI: 10.2147/dddt.s457303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
Ranibizumab, is a humanized, monoclonal antibody fragment that binds and inactivates vascular endothelial growth factor-A (VEGF-A) and VEGF-B. One of the main indications for an intravitreal treatment with ranibizumab is age-related macular degeneration (AMD), which is a retinal disease with a high worldwide socioeconomic impact. Biosimilars constitute biological products that demonstrate similar pharmacodynamic and pharmacokinetic characteristics with a reference product, as well as comparable clinical efficacy, safety and immunogenicity. Since the approval of the first biosimilar Razumab, there has been a variety of new biosimilars available on the market. They offer the advantage of the same good clinical and safety results at a better price. All Ranibizumab biosimilars that have gained approval were tested in double masked Phase 3 clinical studies. The use of Ranibizumab biosimilars in neovascular AMD is well reported in the bibliography. Nevertheless, over the last few years, there is a tendency of using biosimilars in other retinal diseases like retinopathy of prematurity (ROP), diabetic macular edema (DME) or polypoidal choroidal vasculopathy (PCV). In conclusion, ranibizumab biosimilars offer a promising avenue for the management of retinal diseases, especially in countries with lower socioeconomic status, where there is lack of availability of innovator ranibizumab. However, further research is required to fully explore their efficacy, safety, and long-term outcomes in a plethora of retinal diseases.
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Affiliation(s)
| | - Kristina Pfau
- Department of Ophthalmology, University Hospital of Basel, Basel, Switzerland
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Zisis Gatzioufas
- Department of Ophthalmology, University Hospital of Basel, Basel, Switzerland
| | - Georgios D Panos
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham University Hospitals, Nottingham, UK
- Division of Ophthalmology and Visual Sciences, School of Medicine, University of Nottingham, Nottingham, UK
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Gawęcki M, Kiciński K. Advantages of the Utilization of Wide-Field OCT and Wide-Field OCT Angiography in Clinical Practice. Diagnostics (Basel) 2024; 14:321. [PMID: 38337837 PMCID: PMC10855083 DOI: 10.3390/diagnostics14030321] [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: 12/30/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Wide-field (WF) retinal imaging is becoming a standard diagnostic tool for diseases involving the peripheral retina. Technological progress elicited the advent of wide-field optical coherence tomography (WF-OCT) and WF-OCT angiography (WF-OCTA) examinations. This review presents the results of studies that analyzed the implementation of these procedures in clinical practice and refers to them as traditional and ultra-wide-field fluorescein angiography (UWF-FA). A PUBMED search was performed using the terms WF-OCT OR WF-OCTA OR UWF-FA AND the specific clinical entity, and another search for diabetic retinopathy (DR), retinal vein occlusion (RVO), Coats disease, peripheral retinal telangiectasia, peripheral retinal degeneration, lattice degeneration, and posterior vitreous detachment. The analysis only included the studies in which the analyzed field of view for the OCT or OCTA exam was larger than 55 degrees. The evaluation of the extracted studies indicates that WF imaging with OCT and OCTA provides substantial information on retinal disorders involving the peripheral retina. Vascular diseases, such as DR or RVO, can be reliably evaluated using WF-OCTA with results superior to standard-field fluorescein angiography. Nevertheless, UWF-FA provides a larger field of view and still has advantages over WF-OCTA concerning the evaluation of areas of non-perfusion and peripheral neovascularization. Detailed information on the vascular morphology of peripheral changes should be obtained via WF-OCTA and not angiographic examinations. WF-OCT can serve as a valuable tool for the detection and evaluation of vitreoretinal traction, posterior vitreous detachment, and peripheral retinal degeneration, and guide therapeutic decisions on a patient's eligibility for surgical procedures.
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Affiliation(s)
- Maciej Gawęcki
- Dobry Wzrok Ophthalmological Clinic, 80-822 Gdansk, Poland
- Department of Ophthalmology, Pomeranian Hospitals, 84-120 Wejherowo, Poland;
| | - Krzysztof Kiciński
- Department of Ophthalmology, Pomeranian Hospitals, 84-120 Wejherowo, Poland;
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Zhao XY, Zhao Q, Wang CT, Meng LH, Cheng SY, Gu XW, Sadda SR, Chen YX. Central and Peripheral Changes in Retinal Vein Occlusion and Fellow Eyes in Ultra-Widefield Optical Coherence Tomography Angiography. Invest Ophthalmol Vis Sci 2024; 65:6. [PMID: 38306106 PMCID: PMC10851174 DOI: 10.1167/iovs.65.2.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/26/2023] [Indexed: 02/03/2024] Open
Abstract
Purpose To explore the central and peripheral retinal and choroidal changes in retinal vein occlusion (RVO) and fellow eyes using ultra-widefield swept-source optical coherence tomography angiography (UWF-SS-OCTA). Methods Fifteen ischemic central RVO (CRVO), 15 branch RVO (BRVO), and 15 age-matched healthy controls were prospectively recruited. Retinal and choroidal parameters, including retinal vessel flow density (VFD) and vessel linear density (VLD), choroidal vascularity volume (CVV), choroidal vascularity index (CVI), and VFD in the large and medium choroidal vessels (LMCV-VFD), were measured in the central and peripheral regions of the 24 × 20-mm UWF-SS-OCTA images. Results Ischemic CRVO and BRVO eyes showed increased foveal avascular zone area, perimeter, and acircularity index (AI) compared to their fellow eyes and healthy control eyes, and RVO fellow eyes also had larger AI values than controls (P < 0.05). For ischemic CRVO and BRVO eyes versus control eyes, VFD, VLD, CVV, CVI, and LMCV-VFD decreased, but retinal thickness and volume in the superficial capillary plexus, deep capillary plexus, and whole retina increased (P < 0.05). Moreover, RVO fellow eyes also showed significantly decreased retinal VFD, LMCV-VFD, and CVI, as well as increased retinal thickness and volume, compared with control eyes (P < 0.05). Alterations were not consistent throughout the retina, as they involved only the peripheral or central regions in some cases. Conclusions The affected and unaffected fellow eyes of RVO patients both demonstrated central and/or peripheral structural and vascular alterations in the retina and choroid. Because UWF-SS-OCTA enables visualization and evaluation of the vasculature outside the posterior pole, it presents a promising approach to more fully characterize vascular alterations in RVO.
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Affiliation(s)
- Xin-yu Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qing Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chu-ting Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Li-hui Meng
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shi-yu Cheng
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xing-wang Gu
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Srinivas R. Sadda
- Doheny Eye Institute, Pasadena, California, United States
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - You-xin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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11
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Wang Q, Li T, Zhang X, Zeng Y, Yang Y, Zhou Y, Gu X, Xie X, Ling S. Distinctive Imaging Characteristics of Retinal and Cerebral Vessels between Central and Branch Retinal Vein Occlusion by MRI and AI-Based Image Analyzer. Diagnostics (Basel) 2024; 14:267. [PMID: 38337783 PMCID: PMC10854905 DOI: 10.3390/diagnostics14030267] [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: 11/30/2023] [Revised: 01/04/2024] [Accepted: 01/13/2024] [Indexed: 02/12/2024] Open
Abstract
Retinal vessels have been good predictive and prognostic imaging biomarkers for systemic or eye diseases. Numerous studies have shown that the two retinal vein occlusion entities may correlate with cardiovascular and cerebrovascular events or primary open-angle glaucoma. This study aims to investigate if there is a disparity in the correlations between branch RVO (BRVO) and central RVO (CRVO) with systemic disorders or POAG, thus explaining the pathogenic difference between BRVO and CRVO. This retrospective case-control study enrolled 59 RVO subjects (118 eyes), including 25 CRVO and 34 BRVO subjects, who received routine eye and brain MRI examinations. The geometric characteristics of the caliber of the retinal and cerebral blood vessels and the optic nerve subarachnoid space width (ONSASW) were measured. Multivariable logistic regression analysis showed that ONSASW at 3 mm behind the globe (p = 0.044) and the relative retinal venular calibers (p = 0.031) were independent risk factors for the CRVO-affected eyes group in comparison with the BRVO-affected eyes group after adjusting for age, duration of hypertension, BMI, and IOP. In the CRVO-affected eyes, narrower relative retinal arteriolar calibers (p = 0.041) and wider relative venular calibers (p = 0.011) were independent risk factors compared with the CRVO-contralateral normal eyes when adjusting for IOP. We concluded that BRVO may be more associated with cerebrovascular diseases, and CRVO may be correlated with primary angle glaucoma. The geometric characteristics difference between the retinal and cerebrovascular may explain the pathological difference between CRVO and BRVO.
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Affiliation(s)
- Qiyun Wang
- Beijing Tongren Eye Center, Tongren Hospital, Capital Medical University, Beijing 100730, China; (Q.W.); (Y.Z.); (Y.Y.); (X.G.)
- Beijing Retinal and Choroidal Vascular Disorders Study Group, Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Ting Li
- Department of Radiology, Capital Medical University, Beijing Tongren Hospital, Beijing 100176, China;
| | - Xinyuan Zhang
- Beijing Tongren Eye Center, Tongren Hospital, Capital Medical University, Beijing 100730, China; (Q.W.); (Y.Z.); (Y.Y.); (X.G.)
- Beijing Retinal and Choroidal Vascular Disorders Study Group, Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yiyun Zeng
- Beijing Tongren Eye Center, Tongren Hospital, Capital Medical University, Beijing 100730, China; (Q.W.); (Y.Z.); (Y.Y.); (X.G.)
- Beijing Retinal and Choroidal Vascular Disorders Study Group, Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yang Yang
- Beijing Tongren Eye Center, Tongren Hospital, Capital Medical University, Beijing 100730, China; (Q.W.); (Y.Z.); (Y.Y.); (X.G.)
- Beijing Retinal and Choroidal Vascular Disorders Study Group, Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yun Zhou
- China National Clinical Research Center for Neurological Diseases, Tiantan Hospital, Capital Medical University, Beijing 100730, China;
| | - Xinming Gu
- Beijing Tongren Eye Center, Tongren Hospital, Capital Medical University, Beijing 100730, China; (Q.W.); (Y.Z.); (Y.Y.); (X.G.)
- Beijing Retinal and Choroidal Vascular Disorders Study Group, Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Xiaobin Xie
- Eye Hospital of China Academy of Chinese Medical Sciences, Beijing 100040, China;
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Gomi F, Kawasaki R, Ogura Y, Iwasaki K, Takeshima T, Yamabe M, Imai K. Patterns of anti-vascular endothelial growth factor treatment for chorioretinal vascular diseases: Analysis of a nationwide claims database in Japan. Ann Clin Epidemiol 2024; 6:42-50. [PMID: 38606038 PMCID: PMC11006551 DOI: 10.37737/ace.24007] [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] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/28/2023] [Indexed: 04/13/2024]
Abstract
BACKGROUND Although intravitreal anti-vascular endothelial growth factor therapy is currently considered the first-line treatment for chorioretinal vascular diseases in Japan, information regarding its treatment pattern is scarce. This study investigated the patterns of anti-vascular endothelial growth factor treatment for chorioretinal vascular diseases. METHODS A health insurance claims database from acute care hospitals was used to estimate treatment intervals and continuation and drop-out rates regarding the anti-vascular endothelial growth factor. Patients aged ≥50 years diagnosed with neovascular age-related macular degeneration or aged ≥18 years diagnosed with diabetic macular edema or retinal vein occlusion were analyzed. RESULTS Data were included for 76,535, 49,704, and 37,681 patients with neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion, respectively; exactly 8,111, 2,283, and 6,896 received the treatment, respectively. The mean and median interval ranges during the maintenance phase by treatment initiation year were 94-100 and 73-80, 111-120 and 98-102, and 97-103 and 87-93 days for neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion, respectively, without any trend over time. A tendency to increase the treatment continuation rate was indicated in later years by Kaplan-Meier curves. The drop-out rate in the treatment initiation year (2016) was 32% from 63% (2009), 53% from 69% (2014), and 36% from 47% (2013) for neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion, respectively. CONCLUSIONS For all these diseases, the treatment intervals did not change remarkably, and a tendency toward improved treatment continuation was suggested.
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Affiliation(s)
- Fumi Gomi
- Department of Ophthalmology, Hyogo Medical University
| | - Ryo Kawasaki
- Department of Vision Informatics, Osaka University Graduate School of Medicine
| | - Yuichiro Ogura
- Graduate School of Medical Sciences, Nagoya City University
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Li Z, Huang G, Zou B, Chen W, Zhang T, Xu Z, Cai K, Wang T, Sun Y, Wang Y, Jin K, Huang X. Segmentation of Low-Light Optical Coherence Tomography Angiography Images under the Constraints of Vascular Network Topology. Sensors (Basel) 2024; 24:774. [PMID: 38339491 PMCID: PMC10856982 DOI: 10.3390/s24030774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 02/12/2024]
Abstract
Optical coherence tomography angiography (OCTA) offers critical insights into the retinal vascular system, yet its full potential is hindered by challenges in precise image segmentation. Current methodologies struggle with imaging artifacts and clarity issues, particularly under low-light conditions and when using various high-speed CMOS sensors. These challenges are particularly pronounced when diagnosing and classifying diseases such as branch vein occlusion (BVO). To address these issues, we have developed a novel network based on topological structure generation, which transitions from superficial to deep retinal layers to enhance OCTA segmentation accuracy. Our approach not only demonstrates improved performance through qualitative visual comparisons and quantitative metric analyses but also effectively mitigates artifacts caused by low-light OCTA, resulting in reduced noise and enhanced clarity of the images. Furthermore, our system introduces a structured methodology for classifying BVO diseases, bridging a critical gap in this field. The primary aim of these advancements is to elevate the quality of OCTA images and bolster the reliability of their segmentation. Initial evaluations suggest that our method holds promise for establishing robust, fine-grained standards in OCTA vascular segmentation and analysis.
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Affiliation(s)
- Zhi Li
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; (Z.L.); (G.H.); (B.Z.); (W.C.); (T.Z.); (T.W.); (Y.S.)
| | - Gaopeng Huang
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; (Z.L.); (G.H.); (B.Z.); (W.C.); (T.Z.); (T.W.); (Y.S.)
| | - Binfeng Zou
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; (Z.L.); (G.H.); (B.Z.); (W.C.); (T.Z.); (T.W.); (Y.S.)
| | - Wenhao Chen
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; (Z.L.); (G.H.); (B.Z.); (W.C.); (T.Z.); (T.W.); (Y.S.)
| | - Tianyun Zhang
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; (Z.L.); (G.H.); (B.Z.); (W.C.); (T.Z.); (T.W.); (Y.S.)
| | - Zhaoyang Xu
- Department of Paediatrics, University of Cambridge, Cambridge CB2 1TN, UK;
| | - Kunyan Cai
- Faculty of Applied Sciences, Macao Polytechnic University, Macao SAR 999078, China;
| | - Tingyu Wang
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; (Z.L.); (G.H.); (B.Z.); (W.C.); (T.Z.); (T.W.); (Y.S.)
| | - Yaoqi Sun
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; (Z.L.); (G.H.); (B.Z.); (W.C.); (T.Z.); (T.W.); (Y.S.)
- Lishui Institute, Hangzhou Dianzi University, Lishui 323000, China
| | - Yaqi Wang
- College of Media Engineering, Communication University of Zhejiang, Hangzhou 310018, China;
| | - Kai Jin
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310027, China;
| | - Xingru Huang
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; (Z.L.); (G.H.); (B.Z.); (W.C.); (T.Z.); (T.W.); (Y.S.)
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London E3 4BL, UK
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14
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Ugurel E, Narimanfar G, Cilek N, Kesim C, Altan C, Sahin A, Yalcin O. Platelet Proteome Reveals Novel Targets for Hypercoagulation in Pseudoexfoliation Syndrome. Int J Mol Sci 2024; 25:1403. [PMID: 38338682 PMCID: PMC10855978 DOI: 10.3390/ijms25031403] [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: 10/31/2023] [Revised: 12/10/2023] [Accepted: 12/13/2023] [Indexed: 02/12/2024] Open
Abstract
Pseudoexfoliation syndrome (PEX) is characterized by the accumulation of abnormal extracellular matrix material in ocular and non-ocular tissues, including blood vessel walls. Clot-forming dysfunction might be responsible for venous thrombosis in PEX. We investigated global coagulation, the proteome, and functions of platelets in PEX patients and aimed to determine prognostic biomarkers for thrombosis risk in PEX. Peripheral blood was collected from PEX and retinal vein occlusion (RVO) patients, and age-sex matched controls. Viscoelastic hemostasis was evaluated by rotational thromboelastometry (ROTEM). Platelet markers (CD41, CD42, CD61, and CD62p) and endothelial markers (P-selectin, E-selectin, and von Willebrand factor) were investigated by flow cytometry and ELISA, respectively. The platelet proteome was analyzed by 2D fluorescence difference gel electrophoresis followed by mass spectrometry. Clot formation time (CFT) is significantly reduced in PEX patients compared to the controls (p < 0.05). P-selectin levels were higher in PEX patients than in controls (p < 0.05); E-selectin and von Willebrand factor remained unchanged. The monitorization of CFT by ROTEM, and soluble P-selectin, may help assess thrombotic risk in PEX patients. Proteomic analysis revealed differential expression of Profilin-1 in platelets. Profilin-1 regulates the stability of actin-cytoskeleton and may contribute to impaired platelet hemostatic functions. Increased P-selectin levels together with impaired coagulation dynamics might be responsible for the thrombotic events in PEX disease.
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Affiliation(s)
- Elif Ugurel
- Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul 34450, Turkey; (E.U.); (G.N.); (N.C.)
- Department of Physiology, School of Medicine, Koc University, Istanbul 34450, Turkey
| | - Ghazal Narimanfar
- Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul 34450, Turkey; (E.U.); (G.N.); (N.C.)
| | - Neslihan Cilek
- Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul 34450, Turkey; (E.U.); (G.N.); (N.C.)
- Department of Physiology, School of Medicine, Koc University, Istanbul 34450, Turkey
| | - Cem Kesim
- Department of Ophthalmology, Koc University Medical School, Istanbul 34010, Turkey; (C.K.); (A.S.)
| | - Cigdem Altan
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul 34421, Turkey;
| | - Afsun Sahin
- Department of Ophthalmology, Koc University Medical School, Istanbul 34010, Turkey; (C.K.); (A.S.)
| | - Ozlem Yalcin
- Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul 34450, Turkey; (E.U.); (G.N.); (N.C.)
- Department of Physiology, School of Medicine, Koc University, Istanbul 34450, Turkey
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15
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Ji YK, Hua RR, Liu S, Xie CJ, Zhang SC, Yang WH. Intelligent diagnosis of retinal vein occlusion based on color fundus photographs. Int J Ophthalmol 2024; 17:1-6. [PMID: 38239946 PMCID: PMC10754666 DOI: 10.18240/ijo.2024.01.01] [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: 08/29/2023] [Accepted: 10/17/2023] [Indexed: 01/22/2024] Open
Abstract
AIM To develop an artificial intelligence (AI) diagnosis model based on deep learning (DL) algorithm to diagnose different types of retinal vein occlusion (RVO) by recognizing color fundus photographs (CFPs). METHODS Totally 914 CFPs of healthy people and patients with RVO were collected as experimental data sets, and used to train, verify and test the diagnostic model of RVO. All the images were divided into four categories [normal, central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), and macular retinal vein occlusion (MRVO)] by three fundus disease experts. Swin Transformer was used to build the RVO diagnosis model, and different types of RVO diagnosis experiments were conducted. The model's performance was compared to that of the experts. RESULTS The accuracy of the model in the diagnosis of normal, CRVO, BRVO, and MRVO reached 1.000, 0.978, 0.957, and 0.978; the specificity reached 1.000, 0.986, 0.982, and 0.976; the sensitivity reached 1.000, 0.955, 0.917, and 1.000; the F1-Sore reached 1.000, 0.955 0.943, and 0.887 respectively. In addition, the area under curve of normal, CRVO, BRVO, and MRVO diagnosed by the diagnostic model were 1.000, 0.900, 0.959 and 0.970, respectively. The diagnostic results were highly consistent with those of fundus disease experts, and the diagnostic performance was superior. CONCLUSION The diagnostic model developed in this study can well diagnose different types of RVO, effectively relieve the work pressure of clinicians, and provide help for the follow-up clinical diagnosis and treatment of RVO patients.
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Affiliation(s)
- Yu-Ke Ji
- Eye Hospital, Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
| | - Rong-Rong Hua
- College of Electronic Information Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210000, Jiangsu Province, China
| | - Sha Liu
- Eye Hospital, Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
| | - Cui-Juan Xie
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen 518000, Guangdong Province, China
| | - Shao-Chong Zhang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen 518000, Guangdong Province, China
| | - Wei-Hua Yang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen 518000, Guangdong Province, China
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16
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Li W, Bian L, Ma B, Sun T, Liu Y, Sun Z, Zhao L, Feng K, Yang F, Wang X, Chan S, Dou H, Qi H. Interpretable Detection of Diabetic Retinopathy, Retinal Vein Occlusion, Age-Related Macular Degeneration, and Other Fundus Conditions. Diagnostics (Basel) 2024; 14:121. [PMID: 38247998 DOI: 10.3390/diagnostics14020121] [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: 11/15/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
Diabetic retinopathy (DR), retinal vein occlusion (RVO), and age-related macular degeneration (AMD) pose significant global health challenges, often resulting in vision impairment and blindness. Automatic detection of these conditions is crucial, particularly in underserved rural areas with limited access to ophthalmic services. Despite remarkable advancements in artificial intelligence, especially convolutional neural networks (CNNs), their complexity can make interpretation difficult. In this study, we curated a dataset consisting of 15,089 color fundus photographs (CFPs) obtained from 8110 patients who underwent fundus fluorescein angiography (FFA) examination. The primary objective was to construct integrated models that merge CNNs with an attention mechanism. These models were designed for a hierarchical multilabel classification task, focusing on the detection of DR, RVO, AMD, and other fundus conditions. Furthermore, our approach extended to the detailed classification of DR, RVO, and AMD according to their respective subclasses. We employed a methodology that entails the translation of diagnostic information obtained from FFA results into CFPs. Our investigation focused on evaluating the models' ability to achieve precise diagnoses solely based on CFPs. Remarkably, our models showcased improvements across diverse fundus conditions, with the ConvNeXt-base + attention model standing out for its exceptional performance. The ConvNeXt-base + attention model achieved remarkable metrics, including an area under the receiver operating characteristic curve (AUC) of 0.943, a referable F1 score of 0.870, and a Cohen's kappa of 0.778 for DR detection. For RVO, it attained an AUC of 0.960, a referable F1 score of 0.854, and a Cohen's kappa of 0.819. Furthermore, in AMD detection, the model achieved an AUC of 0.959, an F1 score of 0.727, and a Cohen's kappa of 0.686. Impressively, the model demonstrated proficiency in subclassifying RVO and AMD, showcasing commendable sensitivity and specificity. Moreover, our models enhanced interpretability by visualizing attention weights on fundus images, aiding in the identification of disease findings. These outcomes underscore the substantial impact of our models in advancing the detection of DR, RVO, and AMD, offering the potential for improved patient outcomes and positively influencing the healthcare landscape.
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Affiliation(s)
- Wenlong Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Linbo Bian
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Baikai Ma
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Tong Sun
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Yiyun Liu
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Zhengze Sun
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Lin Zhao
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Kang Feng
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Fan Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Xiaona Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Szyyann Chan
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Hongliang Dou
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Hong Qi
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
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17
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Delsoz M, Mousavi SH, Aslam SA. Treatment outcomes for maculopathy secondary to retinal vein occlusion in Afghanistan. Oman J Ophthalmol 2024; 17:43-46. [PMID: 38524332 PMCID: PMC10957068 DOI: 10.4103/ojo.ojo_328_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/12/2023] [Accepted: 09/23/2023] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVES The objective of this study was to investigate the efficacy of intravitreal antivascular endothelial growth factor (VEGF) therapy in the treatment of macular edema secondary to retinal vein occlusion (RVO) in Afghanistan. METHODS A retrospective analysis was conducted of all RVO cases that underwent intravitreal ant-VEGF injection at the two leading hospitals in Kabul. The main outcome measures were visual acuity and central retinal thickness as determined by optical coherence tomography. Information was also collected on the distance traveled by each patient and the frequency of injections. RESULTS One hundred and twenty-five eyes of 121 patients (86 males) with RVO were identified as having undergone treatment, with a mean age of 53.1 years (range 20-80). The only agent used was bevacizumab. The mean central retinal thickness reduced from 624.2 ± 24.9 μm at the baseline to 257.8 ± 5.7 μm following treatment (P < 0.001). There was a small increase in visual acuity from 1.33 LogMAR at the baseline to 1.13 LogMAR following the most recent injection (P = 0.03, paired t-test). The mean distance traveled by patients was 173.9 km (range 2-447 km). CONCLUSION Despite the challenges of health-care provision in Afghanistan, this review shows that the use of intravitreal bevacizumab has provided an effective treatment for macular edema after RVO.
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Affiliation(s)
- Mohammad Delsoz
- NOOR Eye-Care Training Centre, Kabul, Afghanistan
- Medical Research Centre, Kateb University, Kabul, Afghanistan
| | | | - Sher A. Aslam
- Retinal Department, Oxford Eye Hospital, John Radcliffe Hospital, Oxford, UK
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18
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Simpson ARH, Hughes EH, Mullen L, Dowell NG. In vivo measurement of T 1 in the vitreous humor of patients with ischemic retinal disease. Magn Reson Med 2024; 91:381-387. [PMID: 37800364 DOI: 10.1002/mrm.29849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE To demonstrate MR T1 mapping in vivo as a method to non-invasively estimate vitreous oxygen concentration in ischemic eye disease. METHODS Patients with ischemic eye disease (central retinal vein occlusion, ocular ischemic syndrome, and proliferative diabetic retinopathy) were prospectively recruited. MRI was performed on each patient before any treatment, with T1 mapping acquired using an inversion recovery TrueFISP sequence at several inversion times, from a single slice positioned through the center of both eyes in the axial oblique plane. A phantom study measuring seven different concentrations of vitronectin, a protein released in ischemic eye disease, was undertaken to determine its potential confounding effect on T1 . RESULTS Ten participants were recruited (eight central retinal vein occlusion, one ocular ischemic syndrome, and one proliferative diabetic retinopathy). Of the eight central retinal vein occlusion cases, there was a statistically different vitreous T1 in the diseased eye compared to the healthy control eye (4.306 vs. 4.518 s, p = 0.008). T1 times did not significantly alter across the range of vitronectin concentrations. CONCLUSIONS Ischemic eye disease decreases vitreous T1 , potentially implying an increase in vitreous partial pressure of oxygen (pO2 ) concentration given what is known from the relationship between 1/T1 and pO2 . Potential theories for this unexpected result are discussed. This study provides further data on this technique, with potential clinical application in eye disease.
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Affiliation(s)
| | | | - Lisa Mullen
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Brighton, UK
| | - Nicholas G Dowell
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Brighton, UK
- Centre for Regenerative Medicine and Devices, School of Pharmacy, and Bimolecular Sciences, University of Brighton, Brighton, UK
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Baker S, Baker D, Baker R, Brown CJ. Case series of retinal vein occlusions showing early recovery using oral l-methylfolate. Ther Adv Ophthalmol 2024; 16:25158414241240687. [PMID: 38628356 PMCID: PMC11020740 DOI: 10.1177/25158414241240687] [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: 06/08/2023] [Accepted: 02/11/2024] [Indexed: 04/19/2024] Open
Abstract
This case series describes the aggregate rate of recovery in five consecutive subjects (six eyes) with retinal vein occlusion (RVO) who received l-methylfolate and other vitamins via Ocufolin®, a medical food. Subjects were followed for 10-33 months by a single ophthalmologist. Ocufolin® was prescribed at the time of diagnosis and subjects remained on the regimen throughout the time of observation. Examinations were performed in an un-masked fashion at 3-month intervals with recording of best corrected visual acuity (BCVA), average retinal nerve fiber layer (ARNFL) and central macular thickness (CMT), and fundus (examination of the retina, macula, optic nerve, and vessels) photography. Testing was done for vitamin deficiencies, vascular and coagulable risk factors, and methylenetetrahydrofolate reductase (MTHFR) polymorphisms. Vitamin deficiencies and vascular risk factors were found in all subjects, and all four tested subjects carried at least one MTHFR polymorphism. By the end of the study period BCVA in all subjects was 20/25 or better. Cystoid macular edema was identified and measured by optical coherence tomography (OCT). The percent change was calculated and plotted at 3-month intervals using the percent change in thickness from the time of diagnosis and percent change toward normative values for ARNFL and CMT. The total reduction in thickness of ARNFL and CMT from time of diagnosis was 44.19% and 30.27%, respectively. The comparison to normative data shows a reduction of ARNFL from 164.2% to 94% and CMT from 154.4% to 112.7% of normal thickness (100%). Plots showed the aggregate recovery was most rapid over the first 3 months and slowed over the next 3 months with most of the recovery taking place within 6 months of treatment. The rate of improvement in BCVA and resolution of retinal thickening was found to be better than predicted on historical grounds. No subjects progressed from nonischemic to ischemic RVO. Vitamin deficiencies, vascular risk factors, and genetic predisposition to oxidative stress were common in this RVO series. It appears that addressing these factors with Ocufolin® had a salutary effect on recovery.
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Affiliation(s)
- Steven Baker
- Northwest Arkansas NeuroVision, Fayetteville, AR, USA
| | - Dylan Baker
- Becker Friedman Institute for Economics, University of Chicago, Chicago, IL, USA
| | - Robert Baker
- Northwest Arkansas NeuroVision, Fayetteville, AR, USA
| | - Craig J. Brown
- Department of Ophthalmology, College of Medicine, University of Arkansas for Medical Sciences, 1923 East Joyce Blvd, Fayetteville, AR 72703, USA
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Namvar E, Yasemi M, Nowroozzadeh MH, Ahmadieh H. Intravitreal Injection of Anti-Vascular Endothelial Growth Factors Combined with Corticosteroids for the Treatment of Macular Edema Secondary to Retinal Vein Occlusion: A Systematic Review and Meta-Analysis. Semin Ophthalmol 2024; 39:109-119. [PMID: 37621098 DOI: 10.1080/08820538.2023.2249527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/11/2023] [Accepted: 08/13/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE To evaluate the efficacy and safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) and corticosteroid combination therapy for the management of treatment-naïve or recurrent/refractory macular edema caused by retinal vein occlusion (RVO) in comparison with anti-VEGF monotherapy. METHODS In this systematic review and meta-analysis study, the data from publications in the electronic databases including PubMed, Embase, Cochrane Library Central Register of Controlled Trials, ISI and Scopus from January 1, 2007, through November 20, 2020, were compiled. Heterogeneity was statistically quantified by the I2 statistic, and meta-analysis was performed using a random-effects model. RESULTS Twenty-four related studies were identified, including a total of 1280 eyes, which consisted of 685 and 507 patients with central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO), respectively. This study demonstrated a greater improvement in best-corrected visual acuity (BCVA) in the combination group compared to anti-VEGF monotherapy for both CRVO and BRVO cases at 6 months after initiating therapy. The improvement in vision was more notable in BRVO cases than in CRVO cases. However, the changes in central macular thickness (CMT) did not differ significantly between the different treatment approaches, and the results were inconclusive. Including all cases with RVO, there was no inferiority in terms of BCVA improvement and CMT reduction in the triamcinolone subgroup compared with the slow-release dexamethasone implant subgroup. A greater improvement was noticed in terms of BCVA in the sequentially treated subgroup compared to the simultaneous treatment subgroup, while there was a greater reduction in CMT in the simultaneous subgroup with the highest reduction recorded at 1 month after treatment. CONCLUSIONS This study suggests that combination therapy with intravitreal anti-VEGF and corticosteroid (such as intravitreal or subtenon triamcinolone or dexamethasone implant) has a slightly better effect on improving BCVA in cases with BRVO or CRVO at 6 months compared to monotherapy.
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Affiliation(s)
- Ehsan Namvar
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Yasemi
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Hossein Nowroozzadeh
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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21
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Ertop M, Yaylacıoğlu Tuncay F, Arıbaş YK, Özdemir HB, Gürelik G, Atılgan ME, Özdek Ş. Evaluation of Central and Peripheral Retinal Vascular Changes in the Fellow Eyes of Patients with Unilateral Retinal Vein Occlusions. Turk J Ophthalmol 2023; 53:349-355. [PMID: 38059582 PMCID: PMC10750094 DOI: 10.4274/tjo.galenos.2023.94389] [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: 07/26/2022] [Accepted: 03/22/2023] [Indexed: 12/08/2023] Open
Abstract
Objectives To evaluate the subtle peripheral retinal and macular vascular changes in the fellow eyes of patients with unilateral retinal vein occlusion (RVO). Materials and Methods This retrospective study included 53 patients with unilateral RVO and 44 age-matched controls. The frequency of peripheral retinal vascular pathologies in both eyes was evaluated using high quality ultra-wide field fluorescein angiography (UWFFA). Macular vascular density, flow area, and foveal avascular zone measurements from optical coherence tomography angiography (OCTA) were analyzed together with laser flare photometry values in patients and controls. Results Peripheral retinal vascular pathologies were detected on UWFFA in the fellow eyes of 36 (67.9%) patients. No significant central vascular pathologies were detected on OCTA and there was no significant difference in OCTA parameters between the fellow eyes and the controls. Flare values did not differ significantly between the control and the fellow eyes. Conclusion Two thirds of the fellow eyes of unilateral RVO patients had subtle peripheral retinal vascular changes, while there was no significant microvascular change detected with OCTA in the macula. This suggests that vascular changes caused by systemic vascular disorders probably first start in the peripheral retina of the fellow eyes of patients with RVO.
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Affiliation(s)
- Mestan Ertop
- Gazi University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye
| | - Fulya Yaylacıoğlu Tuncay
- University of Health Sciences Türkiye, Gülhane Faculty of Medicine, Department of Medical Biology, Ankara, Türkiye
| | - Yavuz Kemal Arıbaş
- Abdulkadir Yüksel State Hospital, Clinic of Ophthalmology, Gaziantep, Türkiye
| | | | - Gökhan Gürelik
- Gazi University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye
| | - Mehmet Emin Atılgan
- Gazi University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye
| | - Şengül Özdek
- Gazi University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye
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Üçer MB, Cevher S. Assessment of systemic inflammatory response index and other inflammatory indicators in retinal vein occlusion. Medicine (Baltimore) 2023; 102:e36512. [PMID: 38065869 PMCID: PMC10713168 DOI: 10.1097/md.0000000000036512] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy. The study aimed to evaluate the association and the predictive value of inflammatory indicators in RVO. Sixty patients with RVO and 60 healthy individuals were enrolled in this retrospective study. Inflammatory indicators and other hematological parameters obtained from the peripheral venous sample were analyzed and compared among groups. White blood cell count (P = .003), neutrophil (P < .001), neutrophil-to-lymphocyte ratio (NLR) (P < .001), monocyte-to-lymphocyte ratio (MLR) (P < .001), platelet-to-lymphocyte ratio (PLR) (P = .014), systemic immune-inflammation index (SII) (P < .001), and systemic inflammatory response index (SIRI) (P < .001) were significantly higher; the lymphocyte count (P < .001) was significantly lower in patients with RVO. According to receiver operating characteristic analysis, NLR was significant at the good level (area under the curve [AUC] = 0.817, P < .001); SIRI, SII, and MLR were significant at the fair level (AUC = 0.774, P < .001; AUC = 0.733, P < .001, and AUC = 0.724, P < .001, respectively) and PLR (AUC = 0.630, P = .014) was significant at the weak level in terms of RVO prediction. SIRI was superior to other indicators, except NLR, to predict RVO. SIRI, NLR, SII, MLR, and PLR can be used as predictors for identifying the risk of RVO.
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Affiliation(s)
- Mehmet Bariş Üçer
- Department of Ophthalmology, Sincan Training and Research Hospital, Ankara, Turkey
| | - Selim Cevher
- Department of Ophthalmology, Hitit University Erol Olçok Education and Research Hospital, Çorum, Turkey
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Liao D, Zhou Z, Wang F, Zhang B, Wang Y, Zheng Y, Li J. Changes in foveal avascular zone area and retinal vein diameter in patients with retinal vein occlusion detected by fundus fluorescein angiography. Front Med (Lausanne) 2023; 10:1267492. [PMID: 38020114 PMCID: PMC10675846 DOI: 10.3389/fmed.2023.1267492] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose To investigate changes in foveal avascular area (FAZ) and retinal vein diameter in patients with retinal vein occlusion (RVO) after intravitreal ranibizumab, and to analyze the correlation between ranibizumab therapy and visual gain. Methods This retrospective study enrolled 95 eyes of 95 patients who had accepted three consecutive monthly ranibizumab injections, including 50 branch RVOs (BRVOs) and 45 central RVOs (CRVOs). BRVOs were divided into ischemia group (n = 32) and non-ischemia group (n = 18), and CRVOs also had ischemia group (n = 28) and non-ischemia group (n = 17). Comprehensive ophthalmic examinations were performed before the first injection and after 6, 12, and 24 months. The FAZ was manually circumscribed on early-phase images of fundus fluorescein angiography. Retinal vein diameters were measured on fundus photographs. Results After three injections, the FAZ area was significantly enlarged firstly and then reduced in all ischemic RVOs and the non-ischemic BRVOs (p < 0.05), while the retinal vein diameter was significantly reduced firstly and then increased in all groups except for unobstructed branch veins of non-ischemic BRVOs (p < 0.05). The correlation between the FAZ area and best corrected visual acuity was statistically significant in all CRVOs (non-ischemic, r = 0.372; ischemic, r = 0.286; p < 0.01) and ischemic BRVOs (r = 0.180, p < 0.05). Spearman's correlation analysis revealed that the retinal vein diameter was significantly correlated to the larger FAZ area in obstructed branch veins of ischemic BRVOs (r = -0.31, p < 0.01), inferior temporal branch veins of non-ischemic CRVOs (r = -0.461, p < 0.01) and ischemia CRVO groups (superior temporal branch vein, r = -0.226, p < 0.05; inferior temporal branch vein, r = -0.259, p < 0.01). Conclusion After three consecutive monthly ranibizumab injections, the FAZ area was enlarged and retinal vein diameter reduced with gradual recovery to near baseline from 12 months. These results suggest that ranibizumab therapy can worsen macular ischemia and prevent visual gain in the short term. It has important significance for the treatment and prognosis of RVO, although the natural course of RVO may also affect ischemia and visual gain.
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Affiliation(s)
- Dingying Liao
- Department of Ophthalmology, Shenzhen Hospital, Peking University, Shenzhen, China
| | - Zixia Zhou
- Department of Ophthalmology, Shenzhen Hospital, Peking University, Shenzhen, China
| | - Fei Wang
- Department of Ophthalmology, Shenzhen Hospital, Peking University, Shenzhen, China
| | - Bin Zhang
- Department of Ophthalmology, Shenzhen Hospital, Peking University, Shenzhen, China
| | - Yanfen Wang
- Department of Ophthalmology, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Yuping Zheng
- Department of Ophthalmology, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Jinying Li
- Department of Ophthalmology, Shenzhen Hospital, Peking University, Shenzhen, China
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Cehofski LJ, Kruse A, Mæng MO, Kjaergaard B, Grauslund J, Honoré B, Vorum H. Proteome Analysis of Bevacizumab Intervention in Experimental Central Retinal Vein Occlusion. J Pers Med 2023; 13:1580. [PMID: 38003895 PMCID: PMC10672637 DOI: 10.3390/jpm13111580] [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: 09/09/2023] [Revised: 10/17/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Bevacizumab is a frequently used inhibitor of vascular endothelial growth factor (VEGF) in the management of macular edema in central retinal vein occlusion (CRVO). Studying retinal protein changes in bevacizumab intervention may provide insights into mechanisms of action. In nine Danish Landrace pigs, experimental CRVO was induced in both eyes with argon laser. The right eyes received an intravitreal injection of 0.05 mL bevacizumab (n = 9), while the left control eyes received 0.05 mL saline water (NaCl). Retinal samples were collected 15 days after induced CRVO. Label-free quantification nano-liquid chromatography-tandem mass spectrometry identified 59 proteins that were regulated following bevacizumab treatment. Following bevacizumab intervention, altered levels of bevacizumab components, including the Ig gamma-1 chain C region and the Ig kappa chain C region, were observed. Changes in other significantly regulated proteins ranged between 0.58-1.73, including for the NADH-ubiquinone oxidoreductase chain (fold change = 1.73), protein-transport protein Sec24B (fold change = 1.71), glycerol kinase (fold change = 1.61), guanine-nucleotide-binding protein G(T) subunit-gamma-T1 (fold change = 0.67), and prefoldin subunit 6 (fold change = 0.58). A high retinal concentration of bevacizumab was achieved within 15 days. Changes in the additional proteins were limited, suggesting a narrow mechanism of action.
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Affiliation(s)
- Lasse Jørgensen Cehofski
- Department of Ophthalmology, Odense University Hospital, 5000 Odense, Denmark;
- Biomedical Research Laboratory, Aalborg University Hospital, 9000 Aalborg, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Anders Kruse
- Department of Ophthalmology, Aalborg University Hospital, 9000 Aalborg, Denmark; (A.K.); (M.O.M.)
| | - Mads Odgaard Mæng
- Department of Ophthalmology, Aalborg University Hospital, 9000 Aalborg, Denmark; (A.K.); (M.O.M.)
| | - Benedict Kjaergaard
- Biomedical Research Laboratory, Aalborg University Hospital, 9000 Aalborg, Denmark;
| | - Jakob Grauslund
- Department of Ophthalmology, Odense University Hospital, 5000 Odense, Denmark;
| | - Bent Honoré
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark;
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
| | - Henrik Vorum
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark;
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
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Kim S, Kim BH, Han K, Kong M, Song SJ. Association Between Three Atopic Triad and Retinal Vein Occlusion Risk: A Nationwide Population-Based Study. Ophthalmic Epidemiol 2023:1-10. [PMID: 37899646 DOI: 10.1080/09286586.2023.2276193] [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: 07/18/2023] [Accepted: 10/23/2023] [Indexed: 10/31/2023]
Abstract
PURPOSE To evaluate the association between three allergic diseases (allergic dermatitis, allergic rhinitis, and asthma) and the development of retinal vein occlusion (RVO), a major retinal disease that causes visual impairment. METHOD This study used data obtained from the Korean National Health Insurance Claims database between 2009 and 2018. The association between the three atopic triads (allergic dermatitis, allergic rhinitis, and asthma) and the occurrence of sight-threatening RVO, as determined by diagnostic and treatment codes, were analyzed. Multivariate adjusted Cox regression analysis was used to determine the hazard ratios (HRs) and 95% confidence intervals for RVO development in the presence of allergic disease. RESULTS In this population-based study, 2,160,195 (54.6%) individuals were male, 1,794,968 (45.4%) were female, and 620,938 (15.7%) were diagnosed with allergic diseases. Patients with either asthma or allergic rhinitis had a greater risk of RVO (adjusted hazard ratio (aHR) = 1.101, 95% confidence interval [CI] = 1.029-1.178 for asthma; aHR = 1.181, 95% CI = 1.147-1.215 for allergic rhinitis) compared to those without asthma or allergic rhinitis; however, patients with atopic dermatitis did not show a significant association with RVO (aHR = 1.071, 95% CI = 0.889-1.290), after adjusting for other risk factors. CONCLUSION Our study revealed that allergic rhinitis, asthma, and coexisting multiple allergic conditions were associated with an increased risk of RVO. Thus, it may be advisable to suggest an ophthalmological examination for patients with allergies due to the increased possibility of the occurrence of retinal vascular disease.
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Affiliation(s)
- Seongho Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Bo Hee Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Mingui Kong
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Su Jeong Song
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Biomedical Institute for Convergence (BICS), Sungkyunkwan University, Suwon, Republic of Korea
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Klaas JE, Bui V, Maierhofer N, Schworm B, Maier M, Priglinger SG, Siedlecki J. Risk of transient vision loss after intravitreal aflibercept using vial-prepared vs. the novel prefilled syringe formulation. Front Med (Lausanne) 2023; 10:1295633. [PMID: 37954554 PMCID: PMC10634539 DOI: 10.3389/fmed.2023.1295633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose To compare the risk of transient vision loss (TVL) probably attributable to a severe intraocular pressure spike after intravitreal aflibercept application using the novel prefilled syringe (PFS) vs. the established vial system (VS). Methods Datasets of the intravitreal injection service of the Ludwig Maximilians-University Munich and the Technical University Munich, Germany, were screened for documentation of TVL after intravitreal injection of aflibercept. The observation period included two full months prior to the introduction of the novel PFS and two months afterwards. TVL was defined as loss of perception of hand motion for a duration of >30 s. Results Over a period of four months, 1720 intravitreal injections of aflibercept were administered in 672 patients. There were 842 injections with the old VS, and 878 injections using the novel PFS. Using the VS, TVL was noted during two injections (0.24%) in two patients, as compared to 11 cases of TVL (1.25%) in 10 patients with the PFS (p = 0.015). Using the PFS, patients had a 5.3-fold risk of TVL as compared to the VS (OR: 5.33; 95% CI: 1.2-24.1; p = 0.0298). Conclusion There was a more than five-fold risk of TVL using the novel pre-filled aflibercept syringe as compared to the established vial system. During informed consent, this risk should be discussed.
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Affiliation(s)
- Julian E. Klaas
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - Vinh Bui
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | | | - Benedikt Schworm
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - Mathias Maier
- Department of Ophthalmology, Technical University, Munich, Germany
| | | | - Jakob Siedlecki
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
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Sanders FWB, Dumont Jones R, Jones DR, Phillips SV, Williams GS. Treatment of Diabetic Macular Edema or Macular Edema Following Retinal Vein Occlusion Based on Repeated Injection of the Dexamethasone Intravitreal Implant: A Retrospective Real-World Analysis. Clin Ophthalmol 2023; 17:3177-3187. [PMID: 37901284 PMCID: PMC10612511 DOI: 10.2147/opth.s402142] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/11/2023] [Indexed: 10/31/2023] Open
Abstract
Purpose To assess the "real world" utility of repeated injection with the dexamethasone intravitreal implant (DEX) in routine practice. Methods This was a retrospective, single-center analysis of consecutive patients with diabetic macular edema, or macular edema following retinal vein occlusion, treated with DEX. None had received prior intravitreal steroid treatment. DEX was implanted as per the manufacturer's instructions. Results Seventy-eight individuals (95 eyes) were included (50.0% female; mean age: 68.1 ± 12.4 years; mean duration of macular edema: 13.2 ± 12.9 months). Thirty-three eyes (34.7%) had received previous treatment with an anti-vascular endothelial growth factor (anti-VEGF) and/or laser. Thirty eyes (31.6%) underwent one round of DEX implantation; the remainder received 2-5 cycles (total: 225 cycles). Initial DEX treatment led to significant increases in visual acuity (VA) at 6 weeks (mean change: 4.6 letters; P=0.004). Greater VA improvements during the first treatment cycle were associated with inferior baseline VA (P=0.02), borderline associated with baseline central macular thickness (CMT; P=0.06), and independent of prior anti-VEGF treatment (P=0.39). In an analysis of all DEX injections, VA improvements were robust across cycles 1 and 2 but reduced in cycle 3 (P=0.03). CMT improvements did not differ based on injection number (P=0.20). Increases in intraocular pressure (IOP) were largest over the first 6 weeks (but rebounded towards baseline more rapidly) in cycle 1 versus cycles 2 and 3 (P<0.001). IOP rises were typically manageable with topical medications. Conclusion This analysis confirms the broad utility of DEX and may inform decision-making in routine practice.
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Affiliation(s)
| | | | - David R Jones
- Department of Ophthalmology, Singleton Hospital, Swansea, UK
| | - Sean V Phillips
- Department of Ophthalmology, Singleton Hospital, Swansea, UK
| | - Gwyn S Williams
- Department of Ophthalmology, Singleton Hospital, Swansea, UK
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Clausen AR, Stokholm L, Frederiksen KH, Möller S, Blaabjerg M, Pedersen FN, Grauslund J. Retinal vein occlusion as an age-dependent marker of incident dementia in a long-term Danish national cohort. Acta Ophthalmol 2023. [PMID: 37874264 DOI: 10.1111/aos.15797] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/13/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE The aim of this study was to investigate retinal vein occlusion (RVO) as an independent marker of incident dementia. METHODS In a prospective nationwide cohort study, we identified 2 225 568 individuals through the Danish national health registers. Individuals older than 65 years, without unspecified retinal vascular occlusion or dementia were included from 1998 to 2020 and followed until 2022. We calculated the incidence rate (IR) and performed a Cox regression analysis with a hazard ratio (HR) and 95% confidence interval (CI) for RVO (exposure) as a marker of all-cause dementia adjusted for systemic comorbidity. RESULTS We identified 19 669 individuals with RVO who had a higher prevalence of systemic comorbidity at inclusion compared to those without RVO (n = 2 185 483). We performed a Cox regression analysis for age-dependent exposure due to non-proportional hazards in the pre-planned analysis. Exposed individuals younger than 75 years had an increased risk of all-cause dementia (adjusted HR 1.09, 95% CI 1.01-1.18), whereas individuals older than 75 years had a decreased risk of all-cause dementia (adjusted HR 0.92, 95% CI 0.86-0.98). CONCLUSION Individuals with RVO had an age-dependent risk of dementia, with a 9% increased risk in individuals with RVO younger than 75 years and an 8% decreased risk in individuals older than 75 years at the time of exposure.
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Affiliation(s)
- Anna Rebien Clausen
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lonny Stokholm
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- OPEN-Open Patient data Explorative Network, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | | | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- OPEN-Open Patient data Explorative Network, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Morten Blaabjerg
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Neurology, Odense University Hospital, Odense, Denmark
| | - Frederik Nørregaard Pedersen
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jakob Grauslund
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Zhao X, Lin Z, Yu S, Xiao J, Xie L, Xu Y, Tsui CK, Cui K, Zhao L, Zhang G, Zhang S, Lu Y, Lin H, Liang X, Lin D. An artificial intelligence system for the whole process from diagnosis to treatment suggestion of ischemic retinal diseases. Cell Rep Med 2023; 4:101197. [PMID: 37734379 PMCID: PMC10591037 DOI: 10.1016/j.xcrm.2023.101197] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/29/2023] [Accepted: 08/23/2023] [Indexed: 09/23/2023]
Abstract
Ischemic retinal diseases (IRDs) are a series of common blinding diseases that depend on accurate fundus fluorescein angiography (FFA) image interpretation for diagnosis and treatment. An artificial intelligence system (Ai-Doctor) was developed to interpret FFA images. Ai-Doctor performed well in image phase identification (area under the curve [AUC], 0.991-0.999, range), diabetic retinopathy (DR) and branch retinal vein occlusion (BRVO) diagnosis (AUC, 0.979-0.992), and non-perfusion area segmentation (Dice similarity coefficient [DSC], 89.7%-90.1%) and quantification. The segmentation model was expanded to unencountered IRDs (central RVO and retinal vasculitis), with DSCs of 89.2% and 83.6%, respectively. A clinically applicable ischemia index (CAII) was proposed to evaluate ischemic degree; patients with CAII values exceeding 0.17 in BRVO and 0.08 in DR may be associated with increased possibility for laser therapy. Ai-Doctor is expected to achieve accurate FFA image interpretation for IRDs, potentially reducing the reliance on retinal specialists.
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Affiliation(s)
- Xinyu Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China; Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
| | - Zhenzhe Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Shanshan Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Jun Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Liqiong Xie
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Yue Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Ching-Kit Tsui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Kaixuan Cui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Lanqin Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Guoming Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
| | - Yan Lu
- Foshan Second People's Hospital, Foshan 528001, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China; Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou 570311, China; Center for Precision Medicine and Department of Genetics and Biomedical Informatics, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.
| | - Xiaoling Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China.
| | - Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China.
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Zhang JT, Cui S, Li Q, Li JR, Zhang YF, Zheng YH. Sleep-disordered breathing is related to retinal vein occlusion: A meta-analysis. Medicine (Baltimore) 2023; 102:e35411. [PMID: 37832067 PMCID: PMC10578690 DOI: 10.1097/md.0000000000035411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/05/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Previous studies suggest that sleep-disordered breathing (SDB) may be a potential risk factor of retinal vein occlusion (RVO). We conducted a meta-analysis to systematically explore the relationship between RVO and SDB. METHODS Observational studies assessing the relationship between SDB and RVO were retrieved by searches of electronic databases including the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wan Fang databases from database inception to August 9, 2023. In consideration of intra-study heterogeneity, a random-effects model was adopted to combine the results. RESULTS Seven studies (1 retrospective cohort and 6 case-control studies) were included in this meta-analysis, and among 36,628 adults included in those studies, 6452 (17.6%) had SDB. The combined results indicated that SDB was associated with RVO [risk ratio (RR): 1.92, 95% confidence interval (CI): 1.60-2.30, P < .001] with no significant heterogeneity (I2 = 0%). Subgroup analyses showed consistent relationships between SDB and any RVO (RR: 1.73, 95% CI: 1.13-2.28, P < .001), central RVO (RR: 2.20, 95% CI: 1.57-3.08, P < .001), and branch RVO (RR: 1.85, 95% CI: 1.15-2.99, P = .01). Moreover, the relationship was consistent among patients with mild (RR: 1.82, 95% CI: 1.32-2.53, P < .001), moderate (RR: 2.17, 95% CI: 1.65-2.85, P < .001), and severe SDB (RR: 2.66, 95% CI: 1.96-3.62, P < .001). The association was consistent in studies that adjusted for age and sex (RR: 2.17, 95% CI: 1.50-3.13, P < .001), and in studies with additional adjustment for comorbidities (RR: 1.78, 95% CI: 1.42-2.25, P < .001). CONCLUSION SDB is associated with RVO in adults.
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Affiliation(s)
- Jun-Tao Zhang
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Sha Cui
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Qin Li
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Jin-Rong Li
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Yan-Fang Zhang
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Yan-Huang Zheng
- Department Ophthalmology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
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Takahashi VKL, Balbino M, Ruppert ADP, de Carvalho LS, Seixas RCS. Lost to follow-up of patients who received intravitreal anti-vascular endothelial growth factor therapy to treat four different retina disorders in an individual center in Brazil. SAGE Open Med 2023; 11:20503121231199655. [PMID: 37808513 PMCID: PMC10559699 DOI: 10.1177/20503121231199655] [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: 03/04/2023] [Accepted: 08/21/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives To identify risk factors for loss to follow-up in periodic intravitreal anti-vascular endothelial growth factor injections for the treatment patients with diabetic macular edema, subretinal neovascularization, age-related macular degeneration, and retinal vein occlusion in a single eye center in São Paulo, Brazil. Methods This was a retrospective longitudinal study that gathered information from 992 patients who required intravitreal anti-vascular endothelial growth factor drugs over 6 months. The authors included age, eye disease, laterality, monthly income, distance, and payment mode as risk factors. Results Two hundred and seventy patients (29.93%) were lost to follow-up. Multivariate analysis showed age, monthly income, eye involvement, and type of medical assistance independently associated with loss to follow-up. The odds of loss to follow-up were greater among older patients than those less than 50 years (reference), p < 0.001. The odds of loss to follow-up were greater among patients who received unilateral treatment than those who received bilateral injections (p = 0.013). Concerning gross monthly income, there were no differences in the odds of the four salary strata; the data also indicate an absence of difference in the three strata of patients' distance to the clinic. Considering the diagnosis, only age-related macular degeneration showed greater odds of loss to follow-up (p = 0.016). Finally, the data suggest greater odds of loss to follow-up in private patients than in those on a health care plan (p < 0.001). Conclusion Loss to follow-up is paramount because many patients may remain unassisted concerning their eye diseases. Identifying the risk factors is crucial to enforcing measures to increase adherence and the long-term success of the treatment.
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Hein M, Mehnert A, Freund KB, Yu DY, Balaratnasingam C. Variability in Capillary Perfusion Is Increased in Regions of Retinal Ischemia Due to Branch Retinal Vein Occlusion. Invest Ophthalmol Vis Sci 2023; 64:30. [PMID: 37856113 PMCID: PMC10615145 DOI: 10.1167/iovs.64.13.30] [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: 01/16/2023] [Accepted: 09/23/2023] [Indexed: 10/20/2023] Open
Abstract
Purpose To investigate alterations in macular perfusion variability due to branch retinal vein occlusion (BRVO) using a novel approach based on optical coherence tomography angiography (OCTA) coefficient of variation (CoV) analysis. Methods Thirteen eyes of 13 patients with macular ischemia due to BRVO were studied. Multiple consecutive en face OCTA images were acquired. Bias field correction, spatial alignment, and normalization of intensities across the images were performed followed by pixelwise computation of standard deviation divided by the mean to generate a CoV map. Region of interest-based CoV values, derived from this map, for arterioles, venules, and the microvasculature were compared between regions with macular ischemia and control areas of the same eye. Control areas were regions of the same macula that were not affected by the BRVO and had normal retinal vascular structure as seen on multimodal imaging and normal retinal vascular density measurements as quantified using OCTA. Results CoV increased by a mean value of 17.6% within the microvasculature of ischemic regions compared to the control microvasculature (P < 0.0001). CoV measurements of microvasculature were consistently greater in the ischemic area of all 13 eyes compared to control. There were no differences in CoV measurements between ischemic and control areas for arterioles (P = 0.13) and venules (P = 1.0). Conclusions Greater variability in microvasculature perfusion occurs at sites of macular ischemia due to BRVO. We report a novel way for quantifying macular perfusion variability using OCTA. This technique may have applicability for studying the pathophysiology of other retinal vascular diseases.
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Affiliation(s)
- Martin Hein
- Lions Eye Institute, Nedlands, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - Andrew Mehnert
- Lions Eye Institute, Nedlands, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - K. Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York, United States
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
| | - Dao-Yi Yu
- Lions Eye Institute, Nedlands, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - Chandrakumar Balaratnasingam
- Lions Eye Institute, Nedlands, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
- Department of Ophthalmology, Sir Charles Gairdner Hospital, Western Australia, Perth, Australia
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Gulyesil FF, Dogan M, Sabaner MC, Gobeka HH. How Traumatic is Intravitreal Ozurdex Injection? Ocul Immunol Inflamm 2023; 31:1569-1571. [PMID: 33826471 DOI: 10.1080/09273948.2021.1896009] [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: 12/14/2020] [Accepted: 02/22/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND This study intended to illustrate a rare case of pyogenic granuloma (PG) in retinal vein occlusion (RVO) patient after dexamethasone (DEX) implant therapy. CASE DESCRIPTION A 58-year-old female who underwent DEX implant therapy a month ago due to RVO presented with a mass in her right eye. Anterior segment analysis revealed a slowly enlarging, round, fleshy vascular mass indicating PG located at the injection site. Although surgical excision was planned, because of the Covid-19 pandemic, a patient could not come for surgery. Ocular examination revealed a spontaneous PG disappearance three months later. A small mass could, however, be detected using an anterior segment optical coherence tomography. CONCLUSION While superficial PG regression can only be observed by slit-lamp biomicroscopy, extensive root ingrowth can be clearly differentiated by anterior segment optical coherence tomography. Besides, depending on the nature, size, location, and associated symptoms, some PG may be left to regress but with close monitoring.
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Affiliation(s)
- Furkan Fatih Gulyesil
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Mustafa Dogan
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Mehmet Cem Sabaner
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hamidu Hamisi Gobeka
- Department of Ophthalmology, Faculty of Medicine, Agri Ibrahim Cecen University Rectorate, Agri, Turkey
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Rachman MJ, Kalanjati VP, Rimbun R, Khadijah F. Retinal Vein Occlusion Amongst People Vaccinated by mRNA- and Viral Vector- COVID-19 Vaccines: A Systematic Review. Clin Ophthalmol 2023; 17:2825-2842. [PMID: 37794952 PMCID: PMC10545804 DOI: 10.2147/opth.s426428] [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: 06/17/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023] Open
Abstract
Vaccines are highly effective in lowering the mortality due to COVID-19. Although several suspected adverse events or side effects after vaccination including retinal vein occlusion (RVO) have been reported. We conducted a systematic review using PRISMA methods to analyze the occurrence of RVO among people vaccinated by COVID-19 mRNA- vs viral vector- vaccines on 4 databases from 1-1-2021 to 31-12-2022 using specified MeSH terms. All included studies were assessed using JBI critical appraisal tools for eligibility. The final included studies are 31 studies (n=78 cases from 75 patients; 3 of these patients suffered twice). The median age of the patients was 61 years (28 to 96 years old) and most of them were female (52.00%). Thirty-nine patients received the mRNA vaccine (52.00%), while 36 patients received the viral vector vaccine (48.00%) before the event. The RVO diagnoses are based on physical examination confirmed by Fluorescein Angiography (FA), and/or Optical Coherence Tomography (OCT). The median time interval between vaccination and RVO was 6 days in the mRNA vaccine group and 4 days in the viral vector vaccine group. Central retinal vein occlusion (CRVO) and Branch Retinal Vein Occlusion (BRVO) were tied as the most common diagnosis in the mRNA vaccine group (20.51% and 20.51%), whilst in the viral vector vaccine group CRVO was the most common diagnosis (17.94%). Most of these cases had good outcomes with improved visual impairment in one or both eyes. From this review, we could not ascertain that the RVO occurs due to the type of COVID-19 vaccines because of the detailed data on the dosage and the history of illness of each patient. However, the awareness that the RVO could develop after COVID-19 vaccination must be taken into consideration, even though it is rare.
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Affiliation(s)
- Maria Jessica Rachman
- Master Program of Basic Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- Faculty of Medicine, Universitas Ciputra, Surabaya, East Java, Indonesia
| | - Viskasari P Kalanjati
- Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Rimbun Rimbun
- Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Fira Khadijah
- Master Program of Basic Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
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Fang W, Zhai J, Qian ZB, Li HD, Wang MD, Shen LJ. Effect of a novel tyrosine kinase inhibitor nintedanib on bFGF and VEGF concentrations in a rabbit retinal vein occlusion model. Int J Ophthalmol 2023; 16:1450-1455. [PMID: 37724275 PMCID: PMC10475619 DOI: 10.18240/ijo.2023.09.11] [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: 08/31/2022] [Accepted: 06/21/2023] [Indexed: 09/20/2023] Open
Abstract
AIM To evaluate whether a novel tyrosine kinase inhibitor nintedanib could inhibit basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) simultaneously for retinal vascular disease in vivo. METHODS After a laser induced rabbit retinal vein occlusion (RVO) model was made, 0.5 mg of nintedanib was injected intravitreally in the left eye on the third day while the right eye was as a control. Intracameral samples were taken on the day before laser treatment and days 1, 3, 7, 14, 21, and 28 after treatment. Enzyme-linked immunosorbent assay (ELISA) was used to test the bFGF and VEGF-A concentrations in the aqueous humor. RESULTS Both bFGF and VEGF-A rose significantly on the third day after laser treatment in both eyes. In the control eye the bFGF concentration peaked on the 14th day while the VEGF-A concentration dropped rapidly soon after the third day. After nintadanib injection in the study eye, both bFGF and VEGF-A showed a significant reduction on the 4th day (7th day after laser treatment) when compared to the control eye, and kept on low level in the following several weeks. CONCLUSION Intravitreal injection of nintedanib can inhibit the expression of bFGF and VEGF in the process of RVO model to a certain extent, which is expected to become a new method for the treatment of retinal vascular diseases or fibrotic diseases.
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Affiliation(s)
- Wei Fang
- The Eye Hospital of Wenzhou Medical University, School of Opthalmology & Optometry, WMU, Zhejiang Eye Hospital, Hangzhou 310000, Zhejiang Province, China
| | - Jing Zhai
- The Eye Hospital of Wenzhou Medical University, School of Opthalmology & Optometry, WMU, Zhejiang Eye Hospital, Hangzhou 310000, Zhejiang Province, China
| | - Zhen-Bin Qian
- The Eye Hospital of Wenzhou Medical University, School of Opthalmology & Optometry, WMU, Zhejiang Eye Hospital, Hangzhou 310000, Zhejiang Province, China
| | - Hai-Dong Li
- The Eye Hospital of Wenzhou Medical University, School of Opthalmology & Optometry, WMU, Zhejiang Eye Hospital, Hangzhou 310000, Zhejiang Province, China
| | - Meng-Di Wang
- The Eye Hospital of Wenzhou Medical University, School of Opthalmology & Optometry, WMU, Zhejiang Eye Hospital, Hangzhou 310000, Zhejiang Province, China
| | - Li-Jun Shen
- The Eye Hospital of Wenzhou Medical University, School of Opthalmology & Optometry, WMU, Zhejiang Eye Hospital, Hangzhou 310000, Zhejiang Province, China
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Panos GD, Lakshmanan A, Dadoukis P, Ripa M, Motta L, Amoaku WM. Faricimab: Transforming the Future of Macular Diseases Treatment - A Comprehensive Review of Clinical Studies. Drug Des Devel Ther 2023; 17:2861-2873. [PMID: 37746113 PMCID: PMC10516184 DOI: 10.2147/dddt.s427416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/10/2023] [Indexed: 09/26/2023] Open
Abstract
Degenerative eye conditions such as age-related macular degeneration (AMD), diabetic retinopathy, and retinal vein occlusion are major contributors to significant vision loss in developed nations. The primary therapeutic approach for managing complications linked to these diseases involves the intravitreal delivery of anti-vascular endothelial growth factor (VEGF) treatments. Faricimab is a novel, humanised, bispecific antibody that simultaneously binds all VEGF-A isoforms and Angiopoietin-2, which has been approved by regulatory agencies, such as the US Food and Drug Administration (FDA), the UK Medicines and Healthcare products Regulatory Agency (MHRA) and the European Medicines Agency (EMA), for the treatment of neovascular AMD and diabetic macular oedema (DMO). Intravitreal faricimab holds the promise of reducing the treatment burden for patients with these conditions by achieving comparable or superior therapeutic outcomes with fewer clinic visits. The scope of faricimab's application includes addressing complex macular conditions such as DMO. This review intends to elucidate the distinctive pharmacological characteristics of faricimab and provide an overview of the key clinical trials and real-world studies that assess its effectiveness and safety in treating degenerative macular diseases.
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Affiliation(s)
- Georgios D Panos
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham University Hospitals, Nottingham, UK
- Division of Ophthalmology and Visual Sciences, Faculty of Medicine & Health Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Arun Lakshmanan
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham University Hospitals, Nottingham, UK
| | - Panagiotis Dadoukis
- Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
| | - Matteo Ripa
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Kent, UK
| | - Lorenzo Motta
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Kent, UK
| | - Winfried M Amoaku
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham University Hospitals, Nottingham, UK
- Division of Ophthalmology and Visual Sciences, Faculty of Medicine & Health Sciences, School of Medicine, University of Nottingham, Nottingham, UK
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Ren J, Ren A, Huang Z, Deng X, Jiang Z, Xue Y, Fu Z, Smith LE, Ke M, Gong Y. Metabolomic Profiling of Long-Chain Polyunsaturated Fatty Acid Oxidation in Adults with Retinal Vein Occlusion: A Case-Control Study. Am J Clin Nutr 2023; 118:579-590. [PMID: 37454758 DOI: 10.1016/j.ajcnut.2023.07.006] [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: 01/06/2023] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Long-chain polyunsaturated fatty acids (LCPUFAs) and their metabolites are closely related to neovascular eye diseases. However, the clinical significance of their oxylipins in retinal vein occlusion (RVO) remains inconclusive. OBJECTIVES This case-control study aimed to explore metabolomic profiles of LCPUFA oxidation in RVO and to identify potential indicators for diagnosis and pathologic progression. METHODS The plasma concentrations of ω-3 (n-3) and ω-6 (n-6) LCPUFA and their oxylipins in 44 adults with RVO and 36 normal controls were analyzed using ultraperformance liquid chromatography tandem mass spectrometry. Univariate analysis combined with principal component and orthogonal projections to latent structure discriminant analysis was used to screen differential metabolites. Aortic ring and choroidal explant sprouting assays were used to investigate the effects of 5-oxo-eicosatetraenoic acids (ETE) on angiogenesis ex vivo. Tubule formation and wound healing assays were performed to verify its effects on human retinal microvascular endothelial cell functions. RESULTS Higher ω-6 and lower ω-3 LCPUFA plasma concentrations were measured in the adults with RVO compared with control (odds ratio [OR]: 2.34; 95% confidence interval [CI]: 1.42, 3.86; P < 0.001; OR: 0.28; 95% CI: 0.15, 0.51; P < 0.001). Metabolomic analysis revealed 20 LCPUFA and their oxylipins dysregulated in RVO, including increased arachidonic acid (ω-6, OR: 1.85; 95% CI: 1.18, 2.90; P < 0.001) and its lipoxygenase product 5-oxo-ETE (OR: 11.76; 95% CI: 3.73, 37.11; P < 0.001), as well as decreased docosahexaenoic acid (ω-3, OR: 0.13; 95% CI: 0.05, 0.33; P < 0.001). Interestingly, 5-oxo-ETE was downregulated in ischemic compared with nonischemic central RVO. Exogenous 5-oxo-ETE attenuated aortic ring and choroidal explant sprouting and inhibited tubule formation and migration of human retinal microvascular endothelial cells in a dose-dependent manner, possibly via suppressing the vascular endothelial growth factor signaling pathway. CONCLUSIONS The plasma concentrations of ω-6 and ω-3 LCPUFA and their oxylipins were associated with RVO. The ω-6 LCPUFA-derived metabolite 5-oxo-ETE was a potential marker of RVO development and progression.
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Affiliation(s)
- Jiangbo Ren
- Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China; Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Anli Ren
- Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China; Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhengrong Huang
- Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China; Tumor Precision Diagnosis and Treatment Technology and Translational Medicine, Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xizhi Deng
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ziyu Jiang
- Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China; Tumor Precision Diagnosis and Treatment Technology and Translational Medicine, Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China; Human Genetics Resource Preservation Center of Wuhan University, Wuhan University, Wuhan, China
| | - Yanni Xue
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhongjie Fu
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Lois Eh Smith
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Min Ke
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, China.
| | - Yan Gong
- Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China; Tumor Precision Diagnosis and Treatment Technology and Translational Medicine, Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China; Human Genetics Resource Preservation Center of Wuhan University, Wuhan University, Wuhan, China.
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Pattnaik L, Mehra L, Pareek D, Panigrahi PK. Unilateral branch retinal vein occlusion with vitreous hemorrhage mimicking Terson's syndrome. Oman J Ophthalmol 2023; 16:552-554. [PMID: 38059082 PMCID: PMC10697244 DOI: 10.4103/ojo.ojo_5_23] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/11/2023] [Accepted: 06/03/2023] [Indexed: 12/08/2023] Open
Abstract
We report a case of unilateral traumatic vitreous hemorrhage following injury to the anterior cranium. A 55-year-old female presented with gradual loss of vision in her left eye following trauma to the anterior cranium. Funduscopy revealed fresh vitreous hemorrhage. Conservative management was futile with further visual deterioration over the next 2 weeks. During pars plana vitrectomy, fresh retinal hemorrhages were noted along the superotemporal (ST) vein suggesting bleed due to vein rupture. Postoperative fundus fluorescein angiography indicated ST branch retinal vein occlusion. Since trauma can be an inciting factor for both, this case could be a variant of Terson's syndrome.
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Affiliation(s)
- Lolly Pattnaik
- Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Lipika Mehra
- Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Deergha Pareek
- Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Pradeep Kumar Panigrahi
- Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
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Castro C, Marques JH, Silva N, Abreu AC, Furtado MJ, Lume M. Comparison of Color Fundus Photography and Multicolor Fundus Imaging for Detection of Lesions in Diabetic Retinopathy and Retinal Vein Occlusion. Clin Ophthalmol 2023; 17:2515-2524. [PMID: 37641738 PMCID: PMC10460587 DOI: 10.2147/opth.s414603] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/18/2023] [Indexed: 08/31/2023] Open
Abstract
Purpose To evaluate the agreement between conventional fundus photography (CFP) and multicolor fundus imaging (MFI) for the detection of lesions of diabetic retinopathy (DR) and retinal vein occlusion (RVO). Methods Cross-sectional analysis of eyes with DR or RVO who underwent CFP and MFI. All images were independently analyzed by two observers (O1 and O2), and the evaluated lesions were classified as "present" or "absent". Then, a paired comparison between both exams of the same eye was performed, to assess which made it easier to detect the lesions. Results Considering DR, the agreement was substantial for cotton wool spots and photocoagulation scars for both observers (O1: κ=0.75 and κ=0.67; O2: κ=0.71 and κ=0.64, respectively) and for hard exudates for O1 (κ=0.80). These lesions were detected more frequently on MFI. Regarding RVO, the agreement was considered substantial for venous sheathing by O1 (κ=0.64) and moderate for optociliary shunts by O2 (κ=0.60). Optociliary shunts were detected more frequently in CPF by both observers and venous sheathing on MFI by O1. For microaneurysms, retinal hemorrhages, retinal neovascularization, and proliferative membranes, in DR, and retinal hemorrhages, venous engorgement, and retinal neovascularization in RVO, the agreement was almost perfect (κ>0.82). In the paired analysis, both observers considered that, in DR, microaneurysms and retinal hemorrhages were easier to detect on CFP and that retinal neovascularization, cotton wool spots, and photocoagulation scars were easier to identify on MFI. Regarding RVO, optocilliary shunts were easier to identify on CFP and venous engorgement on MFI. Conclusion The agreement of MFI and CFP was substantial to almost perfect for most lesions. MFI seems better to detect cotton wool spots and photocoagulations scars in DR and venous sheathing in RVO. Optocilliary shunts seem easier to detect on CFP.
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Affiliation(s)
- Catarina Castro
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - João Heitor Marques
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Nisa Silva
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Ana Carolina Abreu
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Maria João Furtado
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar – Universidade do Porto, Porto, Portugal
| | - Miguel Lume
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
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Leung HM, Au SCL. Retinal Vein Occlusion after COVID-19 Vaccination-A Review. Vaccines (Basel) 2023; 11:1281. [PMID: 37631850 PMCID: PMC10459858 DOI: 10.3390/vaccines11081281] [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: 06/20/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 08/27/2023] Open
Abstract
Background Retinal vein occlusion (RVO) occurring after COVID-19 vaccination has been reported worldwide. Such a sight-threatening condition occurring after COVID-19 vaccination is a menace to ophthalmic health. This article reviews current evidence related to post-COVID-19 vaccination RVO. Method A total of 29 relevant articles identified on PubMed in January 2023 were selected for review. Observation All cases presented to ophthalmologists with visual loss shortly after COVID-19 vaccination. Mean and median age were both 58. No sex predominance was observed. RVO was diagnosed from findings on dilated fundal examination and ophthalmic imaging. AstraZeneca and BNT vaccines accounted for most cases. Vascular risk factors, e.g., diabetes mellitus and hypertension, were common. Most laboratory tests requested came back unremarkable. Most patients responded well to standard treatment, except those with ophthalmic comorbidities. Visual prognosis was excellent on short-term follow-up. Discussion The causality between RVO and COVID-19 vaccination is undeterminable because of the nature of articles, heterogenous reporting styles, contradicting laboratory findings and co-existing vascular risk factors. Vaccine-induced immune thrombotic thrombocytopenia, retinal vasculitis and homocysteinaemia were proposed to explain post-vaccination RVO. Large-scale studies have demonstrated that the incidence of RVO following COVID vaccination is very low. Nevertheless, the effects of boosters on retinal vasculature and ophthalmic health are still unclear. Conclusions The benefits of COVID-19 vaccination are believed to outweigh its ophthalmic risks. To ensure safe vaccination, the prior optimisation of comorbidities and post-vaccination monitoring are important. COVID-19 vaccines (including boosters) should be offered with reasonable confidence. Further studies are warranted to elucidate the ophthalmic impact of vaccines.
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Affiliation(s)
- Ho-Man Leung
- Hospital Authority, Ma Tau Wai 999077, Hong Kong
| | - Sunny Chi-Lik Au
- Department of Ophthalmology, Tung Wah Eastern Hospital, So Kon Po 999077, Hong Kong
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Lee JY, Wang SM, Jeon SH, Kim MH, Han KD, Roh YJ. The Risk of Retinal Vein Occlusion in Young Patients with Mental Disorders: A Nationwide Cohort Study. J Clin Med 2023; 12:4874. [PMID: 37510989 PMCID: PMC10381617 DOI: 10.3390/jcm12144874] [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: 06/08/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
We investigated the association between mental disorders and the incidence rate of retinal vein occlusion (RVO) in young Korean adults. This nationwide cohort study included subjects aged 20-40 years who underwent the Korean National Health Examination between 2009 and 2012. The diagnoses of RVO and mental disorders were based on the International Classification of Diseases Tenth Revision codes. Multivariate Cox proportional hazard regression models were used to evaluate the objective. In total, 6,891,399 subjects were included at baseline and 6,597,803 subjects (mean age, 30.86 ± 4.99) were finally analyzed for a mean follow-up duration of 7.36 ± 1.13 years, with the mental disorders group followed for 7.27 ± 1.15 years and the non-diagnosed group for 7.37 ± 1.12 years. Among a total of 10,145 subjects diagnosed with RVO, 1304 had been diagnosed with mental disorders, while 8841 had not. Cumulative incidence of RVO demonstrated a substantially higher incidence probability in subjects with mental disorders (log-rank p < 0.0001). Mental disorders were associated with an increased incidence rate of RVO (hazard ratio [HR]: 1.268; 95% confidence interval; [CI]: 1.196-1.344). In the subgroup analysis, subjects with depression, sleep disorder, and anxiety disorder exhibited an increased risk of incidence of RVO in all regression models (all p < 0.001). In conclusion, mental disorders and the incidence rate of RVO were significantly positively correlated in a Korean nationwide population-based cohort study. These findings suggest that mental disorders may also be associated with the pathophysiology of RVO in young adults.
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Affiliation(s)
- Ji-Young Lee
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Seung-Hee Jeon
- Department of Ophthalmology and Visual Science, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Min-Hee Kim
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Kyung-do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea
| | - Young-Jung Roh
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
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Lendzioszek M, Mrugacz M, Bryl A, Poppe E, Zorena K. Prevention and Treatment of Retinal Vein Occlusion: The Role of Diet-A Review. Nutrients 2023; 15:3237. [PMID: 37513655 PMCID: PMC10383741 DOI: 10.3390/nu15143237] [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: 06/16/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Retinal vein occlusion (RVO) is the second most common retinal disorder. In comparison to diabetic retinopathy or age-related macular degeneration, RVO is usually an unexpected event that carries a greater psychological impact. There is strong evidence to suggest that cardiovascular diseases are the most common risk factors in this pathology and it has long been known that a higher consumption of fish, nuts, fruits, and vegetables has a protective effect against these types of conditions. In the last several years, interest in plant-based diets has grown in both the general population and in the scientific community, to the point to which it has become one of the main dietary patterns adopted in Western countries. The aim of this review is to investigate the potential impact of macro- and micronutrients on retinal vein occlusion.
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Affiliation(s)
- Maja Lendzioszek
- Department of Ophthalmology, Voivodship Hospital in Lomza, 18-400 Lomza, Poland
| | - Małgorzata Mrugacz
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Anna Bryl
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Ewa Poppe
- Department of Ophthalmology, Voivodship Hospital in Lomza, 18-400 Lomza, Poland
| | - Katarzyna Zorena
- Department of Immunobiology and Environmental Microbiology, Medical University of Gdansk, 80-211 Gdansk, Poland
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Xing Q, Dai YN, Huang XB, Peng L. Comparison of efficacy of conbercept, aflibercept, and ranibizumab ophthalmic injection in the treatment of macular edema caused by retinal vein occlusion: a Meta-analysis. Int J Ophthalmol 2023; 16:1145-1154. [PMID: 37465496 PMCID: PMC10333252 DOI: 10.18240/ijo.2023.07.21] [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: 09/16/2022] [Accepted: 05/29/2023] [Indexed: 07/20/2023] Open
Abstract
AIM To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor (VEGF) drugs in the treatment of macular edema (ME) due to retinal vein occlusion (RVO) based on the evidence pooled from current clinical trials and observational studies. METHODS A systematic literature search was conducted on nine online databases from inception until April 30, 2022. The main endpoints were best corrected visual acuity (BCVA), central macular thickness (CMT), and adverse events (AEs). Cumulative Meta-analysis was conducted to synthesize the outcomes of the drugs. The retrieved data were analyzed using Stata software (version 12.0). RESULTS A total of 20 studies comprising 1674 eyes met the inclusion criteria to the Meta-analysis. It was observed that conbercept and aflibercept had better visual acuity effects compared with ranibizumab at 1mo [weight mean difference (WMD)=-0.03, P=0.001; WMD=-0.05, P=0.019], but the effects were not different from that of ranibizumab at 6mo. Moreover, there was not statistically significant difference in the proportion of patients gaining ≥15 letters at 12-24mo between aflibercept and ranibizumab [odds ratio (OR)=1.16, P=0.427]. Conbercept had higher mean CMT change effects at 1mo (WMD=-14.43, P=0.014) and 6mo (WMD=-35.63, P≤0.001) compared with ranibizumab. Meanwhile, the mean CMT change effects at 1mo (WMD=-10.14, P=0.170), 6mo (WMD=-26.98, P=0.140) and 12-24mo (WMD=-12.34, P=0.071) were comparable among the groups. Similarly, AEs were not significantly different among the treatments (OR=0.75, P=0.305; OR=1.04, P=0.89). The stability of effect size of mean BCVA and CMT improved with the increase in sample size. Aflibercept and conbercept required fewer injections compared with ranibizumab. CONCLUSION This is the first study to evaluate the efficacy and AEs of intravitreal administration of conbercept, ranibizumab, and aflibercept in the treatment of RVO-ME. Intravitreal aflibercept or conbercept results in better mean change in vision and CMT reduction compared with ranibizumab. Conbercept can be considered to be a promising and innovative drug with good anti-VEGF effects.
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Affiliation(s)
- Qiu Xing
- Department of Ophthalmology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570000, Hainan Province, China
- Department of Ophthalmology, the Second Xiangya Hospital of Central South University, Changsha 410000, Hunan Province, China
| | - Ya-Nan Dai
- Department of Ophthalmology, the Changsha Central Affiliated Hospital, Hengyang Medical School, University of South China, Changsha 410004, Hunan Province, China
| | - Xiao-Bo Huang
- Department of Ophthalmology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570000, Hainan Province, China
| | - Li Peng
- Department of Ophthalmology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570000, Hainan Province, China
- Department of Ophthalmology, the Second Xiangya Hospital of Central South University, Changsha 410000, Hunan Province, China
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Hu KK, Tian CW, Li MH, Wu T, Gong M, Wei XL, Du YR, Hui YN, Du HJ. Differential analysis of aqueous humor cytokine levels in patients with macular edema secondary to diabetic retinopathy or retinal vein occlusion. Int J Ophthalmol 2023; 16:1041-1046. [PMID: 37465512 PMCID: PMC10333249 DOI: 10.18240/ijo.2023.07.06] [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: 02/02/2023] [Accepted: 05/19/2023] [Indexed: 07/20/2023] Open
Abstract
AIM To evaluate the difference and the correlation between the concentrations of cytokines in the aqueous humor of eyes with macular edema secondary to diabetic retinopathy (DR) or retinal vein occlusion (RVO). METHODS This is a retrospective case control study. The aqueous humor samples were collected during intravitreal injection of anti-vascular endothelial growth factor (VEGF) for patients diagnosed with macular edema secondary to DR (DME) or RVO (RVO-ME) at Xijing Hospital from August 2021 to July 2022. Meanwhile, aqueous humor samples during vitrectomy from patients with idiopathic macular hole (IMH) were also collected and served as controls. The aqueous humor concentrations of VEGF, platelet-derived factor (PDGF), interleukin (IL)-6, IL-8, IL-18, tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein 1 (MCP-1) were measured with Human Premixed Multi-Analyte Kit (Luminex). The difference of the aqueous cytokines and the correlation between the two diseases were analyzed. RESULTS A total of 40 eyes of 38 patients were enrolled in the study, including 13 eyes of 11 DME patients (DME group), 16 eyes of 16 RVO-ME patients (RVO-ME group) and 11 eyes of 11 IMH patients (control group). The VEGF, PDGF, IL-6, IL-8, and MCP-1 levels of the aqueous humor were higher in both DME and RVO-ME groups compared with the control group (all P<0.05), the levels of TNF-α was higher in the DME group than in the control group (P<0.05). The VEGF, IL-6, MCP-1, and TNF-α levels in the aqueous humor were significantly higher in the DR group than those in the RVO group (all P<0.05). Correlation analyses revealed that there were complex positive correlations between IL-6, IL-8, IL-18, MCP-1, and TNF-α levels in the aqueous humor of eyes with two diseases. CONCLUSION Although ischemic and inflammatory factors are similarly involved in the pathogenesis of DME and RVO-ME, the roles of these factors are more significant or more likely to be activated in DR patients, suggesting different treatment strategies should be considered for the two diseases.
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Affiliation(s)
- Ke-Ke Hu
- Department of Ophthalmology, Eye Institute of PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Chao-Wei Tian
- Department of Ophthalmology, Eye Institute of PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Man-Hong Li
- Department of Ophthalmology, Eye Institute of PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Tong Wu
- Department of Ophthalmology, Eye Institute of PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Min Gong
- Department of Ophthalmology, Eye Institute of PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Xin-Li Wei
- Department of Ophthalmology, Eye Institute of PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Yu-Ru Du
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Yan-Nian Hui
- Department of Ophthalmology, Eye Institute of PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Hong-Jun Du
- Department of Ophthalmology, Eye Institute of PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
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Mishra P, P S, Panda BB, Sekar A, Naik S. Bilateral Central Retinal Vein Occlusion in Recurrent Frontal Lobe Tumor. Cureus 2023; 15:e41441. [PMID: 37546071 PMCID: PMC10404118 DOI: 10.7759/cureus.41441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Systemic malignancy can induce hypercoagulation and can cause retinal vein occlusion (RVO). Although RVO has been reported in association with breast, renal, lung, prostate, and ovarian malignancies, it has not been reported in brain tumors. We are reporting a case of bilateral central retinal vein occlusion (CRVO) associated with recurrent frontal lobe gliosarcoma. The association was established after ruling out all other systemic causes that can produce bilateral CRVO. The importance of this case report lies in the fact that, while evaluating bilateral CRVO cases, these rare associations should also be kept in mind.
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Affiliation(s)
- Priyadarshini Mishra
- Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Shanmugasundaram P
- Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Bijnya B Panda
- Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Arunkumar Sekar
- Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Suprava Naik
- Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
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Lee H, Yang SW, Kim Y, Shin H, Seo YS, Oh MJ, Choi S, Cho GJ, Hwang HS. Risk of retinopathy in women with pregnancy-induced hypertension: a nationwide population-based cohort study of 9-year follow-up after delivery. Am J Obstet Gynecol MFM 2023; 5:100985. [PMID: 37119970 DOI: 10.1016/j.ajogmf.2023.100985] [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: 02/02/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND The retina is potentially associated with several physiological, hormonal, and metabolic changes during pregnancy. The few available epidemiologic studies of ocular changes in pregnancy have mainly concerned retinopathies. Pregnancy-induced hypertension, which leads to ocular manifestations including blurred vision, photopsia, scotoma, and diplopia, might induce reactive changes in the retinal vessels. Although several studies have suggested the existence of pregnancy-induced hypertension-related retinal ocular disease, there are few large cohort studies on this topic. OBJECTIVE This study aimed to investigate the risk of major retinal diseases including central serous chorioretinopathy, diabetic retinopathy, retinal vein occlusion, retinal artery occlusion, and hypertensive retinopathy in the long-term postpartum stage according to the presence of previous pregnancy-induced hypertension in a large cohort based on the Korean National Health Insurance Database. STUDY DESIGN On the basis of Korean health data, 909,520 patients who delivered from 2012 to 2013 were analyzed. Among them, patients who had previous ocular diseases or hypertension and multiple births were excluded. Finally, 858,057 mothers were assessed for central serous chorioretinopathy (ICD-10: H35.70), diabetic retinopathy (ICD-10: H36.0, E10.31, E10.32, E11.31, E11.32, E12.31, E13.31, E13.32, E14.31, E14.32), retinal vein occlusion (ICD-10: H34.8), retinal artery occlusion (ICD-10: H34.2), and hypertensive retinopathy (ICD-10: H35.02) for 9 years after delivery. Enrolled patients were divided into 2 groups: 10,808 patients with and 847,249 without pregnancy-induced hypertension. The primary outcomes were the incidence of central serous chorioretinopathy, diabetic retinopathy, retinal vein occlusion, retinal artery occlusion, and hypertensive retinopathy 9 years after delivery. Clinical variables were age, parity, cesarean delivery, gestational diabetes mellitus, and postpartum hemorrhage. In addition, pregestational diabetes mellitus, kidney diseases, cerebrovascular diseases, and cardiovascular diseases were adjusted. RESULTS Postpartum retinal disease during the 9 years after delivery and total retinal diseases showed higher rates in patients with pregnancy-induced hypertension. In detail, the rates of central serous chorioretinopathy (0.3% vs 0.1%), diabetic retinopathy (1.79% vs 0.5%), retinal vein occlusion (0.19% vs 0.1%), and hypertensive retinopathy (0.62% vs 0.05%) were higher than those found in patients without pregnancy-induced hypertension. After adjusting for confounding factors, pregnancy-induced hypertension was associated with development of postpartum retinopathy, with a >2-fold increase (hazard ratio, 2.845; 95% confidence interval, 2.54-3.188). Furthermore, pregnancy-induced hypertension affected the development of central serous chorioretinopathy (hazard ratio, 3.681; 95% confidence interval, 2.667-5.082), diabetic retinopathy (hazard ratio, 2.326; 95% confidence interval, 2.013-2.688), retinal vein occlusion (hazard ratio, 2.241; 95% confidence interval, 1.491-3.368), and hypertensive retinopathy (hazard ratio, 11.392; 95% confidence interval, 8.771-14.796) after delivery. CONCLUSION A history of pregnancy-induced hypertension increases the risk of central serous chorioretinopathy, diabetic retinopathy, retinal vein occlusion, and hypertensive retinopathy according to 9-year long-term ophthalmologic follow-up.
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Affiliation(s)
- Hyungwoo Lee
- Department of Ophthalmology, Konkuk University School of Medicine, Seoul, Republic of Korea (Dr Lee)
| | - Seung-Woo Yang
- Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea (Drs Yang and Seo)
| | - Yeji Kim
- Department of Statistics, Korea University, Seoul, Republic of Korea (Ms Kim and Dr Choi)
| | - Hyunju Shin
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea (Drs Shin, Oh, and Cho)
| | - Yong-Soo Seo
- Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea (Drs Yang and Seo)
| | - Min Jeong Oh
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea (Drs Shin, Oh, and Cho)
| | - Sangbum Choi
- Department of Statistics, Korea University, Seoul, Republic of Korea (Ms Kim and Dr Choi)
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea (Drs Shin, Oh, and Cho).
| | - Han-Sung Hwang
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea (Dr Hwang).
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Okonkwo ON, Adenuga OO, Nkanga D, Ovienria W, Ibanga A, Agweye CT, Oyekunle I, Akanbi T. Prevalence and systemic associations of retinal vascular occlusions in Sub-Saharan Africa. Ann Afr Med 2023; 22:279-285. [PMID: 37417014 PMCID: PMC10445699 DOI: 10.4103/aam.aam_44_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/03/2022] [Accepted: 01/02/2023] [Indexed: 07/08/2023] Open
Abstract
Background Retinal vascular occlusions are a common cause of visual impairment. Studies on retinal vascular occlusions in sub-Saharan Africa (SSA) have primarily been retrospective and on retinal vein occlusion (RVO) only. The aim of this study, therefore, was to determine the prevalence and pattern of retinal vascular occlusions and their systemic associations in SSA. Materials and Methods This was a hospital-based, cross-sectional study involving all new patients presenting at the general ophthalmic and specialty retina clinics in four hospitals in Nigeria over a 1 year period. All the patients underwent a comprehensive eye examination. The demographic and clinical data of patients with retinal vascular occlusions were entered into an excel sheet and analyzed using the Statistical Package for the Social Sciences (SPSS) software version 22.0. Statistical significance was indicated by P < 0.05. Results A total of 8614 new patients were seen, and a diagnosis of retinal vascular occlusion was made in 90 eyes of 81 patients giving a disease prevalence of 0.9%. Eighty-one eyes of 72 (88.9%) patients had RVO, while 9 eyes of 9 (11.1%) patients had retinal artery occlusion (RAO). The mean age of patients with RVO and RAO was 59.5 years and 52.4 years, respectively. Increasing age, hypertension, and diabetes were the significant associations with retinal vascular occlusion with P < 0.0001. Conclusion Retinal vascular occlusions are an increasing cause of retinal disease in SSA and tend to occur at an earlier age. They are associated with hypertension, diabetes, and increasing age. Further studies will, however, be required to establish the demographic and clinical profile of patients with RAO in the region.
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Affiliation(s)
| | - Olukorede O. Adenuga
- Department of Ophthalmology, Jos University Teaching Hospital, Jos, Plateau, Nigeria
| | - Dennis Nkanga
- Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
| | - Wilson Ovienria
- Department of Ophthalmology, Irrua Specialist Hospital, Edo, Nigeria
| | - Affiong Ibanga
- Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
| | - Chineze Thelma Agweye
- Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
| | - Idris Oyekunle
- Department of Retina, Eye Foundation Hospital, Lagos, Nigeria
| | - Toyin Akanbi
- Department of Retina, Eye Foundation Hospital, Lagos, Nigeria
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Javed A, Khanna A, Palmer E, Wilde C, Zaman A, Orr G, Kumudhan D, Lakshmanan A, Panos GD. Optical coherence tomography angiography: a review of the current literature. J Int Med Res 2023; 51:3000605231187933. [PMID: 37498178 PMCID: PMC10387790 DOI: 10.1177/03000605231187933] [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] [Indexed: 07/28/2023] Open
Abstract
This narrative review presents a comprehensive examination of optical coherence tomography angiography (OCTA), a non-invasive retinal vascular imaging technology, as reported in the existing literature. Building on the coherence tomography principles of standard OCT, OCTA further delineates the retinal vascular system, thus offering an advanced alternative to conventional dye-based imaging. OCTA provides high-resolution visualisation of both the superficial and deep capillary networks, an achievement previously unattainable. However, image quality may be compromised by factors such as motion artefacts or media opacities, potentially limiting the utility of OCTA in certain patient cohorts. Despite these limitations, OCTA has various potential clinical applications in managing retinal and choroidal vascular diseases. Still, given its considerable cost implications relative to current modalities, further research is warranted to justify its broader application in clinical practice.
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Affiliation(s)
- Ahmed Javed
- Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Aishwarya Khanna
- Department of Ophthalmology, Royal Derby Hospital, Derby, United Kingdom
| | - Eleanor Palmer
- Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Craig Wilde
- Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Anwar Zaman
- Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Gavin Orr
- Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Dharmalingam Kumudhan
- Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Arun Lakshmanan
- Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Georgios D Panos
- Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, United Kingdom
- Division of Ophthalmology and Visual Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Driban M, Kedia N, Arora S, Chhablani J. Novel pharmaceuticals for the management of retinal vein occlusion and linked disorders. Expert Rev Clin Pharmacol 2023; 16:1125-1139. [PMID: 37933706 DOI: 10.1080/17512433.2023.2277882] [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: 08/09/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Retinal vein occlusion (RVO) is the second leading cause of blindness from retinal vascular disease behind diabetic retinopathy. Anti-vascular endothelial growth factor (VEGF) and glucocorticoid therapy are the cornerstones of pharmaceutical treatment for RVO. There is considerable interest in developing new pharmaceuticals in and out of these two classes to reduce costs, lower injection burden, and treat the occlusion itself, rather than the complications. AREAS COVERED In this review, we discuss novel pharmaceuticals for the treatment of RVO outside of current standard of care. We performed a comprehensive literature search encompassing pharmaceuticals that have recently been approved or have shown promising results in early clinical trials or animal models. EXPERT OPINION Anti-VEGF therapy remains the most efficacious treatment for RVO with a very favorable side effect profile. New biosimilars reduce costs while maintaining efficacy. Novel glucocorticoids may be a useful therapy in patients for whom anti-VEGF therapy has failed, or as an adjunct. Pharmaceuticals in other drug classes, particularly those with neuroprotective or regenerative properties, as well as those geared toward treating the occlusion itself, represent exciting options for early RVO therapy, but are likely years away from clinical relevance.
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Affiliation(s)
- Matthew Driban
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nikita Kedia
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Supriya Arora
- Bahamas Vision Center and Princess Margaret Hospital, Nassau, New Providence, Bahamas
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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50
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Muste JC, Russell MW, Iyer AI, Singh RP. Interventions to reduce loss to follow up in common retinal pathology: A systematic review. Eur J Ophthalmol 2023; 33:1513-1516. [PMID: 36537123 DOI: 10.1177/11206721221145058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
PURPOSE Loss to follow-up or fragmented follow-up episodes (LTFU) may contribute to suboptimal clinical outcomes, especially when comparing real world data to clinical trials. This systemic review gathers available evidence around interventions meant to decrease the LTFU in AMD, RVO, and DME patients. PATIENTS AND METHODS PubMed was queried using a literature search strategy and reviewed by the authors. Studies with interventions aimed at reducing lost to follow up were included. RESULTS Ten studies were extracted from 89 candidate publications. DISCUSSION Telephone interventions featuring assistance in scheduling in improving LTFU in urban, African American populations over 50 years old with diabetic retinopathy. The same interventions have shown promise in glaucoma, but remain understudied in AMD, RVO, and other geographic, ethnic, and socioeconomic demographics. CONCLUSION No sole intervention with efficacy in improving LTFU has been developed. A standardized definition of LTFU, as well as testing interventions across broad age, geography, ethnic, racial, and socioeconomic lines. Longitudinal data would also add credence to the efficacy of purported interventions. OTHER No sources of funding for this article.
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Affiliation(s)
- Justin C Muste
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Matthew W Russell
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - Amogh I Iyer
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Rishi P Singh
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
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