1.
Investigation of the relationship between macular pigment levels and rod-mediated dark adaptation in intermediate age-related macular degeneration.
Beirne, RO, McConnell, E
Clinical & experimental optometry. 2019;(6):611-616
-
-
Free full text
-
Abstract
BACKGROUND It has been shown that rod-mediated dark adaptation is significantly delayed in ageing, a change which is exacerbated in age-related macular degeneration (AMD). Levels of lutein and zeaxanthin, the two main constituents of macular pigment have been found in rod outer segments, indicating that the macular pigment may have an influence on rod-mediated dark adaptation. The aim of this study was to determine if rod-mediated dark adaptation is associated with central macular pigment levels in individuals with intermediate stage AMD. METHODS A cross-sectional observational study included individuals with acuity better than 6/15 Snellen and intermediate stage AMD based on graded fundus photographs using an internationally accepted grading scale. Rod-mediated dark adaptation was assessed at five degrees eccentricity in the superior retina (inferior visual field) using the rod intercept time measure from the MacuLogix AdaptDx. Macular pigment optical density was measured at 0.5 degrees eccentricity using a heterochromatic flicker photometry-based method. RESULTS Twenty-seven individuals (mean age 76.7 years) with intermediate stage AMD and 23 age-matched normal controls (mean age 74.0 years) were recruited. Rod-mediated dark adaptation was significantly delayed in intermediate stage AMD compared with healthy controls (32.9 minutes versus 10.7 minutes, p < 0.01). There was no statistically significant correlation between the rod intercept time and the level of macular pigment in those with intermediate AMD (r = -0.04, p = 0.85). CONCLUSION The results did not support the hypothesis that higher macular pigment is associated with improved rod-mediated performance or that higher levels of macular pigment protect rod-mediated function in intermediate AMD.
2.
Evaluation of Efficacy and Safety of Dexamethasone Intravitreal Implants of Vitrectomized and Nonvitrectomized Eyes in a Real-World Study.
Rezkallah, A, Malclès, A, Dot, C, Voirin, N, Agard, É, Vié, AL, Denis, P, Mathis, T, Kodjikian, L
Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics. 2018;(8):596-602
Abstract
PURPOSE To compare the efficacy and safety of the dexamethasone (DEX) intravitreal implant of vitrectomized and nonvitrectomized eyes in real-world conditions. METHODS This was a retrospective, multicenter, observational study. All consecutive patients presenting with at least one 0.7-mg intravitreal injection of DEX implant were included in this study. A total of 186 eyes in 170 patients were analyzed. Fifty-nine eyes were vitrectomized at baseline and 127 eyes had no vitrectomy at the last visit. Among the baseline-vitrectomized eyes analyzed, 72.9% were treatment naive eyes, and 44.1% of nonvitrectomized eyes had no prior treatment. RESULTS There was no statistically significant difference in the variation in best-corrected visual acuity (BCVA) between the 2 groups (P = 0.343). Variations of BCVA and central macular thickness were not significantly different between nonvitrectomized eyes and baseline-vitrectomized eyes. The intraocular pressure profile was the same in both nonvitrectomized eyes and baseline-vitrectomized eyes. The mean interval between injections was 6.9 months (2; 27.7) for nonvitrectomized eyes and 5.2 months (4; 22.1) for baseline-vitrectomized eyes (P = 0.001). The mean number of IVIs was 2 (1; 6) for nonvitrectomized eyes and 2.3 (1; 10) for baseline-vitrectomized eyes (P = 0.188) during the total follow-up period. CONCLUSION This large cohort shows that vitrectomy does not seem to influence the efficacy and safety profile of dexamethasone intravitreal implant for DME.
3.
Association between macular degeneration and mild to moderate chronic kidney disease: A nationwide population-based study.
Chen, CY, Dai, CS, Lee, CC, Shyu, YC, Huang, TS, Yeung, L, Sun, CC, Yang, HY, Wu, IW
Medicine. 2017;(11):e6405
-
-
Free full text
-
Abstract
Chronic kidney disease (CKD) and macular degeneration (MD) are 2 grave diseases leading to significant disability secondary to renal failure and blindness. The 2 diseases share not only common risk factors but also similar pathogenic mechanisms to renal and retinal injuries. Previous epidemiological studies indicated association between these 2 diseases. However, this concept is challenged by recent investigations. Patients with mild to moderate CKD (n = 30,696) between January 1, 1995 and December 31, 2005 were selected from the Taiwan National Health Insurance Database. Controls (n = 122,784) were matched by age, gender, diabetes mellitus type 2, and hypertension status (1:4 ratios). The risk of MD was compared between the 2 groups. The mean age of patients was 54.9 ± 15.7 years. The proportion of MD was 2.7% in mild to moderate CKD patients and 1.9% in normal controls (P < 0.001); and, 0.39% and 0.26% (P < 0.001) in advanced MD. Mild to moderate CKD patients had higher risk for MD [adjusted odds ratio (OR), 1.301; 95% confidence interval (CI), 1.200-1.411; P < 0.001] than normal renal function subjects. The association was more pronounced for advanced MD. From all age strata (10 years increase), the presence of CKD in those patients aged less than 40 years had highest OR for all MD (OR = 2.125, 95% CI: 1.417-3.186, P < 0.001). The results were consistent in interaction terms, highlighting the importance of CKD in young age patient for risk of MD. The high risk for MD in mild to moderate CKD patients remains significant after adjustment for personal habits (alcohol drinking and smoking, model 1; OR: 1.371; 95% CI: 1.265-1.486; P < 0.001), comorbidities (dyslipidemia, cerebrovascular disease, and peripheral vascular disease, model 2; OR: 1.369; 95% CI: 1.264-1.484; P < 0.001) and all these factors (model 3; OR: 1.320, 95% CI: 1.218-1.431, P < 0.001). This association was consistent in the subanalysis, excluding those patients with diabetic retinopathy. Proper diagnosis and timely intervention should be warranted to retard visual loss of these patients.
4.
Image artefacts in swept-source optical coherence tomography angiography.
Ghasemi Falavarjani, K, Al-Sheikh, M, Akil, H, Sadda, SR
The British journal of ophthalmology. 2017;(5):564-568
Abstract
PURPOSE To describe optical coherence tomography angiography (OCTA) image artefacts in eyes with and without ocular pathologies. METHODS The OCTA images of healthy subjects and patients with age-related macular degeneration, diabetic retinopathy and retinal vascular occlusions were retrospectively reviewed. All OCTA images were obtained using a swept-source OCTA instrument (Triton, Topcon). The frequency of various image artefacts including segmentation, banding, motion, projection, masking, unmasking, doubling of the retinal vessels, blink, stretching, out-of-window and crisscross artefacts was assessed. The impact of the artefact on the grading of the images for the foveal avascular zone in deep and superficial retinal layers, capillary non-perfusion and choroidal neovascularisation (CNV) was evaluated. RESULTS OCTA images of 57 eyes of 48 subjects including 23 eyes (40.3%) with CNV, 13 eyes (22.8%) with dry age-related macular degeneration, 9 eyes (15.7%) with cystoid macular oedema due to diabetic retinopathy or retinal vein occlusion and 12 normal eyes (21.1%) were available for evaluation. At least one type of artefact was present in the images from 51 eyes (89.4%). Banding artefact, segmentation, motion, unmasking, blink, vessel doubling, masking and out-of-window artefacts were found in 51 (89.4%), 35 (61.4%), 28 (49.1%), 9 (15.8%), 5 (8.8%), 1 (1.7%), 1 eye (1.7%) and 1 eye (1.7%), respectively. Projection artefact, stretch artefact or crisscross artefact was not observed. Banding, motion and segmentation artefacts were statistically significantly more frequent in eyes with ocular pathology compared with control eyes (all p<0.001). Eyes with choroidal diseases had significantly higher rate of segmentation error in the choriocapillaris slab compared with eyes with only retinal disease (p=0.02). In nine eyes (17.6%), the artefacts were deemed severe enough by the graders to preclude accurate grading of the image. CONCLUSIONS Image artefacts occur frequently in OCTA images. The artefacts are more frequent in eyes with pathology.