Ophthalmologica最新文献

{"title":"Evaluation of an Artificial Intelligence-Based Detector of Sub- and Intraretinal Fluid on a Large Set of Optical Coherence Tomography Volumes in Age-Related Macular Degeneration and Diabetic Macular Edema.","authors":"Oussama Habra,&nbsp;Mathias Gallardo,&nbsp;Till Meyer Zu Westram,&nbsp;Sandro De Zanet,&nbsp;Damian Jaggi,&nbsp;Martin Zinkernagel,&nbsp;Sebastian Wolf,&nbsp;Raphael Sznitman","doi":"10.1159/000527345","DOIUrl":"https://doi.org/10.1159/000527345","url":null,"abstract":"<p><strong>Introduction: </strong>In this retrospective cohort study, we wanted to evaluate the performance and analyze the insights of an artificial intelligence (AI) algorithm in detecting retinal fluid in spectral-domain OCT volume scans from a large cohort of patients with neovascular age-related macular degeneration (AMD) and diabetic macular edema (DME).</p><p><strong>Methods: </strong>A total of 3,981 OCT volumes from 374 patients with AMD and 11,501 OCT volumes from 811 patients with DME were acquired with Heidelberg-Spectralis OCT device (Heidelberg Engineering Inc., Heidelberg, Germany) between 2013 and 2021. Each OCT volume was annotated for the presence or absence of intraretinal fluid (IRF) and subretinal fluid (SRF) by masked reading center graders (ground truth). The performance of an already published AI algorithm to detect IRF and SRF separately, and a combined fluid detector (IRF and/or SRF) of the same OCT volumes was evaluated. An analysis of the sources of disagreement between annotation and prediction and their relationship to central retinal thickness was performed. We computed the mean areas under the curves (AUC) and under the precision-recall curves (AP), accuracy, sensitivity, specificity, and precision.</p><p><strong>Results: </strong>The AUC for IRF was 0.92 and 0.98, for SRF 0.98 and 0.99, in the AMD and DME cohort, respectively. The AP for IRF was 0.89 and 1.00, for SRF 0.97 and 0.93, in the AMD and DME cohort, respectively. The accuracy, specificity, and sensitivity for IRF were 0.87, 0.88, 0.84, and 0.93, 0.95, 0.93, and for SRF 0.93, 0.93, 0.93, and 0.95, 0.95, 0.95 in the AMD and DME cohort, respectively. For detecting any fluid, the AUC was 0.95 and 0.98, and the accuracy, specificity, and sensitivity were 0.89, 0.93, and 0.90 and 0.95, 0.88, and 0.93, in the AMD and DME cohort, respectively. False positives were present when retinal shadow artifacts and strong retinal deformation were present. False negatives were due to small hyporeflective areas in combination with poor image quality. The combined detector correctly predicted more OCT volumes than the single detectors for IRF and SRF, 89.0% versus 81.6% in the AMD and 93.1% versus 88.6% in the DME cohort.</p><p><strong>Discussion/conclusion: </strong>The AI-based fluid detector achieves high performance for retinal fluid detection in a very large dataset dedicated to AMD and DME. Combining single detectors provides better fluid detection accuracy than considering the single detectors separately. The observed independence of the single detectors ensures that the detectors learned features particular to IRF and SRF.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9187166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Hormones in Males and Females with Active Central Serous Chorioretinopathy.","authors":"Joost Brinks,&nbsp;Elon H C van Dijk,&nbsp;Roula Tsonaka,&nbsp;Onno C Meijer,&nbsp;Camiel J F Boon","doi":"10.1159/000526052","DOIUrl":"https://doi.org/10.1159/000526052","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to assess the role of sex hormones in male and female patients with central serous chorioretinopathy (CSC), a disease with a pronounced male predilection.</p><p><strong>Methods: </strong>A total of 206 chronic CSC patients (183 males, 23 females) and 59 healthy controls (29 males, 30 females) were enrolled. Serum testosterone, estradiol, albumin, and sex hormone-binding globulin levels were determined using immunoassays. The free fraction of testosterone and the free testosterone/estradiol ratio were calculated.</p><p><strong>Results: </strong>No differences in the levels of total testosterone and estradiol were observed between CSC patients and healthy controls. Albumin levels were found to be lower in male CSC patients compared to controls (controls 47.8 g/L, patients 46.0 g/L, adj. p = 0.006). Only in females with CSC, sex hormone-binding globulin levels were found to be lower (controls 94.2 nmol/L, patients 50.4 nmol/L, adj. p = 0.001), together with a higher free testosterone/estradiol ratio (controls 0.06, patients 0.18, adj. p = 0.018).</p><p><strong>Conclusions: </strong>In this study, we did not find evidence for a disturbance in sex hormone levels in males with CSC. The lower levels of sex hormone-binding globulin in females with CSC, leading to a disturbed free testosterone/estradiol ratio, warrant further investigation into the role of androgens in females with CSC.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9909722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10691717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controlled Subretinal Injection Pressure Prevents Damage in Pigs.","authors":"Madeline Evers Olufsen,&nbsp;Liva Spindler,&nbsp;Nina Buus Sørensen,&nbsp;Anders Tolstrup Christiansen,&nbsp;Mark Alberti,&nbsp;Steffen Heegaard,&nbsp;Jens Folke Kiilgaard","doi":"10.1159/000522110","DOIUrl":"https://doi.org/10.1159/000522110","url":null,"abstract":"<p><strong>Introduction: </strong>Administration of retinal gene and stem cell therapy in patients with retinal degenerative diseases is in many cases dependent on a subretinal approach. It has been indicated that manual subretinal injection is associated with outer retinal damage, which may be explained by a high flow rate in the injection cannula. In the present porcine study, we evaluated flow-related retinal damage after controlled subretinal injection at different flow rates.</p><p><strong>Methods: </strong>The flow rate through a 41G cannula was estimated at different injection pressures (6-48 pounds per square inch [PSI]) in an in vitro setup. A linear correlation between the flow rate and injection pressure was found from 6 to 32 PSI. In full anesthesia, 12 pigs were vitrectomized and received a controlled subretinal injection of 300 μL balanced saline solution at injection pressures of 14, 24, and 32 PSI (four in each group). Prior to surgery and 2 and 4 weeks after surgery, the eyes were examined by multifocal electroretinogram (mfERG) and fundus photographs. At the end of follow-up, the eyes were enucleated for histology.</p><p><strong>Results: </strong>The in vitro flow study determined that the flow in a 41G cannula shifts from laminar to turbulent at 32 PSI and that the manual injection flow is turbulent. In the porcine study, we showed a significant difference in retinal pigment epithelium (RPE) damage between the three pressure groups (p = 0.0096). There was no significant difference in damage to the outer retina (p = 0.1526), but the high-pressure group (32 PSI) had the most outer retinal damage. The middle-pressure group (24 PSI) showed minimum retinal damage. There was no significant change in the mfERG ratios during follow-up.</p><p><strong>Discussion/conclusion: </strong>This study indicates that an injection pressure at approximately 24 PSI might be safe for subretinal delivery. Retinal damage at low injection pressures may be explained by mechanical damage to the RPE due to prolonged needle time in the subretinal space, while retinal damage at high pressures can be related to high flow in the injection cannula. Controlled subretinal injection pressure of 24 PSI showed minimum mechanical- and flow-related damage to the porcine retina.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39717049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macular Vascular Complexity Analysis of Diabetes Mellitus by Swept-Source Optical Coherence Tomographic Angiography.","authors":"Jiahui Liu,&nbsp;Shuhui Chen,&nbsp;Zhiyi Xu,&nbsp;Wei Wang,&nbsp;Dingqiao Wang,&nbsp;Yongyue Su,&nbsp;Shulun Zhao,&nbsp;Meichan Li,&nbsp;Fengling Chen,&nbsp;Wenyong Huang,&nbsp;Chengguo Zuo,&nbsp;Minyu Chen","doi":"10.1159/000528073","DOIUrl":"https://doi.org/10.1159/000528073","url":null,"abstract":"<p><strong>Purpose: </strong>This study was designed to evaluate the associations between retinal vascular complexity features, including fractal dimension (FD) and blood vessel tortuosity (BVT), and the severity of diabetic retinopathy (DR) by using optical coherence tomographic angiography (OCTA).</p><p><strong>Methods: </strong>In this prospective cross-sectional study, 1,282 ocular-treatment-naive patients with type 2 diabetes mellitus (DM) (1,059 without DR and 223 with DR) registered in the community of Guangzhou, China, were enrolled. OCTA was used to measure FD and BVT in the superficial capillary plexus (SCP) and the deep capillary plexus (DCP). Univariate and multivariate linear regression analyses were performed to analyze the correlation of FD and BVT in different layers with DR severity.</p><p><strong>Results: </strong>In this study, 1,282 patients with DM (1,282 eyes), with a mean age of 64.2 ± 7.8 years, were included. FD in the DCP decreased and BVT in the DCP increased in patients with DR compared with those in patients without DR, even after adjusting for confounding factors (p < 0.05). Trend analysis showed a significant decrease in the FD values as the DR progressed, whereas the BVT progressively increased with worsening DR severity (p < 0.01). The FD in DCP had a statistically significant positive correlation with FD in SCP and a negative correlation with BVT in SCP and BVT in DCP in all of the participants, including the non-DR group, moderate DR group, and severe DR group (p < 0.01).</p><p><strong>Conclusions: </strong>FD and BVT determined using OCTA might be useful parameters for objectively distinguishing DR from non-DR and indicating DR progression.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10624516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Optical Coherence Tomography Angiography Biomarkers for Alport Syndrome.","authors":"Ana Maria Cunha,&nbsp;Daniela Teixeira,&nbsp;Diogo Cabral,&nbsp;Sérgio Estrela-Silva,&nbsp;Fernando Falcão-Reis,&nbsp;Ângela Carneiro","doi":"10.1159/000519242","DOIUrl":"https://doi.org/10.1159/000519242","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate microvascular abnormalities of patients with Alport syndrome (AS) using optical coherence tomography angiography (OCT-A) quantitative biomarkers.</p><p><strong>Methods: </strong>This was cross sectional, prospective evaluation of consecutive patients with AS and healthy subjects. AS diagnosis was performed by the genetic test. All participants underwent a retinal vasculature evaluation by spectral-domain optical coherence tomography (SD-OCT) and OCT-A of the macula. Quantitative analysis included whole vascular density, foveal avascular zone area, fractal dimension (FD), and lacunarity (LAC).</p><p><strong>Results: </strong>Ninety-four eyes were included in this study, 45 eyes from patients with AS and 49 eyes from healthy subjects. The pathogenic mutation in the COL4A5 gene on the chromosome X was found in 14 patients; the pathogenic autosomal recessive mutations in the COL4A3 gene were found in 9 patients. Quantitative evaluation demonstrated a significant difference between AS and healthy subjects on LAC of the superficial capillary plexus and deep capillary plexus (DCP) (p < 0.001 and p < 0.001, respectively) and on FD in the DCP (p < 0.001).</p><p><strong>Conclusion: </strong>The DCP Alport patients have a higher vessel nonuniformity than DCP of healthy subjects. We hypothesize that endothelial cell lesion in the setting of low resistance at the DCP circuit could lead to long-term structural disorganization.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39374693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical Coherence Tomography Prognostic Factors in Age-Related Macular Degeneration Patients with Peripapillary Choroidal Neovascularization.","authors":"Gilad Rabina,&nbsp;Anfisa Ayalon,&nbsp;Michael Mimouni,&nbsp;Nir Stanescu,&nbsp;Elad Moisseiev,&nbsp;Arie Y Nemet,&nbsp;Noa Geffen,&nbsp;Ori Segal","doi":"10.1159/000520930","DOIUrl":"https://doi.org/10.1159/000520930","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to investigate the correlation between optical coherence tomography (OCT) findings and visual acuity outcomes after treatment with intravitreal bevacizumab (IVB) injections for age-related macular degeneration (AMD) patients with peripapillary choroidal neovascularization (PPCNV).</p><p><strong>Methods: </strong>The study involved a retrospective case series of consecutive patients diagnosed with PPCNV secondary to AMD. All patients were treated with IVB injections with a follow-up time of 1 year. Data collected included best-corrected visual acuity (BCVA) and automated and manually measured OCT parameters.</p><p><strong>Results: </strong>A total of 68 eyes were diagnosed with PPMV. Of them, 30 eyes of 30 patients aged 84.3 ± 6.9 years of which 63.3% female gender were included. Baseline BCVA was 0.46 ± 0.62 logMAR (Snellen 20/57), average choroidal thickness was 193.2 ± 22 μm, and mean number of IVB injections was 7.2 ± 1.9. After 1 year, BCVA was 0.56 ± 0.78 logMAR (Snellen 20/72) (p = 0.28). Eyes with greater central retinal thickness (r = -0.36, p = 0.05), greater subretinal hyper-reflective material (SHRM) area (r = -0.37, p = 0.05), and greater sub-retinal fluid (SRF) area (r = -0.73, p < 0.001) had a significantly smaller improvement in BCVA. Eyes with pigment epithelium detachment (PED) (0.68 ± 0.90 vs. 0.21 ± 0.12, p = 0.03) had a significantly worse BCVA.</p><p><strong>Conclusions: </strong>Our data suggest that AMD-related PPCNV with greater foveal thickness, PED size, SHRM, and SRF areas have worse final BCVA prognosis.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39647017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full-Field Electroretinography Changes Associated with Age-Related Macular Degeneration: A Systematic Review with Meta-Analyses.","authors":"Thomas Richard Johansen Forshaw,&nbsp;Yousif Subhi,&nbsp;Sten Andréasson,&nbsp;Torben Lykke Sørensen","doi":"10.1159/000521834","DOIUrl":"https://doi.org/10.1159/000521834","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to systematically review the literature and to perform meta-analyses on full-field electroretinography (ffERG) between healthy controls and age-related macular degeneration (AMD) to map the extent of retinal dysfunction.</p><p><strong>Summary: </strong>We systematically searched 11 databases on 3 March 2021. Eligible studies had to measure retinal function using ffERG in eyes with AMD and in healthy controls. We extracted data on a-wave and b-wave function in dark- and light-adapted ffERG and calculated summary estimates on differences between eyes with AMD and controls using weighted mean differences (WMD). Subgroup analyses were made for early and late AMD. Six studies (n = 481 eyes) were eligible for review (301 with any AMD, 180 controls). For dark-adapted data, any AMD was associated with reduced a-wave amplitude (WMD: -17.16 μV; 95% CI: -31.79 to -2.52 μV; p = 0.02) and b-wave amplitude (WMD: -28.70 μV; 95% CI: -51.40 to -6.01 μV; p = 0.01). For light-adapted data, any AMD was associated with longer a-wave implicit time (WMD: 0.92 ms; 95% CI: 0.12-1.72 ms; p = 0.02), reduced b-wave amplitude (WMD: -13.26 μV; 95% CI: -18.64 to -7.88 μV; p < 0.0001), and longer b-wave implicit time (WMD: 0.69 ms; 95% CI: 0.30-1.08 ms; p = 0.0006). Subgroup analyses found that these changes were only statistically significant in eyes with late AMD, not early AMD.</p><p><strong>Key messages: </strong>Reduced retinal function on ffERG is present in eyes with AMD, in particular those with late AMD. These findings suggest that AMD is a pan-retinal disease with AMD-associated photoreceptor dysfunction beyond the macula.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39810968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Combined Vitrectomy with Intravitreal Corticosteroid Injection for Idiopathic Epiretinal Membrane Removal on Anatomical and Functional Outcomes: A Meta-Analysis.","authors":"Hung-Ju Chen,&nbsp;Chung-Hao Hsiao,&nbsp;Chia-Jen Chang","doi":"10.1159/000522263","DOIUrl":"https://doi.org/10.1159/000522263","url":null,"abstract":"<p><strong>Background: </strong>Macular edema can be a cause of visual loss in eyes undergoing vitrectomy with epiretinal membrane (ERM) peeling.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the efficacy of combined vitrectomy with intravitreal corticosteroid injection for ERM.</p><p><strong>Methods: </strong>We conducted a systematic literature review by searching PubMed, Embase, and Medline up to December 2020 for studies that evaluated the effect of intravitreal corticosteroid injection during vitrectomy for ERM. Follow-up data on postoperative best corrected visual acuity (BCVA) and central macular thickness (CMT) were collected and pooled using the standard mean deviation (SMD) with the corresponding 95% confidence interval (CI). Heterogeneity was statistically quantified using I2 statistics, and a meta-analysis was performed using a random-effects model.</p><p><strong>Results: </strong>Eight studies provided data on a total sample of 443 eyes. The meta-analysis revealed that concomitant intravitreal corticosteroid administration during vitrectomy contributed to a significant reduction in CMT than vitrectomy alone at 3 months after operation (pooled SMD = -0.353; 95% CI: -0.594 to -0.111; p = 0.004). However, between the two groups, no significant difference was found in CMT reduction at 1 and 6 months after operation and in postoperative BCVA improvement at 1, 3, and 6 months after operation.</p><p><strong>Conclusion: </strong>Combined treatment with vitrectomy and intravitreal corticosteroid injection may accelerate CMT reduction 3 months after ERM surgery. However, it did not result in a significant change in CMT and BCVA compared with vitrectomy alone at the end of follow-up.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39903568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occurrence of Macular Neovascularization after Retinal Pigment Epithelium-Choroid Translocation Surgery to Treat Complicated Age-Related Macular Degeneration: Incidence, Management, and Outcome.","authors":"Charlotte De Sutter,&nbsp;Pieter-Paul Schauwvlieghe,&nbsp;Joke Ruys,&nbsp;Ine Cosemans,&nbsp;Jozef Depla,&nbsp;Sven Van Laere,&nbsp;Marc Veckeneer","doi":"10.1159/000519519","DOIUrl":"https://doi.org/10.1159/000519519","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates the incidence, clinical characteristics, and treatment response of macular neovascularization (MNV) occurring after retinal pigment epithelium (RPE) and choroid graft translocation surgery (RPE-choroid TS).</p><p><strong>Methods: </strong>Retrospective analysis of 36 eyes of 36 consecutive patients who underwent RPE-choroid TS. Longer term follow-up of graft survival focusing on the occurrence of MNV was performed using multimodal imaging.</p><p><strong>Results: </strong>Indications for RPE-choroid TS included complications of neovascular age-related macular degeneration in 34 patients and drusenoid pigment epithelial detachment in 2 patients. With a mean follow-up of 30 months, 8 patients out of 36 developed signs of MNV. Of these 8 patients, 4 presented with a drop in visual acuity (VA) due to centrally located type 3 MNV. Early diagnosis and treatment prevented significant functional consequences. Four patients developed type 2 MNV at the border of the graft, which did not tend to affect the VA.</p><p><strong>Conclusion: </strong>We report a high incidence of MNV after RPE-choroid TS. Early diagnosis and treatment may preserve function in these patients. The type of MNV and location can be used to guide the management.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39422374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heritability and Risk Factors of Incident Small and Large Drusen in the Copenhagen Twin Cohort Eye Study: A 20-Year Follow-Up.","authors":"Mohamed Belmouhand,&nbsp;Simon Paul Rothenbuehler,&nbsp;Jakob Bjerager,&nbsp;Sami Dabbah,&nbsp;Jacob B Hjelmborg,&nbsp;Inger Christine Munch,&nbsp;Christine Dalgård,&nbsp;Michael Larsen","doi":"10.1159/000525652","DOIUrl":"https://doi.org/10.1159/000525652","url":null,"abstract":"<p><strong>Introduction: </strong>The transition from a normal fundus to one with early drusen (≥20 small hard drusen) to age-related macular degeneration (AMD) in the form of drusen ≥63 μm in diameter is of interest, because small hard drusen may be precursors of large drusen. Study of AMD precursor lesions may provide valuable insight into factors that initiate AMD. Here, the progression of drusen was studied over an interval of 20 years in a population-based twin cohort.</p><p><strong>Methods: </strong>Single-center, 20-year follow-up of 138 twins include biometry, fundus optical coherence tomography, and fundus photography. Macular characteristics were hierarchically classified as (per eye) (1) <20 small hard drusen, (2) ≥20 small hard drusen, (3) drusen ≥63 μm, or (4) ≥20 small hard drusen combined with drusen ≥63 μm. Additive and dominant genetic effects as well as shared and nonshared environmental effects were analyzed in a bivariate biprobit model with a classic liability-threshold approach and polygenic modeling with random effects.</p><p><strong>Results: </strong>Median participant age was 59 (range 41-66) years. Of 25 (18%) cases of incident macular drusen, 7 had ≥20 small hard drusen, and 18 had drusen ≥63 μm at follow-up, whereas no participant had developed both traits simultaneously. Smoking was associated with incident ≥20 small hard drusen (p = 0.04) and incident drusen ≥63 μm (p = 0.003). Having ≥20 small hard drusen at baseline was associated with incident drusen ≥63 μm at follow-up (p = 0.02). Development of drusen ≥63 μm was attributable to 49% genetic effects and 51% environmental effects.</p><p><strong>Conclusion: </strong>The risk of progressing from 0 to 19 small hard macular drusen per eye to having ≥20 small hard drusen or drusen ≥63 μm at follow-up was associated with smoking and genetic predisposition. Having ≥20 small hard drusen in the absence of drusen ≥63 μm at baseline was associated with incident drusen ≥63 μm when examined 20 years later. The study confirms that small hard macular drusen is a forewarning of AMD and that progression to AMD may be hindered by avoidance of smoking.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40634013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}