ORCID Profile
0000-0002-7492-6303
Current Organisations
Osaka University Hospital
,
Osaka University Graduate School of Medicine
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Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.OPHTHA.2018.04.007
Abstract: Diabetes mellitus (DM) is a global epidemic and affects populations in both developing and developed countries, with differing health care and resource levels. Diabetic retinopathy (DR) is a major complication of DM and a leading cause of vision loss in working middle-aged adults. Vision loss from DR can be prevented with broad-level public health strategies, but these need to be tailored to a country's and population's resource setting. Designing DR screening programs, with appropriate and timely referral to facilities with trained eye care professionals, and using cost-effective treatment for vision-threatening levels of DR can prevent vision loss. The International Council of Ophthalmology Guidelines for Diabetic Eye Care 2017 summarize and offer a comprehensive guide for DR screening, referral and follow-up schedules for DR, and appropriate management of vision-threatening DR, including diabetic macular edema (DME) and proliferative DR, for countries with high- and low- or intermediate-resource settings. The guidelines include updated evidence on screening and referral criteria, the minimum requirements for a screening vision and retinal examination, follow-up care, and management of DR and DME, including laser photocoagulation and appropriate use of intravitreal anti-vascular endothelial growth factor inhibitors and, in specific situations, intravitreal corticosteroids. Recommendations for management of DR in patients during pregnancy and with concomitant cataract also are included. The guidelines offer suggestions for monitoring outcomes and indicators of success at a population level.
Publisher: Springer Science and Business Media LLC
Date: 03-02-2020
Publisher: MDPI AG
Date: 25-10-2022
DOI: 10.3390/JCM11216274
Abstract: The progression of age-related macular degeneration (AMD) is determined by environmental and genetic factors, and phenotypic or molecular risk factors have been investigated extensively. Interestingly, risk factor profiles for advanced AMD differ among in iduals, and one of the causes of variation may be explained by their ethnic background. Recent advances in retinal imaging technology have led to the identification of previously unrecognized risk factors for advanced AMD on optical coherence tomography (OCT) and OCT angiography, which expands the concept of traditional imaging risk factors such as drusen and pigmentary abnormalities visible on color fundus photographs. This OCT imaging modality has identified novel pathognomonic changes for early AMD, including the associated photoreceptor, retinal pigment epithelium, and underlying choroidal changes. Regarding features of multimodal imaging associated with the presence or progression of geographic atrophy, there is an international expert consensus classification system however, features associated with the progression of macular neovascularization (MNV) are still obscure. To make a consensus towards understanding features associated with the risk of MNV, this review focuses on the early stages of AMD by summarizing imaging characteristics and early signs and classifications in view of advanced multimodal imaging technology. Recent evidence suggests that neovascular AMD is not a single disease entity but a heterogeneous disease characterized by MNV. Besides drusen, OCT features associated with pigment abnormalities, such as shallow irregular RPE elevation (SIRE, also known as double-layer sign), pachychoroid pigment epitheliopathy, and choriocapillaris ischemia, seem to confer a high risk of MNV developing, especially for Asian populations.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.AJO.2015.01.022
Abstract: To develop a classification and grading system for myopic maculopathy. Development and evaluation of a classification system for myopic maculopathy based on observational case series. A comprehensive set of myopic macular lesions was defined via literature review and through consensus meetings among retinal specialists and clinician scientists. A classification of myopic maculopathy was formulated based on fundus photographs and a modified Delphi process and consensus. Inter- and intraobserver reproducibility, assessed as agreement (%) and weighted kappa values, were evaluated. One hundred retinal photographs with myopia and myopic macular lesions were selected from case series at the High Myopia Clinic of the Tokyo Medical and Dental University, Tokyo, Japan. We defined 5 categories of myopic maculopathy including "no myopic retinal degenerative lesion" (Category 0), "tessellated fundus" (Category 1), "diffuse chorioretinal atrophy" (Category 2), "patchy chorioretinal atrophy" (Category 3), and "macular atrophy" (Category 4). Three additional features to supplement these categories were defined as "plus" lesions, namely, lacquer cracks, myopic choroidal neovascularization, and Fuchs spot. Posterior staphyloma was considered as a further, important sign of myopic retinopathy. The intraobserver agreement was ≥85% and the corresponding weighted kappa statistic was ≥0.6 between observations. After a brief training session, interobserver kappa statistics reached the predefined satisfactory level (≥0.4), considered as above moderate agreement. We propose a classification system for myopic maculopathy that was found to be reproducible. Applying a uniform classification in different studies will facilitate communication and comparison of findings from clinical trials and epidemiologic studies.
Publisher: Springer Science and Business Media LLC
Date: 18-07-2009
DOI: 10.1007/S00125-009-1459-8
Abstract: The purpose of the study was to evaluate the association between retinal vascular calibre and micro- and macrovascular complications in a population-based cohort of Danish type 1 diabetic patients. This was a cross-sectional study of 208 long-surviving type 1 diabetic patients from a population-based Danish cohort. Retinal photographs were obtained at a clinical examination attended by each participant in 2007-2008, and retinal vascular calibre was measured and summarised as the central retinal artery or vein equivalent (CRAE or CRVE) using a computer-based program and a standardised protocol. Associations between retinal vascular calibre and micro- and macrovascular complications were examined after adjusting for confounding clinical characteristics. Retinal photographs were gradable for 188 of 208 patients (90.3%). The median age and duration of diabetes for patients with gradable photos were 57.9 and 42 years, respectively. After multivariate adjustments, in iduals with narrower retinal arterioles were more likely to have nephropathy (OR 2.17, 95% CI 1.29-3.68, per SD decrease in CRAE) and macrovascular disease (OR 3.17, 95% CI 1.59-6.34, per SD decrease in CRAE), but not neuropathy (OR 1.10, 95% CI 0.70-1.71, per SD decrease in CRAE). Retinal venular calibre was not associated with any micro- or macrovascular complications. In type 1 diabetic patients, retinal arteriolar narrowing is associated with nephropathy and macrovascular disease independently of other clinical characteristics. If supported by further prospective studies, measurement of retinal vessel diameter may allow a non-invasive evaluation of the risk of diabetes-related complications.
Publisher: The Optical Society
Date: 21-10-2019
Publisher: IEEE
Date: 03-2020
Publisher: IEEE
Date: 08-2011
Publisher: IEEE
Date: 02-2013
Publisher: Japan Atherosclerosis Society
Date: 2017
DOI: 10.5551/JAT.37291
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.OPHTHA.2012.08.029
Abstract: Diabetic retinopathy (DR) is linked to cardiovascular risk in diabetic patients. This study examined whether mild-stage DR is associated with risk of coronary heart disease (CHD) and stroke in type 2 diabetic patients of the Japan Diabetes Complications Study (JDCS). Prospective cohort study. In the JDCS, there were 2033 Japanese persons with type 2 diabetes free of cardiovascular diseases at baseline. Diabetic retinopathy was ascertained from clinical and photographic grading (70%) following the international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Incident CHD and stroke were followed up prospectively annually up to 8 years. Eight-year incidence of CHD and stroke compared between persons with or without DR. After adjusting for traditional cardiovascular risk factors, persons with mild to moderate nonproliferative DR had a higher risk of CHD (hazard ratio [HR], 1.69 95% confidence interval [CI], 1.17-2.97) and stroke (HR, 2.69 95% CI, 1.03-4.86). Presence of retinal hemorrhages or microaneurysms was associated with risk of CHD (HR, 1.63 95% CI, 1.04-2.56) but was not associated with stroke (P = 0.06). Presence of cotton-wool spots was associated with risk of incident stroke (HR, 2.39 95% CI, 1.35-4.24) but was not associated with CHD (P = 0.66). When information about DR was added in the prediction models for CHD and stroke based on traditional cardiovascular risk factors, the area under the receiver operating curve improved from 0.682 to 0.692 and 0.640 to 0.677, and 9% and 13% of persons were reclassified correctly for CHD and stroke, respectively. Type 2 diabetic patients with even a mild stage of DR, such as dot hemorrhages, are already at higher risk of CHD and stroke independent of traditional risk factors.
Publisher: BMJ
Date: 25-04-2019
DOI: 10.1136/BJOPHTHALMOL-2018-313809
Abstract: To investigate the efficacy of therapeutic soft contact lenses (SCLs) in gelatinous drop-like corneal dystrophy (GDLD) management. This was a retrospective, consecutive, observational case series, including 20 patients (40 eyes) with GDLD treated in Osaka University Hospital within the last 15 years. We tested the effects of therapeutic SCL on clinical features, visual acuity and surgical interventions. Examinations for clinical features and visual acuity were done on patients who had no surgical intervention for 3 years. Scoring and evaluation of changes in three main clinical GDLD features and visual acuity (logMAR units) were performed using Fisher’s exact test and Mann-Whitney U test. Surgery-free survival time was compared by Kaplan-Meier analyses in all patients. We found a significantly lower rate of progression in GDLD nodular lesions in patients wearing SCLs compared with those who did not (p=0.0179). No suppressant effects were observed regarding opacity and neovascularisation, and no significant improvements were found in visual acuity (in logMAR values, SCL-on: mean=− 0.036, median=0 SCL-off: mean=0.149, median=+ 0.088 p=0.14). The surgery-free survival time for all 16 SCL-on eyes was 2770 ± 1918 days, significantly longer than that for 22 SCL-off eyes, 1342 ± 1323 days (Kaplan-Meier analysis, p=0.0007), suggesting that therapeutic SCL extends the period until surgical intervention and reduces their necessity in patients with GDLD. Wearing therapeutic SCLs in GDLD slows the progression of nodular lesions and decreases the need for surgical interventions.
Publisher: Springer Science and Business Media LLC
Date: 06-04-2020
DOI: 10.1038/S41598-020-62483-0
Abstract: This prospective randomized double-masked study investigated the effects of 20 mg lutein supplementation with two different capsules (beeswax or glycerol fatty acid esters) for 6 months on the fellow eyes of 39 Japanese patients with unilateral age-related macular degeneration, and assessed the factors associated with baseline plasma lutein concentration via lifestyle interviews. Macular pigment optical density (MPOD), determined with the two-wavelength autofluorescence method, increased over time in the beeswax group (ANOVA, p = 0.0451), although the increase from 3 months to 6 months was only marginally significant. No significant increase was observed in the glycerol fatty acid esters group (ANOVA, p = 0.7396). Plasma lutein concentrations significantly increased at 3 and 6 months from baseline in both groups (both p 0.01). In a multiple regression model, age was negatively associated with higher plasma lutein concentration (p = 0.0305), while consumption of green vegetables was positively associated with baseline plasma lutein concentration (p = 0.0322). In conclusion, a significant increase in MPOD was not fully confirmed with 6 months intake duration despite a significant increase in plasma lutein concentrations. Consumption of green vegetable was confirmed to be associated with plasma lutein concentration after adjusting for other potential factors including age.
Publisher: Mary Ann Liebert Inc
Date: 12-2017
Publisher: Springer Science and Business Media LLC
Date: 30-06-2017
DOI: 10.1007/S10384-017-0523-Z
Abstract: To investigate a novel optical coherence tomography (OCT)-derived variable, circumpapillary mean retinal shadow width (cpMRSW), and to elucidate its association with normal-tension glaucoma (NTG). For the purpose of validation, we measured retinal vascular calibers in 68 arterioles and 100 venules of 12 NTG patients and 12 healthy subjects and compared the width of the visible retinal shadows in spectral-domain OCT images and the caliber of retinal vessels in retinal photographs. Then we calculated cpMRSW in 78 NTG eyes and 25 age-matched healthy control eyes. Additionally, we ided the patients into early (mean deviation: MD > -6 dB), moderate (MD -6 to -12 dB), and severe (MD < -12 dB) NTG groups, and compared cpMRSW in these groups. Finally, we calculated the area under the receiver operating characteristic (ROC) curve in order to determine the power of mean retinal shadow width to distinguish the groups. OCT retinal shadow width was significantly correlated with photography-measured retinal caliber (r = 0.82, P < 0.001). CpMRSW was significantly different between the control and NTG patients (control: 107.3 ± 7.0 µm, mild: 99.4 ± 8.6 µm, moderate: 99.7 ± 9.5 µm, severe: 90.5 ± 12.0 µm, P < 0.001), despite similar distributions in systemic variables. An ROC analysis revealed that cpMRSW could differentiate NTGs from normal eyes (area under the ROC curve: 0.81). Our new software for measuring mean retinal shadow width in OCT images may be a valuable tool for detecting NTG and diagnosing its severity.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 19-11-2013
Abstract: To determine the relationship between axial length (AL), retinal function, and relative oxygen (O₂) consumption to better understand the protective effect of axial elongation on diabetic retinopathy development. Measurements of AL, multifocal electroretinogram (mfERG), and relative O₂ consumption (difference between arteriolar and venular O₂ saturation levels or A-V difference) were performed on 50 healthy in iduals. The relationships between AL, mfERG litude, and A-V difference were analyzed using linear regression models. Path analysis was performed to determine the direct and indirect effects (via mfERG litude) of AL on A-V difference. mfERG P1 litude was positively associated with A-V difference (β = 0.33 95% confidence interval [CI]: 0.23-0.42). Increased AL was significantly associated with a decrease in A-V difference (β = -1.08 95% CI: -1.52 to -0.65) as well as a decrease in retinal function (β = -3.14, 95% CI: -4.07 to -2.20). Path analysis models including AL (study factor), retinal function (intermediate variable), and A-V difference (outcome variable) showed that AL had little direct association with A-V difference (β(p) = -0.002), while the indirect effect of AL on A-V difference via changes in retinal function were substantial (β(p) = -0.51). In eyes with longer AL, the reduction in A-V difference is explained by the parallel reduction in retinal function. These findings suggest that longer eyes have decreased retinal function and O₂ consumption, and thus are relatively less hypoxic in the presence of diabetes, which may partly explain the reduced risk of DR in these eyes.
Publisher: Public Library of Science (PLoS)
Date: 21-10-2020
Publisher: Elsevier BV
Date: 06-2020
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.EXER.2013.10.010
Abstract: The fractal dimension is a global measure of complexity and is useful for quantifying anatomical structures, including the retinal vascular network. A previous study found a linear declining trend with aging on the retinal vascular fractal dimension (D
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2009
Publisher: Elsevier BV
Date: 2018
Publisher: Public Library of Science (PLoS)
Date: 18-01-2022
DOI: 10.1371/JOURNAL.PDIG.0000001
Abstract: Machine learning (ML) and deep learning (DL) are changing the world and reshaping the medical field. Thus, we conducted a systematic review to determine the status of regulatory-approved ML/DL-based medical devices in Japan, a leading stakeholder in international regulatory harmonization. Information about the medical devices were obtained from the Japan Association for the Advancement of Medical Equipment search service. The usage of ML/DL methodology in the medical devices was confirmed using public announcements or by contacting the marketing authorization holders via e-mail when the public announcements were insufficient for confirmation. Among the 114,150 medical devices found, 11 were regulatory-approved ML/DL-based Software as a Medical Device, with 6 products (54.5%) related to radiology and 5 products (45.5%) related to gastroenterology. The domestic ML/DL-based Software as a Medical Device were mostly related to health check-ups, which are common in Japan. Our review can help understanding the global overview that can foster international competitiveness and further tailored advancements.
Publisher: Springer Science and Business Media LLC
Date: 25-09-2019
DOI: 10.1007/S10384-018-0623-4
Abstract: To investigate the visual impairment certification status in Japan. Observational cross-sectional study. We asked all welfare offices throughout Japan to submit data concerning age, sex, causative diseases, and visual impairment grades for newly certified visually impaired in iduals aged ≥ 18 years in the fiscal year of 2015. The certification was based on criteria of the Act on Welfare of Physically Disabled Persons. In total, data were collected for 12,505 newly certified visually impaired in iduals. The most common age group for these in iduals was 80-89 years (29.6%), followed by 70-79 (26.3%) and 60-69 (17.3%) years. The most common causative disease was glaucoma (28.6%), followed by retinitis pigmentosa (14.0%), diabetic retinopathy (12.8%), and macular degeneration (8.0%). Glaucoma was the most common causative disease in both sexes (30.2% in men and 27.0% in women). The most common impairment grade was grade 2 (31.8%), followed by grades 5 (24.3%) and grade 1 (16.1%). The number of visually impaired in iduals with underlying glaucoma had increased in comparison with the number in the most recent surveys (from fiscal years 2007 to 2009), whereas the number of in iduals with underlying diabetic retinopathy and macular degeneration had decreased. To our knowledge, this is the first nation-wide complete enumeration survey of newly certified visually impaired in iduals in Japan. These findings may contribute to administrative activities concerning medical welfare as well as educational activities for preventing visual impairment.
Publisher: JMIR Publications Inc.
Date: 31-07-2023
Publisher: Springer Science and Business Media LLC
Date: 08-07-2023
DOI: 10.1007/S00592-023-02140-W
Abstract: Bariatric surgery is used to induce weight loss and glycemic stability in type 2 diabetes (T2D). It has been a concern that this may lead to early worsening of diabetic retinopathy (DR) due to a rapid decline in HbA1c. In this study, we evaluated the risk of short and long-term DR development and need for ocular intervention in an entire nation of in iduals with T2D undergoing bariatric surgery. The study comprised a national, register-based cohort of in iduals with T2D screened for DR. Cases were matched by age, sex and DR level at the date of surgery (index date) with non-bariatric controls. We extracted information on DR levels, in- and outpatient treatments, pharmaceutical prescriptions and laboratory values. We evaluated worsening of DR (incident and progressive DR) at follow-up (6 and 36 months). Amongst 238,967 in iduals with T2D, who attended diabetic eye screening, we identified 553 that underwent bariatric surgery (0.2%) and 2677 non-bariatric controls. Median age was 49 years, and 63% were female. Cases had more comorbidities, lower HbA1c as well as more frequent use of glucose-lowering and antihypertensive medication than controls at index date. In a fully adjusted logistic regression model, the risk of DR worsening for cases was not significantly different compared to controls, neither short-term (OR 0.41 [CI 95% 0.13 1.33], p = 0.14) nor long-term (OR 0.64 [CI 95% 0.33 1.24], p = 0.18). In this nationwide study, bariatric surgery did not associate with increased risk of short- or long-term DR worsening.
Publisher: Informa UK Limited
Date: 12-2020
DOI: 10.2147/CLEP.S273016
Publisher: Elsevier BV
Date: 05-2008
Publisher: The Korean Welding and Joining Society
Date: 28-02-2018
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.CMPB.2013.02.004
Abstract: Recent research suggests that retinal vessel caliber (or cross-sectional width) measured from retinal photographs is an important feature for predicting cardiovascular diseases (CVDs). One of the most utilized measures is to quantify retinal arteriolar and venular caliber as the Central Retinal Artery Equivalent (CRAE) and Central Retinal Vein Equivalent (CRVE). However, current computer tools utilize manual or semi-automatic grading methods to estimate CRAE and CRVE. These methods involve a significant amount of grader's time and can add a significant level of inaccuracy due to repetitive nature of grading and intragrader distances. An automatic and time efficient grading of the vessel caliber with highly repeatable measurement is essential, but is technically challenging due to a substantial variation of the retinal blood vessels' properties. In this paper, we propose a new technique to measure the retinal vessel caliber, which is an "edge-based" vessel tracking method. We measured CRAE and CRVE from each of the vessel types. We achieve very high accuracy (average 96.23%) for each of the cross-sectional width measurement compared to manually graded width. For overall vessel caliber measurement accuracy of CRAE and CRVE, we compared the results with an existing semi-automatic method which showed high correlation of 0.85 and 0.92, respectively. The intra-grader reproducibility of our method was high, with the correlation coefficient of 0.881 for CRAE and 0.875 for CRVE.
Publisher: American Diabetes Association
Date: 13-08-2013
DOI: 10.2337/DC12-2327
Abstract: To examine the interactive relationship between diabetic retinopathy (DR) and diabetic nephropathy (DN) in type 2 diabetic patients and to elucidate the role of DR and microalbuminuria on the onset of macroalbuminuria and renal function decline. We explored the effects of DR and microalbuminuria on the progression of DN from normoalbuminuria and low microalbuminuria (& mg/gCr) to macroalbuminuria or renal function decline in the Japan Diabetes Complications Study (JDCS), which is a nationwide randomized controlled study of type 2 diabetic patients focusing on lifestyle modification. Patients were ided into four groups according to presence or absence of DR and MA: normoalbuminuria without DR [NA(DR−)] (n = 773), normoalbuminuria with DR [NA(DR+)] (n = 279), microalbuminuria without DR [MA(DR−)] (n = 277), and microalbuminuria with DR [MA(DR+)] (n = 146). Basal urinary albumin-to-creatinine ratio and DR status were determined at baseline and followed for a median of 8.0 years. Annual incidence rates of macroalbuminuria were 1.6/1,000 person-years (9 incidences), 3.9/1,000 person-years (8 incidences), 18.4/1,000 person-years (34 incidences), and 22.1/1,000 person-years (22 incidences) in the four groups, respectively. Multivariate-adjusted hazard ratios of the progression to macroalbuminuria were 2.48 (95% CI 0.94–6.50 P = 0.07), 10.40 (4.91–22.03 P & 0.01), and 11.55 (5.24–25.45 P & 0.01) in NA(DR+), MA(DR−), and MA(DR+), respectively, in comparison with NA(DR−). Decline in estimated glomerular filtration rate (GFR) per year was two to three times faster in MA(DR+) (−1.92 mL/min/1.73 m2/year) than in the other groups. In normo- and low microalbuminuric Japanese type 2 diabetic patients, presence of microalbuminuria at baseline was associated with higher risk of macroalbuminuria in 8 years. Patients with microalbuminuria and DR showed the fastest GFR decline. Albuminuria and DR should be considered as risk factors of renal prognosis in type 2 diabetic patients. An open sharing of information will benefit both ophthalmologists and diabetologists.
Publisher: Springer Science and Business Media LLC
Date: 04-05-2012
DOI: 10.1038/EYE.2012.72
Publisher: Wiley
Date: 28-08-2014
DOI: 10.1111/CEO.12387
Abstract: There are limited data available on the variables that might affect retinal vessel oxygen saturation (SO₂) in diabetes. Therefore, the aim of this study is to assess factors associated with retinal oximetry values in persons with diabetes. Clinic-based cross-sectional study. Fifty-eight persons with diabetes aged 18+ years, recruited from the University of Melbourne, the Royal Victorian Eye and Ear Hospital, and St. Vincent's Hospital (Melbourne), Australia. Retinal oximetry was performed using the oximetry module of the Vesselmap system (Imedos UG, Jena, Germany) in 92 diabetic eyes. Generalized estimating equation models were used to estimate the associations between candidate variables (age gender retinal capillary flow duration of diabetes hypertension smoking status presence of diabetic retinopathy [DR] glycated haemoglobin triglyceride total cholesterol finger SO₂ and ocular perfusion pressure) with retinal oximetry measures. Arteriolar SO₂, venular SO₂ and the arterio-venous (A-V) difference. Of the candidate factors assessed, only the presence of DR was significantly associated with increased venular SO₂ and decreased A-V difference in unadjusted analyses. In models adjusting for age and gender and significant variables from unadjusted analyses, compared with no DR, the presence of DR was significantly associated with greater retinal venular SO₂ values (β = 3.65%, 95% confidence interval: 0.67-6.63%) and decreased A-V difference (β = -2.00%, 95% confidence interval: -3.46 to -0.53%). In patients with diabetes, eyes with DR were associated with increased venular SO₂ and decreased A-V difference compared with eyes without DR, suggesting an altered metabolic state in DR.
Publisher: Springer Science and Business Media LLC
Date: 22-06-2015
DOI: 10.1038/NUTD.2015.15
Abstract: We aimed to determine whether retinal microvascular changes in vessel calibers at baseline are associated with the future risk of developing the metabolic syndrome over 4 years in an adult cohort of Japanese in iduals ( n =90) who attended a health-screening program. Retinal vessel caliber was calculated as the central retinal artery equivalent and vein equivalent (CRAE) from non-mydriatic digital fundus images using semiautomated standardized software. There were 18 cases (20%) that developed metabolic syndrome over 4 years. Narrower arteriolar caliber at baseline was associated with an increased risk of incident metabolic syndrome over 4 years after adjusting for potential confounding risk factors including in idual cardiovascular risk factors related to the metabolic syndrome (adjusted odds ratio per 1 s.d. change in CRAE: 2.92, 95% confidence interval 1.03, 8.24 P =0.043). Persons with wider venular caliber at baseline were more likely to have incident metabolic syndrome, but this was not statistically significant. Retinal vascular caliber might provide independent and useful information to predict incident metabolic syndrome in a health screening program.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 19-09-2017
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.JNUTBIO.2016.10.018
Abstract: Patients with nonalcoholic fatty liver disease may subsequently develop nonalcoholic steatohepatitis after suffering from a second insult, such as oxidative stress. Aim of this study was to investigate the pathogenesis of the liver injury caused when lipids accumulate under conditions of intrinsic oxidative stress using mice that are deficient in superoxide dismutase 1 (SOD1) and the leptin receptor (Lepr). We established Sod1
Publisher: MDPI AG
Date: 15-03-2022
DOI: 10.3390/JCM11061617
Abstract: This population-based cross-sectional study investigated the influence of dietary patterns on age-related macular degeneration (AMD) in a Japanese population. The Tsuruoka Metabolomics Cohort Study enrolled a general population aged 35–74 years from among participants in annual health check-up programs in Tsuruoka City, Japan. Eating habits were assessed using a food frequency questionnaire. Principal component analysis was used to identify dietary patterns among food items. The association between quartiles of scores for each dietary pattern and intermediate AMD was assessed using multivariate logistic regression models. Of 3433 participants, 415 had intermediate AMD. We identified four principal components comprising the Vegetable-rich pattern, Varied staple food pattern, Animal-rich pattern, and Seafood-rich pattern. After adjusting for potential confounders, higher Varied staple food diet scores were associated with a lower prevalence of intermediate AMD (fourth vs. first quartile) (OR, 0.63 95% confidence interval [CI], 0.46–0.86). A significant trend of decreasing ORs for intermediate AMD associated with increasing Varied staple food diet scores was noted (p for trend = 0.002). There was no significant association between the other dietary patterns and intermediate AMD. In a Japanese population, in iduals with a dietary pattern score high in the Varied staple food pattern had a lower prevalence of intermediate AMD.
Publisher: BMJ
Date: 25-07-2008
Abstract: To describe the prevalence and risk factors of epiretinal membranes (ERM) in Asian Malays and to compare this with a white population. The Singapore Malay Eye Study examined 3280 persons (78.7% response rate) aged 40-80 years in Singapore during 2004-6. ERM were graded from retinal photographs using standardised procedures at the University of Sydney, and rates were compared with those from the Blue Mountains Eye Study (BMES). Of the 3,280 participants, 3,265 had sufficient quality photographs for grading. The age-standardised prevalence of ERM was 7.9% (95% CI 7.1 to 8.7%) in the Singapore Census population. The prevalence of ERM was higher in Malays than in Caucasians from the BMES (age-standardised prevalence: 15.8% (CI 14.2 to 17.2%) in Malays vs 6.8% (CI 5.9 to 7.6%) in Caucasians). Of the 384 persons with ERM, 124 (32.3%) had secondary ERM. Age, female gender, hyperopia and narrower retinal arteriolar diameter were associated with higher prevalence of ERM, after adjusting for age and/or gender. The prevalence of ERM in Asian Malays was higher than that in the Caucasians. Risk factors for ERM were older age, female gender, hyperopic refraction and narrower retinal arteriolar diameter.
Publisher: Springer Science and Business Media LLC
Date: 22-06-2020
Publisher: BMJ
Date: 26-10-2007
Abstract: To determine the relationship of metabolic syndrome and its components with retinopathy and other retinal microvascular signs in a Japanese population. The Funagata study recruited 1961 (53.3% of eligible) Japanese aged 35 or older. The metabolic syndrome was diagnosed primarily using definitions of the International Diabetes Federation. Retinopathy and retinal microvascular signs were assessed from fundus photographs. Retinal arteriolar and venular diameters were measured using a computer-assisted programme. Data were available for analysis in 1638 persons for retinopathy and retinal microvascular signs and 921 persons for retinal vessel diameters. Various components of the metabolic syndrome were associated with retinal microvascular signs: a larger waist circumference was associated with wider venular diameter and retinopathy lesions a higher blood pressure level was associated with focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar wall reflex and narrower arteriolar diameter and a higher triglyceride level was associated with enhanced arteriolar wall reflex. Overall, persons with the metabolic syndrome were more likely to have retinopathy (odds ratio 1.64, 95% CI: 1.02 to 2.64) and wider venular diameter 4.69 microm (95% CI: 1.20 to 8.19 microm) than persons without the metabolic syndrome. We report associations of metabolic syndrome components with retinopathy and wider venular diameter in Japanese adults. These data suggest that metabolic abnormalities, indicated by metabolic syndrome components, are associated with microvascular changes in the retina. There was no synergistic effect of the metabolic syndrome on retinal microvascular changes beyond its in idual components.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 24-08-2012
DOI: 10.1167/IOVS.11-9326
Abstract: Changes in retinal vascular parameters have been shown to be associated with systemic vascular diseases. In this study, we assessed the physiologic variations in retinal vascular measurements during the cardiac cycle. Fundus images were taken using electrocardiogram-synchronized retinal camera at nine distinct cardiac points from 15 healthy volunteers (135 images). Analyses of retinal vessel geometric measures, including retinal vessel caliber (in idual and summary), tortuosity, branching angle, length-diameter ratio (LDR), and optimality deviation, were performed using semiautomated computer software. Repeated-measures ANOVAs were used to obtain the means and to estimate the variation of each cardiac point compared with cardiac point 1. There was a significant variation of the caliber of the in idual arteriolar and venular vessels. However, there was no significant variation found for vessel caliber summary, represented by the central retinal arteriolar equivalent (CRAE) and the central retinal venular equivalent (CRVE). There was also no significant variation found for tortuosity and branching angle, and LDR showed none or very little variations at different cardiac points: variations in caliber ranges between 0 and 4.1%, tortuosity 0 and 1.5%, branching angle 0 and 3.5%, and LDR 0 and 2% all values for variations, P > 0.1 linear trend, P > 0.5 and nonlinear trend, P > 0.8. This study showed that there were minimal variations in the CRAE, CRVE, tortuosity, and branching angle that are clinically used for two-dimensional measures of retinal vascular geometry during cardiac cycles. However, there was significant variation in the caliber of the in idual vessels over the cardiac cycle.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 21-01-2013
Abstract: Wider retinal venular caliber is shown to be associated with an increased risk of stroke, and smoking is associated with a wider retinal venular caliber. However, the impact of smoking cessation on the retinal vessels has not been previously reported. We examined this issue in an adult cohort of atomic bomb survivors. In the Adult Health Study of Japanese atomic bomb survivors, 1664 subjects had retinal photographs taken from 2006 to 2008. The central retinal artery and vein equivalents (CRAE and CRVE) were calculated using a semiautomated software program. Multiple surveys have assessed the effects of smoking since 1963. The associations between smoking, the time since cessation, and the retinal vessel caliber were determined using linear mixed effects models. The CRVE was associated with an increased number of cigarettes smoked per day among women after adjusting for potential confounding factors (age, sex, blood pressure, hypertensive medications, white blood cell count, diabetes, body mass index, lipids, and radiation dose). Females who smoked 10 cigarettes per day had a 6.9-μm wider mean CRVE (P = 0.001) than nonsmokers. Females who had stopped smoking for 10 or more years had a mean CRVE similar to those who had never smoked (191.8 vs. 194.4 μm P = 0.23). These associations were not observed in males or for CRAE. Wider retinal venular caliber is associated with smoking in Japanese females however, this association becomes nonsignificant after 10 or more years of smoking cessation, suggesting that the impact of smoking on retinal venular dilation is reversible following long-term smoking cessation.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 02-07-2014
Abstract: The pathway linking late-life malnutrition to greater risk of cardiovascular disease is unclear. Microcirulatory changes assessed by retinal vascular caliber have been linked with increased risk of stroke and coronary heart disease. The purpose of this study was to examine whether retinal vascular calibers are associated with malnutrition in elderly subjects free of cardiovascular diseases. This was a cross-sectional analysis of a community-dwelling cohort comprising 1145 in iduals aged 60 years and older. Retinal vascular caliber was measured from fundus photographs using a semiautomated, standardized imaging software. Malnutrition was assessed using body mass index (BMI) < 18.5 kg/m(2) and biomarkers of protein malnutrition: plasma albumin and transthyretin. In a multivariate model controlling for cardiovascular risk factors, retinal venular caliber was related to BMI (P = 0.0002) with an increased mean caliber for in iduals with obesity and for those with low BMI. After multivariate adjustment for age, sex, hypertension, smoking, high-density lipoprotein (HDL) cholesterol, glomerular filtration rate and BMI, lower levels of albumin or transthyretin were associated with larger retinal venular caliber (P = 0.026 and P = 0.0018, respectively), that remain significant when adjusting for CRP (P = 0.040 and P = 0.0060, respectively) or orosomucoid (P = 0.034 and P = 0.0020, respectively). The relationships between retinal arteriolar caliber and BMI, albumin and transthyretin did not reach significance (P = 0.14, P = 0.12, and P = 0.15, respectively). Protein malnutrition was identified as an additional factor associated with retinal venular dilatation beyond inflammation. This suggests that early microvascular changes may be one of the underlying mechanisms of increased risk of cardiovascular disease observed in elderly subjects suffering from malnutrition.
Publisher: Elsevier BV
Date: 04-2011
Publisher: Japanese Circulation Society
Date: 25-07-2018
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.ORET.2019.11.015
Abstract: To evaluate differences in the progression pattern among subtypes of retinopathy of prematurity (ROP). Retrospective cohort study. Premature infants screened for ROP. Medical records of 578 premature infants who were screened at the neonatal intensive care unit from September 2009 through March 2016 were reviewed. We matched for the number of patients, gestational age at birth, and postmenstrual age at the first examination between infants with spontaneously regressed ROP and those with treated ROP. A total of 133 premature infants who were born before 27 weeks' gestation were included. The mean age at onset of any ROP and the duration from the initial examination to onset were compared between infants with regressed ROP and those with treated ROP. The mean age at treatment and the duration from onset to treatment were compared between infants with type 1 ROP and those with aggressive posterior ROP (AP-ROP). Data were analyzed for 1 randomly selected eye for each infant. Of 133 premature infants with any ROP, 67 regressed spontaneously, 43 demonstrated type 1 ROP, and 23 demonstrated AP-ROP. In idual trajectories of ROP progression over time showed that AP-ROP progressed through the stages in a steep linear manner in most cases. In contrast, the type 1 ROP and regressed ROP developed in a slower, stepwise manner. In infants with ROP, the disease trajectories across ROP stages are different based on the ROP subtype, despite postmenstrual age at onset being comparable across subtypes. Our findings could be useful for managing follow-up screening.
Publisher: Informa UK Limited
Date: 04-11-2011
DOI: 10.3109/09286586.2011.602505
Abstract: To compare the frequency and pattern of bilateral involvement of early and late age-related macular degeneration (AMD) between Asian Malays and Caucasians. We used cross-sectional data from the baseline examination for subjects aged 50-79 years in the Singapore Malay Eye Study (SiMES) (N = 2,453) and the Blue Mountains Eye Study (BMES) (N = 3,265). We assessed AMD signs using a common protocol modified from the Wisconsin Age-related Maculopathy Grading System at the University of Sydney. We compared frequencies or proportions of AMD cases with bilateral involvement between the two populations. There were 173 cases and 169 cases with any AMD (either early or late AMD in at least one eye), and 78 cases (45.1%) and 52 cases (30.8%) with bilateral AMD in the BMES and the SiMES, respectively. Age-standardized frequency of bilateral involvement was comparable between the BMES (29.5%, 95% confidence interval(CI) 18.5-40.5%) and the SiMES (25.6%, 95%CI 17.0-34.0%). Older age was associated with higher risk of bilateral AMD (gender-adjusted odds ratio per 1 year for the BMES and the SiMES: 1.08 [95% CI 1.05-1.11] and 1.06 [95% CI 1.02-1.10], respectively). The frequency of bilateral AMD was comparable between Asian Malays in the SiMES and the Caucasian population of the BMES. Other than older age, we did not find any characteristics associated with the bilateral involvement of AMD.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 28-06-2012
DOI: 10.1167/IOVS.11-8596
Abstract: Retinal vessel attenuation is a key finding in the diagnosis of retinitis pigmentosa (RP), but there have been no studies to determine whether quantitative measurement of this retinal sign is useful. We aimed to investigate retinal vessel caliber and its relationship with the severity of RP. This is a cross-sectional study based on 74 patients (145 eyes) with RP who had visual field assessment with Goldmann permeter and good-quality retinal images for vessel size measurements identified by retrospective medial chart review (1973-2007) in the electrophysiology clinic of a tertiary eye hospital in Australia. Retinal vessel calibers were measured using a computer-based program as the central retinal artery and vein equivalent (CRAE and CRVE). Goldmann visual field area for III4e white test light was measured quantitatively using ImageJ software as a clinical parameter to indicate the severity of RP. We used the generalized estimating equation models to estimate the difference in retina vessel calibers accounting for correlation between right and left eyes. Mean CRAE and CRVE were significantly narrower in persons with smaller visual field area. For each 100 cm2 decrease in visual field area, CRAE and CRVE decreased by -15.2 μm (95% confidence interval -20.7, -9.78) and -26.8 μm (-35.1, -18.5), respectively (both P<0.001). In RP patients, the severity of visual field loss is correlated with retinal vessel attenuation. Quantitative retinal vessel caliber measurement may be a useful additional clinical marker for monitoring progression of RP or potential treatment response.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.OPHTHA.2012.07.007
Abstract: To examine associations between quantitatively measured retinal vessel caliber and the 10-year incidence of primary open-angle glaucoma (OAG). Population-based cohort study. The Blue Mountains Eye Study examined 3654 persons at baseline and 2461 persons at either 5 years, 10 years, or both times. After excluding 44 subjects with OAG at baseline, 2417 participants at risk of OAG at the 5- or 10-year examinations were included. Retinal vessel calibers of baseline retinal photographs were measured using a computer-based program and summarized as central retinal artery and vein equivalents (CRAE, CRVE). Incident OAG was defined as the development of typical glaucomatous visual field loss combined with matching optic disc rim thinning and an enlarged cup-to-disc (C:D) ratio of >0.7 or C:D asymmetry between the 2 eyes (≥0.3) at either the 5- or 10-year examination. Generalized estimating equation models were used to account for correlation between eyes while adjusting for glaucoma risk characteristics including intraocular pressure (IOP) or ocular perfusion pressure (OPP). We assessed the 10-year incidence of OAG. There were 82 persons (104 eyes) who developed incident OAG over the 10-year follow-up. After adjusting for age, sex, family history of glaucoma, smoking, diabetes, hypertension, hypercholesterolemia, body mass index, spherical equivalent refraction, and C:D ratio, narrower CRAE was associated with higher risk of incident OAG (adjusted odds ratio [OR], 1.77 95% confidence interval [CI], 1.12-2.79, per standard deviation decrease in CRAE). This association persisted after further adjustment for IOP (adjusted OR, 1.87 95% CI, 1.14-3.05) or OPP (adjusted OR, 1.76 95% CI, 1.11-2.78), and remained significant when analyses were confined to eyes with IOP<20 mmHg and C:D ratio<0.6 at baseline. There were no independent associations between CRVE and incident OAG. Retinal arteriolar narrowing, quantitatively measured from retinal photographs, was associated with long-term risk of OAG. These data support the concept that early vascular changes are involved in the pathogenesis of OAG and suggest that computer-based measurements of retinal vessel caliber may be useful to identify people with an increased risk of developing the clinical stage of glaucoma. The authors have no proprietary or commercial interest in any of the materials discussed in this article.
Publisher: Elsevier BV
Date: 12-2023
Publisher: Elsevier BV
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 12-08-2022
DOI: 10.1007/S00592-022-01946-4
Abstract: A nationwide diabetic retinopathy (DR) screening program has been established in Denmark since 2013. We aimed to perform an evaluation of adherence to DR screenings and to examine whether non-adherence was correlated to DR progression. The population consisted of a register-based cohort, who participated in the screening program from 2013 to 2018. We analyzed age, gender, marital status, DR level (International Clinical DR severity scale, none, mild-, moderate-, severe non-proliferative DR (NPDR) and proliferative DR (PDR)), comorbidities and socioeconomic factors. The attendance pattern of patients was grouped as either timely (no delays 33%), delayed (delays 33%) or one-time attendance (unexplained). We included 205,970 patients with 591,136 screenings. Rates of timely, delayed and one-time attendance were 53.0%, 35.5% and 11.5%, respectively. DR level at baseline was associated with delays (mild-, moderate-, severe NPDR and PDR) and one-time attendance (moderate-, severe NPDR and PDR) with relative risk ratios (RRR) of 1.68, 2.27, 3.14, 2.44 and 1.18, 2.07, 1.26, respectively ( P 0.05). Delays at previous screenings were associated with progression to severe NPDR or PDR (hazard ratio (HR) 2.27, 6.25 and 12.84 for 1, 2 and 3+ delays, respectively). Any given delay doubled the risk of progression (HR 2.28). In a national cohort of 205,970 patients, almost half of the patients attended DR screening later than scheduled or dropped out after first screening episode. This was, in particular, true for patients with any levels of DR at baseline. DR progression in patients with delayed attendance, increased with the number of missed appointments.
Publisher: Springer Science and Business Media LLC
Date: 04-11-2020
DOI: 10.1186/S40942-020-00249-6
Abstract: The purpose of this study was to evaluate the area of retinal neovascularization in patients with treatment-naïve proliferative diabetic retinopathy (PDR) as measured by optical coherence tomography angiography (OCT-A) as a marker of subsequent treatment response after panretinal photocoagulation (PRP), and to examine if this area correlated with area of retinal neovascularization as measured by fluorescein angiography (FA). En face OCT-A scans (4.5 × 4.5 mm) of neovascularizations were obtained at baseline (BL) before PRP and at month (M) 3 and M6 after treatment. Progression of PDR were defined as lesion growth (assessed by ophthalmoscopy and wide-field fundus photo) or increasing leakage by Optos ultra-widefield FA, and patients were ided into two groups progression or non-progression. Mann–Whitney U test and Wilcoxon signed-rank test were used to analyse differences between groups and between time points. Areas of retinal neovascularizations (OCT-A and FA) were calculated by algorithms developed in Python (version 3.6.8, The Python Software Foundation, USA). Of 21 eyes included, 14 had progression of disease. Median OCT-A area did not differ between the two groups (progression vs. non-progression) at BL (76.40 ± 162.03 vs. 72.62 ± 94.15, p = 0.43) but were statistically significantly larger in the progression group at M6 (276.69 ± 168.78 vs. 61.30 ± 70.90, p = 0.025). Median FA area did not differ in the progression vs. the non-progression group at BL (111.42 ± 143.08 vs. 60.80 ± 54.83, p = 0.05) or at M6 (200.12 ± 91.81 vs. 123.86 ± 162.16, p = 0.62). Intraclass correlation between area by OCT-A and FA was −5.99 (95% CI: −35.28–0.993), p = 0.71. In this study of patients with treatment-naïve PDR, we showed that increasing area of retinal neovascularizations measured by OCT-A at M6 indicated progression of disease after PRP treatment. Our results suggest that area by OCT-A reflects disease activity and that it can be used as an indicator to monitor the progression of PDR over time, and to evaluate treatment response six months after PRP. Trial registration clinicaltrials.gov (identifier: NCT03113006). Registered April 13, 2017.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 26-06-2020
DOI: 10.1167/IOVS.61.6.57
Publisher: Springer Science and Business Media LLC
Date: 03-09-2019
DOI: 10.1007/S00417-019-04456-2
Abstract: At present, the standard treatment of neovascular age-related macular degeneration (AMD) is the repeated administration of antivascular endothelial growth factor (VEGF) agents. However, we often encounter patients who develop tachyphylaxis for anti-VEGF agents. In this study, we investigated the characteristics of patients who developed tachyphylaxis on repeated intravitreal aflibercept (IVA) injections for neovascular AMD and the frequency of tachyphylaxis. Three hundred thirteen eyes (313 patients) with treatment-naïve AMD who achieved resolution soon after starting IVA and were followed up for ≥ 12 months were enrolled in this retrospective, interventional, consecutive case series. The eyes were investigated for tachyphylaxis to aflibercept. Tachyphylaxis was defined as absence of any improvement (more than 100 μm) in or worsening of CRT within 1 month after more than two repeated monthly IVA injections when the exudative change remained. Twenty-eight (8.9%) of the 313 eyes developed tachyphylaxis (occult with no classic, n = 14 polypoidal choroidal vasculopathy, n = 14) at an annual rate of about 3%. The mean number of IVA injections was 10.5 ± 7.8, and the mean interval until tachyphylaxis was 20.9 ± 14.0 months. There was a significant difference in the AMD subtypes between the group with tachyphylaxis and the group without it (p = 0.0029). Occult with no classic type and polypoidal choroidal vasculopathy were the only AMD subtypes in the eyes with tachyphylaxis. In the analysis of the eyes that had occult with no classic or polypoidal choroidal vasculopathy, only intraretinal edema was significantly less common (p = 0.042). A combination of photodynamic therapy and aflibercept was effective in 13 (87%) of 15 eyes with tachyphylaxis, and switching to intravitreal ranibizumab was effective in 5 (56%) of 9 eyes. Tachyphylaxis occurs after repeated IVA injections in a minority of patients with AMD for a long term and is more likely to occur in eyes with lesions beneath the retinal pigment epithelium and no intraretinal edema. Treatment of AMD should be performed keeping this fact in mind, while considering the consecutive treatment.
Publisher: Elsevier BV
Date: 07-2010
DOI: 10.1016/J.OPHTHA.2009.10.047
Abstract: Fractal analysis is a method to quantify the geometric pattern and complexity of the retinal vessels. This study examined the association of retinal fractal dimension (D(f)) and microvascular and macrovascular complications in a population-based cohort of Danish patients with type 1 diabetes. Cross-sectional study. This was a cross-sectional study of 208 long-term surviving type 1 diabetes patients from a population-based Danish cohort identified in 1973. Retinal photographs were obtained at a clinical examination in 2007 or 2008. D(f) was measured with a semiautomatic computer-based program (International Retinal Imaging Software National University of Singapore, Republic of Singapore University of Sydney, Sydney, and University of Melbourne, Melbourne, Australia). D(f) of the retinal vasculature was measured within a predefined circular region of 3.5 optic disc radii centered on the optic disc. Line tracing of the vasculature was provided by the program. Any artifacts were removed by the grader, and the box-counting method then was used by the program to calculate D(f). The association of D(f) with proliferative retinopathy, nephropathy, neuropathy, and macrovascular disease (coronary heart disease, stroke, peripheral artery disease) was examined. Retinal fractals were gradable in at least 1 eye in 178 (86.6%) of 208 patients. Median age and duration of diabetes for these patients were 57.8 years and 42 years, respectively. Median D(f) was 1.4610 (range, 1.3774-1.5188). After adjustments for age, gender, duration of diabetes, systolic blood pressure, and smoking, persons with lower D(f) were more likely to have proliferative retinopathy (odds ratio [OR], 1.45 per standard deviation [SD] decrease in D(f) 95% confidence interval [CI], 1.04-2.03) and neuropathy (OR, 1.42 per SD decrease in D(f) 95% CI, 1.01-2.01). There was also a trend of an association between lower D(f) and nephropathy (OR, 1.39 per SD decrease in D(f) 95% CI, 0.97-2.01) but not macrovascular disease. Furthermore, persons with lower D(f) were older. This study adds to the evidence that D(f) may have some role as a global measure of retinal vasculature and its association with systemic disease. Prospective studies clarifying this role are needed. The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Publisher: Springer Science and Business Media LLC
Date: 08-08-2009
DOI: 10.1038/EYE.2008.238
Abstract: To determine the prevalence and risk factors of epiretinal membranes (ERM) in a Japanese population. The Funagata Study examined 1758 Japanese aged 35 years or older (42% of eligible) from June 2000 to June 2002. A total of 1723 (98.0%) participants had non-mydriatic fundus photographs of the right eye to grade the presence of ERM, using the Blue Mountains Eye Study (BMES) protocol. After age standardization, the prevalence of ERM in the right eyes of the participants included in this study was compared with that reported from right eyes of participants in the BMES and the Beaver Dam Eye Study (BDES). ERM detected in eyes with diabetic retinopathy and other retinal lesions were excluded from the analysis of associations. Multiple logistic regression models were used to determine risk factors for the presence of ERM, adjusting for age and gender. There were 84 right eyes with ERM, representing 5.44% of this s le. After age standardization, the prevalence rate (5.7%) was within the range reported in the BMES (3.5%) and the BDES (6.9%). Older age (gender-adjusted odds ratio (OR) per 10 years: 1.72, 95% confidence interval (CI): 1.40-2.11) and diabetes (age-gender-adjusted OR: 1.84, 95% CI: 1.01-3.37) were the only two factors associated with ERM. We found a similar prevalence of ERM in the Japanese as in mainly white populations. Increasing age and diabetes were risk factors for ERM in this adult Japanese population.
Publisher: Mary Ann Liebert Inc
Date: 12-2011
Abstract: Retinal microvasculature provides a direct means to assess microvascular health in vivo. We examined whether retinal vessel caliber is associated with the presence of metabolic syndrome in Japanese adults in a health screening program. We examined 1,003 Japanese adults through the health screening program conducted at the Shinoda General Hospital. Retinal vessel caliber was measured from digital fundus images using validated, semiautomated computer-assisted software. Metabolic syndrome was defined according to the definition proposed by the Joint Interim Statement in 2009. Cross-sectional associations between retinal vascular caliber and metabolic syndrome or its in idual components were determined as odds ratios (ORs) using multiple logistic regression models. The overall prevalence of metabolic syndrome in the study s le was 29.9%. Persons with increased waist circumference and elevated triglycerides and blood pressure had significantly narrower retinal arterial diameters. Persons with increased waist circumference also had wider retinal venular diameters. Narrower retinal arterial diameters and wider retinal venular diameters were associated with a higher prevalence of metabolic syndrome (OR per -1 standard deviation (SD) change in arteriolar caliber=2.15, 95% confidence interval (CI) 1.45-3.18 OR per +1 SD change in venular caliber=1.53, 95% CI 1.04-2.26). We observed cross-sectional associations between retinal vessel caliber changes and metabolic syndrome and its components. We demonstrated that retinal vessel caliber assessments are feasible in health screening programs in a timely manner. Further longitudinal studies are warranted to determine whether retinal vessel caliber measurements can be used as noninvasive assessment to evaluate vascular health related to metabolic syndrome and cardiovascular diseases in health screening program.
Publisher: Wiley
Date: 11-07-2013
DOI: 10.1111/AOS.12114
Publisher: IEEE
Date: 07-2010
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2010
DOI: 10.1161/STROKEAHA.110.585042
Abstract: Background and Purpose— Cerebral atrophy, detected as ventricular enlargement or sulcal widening on MRI, is recognized as a risk factor for vascular dementia or Alzheimer disease. However, its underlying pathophysiology is not known. We examined whether retinal microvascular assessment could provide predictive information on the risk of ventricular enlargement and sulcal widening on MRI. Methods— A prospective, population-based study was conducted of 810 middle-aged persons without clinical stroke or MRI infarcts. All participants had a first cranial MRI and retinal photography in 1993 to 1995 and returned for a repeated MRI in 2004 to 2006 (median follow-up of 10.5 years). Retinal photographs were graded for presence of retinopathy and retinal microvascular abnormalities, and MRI images were graded for ventricular size and sulcal size according to standardized protocols. Ventricular enlargement and sulcal widening were defined as an increase in ventricular size or sulcal size of ≥3 of 10 grades between baseline and follow-up. Results— After adjusting for age, gender, and cardiovascular risk factors, retinopathy and arteriovenous nicking at baseline were associated with 10-year ventricular enlargement (OR and 95% CI: 2.03, 1.20 to 4.42 for retinopathy and 2.19, 1.23 to 3.90 for arteriovenous nicking). Retinal signs were not associated with 10-year sulcal widening. Conclusions— Retinopathy and arteriovenous nicking are predictive of long-term risk of ventricular enlargement, but not of sulcal widening, independent of cardiovascular risk factors. These data support a microvascular etiology for subcortical but not cortical cerebral atrophy.
Publisher: IEEE
Date: 07-2013
Publisher: Informa UK Limited
Date: 15-02-2012
DOI: 10.3109/13697137.2011.648232
Abstract: Evidence is accumulating that progestogens may play a crucial role in the development of breast cancer under contraception and hormone therapy in reproductive and menopausal women. Progesterone receptor membrane component 1 (PGRMC1) expressed in breast cancer may be important in tumorigenesis and thus may increase breast cancer risk. The aim of this project was to investigate the influence of progesterone and nine synthetic progestins on MCF-7 breast cancer cells overexpressing PGRMC1. MCF-7 cells were stably transfected with PGRMC1 expression plasmid (WT-12). To test the effects of progestogerone (P) and the synthetic progestins chlormadinone acetate (CMA), desogestrel (DSG), drospirenone (DRSP), dydrogesterone (DYD), levonorgestrel (LNG), medroxyprogesterone acetate (MPA), nomegestrol (NOM) and norethisterone (NET) on cell proliferation, MCF-7 and WT-12 cells were stimulated with different concentrations (0.01-1 µmol/l). In MCF-7 cells, DRSP, DSG, DYD, LNG and NET increased the proliferation at 1 µmol/l, the effect being highest for NET with about 20%. In WT-12 cells, the same progestins, but additionally MPA, showed a significant increase, which was much higher (30-245%) than in MCF-7 cells. Here again, NET showed the highest proliferative effect. No effect was found for CMA, NOM and P. Some synthetic progestins trigger a proliferative response of PGRMC1-overexpressed MCF-7 cancer cells. The effect of progestogens on breast cancer tumorigenesis may clearly depend on the specific pharmacology of the various synthetic progestins.
Publisher: Informa UK Limited
Date: 08-05-2013
DOI: 10.3109/02713683.2013.798420
Abstract: To identify retinal vascular features that precede the development of branch retinal vein occlusion (BRVO) by comparing case eyes and fellow eyes. We identified 25 persons who attended an annual health screening program at Osaka Health Science Center, Osaka, Japan, and then developed BRVO in one eye between 1995 and 2009. We retrospectively reviewed retinal images of these subjects taken 1-5 years prior to the development of BRVO and compared the prevalence of retinal vascular features between case eyes and contralateral fellow eyes. Potential local retinal vascular features considered were (1) severe arterio-venous (AV) nicking, (2) a smaller angle at the crossing of the arteriole and venule, (3) double crossing, (4) crossing near venular bifurcation and (5) isolated retinopathy. The central retinal artery equivalent (CRAE), vein equivalent (CRVE) and AV ratio (CRAE ided by CRVE) were quantitatively estimated using a standardized imaging software (University of Wisconsin). Compared to the fellow eye, severe AV nicking (39.1% versus 2.6%, <0.001), isolated retinopathy (47.8% versus 7.69%, p < 0.001) and a smaller angle at the crossing site (82.6% versus 46.2%, p = 0.005) were more prevalent in eyes with BRVO compared with fellow eyes. Case eyes had a significantly smaller AV ratio at 1-5 years prior to the development of BRVO compared with fellow eyes (0.68 versus 0.73, p = 0.03). In addition to severe AV nicking, a well-known sign linked to BRVO, this study identified two new potential retinal vascular features--isolated retinopathy and a smaller angle at the crossing site--associated with BRVO development. We also found that a discrepancy in the AV ratio between eyes (i.e. a smaller AV ratio than the fellow eye) can be a quantitative indicator of a higher BRVO risk. These findings warrant further validation in longitudinal studies.
Publisher: BMJ
Date: 08-2017
DOI: 10.1136/BJOPHTHALMOL-2017-310576
Abstract: Proliferative diabetic retinopathy (PDR) is a severe blinding condition. We investigated whether retinal metabolism, measured by retinal oximetry, may predict PDR activity after panretinal laser photocoagulation (PRP). We performed a prospective, interventional, clinical study of patients with treatment-naive PDR. Wide-field fluorescein angiography (OPTOS, Optomap) and global and focal retinal oximetry (Oxymap T1) were performed at baseline (BL), and 3 months (3M) after PRP. Angiographic findings were used to ide patients according to progression or non-progression of PDR after PRP. We evaluated differences in global and focal retinal oxygen saturation between patients with and without progression of PDR after PRP treatment. We included 45 eyes of 37 patients (median age and duration of diabetes were 51.6 and 20 years). Eyes with progression of PDR developed a higher retinal venous oxygen saturation than eyes with non-progression at 3M (global: +5.9% (95% CI –1.5 to 12.9), focal: +5.4%, (95% CI –4.1 to 14.8)). Likewise, progression of PDR was associated with a lower arteriovenular (AV) oxygen difference between BL and 3M (global: –6.1%, (95% CI –13.4 to –1.4), focal: –4.5% (95% CI –12.1 to 3.2)). In a multiple logistic regression model, increment in global retinal venular oxygen saturation (OR 1.30 per 1%-point increment, p=0.017) and decrement in AV oxygen saturation difference (OR 0.72 per 1%-point increment, p=0.016) at 3M independently predicted progression of PDR. Development of higher retinal venular and lower AV global oxygen saturation independently predicts progression of PDR despite standard PRP and might be a potential non-invasive marker of angiogenic disease activity.
Publisher: MDPI AG
Date: 27-04-2022
DOI: 10.3390/DIAGNOSTICS12051100
Abstract: We aimed to evaluate the accuracy of glaucoma screening using fundus photography combined with optical coherence tomography and determine the agreement between ophthalmologists and ophthalmology residents. We used a comprehensive ophthalmologic examination dataset obtained from 503 cases (1006 eyes). Of the 1006 eyes, 132 had a confirmed glaucoma diagnosis. Overall, 24 doctors, comprising two groups (ophthalmologists and ophthalmology residents, 12 in iduals/group), analyzed the data presented in three screening strategies as follows: (1) fundus photography alone, (2) fundus photography + optical coherence tomography, and (3) fundus photography + optical coherence tomography + comprehensive examination. We investigated the diagnostic accuracy (sensitivity and specificity). The respective sensitivity and specificity values for the diagnostic accuracy obtained by 24 doctors, 12 ophthalmologists, and 12 ophthalmology residents were as follows: (1) fundus photography: sensitivity, 55.4%, 55.4%, and 55.4% specificity, 91.8%, 94.0%, and 89.6% (2) fundus photography + OCT: sensitivity, 80.0%, 82.3%, and 77.8% specificity, 91.7%, 92.9%, and 90.6% and (3) fundus photography + OCT + comprehensive examination: sensitivity 78.4%, 79.8%, and 77.1% specificity, 92.7%, 94.0%, and 91.3%. The diagnostic accuracy of glaucoma screening significantly increased with optical coherence tomography. Following its addition, ophthalmologists could more effectively improve the diagnostic accuracy than ophthalmology residents. Screening accuracy is improved when optical coherence tomography is added to fundus photography.
Publisher: Informa UK Limited
Date: 08-05-2013
DOI: 10.3109/02713683.2012.754046
Abstract: To examine retinal vessel calibre in autoimmune rheumatic disease. Patients with autoimmune rheumatic disease were recruited from a Rheumatology clinic. Retinal vessel calibre was measured from fundus photographs, and summarised as the central retinal artery and vein equivalents (CRAE and CRVE) using a semi-automated computer-assisted method. The 124 patients studied had rheumatoid arthritis (n = 76, 61%), systemic lupus erythematosus (n = 17, 14%), psoriatic arthritis (n = 11, 9%) or another rheumatological disease (n = 20, 16%). Retinal venular calibre was increased in patients with autoimmune rheumatic disease (+11.6 µm, 95% Confidence interval [CI] 3.8 - 19.3, p = 0.01) compared with other hospital patients, after adjusting for baseline differences. This increase was also present in the subgroup with rheumatoid arthritis (p = 0.01). Patients with a rheumatic disease and elevated C-reactive protein (CRP) levels had wider retinal venules than those with a lower CRP (mean CRVE: 247.8 ± 28.0 versus 216.6 ± 25.3, p < 0.01), and than other hospital patients with increased CRP (mean CRVE: 247.8 ± 28.0 versus 216.4 ± 25.9, p < 0.01). In iduals with an autoimmune rheumatic disease have wider retinal venules than other hospital patients. This increase in calibre may be due to the underlying inflammatory activity.
Publisher: Springer Berlin Heidelberg
Date: 2012
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 20-03-2014
Abstract: To assess the relationship between macular thickness and volume as characterized by optical coherence tomography (OCT) and known risk factors for diabetic retinopathy (DR) or macular edema (DME) in type 2 diabetic patients with no DME. Seventy-four patients with type 2 diabetes without DME and no or only minimal DR (n = 67 with no DR n = 7 with minimal DR mean age, 59.5 years) were recruited at a tertiary eye hospital. Central subfield macular thickness (CSMT circle of 500-μm radius) and central subfield macular volume (CSMV) were measured using spectral-domain OCT. Associations between OCT parameters and known risk factors for DR were examined using multiple linear regression models. The mean CSMT and CSMV values were 273.7 ± 17.8 μm and 0.215 ± 0.015 mm(3), respectively. After adjusting for age, sex, duration of diabetes, hemoglobin A1c, and urine protein, low-density lipoprotein (LDL) cholesterol was positively associated with CSMT and CSMV each 1 mmol/L increase in LDL was associated with a mean increase in CSMT of 6.52 μm (95% confidence interval [CI], 1.96-11.08 P = 0.006) and a mean increase in CSMV of 0.0047 mm(3) (95% CI, 0.001-0.0085 P = 0.015). A higher LDL cholesterol level was associated with increased CSMT and CSMV in diabetic patients without DME. Prospective longitudinal studies are warranted to assess whether having both elevated levels of LDL and higher CSMT or CSMV is a risk indicator for subsequent development of DME.
Publisher: Wiley
Date: 21-06-2018
DOI: 10.1111/DOM.13372
Abstract: Fenofibrate and statins reduced the need for diabetic retinopathy (DR)-related treatment in clinical trials. We aimed to determine whether use of lipid-lowering medication reduces the risk of DR and the need for treatment in patients with type 2 diabetes using a real-world health claims database. This was an observational analysis using a nation-wide health claims database of the Japan Medical Data Center (JMDC). Type 2 diabetes was defined according to ICD-10 codes for use of glucose-lowering medication. Use of lipid-lowering medication for at least 1 year was confirmed by the Anatomical Therapeutic Chemical Classification System. DR and diabetic macular edema (DME) were determined by ICD-10 codes. DR-related treatments were determined by health insurance claims. A propensity score for use of lipid-lowering medication was estimated, and a doubly robust estimator, using the inverse probability weighting model with regression adjustment, was obtained to determine odds ratios (OR) with 95% confidence interval (95% CI) for cumulative incidence of DR and its treatments over 3 years. There were 69 070 in iduals with type 2 diabetes at baseline, among whom DR developed in 5687 over a period of 3 years. Use of lipid-lowering medication was associated with decreased risk of incidence of DR (OR, 0.772 95% CI, 0.720-0.827 P < .001). Use of lipid-lowering medication was also associated with decreased incidence of DME, any treatments for DR, laser photocoagulation and vitrectomy in patients with DR at baseline. In a population of patients with type 2 diabetes with a variety of risk profiles, use of lipid-lowering medication reduced the risk of DR and thus the risks involved in treatment with laser photocoagulation and vitrectomy.
Publisher: IEEE
Date: 08-2010
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.OPHTHA.2008.02.012
Abstract: To describe the prevalence of age-related macular degeneration (AMD) in an Asian Malay population. Population-based cross-sectional study. An age-stratified random s le of Malay persons aged 40 to 80 years living in Singapore. Participants were invited to a central clinic for a comprehensive examination. Early and late AMD signs were graded from retinal photographs following the Wisconsin grading system. Of 3280 participants who participated (78.7% response rate), 3265 had photographs of sufficient quality for grading of AMD signs. Early and late AMD were present in 160 (4.9%) and 23 (0.70%) participants, respectively. After age standardization, the prevalence of early AMD in Malay persons aged 40 to 80 years was estimated to be 3.5% (95% confidence interval [CI], 2.9%-4.1%) and that of late AMD was 0.34% (95% CI, 0.20%-0.49%). Early AMD was more prevalent in men than in women (6.1% vs. 3.8%) this was significant despite adjusting for age and smoking (odds ratio [OR], 1.56 95% CI, 1.11-2.20). Late AMD also was more prevalent in men than in women (1.0% vs. 0.4%), although this was not statistically significant after adjusting for age and smoking (OR, 1.39 95% CI, 0.52-3.68). The prevalence of early and late AMD was similar to that reported in the Blue Mountains Eye Study among white persons. The prevalence of AMD in Asian Malay people is similar to that in white persons from the Blue Mountains Eye Study. Early AMD signs were more frequent in men compared with women, an association that was not fully explained by the higher smoking rates in men.
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.FREERADBIOMED.2019.10.007
Abstract: Appropriate diet is essential for the regulation of age-related macular degeneration (AMD). In particular the type of dietary polyunsaturated fatty acids (PUFA) and poor antioxidant status including carotenoid levels concomitantly contribute to AMD risk. Build-up of oxidative stress in AMD induces PUFA oxidation, and a mix of lipid oxidation products (LOPs) are generated. However, LOPs are not comprehensively evaluated in AMD. LOPs are considered biomarkers of oxidative stress but also contributes to inflammatory response. In this cross-sectional case-control study, plasma omega-6/omega-3 PUFA ratios and antioxidant status (glutathione, superoxide dismutase and catalase), and plasma and urinary LOPs (41 types) were determined to evaluate its odds-ratio in the risk of developing exudative AMD (n = 99) compared to age-gender-matched healthy controls (n = 198) in adults with Chinese diet. The odds ratio of developing exudative AMD increased with LOPs from omega-6 PUFA and decreased from those of omega-3 PUFA. These observations were associated with a high plasma omega-6/omega-3 PUFA ratio and low carotenoid levels. In short, poor PUFA and antioxidant status increased the production of omega-6 PUFA LOPs such as dihomo-isoprostane and dihomo-isofuran, and lowered omega-3 PUFA LOPs such as neuroprostanes due to the high omega-6/omega-3 PUFA ratios they were also correlated to the risk of AMD development. These findings indicate the generation of specific LOPs is associated with the development of exudative AMD.
Publisher: Oxford University Press (OUP)
Date: 02-06-2010
DOI: 10.1093/BRAIN/AWQ127
Publisher: Springer Science and Business Media LLC
Date: 08-04-2019
DOI: 10.1038/S41598-020-63134-0
Abstract: Hyperuricemia is associated with all-cause and cardiovascular mortality. However, the threshold value of serum uric acid levels for increased risk of mortality has not been determined. This large-scale cohort study used a nationwide database of 500,511 Japanese subjects (40–74 years) who participated in the annual health checkup and were followed up for 7 years. The association of serum uric acid levels at baseline with cardiovascular and all-cause mortality was examined. The Cox proportional hazard model analysis with adjustment for possible confounders revealed that the all-cause and cardiovascular mortality showed a J-shaped association with serum uric acid levels at baseline in both men and women. A significant increase in the hazard ratio for all-cause mortality was noted with serum uric acid levels ≥ 7 mg/dL in men and ≥ 5 mg/dL in women. A similar trend was observed for cardiovascular mortality. This study disclosed that even a slight increase in serum uric acid levels was an independent risk factor for all-cause and cardiovascular mortality in both men and women in a community-based population. Moreover, the threshold values of uric acid for mortality might be different for men and women.
Publisher: Hindawi Limited
Date: 2016
DOI: 10.1155/2016/3016245
Abstract: Current methods of cardiovascular risk assessment are performed using health factors which are often based on the Framingham study. However, these methods have significant limitations due to their poor sensitivity and specificity. We have compared the parameters from the Framingham equation with linear regression analysis to establish the effect of training of the model for the local database. Support vector machine was used to determine the effectiveness of machine learning approach with the Framingham health parameters for risk assessment of cardiovascular disease (CVD). The result shows that while linear model trained using local database was an improvement on Framingham model, SVM based risk assessment model had high sensitivity and specificity of prediction of CVD. This indicates that using the health parameters identified using Framingham study, machine learning approach overcomes the low sensitivity and specificity of Framingham model.
Publisher: Wiley
Date: 29-03-2016
DOI: 10.1111/CEO.12720
Abstract: To compare visual and anatomical outcomes between intravitreous bevacizumab (BVB, Avastin) and triamcinolone (TA, Triesence) when administered at the time of cataract surgery in patients with diabetic macular oedema (DME). Prospective, single-masked, randomized clinical trial at The Royal Victorian Eye and Ear Hospital, Melbourne. Patients with clinically significant cataract and either centre-involving DME or DME treated within the previous 24 months. Participants were randomized 1:1 to receive intravitreous BVB 1.25 mg or TA 4 mg during cataract surgery, and at subsequent review if required over 6 months. Change in central macular thickness (CMT) and best corrected visual acuity at 6 months. Forty-one patients (mean age 66.4 years, 73.2% male) were recruited. Visual acuity and CMT were similar between groups at baseline (P > 0.2).After six months, both groups gained vision (mean +21.4 letters in TA group P < 0.0001, +12.5 letters in BVB, P = 0.002), with no significant difference between groups (P = 0.085). In addition, 60.9% of eyes receiving TA achieved a VA of ≥6/12 compared to 73.3% in the BVB group (P = 0.501). However, only TA was associated with a sustained reduction in CMT (-43.8-µm reduction TA vs. +37.3-µm increase BVB, P = 0.006 over 6 months). Following surgery, additional injections were required in 70.6% of participants in the BVB group, compared to 16.7% in the TA group (P < 0.0001). Three patients in the TA group experienced a rise of IOP over 21 mmHg (12.5%) during the 6-month follow-up BVB had no cases (P = 0.130). There were no cases of endophthalmitis in either group. When administered at the time of cataract surgery in patients with DME, at 6 months both TA and BVB improve visual acuity however, only TA results in a sustained reduction in CMT. Further follow-up will determine whether this translates into better long-term visual outcomes in the TA group.
Publisher: American Diabetes Association
Date: 15-06-2012
DOI: 10.2337/DB11-1272
Abstract: Serum apolipoprotein (apo)AI and -B have been shown to be associated with diabetic retinopathy, but the underlying mechanisms are unclear. We investigated whether apoAI and apoB levels are associated with measures of systemic and retinal microvascular function in patients with diabetes. We recruited 224 diabetic patients (85 type 1 and 139 type 2) and assessed serum lipids and lipoproteins from fasting blood, skin responses to sodium nitroprusside (endothelium independent) and acetylcholine (ACh) (endothelium dependent) iontophoresis, flicker-light–induced retinal vasodilatation, and retinal vascular tortuosity. After adjustment for age and sex, every SD increase in apoAI level was associated with ACh-induced skin perfusion (mean change 1.27% P & 0.001 for apoAI) and flicker-light retinal arteriolar vasodilatation (0.33% P = 0.003) and was associated inversely with arteriolar tortuosity (−2.83 × 10−5 P = 0.044). Each SD increase in apoB was associated with arteriolar tortuosity only (1.75 × 10−5 P = 0.050). These associations, except for apoB, remained in multivariate models. Serum apoAI was associated with increased vasomotor responsiveness to ACh and flickering light and inversely related to retinal vessel tortuosity—a characteristic that has both structural and functional dimensions. These findings provide additional insights into the potential mechanisms of apos in the pathogenesis of diabetic retinopathy and other diabetic microvascular complications.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 12-2009
DOI: 10.1167/IOVS.09-3442
Abstract: Subtle changes in retinal vascular caliber have been shown to predict diabetic retinopathy and other diabetic complications. This study was undertaken to investigate whether retinal vascular caliber correlates with light-flicker-induced retinal vasodilation, a measure of endothelial function. The participants were 224 persons with diabetes (85 type 1 and 139 type 2) and 103 persons without diabetes (controls). Flicker-induced retinal vasodilation (percentage increase over baseline diameter) was measured with a vessel analyzer. Retinal vascular caliber was measured from digital retinal photographs according to a standardized, validated protocol. Data from both right and left eyes were used and modeled with generalized estimating equations to account for correlation between eyes. In persons with diabetes, after adjustment for age and sex, reduced flicker-induced vasodilation was associated with wider retinal vascular caliber. Eyes with the lowest tertiles of flicker-induced arteriolar dilation had wider arteriolar caliber (5.40 mum 95% confidence interval [CI], 1.76-9.05) and eyes with the lowest tertiles of flicker-induced venular dilation had corresponding wider venular caliber (12.4 mum 95% CI, 6.48-18.2), respectively, than eyes with the highest tertile of vasodilation. These associations persisted after further adjusting for diabetes duration, systolic blood pressure, fasting glucose, lipids, body mass index, current smoking, and presence of diabetic retinopathy. No associations were evident in persons without diabetes. Changes in retinal vascular caliber (wider arterioles and venules) are associated with impaired flicker-induced vasodilation in persons with diabetes. Determining whether endothelial dysfunction explains the link between retinal vascular caliber and risks of diabetic microvascular complications calls for further study.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 05-12-2018
Abstract: To determine the relevance of epiretinal membranes (ERMs) in primary open-angle glaucoma (POAG) and potential risk for glaucoma severity. Sixty eyes of 30 patients with POAG who had a unilateral ERM were analyzed 60 nonglaucomatous eyes of 30 patients with a unilateral ERM also were recruited in this institutional cross-sectional study. Patients underwent swept-source (SS) optical coherence tomography (OCT) imaging and visual field testing. Intrain idual differences in the SS-OCT retinal nerve fiber layer (RNFL) disc cupping area measurements and visual field outcomes were analyzed in the two groups. In patients with POAG, the mean circumpapillary RNFL thickness in the eyes with an ERM was 75.6 ± 16.5 μm superiorly and 71.8 ± 26.0 inferiorly compared with the fellow eyes without an ERM (87.2 ± 23.6 μm, P = 0.0061 and 81.3 ± 27.7 μm, P = 0.034, respectively). The areas of disc cupping and cup-to-disc ratio seen on OCT horizontal and vertical B-scans were larger in eyes with an ERM than in the fellow eyes without ERM (P = 0.0004 and P = 0.0011, respectively). The average mean deviations were -11.6 ± 7.5 dB in the ERM group and -8.19 ± 6.4 dB in the group with no ERM (P = 0.029). Eyes with an ERM received more antiglaucoma eye drops (P = 0.018). Those differences were not seen between eyes with an ERM or fellow eyes in patients without glaucoma. The presence of an ERM can be a potential risk factor for unilateral severity in eyes with POAG.
Publisher: Wiley
Date: 05-05-2008
Publisher: IEEE
Date: 02-2013
Publisher: Springer Science and Business Media LLC
Date: 28-01-2011
DOI: 10.1007/S00417-011-1620-1
Abstract: To investigate the subfoveal choroidal thickness in eyes with typical age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV), using enhanced depth imaging optical coherence tomography. Retrospective observational case series of 44 eyes of 44 patients (12 females and 32 males) with typical AMD or PCV located in the subfoveal region. Cross-sectional images of the choroid of each of the involved eyes were obtained by a spectral-domain OCT. The choroidal thickness under the fovea was retrospectively studied. Of the 44 eyes involved in this study, 21 eyes were diagnosed as typical AMD and the other 23 eyes were diagnosed as PCV. The difference in subfoveal choroidal thickness between the eyes with typical AMD (245 μm) and those with PCV (293 μm) was statistically significant, even after adjusting for age, spherical equivalent, and gender distribution (P = 0.045). When compared to eyes with subfoveal choroidal thickness less than 300 μm, those with subfoveal choroidal thickness of 300 μm or more were 5.6 times more likely to have PCV (adjusted odds ratio 5.60, 95% confidence interval 1.30-24.0, P = 0.021). The choroid under the fovea was thicker in eyes with PCV than those with typical AMD. This result suggests that the choroidal vascular lesion seen in PCV may not be just the choroidal neovascularization accompanied by saccular capillary dilations at the border, but may have a significant structural difference in the choroid compared to typical AMD.
Publisher: IEEE
Date: 07-2017
Publisher: BMJ
Date: 08-2018
DOI: 10.1136/BJOPHTHALMOL-2018-312195
Abstract: With the perspective to provide in idualised panretinal laser photocoagulation (PRP) for proliferative diabetic retinopathy (PDR), we evaluated if retinal peripheral capillary non-perfusion (PCNP) and oximetry, as non-invasive markers of retinal metabolism and function, could predict disease activity 6 months after PRP. We performed a prospective, interventional study of patients with treatment-naïve PDR. Retinal oximetry and ultra-widefield fluorescein angiography were performed at baseline (BL) and three (3M) and 6 months (6M) after PRP by a navigated laser system. At 6M follow-up, patients were ided according to disease activity: active or inactive. We included 33 eyes, and 69.6% were men. At BL, the median age and duration of diabetes (with IQRs) were 51.6±23.4 and 20.0±15.0 years. Haemoglobin A 1c was 63.0±17.0 mmol/mol and blood pressure was 152±37/82±24 mm Hg. At BL and M6, patients with postoperative disease activity (30.3.%, n=10) had a larger area with PCNP than those with inactive PDR (BL: 51%–75% vs 26%–50%, p=0.03 6M: 51%–75% vs 26%–50%, p=0.03). The area of PCNP did not change from BL to 6M in either group (inactive PDR: p=0.38, active PDR: p=0.87). Changes in retinal oxygen saturation were not found to be clinical relevant. We found the area of PCNP at all timepoints to be statistically larger in patients with active PDR 6 months after PRP treatment. Therefore, the area of PCNP, at baseline, may serve as a potential predictive marker for PDR activity after treatment.
Publisher: Informa UK Limited
Date: 29-12-2016
DOI: 10.1080/09286586.2016.1255763
Abstract: There are no available data about diabetic retinopathy (DR) in the Indonesian population. This report summarizes the rationale and study design of the Jogjakarta Eye Diabetic Study in the Community (JOGED.COM), a community-based study to estimate the prevalence and risk factors of DR in persons with type 2 diabetes in Jogjakarta, Indonesia. The JOGED.COM aimed to examine a cross-sectional s le of 1200 persons with type 2 diabetes aged 30 years and older residing in the study area. We identified 121 community health centers (CHCs) in Jogjakarta and listed 35 CHCs with non-communicable diseases facilities. Multi-stage, clustered random s ling was used to select 22 CHCs randomly. We included CHCs with coverage population >30,000, and excluded those classified as 100% rural. Lists of persons with diabetes confirmed by their family physician were provided from each CHC. Examinations procedures included detailed interviews, general and eye examinations, anthropometry and body composition scan, and dilated fundus photography. We collaborated with local health authorities, family physicians, and local health practitioners in the recruitment phase. A total of 1435 invitations were distributed, and 1184 people (82.5%) with type 2 diabetes participated in this study, of whom 1138 (79.3%) had completed data with gradable retinal images. JOGED.COM is the first epidemiologic study of DR in an Indonesian population. This study will provide key information about the prevalence and risk factors of DR in the community. These data are very important for future health promotion programs to reduce the burden of DR in the population.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2019
Publisher: BMJ
Date: 09-12-2017
DOI: 10.1136/BJOPHTHALMOL-2016-309504
Abstract: It has been suggested that local and systemic oxidative stress levels are causal risk factors for glaucoma. To evaluate the effect of age on the role of systemic oxidative stress in open-angle glaucoma (OAG). This study included 502 eyes of 251 Japanese patients with OAG. Systemic oxidative stress was assessed with skin autofluorescence (SAF), an indicator of advanced glycogen end products. We selected the youngest and oldest patients by quartile (≤58 and ≥74 years old, respectively) and determined the univariate correlation between SAF and mean deviation (MD) of the visual field in both eyes of each group. We also investigated the association between SAF and glaucoma in the youngest group with a logistic regression analysis. The younger subjects with OAG with high SAF had significantly lower better-eye MD than the younger subjects with normal SAF (p<0.01), but the older subjects had similar better-eye MD regardless of SAF level. Furthermore, SAF was negatively correlated with MD in the youngest subjects (better eye: r=-0.35, p<0.01, worse eye: r=-0.28, p=0.02), but not in the older subjects. Finally, mixed-effects regression analysis showed that SAF contributed to the MD in the younger patients with OAG (p=0.01). We found that the relationship between systemic oxidative stress and visual field loss was strongest in relatively young patients with OAG, suggesting that the potential benefit of antioxidant therapies to combat systemic oxidative stress might be dependent on the age of the patient.
Publisher: Informa UK Limited
Date: 13-09-2020
Publisher: Springer Science and Business Media LLC
Date: 05-06-2010
DOI: 10.1007/S00125-010-1811-Z
Abstract: The fractal dimension (D(f)) of the retinal vasculature is a global measure of its branching pattern complexity. We examined the relationship of retinal D(f) with diabetes. We conducted a cross-sectional study of 1,577 participants with diabetes and impaired glucose metabolism and normal controls from the population-based Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Retinal D(f) was quantified from fundus photographs using a computer-based programme and diabetes status was determined by oral glucose tolerance test based on the WHO criteria. After adjustment for age, sex and vascular risk factors, persons with higher retinal D(f) were more likely to have diabetes (OR 1.56 95% CI 1.14-2.14, highest vs lowest fractal tertile). This relationship remained with further adjustment for retinal arteriolar calibre and presence of retinopathy (OR 1.64 95% CI 1.19-2.27), and after excluding participants with retinopathy (OR 1.60 95% CI 1.16-2.21). Retinal D (f) was not related to impaired glucose tolerance or impaired fasting glucose (OR 1.19 95% CI 0.85-1.67). In iduals with diabetes, but not with impaired glucose metabolism, have greater retinal D(f), reflecting greater complexity of the retinal vasculature. Our findings suggest the presence of early microvascular changes in the retinal vasculature of persons with diabetes, even in the absence of overt retinopathy.
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.NEUROBIOLAGING.2010.04.010
Abstract: Previous work suggests a general reduction in complexity with aging, referred to as the aging-complexity theory. Fractal dimension (FD) of the vessels in the retina is a global measure of the complexity of the vasculature. However, earlier works did not find any correlation between aging and FD of the retinal vasculature, in contrast to the findings of reduced complexity in other parts of the body. The authors tested the hypothesis that reduced complexity develops with advancing age in the structure of the retinal vasculature. To overcome the limitations of earlier works, a three-dimensional representation of the vasculature, together with Fourier fractal dimension (FFD) techniques, was used. Based on the analysis of 748 retinal images taken of persons aged 49-89 years, we observed a significant decrease in the FFD with aging (p < 0.0001). These data provide evidence supporting rarefaction (i.e. reduction) of the retinal vasculature with aging, consistent with observations from other human organ systems.
Publisher: Springer International Publishing
Date: 29-12-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2012
DOI: 10.1161/STROKEAHA.112.673335
Abstract: Small-vessel disease contributes to the pathophysiology of stroke, and retinal microvascular signs have been linked to the risk of stroke. We examined the relationship of retinal signs with incident stroke in a multiethnic cohort. The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study that enrolled participants without clinical cardiovascular diseases from 6 US communities between 2000 and 2002. Of the participants, 4849 (71.2%) had fundus photography performed in 2002 to 2004. Retinopathy and retinal vessel caliber were assessed from retinal images. Stroke risk factors including high-sensitivity C-reactive protein, carotid artery intima-media thickness, and coronary artery calcium were measured using standardized protocols. Incident stroke was confirmed from medical record review and death certificates. After 6 years of follow-up, there were 62 incident strokes. Narrower retinal arteriolar caliber was associated with increased risk of stroke after adjusting for conventional cardiovascular risk factors (adjusted incidence rate ratio, 2.83 95% CI, 1.34—5.95 P =0.006 adjusted hazard ratio, 3.01 95% CI, 1.29–6.99 P =0.011). Retinopathy in persons without diabetes was associated with increased risk of stroke (adjusted adjusted incidence rate ratio, 2.96 95% CI, 1.50–5.84 P =0.002 adjusted hazard ratio, 3.07 95% CI, 1.17–8.09 P =0.023). These associations remained significant after adjusting for high-sensitivity C-reactive protein, carotid intima-media thickness, or coronary artery calcium. Narrower retinal arteriolar caliber and retinopathy in nondiabetic persons were associated with increased risk of stroke in this relatively healthy multiethnic cohort independent of traditional risk factors and measures of atherosclerosis. The association between narrower retinal arteriolar caliber and stroke warrants further investigation.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 23-11-2015
Abstract: To assess the associations between dietary intake of polyunsaturated fatty acids (PUFAs) and diabetic retinopathy (DR). This was a cross-sectional study of 379 patients (median age: 66.0 years) with diabetes attending a diabetes eye clinic. Daily fatty acid intake was assessed by using a validated Food Frequency Questionnaire and adjusted for energy intake. Diabetic retinopathy was graded from fundus photographs as no DR, nonproliferative DR, or proliferative DR. Patients were categorized as "well-controlled diabetes" (n = 123) and "poorly controlled diabetes" (n = 256), defined as glycated hemoglobin (HbA1c) level < 7.0% or ≥ 7.0%, respectively. There were no associations between any fatty acid intake and DR. However, among patients with well-controlled diabetes, increasing daily intake of PUFAs was associated with a reduced likelihood of the presence (odds ratio [OR]: 0.18 95% confidence interval [CI]: 0.06-0.59) and severity of DR after adjusting for age, sex, HbA1c, mean arterial blood pressure, and duration of diabetes. Moreover, an increased saturated fatty acid (SFA) intake was associated with increased likelihood of the presence (OR: 2.37 95% CI: 1.15-4.88) and severity of DR. No association was found among those with poorly controlled diabetes. Increasing PUFA intake was associated with a reduced likelihood of the presence and severity of DR in well-controlled diabetes, whereas increasing SFA intake was associated with an increased likelihood of the presence and severity of DR. Further studies to confirm this observation are warranted to elucidate the underlying mechanisms and potential role of dietary PUFA and SFA intake in the management of DR.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 12-2010
DOI: 10.1167/IOVS.10-5229
Abstract: To describe the association between refractive errors, ocular biometry, and age-related macular degeneration (AMD) in an Asian Malay population in Singapore. A population-based study of 3280 Malay in iduals aged 40 to 80 years was conducted in Singapore. Early- and late-AMD signs were graded from retinal photographs according to the Wisconsin grading system. Autorefraction, followed by subjective refraction, was performed to obtain spherical equivalent refraction (SER) in diopters, with emmetropia defined as SER -0.5 to +0.5 D, hyperopia as > +0.5 D, and myopia as < -0.5 D. Partial coherence laser interferometry was used to measure axial length, anterior chamber depth, and corneal curvature. The association between refractive status, ocular biometry and the prevalence of both early and late AMD were analyzed. Hyperopic refractive error (odds ratio [OR] 1.54 95% confidence interval [CI] 1.00-2.36 compared with myopia, P = 0.05), shorter axial length (OR, 1.91 CI, 1.05-3.46, comparing 1st vs. 4th quartiles P = 0.03), and steeper corneal curvature (OR, 1.93 CI, 1.16-3.20, comparing 1st vs. 4th quartiles, P = 0.01) were significantly associated with early AMD, after adjustment for age, sex, smoking, education, height, and systolic blood pressure. Each diopter increase in hyperopic refraction and each millimeter decrease in axial length was associated with an 8% (OR, 1.08 CI, 1.01-1.16 P = 0.03) and 29% (OR, 1.29 CI, 1.06-1.57 P = 0.01) increased risk of early AMD, respectively. No significant association was noted of refractive error and ocular biometry with late AMD. Hyperopic refractive error and shorter axial length are associated with early AMD in Asian eyes.
Publisher: Public Library of Science (PLoS)
Date: 03-04-2018
Publisher: BMJ
Date: 03-04-2021
DOI: 10.1136/BJOPHTHALMOL-2020-315945
Abstract: To determine the preoperative ocular factors and surgical methods that led to best-corrected visual acuity (BCVA) after pars plana vitrectomy (PPV) or scleral buckling (SB) for rhegmatogenous retinal detachment (RRD). This was a prospective, nationwide, multicentre, observational study. Data from the Japanese Retina and Vitreous Society registry from 2016 to 2017 were used to determine the association between preoperative clinical factors, surgical procedures and postoperative BCVA at 6 months. Japanese in iduals years of age were included. Eyes with proliferative vitreoretinopathy were included. The primary outcome was the percentage of eyes that achieved 20/25 vision. Of the 3219 registered cases, 2192 met the inclusion criteria (344 SB, 1738 PPV, 110 PPV+SB). Cases with preoperative BCVA (≤0 logarithm of the minimum angle of resolution (logMAR) units) had good postoperative BCVA (OR=3.97, CI 2.87 to 5.51). Older age ( years), low intraocular pressure ( mm Hg), high myopia ( −5 dioptres), multiple retinal breaks ( ), giant retinal tear ( °), wide retinal detachment ( quadrants) and macula-off detachment were associated with less probability of postoperative 20/25 vision (OR=0.39, 0.64, 0.62, 0.60, 0.12, 0.51 and 0.36, respectively). Postoperative BCVA was 0.03±0.23 and 0.10±0.32 logMAR units after SB and PPV, respectively. The percentage of cases that achieved 20/25 vision was not significantly different after PPV or SB if cases that had concurrent cataract surgery were excluded (p=0.251). Better BCVA in patients with RRD who had undergone PPV was observed. However, if concurrent cataract surgery is not performed, BCVA will be comparable with either PPV or SB.
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.ATHEROSCLEROSIS.2013.12.044
Abstract: Retinal microvascular signs are markers of cardiovascular disease risk. There are limited data, on relationships between retinal microvascular signs and retinal microvascular endothelial function. We sought to determine the relationship of retinal vascular signs with retinal microvascular endothelial function in patients with or at high risk of coronary artery disease. Participants with atherosclerosis risk factors and coronary disease (n=258 mean age 57±11 years) were recruited to have static and dynamic retinal vascular assessment. Retinal arteriolar dilatation in response to flicker light (FI-RAD) was measured using the Digital Vessel Analyser and expressed as percentage increase over baseline diameter. Static retinal photographs were acquired utilising a digital fundus camera for measurement of central retinal artery and vein equivalent (CRAE and CRVE), arteriovenous nicking (AVN) and focal arteriolar narrowing (FAN). Intra-class correlation coefficient was 0.82 for flicker-light induced retinal arteriolar dilatation. There were modest associations in retinal vascular measurements between eyes. For each 10 μm decrease in retinal arteriolar diameter, the absolute increase in FI-RAD was 0.28% (95% CI 0.11, 0.45 p=0.002) independent of age, gender and atherosclerosis risk factors. AVN and FAN were associated with attenuated FI-RAD (β=-0.67% 95% CI -1.20, -0.15 p=0.012) and (β=-0.83% 95% CI -1.44, -0.23 p=0.007) respectively after adjustment for age and gender. Assessment of retinal microvascular endothelial function is reproducible and correlated with retinal microvascular structure and signs, independent of atherosclerosis risk factors. Assessment of retinal vascular structure and function may provide insights into atherosclerotic disease.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.IJCARD.2017.11.019
Abstract: Anemia has been shown to worsen cardiovascular diseases. However, it is unclear whether there is a gender difference in the impact of anemia on subclinical myocardial damage and cardiovascular mortality in the general population. A prospective cohort study was conducted in a community based on annual health checks. Serum heart-type fatty acid binding protein (H-FABP) levels, which is a marker for myocardial damage, and blood counts were measured at baseline in subjects without previous cardiovascular diseases (n=3111). There were 343 subjects (11.0%) with anemia at baseline. H-FABP levels were inversely correlated with hemoglobin concentrations in male subjects, whereas there was no such correlation in female subjects, irrespective of the status of menopause. Prevalence of myocardial damage (H-FABP ≥4.3ng/ml) was significantly higher in male subjects with anemia than those without, irrespective of the type of anemia (microcytic, normocytic, and macrocytic). Multivariate logistic regression analysis revealed that anemia was an independent predictor of myocardial damage after adjusting for confounders. During 10years of follow-up, there were 204 all-cause deaths including 57 cardiovascular deaths. Kaplan-Meier analysis demonstrated that cardiovascular mortality was higher in male subjects with anemia than in those without. However, anemia was not associated with cardiovascular mortality in female subjects. Multivariate Cox proportional hazard analysis revealed that anemia was an independent predictor of all-cause and cardiovascular mortalities after adjusting for confounders. Anemia was an independent predictor of all-cause and cardiovascular mortalities, and subclinical myocardial damage in male subjects, but not in female subjects.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2014
Publisher: IEEE
Date: 2012
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.DIABRES.2018.08.012
Abstract: Diabetic retinopathy (DR) screening is one of the keys in successful diabetes care, but the participation in DR screening is sub-optimal. This study aims to assess the factors associated with participation in a DR screening program in a rural district of Bangladesh. 213 persons with diabetes identified in a population-based assessment of over 3000 persons ≥ 40 years were offered free of cost screening for DR. Awareness, attitudes and practice about diabetes and common eye diseases along with socio-demographic factors were assessed. 68 (32%) patients participated in the screening program. After multivariate adjustment, awareness related to diabetes causes eye disease (odds ratio (OR) 8.47, 95% confidence interval (CI) 3.95-18.18), awareness of DR (OR 5.15, 95% CI 1.89-14.01) and awareness of the possibility to prevent DR-related vision loss (OR 3.15, 95% CI 1.53-6.51) were associated with higher proportion of participation. Lack of confidence upon skills of ophthalmic assistants and fear of complications were barriers but socio-economic condition was not a barrier in attending the screening program. The major factor associated with participation in DR screening is diabetes-related health literacy in rural Bangladesh. Public health promotion program should be designed to provide health education to increase participation in the screening program.
Publisher: Informa UK Limited
Date: 14-09-2012
DOI: 10.3109/09286586.2012.702258
Abstract: To assess the correlation and reproducibility of retinal vascular geometric measurements obtained from two stereo-paired fundus images. Thirty stereoscopic pairs of color optic disc-centered photographs from the Blue Mountains Eye Study were analyzed. Side-by-side grading was performed by a single grader, using semi-automated computer software to quantify the following retinal geometric parameters: (1) retinal arteriolar/venular caliber (CRAE/CRVE) (2) arteriole-to-venule ratio (AVR) (3) branching angle and (4) tortuosity. We used Pearson correlation (r), intra-class correlation coefficient (ICC), and Bland-Altman plots to assess within-pair correlation and reproducibility for each parameter measured. Inter- and intra-grader r and ICC were high (all r > 0.90 and ICC > 0.90), except for branching angle (ICCs between 0.69-0.83). There was no significant difference between within-pair means of all retinal vascular geometric parameters, before and after excluding poor quality images. CRAE, CRVE, AVR, and arteriolar and venular tortuosity showed very high within-pair correlation and agreement (all r > 0.80 and all ICC > 0.90 respectively). Arteriolar and venular branching angles demonstrated moderate within-pair correlation (r = 0.65 and r = 0.62, respectively) and within-pair agreement (ICC = 0.76 and ICC = 0.77, respectively). Use of computer-assisted software to measure retinal vascular geometric parameters from paired fundus images was highly repeatable and is robust to differences in photographic angles of paired stereo images. Such measurements can be applied to evaluate temporal changes in longitudinal studies.
Publisher: Elsevier BV
Date: 2003
DOI: 10.1016/S0002-9394(02)01819-6
Abstract: To determine the early postoperative changes in retinal thickness and complications after pars plana vitrectomy for diabetic macular edema. Consecutive interventional case series. Studied retrospectively, pars plana vitrectomy was performed on 65 consecutive eyes of 63 patients with diabetic macular edema. The follow-up interval ranged from 6 to 36 months (12.6 +/- 7.4 months [mean +/- standard deviation (SD)]). The indications of pars plana vitrectomy in this study were (1) diffuse diabetic macular edema, (2) preoperative visual acuity less than 20/40, and (3) noneffective macular photocoagulation therapy. Preoperative and postoperative examinations by stereoscopic biomicroscopy, color fundus photography of the macula and optical coherence tomography (OCT) were performed on all eyes. Preoperatively, direct photocoagulation to microaneurysms in the macula had been performed in 48 eyes, and focal/grid photocoagulation had been performed in five eyes. Preoperative examination showed that epiretinal membranes were observed in 20 eyes, cystoid macular edema in 40 eyes, and 23 eyes had a complete posterior vitreous detachment (PVD). Epimacular membranes, removed during surgery, were examined histopathologically. The postoperative mean best-corrected visual acuity (logarithm of the minimum angle of resolution [logMAR] = 0.696 +/- 0.491 [mean +/- SD]) was significantly better than the preoperative mean best-corrected visual acuity (0.827 +/- 0.361 P <.0001 Wilcoxon signed-rank test). The final visual acuity improved by 2 or more lines in 32 of 65 eyes (45%), remained unchanged in 32 of 65 eyes (49%), and exacerbated after the surgery in 4 of 65 eyes (6%) due to neovascular glaucoma (2 eyes) and residual cystoid macular edema (2 eyes). The postoperative foveal retinal thickness (224.9 +/- 116.9 microm) at the last visit was significantly thinner than the preoperative foveal retinal thickness (463.7 +/- 177.3 microm P <.0001 Wilcoxon signed-rank test). The foveal retinal thickness did not decrease linearly but fluctuated: The mean postoperative retinal thickness had decreased significantly 7 days after surgery, then remained unchanged for approximately 1 month, and thereafter gradually decreased until 4 months. The intraoperative and postoperative complications included peripheral retinal tear in 3 of 65 (4.6%) eyes, postoperative rhegmatogenous retinal detachment in 1 of 65 (1.5%) eyes, neovascular glaucoma in 3 of 65 (5%) eyes, recurrent vitreous hemorrhage in 1 of 65 (1.5%) eyes, hard exudates in the center of the macula in 3 of 56 (4.6%) eyes, postoperative epiretinal membrane formation in 9 of 65 (13.8%) eyes, and a lamellar macular hole in 1 of 65 (1.5%) eyes. Vitrectomy for diabetic macular edema is an effective procedure for reducing the edema and improving visual acuity. Because the postoperative reduction in retinal thickness is not complete until 4 months, the assessment of vitrectomy on foveal thickness should not be made until this time. In addition, there are severe complications from vitrectomy for diabetic macular edema, and careful preoperative and postoperative examinations and surgical methods are required.
Publisher: Springer Science and Business Media LLC
Date: 09-2009
DOI: 10.1007/S10384-009-0703-6
Abstract: To evaluate the benefit of the combination of a single sub-Tenon injection of triamcinolone acetonide (STTA) with photodynamic therapy (PDT) for the treatment of age-related macular degeneration (AMD) in Japanese patients. The medical records of 111 eyes of 111 patients were reviewed retrospectively. Forty-five eyes underwent combined treatment with STTA and PDT, and 66 eyes underwent PDT alone. Time to vision loss, defined as a change of 0.3 or more logarithm of minimum angle of resolution (logMAR) units, and time to retreatment were evaluated using the Kaplan-Meier survival analyses. Cox regression models were used to estimate the hazard ratios for those end points to investigate clinical risk characteristics. Patients who underwent combined STTA with PDT had a significantly lower risk of retreatment than did those who underwent PDT alone (hazard ratio, 0.59 95% confidence interval, 0.36-0.99). This beneficial association was found only in patients without polypoidal choroidal vasculopathy (PCV) lesions. However, combined treatment with STTA and PDT had no beneficial effect in reducing visual loss when compared with treatment with PDT alone. Combined treatment with STTA and PDT had a beneficial effect in reducing retreatment of AMD in Japanese patients. Those who had PCV lesions did not benefit from this additional treatment.
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.OPHTHA.2009.10.007
Abstract: To determine the prevalence of age-related macular degeneration (AMD) in Asian populations and to compare this with prevalence in white populations. A clear understanding of AMD prevalence in Asians is essential to meet future demands for eye health care. We searched published literature reporting AMD prevalence in Asian populations. We limited studies examined to those using standardized grading systems (either the Wisconsin Age-Related Maculopathy Grading System or the international classification proposed by the International ARM Epidemiological Study Group). We used metaanalytical methods to calculate age-specific pooled prevalence of AMD using inverse-variance weighting in a random effect model. We also calculated pooled estimates of age-standardized prevalence. A metaregression model was used to examine gender differences and differences between Asian and white populations. We identified 9 studies reporting AMD prevalence from 4 Asian populations. Pooled prevalence estimates of early and late AMD in Asian populations aged 40 to 79 years were 6.8% (95% confidence interval [CI], 4.6%-8.9%) and 0.56% (95% CI, 0.30%-0.81%), respectively corresponding prevalence estimates in white populations were 8.8% (95% CI, 3.8%-13.8%) and 0.59% (95% CI, 0.35%-0.84%), respectively. Reliable prevalence estimates of AMD in Asian persons aged > or =80 years were not available owing to small subject numbers in this age category. Among persons aged 40 to 79 years, the age-specific prevalence of late AMD in Asians was comparable with that reported from white populations, but early AMD signs were less common among Asians. Further studies in Asian populations are warranted to investigate whether certain specific AMD phenotypes or subtypes, such as polypoidal choroidal vasculopathy, are more common.
Publisher: American Diabetes Association
Date: 10-02-2012
DOI: 10.2337/DC11-1909
Abstract: To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes. A pooled analysis using in idual participant data from population-based studies around the world was performed. A systematic literature review was conducted to identify all population-based studies in general populations or in iduals with diabetes who had ascertained DR from retinal photographs. Studies provided data for DR end points, including any DR, proliferative DR, diabetic macular edema, and VTDR, and also major systemic risk factors. Pooled prevalence estimates were directly age-standardized to the 2010 World Diabetes Population aged 20–79 years. A total of 35 studies (1980–2008) provided data from 22,896 in iduals with diabetes. The overall prevalence was 34.6% (95% CI 34.5–34.8) for any DR, 6.96% (6.87–7.04) for proliferative DR, 6.81% (6.74–6.89) for diabetic macular edema, and 10.2% (10.1–10.3) for VTDR. All DR prevalence end points increased with diabetes duration, hemoglobin A1c, and blood pressure levels and were higher in people with type 1 compared with type 2 diabetes. There are approximately 93 million people with DR, 17 million with proliferative DR, 21 million with diabetic macular edema, and 28 million with VTDR worldwide. Longer diabetes duration and poorer glycemic and blood pressure control are strongly associated with DR. These data highlight the substantial worldwide public health burden of DR and the importance of modifiable risk factors in its occurrence. This study is limited by data pooled from studies at different time points, with different methodologies and population characteristics.
Publisher: Wiley
Date: 23-12-2020
DOI: 10.1111/AOS.14727
Abstract: The purpose of this study was to evaluate the association between retinal laser burden and vascular oxygen saturation in patients with proliferative diabetic retinopathy (PDR) treated with different extent of retinal laser. The study was a prospective, interventional study of patients with treatment‐naïve PDR. Patients were treated with navigated retinal laser (Navilas ® , OD‐OS GmbH, Teltow, Germany) in different doses. Retinal oximetry was obtained at baseline (BL) prior to laser and after 6 months (M6). Patients were ided into three groups according to total laser spots applied: spots (Group 1), 1500–2000 spots (Group 2), and spots (Group 3). We included 33 eyes of 28 patients with treatment‐naïve PDR. The groups did not differ according in BL characteristics. Between BL and M6, retinal arteriolar oxygen saturation did not change but retinal venular oxygen saturation (median with interquartile range) decreased in Groups 1 and 2 (1: 65.5 ± 8.8% versus 60.5 ± 9.5%, p = 0.04 2: 65.3 ± 7.3% versus 63.0 ± 13.5%, p = 0.04). Focal retinal venular oxygen saturation, located to quadrants with retinal neovascularization, decreased in Group 2 from BL to M6 (67.5 ± 13.3% versus 61.5 ± 8.8%, p = 0.04). Retinal venular diameter decreased from BL to M6 in Group 1 (174.5 ± 15.3 μm versus 165.1 ± 28.7 μm, p = 0.01). In this study of patients with treatment‐naïve PDR, we showed that a less extensive laser treatment caused a reduction in retinal venular oxygen saturation and diameter 6 months after treatment. Our results suggest that less extensive laser treatment may be sufficient to improve the retinal metabolic environment conducive to PDR regression.
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.AMJCARD.2014.12.011
Abstract: Endothelial dysfunction is a key feature of atherosclerosis. Retinal microvascular endothelial function can be assessed using noninvasive dynamic vessel imaging techniques. Whether it is impaired in subjects with coronary artery disease (CAD) is unknown. The aim of this study was to examine the relation of retinal microvascular endothelial function with CAD. Vascular studies were performed in 197 prospectively recruited subjects ided into 2 groups: those without CAD but ≥2 cardiovascular risk factors (non-CAD controls n = 119) and those with stable CAD (n = 78). Retinal microvascular endothelial dysfunction was assessed by measuring retinal arteriolar and venular dilatation to flicker light, a nitric oxide-dependent phenomenon, expressed as percentage increase over baseline diameter. Fingertip pulse-volume litude was measured to calculate reactive hyperaemia index and brachial artery flow-mediated dilatation assessed as measures of peripheral microvascular and conduit vessel endothelial function, respectively. Mean retinal arteriolar dilatation was attenuated in patients with CAD compared with non-CAD controls (1.51 ± 1.51% vs 2.37 ± 1.95%, p = 0.001). Retinal arteriolar dilatation was independently associated with CAD after adjustment for age, gender, cardiovascular risk factors, and medication use (odds ratio 1.60, 95% confidence interval 1.14 to 2.25, p = 0.007). Reactive hyperaemia index and flow-mediated dilatation were not different. In conclusion, the capacity of retinal arterioles to dilate in response to flicker light is an independent predictor of the presence of CAD and suggests that retinal microvascular endothelial dysfunction is a marker for underlying CAD.
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1016/J.OPHTHA.2009.09.035
Abstract: To assess the influence of the spectrum of diabetic retinopathy (DR) on vision-specific function in an Asian population. Population-based cross-sectional study. Persons aged 40 to 80 years of Malay ethnicity in Singapore. The Singapore Malay Eye Study was a population-based, cross-sectional study of 3280 Asian Malays (78.7% response rate). Five end points were considered: (1) any DR, (2) macular edema (ME), (3) clinically significant macular edema (CSME), (4) vision-threatening DR (VTDR), and (5) DR severity levels ranging from none to proliferative diabetic retinopathy (PDR). Vision function was assessed using the Vision-Specific Functioning Scale validated using Rasch analysis. Vision-specific functioning score. Of 357 diabetic participants in the study, 23.2% had any DR, 5.6% had ME, 5.0% had CSME, 10.6% had VTDR, and 6.2% had PDR. In linear regression models adjusting for age, gender, stroke, diabetic risk factors, and socioeconomic factors, poorer vision-specific function was associated independently with any DR (beta, -0.21 P<0.05), ME (beta, -0.48 P<0.05), CSME (beta, -0.42 P<0.05), VTDR (beta, -0.64 P<0.05), and PDR (beta, -0.92 P<0.001). When controlling further for presenting visual acuity, VTDR (beta, -0.37 P = 0.01) and PDR (beta, -0.61 P = 0.002) were the only 2 DR categories independently associated with poorer vision-specific function and PDR. Persons with VTDR and PDR were 6 to 12 times more likely to report lower participation in daily living activities than those without these DR levels. People with VTDR and PDR have substantial difficulty undertaking vision-specific daily activities. These findings reinforce the importance of preventative efforts targeted at the earliest DR stages to prevent progression to later stages of DR. Proprietary or commercial disclosure may be found after the references.
Publisher: IEEE
Date: 2012
Publisher: Public Library of Science (PLoS)
Date: 18-10-2016
Publisher: S. Karger AG
Date: 2015
DOI: 10.1159/000368533
Abstract: b i Background/Aims: /i /b In iduals who reach end-stage kidney disease (CKD5) have a high risk of vascular events that persists even after renal transplantation. This study compared the prevalence and severity of microvascular disease in transplant recipients and patients with CKD5. b i Methods: /i /b In iduals with a renal transplant or CKD5 were recruited consecutively from renal clinics, and underwent bilateral retinal photography (Canon CR5-45, Canon). Their retinal images were deidentified and reviewed for hypertensive/microvascular signs by an ophthalmologist and a trained grader (Wong and Mitchell classification), and for vessel caliber at a grading centre using a computer-assisted method and Knudtson's modification of the Parr-Hubbard formula. b i Results: /i /b Ninety-two transplant recipients (median duration 6.4 years, range 0.8 to 28.8) and 70 subjects with CKD5 were studied. Transplant recipients were younger (p .001), with a higher eGFR (p 0.001), but were just as likely to have a moderate-severe hypertensive/microvascular retinopathy (46/92, 50%) as subjects with CKD5 (38/70, 54% OR 0.84, CI 0.45 to 1.57, p=0.64), and had similar mean arteriole and venular calibres (135.1 ± 7.5 µm and 137.9 ± 14.9 µm, p=0.12 and 199.1 ± 17.8 µm and 202.4 ± 27.8 µm, p=0.36, respectively). Arteriole and venular caliber were not different in nine patients examined before and after transplantation (p=0.62 and p=0.11, respectively). b i Conclusions: /i /b Hypertensive/microvascular disease occurred just as often and was generally as severe in transplant recipients and subjects with CKD5. Microvascular disease potentially contributes to increased cardiac events post- transplantation.
Publisher: Springer Science and Business Media LLC
Date: 15-01-2018
DOI: 10.1038/S41598-017-18487-4
Abstract: The Tsuruoka Metabolomics Cohort Study included subjects aged 35–74 years from participants in annual health check-up programs in Tsuruoka, Japan. The gender-specific associations of early age-related macular degeneration (AMD) with systemic and genetic factors was assessed cross-sectionally. Of these, 3,988 subjects had fundus photographs of sufficient quality, and early AMD was present in 12.3% and 10.3% of men and women, respectively. In men, higher levels of high-density lipoprotein cholesterol and lower levels of triglycerides were associated with increased odds of having early AMD after adjusting for potential risk factors (for each 1 mmol/L increase, odds ratio [OR]: 1.61 and 0.78, 95% confidence interval [CI]: 1.17–2.23 and 0.64–0.96, respectively). In women, higher levels of total cholesterol and low-density lipoprotein cholesterol were associated with increased risk of having early AMD (OR: 1.21 and 1.26, 95% CI: 1.01–1.44 and 1.03–1.53, respectively). Sub-analysis demonstrated that women with ARMS2 A69S polymorphisms had a stronger risk for early AMD (OR: 3.25, 95% CI: 2.10–5.04) than men (OR: 1.65, 95% CI: 1.02–2.69). Differential associations of early AMD with both systemic and genetic factors by sex were demonstrated in a Japanese cohort, which suggests that disease process of early AMD could be different by sex.
Publisher: S. Karger AG
Date: 2012
DOI: 10.1159/000341732
Abstract: b i Background/Aims: /i /b The effects of haemodialysis on the microcirculation are poorly understood. This study examined the changes in small vessel calibre. b i Methods: /i /b 24 patients (including 12 males, median age 62.5 years, range 30–87) underwent digital retinal photography immediately before and after routine haemodialysis. Arteriolar and venular calibres were measured from the images by a trained grader using a highly reproducible, computer-assisted method. b i Results: /i /b Patients had an average 2.0 ± 0.3 litres of fluid removed with dialysis, and their mean arterial blood pressure fell by 6.8 mm Hg (CI 13.8–0.2, p = 0.06). Retinal arteriole calibre did not change (mean difference 2.3 µm, CI –1.1 to 5.7, p = 0.17) but the venules dilated (mean difference 12.7 µm, CI 7.3–18.3, p 0.001). Calibre returned to baseline by 2 h. Venules dilated less in diabetics than non-diabetics (mean difference –6.2 µm, CI –9.6 to –2.9, p 0.01). Retinal venular dilatation correlated positively with the volume of fluid removed per kilogramme body weight (5.9, CI 0.2–11.5, p = 0.04), and negatively with the fall in mean arterial pressure (–0.36, CI –0.72 to –0.01, p 0.05) after adjusting for age, gender, diabetes and dyslipidaemia. b i Conclusion: /i /b Haemodialysis is associated with systemic venular dilatation.
Publisher: Wiley
Date: 02-10-2015
DOI: 10.1111/CEO.12405
Publisher: Wiley
Date: 2012
DOI: 10.1111/J.1442-9071.2011.02599.X
Abstract: People with vision-threatening diabetic retinopathy are likely to experience enhanced social and emotional strain. Critically, those with both vision-threatening diabetic retinopathy and psychosocial problems may have significantly reduced levels of functioning compared with psychologically healthy counterparts. This can cause inadequate compliance, increased strain on family functioning, worse diabetes control, increased progression of diabetic retinopathy and, consequently, further psychosocial stress resulting in a number of concerning implications for disease management, clinical outcomes and healthcare costs. However, the emotional and social health consequences of diabetic retinopathy have not yet been systematically explored. This information is crucial as it allows for a targeted approach to treatment and prevention and avoidance of the potentially detrimental implications described above. Therefore, this paper reviews the current qualitative and quantitative evidence regarding the social and emotional impact of diabetic retinopathy and identifies directions for future research. Key search terms were applied to the electronic databases Pubmed, ISI Web of Science and Embase and the bibliographies of relevant papers were systematically reviewed for additional references. Overall, the evidence suggests that diabetic retinopathy and associated vision loss have several debilitating effects, including disruption of family functioning, relationships and roles increased social isolation and dependence and deterioration of work prospects resulting in increased financial strain. Adverse emotional responses include fear, anxiety, vulnerability, guilt, loss of confidence, anger, stress and self-perception issues. However, the research to date is largely qualitative in nature, with most quantitative studies being small, cross-sectional and somewhat outdated. Similarly, the outcome measures used in many studies to date are suboptimal in terms of content and validity. Therefore, this review identifies the need for improved outcome measures to provide valid, meaningful measurement of the social and emotional impact of diabetic retinopathy and discusses potential directions for future research such as item banking and computer adaptive testing.
Publisher: Springer Science and Business Media LLC
Date: 10-12-2015
DOI: 10.1038/JHG.2015.148
Abstract: Obesity is associated with environmental factors however, information about gene-environment interactions is lacking. We aimed to elucidate the effects of gene-environment interactions on obesity, specifically between genetic predisposition and various obesity-related lifestyle factors, using data from a population-based prospective cohort study. The genetic risk score (GRS) calculated from East Asian ancestry single-nucleotide polymorphisms was significantly associated with the body mass index (BMI) at baseline (P<0.001). Significant gene-environment interactions were observed for six nutritional factors, alcohol intake, metabolic equivalents-hour per day and the homeostasis model assessment ratio. The GRS altered the effects of lifestyle factors on BMI. Increases in the BMI at baseline per unit intake for each nutritional factor differed depending on the GRS. However, we did not observe significant correlations between the GRS and annual changes in BMI during the follow-up period. This study suggests that the effects of lifestyle factors on obesity differ depending on the genetic risk factors. The approach used to evaluate gene-environment interaction in this study may be applicable to the practice of preventive medicine.
Publisher: American Diabetes Association
Date: 20-01-2011
DOI: 10.2337/DC10-0793
Abstract: To describe and compare the associations of serum lipoproteins and apolipoproteins with diabetic retinopathy. This was a cross-sectional study of 224 diabetic patients (85 type 1 and 139 type 2) from a diabetes clinic. Diabetic retinopathy was graded from fundus photographs according to the Airlie House Classification system and categorized into mild, moderate, and vision-threatening diabetic retinopathy (VTDR). Serum traditional lipids (total, LDL, non–HDL, and HDL cholesterol and triglycerides) and apolipoprotein AI (apoAI), apolipoprotein B (apoB), and the apoB-to-apoAI ratio were assessed. Diabetic retinopathy was present in 133 (59.4%) in iduals. After adjustment for age, sex, diabetes duration, A1C, systolic blood pressure, and diabetes medications, the HDL cholesterol level was inversely associated with diabetic retinopathy (odds ratio 0.39 [95% CI 0.16–0.94], highest versus lowest quartile Ptrend = 0.017). The ApoAI level was inversely associated with diabetic retinopathy (per SD increase, 0.76 [95% CI 0.59–0.98]), whereas apoB (per SD increase, 1.31 [1.02–1.68]) and the apoB-to-apoAI ratio (per SD increase, 1.48 [1.13–1.95]) were positively associated with diabetic retinopathy. Results were similar for mild to moderate diabetic retinopathy and VTDR. Traditional lipid levels improved the area under the receiver operating curve by 1.8%, whereas apolipoproteins improved the area by 8.2%. ApoAI and apoB and the apoB-to-apoAI ratio were significantly and independently associated with diabetic retinopathy and diabetic retinopathy severity and improved the ability to discriminate diabetic retinopathy by 8%. Serum apolipoprotein levels may therefore be stronger biomarkers of diabetic retinopathy than traditional lipid measures.
Publisher: MDPI AG
Date: 25-07-2019
DOI: 10.3390/NU11081720
Abstract: The role of diet and circulatory carotenoids and docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are implicated in age-related macular degeneration (AMD) but not well studied in Chinese. However, other fatty acids were not comprehensively evaluated if it had additional consequence on AMD. This study investigated the relationship among dietary habits, fatty acids levels, carotenoids and AMD in Hong Kong Chinese adults. In this cross-sectional case-controlled study, plasma fatty acids including, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA), and carotenoids levels were quantified between patients with neovascular AMD (n = 99) and age-gender-matched controls (n = 198). A food frequency questionnaire was also conducted. Low blood carotenoid levels and omega-3 PUFAs namely DHA, EPA and -linolenic acid increased the odds ratio of developing neovascular AMD. High blood omega-6 PUFAs specifically arachidonic acid and eicosadienoic acid, oleic acid (a MUFA) and SFA levels increased the odds ratio of having neovascular AMD. Neovascular AMD group had significantly less omega-3 PUFA rich food (vegetables, nuts, seafood) intake and higher SFA (meat) intake than controls. In short, neovascular AMD was associated with lower circulatory levels of carotenoids and omega-3 PUFAs, and higher level of omega-6 PUFAs, oleic acid and SFAs in the Hong Kong Chinese population. These findings enhance the understandings of dietary impacts on neovascular AMD and provide a context for future nutritional intervention studies.
Publisher: Wiley
Date: 29-11-2017
DOI: 10.1111/AOS.13617
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 06-2023
Publisher: Wiley
Date: 18-08-2012
DOI: 10.1111/J.1442-9071.2011.02613.X
Abstract: To describe the changes in retinal vascular calibre in response to intravitreal ranibizumab injections in patients with neovascular age-related macular degeneration. Prospective interventional case series. Treatment naïve patients with neovascular age-related macular degeneration were recruited over a 1-year period. Each patient received three monthly intravitreal injections according to a 'loading dose'. Retinal arteriolar and venular calibre was measured from digital fundus photographs and summarized as central retinal artery equivalent and central retinal vein equivalent at baseline and 3 months. Central retinal artery equivalent and central retinal vein equivalent changes from baseline to 3 months. Seventy-four eyes of 71 patients had good quality images for grading vessel calibre at baseline and at 3 months in treated (study) eyes and 51 eyes of 51 patients had good quality images in fellow (control) eyes. Over 3 months, in study eyes treated with ranibizumab, there was a significant increase in central retinal vein equivalent over baseline (+6.20 µm, P = 0.005), but no significant change in central retinal artery equivalent (+0.86 µm, P = 0.55). In control eyes, there was no change in central retinal vein equivalent (-0.82 µm, P = 0.70) or central retinal artery equivalent (0.34 µm, P = 0.75). Intravitreal ranibizumab has a significant vasodilational effect on retinal venular calibre in eyes treated for neovascular age-related macular degeneration. The reason for this change is unclear, but may relate to changes in blood flow or inflammatory changes within the retina.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2011
DOI: 10.2215/CJN.10291110
Abstract: In iduals with chronic kidney disease (CKD) stages 3 to 5 have an increased risk of cardiac and other vascular disease. Here we examined the association of CKD 3 to 5 with small vessel caliber. This was a cross-sectional observational study of 126 patients with CKD stages 3 to 5 (estimated GFR [eGFR] ml/min per 1.73 m 2 ) and 126 age- and gender-matched hospital patients with CKD 1 or 2. Retinal vessel diameters were measured from digital fundus images by a trained grader using a computer-assisted method and summarized as the central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE). Patients with CKD 3 to 5 had a smaller mean CRAE and CRVE than hospital controls (139.4 ± 17.8 μm versus 148.5 ± 16.0 μm, P 0.001 and 205.0 ± 30.7 μm versus 217.4 ± 25.8 μm, respectively P = 0.001). CRAE and CRVE decreased progressively with each stage of renal failure CKD1–2 to 5 ( P for trend = 0.08 and 0.04, respectively). CKD and hypertension were independent determinants of arteriolar narrowing after adjusting for age, gender, diabetes, dyslipidemia, and smoking history. Patients with CKD 5 and diabetes had a larger mean CRAE and CRVE than nondiabetics (141.4 ± 14.9 μm versus 132.9 ± 14.2 μm 211.1 ± 34.4 μm versus 194.8 ± 23.8 μm). The microvasculature is narrowed in patients with reduced eGFR.
Publisher: Wiley
Date: 19-12-2011
Publisher: Oxford University Press (OUP)
Date: 20-12-2011
DOI: 10.1093/RHEUMATOLOGY/KEQ428
Abstract: Alterations in retinal vascular calibre, particularly wider venular calibre, have been independently associated with elevated markers of inflammation and cardiovascular risk in the general population. We hypothesized that retinal vascular calibre would be altered in patients with RA, who are known to have both elevated cardiovascular risk and chronic, systemic inflammation. Retinal vascular calibre was measured from digital retinal photographs using computerized methods in 51 RA patients and 51 age- and gender-matched controls. Retinal vascular calibre was compared between RA and control patients with adjustment for relevant variables including cardiovascular risk factors and companion vessel calibre. The relationship between retinal venular calibre and inflammation was assessed by comparing controls and RA patients with high and lower disease activity. Retinal venular calibre [mean (s.d.)] was significantly wider in RA patients than in controls [235.9 (24.6) vs. 211.6 (21.0) µm, P < 0.001]. After adjustment for all relevant variables, mean venular calibre remained 20.3 µm (95% CI 10.4, 30.3) wider in RA patients compared with controls. Retinal venular calibre [mean (s.d.)] also increased with increasing levels of systemic inflammation: 211.6 (21.0) µm in controls, 232.3 (22.4) µm in RA patients with moderate or lower disease activity and 255.5 (28.3) µm in RA patients with high disease activity (P for trend < 0.0001). This study demonstrates that RA patients have dilated retinal venular calibre, reflecting systemic inflammation and possibly increased cardiovascular risk. Longitudinal studies correlating retinal vascular calibre with subsequent cardiovascular events will clarify the clinical utility of this test in patients with RA.
Publisher: American Medical Association (AMA)
Date: 04-2012
DOI: 10.1001/ARCHOPHTHALMOL.2011.376
Abstract: To describe the prevalence of and risk factors for age-related macular degeneration (AMD) in a multiethnic Asian cohort of Chinese, Malay, and Indian persons. In this population-based study, 3172 persons of Chinese, Malay, and Indian ethnicities 40 years and older were included. Participants underwent comprehensive systemic and ocular examination, retinal photography, and laboratory investigations. Early and late AMD signs were graded from retinal photographs. Age-standardized prevalence estimates were calculated using the 2010 Singapore adult population as the standard population. Association with a range of systemic risk factors was analyzed. Of 3172 participants, AMD was present in 211 subjects. Age-standardized prevalence of AMD was 7.0% in persons 40 years and older. The age-standardized prevalence was similar in all 3 Asian ethnic groups: Chinese, 7.3% Malay, 7.7% and Indian, 5.7% (P value = .44). The prevalence increased with age and was higher in men. Of the range of risk factors evaluated, only myopic refractive error (<-0.5 D) was significantly associated with a lower risk for AMD (odds ratio, 0.44 P < .001, compared with emmetropia) in Chinese men. The prevalence of AMD was similar in the 3 major ethnic groups in Asia and comparable with white populations. Myopic refractive error was associated with reduced risk of AMD in Chinese men.
Publisher: Informa UK Limited
Date: 18-06-2016
DOI: 10.3109/02713683.2015.1034371
Abstract: To investigate the association between retinal vascular tortuosity and traditional- and vascular-related risk factors in persons with diabetes. We recruited 224 diabetic patients. Retinal vascular tortuosity was measured from fundus photographs. Association of tortuosity with the following factors was assessed after adjusting for significant co-factors: diabetes duration, HbA1c, systolic blood pressure (SBP), cholesterol and body mass index (BMI), flicker-light induced retinal vasodilatation, and markers of endothelial function and inflammation (skin microvacular responses to acetylcholine iontophoresis, soluble e-selectin, inter-cellular adhesion molecule-1, vascular cell adhesion molecule-1, endothelin-1, total nitrite, C-reactive protein). Adjusting for age and gender, longer diabetes duration was associated with more tortuous retinal arterioles (mean difference in arteriolar tortuosity 5.85 × 10(-5), 95% Confidence Interval 1.44-10.3 × 10(-5) p = 0.016 ≤10 versus >10 years duration). Reduced flicker-light induced retinal vasodilatation was associated with tortuous arterioles and venules (mean difference in arteriolar tortuosity 5.62 × 10(-5), 4.50-6.72 × 10(-5) p < 0.001 and in venules 5.94 × 10(-5), 3.33-8.55 × 10(-5) p < 0.001 comparing highest versus lowest tertile of flicker-light vasodilatation). These associations remained after adjusting for co-factors. Diabetes duration explained about 36% and flicker-light vasodilatation 25% of the variation in retinal arteriolar tortuosity. No associations were found between retinal arteriolar or venular tortuosity and HBA1c, SBP, cholesterol, BMI and serum markers of endothelial function. Increased retinal arteriolar tortuosity was related to longer diabetes duration and reduced flicker-light induced vasodilatory response, suggesting that retinal vascular tortuosity in adults with diabetes may be influenced by multiple diabetes-related physio-pathological changes.
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.JJCC.2015.08.015
Abstract: It has been reported that there are regional differences in the incidence of acute myocardial infarction (AMI) in Japan. The purpose of this study was to investigate trends in regional differences in AMI incidence and dyslipidemia between coastal and inland areas. We investigated trends in AMI incidence and risk factors in 5325 first-ever AMI patients residing in a coastal area (n=1817), a rural inland area (n=1959), or an urban inland area (n=1549) for the periods 1994-2002, and 2003-2010, using data from the Yamagata AMI Registry. Patients in the coastal area were significantly older than those in rural and urban inland areas and had a lower prevalence of dyslipidemia. The age-adjusted incidence rate of AMI was significantly lower in coastal and rural inland areas patients than those from urban inland area (males: 43.3, 42.2, and 51.3/10(5) person-years females: 17.4, 20.0, and 23.7/10(5) person-years, respectively) during 2 observation periods. Due to a large increase in AMI incidence in younger males of the coastal area and a decrease in AMI incidence in late elderly females of the urban inland area, no significant regional differences in the age-adjusted incidence rates of AMI were observed during the 2003-2010 period in both genders. The increase in AMI incidence in males in the coastal area was associated with an increasing prevalence of dyslipidemia. There were no longer any regional differences observed in AMI incidence, which was considered to be associated with increased dyslipidemia especially in the coastal area.
Publisher: Public Library of Science (PLoS)
Date: 23-06-2017
Publisher: Wiley
Date: 14-02-2013
DOI: 10.1111/AOS.12094
Abstract: To assess the relation between retinal vascular caliber and renal function. Eighty apparently healthy subjects screened for cardiovascular risk factors (mean age 47 years, 51% female, 36% hypertensive, without diabetes or renal dysfunction) were recruited. Retinal vascular calibers were measured from fundus photographs and expressed as central retinal artery and venular equivalent. Renal function was assessed by measurement of glomerular filtration rate (urinary clearance of 99mTc-DTPA) and urinary albumin/creatinine ratio. Mean glomerular filtration rate was 117 ml/min/1.73m(2). Overall, central retinal artery and venular equivalent were positively correlated with glomerular filtration rate (r = +0.31, p = 0.005 and r = +0.30, p = 0.006, respectively). In addition, central retinal artery equivalent was negatively correlated with urinary albumin/creatinine ratio (r = -0.34, p = 0.002). No significant relationship was found between central retinal venular equivalent and urinary albumin/creatinine ratio (r = +0.12, p = 0.32). The observed relations between retinal vascular calibers and renal function parameters remained significant after adjusting for potential confounding factors. In apparently healthy subjects with normal renal function, retinal arteriolar and venular calibers were negatively correlated with kidney function, suggesting common determinants of these preclinical target organ damages.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 31-10-2017
Publisher: Springer Science and Business Media LLC
Date: 28-08-2009
DOI: 10.1038/HR.2009.130
Abstract: Blood pressure has a significant effect on retinal arterioles. There are few data on whether this effect varies by race/ethnicity. We examined the relationship of blood pressure and retinal vascular caliber in a multi-ethnic Asian population. The study is population-based and cross sectional in design. A total of 3749 Chinese, Malay and Indian participants aged > or =24 years residing in Singapore were included in the study. Retinal vascular caliber was measured using a computer program from digital retinal photographs. The associations of retinal vascular caliber with blood pressure and hypertension in each racial/ethnic group were analyzed. The main outcome measures are retinal arteriolar caliber and venular caliber. The results show that retinal arterioles were narrower in persons with uncontrolled/untreated hypertension (140.0 microm) as compared with persons with controlled hypertension (142.1 microm, P=0.0001) and those with no hypertension (146.0 microm, P<0.0001). On controlling for age, gender, body mass index, lipids and smoking, each 10 mm Hg increase in mean arterial blood pressure was associated with a 3.1 microm decrease in arteriolar caliber (P<0.0001), with a similar magnitude seen in all three racial/ethnic groups: 3.1 microm in Chinese, 2.8 microm in Malays and 3.2 microm in Indians (P<0.0001 for all). Each 10 mm Hg increase in mean arterial blood pressure was associated with a 1.8 microm increase in venular caliber (P<0.0001) furthermore, the magnitude of this effect was similar across the three racial/ethnic groups. The effect of blood pressure on the retinal vasculature was similar across three major racial/ethnic groups in Asia.
Publisher: Informa UK Limited
Date: 17-12-2015
DOI: 10.3109/09286586.2014.988876
Abstract: To evaluate the cost-effectiveness for a screening interval longer than 1 year detecting diabetic retinopathy (DR) through the estimation of incremental costs per quality-adjusted life year (QALY) based on the best available clinical data in Japan. A Markov model with a probabilistic cohort analysis was framed to calculate incremental costs per QALY gained by implementing a screening program detecting DR in Japan. A 1-year cycle length and population size of 50,000 with a 50-year time horizon (age 40-90 years) was used. Best available clinical data from publications and national surveillance data was used, and a model was designed including current diagnosis and management of DR with corresponding visual outcomes. One-way and probabilistic sensitivity analyses were performed considering uncertainties in the parameters. In the base-case analysis, the strategy with a screening program resulted in an incremental cost of 5,147 Japanese yen (¥ US$64.6) and incremental effectiveness of 0.0054 QALYs per person screened. The incremental cost-effectiveness ratio was ¥944,981 (US$11,857) per QALY. The simulation suggested that screening would result in a significant reduction in blindness in people aged 40 years or over (-16%). Sensitivity analyses suggested that in order to achieve both reductions in blindness and cost-effectiveness in Japan, the screening program should screen those aged 53-84 years, at intervals of 3 years or less. An eye screening program in Japan would be cost-effective in detecting DR and preventing blindness from DR, even allowing for the uncertainties in estimates of costs, utility, and current management of DR.
Publisher: Springer Science and Business Media LLC
Date: 19-05-2020
Publisher: Springer Science and Business Media LLC
Date: 12-2012
Abstract: Whether the increase in vascular disease prevalence and mortality in OA populations is a result of co-occurrence of cardiovascular disease and OA, which are both common in the older population, is due to OA treatments or to the common association with reduced physical activity and/or obesity is unclear. One way to explore this non-invasively is to examine the cross-sectional relationship between changes in retinal microvasculature, which have been shown to be markers of generalized vascular pathology, and knee structural changes in an asymptomatic community-based population. A community s le of 289 (61% women) aged 50–79 years with no knee symptoms underwent magnetic resonance imaging (MRI) of their dominant knee in 2003. Cartilage volume and bone marrow lesions (BMLs) were determined. All subjects also had retinal photographs taken from which retinal arteriolar and venular diameters were determined and summarized as the central retinal arteriolar equivalent (CRAE) and the central retinal venular equivalent (CRVE). Retinal venular diameter was significantly wider in subjects with a BML compared with subjects without a BML (mean (SD) 214.2 (2.8) μm versus 207.5 (1.1) μm respectively independent of age, gender and BMI. A trend for decreased medial tibial cartilage with increasing CRAE was also observed (regression coefficient −2.70 μl, 95%CI-5.74, 0.5, p=0.08). These findings suggest that vascular pathology, indicative of inflammatory processes, is associated with early structural knee changes. The role of micro-vascular changes in the pathogenesis of OA warrants further investigation.
Publisher: Elsevier BV
Date: 07-2003
DOI: 10.1016/S0002-9394(03)00094-1
Abstract: To report the optical coherence tomography (OCT)-determined progressive changes in a macular hole (MH) following vitreous surgery with a gas t onade. Observational case report. A 60-year-old woman with an idiopathic full-thickness MH (Gass, Stage 2) in the left eye underwent vitreous surgery with a gas t onade. The progressive closure of the MH was followed by OCT because an unplanned decrease of the gas t onade made the macula accessible to OCT examination. On day 1, the tissue surrounding the MH extended into the center, and on day 2, the subretinal fluid and foveal cysts decreased and the retinal separation was reduced. On the third postoperative day, the MH was closed and the foveal contour was similar to that of normal retinas. These results demonstrated that a small MH appears to be closed by 3 days after vitrectomy with gas t onade. Although we cannot generalize to all sizes of MH, our findings suggest that small MHs are closed much earlier than reported and that the duration of maintaining a prone position can be shortened.
Publisher: Public Library of Science (PLoS)
Date: 26-07-2013
Publisher: IEEE
Date: 04-1970
Publisher: Public Library of Science (PLoS)
Date: 11-01-2023
DOI: 10.1371/JOURNAL.PDIG.0000174
Abstract: The morphological feature of retinal arterio-venous crossing patterns is a valuable source of cardiovascular risk stratification as it directly captures vascular health. Although Scheie’s classification, which was proposed in 1953, has been used to grade the severity of arteriolosclerosis as diagnostic criteria, it is not widely used in clinical settings as mastering this grading is challenging as it requires vast experience. In this paper, we propose a deep learning approach to replicate a diagnostic process of ophthalmologists while providing a checkpoint to secure explainability to understand the grading process. The proposed pipeline is three-fold to replicate a diagnostic process of ophthalmologists. First, we adopt segmentation and classification models to automatically obtain vessels in a retinal image with the corresponding artery/vein labels and find candidate arterio-venous crossing points. Second, we use a classification model to validate the true crossing point. At last, the grade of severity for the vessel crossings is classified. To better address the problem of label ambiguity and imbalanced label distribution, we propose a new model, named multi-diagnosis team network (MDTNet), in which the sub-models with different structures or different loss functions provide different decisions. MDTNet unifies these erse theories to give the final decision with high accuracy. Our automated grading pipeline was able to validate crossing points with precision and recall of 96.3% and 96.3%, respectively. Among correctly detected crossing points, the kappa value for the agreement between the grading by a retina specialist and the estimated score was 0.85, with an accuracy of 0.92. The numerical results demonstrate that our method can achieve a good performance in both arterio-venous crossing validation and severity grading tasks following the diagnostic process of ophthalmologists. By the proposed models, we could build a pipeline reproducing ophthalmologists’ diagnostic process without requiring subjective feature extractions. The code is available ( onscienceli/MDTNet ).
Publisher: Informa UK Limited
Date: 30-09-2011
DOI: 10.3109/09286586.2011.594206
Abstract: To examine the association between glucose metabolism and central corneal thickness (CCT) in Japanese adults. A sub-s le of 322 Japanese adults participating in the Funagata Study was included in this analysis. CCT was measured using a specular microscope. Glucose metabolism was examined using 75-g oral glucose tolerance test. Mean differences in CCT (μm) and 95% confidence intervals were estimated with univariate, age-sex-adjusted and multivariate models using multiple linear regression. The mean (± standard deviation) age of the study s le was 63.7 ± 11.4 years and 44% were men. The mean fasting plasma glucose (FPG), 2-hour post-load plasma glucose (2hPG) and haemoglobin A1c (HbA1c) concentrations were 96.8 ± 12.6mg/dl, 123.6 ± 41.2mg/dl and 5.3 ± 0.4%, respectively. CCT was normally distributed in the study s le, and the mean CCT was 544.7 ± 34.6μm. After multivariate adjustment, characteristics associated with increased CCT were 2hPG and HbA1c concentrations, impaired glucose tolerance, diabetes, body weight or body mass index and current smoking. Impaired glucose tolerance, diabetes, obesity and current smoking are associated with increased CCT. Additional studies are required to examine whether interventions to affect these characteristics may reduce CCT.
Publisher: Public Library of Science (PLoS)
Date: 14-05-2015
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.AJO.2008.07.006
Abstract: To investigate the relationship between retinal vascular caliber and age-related macular degeneration (AMD). Population-based cross-sectional study. Three thousand two hundred and eighty (78.7% response rate) Malay Singaporeans aged 40 to 80 years residing in 15 districts of Singapore underwent retinal photography. Retinal vessel caliber was measured from retinal photographs using a validated computer-based technique. AMD was assessed following a modified Wisconsin Age-Related Maculopathy Grading System. Retinal data were available from 3,265 subjects (99.5% of 3,280) for this study. Early and late AMD prevalence were 4.9% (n = 160) and 0.7% (n = 23) of the population, respectively, or in 205 (3.1%) and 30 (0.5%) eyes examined, respectively. After controlling for age and arteriolar caliber, wider venular caliber was associated with higher prevalence of early AMD (odds ratio [OR] per one standard deviation [SD] increment in venular caliber, 1.53 95% confidence interval [CI], 1.13 to 2.09). This association remained significant after further adjustment for gender, smoking, hypertension, diabetes, and body mass index (OR per one SD, 1.52 95% CI, 1.11 to 2.09). There was no significant association between retinal arteriolar caliber and early AMD, or between arteriolar or venular caliber and late AMD. Wider venular caliber was associated independently with early AMD. This finding may suggest that pathogenic processes linking to wider venular caliber be shared by early AMD and common cardiovascular risk factors such as inflammation, dyslipidemia, and endothelial dysfunction.
Publisher: IEEE
Date: 02-2013
Publisher: Elsevier BV
Date: 10-2023
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.IJCARD.2017.04.049
Abstract: Obstructive lung disorder (OLD) is known to be associated with cardiovascular disease. However, the impact of restrictive lung disorder (RLD) on cardiovascular mortality has not been fully investigated in the apparently healthy general population. To clarify whether RLD is associated with cardiovascular mortality in the general population. This community-based cohort study included 3247 subjects who participated in an annual health check in Takahata. We performed spirometry in registered subjects and found that 194 (6%) had RLD, 262 (8%) had OLD, and 73 (2%) had RLD and OLD (Mixed). During a 10-year follow-up, there were 210 deaths, including 57 cardiovascular deaths. Cardiovascular mortality of subjects with RLD was significantly higher than that of subjects with normal lung function. Although the subjects with RLD were younger, comprised fewer smokers, and were more likely to be female than those with OLD, cardiovascular mortality of subjects with RLD was comparable to that of subjects with OLD. Subjects with RLD had a higher prevalence of atrial fibrillation (AF) than those with OLD, and the prevalence of AF was increased with advanced severity of RLD. Multivariate Cox proportional hazard analysis revealed that RLD was an independent predictor of cardiovascular death (hazard ratio 2.61, 95% confidence interval, 1.22-5.21) after adjustment for confounders, but OLD was not. The net reclassification improvement and integrated discrimination improvement were significantly increased by the addition of RLD to conventional cardiovascular risk factors. The presence of RLD was associated with cardiovascular mortality in the general population.
Publisher: Springer Science and Business Media LLC
Date: 26-04-2019
Publisher: Springer Science and Business Media LLC
Date: 21-01-2020
DOI: 10.1038/S41598-019-57260-7
Abstract: The study subjects were residents of Chikusei city, Japan, aged 40 years or older who attended annual health check-up programs and participated in the JPHC-NEXT Eye Study which performed non-mydriatic fundus photography of both eyes. The relationship of glaucomatous fundus changes such as optic disc cupping (cup to disc ratio ≥ 0.7) and retinal nerve fiber layer defect (NFLD) with the presence of epiretinal membrane (ERM) were examined cross-sectionally. A total of 1990 persons gave consent to participate in this study in 2013. The overall prevalence of ERM was 12.9%. Of these, 1755 had fundus photographs of sufficient quality and no history of intraocular surgery (mean age: 62.3 ± 10.0 years). After adjusting for age, sex and refractive error, NFLD was positively associated with the presence of ERM (odds ratio [OR]: 2.48 95% confidence interval [CI]: 1.24, 4.96 P = 0.010), but optic disc cupping was not (OR: 1.33 CI: 0.71, 2.48 P = 0.37). The results did not necessarily suggest an association between glaucoma and ERM, but indicated an association between NFLD and ERM.
Publisher: American Diabetes Association
Date: 20-05-2011
DOI: 10.2337/DC10-1985
Abstract: Endothelial dysfunction has been hypothesized as a possible pathogenic factor in the development of diabetic retinopathy (DR). We examined the relationship of DR to endothelium-dependent and endothelium-independent responses in skin microvascular flow. Participants consisted of 224 in iduals with diabetes: 85 with type 1 diabetes and 139 with type 2 diabetes. Sodium nitroprusside (SNP) and acetylcholine (ACh) were delivered across the skin by iontophoresis. Laser Doppler flowmetry was used to assess the skin microcirculation response to SNP (endothelium-independent response) and ACh (endothelium-dependent response). The presence and severity of DR were graded from retinal photographs using a standard protocol. Of 224 participants, 64.3% had DR. After multivariable adjustment, participants with reduced responses to SNP or ACh were more likely to have DR, with an odds ratio (OR) of 2.33 (95% CI 1.09–5.01) for SNP and 2.20 (1.05–4.61) for ACh, comparing participants with responses below and above the median values. Participants with reduced responses (below the median) to both SNP and ACh were nearly four times more likely to have DR (OR 3.86 [1.45–10.3]) than those with SNP and ACh both above the median values. The presence of DR was associated with a reduction in skin microcirculation responses to iontophoresis of both SNP and ACh, suggesting that vascular processes associated with both endothelial dysfunction and endothelial function-independent mechanisms may be pathogenically related to DR.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 20-03-2014
Abstract: To assess factors associated with retinal oximetry values in healthy young adults. Retinal oximetry readings were assessed using the oximetry module of the Vesselmap System in 100 eyes of 50 healthy subjects aged 18 to 58 years. Generalized estimating equation models were used to estimate the associations of candidate variables (age, sex, retinal capillary flow, HbA1c, triglyceride, total cholesterol, ocular perfusion pressure, and finger oxygen saturation [SO2]) with retinal oximetry measures (arteriolar SO2, venular SO2, and the arterio-venous [A-V] difference). Of the candidate factors assessed, only age and finger SO2 were found to be significantly associated with one or more measures of retinal oximetry in unadjusted analyses. After adjusting for age, sex, and significant factors from unadjusted analyses, age and finger SO2 values remained significant. Age was associated with retinal arteriolar and venular SO2 values (per year increase in age, β = 0.31, 95% confidence interval [CI]: 0.15-0.48 and β = 0.26, 95% CI: 0.08-0.43, respectively), but not associated with the A-V difference. Finger SO2 values were associated with retinal arteriolar SO2 and A-V difference (per percentage change in finger SO2, β = 1.34, 95% CI: 0.40-2.28 and β = 0.74, 95% CI: 0.36-1.11, respectively), but not with venular SO2. In healthy young adults, age was positively associated with the retinal arteriolar and venular SO2 values, whereas finger SO2 was positively correlated with greater arteriolar SO2 and A-V difference. Our findings serve as a basis for future studies assessing retinal oximetry values in young adults under normal and pathophysiological conditions.
Publisher: Springer Science and Business Media LLC
Date: 09-01-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2022
DOI: 10.1097/J.JCRS.0000000000000983
Abstract: To evaluate the performance of a new formula of intraocular lens (IOL) power calculation (the O formula) based on ray tracing without commonly used parameters, including ultrasound-compatible axial length, keratometry readings, and A-constant. Tokyo Medical Center, Tokyo, Japan. Retrospective consecutive case series. 423 eyes (423 patients) implanted with a single-piece, L-loop, acrylic IOL were enrolled. All biometric data for the O formula were obtained by anterior segment swept-source optical coherence tomography (SS-OCT) and SS-OCT–based biometer. The performance of the O formula was compared with those of the Barrett Universal II (BUII) and Kane formulas at 1 month postoperatively. Statistical analysis was applied according to a heteroscedastic test with SD of prediction errors as the main parameter for formula performance. The SD of the O formula (0.426) was statistically significantly lower than that of the BUII formula (0.464, P = .034) but not statistically significantly different from that of the Kane formula (0.433, P = .601). The percentages of patients with refractive prediction errors within ±0.50 diopter (D) and ±1.00 D of the O, BUII, and Kane formulas were 75.4% and 98.6%, 77.1% and 97.9%, and 76.6% and 98.1%, respectively. The O formula, based on ray tracing using SS-OCT–based devices, is one of the promising approaches for IOL power calculation, although additional larger scale studies are needed. It may be used as an alternative in IOL power calculation because of its independence from commonly used parameters.
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.AJO.2014.12.025
Abstract: To investigate changes in choroidal thickness after aflibercept therapy for neovascular age-related macular degeneration (AMD). Retrospective, consecutive, interventional case series. This study included 102 eyes of 102 patients with treatment-naïve neovascular AMD. All 102 eyes underwent 3 consecutive monthly 2.0 mg intravitreal aflibercept injections at baseline, 1 month, and 2 months. Choroidal thickness during 3 months were evaluated using either swept-source optical coherence tomography (OCT) or enhanced-depth imaging OCT. Of the 102 eyes, 46 eyes (45.1%) were diagnosed as typical neovascular AMD and 56 eyes (54.9%) as polypoidal choroidal vasculopathy. After intravitreal aflibercept injections, the mean subfoveal choroidal thickness decreased from 252.0 ± 99.7 μm at baseline to 217.9 ± 95.6 μm at 3 months (P < .0001 percentage change from baseline, 86.5%). Mean choroidal thickness measured at 3 mm from the foveal center in the superior, inferior, temporal, and nasal directions also decreased significantly from 258.7 ± 85.9 μm to 236.4 ± 84.6 μm, 229.9 ± 93.0 μm to 208.6 ± 86.5 μm, 237.4 ± 86.5 μm to 214.6 ± 79.5 μm, and 183.7 ± 97.0 μm to 162.3 ± 90.6 μm, respectively (P < .0001 for all directions). Both subtypes of neovascular AMD demonstrated a similar trend toward decreasing choroidal thickness during the follow-up period. Choroidal thickness significantly decreased not only at the foveal center but also in the entire macula after 3 monthly intravitreal aflibercept injections for neovascular AMD.
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.AJO.2019.03.027
Abstract: We aimed to externally validate the performance of new screening criteria for retinopathy of prematurity (ROP) developed in the Postnatal Growth and Retinopathy of Prematurity (G-ROP) study among a Japanese cohort. Validation of screening criteria. We reviewed premature infants screened for ROP between September 2009 and May 2017 at a single institution. The G-ROP criteria, except hydrocephalus, were applied as a prediction model for infants with both a known outcome of ROP and serial measurements of weight gain. We assessed sensitivity and specificity for treatment-requiring ROP, and reduction in the number of infants who receive ROP screening and in the number of retinal examinations. Of 692 premature infants screened for ROP, 537 had information of ROP outcome and weight gain. In this cohort, 81 infants required treatment for ROP in 218 infants, ROP regressed spontaneously and 238 infants did not develop any ROP. The G-ROP model reached a sensitivity of 100% (95% confidence interval [CI], 95.4%-100%) and specificity of 28.9% (95% CI, 24.9%-33.2%). No infants required any treatment for ROP before the date of risk determination. The number of infants requiring screening and the number of examinations would have been reduced by 24.5% and 12.9%, respectively. This is the first validation study of the G-ROP criteria in a developed country other than North America. The criteria demonstrated high sensitivity in this Japanese cohort, even though the criterion of hydrocephalus was excluded.
Publisher: AMPCo
Date: 02-2013
DOI: 10.5694/MJA12.11121
Abstract: To evaluate the feasibility of a novel diabetic retinopathy (DR) screening model using a pathology collection centre (PCC) as a screening site. Cross-sectional pilot study conducted in one urban PCC in Victoria between 1 September 2009 and 15 March 2010. Trained pathology staff screened participants for DR using undilated, non-stereoscopic colour fundus photography. Participants were patients who spoke English, were aged at least 12 years, had type 1 or type 2 diabetes, and did not undertake biannual DR screening. Proportion of patients who do not participate in biannual DR screening proportion of patients who accept DR screening while attending a PCC proportion of gradable images patient acceptance of the screening model and effectiveness of the follow-up pathway. Over 6 months, 289 English-speaking patients with diabetes attended the PCC, of whom 99 (34.3%) had not undertaken biannual DR screening. Of these, 93 (93.9%) accepted our screening service. Overall, retinal images were sufficient for interpretation in 88 patients (94.6%) and the median time for photography was 6 minutes (interquartile range, 10 minutes). Two, eight and six cases of minimal, mild and moderate non-proliferative DR (NPDR) in the worst eye were found, respectively. Dissemination of screening results to treating doctors and patients was found to be suboptimal and will need to be revised. DR screening in one urban PCC appears to be a feasible alternative for diabetic patients who do not undertake biannual screening for DR.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2013
Publisher: Asia Pacific Academy of Ophthalmology
Date: 2018
DOI: 10.22608/APO.2018136
Publisher: American Medical Association (AMA)
Date: 02-2020
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.AJO.2017.06.019
Abstract: To report the prevalence of diabetic retinopathy (DR) and DR-related blindness in an Indonesian population with type 2 diabetes. Design: Population-based cross-sectional study. Community health centers. We recruited 1184 people aged older than 30 years with type 2 diabetes residing in Jogjakarta, Indonesia. Multistage, clustered random s ling based on regencies and districts in Jogjakarta was used. Detailed interviews, general and eye examinations, and anthropometric measurement were performed. Disc- and macula-centered retinal photographs were taken to assess DR. The definition of DR followed a modified Airlie House classification system and was categorized into mild, moderate, and vision-threatening DR (VTDR). Prevalence and severity of DR. The median (range) age and diabetes duration of participants was 59 (52-65) and 4 (2-9) years. The prevalence of DR was 43.1% (95% confidence interval 39.6%-46.6%), with mild, moderate, and severe NPDR and PDR to be 9.41%, 7.46%, 11.1%, and 12.1%, respectively. The prevalence of VTDR was 26.3% (23.1%-29.5%). Longer diabetes duration, higher fasting glucose, presence of hypertension, and foot ulcers were associated with DR and VTDR. The prevalence of bilateral blindness was 4% and 7.7% in persons with DR and VTDR. This study reports a high prevalence of any DR and VTDR among Indonesian adults with type 2 diabetes in urban and rural areas: approximately 1 in 4 adults with diabetes had VTDR and 1 in 12 of those with VTDR was bilaterally blind, suggesting the need for appropriate screening and management of DR among the Indonesian population.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2013
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 09-04-2014
Abstract: Macular diseases may be associated with an altered retinal vasculature. We describe and test new software for the measurement of retinal vascular fractal dimension to quantify the complexity of retinal vasculature at the macula (D mac) and to compare this with fractal dimension measured around the optic disc (D disc). A total of 342 macular-centered and optic disc-centered digital retinal photographs from 171 subjects was selected randomly from a population-based study. Retinal vascular fractional dimension (Df) was measured by two trained graders using a computer-assisted program (SIVA-FA, software version 1.0, National University of Singapore) on macula-centered (D mac) and optic disc-centered (D disc) photographs, to assess intergrader reliability. Measurements were repeated after two weeks to determine intragrader reliability. A separate 50 pairs of consecutively repeated images were selected and measured using SIVA-FA to assess intrasession reliability. Reliability analyses were conducted using intraclass correlation coefficients (ICC), and multiple linear regression analyses were performed to compare factors associated with D mac and D disc measurements. The mean (SD) D mac and D disc values were 1.453 (0.060) and 1.484 (0.043), respectively, and were highly correlated (r = 0.70, P < 0.001). Intragrader, intergrader, and intrasession reliability for both Df measures was high (ICCs ranging from 0.88-0.99). In multiple regression analyses, age (both β = -0.03, P < 0.001) and hypertension (β = -0.02, P = 0.011 β = -0.02, P = 0.021, respectively) were independently associated with D mac and D disc. The complexity of the retinal vasculature in the macula can be measured reliably and may be a useful tool to study parafoveal vascular networks in macula diseases, such as diabetic maculopathy.
Publisher: Springer Science and Business Media LLC
Date: 09-03-2021
Publisher: JMIR Publications Inc.
Date: 25-09-2023
DOI: 10.2196/51303
Publisher: Hindawi Limited
Date: 2014
DOI: 10.1155/2014/467462
Abstract: Fractal dimensions (FDs) are frequently used for summarizing the complexity of retinal vascular. However, previous techniques on this topic were not zone specific. A new methodology to measure FD of a specific zone in retinal images has been developed and tested as a marker for stroke prediction. Higuchi’s fractal dimension was measured in circumferential direction (FDC) with respect to optic disk (OD), in three concentric regions between OD boundary and 1.5 OD diameter from its margin. The significance of its association with future episode of stroke event was tested using the Blue Mountain Eye Study (BMES) database and compared against spectrum fractal dimension (SFD) and box-counting (BC) dimension. Kruskal-Wallis analysis revealed FDC as a better predictor of stroke ( H = 5.80 , P = 0.016 , α = 0.05 ) compared with SFD ( H = 0.51 , P = 0.475 , α = 0.05 ) and BC ( H = 0.41 , P = 0.520 , α = 0.05 ) with overall lower median value for the cases compared to the control group. This work has shown that there is a significant association between zone specific FDC of eye fundus images with future episode of stroke while this difference is not significant when other FD methods are employed.
Publisher: Public Library of Science (PLoS)
Date: 24-10-2016
Publisher: American Diabetes Association
Date: 10-2020
DOI: 10.2337/DC17-2612
Abstract: To compare four screening strategies for diabetic macular edema (DME). Patients attending diabetic retinopathy screening were recruited and received macular optical coherence tomography (OCT), in addition to visual acuity (VA) and fundus photography (FP) assessments, as part of the standard protocol. Two retina specialists provided the reference grading by independently assessing each subject’s screened data for DME. The current standard protocol (strategy A) was compared for sensitivity, specificity, quality-adjusted life-year (QALY) gained, and incremental cost-effectiveness ratio (ICER) with three alternative candidate protocols using a simulation model with the same subjects. In strategy B, macular hemorrhage or microaneurysm on FP were removed as surrogate markers for possible DME. Strategy C used best-corrected instead of habitual inhole VA and added central subfield thickness (CST) & μm on OCT in suspected cases as a confirmation marker for possible DME. Strategy D used CST & μm OCT in all subjects as a surrogate marker for suspected DME. We recruited 2,277 subjects (mean age 62.80 ± 11.75 years, 43.7% male). The sensitivities and specificities were 40.95% and 86.60%, 22.86% and 95.63%, 32.38% and 100%, and 74.47% and 98.34% for strategies A, B, C, and D, respectively. The costs (in U.S. dollars) of each QALY gained for strategies A, B, C, and D were $7,447.50, $8,428.70, $5,992.30, and $4,113.50, respectively. The high false-positive rate of the current protocol generates unnecessary referrals, which are inconvenient for patients and costly for society. Incorporating universal OCT for screening DME can reduce false-positive results by eightfold, while improving sensitivity and long-term cost-effectiveness.
Publisher: Wiley
Date: 23-09-2019
DOI: 10.1111/AOS.14232
Abstract: Ocular and brain microcirculation share embryological and histological similarities. The retinal vascular fractal dimension (FD) is a marker of retinal vascular complexity of the vascular tree. The purpose of this study was to explore the relationship between cerebral blood flow (CBF), retinal vascular FD and other retinal vascular markers. Cross-sectional analysis comprising 26 in iduals ≥65 years old from the Cognitive REServe and Clinical ENDOphenotype (CRESCENDO) cohort of relative healthy older adults. Retinal vascular FD was measured from fundus photographs by using the semi-automated Singapore Eye Vessel Assessment (SIVA) software. CBF was estimated using a 2D pulsed ASL MRI sequence. Associations between blood flow and retinal parameters were analysed using linear regression models adjusted for age and sex. Cerebral blood flow was positively associated with venular FD (R Retinal venular complexity summarized by the FD was associated with cerebral blood flow as well as retinal arteriolar tortuosity and branching angle. Larger prospective clinical studies are needed to confirm these results.
Publisher: Wiley
Date: 02-2010
DOI: 10.1111/J.1549-8719.2009.00006.X
Abstract: To determine whether retinal arteriolar narrowing, possibly reflecting peripheral arteriolar vasoconstriction, predicts risk of hypertension in Japanese persons. The Funagata study is a population-based cohort study of Japanese aged 35+ years. Baseline examinations were conducted in 2000-2002 among 1058 persons without hypertension. Of these, 581 persons (55%) returned for a 5-year follow-up examination, with data on 563 available for analyses. Retinal photographs taken at the baseline visits were assessed for retinal arteriolar or venular diameter and retinal vessel wall signs using standardized protocols. Hypertension was defined if systolic blood pressure > or =140 mmHg, diastolic blood pressure > or =90 mmHg or from self-reported clinical diagnosis, including the use of antihypertensive medications. Incident hypertension was defined as an absence of hypertension at baseline but presence of hypertension at the follow-up visit. One hundred ninety-three subjects (34.3%) had developed hypertension at 5-year follow-up. After adjusting for age, gender, baseline blood pressure and other risk factors, narrower retinal arterioles at baseline was significantly associated with an increased risk of incident hypertension (odds ratio per standard deviation decrease in arteriolar diameter: 1.53, 95% confidence interval: 1.08-2.18). Our findings support the concept that arteriolar narrowing, evident in the retina, signals an increased risk of developing hypertension in Japanese persons.
Publisher: Informa UK Limited
Date: 18-08-2014
DOI: 10.3109/09286586.2014.950280
Abstract: Retinal vascular fractal dimension, a measure of the density of the retinal vasculature, has been suggested as a marker of systemic microvascular disorders in diabetes. As hemoglobin concentration is tightly related to vascular physiology and hypoxia, the hypothesis was that hemoglobin concentration would be associated with retinal vascular fractals in a relevant population. In a cross-sectional study of 204 long-term type 1 diabetes patients from a population-based cohort, retinal digital photos were captured and graded for fractal dimension (Df) by International Retinal Imaging Software - Fractal (IRIS-Fractal). Df was calculated from a disc-centered retinal photo from the right eye. Hemoglobin concentrations were measured using routine equipment. Of 175 patients with gradable images, median age was 57.7 years and median duration of diabetes was 42 years. Median retinal Df was 1.4606 (inter-quartile range 0.0264). A positive correlation was found between hemoglobin concentration and retinal vascular Df (r = 0.23, p = 0.0018). In a multiple linear regression model, Df was associated with hemoglobin (coefficient 0.0054 per 1.0 mmol/L increase in hemoglobin, p = 0.01) and age (coefficient -0.0046 for each 10-year increase in age, p = 0.04). Hemoglobin correlated independently with retinal vascular fractals indicating a relationship between hemoglobin availability and retinal vascular structure.
Publisher: Wiley
Date: 04-2011
DOI: 10.1111/J.1442-9071.2010.02455.X
Abstract: Glaucoma, one of the major causes of blindness in the world, is a progressive optic neuropathy. Elevated intraocular pressure is a well-known major risk factor for glaucoma. In addition, there is growing evidence that vascular factors may play a role in glaucoma pathogenesis. Systemic (e.g. hypertension, diabetes) and ocular vascular factors (e.g. ocular blood flow, ocular perfusion pressure) have been assessed for associations with glaucoma. However, direct and convincing evidence for primary mechanisms of glaucoma is still lacking. The aim of this review is to summarize the evidence implicating vascular factors in the pathogenesis of glaucoma, with particular emphasis on the role of ocular blood flow and ocular circulation as risk factors for primary open angle glaucoma.
Publisher: MDPI AG
Date: 21-02-2021
DOI: 10.3390/NU13020689
Abstract: This study investigates the associations between sodium intake and diabetes complications in a nationwide cohort of elderly Japanese patients with type 2 diabetes aged 65–85. Data from 912 in iduals regarding their dietary intake at baseline is analyzed and assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes are times to diabetic retinopathy, overt nephropathy, cardiovascular disease (CVD), and all-cause mortality during six years. We find that mean sodium intake in quartiles ranges from 2.5 g to 5.9 g/day. After adjustment for confounders, no significant associations are observed between sodium intake quartiles and incidence of diabetes complications and mortality, except for a significant trend for an increased risk of diabetic retinopathy (p = 0.039). Among patients whose vegetable intake was less than the average of 268.7 g, hazard ratios (HRs) for diabetic retinopathy in patients in the second, third, and fourth quartiles of sodium intake compared with the first quartile were 0.87 (95% CI, 0.31–2.41), 2.61 (1.00–6.83), and 3.70 (1.37–10.02), respectively. Findings indicate that high sodium intake under conditions of low vegetable intake is associated with an elevated incidence of diabetic retinopathy in elderly patients with type 2 diabetes.
Publisher: Wiley
Date: 08-2009
DOI: 10.1080/10739680902975222
Abstract: The aim of this study was to examine the relationship of retinal vascular caliber with diabetes and impaired fasting glucose (IFG) in a multiethnic Asian population. This work was a population-based cross-sectional study comprising 3,404 Singaporean Chinese, Indian, and Malay participants. Retinal arteriolar and venular diameters, CRAE and CRVE, respectively were measured from digital retinal photographs. Diabetes was defined as physician-diagnosis of diabetes, self-reported use of diabetic medication, or fasting plasma glucose (FPG) > or = 7 mmol/L IFG as FPG 6.1-6.9 mmol/L. After adjusting for age, gender, ethnicity, systolic blood pressure, body mass index, total cholesterol, triglycerides, smoking, and vascular caliber (Model 3), participants with diabetes had both larger CRAE and CRVE, compared to those with normal fasting glucose (NFG) or IFG. In a multivariate analysis, including clinical risk factors and CRVE, mean CRAE increased from 143.6 microm in NFG to 145.3 microm with diabetes (P for trend = 0.01). On the other hand, each mmol/L increase in FPG was associated with a 0.51-microm increase in CRVE (P=0.006). In a subgroup analysis stratified by ethnicity, the association between FPG and larger CRVE was predominantly present among ethnic Indians (0.9-microm increase in CRVE per mmol/L increase in FPG). Diabetes was associated with larger retinal arteriolar diameters and glucose level was associated with larger retinal venular diameters in this multiethnic Asian population. The magnitude of association between glucose level and venular widening was stronger among ethnic Indians.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 11-12-2014
Abstract: To investigate the relationship between age and ocular higher-order wavefront aberrations (HOAs) in an adult Japanese population, in addition to factors associated with HOA variations. In the Yamagata Study (Funagata) cohort, 227 adult Japanese participants (aged 37-86 years) underwent systemic and ophthalmologic examinations in 2012. Ocular, corneal, and internal HOAs were measured in micrometers. From the Zernike coefficients, we calculated the root mean square of the total HOA, coma, and spherical aberration for a pupil diameter of 4 mm. Linear regression analyses were used to determine whether HOAs were associated with age or other factors. Multiple adjusted linear regression analyses demonstrated that all components of logarithmic HOAs increase with age. Ocular, corneal, and internal HOAs increased by 0.012/y (P < 0.001), 0.007/y (P = 0.010), and 0.014/y (P < 0.001), respectively. Ocular coma also significantly increased with age (0.010/y, P = 0.007), but corneal (P = 0.963) and internal (P = 0.476) coma did not. Age-related spherical aberration increased only in the internal component (0.019/y, P = 0.001). In addition to age, ocular and corneal HOAs were mainly affected by corneal indexes. Aging is associated with increases in ocular HOAs, independent of other possible confounding factors. The association of ocular HOAs with corneal parameters indicates that ocular HOAs are mainly generated by the cornea. Internal HOAs, supposedly generated from cataract progression, may be associated with systemic factors, including serum creatinine levels and blood pressure.
Publisher: Springer Science and Business Media LLC
Date: 16-04-2021
Publisher: American Diabetes Association
Date: 29-07-2009
DOI: 10.2337/DC09-0075
Abstract: Flicker light–induced retinal vasodilation may reflect endothelial function in the retinal circulation. We investigated flicker light–induced vasodilation in in iduals with diabetes and diabetic retinopathy. Participants consisted of 224 in iduals with diabetes and 103 nondiabetic control subjects. Flicker light–induced retinal vasodilation (percentage increase over baseline diameter) was measured using the Dynamic Vessel Analyzer. Diabetic retinopathy was graded from retinal photographs. Mean ± SD age was 56.5 ± 11.8 years for those with diabetes and 48.0 ± 16.3 years for control subjects. Mean arteriolar and venular dilation after flicker light stimulation were reduced in participants with diabetes compared with those in control subjects (1.43 ± 2.10 vs. 3.46 ± 2.36%, P & 0.001 for arteriolar and 2.83 ± 2.10 vs. 3.98 ± 1.84%, P & 0.001 for venular dilation). After adjustment for age, sex, diabetes duration, fasting glucose, cholesterol and triglyceride levels, current smoking status, systolic blood pressure, and use of antihypertensive and lipid-lowering medications, participants with reduced flicker light–induced vasodilation were more likely to have diabetes (odds ratio 19.7 [95% CI 6.5–59.1], P & 0.001 and 8.14 [3.1–21.4], P & 0.001, comparing lowest vs. highest tertile of arteriolar and venular dilation, respectively). Diabetic participants with reduced flicker light–induced vasodilation were more likely to have diabetic retinopathy (2.2 [1.2–4.0], P = 0.01 for arteriolar dilation and 2.5 [1.3–4.5], P = 0.004 for venular dilation). Reduced retinal vasodilation after flicker light stimulation is independently associated with diabetes status and, in in iduals with diabetes, with diabetic retinopathy. Our findings may therefore support endothelial dysfunction as a pathophysiological mechanism underlying diabetes and its microvascular manifestations.
Publisher: American Diabetes Association
Date: 11-11-2020
DOI: 10.2337/DC20-1534
Publisher: IEEE
Date: 09-2013
Publisher: Wiley
Date: 30-10-2015
DOI: 10.1111/CAS.12811
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 02-2011
Publisher: Wiley
Date: 28-07-2011
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 30-03-2017
Abstract: To report a semiautomated retinal vessel caliber measurement system that measures central retinal artery (vein) equivalent (CRAE [CRVE]) with in idual correction for magnification errors under conditions assuming optimal focus. The focusing condition of the subject eye fundus camera optical system was in idually determined by constructing an optical model of each eye applying its refractive error, corneal curvature, and axial length (AL) to Gullstrand's schematic eye, and by adjusting the position of the camera's focusing lenses using each eye's refractive error. Once the focusing condition of the entire optical system was fulfilled, magnification of the fundus images was calculated using paraxial ray tracing. Measurements of CRAE (CRVE) were performed in an annular area centered on the optic disc with magnification-corrected diameter from 1.8 to 2.7 mm. Reproducibility of the measurements of the results using the new method and comparison with those using interactive vessel analysis (IVAN) were performed in normal Japanese eyes. Intra- and interexaminer intraclass correlation coefficient (ICC) for CRAE (CRVE) measurements was greater than 0.978. CRAE (CRVE) using the new method averaged 148.9 ± 10.9 μm (225.0 ± 13.9 μm mean ± SD, N = 99). Differences between the new method and IVAN were greater with increasing AL (P < 0.001). The new method yielded CRAE (CRVE) in good agreement with IVAN in eyes with AL of approximately 24 mm. However, the new method yielded smaller values in eyes with shorter AL and vice versa. A new accurate and reproducible method to measure CRAE (CRVE) from fundus photographs was reported.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2009
Publisher: Wiley
Date: 05-2017
DOI: 10.1111/MICC.12344
Abstract: The aim of this study was to assess the relationship between retinal vascular caliber and target organ damage in HT patients. Data were collected on cardiac, renal, vascular, and retinal variables in 88 consecutive never-treated HT subjects. Retinal vascular calibers were measured from fundus photographs by using a semi-automated computer-assisted program and summarized as CRAE and CRVE. Mean CRAE and CRVE were significantly lower in patients with left ventricular hypertrophy (left ventricular mass ≥110 g/m² for women, 125 g/m² for men) than in those with normal left ventricular (CRAE: 129.4±3.7 vs 138.2±2.3 μm P=.04 CRVE: 195.6±4.4 vs 209.8±2.7 μm P=.008). CRAE and CRVE were negatively correlated with urinary albumin excretion (β±SE=-15.4±3.2, P<.0001 and β±SE=-11.9±4.4, P=.001, respectively) but were not correlated with estimated glomerular filtration rate (P=.21 and P=.75, respectively), carotid-to-femoral pulse wave velocity (P=.24 and P=.14), or carotid augmentation index (P=.43 and P=.16). In never-treated HT patients, reduced CRAE and CRVE were associated with cardiac and renal preclinical damage, ie, left ventricular hypertrophy and albuminuria, but not estimated glomerular filtration rate or vascular stiffness.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2021
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.ATHORACSUR.2015.03.099
Abstract: To (1) determine the prevalence of hypertension late after coarctation repair in patients with normal-sized transverse arches, and (2) evaluate the potential for end-organ damage related to hypertension after coarctation repair. There are no studies specifically investigating end-organ damage and hypertension after coarctation repair using noninvasive techniques. Eighty-two patients aged 10 years or greater with a coarctation repair and a normal-sized arch operated on between 1978 and 2010, underwent a transthoracic echocardiogram, 24-hour blood pressure (BP) monitoring, and retinal imaging. Median age at repair was 1 year (interquartile range, 0 to 6) 45% (37 of 82) were operated in the first year of life. After a follow-up of 24 ± 7 years, 27% (22 of 82) and 50% (41 of 82) suffered resting hypertension and resting prehypertension, respectively. On 24-hour BP monitoring, 61% (49 of 80) and 21% (17 of 80) suffered hypertension and prehypertension, respectively. Arch reobstruction (echo gradient > 25 mm Hg) was present in only 15% (12 of 82), and in only 15% (7 of 47) with 24-hour hypertension. Resting hypertension was associated with a smaller central retinal artery equivalent (average width of arterioles) and central retinal vein equivalent (average width of venules) (p = 0.0006 and p = 0.003, respectively). Left ventricular hypertrophy on echocardiography was present in 63% (31 of 49) with 24-hour hypertension compared with only 42% (13 of 31) with normal 24-hour BP (p = 0.06). There is a high rate of hypertension late after coarctation repair, even in patients with unobstructed arches. The presence of retinal imaging abnormalities and left ventricular hypertrophy signals the presence of end-organ damage in this young adult population. Regular follow-up with 24-hour BP monitoring is warranted.
Publisher: Wiley
Date: 27-06-2013
DOI: 10.1111/AOS.12173
Abstract: To determine the reliability and reproducibility of the Vesselmap Oximetry Module for arteriolar and venular oxygen saturation (SO2 ) of the same retinal area, specified by a peripapillary annulus, in healthy subjects. Fundus oximetry images were obtained, using a standardized protocol by a single observer, from the right eye of 20 healthy in iduals. Age range was 19-45 years old, and images were analysed using the oximetry module of the Vesselmap System (Imedos, UG, Germany). Intra-observer reliability (assessment of two measurements of SO2 values performed 5 days apart) interobserver reliability (assessment of SO2 performed by two different trained observers) and intrasubject reproducibility (comparison of SO2 measurements of two different images of the same subject and retinal area, taken 10 min apart) were assessed. The standard deviations between the repeated measurements (SDr), together with the intraclass correlation coefficient (ICC), of these three parameters were calculated. The SDr for intra-observer reliability was 0.56% and 0.55% for arteriolar and venular SO2 , respectively. The results were similar for intrasubject reproducibility (0.69% and 0.79% for arteriolar and venular SO2, respectively) interobserver reliability, however, was higher (SDr 1.22% and 1.01% for arteriolar and venular SO2 , respectively). The ICC values for intra-observer reliability were 0.99 for both arteriolar and venular SO2 . The results were similar for both interobserver reliability (0.94 for arteriolar SO2 and 0.96 for venular SO2 ) and intrasubject reproducibility (0.98 for both arteriolar and venular SO2 ). Retinal oxygen saturation values taken using the oximetry module of the Vesselmap System are highly reliable and reproducible, provided the image quality is standardized, the same measurement area is analysed in each image, and the number of observers analysing the images is kept to a minimum.
Publisher: Springer Science and Business Media LLC
Date: 18-06-2012
DOI: 10.1007/S10916-010-9536-6
Abstract: Recent advances in medical imaging modality have enabled us to identify new features in retinal vasculature. One of the features is retinal vascular tortuosity which has been shown to become a predictive factor for cardiovascular diseases and diabetes. The changes in retinal vascular tortuosity might be a sign of severity or improvement of the disease. In this paper, we propose a new method for measuring retinal vascular tortuosity. We adopt a new technique to analyze tortuosity that consider vessel-segment's width simultaneously. Our proposed method measures vessel-segment's tortuosity on its edge. A qualitative assessment shows that the method is appropriate for measuring the tortuosity of the vessels in different widths and directions in the image. Finally, a comparison distinguishing tortuous vs. non tortuous vessels demonstrates that the proposed approach may be suitable for predicting or earlier diagnosis of diabetes or cardiovascular diseases.
Publisher: Mary Ann Liebert Inc
Date: 05-2016
Publisher: Elsevier BV
Date: 07-2011
Publisher: Wiley
Date: 30-11-2020
DOI: 10.1111/AOS.14690
Abstract: To report a new severity grading system for Fuchs endothelial corneal dystrophy (FECD) using anterior segment optical coherence tomography (AS‐OCT). This observational case series included 75 eyes of 43 patients with FECD and 33 eyes of 33 healthy subjects. Pachymetry and posterior elevation maps were used to determine the AS‐OCT‐based grading scores. FECD severity was graded from 0–3 as follows: 0, normal 1, guttae only 2, stromal oedema and 3, epithelial and stromal oedema. We further investigated the central corneal thickness (CCT), thinnest corneal thickness (TCT), anterior and posterior best‐fit spheres (BFS), and the distance between the central cornea and the thinnest point. Thirty‐three eyes were graded as 0, four as 1, thirteen as 2, fourteen as 3, twenty‐nine as 4, eleven as 5 and four as 6 by the modified Krachmer grade. Thirty‐three, 41, 30 and 4 eyes were graded as 0, 1, 2 and 3, respectively, by the AS‐OCT‐based grading system. The inter‐observer agreement was 100% for the AS‐OCT‐based grading system. The CCT, TCT, posterior BFS, and distance between the central cornea and thinnest point were significantly different between AS‐OCT‐based grades (p = 0.0001, 0.0001, 0.0036 and 0.0001, respectively). Anterior BFS was not significantly different with the AS‐OCT‐based grades (p = 0.1184). We devised a new severity grading using only objective evaluation and quantitatively demonstrated corneal thickening, predominant flattening of the posterior corneal surface compared with the anterior surface, and displacement of the thinnest point away from the central cornea with FECD progression.
Publisher: BMJ
Date: 12-10-2011
Abstract: Understanding the impact of a condition from the patient's perspective is important, and different types of patient-reported outcomes or instruments are available to help with this. This review article summarises the current evidence on the impact of diabetic retinopathy (DR) and its associated vision impairment on patient-reported outcomes. We have included research that has used a range of outcome measures to assess the impact of DR on generic health-related quality of life, utility, vision-functioning and vision-specific quality of life. This review also offers clarification on frequently misused psychometric terminologies to help clinicians and researchers better understand the literature associated with patient-reported outcome research. Overall, the evidence suggests that DR, particularly in its vision-threatening stages, has a substantial, negative impact on the patient. However, our understanding of the impact of DR is currently restricted due to limitations inherent in currently available patient-reported outcome measures. We conclude by discussing potential directions for future research in this area, such as item banking and computer adaptive testing.
Publisher: Wiley
Date: 17-04-2023
DOI: 10.1111/AOS.15667
Abstract: The Danish Registry of Diabetic Retinopathy includes information from 000 patients who attends diabetic retinopathy (DR) screening in Denmark. Screening of patients with uncomplicated type 2 diabetes is often performed by practicing ophthalmologists, while patients with type 1 and complicated type 2 diabetes attends screening at hospitals. We performed a clinical reliability study of retinal images from Danish screening facilities to explore the inter‐grader agreement between the primary screening ophthalmologist and a blinded, certified grader. Invitations to participate were sent to screening facilities across Denmark. The primary grader uploaded fundus photographs with information on estimated level of DR (International Clinical Diabetic Retinopathy scale as 0 [no DR], 1–3 [mild, moderate or severe nonproliferative DR {NPDR}], or 4 [proliferative DR {PDR}]), region of screening, image style, and screening facility. Images were then regraded by a blinded, certified, secondary grader. Weighted kappa analysis was performed to evaluate agreement. Fundus photographs from 230 patients (458 eyes) were received from practicing ophthalmologists (52.6%) and hospital‐based grading centres (47.4%) from all Danish regions. Reported levels of DR by the primary graders were 66.8%, 12.2%, 13.1%, 1.3% and 5.5% for DR levels 0–4. The overall agreement between primary and secondary graders was 93% ( κ = 0.83). Based on screening facility agreement was 96% ( κ = 0.89) and 90% ( κ = 0.76) for practicing ophthalmologists and hospital‐based graders. In this nationwide study, we observed a high overall inter‐grader agreement and based on this, it is reasonable to assume that reported DR gradings in the screening programme in Denmark, accurately reflect the truth.
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.DIABET.2017.06.002
Abstract: Hypoglycaemia is a common complication in diabetes patients. However, its relationship with retinopathy has not been well documented in patients with type 2 diabetes (T2D). This study aimed to investigate the associations between hypoglycaemia and the incidence and progression of diabetic retinopathy (DR). In this longitudinal cohort study, which was part of the Japan Diabetes Complications Study (JDCS), adult patients with T2D were recruited at 59 diabetes clinics across Japan. Their history of hypoglycaemia was assessed by standardized self-reported questionnaires. Severe hypoglycaemia was defined as having at least one episode with coma requiring an outpatients visit or hospitalization. Adjusted hazard ratios (HRs) for incidence and progression of DR over 8 years of follow-up were determined. Of 1221 patients without DR, 127 (10.4%) had experienced non-severe hypoglycaemia within the previous year, whereas 10 (0.8%) reported severe hypoglycaemia episodes. During the 8-year follow-up involving 8492 person-years, 329 patients developed DR. In 410 patients with prevalent DR, the adjusted HRs for incident DR were 4.35 (95% CI: 1.98-9.56 P<0.01) and, for progression of DR, 2.29 (95% CI: 0.45-11.78 P=0.32) with severe hypoglycaemia. Having a history of severe hypoglycaemia was one of the strongest predictors of incident DR in patients with T2D, with a fourfold increased risk. Identifying patients with greater risks of DR based on their history of hypoglycaemia may help to personalize risk evaluation in patients with diabetes.
Publisher: BMJ
Date: 03-2021
DOI: 10.1136/BMJOPHTH-2020-000661
Abstract: We examined the hypothesis that baseline retinal vascular geometry in patients with proliferative diabetic retinopathy (PDR) predicts disease activity 6 months after panretinal photocoagulation (PRP). We included 47 eyes from 40 patients with treatment-naïve PDR in a 6-month prospective study. Diagnosis of PDR and disease activity was evaluated by wide-field fluorescein angiography (Optomap, Optos, Dunfermline, Scotland, UK). At baseline and 6-month follow-up, the retinal vessel geometry was measured on optic disc centred images using semiautomated software Vessel Assessment and Measurement Platform for Images of the Retina (VAMPIRE, Dundee, Scotland). At baseline, mean age and duration of diabetes was 51.6 and 21.4 years, and 62.5% were men. Seventeen eyes (36.2%) had progression of PDR during follow-up. At baseline, we found higher retinal arteriolar calibre (31.3±0.8 vs 28.8±0.8 pixels, p=0.02) and venous fractal dimension (F D ) (1.257±0.011 vs 1.222±0.011, p=0.02) in eyes with progression of PDR as compared with eyes with non-progression. In a multiple logistic regression model, both higher retinal arteriolar calibre (OR 1.34, 95% CI, 1.09 to 1.64, p .01) and venular F D (OR 1.15, 95% CI, 1.04 to 1.27, p .01) predicted progression of PDR. Venular calibre was seen to increase from baseline to month six regardless of disease progression (non-progression 45.0±0.7 vs 52.7±1.8 pixels, p .01 progression 46.2±0.8 vs 51.0±1.7 pixels, p .01). Our prospective study showed that arteriolar calibre and venular F D at baseline were predictive of disease activity 6 months after PRP treatment in patients with treatment-naïve PDR.
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.OPHTHA.2019.05.027
Abstract: To present phenotypic features of 22 patients with S-antigen (SAG) mutations. Retrospective cohort study. Twenty-one Japanese patients from 16 families with a homozygous c.924delA mutation and 1 patient with a homozygous c.636delT mutation in the SAG gene. Clinical records on symptoms best-corrected visual acuity and Goldmann perimetry, fundus photography, fundus autofluorescence (FAF), OCT, and electroretinography results were reviewed. Best-corrected visual acuity, Goldmann perimetry results, imaging findings, and electroretinography results. Ten patients had Oguchi disease and 12 had retinitis pigmentosa (RP) with mean follow-up periods of 13.8 and 10.2 years, respectively. Retinitis pigmentosa patients were older (mean age, 56.0 years) than those with Oguchi disease (mean age, 22.1 years P < 0.001) at the initial visit. Night blindness noted in childhood was the most common initial symptom for both Oguchi disease (80.0%) and RP (91.7%) patients. Best-corrected visual acuity in the logarithm of the minimum angle of resolution (logMAR) was well preserved in Oguchi disease patients (mean, 0.02 logMAR in both eyes) but reduced in most RP patients (mean, 1.32 logMAR [right eye] and 1.35 logMAR [left eye]). Similarly, the visual field in the retinal area was preserved in Oguchi disease patients (mean, 677 mm Retinitis pigmentosa with SAG mutations often shows a characteristic golden sheen surrounding posterior pigmentary retinal degeneration. Oguchi disease can show progressive degeneration in adulthood, rarely resulting in RP.
Publisher: Springer Science and Business Media LLC
Date: 16-04-2009
DOI: 10.1038/JHH.2009.27
Publisher: IEEE
Date: 12-2010
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.COMPBIOMED.2013.07.018
Abstract: Retinal imaging can facilitate the measurement and quantification of subtle variations and abnormalities in retinal vasculature. Retinal vascular imaging may thus offer potential as a noninvasive research tool to probe the role and pathophysiology of the microvasculature, and as a cardiovascular risk prediction tool. In order to perform this, an accurate method must be provided that is statistically sound and repeatable. This paper presents the methodology of such a system that assists physicians in measuring vessel caliber (i.e., diameters or width) from digitized fundus photographs. The system involves texture and edge information to measure and quantify vessel caliber. The graphical user interfaces are developed to allow retinal image graders to select in idual vessel area that automatically returns the vessel calibers for noisy images. The accuracy of the method is validated using the measured caliber from graders and an existing method. The system provides very high accuracy vessel caliber measurement which is also reproducible with high consistency.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.OPHTHA.2019.05.021
Abstract: To determine the association of retinal thickness with cognitive function in Japanese persons. Cross-sectional, population-based survey. A total of 1293 Japanese persons aged 65 to 86 years who resided in the Saku area in the Japan Public Health Center-Based Prospective Study participated in the eye and mental health screening. Participants underwent comprehensive ophthalmic assessment, including fundus photography, measurement of intraocular pressure, and determination of refraction status. We assessed the thickness of the macular retinal nerve fiber layer (mRNFL), ganglion cell-inner plexiform layer (GC-IPL), and ganglion cell complex (GCC, which includes the retinal nerve fiber layer and GC-IPL), and the full thickness in the macula and peripapillary retinal nerve fiber layer (ppRNFL) using spectral-domain (SD) OCT. Cognitive tests consisted of the Mini-Mental State Examination, Wechsler Memory Scale Revised logical memory I/II subtest, clock drawing test, and Clinical Dementia Rating Scale. These were used to designate the participants in the following 3 groups: Normal, those with mild cognitive impairment (MCI), and those with dementia. Multivariable logistic regression models were used to analyze associations between retinal thickness and cognitive function after adjusting potential confounding factors. Association of retinal thickness with cognitive function. Among the 1293 potential subjects, 114 were excluded for a diagnosis of depression, 64 were excluded for retinal disease, and 140 were excluded for scanning errors or suboptimal OCT images. The remaining 975 participants (mean age, 73.2 years) were included in this analysis. Significant differences were found in the 3 groups in all layers and GCC thickness, but not in ppRNFL thickness. After adjusting for age, sex, educational status, and refraction, full macular thickness and GCC thickness were inversely associated with the presence of dementia, but ppRNFL thickness was not. Furthermore, GC-IPL, GCC, and full macular thicknesses were all associated with the presence of dementia in the inferior sectors. Macular thickness was associated with the presence of dementia, but ppRNFL was not. Our results suggest that OCT measurements of the macula could be superior to those of the ppRNFL in assessing neurodegenerative changes and a potentially useful diagnostic biomarker of cognitive function.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2014
Publisher: IEEE
Date: 07-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 16-05-2011
Publisher: Informa UK Limited
Date: 12-2009
DOI: 10.3109/02713680903353764
Abstract: Dilation of retinal vessels in response to diffuse luminance flicker may reflect endothelial function. Although this has previously been shown to be reproducible in whites, there have been no similar data in Asians. We assess the reproducibility of repeated measurements of this response in Asians. Healthy Asians (n = 33) with normal vision and no history of glaucoma, age-related macular degeneration, cataract, or retinal arterial/venous occlusion participated in this study. Repeated measures from the same subjects were taken 30-60 min apart using the Dynamic Vessel Analyser (DVA, IMEDOS, Jena, Germany). Modification was made to the shape of the light source for Asian participants. Correlations of the first and second measures were assessed using Pearson correlation (R(2)), and agreement between the two measures was shown using Bland-Altman plots. After modification to the shape of the light source, almost perfect correlation was found between the 1st and 2nd measurements of baseline arteriolar (R(2) = 0.95) and venular diameters (R(2) = 0.98) of arteriolar maximum dilation (R(2) = 0.85). Substantially high correlation between the 1st and 2nd measurements of venular maximum dilation was found (R(2) = 0.80). Measurements of the dilation response of retinal vessels to diffuse luminance flicker an Asian s le using the DVA show high reproducibility for repeated measures over a short period of time. Such measurements may allow non-invasive quantification of endothelial function to study its association with systemic and ocular diseases.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 11-08-2015
Abstract: To investigate the association between radiation exposure from the atomic bombings and the prevalence of age-related macular degeneration (AMD) among older residents of Hiroshima and Nagasaki. The Adult Health Study is a cohort study of atomic bomb survivors living in Hiroshima and Nagasaki, comprising 2153 participants who underwent examinations with retinal fundus photographs in 2006-2008. The radiation dose to the eye for the analysis was estimated with the revised dosimetry system (DS02). The retinal photographs were graded according to the Wisconsin Age-Related Maculopathy Grading System modified for nonstereoscopic retinal images. Early and late AMD were defined according to the type of lesion detected in the worse eye of the participants. Person-specific data were analyzed by using a logistic regression model to assess the association between radiation dose and AMD. Among the 1824 subjects with gradable retinal images (84.7% of the overall participants), the estimated eye dose was widely distributed, with a mean of 0.45 Gy and standard deviation of 0.74 Gy. The prevalence of early and late AMD was 10.5% and 0.3%, respectively. There were no significant associations between radiation dose and AMD, with each 1-Gy increase in exposure, adjusted odds ratio was 0.93 (95% confidence interval [CI], 0.75-1.15) for early AMD and 0.79 (95% CI, 0.21-2.94) for late AMD. No significant associations were found between atomic bomb irradiation early in life and the prevalence of early or late AMD later in life among Japanese atomic bomb survivors.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 17-03-2020
DOI: 10.1167/IOVS.61.3.23
Publisher: Springer Science and Business Media LLC
Date: 06-2011
DOI: 10.1007/S00125-011-2199-0
Abstract: The aim of this study was to determine the incidence and progression rates of diabetic retinopathy and their associations in Japanese in iduals with type 2 diabetes. This is a part of the Japan Diabetic Complications Study (JDCS), a multi-centred randomised trial of type 2 diabetes patients aged 40-70 years with an 8 year follow-up. There were 1,221 patients without diabetic retinopathy at baseline incidence of diabetic retinopathy was defined as the development of any diabetic retinopathy. There were 410 patients with mild non-proliferative diabetic retinopathy at baseline progression of diabetic retinopathy was defined as the development of severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy. We used multivariate proportional Cox hazard models, and generalised additive models were also applied to identify potential threshold effect. The incidence and progression rate of diabetic retinopathy was 38.3/1,000 person-years and 21.1/1,000 person-years, respectively. Higher HbA(1c) (adjusted HR [aHR] per 1% [10.9 mmol/mol] 1.36 [95% CI 1.28-1.45]), longer duration of diabetes (aHR per 5 year period 1.26 [95% CI 1.17-1.35]), higher systolic blood pressure (aHR per +10 mmHg 1.01 [95% CI 1.00-1.02]) and higher body mass index (aHR per 1 kg/m(2) 1.05 [95% CI 1.00-1.09]) were associated with incident diabetic retinopathy. The association between HbA(1c) and incident diabetic retinopathy was linear the association with duration of diabetes increased rapidly between 5 and 10 years. Higher HbA(1c) was also associated with progression of diabetic retinopathy (aHR per 1% [10.9 mmol/mol] 1.66 [95% CI 1.41-1.96]). Observed incidence and progression rates of diabetic retinopathy seemed lower than that in western populations. HbA(1c) was the only factor associated with both incidence and progression of diabetic retinopathy. The strength of the association between duration of diabetes and incidence of diabetic retinopathy increased rapidly during a period of 5 to 10 years duration of diabetes. C000000222 ( www.umin.ac.jp ) This study is supported by the Ministry of Health, Labour and Welfare, Japan.
Publisher: Elsevier BV
Date: 05-2011
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 11-2013
Publisher: Wiley
Date: 30-05-2014
DOI: 10.1111/CEO.12354
Publisher: IOP Publishing
Date: 12-06-2014
Publisher: Springer Science and Business Media LLC
Date: 23-11-2019
DOI: 10.1007/S10384-019-00702-6
Abstract: To report the demographics and clinical characteristics of patients with a primary retinal detachment (RD). Prospective cohort study by a registry design. Patients with RD treated at vitreoretinal sub-specialty institutions in Japan from February 2016 to March 2017. Descriptive statistics for the primary RD, and multivariable ordered logistic regression and multiple linear regression analyses were performed. 3178 eyes of 3178 cases were analyzed. The interval from onset to surgery was significantly shorter in patients in the 40-year age group than in other age groups except for the 50-year age group (P<0.05, Steel-Dwass test). The proportion of complex cases was significantly higher in the 10-year, 70-year, and 80+ year age groups than in the 40 and 50-year age groups (P<0.05, Steel-Dwass test). The size of RD was significantly associated with the male sex (odds ratio, 1.29 95% confidence interval [CI], 1.07 to 1.56 P=0.0085) and the interval from onset to surgery (odds ratio, 1.03 95% CI, 1.01 to 1.04 P=0.0014). Low IOPs in eyes with RD were significantly associated with an older age (-0.24 mmHg/10 years, 95% CI, -0.32 to -0.16], P<0.0001) and larger RD area (-0.91 mmHg/quadrant, 95% CI, [-1.06 to -0.76], P <0.0001). Profile and clinical characteristics of patients with a primary RD were not exactly the same as previous reports. A preoperative low IOP was associated with several ocular factors while the area of RD was associated not only with ocular but with social factors as well.
Location: Japan
Location: United States of America
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End Date: 2012
Funder: Japan Society for the Promotion of Science
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Funder: Japan Society for the Promotion of Science
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Funder: Japan Society for the Promotion of Science
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Funder: Japan Society for the Promotion of Science
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Funder: National Health and Medical Research Council
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Funder: National Health and Medical Research Council
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Funder: Japan Society for the Promotion of Science
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Funder: Ministry of Health Labour and Welfare
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Funder: Ministry of Health Labour and Welfare
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Funder: Ministry of Health Labour and Welfare
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Funder: Japan Society for the Promotion of Science
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Funder: Japan Society for the Promotion of Science
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Funder: Ministry of Health Labour and Welfare
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Funder: Ministry of Health Labour and Welfare
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Funder: Japan Society for the Promotion of Science
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Funder: Japan Society for the Promotion of Science
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Funder: Japan Society for the Promotion of Science
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Funder: Japan Society for the Promotion of Science
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End Date: 2021
Funder: Japan Society for the Promotion of Science
View Funded ActivityStart Date: 2020
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Funder: Japan Society for the Promotion of Science
View Funded ActivityStart Date: 2010
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Funder: National Health and Medical Research Council
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Funder: Japan Society for the Promotion of Science
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Funder: Japan Society for the Promotion of Science
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Funder: Japan Society for the Promotion of Science
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Funder: Ministry of Health Labour and Welfare
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Funder: Ministry of Health Labour and Welfare
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Funder: Japan Society for the Promotion of Science
View Funded ActivityStart Date: 1999
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Funder: Japan Society for the Promotion of Science
View Funded ActivityStart Date: 2010
End Date: 2012
Funder: Japan Society for the Promotion of Science
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