scholarly journals Quantitative cone contrast threshold testing in patients with differing pathophysiological mechanisms causing retinal diseases

2020 ◽  
Author(s):  
Kayla M. White ◽  
Caroline Frambach ◽  
John Doan ◽  
Urmi V. Mehta ◽  
Itamar Livnat ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Visual Function ◽  
Age Related Macular Degeneration ◽  
Contrast Threshold ◽  
Retinal Diseases ◽  
Disease States ◽  
Vein Occlusion ◽  
Age Related ◽  
Threshold Testing

AbstractPurposeCone contrast threshold testing (CCT) provides quantitative measurements of color and contrast function to reveal changes in vision quality that is not a standard endpoint in clinical trials. We utilize CCT to measure visual function in patients with multiple sclerosis (MS), age-related macular degeneration (AMD), epiretinal membrane (ERM), and retinal vein occlusion (RVO).MethodsRetrospective data was gathered from 268 patients of the Gavin Herbert Eye Institute. Subjects included 17 patients with MS, 45 patients with AMD, 41 patients with ERM, 11 patients with RVO, and 123 age and visual acuity-matched healthy controls. Patients underwent the primary measurement outcome, CCT testing, as well as Sloan visual acuity test and spectral domain optical coherence tomography during normal care.ResultsColor and contrast deficits were present in MS patients regardless of history of optic neuritis. AMD with intermediate or worse disease demonstrated reduced CCT scores. All 3 stages of ERM demonstrated cone contrast deficits. Despite restoration of visual acuity, RVO-affected eyes demonstrated poorer CCT performance than unaffected fellow eyes.ConclusionsCCT demonstrates color and contrast deficits for multiple retinal diseases with differing pathophysiology. Further prospective studies of CCT in other disease states and with larger samples sizes is warranted.Brief Summary StatementIn a retrospective analysis of 268 adults, cone contrast threshold testing (CCT) demonstrates patterns of visual function deficits in multiple sclerosis and age-related macular degeneration and similar declines in epiretinal membranes and retinal vein occlusion beyond standard visual acuity. Across all disease states, color and contrast vision were negatively impacted.

scholarly journals Review of Subthreshold Diode Micropulse Laser Treatment for Retinal Diseases

2018 ◽  
Vol 1 (1) ◽  
pp. 62-70
Author(s):  
Juhn AT ◽  
Shyu AP ◽  
Benjamin J ◽  
Zhang Y
Keyword(s):  
Diabetic Retinopathy ◽  
Treatment Modality ◽  
Branch Retinal Vein Occlusion ◽  
Age Related Macular Degeneration ◽  
Clinical Settings ◽  
Retinal Diseases ◽  
Micropulse Laser ◽  
Vein Occlusion ◽  
Age Related ◽  
New Treatment

Subthreshold Diode Micropulse (SDM) laser is a relatively new treatment modality that confers very little to no anatomical risk to the retina. However, its efficacy is still being studied, and the scenario where SDM is most useful is still being elucidated. This paper reviews articles from 1997 to 2017 and reviews the settings, results, and outcomes of SDM in various clinical settings including diabetic macular edema, branch retinal vein occlusion, central serous Chorioretinopathy, proliferative diabetic retinopathy, and age-related macular degeneration.

scholarly journals Correlation Between Improvement in Visual Acuity and QOL After Ranibizumab Treatment for Age-related Macular Degeneration Patients: QUATRO Study

2020 ◽  
Author(s):  
Yuji Oshima ◽  
Yumi Ishibashi ◽  
Naoyasu Umeda ◽  
Tatsuo Nagata ◽  
Shigeo Yoshida ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Visual Function ◽  
Age Related Macular Degeneration ◽  
Open Label ◽  
Satisfaction Questionnaire ◽  
Age Related ◽  
The Mean ◽  
Baseline Visual Acuity ◽  
Ranibizumab Treatment

Abstract Background: To evaluate the correlation between visual acuity improvement and vision-related QOL after ranibizumab treatment in Japanese patients with AMD.Methods: In this one-year prospective, interventional, open-label, multicenter study involving four sites, patients with neovascular AMD were enrolled and observed for 12 months. Treatment-naïve patients received 0.5 mg ranibizumab as needed (PRN) after three initial monthly doses. The best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at every visit. Fluorescein and indocyanine green angiography, and evaluations with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and patient satisfaction questionnaire were performed at baseline and 3 and 12 months after initial treatment. The primary endpoint was the change in BCVA and QOL 3 months after ranibizumab treatment. Secondary endpoints included change in BCVA, QOL, CMT, and patient satisfaction over 12 months.Results: The study enrolled 100 patients. The mean logMAR BCVA after the 3-month treatment improved significantly from 0.43 to 0.30 (p<0.0001). The mean NEI-VFQ-25 composite scores were higher after 3 months of ranibizumab treatment, improving from 79.48 to 84.13 (p<0.0001). The changes in the NEI-VFQ-25 score and BCVA showed significant correlation in the poor baseline visual acuity group (decimal BCVA below 0.5, p=0.02) but not in the better baseline visual acuity group (decimal BCVA above 0.6, p=0.1) after the three loading doses. There were no significant differences in the satisfaction questionnaire score from baseline to after the three loading doses (p=0.5466). The average CMT improved significantly from 340 to 264 mm after the loading doses (p<0.0001).Conclusions: Intravitreal ranibizumab treatment resulted in improvement in visual acuity, anatomical change, and visual function change in Japanese AMD patients. Significant improvement was seen in patient visual function, but this was not correlated with changes in VA in patients with higher or lower baseline VA. The patients' satisfaction with the treatment remained unchanged during the study period.

scholarly journals Targeting Pyroptotic Cell Death Pathways in Retinal Disease

2022 ◽  
Vol 8 ◽  
Author(s):  
Mary Zhao ◽  
Siqi Li ◽  
Joanne A. Matsubara
Keyword(s):  
Cell Death ◽  
Retinal Disease ◽  
Age Related Macular Degeneration ◽  
Retinal Diseases ◽  
Disease States ◽  
Cell Death Pathways ◽  
Pyrin Domain ◽  
Age Related ◽  
Inflammatory Caspases ◽  
Receptor Family

Pyroptosis is a gasdermin-mediated, pro-inflammatory form of cell death distinct from apoptosis. In recent years, increasing attention has shifted toward pyroptosis as more studies demonstrate its involvement in diverse inflammatory disease states, including retinal diseases. This review discusses how currently known pyroptotic cell death pathways have been implicated in models of age-related macular degeneration, diabetic retinopathy, and glaucoma. We also identify potential future therapeutic strategies for these retinopathies that target drivers of pyroptotic cell death. Presently, the drivers of pyroptosis that have been studied the most in retinal cells are the nucleotide-binding and oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, caspase-1, and gasdermin D (GSDMD). Targeting these proteins may help us develop new drug therapies, or supplement existing therapies, in the treatment of retinal diseases. As novel mechanisms of pyroptosis come to light, including those involving other inflammatory caspases and members of the gasdermin protein family, more targets for pyroptosis-mediated therapies in retinal disease can be explored.

scholarly journals Intravitreal Anti Vascular Endothelial Growth Factor Agents in The Management of Retinal Diseases: An Audit

2017 ◽  
Vol 11 (1) ◽  
pp. 315-321 ◽  
Author(s):  
Bassey Fiebai ◽  
Victor Odogu
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Diabetic Macular Edema ◽  
Age Related Macular Degeneration ◽  
Retinal Diseases ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Type

Purpose: The study aimed to describe our initial experience with the use of anti vascular endothelial growth factors (anti-VEGFs) in the treatment of retinal diseases. Methods: The case records of all patients who had received at least 3 doses of intravitreal anti- VEGF injections between January 2012 to December 2016 were reviewed. Information culled from the data was age, sex, indications for treatment, type of injection, presenting visual acuity, post injection visual acuity, systemic and ocular co morbidities. Results were analyzed using Statistical Package for Social Sciences (SPSS) 20.0 for Windows statistical software Results: A total of 190 injections were given during the study period, to 58 eyes of 50 patients. Twenty-eight females (56.00%) and twenty-two males (44.00%) were seen with a mean age of 59.6± 11.66. Bevacizumab was the most frequently administered anti- VEGF, 142 (74.74%) while only 48(25.26%) injections of Ranibizumab were given. Three eyes had both bevacizumab and ranibizumab (1.58%). Retinal vein occlusion 61(32.11%) was the commonest indication for the injections followed by diabetic macular edema 43(22.63%) and proliferative diabetic retinopathy 42(22.11%). Others were neovascular age related macular degeneration, neovascular glaucoma, vitreous hemorrhage, myopic choroidal neovascularization and cystoid macular edema. There was an association between age and disease, (p = 0.001). There was an improvement in visual acuity after intervention in cases with retinal vein occlusion and diabetic macular edema, and this was statistically significant. Hypertension was the commonest systemic disorder in this series 81(42.36%) and the supero-temporal quadrant 131(68.95%) was the most preferred position to administer the injection. Floaters was the commonest complication seen. Conclusion: Anti VEGFs have become an invaluable tool in the management of a number of retinal diseases in our center. However, the cost implications are a hindrance to an increased uptake of this form of treatment. Cheaper alternative preparations should be made available to encourage the uptake. Government in developing countries should be encouraged to bear the health burden of the old aged pensioner (OAP).

scholarly journals Correlation between improvement in visual acuity and QOL after Ranibizumab treatment for age-related macular degeneration patients: QUATRO study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuji Oshima ◽  
Yumi Ishibashi ◽  
Naoyasu Umeda ◽  
Tatsuo Nagata ◽  
Shigeo Yoshida ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Function ◽  
Age Related Macular Degeneration ◽  
Open Label ◽  
Intravitreal Ranibizumab ◽  
Satisfaction Questionnaire ◽  
Age Related ◽  
The Mean ◽  
Baseline Visual Acuity ◽  
Ranibizumab Treatment

Abstract Background To evaluate the correlation between visual acuity improvement and vision-related QOL after ranibizumab treatment in Japanese patients with AMD. Methods In this one-year prospective, interventional, open-label, multicenter study involving four sites, patients with neovascular AMD were enrolled and observed for 12 months. Treatment-naïve patients received 0.5 mg ranibizumab as needed after three initial monthly doses. The best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at every visit. Evaluations with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and patient satisfaction questionnaire were performed at baseline and 3 and 12 months after initial treatment. The primary endpoint was change in BCVA and QOL 3 months after ranibizumab treatment. QOL outcomes were also assessed in the better and poor BVCA subgroups. Results The study enrolled 100 patients. The mean logMAR BCVA after treatment improved significantly from 0.43 to 0.30 at 3 months (p< 0.0001), and 0.28 at 12 months (p< 0.0001). The mean NEI-VFQ-25 composite scores improved from 79.48 to 84.13 at 3 months (p< 0.0001), and 86.0 at 12 months (p< 0.0001). The 3 and 12-month changes in NEI-VFQ-25 score and BCVA showed significant correlation. In the poor baseline visual acuity group (decimal BCVA ≤0.5), there was a significant correlation between the changes in the NEI-VFQ-25 score and BCVA (p=0.02) but not in the better baseline visual acuity group (decimal BCVA > 0.6, p=0.1) at 3 months. There were no significant differences in the satisfaction questionnaire score from baseline to at 3 months (p=0.54) and 12 months (p=0.23). The average CMT improved significantly from 340 to 264 μm at 3 months (p< 0.0001) and to 268 μm at 12 months (p< 0.0001). Conclusions Intravitreal ranibizumab treatment resulted in improvement in visual acuity, anatomical change, and visual function change in Japanese AMD patients. Significant improvement was seen in patient visual function, and this was correlated with changes in VA, except immediately after loading dose treatment in patients with higher baseline VA. The patients’ satisfaction with the treatment remained unchanged during the study period. Trial registration This study is registered at UMIN Clinical Trials Registry (UMIN000012013). Registered October 10, 2013, as prospective study.

scholarly journals Visual acuity outcomes and anti-VEGF therapy intensity in macular oedema due to retinal vein occlusion: a real-world analysis of 15 613 patient eyes

2020 ◽  
pp. bjophthalmol-2020-317337
Author(s):  
Thomas Ciulla ◽  
John S Pollack ◽  
David F Williams
Keyword(s):  
Visual Acuity ◽  
Retinal Vein Occlusion ◽  
Macular Oedema ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Age Related ◽  
Treatment Naïve ◽  
Randomised Controlled

Background/AimsTo assess visual acuity (VA) outcomes and antivascular endothelial growth factor (anti-VEGF) therapy intensity in retinal vein occlusion (RVO)-related macular oedema (ME).MethodsA retrospective study was completed in treatment-naïve patients with RVO-related ME from 2013 to 2019, using the Vestrum Health Retina Database.ResultsMean baseline age was 72.4 years and 54% were women. In 6 months, in 8876 eyes with branch retinal vein occlusion (BRVO)-related ME, after a mean of 4.5 anti-VEGF injections, VA increased by 9.4 letters (95% confidence interval (CI) for change in VA +8.94 to +9.78, p<0.001) from a baseline of 55.1 letters. In 6737 eyes with central retinal vein occlusion (CRVO)-related ME, after a mean of 4.6 anti-VEGF injections over 6 months, VA improved by 9.2 letters (95% CI +8.50 to +9.87, p<0.001) from a baseline of 37.2 letters. In 1 year, VA gain was similar (BRVO: 7.4 injections, +8.1 letters, 95% CI +7.55 to +8.57, p<0.001; CRVO: 7.6 injections, +7.1 letters, 95% CI +6.31 to +7.95, p<0.001). In 6 months and 1 year, mean letters gain increased with number of anti-VEGF injections. Patient eyes with baseline VA of 20/40 or better tended to lose VA in 1 year.ConclusionMean change in VA correlates with treatment intensity, but patients with better VA at presentation are susceptible to vision loss, reflecting a ceiling effect. Assessed with the same database, VA gains compare favourably with 1-year VA gains in neovascular age-related macular degeneration and diabetic ME, but exhibit a larger gap when compared with corresponding randomised controlled trials.

scholarly journals Exploratory Study on Visual Acuity and Patient-Perceived Visual Function in Patients with Subretinal Drusenoid Deposits

2020 ◽  
Vol 9 (9) ◽  
pp. 2832
Author(s):  
Manjot K. Grewal ◽  
Shruti Chandra ◽  
Sarega Gurudas ◽  
Alan Bird ◽  
Glen Jeffery ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Disease Severity ◽  
Visual Function ◽  
Healthy Aging ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Function Tests ◽  
Age Related ◽  
Low Luminance ◽  
Subretinal Drusenoid Deposits

Purpose: To investigate the value of visual acuity and patient-perceived visual function test when subretinal drusenoid deposits (SDD) are incorporated into the classification of age-related macular degeneration (AMD). A total of 50 participants were recruited into the study in these groups: healthy ageing (n = 11), intermediate AMD (iAMD) with no SDD (n = 17), iAMD with SDD (n = 11) and non-foveal atrophic AMD (n = 11) confirmed by two retinal imaging modalities. Best-corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) were measured and low luminance deficit (LLD) was calculated. Participants were also interviewed with the low luminance questionnaire (LLQ). Linear regression was used to assess function–function relations. Compared with healthy participants, BCVA and LLVA scores were significantly reduced in the atrophic AMD group (p < 0.0001 and p = 0.00016, respectively) and in patients with SDD (p = 0.028 and p = 0.045, respectively). Participants with atrophy also had reduced BCVA (p = 0.001) and LLVA (p = 0.009) compared with the iAMD no SDD group. However, there were no differences in visual function tests between healthy aging and iAMD without SDD and between iAMD with SDD and atrophic AMD groups. The LLD score did not differ between groups. BCVA and LLVA correlated well. The LLQ did not correlate with visual function tests. This study shows that LLD is not a marker of disease severity as assessed clinically. Although LLQ is a good marker for disease severity using the current AMD classification, it does not differentiate between eyes with and without SDD. Eyes with non-macular geographic atrophy and SDD had lower function than eyes with no SDD and healthy controls.

scholarly journals Visual Function and Patient Satisfaction with Multifocal Intraocular Lenses in Patients with Glaucoma and Dry Age-Related Macular Degeneration

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Carmen Sánchez-Sánchez ◽  
Laureano A. Rementería-Capelo ◽  
Beatriz Puerto ◽  
Cristina López-Caballero ◽  
Aida Morán ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Contrast Sensitivity ◽  
Visual Function ◽  
Intraocular Lenses ◽  
Age Related Macular Degeneration ◽  
Multifocal Intraocular Lenses ◽  
Age Related ◽  
Increased Risk ◽  
Preperimetric Glaucoma

Purpose. To report visual function and self-reported satisfaction of patients with glaucoma and dry age-related macular degeneration (dAMD) implanted with multifocal intraocular lenses (MIOL). Methods. Patients with glaucoma or dAMD as well as healthy individuals implanted with MIOL were invited to participate. Explorations performed were uncorrected and corrected distance visual acuity (UDVA and CDVA), low-contrast visual acuity (LCVA), binocular contrast sensitivity, and defocus curves. Patients completed the Catquest-9 questionnaire and reported on the presence of dysphotopsias and the need for spectacles. Results. 38 subjects were included: 11 in the healthy/control group and 9 each in the preperimetric glaucoma, perimetric glaucoma, and dAMD groups. Controls had statistically better monocular UDVA, CDVA, and LCVA than patients with glaucoma and dAMD, as well as better binocular acuity in the defocus curves between −2.00 D and +0.50 D. Differences between controls and patients with preperimetric glaucoma were not statistically significant. Between −3.0 D and +0.5 D, all groups except dAMD achieved acuities better than 0.2 logMAR. Patients with dAMD had worse contrast sensitivity than all others for 3 cycles per degree (cpd), and patients with glaucoma had worse values than all others for 12 cpd; other differences did not reach statistical significance. Healthy subjects and patients with preperimetric glaucoma perceived halos more often than patients with glaucoma or dAMD, while suffering less from glare. Patients with glaucoma and dAMD found more difficulties when driving at night and required spectacles for near more often than the other subjects. Patients with dAMD were less satisfied with their vision. Conclusions. MIOLs may be implanted in patients with preperimetric glaucoma with little fear of patient dissatisfaction. In glaucoma and dAMD, MIOLs might be considered with caution, after explaining the increased risk of glare and the higher need for spectacle correction for reading.

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