Prevalence and characteristics of macular atrophy in eyes with neovascular age-related macular degeneration. A study from a long-term observational dataset: the Fight Retinal Blindness! project

2019 ◽  
Vol 104 (8) ◽  
pp. 1064-1069
Author(s):  
Vincent Daien ◽  
Vuong Nguyen ◽  
Rohan W Essex ◽  
Robin Guymer ◽  
Jennifer J Arnold ◽  
...  
Keyword(s):  
Risk Factors ◽  
Macular Degeneration ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Vegf Inhibitors ◽  
Cross Sectional ◽  
Macular Atrophy ◽  
Anti Vegf ◽  
Age Related ◽  
History Of

BackgroundTo assess the prevalence and characteristics associated with macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD) treated with vascular endothelial growth factor (VEGF) inhibitors.MethodsThis was a retrospective, cross-sectional study of nAMD eyes that commenced anti-VEGF between January 2006 and August 2016. MA (absent/extrafoveal/subfoveal) was graded by treating practitioners based on multimodal imaging from April 2016. The prevalence of MA over time and risk factors of MA were assessed.ResultsThe prevalence of MA in a cohort of 1689 eyes was 9.9% (22/222) in eyes within 1 year of starting treatment, 41.5% (71/171) after 5 years and 48.4% (30/62) after 9 years of treatment. Risk factors for subfoveal MA included the proportion of visits at which the lesion was graded as inactive ((adjusted OR (AOR) 3.72 for the highest vs lowest the quartile of frequency of inactive gradings (95% CI 2.33 to 6.07)), age (AOR 1.05 per year (95% CI 1.02 to 1.07)), baseline visual acuity (AOR 3.9 for ≤35 letters vs ≥70 letters (95% CI 2.4 to 6.4)) and the number of injections received (AOR 1.20 every 10 injections (95% CI 1.08 to 1.33)). Similar associations were observed with extrafoveal MA.ConclusionsThe risk of MA appeared to drop in eyes that had not developed it within 5 years. Low choroidal neovascularisation activity was by far the strongest predictor. We could not determine whether the increased prevalence of MA with time was due to anti-VEGF treatment or the natural history of the condition.

Prevalence and factors associated with age-related macular degeneration in a southwestern island population of Japan: the Kumejima Study

2017 ◽  
Vol 102 (8) ◽  
pp. 1047-1053 ◽  
Author(s):  
Ryo Obata ◽  
Yasuo Yanagi ◽  
Tatsuya Inoue ◽  
Miho Yasuda ◽  
Yuji Oshima ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Population Based ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Island Population ◽  
Cross Sectional ◽  
Factors Associated ◽  
Age Related ◽  
History Of ◽  
Low Prevalence

AimsTo evaluate the prevalence of and factors associated with age-related macular degeneration (AMD) in a rural population of southwestern Japan.MethodsThis population-based cross-sectional study of all residents aged 40 years or older was conducted on the island of Kumejima, Okinawa, Japan. Of 4632 eligible residents, 3762 completed a comprehensive questionnaire and underwent ocular examination (participant rate, 81.2%). A non-mydriatic fundus photograph was used to grade AMD lesions according to the Wisconsin protocol. Prevalence of AMD was calculated and factors associated with AMD were identified by logistic regression.ResultsOf 3068 subjects with gradable photographs, 469 had early AMD and 4 had late AMD. Age-adjusted prevalence was 13.4% for any AMD, 13.3% for early AMD and 0.09% for late AMD. In multivariate analysis, any AMD was positively associated with age (OR 1.04 per year, 95% CI 1.03 to 1.05), male sex (OR 1.42, 95% CI 1.14 to 1.75) and history of cataract surgery (OR 1.35, 95% CI 1.00 to 1.82) and was negatively associated with longer axial length (OR 0.85 per millimetre, 95% CI 0.74 to 0.96). Early AMD similarly showed significant associations with these same factors.ConclusionsPrevalence of early or late AMD in a southwestern island population of Japan was 13.4% or 0.09%. Our data suggest relatively high prevalence for early AMD and low prevalence for late AMD in this sample of rural Japanese population. Significant factors associated with any or early AMD were mostly similar to that of previous studies.

Treatment of neovascular age related macular degeneration during COVID-19 pandemic: The short term consequences of unintended lapses

2021 ◽  
pp. 112067212110106
Author(s):  
Mehmet Ali Sekeroglu ◽  
Hilal Kilinc Hekimsoy ◽  
Tugce Horozoglu Ceran ◽  
Sibel Doguizi
Keyword(s):  
Macular Degeneration ◽  
Subretinal Fluid ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Short Term ◽  
Cross Sectional ◽  
Anti Vegf ◽  
Age Related ◽  
Optical Coherence Tomography Imaging ◽  
Endothelial Growth Factor

Aim: To investigate the short-term effects of COVID-19 pandemic related unintended treatment lapses on neovascular age related macular degeneration (nAMD) patients. Methods: In this prospective cross-sectional study, 140 patients who had at least one anti-vascular endothelial growth factor (VEGF) injection for nAMD within 12 months before COVID-19 pandemic and who had at least 3 months of unintended lapse for control visits during pandemic were recruited and underwent a detailed opthalmological examination and optical coherence tomography imaging. Results: Of these 140 eyes, 113 (80.7%) were active with presence of either intraretinal and/or subretinal fluid and necessitated intravitreal anti-VEGF injections; and 20 (14.3%) of them complicated with subretinal hemorrhage. The mean interval of clinical visits and intravitreal antiVEGF injections were found to be prolonged during COVID-19 pandemics, which demonstrates a statistically significant lapse for both ( p = 0.001 and p = 0.003 consecutively). The decreased visual acuity due to lapse was positively correlated with number of intravitreal anti-VEGF injections at last 6 months before COVID-19 pandemic ( r = 0.217, p = 0.010) and central subfoveal thickness at first post-COVID-19 visit ( r = 0.175, p = 0.038); and negatively correlated with follow-up duration ( r = −0.231, p = 0.006) and number of control visits ( r = −0.243, p = 0.004). Fifteen (16.9%) of the 89 patients who had drusen in the fellow eye before COVID-19 pandemic evolved to nAMD with an accompanying subretinal and/or intraretinal fluid. Conclusion: Unintended lapses during COVID-19 pandemic resulted with poor functional and structural outcomes for nAMD patients, especially for those at the beginning of the treatment period and who still have an unstable clinical course.

Patient Use of Dietary Supplements, Home Monitoring, or Genetic Testing for Nonneovascular Age-Related Macular Degeneration

2021 ◽  
pp. 247412642198922
Author(s):  
Brittany C. Tsou ◽  
T.Y. Alvin Liu ◽  
Jun Kong ◽  
Susan B. Bressler ◽  
J. Fernando Arevalo ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Macular Degeneration ◽  
Dietary Supplements ◽  
Home Monitoring ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Supplement Use ◽  
Age Related ◽  
Disease Study

Purpose: This work evaluated the use and type of dietary supplements and home monitoring for nonneovascular age-related macular degeneration (AMD), as well as the prevalence of genetic testing among patients with AMD. Methods: A cross-sectional study was conducted of 129 participants older than 50 years who completed self-administered questionnaires regarding usage and type of dietary supplements and home monitoring, as well as the participants’ use of genetic testing for AMD. Results: Of 91 participants with AMD, 83 (91.2%) took vitamins, including 55 (60.4%) who used an Age-Related Eye Disease Study (AREDS) or AREDS2 formulation. Of 38 without AMD, 31 (81.6%) took vitamins (difference from participants with AMD = 9.6% [95% CI, 0%-23.2%]), including 2 on an AREDS formulation. Among 82 participants with AMD who were AREDS candidates (intermediate or advanced AMD in 1 or both eyes), 51 (62.2%; 95% CI, 51.7%-72.7%) took an AREDS or AREDS2 formulation, and 31 (37.8%) did not (5 were unsure). Additionally, 50 (61.0%; 95% CI, 50.4%-71.6%) AREDS candidates did some type of home monitoring. Only 1 (1.2%; 95% CI, 0%-3.6%) underwent genetic testing for AMD. Among 9 with AMD who were not AREDS candidates, 4 (44.4%) used an AREDS formulation, 4 (44.4%) did not, and 1 (11.1%) was unsure; only 1 (11.1%) of these 9 performed home monitoring. Conclusions: Despite similar results from past surveys and AREDS2 data supporting supplement use in 2013 and home monitoring in 2014, these findings suggest about one-third of AREDS candidates do not do so, providing further support for improving education regarding appropriate supplement and home monitoring usage. Genetic testing for AMD also appears infrequent.

scholarly journals Association of Human Plasma Metabolomics with Delayed Dark Adaptation in Age-Related Macular Degeneration

Metabolites ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 183
Author(s):  
Kevin M Mendez ◽  
Janice Kim ◽  
Inês Laíns ◽  
Archana Nigalye ◽  
Raviv Katz ◽  
...  
Keyword(s):  
Amino Acids ◽  
Fatty Acid ◽  
Macular Degeneration ◽  
Dark Adaptation ◽  
Ultra Performance Liquid Chromatography ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Age Related ◽  
Vitreoretinal Disease

The purpose of this study was to analyze the association between plasma metabolite levels and dark adaptation (DA) in age-related macular degeneration (AMD). This was a cross-sectional study including patients with AMD (early, intermediate, and late) and control subjects older than 50 years without any vitreoretinal disease. Fasting blood samples were collected and used for metabolomic profiling with ultra-performance liquid chromatography–mass spectrometry (LC-MS). Patients were also tested with the AdaptDx (MacuLogix, Middletown, PA, USA) DA extended protocol (20 min). Two measures of dark adaptation were calculated and used: rod-intercept time (RIT) and area under the dark adaptation curve (AUDAC). Associations between dark adaption and metabolite levels were tested using multilevel mixed-effects linear modelling, adjusting for age, gender, body mass index (BMI), smoking, race, AMD stage, and Age-Related Eye Disease Study (AREDS) formulation supplementation. We included a total of 71 subjects: 53 with AMD (13 early AMD, 31 intermediate AMD, and 9 late AMD) and 18 controls. Our results revealed that fatty acid-related lipids and amino acids related to glutamate and leucine, isoleucine and valine metabolism were associated with RIT (p < 0.01). Similar results were found when AUDAC was used as the outcome. Fatty acid-related lipids and amino acids are associated with DA, thus suggesting that oxidative stress and mitochondrial dysfunction likely play a role in AMD and visual impairment in this condition.

scholarly journals Incidence of elevated intraocular pressure after intravitreal injection in Japanese patients with age-related macular degeneration

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maiko Maruyama-Inoue ◽  
Tatsuya Inoue ◽  
Shaheeda Mohamed ◽  
Yoko Kitajima ◽  
Shoko Ikeda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
Macular Degeneration ◽  
Intravitreal Injection ◽  
Odds Ratio ◽  
Japanese Patients ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Elevated Intraocular Pressure ◽  
History Of

AbstractThe purpose of this study was to report the incidence of elevated intraocular pressure (IOP) after intravitreal injection (IVI) of anti-vascular endothelial growth factor (VEGF) in Japanese patients with age-related macular degeneration (AMD). A retrospective study of chart review of patients who underwent ≥ 10 intravitreal anti-VEGF injections between April 2009 and December 2019 was conducted. Elevated IOP was defined as IOP ≥ 25 mmHg at one visit. Cases with elevated IOP resulting from IVI were identified. Furthermore, the association between elevated IOP and some parameters, as the risk factors that influence elevated IOP, was investigated. A total of 402 eyes of 370 patients were included in this study. Twenty-eight eyes of 26 patients (7.0%) were identified as cases with elevated IOP after IVI. The mean time of elevation after baseline was 50.6 ± 26.5 months. History of glaucoma (p = 0.021; odds ratio, 5.85), treatment modality (p = 0.019; odds ratio, 6.32), and total number of injections (p = 0.003; odds ratio, 1.03) were significantly associated with elevated IOP. A late complication of elevated IOP is associated with IVI in patients with AMD. Particularly, history of glaucoma and treat and extend regimen with frequent injections were found to be risk factors of elevated IOP.

scholarly journals Cross-sectional study of the association between age-related macular degeneration and arthritis in the National Health and Nutrition Examination Survey 2005–2008

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e035805
Author(s):  
Zhuoting Zhu ◽  
Huan Liao ◽  
Sen Liu ◽  
Jian Zhang ◽  
Yifan Chen ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
National Health ◽  
Logistic Models ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Nutrition Examination Survey ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Age Related

ObjectiveTo explore the association between age-related macular degeneration (AMD) and arthritis in a representative sample of the US population.DesignPopulation-based, cross-sectional study.SettingThe National Health and Nutrition Examination Survey (NHANES) 2005–2008.ParticipantsA total of 4813 participants aged 40 years and older with available information on AMD and arthritis in the 2005–2008 NHANES.MethodsThe status and types of arthritis were obtained from questionnaires. Non-mydriatic fundus photographs were collected. The types of AMD were assessed using the modified Wisconsin Age-Related Maculopathy Grading Classification Scheme. The association between arthritis and AMD was evaluated using logistic regression models.ResultsAfter adjusting for covariates, participants with any or early AMD had significantly lower odds of having any type of arthritis (any AMD: OR=0.56, 95% CI: 0.36–0.86; early AMD: OR=0.55, 95% CI: 0.34–0.88) or osteoarthritis (OA) (any AMD: OR=0.43, 95% CI: 0.26–0.71; early AMD: OR=0.44, 95% CI: 0.25–0.76) compared with those without AMD. When considering AMD as the outcome, significant negative associations were also found between any arthritis or OA and any (any arthritis: OR=0.64, 95% CI: 0.43–0.94; OA: OR=0.52, 95% CI: 0.33–0.82) or early AMD (any arthritis: OR=0.61, 95% CI: 0.40–0.93; OA: OR=0.51, 95% CI: 0.31–0.86) in the multivariable logistic models. There was no significant association between different types of arthritis and late AMD.ConclusionsPeople with arthritis, especially those with OA, were less likely to have AMD compared with those without arthritis and vice versa. Further studies are needed to confirm this potential protective effect of arthritis and/or arthritis treatment on AMD and to explore the underlying mechanisms.

Long-term outcome of neovascular age-related macular degeneration: association between treatment outcome and major risk alleles

2021 ◽  
pp. bjophthalmol-2021-319054
Author(s):  
Brice Nguedia Vofo ◽  
Gala Beykin ◽  
Jaime Levy ◽  
Itay Chowers
Keyword(s):  
Macular Degeneration ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Long Term Outcome ◽  
Risk Alleles ◽  
Macular Atrophy ◽  
Anti Vegf ◽  
Age Related

AimsTo evaluate the long-term functional and anatomical outcomes of neovascular age-related macular degeneration (nvAMD) treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) for up to 10 years, and to identify associated risk factors.MethodsClinical and optical coherence tomography findings were retrieved for nvAMD cases treated with intravitreal anti-VEGF compounds using a treat-and-extend protocol. In addition, the major risk alleles for AMD in the CFH (rs1061170), HTRA1 (rs1200638) and C3 (rs2230199) genes were genotyped.ResultsFrom 276 eligible eyes in 206 patients, 80 eyes (29%) in 66 patients (32.0%) had a follow-up period of ≥8 years and were included in this study. Over a 10-year period, 73.3±28.0 (mean±SD) anti-VEGF injections were administered. Best-corrected visual acuity (BCVA; LogMAR) deteriorated from 0.55±0.53 at baseline to 1.00±0.73 at 10 years (p<0.0005). Central subfield thickness (CST) decreased from 415.8±162.1 µm at baseline to 323±113.6 µm (p<0.0005) after three monthly injections and remained lower than baseline throughout the follow-up period. Visual outcome was associated with BCVA and intraretinal fluid (IRF) at baseline, macular atrophy, and macular thinning at follow-up. The decrease in CST was inversely correlated with the number of CFH and/or C3 risk alleles carried by the patient (Pearson’s r: −0.608; p=0.003).ConclusionsPatients with nvAMD who received anti-VEGF therapy for 10 years developed substantial vision loss associated with the presence of IRF at baseline and macular atrophy. Major risk alleles for AMD in two complement genes were associated with a reduced long-term reduction in macular thickness.

scholarly journals Causes of low vision and use of optical aids in the elderly

2004 ◽  
Vol 59 (4) ◽  
pp. 157-160 ◽  
Author(s):  
Keila Monteiro de Carvalho ◽  
Gelse Beatriz Martins Monteiro ◽  
Cassiano Rodrigues Isaac ◽  
Lineu Oto Shiroma ◽  
Marcela Scabello Amaral
Keyword(s):  
Macular Degeneration ◽  
Elderly Population ◽  
Low Vision ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Rehabilitation Service ◽  
Visual Rehabilitation ◽  
Cross Sectional ◽  
Age Related

PURPOSE: To determine the causes of low vision in an elderly population attended by a university visual rehabilitation service and to check for the use of prescribed optical aids. METHOD: A cross-sectional study was carried out on patients aged 60 years or over attending for the first time a university low vision service in 2001. Ophthalmic reevaluation and interview were performed by means of a structured questionnaire in 2002. RESULTS: The sample comprised 50 subjects aged between 60 and 90 years. Severe low vision (<FONT FACE=Symbol><</FONT>20/200) was present in 68.0% of patients. The main cause of low vision was age-related macular degeneration (44.0%). Regarding literacy, 16.0% were illiterate and 72.0% had completed fundamental schooling. Thirty-one patients (62.0%) had been prescribed optical aids; 54.8% of these patients stated that they use them. A majority (70.6%) held a favorable opinion of these aids. CONCLUSIONS: The main cause of low vision was age-related macular degeneration. Approximately half of those receiving prescriptions reported actually using the aids in their daily activities. Making best use of residual vision in the elderly population with visual impairment is a priority, given the social context, if the independence necessary for enhanced quality of life is to be achieved.

scholarly journals A Pattern of Age-related Macular Degeneration

2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Suprada Pokhrel ◽  
O K Malla ◽  
C L Pradhananga ◽  
S N Joshi
Keyword(s):  
Macular Degeneration ◽  
College Teaching ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Increased Risk ◽  
Number Of Individuals

Introduction: Age related macular degeneration is a disorder of the macula most often clinicallyapparent affecting central vision and is one of the leading causes of blindness in the populationabove 50 years. The aim of this study is to determine clinical profi le of AMD in Nepalese presentingto a Teaching Hospital in Kathmandu.Methods: It was a hospital-based cross-sectional study. The subjects included in the study were thosepresenting to the Ophthalmology department of Kathmandu Medical College Teaching Hospitalfrom July 2007- Dec 2007.The total number of individuals included in the study were 402 and totalnumber of eyes were 804.Results: AMD was observed in 5.2% out of 402 subjects of 40 years and above age group withprevalence increasing with age. The prevalence of AMD was 0.7% within 40-50 years of age-groupindividuals increasing to 2.6% in 51-60 years, 6.5% in 61-70 years and to 19.3% among subjectsabove 71 years. This study revealed that the prevalence of AMD in females was higher with femalepreponderance in ratio of 2.5:1. 52.5 % AMD subjects in our study had visual impairment with 6/24-6/60 vision and 15% had vision <3/60-PL. Our study revealed statistically signifi cant increased riskfor AMD with aging (p=0.00). Increased risk was observed in female gender and diabetics though theOdds ratio (OR) was statistically insignifi cant (p=>0.01).Conclusions: Prevalence of AMD in Nepalese presenting to Kathmandu Medical College TeachingHospital was 5% with female preponderance in ratio of 2.5:1. Aging showed statistically signifi cantincreased risk for AMD development in this study.Key Words: Age-related macular degeneration, blindness, Nepalese, prevalence

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