The effect of pre-eclampsia on retinal microvascular caliber at delivery and post-partum

Background The retinal microcirculation provides a unique view of microvessel structure by means of non-invasive, retinal image analysis. The aim of the study was to compare the retinal vessel caliber at delivery and one-year post-partum between women who have had pre-eclampsia during pregnancy to a normotensive control group. Methods Digital photos of the eye were taken at delivery and one-year post-partum. Retinal vessels were analysed and summarised as the corrected central retinal arteriolar equivalent and corrected central retinal venular equivalent. Results The corrected central retinal arteriolar equivalent and corrected central retinal venular equivalent were significantly lower in the pre-eclamptic group compared to the control group both at delivery and one-year post-partum ( p < 0.001). Conclusion Retinal artery and venular caliber changes that occur during pregnancies affected by pre-eclampsia persist for up to one-year post-partum. These changes may reflect a permanent, long-term microvascular dysfunction and may be useful as a biomarker of future vascular risk.

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Comparisons between retinal vessel calibers and various optic disc morphologic parameters with different optic disc appearances: The Glaucoma Stereo Analysis Study

PLoS ONE ◽

10.1371/journal.pone.0250245 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0250245

Author(s):

Kazunobu Sugihara ◽

Yasuyuki Takai ◽

Ryo Kawasaki ◽

Koji Nitta ◽

Maki Katai ◽

...

Keyword(s):

Visual Field ◽

Optic Disc ◽

Collaborative Study ◽

Retinal Vessel ◽

Analysis Study ◽

Stereo Analysis ◽

Fundus Photographs ◽

Retinal Arteriolar ◽

Central Retinal Arteriolar Equivalent ◽

Central Retinal Venular Equivalent

The Glaucoma Stereo Analysis Study (GSAS) is a multicenter collaborative study of the characteristics of glaucomatous optic disc morphology using a stereo fundus camera. This study evaluated the retinal vessel calibers and correlations using GSAS fundus photographs between retinal vessels and 38 optic nerve head (ONH) morphologic parameters comprehensively. In all 240 eyes, the mean central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were 138.4 and 216.5 μm, respectively; the CRAE correlated with age, visual field scores and 19 ONH parameters and CRVE correlated with age, intraocular pressure, visual field scores and 11 ONH parameters. Among the different optic disc appearances including focal ischemia (FI) (n = 53, 22%), generalized enlargement (GE) (n = 53, 22%), myopic glaucoma (MY) (n = 112, 47%), and senile sclerosis (SS) (n = 22, 9%), the CRAE did not differ significantly; CRVE was significantly narrower in SS than in FI and MY. In FI, GE, MY, and SS disc types, CRAE correlated with 3, 14, 9, and 2 ONH parameters, respectively, and CRVE corelated with 9, 0, 12, and 6 ONH parameters, respectively. We confirmed previous observations on the effect of retinal vessel narrowing on glaucomatous changes in the ONH and visual field. The associations between retinal vessel caliber and ONH morphologic parameters vary among different optic disc appearances, suggesting different effects of vascular changes in each disc type.

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Long-term changes in retinal vascular diameter and cognitive impairment in type 1 diabetes

Diabetes and Vascular Disease Research ◽

10.1177/1479164118758581 ◽

2018 ◽

Vol 15 (3) ◽

pp. 223-232 ◽

Cited By ~ 3

Author(s):

Karen A Nunley ◽

Andrea L Metti ◽

Ronald Klein ◽

Barbara E Klein ◽

Judith A Saxton ◽

...

Keyword(s):

Type 1 Diabetes ◽

Cognitive Impairment ◽

White Matter ◽

White Matter Hyperintensities ◽

Proliferative Retinopathy ◽

Retinal Arteriolar ◽

Central Retinal Arteriolar Equivalent ◽

Central Retinal Venular Equivalent

Objective: To assess associations between cognitive impairment and longitudinal changes in retinal microvasculature, over 18 years, in adults with type 1 diabetes. Research design and methods: Participants of the Pittsburgh Epidemiology of Diabetes Complications Study received ≥3 fundus photographs between baseline (1986–1988) and time of cognitive assessment (2010–2015: N = 119; 52% male; mean age and type 1 diabetes duration 43 and 34 years, respectively). Central retinal arteriolar equivalent and central retinal venular equivalent were estimated via computer-based methods; overall magnitude and speed of narrowing were quantified as cumulative average and slope, respectively. Median regression models estimated associations of central retinal arteriolar equivalent and central retinal venular equivalent measures with cognitive impairment status, adjusted for type 1 diabetes duration. Interactions with HbA1c, proliferative retinopathy and white matter hyperintensities were assessed. Results: Compared with participants without cognitive impairment, those with clinically relevant cognitive impairment experienced 1.8% greater and 31.1% faster central retinal arteriolar equivalent narrowing during prior years (t = −2.93, p = 0.004 and t = −3.97, p < 0.0001, respectively). Interactions with HbA1c, proliferative retinopathy and white matter hyperintensities were not significant. No associations were found between central retinal arteriolar equivalent at baseline, at time of cognitive testing, or any central retinal venular equivalent measures, and cognitive impairment. Conclusion: Long-term arterial retinal changes could indicate type 1 diabetes–related cognitive impairment. Studies examining longitudinal central retinal arteriolar equivalent changes as early biomarkers of cognitive impairment risk are warranted.

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Postpartum questionnaire survey of women who tested negative in a non-invasive prenatal testing: examining negative emotions towards the test

Journal of Human Genetics ◽

10.1038/s10038-020-00879-6 ◽

2020 ◽

Author(s):

Tatsuko Hirose ◽

Nahoko Shirato ◽

Mikiko Izumi ◽

Keiko Miyagami ◽

Akihiko Sekizawa

Keyword(s):

Genetic Counseling ◽

Negative Emotion ◽

Negative Emotions ◽

Prenatal Testing ◽

Anxiety And Depression ◽

Control Group ◽

Psychosocial Status ◽

Non Invasive ◽

Fetal Aneuploidy ◽

One Year

AbstractNon-invasive prenatal testing (NIPT) is used worldwide to screen for fetal aneuploidy. Although previous studies on the psychosocial aspects of NIPT have focused on satisfaction regarding the test, we surveyed women who experienced negative emotions after receiving NIPT. From January 2018 to March 2019, we surveyed pregnant women whose NIPT results were negative, one year after the test. Of the 526 respondents, 35 (6.7%) regretted receiving NIPT and blamed themselves for taking it. We assigned this 6.7% of respondents to the negative emotion group. Although, 76.5% of the participants in the negative emotion group reported they would like to take NIPT for their next pregnancy, it was significantly lower as compared to the control group (92%). Furthermore, 31.9% of respondents in the control group reported that they would recommend similar tests to their relatives and friends. Conversely, in the negative emotion group, this proportion was lower at 17.1%. This suggests that guilt over testing may be meaningful. Thus, this study showed that some NIPT examinees regretted taking the test and blamed themselves. Respondents reported experiencing stress, anxiety, and depression even before NIPT affirming that it is important to address pregnant women’s psychosocial status during pre-test genetic counseling.

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Retinal vascular caliber changes after laser photocoagulation in diabetic retinopathy

Medical Journal of Indonesia ◽

10.13181/mji.oa.203806 ◽

2020 ◽

Vol 29 (4) ◽

pp. 366-71

Author(s):

Habibah Setyawati Muhiddin ◽

Idayani Panggalo ◽

Andi Muhammad Ichsan ◽

Budu ◽

Emanuele Trucco ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Oxygen Tension ◽

Laser Photocoagulation ◽

Retinal Vessels ◽

Retinal Vascular Caliber ◽

Before And After ◽

Vascular Dilatation ◽

Retinal Arteriolar ◽

Central Retinal Arteriolar Equivalent ◽

Central Retinal Venular Equivalent

BACKGROUND Diabetic retinopathy causes vascular dilatation caused by hypoxia, whereas oxygen tension improvement leads to retinal vessels narrowing. Given that laser photocoagulation aims to increase the oxygen tension in the retina, we hypothesized that the narrowing of vessel caliber after the treatment could be possibly demonstrated. This study aimed to assess the changes in the caliber of retinal vessels before and after laser photocoagulation in diabetic retinopathy. METHODS This research was a prospective cohort study on the treatment of diabetic retinopathy by laser photocoagulation, and it was conducted at Universitas Hasanuddin Hospital, Makassar, Indonesia between November 2017–April 2018. Retinal vascular caliber changes were analyzed before and 6–8 weeks after photocoagulation in 30 diabetic eyes. Central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were measured using the vessel assessment and measurement platform software for images of the retina (VAMPIRE) manual annotation tool. RESULTS A significant decrease of CRVE was observed after laser photocoagulation (p<0.001), but CRAE was not reduced significantly (p = 0.067). No difference was recorded between CRVE and CRAE post-laser photocoagulation (p = 0.14), implying a reduction in vein caliber toward normal in the treated eyes. CONCLUSIONS Laser photocoagulation decreases the CRVE in diabetic retinopathy despite the absence of changes in the grade of diabetic retinopathy.

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Efektifitas Bladder Training Sitz Bath Terhadap Fungsi Eliminasi Spontan Pada Ibu Post Partum Spontan

Jurnal Ilmu Kesehatan MAKIA ◽

10.37413/jmakia.v2i1.7 ◽

2016 ◽

Vol 2 (1) ◽

Author(s):

Devi Endah Saraswati

Keyword(s):

Post Partum ◽

T Test ◽

Control Group ◽

P Value ◽

Test Results ◽

Sitz Bath ◽

Bladder Training ◽

Uterine Contractions ◽

Non Invasive ◽

First Time

ABSTRAK Salah satu penyebab perdarahan postpartum adalah gangguan kontraksi uterus yang dapat diakibatkan oleh adanya retensio urin. Mengatasi masalah berkemih salah satu dapat dilakukan dengan intervensi bladder training dan salah satu intervensi non invasif menggunakan alat Sitz bath dengan prinsip hidroterapi.Penelitian ini bertujuan mengetahui efektifitas bladder training sitz bath terhadap proses eliminasi spontan pada ibu post partum spontan dengan kriteria waktu pertama BAK dan jumlah BAK. Jenis penelitian ini adalah quasy eksperimental. Subyek penelitian adalah 20 ibu nifas dengan persalinan spontan di RS Aisyiyah Bojonegoro yang dibagi menjadi dua kelompok, kelompok pertama 10 ibu nifas diberikan intervensi blader training sitz bath dan kelompok kedua 10 ibu nifas sebagai kelompok kontrol. Analisis yang digunakan menggunakan uji Independent t test. Hasil uji Independent t test didapatkan nilai p value untuk waktu pertama BAK = 0,02 dan jumlah BAK dengan nilai p value = 0,062. Bladder taining sith bath efektif terhadap proses eliminasi spontan pada ibu post partum Kata Kunci : Bladder tarining sitz bath, retensi urin, post partum spontan ABSTRACT One of the causes of postpartum hemorrhage is uterine contractions disorder that can be caused by the retention of urine. One intervention can be done with bladder training and one non-invasive interventions using a sitz bath with the principles of hydrotherapy.This study aims to determine the effectiveness of bladder training sitz bath to a process of elimination of maternal post-partum spontaneous spontaneously with time criteria time first BAK and sum of BAK.The study is an experimental quasy. Subjects were 20 puerperal women with spontaneous labor at the hospital Aisyiyah Bojonegoro are divided into two groups, the first group of 10 puerperal women given training blader intervention sitz bath and a second group of 10 puerperal women as a control group. The analysis using the test Independent t test. The test results Independent t test p value obtained for the first time = 0.02 BAK and BAK number with p value = 0.062. Bladder sith bath taining effective against spontaneous process of elimination of maternal postpartum. Keywords: Bladder tarining sitz bath, urinary retention, post partum spontaneous

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Retinal Vessel Diameters and Blood Pressure Progression in Children

Hypertension ◽

10.1161/hypertensionaha.120.14695 ◽

2020 ◽

Vol 76 (2) ◽

pp. 450-457 ◽

Cited By ~ 4

Author(s):

Giulia Lona ◽

Katharina Endes ◽

Sabrina Köchli ◽

Denis Infanger ◽

Lukas Zahner ◽

...

Keyword(s):

Blood Pressure ◽

Subsequent Development ◽

Retinal Vessel ◽

Good Evidence ◽

Retinal Arterioles ◽

Microvascular Alterations ◽

Retinal Arteriolar ◽

Central Retinal Venular Equivalent ◽

Retinal Vessel Diameters

The prevalence of high childhood blood pressure (BP) is rising globally and has been associated with subclinical vascular impairments in children. Longitudinal data on the association of microvascular alterations with the development of high BP in children are lacking. We aimed to analyze the association of central retinal arteriolar (CRAE) and venular (CRVE) diameters with development of higher BP over 4 years in young school children. In 2014, 391 children aged 6 to 8 years were screened for BP and retinal vessel diameters using standardized protocols. Retinal vessel analysis was performed using a retinal vessel analyzer to determine CRAE and central retinal venular equivalent. In the follow-up of 2018, all parameters were assessed in 262 children using the same standardized protocols. During follow-up, systolic and diastolic BP increased significantly (Δ 3.965±8.25 and 1.733±7.63 mm Hg, respectively), while CRAE decreased by Δ −6.325±8.55 µm without significant changes in central retinal venular equivalent (Δ −0.163±7.94 µm). Children with narrower CRAE at baseline developed higher systolic BP after four years (β [95% CI] 0.78 [0.170–1.398] mm Hg per 10 µm decrease, P =0.012). Children with increased systolic or diastolic BP at baseline developed narrower CRAE (β [95% CI] −0.154 [−0.294 to −0.014] µm per 1mmHg, P =0.031 and β [95% CI] −0.02 [−0.344 to −0.057] µm per 1 mmHg, P =0.006, respectively) at follow-up. Narrowing of retinal arterioles predicted evolution of systolic BP. In turn, higher initial systolic and diastolic BP was associated with subsequent development of microvascular impairments. Our results give good evidence for a bivariate temporal relationship between BP and microvascular health in children.

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POS0807 RETINAL VESSEL CALIBERS AS A NON-INVASIVE BIOMARKER OF INFLAMMATORY BURDEN IN PRIMARY SYSTEMIC VASCULITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1950 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 656.1-656

Author(s):

O. Argyropoulou ◽

E. Aissopou ◽

A. Argyris ◽

A. Goules ◽

C. Mavragani ◽

...

Keyword(s):

Disease Activity ◽

Statistical Significance ◽

Immunosuppressive Treatment ◽

Retinal Vessel ◽

Inactive Disease ◽

Control Group ◽

Common Disease ◽

Bivariate Correlation ◽

Retinal Microcirculation ◽

Active Disease

Background:Primary Systemic Vasculitides (PSV) constitute a heterogeneous group of rare and potentially life-threatening autoimmune diseases, characterized by a varying degree of inflammatory response, leading to local or generalized vascular disease. Vessel involvement accounts for the micro- and macrovascular complications of the disease, along with the classic risk factors including, among others age and chronic use of steroids (1). Early identification of high-risk patients for cardiovascular disease (CVD) development and the contribution of inflammation towards this adverse outcome are still unmet needs. Alterations of retinal microcirculation have been independently associated with increased CVD risk in the general population (2). The potential changes of retinal vasculature and their association with disease activity and the magnitude of inflammation have not been studied in PSV so far.Objectives:To explore the effect of disease activity and inflammation on retinal microcirculation in PSV, classified according to vessel size as large, medium or small vessel vasculitides (LVV, MVV or SVV respectively), and polymyalgia rheumatica (PMR) without vasculitis.Methods:Fifty-nine patients, 43 with active disease [30 active vasculitis (12 LVV, 4 MVV, 14 SVV) and 13 PMR] and 16 with chronic inactive disease (13 vasculitis, 3 PMR) were studied. All patients were matched at 1:1 ratio with 59 controls, without underlying autoimmune/autoinflammatory disorder, neoplasia or infection, according to age, gender, CVD history, BMI, smoking, arterial hypertension, dyslipidemia, diabetes mellitus and treatment related to comorbidities. A total of 32 rheumatoid arthritis (RA) patients with mild to moderate inflammatory component as defined by standard of care acute phase reactants (ESR and CRP) and 16 chronic RA patients with normal ESR and CRP levels, matched 1:1 according to all the above parameters with 32 active and 16 inactive vasculitis/PMR patients respectively, served as disease controls. Digital retinal images were obtained and retinal vessel calibers were measured with a validated software to determine central retinal arteriolar and venular equivalents ratio (CRAE and CRVE respectively). For 16 patients with active vasculitis/PMR, retinal examination was performed in two time points (baseline and ≤ 6 months later).Results:In the overall population, patients with active Vasculitis/PMR had increased CRVE (213.8±21.7 vs 201.3±17.1, p<0.001) and CRAE (180.0±19.2 vs 164.1±17.5 p<0.001) compared to healthy controls. Separating patients according to disease type, we found that in LVV, MVV and PMR, CRAE (p≤0.05) and CRVE (p<0.05) were increased compared to control group, while in SVV only CRAE was increased (p<0.001). Interestingly, chronic patients with disease in remission displayed higher CRAE compared to matched controls (179.8±17.2 vs 169.1±11.1, p=0.006). After immunosuppressive treatment for ≤ 6 months CRVE and to a lesser extent CRAE were reduced (p=0.048 and 0.149 respectively) with a stronger statistical significance found in the Vasculitis group (p=0.026 and 0.069 respectively). Pearson’s linear correlation coefficient in active disease state (at baseline examination) revealed positive bivariate correlation only between CRVE with ESR and CRP. Patients with Vasculitis/PMR had also increased CRAE when compared to RA patients in both active and inactive disease status (182.8±19.4 vs 170.1±18.4, p<0.001 and 179.8±17.2 vs 166.3±17.9, p=0.005 respectively).Conclusion:Systemic inflammation alters retinal microcirculation in both a reversible (venules) and irreversible (arterioles) way, independently of PSV form. Thus, common disease specific pathogenetic mechanisms related to inflammation may be implicated in vascular remodeling. Sequential follow-up of PSV patients will address whether retinal vessel calibers may serve as a biomarker of disease activity and CVD development.References:[1]Argyropoulou OD et al. Curr Opin Rheumatol 2017.[2]Shaohua G et al. Current Atherosclerosis reports 2020.Disclosure of Interests:None declared

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Levels of Prothrombin Fragment F1+2 in Patients with Hyperhomocysteinemia and a History of Venous Thromboembolism

Thrombosis and Haemostasis ◽

10.1055/s-0038-1665405 ◽

1997 ◽

Vol 78 (05) ◽

pp. 1327-1331 ◽

Cited By ~ 21

Author(s):

Paul A Kyrle ◽

Andreas Stümpflen ◽

Mirko Hirschl ◽

Christine Bialonczyk ◽

Kurt Herkner ◽

...

Keyword(s):

Venous Thromboembolism ◽

Thrombin Generation ◽

Oral Anticoagulant Therapy ◽

Oral Anticoagulants ◽

Control Group ◽

Prothrombin Fragment ◽

Hemostatic System ◽

Significant Difference ◽

System Activation ◽

One Year

SummaryIncreased thrombin generation occurs in many individuals with inherited defects in the antithrombin or protein C anticoagulant pathways and is also seen in patients with thrombosis without a defined clotting abnormality. Hyperhomocysteinemia (H-HC) is an important risk factor of venous thromboembolism (VTE). We prospectively followed 48 patients with H-HC (median age 62 years, range 26-83; 18 males) and 183 patients (median age 50 years, range 18-85; 83 males) without H-HC for a period of up to one year. Prothrombin fragment Fl+2 (Fl+2) was determined in the patient’s plasma as a measure of thrombin generation during and at several time points after discontinuation of secondary thromboprophylaxis with oral anticoagulants. While on anticoagulants, patients with H-HC had significantly higher Fl+2 levels than patients without H-HC (mean 0.52 ± 0.49 nmol/1, median 0.4, range 0.2-2.8, versus 0.36 ± 0.2 nmol/1, median 0.3, range 0.1-2.1; p = 0.02). Three weeks and 3,6,9 and 12 months after discontinuation of oral anticoagulants, up to 20% of the patients with H-HC and 5 to 6% without H-HC had higher Fl+2 levels than a corresponding age- and sex-matched control group. 16% of the patients with H-HC and 4% of the patients without H-HC had either Fl+2 levels above the upper limit of normal controls at least at 2 occasions or (an) elevated Fl+2 level(s) followed by recurrent VTE. No statistical significant difference in the Fl+2 levels was seen between patients with and without H-HC. We conclude that a permanent hemostatic system activation is detectable in a proportion of patients with H-HC after discontinuation of oral anticoagulant therapy following VTE. Furthermore, secondary thromboprophylaxis with conventional doses of oral anticoagulants may not be sufficient to suppress hemostatic system activation in patients with H-HC.

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RELATED FACTORS TO RELAPSE IN DEPRESSED PATIENTS AFTER COGNITIVE BEHAVIOURAL THERAPY DURING ONE YEAR PROSPECTIVE FOLLOW-UP

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.5.2 ◽

2011 ◽

pp. 13-19

Author(s):

Nhu Minh Hang Tran ◽

Huu Cat Nguyen ◽

Dang Doanh Nguyen ◽

Van Luong Ngo ◽

Vu Hoang Nguyen ◽

...

Keyword(s):

Cognitive Behavioral Therapy ◽

Relapse Rate ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Control Group ◽

Controlled Clinical Trial ◽

Related Factors ◽

Depressed Patients ◽

One Year

Objectives: To determine factors impact on the relapse in depressed patients treated with Cognitive Behavioral Therapy (CBT) during one year follow-up. Materials and Methods: 80 depressed patients divided into two groups, group 1: included 40 patients treated with CBT; group 2: 40 patients on amitriptyline. Non-randomized controlled clinical trial, opened, longiditual and prospective research. Results and Conclusions: relapse rate after CBT during 1 year follow-up is 10% (compared to 25% in control group), related factors to relapse rate in depression after CBT are age and education. Shared predictors between 2 groups are severity and recurrence of depression. Key words: Depression, relapse, Cognitive Behavioral Therapy (CBT)

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Hallazgos oftalmológicos en enfermedad de Fabry: relación de su severidad en una familia mexicana

Latin american journal of clinical sciences and medical technology ◽

10.34141/ljcs4143209 ◽

2019 ◽

Vol 1 (1) ◽

pp. 43-49

Author(s):

Araceli Borja Borja ◽

Gabriela Salas Pérez ◽

Pablo Radillo Díaz

Keyword(s):

Premature Mortality ◽

Retinal Vessel ◽

Multiple Organ ◽

High Morbidity ◽

Lysosomal Storage ◽

Enzyme Replacement ◽

Non Invasive ◽

High Incidence ◽

Cornea Verticillata ◽

Gla Gene

Introduction. Fabry disease (FD) is a lysosomal storage disorder associated with multiple organ dysfunction which eventually leads to high morbidity and premature mortality. Ophthalmologic findings in FD are very common and have been described extensively. We describe the ophthalmologic findings of a family diagnosed with FD at Hospital de Especialidades de Puebla and establish their relationship with other phenotypic findings. Cases Presentation. A renal, cardiac, audiological, neurological, and ophthalmologic evaluation was carried out. The disease was confirmed by GLA gene sequencing. The ophthalmologic assessment was focused on the changes described in the literature, as well as the search for other anomalies possibly related to the disease. All the patients had the c.260delA (P.Glu87Glyfs*34) mutation in the GLA gene. The main ophthalmologic finding in our patients was cornea verticillata (in 100 % of the female patients). Other ophthalmologic manifestations were dry eye, retinal vessel tortuosity, ametropia, chromatic vision disorders, ocular annexes, eyelids, and conjuntiva disorders. Conclusions. Most of the assessed patients showed ophthalmologic changes, consistent with the results described in the literature. A remarkable finding in the sample was the high incidence of changes in women, in whom one would not expect the disease to be as severe because they are heterozygous. Ophthalmologic abnormalities in FD require deeper evaluation to establish their possible use as markers of disease progression and/or enzyme replacement therapy initiation due to the benefit of the non-invasive nature of ophthalmologic evaluations.

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