Profiling Cognitive Performance and Sleep Quality Measures in Patients with Age-Related Macular Degeneration (Preprint)

2021 ◽  
Author(s):  
Mehrdad Afarid ◽  
Hooman Rezaie ◽  
Behzad Khademi1 ◽  
Mohammad Nami

BACKGROUND This study aimed at profiling cognitive functions in patients with age-related macular degeneration (AMD). OBJECTIVE The aim of our study was to evaluate cognitive functions in patients diagnosed with AMD METHODS This cross-sectional investigation enrolled 45 patients with AMD and 45 age- and sex-matched controls. The overall cognitive performance in AMD sufferer versus control subjects was asses using the Persian version of the Addenbrooke’s Cognitive Examination battery (ACE-R). Subjects’ sleep quality was also evaluated using the Pittsburgh Sleep Quality Index (PSQI). The mean global assessment and subscale scores were statistically compared between groups. RESULTS The mean global scores for ACE-R in AMD and control groups (80.4±12.3 and 86 ± 9.6, respectively) were found to be statistically different (p=0.018). On the other hand there was no significant difference (p=0.793) between the AMD and control groups in terms of PSQI scores (9.7±2.8 and 9.8±2.8, respectively). CONCLUSIONS AMD patients seem to have cognitively underperformed in memory and verbal fluency domains compared to the control group. Evidence on cognitive impairments in patients with AMD may possibly herald neurocognitive insufficiencies and have common pathological mechanisms with dementias.

2021 ◽  
Author(s):  
Amirsaeid Moloodi ◽  
Hooman Rezaie ◽  
Behzad Khademi ◽  
Mohammad Nami

Objective: This study aimed at profiling cognitive functions in patients with age-related macular degeneration (AMD).Method: This cross-sectional investigation enrolled 45 patients with AMD and 45 age- and sex-matched controls. The overall cognitive performance in AMD sufferer versus control subjects was asses using the Persian version of the Addenbrooke’s Cognitive Examination battery (ACE-R). Subjects’ sleep quality was also evaluated using the Pittsburgh Sleep Quality Index (PSQI). The mean global assessment and subscale scores were statistically compared between groups.Results: The mean global scores for ACE-R in AMD and control groups (80.4±12.3 and 86 ± 9.6, respectively) were found to be statistically different (p=0.018). On the other hand there was no significant difference (p=0.793) between the AMD and control groups in terms of PSQI scores (9.7±2.8 and 9.8±2.8, respectively). Conclusion: AMD patients seem to have cognitively underperformed in memory and verbal fluency domains compared to the control group. Evidence on cognitive impairments in patients with AMD may possibly herald neurocognitive insufficiencies and have common pathological mechanisms with dementias.


2018 ◽  
Vol 28 (1) ◽  
pp. 80-86
Author(s):  
Caner Kara ◽  
Pınar Ç. Özdal ◽  
Emrullah Beyazyıldız ◽  
Nurgül E. Özcan ◽  
Mehmet Y. Teke ◽  
...  

Purpose: To investigate the levels of circulating CD34+ stem cells in patients with neovascular type age-related macular degeneration (AMD) and its relation with clinical and optical coherence tomography (OCT) findings. Methods: The study consisted of 55 patients: 28 patients (18 male and 10 female) with neovascular type AMD as a study group and 27 patients (12 male and 15 female) scheduled for cataract surgery as a control group. The level of CD34+ stem cells was measured by flow cytometry. Demographic and clinical data were recorded. Results: The mean ages of patients in the study and control groups were 71 ± 8 and 68 ± 6 years, respectively. There was no statistically significant difference in terms of age, sex, or systemic disease association between study and control groups. However, smoking status was significantly higher in the study group (67.9% vs 37.0%; p = 0.02). Stem cell levels were significantly higher in the study group (1.5 ± 0.9 vs 0.5 ± 0.3; p<0.001), but there was no relation between stem cell levels and clinical and OCT findings. Conclusions: Increased circulating CD34+ stem cell levels were observed in patients with choroidal neovascular membrane associated with AMD, but no significant relation was found between cell levels and clinical and OCT findings.


2020 ◽  
Author(s):  
Mohsen Farvardin ◽  
Seyed esmaeil mousavi ◽  
Kamran Zare ◽  
Somaye Bazdar ◽  
Zahra Farvardin ◽  
...  

Abstract Background: Age-related macular degeneration (AMD) is regarded amongst as a common conditions resulting in visual impairment in elderly. Age and gender are unmodifiable risk factors for AMD, obesity, smoking, and hyperlipidemia are known to be modifiable culprits. This has remained controversial for hypertension and thyroid dysfunction. The present study attempted to investigate possible links between thyroid dysfunction and incidence of wet AMD.Methods: The present case-control study enrolled a total number of 90 patients with wet AMD and 90sex-, age-matched control subjects through a convenient sequential sampling method. Thyroid hormones were profiled in serum assay. Statistical measures were done to compare means between groups.Results: Our findings showed a significant difference in free T4 levels between the between wet AMD and control groups (p = 0.002), though this has not been the case for T3 and TSH l. In addition, there were no differences in serum lipid profile between groups. Although there found to be no significant difference in the past history of hypertension and hyperlipidemia between wet AMD and control groups, history of smoking was higher in controls) (p = 0.039).Conclusion: Based on our findings retinal examination and proper screening need to perhaps be a part of the overall health examination especially in elderly subjects with thyroid dysfunction. The clinical significance and related recommendations on the above need ti substantiated in future community-based research.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0251931
Author(s):  
Yan Xin ◽  
Kang Zefeng ◽  
Li Ling ◽  
Guan Ruijuan

Objective To investigate the association between the nuclear factor kappa B (NF-kB) gene polymorphism and age-related macular degeneration (AMD) in a high-altitude population. Methods Fifty-five patients with AMD and 57 control subjects were recruited from the Qinghai Provincial People’s Hospital, China. Genomic DNA was extracted from the blood sample of each participant. Four NF-kB polymorphisms (rs3774959, rs3774932, rs3774937, and rs230526) were genotyped using a MassARRAY system. The genotype and allele frequencies were compared between the case and control groups using the chi-squared test or Fisher’s exact test. Results There was no significant difference in sex, age, hypertension, diabetes, blood lipid level or smoking and drinking status between the AMD and control groups (P > 0.05). The genotype distributions of four NF-kB polymorphisms were in accordance with Hardy-Weinberg equilibrium in the control group (P > 0.05). The frequencies of genotype AA of rs3774932 and genotype CC of rs3774937 were nominally significantly higher in the AMD group than in the control group (P = 0.046 and 0.023, respectively), although these associations did not survive the Bonferroni correction (corrected P > 0.05). Genotype distributions of rs3774959 and rs230526 were not significantly different between the two groups (P = 0.08 and 0.16, respectively). No significant difference in the allele frequencies of the four polymorphisms was found between the AMD and control groups (P > 0.05). Conclusions Genotype AA of rs3774932 and genotype CC of rs3774937 in NF-kB might be risk factors for AMD.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M S Abdaltawab ◽  
Z F Ismail ◽  
W M A Ebeid ◽  
S M Fawzy

Abstract Aim of the Work The aim of this work is to compare the response of treatment with ranibizumab in terms of visual acuity in cases of CNV secondary to pathological myopia versus CNV secondary to age-related macular degeneration. Methods This prospective, comparative study included ten eyes newly diagnosed as having CNV secondary to pathological myopia, and 10 eyes newly diagnosed as having subfoveal active CNV secondary to AMD. All patients had 3 monthly intravitreal Injections of 0.50 mg (in 0.05 ml of solution) ranibizumab with monthly evaluation of best corrected visual acuity (BCVA) by Landolt C chart, and also calculated in Logarithm of Minimum Angle of Resolution (Log MAR). Results pretreatment there was no significant difference between the two groups as the mean VA (Log Mar) was 1.31 ± 0.2 in AMD group and 1.17 ± 0.3 in MCNV group of P value = 0.431 and also post three IVI of ranibizumab showed no significant difference between the two groups as the mean VA (Log Mar) was 1.22 ± 0.2 for AMD and 1.22 ± 0.5 for MCNV of P value = 0.635. Conclusion there was no significant difference in BCVA between AMD and MCNV groups after three intravitreal injections of ranibizumab.


2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Jianqing Li ◽  
Jiayi Xu ◽  
Yiyi Chen ◽  
Jiaju Zhang ◽  
Yihong Cao ◽  
...  

Purpose. Intravitreal antivascular endothelial growth factor (anti-VEGF) therapy has been widely used for the treatment of neovascularization (NV) secondary to age-related macular degeneration (AMD). This study aimed to compare the efficacy among different subtypes of neovascular age-related macular degeneration (nAMD). Methods. PubMed, Embase, and the Cochrane Library were searched for eligible studies. We performed meta-analysis using Review Manager 5.3 and Stata/SE 12.0. Results. A total of 24 studies met our inclusion criteria and were included in the systematic review. At 3 months, the mean logarithm of the minimum angle of resolution (logMAR) improvements were −0.09, −0.18, and −0.23 for type 1, 2, and 3, respectively, while the mean macular thickness (MT) changes were −104.83, −130.76, and −196.29 μm. At 12 months, the mean changes in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters were 6.38, 8.12, and 9.37, while the MT decrease was 126.51, 126.52, and 139.85 μm, respectively. However, statistically significant difference was only found between type 1 and 3 in vision improvement, both in the short term (p=0.0002) and long term (p=0.01). Conclusions. The reactivity to VEGF inhibitors varied among different subtypes of nAMD. The efficacy of intravitreal anti-VEGF therapy in type 3 nAMD was statistically better than type 1 when considering vision improvement at 3 and 12 months. Thus, the lesion subtype is a predictor for the treatment outcome which can help guide prognosis.


2017 ◽  
Vol 102 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Imoro Zeba Braimah ◽  
Komal Agarwal ◽  
Ahmad Mansour ◽  
Jay Chhablani

AimTo evaluate 12-month outcome of intravitreal ziv-aflibercept (IVZ) therapy in eyes with neovascular age-related macular degeneration (nAMD) that are non-responsive to bevacizumab and ranibizumab.MethodsThis retrospective study included 16 eyes (14 patients) with nAMD who were on prior treatment with bevacizumab and ranibizumab and were treated with as-needed IVZ (1.25 mg/0.05 mL) for 12 months. The primary outcome measure was the mean change in best corrected visual acuity (BCVA) and secondary outcome measures included mean change in central macular thickness (CMT), retinal pigment epithelial detachment (RPED) heights, longest treatment free interval, presence of subretinal fluid (SRF) and intraretinal fluid (IRF) and adverse events.ResultsThere was no change in the mean logarithm of minimum angle of resolution (logMAR) BCVA at baseline and following treatment with IVZ therapy (p=0.978). The mean number of IVZ injections during 12 months was 5.9±3.3, and the mean number of antivascular endothelial growth factors (VEGFs) injections prior to switching to IVZ was 8.4±4.7. The mean treatment free interval was longer during IVZ therapy (114.4±67.1 days) compared with 76.3±54.6 days before IVZ therapy (p=0.03). Five (31.25%) eyes had visual gains of at least 0.1 logMAR, 3 (18.75%) eyes had stable BCVA (within 0.1 logMAR) and 8 (50%) eyes had BCVA decline of at least 0.1 logMAR. There was no significant difference in the mean CMT, RPED heights and presence of IRF and SRF at 12 months compared with baseline. No adverse events were noted.ConclusionIVZ increased the treatment free interval in non-responders but no significant change in visual and anatomic outcomes.


2021 ◽  
Vol 13 ◽  
pp. 251584142110228
Author(s):  
Dilan Yildiz ◽  
Akin Cakir ◽  
Burak Erden ◽  
Selim Bolukbasi ◽  
Serkan Erdenöz ◽  
...  

Objective: To compare the anatomical and functional outcomes of intensive and relaxed intravitreal aflibercept regimen in the management of neovascular age-related macular degeneration. Methods: The medical records of 50 eyes of 50 patients with treatment-naive neovascular age-related macular degeneration, who underwent intravitreal aflibercept therapy in the Retinal Department of University of Health Sciences Okmeydanı Training and Research Hospital (Istanbul, Turkey), were retrospectively reviewed. The demographic features and best-corrected visual acuities at baseline and at 1st-, 2nd-, 3rd-, 4th-, 6th-, 10th- and 12th- months, optical coherence tomography measurements, presence of intraretinal fluid, subretinal fluid and intraocular pressure values were studied. The patients were divided into two groups: intensive (subretinal fluid intolerant) and relaxed (<200 microns subretinal fluid tolerated) intravitreal aflibercept regimens. Results: The change in the mean best-corrected visual acuities from baseline to 12th month was 13.72 ± 33.97 letters in the intensive treatment group and 8.68 ± 27.22 in the relaxed group. There was no statistically significant difference between the groups ( p = 0.566). Similar proportions of both groups achieved ⩾10 letters gain (%48 vs. %40, respectively; p = 0.755) and ⩾10 letters loss (%20 vs. %24, respectively; p = 0.755). The mean central subfield thickness values decreased statistically significantly in both groups ( p < 0.001). There was no statistically significant difference between the groups (442.40 ± 161.32 to 318.0 ± 63.10 vs. 431.64 ± 151.52 to 303.08 ± 140.91, respectively; p = 0.724). The mean total injection numbers were significantly lower in the relaxed group (6.4 ± 1.65 vs. 4.8 ± 1.45, respectively; p = 0.01). Conclusion: Relaxed intravitreal aflibercept regimen has comparable efficiency and safety outcomes at 12 months with intensive intravitreal aflibercept regimen with fewer injections in the management of neovascular age-related macular degeneration.


2019 ◽  
Author(s):  
Ahmed Abdelwahab Saad ◽  
Daniela Vaideanu-Collins ◽  
Lyudmila Kishikova ◽  
Marco Isac ◽  
Dina Hamada ◽  
...  

Abstract Background To compare the outcome of vitrectomy, subretinal tissue plasminogen activator (TPA), and gas with and without subretinal air versus Intravitreal TPA and gas in the treatment of sub macular haemorrhage (SMH) due to Neovascular age related macular degeneration Methods We analysed the notes of 29 cases presented with SMH in the period between 01/2016 and 09/2018 in James Cook University Hospital. Presenting visual acuity (BCVA), size and location of SMH, Procedure done, final BCVA at 6 months and any surgical complications were recorded. 11 Cases (Group 1) received intravitreal TPA (50ug in 0.1 ML), 0.3 ml of pure SF6. 18 cases (Group 2) received 23 G Pars Plana vitrectomy, Subretinal TPA injection (25ug in 0.1 ml), and 20% SF6 gas filling. Group 2 was further divided into 2A (10 patients) who received only subretinal TPA and group 2B (8 patients) who received additional 0.1 ml subretinal air.Results The mean BCVA at presentation was 0.0068 in group 1 and 0.0067 in group 2 (p= 0.8734). The mean postoperative BCVA at six months was 0.31 in group 1 and 0.58 in group 2 (p=0.0015). Subgroup analysis of group 2 didn’t show statistically significant difference in outcome when adding subretinal air to the vitrectomy procedure (p=0.7009).Conclusion Vitrectomy, gas and subretinal TPA has more successful displacement rate and better visual outcome than Intravitreal TPA & Gas alone in treating SMH involving the fovea in AMD. Additional subretinal air doesn't seem to improve the outcome in cases having vitrectcomy.


2020 ◽  
pp. 112067212096469
Author(s):  
Matteo Fallico ◽  
Andrew J Lotery ◽  
Antonio Longo ◽  
Teresio Avitabile ◽  
Vincenza Bonfiglio ◽  
...  

Purpose: To compare efficacy of treat and extend (T&E) versus fixed regimen treatment protocols in neovascular age-related macular degeneration (nAMD). Methods: Randomized clinical trials (RCTs) comparing T&E versus fixed regimen protocols for nAMD were systematically searched. Primary outcome was to compare the mean best corrected visual acuity (BCVA) change in T&E regimen versus fixed regimen. Secondary outcomes were change in the mean optical coherence tomography (OCT) central retinal thickness (CRT) and mean number of injections. Standardized mean difference (SMD) along with 95% confidence intervals (CIs) were calculated. Random-effect models were used for meta-analyses. Results: Four RCTs were included, with a total of 649 and 621 eyes in the T&E and fixed regimen cohort at 12 months, and 267 and 249 eyes at 24 months. Pooled analysis of mean BCVA change included all four RCTs at 12 months and two RCTs at 24 months, showing no difference between the two groups (12-month: SMD = 0.08, 95% CI: −0.20 to 0.35, p = 0.55; 24-month: SMD = 0.04, 95% CI: −0.13 to 0.21, p = 0.64). Pooled analysis of OCT CRT change at 12 months included three studies, showing no difference between the two groups (SMD = 0.03, 95% CI: −0.46 to 0.51, p = 0.91). Pooled analysis of mean injection number included all four RCTs at 12 months and two RCTs at 24 months, showing significant difference between the two groups (12-month: SMD = −1.11, 95% CI: −1.67 to −0.56, p < 0.001; 24-month: SMD = −1.34, 95% CI: −1.54 to −1.15, p < 0.001). Conclusion: A T&E regimen proved as effective as a fixed dosage regimen throughout a 24-month follow-up and with a lower number of injections.


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