scholarly journals The relation of phacoemulsification and progression of age-related macular degeneration

2021 ◽  
Vol 9 (2) ◽  
pp. 32-39
Author(s):  
O.U. Denisyuk

Background. It is currently impossible to draw definitive conclusions whether phacoemulsification (PhE) is safe for people with age-related macular degeneration (ARMD). It is not clear if PhE causes the progression of ARMD and affects visual acuity (VA). The purpose was to analyze the possible association of PhE with ARMD progression in the early and late (up to 18 months after surgery) period. Materials and methods. The study included 86 patients (93 eyes), 37 men and 49 women aged 60 to 82 years, who were operated for PhE (implantation of soft intraocular lens on the camera Infiniti, “Alcon”, USA). ARMD was assessed based on the classification of the American Academy of Ophthalmologists (AREDS, 2001). Patients were examined 1, 3, 6, 12 and 18 months after surgery. For statistical processing of obtained data, Statistica 10 (StatSoft, Inc., USA) and MedCalc Statistical Software 18 (MedCalc Software bvba, Belgium) were used. Results. In 69.9 % of eyes with cataract, ARMD was registered: early and midstage (AREDS 2 and 3) was diagnosed in 16.1 % of cases, late stage (AREDS 4.1) — in 25.8 %, and exudative (AREDS 4.2) — in 28.0 %. VA before surgery was consistent with the stage of ARMD and was worse in AREDS 4. To evaluate the progression of ARMD, the index of progression (IP) was developed characterizing the average rate of ARMD clinical manifestations change. The progression of ARMD within 18 months (IP > 0) after the PhE was observed in 33.3 % of cases, including 12.9 % of first determined ARMD. Patients without ARMD progression were 6 years younger than those that had progression (p = 0.001). When IP = 0.100, the disorder progressed at the early stages (3 months); when IP = 0.033, in the later period (12 and 18 months). After surgery, VA was significantly increased, which depended on the initial stage of ARMD (VA was worse at the late stage and in AREDS 4) and ARMD progression (VA was worse when IP > 0, and in the cases of progression when IP = 0.033, that is, with the later ARMD progression). Conclusions. The characteristics of the stages of ARMD and VA dynamics after PhE suggest a positive impact of PhE on the ARMDS progression.

2018 ◽  
Vol 136 (11) ◽  
pp. 1305 ◽  
Author(s):  
Phillippe Burlina ◽  
Neil Joshi ◽  
Katia D. Pacheco ◽  
David E. Freund ◽  
Jun Kong ◽  
...  

2019 ◽  
Vol 16 (5) ◽  
pp. 623-629
Author(s):  
Antonio Pinna ◽  
Giuliana Solinas ◽  
Ermete Giancipoli ◽  
Tiziana Porcu ◽  
Angelo Zinellu ◽  
...  

2019 ◽  
Vol 30 (1) ◽  
pp. 9-26 ◽  
Author(s):  
Oscar Julian Perdomo Charry ◽  
Fabio Augusto González Osorio

Artificial intelligence is having an important effect on different areas of medicine, and ophthalmology has not been the exception. In particular, deep learning methods have been applied successfully to the detection of clinical signs and the classification of ocular diseases. This represents a great potential to increase the number of people correctly diagnosed. In ophthalmology, deep learning methods have primarily been applied to eye fundus images and optical coherence tomography. On the one hand, these methods have achieved an outstanding performance in the detection of ocular diseases such as: diabetic retinopathy, glaucoma, diabetic macular degeneration and age-related macular degeneration.  On the other hand, several worldwide challenges have shared big eye imaging datasets with segmentation of part of the eyes, clinical signs and the ocular diagnostic performed by experts. In addition, these methods are breaking the stigma of black-box models, with the delivering of interpretable clinically information. This review provides an overview of the state-of-the-art deep learning methods used in ophthalmic images, databases and potential challenges for ocular diagnosis


Author(s):  
Lei Feng ◽  
Si Chen ◽  
Huatuo Dai ◽  
Rajkumar Dorajoo ◽  
Jianjun Liu ◽  
...  

BackgroundCentral serous chorioretinopathy (CSC) is a severe and heterogeneous chorioretinal disorder. Shared clinical manifestations between CSC and age-related macular degeneration (AMD) and the confirmation of CFH as genetic risk locus for both CSC and AMD suggest possible common pathophysiologic mechanisms between two diseases.MethodsTo advance the understanding of genetic susceptibility of CSC and further investigate genetic pleiotropy between CSC and AMD, we performed genetic association analysis of 38 AMD-associated single nucleotide polymorphisms (SNPs) in a Chinese CSC cohort, consisting of 464 patients and 548 matched healthy controls.ResultsTwelve SNPs were found to be associated with CSC at nominal significance (p < 0.05), and four SNPs on chromosomes 1, 4, and 15 showed strong associations whose evidences surpassed Bonferroni (BF)-corrected significance [rs1410996, odds ratios (OR) = 1.47, p = 2.37 × 10–5; rs1329428, OR = 1.40, p = 3.32 × 10–4; rs4698775, OR = 1.45, p = 2.20 × 10–4; and rs2043085, OR = 1.44, p = 1.91 × 10–4]. While the genetic risk effects of rs1410996 and rs1329428 (within the well-established locus CFH) are correlated (due to high LD), rs4698775 on chromosome 4 and rs2043085 on chromosome 15 are novel risk loci for CSC. Polygenetic risk score (PRS) constructed by using three independent SNPs (rs1410996, rs4698775, and rs2043085) showed highly significant association with CSC (p = 2.10 × 10–7), with the top 10% of subjects with high PRS showing 6.39 times higher risk than the bottom 10% of subjects with lowest PRS. Three SNPs were also found to be associated with clinic manifestations of CSC patients. In addition, by comparing the genetic effects (ORs) of these 38 SNPs between CSC and AMD, our study revealed significant, but complex genetic pleiotropic effect between the two diseases.ConclusionBy discovering two novel genetic risk loci and revealing significant genetic pleiotropic effect between CSC and AMD, the current study has provided novel insights into the role of genetic composition in the pathogenesis of CSC.


2022 ◽  
pp. neurintsurg-2021-018222
Author(s):  
Ivan Lylyk ◽  
Carlos Bleise ◽  
Pedro N Lylyk ◽  
Nicolas Perez ◽  
Javier Lundquist ◽  
...  

BackgroundThere is considerable overlap of contributors to cardiovascular disease and the development of age-related macular degeneration (AMD). Compromised ocular microcirculation due to aging and vascular disease contribute to retinal dysfunction and vision loss. Decreased choroidal perfusion is evident in eyes with dry AMD and is thought to play a role in retinal pigment epithelial dysfunction, the rate of development of geographic atrophy, and the development of neovascularization. The aim of the study was to demonstrate that AMD is correlated with a compromised blood flow in the ocular pathway and show OA angioplasty as a potential treatment of late-stage AMD.MethodsBased on the potential for the ophthalmic artery (OA) to be an anatomical target for the treatment of AMD as outlined above, five patients were found to be eligible for compassionate use treatment, presenting clinically significant late-stage AMD with profound vision loss in one or both eyes, and are included in this retrospective study.ResultsOA narrowing, or significant calcium burden at the ophthalmic segment of the internal carotid artery compromising the origin of the OA was confirmed in all cases. Subsequent OA cannulation was achieved in all patients with some difficulty. Subjective patient reports indicated that all patients perceived a benefit following the procedure; however, improved postoperative visual acuity did not confirm that perceived benefit for one of the patients.ConclusionsFeasibility and safety of the OA angioplasty were demonstrated, and a benefit perceived in five patients with profound vision loss and a desire to achieve improved quality of life. A clinical trial with controlled schedule, imaging, and methodologies is needed to confirm these results.


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