Changes in visual acuity in patients with dry form of age-related macular degeneration after low-energy light therapy and medication

2016 ◽  
Vol 63 (5) ◽  
pp. 22-28
Author(s):  
A. Sergienko ◽  
◽  
N. Dzyuba ◽  
2016 ◽  
Vol 23 (3) ◽  
Author(s):  
N. O. Dziuba ◽  
A. M. Sergienko

Age-related macular degeneration (AMD) is a leading cause of irreversible loss of central vision in people over 60 years of age. One of the most important risk factors for AMD is decrease in macular pigment optical density (MPOD). Search for new possible ways of (MPOD) improvement in AMD treatment is very important.The objective of the research was to study the indices of macular pigment optical density in patients with the dry form of AMD after two courses of low-energy light therapy and conservative treatment.Material and methods. The main group (MG) included 87 patients (146 eyes) who underwent two courses of low-energy light therapy (LLT) in combination with two courses of conservative treatment in hospital for 10 days at intervals of six months each. The control group (CG) consisted of 75 patients (135 eyes) who underwent only two courses of conservative therapy in the hospital for 10 days at intervals of six months each. Observations were conducted before, after treatment, after 1, 3 and 6 months after each course of treatment. The total period of follow-up was 1 year. LLT was performed using the device Spektra Light (Canada). All patients were generally conducted eye examination. MPOD was measured using densitometer “Maculux praxis” (Germany) by heterochromatic flicker photometry.Results. MPOD index increased from 0.249 ± 0.011 units to 0.360 ± 0.016 units, by 0.111 ± 0.014 units (44.6%) in 1 month after the first course of treatment, up to 0.344 ± 0.015 units, by 0.095 ± 0.013 units (38.2%) after 3 months, up to 0.321 ± 0.014 units, by 0.072 ± 0.013 (28.9%) in 6 months (p<0.05) in patients of MG. Stabilization of the index from 0.248 ± 0.012 units before the treatment and 0.243 ± 0.011 6 months after the first course of treatment (p>0.05) occurred in patients of the KG. MPOD indices increased from 0.321 ± 0.014 units to 0.431 ± 0.017 units, by 0.110 ± 0.016 units (34.3%) in 1 month after the second course of treatment, up to 0.412 ± 0.017 units, by 0.091 ± 0.016 units (28.4%) in 3 months, and up to 0.388 ± 0.016 units, by 0.067 ± 0.015 (20.9%) in 6 months (p<0.05) in patients of the MG. Stabilization of the index from 0.243 ± 0.011 units before the treatment and 0.237 ± 0.011 in 6 months after the second course of treatment (p>0.05) was observed in patients of KG.Conclusions. 1. Statistically significant increase in macular pigment optical density from 0.249 ± 0.011 units to 0.388 ± 0.016, by 0.139 ± 0.014 units (by 55.8%) was noted in patients who underwent two courses of low-energy light therapy in combination with a course of conservative treatment. Macular pigment optical density index did not change in the patients in the control group. 2. Two courses of low-energy light therapy in combination with a course of conservative treatment increases the concentration of macular pigment, as evidenced by the increase in indices of macular pigment optical density in comparison with conservative treatment, during which indices stabilize. 


2019 ◽  
Vol 4 (1) ◽  
pp. e000273
Author(s):  
Irina Balikova ◽  
Laurence Postelmans ◽  
Brigitte Pasteels ◽  
Pascale Coquelet ◽  
Janet Catherine ◽  
...  

ObjectiveAge-related macular degeneration (ARMD) is a leading cause of visual impairment. Intravitreal injections of anti-vascular endothelial growth factor (VEGF) are the standard treatment for wet ARMD. There is however, variability in patient responses, suggesting patient-specific factors influencing drug efficacy. We tested whether single nucleotide polymorphisms (SNPs) in genes encoding VEGF pathway members contribute to therapy response.Methods and analysisA retrospective cohort of 281 European wet ARMD patients treated with anti-VEGF was genotyped for 138 tagging SNPs in the VEGF pathway. Per patient, we collected best corrected visual acuity at baseline, after three loading injections and at 12 months. We also registered the injection number and changes in retinal morphology after three loading injections (central foveal thickness (CFT), intraretinal cysts and serous neuroepithelium detachment). Changes in CFT after 3 months were our primary outcome measure. Association of SNPs to response was assessed by binomial logistic regression. Replication was attempted by associating visual acuity changes to genotypes in an independent Japanese cohort.ResultsAssociation with treatment response was detected for seven SNPs, including in FLT4 (rs55667289: OR=0.746, 95% CI 0.63 to 0.88, p=0.0005) and KDR (rs7691507: OR=1.056, 95% CI 1.02 to 1.10, p=0.005; and rs2305945: OR=0.963, 95% CI 0.93 to 1.00, p=0.0472). Only association with rs55667289 in FLT4 survived multiple testing correction. This SNP was unavailable for testing in the replication cohort. Of six SNPs tested for replication, one was significant although not after multiple testing correction.ConclusionIdentifying genetic variants that define treatment response can help to develop individualised therapeutic approaches for wet ARMD patients and may point towards new targets in non-responders.


Author(s):  
Kai Xiong Cheong ◽  
Alvin Wei Jun Teo ◽  
Chui Ming Gemmy Cheung ◽  
Issac Horng Khit Too ◽  
Usha Chakravarthy ◽  
...  

Eye ◽  
2017 ◽  
Vol 31 (6) ◽  
pp. 978-980 ◽  
Author(s):  
A Rasmussen ◽  
J Fuchs ◽  
L H Hansen ◽  
M Larsen ◽  
B Sander ◽  
...  

Ophthalmology ◽  
2001 ◽  
Vol 108 (10) ◽  
pp. 1893-1900 ◽  
Author(s):  
Barbara L Brody ◽  
Anthony C Gamst ◽  
Rebecca A Williams ◽  
Amanda R Smith ◽  
Philip W Lau ◽  
...  

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