scholarly journals Depression, Anxiety, Somatization Disorder, and Adjustment Disorder in Older Patients with Exudative Age-related Macular Degeneration

2021 ◽  
Vol 62 (8) ◽  
pp. 1069-1075
Author(s):  
Hee Chul Lee ◽  
Hyewon Nam ◽  
Dongwoo Kang ◽  
Myeong In Yeom

Purpose: The aim of this study was to analyze the prevalence of depression, anxiety, somatization disorder, and adjustment disorder in older patients diagnosed with exudative age-related macular degeneration (AMD) and to evaluate the relationship between exudative AMD and psychological disease.Methods: The 2016 Health Insurance Review and Assessment Service-Aged Patient Sample was applied in this study. The subjects were divided into two groups: AMD patients undergoing intravitreal injection treatment and a control group. Comorbidities were evaluated using the Charlson Comorbidity Index.Results: A total of 1,319,052 subjects were selected, of which 3,134 were in the exudative AMD group receiving intravitreal injections. The average age of the subjects was 74.7 ± 6.7 years, and 41.8% were male. In patients with exudative AMD, the prevalence of depression, anxiety, somatization disorder, and adjustment disorder were 16%, 20%, 0.5%, and 0.4%, respectively; in particular, the prevalence of depression and adjustment disorder were significantly higher than in the control group. In multivariate regression analysis, exudative AMD was a significant factor of depression (odds ratio [OR] 1.2, 95% confidence interval [CI] 1.08-1.31, p < 0.001) and adjustment disorder (OR 2.47, 95% CI 1.47-4.18, p < 0.001). However, the association between AMD and anxiety or somatization disorder was not statistically significant.Conclusions: Exudative AMD showed a significant association with psychiatric disease, such as depression, and requires close clinical attention.

2020 ◽  
Vol 5 (1) ◽  
pp. e000451
Author(s):  
Shaun Ittiara ◽  
Anya S Hariprasad ◽  
Leonard V Messner ◽  
David J Tresley ◽  
Danielle Leong ◽  
...  

ObjectiveThis study aimed to determine which colour contrast sensitivity differences exist in early to advanced age-related macular degeneration (AMD) and examine the potential utility of the King-Devick Variable Color Contrast Sensitivity Chart in detecting AMD severity.Methods and analysisA total of 85 participants (144 total eyes) were recruited from multiple clinical practices and enrolled in the study. The control group consisted of 57 healthy eyes. The non-exudative AMD (NE-AMD) group consisted of 45 eyes. The exudative AMD (E-AMD) group consisted of 42 eyes. In a single study visit, monocular best-corrected visual acuity (BCVA) at 40 cm with 100% black contrast was determined for each eye. Using the BCVA line, the number of letters correctly identified (out of 10) was recorded for various colour presentations (red, green, blue and yellow) and at decreasing contrast levels (100%, 75%, 50% and 25%).ResultsOur results show worse visual performance under various colour contrast settings in E-AMD patients compared with healthy controls and NE-AMD. Colour contrast performance using blue and yellow differentiated more advanced stages of disease in E-AMD from earlier NE-AMD disease. Blue and black colour contrast performance more accurately identified the E-AMD group from healthy controls and the NE-AMD group.ConclusionThe findings of this study demonstrate that colour contrast, particularly with black, blue and yellow, is impaired in E-AMD suggesting the potential for colour contrast measures to serve as an adjunctive clinical tool in identifying subtle altered visual function as well as the potential for detecting disease severity.


2020 ◽  
Vol 9 (3) ◽  
pp. 631 ◽  
Author(s):  
Juan M. Chao de la Barca ◽  
Barnabé Rondet-Courbis ◽  
Marc Ferré ◽  
Jeanne Muller ◽  
Adrien Buisset ◽  
...  

To determine the plasma metabolomic profile of exudative age-related macular degeneration (AMD), we performed a targeted metabolomics study on the plasma from patients (n = 40, mean age = 81.1) compared to an age- and sex-matched control group (n = 40, mean age = 81.8). All included patients had documented exudative AMD, causing significant visual loss (mean logMAR visual acuity = 0.63), compared to the control group. Patients and controls did not differ in terms of body mass index and co-morbidities. Among the 188 metabolites analyzed, 150 (79.8%) were accurately measured. The concentrations of 18 metabolites were significantly modified in the AMD group, but only six of them remained significantly different after Benjamini–Hochberg correction. Valine, lysine, carnitine, valerylcarnitine and proline were increased, while carnosine, a dipeptide disclosing anti-oxidant and anti-glycating properties, was, on average, reduced by 50% in AMD compared to controls. Moreover, carnosine was undetectable for 49% of AMD patients compared to 18% in the control group (p-value = 0.0035). Carnitine is involved in the transfer of fatty acids within the mitochondria; proline, lysine and valerylcarnitine are substrates for mitochondrial electrons transferring flavoproteins, and proline is one of the main metabolites supplying energy to the retina. Overall, our results reveal six new metabolites involved in the plasma metabolomic profile of exudative AMD, suggesting mitochondrial energetic impairments and carnosine deficiency.


2021 ◽  
pp. 112067212110026
Author(s):  
Pablo Gili ◽  
Leyre Lloreda Martín ◽  
José-Carlos Martín-Rodrigo ◽  
Naon Kim-Yeon ◽  
Laura Modamio-Gardeta ◽  
...  

Purpose: To identify the association between single-nucleotide polymorphisms (SNPs) in CFH, ARMS2, HTRA1, CFB, C2, and C3 genes and exudative age-related macular degeneration (AMD) in a Spanish population. Methods: In 187 exudative AMD patients and 196 healthy controls (61% women, mean age 75 years), 12 SNPs as risk factors for AMD in CFH (rs1410996, rs1061170, r380390), ARMS2 (rs10490924, rs10490923), HTRA1 (rs11200638), CFB (rs641153), C2 (rs547154, rs9332739), and C3 (rs147859257, rs2230199, rs1047286) genes were analyzed. Results: The G allele was the most frequent in CFH gene (rs1410996) with a 7-fold increased risk of AMD (OR 7.69, 95% CI 3.17–18.69), whereas carriers of C allele in CFH (rs1061170) showed a 3-fold increased risk for AMD (OR 3.22, 95% CI 1.93–5.40). In CFH (rs380390), the presence of G allele increased the risk for AMD by 2-fold (OR 2.52, 95% CI 1.47–4.30). In ARMS2 (rs10490924), the T-allele was associated with an almost 5-fold increased risk (OR 5.49, 95% CI 3.23–9.31). The A allele in HTRA1 (rs11200638) was more prevalent in AMD versus controls (OR 6.44, 95% CI 3.62–11.47). In C2 gene (rs9332739) the presence of C increased risk for AMD by 3-fold (OR 3.10, 95% CI 1.06–9.06). Conclusion: SNPs in CFH, ARMS2, HTRA1, and C2 genes were associated in our study with an increased risk for exudative AMD in Spanish patients.


2021 ◽  
Vol 10 (12) ◽  
pp. 2580
Author(s):  
Omar A. Halawa ◽  
Jonathan B. Lin ◽  
Joan W. Miller ◽  
Demetrios G. Vavvas

Age-related macular degeneration (AMD) is a leading cause of irreversible blindness among older adults in the Western world. While therapies exist for patients with exudative AMD, there are currently no approved therapies for non-exudative AMD and its advanced form of geographic atrophy (GA). The discovery of genetic variants in complement protein loci with increased susceptibility to AMD has led to the investigation of the role of complement inhibition in AMD with a focus on GA. Here, we review completed and ongoing clinical trials evaluating the safety and efficacy of these studies. Overall, complement inhibition in GA has yielded mixed results. The inhibition of complement factor D has failed pivotal phase 3 trials. Studies of C3 and C5 inhibition meeting their primary endpoint are limited by high rates of discontinuation and withdrawal in the treatment arm and higher risks of conversion to exudative AMD. Studies evaluating other complement members (CFB, CFH, CFI and inhibitors of membrane attack complex—CD59) are ongoing and could offer other viable strategies.


2021 ◽  
Vol 10 (12) ◽  
pp. 2658
Author(s):  
Alexis Khorrami Kashi ◽  
Eric Souied ◽  
Selim Fares ◽  
Enrico Borrelli ◽  
Vittorio Capuano ◽  
...  

We evaluated the spectrum of choriocapillaris (CC) abnormalities in the fellow eyes of unilateral exudative age-related macular degeneration (AMD) patients using swept-source optical coherence tomography angiography (SS-OCTA). Fellow eyes of unilateral exudative AMD patients were prospectively included between May 2018 and October 2018. Patients underwent a multimodal imaging including a SS-OCTA. Demographics and clinical findings were analyzed. The estimated prevalence of macular neovascularization (MNV) was computed. Number and size of flow deficits (FDs) and percentage of flow deficits (FD%) were computed on the compensated CC flow images with the Fiji software. We included 97 eyes of 97 patients (mean age was 80 ± 7.66 years, 39 males, 58 females). The prevalence of MNV in the studied eyes was 8.25% (8/97 eyes). In the 89 non-neovascular eyes, FD% averaged 45.84% ± 11.63%, with a corresponding total area of FDs of 4.19 ± 1.12 mm2. There was a higher prevalence of drusenoid pigment epithelial detachment in eyes with subclinical neovascularization (p = 0.021). Fellow eyes with unilateral exudative AMD encompassed a series of CC abnormalities, from FDs of the aging CC to subclinical non-exudative MNV.


2019 ◽  
Vol 3 (4) ◽  
pp. 211-214 ◽  
Author(s):  
Daniel Olson ◽  
Xinxin Zhang ◽  
Michael F. Ward ◽  
Patrick Le ◽  
Omar M. Ismail ◽  
...  

Purpose: The purpose of this article is to investigate how age-related macular degeneration (AMD) is associated with anxiety and depression. Methods: An online repository of deidentified patient data was queried to identify and retrospectively analyze patients with AMD, depression, or anxiety via ICD-9 and ICD-10 codes. Odds ratios were calculated between AMD and anxiety and depression, respectively. Results: Of the 51 019 patients analyzed in this study, 11 681 (22.9%) had depression, 8727 (17.1%) had anxiety, and 2752 (5.4%) had AMD. The prevalence of anxiety among AMD patients was 18.2%, and the prevalence of depression among AMD patients was 25.0%. The odds of a patient with AMD carrying a diagnosis of anxiety are 1.3 (95% CI 1.2, 1.5) times higher than a patient without AMD, and the odds of carrying a diagnosis of depression are also 1.3 (95% CI 1.1, 1.4) times more likely. Conclusions: Patients with AMD have increased odds of suffering from comorbid anxiety and depression. Ophthalmologists should consider mental health screens and appropriate referrals as new diagnoses of AMD are made or as the disease progresses.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037028
Author(s):  
Chi Chin Sun ◽  
Ting-Shuo Huang ◽  
Tsai-Sheng Fu ◽  
Chia-Yi Lee ◽  
Bing-Yu Chen ◽  
...  

ObjectivesVisual impairment is an important risk factor for fracture in the elderly population. Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment in elderly people. This study was conducted to explore the relationship between AMD and incident fractures in patients with osteoporosis (OS).DesignRetrospective analysis of Taiwan’s National Health Insurance Research Database (NHIRD).SettingA multicenter study conducted in Taiwan.Participants and controlsThe current study used the NHIRD in Taiwan between 1996 and 2011. A total of 13 584 and 54 336 patients with OS were enrolled in the AMD group and the non-AMD group, respectively.InterventionPatients with OS were included from the Taiwan’s NHIRD after exclusion, and each patient with AMD was matched for age, sex and comorbidities to four patients with non-AMD OS, who served as the control group. A Cox proportional hazard model was used for the multivariable analysis.Primary outcome measuresTransitions for OS to spine fracture, OS to hip fracture, OS to humero-radio-ulnar fracture and OS to death.ResultsThe risks of spine and hip fractures were significantly higher in the AMD group (HR=1.09, 95% CI=1.04 to 1.15, p<0.001; HR=1.18; 95% CI=1.08 to 1.30, p=0.001, respectively) than in the non-AMD group. The incidence of humero-radio-ulnar fracture between AMD and non-AMD individuals was similar (HR=0.98; 95% CI=0.90 to 1.06; p=0.599). However, the risk of death was higher in patients with OS with older age, male sex and all types of comorbidity (p<0.05), except for hyperthyroidism (p=0.200).ConclusionPatients with OS with AMD had a greater risk of spine and hip fractures than did patients without AMD.


2012 ◽  
Vol 06 (01) ◽  
pp. 48
Author(s):  
Omar S Punjab ◽  
Peter K Kaiser ◽  
◽  

There have been several recent studies that support the idea that posterior vitreomacular adhesion (VMA) might be associated with the development and progression of exudative age-related macular degeneration (AMD). Although VMA itself does not cause exudative AMD, retina specialists should consider the presence or absence of VMA when evaluating and treating patients with exudative AMD. This article reviews the recent literature regarding the posterior hyaloid and its relationship to exudative AMD.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Jan Studnička ◽  
Eva Rencová ◽  
Milan Bláha ◽  
Pavel Rozsíval ◽  
Miriam Lánská ◽  
...  

Purpose. Determining long-term effects of rheohaemapheresis on the dry form of age-related macular degeneration.Methods. This study evaluates 19 patients, average age of 67.6 years, treated with rheohaemapheresis and 18 patients, average age of 72.8 years, comprising the control group. Minimum follow up period was 3.5 years. Each treated patient received a series of 8 sessions of rheohaemapheresis of 1.5 plasma volumes within 10 weeks. We measured the drusenoid pigment epithelium detachment (DPED), best-corrected visual acuity (BCVA), electroretinography (ERG), and rheological parameters.Results. In the treatment group, the baseline BCVA was 0.74 (0.36–1.0) 95% CI and BCVA after 3.5 years was 0.79 (0.41–1.0) 95% CI (P=0.726). In the control group, the baseline BCVA was 0.71 (0.15–1.0) 95% CI and BCVA after 3.5 years decreased to 0.7 (0.32–0.87) 95% CI (P=0.031). Baseline DPED was 6.78 ± 3.79 mm2; after 3.5 years, it decreased to 4.13 ± 3.84 mm2(P<0.001). In the control group, the baseline DPED was 4.09 ± 3.48 mm2; after 3.5 years, it increased to 6.69 ± 4.2 mm2(P=0.001). We noted increasing levels of positive wave peaking at 50 milliseconds (P50) after treatment (P=0.022) and a stable amplitude of photopic responses of treated patients.Conclusion. Over the long term, rheohaemapheresis reduced the DPED, improved the function of photoreceptors, and prevented the decline of BCVA.


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