Geigy Scientific Tables

Smoke and autoimmunity: The fire behind the disease.

Background Retinal vein occlusion (RVO) is the second most common retinal vascular disorder that affected 16.4 million people worldwide in 2008. The last decade has seen new epidemiological data on RVO, enabling us to provide a contemporary estimation of RVO epidemiology. Methods We searched PubMed, Medline, Embase, GLOBAL HEALTH, World Health Organization Global Health Library, China National Knowledge Infrastructure for studies that reported prevalence or incidence of RVO in the general population. The age- and sex-specific prevalence of RVO was estimated by a multilevel mixed-effects logistic regression, the incidence of RVO and potential risk factors for RVO were respectively pooled by a random-effects meta-analysis. Results The prevalence of any RVO, branch RVO (BRVO) and central RVO (CRVO) all increased with advanced age, but didn't differ significantly between sexes. In 2015, the global prevalence of any RVO, BRVO and CRVO in people aged 30-89 years was 0.77% (95% confidence interval CI = 0.55-1.08), 0.64% (95% CI = 0.47-0.87) and 0.13% (95% CI = 0.08-0.21), equivalent to an overall of 28.06 million, 23.38 million and 4.67 million affected people. For any RVO, the pooled five-year cumulative incidence was 0.86% (95% CI = 0.70-1.07) and the pooled ten-year cumulative incidence was 1.63% (95% CI = 1.38-1.92). Hypertension was the strongest risk factor for any RVO, with a meta- odds ratio (OR) of 2.82 (95% CI = 2.12-3.75). Conclusions This study provides an updated summary of RVO epidemiology in the general population. More epidemiological studies worldwide are still needed to better understand the global disease burden of RVO.

/pdf/global-epidemiology-of-retinal-vein-occlusion-a-systematic-4bluz34u71.pdf

Global epidemiology of retinal vein occlusion: a systematic review and meta-analysis of prevalence, incidence, and risk factors

https://www.zora.uzh.ch/id/eprint/127998/1/Rodrigues_1.pdf

Defining a Minimum Set of Standardized Patient-centered Outcome Measures for Macular Degeneration

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jth.12982

Prevalence and risk factors of retinal vein occlusion: the Gutenberg Health Study.

Retinal vein occlusion (RVO) is a major cause of vision loss. Of the two main types of RVO, branch retinal vein occlusion (BRVO) is 4 to 6 times more prevalent than central retinal vein occlusion (CRVO). A basic risk factor for RVO is advancing age. Further risk factors include systemic conditions like hypertension, arteriosclerosis, diabetes mellitus, hyperlipidemia, vascular cerebral stroke, blood hyperviscosity, and thrombophilia. A strong risk factor for RVO is the metabolic syndrome (hypertension, diabetes mellitus, and hyperlipidemia). Individuals with end-organ damage caused by diabetes mellitus and hypertension have greatly increased risk for RVO. Socioeconomic status seems to be a risk factor too. American blacks are more often diagnosed with RVO than non-Hispanic whites. Females are, according to some studies, at lower risk than men. The role of thrombophilic risk factors in RVO is still controversial. Congenital thrombophilic diseases like factor V Leiden mutation, hyperhomocysteinemia and anticardiolipin antibodies increase the risk of RVO. Cigarette smoking also increases the risk of RVO as do systemic inflammatory conditions like vasculitis and Behcet disease. Ophthalmic risk factors for RVO are ocular hypertension and glaucoma, higher ocular perfusion pressure, and changes in the retinal arteries.

https://downloads.hindawi.com/journals/joph/2014/724780.pdf

Risk factors for central and branch retinal vein occlusion: a meta-analysis of published clinical data

To evaluate the efficacy and safety of two individualized ranibizumab retreatment schemes in neovascular age-related macular degeneration. Patients (N = 671) were randomized (1:1) to receive three initial monthly ranibizumab 0.5 mg injections, then retreatment guided by either best-corrected visual acuity (BCVA) loss (Group I) or BCVA loss and/or signs of disease activity on optical coherence tomography (OCT; Group II). The study was terminated prematurely and the decision to discontinue the study was made by the sponsor. Efficacy analyses were performed on patients who completed 12 months of the originally planned 24-month study. Safety analyses are presented for all safety analyzable patients. Of 671 randomized patients, 305 completed 12 months of the study. For the 12-month completers, baseline mean (standard deviation) BCVA and reading-center evaluated central subfield thickness (CSFT) were comparable [Group I: 60.9 (13.10) letters and 517.7(201.79) μm; Group II: 60.2 (12.21) letters and 515.3 (198.37) μm]. The change from baseline at Month 12 in BCVA was 6.7 (13.48) letters in Group I and 8.3 (13.53) letters in Group II and the change in CSFT was − 161.3 (163.48) μm and − 175.3 (170.45) μm, respectively. The mean number of ranibizumab injections was 8.2 in Group I and 8.4 in Group II. Ranibizumab treatment resulted in visual and anatomic gains at 12 months for both retreatment strategies, with a trend in favor of OCT-guided vs BCVA loss guided retreatment. No new safety signals were seen. www.ClinicalTrials.gov (NCT01780935). Registered 31 January 2013.

/pdf/functional-versus-functional-and-anatomical-criteria-guided-3c9ezdkofg.pdf

Functional versus functional and anatomical criteria-guided ranibizumab treatment in patients with neovascular age-related macular degeneration - results from the randomized, phase IIIb OCTAVE study.

The disease is classified along with idiopathic iuxtapapillary retinal teleangiectasis and Coat's disease in the group of retinal teleangiectases. The disease was first described by Leber in 1912. Sometimes the disease is considered an early form of Coat's disease. The condition is usually unilateral, only rarely bilateral. Aneurysms are most frequently in a temporal position, in the medium to remote periphery of the retina. On examination by fluorescein angiography they reveal leakage. The disease has a very slow progression and is usually diagnosed in advanced age. Leber's miliary aneurysms are very frequently surrounded by hard whitish exsudates. They can be complicated by vascular dilatations, neovascularizations, thromboses, retrovitreal haemorrhages and macular changes. Their size is greater than in diabetic retinopathy. Some aneurysms may be thrombotized. In some instances exsudative detachment of the retina was described. Treatment is based on laser photocoagulation. Laser scars should not be very intense to avoid damage of Bruch's membrane and development of neovascularizations and proliferations. Cryotherapy is indicated when the aneurysms are in the periphery. The submitted case-report describes a patient with the bilateral form of Leber's miliary aneurysms. On one eye the disease was complicated by the development of neovascularizations with repeated haemorrhage into the vitreous body. In the submitted paper the authors describe the gradual progression of the disease incl. the finding of fluorescein angiography and the selected therapeutic method which contributed to stabilization of satisfactory visual functions.

[Leber's miliary aneurysms--case report].

https://people.maths.ox.ac.uk/maini/PKM%20publications/177.pdf

Extracellular volume regulation and growth

Aims. To determine the effectiveness of second line treatments in patients with neovascular AMD who did not respond adequately to primary treatment. Methods. Retrospective, multicentre assessment. The frequency of primary treatment failure and outcomes of subsequent secondary treatment were assessed according to the type of primary treatment, type of CNV and change in BCVA over a 12 month period. Results. At the time of assessment 750 entries (750 treated eyes, 725 treated patients) had follow-up longer than 12 months. A treatment change required 7.7% subjects treated with ranibizumab, 20.5% with pegaptanib and 22% with PDT and verteporfin. Average BCVA of all patients at the beginning of primary treatment was 50.7 ± 3 letters and 43 ± 3.5 letters in 12 th month (P<0.001). The mean decrease in BCVA was 7.7 ± 0.6 letters during the first 6 months of observation. During the next 6 months, no significant change occurred. The change of primary therapy was required on average after 6.5 ± 2.1 months. Conclusion. BCVA loss was the most significantly decelerated in patients who received ranibizumab as a secondary therapy following unsuccessful treatment with pegaptanib sodium.

/pdf/effects-of-treatment-change-in-patients-with-neovascular-age-4tif138nrm.pdf

Petr Kolar

Papers

Risk factors for central and branch retinal vein occlusion: a meta-analysis of published clinical data

Functional versus functional and anatomical criteria-guided ranibizumab treatment in patients with neovascular age-related macular degeneration - results from the randomized, phase IIIb OCTAVE study.

[Leber's miliary aneurysms--case report].

Extracellular volume regulation and growth

Effects of treatment change in patients with neovascular age-related macular degeneration; Results from the Czech National Registry