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[PMID]:29049720
[Au] Autor:Corbelli E; Sacconi R; Rabiolo A; Mercuri S; Carnevali A; Querques L; Bandello F; Querques G
[Ad] Endereço:Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
[Ti] Título:Optical Coherence Tomography Angiography in the Evaluation of Geographic Atrophy Area Extension.
[So] Source:Invest Ophthalmol Vis Sci;58(12):5201-5208, 2017 Oct 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To investigate the application of optical coherence tomography angiography (OCT-A) in evaluation of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Methods: Patients with GA were prospectively enrolled and studied with blue fundus autofluorescence (FAF), en face structural OCT, and OCT-A. OCT-A images were acquired using a slab of whole choroid, whereas en face structural OCT images were obtained at the ellipsoid zone (EZ), at the choroidal (CH) level, and at the scleral (SC) level. Three readers independently measured the GA extension areas and evaluated the foveal sparing in each examination. Intraobserver/interobserver agreements and agreement between each couple of imaging techniques were assessed. Results: A total of 47 eyes (26 patients, mean age 76 ± 7 years) with GA (mean area using FAF: 8.77 ± 5.00 mm2) were included. Intraobserver and interobserver agreement was excellent for all imaging techniques (intraclass correlation coefficient [ICC] > 0.985), even if en face EZ structural OCT revealed the poorest quality agreement limits. Considering the analysis between each couple of imaging techniques, ICC was excellent between OCT-A compared with FAF (ICC: 0.995), followed by en face structural OCT at CH level (ICC: 0.992), at SC level (ICC: 0.986), and at EZ level (ICC: 0.973). No differences were detected between multifocal and monofocal GA lesions. Considering the evaluation of foveal involvement, lower agreements were disclosed between FAF and all other imaging techniques. Conclusions: OCT-A is a reliable technique for easily visualizing and quantifying GA with the advantages, compared to current imaging techniques, of offering together both structural and blood flow information regarding retinal and choroidal layers and excluding choroidal neovascularization.
[Mh] Termos MeSH primário: Angiografia por Tomografia Computadorizada
Atrofia Geográfica/diagnóstico por imagem
Tomografia de Coerência Óptica
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Atrofia Geográfica/etiologia
Seres Humanos
Degeneração Macular/complicações
Masculino
Variações Dependentes do Observador
Imagem Óptica
Estudos Prospectivos
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-22508


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[PMID]:28973332
[Au] Autor:Dysli C; Fink R; Wolf S; Zinkernagel MS
[Ad] Endereço:Department of Ophthalmology, Inselspital, Bern University Hospital, Department for BioMedical Research, University of Bern, Bern, Switzerland.
[Ti] Título:Fluorescence Lifetimes of Drusen in Age-Related Macular Degeneration.
[So] Source:Invest Ophthalmol Vis Sci;58(11):4856-4862, 2017 Sep 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: The purpose of this study was to characterize fundus autofluorescence lifetimes of retinal drusen in patients with AMD. Methods: Patients with AMD and retinal drusen and healthy controls of similar age were examined. A fluorescence lifetime imaging ophthalmoscope was used. Retinal autofluorescence was excited using a 473-nm pulsed laser, and fundus autofluorescence lifetimes of the central retina (30°) were measured in two distinct spectral channels (short: 498 to 560 nm [SSC]; long: 560 to 720 nm [LSC]). Mean retinal autofluorescence lifetimes, corresponding fundus autofluorescence intensity images, spectral domain optical coherence tomography, color fundus images, and clinical data were investigated. Patients were analyzed in two distinct groups (soft drusen and reticular pseudodrusen) and compared with control subjects. Results: Sixty-four eyes of 64 patients with AMD and retinal drusen (age: mean ± SD, 78 ± 8.5 years; range, 59 to 94 years) were investigated and compared with a control group of 20 age-matched healthy subjects. Mean retinal autofluorescence lifetimes in patients with AMD was significantly prolonged compared with the healthy control eyes (mean ± SEM: SSC, 486 ± 18 vs. 332 ± 11 ps, P < 0.0001; LSC: 493 ± 9 vs. 382 ± 17 ps, P < 0.0001). Areas of drusen featured a wide range of fluorescence lifetime values. Long lifetimes were identified in areas of atrophy and in areas of intraretinal hyperreflective deposits. Short lifetimes corresponded to deposits within the photoreceptor outer segment band. Conclusions: Mean retinal autofluorescence lifetimes in AMD patients are significantly prolonged. Intraretinal deposits cause prolonged lifetimes, whereas deposits in the area of the outer photoreceptor segments lead to short fluorescence lifetimes.
[Mh] Termos MeSH primário: Degeneração Macular/patologia
Drusas Retinianas/patologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Casos e Controles
Feminino
Angiofluoresceinografia/métodos
Fundo de Olho
Atrofia Geográfica/patologia
Seres Humanos
Masculino
Meia-Idade
Oftalmoscopia/métodos
Tomografia de Coerência Óptica/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171004
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-22184


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[PMID]:28892825
[Au] Autor:Merle BMJ; Silver RE; Rosner B; Seddon JM
[Ad] Endereço:University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Lifelong Exposures, Health and Aging, Bordeaux, France.
[Ti] Título:Associations Between Vitamin D Intake and Progression to Incident Advanced Age-Related Macular Degeneration.
[So] Source:Invest Ophthalmol Vis Sci;58(11):4569-4578, 2017 Sep 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: There is growing evidence of the importance of nutrition in age-related macular degeneration (AMD), but no prospective studies have explored the impact of vitamin D. We evaluated the association between vitamin D intake and progression to advanced AMD. Methods: Among 2146 participants (3965 eyes), 541 (777 eyes) progressed from early or intermediate AMD to advanced disease (mean follow-up: 9.4 years) based on ocular imaging. Nutrients were log transformed and calorie adjusted. Survival analysis was used to assess associations between incident advanced disease and vitamin D intake. Neovascular disease (NV) and geographic atrophy (GA) were evaluated separately. Combined effects of dietary vitamin D and calcium were assessed based on high or low consumption of each nutrient. Results: There was a lower risk of progression to advanced AMD in the highest versus lowest quintile of dietary vitamin D intake after adjustment for demographic, behavioral, ocular, and nutritional factors (hazard ratio [HR]: 0.60; 95% confidence interval [CI]: 0.43-0.83; P trend = 0.0007). Similar results were observed for NV (HR: 0.59; 95% CI: 0.39-0.89; P trend = 0.005) but not GA (HR: 0.83; 95% CI: 0.53-1.30; P trend = 0.35). A protective effect was observed for advanced AMD among participants with high vitamin D and low calcium compared to the group with low levels for each nutrient (HR: 0.67; 95% CI: 0.50-0.88; P = 0.005). When supplement use was considered, the effect was in the protective direction but was not significant. Conclusions: A diet rich in vitamin D may prevent or delay progression to advanced AMD, especially NV. Additional exploration is needed to elucidate the potential protective role of vitamin D and its contribution to reducing visual loss.
[Mh] Termos MeSH primário: Dieta
Atrofia Geográfica/prevenção & controle
Vitamina D/administração & dosagem
Vitaminas/administração & dosagem
Degeneração Macular Exsudativa/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Registros de Dieta
Suplementos Nutricionais
Progressão da Doença
Ingestão de Energia
Feminino
Seguimentos
Atrofia Geográfica/epidemiologia
Seres Humanos
Incidência
Masculino
Meia-Idade
Fenômenos Fisiológicos da Nutrição
Estudos Prospectivos
Fatores de Risco
Degeneração Macular Exsudativa/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vitamins); 1406-16-2 (Vitamin D)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170912
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-21673


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[PMID]:28816076
[Au] Autor:Li H; Chintalapudi SR; Jablonski MM
[Ad] Endereço:a Department of Ophthalmology, The Second Xiangya Hospital , Central South University , Changsha , China.
[Ti] Título:Current drug and molecular therapies for the treatment of atrophic age-related macular degeneration: phase I to phase III clinical development.
[So] Source:Expert Opin Investig Drugs;26(10):1103-1114, 2017 Oct.
[Is] ISSN:1744-7658
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Age-related macular degeneration (AMD) is the leading cause of vision loss among the elderly. Atrophic AMD, including early, intermediate and geographic atrophy (GA), accounts for ~90% of all cases. It is a multifactorial degeneration characterized by chronic inflammation, oxidative stress and aging components. Although no FDA-approved treatment yet exists for the late stage of atrophic AMD, multiple pathological mechanisms are partially known and several promising therapies are in various stages of development. Areas covered: Underlying mechanisms that define atrophic AMD will help provide novel therapeutic targets that will address this largely unmet clinical need. The purpose of this paper is to review current promising drugs that are being evaluated in clinical trials. Because no pharmacological treatments are currently available for late stage of atrophic AMD, any new therapy would have extensive market potential. Expert opinion: The number of AMD patients is predicted to increase to ~30 million worldwide by 2020. In response to this enormous unmet clinical need, new promising therapies are being developed and evaluated in clinical trials. We propose that the assessment of novel interventions will also need to consider the genotypes of participants, as the benefit may be determined by polymorphisms in an individual's genetic background.
[Mh] Termos MeSH primário: Desenho de Drogas
Drogas em Investigação/uso terapêutico
Degeneração Macular/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Animais
Drogas em Investigação/farmacologia
Atrofia Geográfica/tratamento farmacológico
Atrofia Geográfica/fisiopatologia
Seres Humanos
Inflamação/tratamento farmacológico
Inflamação/fisiopatologia
Degeneração Macular/fisiopatologia
Terapia de Alvo Molecular
Estresse Oxidativo/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Drugs, Investigational)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1080/13543784.2017.1369042


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[PMID]:28785769
[Au] Autor:Curcio CA; Zanzottera EC; Ach T; Balaratnasingam C; Freund KB
[Ad] Endereço:Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, Alabama, United States.
[Ti] Título:Activated Retinal Pigment Epithelium, an Optical Coherence Tomography Biomarker for Progression in Age-Related Macular Degeneration.
[So] Source:Invest Ophthalmol Vis Sci;58(6):BIO211-BIO226, 2017 May 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To summarize and contextualize recent histology and clinical imaging publications on retinal pigment epithelium (RPE) fate in advanced age-related macular degeneration (AMD); to support RPE activation and migration as important precursors to atrophy, manifest as intraretinal hyperreflective foci in spectral-domain optical coherence tomography (SDOCT). Methods: The Project MACULA online resource for AMD histopathology was surveyed systematically to form a catalog of 15 phenotypes of RPE and RPE-derived cells and layer thicknesses in advanced disease. Phenotypes were also sought in correlations with clinical longitudinal eye-tracked SDOCT and with ex vivo imaging-histopathology correlations in geographic atrophy (GA) and pigment epithelium detachments (PED). Results: The morphology catalog suggested two main pathways of RPE fate: basolateral shedding of intracellular organelles (apparent apoptosis in situ) and activation with anterior migration. Acquired vitelliform lesions may represent a third pathway. Migrated cells are packed with RPE organelles and confirmed as hyperreflective on SDOCT. RPE layer thickening due to cellular dysmorphia and thick basal laminar deposit is observed near the border of GA. Drusenoid PED show a life cycle of slow growth and rapid collapse preceded by RPE layer disruption and anterior migration. Conclusions: RPE activation and migration comprise an important precursor to atrophy that can be observed at the cellular level in vivo via validated SDOCT. Collapse of large drusen and drusenoid PED appears to occur when RPE death and migration prevent continued production of druse components. Data implicate excessive diffusion distance from choriocapillaris in RPE death as well as support a potential benefit in targeting drusen in GA.
[Mh] Termos MeSH primário: Biomarcadores
Atrofia Geográfica/diagnóstico
Epitélio Pigmentado da Retina/patologia
[Mh] Termos MeSH secundário: Idoso
Movimento Celular
Neovascularização de Coroide/patologia
Progressão da Doença
Feminino
Angiofluoresceinografia
Seres Humanos
Masculino
Descolamento Retiniano/patologia
Drusas Retinianas/patologia
Tomografia de Coerência Óptica
Acuidade Visual
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-21872


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[PMID]:28756618
[Au] Autor:Evans JR; Lawrenson JG
[Ad] Endereço:Cochrane Eyes and Vision, ICEH, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK, WC1E 7HT.
[Ti] Título:Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration.
[So] Source:Cochrane Database Syst Rev;7:CD000254, 2017 07 31.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: It has been proposed that antioxidants may prevent cellular damage in the retina by reacting with free radicals that are produced in the process of light absorption. Higher dietary levels of antioxidant vitamins and minerals may reduce the risk of progression of age-related macular degeneration (AMD). OBJECTIVES: The objective of this review was to assess the effects of antioxidant vitamin or mineral supplementation on the progression of AMD in people with AMD. SEARCH METHODS: We searched CENTRAL (2017, Issue 2), MEDLINE Ovid (1946 to March 2017), Embase Ovid (1947 to March 2017), AMED (1985 to March 2017), OpenGrey (System for Information on Grey Literature in Europe, the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 29 March 2017. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that compared antioxidant vitamin or mineral supplementation (alone or in combination) to placebo or no intervention, in people with AMD. DATA COLLECTION AND ANALYSIS: Both review authors independently assessed risk of bias in the included studies and extracted data. One author entered data into RevMan 5; the other author checked the data entry. We graded the certainty of the evidence using GRADE. MAIN RESULTS: We included 19 studies conducted in USA, Europe, China, and Australia. We judged the trials that contributed data to the review to be at low or unclear risk of bias.Nine studies compared multivitamins with placebo (7 studies) or no treatment (2 studies) in people with early and moderate AMD. The duration of supplementation and follow-up ranged from nine months to six years; one trial followed up beyond two years. Most evidence came from the Age-Related Eye Disease Study (AREDS) in the USA. People taking antioxidant vitamins were less likely to progress to late AMD (odds ratio (OR) 0.72, 95% confidence interval (CI) 0.58 to 0.90; 2445 participants; 3 RCTs; moderate-certainty evidence). In people with very early signs of AMD, who are at low risk of progression, this would mean that there would be approximately 4 fewer cases of progression to late AMD for every 1000 people taking vitamins (1 fewer to 6 fewer cases). In people at high risk of progression (i.e. people with moderate AMD) this would correspond to approximately 8 fewer cases of progression for every 100 people taking vitamins (3 fewer to 13 fewer). In one study of 1206 people, there was a lower risk of progression for both neovascular AMD (OR 0.62, 95% CI 0.47 to 0.82; moderate-certainty evidence) and geographic atrophy (OR 0.75, 95% CI 0.51 to 1.10; moderate-certainty evidence) and a lower risk of losing 3 or more lines of visual acuity (OR 0.77, 95% CI 0.62 to 0.96; 1791 participants; moderate-certainty evidence). Low-certainty evidence from one study of 110 people suggested higher quality of life scores (National Eye Institute Visual Function Questionnaire) in treated compared with the non-treated people after 24 months (mean difference (MD) 12.30, 95% CI 4.24 to 20.36). Six studies compared lutein (with or without zeaxanthin) with placebo. The duration of supplementation and follow-up ranged from six months to five years. Most evidence came from the AREDS2 study in the USA. People taking lutein or zeaxanthin may have similar or slightly reduced risk of progression to late AMD (RR 0.94, 95% CI 0.87 to 1.01; 6891 eyes; low-certainty evidence), neovascular AMD (RR 0.92, 95% CI 0.84 to 1.02; 6891 eyes; low-certainty evidence), and geographic atrophy (RR 0.92, 95% CI 0.80 to 1.05; 6891 eyes; low-certainty evidence). A similar risk of progression to visual loss of 15 or more letters was seen in the lutein and control groups (RR 0.98, 95% CI 0.91 to 1.05; 6656 eyes; low-certainty evidence). Quality of life (measured with Visual Function Questionnaire) was similar between groups in one study of 108 participants (MD 1.48, 95% -5.53 to 8.49, moderate-certainty evidence). One study, conducted in Australia, compared vitamin E with placebo. This study randomised 1204 people to vitamin E or placebo, and followed up for four years. Participants were enrolled from the general population; 19% had AMD. The number of late AMD events was low (N = 7) and the estimate of effect was uncertain (RR 1.36, 95% CI 0.31 to 6.05, very low-certainty evidence). There were no data on neovascular AMD or geographic atrophy.There was no evidence of any effect of treatment on visual loss (RR 1.04, 95% CI 0.74 to 1.47, low-certainty evidence). There were no data on quality of life. Five studies compared zinc with placebo. The duration of supplementation and follow-up ranged from six months to seven years. People taking zinc supplements may be less likely to progress to late AMD (OR 0.83, 95% CI 0.70 to 0.98; 3790 participants; 3 RCTs; low-certainty evidence), neovascular AMD (OR 0.76, 95% CI 0.62 to 0.93; 2442 participants; 1 RCT; moderate-certainty evidence), geographic atrophy (OR 0.84, 95% CI 0.64 to 1.10; 2442 participants; 1 RCT; moderate-certainty evidence), or visual loss (OR 0.87, 95% CI 0.75 to 1.00; 3791 participants; 2 RCTs; moderate-certainty evidence). There were no data reported on quality of life.Very low-certainty evidence was available on adverse effects because the included studies were underpowered and adverse effects inconsistently reported. AUTHORS' CONCLUSIONS: People with AMD may experience some delay in progression of the disease with multivitamin antioxidant vitamin and mineral supplementation. This finding was largely drawn from one large trial, conducted in a relatively well-nourished American population. We do not know the generalisability of these findings to other populations. Although generally regarded as safe, vitamin supplements may have harmful effects. A systematic review of the evidence on harms of vitamin supplements is needed. Supplements containing lutein and zeaxanthin are heavily marketed for people with age-related macular degeneration but our review shows they may have little or no effect on the progression of AMD.
[Mh] Termos MeSH primário: Antioxidantes/uso terapêutico
Degeneração Macular/prevenção & controle
Minerais/uso terapêutico
Vitaminas/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Suplementos Nutricionais
Progressão da Doença
Atrofia Geográfica/prevenção & controle
Seres Humanos
Luteína/uso terapêutico
Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Vitamina E/uso terapêutico
Zeaxantinas/uso terapêutico
Zinco/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Antioxidants); 0 (Minerals); 0 (Vitamins); 0 (Zeaxanthins); 1406-18-4 (Vitamin E); J41CSQ7QDS (Zinc); X72A60C9MT (Lutein)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170731
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD000254.pub4


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[PMID]:28750115
[Au] Autor:Cipriani V; Hogg RE; Sofat R; Moore AT; Webster AR; Yates JRW; Fletcher AE; European Eye (EUREYE) Study Group
[Ad] Endereço:Department of Ocular Biology and Therapeutics, UCL Institute of Ophthalmology, University College London, London, England.
[Ti] Título:Association of C-Reactive Protein Genetic Polymorphisms With Late Age-Related Macular Degeneration.
[So] Source:JAMA Ophthalmol;135(9):909-916, 2017 Sep 01.
[Is] ISSN:2168-6173
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: C-reactive protein (CRP) is a circulating inflammatory marker associated with late age-related macular degeneration (AMD). It remains uncertain whether the association between CRP concentrations and AMD is causal. Objective: To assess whether CRP (OMIM 123260) single-nucleotide polymorphisms that influence circulating CRP concentrations are associated with late AMD. Design, Setting, and Participants: Participants in 2 UK, hospital-based, case-control studies (Cambridge AMD study and Moorfields Eye Hospital AMD study) and 1 pan-European, cross-sectional, population-based study (the European Eye [EUREYE] Study) were recruited between November 6, 2000, and April 30, 2007. Participants underwent dilated stereo-digital fundus photography graded according to the International Classification of Age-related Maculopathy and Macular Degeneration. There were 1727 cases of late AMD (1151 neovascular, 384 geographic atrophy, and 192 mixed [neovascular AMD and geographic atrophy]) and 1153 controls. Early AMD cases (n = 574) were included only from the EUREYE Study. Data analysis was performed from August 1 to November 30, 2016. Four common single-nucleotide polymorphisms (rs1205, rs1130864, rs1800947, and rs3093077) were selected based on demonstrated influence on circulating CRP concentrations in the literature. In one study, genotyping of rs3093077 failed, and rs1800947 was typed in only 1 study. Main Outcomes and Measures: A genetic multiplicative model was used for the association of single-nucleotide polymorphisms with late AMD adjusted for age and sex. Results: Among the 1727 patients with late AMD, the mean (SD) age was 78.7 (7.4) years, and 668 (38.7%) were men. The mean (SD) age of the controls was 74.9 (7.0) years, and 510 (44.2%) were men. In the pooled results of all 3 studies, neither rs1205 (odds ratio [OR], 0.99; 95% CI, 0.86-1.14) nor rs1130864 (OR, 0.96; 95% CI, 0.83-1.11) was associated with late AMD. For geographic atrophy, rs1205 had an OR of 0.91 (95% CI, 0.74-1.13) and rs1130864 had an OR of 0.94 (95% CI, 0.76-1.16). For neovascular AMD, rs1205 had an OR of 1.01 (95% CI, 0.87-1.19) and rs1130864 had an OR of 0.99 (95% CI, 0.84-1.16). There was no association of rs3093077 and rs1800947 with late AMD or any late AMD phenotype. There were no significant findings for early AMD. Conclusions and Relevance: Our results do not support a causal association between CRP concentrations and AMD.
[Mh] Termos MeSH primário: Proteína C-Reativa/genética
Atrofia Geográfica/genética
Polimorfismo de Nucleotídeo Único
Degeneração Macular Exsudativa/genética
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Proteína C-Reativa/metabolismo
Estudos de Casos e Controles
Estudos Transversais
Feminino
Estudos de Associação Genética
Técnicas de Genotipagem
Atrofia Geográfica/sangue
Seres Humanos
Masculino
Nefelometria e Turbidimetria
Razão de Chances
Degeneração Macular Exsudativa/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; MULTICENTER STUDY
[Nm] Nome de substância:
9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1001/jamaophthalmol.2017.2191


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[PMID]:28734811
[Au] Autor:Capuano V; Miere A; Querques L; Sacconi R; Carnevali A; Amoroso F; Bandello F; Souied EH; Querques G
[Ad] Endereço:Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, University of Paris Est Créteil, Créteil, France.
[Ti] Título:Treatment-Naïve Quiescent Choroidal Neovascularization in Geographic Atrophy Secondary to Nonexudative Age-Related Macular Degeneration.
[So] Source:Am J Ophthalmol;182:45-55, 2017 Oct.
[Is] ISSN:1879-1891
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To describe the characteristics and natural history of quiescent choroidal neovascularization (CNV) in geographic atrophy (GA) secondary to nonexudative age-related macular degeneration (AMD) through multimodal imaging. DESIGN: Retrospective observational case series. METHODS: Patients diagnosed with quiescent CNV were analyzed in 2 high-volume referral centers. Imaging features obtained using fluorescein angiography (FA), indocyanine green angiography (ICGA), structural optical coherence tomography (OCT), and OCT angiography (OCT-A) were noted at first presentation and during the study period. RESULTS: Nineteen eyes of 19 patients were included. Mean (+SD) follow-up was 45.7 ± 14.7 months. Quiescent CNV appeared as an ill-defined hyperfluorescent lesion without leakage or pooling of dye in the late phase of FA. On ICGA, quiescent CNV appeared as a distinct area of hyperfluorescence (vascular network) in early to intermediate frames and as a hyperfluorescent plaque in the late frame (late plaque). OCT-A revealed a flow signal beneath the small irregular elevation of the retinal pigment epithelium at the site of the quiescent CNV visualized by structural OCT. During the study period, 5 of the 19 CNV patients developed exudation. The remainder showed specific alterations in both structural OCT and OCT-A imaging. At last follow-up, 92% of the quiescent CNV seemed to cover the area spared from atrophy. CONCLUSIONS: The characteristics of the quiescent CNVs were very similar to those already described for intermediate AMD, although they had several specific features in the context of GA.
[Mh] Termos MeSH primário: Neovascularização de Coroide/diagnóstico
Atrofia Geográfica/diagnóstico
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Neovascularização de Coroide/etiologia
Corantes/administração & dosagem
Exsudatos e Transudatos
Feminino
Angiofluoresceinografia
Seguimentos
Atrofia Geográfica/complicações
Seres Humanos
Verde de Indocianina/administração & dosagem
Masculino
Imagem Multimodal
Encaminhamento e Consulta
Estudos Retrospectivos
Tomografia de Coerência Óptica/métodos
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Coloring Agents); IX6J1063HV (Indocyanine Green)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170724
[St] Status:MEDLINE


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[PMID]:28728186
[Au] Autor:Carnevali A; Querques G
[Ti] Título:Choroidal Neovascularization and Geographic Atrophy are Potential Complications of Early Onset Large Colloid Drusen.
[So] Source:Ophthalmic Surg Lasers Imaging Retina;48(7):586-590, 2017 Jul 01.
[Is] ISSN:2325-8179
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The authors report a case of large colloid drusen (LCD) complicated by choroidal neovascularization (CNV) and geographic atrophy (GA). A 54-year-old man was referred to the authors' department with diagnosis of early onset retinal drusen. Multimodal imaging led to a diagnosis of LCD complicated by GA in the right eye and CNV in the left eye. The patient received a single injection of intravitreal aflibercept (Eylea; Regeneron, Tarrytown, NY) in the left eye. Six months later, best-corrected visual acuity improved to 20/25, and spectral-domain optical coherence tomography still showed absence of subretinal and intraretinal fluid. GA and CNV are possible complications of LCD, and contrary to previous beliefs, it should therefore not be considered as a benign condition. Intravitreal aflibercept could be considered as a useful treatment in cases complicated by CNV. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:586-590.].
[Mh] Termos MeSH primário: Neovascularização de Coroide/etiologia
Atrofia Geográfica/etiologia
Drusas Retinianas/complicações
[Mh] Termos MeSH secundário: Neovascularização de Coroide/diagnóstico
Neovascularização de Coroide/tratamento farmacológico
Angiofluoresceinografia/métodos
Seguimentos
Fundo de Olho
Atrofia Geográfica/complicações
Atrofia Geográfica/tratamento farmacológico
Seres Humanos
Injeções Intravítreas
Masculino
Meia-Idade
Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem
Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores
Proteínas Recombinantes de Fusão/administração & dosagem
Drusas Retinianas/diagnóstico
Drusas Retinianas/tratamento farmacológico
Fatores de Tempo
Tomografia de Coerência Óptica/métodos
Acuidade Visual
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Recombinant Fusion Proteins); 15C2VL427D (aflibercept); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.3928/23258160-20170630-11


  10 / 530 MEDLINE  
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[PMID]:28715590
[Au] Autor:Ferrara D; Silver RE; Louzada RN; Novais EA; Collins GK; Seddon JM
[Ad] Endereço:Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, United States.
[Ti] Título:Optical Coherence Tomography Features Preceding the Onset of Advanced Age-Related Macular Degeneration.
[So] Source:Invest Ophthalmol Vis Sci;58(9):3519-3529, 2017 Jul 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: Age-related macular degeneration (AMD) is a progressive disease with multifactorial etiology. There is a need to identify clinical features that are harbingers of advanced disease. We evaluated morphologic features of the retina and choroid on optical coherence tomography (OCT) to determine if they predict progression to advanced disease. Methods: Progressors transitioned from early or intermediate AMD to advanced disease (n = 40 eyes), and were matched on baseline AMD grade and follow-up interval to nonprogressors who did not develop advanced AMD (n = 40 eyes). Features of the neurosensory retina, photoreceptors, retinal pigment epithelium (RPE), and choroid were evaluated. Logistic regression was used to evaluate univariate associations between features and progression to overall advanced AMD, geographic atrophy (GA), and neovascular disease (NV). Multivariate associations based on stepwise regression models were also assessed. Results: Ellipsoid zone disruption was associated with progression to overall advanced AMD and NV (odds ratios [ORs]: 17.9 and 30.6; P < 0.001), with a similar trend observed for GA. Drusenoid RPE detachment, RPE thickening, and retinal pigmentary hyperreflective material were significantly associated with higher risk of progression to advanced AMD (ORs: 5.0-8.5) and NV (ORs: 10.8-17.2). Pigmentary hyperreflective material was associated with progression to GA (OR: 7.5, P = 0.009). Total retinal thickness, pigmentary hyperreflective material, nascent GA features, and choroidal vessel abnormalities were independently associated with progression to advanced AMD in a multivariate stepwise model. Conclusions: Abnormalities in the photoreceptors, retinal thickness, RPE, and choroid were associated with higher risk of developing advanced AMD. These findings provide insights into disease progression, and may be helpful to identify earlier endpoints for clinical studies.
[Mh] Termos MeSH primário: Corioide/diagnóstico por imagem
Neovascularização de Coroide/diagnóstico
Atrofia Geográfica/diagnóstico
Retina/diagnóstico por imagem
Drusas Retinianas/diagnóstico
Tomografia de Coerência Óptica
Degeneração Macular Exsudativa/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Inibidores da Angiogênese/uso terapêutico
Neovascularização de Coroide/tratamento farmacológico
Progressão da Doença
Feminino
Angiofluoresceinografia
Seguimentos
Atrofia Geográfica/tratamento farmacológico
Seres Humanos
Injeções Intravítreas
Masculino
Estudos Prospectivos
Ranibizumab/uso terapêutico
Drusas Retinianas/tratamento farmacológico
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
Degeneração Macular Exsudativa/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (VEGFA protein, human); 0 (Vascular Endothelial Growth Factor A); ZL1R02VT79 (Ranibizumab)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170728
[Lr] Data última revisão:
170728
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170718
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-21696



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