Hyperhomocysteinemia in Patients with Polypoidal Choroidal Vasculopathy: A Case Control Study

<div><p>Purpose</p><p>To determine whether elevated plasma homocysteine and serum high sensitivity C-reactive protein (hsCRP) levels, two established risk factors of vascular diseases, are associated with polypoidal choroidal vasculopathy (PCV).</p><p>Design</p><p>Retrospective case-control study.</p><p>Methods</p><p>One hundred and nineteen consecutive patients with PCV and 119 matched controls were enrolled in a tertiary hospital from September 2008 to June 2013. Plasma homocysteine and serum hsCRP levels were measured. Associations among plasma homocysteine, serum hsCRP levels and PCV were further evaluated using multivariable logistic regression analysis.</p><p>Results</p><p>The median plasma homocysteine level was significantly higher in patients with PCV than in the controls (12.20 µmol/L vs. 9.80 µmol/L, p<0.001). The median serum hsCRP level was slightly higher in the PCV group (0.16 mg/dl vs. 0.11 mg/dl in control group, p = 0.07). After multivariable logistic regression analysis, each 1 µmol/L increase of plasma homocysteine was associated with a 1.5-fold increase in likelihood of having PCV (OR, 1.54; 95% confidence interval (CI), 1.33–1.79, p<0.001).</p><p>Conclusions</p><p>Hyperhomocysteinemia was associated with PCV and might play a role in the pathogenesis of PCV.</p></div

Plasma homocysteine and serum C-reactive protein levels in overall and different genders of patients with polypoidal choroidal vasculopathy and the control subjects.

<p>hsCRP, high sensitivity C-reactive protein; PCV, polypoidal choroidal vasculopathy</p><p>Continuous variables are presented as median (interquartile range) and compared using the Mann-Whitney U test.</p>a<p>Only 117 patients of PCV and 112 control subjects received examination of the serum hsCRP level.</p><p>Plasma homocysteine and serum C-reactive protein levels in overall and different genders of patients with polypoidal choroidal vasculopathy and the control subjects.</p

Basic characteristics of patients with polypoidal choroidal vasculopathy and the control subjects.

<p>PCV, polypoidal choroidal vasculopathy;</p><p>Continuous variables are presented as mean ± standard deviation (range) and compared using Student's <i>t</i>-test.</p><p>Categorical variables were presented as numbers (percentage) and compared using Pearson's chi-square test.</p><p>Basic characteristics of patients with polypoidal choroidal vasculopathy and the control subjects.</p

Distribution of polypoidal choroidal vasculopathy cases and controls within tertiles of homocysteine and C-reactive protein levels.

<p>CI, confidence interval; hsCRP, high sensitivity C-reactive protein; OR, odds ratio; PCV, polypoidal choroidal vasculopathy</p><p>Categorical variables were presented as numbers (percentage).</p>a<p>Adjusted for age, gender, hypertension, diabetes mellitus, coronary artery disease, cerebrovascular event, smoking and alcohol consumption.</p>b<p>Only 117 patients of PCV and 112 control subjects received examination of the serum hsCRP level.</p><p>Distribution of polypoidal choroidal vasculopathy cases and controls within tertiles of homocysteine and C-reactive protein levels.</p

Patient-Reported Vision-Related Quality-of-Life Differences between Primary Angle-Closure Glaucoma and Primary Open-Angle Glaucoma

<div><p>Purpose</p><p>To investigate the different impacts on patient-reported vision-related quality of life (pVRQOL) outcomes in patients with primary angle-closure glaucoma(PACG) and primary open-angle glaucoma(POAG).</p><p>Methods</p><p>Prospective cross-sectional study. PACG and POAG patients who had a best-corrected visual acuity(BCVA) in the better eye equal to or better than 20/60, intraocular pressure controlled at or below 25 mmHg and reliable visual field test were invited to participate. The control group included patients with BCVA in the better eye equal to or better than 20/60 and who did not have major eye disease. A validated Taiwanese version of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25(T)) was performed to assess pVRQOL. The association between each domain of NEI VFQ-25(T) among 3 groups was determined using multivariable linear regression analysis.</p><p>Results</p><p>A total of 106 PACG, 186 POAG, and 95 controls were enrolled. In multivariable regression analysis of all three groups(PACG/POAG/controls), compared to POAG, PACG showed a weakly positive association with social functioning (R² = 0.13, β = 0.22, <i>P</i> = 0.04). PACG showed no significantly negative impact on pVRQOL compared to controls. Taking only glaucoma patients into consideration, PACG patients had a higher score on social functioning compared to POAG (R² = 0.16, β = 0.27, <i>P</i> = 0.01). The results of other domains of NEI VFQ-25(T) between the two groups did not differ significantly(p>0.05).</p><p>Conclusions</p><p>In patients with controlled disease, the impact of PACG and POAG on most domains of NEI VFQ-25(T) were similar, except for better social functioning in PACG compared to POAG.</p></div

Results of the multivariable linear regression model for selected scores on the NEI-VFQ 25 in patients with primary angle-closure glaucoma, primary open-angle glaucoma, and control subjects.

<p>Results of the multivariable linear regression model for selected scores on the NEI-VFQ 25 in patients with primary angle-closure glaucoma, primary open-angle glaucoma, and control subjects.</p

Results of the multivariable linear regression model for selected scores on the NEI-VFQ 25 in patients with primary angle-closure glaucoma and primary open-angle glaucoma.

<p>Results of the multivariable linear regression model for selected scores on the NEI-VFQ 25 in patients with primary angle-closure glaucoma and primary open-angle glaucoma.</p

Ophthalmologic characteristics in patients with primary angle-closure glaucoma, primary open-angle glaucoma, and control subjects.

<p>Ophthalmologic characteristics in patients with primary angle-closure glaucoma, primary open-angle glaucoma, and control subjects.</p

Demographic and socioeconomic data in patients with primary angle-closure glaucoma, primary open-angle glaucoma, and control subjects.

<p>Demographic and socioeconomic data in patients with primary angle-closure glaucoma, primary open-angle glaucoma, and control subjects.</p