Clinical and Epidemiologic Research Vitreomacular Adhesion and Its Association With Age- Related Macular Degeneration in a Population-Based Setting: The Alienor Study

PURPOSE. The purpose of this study was to describe vitreomacular adhesion (VMA), diagnosed with spectral-domain optical coherence tomography (SD-OCT), its risk factors, and its association with AMD in a population-based study of French elderly subjects. METHODS. Six hundred twenty-two of 624 (99.7%) participants of the Alienor study (Bordeaux, France), ‡75 years of age, had gradable SD-OCT scans of the macula in at least one eye. VMA was defined as visible perifoveal vitreous separation with remaining vitreomacular attachment and unperturbed foveal morphologic features. Late AMD was classified from retinal color photographs, SD-OCT, and ophthalmologic history. Early AMD was classified from retinal photographs and defined by the presence of large drusen and/or reticular drusen and/or pigmentary abnormalities. RESULTS. The prevalence of VMA was 15.8%, decreased with age (18.1% in subjects 75 to 84 years of age versus 8.9% after 85 years of age), and was higher in men than women (20.6% vs. 12.8%). VMA also tended to be less frequent in eyes with a history of cataract surgery (odds ratio [OR] ¼ 0.66, P ¼ 0.05), after adjustment for age and sex. No associations of VMA with other risk factors (cardiovascular risk factors, dietary intake of omega-3 fatty acids, lifetime ultraviolet radiation exposure, major AMD genetic polymorphisms) were found. After multivariate adjustment, VMA was not significantly associated with early or late AMD (OR ¼ 1.14, P ¼ 0.70 and OR ¼ 0.78, P ¼ 0.51 for early and late AMD, respectively). CONCLUSIONS. VMA was visible on SD-OCT in 16% in this sample of elderly French subjects but was not associated with AMD. Prospective studies of the associations of VMA with AMD are needed

Transverse-Momentum Distributions and Spherical Symmetry

Transverse-momentum dependent parton distributions (TMDs) are studied in the framework of quark models. In particular, quark model relations among TMDs are reviewed and their physical origin is discussed in terms of rotational-symmetry properties of the nucleon state in its rest frame.Comment: 8 pages, 2 figures, prepared for the workshop "30 years of strong interactions", Spa, Belgium, 6-8 April 201

Association of systemic medication use with glaucoma and intraocular pressure: the E3 Consortium

PURPOSE: To investigate the association of commonly used systemic medications with glaucoma and intraocular pressure (IOP) in the European population. DESIGN: Meta-analysis of eleven population-based cohort studies of the European Eye Epidemiology (E3) consortium. PARTICIPANTS: A total of 143240 participants were included in the glaucoma analyses and 47177 participants in the IOP analyses. METHODS: We examined associations of four categories of systemic medications (antihypertensive medications: beta-blockers, diuretics, calcium channel blockers [CCBs], alpha-agonists, angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers; lipid-lowering medications; antidepressants; antidiabetic medications) with glaucoma prevalence and IOP. Glaucoma ascertainment and IOP measurement method were according to individual study protocols. Multivariable regression analyses were carried out in each study and results were pooled using random effects meta-analyses. Associations with antidiabetic medications were examined in diabetic participants only. MAIN OUTCOME MEASURES: Glaucoma prevalence and IOP. RESULTS: In the meta-analyses of our maximally-adjusted multivariable models, use of CCBs was associated with a higher prevalence of glaucoma (odds ratio [OR] with corresponding 95% confidence interval [95% CI]: 1.23 [1.08 to 1.39]). This association was stronger for monotherapy of CCBs with direct cardiac effects (OR [95% CI]: 1.96 [1.23 to 3.12]). The use of other antihypertensive medications, lipid-lowering medications, antidepressants or antidiabetic medications were not clearly associated with glaucoma. Use of systemic beta-blockers was associated with a lower IOP (Beta [95% CI]: -0.33 [-0.57 to -0.08] mmHg). Monotherapy of both selective (Beta [95% CI]: -0.45 [-0.74 to -0.16] mmHg) and non-selective (Beta [95% CI]: -0.54 [-0.94 to -0.15] mmHg) systemic beta-blockers was associated with lower IOP. There was a suggestive association between use of high-ceiling diuretics and lower IOP (Beta [95% CI]: -0.30 [-0.47; -0.14] mmHg), but not when used as monotherapy. Use of other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were not associated with IOP. CONCLUSIONS: We identified a potentially harmful association between use of CCBs and glaucoma prevalence. Additionally, we observed and quantified the association of lower IOP with systemic beta-blocker use. Both findings are potentially important given that glaucoma patients frequently use systemic antihypertensive medications. Determining whether the CCB association is causal should be a research priority

Ophthalmology

PURPOSE: To investigate systemic and ocular determinants of peripapillary retinal nerve fiber layer thickness (pRNFLT) in the European population. DESIGN: Cross-sectional meta-analysis. PARTICIPANTS: A total of 16 084 European adults from 8 cohort studies (mean age range, 56.9+/-12.3-82.1+/-4.2 years) of the European Eye Epidemiology (E3) consortium. METHODS: We examined associations with pRNFLT measured by spectral-domain OCT in each study using multivariable linear regression and pooled results using random effects meta-analysis. MAIN OUTCOME MEASURES: Determinants of pRNFLT. RESULTS: Mean pRNFLT ranged from 86.8+/-21.4 mum in the Rotterdam Study I to 104.7+/-12.5 mum in the Rotterdam Study III. We found the following factors to be associated with reduced pRNFLT: Older age (beta = -0.38 mum/year; 95% confidence interval [CI], -0.57 to -0.18), higher intraocular pressure (IOP) (beta = -0.36 mum/mmHg; 95% CI, -0.56 to -0.15), visual impairment (beta = -5.50 mum; 95% CI, -9.37 to -1.64), and history of systemic hypertension (beta = -0.54 mum; 95% CI, -1.01 to -0.07) and stroke (beta = -1.94 mum; 95% CI, -3.17 to -0.72). A suggestive, albeit nonsignificant, association was observed for dementia (beta = -3.11 mum; 95% CI, -6.22 to 0.01). Higher pRNFLT was associated with more hyperopic spherical equivalent (beta = 1.39 mum/diopter; 95% CI, 1.19-1.59) and smoking (beta = 1.53 mum; 95% CI, 1.00-2.06 for current smokers compared with never-smokers). CONCLUSIONS: In addition to previously described determinants such as age and refraction, we found that systemic vascular and neurovascular diseases were associated with reduced pRNFLT. These may be of clinical relevance, especially in glaucoma monitoring of patients with newly occurring vascular comorbidities

Analyse épidémiologique du glaucome dans une population âgée : l'étude ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et maladies Occulaires)

Glaucoma is a neurodegenerative disease defined by a progressive loss of optic nerve axons and retinal ganglion cells resulting in a characteristic enlargement of the optic nerve head cup and associated visual field defects. It remains the first cause of irreversible blindness worldwide and intraocular pressure (IOP) is the main risk factor. The ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) study is a population-based study. It aims to assess the associations of age-related eye diseases with nutritional, demographic and environmental factors in a representative population of the Bordeaux area. In 2009-2010, 624 subjects, aged 74 years or more, underwent a complete eye examination, including an optic nerve head evaluation using retinophotography and a spectral-domain optical coherence tomography (SD-OCT), an IOP measurement using air-puff tonometry and an evaluation of biomechanical properties of the cornea. A measurement of skin accumulation of advanced glycation end-products was performed using an autofluorescence reader. Glaucoma diagnosis was made using ISGEO (International Society for Epidemiologic and Geographical Ophthalmology) criteria. Biomechanical properties of the cornea were modified by increasing age and in subjects having a higher lifetime ambient ultraviolet exposure. Central corneal thickness was thicker in former smokers. Skin autofluorescence values ≥ 2.7 AU (Arbitrary Unit) were independently associated with glaucoma. SD-OCT retinal nerve fiber layer thickness parameters had good diagnostic performances for discriminating glaucoma and control subjects and the normative database had good diagnostic performances if at least one parameter was considered abnormal by the machine. Our study provides new insights on glaucoma risk factors and determinants of glaucoma risk factors. Furthermore diagnostic performances of SD-OCT may provide valuable information in a screening strategy to optimize glaucoma detection in a general population of elderly people.Le glaucome est une maladie neurodégénérative qui se définit par une perte progressive en fibres nerveuses rétiniennes et un rétrécissement du champ visuel. Il s’agit de la première cause de cécité irréversible dans le monde et le principal facteur de risque est la pression intraoculaire (PIO). L’étude ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) est une étude épidémiologique qui a pour but de déterminer l’incidence des différentes pathologies oculaires liées à l’âge avec les facteurs nutritionnels, démographiques ou environnementaux dans une population représentative de la région de Bordeaux. En 2009-2010, 624 sujets âgés de plus de 74 ans ont bénéficié d’un examen ophtalmologique complet incluant un examen du nerf optique en rétinophotographie et en tomographie à cohérence optique spectral-domain (SD-OCT), d’une mesure la PIO au tonomètre à air et d’une évaluation des propriétés biomécaniques de la cornée. Une mesure de l’accumulation cutanée de produits de glycation avancée a été réalisée par autofluorescence. Le diagnostic de glaucome a été réalisé en utilisant les critères de la classification ISGEO (International Society for Epidemiologic and Geographical Ophthalmology). Les paramètres biomécaniques de la cornée étaient modifiés avec l’âge et chez les sujets ayant une histoire résidentielle à des latitudes plus exposées aux ultraviolets ambiants. L’épaisseur de cornée était plus élevée chez les sujets anciennement fumeurs. L’autofluorescence cutanée ≥ 2.7 UA (Unité Arbitraire) était indépendamment associée au glaucome. Les paramètres d’épaisseur en fibres nerveuses rétiniennes du SD-OCT présentaient de bonnes performances diagnostiques pour discriminer les sujets glaucomateux des témoins et la base normative présentait de bonnes performances discriminatives lorsqu’au moins un des paramètres était considéré comme anormal. Notre étude apporte des résultats originaux en termes de facteurs de risque de glaucome ou de déterminants des facteurs de risque de glaucome. De plus les performances diagnostiques du SD-OCT pourraient fournir des informations utiles pour optimiser les stratégies de dépistage du glaucome dans une population générale âgée

Epidemiology ou glaucoma in an elderly population : the Alienor Study

Le glaucome est une maladie neurodégénérative qui se définit par une perte progressive en fibres nerveuses rétiniennes et un rétrécissement du champ visuel. Il s’agit de la première cause de cécité irréversible dans le monde et le principal facteur de risque est la pression intraoculaire (PIO). L’étude ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) est une étude épidémiologique qui a pour but de déterminer l’incidence des différentes pathologies oculaires liées à l’âge avec les facteurs nutritionnels, démographiques ou environnementaux dans une population représentative de la région de Bordeaux. En 2009-2010, 624 sujets âgés de plus de 74 ans ont bénéficié d’un examen ophtalmologique complet incluant un examen du nerf optique en rétinophotographie et en tomographie à cohérence optique spectral-domain (SD-OCT), d’une mesure la PIO au tonomètre à air et d’une évaluation des propriétés biomécaniques de la cornée. Une mesure de l’accumulation cutanée de produits de glycation avancée a été réalisée par autofluorescence. Le diagnostic de glaucome a été réalisé en utilisant les critères de la classification ISGEO (International Society for Epidemiologic and Geographical Ophthalmology). Les paramètres biomécaniques de la cornée étaient modifiés avec l’âge et chez les sujets ayant une histoire résidentielle à des latitudes plus exposées aux ultraviolets ambiants. L’épaisseur de cornée était plus élevée chez les sujets anciennement fumeurs. L’autofluorescence cutanée ≥ 2.7 UA (Unité Arbitraire) était indépendamment associée au glaucome. Les paramètres d’épaisseur en fibres nerveuses rétiniennes du SD-OCT présentaient de bonnes performances diagnostiques pour discriminer les sujets glaucomateux des témoins et la base normative présentait de bonnes performances discriminatives lorsqu’au moins un des paramètres était considéré comme anormal. Notre étude apporte des résultats originaux en termes de facteurs de risque de glaucome ou de déterminants des facteurs de risque de glaucome. De plus les performances diagnostiques du SD-OCT pourraient fournir des informations utiles pour optimiser les stratégies de dépistage du glaucome dans une population générale âgée.Glaucoma is a neurodegenerative disease defined by a progressive loss of optic nerve axons and retinal ganglion cells resulting in a characteristic enlargement of the optic nerve head cup and associated visual field defects. It remains the first cause of irreversible blindness worldwide and intraocular pressure (IOP) is the main risk factor. The ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) study is a population-based study. It aims to assess the associations of age-related eye diseases with nutritional, demographic and environmental factors in a representative population of the Bordeaux area. In 2009-2010, 624 subjects, aged 74 years or more, underwent a complete eye examination, including an optic nerve head evaluation using retinophotography and a spectral-domain optical coherence tomography (SD-OCT), an IOP measurement using air-puff tonometry and an evaluation of biomechanical properties of the cornea. A measurement of skin accumulation of advanced glycation end-products was performed using an autofluorescence reader. Glaucoma diagnosis was made using ISGEO (International Society for Epidemiologic and Geographical Ophthalmology) criteria. Biomechanical properties of the cornea were modified by increasing age and in subjects having a higher lifetime ambient ultraviolet exposure. Central corneal thickness was thicker in former smokers. Skin autofluorescence values ≥ 2.7 AU (Arbitrary Unit) were independently associated with glaucoma. SD-OCT retinal nerve fiber layer thickness parameters had good diagnostic performances for discriminating glaucoma and control subjects and the normative database had good diagnostic performances if at least one parameter was considered abnormal by the machine. Our study provides new insights on glaucoma risk factors and determinants of glaucoma risk factors. Furthermore diagnostic performances of SD-OCT may provide valuable information in a screening strategy to optimize glaucoma detection in a general population of elderly people

Intérêt de l'ocular response analyser (ORA®) dans le dépistage des formes frustes de Keratocone

BORDEAUX2-BU Santé (330632101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Patient-Reported Difference following Implantation of a Blue Light-Filtering Aspheric Intraocular Lens and a UV-Filtering Aspheric Intraocular Lens

We report on a series of 6 patients who experienced yellow vision after uncomplicated cataract surgery in their second eye. In the first eye, an aspheric blue-light filtering intraocular lens (IOL) was implanted, followed by the implantation of a 1-Piece aspheric IOL in the second eye. The time between the surgeries ranged from 12 months to 3 years. The patients experienced noticeable differences between the yellow and the clear lens. It is suggested to avoid mixing blue light-filtering and UV-filtering IOLs in the same patient, particularly in those who have high expectations following cataract surgery