ObjectiveTo investigate the relationship of the age-related maculopathy susceptibility 2 (ARMS2) A69S polymorphism and polypoidal choroidal vasculopathy (PCV), and to explore the distribution of risk allele in PCV and exudative age-related macular degeneration (wAMD). MethodsThis is a systemic review and meta-analysis. A literature research was performed in Pubmed, Embase, Web of Knowledge, Chinese national Knowledge Infrastructure and Wanfang Medicine Database by the key words of "ARMS2, LOC387715, A69S, rs10490924, age related macular degeneration, polypoidal choroidal vasculopathy, single nucleotide polymorphism". Case-control studies were included, while review, case report, or systemic reviews were excluded. The latest one of multiple articles was included only which published by the same group. The results of individual studies were pooled using the software Review Manager 5.1.4, and the correlation between allele frequencies, genotype and phenotype were analyzed. ResultsA total of 14 articles, consisting 2007 PCV patients, 1308 wAMD patients and 3286 controls were recruited. The pooled odds ratio (OR) in random-effects models for genotype TT versus wild homozygous genotype GG is 5.20 (95% CI: 3.90-6.95). Heterozygous genotype GT mildly increased the risk in affecting PCV, and the OR of GT versus GG is 1.85 (95% CI: 1.42-2.40. The frequency of T allele in wAMD was higher than in PCV, pool OR=1.60 (95% CI: 1.31-1.96). ConclusionsThe ARMS2 A69S variant is associated with PCV. Genotypes of TT and GT had an effect in increasing the risk of PCV, and the effect is even greater in genotype of TT. T allele had an effect in increasing the risk of PCV and wAMD, and the risk for wAMD is slightly greater than for PCV.
ObjectiveTo evaluate the spectral domain optical coherence tomography (SD-OCT) characteristics of polypoidal choroidal vasculopathy (PCV) and its correlation with the visual acuity after photodynamic therapy (PDT) combined with intravitreal ranibizumab. MethodsTwenty-six eyes of 26 patients with PCV diagnosed by indocyanine green angiography (ICGA) were enrolled in this study. All the patients were examined for best corrected visual acuity (BCVA), slit lamp microscope, SD-OCT, fundus fluorescein angiography (FFA) and ICGA before and 1, 3 months after treatment. The mean baseline BCVA was (31.46±16.87) letters, mean central retinal thickness (CRT) was (581.19±309.05) μm, and mean subfoveal choroidal thickness (SFCT) was (248.92±95.45) μm. Patients were divided into 2 groups according to the final visual improvement after 6 month of treatment: GR or sensitive Group (17 eyes) and PR or non-sensitive Group (9 eyes). GR group included 12 males and 5 females, with a mean age of (65.24±7.03) years, a mean CRT of (619.06±335.07) μm and a mean SFCT of (271.24±106.61) μm. There were 4 eyes with subretinal hemorrhage (SRH), 2 eyes with interface retinal fluid (IRF), 13 eyes with subretinal fluids (SRF) and 15 eyes with pigment epithelial detachment (PED). PR group included 8 males and 1female, with a mean age of (64.00±7.02) years, a mean CRT of (509.67±255.21) μm and a mean SFCT of (271.24±106.61) μm. There were 6 eyes with subretinal hemorrhage (SRH), 5 eyes with interface retinal fluid (IRF), 6 eyes with subretinal fluids (SRF) and 8 eyes with pigment epithelial detachment (PED). The difference of sex, age, CRT and SFCT between these two groups was not significant (P>0.05). The relationship of baseline SD-OCT and post-treatment BCVA was analyzed. ResultsOn 1, 2, 3, 6 months after treatment, the BCVA were (38.46±19.81), (40.04±20.80), (42.96±21.63), (43.77±20.91) letters respectively. On 6 months after treatment, the mean CRT in GR and PR group were (360.71±276.54), (341.44±193.68) μm respectively (P>0.05). 64.71% (11/17) eyes in GR group and 22.22% (2/9) eyes in PR group had a SFCT thicker than 263μm. The difference was statistical significant between two groups [odds ratio (OR):0.052, 95% confidence interval (CI):0.005-0.533; P=0.013]. Logistic regression analysis showed that existence of IRF (OR=9.375, 95% CI: 1.299-67.645; P=0.026) or SRH (OR=6.500, 95% CI: 1.094-38.633; P=0.040) at baseline was negative prognostic factor to treatment. ConclusionThick SFCT is a protective factor, however, existence of IRF or SRH at baseline is negative prognostic factor of final visual improvement.
Objective To observe the levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) in aqueous humor of patients with macular edema secondary to central retinal vein occlusion (CRVO). Methods Forty eyes of 40 consecutive patients with macular edema secondary to CRVO (CRVO group) were enrolled in this study. The patients included 25 males and 15 females. The patient age ranged from 38 to 76 years. The control group was 20 patients with senile cataract who underwent phacoemulsification, including 10 males and 10 females. The levels of VEGF165, VEGF165b, IL-6 and MCP-1 in aqueous humor were determined by enzymelinked immunosorbent assay. The correlation of VEGF, and IL-6, and MCP-1 were analyzed. Results The median aqueous level of VEGF165, IL-6 and MCP-1 were 1089.0, 165.6, 1253.0 pg/ml respectively in CRVO group, which were higher than the control group's results (168.2, 4.7, 216.4 pg/ml respectively), the differences were statistically significant (Z=-4.549, -6.008, -5.343;P＜0.001). The VEGF165b in CRVO group and control group were 834.0, 915.9 pg/ml respectively, the difference was not statistically significant (Z=-0.207，P＞0.05). The ratio of VEGF165b to VEGF165 in CRVO group and control group were 2.71, 7.28 respectively, the difference was statistically significant (t=-3.007，P＜0.05). There was a highly positive correlation between IL-6 and VEGF in CRVO group (r=0.526,P=0.001) and also mild positive correlation in control group (r=0.425，P=0.070). No correlation between MCP-1 and VEGF was observed in both groups (CRVO group: r=0.211,P＞0.05. Control group: r=-0.019,P＞0.05). Conclusions VEGF165, IL-6 and MCP-1 levels were increased in CRVO patients while the VEGF165b was normal. The ratio between VEGF165b and VEGF165 in aqueous humor of patients with macular edema secondary to CRVO was decreased.
Objective To observe the choroidal thickness of patients with chronic central serous chorioretinopathy (CSC) in affected eyes and unaffected fellow eyes.Methods Forty-five chronic CSC patients diagnosed by fundus pre-set lens, fundus fluorescein angiography (FFA) and indocyanine green angiography were enrolled in this study. The patients included 36 males and nine females, with a mean age of (46.18plusmn;8.20) years, with a mean duration of (16.34plusmn;7.23) months. Thirty-six patients were affected unilaterally and nine patients affected bilaterally. The patients were divided into affected eyes group (group A, 51 eyes) and unaffected fellow eyes group (group B,39 eyes). Fifty age-, sex- and diopter- matched normal subjects (50 eyes) were enrolled in this study as control group (group C). Enhanced depth imaging (EDI) choroidal scans were obtained in all eyes by using spectral-domain optical coherence tomography. Subfoveal choroidal thickness (SFCT) and choroidal thickness at 3 mm nasal (NCT3 mm), temporal (TCT3 mm), superior (SCT3 mm), inferior (ICT3 mm) to the fovea were measured.Results The mean SFCT of group A, B and C were (436.76plusmn;87.01), (394.71plusmn;61.63), (294.86plusmn;75.30) mu;m respectively. The mean SFCT of group A and B were thicker than group C, the difference was significant among three groups (F=44.791,P＜0.001). There were difference between group A, B, C in NCT3 mm, TCT3 mm, SCT3 mm and ICT3 mm (F=15.816, 22.823, 15.147, 11.527;P＜0.001). The mean SFCT in affected eyes of unilateral patients was (416.34plusmn;79.44) mu;m, which was thicker than that in unaffected fellow eyes (t=2.897, P=0.007). Conclusion Choroidal thickness increased significantly in affected eyes and unaffected fellow eyes in patients with chronic CSC.
Objective To compare neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV) in age at diagnosis, gender and disease laterality. Methods One hundred fourteen nAMD patients (114 eyes) and 145 PCV patients (186 eyes) diagnosed by fundus fluorescein angiography (FFA) and indocyanine green angiography were enrolled in this retrospective study. The age at diagnosis, gender and disease laterality of all the patients were collected. Independent sample t-test, chi;2 test and Fisher's exact test were used to compare the age at diagnosis, gender and disease laterality between nAMD and PCV patients. Results The mean age at diagnosis of nAMD group and PCV group were (68.30plusmn;9.86), (65.67plusmn;9.04) years respectively, the difference was statistically significant (t=-2.168, P=0.031). The patients under 70 years old accounts for 50.88% in nAMD group, which is lower than that in PCV group (63.45%), the difference was statistically significant (chi;2 =4.138, P=0.042). The male/female ratio of nAMD group and PCV group were 3.56∶1 and 2.02∶1 respectively, the difference was statistically significant (chi;2 =3.937, P=0.047). Thirty patients (26.32%) and 41 patients (49.46%) were affected unilaterally in nAMD and PCV group, respectively. The difference of bilateral incidence between two groups was not statistically significant (chi;2 =0.123, P=0.726). There were 69 right eyes (47.92%) and 75 left eyes (52.08%) in nAMD group, 92 right eyes (49.46%) and 94 left eyes (50.54%) in PCV group. The difference of disease laterality between two groups was not statistically significant (chi;2 =0.078，P=0.637). Conclusions PCV patients present at younger age than nAMD. nAMD is more prone to affected males than PCV. Nearly a quarter patients are bilateral in nAMD or PCV, there is no difference in bilateral incidence between these two diseases.
Objective To observe the choroidal thickness and its relationship with age and refraction status in Chinese population. Methods 180 healthy volunteers (360 eyes) were enrolled in this study. Based on the age, the volunteers were divided into A (20-29 years old), B (30-39 year old), C (40-49 years old), D (50-59 year old), E (60-69 year old), and F (70-85 year old) group, with 33, 31, 29, 30, 31, 26 volunteers respectively. And the volunteers were divided into ＜60 years old group with 123 volunteers and ge; 60 years old group with 57 volunteers. Enhanced depth imaging (EDI) choroidal scans were obtained in all eyes by using spectraldomain optical coherence tomography. Subfoveal choroidal thickness (CT) and CT at 1 mm/3 mm temporal, nasal, superior, inferior to the fovea (S 1 mm, I1 mm, T1 mm, N 1 mm, S, I3 mm, T3 mm, N3 mm) were measured. The differences of CT between different quadrants, genders, eyes and ages were comparatively analyzed. The correlations between age, refraction status and CT in the volunteers of ＜60 years old and ge; 60 years old group were analyzed. Results The subfoveal CT was (262.78plusmn;84.38) mu;m. The differences were significant between subfoveal CT and all the quadrants CT (P＜0.05) except for S1 mm and T1 mm (P＞0.05 ). There was no difference between genders or eyes in subfoveal CT (P＞0.05 ). There was no difference between A, B, C, D group in subfoveal CT (P＞0.05 ). The subfoveal CT of E and F group were thinner than A, B, C, D group (P＜0.05). In the ＜60 years old group, there was a positive correlation between refraction status and CT (r=0.147,P＜0.05); but no correlation between age and CT (r=－0.055, P＞0.05 ). In the ge; 60 years old group, there was a significant negative correlation between CT and age (r=－0.543, P＜0.05), but no correlation between refraction status and CT (r=-0.008, P＞0.05). Conclusions The average subfoveal CT in Chinese population was (262.78plusmn;84.38) mu;m. The refraction status is the main influence factors in subjects ＜60 years old, while the age is the main influence factors in subjects ge;60 years old.