Dataset Information

Smoking and choroidal thickness in patients over 65 with early-atrophic age-related macular degeneration and normals.

ABSTRACT: OBJECTIVE: To compare macular choroidal thickness between cigarette smokers, those with a history of smoking, and nonsmokers in patients over 65 years of age with early-atrophic age-related macular degeneration (AMD) and normals. METHODS: Prospective, consecutive, observational case series. Enhanced depth imaging spectral domain optical coherence tomography 12-line radial scans were performed and choroidal thickness manually quantified at 84 points in the central 3?mm of the macula. Data of normals, soft drusen alone, and soft drusen with additional features of early AMD were compared. A multivariate analysis of variance (MANOVA) model, controlling for age, was constructed to evaluate the effect of smoking history and AMD features on choroidal thickness. RESULTS: A history of smoking was significantly associated with a thinner choroid across all patients via logistic regression (P=0.004; O.R.=12.4). Mean macular choroidal thickness was thinner for smokers (148±63??m) than for nonsmokers (181±65??m) among all diagnosis categories (P=0.003). Subgroup analysis of patients with AMD features revealed a similar decreased choroidal thickness in smokers (121±41??m) compared with nonsmokers (146±46??m, P=0.006). Bivariate analysis revealed an association between increased pack-years of smoking and a thin choroid across all patients (P<0.001) and among patients with features of early AMD (P<0.001). Both the presence of features of macular degeneration (P<0.001) and a history of smoking (P=0.024) were associated with decreased choroidal thickness in a MANOVA model. CONCLUSION: Chronic cigarette smoke exposure may be associated with decreased choroidal thickness. There may be an anatomic sequelae to chronic tobacco smoke exposure that underlies previously reported AMD risk.

SUBMITTER: Sigler EJ

PROVIDER: S-EPMC4094797 | biostudies-other | 2014 Jul

REPOSITORIES: biostudies-other

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Smoking and choroidal thickness in patients over 65 with early-atrophic age-related macular degeneration and normals.

Sigler E J EJ Randolph J C JC Calzada J I JI Charles S S

Eye (London, England) 20140516 7

<h4>Objective</h4>To compare macular choroidal thickness between cigarette smokers, those with a history of smoking, and nonsmokers in patients over 65 years of age with early-atrophic age-related macular degeneration (AMD) and normals.<h4>Methods</h4>Prospective, consecutive, observational case series. Enhanced depth imaging spectral domain optical coherence tomography 12-line radial scans were performed and choroidal thickness manually quantified at 84 points in the central 3 mm of the macula. ...[more]

PMID: 24833184

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Project description:Background and Objectives: Patients with cataract and age-related macular degeneration (AMD) may safely undergo cataract phacoemulsification to enhance visual acuity. Although it has not been proven that cataract surgery can cause AMD progression, different phacoemulsification effects are observed not only on retinal but also on choroidal tissues. The purpose of this study was to evaluate the effect of phacoemulsification on the choroidal thickness (CT) in eyes with and without AMD. Materials and Methods: In 32 eyes of 32 patients with senile cataract (No-AMD group) and in 32 eyes of 32 patients with cataract and dry AMD (AMD group), who had phacoemulsification without intraoperative complications and intraocular lens implantation, foveal retinal thickness (FRT) and CT were evaluated three times: at 1-2 post meridiem preoperatively, then 1 month and 3 months postoperatively, using 1050 nm swept source-optical coherence tomography (Topcon, Tokyo, Japan). Results: In both groups, a significant increase in FRT was observed after one month and a decrease after three months without reaching the baseline. One month after surgery, a sectorial CT increase was apparent in all sectors in both groups. A negative association between CT and age was disclosed in the No-AMD group almost for all regions at all time points. Furthermore, CT was significantly negatively associated with axial length (AL) in all sectors at all time points in the AMD group. Conclusion: Uneventful phacoemulsification may induce changes in the posterior eye segment. An increase in CT and FRT was observed in both groups one month after the surgery. However, three months after surgery, CT changes were different in both groups, while FRT decreased in both groups. CT changes negatively associated with age in the No-AMD group and with AL in the AMD eyes. These postoperative changes in the choroid and retina may not only lead to the late-onset pseudophakic cystoid macular edema but also to progression of AMD.

Project description:PurposeLoss of photoreceptors in atrophic age-related macular degeneration results in severe visual impairment, although some peripheral vision is retained. To restore central vision without compromising the residual peripheral field, we developed a wireless photovoltaic retinal implant (PRIMA; Pixium Vision, Paris, France) in which pixels convert images projected from video glasses using near-infrared light into electric current to stimulate the nearby inner retinal neurons.DesignWe carried out a first-in-human clinical trial to test the safety and efficacy of the prosthesis in patients with geographic atrophy (ClinicalTrials.gov identifier, NCT03333954).ParticipantsFive patients with geographic atrophy zone of at least 3 optic disc diameters, no foveal light perception, and best-corrected visual acuity of 20/400 to 20/1000 in the worse-seeing study eye.MethodsThe 2-mm wide, 30-μm thick chip, containing 378 pixels (each 100 μm in diameter), was implanted subretinally in the area of atrophy (absolute scotoma).Main outcome measuresAnatomic outcomes were assessed with fundus photography and OCT for up to 12 months of follow-up. Prosthetic vision was assessed by mapping light perception, bar orientation, letter recognition, and Landolt C acuity.ResultsIn all patients, the prosthesis was implanted successfully under the macula, although in 2 patients, it was implanted in unintended locations: within the choroid and off center by 2 mm. All 5 patients could perceive white-yellow prosthetic visual patterns with adjustable brightness in the previous scotomata. The 3 with optimal placement of the implant demonstrated prosthetic acuity of 20/460 to 20/550, and the patient with the off-center implant demonstrated 20/800 acuity. Residual natural acuity did not decrease after implantation in any patient.ConclusionsImplantation of the PRIMA did not decrease the residual natural acuity, and it restored visual sensitivity in the former scotoma in each of the 5 patients. In 3 patients with the proper placement of the chip, prosthetic visual acuity was only 10% to 30% less than the level expected from the pixel pitch (20/420). Therefore, the use of optical or electronic magnification in the glasses as well as smaller pixels in future implants may improve visual acuity even further.

Dataset Information

Smoking and choroidal thickness in patients over 65 with early-atrophic age-related macular degeneration and normals.

Publications

Smoking and choroidal thickness in patients over 65 with early-atrophic age-related macular degeneration and normals.

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