Background: Age-related macular degeneration (AMD) and cardiovascular disease share common risk factors. Inflammatory biomarkers, including C-reactive protein (CRP),interleukin 6 (IL- 6), soluble tumor necrosis factor...Background: Age-related macular degeneration (AMD) and cardiovascular disease share common risk factors. Inflammatory biomarkers, including C-reactive protein (CRP),interleukin 6 (IL- 6), soluble tumor necrosis factor alpha receptor 2, soluble intercellular and vascular adhesion molecules (intercellular adhesion molecule 1 and vascular cell adhesion molecule 1), and lipid biomarkers, including lipoprotein(a) and apolipoprotein B, have all been associated with cardiovascular disease. We previously found an association betweenAMD and CRP in a cross-sectional analysis, but the prospective relationships between AMD, CRP, and the other cardiovascular disease markers are unknown. Objective: To test the hypothesis that baseline cardiovascular disease biomarkers are associated with subsequent increased risk for progression ofAMD.Design, Setting, and Participants: This prospective cohort study involved 251 participants aged 60 years and older who had some sign of nonexudative AMD and visual acuity of 20/200 or better in at least one eye at baseline. The AMD status was assessed by standardized grading of fundus photographs, and stored fasting blood specimens obtained at baseline were analyzed for levels of the various biomarkers. The average follow-up time was 4.6 years. Main Outcome Measures: Relationship between biomarkers and incidence rates of progression of AMD. Results: Comparing the highest quartile with the lowest quartile, CRP was associated with progression of AMD, with a multivariate adjusted relative risk (RR) of 2.10 (95% confidence interval (CI), 1.06- 4.18; P for trend, .046) controlling for body mass index, smoking, and other cardiovascular variables and a multivariate adjusted RR of 2.02 (95% CI, 1.00- 4.04; P for trend, .06) controlling additionally for antioxidant nutrients. Interleukin 6 was also related to progression of AMD, with a multivariate adjusted RR of 1.81 (95% CI, 0.97- 3.36; P for trend, .03). Comparing the highest quartile with the lowest quartile, the effect estimates for vascular cell adh展开更多
The clinical and genetic relationships between Alzheimer’ s disease(AD)and glaucoma remain obscure.The aim of this study was to determine the prevalence of openangle glaucoma(OAG)in patients with AD and whether the a...The clinical and genetic relationships between Alzheimer’ s disease(AD)and glaucoma remain obscure.The aim of this study was to determine the prevalence of openangle glaucoma(OAG)in patients with AD and whether the apolipoprotein E(APOE)4 allele is associated with AD,with or without OAG,in Japanese.The groups consisted of 172 patients with the diagnostic criteria of AD and 176 age-matched controls.Ophthalmic examinations were conducted,and genomic analysis was performed by PCR and digestion of products with an enzyme.OAG was found in 41(23.8%)of the AD patients,which was a significantly(p=0.0002)higher prevalence than that in the controls(9.9%).Furthermore,there was no significant difference between intraocular pressures(IOPs)in AD patients with OAG and without OAG.The percentage of AD patients who carried an APOE 4 allele(29.5%)was significantly(p=0.0007)higher than that of the controls(9.1%).However,the percentage of AD patients with OAG who carried an APOE 4 allele(35.7%)was not significantly different than that of AD patients without OAG(27.7%,p=0.42).In summary,the prevalence of OAG is high in Japanese patients with AD,suggesting that common factors other than APOE may contribute to the two diseases.展开更多
PURPOSE: To determine the incidence of dry eye and its risk factors after myopic laser-assisted in situ keratomileusis (LASIK). DESIGN: Single-center,prospective randomized clinical trial of 35 adult patients,aged 24 ...PURPOSE: To determine the incidence of dry eye and its risk factors after myopic laser-assisted in situ keratomileusis (LASIK). DESIGN: Single-center,prospective randomized clinical trial of 35 adult patients,aged 24 to 54 years,with myopia undergoing LASIK. METHODS: SETTING AND STUDY POPULATION: Participants were randomized to undergo LASIK with a superior or a nasal hinge flap. They were evaluated at 1 week and 1,3,and 6 months after surgery. INTERVENTION: Bilateral LASIK with either a superior-hinge Hansatome microkeratome (n=17) or a nasal-hinge Amadeus microkeratome (n=18). MAIN OUTCOME MEASURES: The criterion for dry eye was a total corneal fluorescein staining score ≥ 3. Visual acuity,ocular surface parameters,and corneal sensitivity were also analyzed. Cox proportional-hazard regression was used to assess rate ratios (RRs) with 95% confidence intervals. RESULTS: The incidence of dry eye in the nasal-and superior-hinge group was eight (47.06% ) of 17 and nine (52.94% ) of 17 at 1 week,seven (38.89% ) of 18 and seven (41.18% ) of 17 at 1 month,four (25% ) of 16 and three (17.65% ) of 17 at 3 months,and two (12.50% ) of 16 and six (35.29% ) of 17 at 6 months,respectively. Dry eye was associated with level of preoperative myopia (RR 0.88/each diopter,P=.04),laser-calculated ablation depth (RR 1.01/μ m,P=0.01),and combined ablation depth and flap thickness (RR 1.01/μ m,P=0.01). CONCLUSIONS: Dry eye occurs commonly after LASIK surgery in patients with no history of dry eye. The risk of developing dry eye is correlated with the degree of preoperative myopia and the depth of laser treatment.展开更多
文摘Background: Age-related macular degeneration (AMD) and cardiovascular disease share common risk factors. Inflammatory biomarkers, including C-reactive protein (CRP),interleukin 6 (IL- 6), soluble tumor necrosis factor alpha receptor 2, soluble intercellular and vascular adhesion molecules (intercellular adhesion molecule 1 and vascular cell adhesion molecule 1), and lipid biomarkers, including lipoprotein(a) and apolipoprotein B, have all been associated with cardiovascular disease. We previously found an association betweenAMD and CRP in a cross-sectional analysis, but the prospective relationships between AMD, CRP, and the other cardiovascular disease markers are unknown. Objective: To test the hypothesis that baseline cardiovascular disease biomarkers are associated with subsequent increased risk for progression ofAMD.Design, Setting, and Participants: This prospective cohort study involved 251 participants aged 60 years and older who had some sign of nonexudative AMD and visual acuity of 20/200 or better in at least one eye at baseline. The AMD status was assessed by standardized grading of fundus photographs, and stored fasting blood specimens obtained at baseline were analyzed for levels of the various biomarkers. The average follow-up time was 4.6 years. Main Outcome Measures: Relationship between biomarkers and incidence rates of progression of AMD. Results: Comparing the highest quartile with the lowest quartile, CRP was associated with progression of AMD, with a multivariate adjusted relative risk (RR) of 2.10 (95% confidence interval (CI), 1.06- 4.18; P for trend, .046) controlling for body mass index, smoking, and other cardiovascular variables and a multivariate adjusted RR of 2.02 (95% CI, 1.00- 4.04; P for trend, .06) controlling additionally for antioxidant nutrients. Interleukin 6 was also related to progression of AMD, with a multivariate adjusted RR of 1.81 (95% CI, 0.97- 3.36; P for trend, .03). Comparing the highest quartile with the lowest quartile, the effect estimates for vascular cell adh
文摘The clinical and genetic relationships between Alzheimer’ s disease(AD)and glaucoma remain obscure.The aim of this study was to determine the prevalence of openangle glaucoma(OAG)in patients with AD and whether the apolipoprotein E(APOE)4 allele is associated with AD,with or without OAG,in Japanese.The groups consisted of 172 patients with the diagnostic criteria of AD and 176 age-matched controls.Ophthalmic examinations were conducted,and genomic analysis was performed by PCR and digestion of products with an enzyme.OAG was found in 41(23.8%)of the AD patients,which was a significantly(p=0.0002)higher prevalence than that in the controls(9.9%).Furthermore,there was no significant difference between intraocular pressures(IOPs)in AD patients with OAG and without OAG.The percentage of AD patients who carried an APOE 4 allele(29.5%)was significantly(p=0.0007)higher than that of the controls(9.1%).However,the percentage of AD patients with OAG who carried an APOE 4 allele(35.7%)was not significantly different than that of AD patients without OAG(27.7%,p=0.42).In summary,the prevalence of OAG is high in Japanese patients with AD,suggesting that common factors other than APOE may contribute to the two diseases.
文摘PURPOSE: To determine the incidence of dry eye and its risk factors after myopic laser-assisted in situ keratomileusis (LASIK). DESIGN: Single-center,prospective randomized clinical trial of 35 adult patients,aged 24 to 54 years,with myopia undergoing LASIK. METHODS: SETTING AND STUDY POPULATION: Participants were randomized to undergo LASIK with a superior or a nasal hinge flap. They were evaluated at 1 week and 1,3,and 6 months after surgery. INTERVENTION: Bilateral LASIK with either a superior-hinge Hansatome microkeratome (n=17) or a nasal-hinge Amadeus microkeratome (n=18). MAIN OUTCOME MEASURES: The criterion for dry eye was a total corneal fluorescein staining score ≥ 3. Visual acuity,ocular surface parameters,and corneal sensitivity were also analyzed. Cox proportional-hazard regression was used to assess rate ratios (RRs) with 95% confidence intervals. RESULTS: The incidence of dry eye in the nasal-and superior-hinge group was eight (47.06% ) of 17 and nine (52.94% ) of 17 at 1 week,seven (38.89% ) of 18 and seven (41.18% ) of 17 at 1 month,four (25% ) of 16 and three (17.65% ) of 17 at 3 months,and two (12.50% ) of 16 and six (35.29% ) of 17 at 6 months,respectively. Dry eye was associated with level of preoperative myopia (RR 0.88/each diopter,P=.04),laser-calculated ablation depth (RR 1.01/μ m,P=0.01),and combined ablation depth and flap thickness (RR 1.01/μ m,P=0.01). CONCLUSIONS: Dry eye occurs commonly after LASIK surgery in patients with no history of dry eye. The risk of developing dry eye is correlated with the degree of preoperative myopia and the depth of laser treatment.
