Search

Your search keyword '"Pfeiffer, N."' showing total 23 results
Start Over Author "Pfeiffer, N." Journal ophthalmology
23 results on '"Pfeiffer, N."'

1. The Decreasing Prevalence of Nonrefractive Visual Impairment in Older Europeans: A Meta-analysis of Published and Unpublished Data

Author

Delcourt, C., Le Goff, M., von Hanno, T., Mirshahi, A., Khawaja, A. P., Verhoeven, V. J. M., Hogg, R. E., Anastosopoulos, E., Cachulo, M. L., Hohn, R., Wolfram, C., Bron, A., Miotto, S., Carriere, I., Colijn, J. M., Buitendijk, G. H. S., Evans, J., Nitsch, D., Founti, P., Yip, J. L. Y., Pfeiffer, N., Creuzot-Garcher, C., Silva, R., Piermarocchi, S., Topouzis, F., Bertelsen, G., Foster, P. J., Fletcher, A., Klaver, C. C. W., Korobelnik, J. -F., Acar, N., Azuara-Blanco, A., Berendschot, T., Bergen, A., Binquet, C., Bird, A., Bobak, M., Boon, C., Bretillon, L., Broe, R., Buitendijk, G., Capuano, V., Chakravarthy, U., Chan, M., Chang, P., Colijn, J., Cougnard-Gregoire, A., Cree, A., Cumberland, P., Cunha-Vaz, J., Daien, V., De Jong, E., Deak, G., Delyfer, M. -N., den Hollander, A., Dietzel, M., Erke, M. G., Faria, P., Farinha, C., Fauser, S., Finger, R., Foster, P., Gorgels, T., Grauslund, J., Grus, F., Hammond, C., Hansen, M., Helmer, C., Hense, H. -W., Hermann, M., Hoehn, R., Hogg, R., Holz, F., Hoyng, C., Jansonius, N., Janssen, S., Kersten, E., Khawaja, A., Klaver, C., Lamparter, J., Lechanteur, Y., Lehtimaki, T., Leung, I., Lotery, A., Mauschitz, M., Meester, M., Merle, B., Meyer zu Westrup, V., Midena, E., Mohan-Said, S., Mueller, M., Muldrew, A., Murta, J., Nickels, S., Nunes, S., Owen, C., Peto, T., Prokofyeva, E., Rahi, J., Raitakari, O., Rauscher, F., Ribeiro, L., Rougier, M. -B., Rudnicka, A., Randjvar, Sahel, Salonikiou, A., Sanchez, C., Schmitz-Valckenberg, S., Schouten, J., Schuster, A., Schweitzer, C., Segato, T., Shehata, J., Silvestri, G., Simader, C., Souied, E., Speckauskas, M., Springelkamp, H., Tapp, R., van Leeuwen, E., Verhoeven, V., Verzijden, T., Von Hanno, T., Vujosevic, S., Wiedemann, P., Williams, K., Yip, J., and Zerbib, J.

Subjects
Europe, Aged, Humans, Prevalence, Vision, Low, Visually Impaired Persons, Visual Acuity, Vision, Low
Abstract

TOPIC: To estimate the prevalence of nonrefractive visual impairment and blindness in European persons 55 years of age and older. CLINICAL RELEVANCE: Few visual impairment and blindness prevalence estimates are available for the European population. In addition, many of the data collected in European population-based studies currently are unpublished and have not been included in previous estimates. METHODS: Fourteen European population-based studies participating in the European Eye Epidemiology Consortium (n = 70 723) were included. Each study provided nonrefractive visual impairment and blindness prevalence estimates stratified by age (10-year strata) and gender. Nonrefractive visual impairment and blindness were defined as best-corrected visual acuity worse than 20/60 and 20/400 in the better eye, respectively. Using random effects meta-analysis, prevalence rates were estimated according to age, gender, geographical area, and period (1991-2006 and 2007-2012). Because no data were available for Central and Eastern Europe, population projections for numbers of affected people were estimated using Eurostat population estimates for European high-income countries in 2000 and 2010. RESULTS: The age-standardized prevalence of nonrefractive visual impairment in people 55 years of age or older decreased from 2.22% (95% confidence interval [CI], 1.34-3.10) from 1991 through 2006 to 0.92% (95% CI, 0.42-1.42) from 2007 through 2012. It strongly increased with age in both periods (up to 15.69% and 4.39% in participants 85 years of age or older from 1991 through 2006 and from 2007 through 2012, respectively). Age-standardized prevalence of visual impairment tended to be higher in women than men from 1991 through 2006 (2.67% vs. 1.88%), but not from 2007 through 2012 (0.87% vs. 0.88%). No differences were observed between northern, western, and southern regions of Europe. The projected numbers of affected older inhabitants in European high-income countries decreased from 2.5 million affected individuals in 2000 to 1.2 million in 2010. Of those, 584 000 were blind in 2000, in comparison with 170 000 who were blind in 2010. CONCLUSIONS: Despite the increase in the European older population, our study indicated that the number of visually impaired people has decreased in European high-income countries in the last 20 years. This may be the result of major improvements in eye care and prevention, the decreasing prevalence of eye diseases, or both.

Published
2018

2. Increased High-Density Lipoprotein Levels Associated with Age-Related Macular Degeneration: Evidence from the EYE-RISK and European Eye Epidemiology Consortia

Author

Colijn, J. M., Verzijden, T., Meester-Smoor, M. A., Klaver, C. C. W., Demirkan, A., Ahmad, S., van Duijn, C. M., den Hollander, A. I., Kersten, E., Hoyng, C. B., Cougnard-Gregoire, A., Merle, B. M. J., Korobelnik, J. -F., Delcourt, C., Papageorgiou, G., Mulder, M. T., Costa, M. A., Silva, R., Benlian, P., Bertelsen, G., Bron, A. M., Creuzot-Garcher, C., Claes, B., Hense, H. -W., Erke, M. G., Fauser, S., Foster, P. J., Khawaja, A. P., Hammond, C. J., Williams, K. M., Piermarocchi, S., Segato, T., Souied, E. H., Acar, N., Altay, L., Anastosopoulos, E., Azuara-Blanco, A., Berendschot, T., Bergen, A., Binquet, C., Bird, A., Bobak, M., Larsen, M. B., Boon, C., Bourne, R., Bretillon, L., Broe, R., Bron, A., Buitendijk, G., Cachulo, M. L., Capuano, V., Carriere, I., Chakravarthy, U., Chan, M., Chang, P., Colijn, J., Cree, A., Cumberland, P., Cunha-Vaz, J., Daien, V., De Jong, E., Deak, G., Delyfer, M. -N., Hollander, A. D., Dietzel, M., Faria, P., Farinha, C., Finger, R., Fletcher, A., Foster, P., Founti, P., Gorgels, T., Grauslund, J., Grus, F., Hammond, C., Heesterbeek, T., Hermann, M., Hoehn, R., Hogg, R., Holz, F., Hoyng, C., Jansonius, N., Janssen, S., de Jong, E., Khawaja, A., Klaver, C., Lamparter, J., Le Goff, M., Lehtimaki, T., Leung, I., Lotery, A., Mauschitz, M., Meester, M., Merle, B., Meyer zu Westrup, V., Midena, E., Miotto, S., Mirshahi, A., Mohan-Said, S., Mueller, M., Muldrew, A., Murta, J., Nickels, S., Nunes, S., Owen, C., Peto, T., Pfeiffer, N., Prokofyeva, E., Rahi, J., Raitakari, O., Rauscher, F., Ribeiro, L., Rougier, M. -B., Rudnicka, A., Randjvar, Sahel, Salonikiou, A., Sanchez, C., Schick, T., Schmitz-Valckenberg, S., Schuster, A., Schweitzer, C., Shehata, J., Silvestri, G., Simader, C., Souied, E., Speckauskas, M., Springelkamp, H., Tapp, R., Topouzis, F., van Leeuwen, E., Verhoeven, V., Vingerling, H., Von Hanno, T., Williams, K., Wolfram, C., Yip, J., Zerbib, J., Ajana, S., Arango-Gonzalez, B., Arndt, V., Bhatia, V., Bhattacharya, S. S., Biarnes, M., Borrell, A., Buhren, S., Calado, S. M., Dammeier, S., de Jong, E. K., De la Cerda, B., Diaz-Corrales, F. J., Diether, S., Emri, E., Endermann, T., Ferraro, L. L., Garcia, M., Heesterbeek, T. J., Honisch, S., Kilger, E., Langen, H., Lengyel, I., Luthert, P., Maugeais, C., Meester-Smoor, M., Merle Inserm, B. M. J., Mones, J., Nogoceke, E., Pool, F. M., Rodriguez, E., Ueffing, M., Ulrich Bartz-Schmidt, K. U., van Leeuwen, E. M., and Zumbansen, M.

Subjects
Male, Magnetic Resonance Spectroscopy, HDL, genetic structures, European Continental Ancestry Group, Polymorphism, Single Nucleotide, White People, LDL, Macular Degeneration, Risk Factors, 80 and over, Odds Ratio, Humans, Metabolomics, European Union, Polymorphism, Triglycerides, Aged, Aged, 80 and over, Cholesterol, HDL, Single Nucleotide, Cholesterol, LDL, Middle Aged, Lipid Metabolism, eye diseases, Cholesterol Ester Transfer Proteins, Cholesterol, Cross-Sectional Studies, lipids (amino acids, peptides, and proteins), Female, sense organs
Abstract

Purpose Genetic and epidemiologic studies have shown that lipid genes and high-density lipoproteins (HDLs) are implicated in age-related macular degeneration (AMD). We studied circulating lipid levels in relationship to AMD in a large European dataset. Design Pooled analysis of cross-sectional data. Participants Individuals (N = 30 953) aged 50 years or older participating in the European Eye Epidemiology (E3) consortium and 1530 individuals from the Rotterdam Study with lipid subfraction data. Methods AMD features were graded on fundus photographs using the Rotterdam classification. Routine blood lipid measurements, genetics, medication, and potential confounders were extracted from the E3 database. In a subgroup of the Rotterdam Study, lipid subfractions were identified by the Nightingale biomarker platform. Random-intercepts mixed-effects models incorporating confounders and study site as a random effect were used to estimate associations. Main Outcome Measures AMD features and stage; lipid measurements. Results HDL was associated with an increased risk of AMD (odds ratio [OR], 1.21 per 1-mmol/l increase; 95% confidence interval [CI], 1.14–1.29), whereas triglycerides were associated with a decreased risk (OR, 0.94 per 1-mmol/l increase; 95% CI, 0.91–0.97). Both were associated with drusen size. Higher HDL raised the odds of larger drusen, whereas higher triglycerides decreases the odds. LDL cholesterol reached statistical significance only in the association with early AMD (P = 0.045). Regarding lipid subfractions, the concentration of extra-large HDL particles showed the most prominent association with AMD (OR, 1.24; 95% CI, 1.10–1.40). The cholesteryl ester transfer protein risk variant (rs17231506) for AMD was in line with increased HDL levels (P = 7.7 × 10–7), but lipase C risk variants (rs2043085, rs2070895) were associated in an opposite way (P = 1.0 × 10–6 and P = 1.6 × 10–4). Conclusions Our study suggested that HDL cholesterol is associated with increased risk of AMD and that triglycerides are negatively associated. Both show the strongest association with early AMD and drusen. Extra-large HDL subfractions seem to be drivers in the relationship with AMD, and variants in lipid genes play a more ambiguous role in this association. Whether systemic lipids directly influence AMD or represent lipid metabolism in the retina remains to be answered.

Published
2018

3. Predictive factors for open-angle glaucoma among patients with ocular hypertension in the European Glaucoma Prevention Study

Author

European Glaucoma Prevention Study Group, Miglior, S, Pfeiffer, N, Torri, V, Zeyen, T, Cunha Vaz, J, Adamsons, I, Cesareo, M, Miglior, S, Pfeiffer, N, Torri, V, and The European Glaucoma Prevention Study, G

Subjects
Glaucoma, ocular hypertension, predictive factors, Male, medicine.medical_specialty, Intraocular pressure, genetic structures, Open angle glaucoma, Settore MED/06 - Oncologia Medica, Visual Acuity, Ocular hypertension, Glaucoma, Thiophenes, Dorzolamide, Double-Blind Method, Risk Factors, Ophthalmology, Medicine, Humans, Antihypertensive Agents, Intraocular Pressure, Proportional Hazards Models, Sulfonamides, business.industry, Hazard ratio, Middle Aged, medicine.disease, Prognosis, eye diseases, Confidence interval, Europe, medicine.anatomical_structure, Disease Progression, Female, Ocular Hypertension, sense organs, business, Glaucoma, Open-Angle, medicine.drug, Optic disc
Abstract

Objective: To evaluate the predictive factors of open-angle glaucoma (OAG) in patients affected by ocular hypertension enrolled in the European Glaucoma Prevention Study (EGPS). Design: Randomized, double-masked, controlled clinical trial. Participants: One thousand seventy-seven patients, ≥30 years old, were enrolled at 18 European centers. The patients met inclusion criteria: intraocular pressure, 22 to 29 mmHg; 2 normal and reliable visual fields (VFs) (on the basis of mean deviation and corrected pattern standard deviation [PSD]); and a normal optic disc, as determined by an optic disc reading center. Intervention: Treatment with dorzolamide or a placebo (the vehicle of dorzolamide) in one or both eyes. Main Outcome Measures: Efficacy end points were VF and/or optic disc changes. Baseline demographic and clinical data were collected before randomization, except for corneal thickness measurements, which were determined during follow-up. Proportional hazards models were used to identify factors that predicted which participants in the EGPS had developed OAG. Results: In multivariate analyses, factors that predicted the development of OAG included older age (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.04-1.69), larger vertical cup-to-disc (C/D) ratio (HR, 1.34; 95% CI, 1.14-1.58), larger vertical C/D ratio asymmetry (HR, 1.46; 95% CI, 1.11-1.93), higher PSD (HR, 1.66; 95% CI, 1.15-2.38), and lesser central corneal thickness (HR, 1.32; 95% CI, 1.05-1.67). Conclusions: Baseline age, vertical C/D ratio, vertical C/D ratio asymmetry, and PSD were good predictors of the onset of OAG in the EGPS. Central corneal thickness was found to be a powerful predictor of the development of OAG. The EGPS results agree with the findings of the Ocular Hypertension Treatment Study and support the need for a thorough evaluation of patients with ocular hypertension. © 2007 American Academy of Ophthalmology.

Published
2005

4. The European glaucoma prevention study design and baseline description of the participants

Author

Miglior, S, Zeyen, T, Pfeiffer, N, Cunha-Vaz, J, Linsen, Mc, Pellicci, L, Janssens, A, van der Veken, A, Nerinckx, F, Boeyden, V, Detry-Morel, M, Kestelijn, P, Van den Abeele, K, Jacobs, K, Decock, C, Goethals, M, Pourjavan, S, Maris, K, Kersten, I, Vogel, A, Herkel, U, Schwenn, O, Maser-Wahle, M, Funk, J, Schmidt, B, Akbariyeh, N, Burk, R, Thomsen, A, Grehn, F, Marquardt, D, Orzalesi, N, Rossetti, L, Ferrante, M, Mandelli, L, Marini, S, Bagno, S, Bertoni, G, Blini, M, De Molfetta, M, Bonomi, L, Morbio, R, Marraffa, M, Maraini, G, Gandolfi, S, Williams, S, Cimino, L, Dondi, P, Lumbroso, B, Manni, G, Cocco, F, Glorialanza, G, Villani, Cm, Pocobelli, A, Cesareo, M, Cupo, G, Neuschuler, R, Pernini, C, Catalani, R, Ribeiro, L, Faria, I, Pereira, Jm, Chingui, S, Duarte, L, Carvalheira, F, Baltar, A, Simao, A, Arede, J, Magalhaes, A, Abrantes, P, Reina, M, Silva, Jp, Romano, G, Silva, S, Torri, V, Poli, D, Nerviani, C, Tinazzi, A, Adamsons, I, Caprioli, J, Wormald, R, Hejil, A, Airaksinen, J, Michaelis, J, Floriani, I, Shedden, A, Gottfried, E, Hutzelmann, J, Rusk, C, Reines, S, Spector, R, Hombrey, J, Snyder, H, Gacos, J, Snapinn, S, Getson, A, Amos, J, Serruys, K, Malbecq, W, John, E, Chapman, J, Beck, J, Tessi, C, Rao, N, Bottari, Fp, D'Achille, R, Wilkins, A, Magerl, K, Bauer, C, Derouwaux, C, Cunha, M, Santana, R, Andrade, Lg, Bule, S, Melo, R, Baumont, H, Bonaventura, I, Miglior, S, Zeyen, T, Pfeiffer, N, Cunha Vaz, J, Torri, V, and Adamsons, I

Subjects
Adult, Male, medicine.medical_specialty, Intraocular pressure, Visual acuity, genetic structures, Visual Acuity, Glaucoma, Ocular hypertension, Thiophenes, Sulfonamide, law.invention, Visual Field Test, Randomized controlled trial, Dorzolamide, Double-Blind Method, Thiophene, law, Ophthalmology, medicine, Humans, Dioptre, Antihypertensive Agents, Intraocular Pressure, Aged, Aged, 80 and over, Sulfonamides, business.industry, Middle Aged, medicine.disease, eye diseases, Europe, Antihypertensive Agent, medicine.anatomical_structure, Research Design, Visual Field Tests, Female, Ocular Hypertension, sense organs, medicine.symptom, Safety, Visual Fields, business, Glaucoma, Open-Angle, Human, Optic disc, medicine.drug
Abstract

Objectives The European Glaucoma Prevention Study seeks to evaluate the efficacy of reducing intraocular pressure (IOP), with dorzolamide to prevent or delay patients affected by ocular hypertension from developing primary open-angle glaucoma. Design Randomized, double-blinded, controlled clinical trial. Participants Patients (age > or =30 years) were enrolled from 18 European centers. The patients fulfilled a series of inclusion criteria including the measurements of IOP (22-29 mmHg), two normal and reliable visual fields (VFs) (on the basis of mean defect and corrected pattern standard deviation/corrected loss of variance of standard 30/II Humphrey or Octopus perimetry), and normal optic disc as determined by the Optic Disc Reading Center (vertical and horizontal cup-to-disc ratios; asymmetry between the two eyes Intervention Patients were randomized to the treatment with dorzolamide or a placebo. Main outcome measures End points are VF and/or optic disc changes. A VF change during the follow-up must be confirmed by two further positive tests. Optic disc change is defined by the agreement of two out of three independent observers evaluating optic disc stereo-slides. Results One thousand seventy-seven subjects were randomized between January 1, 1997 and May 31, 1999. The mean age was 57.03 +/- 10.3 years; 54.41% were women and 99.9% were Caucasian. Mean IOP was 23.6 +/- 1.6 mmHg in both eyes. Mean visual acuity was 0.97 +/- 0.11 in both eyes; mean refraction was 0.23 +/- 1.76 diopters in the right eye and 0.18 +/- 1.79 diopters in the left eye. Previous use of medication for ocular hypertension was reported by 38.4% of the patients, systemic hypertension by 28.1%, cardiovascular diseases by 12.9%, and diabetes mellitus by 4.7%. The qualifying VFs were normal and reliable according to protocol criteria. Conclusions The mean IOP of the patients enrolled in the European Glaucoma Prevention Study is consistent with the estimated mean IOP (within the range of 22-29 mmHg) found in a large sample of the European population. The European Glaucoma Prevention Study should be able to better address the clinical question of whether pharmacological reduction of IOP (by means of dorzolamide) in ocular hypertension patients at moderate risk for developing primary open-angle glaucoma effectively lowers the incidence of primary open-angle glaucoma.

Published
2002

5. Reproducibility of evaluation of optic disc change for glaucoma with stereo optic disc photographs

Author

Miglior, S, Zeyen, T, Pfeiffer, N, Cunha-Vaz, J, Linsen, Mc, Pellicci, L, Janssens, A, van der Veken, A, Nerinckx, F, Boeyden, V, Czupper, M, Wendrix, G, Detry-Morel, M, Kestelyn, P, Van den Abeele, K, Jacobs, K, Decock, C, Goethals, M, Pourjavan, S, Maris, K, Deghislage, C, Kersten, I, Vogel, A, Herkel, U, Schwenn, O, Maser-Wahle, M, Funk, J, Schmidt, B, Akbariyeh, N, Burk, R, Thomsen, A, Grehn, F, Marquardt, D, Orzalesi, N, Rossetti, L, Ferrante, M, Mandelli, L, Marini, S, Bertoni, G, Blini, M, De Molfetta, M, Bonomi, L, Morbio, R, Marraffa, M, Maraini, G, Gandolfi, S, Williams, S, Cimino, L, Dondi, P, Lumbroso, B, Manni, G, Cocco, F, Glorialanza, G, Villani, Cm, Pocobelli, A, Cesareo, M, Cupo, G, Neuschuler, R, Pernini, C, Catalani, R, Ribeiro, L, Faria, I, Pereira, Jm, Chingui, S, Duarte, L, Carvalheira, F, Baltar, A, Simao, A, Arede, J, Magalhaes, A, Abrantes, P, Reina, M, Silva, Jp, Romano, G, Silva, S, Torri, V, Poli, D, Nerviani, C, Tinazzi, A, Floriani, I, Adamsons, I, Caprioli, J, Wormald, R, Heijl, A, Airaksinen, J, Michaelis, J, Shedden, A, Gottfried, E, Hutzelmann, J, Rusk, C, Reines, S, Spector, R, Hombrey, J, Snyder, H, Gacos, J, Snapinn, S, Getson, A, Amos, J, Serruys, K, Malbecq, W, John, E, Chapman, J, Beck, J, Tessi, C, Rao, N, Bottari, Fp, D'Achille, R, Wilkins, A, Bauer, C, Derouwaux, C, Van der Straeten, A, Cunha, M, Santana, R, Andrade, Lg, Bule, S, Melo, R, Baumont, H, and Bonaventura, I

Subjects
medicine.medical_specialty, genetic structures, Optic Disk, Optic disk, Glaucoma, Interobserver reproducibility, Cohen's kappa, Double-Blind Method, Ophthalmology, Optic Nerve Diseases, medicine, Photography, Humans, Observer Variation, Reproducibility, business.industry, Outcome measures, Reproducibility of Results, medicine.disease, eye diseases, Confidence interval, medicine.anatomical_structure, sense organs, business, Optic disc
Abstract

PURPOSE To determine the reproducibility of the assessment for glaucomatous change in serial optic disc stereo-slides. DESIGN Masked interobserver variability study. PARTICIPANTS Serial optic disc stereo-slides from 40 patients. METHODS Three independent ophthalmologists evaluated for change a set of two serial 20 degrees optic disc color stereo-slides of 40 patients. This test set was not from European Glaucoma Prevention Study (EGPS) patients. Each observer performed two evaluations at least 30 days apart and was masked from the temporal sequence of the slides and his or her previous evaluation. Each patient was graded as changed or stable by two-out-of-three agreement. A kappa statistic was used to calculate the intra- and interobserver reproducibility as well as the assignment reproducibility (first consensus versus second consensus). The same procedure was followed to test the reproducibility when another experienced ophthalmologist was added to one of the three reading centers. MAIN OUTCOME MEASURES Reproducibility in evaluating glaucomatous optic disc change. RESULTS The intraobserver reproducibility (95% confidence interval [CI]) in the evaluation of change ranged between 0.79 (0.45-1.14) and 1.00 (0.69-1.31). The interobserver reproducibility (95% CI) in the evaluation of change ranged between 0.45 (0.15-0.75) and 0.75 (0.44-1.06). The assignment reproducibility (first consensus versus second consensus in the evaluation of change) between the senior EGPS readers was 0.94 (0.63-1.25). The assignment reproducibility when another experienced ophthalmologist replaced one of the readers was 0.94 (0.63-1.25). CONCLUSIONS The assignment reproducibility of three expert readers looking for glaucomatous change in serial optic disc stereo-slides was excellent. It remained so when one of the three experts was replaced by another experienced reader.

Published
2003

10. Association of Systemic Medication Use with Glaucoma and Intraocular Pressure: The European Eye Epidemiology Consortium.

Author

Vergroesen JE, Schuster AK, Stuart KV, Asefa NG, Cougnard-Grégoire A, Delcourt C, Schweitzer C, Barreto P, Coimbra R, Foster PJ, Luben RN, Pfeiffer N, Stingl JV, Kirsten T, Rauscher FG, Wirkner K, Jansonius NM, Arnould L, Creuzot-Garcher CP, Stricker BH, Keskini C, Topouzis F, Bertelsen G, Eggen AE, Bikbov MM, Jonas JB, Klaver CCW, Ramdas WD, and Khawaja AP

Subjects
Humans, Antihypertensive Agents adverse effects, Adrenergic beta-Antagonists adverse effects, Calcium Channel Blockers, Diuretics, Hypoglycemic Agents, Lipids, Intraocular Pressure, Glaucoma drug therapy, Glaucoma epidemiology
Abstract

Purpose: To investigate the association of commonly used systemic medications with glaucoma and intraocular pressure (IOP) in the European population., Design: Meta-analysis of 11 population-based cohort studies of the European Eye Epidemiology Consortium., Participants: The glaucoma analyses included 143 240 participants and the IOP analyses included 47 177 participants., Methods: We examined associations of 4 categories of systemic medications-antihypertensive medications (β-blockers, diuretics, calcium channel blockers [CCBs], α-agonists, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers), lipid-lowering medications, antidepressants, and antidiabetic medications-with glaucoma prevalence and IOP. Glaucoma ascertainment and IOP measurement method were according to individual study protocols. Results of multivariable regression analyses of each study were pooled using random effects meta-analyses. Associations with antidiabetic medications were examined in participants with diabetes 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], 1.23; 95% confidence interval [CI], 1.08 to 1.39). This association was stronger for monotherapy of CCBs with direct cardiac effects (OR, 1.96; 95% CI, 1.23 to 3.12). No other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were associated with glaucoma. Use of systemic β-blockers was associated with a lower IOP (β coefficient, -0.33 mmHg; 95% CI, -0.57 to -0.08 mmHg). Monotherapy of both selective systemic β-blockers (β coefficient, -0.45 mmHg; 95% CI -0.74 to -0.16 mmHg) and nonselective systemic β-blockers (β coefficient, -0.54 mmHg; 95% CI, -0.94 to -0.15 mmHg) was associated with lower IOP. A suggestive association was found between use of high-ceiling diuretics and lower IOP (β coefficient, -0.30 mmHg; 95% CI, -0.47 to -0.14 mmHg) but not when used as monotherapy. No other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were 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 β-blocker use. Both findings potentially are important, given that patients with glaucoma frequently use systemic antihypertensive medications. Determining causality of the CCB association should be a research priority., Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article., (Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Published
2023
Full Text
View/download PDF

11. Five-Year Cumulative Incidence and Progression of Myopic Maculopathy in a German Population.

Author

Hopf S, Heidt F, Korb CA, Schulz A, Münzel T, Wild PS, Beutel M, Schmidtmann I, Lackner KJ, Pfeiffer N, and Schuster AK

Subjects
Adult, Aged, Cohort Studies, Female, Fundus Oculi, Humans, Incidence, Middle Aged, Risk Factors, Visual Acuity, Macular Degeneration complications, Macular Degeneration diagnosis, Macular Degeneration epidemiology, Myopia, Degenerative complications, Myopia, Degenerative diagnosis, Myopia, Degenerative epidemiology, Retinal Diseases complications, Retinal Diseases diagnosis, Retinal Diseases epidemiology
Abstract

Purpose: To investigate the 5-year cumulative incidence and progression of myopic maculopathy in the general population in Germany and to analyze potential risk factors., Design: The Gutenberg Health Study (GHS) is a population-based cohort study including 15 010 participants aged 35 to 74 years at baseline., Participants: A total of 494 eyes of 323 participants (mean age, 50.2 ± 9.2 years; median, -7.25 diopters [D] myopic refractive error) without myopic maculopathy at baseline and 34 eyes of 27 subjects (mean age, 56.7 ± 9.1 years; median, -8.75 D myopic refractive error) with myopic maculopathy met the inclusion conditions, phakic eyes with spherical equivalent ≤-6 D (baseline), and had gradable fundus photographs at baseline and 5-year follow-up., Methods: Myopic maculopathy incidence and progression were assessed by grading of fundus photographs according to a recent international photographic classification system (META-PM). Multivariable logistic regression analysis was used to assess risk factors for progression of myopic maculopathy., Main Outcome Measures: Estimates for incidence and progression of myopic maculopathy., Results: The 5-year cumulative incidence of myopic maculopathy was 0.3% (95% confidence interval [CI], 0.02-1.99; n = 1). Progression occurred in 17 of 34 eyes (50%) with prior myopic maculopathy over 5 years with 4 changes in category. The most common types of progression were enlargement of diffuse and patchy chorioretinal atrophy; a new pathology was present in 8 eyes. Higher intraocular pressure (IOP) (odds ratio [OR], 1.62; 95% CI, 1.51-1.59; P = 0.035) was associated with progression of myopic maculopathy. Female gender (OR, 5.54; 95% CI, 0.93-32.92; P = 0.060) and higher myopic refractive error (OR, 1.62 per diopter; 95% CI, 0.99-1.49; P = 0.063) showed a tendency toward progression., Conclusions: Incidence of myopic maculopathy is rare in highly myopic eyes in the general population aged 35 to 74 years in Germany. Progression of myopic maculopathy in the German population occurred in 50% of highly myopic eyes. We presented population-based 5-year follow-up data on incidence and progression of myopic maculopathy in Europe., (Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Published
2022
Full Text
View/download PDF

13. Prevalence of Strabismus and Its Impact on Vision-Related Quality of Life: Results from the German Population-Based Gutenberg Health Study.

Author

Fieß A, Elflein HM, Urschitz MS, Pesudovs K, Münzel T, Wild PS, Michal M, Lackner KJ, Pfeiffer N, Nickels S, and Schuster AK

Subjects
Cross-Sectional Studies, Female, Germany epidemiology, Humans, Male, Middle Aged, Prevalence, Strabismus psychology, Population Surveillance, Quality of Life, Strabismus epidemiology, Visual Acuity physiology
Abstract

Purpose: This study investigates the prevalence of manifest strabismus and its subtypes in adulthood and analyzes the risk factors and its impact on vision-related quality of life (VRQoL)., Design: The Gutenberg Health Study (GHS) is a population-based, observational cohort study. A cross-sectional analysis of the baseline examination was conducted., Participants: Participants aged 35 to 74 years were included (n = 15  010)., Methods: All participants were examined with a comprehensive ophthalmologic and general examination including the Hirschberg corneal reflex test to detect manifest strabismus. The following risk factors were analyzed: age, sex, socioeconomic status, birth weight, maternal age at birth, anisometropia, astigmatism, spherical equivalent, low visual acuity in the worse seeing eye (≥1.3 logMAR), and cardiovascular factors, and included in multivariable logistic regression analysis. Lifetime period prevalence and point prevalence of manifest strabismus were computed, and VRQoL was compared between participants with and without strabismus., Main Outcome Measure: Strabismus prevalence., Results: A total of 14  700 participants (age, 55.0±11.1 years; 49.5% were female) were included in this analysis. The weighted prevalence of ever having strabismus was 2.9% (2.6%-3.2%), and the point prevalence for concomitant strabismus was 2.5% (2.3%-2.8%). Esotropia was twice as frequent as exotropia, and 2 participants had paralytic strabismus. Concomitant strabismus was associated with age 65 to 69 years (odds ratio [OR], 0.13 [0.05-0.39], P < 0.001); age 70 to 74 years (OR, 0.14 [0.05-0.4], P < 0.001); anisometropia (>1.0 diopters [D]: OR, 3.61 [2.32-5.62], P < 0.001; >2.0 D: OR, 6.93 [4.23-11.35], P < 0.001); astigmatism (≥1.0 D: OR, 2.09 [1.42-3.08], P < 0.001; ≥2.0 D: OR, 3.74 [2.35-5.97], P < 0.001); spherical equivalent (per diopter: OR, 1.43 [1.33-1.53], P < 0.001); and low visual acuity in the worse seeing eye (≥1.3 logMAR: OR, 21.7 [11.2-42.0], P < 0.001). VRQoL was lower in participants with strabismus compared with participants without strabismus in adjusted analysis (B = -5.96, P < 0.001)., Conclusions: Strabismus is a frequent chronic eye condition that is associated with a lower VRQoL. Individuals with anisometropia, astigmatism, and hyperopia are more likely to have strabismus. In addition, low visual acuity in the worse eye was linked to strabismus prevalence., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Published
2020
Full Text
View/download PDF

14. Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future.

Author

Colijn JM, Buitendijk GHS, Prokofyeva E, Alves D, Cachulo ML, Khawaja AP, Cougnard-Gregoire A, Merle BMJ, Korb C, Erke MG, Bron A, Anastasopoulos E, Meester-Smoor MA, Segato T, Piermarocchi S, de Jong PTVM, Vingerling JR, Topouzis F, Creuzot-Garcher C, Bertelsen G, Pfeiffer N, Fletcher AE, Foster PJ, Silva R, Korobelnik JF, Delcourt C, and Klaver CCW

Subjects
Age Distribution, Aged, Aged, 80 and over, Europe epidemiology, Female, Forecasting, Geographic Atrophy physiopathology, Humans, Male, Middle Aged, Prevalence, Risk Factors, Sex Distribution, Visual Acuity physiology, Wet Macular Degeneration physiopathology, White People statistics & numerical data, Geographic Atrophy epidemiology, Wet Macular Degeneration epidemiology
Abstract

Purpose: Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future., Design: Meta-analysis of prevalence data., Participants: A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe., Methods: AMD was diagnosed based on fundus photographs using the Rotterdam Classification. Prevalence of early and late AMD was calculated using random-effects meta-analysis stratified for age, birth cohort, gender, geographic region, and time period of the study. Best-corrected visual acuity (BCVA) was compared between late AMD subtypes; geographic atrophy (GA) and choroidal neovascularization (CNV)., Main Outcome Measures: Prevalence of early and late AMD, BCVA, and number of AMD cases., Results: Prevalence of early AMD increased from 3.5% (95% confidence interval [CI] 2.1%-5.0%) in those aged 55-59 years to 17.6% (95% CI 13.6%-21.5%) in those aged ≥85 years; for late AMD these figures were 0.1% (95% CI 0.04%-0.3%) and 9.8% (95% CI 6.3%-13.3%), respectively. We observed a decreasing prevalence of late AMD after 2006, which became most prominent after age 70. Prevalences were similar for gender across all age groups except for late AMD in the oldest age category, and a trend was found showing a higher prevalence of CNV in Northern Europe. After 2006, fewer eyes and fewer ≥80-year-old subjects with CNV were visually impaired (P = 0.016). Projections of AMD showed an almost doubling of affected persons despite a decreasing prevalence. By 2040, the number of individuals in Europe with early AMD will range between 14.9 and 21.5 million, and for late AMD between 3.9 and 4.8 million., Conclusion: We observed a decreasing prevalence of AMD and an improvement in visual acuity in CNV occuring over the past 2 decades in Europe. Healthier lifestyles and implementation of anti-vascular endothelial growth factor treatment are the most likely explanations. Nevertheless, the numbers of affected subjects will increase considerably in the next 2 decades. AMD continues to remain a significant public health problem among Europeans., (Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Published
2017
Full Text
View/download PDF

15. A Randomized Trial of a Schlemm's Canal Microstent with Phacoemulsification for Reducing Intraocular Pressure in Open-Angle Glaucoma.

Author

Pfeiffer N, Garcia-Feijoo J, Martinez-de-la-Casa JM, Larrosa JM, Fea A, Lemij H, Gandolfi S, Schwenn O, Lorenz K, and Samuelson TW

Subjects
Adult, Aged, Aged, 80 and over, Antihypertensive Agents administration & dosage, Female, Follow-Up Studies, Glaucoma, Open-Angle physiopathology, Humans, Lens Implantation, Intraocular, Male, Middle Aged, Prospective Studies, Prosthesis Implantation, Single-Blind Method, Tonometry, Ocular, Visual Acuity physiology, Visual Fields, Young Adult, Glaucoma Drainage Implants, Glaucoma, Open-Angle surgery, Intraocular Pressure physiology, Limbus Corneae surgery, Phacoemulsification, Stents
Abstract

Purpose: To assess the safety and effectiveness of the Hydrus Microstent (Ivantis, Inc, Irvine, CA) with concurrent cataract surgery (CS) for reducing intraocular pressure (IOP) in open-angle glaucoma (OAG)., Design: Prospective, multicenter, randomized, single-masked, controlled clinical trial., Participants: One hundred eyes from 100 patients 21 to 80 years of age with OAG and cataract with IOP of 24 mmHg or less with 4 or fewer hypotensive medications and a washed-out diurnal IOP (DIOP) of 21 to 36 mmHg., Methods: On the day of surgery, patients were randomized 1:1 to undergo CS with the microstent or CS alone. Postoperative follow-up was at 1 day, 1 week, and 1, 3, 6, 12, 18, and 24 months. Washout of hypotensive medications was repeated at 12 and 24 months., Main Outcome Measures: Response to treatment was defined as a 20% or more decrease in washed out DIOP at 12 and 24 months of follow-up compared with baseline. Mean DIOP at 12 and 24 months, the proportion of subjects requiring medications at follow-up, and the mean number of medications were analyzed. Safety measures included change in visual acuity, slit-lamp observations, and adverse events., Results: The proportion of patients with a 20% reduction in washed out DIOP was significantly higher in the Hydrus plus CS group at 24 months compared with the CS group (80% vs. 46%; P = 0.0008). Washed out mean DIOP in the Hydrus plus CS group was significantly lower at 24 months compared with the CS group (16.9±3.3 mmHg vs. 19.2±4.7 mmHg; P = 0.0093), and the proportion of patients using no hypotensive medications was significantly higher at 24 months in the Hydrus plus CS group (73% vs. 38%; P = 0.0008). There were no differences in follow-up visual acuity between groups. The only notable device-related adverse event was focal peripheral anterior synechiae (1-2 mm in length). Otherwise, adverse event frequency was similar in the 2 groups., Conclusions: Intraocular pressure was clinically and statistically significantly lower at 2 years in the Hydrus plus CS group compared with the CS alone group, with no differences in safety., (Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Published
2015
Full Text
View/download PDF

16. Increasing Prevalence of Myopia in Europe and the Impact of Education.

Author

Williams KM, Bertelsen G, Cumberland P, Wolfram C, Verhoeven VJ, Anastasopoulos E, Buitendijk GH, Cougnard-Grégoire A, Creuzot-Garcher C, Erke MG, Hogg R, Höhn R, Hysi P, Khawaja AP, Korobelnik JF, Ried J, Vingerling JR, Bron A, Dartigues JF, Fletcher A, Hofman A, Kuijpers RW, Luben RN, Oxele K, Topouzis F, von Hanno T, Mirshahi A, Foster PJ, van Duijn CM, Pfeiffer N, Delcourt C, Klaver CC, Rahi J, and Hammond CJ

Subjects
Adult, Age Distribution, Aged, Aged, 80 and over, Cross-Sectional Studies, Ethnicity, Europe epidemiology, Female, Humans, Male, Middle Aged, Prevalence, Risk Factors, Sex Distribution, Educational Status, European Union statistics & numerical data, Myopia epidemiology
Abstract

Purpose: To investigate whether myopia is becoming more common across Europe and explore whether increasing education levels, an important environmental risk factor for myopia, might explain any temporal trend., Design: Meta-analysis of population-based, cross-sectional studies from the European Eye Epidemiology (E(3)) Consortium., Participants: The E(3) Consortium is a collaborative network of epidemiological studies of common eye diseases in adults across Europe. Refractive data were available for 61 946 participants from 15 population-based studies performed between 1990 and 2013; participants had a range of median ages from 44 to 78 years., Methods: Noncycloplegic refraction, year of birth, and highest educational level achieved were obtained for all participants. Myopia was defined as a mean spherical equivalent ≤-0.75 diopters. A random-effects meta-analysis of age-specific myopia prevalence was performed, with sequential analyses stratified by year of birth and highest level of educational attainment., Main Outcome Measures: Variation in age-specific myopia prevalence for differing years of birth and educational level., Results: There was a significant cohort effect for increasing myopia prevalence across more recent birth decades; age-standardized myopia prevalence increased from 17.8% (95% confidence interval [CI], 17.6-18.1) to 23.5% (95% CI, 23.2-23.7) in those born between 1910 and 1939 compared with 1940 and 1979 (P = 0.03). Education was significantly associated with myopia; for those completing primary, secondary, and higher education, the age-standardized prevalences were 25.4% (CI, 25.0-25.8), 29.1% (CI, 28.8-29.5), and 36.6% (CI, 36.1-37.2), respectively. Although more recent birth cohorts were more educated, this did not fully explain the cohort effect. Compared with the reference risk of participants born in the 1920s with only primary education, higher education or being born in the 1960s doubled the myopia prevalence ratio-2.43 (CI, 1.26-4.17) and 2.62 (CI, 1.31-5.00), respectively-whereas individuals born in the 1960s and completing higher education had approximately 4 times the reference risk: a prevalence ratio of 3.76 (CI, 2.21-6.57)., Conclusions: Myopia is becoming more common in Europe; although education levels have increased and are associated with myopia, higher education seems to be an additive rather than explanatory factor. Increasing levels of myopia carry significant clinical and economic implications, with more people at risk of the sight-threatening complications associated with high myopia., (Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Published
2015
Full Text
View/download PDF

17. Myopia and level of education: results from the Gutenberg Health Study.

Author

Mirshahi A, Ponto KA, Hoehn R, Zwiener I, Zeller T, Lackner K, Beutel ME, and Pfeiffer N

Subjects
Adult, Age Factors, Aged, Cohort Studies, Cross-Sectional Studies, Education, Professional statistics & numerical data, Educational Status, Female, Germany epidemiology, Humans, Linear Models, Male, Middle Aged, Polymorphism, Single Nucleotide, Refractive Errors epidemiology, Sex Factors, Myopia epidemiology
Abstract

Purpose: To analyze the association between myopia and educational level in an adult European cohort., Design: Population-based cross-sectional study., Participants: A cohort of the Gutenberg Health Study, including 4658 eligible enrollees between 35 and 74 years of age., Methods: We applied a standardized protocol entailing a comprehensive questionnaire; thorough ophthalmic, general, cardiovascular, and psychological examinations; and laboratory tests, including genetic analyses. We documented achievement levels in school education and post-school professional education. The spherical equivalent (SE) was determined by noncycloplegic autorefractometry. We fitted mixed linear models including age, gender, and 45 myopia-associated single nucleotide polymorphisms (SNP) as covariates., Main Outcome Measures: Prevalence and magnitude of myopia in association with years spent in school and level of post-school professional education., Results: Individuals who graduated from school after 13 years were more myopic (median, -0.5 diopters [D]; first quartile [Q1]/third quartile [Q3], -2.1/0.3 D) than those who graduated after 10 years (median, -0.2 D; Q1/Q3, -1.3/0.8 D), than those who graduated after 9 years (median, 0.3 D; Q1/Q3, -0.6/1.4 D), and than those who never finished secondary school (median, 0.2 D; Q1/Q3, -0.5/1.8 D; P<0.001, respectively). The same holds true for persons with a university degree (median, -0.6 D; Q1/Q3, -2.3/0.3 D) versus those who finished secondary vocational school (median, 0 D; Q1/Q3, -1.1/0.8 D) or primary vocational school (median, 0 D; Q1/Q3, -0.9/1.1 D) versus persons without any post-school professional qualification (median, 0.6 D; Q1/Q3, -0.4/1.7 D; P<0.001, respectively). Of persons who graduated from school after 13 years, 50.9% were myopic (SE, ≤-0.5 D) versus 41.6%, 27.1%, and 26.9% after 10 years, in those who graduated after 9 years, and in those who never graduated from secondary school, respectively (P<0.001). In university graduates, the proportion of myopic persons was higher (53%) than that of those who graduated from secondary (34.8%) or primary (34.7%) vocational schools and than in those without any professional training (23.9%; P<0.001, respectively). In multivariate analyses: higher school and professional levels of education were associated with a more myopic SE independent of gender. There was a small effect of age and SNPs., Conclusions: Higher levels of school and post-school professional education are associated with a more myopic refraction. Participants with higher educational achievements more often were myopic than individuals with less education., (Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Published
2014
Full Text
View/download PDF

18. Distribution of intraocular pressure and its association with ocular features and cardiovascular risk factors: the Gutenberg Health Study.

Author

Hoehn R, Mirshahi A, Hoffmann EM, Kottler UB, Wild PS, Laubert-Reh D, and Pfeiffer N

Subjects
Adult, Age Factors, Aged, Cross-Sectional Studies, Female, Germany epidemiology, Humans, Male, Middle Aged, Ocular Hypertension epidemiology, Prevalence, Prospective Studies, Regression Analysis, Risk Factors, Sex Factors, Cardiovascular Diseases etiology, Intraocular Pressure physiology, Ocular Hypertension physiopathology
Abstract

Purpose: To describe the distribution of intraocular pressure (IOP) and its association with ocular features and cardiovascular risk factors in an adult European cohort., Design: Population-based, cross-sectional study., Participants: This analysis was based on a Gutenberg Health Study (GHS) cohort that included 4335 eligible enrollees from among 5000 subjects who participated in the survey from 2007 through 2008. The age range was 35 to 74 years at enrollment., Methods: Participants underwent a standardized protocol with a comprehensive questionnaire; ophthalmic examination including slit-lamp biomicroscopy, noncontact tonometry, fundus photography, central corneal thickness measurement, and visual field testing; and a thorough general examination focused on cardiovascular parameters, psychological evaluation, and laboratory tests, including genetic analysis., Main Outcome Measures: Mean and reference interval of IOP stratified by age, gender, and eye., Results: Mean ± standard deviation (SD) IOP was 14.0 ± 2.6 mmHg in both eyes, 13.9 ± 2.7 mmHg in right eyes, and 14.0 ± 2.7 mmHg in left eyes. Mean ± SD IOP in men (n = 2216) and in women (n = 2119) was 14.1 ± 2.7 mmHg and 13.9 ± 2.5 mmHg with an intersex difference (P = 0.009). Positive univariate associations with higher IOP were detected for brown iris color, central corneal thickness, hypertension, diabetes, smoking, obesity, dyslipidemia, body mass index, weight, hip size (women only), waist circumference, and waist-to-hip ratio. Multivariate testing revealed male gender, central corneal thickness, brown iris color, hypertension, smoking, and waist-to-hip ratio to be correlated with higher IOP. In women, age correlated negatively with IOP in the multivariate analysis., Conclusions: Intraocular pressure distribution in this cohort yielded a lower mean IOP than in similar white study populations. Increasing age in women correlated with lower IOP. Association analyses with several systemic characteristics revealed that cardiovascular risk factors correlated with higher IOP., Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article., (Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Published
2013
Full Text
View/download PDF

19. Clinical relevance of thyroid-stimulating immunoglobulins in graves' ophthalmopathy.

Author

Ponto KA, Kanitz M, Olivo PD, Pitz S, Pfeiffer N, and Kahaly GJ

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Biological Assay, Biomarkers blood, Cross-Sectional Studies, Diplopia blood, Diplopia physiopathology, Female, Graves Ophthalmopathy physiopathology, Humans, Male, Middle Aged, Prevalence, Sensitivity and Specificity, Severity of Illness Index, Young Adult, Graves Ophthalmopathy immunology, Immunoglobulins, Thyroid-Stimulating blood
Abstract

Purpose: Thyroid-stimulating immunoglobulins (TSIs) likely mediate Graves' ophthalmopathy (GO). The clinical relevance of these functional autoantibodies was assessed in GO., Design: Cross-sectional trial., Participants: A total of 108 untreated patients with GO., Methods: Thyroid-stimulating immunoglobulins, assessed with a novel bioassay, bind to the thyrotropin receptor (TSHR) and transmit signals for cyclic adenosine monophosphate (cAMP)-dependent activation of luciferase gene expression. The cAMP/cAMP response element-binding protein/cAMP-regulatory element complex induces luciferase that is quantified after cell lysis. The TSI levels were correlated with activity and severity of GO and compared with a TSHR binding inhibitory immunoglobulin (TBII) assay., Main Outcome Measures: Thyroid-stimulating immunoglobulins, activity and severity of GO, diplopia, and TBII., Results: Thyroid-stimulating immunoglobulins were detected in 106 of 108 patients (98%) with GO. All 53 hyperthyroid patients were TSI positive versus 47 patients (89%) who were TBII positive. All 69 patients with active GO were TSI positive, whereas only 58 of 69 patients (84%) were TBII positive. Thyroid-stimulating immunoglobulins correlated with the activity (r=0.83, P < 0.001) and severity (r=0.81, P < 0.001) of GO. All 59 patients with GO with diplopia were TSI positive, and 50 of 59 patients (85%) were TBII positive. Among patients with moderate-to-severe and mild GO, 75 of 75 (100%) and 31 of 33 (94%) were TSI positive compared with TBII positivity in 63 of 75 (84%) and 24 of 33 (73%), respectively. The TSI levels were higher in moderate-to-severe versus mild GO (489%±137% vs. 251%±100%, P < 0.001). Chemosis and GO activity predicted TSI levels alone (P < 0.001, multivariable analysis). The TSI levels were higher in patients with chemosis (527%±131%) than in patients without chemosis (313%±127%, P < 0.001)., Conclusions: Thyroid-stimulating immunoglobulins show more significant association with clinical features of GO than TBII and may be regarded as functional biomarkers for GO., Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references., (Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Published
2011
Full Text
View/download PDF

20. Central corneal thickness in the European Glaucoma Prevention Study.

Author

Pfeiffer N, Torri V, Miglior S, Zeyen T, Adamsons I, and Cunha-Vaz J

Subjects
Adult, Age Factors, Aged, Diabetes Complications, Double-Blind Method, Female, Humans, Male, Middle Aged, Ocular Hypertension physiopathology, Sex Factors, Ultrasonography, Cornea diagnostic imaging, Glaucoma prevention & control, Intraocular Pressure drug effects, Ocular Hypertension diagnostic imaging, Ocular Hypertension drug therapy, Sulfonamides therapeutic use, Thiophenes therapeutic use
Abstract

Purpose: To measure central corneal thickness (CCT) within the participants of the European Glaucoma Prevention Study (EGPS). This study was designed to test if lowering intraocular pressure (IOP) by means of dorzolamide is able to prevent or delay conversion from ocular hypertension to glaucoma., Design: Randomized, double-masked, controlled, observational clinical trial., Participants: Eight hundred fifty-four of 1077 ocular hypertensive participants within the EGPS were investigated. Four hundred twenty-nine patients were treated with dorzolamide and 425 patients received placebo., Intervention: Treatment with dorzolamide or placebo (the vehicle of dorzolamide) in 1 or both eyes., Main Outcome Measures: Central corneal thickness as measured by ultrasound pachymetry (DGH-500 Pachette; DGH Technologies, Exton, PA). The CCT measurements were obtained in the morning before measuring IOP. Five measurements were taken from each eye of each patient within 5 minutes of application of anesthetic eye drops., Results: Mean CCT was 572.6+/-37.4 microm (range, 458.5-695.6 microm). The CCT was higher in younger patients, male patients, and diabetic patients. Mean CCTs for the 429 patients receiving dorzolamide were 574.2+/-38.48 microm (range, 458.5-695.6 microm) and 571.0+/-36.21 microm (469.7-690.1 microm) for the 425 patients receiving placebo (P = 0.205). Central corneal thickness did not correlate with refraction, baseline IOP, or systemic hypertension., Conclusion: Central corneal thickness measurements within the EGPS were greater than those reported in other studies of normal eyes without ocular hypertension. Larger CCT measurements correlated with male gender, younger age, and diabetes.

Published
2007
Full Text
View/download PDF

21. Predictive factors for open-angle glaucoma among patients with ocular hypertension in the European Glaucoma Prevention Study.

Author

Miglior S, Pfeiffer N, Torri V, Zeyen T, Cunha-Vaz J, and Adamsons I

Subjects
Antihypertensive Agents therapeutic use, Disease Progression, Double-Blind Method, Europe, Female, Glaucoma, Open-Angle diagnosis, Glaucoma, Open-Angle prevention & control, Humans, Intraocular Pressure drug effects, Male, Middle Aged, Ocular Hypertension drug therapy, Prognosis, Proportional Hazards Models, Risk Factors, Sulfonamides therapeutic use, Thiophenes therapeutic use, Visual Acuity, Glaucoma, Open-Angle etiology, Ocular Hypertension complications
Abstract

Objective: To evaluate the predictive factors of open-angle glaucoma (OAG) in patients affected by ocular hypertension enrolled in the European Glaucoma Prevention Study (EGPS)., Design: Randomized, double-masked, controlled clinical trial., Participants: One thousand seventy-seven patients, > or =30 years old, were enrolled at 18 European centers. The patients met inclusion criteria: intraocular pressure, 22 to 29 mmHg; 2 normal and reliable visual fields (VFs) (on the basis of mean deviation and corrected pattern standard deviation [PSD]); and a normal optic disc, as determined by an optic disc reading center., Intervention: Treatment with dorzolamide or a placebo (the vehicle of dorzolamide) in one or both eyes., Main Outcome Measures: Efficacy end points were VF and/or optic disc changes. Baseline demographic and clinical data were collected before randomization, except for corneal thickness measurements, which were determined during follow-up. Proportional hazards models were used to identify factors that predicted which participants in the EGPS had developed OAG., Results: In multivariate analyses, factors that predicted the development of OAG included older age (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.04-1.69), larger vertical cup-to-disc (C/D) ratio (HR, 1.34; 95% CI, 1.14-1.58), larger vertical C/D ratio asymmetry (HR, 1.46; 95% CI, 1.11-1.93), higher PSD (HR, 1.66; 95% CI, 1.15-2.38), and lesser central corneal thickness (HR, 1.32; 95% CI, 1.05-1.67)., Conclusions: Baseline age, vertical C/D ratio, vertical C/D ratio asymmetry, and PSD were good predictors of the onset of OAG in the EGPS. Central corneal thickness was found to be a powerful predictor of the development of OAG. The EGPS results agree with the findings of the Ocular Hypertension Treatment Study and support the need for a thorough evaluation of patients with ocular hypertension.

Published
2007
Full Text
View/download PDF

22. Results of the European Glaucoma Prevention Study.

Author

Miglior S, Zeyen T, Pfeiffer N, Cunha-Vaz J, Torri V, and Adamsons I

Subjects
Administration, Topical, Adult, Aged, Aged, 80 and over, Carbonic Anhydrase Inhibitors administration & dosage, Carbonic Anhydrase Inhibitors adverse effects, Disease Progression, Double-Blind Method, Europe, Female, Humans, Incidence, Male, Middle Aged, Ocular Hypertension drug therapy, Quality Assurance, Health Care, Safety, Sulfonamides administration & dosage, Sulfonamides adverse effects, Thiophenes administration & dosage, Thiophenes adverse effects, Treatment Outcome, Carbonic Anhydrase Inhibitors therapeutic use, Glaucoma, Open-Angle prevention & control, Intraocular Pressure drug effects, Sulfonamides therapeutic use, Thiophenes therapeutic use
Abstract

Objective: The European Glaucoma Prevention Study (EGPS) seeks to evaluate the efficacy of reduction of intraocular pressure (IOP) by dorzolamide in preventing or delaying primary open-angle glaucoma (POAG) in patients affected by ocular hypertension (OHT)., Design: Randomized, double-masked, controlled clinical trial., Participants: One thousand eighty-one patients (age, > or =30 years) were enrolled by 18 European centers. The patients fulfilled a series of inclusion criteria, including: IOP 22 to 29 mmHg; 2 normal and reliable visual fields (on the basis of mean deviation and corrected pattern standard deviation or corrected loss variance of standard 30/II Humphrey or Octopus perimetry); normal optic disc as determined by the Optic Disc Reading Center., Intervention: Patients were randomized to treatment with dorzolamide or placebo (the vehicle of dorzolamide)., Main Outcome Measures: Efficacy end points were visual field, optic disc changes, or both. A visual field change during follow-up had to be confirmed by 2 further positive tests. Optic disc change was defined on the basis of the agreement of 2 of 3 independent observers evaluating optic disc stereo slides. The safety end point was an IOP of more than 35 mmHg on 2 consecutive examinations., Results: During the course of the study, the mean percent reduction in IOP in the dorzolamide group was 15% after 6 months and 22% after 5 years. Mean IOP declined by 9% after 6 months and by 19% after 5 years in the placebo group. At 60 months, the cumulative probability of converting to an efficacy end point was 13.4% in the dorzolamide group and 14.1% in the placebo group (hazard ratio, 0.86; 95% confidence interval [CI], 0.58-1.26; P = 0.45). The cumulative probability of developing an efficacy or a safety end point was 13.7% in the dorzolamide group and 16.4% in the placebo group (hazard ratio, 0.73; 95% CI, 0.51-1.06; P = 0.1)., Conclusions: Dorzolamide reduced IOP by 15% to 22% throughout the 5 years of the trial. However, the EGPS failed to detect a statistically significant difference between medical therapy and placebo in reducing the incidence of POAG among a large population of OHT patients at moderate risk for developing POAG, because placebo also significantly and consistently lowered IOP.

Published
2005
Full Text
View/download PDF

23. Reproducibility of evaluation of optic disc change for glaucoma with stereo optic disc photographs.

Author

Zeyen T, Miglior S, Pfeiffer N, Cunha-Vaz J, and Adamsons I

Subjects
Double-Blind Method, Glaucoma classification, Humans, Observer Variation, Optic Nerve Diseases classification, Reproducibility of Results, Glaucoma diagnosis, Optic Disk pathology, Optic Nerve Diseases diagnosis, Photography methods
Abstract

Purpose: To determine the reproducibility of the assessment for glaucomatous change in serial optic disc stereo-slides., Design: Masked interobserver variability study., Participants: Serial optic disc stereo-slides from 40 patients., Methods: Three independent ophthalmologists evaluated for change a set of two serial 20 degrees optic disc color stereo-slides of 40 patients. This test set was not from European Glaucoma Prevention Study (EGPS) patients. Each observer performed two evaluations at least 30 days apart and was masked from the temporal sequence of the slides and his or her previous evaluation. Each patient was graded as changed or stable by two-out-of-three agreement. A kappa statistic was used to calculate the intra- and interobserver reproducibility as well as the assignment reproducibility (first consensus versus second consensus). The same procedure was followed to test the reproducibility when another experienced ophthalmologist was added to one of the three reading centers., Main Outcome Measures: Reproducibility in evaluating glaucomatous optic disc change., Results: The intraobserver reproducibility (95% confidence interval [CI]) in the evaluation of change ranged between 0.79 (0.45-1.14) and 1.00 (0.69-1.31). The interobserver reproducibility (95% CI) in the evaluation of change ranged between 0.45 (0.15-0.75) and 0.75 (0.44-1.06). The assignment reproducibility (first consensus versus second consensus in the evaluation of change) between the senior EGPS readers was 0.94 (0.63-1.25). The assignment reproducibility when another experienced ophthalmologist replaced one of the readers was 0.94 (0.63-1.25)., Conclusions: The assignment reproducibility of three expert readers looking for glaucomatous change in serial optic disc stereo-slides was excellent. It remained so when one of the three experts was replaced by another experienced reader.

Published
2003
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results