WorldWideScience

Sample records for non-nv amd patients

  1. MicroRNA signatures in vitreous humour and plasma of patients with exudative AMD

    OpenAIRE

    Ménard, Catherine; Rezende, Flavio A.; Miloudi, Khalil; Wilson, Ariel; Tétreault, Nicolas; Hardy, Pierre; SanGiovanni, John Paul; De Guire, Vincent; Sapieha, Przemyslaw

    2016-01-01

    Age-related macular degeneration (AMD) is a leading cause of blindness worldwide affecting individuals over the age of 50. The neovascular form (NV AMD) is characterized by choroidal neovascularization (CNV) and responsible for the majority of central vision impairment. Using non-biased microRNA arrays and individual TaqMan qPCRs, we profiled miRNAs in the vitreous humour and plasma of patients with NV AMD. We identified a disease-associated increase in miR-146a and a decrease in miR-106b and...

  2. Current barriers to treatment for wet age-related macular degeneration (wAMD): findings from the wAMD patient and caregiver survey

    Science.gov (United States)

    Varano, Monica; Eter, Nicole; Winyard, Steve; Wittrup-Jensen, Kim U; Navarro, Rafael; Heraghty, Julie

    2015-01-01

    Purpose A cross-sectional survey to evaluate the current management of wet age-related macular degeneration (wAMD) and to identify barriers to treatment from a patient and caregiver perspective. Methods An ophthalmologist-devised questionnaire was given to a global cohort of patients who were receiving (or had previously received) antivascular endothelial growth factor injections and to caregivers (paid and unpaid) to evaluate the impact of wAMD on their lives. Results Responders included 910 patients and 890 caregivers; wAMD was diagnosed in both eyes in 45% of patients, and 64% had been receiving injections for > 1 year. Many caregivers were a child/grandchild (47%) or partner (23%) of the patient; only 7% were professional caregivers. Most (73%) patients visited a health care professional within 1 month of experiencing vision changes and 54% began treatment immediately. Most patients and caregivers reported a number of obstacles in managing wAMD, including the treatment itself (35% and 39%, respectively). Sixteen percent of patients also missed a clinic visit. Conclusion Most patients seek medical assistance promptly for a change in vision; however, about a quarter of them do not. This highlights a lack of awareness surrounding eye health and the impact of a delayed diagnosis. Most patients and caregivers identified a number of obstacles in managing wAMD. PMID:26664038

  3. Current barriers to treatment for wet age-related macular degeneration (wAMD: findings from the wAMD patient and caregiver survey

    Directory of Open Access Journals (Sweden)

    Varano M

    2015-12-01

    Full Text Available Monica Varano,1 Nicole Eter,2 Steve Winyard,3 Kim U Wittrup-Jensen,4 Rafael Navarro,5 Julie Heraghty6On behalf of the wAMD Patient and Caregiver Survey Committee members1Department of Ophthalmology, Fondazione GB Bietti-IRCCS, Rome, Italy; 2Department of Ophthalmology, University of Münster, Münster, Germany; 3Department of Policy and Campaigns, Royal National Institute of Blind People, London, UK; 4Bayer Pharma AG, Berlin, Germany; 5Instituto de Microcirugía Ocular, Barcelona, Spain; 6Macular Disease Foundation Australia, Sydney, NSW, AustraliaPurpose: A cross-sectional survey to evaluate the current management of wet age-related macular degeneration (wAMD and to identify barriers to treatment from a patient and caregiver perspective.Methods: An ophthalmologist-devised questionnaire was given to a global cohort of patients who were receiving (or had previously received antivascular endothelial growth factor injections and to caregivers (paid and unpaid to evaluate the impact of wAMD on their lives.Results: Responders included 910 patients and 890 caregivers; wAMD was diagnosed in both eyes in 45% of patients, and 64% had been receiving injections for >1 year. Many caregivers were a child/grandchild (47% or partner (23% of the patient; only 7% were professional caregivers. Most (73% patients visited a health care professional within 1 month of experiencing vision changes and 54% began treatment immediately. Most patients and caregivers reported a number of obstacles in managing wAMD, including the treatment itself (35% and 39%, respectively. Sixteen percent of patients also missed a clinic visit.Conclusion: Most patients seek medical assistance promptly for a change in vision; however, about a quarter of them do not. This highlights a lack of awareness surrounding eye health and the impact of a delayed diagnosis. Most patients and caregivers identified a number of obstacles in managing wAMD.Keywords: antivascular endothelial growth factor

  4. Action on AMD. Optimising patient management: act now to ensure current and continual delivery of best possible patient care.

    Science.gov (United States)

    Amoaku, W; Blakeney, S; Freeman, M; Gale, R; Johnston, R; Kelly, S P; McLaughlan, B; Sahu, D; Varma, D

    2012-02-01

    In recent years, there have been significant advances in the clinical management of patients with wet age-related macular degeneration (wet AMD)--a rapidly progressing and potentially blinding degenerative eye disease. Wet AMD is responsible for more than half of registered severe sight impairment (blindness) in the United Kingdom, and patients who are being treated for wet AMD require frequent and long-term follow-up for treatment to be most effective. The clinical workload associated with the frequent follow-up required is substantial. Furthermore, as more new patients are diagnosed and the population continues to age, the patient population will continue to increase. It is thus vital that clinical services continue to adapt so that they can provide a fast and efficient service for patients with wet AMD. This Action on AMD document has been developed by eye health-care professionals and patient representatives, the Action on AMD group. It is intended to highlight the urgent and continuing need for change within wet AMD services. This document also serves as a guide for eye health-care professionals, NHS commissioners, and providers to present possible solutions for improving NHS retinal and macular services. Examples of good practice and service development are considered and can be drawn upon to help services meet the recommended quality of care and achieve best possible outcomes.

  5. Photometric Evaluation of Soft Tissue Changes in CLP Patients: Le Fort I Advancement Osteotomy (ALO) Versus Anterior Maxillary Distraction (AMD)

    National Research Council Canada - National Science Library

    Paulose, Joby; Markose, Eldho

    2014-01-01

    ...) and anterior maxillary distraction (AMD).Twenty patients with maxillary hypoplasia associated with cleft lip and palate who had undergone either LeFort I osteotomy or distraction osteogenesis with maxillary advancement were included in this study...

  6. Regression of Some High-risk Features of Age-related Macular Degeneration (AMD in Patients Receiving Intensive Statin Treatment

    Directory of Open Access Journals (Sweden)

    Demetrios G. Vavvas

    2016-03-01

    Conclusions: High-dose statins may result in resolution of drusenoid pigment epithelial detachments (PEDs and improvement in VA, without atrophy or neovascularization in a high-risk subgroup of AMD patients. Confirmation from larger studies is warranted.

  7. Current barriers to treatment for wet age-related macular degeneration (wAMD): findings from the wAMD patient and caregiver survey

    OpenAIRE

    Varano M; Eter N; Winyard S; Wittrup-Jensen KU; Navarro R; Heraghty J

    2015-01-01

    Monica Varano,1 Nicole Eter,2 Steve Winyard,3 Kim U Wittrup-Jensen,4 Rafael Navarro,5 Julie Heraghty6On behalf of the wAMD Patient and Caregiver Survey Committee members1Department of Ophthalmology, Fondazione GB Bietti-IRCCS, Rome, Italy; 2Department of Ophthalmology, University of Münster, Münster, Germany; 3Department of Policy and Campaigns, Royal National Institute of Blind People, London, UK; 4Bayer Pharma AG, Berlin, Germany; 5Instituto de Microcirugía Ocul...

  8. Inflammatory biomarkers for AMD.

    Science.gov (United States)

    Stanton, Chloe M; Wright, Alan F

    2014-01-01

    Age-related macular degeneration (AMD) is the leading cause of blindness worldwide, affecting an estimated 50 million individuals aged over 65 years.Environmental and genetic risk-factors implicate chronic inflammation in the etiology of AMD, contributing to the formation of drusen, retinal pigment epithelial cell dysfunction and photoreceptor cell death. Consistent with a role for chronic inflammation in AMD pathogenesis, several inflammatory mediators, including complement components, chemokines and cytokines, are elevated at both the local and systemic levels in AMD patients. These mediators have diverse roles in the alternative complement pathway, including recruitment of inflammatory cells, activation of the inflammasome, promotion of neovascularisation and in the resolution of inflammation. The utility of inflammatory biomarkers in assessing individual risk and progression of the disease is controversial. However, understanding the role of these inflammatory mediators in AMD onset, progression and response to treatment may increase our knowledge of disease pathogenesis and provide novel therapeutic options in the future.

  9. DNA Damage/Repair and Polymorphism of the hOGG1 Gene in Lymphocytes of AMD Patients

    Directory of Open Access Journals (Sweden)

    Katarzyna Wozniak

    2009-01-01

    Full Text Available Oxidative stress is thought to play a role in the pathogenesis of age-related macular degeneration (AMD. We determined the extent of oxidative DNA damage and the kinetics of its removal as well as the genotypes of the Ser326Cys polymorphism of the hOGG1 gene in lymphocytes of 30 wet AMD patients and 30 controls. Oxidative DNA damage induced by hydrogen peroxide and its repair were evaluated by the comet assay and DNA repair enzymes. We observed a higher extent of endogenous oxidative DNA damage and a lower efficacy of its repair in AMD patients as compared with the controls. We did not find any correlation between the extent of DNA damage and efficacy of DNA repair with genotypes of the Ser326Cys polymorphism. The results obtained suggest that oxidative DNA damage and inefficient DNA repair can be associated with AMD and the variability of the hOOG1 gene may not contribute to this association.

  10. Epidemiological and Clinical Baseline Characteristics as Predictive Biomarkers of Response to Anti-VEGF Treatment in Patients with Neovascular AMD

    Directory of Open Access Journals (Sweden)

    Miltiadis K. Tsilimbaris

    2016-01-01

    Full Text Available Purpose. To review the current literature investigating patient response to antivascular endothelial growth factor-A (VEGF therapy in the treatment of neovascular age-related macular degeneration (nAMD and to identify baseline characteristics that might predict response. Method. A literature search of the PubMed database was performed, using the keywords: AMD, anti-VEGF, biomarker, optical coherence tomography, treatment outcome, and predictor. The search was limited to articles published from 2006 to date. Exclusion criteria included phase 1 trials, case reports, studies focusing on indications other than nAMD, and oncology. Results. A total of 1467 articles were identified, of which 845 were excluded. Of the 622 remaining references, 47 met all the search criteria and were included in this review. Conclusion. Several baseline characteristics correlated with anti-VEGF treatment response, including best-corrected visual acuity, age, lesion size, and retinal thickness. The majority of factors were associated with disease duration, suggesting that longer disease duration before treatment results in worse treatment outcomes. This highlights the need for early treatment for patients with nAMD to gain optimal treatment outcomes. Many of the identified baseline characteristics are interconnected and cannot be evaluated in isolation; therefore multivariate analyses will be required to determine any specific relationship with treatment response.

  11. Polarisation-sensitive OCT is useful for evaluating retinal pigment epithelial lesions in patients with neovascular AMD

    Science.gov (United States)

    Schütze, Christopher; Teleky, Katharina; Baumann, Bernhard; Pircher, Michael; Götzinger, Erich; Hitzenberger, Christoph K; Schmidt-Erfurth, Ursula

    2016-01-01

    Background/aims To examine the reproducibility of lesion dimensions of the retinal pigment epithelium (RPE) in neovascular age-related macular degeneration (AMD) with polarisation-sensitive optical coherence tomography (PS-OCT), specifically imaging the RPE. Methods Twenty-six patients (28 eyes) with neovascular AMD were included in this study, and examined by a PS-OCT prototype. Each patient was scanned five times at a 1-day visit. The PS-OCT B-scan located closest to the macular centre presenting with RPE atrophy was identified, and the longitudinal diameter of the lesion was quantified manually using AutoCAD 2008. This procedure was followed for the identical B-scan position in all five scans per eye and patient. Reproducibility of qualitative changes in PS-OCT was evaluated. Interobserver variability was assessed. Results were compared with intensity-based spectral-domain OCT (SD-OCT) imaging. Results Mean variability of all atrophy lesion dimensions was 0.10 mm (SD±=0.06 mm). Coefficient of variation (SD±/mean) was 0.06 on average (SD±=0.03). Interobserver variability assessment showed a mean difference of 0.02 mm across all patients regarding RPE lesion size evaluation (paired t test: p=0.38). Spearman correlation coefficient was r=0.98, p<0.001. Results revealed a good overall reproducibility of ∼90%. PS-OCT specifically detected the RPE in all eyes compared with conventional intensity-based SD-OCT that was not capable to clearly identify RPE atrophy in 25 eyes (89.3%, p<0.01). Conclusions PS-OCT offers good reproducibility of RPE atrophy assessment in neovascular AMD, and may be suitable for precise RPE evaluation in clinical practice. PS-OCT unambiguously identifies RPE changes in choroidal neovascularisation compared with intensity-based SD-OCT that does not identify the RPE status reliably. PMID:26183936

  12. Five-year visual acuity outcomes and injection patterns in patients with pro-re-nata treatments for AMD, DME, RVO and myopic CNV.

    Science.gov (United States)

    Wecker, Thomas; Ehlken, Christoph; Bühler, Anima; Lange, Clemens; Agostini, Hansjürgen; Böhringer, Daniel; Stahl, Andreas

    2017-03-01

    Anti vascular endothelial growth factor (VEGF) therapy is an established treatment for various retinal diseases. Long-term data on injection frequencies and visual acuity (VA), however, are still rare. Five-year analysis of real-life VA developments and injection patterns from 2072 patients (2577 eyes; 33 187 injections) with chronically active disease undergoing pro-re-nata treatment for age-related macular degeneration (AMD), diabetic macular oedema (DME), retinal vein occlusion (RVO) and myopic choroidal neovascularisation (CNV). Maximum mean VA gain in year 1 was+5.2 letters in AMD, +6.2 in DME, +10 in RVO and+7.2 in myopic CNV. Over 5 years, however, VA in patients with AMD declined. By year 5, 34% of patients with AMD had experienced VA loss of >15 letters, 56% had remained stable and 10% had gained >15 letters. Long-term VA developments in DME and RVO were more favourable with 81% of DME and 79% of patients with RVO gaining or maintaining vision at 5 years. In AMD, median injection frequency was six in year 1 and between four and five in consecutive years. In DME and RVO, median injection frequency was six in year 1 but lower compared with AMD in consecutive years. Injection frequency in DME was weakly associated with patient age (rs=0.1; p=0.03). In AMD, the initial VA gain was not maintained long term despite higher injection numbers compared with DME, RVO and myopic CNV. The presented real-world data provide a peer-group-based estimate of VA developments and injection frequencies for counselling patients undergoing long-term anti-VEGF therapy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Effect of the Gas6 c.834+7G>A polymorphism and the interaction of known risk factors on AMD pathogenesis in Hungarian patients.

    Directory of Open Access Journals (Sweden)

    Gergely Losonczy

    Full Text Available Age-related macular degeneration (AMD is the leading cause of blindness in the elderly in the developed world. Numerous genetic factors contribute to the development of the multifactorial disease. We performed a case-control study to assess the risk conferred by known and candidate genetic polymorphisms on the development of AMD. We searched for genetic interactions and for differences in dry and wet AMD etiology. We enrolled 213 patients with exudative, 67 patients with dry AMD and 106 age and ethnically matched controls. Altogether 12 polymorphisms in Apolipoprotein E, complement factor H, complement factor I, complement component 3, blood coagulation factor XIII, HTRA1, LOC387715, Gas6 and MerTK genes were tested. No association was found between either the exudative or the dry form and the polymorphisms in the Apolipoprotein E, complement factor I, FXIII and MerTK genes. Gas6 c.834+7G>A polymorphism was found to be significantly protective irrespective of other genotypes, reducing the odds of wet type AMD by a half (OR = 0.50, 95%CI: 0.26-0.97, p = 0.04. Multiple regression models revealed an interesting genetic interaction in the dry AMD subgroup. In the absence of C3 risk allele, mutant genotypes of both CFH and HTRA1 behaved as strongly significant risk factors (OR = 7.96, 95%CI: 2.39 = 26.50, p = 0.0007, and OR = 36.02, 95%CI: 3.30-393.02, p = 0.0033, respectively, but reduced to neutrality otherwise. The risk allele of C3 was observed to carry a significant risk in the simultaneous absence of homozygous CFH and HTRA1 polymorphisms only, in which case it was associated with a near-five-fold relative increase in the odds of dry type AMD (OR = 4.93, 95%CI: 1.98-12.25, p = 0.0006. Our results suggest a protective role of Gas6 c.834+7G>A polymorphism in exudative AMD development. In addition, novel genetic interactions were revealed between CFH, HTRA1 and C3 polymorphisms that might contribute to the

  14. Effect of the Gas6 c.834+7G>A polymorphism and the interaction of known risk factors on AMD pathogenesis in Hungarian patients.

    Science.gov (United States)

    Losonczy, Gergely; Vajas, Attila; Takács, Lili; Dzsudzsák, Erika; Fekete, Agnes; Márhoffer, Eva; Kardos, László; Ajzner, Eva; Hurtado, Begoña; de Frutos, Pablo Garcia; Berta, András; Balogh, István

    2012-01-01

    Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly in the developed world. Numerous genetic factors contribute to the development of the multifactorial disease. We performed a case-control study to assess the risk conferred by known and candidate genetic polymorphisms on the development of AMD. We searched for genetic interactions and for differences in dry and wet AMD etiology. We enrolled 213 patients with exudative, 67 patients with dry AMD and 106 age and ethnically matched controls. Altogether 12 polymorphisms in Apolipoprotein E, complement factor H, complement factor I, complement component 3, blood coagulation factor XIII, HTRA1, LOC387715, Gas6 and MerTK genes were tested. No association was found between either the exudative or the dry form and the polymorphisms in the Apolipoprotein E, complement factor I, FXIII and MerTK genes. Gas6 c.834+7G>A polymorphism was found to be significantly protective irrespective of other genotypes, reducing the odds of wet type AMD by a half (OR = 0.50, 95%CI: 0.26-0.97, p = 0.04). Multiple regression models revealed an interesting genetic interaction in the dry AMD subgroup. In the absence of C3 risk allele, mutant genotypes of both CFH and HTRA1 behaved as strongly significant risk factors (OR = 7.96, 95%CI: 2.39 = 26.50, p = 0.0007, and OR = 36.02, 95%CI: 3.30-393.02, p = 0.0033, respectively), but reduced to neutrality otherwise. The risk allele of C3 was observed to carry a significant risk in the simultaneous absence of homozygous CFH and HTRA1 polymorphisms only, in which case it was associated with a near-five-fold relative increase in the odds of dry type AMD (OR = 4.93, 95%CI: 1.98-12.25, p = 0.0006). Our results suggest a protective role of Gas6 c.834+7G>A polymorphism in exudative AMD development. In addition, novel genetic interactions were revealed between CFH, HTRA1 and C3 polymorphisms that might contribute to the pathogenesis of dry

  15. The emotional and physical impact of wet age-related macular degeneration: findings from the wAMD Patient and Caregiver Survey

    Directory of Open Access Journals (Sweden)

    Varano M

    2016-02-01

    Full Text Available Monica Varano,1 Nicole Eter,2 Steve Winyard,3 Kim U Wittrup-Jensen,4 Rafael Navarro,5 Julie Heraghty6 On behalf of the wAMD Patient and Caregiver Survey Committee members 1Department of Ophthalmology, Fondazione GB Bietti-IRCCS, Rome, Italy; 2Department of Ophthalmology, University of Münster, Münster, Germany; 3Department of Policy and Campaigns, Royal National Institute of Blind People, London, UK; 4Bayer Pharma AG, Berlin, Germany; 5Instituto de Microcirugia Ocular, Barcelona, Spain; 6Macular Disease Foundation Australia, Sydney, NSW, Australia Objectives: This was a cross-sectional survey to evaluate the physical and emotional impact of wet age-related macular degeneration (wAMD on a global cohort of patients who were receiving (or had previously received antivascular endothelial growth factor injections, and caregivers (paid and unpaid.Methods: The survey was performed in nine countries using an ophthalmologist-devised questionnaire.Results: A total of 910 patients and 890 caregivers completed the questionnaire. Most patients had been diagnosed and receiving antivascular endothelial growth factor injections for more than 1 year (74.7% and 63.8%, respectively, and many patients (82.1% received support from a caregiver (usually a child/grandchild [47.3%] or partner [23.3%]. wAMD had a negative impact on most patients (71.6%; many rated fear (44.9%, sadness (39.9%, frustration (37.3%, and depression (34.0% as common. It was linked to physical consequences, such as difficulty in reading (61.1%. Many effects were significantly greater in patients with a longer duration of disease or with wAMD in both eyes. Some caregivers (unpaid also reported that caregiving had a negative impact on them (31.1%; many reported emotions such as sadness (34.9% and depression (24.4%, but many also felt useful (48.4%. Overall, 27.2% of caregivers (unpaid rated caregiving as inconvenient; this was linked to days of employment/personal obligations missed

  16. The emotional and physical impact of wet age-related macular degeneration: findings from the wAMD Patient and Caregiver Survey

    Science.gov (United States)

    Varano, Monica; Eter, Nicole; Winyard, Steve; Wittrup-Jensen, Kim U; Navarro, Rafael; Heraghty, Julie

    2016-01-01

    Objectives This was a cross-sectional survey to evaluate the physical and emotional impact of wet age-related macular degeneration (wAMD) on a global cohort of patients who were receiving (or had previously received) antivascular endothelial growth factor injections, and caregivers (paid and unpaid). Methods The survey was performed in nine countries using an ophthalmologist-devised questionnaire. Results A total of 910 patients and 890 caregivers completed the questionnaire. Most patients had been diagnosed and receiving antivascular endothelial growth factor injections for more than 1 year (74.7% and 63.8%, respectively), and many patients (82.1%) received support from a caregiver (usually a child/grandchild [47.3%] or partner [23.3%]). wAMD had a negative impact on most patients (71.6%); many rated fear (44.9%), sadness (39.9%), frustration (37.3%), and depression (34.0%) as common. It was linked to physical consequences, such as difficulty in reading (61.1%). Many effects were significantly greater in patients with a longer duration of disease or with wAMD in both eyes. Some caregivers (unpaid) also reported that caregiving had a negative impact on them (31.1%); many reported emotions such as sadness (34.9%) and depression (24.4%), but many also felt useful (48.4%). Overall, 27.2% of caregivers (unpaid) rated caregiving as inconvenient; this was linked to days of employment/personal obligations missed. Conclusion wAMD has a significant negative impact on the lives of patients, including vision-related depression, poor mobility, and limitations in day-to-day activities. The impact on nonprofessional caregivers may be underestimated in terms of emotional impact (such as depression) and loss of productivity. PMID:26893539

  17. AMD in Mrk 509

    CERN Document Server

    Adhikari, T P; Sobolewska, M; Czerny, B

    2015-01-01

    In this paper we model the observed absorption measure distribution (AMD) in Mrk 509 with a single-zone absorber in pressure equilibrium. AMD is usually constructed from observations of narrow absorption lines in radio-quiet active galaxies with warm absorbers. We study the properties of the warm absorber in Mrk 509 using recently published broad-band spectral energy distribution observed with different instruments. This spectrum is an input in radiative transfer computations with full photoionisation treatment using titan code. We show that the simplest way to fully reproduce the shape of AMD is to assume that the warm absorber is a single zone under constant total pressure. With this assumption we found theoretical AMD which matches the observed one determined on the basis of 600 ks RGS XMM-Newton spectrum of Mrk 509. Our model puts strong constraints that the density of the warm absorber should be high enough to produce strong opacity jumps which are responsible for observed AMD dips.

  18. AMD genetics in India: The missing links

    Directory of Open Access Journals (Sweden)

    Akshay eAnand

    2016-05-01

    Full Text Available Age related macular degeneration is a disease condition which occurs in aged peoples. There are various changes occurs at the cellular, molecular and physiological levels with age (Kaushal et al, 2013; Samiec et al 1988. Drusen deposition between RPE and Bruch’s membrane is one of the key features in AMD patients (Mullins RF et al, 2000; Hagemana et al, 2001 as Aβ/tau aggregates in AD patients. The primary goal of this review is to discuss whether the various candidate genes and associated biomarkers, that are supposed to play an independent role in progression of AMD, exert deleterious effect on phenotype, alone or in combination, in Indian AMD patients from the same ethnic group. A statistical model for probable interaction between genes could also be derived from such analysis. We can use multiple modalities to identify and enrol AMD patients based on established clinical criteria and examine the risk factors to determine if these genes are associated with risk factors, biomarkers or disease by Mendelian randomization. Similarly, there are large numbers of single nucleotide polymorphisms (SNPs identified in human population. Even non-synonymous SNPs (nsSNPs are believed to induce deleterious effects on the functionality of various proteins. The study of such snSNPs could provide a better genetic insight for diverse phenotypes of AMD patients, predicting significant risk factors for the disease. Therefore, the prediction of biological effect of nsSNPs in the candidate genes is highly solicited.Therefore, genotyping and levels of protein expression of various genes would provide bigger canvas in genetic complexity of AMD pathology which should be evaluated by valid statistical and bioinformatics’ tools. Longitudinal follow up of Indian AMD patients to evaluate the temporal effect of SNPs and biomarkers on progression of disease could also provide unique strategy in the field.

  19. The emotional and physical impact of wet age-related macular degeneration: findings from the wAMD Patient and Caregiver Survey

    OpenAIRE

    Varano M; Eter N; Winyard S; Wittrup-Jensen KU; Navarro R; Heraghty J

    2016-01-01

    Monica Varano,1 Nicole Eter,2 Steve Winyard,3 Kim U Wittrup-Jensen,4 Rafael Navarro,5 Julie Heraghty6 On behalf of the wAMD Patient and Caregiver Survey Committee members 1Department of Ophthalmology, Fondazione GB Bietti-IRCCS, Rome, Italy; 2Department of Ophthalmology, University of Münster, Münster, Germany; 3Department of Policy and Campaigns, Royal National Institute of Blind People, London, UK; 4Bayer Pharma AG, Berlin, Germany; 5Instituto de Microcirugia Ocular, Bar...

  20. CFH Y402H confers similar risk of soft drusen and both forms of advanced AMD.

    Directory of Open Access Journals (Sweden)

    Kristinn P Magnusson

    2006-01-01

    Full Text Available BACKGROUND: Age-related macular degeneration (AMD is the most common cause of irreversible visual impairment in the developed world. The two forms of advanced AMD, geographic atrophy and neovascular AMD, represent different pathological processes in the macula that lead to loss of central vision. Soft drusen, characterized by deposits in the macula without visual loss, are considered to be a precursor of advanced AMD. Recently, it has been proposed that a common missense variant, Y402H, in the Complement Factor H (CFH gene increases the risk for advanced AMD. However, its impact on soft drusen, GA, or neovascular AMD--or the relationship between them--is unclear. METHODS AND FINDINGS: We genotyped 581 Icelandic patients with advanced AMD (278 neovascular AMD, 203 GA, and 100 with mixed neovascular AMD/GA, and 435 with early AMD (of whom 220 had soft drusen. A second cohort of 431 US patients from Utah, 322 with advanced AMD (244 neovascular AMD and 78 GA and 109 early-AMD cases with soft drusen, were analyzed. We confirmed that the CFH Y402H variant shows significant association to advanced AMD, with odds ratio of 2.39 in Icelandic patients (p = 5.9 x 10(-12 and odds ratio of 2.14 in US patients from Utah (p = 2.0 x 10(-9 with advanced AMD. Furthermore, we show that the Y402H variant confers similar risk of soft drusen and both forms of advanced AMD (GA or neovascular AMD. CONCLUSION: Soft drusen occur prior to progression to advanced AMD and represent a histological feature shared by neovascular AMD and GA. Our results suggest that CFH is a major risk factor of soft drusen, and additional genetic factors and/or environmental factors may be required for progression to advanced AMD.

  1. CFH Y402H Confers Similar Risk of Soft Drusen and Both Forms of Advanced AMD.

    Directory of Open Access Journals (Sweden)

    2005-11-01

    Full Text Available BACKGROUND: Age-related macular degeneration (AMD is the most common cause of irreversible visual impairment in the developed world. The two forms of advanced AMD, geographic atrophy and neovascular AMD, represent different pathological processes in the macula that lead to loss of central vision. Soft drusen, characterized by deposits in the macula without visual loss, are considered to be a precursor of advanced AMD. Recently, it has been proposed that a common missense variant, Y402H, in the Complement Factor H (CFH gene increases the risk for advanced AMD. However, its impact on soft drusen, GA, or neovascular AMD-or the relationship between them-is unclear. METHODS AND FINDINGS: We genotyped 581 Icelandic patients with advanced AMD (278 neovascular AMD, 203 GA, and 100 with mixed neovascular AMD/GA, and 435 with early AMD (of whom 220 had soft drusen. A second cohort of 431 US patients from Utah, 322 with advanced AMD (244 neovascular AMD and 78 GA and 109 early-AMD cases with soft drusen, were analyzed. We confirmed that the CFH Y402H variant shows significant association to advanced AMD, with odds ratio of 2.39 in Icelandic patients (p = 5.9 x 10(-12 and odds ratio of 2.14 in US patients from Utah (p = 2.0 x 10(-9 with advanced AMD. Furthermore, we show that the Y402H variant confers similar risk of soft drusen and both forms of advanced AMD (GA or neovascular AMD. CONCLUSION: Soft drusen occur prior to progression to advanced AMD and represent a histological feature shared by neovascular AMD and GA. Our results suggest that CFH is a major risk factor of soft drusen, and additional genetic factors and/or environmental factors may be required for progression to advanced AMD.

  2. CFH Y402H confers similar risk of soft drusen and both forms of advanced AMD.

    Directory of Open Access Journals (Sweden)

    Kristinn P Magnusson

    2006-01-01

    Full Text Available Age-related macular degeneration (AMD is the most common cause of irreversible visual impairment in the developed world. The two forms of advanced AMD, geographic atrophy and neovascular AMD, represent different pathological processes in the macula that lead to loss of central vision. Soft drusen, characterized by deposits in the macula without visual loss, are considered to be a precursor of advanced AMD. Recently, it has been proposed that a common missense variant, Y402H, in the Complement Factor H (CFH gene increases the risk for advanced AMD. However, its impact on soft drusen, GA, or neovascular AMD--or the relationship between them--is unclear.We genotyped 581 Icelandic patients with advanced AMD (278 neovascular AMD, 203 GA, and 100 with mixed neovascular AMD/GA, and 435 with early AMD (of whom 220 had soft drusen. A second cohort of 431 US patients from Utah, 322 with advanced AMD (244 neovascular AMD and 78 GA and 109 early-AMD cases with soft drusen, were analyzed. We confirmed that the CFH Y402H variant shows significant association to advanced AMD, with odds ratio of 2.39 in Icelandic patients (p = 5.9 x 10(-12 and odds ratio of 2.14 in US patients from Utah (p = 2.0 x 10(-9 with advanced AMD. Furthermore, we show that the Y402H variant confers similar risk of soft drusen and both forms of advanced AMD (GA or neovascular AMD.Soft drusen occur prior to progression to advanced AMD and represent a histological feature shared by neovascular AMD and GA. Our results suggest that CFH is a major risk factor of soft drusen, and additional genetic factors and/or environmental factors may be required for progression to advanced AMD.

  3. Second-year visual acuity outcomes of nAMD patients treated with aflibercept: data analysis from the UK Aflibercept Users Group.

    Science.gov (United States)

    Almuhtaseb, H; Johnston, R L; Talks, J S; Lotery, A J

    2017-06-16

    PurposeTo audit the visual acuity (VA) outcomes achieved at the end of year two in 17 UK centres, which followed the year 1 VIEW protocol in year 1, but a variable approach in year 2 for aflibercept for neovascular macular degeneration (nAMD).Patients and methodsRetrospective data analysis, from an electronic medical record, of a consecutive series of treatment-naive nAMD patients who received aflibercept for 2 consecutive years, having followed the VIEW protocol in year one, defined as eyes having received 7 or 8 injections from baseline.ResultsThe mean number of intravitreal injections (IVI)s during year 2 was 3.7 in 1180 eyes (1083 patients). The mean baseline VA of the whole cohort was 56.3 ETDRS letters, improving to 61.3 at 1 year (+5) and 59.1 (+2.8) at the end of year 2. The mean VA letter score at the end of year 2, stratified by number of IVIs into three groups was as follows: group A, 57.3 (gain of +1.7) (44% of eyes (/=6 IVIs)). Even though there were VA gains in the three groups over the 2-years, there was a drop in VA in year one to two. Eyes that received >/=6 IVIs (group C) had a smaller reduction of VA during year 2 than those which received year 1 results in higher VA gains in year 2 of treatment.Eye advance online publication, 16 June 2017; doi:10.1038/eye.2017.108.

  4. [Age-related macular degeneration (AMD)].

    Science.gov (United States)

    Michels, Stephan; Kurz-Levin, Malaika

    2009-03-01

    Today age-related macular degeneration (AMD) is the most frequent cause for legal blindness in western industrialized countries. The prevalence of this disease rises with increasing age. A multifactorial pathogenesis of AMD is postulated including genetic predisposition and environmental risk factors. The most relevant modifiable risk factor is smoking. Up to today there is no cure of this chronic disease. Prophylaxis, including a healthy diet and antioxidants as nutrional supplements for selected patients, aims to slow down the disease progression. Significant progress has been made in the treatment of the neovascular form of the disease using inhibitors of the vascular endothelial growth factor (VEGF).

  5. The complex model of risk and progression of AMD estimation

    Directory of Open Access Journals (Sweden)

    V. S. Akopyan

    2012-01-01

    Full Text Available Purpose: to develop a method and a statistical model to estimate individual risk of AMD and the risk for progression to advanced AMD using clinical and genetic risk factors.Methods: A statistical risk assessment model was developed using stepwise binary logistic regression analysis. to estimate the population differences in the prevalence of allelic variants of genes and for the development of models adapted to the population of Moscow region genotyping and assessment of the influence of other risk factors was performed in two groups: patients with differ- ent stages of AMD (n = 74, and control group (n = 116. Genetic risk factors included in the study: polymorphisms in the complement system genes (C3 and CFH, genes at 10q26 locus (ARMS2 and HtRA1, polymorphism in the mitochondrial gene Mt-ND2. Clinical risk factors included in the study: age, gender, high body mass index, smoking history.Results: A comprehensive analysis of genetic and clinical risk factors for AMD in the study group was performed. Compiled statis- tical model assessment of individual risk of AMD, the sensitivity of the model — 66.7%, specificity — 78.5%, AUC = 0.76. Risk factors of late AMD, compiled a statistical model describing the probability of late AMD, the sensitivity of the model — 66.7%, specificity — 78.3%, AUC = 0.73. the developed system allows determining the most likely version of the current late AMD: dry or wet.Conclusion: the developed test system and the mathematical algorhythm for determining the risk of AMD, risk of progression to advanced AMD have fair diagnostic informative and promising for use in clinical practice.

  6. The complex model of risk and progression of AMD estimation

    Directory of Open Access Journals (Sweden)

    V. S. Akopyan

    2014-07-01

    Full Text Available Purpose: to develop a method and a statistical model to estimate individual risk of AMD and the risk for progression to advanced AMD using clinical and genetic risk factors.Methods: A statistical risk assessment model was developed using stepwise binary logistic regression analysis. to estimate the population differences in the prevalence of allelic variants of genes and for the development of models adapted to the population of Moscow region genotyping and assessment of the influence of other risk factors was performed in two groups: patients with differ- ent stages of AMD (n = 74, and control group (n = 116. Genetic risk factors included in the study: polymorphisms in the complement system genes (C3 and CFH, genes at 10q26 locus (ARMS2 and HtRA1, polymorphism in the mitochondrial gene Mt-ND2. Clinical risk factors included in the study: age, gender, high body mass index, smoking history.Results: A comprehensive analysis of genetic and clinical risk factors for AMD in the study group was performed. Compiled statis- tical model assessment of individual risk of AMD, the sensitivity of the model — 66.7%, specificity — 78.5%, AUC = 0.76. Risk factors of late AMD, compiled a statistical model describing the probability of late AMD, the sensitivity of the model — 66.7%, specificity — 78.3%, AUC = 0.73. the developed system allows determining the most likely version of the current late AMD: dry or wet.Conclusion: the developed test system and the mathematical algorhythm for determining the risk of AMD, risk of progression to advanced AMD have fair diagnostic informative and promising for use in clinical practice.

  7. Method development to quantify Bv8 expression in circulating CD11b+ cells in patients with neovascular age-related macular degeneration (nvAMD) exhibiting Anti-VEGF refractoriness.

    Science.gov (United States)

    Catchpole, Timothy; Daniels, Tad; Perkins, Jill; Csaky, Karl G

    2016-07-01

    A subset of neovascular age-related macular degeneration (nvAMD) subjects appears to be refractory to the effects of anti-VEGF treatment and require frequent intravitreal injections. Prokineticin-2 (Bv8) expression in CD11b(+) cells has been linked to anti-VEGF response. We have developed a reproducible method to quantify gene expression in circulating CD11b + cells. Utilizing this method we tested the hypothesis that high Bv8 expression in circulating CD11b(+) cells is associated with anti-VEGF refractoriness in nvAMD patients. Two groups of nvAMD subjects undergoing treatment with anti-VEGF agents were recruited and classified as refractory or non-refractory to anti-VEGF treatment (n = 33 for each group). Two blood draws were obtained from each subject 1-9 months apart. Peripheral blood mononuclear cells (PBMCs) were isolated and CD11b(+) cells were purified via magnetic bead separation. RNA was purified, and relative expression of Bv8 among the subjects was compared via quantitative PCR analysis. Utilizing this approach no significant difference was detected in the mean LogRQ values between the first and second blood draws (t-test, p = 0.826) indicating low intra-patient variability and demonstrating good reproducibility of the assay. There was no significant difference in Bv8 expression between nvAMD subjects classified as refractory versus non-refractory. We were unable to find a correlation between Bv8 expression in CD11b + cells and anti-VEGF refractoriness in human nvAMD subjects. Relatively high expression in Bv8 in these subjects did not correlate with clinical treatment history, as measured by the frequency of injections. Utilizing this well characterized technique, studies are underway to examine alternative gene expression profiles in various circulating cell populations that may contribute to anti-VEGF refractoriness.

  8. The profile and prognosis of patients hospitalised with heart failure. The value of discharge blood pressure amd cholesterol.

    Science.gov (United States)

    Jindrich, Spinar; Ondrej, Ludka; Viktor, Musil; Zbynek, Pozdisek; Tomas, Pavlik; Ladislav, Dusek; Jiri, Vitovec; Lenka, Spinarova; Miroslav, Soucek

    2008-11-01

    The aim of the present prospective, single centre observational study was to describe the profile and prognosis of patients hospitalised with chronic heart failure and to determine the value of discharge blood pressure and cholesterol for long-term survival. From among 2,346 hospitalised patients, 320 (13.6%) suffered from chronic heart failure and 28 (8.8%) died during hospitalisation. The in-patient mortality rate was similar to that in patients not suffering from chronic heart failure (P = 0, 3). Of 292 patients who were discharged, 162 (55%) died during the subsequent 5 years. The predetermined parameters of pure prognosis were associated with lower diastolic blood pressure (P = 0.008) and lower cholesterol (P = 0.012). A poor prognosis was associated with lower systolic blood pressure plus lower cholesterol and lower diastolic blood pressure and lower cholesterol. Other independent prognostic parameters were older age (P disease (P chronic heart failure and discharged home have a worse prognosis if their systolic and/or diastolic blood pressures and/or cholesterol levels are too low. The optimal values seem to be levels that are around the recommended targets, that is a systolic BP of 140 mmHg, diastolic BP of 90 mmHg, and a cholesterol level of 5 mmol/L.

  9. Sykdomsutvikling og behandlingsstrategier ved våt AMD.

    OpenAIRE

    Brynstad, Lydia

    2013-01-01

    Abstract: Age-related macular degeneration is a leading cause of severe visual loss and reading disability in the population >60 years of age. The incidence is high and increasing as the elderly population expands. The pathogenesis is multifactorial, and the disease affects the retina, retinal pigment epithelium (RPE), Bruchs membrane and choriocapillaries. There are two different types, or stages, of AMD: dry (atrophic) and wet (neovascular) form of AMD. About 80 % of the patients affected b...

  10. AMD ja ATI kolivad kokku / Kalle Kose

    Index Scriptorium Estoniae

    Kose, Kalle

    2006-01-01

    Maailma suuruselt teise personaalarvutite protsessorite valmistaja Advanced Micro Devices (AMD) liitumisest graafikakaartide tootja ATI Technologies'iga (ATI). Vt. ka: 5 küsimust AMD-le. Küsimustele vastab AMD regiooni esindaja Stockholmis Martin Sjögren

  11. AMD ja ATI kolivad kokku / Kalle Kose

    Index Scriptorium Estoniae

    Kose, Kalle

    2006-01-01

    Maailma suuruselt teise personaalarvutite protsessorite valmistaja Advanced Micro Devices (AMD) liitumisest graafikakaartide tootja ATI Technologies'iga (ATI). Vt. ka: 5 küsimust AMD-le. Küsimustele vastab AMD regiooni esindaja Stockholmis Martin Sjögren

  12. AMD's 64-bit Opteron processor

    CERN Document Server

    CERN. Geneva

    2003-01-01

    This talk concentrates on issues that relate to obtaining peak performance from the Opteron processor. Compiler options, memory layout, MPI issues in multi-processor configurations and the use of a NUMA kernel will be covered. A discussion of recent benchmarking projects and results will also be included.BiographiesDavid RichDavid directs AMD's efforts in high performance computing and also in the use of Opteron processors...

  13. Visual, Musculoskeletal, and Balance Complaints in AMD: A Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Christina Zetterlund

    2016-01-01

    Full Text Available Purpose. To investigate whether patients with age-related macular degeneration (AMD run a potentially higher risk of developing visual, musculoskeletal, and balance complaints than age-matched controls with normal vision. Methods. Visual assessments, self-rated visual function, self-rated visual, musculoskeletal, and balance complaints, and perceived general health were obtained in 37 AMD patients and 18 controls, at baseline and after an average of 3.8 years later. Results. At follow-up both groups reported decreased visual acuity (VA and visual function, but only AMD patients reported significantly increased visual, musculoskeletal, and balance complaints. Decreased VA, need for larger font size when reading, need for larger magnification, and decreased self-rated visual function were identified as risk markers for increased complaints in AMD patients. These complaints were also identified as risk markers for decreased health. For controls, decreased VA and self-reported visual function were associated with increased visual and balance complaints. Conclusions. Visual deterioration was a risk marker for increased visual, musculoskeletal, balance, and health complaints in AMD patients. Specifically, magnifying visual aids, such as CCTV, were a risk marker for increased complaints in AMD patients. This calls for early and coordinated actions to treat and prevent visual, musculoskeletal, balance, and health complaints in AMD patients.

  14. Visual, Musculoskeletal, and Balance Complaints in AMD: A Follow-Up Study.

    Science.gov (United States)

    Zetterlund, Christina; Richter, Hans Olof; Lundqvist, Lars-Olov

    2016-01-01

    Purpose. To investigate whether patients with age-related macular degeneration (AMD) run a potentially higher risk of developing visual, musculoskeletal, and balance complaints than age-matched controls with normal vision. Methods. Visual assessments, self-rated visual function, self-rated visual, musculoskeletal, and balance complaints, and perceived general health were obtained in 37 AMD patients and 18 controls, at baseline and after an average of 3.8 years later. Results. At follow-up both groups reported decreased visual acuity (VA) and visual function, but only AMD patients reported significantly increased visual, musculoskeletal, and balance complaints. Decreased VA, need for larger font size when reading, need for larger magnification, and decreased self-rated visual function were identified as risk markers for increased complaints in AMD patients. These complaints were also identified as risk markers for decreased health. For controls, decreased VA and self-reported visual function were associated with increased visual and balance complaints. Conclusions. Visual deterioration was a risk marker for increased visual, musculoskeletal, balance, and health complaints in AMD patients. Specifically, magnifying visual aids, such as CCTV, were a risk marker for increased complaints in AMD patients. This calls for early and coordinated actions to treat and prevent visual, musculoskeletal, balance, and health complaints in AMD patients.

  15. NLRP3 Inflammasome and Pathobiology in AMD.

    Science.gov (United States)

    Celkova, Lucia; Doyle, Sarah L; Campbell, Matthew

    2015-01-14

    Age-related macular degeneration (AMD) is the leading cause of central vision loss and blindness in the elderly. It is characterized by a progressive loss of photoreceptors in the macula due to damage to the retinal pigment epithelium (RPE). Clinically, it is manifested by drusen deposition between the RPE and underlying choroid and accumulation of lipofuscin in the RPE. End-stage disease is characterized by geographic atrophy (dry AMD) or choroidal neovascularization (wet AMD). The NLRP3 inflammasome has recently been implicated in the disease pathology. Here we review the current knowledge on the involvement of this multiprotein complex and its effector cytokines interleukin-1β (IL-1β) and IL-18 in AMD progression. We also describe cell death mechanisms that have been proposed to underlie RPE degeneration in AMD and discuss the role of autophagy in the regulation of disease progression.

  16. NLRP3 Inflammasome and Pathobiology in AMD

    Directory of Open Access Journals (Sweden)

    Lucia Celkova

    2015-01-01

    Full Text Available Age-related macular degeneration (AMD is the leading cause of central vision loss and blindness in the elderly. It is characterized by a progressive loss of photoreceptors in the macula due to damage to the retinal pigment epithelium (RPE. Clinically, it is manifested by drusen deposition between the RPE and underlying choroid and accumulation of lipofuscin in the RPE. End-stage disease is characterized by geographic atrophy (dry AMD or choroidal neovascularization (wet AMD. The NLRP3 inflammasome has recently been implicated in the disease pathology. Here we review the current knowledge on the involvement of this multiprotein complex and its effector cytokines interleukin-1β (IL-1β and IL-18 in AMD progression. We also describe cell death mechanisms that have been proposed to underlie RPE degeneration in AMD and discuss the role of autophagy in the regulation of disease progression.

  17. The genetics of age-related macular degeneration (AMD)--Novel targets for designing treatment options?

    Science.gov (United States)

    Grassmann, Felix; Fauser, Sascha; Weber, Bernhard H F

    2015-09-01

    Age-related macular degeneration (AMD) is a progressive disease of the central retina and the main cause of legal blindness in industrialized countries. Risk to develop the disease is conferred by both individual as well as genetic factors with the latter being increasingly deciphered over the last decade. Therapeutically, striking advances have been made for the treatment of the neovascular form of late stage AMD while for the late stage atrophic form of the disease, which accounts for almost half of the visually impaired, there is currently no effective therapy on the market. This review highlights our current knowledge on the genetic architecture of early and late stage AMD and explores its potential for the discovery of novel, target-guided treatment options. We reflect on current clinical and experimental therapies for all forms of AMD and specifically note a persisting lack of efficacy for treatment in atrophic AMD. We further explore the current insight in AMD-associated genes and pathways and critically question whether this knowledge is suited to design novel treatment options. Specifically, we point out that known genetic factors associated with AMD govern the risk to develop disease and thus may not play a role in its severity or progression. Treatments based on such knowledge appear appropriate rather for prevention than treatment of manifest disease. As a consequence, future research in AMD needs to be greatly focused on approaches relevant to the patients and their medical needs.

  18. Improving treatment provision of Wet AMD with intravitreal ranibizumab.

    Science.gov (United States)

    Ghazala, Fadi; Hovan, Marta; Mahmood, Sajjad

    2013-01-01

    Wet age-related macular degeneration (AMD) treatment using intravitreal ranibizumab needs to be started as soon as possible and treatment must be administered based on regular review to achieve the best results. In clinical practice this tight schedule is a challenge and methods of carrying out such timely treatment is the objective of this quality improvement work. A departmental audit was carried out on the service providing treatment for patients with wet AMD in 2009. This audit identified that the appointment system did not meet the ideal standards and subsequently wet AMD patients' visual outcome were poorer than the standard set in trials where the patients were seen and treated at predetermined intervals. In order to enhance the visual benefit of the administered therapy for our patients we thought it necessary to find ways to see and treat patients sooner as well as reduce time intervals between follow-up appointments. The quality improvement was carried out through redesigning the service in the macular treatment centre of Manchester Royal Eye Hospital. Three main strategies were implemented including: changes to the appointment system, expansion of the treatment facility and employment of additional staff. Following changes made, regular re-audits were used to analyse the effectiveness of the new strategies. The changes introduced have brought appointment standards to the level of Royal College of Ophthalmologists' recommendations. Consequently visual outcomes were approaching the standards set by landmark studies. The visual improvement of treated patients seen in the 2011 audit are comparable to other reports outside clinical trials in the UK. In order to enhance the efficacy of ranibizumab for wet AMD it is essential for treatment to be initiated as soon as possible and administered to patients at the recommended time intervals. The actions we have taken were effective in helping develop a service performing to higher standards.

  19. Visual, Musculoskeletal, and Balance Complaints in AMD: A Follow-Up Study

    OpenAIRE

    Christina Zetterlund; Hans Olof Richter; Lars-Olov Lundqvist

    2016-01-01

    Purpose. To investigate whether patients with age-related macular degeneration (AMD) run a potentially higher risk of developing visual, musculoskeletal, and balance complaints than age-matched controls with normal vision. Methods. Visual assessments, self-rated visual function, self-rated visual, musculoskeletal, and balance complaints, and perceived general health were obtained in 37 AMD patients and 18 controls, at baseline and after an average of 3.8 years later. Results. At follow-up bot...

  20. [The results of wet AMD treatment by intravitreal injections--preliminary report].

    Science.gov (United States)

    Okruszko, Anna; Borucka, Anna I; Ulińska, Magdalena; Szaflik, Jerzy

    2007-01-01

    Age-related macular degeneration (AMD) is the leading cause of irreversible, severe loss of vision in the developed countries. One of the modern methods of treatment in neovascular form of AMD are repeated intravitreal injections of ranibizumab (Lucentis). Ranibizumab is a recombinant, humanized, monoclonal antibody that neutralizes all biologically active forms of vascular endothelial growth factor A (VEGF-A). The aim of the study was to analyze the results of intravitreal ranibizumab injections in wet AMD patients. There were 57 patients enrolled in the study. 87% of them avoided any loss of visual acuity and 47.3% gained at least one line at visual acuity chart. Authors conclude that treatment with repeated intravitreal injections of ranibizumab is effective in neovascular form of AMD.

  1. Tapping Stem Cells to Target AMD: Challenges and Prospects

    Directory of Open Access Journals (Sweden)

    Caroline Brandl

    2015-01-01

    Full Text Available Human pluripotent stem cells (hPSCs are increasingly gaining attention in biomedicine as valuable resources to establish patient-derived cell culture models of the cell type known to express the primary pathology. The idea of “a patient in a dish” aims at basic, but also clinical, applications with the promise to mimic individual genetic and metabolic complexities barely reflected in current invertebrate or vertebrate animal model systems. This may particularly be true for the inherited and complex diseases of the retina, as this tissue has anatomical and physiological aspects unique to the human eye. For example, the complex age-related macular degeneration (AMD, the leading cause of blindness in Western societies, can be attributed to a large number of genetic and individual factors with so far unclear modes of mutual interaction. Here, we review the current status and future prospects of utilizing hPSCs, specifically induced pluripotent stem cells (iPSCs, in basic and clinical AMD research, but also in assessing potential treatment options. We provide an outline of concepts for disease modelling and summarize ongoing and projected clinical trials for stem cell-based therapy in late-stage AMD.

  2. Foveal localization in non-exudative AMD using scanning laser polarimetry.

    Science.gov (United States)

    VanNasdale, Dean A; Elsner, Ann E; Kohne, Kimberly D; Peabody, Todd D; Malinovsky, Victor E; Haggerty, Bryan P; Weber, Anke; Clark, Christopher A

    2012-05-01

    To determine whether custom scanning laser polarimetry (SLP) images, differing in polarization content, can be used to accurately localize the fovea in the presence of non-exudative age-related macular degeneration (AMD). To determine whether alterations to the foveal structure in non-exudative AMD significantly disrupts the birefringent Henle fiber layer, responsible for the macular cross pattern in some SLP images. To determine whether phase retardation information, specifically color-coded information representing its magnitude and axis, allow better foveal localization than images including retardation amplitude only. SLP images were acquired in 25 AMD subjects and 25 age-matched controls. Raw data were used to generate five custom image types differing in polarization content. The foveal location was marked by three graders in each image type for each subject. The difference in variability was compared between the AMD subjects and matched controls. We further determined whether the orientation of Henle fiber layer phase retardation improved localization in 10 subjects with the highest variability in images including only phase retardation amplitude. Images that differed in polarization content led to strikingly different visualizations of AMD pathology. The Henle fiber layer remained sufficiently intact to assist in fovea localization in all subjects but with more variability in the AMD group. For both the AMD and matched control group, images containing birefringence amplitude and orientation information reduced the amount of intragrader, intergrader, and interimage variability for estimating foveal location. The disruption in Henle fiber birefringence was evident in the eyes with AMD but nevertheless was sufficient to help in foveal localization despite macular pathology. Phase retardation amplitude and axis of orientation can be a useful tool in foveal localization in patients with AMD.

  3. Epimacular brachytherapy for wet AMD: current perspectives.

    Science.gov (United States)

    Casaroli-Marano, Ricardo P; Alforja, Socorro; Giralt, Joan; Farah, Michel E

    2014-01-01

    Age-related macular degeneration (AMD) is considered the most common cause of blindness in the over-60 age group in developed countries. There are basically two forms of presentation: geographic (dry or atrophic) and wet (neovascular or exudative). Geographic atrophy accounts for approximately 85%-90% of ophthalmic frames and leads to a progressive degeneration of the retinal pigment epithelium and the photoreceptors. Wet AMD causes the highest percentage of central vision loss secondary to disease. This neovascular form involves an angiogenic process in which newly formed choroidal vessels invade the macular area. Today, intravitreal anti-angiogenic drugs attempt to block the angiogenic events and represent a major advance in the treatment of wet AMD. Currently, combination therapy for wet AMD includes different forms of radiation delivery. Epimacular brachytherapy (EMBT) seems to be a useful approach to be associated with current anti-vascular endothelial growth factor agents, presenting an acceptable efficacy and safety profile. However, at the present stage of research, the results of the clinical trials carried out to date are insufficient to justify extending routine use of EMBT for the treatment of wet AMD.

  4. Remediation of AMD using industrial waste adsorbents

    Science.gov (United States)

    Mohammed, Nuur Hani Bte; Yaacob, Wan Zuhairi Wan

    2016-11-01

    The study investigates the characteristic of industrial waste as adsorbents and its potential as heavy metals absorbents in AMD samples. The AMD sample was collected from active mine pond and the pH was measured in situ. The metal contents were analyzed by ICP-MS. The AMD water was very acidic (pH< 3.5), and the average heavy metals content in AMD were high especially in Fe (822.029 mg/l). Fly ash was found to be the most effective absorbent material containing high percentage of CaO (57.24%) and SiO2 (13.88%), followed by ladle furnace slag containing of high amount of CaO (51.52%) and Al2O3 (21.23%), while biomass ash consists of SiO2 (43.07%) and CaO (12.97%). Tank analysis display a huge changes due to pH value change from acidity to nearly neutral phases. After 50 days, fly ash remediation successfully increase the AMD pH values from pH 2.57-7.09, while slag change from acidity to nearly alkaline phase from pH 2.60-7.3 and biomass has change to pH 2.54-6.8. Fly ash has successfully remove Fe, Mn, Cu, and Ni. Meanwhile, slag sample displays as an effective adsorbent to adsorb more Pb and Cd in acid mine drainage.

  5. The role of complement in AMD.

    Science.gov (United States)

    Zipfel, Peter F; Lauer, Nadine; Skerka, Christine

    2010-01-01

    Age related macular degeneration (AMD) is a common form of blindness in the western world and genetic variations of several complement genes, including the complement regulator Factor H, the central complement component C3, Factor B, C2, and also Factor I confer a risk for the disease. However deletion of a chromosomal segment in the Factor H gene cluster on human chromosome 1, which results in the deficiency of the terminal pathway regulator CFHR1, and of the putative complement regulator CFHR3 has a protective effect for development of AMD. The Factor H gene encodes two proteins Factor H and FHL1 which are derived from alternatively processed transcripts. In particular a sequence variation at position 402 of both Factor H and FHL1 is associated with a risk for AMD. A tyrosine residue at position 402 represents the protective and a histidine residue the risk variant. AMD is considered a chronic inflammatory disease, which can be caused by defective and inappropriate regulation of the continuously activated alternative complement pathway. This activation generates complement effector products and inflammatory mediators that stimulate further inflammatory reactions. Defective regulation can lead to formation of immune deposits, drusen and ultimately translate into damage of retinal pigment epithelial cells, rupture of the interface between these epithelial cells and the Bruch's membrane and vision loss. Here we describe the role of complement in the retina and summarize the current concept how defective or inappropriate local complement control contributes to inflammation and the pathophysiology of AMD.

  6. AMD APU中国发布

    Institute of Scientific and Technical Information of China (English)

    魔之左手

    2011-01-01

    近日AMD在北京举办了主题为“融聚创‘芯’·加速‘视’界”的AMD FUSion APU中国发布会.30余款首批基于APU的笔记本、一体机、HTPC和准系统等新品在会上亮相。此次发布的AMD Fusion APU(加速处理器)包括E系列和C系列产品.

  7. Association of Htra1 Gene Polymorphisms with the Risk of Developing AMD in Iranian Population

    Directory of Open Access Journals (Sweden)

    Mohammad Askari

    2015-10-01

    Full Text Available Background: Half of the cases of vision loss in people under 60 years of age have been attributed to age-related macular degeneration (AMD. This is a multifactorial disease with late onset. It has been demonstrated that many different genetic loci are implicated in the risk of developing AMD in different populations. In the current study, we investigated the association of high-temperature requirement A-1 (HTRA1 gene polymorphisms with the risk of developing AMD in the Iranian population. Methods: Genomic DNA samples were extracted from 120 patients with AMD and 120 healthy age- and sex-matched controls. A 385 base-pair fragment of the HTRA1 gene promoter region was amplified using the polymerase chain reaction (PCR technique and sequenced. The frequencies of the alleles were calculated and statistical analysis was performed using SPSS software. Results: Our study demonstrated that the rate of polymorphisms rs11200638 -625 G>A and rs2672598 -487T>C were significantly greater in AMD patients than in healthy controls from the Iranian population. Conclusions: The results of our study indicate that HTRA1 gene promoter region polymorphisms are associated with the risk of developing AMD in the Iranian population

  8. AMD and TACC Consolidation: A Delphi Study

    Science.gov (United States)

    2013-06-01

    single or several AMDs. Figure 1: US Probability of Fault Zones ( Fogler , 2010) Regardless of whether consolidation is pursued or not, a...and Information Technology (7 th ed.). New York, NY: McGraw-Hill/Irwin, 2011. Fogler , Peter. “Earthquakes: Risk, Detection, Warning, and Research

  9. Epimacular brachytherapy for wet AMD: current perspectives

    Directory of Open Access Journals (Sweden)

    Casaroli-Marano RP

    2014-08-01

    Full Text Available Ricardo P Casaroli-Marano,1,2 Socorro Alforja,1 Joan Giralt,1 Michel E Farah2 1Instituto Clínic de Oftalmología (Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; 2Department of Ophthalmology and Visual Sciences, Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Sao Paulo, Brazil Abstract: Age-related macular degeneration (AMD is considered the most common cause of blindness in the over-60 age group in developed countries. There are basically two forms of presentation: geographic (dry or atrophic and wet (neovascular or exudative. Geographic atrophy accounts for approximately 85%–90% of ophthalmic frames and leads to a progressive degeneration of the retinal pigment epithelium and the photoreceptors. Wet AMD causes the highest percentage of central vision loss secondary to disease. This neovascular form involves an angiogenic process in which newly formed choroidal vessels invade the macular area. Today, intravitreal anti-angiogenic drugs attempt to block the angiogenic events and represent a major advance in the treatment of wet AMD. Currently, combination therapy for wet AMD includes different forms of radiation delivery. Epimacular brachytherapy (EMBT seems to be a useful approach to be associated with current anti-vascular endothelial growth factor agents, presenting an acceptable efficacy and safety profile. However, at the present stage of research, the results of the clinical trials carried out to date are insufficient to justify extending routine use of EMBT for the treatment of wet AMD. Keywords: macular degeneration, radiation, vascular endothelial growth factor, combined therapy, intravitreal therapy, vitrectomy

  10. Tree-fold loop approximation of AMD

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Akira [Tohoku Univ., Sendai (Japan). Faculty of Science

    1997-05-01

    AMD (antisymmetrized molecular dynamics) is a frame work for describing a wave function of nucleon multi-body system by Slater determinant of Gaussian wave flux, and a theory for integrally describing a wide range of nuclear reactions such as intermittent energy heavy ion reaction, nucleon incident reaction and so forth. The aim of this study is induction on approximation equation of expected value, {nu}, in correlation capable of calculation with time proportional A (exp 3) (or lower), and to make AMD applicable to the heavier system such as Au+Au. As it must be avoided to break characteristics of AMD, it needs not to be anxious only by approximating the {nu}-value. However, in order to give this approximation any meaning, error of this approximation will have to be sufficiently small in comparison with bond energy of atomic nucleus and smaller than 1 MeV/nucleon. As the absolute expected value in correlation may be larger than 50 MeV/nucleon, the approximation is required to have a high accuracy within 2 percent. (G.K.)

  11. Regulation of signaling events involved in the pathophysiology of neovascular AMD.

    Science.gov (United States)

    Wang, Haibo; Hartnett, M Elizabeth

    2016-01-01

    Neovascular age-related macular degeneration (AMD) is a complex disease in which an individual's genetic predisposition is affected by aging and environmental stresses, which trigger signaling pathways involving inflammation, oxidation, and/or angiogenesis in the RPE cells and choroidal endothelial cells (CECs), to lead to vision loss from choroidal neovascularization. Antiangiogenic therapies have greatly improved clinical outcomes in the last decade; however, vision improves in less than half of patients treated for neovascular AMD, and treatments remain inadequate for atrophic AMD. Many studies focus on genetic predisposition or the association of outcomes in trials of human neovascular AMD but are unable to evaluate the effects between different cell types involved in AMD and the signaling events that take place to cause pathologic biologic events. This manuscript complements other reviews in that it describes what is known generally in human AMD studies and clinical trials testing methods to inhibit vascular endothelial growth factor (VEGF inhibitors) and presents pathologic signaling events that develop in two important cell types, the RPE cells and the CECs, when stimulated by stresses or placed into conditions similar to what is currently understood to occur in neovascular AMD. This manuscript complements other reviews by discussing signaling events that are activated by cell-cell or cell-matrix interactions. These considerations are particularly important when considering growth factors, such as VEGF, which are important in physiologic and pathologic processes, or GTPases that are present but active only if GTP bound. In either case, it is essential to understand the role of signaling activation to distinguish what is pathologic from what is physiologic. Particularly important is the essential role of activated Rac1 in CEC transmigration of the RPE monolayer, an important step in blindness associated with neovascular AMD. Other concepts discussed include

  12. Introducing Anti-Vascular Endothelial Growth Factor Therapies for AMD Did Not Raise Risk of Myocardial Infarction, Stroke, and Death.

    Science.gov (United States)

    Yashkin, Arseniy P; Hahn, Paul; Sloan, Frank A

    2016-10-01

    To assess the effect of availability of anti-vascular endothelial growth factor (VEGF) therapy on mortality and hospitalizations for acute myocardial infarction (AMI) and stroke over a 5-year follow-up period in United States Medicare beneficiaries newly diagnosed with exudative age-related macular degeneration (AMD) in 2006 compared with control groups consisting of beneficiaries (1) newly diagnosed with exudative AMD at a time when anti-VEGF therapy was not possible and (2) newly diagnosed with nonexudative AMD. Retrospective cohort study. Beneficiaries newly diagnosed with exudative and nonexudative AMD in 2000 and 2006 selected from a random longitudinal sample of Medicare 5% claims and enrollment files. Beneficiaries with a first diagnosis of exudative AMD in 2006 were the treatment group; beneficiaries newly diagnosed with exudative AMD in 2000 or nonexudative AMD in 2000 or 2006 were control groups. To deal with potential selection bias, we designed an intent-to-treat study, which controlled for nonadherence to prescribed regimens. The treatment group consisted of patients with clinically appropriate characteristics to receive anti-VEGF injections given that the therapy is available, bypassing the need to monitor whether treatment was actually received. Control groups consisted of patients with clinically appropriate characteristics but first diagnosed at a time when the therapy was unavailable (2000) and similar patients but for whom the therapy was not clinically indicated (2000, 2006). We used a Cox proportional hazard model. All-cause mortality and hospitalization for AMI and stroke during follow-up. No statistically significant changes in probabilities of death and hospitalizations for AMI and stroke within a 5-year follow-up period were identified in exudative AMD beneficiaries newly diagnosed in 2006, the beginning of widespread anti-VEGF use, compared with 2000. As an alternative to our main analysis, which excluded beneficiaries from nonexudative

  13. Defining response to anti-VEGF therapies in neovascular AMD.

    Science.gov (United States)

    Amoaku, W M; Chakravarthy, U; Gale, R; Gavin, M; Ghanchi, F; Gibson, J; Harding, S; Johnston, R L; Kelly, S P; Kelly, S; Lotery, A; Mahmood, S; Menon, G; Sivaprasad, S; Talks, J; Tufail, A; Yang, Y

    2015-06-01

    The introduction of anti-vascular endothelial growth factor (anti-VEGF) has made significant impact on the reduction of the visual loss due to neovascular age-related macular degeneration (n-AMD). There are significant inter-individual differences in response to an anti-VEGF agent, made more complex by the availability of multiple anti-VEGF agents with different molecular configurations. The response to anti-VEGF therapy have been found to be dependent on a variety of factors including patient's age, lesion characteristics, lesion duration, baseline visual acuity (VA) and the presence of particular genotype risk alleles. Furthermore, a proportion of eyes with n-AMD show a decline in acuity or morphology, despite therapy or require very frequent re-treatment. There is currently no consensus as to how to classify optimal response, or lack of it, with these therapies. There is, in particular, confusion over terms such as 'responder status' after treatment for n-AMD, 'tachyphylaxis' and 'recalcitrant' n-AMD. This document aims to provide a consensus on definition/categorisation of the response of n-AMD to anti-VEGF therapies and on the time points at which response to treatment should be determined. Primary response is best determined at 1 month following the last initiation dose, while maintained treatment (secondary) response is determined any time after the 4th visit. In a particular eye, secondary responses do not mirror and cannot be predicted from that in the primary phase. Morphological and functional responses to anti-VEGF treatments, do not necessarily correlate, and may be dissociated in an individual eye. Furthermore, there is a ceiling effect that can negate the currently used functional metrics such as >5 letters improvement when the baseline VA is good (ETDRS>70 letters). It is therefore important to use a combination of both the parameters in determining the response.The following are proposed definitions: optimal (good) response is defined as when there

  14. AMD-stability and the classification of planetary systems

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    Laskar, J.; Petit, A. C.

    2017-09-01

    We present here in full detail the evolution of the angular momentum deficit (AMD) during collisions as it was described in Laskar (2000, Phys. Rev. Lett., 84, 3240). Since then, the AMD has been revealed to be a key parameter for the understanding of the outcome of planetary formation models. We define here the AMD-stability criterion that can be easily verified on a newly discovered planetary system. We show how AMD-stability can be used to establish a classification of the multiplanet systems in order to exhibit the planetary systems that are long-term stable because they are AMD-stable, and those that are AMD-unstable which then require some additional dynamical studies to conclude on their stability. The AMD-stability classification is applied to the 131 multiplanet systems from The Extrasolar Planet Encyclopaedia database for which the orbital elements are sufficiently well known. The AMD-stability coefficients of selected planetary systems are available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/605/A72

  15. Does DcR1 (TNF-related apoptosis-inducing-ligand Receptor 3) have any role in human AMD pathogenesis?

    Science.gov (United States)

    Anand, Akshay; Sharma, Neel K; Singh, Ramandeep; Gupta, Amod; Prabhakar, Sudesh; Jindal, Neeru; Bhatt, Arvind K; Sharma, Suresh K; Gupta, Pawan K

    2014-02-18

    It has been postulated that there is a link between age related degenerative diseases and cancer. The TNF-related apoptosis-inducing ligand (TRAIL) has been shown to selectively kill tumor cells by binding to pro-apoptotic and anti-apoptotic receptors. Our aim was to study the levels of anti-apoptotic receptor (DcR1) in age related macular degeneration (AMD) and controls. AMD patients (115) were classified into two groups: Dry and Wet AMD. Wet AMDs were further classified into occult, predominant classic and minimal classic. 61 healthy individuals were recruited as normal controls. After normalization with total protein, DcR1 levels were analyzed by ELISA. Mann Whitney U-statistic was used for analysis of DcR1 ELISA results. We have observed DcR1 levels in serum sample which were significantly lower in AMD patients as compared to controls (p = 0.001). On the other hand, we did not find difference in DcR1 levels between wet and dry AMD. The present study defines the plausible role of DcR1 in AMD pathology signifying a new therapeutic target for AMD.

  16. Retinal Remodeling And Metabolic Alterations in Human AMD

    Directory of Open Access Journals (Sweden)

    Bryan William Jones

    2016-04-01

    Full Text Available Age-related macular degeneration (AMD is a progressive retinal degeneration resulting in central visual field loss, ultimately causing debilitating blindness. AMD affects 18% of Americans from 65 to 74, 30% older than 74 years of age and is the leading cause of severe vision loss and blindness in Western populations. While many genetic and environmental risk factors are known for AMD, we currently know less about the mechanisms mediating disease progression.The pathways and mechanisms through which genetic and non-genetic risk factors modulate development of AMD pathogenesis remain largely unexplored. Moreover, current treatment for AMD is palliative and limited to wet/exudative forms. Retina is a complex, heterocellular tissue and most retinal cell classes are impacted or altered in AMD. Defining disease and stage-specific cytoarchitectural and metabolic responses in AMD is critical for highlighting targets for intervention. The goal of this paper is to illustrate cell types impacted in AMD and demonstrate the implications of those changes, likely beginning in the retinal pigment epithelium (RPE, for remodeling of the the neural retina.Tracking heterocellular responses in disease progression is best achieved with computational molecular phenotyping (CMP, a tool that enables acquisition of a small molecule fingerprint for every cell in the retina. CMP uncovered critical cellular and molecular pathologies (remodeling and reprogramming in progressive retinal degenerations such as retinitis pigmentosa (RP. We now applied these approaches to normal human and AMD tissues mapping progression of cellular and molecular changes in AMD retinas, including late-stage forms of the disease.Major findings: 1 Evidence of metabolic instability in RPE in dry-AMD.2 Photoreceptors show clear indications of stress prior to cell death.3 Cone opsin processing by the RPE in AMD retinas may be differentially compromised vs. rod opsin.4 Müller cells in AMD exhibit

  17. Preclinical aspects of anti-VEGF agents for the treatment of wet AMD: ranibizumab and bevacizumab.

    Science.gov (United States)

    Meyer, C H; Holz, F G

    2011-06-01

    Three anti-vascular endothelial growth factor (VEGF) therapies are currently used for the treatment of patients with wet age-related macular degeneration (AMD): pegaptanib, ranibizumab, and bevacizumab. Ranibizumab is an antibody fragment approved for the treatment of wet AMD. Bevacizumab is a full-length antibody registered for use in oncology but unlicensed for wet AMD. However, it is used off-label worldwide not only for wet AMD but also for various other ocular diseases associated with macular edema and abnormal vessel growth. We consider aspects of ranibizumab and bevacizumab in relation to their molecular characteristics, in vitro and in vivo properties, and preclinical safety data. Before 2009, most studies described the short-term toxicity of bevacizumab in multiple cell types of the eye. Since 2009, an increasing number of studies have compared the properties of ranibizumab and bevacizumab and investigated their impact on retinal cell functioning. Compared with bevacizumab, ranibizumab neutralizes VEGF better at low concentrations, maintains efficacy for longer, and has a higher retinal penetration and potency. Studies in animals demonstrate ranibizumab to be better localized to the injected eye, whereas bevacizumab appears to have a greater effect in the fellow eye. In humans, a localized and systemic effect has been reported for both molecules. In conclusion, overlapping yet distinct pharmacological properties of ranibizumab and bevacizumab indicate that safety or efficacy data from one cannot be extrapolated to the other.

  18. Effect of SDF-1/Cxcr4 Signaling Antagonist AMD3100 on Bone Mineralization in Distraction Osteogenesis.

    Science.gov (United States)

    Xu, Jia; Chen, Yuanfeng; Liu, Yang; Zhang, Jinfang; Kang, Qinglin; Ho, Kiwai; Chai, Yimin; Li, Gang

    2017-03-16

    Distraction osteogenesis (DO) is a widely applied technique in orthopedics surgery, which involves rapid stem cell migration, homing, and differentiation. Interactions between the chemokine receptor Cxcr4 and its ligand, stromal derived factor-1 (SDF-1), regulate hematopoietic stem cell trafficking to the ischemic area and induce their subsequent differentiation. Here, we examined SDF-1 expression and further investigated the role of SDF-1/Cxcr4 signaling antagonist AMD3100 during bone regeneration in rat DO model. The results showed that expression levels of SDF-1 and osteogenic genes were higher in DO zones than in the fracture zones, and SDF-1 expression level was the highest at the termination of the distraction phase. Radiological, mechanical, and histological analyses demonstrated that the local administration of AMD3100 (400 μM) to DO rats significantly inhibited new bone formation. In the rat bone marrow mesenchymal stem cells culture, comparing to the group treated with osteogenic induction medium, AMD3100 supplement led to a considerable decrease in the expression of alkaline phosphatase and early osteogenic marker genes. However, the amount of calcium deposits in rat MSCs did not differ between the groups. Therefore, our study demonstrated that the DO process induced higher expression of SDF-1, which collated to rapid induction of callus formation. Local application of SDF-1/Cxcr4 signaling antagonist AMD3100 significantly inhibited bone mineralization and osteogenesis in DO, which may represent a potential therapeutic approach to the enhancement of bone consolidation in patients undergoing DO.

  19. New paradigms in the treatment of wet AMD: the impact of anti-VEGF therapy.

    Science.gov (United States)

    Menon, G; Walters, G

    2009-03-01

    The incidence of age-related macular degeneration (AMD) in the United Kingdom is increasing with the ageing population. The wet form of this progressive and potentially blinding disease can develop very rapidly and lead to severe loss of central vision and reduction in quality of life, sometimes in just a matter of weeks. Recent advances in the treatment of wet AMD with the licensing of anti-vascular endothelial growth factor therapies, coupled with current guidance from the Scottish Medicines Consortium and the National Institute of Health and Clinical Excellence have led to a subsequent increase in workload at AMD clinics due to the increased number of patients now eligible for treatment. In addition, the Royal College of Ophthalmologists recommend a 2-week diagnosis to treatment schedule due to the aggressive nature of the disease. The role of the retinal specialist is thus changing, and business management skills are becoming increasingly necessary to obtain the necessary resources to implement the guidance. Through prior experience and formal external evaluation of services at Frimley Park and Harrogate District Hospitals, a number of critical success factors have been developed for optimising treatment pathways in efficient wet AMD clinics.

  20. Initial non-responders to ranibizumab in the treatment of age-related macular degeneration (AMD

    Directory of Open Access Journals (Sweden)

    Otsuji T

    2013-07-01

    Full Text Available Tsuyoshi Otsuji,1 Yoshimi Nagai,2 Kenichiro Sho,1 Akiko Tsumura,1 Naoko Koike,1 Mei Tsuda,1 Tetsuya Nishimura,1 Kanji Takahashi2 1Department of Ophthalmology, Kansai Medical University, Takii Hospital, Osaka, Japan; 2Department of Ophthalmology, Kansai Medical University, Hirakata Hospital, Osaka, Japan Background: Patients with exudative age-related macular degeneration (AMD who did not respond to ranibizumab at the induction phase were assessed and referred to as initial non-responders. Methods: We retrospectively reviewed the medical records of 215 patients (218 eyes with exudative AMD. For the initial treatments, patients received three intravitreal injections of ranibizumab (IVR every 4 weeks. Minimum follow-up period was 12 months. We defined patients with no improvement of best corrected logMAR visual acuity (BCVA, and with no decrease of central retinal thickness (CRT at the end of the initial treatment, as initial non-responders. Patients who had previous treatment history prior to this investigation were included, but patients who had photodynamic therapy (PDT with IVR were excluded. Results: Twenty-two eyes (10.1% were identified as initial non-responders. The mean BCVA of initial non-responders before IVR and after induction phase were 0.39 and 0.36, respectively. There was no significant difference between these values, however the mean BCVA decreased significantly to 0.55 at 12 months after the beginning of the induction phase (P = 0.021. The mean greatest linear dimension (GLD of the lesion before IVR of initial non-responders was 4,121 µm. We found 16 eyes with typical AMD, and six eyes with polypoidal choroidal vasculopathy. One eye had predominantly classic choroidal neovascularization (CNV, and others had occult CNV of typical AMD. As additional treatments, twelve eyes received PDT, and in three of the eyes exudation remained after PDT. Conclusion: Initial non-responders were more prevalent in patients with occult CNV than in

  1. Retinal Spectral Domain Optical Coherence Tomography in Early Atrophic Age-Related Macular Degeneration (AMD and a New Metric for Objective Evaluation of the Efficacy of Ocular Nutrition

    Directory of Open Access Journals (Sweden)

    Stuart Richer

    2012-11-01

    Full Text Available Purpose: A challenge in ocular preventive medicine is identification of patients with early pathological retinal damage that might benefit from nutritional intervention. The purpose of this study is to evaluate retinal thinning (RT in early atrophic age-related macular degeneration (AMD against visual function data from the Zeaxanthin and Visual Function (ZVF randomized double masked placebo controlled clinical trial (FDA IND #78973. Methods: Retrospective, observational case series of medical center veterans with minimal visible AMD retinopathy (AREDS Report #18 simplified grading 1.4/4.0 bilateral retinopathy. Foveal and extra-foveal four quadrant SDOCT RT measurements were evaluated in n = 54 clinical and ZVF AMD patients. RT by age was determined and compared to the OptoVue SD OCT normative database. RT by quadrant in a subset of n = 29 ZVF patients was correlated with contrast sensitivity and parafoveal blue cone increment thresholds. Results: Foveal RT in AMD patients and non-AMD patients was preserved with age. Extrafoveal regions, however, showed significant slope differences between AMD patients and non-AMD patients, with the superior and nasal quadrants most vulnerable to retinal thinning (sup quad: −5.5 μm/decade thinning vs. Non-AMD: −1.1 μm/decade, P < 0.02; nasal quad: −5.0 μm/decade thinning vs. Non-AMD: −1.0 μm/decade, P < 0.04. Two measures of extrafoveal visual deterioration were correlated: A significant inverse correlation between % RT and contrast sensitivity (r = −0.33, P = 0.01, 2 Tailed Paired T and an elevated extrafoveal increment blue cone threshold (r = +0.34, P = 0.01, 2 Tailed T. Additional SD OCT RT data for the non-AMD oldest age group (ages 82–91 is needed to fully substantiate the model. Conclusion: A simple new SD OCT clinical metric called “% extra-foveal RT” correlates well with functional visual loss in early AMD patients having minimal visible retinopathy. This metric can be used to

  2. Active Control Strategy for Offshore Structures Accounting for AMD Constraints

    Institute of Scientific and Technical Information of China (English)

    Ji Chunyan(嵇春艳); Li Huajun; Meng Qingmin

    2004-01-01

    Most of active mass damper systems are designed or installed for the onshore structural response reduction to quite small earthquake or strong wind excitation. When they are applied to offshore structures, they will stop their operations during severe sea state (including strong wind, wave and fluid). For controlling the excessive vibration of offshore structure excited by wave loading, this paper presents a methodology keeping AMD operations even in severe sea state. And the controller was designed by LQG control algorithm accounting for the limits of AMD stroke and control input force. In order to investigate the feasibility and effectiveness of the proposed method, a numerical example applied to an offshore platform is presented in this paper. The numerical results demonstrate that the proposed algorithm is effective in reducing the vibration of offshore structure by choosing appropriate feedback gain among several gain candidates based on the AMD limits.

  3. AMD and the alternative complement pathway: genetics and functional implications.

    Science.gov (United States)

    Tan, Perciliz L; Bowes Rickman, Catherine; Katsanis, Nicholas

    2016-06-21

    Age-related macular degeneration (AMD) is an ocular neurodegenerative disorder and is the leading cause of legal blindness in Western societies, with a prevalence of up to 8 % over the age of 60, which continues to increase with age. AMD is characterized by the progressive breakdown of the macula (the central region of the retina), resulting in the loss of central vision including visual acuity. While its molecular etiology remains unclear, advances in genetics and genomics have illuminated the genetic architecture of the disease and have generated attractive pathomechanistic hypotheses. Here, we review the genetic architecture of AMD, considering the contribution of both common and rare alleles to susceptibility, and we explore the possible mechanistic links between photoreceptor degeneration and the alternative complement pathway, a cascade that has emerged as the most potent genetic driver of this disorder.

  4. Anti-VEGF Treatment Strategies for Wet AMD

    Directory of Open Access Journals (Sweden)

    Jaclyn L. Kovach

    2012-01-01

    Full Text Available Over the past few years, antivascular endothelial growth factor (VEGF therapy has become a standard treatment for neovascular age-related macular degeneration (AMD. During this time, treatment strategies have evolved from a monthly dosing schedule to individualized regimens. This paper will review the currently available anti-VEGF agents and evidence-based treatment strategies.

  5. Anti-VEGF Treatment Strategies for Wet AMD.

    Science.gov (United States)

    Kovach, Jaclyn L; Schwartz, Stephen G; Flynn, Harry W; Scott, Ingrid U

    2012-01-01

    Over the past few years, antivascular endothelial growth factor (VEGF) therapy has become a standard treatment for neovascular age-related macular degeneration (AMD). During this time, treatment strategies have evolved from a monthly dosing schedule to individualized regimens. This paper will review the currently available anti-VEGF agents and evidence-based treatment strategies.

  6. Mitigating health problems associated with AMD in South Africa

    CSIR Research Space (South Africa)

    Schachtschneider, K

    2012-03-01

    Full Text Available Acid mine drainage (AMD) is a serious threat to water quality in South Africa. Questions are being asked to South African government leaders as to what they are doing to mitigate the effects that South Africa’s mining industry is having...

  7. Removal of phosphorus using AMD-treated lignocellulosic material

    Science.gov (United States)

    James S. Han; Soo-Hong Min; Yeong-Kwan Kim

    2005-01-01

    Excess nutrients, including phosphorus, can cause eutrophication in surface water and reservoirs. We tested the phosphate removal capacity of juniper fiber through isotherm, kinetic, column, and field tests. Heavy metals from an acid mine drainage (AMD) site were precipitated on the surface ofjuniper fiber. The modified fiber was tested in laboratory- caled batch and...

  8. Anti-VEGF Treatment Strategies for Wet AMD

    Science.gov (United States)

    Kovach, Jaclyn L.; Schwartz, Stephen G.; Flynn, Harry W.; Scott, Ingrid U.

    2012-01-01

    Over the past few years, antivascular endothelial growth factor (VEGF) therapy has become a standard treatment for neovascular age-related macular degeneration (AMD). During this time, treatment strategies have evolved from a monthly dosing schedule to individualized regimens. This paper will review the currently available anti-VEGF agents and evidence-based treatment strategies. PMID:22523653

  9. AMD183穿浪双体客船

    Institute of Scientific and Technical Information of China (English)

    唐志祥; 徐文珊

    2000-01-01

    This paper firstly analyzed the hi-speed passenger ship market along the coastal lines in Fujian Province in brief and then made detailed introductions to the prototype AMD 183 hi-speed wavepiecing catamaran on its hull structure, superstructure and marine equipment etc.

  10. Autonomous mine detection system (AMDS) neutralization payload module

    Science.gov (United States)

    Majerus, M.; Vanaman, R.; Wright, N.

    2010-04-01

    The Autonomous Mine Detection System (AMDS) program is developing a landmine and explosive hazards standoff detection, marking, and neutralization system for dismounted soldiers. The AMDS Capabilities Development Document (CDD) has identified the requirement to deploy three payload modules for small robotic platforms: mine detection and marking, explosives detection and marking, and neutralization. This paper addresses the neutralization payload module. There are a number of challenges that must be overcome for the neutralization payload module to be successfully integrated into AMDS. The neutralizer must meet stringent size, weight, and power (SWaP) requirements to be compatible with a small robot. The neutralizer must be effective against a broad threat, to include metal and plastic-cased Anti-Personnel (AP) and Anti-Tank (AT) landmines, explosive devices, and Unexploded Explosive Ordnance (UXO.) It must adapt to a variety of threat concealments, overburdens, and emplacement methods, to include soil, gravel, asphalt, and concrete. A unique neutralization technology is being investigated for adaptation to the AMDS Neutralization Module. This paper will describe review this technology and how the other two payload modules influence its design for minimizing SWaP. Recent modeling and experimental efforts will be included.

  11. Geophysical delineation of AMD in the Cradle of Humankind

    CSIR Research Space (South Africa)

    Van Schoor, Michael

    2016-08-01

    Full Text Available Acid mine drainage (AMD) and its effect on surface and groundwater resources in the Cradle of Humankind (COH) area near Krugersdorp is a pertinent and well-documented concern. In 2008, a water resources monitoring programme for the area...

  12. Nitrogen metabolism and growth enhancement in tomato plants challenged with Trichoderma harzianum expressing the Aspergillus nidulans acetamidase amdS gene

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    Sara Domínguez

    2016-08-01

    Full Text Available Trichoderma is a fungal genus that includes species that are currently being used as biological control agents and/or as biofertilizers. In addition to the direct application of Trichoderma spp. as biocontrol agents in plant protection, recent studies have focused on the beneficial responses exerted on plants, stimulating the growth, activating the defenses, and/or improving nutrient uptake. The amdS gene, encoding an acetamidase of Aspergillus, has been used as a selectable marker for the transformation of filamentous fungi, including Trichoderma spp., but the physiological effects of the introduction of this gene into the genome of these microorganisms still remains unexplored. No evidence of amdS orthologous genes has been detected within the Trichoderma spp. genomes and the amdS heterologous expression in T. harzianum T34 did not affect the growth of this fungus in media lacking acetamide. However, it did confer the ability for the fungus to use this amide as a nitrogen source. Although a similar antagonistic behavior was observed for T34 and amdS transformants in dual cultures against Rhizoctonia solani, Botrytis cinerea and Fusarium oxysporum, a significantly higher antifungal activity was detected in amdS transformants against F. oxysporum, compared to that of T34, in membrane assays on media lacking acetamide. In Trichoderma-tomato interaction assays, amdS transformants were able to promote plant growth to a greater extent than the wild-type T34, although compared with this strain the transformants showed similar capability to colonize tomato roots. Gene expression patterns from aerial parts of 3-week-old tomato plants treated with T34 and the amdS transformants have also been investigated using GeneChip Tomato Genome Arrays. The downregulation of defense genes and the upregulation of carbon and nitrogen metabolism genes observed in the microarrays were accompanied by i enhanced growth, ii increased carbon and nitrogen levels and iii a

  13. Safety of ranibizumab therapy in wet AMD and the role of vascular endothelial growth factors in physiological angiogenesis.

    Science.gov (United States)

    Figurska, Małgorzata; Robaszkiewicz, Jacek; Wierzbowska, Joanna

    2010-01-01

    Vascular endothelial growth factor - A (VEGF-A), is a major factor implicated in choroidal neovascularisation (CNV) and therefore a target for therapeutic agents in wet age related macular degeneration (AMD). Ranibiuzumab (Lucentis) blocks all active isoforms of VEGF-A and the products of their degradation. It penetrates through all layers of the retina in order to reach the target tissue. It is quickly removed from the system and it is characterised by low level of immunogenicity. The essence of angiogenesis is formation of new vessels by branching and expansion of already existing ones. Angiogenesis is an important physiological process that takes place during the healing of wounds, reconstruction of hypoxic injury and reproduction. However some diseases such as cancer, arthritis, diabetes and neovascular AMD are associated with persistent unregulated angiogenesis. There is an important question whether binding vascular-endothelial growth factors in wet AMD therapies using ranibizumab is correlated with the increase of the incidence of systematic adverse effects (AEs), such as cardiovascular episodes or thrombosis. The aim of this article is to present ranibizumab as a safe drug in treating wet AMD patients. Even though the concentration of Lucentis administered in a dose of 0.3 or 0.5 mg into the vitreous body in the organism is very low, the incidence of AEs during the anti-VEGF therapy was traced. In MARINA and ANCHOR studies, occurrence of possible AEs was observed. No statistically significant differences were shown in the AEs frequency between the patients treated with ranibizumab and the control group, and in correlation with the general population of patients suffering from wet AMD.

  14. Combination of Aflibercept and Bromfenac Therapy in Age-Related Macular Degeneration: A Pilot Study Aflibercept and Bromfenac in AMD.

    Science.gov (United States)

    Wyględowska-Promieńska, Dorota; Piotrowska-Gwóźdź, Anna; Piotrowska-Seweryn, Agnieszka; Mazur-Piotrowska, Grażyna

    2015-12-15

    BACKGROUND Among many protocols for treatment of exudative AMD, combined therapy of anti-VEGF agents and non-steroidal anti-inflammatory drugs (NSAIDs) seems to be an ideal alternative to monotherapy based on ranibizumab or bevacizumab. The aim of this study was to evaluate the effectiveness of aflibercept and bromfenac in the treatment of exudative AMD. MATERIAL AND METHODS The study was conducted on a group of 27 patients with exudative AMD who were administered intravitreal aflibercept and topical bromfenac (study group) once a month. Additional injections were administered up to 3 months after the third administration, depending on response to treatment. The control group consisted of subjects treated with aflibercept only. Visual acuity and anatomical outcomes in optical coherence tomography (OCT) were assessed at baseline visit, 4 months after the first dose, and 6 months after the start of the treatment. RESULTS Visual acuity improved over time in the study group and the differences between the groups were statistically significant. No statistically significant differences were found in OCT parameters. CONCLUSIONS Combined therapy of aflibercept and bromfenac in the treatment of wet AMD is more effective than single aflibercept therapy.

  15. AMD--the retinal disease with an unprecised etiopathogenesis: in search of effective therapeutics.

    Science.gov (United States)

    Nowak, Jerzy Z

    2014-01-01

    AMD (age-related macular degeneration) is a progressive vision-threatening ocular disease, affecting central region of the retina--the macula--and manifesting in the elderly. AMD is a degenerative disease, and the degeneration affects primarily the retinal pigment epithelial (RPE) cells and secondarily the photoreceptors, leading consequently to disturbances or partial loss of central vision and legal blindness. Clinically, the disease is classified as: atrophic--dry AMD (in majority of cases), and neovascular--wet AMD (with choroidal neovascularization--CNV: 10-15% of all AMD cases). Pathogenesis of AMD is complex, multifactorial and only poorly recognized. Main risk factors include: advanced age, genetic predispositions, environmental determinants, history of exposure to intensive light and smoking. At least four molecular processes contribute to the development of AMD pathology: lipofuscinogenesis, drusogenesis, inflammation and choroidal neovascularization (in wet AMD). Since vascular endothelial growth factor (VEGF) is a predominant proangiogenic factor in CNV. the wet AMD can be treated with intravitreous application of "anti-VEGF" agents (Avastin, Lucentis, Eylea). Till now, there is no approved therapy for dry AMD, although several agents/treatments are currently in clinical trials. This paper briefly describes major molecular and cellular events leading to AMD, and presents currently used and new experimental therapeutic strategies against AMD.

  16. MP-1 biofeedback: luminous pattern stimulus versus acoustic biofeedback in age related macular degeneration (AMD).

    Science.gov (United States)

    Vingolo, Enzo M; Salvatore, Serena; Limoli, Paolo G

    2013-03-01

    In this study we evaluated the efficacy of visual rehabilitation by means of two different types of biofeedback techniques in patients with age related macular degeneration (AMD). Thirty patients, bilaterally affected by AMD, were randomly divided in two groups: one group was treated with an acoustic biofeedback (AB group), the other was treated with luminous biofeedback of a black and white checkerboard flickering during the examination (LB group). All patients underwent a complete ophthalmological examination. Rehabilitation consisted of 12 training sessions of 10 min for each eye performed once a week for both groups. Both groups showed better visual performance after rehabilitation and luminous flickering biofeedback stimulus showed a statistically significant improvement in training the patients to modify their preferred retinal locus in comparison to acoustic biofeedback. This suggests that it might be possible in the damaged retina to override dead photoreceptor and outer retinal layers and involve residual surviving cells, as well as amplify and integrate retinal and brain cortex plasticity by using other spared channels towards associative pathways.

  17. Modelling of acid mine drainage (AMD in columns

    Directory of Open Access Journals (Sweden)

    C. M. Bernardes de Souza

    2011-09-01

    Full Text Available A model is proposed in this paper to describe the generation of acid mine drainage (AMD in leaching columns. The model considers: (i Water flow through the column, which is calculated using the 1 - D analytic solution of the Richards' equation assuming the existence of a similarity relationship between the water retention function and the water content profiles at a given time; and (ii Pyrite oxidation weighted by microbiological effects occurring in spherical particles according to the shrinking core model. Mass balances of oxygen and pyrite were derived in order to evaluate the intrinsic oxidation rate and the pyrite fraction reacted with time and column position. The model was used to simulate a six month operation of a leaching column, which comprised successive weekly cycles of dry and wet periods. Simulation results demonstrated that AMD generation is strongly affected by the presence of microorganisms. A relative deviation of 5% between simulation and experimental data was obtained.

  18. What effects has the cataract surgery on the development and progression of Age-Related Macular Degeneration (AMD?

    Directory of Open Access Journals (Sweden)

    Willich, Stefan N.

    2006-12-01

    Full Text Available Background: The cataract (Cataracta senilis is the most frequent eye disease of elderly people worldwide. In Germany, the cataract operation - with currently 450,000 interventions each year the most frequent operation in ophthalmology – can be seen as routine surgery. The age related macular degeneration (AMD is a further one of the most common, age-related eye diseases and the most frequent cause of blindness of elderly people in industrial nations. Due to demographic changes an increasing number of patients will suffer from cataract and AMD at the same time. This coincidence leads to a greater interest in the question of a mutual influence of both diseases, respectively their therapies, on each other. Objectives: The aim of this report was the evaluation of the medical and health economic effects of cataract operations on the development and progression of an age related macular degeneration (AMD. It was differentiated between first manifestations of AMD, progression of early stages of AMD and influence on further impairment in late stages of AMD. Methods: The relevant publications for this report were identified by DIMDI via structured database enquiry as well as common, self-made enquiry and were evaluated, based on the criteria of evidence based medicine. The present report included German and English literature published since 1983. Results: The database enquiry generated a record of 2769 issue-related publications. Eight medical publications were eligible for analysis in the course of the present HTA report. No relevant studies on health economical, ethical, social or legal issues could be included. Three epidemiological cohort studies provided some evidence for a promoting influence of cataract extractions on the progression of early types of AMD. Two of the epidemiological studies assessed the risk of first manifestation of AMD after cataract extraction. Both came up with up with increased incidences that did not reach statistical

  19. Remediation of AMD using natural and waste material

    Energy Technology Data Exchange (ETDEWEB)

    Basir, Nur Athirah Mohamad; Yaacob, Wan Zuhairi Wan [Pusat pengajian Sains Sekitaran dan Sumber Alam, Fakulti Sains dan Teknologi, Universiti Kebangsaan (Malaysia)

    2014-09-03

    Acid Mine Drainage (AMD) is highly acidic, sulphate rich and frequently carries a high transition metal and heavy metal burden. These AMD's eventually migrate into streams and rivers and impact negatively on the quality of these water bodies. So it is dire necessary to treat this AMD. Various materials such as ladle furnace slag (LFS), bentonite, zeolite, active carbon and kaolinite are currently available to remove heavy metals from contaminated water. All these materials are capable to rise up the pH value and adsorb heavy metals. The process is divided into two stages; screening test and tank experiment. Screening test is conduct by using Batch Equilibrium Test (BET), X-Ray Fluorescene (XRF) identification also Scanning Electron Microscopic (SEM) characteristic. The results showed that all the concentration of heavy metal are decreasing extremely and pH value rise up except for kaolinite. From screening test only ladle furnace slag, bentonite, zeolite and active carbon are chosen for the tank experiment. Tank experiment design with 18cm (H) X 15cm (L) X 15cm (H) was made by silica glass. All these treatment materials were stirred in the tank for 30 days. Initial pH for all tanks is 2.4 and after 30 days is changing into 6.11, 3.91, 2.98 and 2.71 for LFS, bentonite, active carbon as well as zeolite respectively. LFS is the best material for absorption of Zn, Mn and Cu in the synthetic solution. Meanwhile, bentonite is the best absorbent for Ni, Fe and Cd. The conclusion shows that LFS might have big potentials to control AMD pollution base on neutralize pH resulting in a great improvement in the quality of the water.

  20. The Aspergillus nidulans amdS gene as a marker for the identification of multicopy T-DNA integration events in Agrobacterium-mediated transformation of Aspergillus awamori

    NARCIS (Netherlands)

    Michielse, C.B.; Ram, A.F.J.; Hondel, C.A.M.J.J. van den

    2004-01-01

    The Aspergillus nidulans amdS selection marker was used for the identification of multicopy T-DNA insertions in Agrobacterium-mediated transformation of Asp. awamori. The selection of transformants on agar plates containing acetamide as sole nitrogen source and hygromycin resulted in a six-fold decr

  1. Interesting Characteristics of AMD Barcelona Floating Point Execution

    Energy Technology Data Exchange (ETDEWEB)

    Bales, Benjamin B [ORNL; Barrett, Richard F [ORNL

    2009-01-01

    In almost all modern scientific applications, developers achieve the greatest performance gains by tuning algorithms, communication systems, and memory access patterns, while leaving low level instruction optimizations to the compiler. Given the increasingly varied and complicated x86 architectures, the value of these optimizations is unclear, and, due to time and complexity constraints, it is difficult for many programmers to experiment with them. In this report we explore the potential gains of these 'last mile' optimization efforts on an AMD Barcelona processor, providing readers with relevant information so that they can decide whether investment in the presented optimizations is worthwhile.

  2. A New System for Measuring Auto-Fluorescence Changes in Neovascular-AMD after Intravitreal Injection of Bavecizumab

    Directory of Open Access Journals (Sweden)

    Mohammad Norouzifard

    2011-07-01

    Full Text Available Age-Related Macular Degeneration (AMD is the second disease diabetes which causes blindness in aged people. The only remedy for AMD is intravenous injection of bavecizumab. To prove the efficiency of remedy, the degenerated cells in Macula should be measured. In this article, a modern system is introduced to measure Auto-Fluorescence in Macula part of retina in order to obtain number of degenerated cells. The system consists of three main parts: Pre-processing stage is omission of margins and reversion of images in retina. Analysis stage is in charge of classification of images and elicitation of their features. In classification the target areas are identified by methods like morphology, dynamic threshold and connected comportments and the features of target area including Euclidean distance to the center of image and density. In the stage of understanding by gathering the features of each class, we will get the measurable parameter of evaluating Auto Fluorescence by the help of which we can count the number of degenerated cells of Macula area. The results are coming from statistical analysis, including linear regression and correlation of data. Experiments have been done on a database of 34 retina images of AMD patients. The average statistical error rate is equal to76 percent. In clinical reviews, the founded relation to disinflation of Macula has been proved, while there were no proved relations to the vision decreasing or increasing of patients.

  3. Intravitreal aflibercept (A-IVI) for the treatment of neovascular age-related macular degeneration (nv-AMD): one year experience

    OpenAIRE

    Papavasileiou, Evangelia; Zygoura, V; Richardson, T.; Cortis, D; Eleftheriadis, Haralabos; Jackson, Timothy Llewwllyn

    2015-01-01

    OBJECTIVE: To report the anatomical and functional results of intravitreal injections of aflibercept (Eylea) (A-IVI) for the treatment of naïve eyes with neovascular age-related macular degeneration (nv-AMD). SUBJECTS AND METHODS: This retrospective, one-center, non-comparative chart review included 26 treatment naïve eyes with nv-AMD of 26 patients (14 male) with a mean age of 80.5 (range 63-91) who had a complete follow-up of 14 months. The morphological analysis included spectral domain op...

  4. Nutritional Supplementation Inhibits the Increase in Serum Malondialdehyde in Patients with Wet Age-Related Macular Degeneration.

    Science.gov (United States)

    Matsuura, Toshiyuki; Takayama, Kei; Kaneko, Hiroki; Ye, Fuxiang; Fukukita, Hiroshi; Tsunekawa, Taichi; Kataoka, Keiko; Hwang, Shiang-Jyi; Nagasaka, Yosuke; Ito, Yasuki; Terasaki, Hiroko

    2017-01-01

    Purpose. To compare serum levels of malondialdehyde (MDA) in patients with wet age-related macular degeneration (wAMD), patients with dry AMD (dAMD), and patients without AMD and to evaluate the efficacy of nutritional supplementation for treating elevated serum MDA in patients with wAMD. Methods. MDA levels were measured in sera from 20 patients with wAMD, 20 with dAMD, and 24 without AMD. Patients with wAMD were randomized to receive or not receive nutritional supplementation (10 patients in each group), and MDA levels were measured after 3 months of treatment. Results. MDA levels in patients with wAMD were significantly greater compared with patients without AMD. In eyes with wAMD, there was a significant correlation between MDA levels and choroidal neovascularization lesion area. Serum MDA levels decreased in most patients that received supplementation and significantly increased in those who did not. Conclusion. Baseline serum MDA levels were elevated in patients with wAMD, and MDA levels were directly correlated with choroidal neovascularization lesion area. In addition, nutritional supplementation appeared to exert a protective effect against oxidative stress in patients with wAMD.

  5. Nutritional Supplementation Inhibits the Increase in Serum Malondialdehyde in Patients with Wet Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Toshiyuki Matsuura

    2017-01-01

    Full Text Available Purpose. To compare serum levels of malondialdehyde (MDA in patients with wet age-related macular degeneration (wAMD, patients with dry AMD (dAMD, and patients without AMD and to evaluate the efficacy of nutritional supplementation for treating elevated serum MDA in patients with wAMD. Methods. MDA levels were measured in sera from 20 patients with wAMD, 20 with dAMD, and 24 without AMD. Patients with wAMD were randomized to receive or not receive nutritional supplementation (10 patients in each group, and MDA levels were measured after 3 months of treatment. Results. MDA levels in patients with wAMD were significantly greater compared with patients without AMD. In eyes with wAMD, there was a significant correlation between MDA levels and choroidal neovascularization lesion area. Serum MDA levels decreased in most patients that received supplementation and significantly increased in those who did not. Conclusion. Baseline serum MDA levels were elevated in patients with wAMD, and MDA levels were directly correlated with choroidal neovascularization lesion area. In addition, nutritional supplementation appeared to exert a protective effect against oxidative stress in patients with wAMD.

  6. Nutritional Supplementation Inhibits the Increase in Serum Malondialdehyde in Patients with Wet Age-Related Macular Degeneration

    Science.gov (United States)

    Fukukita, Hiroshi; Tsunekawa, Taichi; Kataoka, Keiko; Hwang, Shiang-Jyi; Nagasaka, Yosuke; Ito, Yasuki; Terasaki, Hiroko

    2017-01-01

    Purpose. To compare serum levels of malondialdehyde (MDA) in patients with wet age-related macular degeneration (wAMD), patients with dry AMD (dAMD), and patients without AMD and to evaluate the efficacy of nutritional supplementation for treating elevated serum MDA in patients with wAMD. Methods. MDA levels were measured in sera from 20 patients with wAMD, 20 with dAMD, and 24 without AMD. Patients with wAMD were randomized to receive or not receive nutritional supplementation (10 patients in each group), and MDA levels were measured after 3 months of treatment. Results. MDA levels in patients with wAMD were significantly greater compared with patients without AMD. In eyes with wAMD, there was a significant correlation between MDA levels and choroidal neovascularization lesion area. Serum MDA levels decreased in most patients that received supplementation and significantly increased in those who did not. Conclusion. Baseline serum MDA levels were elevated in patients with wAMD, and MDA levels were directly correlated with choroidal neovascularization lesion area. In addition, nutritional supplementation appeared to exert a protective effect against oxidative stress in patients with wAMD. PMID:28243361

  7. Potential of Induced Pluripotent Stem Cells (iPSCs) for Treating Age-Related Macular Degeneration (AMD).

    Science.gov (United States)

    Fields, Mark; Cai, Hui; Gong, Jie; Del Priore, Lucian

    2016-12-08

    The field of stem cell biology has rapidly evolved in the last few decades. In the area of regenerative medicine, clinical applications using stem cells hold the potential to be a powerful tool in the treatment of a wide variety of diseases, in particular, disorders of the eye. Embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) are promising technologies that can potentially provide an unlimited source of cells for cell replacement therapy in the treatment of retinal degenerative disorders such as age-related macular degeneration (AMD), Stargardt disease, and other disorders. ESCs and iPSCs have been used to generate retinal pigment epithelium (RPE) cells and their functional behavior has been tested in vitro and in vivo in animal models. Additionally, iPSC-derived RPE cells provide an autologous source of cells for therapeutic use, as well as allow for novel approaches in disease modeling and drug development platforms. Clinical trials are currently testing the safety and efficacy of these cells in patients with AMD. In this review, the current status of iPSC disease modeling of AMD is discussed, as well as the challenges and potential of this technology as a viable option for cell replacement therapy in retinal degeneration.

  8. Heat shock proteins as gatekeepers of proteolytic pathways-Implications for age-related macular degeneration (AMD).

    Science.gov (United States)

    Kaarniranta, Kai; Salminen, Antero; Eskelinen, Eeva-Liisa; Kopitz, Jürgen

    2009-04-01

    Age-related macular degeneration (AMD) is the major diagnosis for severe and irreversible central loss of vision in elderly people in the developed countries. The loss of vision involves primarily a progressive degeneration and cell death of postmitotic retinal pigment epithelial cells (RPE), which secondarily evokes adverse effects on photoreceptor cells. The RPE cells are exposed to chronic oxidative stress from three sources: their high levels of oxygen consumption, their exposure to the high levels of lipid peroxidation derived from the photoreceptor outer segments and their exposure to constant light stimuli. Cells increase the expression of heat shock proteins (HSPs) in order to normalize their growth conditions in response to various environmental stress factors, e.g. oxidative stress. The HSPs function as molecular chaperones by preventing the accumulation of cellular cytotoxic protein aggregates and assisting in correct folding of both nascent and misfolded proteins. Increased HSPs levels are observed in the retina of AMD patients, evidence of stressed tissue. A hallmark of RPE cell aging is lysosomal lipofuscin accumulation reflecting a weakened capacity to degrade proteins in lysosomes. The presence of lipofuscin increases the misfolding of intracellular proteins, which evokes additional stress in the RPE cells. If the capacity of HSPs to repair protein damages is overwhelmed, then the proteins are mainly cleared in proteasomes or in lysosomes. In this review, we discuss the role of heat shock proteins, proteasomes, and lysosomes and autophagic processes in RPE cell proteolysis and how these might be involved in development of AMD. In addition to classical lysosomal proteolysis, we focus on the increasing evidence that, HSPs, proteasomes and autophagy regulate protein turnover in the RPE cells and thus have important roles in AMD disease.

  9. Aflibercept in wet AMD: specific role and optimal use

    Directory of Open Access Journals (Sweden)

    Semeraro F

    2013-08-01

    performed using the following terms (or combination of terms: vascular endothelial growth factors, VEGF, age-related macular degeneration, VEGF-Trap eye in wet AMD, VEGF-Trap eye in diabetic retinopathy, VEGF-Trap eye in retinal vein occlusions, aflibercept. Studies were limited to those published in English.Results and conclusion: Two Phase III clinical trials, VEGF Trap-eye Investigation of Efficacy and Safety in Wet AMD (VIEW 1 and 2, comparing VEGF Trap-eye to ranibizumab demonstrated the noninferiority of this novel compound. The clinical equivalence of this compound against ranibizumab is maintained even when the injections are administered at 8-week intervals, which indicates the potential to reduce the risk of monthly intravitreal injections and the burden of monthly monitoring.Keywords: aflibercept, AMD, neovascularization, VEGF, VEGF inhibition, VEGF-Trap eye

  10. AMD Sabine平台将支持DirectX 11

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    2011年发布的AMD Sabine主流桌面与移动平台,将装备AMD公司最新的Llano APU(即在同一硅片上集成了CPU与GPU的加速处理芯片)。日前一份泄露的AMD移动平台路线图显示,Sabine平台的南桥芯片将支持USB3.0标准,提供16个USB接口、6个SATA接口以及RAID技术。该平台还支持DDR3 1600MHz内存控制器.集成时钟发生器和DAC数模转换器,

  11. Lack of the P2X7 receptor protects against AMD-like defects and microparticle accumulation in a chronic oxidative stress-induced mouse model of AMD.

    Science.gov (United States)

    Carver, Kyle A; Lin, C M; Bowes Rickman, Catherine; Yang, Dongli

    2017-01-01

    The P2X7 receptor (P2X7R) is an ATP-gated ion channel that is a key player in oxidative stress under pathological conditions. The P2X7R is expressed in the retinal pigmented epithelium (RPE) and neural retina. Chronic oxidative stress contributes to the pathogenesis of age-related macular degeneration (AMD). Mice lacking Cu, Zn superoxide dismutase (Sod1) developed chronic oxidative stress as well as AMD-like features, but whether the P2X7R plays a causative role in oxidative stress-induced AMD is unknown. Thus, the main purpose of this study was to test if concurrent knockout (KO) of P2X7R could block AMD-like defects seen in Sod1 KO mice. Using multiple approaches, we demonstrate that Sod1 KO causes AMD-like defects, including positive staining for oxidative stress markers, 3-nitrotyrosine and carboxymethyl lysine, thinning of the RPE and retina, thickening of Bruch's membrane, presence of basal laminar and linear deposits, RPE barrier disruption and accumulation of microglia/macrophages. Moreover, we find that Sod1 KO mice accumulate more microparticles (MPs) within RPE/choroid tissues. Concurrent KO of the P2X7R protects against AMD-like defects and MP accumulation in Sod1 KO mice. Together, we show for the first time, that deficiency of P2X7R prevents in vivo oxidative stress-induced accumulation of MPs and AMD-like defects. This work could potentially lead to novel therapies for AMD and other oxidative stress-driven diseases.

  12. Prediction of age-related macular degeneration in the general population: The three continent AMD consortium

    NARCIS (Netherlands)

    G.H.S. Buitendijk (Gabrielle); E. Rochtchina (Elena); C.E. Myers (Chelsea); C.M. van Duijn (Cock); K.E. Lee (Kristine); B.E.K. Klein (Barbara); S.M. Meuer (Stacy); P.T.V.M. de Jong (Paulus); E.G. Holliday (Elizabeth); A.G. Tan (Ava); A.G. Uitterlinden (André); T.A. Sivakumaran (Theru); J. Attia (John); A. Hofman (Albert); P. Mitchell (Paul); J.R. Vingerling (Hans); S.K. Iyengar (Sudha); A.C.J.W. Janssens (Cécile); J.J. Wang (Jie Jin); B.E.K. Klein (Barbara); C.C.W. Klaver (Caroline)

    2013-01-01

    textabstractPurpose Prediction models for age-related macular degeneration (AMD) based on case-control studies have a tendency to overestimate risks. The aim of this study is to develop a prediction model for late AMD based on data from population-based studies. Design Three population-based studies

  13. It's not all about acid mine drainage (AMD) on the West Rand - there is dust too

    CSIR Research Space (South Africa)

    Oosthuizen, R

    2012-08-01

    Full Text Available The West Rand is part of the Gauteng Province and is surrounded by mining activities. There have been several media and scientific reports about acid mine drainage (AMD) in this area. However, AMD is not the only environmental problem faced...

  14. The Revival of a Failed Constructed Wetland Treating of a High Fe Load AMD

    Science.gov (United States)

    A.D. Karathanasis; C.D. Barton

    1999-01-01

    Acid mine drainage (AMD) from abandoned mines has significantly impaired water quality in eastern Kentucky. A small surface flow wetland constructed in 1989 to reduce AMD effects and subsequently failed after six months of operation was renovated by incorporating anoxic limestone drains (ALDs) and anaerobic subsurface drains promoting vertical flow through successive...

  15. Complement activation and choriocapillaris loss in early AMD: implications for pathophysiology and therapy.

    Science.gov (United States)

    Whitmore, S Scott; Sohn, Elliott H; Chirco, Kathleen R; Drack, Arlene V; Stone, Edwin M; Tucker, Budd A; Mullins, Robert F

    2015-03-01

    Age-related macular degeneration (AMD) is a common and devastating disease that can result in severe visual dysfunction. Over the last decade, great progress has been made in identifying genetic variants that contribute to AMD, many of which lie in genes involved in the complement cascade. In this review we discuss the significance of complement activation in AMD, particularly with respect to the formation of the membrane attack complex in the aging choriocapillaris. We review the clinical, histological and biochemical data that indicate that vascular loss in the choroid occurs very early in the pathogenesis of AMD, and discuss the potential impact of vascular dropout on the retinal pigment epithelium, Bruch's membrane and the photoreceptor cells. Finally, we present a hypothesis for the pathogenesis of early AMD and consider the implications of this model on the development of new therapies.

  16. The major risk alleles of age-related macular degeneration (AMD) in CFH do not play a major role in rheumatoid arthritis (RA).

    Science.gov (United States)

    Trouw, L A; Böhringer, S; Daha, N A; Stahl, E A; Raychaudhuri, S; Kurreeman, F A; Stoeken-Rijsbergen, G; Houwing-Duistermaat, J J; Huizinga, T W; Toes, R E

    2011-12-01

    Because activation of the alternative pathway (AP) of the complement system is an important aspect of both age-related macular degeneration (AMD) and rheumatoid arthritis (RA), we wished to address the question whether genetic risk factors of the AP inhibitor complement factor H (CFH) for AMD would also be risk factors for RA. For this purpose we genotyped single nucleotide polymorphisms (SNPs) in a Dutch set of RA patients and controls. Similarly, a meta-analysis using a Spanish cohort of RA as well as six large genome-wide association studies (GWAS) studies was performed. For these SNPs we analysed more than 6000 patients and 20,000 controls. The CFH variants, I62V, Y402H, IVS1 and IVS10, known to associate strongly with AMD, did not show a significant association with the risk of developing RA despite a strong statistical power to detect such differences. In conclusion, the major risk alleles of AMD in CFH do not have a similar effect on developing RA.

  17. Comparing humans and deep learning performance for grading AMD: A study in using universal deep features and transfer learning for automated AMD analysis.

    Science.gov (United States)

    Burlina, Philippe; Pacheco, Katia D; Joshi, Neil; Freund, David E; Bressler, Neil M

    2017-03-01

    When left untreated, age-related macular degeneration (AMD) is the leading cause of vision loss in people over fifty in the US. Currently it is estimated that about eight million US individuals have the intermediate stage of AMD that is often asymptomatic with regard to visual deficit. These individuals are at high risk for progressing to the advanced stage where the often treatable choroidal neovascular form of AMD can occur. Careful monitoring to detect the onset and prompt treatment of the neovascular form as well as dietary supplementation can reduce the risk of vision loss from AMD, therefore, preferred practice patterns recommend identifying individuals with the intermediate stage in a timely manner. Past automated retinal image analysis (ARIA) methods applied on fundus imagery have relied on engineered and hand-designed visual features. We instead detail the novel application of a machine learning approach using deep learning for the problem of ARIA and AMD analysis. We use transfer learning and universal features derived from deep convolutional neural networks (DCNN). We address clinically relevant 4-class, 3-class, and 2-class AMD severity classification problems. Using 5664 color fundus images from the NIH AREDS dataset and DCNN universal features, we obtain values for accuracy for the (4-, 3-, 2-) class classification problem of (79.4%, 81.5%, 93.4%) for machine vs. (75.8%, 85.0%, 95.2%) for physician grading. This study demonstrates the efficacy of machine grading based on deep universal features/transfer learning when applied to ARIA and is a promising step in providing a pre-screener to identify individuals with intermediate AMD and also as a tool that can facilitate identifying such individuals for clinical studies aimed at developing improved therapies. It also demonstrates comparable performance between computer and physician grading. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Predictive Factors in OCT Analysis for Visual Outcome in Exudative AMD

    Directory of Open Access Journals (Sweden)

    Maria-Andreea Gamulescu

    2012-01-01

    Full Text Available Background. Reliable predictive factors for therapy outcome may enable treating physicians to counsel their patients more efficiently concerning probability of improvement or time point of discontinuation of a certain therapy. Methods. This is a retrospective analysis of 87 patients with exudative age-related macular degeneration who received three monthly intravitreal ranibizumab injections. Visual acuity before initiation of intravitreal therapy and 4–6 weeks after last intravitreal injection was compared and related to the preoperative visualisation of continuity of the outer retinal layers as assessed by OCT: external limiting membrane (ELM, inner photoreceptor segments (IPS, junction between inner and outer segments (IS/OS, and outer photoreceptor segments (OPS. Results. Visual acuity increased in 40 of 87 (46.0% patients, it remained stable in 25 (28.7%, and 22 (25.3% patients had decreased visual acuity four to six weeks after triple intravitreal ranibizumab injections. No statistically significant predictive value could be demonstrated for grade of continuity of outer retinal layers concerning visual acuity development. Conclusions. In our series of AMD patients, grade of continuity of outer retinal layers was not a significant predictive value for visual acuity development after triple ranibizumab injections.

  19. Predictive Factors in OCT Analysis for Visual Outcome in Exudative AMD.

    Science.gov (United States)

    Gamulescu, Maria-Andreea; Panagakis, Georgios; Theek, Carmen; Helbig, Horst

    2012-01-01

    Background. Reliable predictive factors for therapy outcome may enable treating physicians to counsel their patients more efficiently concerning probability of improvement or time point of discontinuation of a certain therapy. Methods. This is a retrospective analysis of 87 patients with exudative age-related macular degeneration who received three monthly intravitreal ranibizumab injections. Visual acuity before initiation of intravitreal therapy and 4-6 weeks after last intravitreal injection was compared and related to the preoperative visualisation of continuity of the outer retinal layers as assessed by OCT: external limiting membrane (ELM), inner photoreceptor segments (IPS), junction between inner and outer segments (IS/OS), and outer photoreceptor segments (OPS). Results. Visual acuity increased in 40 of 87 (46.0%) patients, it remained stable in 25 (28.7%), and 22 (25.3%) patients had decreased visual acuity four to six weeks after triple intravitreal ranibizumab injections. No statistically significant predictive value could be demonstrated for grade of continuity of outer retinal layers concerning visual acuity development. Conclusions. In our series of AMD patients, grade of continuity of outer retinal layers was not a significant predictive value for visual acuity development after triple ranibizumab injections.

  20. Anxiety and depression in patients with advanced macular degeneration: current perspectives.

    Science.gov (United States)

    Cimarolli, Verena R; Casten, Robin J; Rovner, Barry W; Heyl, Vera; Sörensen, Silvia; Horowitz, Amy

    2016-01-01

    Age-related macular degeneration (AMD) - despite advances in prevention and medical treatment options - remains prevalent among older adults, often resulting in functional losses that negatively affect the mental health of older adults. In particular, the prevalence of both anxiety and depression in patients with AMD is high. Along with medical treatment options, low vision rehabilitation and AMD-specific behavioral and self-management programs have been developed and have demonstrated effectiveness in improving the mental health of AMD patients. This article reviews the prevalence of anxiety and depression in patients with advanced AMD, discusses potential mechanisms accounting for the development of depression and anxiety in AMD patients, presents the state-of the-art of available interventions for addressing anxiety and depression in AMD patients, and delineates recommendations for eye care professionals regarding how to screen for these two prevalent mental health problems and how to facilitate appropriate treatment for patients with AMD.

  1. Removal of phosphorus from wastewater using ferroxysorb sorption media produced from amd sludge

    Science.gov (United States)

    Sibrell, P.L.; Tucker, T.W.; Kehler, T.; Fletcher, J.W.

    2008-01-01

    Treatment of acid mine drainage (AMD), whether with lime, limestone, caustic or simple aeration, nearly always results in generation of a metal hydroxide sludge. Disposal of the sludge often constitutes a significant fraction of the operating cost for the AMD treatment plant. Research at the USGS - Leetown Science Center has shown that AMD sludge, with its high content of aluminum and iron oxides, has a high affinity of phosphorus (P). Anthropogenic sources of P are associated with eutrophication and degradation of aquatic environments, resulting in anoxic dead zones in certain sensitive waterways. In this paper, we describe a method of converting the AMD sludge from a liability into an asset - Ferroxysorb P removal media - which can be used to remove excess P from wastewater. Three different Ferroxysorb media samples were produced from differing AMD sources and tested for P removal. Adsorption isotherms confirmed that the media had a high sorption capacity for P, as high as 19,000 mg/kg. The technology was demonstrated at an active fish hatchery, where the media remained in service for over three months without stripping or regeneration. Over that period of time, the calculated P removal was 50%, even at a very low influent P concentration of 60 parts per billion. In summary, use of the AMD-derived Ferroxysorb sorption media will reduce AMD treatment costs while at the same time helping to resolve the pressing environmental issue of eutrophication and degradation of sensitive waterways.

  2. Managing landmine detection sensors: results from application to AMDS data

    Science.gov (United States)

    Kolba, Mark P.; Collins, Leslie M.

    2007-04-01

    Previous work by the authors using information-based sensor management for static target detection has utilized a probability of error performance metric that assumes knowledge of the number of targets present in a grid of cells. Using this probability of error performance metric, target locations are estimated as the N cells with the largest posterior state probabilities of containing a target. In a realistic application, however, the number of targets is not known a priori. The sequential probability ratio test (SPRT) developed by Wald is therefore implemented within the previously developed sensor management framework to allow cell-level decisions of "target" or "no target" to be made based on the observed sensor data. Using these cell-level decisions, more traditional performance metrics such as probability of detection and probability of false alarm may then be calculated for the entire region of interest. The resulting sensor management framework is implemented on a large set of data from the U.S. Army's autonomous mine detection sensors (AMDS) program that has been collected using both ground penetrating radar (GPR) and electromagnetic induction (EMI) sensors. The performance of the sensor manager is compared to two different direct search techniques, and the sensor manager is found to achieve the same P d performance at a lower cost than either of the direct search techniques. Furthermore, uncertainty in the sensor performance characteristics is also modeled, and the use of uncertainty modeling allows a higher P d to be obtained than is possible when uncertainty is not modeled within the sensor management framework.

  3. The treatment of wet AMD in Canada: access to therapy (policy review).

    Science.gov (United States)

    Cruess, Alan; Maberley, David; Wong, David; Chen, John

    2009-10-01

    Age-related macular degeneration (AMD) is the leading cause of blindness in North America, affecting 2 million Canadians older than age 50 years. AMD is subdivided into 2 types: an atrophic form, so-called "dry" AMD, and an exudative or "wet" form, characterized by the presence of choroidal neovascularization (CNV). Since 2000, after decades with no effective therapy aside from thermal obliterative laser treatment of CNV, 3 new treatments have been approved, each offering significant therapeutic advances at increasingly higher prices, and in an increasingly cost-containment-oriented payer environment. Many of Canada's public drug plans have been relatively slow to fund evidence-based, approved treatments. This paper reviews the disease, as well as the current private and public coverage for wet AMD treatments.

  4. Kiibitootja AMD on võitmas turuosa suure rivaali Inteli käest / Lauri Matsulevitsh

    Index Scriptorium Estoniae

    Matsulevitsh, Lauri

    2006-01-01

    Arvutiprotsessorite tootja Advanced Micro Devices (AMD) näitas oma lõppenud kvartalis teenitud kasumiga, et hakkab konkurent Intelile järgi jõudma. Diagramm: Aktsia hind. Kommenteerib Peeter Teder

  5. Kiibitootja AMD on võitmas turuosa suure rivaali Inteli käest / Lauri Matsulevitsh

    Index Scriptorium Estoniae

    Matsulevitsh, Lauri

    2006-01-01

    Arvutiprotsessorite tootja Advanced Micro Devices (AMD) näitas oma lõppenud kvartalis teenitud kasumiga, et hakkab konkurent Intelile järgi jõudma. Diagramm: Aktsia hind. Kommenteerib Peeter Teder

  6. Microbial ecology of a novel sulphur cycling consortia from AMD: implications for acid generation

    Science.gov (United States)

    Loiselle, L. M.; Norlund, K. L.; Hitchcock, A. P.; Warren, L. A.

    2009-05-01

    Recent work1 identified a novel microbial consortia consisting of two bacterial strains common to acid mine drainage (AMD) environments (autotrophic sulphur oxidizer Acidithiobacillus ferrooxidans and heterotrophic Acidiphilium spp.) in an environmental enrichment from a mine tailings lake. The two strains showed a specific spatial arrangement within an EPS macrostructure or "pod" allowing linked metabolic redox cycling of sulphur. Sulphur species characterisation of the pods using scanning transmission X-ray microscopy (STXM) indicated that autotrophic tetrathionate disproportionation by A. ferrooxidans producing colloidal elemental sulphur (S0) is coupled to heterotrophic S0 reduction by Acidiphilium spp. Geochemical modelling of the microbial sulphur reactions indicated that if they are widespread in AMD environments, then global AMD-driven CO2 liberation from mineral weathering have been overestimated by 40-90%1. Given the common co-occurrence of these two bacteria in AMD settings, the purpose of this study was to evaluate if these pods could be induced in the laboratory by pure strains and if so, whether their combined sulphur geochemistry mimicked the previous findings. Laboratory batch experiments assessed the development of pods with pure strain type cultures (A. ferrooxidans ATCC 19859 with mixotroph Acidiphilium acidophilum ATCC 738 or strict heterotroph Acp. cryptum ATCC 2158) using fluorescent in situ hybridization (FISH) imaging. The microbial sulphur geochemistry was characterized under autotrophic conditions identical to those used with the environmental AMD enrichment in which the pods were discovered. Results showed that the combined pure strain A. ferrooxidans and Acp. acidophilum form pods identical in structure to the AMD enrichment. To test the hypothesis that these pods form for mutual metabolic benefit, experiments were performed amending pure strain and AMD enrichment bacterial treatments with organic carbon and/or additional sulphur to

  7. Combinatorial G-CSF/AMD3100 treatment in cardiac repair after myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Constantin Rüder

    Full Text Available Several studies suggest that circulating bone marrow derived stem cells promote the regeneration of ischemic tissues. For hematopoietic stem cell transplantation combinatorial granulocyte-colony stimulating factor (G-CSF/Plerixafor (AMD3100 administration was shown to enhance mobilization of bone marrow derived stem cells compared to G-CSF monotherapy. Here we tested the hypothesis whether combinatorial G-CSF/AMD3100 therapy has beneficial effects in cardiac recovery in a mouse model of myocardial infarction.We analyzed the effect of single G-CSF (250 µg/kg/day and combinatorial G-CSF/AMD3100 (100 µg/kg/day treatment on cardiac morphology, vascularization, and hemodynamics 28 days after permanent ligation of the left anterior descending artery (LAD. G-CSF treatment started directly after induction of myocardial infarction (MI for 3 consecutive days followed by a single AMD3100 application on day three after MI in the G-CSF/AMD3100 group. Cell mobilization was assessed by flow cytometry of blood samples drawn from tail vein on day 0, 7, and 14.Peripheral blood analysis 7 days after MI showed enhanced mobilization of white blood cells (WBC and endothelial progenitor cells (EPC upon G-CSF and combinatorial G-CSF/AMD3100 treatment. However, single or combinatorial treatment showed no improvement in survival, left ventricular function, and infarction size compared to the saline treated control group 28 days after MI. Furthermore, no differences in histology and vascularization of infarcted hearts could be observed.Although the implemented treatment regimen caused no adverse effects, our data show that combinatorial G-CSF/AMD therapy does not promote myocardial regeneration after permanent LAD occlusion.

  8. Fate of Fe, As in Acid Mine Drainage (AMD) was created Disused Metal Mine

    Science.gov (United States)

    Yu, H.; Kang, D. H.; Kim, S. J.; So, Y.

    2015-12-01

    This study is a natural reduction of Fe and As in AMD. AMD is produced by oxidation of pyrite, the iron, the sulfate mineral dissolution action. It is generated by the sulfide minerals, water, oxygen, the reaction of microorganisms in the underground. AMD is low pH due to dissolved minerals in the mine are different kinds of heavy metals will leach. If the flow out of mines and react with dissolved oxygen (DO) is increased, due to oxidation and microbiological activity of the Fe it is precipitated biomat is produced. This study area is Ilgwng disused mines in the Republic of Korea Busan Gijanggun. March to September 2010 taken by the AMD and biomat analyze Fe and As. The main mineral is Chalcopyrite (Cu2Fe2S4), Arsenopyrite (FeAsS), Pyrite (FeS2), Pyrrhotite (Fe1-xS), Sphalerite (ZnS), Galena (PbS), Scheelite (CaWO4), Wolframite ((Fe, Mn)WO4) and the like. Analysis of the AMD of underground pH 2.4~2.8, DO 1.3~4.8mg/L, Fe 474.3~178.8mg/L, As 0~3.2mg/L. Analysis AMD of the flow out of mine pH 2.3~2.9, DO 6.7~9.5mg/L, Fe 81.9~438.7L, As 0~2.8mg/L. The content of Fe in the biomat is 244.242mg/kg, the content of As is 5647mg/kg in the adsorption reaction of the Fe. AMD of disused metal mine mineral leaching occur in a reducing environment, in an oxidizing environment it caused precipitation and adsorption reactions.

  9. An eye on the future of inflammasomes and drug development in AMD.

    Science.gov (United States)

    Campbell, Matthew; Doyle, Sarah L

    2013-09-01

    Age-related macular degeneration (AMD) is the leading cause of central vision loss worldwide. While activation of the immune system has been implicated in disease progression, the pathways involved remain relatively unclear. Typically, inflammatory responses are caused as a result of pathogenic infection. However, in chronic conditions, like AMD, a form of 'sterile' inflammation can exist in localised areas of the body in response to modified host-derived elements and particulate matter accumulation, due to the activation of a complex termed the 'inflammasome'. Inflammasomes control the activity of two major pro-inflammatory cytokines, namely, interleukin (IL)-1β and IL-18, by allowing for their cleavage from inactive pro-forms into mature cytokines. The major pathological hallmark common to both 'dry' and 'wet' AMD is the presence of extracellular deposits, known as drusen, below the retinal pigment epithelium in the macula of the eye. Past studies have shown that host-derived particulate matter such as amyloid deposits and atherosclerotic plaques can be 'sensed' by the NLRP3-inflammasome causing cleavage of pro-IL-1β and pro-IL-18. We have recently reported that the NLRP3-inflammasome can also 'sense' drusen isolated from human AMD donor eyes and that IL-18 protects against the development of choroidal neovascularisation in a model that mimics 'wet' AMD. In fact, since then, a number of studies have reported roles for the NLRP3-inflammasome in AMD. This review will focus on describing, comparing and contrasting these reports and analyzing the potential for manipulating the NLRP3-inflammasome as a therapy for AMD.

  10. [Treatment of wet AMD with less than 12 injections of Ranibizumab per year].

    Science.gov (United States)

    Gerding, H

    2010-04-01

    Treatment of acute wet AMD with Ranibizumab effectively stabilizes and improves visual function on a long-term follow-up basis. At present, one of the most important topics of scientific discussion is whether the functional gain in these patients can be achieved and maintained with less than 12 intravitreal injections of Ranibizumab per year. The data available so far is reviewed in this analysis. The present status can be summarized as follows: 1) It seems evident that monthly injections during the first 12 months are functionally more effective than approaches with a reduced number of treatments; 2) the gain obtained during the first three months of Ranibizumab treatment is partially lost towards the end of the year under reduced treatment frequencies; 3) fixed regimens of quarterly injections do not provide any advantage compared to individually indicated re-injections; 4) a trend towards low functional efficacy can be recognised when less than 5 treatments per year are applied; 5) individual loading at the beginning of the treatment does not provide any advantages compared to a fixed loading regimen of 3 injections.

  11. A novel fully automated molecular diagnostic system (AMDS for colorectal cancer mutation detection.

    Directory of Open Access Journals (Sweden)

    Shiro Kitano

    Full Text Available BACKGROUND: KRAS, BRAF and PIK3CA mutations are frequently observed in colorectal cancer (CRC. In particular, KRAS mutations are strong predictors for clinical outcomes of EGFR-targeted treatments such as cetuximab and panitumumab in metastatic colorectal cancer (mCRC. For mutation analysis, the current methods are time-consuming, and not readily available to all oncologists and pathologists. We have developed a novel, simple, sensitive and fully automated molecular diagnostic system (AMDS for point of care testing (POCT. Here we report the results of a comparison study between AMDS and direct sequencing (DS in the detection of KRAS, BRAF and PI3KCA somatic mutations. METHODOLOGY/PRINCIPAL FINDING: DNA was extracted from a slice of either frozen (n = 89 or formalin-fixed and paraffin-embedded (FFPE CRC tissue (n = 70, and then used for mutation analysis by AMDS and DS. All mutations (n = 41 among frozen and 27 among FFPE samples detected by DS were also successfully (100% detected by the AMDS. However, 8 frozen and 6 FFPE samples detected as wild-type in the DS analysis were shown as mutants in the AMDS analysis. By cloning-sequencing assays, these discordant samples were confirmed as true mutants. One sample had simultaneous "hot spot" mutations of KRAS and PIK3CA, and cloning assay comfirmed that E542K and E545K were not on the same allele. Genotyping call rates for DS were 100.0% (89/89 and 74.3% (52/70 in frozen and FFPE samples, respectively, for the first attempt; whereas that of AMDS was 100.0% for both sample sets. For automated DNA extraction and mutation detection by AMDS, frozen tissues (n = 41 were successfully detected all mutations within 70 minutes. CONCLUSIONS/SIGNIFICANCE: AMDS has superior sensitivity and accuracy over DS, and is much easier to execute than conventional labor intensive manual mutation analysis. AMDS has great potential for POCT equipment for mutation analysis.

  12. The influence of biofilms on the migration of uranium in acid mine drainage (AMD) waters

    Energy Technology Data Exchange (ETDEWEB)

    Krawczyk-Baersch, E., E-mail: E.Krawczyk-Baersch@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiochemistry, P.O. Box 51 01 19, D-01314 Dresden (Germany); Luensdorf, H. [Helmholtz Centre for Infection Research, Department of Vaccinology and Applied Microbiology, Inhoffenstr. 7, D-38124 Braunschweig (Germany); Arnold, T.; Brendler, V. [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiochemistry, P.O. Box 51 01 19, D-01314 Dresden (Germany); Eisbein, E. [TU Bergakademie Freiberg, Institute of Physical Chemistry, Akademiestrasse 6, D-09596 Freiberg (Germany); Jenk, U.; Zimmermann, U. [Wismut GmbH, Jagdschaenkenstr. 29, D-09117 Chemnitz (Germany)

    2011-07-15

    The uranium mine in Koenigstein (Germany) is currently in the process of being flooded. Huge mass of Ferrovum myxofaciens dominated biofilms are growing in the acid mine drainage (AMD) water as macroscopic streamers and as stalactite-like snottites hanging from the ceiling of the galleries. Microsensor measurements were performed in the AMD water as well as in the biofilms from the drainage channel on-site and in the laboratory. The analytical data of the AMD water was used for the thermodynamic calculation of the predominance fields of the aquatic uranium sulfate (UO{sub 2}SO{sub 4}) and UO{sub 2}{sup ++} speciation as well as of the solid uranium species Uranophane [Ca(UO{sub 2}){sub 2}(SiO{sub 3}OH){sub 2}{center_dot}5H{sub 2}O] and Coffinite [U(SiO{sub 4}){sub 1-x}(OH){sub 4x}], which are defined in the stability field of pH > 4.8 and Eh < 960 mV and pH > 0 and Eh < 300 mV, respectively. The plotting of the measured redox potential and pH of the AMD water and the biofilm into the calculated pH-Eh diagram showed that an aqueous uranium(VI) sulfate complex exists under the ambient conditions. According to thermodynamic calculations a retention of uranium from the AMD water by forming solid uranium(VI) or uranium(IV) species will be inhibited until the pH will increase to > 4.8. Even analysis by Energy-filtered Transmission Electron Microscopy (EF-TEM) and electron energy loss spectroscopy (EELS) within the biofilms did not provide any microscopic or spectroscopic evidence for the presence of uranium immobilization. In laboratory experiments the first phase of the flooding process was simulated by increasing the pH of the AMD water. The results of the experiments indicated that the F. myxofaciens dominated biofilms may have a substantial impact on the migration of uranium. The AMD water remained acid although it was permanently neutralized with the consequence that the retention of uranium from the aqueous solution by the formation of solid uranium species will be

  13. Modification of AMD wave functions and application to the breaking of the N=20 magic number

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Masaaki; Horiuchi, Hisashi [Kyoto Univ. (Japan). Dept. of Physics

    2001-09-01

    By using the deformed Gaussian instead of the spherical one, we have modified the AMD (Antisymmetrized Molecular Dynamics) wave functions. The calculation results with this modified AMD shows the drastic improvement of the deformation properties of Mg isotopes. This improvement means that this new version of AMD can treat the deformation of mean field properly than before and the deformation of mean field is important in Mg isotopes. With this new version of AMD, we have also calculated 32Mg in which the breaking of magic number N=20 is experimentally known. In this nucleus, {beta}-energy surface is also drastically changed by the modification AMD wave function. Our results show that this nucleus is indeed deformed and neutron's 2p2h state is dominant in its ground state. This ground state reproduces the experimental data and shows the breaking of the magic number N=20 clearly. Additionally, near the ground state, there is also very interesting state which has neutron's 4p4h structure and shows parity violating density distribution and cluster-like nature. (author)

  14. Soil stabilisation using AMD sludge, compost and lignite: TCLP leachability and continuous acid leaching.

    Science.gov (United States)

    Tsang, Daniel C W; Olds, William E; Weber, Paul A; Yip, Alex C K

    2013-11-01

    Utilising locally available industrial by-products for in situ metal stabilisation presents a low-cost remediation approach for contaminated soil. This study explored the potential use of inorganic (acid mine drainage (AMD) sludge and zero-valent iron) and carbonaceous materials (green waste compost, manure compost, and lignite) for minimising the environmental risks of As and Cu at a timber treatment site. After 9-month soil incubation, significant sequestration of As and Cu in soil solution was accomplished by AMD sludge, on which adsorption and co-precipitation could take place. The efficacy of AMD sludge was comparable to that of zero-valent iron. There was marginal benefit of adding carbonaceous materials. However, in a moderately aggressive environment (Toxicity Characteristic Leaching Procedure), AMD sludge only suppressed the leachability of As but not Cu. Therefore, the provision of compost and lignite augmented the simultaneous reduction of Cu leachability, probably via surface complexation with oxygen-containing functional groups. Under continuous acid leaching in column experiments, combined application of AMD sludge with compost proved more effective than AMD sludge with lignite. This was possibly attributed to the larger amount of dissolved organic matter with aromatic moieties from lignite, which may enhance Cu and As mobility. Nevertheless, care should be taken to mitigate ecological impact associated with short-term substantial Ca release and continuous release of Al at a moderate level under acid leaching. This study also articulated the engineering implications and provided recommendations for field deployment, material processing, and assessment framework to ensure an environmentally sound application of reactive materials. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Why AMD is a disease of ageing and not of development: mechanisms and insights

    Directory of Open Access Journals (Sweden)

    Kaushal eSharma

    2014-07-01

    Full Text Available Age related macular degeneration (AMD is retinal degenerative disorder which starts with the progression of age. Metabolism plays important role in initiation of ageing related diseases. The cholesterol metabolism components and their oxidized products like 7-ketocholesterol have been shown impact on RPE cells degeneration. These molecules can initiate the mitochondrial apoptotic process and also influenced the complements factors and expression of angiogenic proteins like VEGF etc. In this review we have suggested that AMD is ageing disorder not developmental which has been substantiated with disrupted cholesterol metabolism as described in several age related degenerative diseases.

  16. AMD3465, a monomacrocyclic CXCR4 antagonist and potent HIV entry inhibitor

    DEFF Research Database (Denmark)

    Hatse, Sigrid; Princen, Katrien; De Clercq, Erik;

    2005-01-01

    and selective anti-HIV activity against CXCR4-using (X4) viruses and showed antiviral efficacy in X4 HIV-1-infected persons in a phase II clinical trial. However, AMD3100 lacks oral bioavailability due to its high overall positive charge. Initial structure-activity relationship studies with bicyclam analogues...

  17. Dominance of Ferritrophicum populations at an AMD site with rapid iron oxidation

    Science.gov (United States)

    Grettenberger, C.; Pearce, A.; Bibby, K. J.; Burgos, W.; Jones, D. S.; Macalady, J.

    2015-12-01

    Acid mine drainage is a major environmental problem affecting watersheds across the globe. Bioremediation of AMD relies on microbial communities to oxidize and thus remove iron from the system. Iron-oxidation rates in AMD environments are highly variable across sites. At Scalp Level Run in Summerset County PA, iron-oxidation rates are five to eight times faster than other coal-associated AMD sites. We examined the microbial community at Scalp Level Run to determine whether a unique microbial community may be responsible for the observed rapid iron-oxidation rates. Using MiSeq sequence tags, 16S rRNA gene clone libraries, and fluorescence in situ hybridization, we found that Scalp Level Run sediments host microbial populations closely related to the betaproteobacterium Ferritrophicum radicicola, an iron-oxidizing species isolated from an acid mine drainage wetland in Virginia. Ferritrophicum spp. was not found at the four other coal-associated AMD sites in the study and is uncommon in the published literature. The influence of Ferritrophicum spp. populations in biogeochemical cycling, specifically their role in determining the iron-oxidation rate at Scalp Level Run is unknown. Therefore, we employed metagenomic sequencing to examine the metabolic potential of the microbial community at Scalp Level Run.

  18. Use of a twin dataset to identify AMD-related visual patterns controlled by genetic factors

    Science.gov (United States)

    Quellec, Gwénolé; Abràmoff, Michael D.; Russell, Stephen R.

    2010-03-01

    The mapping of genotype to the phenotype of age-related macular degeneration (AMD) is expected to improve the diagnosis and treatment of the disease in a near future. In this study, we focused on the first step to discover this mapping: we identified visual patterns related to AMD which seem to be controlled by genetic factors, without explicitly relating them to the genes. For this purpose, we used a dataset of eye fundus photographs from 74 twin pairs, either monozygotic twins, who have the same genotype, or dizygotic twins, whose genes responsible for AMD are less likely to be identical. If we are able to differentiate monozygotic twins from dizygotic twins, based on a given visual pattern, then this pattern is likely to be controlled by genetic factors. The main visible consequence of AMD is the apparition of drusen between the retinal pigment epithelium and Bruch's membrane. We developed two automated drusen detectors based on the wavelet transform: a shape-based detector for hard drusen, and a texture- and color- based detector for soft drusen. Forty visual features were evaluated at the location of the automatically detected drusen. These features characterize the texture, the shape, the color, the spatial distribution, or the amount of drusen. A distance measure between twin pairs was defined for each visual feature; a smaller distance should be measured between monozygotic twins for visual features controlled by genetic factors. The predictions of several visual features (75.7% accuracy) are comparable or better than the predictions of human experts.

  19. Recent patents relating to diagnostic advances in age related macular degeneration (AMD).

    Science.gov (United States)

    Cantsilieris, Stuart; Schache, Maria; Ashdown, M Luisa; Baird, Paul N

    2009-01-01

    Age Related Macular Degeneration (AMD) is a complex neurodegenerative disorder accounting for 50% of blind registrations in the western world. Its substantial impact on quality of life has been a main driver in research to understand its etiology, which up until recently was mostly unknown. In the last three years our understanding of the molecular pathology of AMD has increased dramatically with the identification of two major AMD loci comprising of, Complement Factor H (CFH) and a chromosome 10q26 locus consisting of the Heat Shock Serine Protease (HTRA1) and LOC387715 genes. These two loci have been described as associated with over 50% of disease in certain ethnicities. The rapid pace in our understanding of the complex biology of this disease has placed a large emphasis on gene patenting, especially with the licensing of the CFH and chromosome 10 patents to a private life science company called Optherion Inc. The patents discussed in this review highlight the important discoveries that have contributed to our understanding of AMD and provide valuable information as to where research in this area will be heading in the future.

  20. Avati teaduskeskus maakula ealise degeneratsiooniga (AMD-ga) võitlemiseks

    Index Scriptorium Estoniae

    2007-01-01

    Euroopa esimene silma kollatähni ehk makulaarse pigmendi uurimisgrupi keskus (MPRG) Iirimaal Waterfordi tehnoloogiainstituudis uurib toitumise mõju võitluses maailma enim levinud pimedaks jäämise põhjusega - kollatähni kärbumise ehk maakula ealise degeneratsiooniga (AMD-ga)

  1. Utilization of AMD sludges from the anthracite region of Pennsylvania for removal of phosphorus from wastewater

    Science.gov (United States)

    Sibrell, P.L.; Cravotta, C.A.; Lehman, W.G.; Reichert, W.

    2010-01-01

    Excess phosphorus (P) inputs from human sewage, animal feeding operations, and nonpoint source discharges to the environment have resulted in the eutrophication of sensitive receiving bodies of water such as the Great Lakes and Chesapeake Bay. Phosphorus loads in wastewater discharged from such sources can be decreased by conventional treatment with iron and aluminum salts but these chemical reagents are expensive or impractical for many applications. Acid mine drainage (AMD) sludges are an inexpensive source of iron and aluminum hydrous oxides that could offer an attractive alternative to chemical reagent dosing for the removal of P from local wastewater. Previous investigations have focused on AMD sludges generated in the bituminous coal region of western Pennsylvania, and confirmed that some of those sludges are good sorbents for P over a wide range of operating conditions. In this study, we sampled sludges produced by AMD treatment at six different sites in the anthracite region of Pennsylvania for potential use as P sequestration sorbents. Sludge samples were dried, characterized, and then tested for P removal from water. In addition, the concentrations of acid-extractable metals and other impurities were investigated. Test results revealed that sludges from four of the sites showed good P sorption and were unlikely to add contaminants to treated water. These results indicate that AMD sludges could be beneficially used to sequester P from the environment, while at the same time decreasing the expense of sludge disposal.

  2. The influence of biofilms on the migration of uranium in acid mine drainage (AMD) waters.

    Science.gov (United States)

    Krawczyk-Bärsch, E; Lünsdorf, H; Arnold, T; Brendler, V; Eisbein, E; Jenk, U; Zimmermann, U

    2011-07-15

    The uranium mine in Königstein (Germany) is currently in the process of being flooded. Huge mass of Ferrovum myxofaciens dominated biofilms are growing in the acid mine drainage (AMD) water as macroscopic streamers and as stalactite-like snottites hanging from the ceiling of the galleries. Microsensor measurements were performed in the AMD water as well as in the biofilms from the drainage channel on-site and in the laboratory. The analytical data of the AMD water was used for the thermodynamic calculation of the predominance fields of the aquatic uranium sulfate (UO(2)SO(4)) and UO(2)(++) speciation as well as of the solid uranium species Uranophane [Ca(UO(2))(2)(SiO(3)OH)(2)∙5H(2)O] and Coffinite [U(SiO(4))(1-x)(OH)(4x)], which are defined in the stability field of pH>4.8 and Eh0 and Eh4.8. Even analysis by Energy-filtered Transmission Electron Microscopy (EF-TEM) and electron energy loss spectroscopy (EELS) within the biofilms did not provide any microscopic or spectroscopic evidence for the presence of uranium immobilization. In laboratory experiments the first phase of the flooding process was simulated by increasing the pH of the AMD water. The results of the experiments indicated that the F. myxofaciens dominated biofilms may have a substantial impact on the migration of uranium. The AMD water remained acid although it was permanently neutralized with the consequence that the retention of uranium from the aqueous solution by the formation of solid uranium species will be inhibited. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. [Laser photocoagulation and photodynamic therapy (PDT) with verteporfin for retinal angiomatous proliferation (RAP) in age-related macular degeneration (AMD)].

    Science.gov (United States)

    Stoffelns, B M; Kramann, C; Schoepfer, K

    2008-05-01

    Retinal angiomatous proliferation (RAP) is a subtype of neovascular age-related macular degeneration (AMD) with particularly bad prognosis. Diverse treatment modalities are performed. This is a retrospective review on the treatment results of 41 consecutive patients from 1/2003 to 12/2005 with RAP stage 1-3 (Yannuzzi classification), who were treated with laser photocoagulation, photodynamic therapy (PDT) and intravitreal injection of triamcinolone acetonide (IVT). Follow-up was 12 months minimally. In RAP stage I complete closure of the vascular lesion in 14 / 22 eyes was achieved by 1.2 +/- 0.5 sessions of laser photocoagulation (4 x combined with IVT) and in 3/14 eyes with photodynamic therapy (2 +/- 0.5 sessions). In RAP stage II closure of the lesion was achieved by 3.2 +/- 0.6 sessions of photodynamic therapy in 6/14 eyes (4 x combined with IVT). In RAP stage III closure of the lesion was achieved by 3.2 +/- 0.4 sessions of photodynamic therapy in 0 / 5 eyes (3 x combined with IVT). A rip of the retinal pigment epithelium was observed in 2/14 eyes of RAP stage II and 2/5 eyes of RAP stage III. Visual acuity improved in 9/17 eyes with occlusion of RAP stage I. Without closure of the vascular lesion all eyes got legally blind (visual acuity 1/50 or less). Early detection and subsequent direct treatment of RAP stage I in AMD is recommended. In advanced stages anatomical closure of the vascular complex is rarely achieved and the risk is improved for development of tears in the retinal pigment epithelium and getting legally blind.

  4. Age-related macular degeneration in a randomized controlled trial of low-dose aspirin: Rationale and study design of the ASPREE-AMD study

    Directory of Open Access Journals (Sweden)

    Liubov Robman

    2017-06-01

    Conclusion: The study findings will be of significant clinical and public interest due to a potential to identify a possible low cost therapy for preventing AMD worldwide and to determine risk/benefit balance of the aspirin usage by the AMD-affected elderly. The ASPREE-AMD study provides a unique opportunity to determine the effect of aspirin on AMD incidence and progression, by adding retinal imaging to an ongoing, large-scale primary prevention randomized clinical trial.

  5. Machine learning based detection of age-related macular degeneration (AMD) and diabetic macular edema (DME) from optical coherence tomography (OCT) images.

    Science.gov (United States)

    Wang, Yu; Zhang, Yaonan; Yao, Zhaomin; Zhao, Ruixue; Zhou, Fengfeng

    2016-12-01

    Non-lethal macular diseases greatly impact patients' life quality, and will cause vision loss at the late stages. Visual inspection of the optical coherence tomography (OCT) images by the experienced clinicians is the main diagnosis technique. We proposed a computer-aided diagnosis (CAD) model to discriminate age-related macular degeneration (AMD), diabetic macular edema (DME) and healthy macula. The linear configuration pattern (LCP) based features of the OCT images were screened by the Correlation-based Feature Subset (CFS) selection algorithm. And the best model based on the sequential minimal optimization (SMO) algorithm achieved 99.3% in the overall accuracy for the three classes of samples.

  6. Massive choroidal hemorrhage after intravitreal administration of bevacizumab (Avastin® for AMD followed by controlateral sympathetic ophthalmia

    Directory of Open Access Journals (Sweden)

    Dimitrios Brouzas

    2009-08-01

    Full Text Available Dimitrios Brouzas, Chryssanthi Koutsandrea, Marilita Moschos, Spiros Papadimitriou, Ioannis Ladas, Michael Apostolopoulos1st Eye Department , University of Athens, Athens, GreecePurpose: To report a severe ocular complication initiated ten days after intravitreal administration of bevacizumab (Avastin®, in a patient with exudative age-related macular degeneration (AMD.Patients and method: Case report.Results: Ten days after intravitreal injection of 1.25 mg Avastin®, the patient manifested acute loss of vision with excruciating pain. An extensive choroidal detachment was evident in close contact with the lens, which necessitated an emergency sclerotomy with reconstruction of the anterior chamber. Four months later, the eye proceeded to phthisis bulbi. Five months after the injection, the patient complained of mild pain, photophobia, and visual acuity deterioration from the fellow eye. The diagnosis of sympathetic ophthalmia was suggested and treated with intravitreal injections of triamcinolone acetonide every three months with good response, complicated by elevation of intraocular pressure which we managed with Ahmet valve implantation.Conclusion: Serious ocular complications after intravitreal of Avastin® can not be excluded, including massive choroidal hemorrhage and sympathetic ophthalmia of the fellow eye.Keywords: Avastin® complication, intravitreal injection, choroidal detachment, Phthisis bulbi, sympathetic ophthalmia

  7. Metal ion enhanced binding of AMD3100 to Asp262 in the CXCR4 receptor

    DEFF Research Database (Denmark)

    Gerlach, Lars Ole; Jakobsen, Janus S; Jensen, Kasper P;

    2003-01-01

    +), Zn(2+), or Ni(2+) into the cyclam rings of the compound. The rank order of the transition metal ions correlated with the calculated binding energy between free acetate and the metal ions coordinated in a cyclam ring. Construction of AMD3100 substituted with only a single Cu(2+) or Ni(2+) ion...... demonstrated that the increase in binding affinity of the metal ion substituted bicyclam is achieved through an enhanced interaction of just one of the ring systems. Mutational analysis of potential metal ion binding residues in the main ligand binding crevice of the CXCR4 receptor showed that although binding...... of the bicyclam is dependent on both Asp(171) and Asp(262), the enhancing effect of the metal ion was selectively eliminated by substitution of Asp(262) located at the extracellular end of TM-VI. It is concluded that the increased binding affinity of the metal ion substituted AMD3100 is obtained through enhanced...

  8. Air and Missile Defense Intelligence Preparation of the Battlefield (AMD IPB)

    Science.gov (United States)

    2016-03-31

    dissemination of tactical warning; and mission assignment, targeting data, and post- strike assessment to the appropriate joint AMD element. For each...destroy or disrupt the aerial platforms or the TBMs before their launch. Attack operations can be preemptive or reactive as part of counter air...strategic attack, interdiction, fire support, maneuver, antisubmarine warfare, anti-surface warfare, strike warfare, amphibious, or special operations

  9. Pathogenesis and prophylaxis of AMD: focus on oxidative stress and antioxidants

    Directory of Open Access Journals (Sweden)

    Anna Wiktorowska-Owczarek

    2010-07-01

    Full Text Available Age-related macular degeneration (AMD is the leading cause of severe visual loss and blindness in people over 55. Its pathogenesis – likely multifactorial, involving a complex interaction of metabolic, functional, genetic and environmental factors – remains poorly understood. Among molecular links in pathogenesis of AMD is the oxidative stress in the retina, a structure that is particularly susceptible to damage by reactive oxygen species (ROS since photoreceptor outer segment (POS membranes are rich in polyunsaturated fatty acids which can be readily oxidized and can initiate a cytotoxic chain reaction. Occurring in the neighborhood of photoreceptors, the retinal pigment epithelial cells (RPE actively contribute to both the retinoid cycle and catabolism of constantly shed and phagocytized parts of photoreceptor outer segments. Enzymatic degradation of photoreceptor fragments occurring in RPE phagolysosomes is not complete and undigested material in the form of insoluble aggregates, called lipofuscin, is deposited in lysosomes of RPE cells. Lipofuscin contains a mixture of diverse molecular components including retinoid-derived compounds, some of which displaying potent photoinducible properties, contributing to an enhancement and propagation of the oxidative stress. The retina possesses defense mechanisms against the oxidative stress that effectively neutralize the consequences of reactive oxygen species actions under normal conditions. A key role in the antioxidant defense plays an array of substances, including: xanthophylls (lutein and zeaxanthin, vitamin C and E, and glutathione. This paper surveys the current concepts on the role of the oxidative stress in pathophysiology of AMD, and describes major components of the antioxidant defense system, including their use in AMD prophylaxis and therapy.

  10. Regulation of signaling events involved in the pathophysiology of neovascular AMD

    OpenAIRE

    Wang, Haibo; Hartnett, M. Elizabeth

    2016-01-01

    Neovascular age-related macular degeneration (AMD) is a complex disease in which an individual’s genetic predisposition is affected by aging and environmental stresses, which trigger signaling pathways involving inflammation, oxidation, and/or angiogenesis in the RPE cells and choroidal endothelial cells (CECs), to lead to vision loss from choroidal neovascularization. Antiangiogenic therapies have greatly improved clinical outcomes in the last decade; however, vision improves in less than ha...

  11. Complement System in Pathogenesis of AMD: Dual Player in Degeneration and Protection of Retinal Tissue

    Directory of Open Access Journals (Sweden)

    Milosz P. Kawa

    2014-01-01

    Full Text Available Age-related macular degeneration (AMD is the most common cause of blindness among the elderly, especially in Western countries. Although the prevalence, risk factors, and clinical course of the disease are well described, its pathogenesis is not entirely elucidated. AMD is associated with a variety of biochemical abnormalities, including complement components deposition in the retinal pigment epithelium-Bruch’s membrane-choriocapillaris complex. Although the complement system (CS is increasingly recognized as mediating important roles in retinal biology, its particular role in AMD pathogenesis has not been precisely defined. Unrestricted activation of the CS following injury may directly damage retinal tissue and recruit immune cells to the vicinity of active complement cascades, therefore detrimentally causing bystander damage to surrounding cells and tissues. On the other hand, recent evidence supports the notion that an active complement pathway is a necessity for the normal maintenance of the neurosensory retina. In this scenario, complement activation appears to have beneficial effect as it promotes cell survival and tissue remodeling by facilitating the rapid removal of dying cells and resulting cellular debris, thus demonstrating anti-inflammatory and neuroprotective activities. In this review, we discuss both the beneficial and detrimental roles of CS in degenerative retina, focusing on the diverse aspects of CS functions that may promote or inhibit macular disease.

  12. Complement system in pathogenesis of AMD: dual player in degeneration and protection of retinal tissue.

    Science.gov (United States)

    Kawa, Milosz P; Machalinska, Anna; Roginska, Dorota; Machalinski, Boguslaw

    2014-01-01

    Age-related macular degeneration (AMD) is the most common cause of blindness among the elderly, especially in Western countries. Although the prevalence, risk factors, and clinical course of the disease are well described, its pathogenesis is not entirely elucidated. AMD is associated with a variety of biochemical abnormalities, including complement components deposition in the retinal pigment epithelium-Bruch's membrane-choriocapillaris complex. Although the complement system (CS) is increasingly recognized as mediating important roles in retinal biology, its particular role in AMD pathogenesis has not been precisely defined. Unrestricted activation of the CS following injury may directly damage retinal tissue and recruit immune cells to the vicinity of active complement cascades, therefore detrimentally causing bystander damage to surrounding cells and tissues. On the other hand, recent evidence supports the notion that an active complement pathway is a necessity for the normal maintenance of the neurosensory retina. In this scenario, complement activation appears to have beneficial effect as it promotes cell survival and tissue remodeling by facilitating the rapid removal of dying cells and resulting cellular debris, thus demonstrating anti-inflammatory and neuroprotective activities. In this review, we discuss both the beneficial and detrimental roles of CS in degenerative retina, focusing on the diverse aspects of CS functions that may promote or inhibit macular disease.

  13. Understanding and Mitigating Multicore Performance Issues on theAMD Opteron Architecture

    Energy Technology Data Exchange (ETDEWEB)

    Levesque, John; Larkin, Jeff; Foster, Martyn; Glenski, Joe; Geissler, Garry; Whalen, Stephen; Waldecker, Brian; Carter, Jonathan; Skinner, David; He, Helen; Wasserman, Harvey; Shalf, John; Shan,Hongzhang; Strohmaier, Erich

    2007-03-07

    Over the past 15 years, microprocessor performance hasdoubled approximately every 18 months through increased clock rates andprocessing efficiency. In the past few years, clock frequency growth hasstalled, and microprocessor manufacturers such as AMD have moved towardsdoubling the number of cores every 18 months in order to maintainhistorical growth rates in chip performance. This document investigatesthe ramifications of multicore processor technology on the new Cray XT4?systems based on AMD processor technology. We begin by walking throughthe AMD single-core and dual-core and upcoming quad-core processorarchitectures. This is followed by a discussion of methods for collectingperformance counter data to understand code performance on the Cray XT3?and XT4? systems. We then use the performance counter data to analyze theimpact of multicore processors on the performance of microbenchmarks suchas STREAM, application kernels such as the NAS Parallel Benchmarks, andfull application codes that comprise the NERSC-5 SSP benchmark suite. Weexplore compiler options and software optimization techniques that canmitigate the memory bandwidth contention that can reduce computingefficiency on multicore processors. The last section provides a casestudy of applying the dual-core optimizations to the NAS ParallelBenchmarks to dramatically improve their performance.

  14. mTORC1-dependent AMD1 regulation sustains polyamine metabolism in prostate cancer.

    Science.gov (United States)

    Zabala-Letona, Amaia; Arruabarrena-Aristorena, Amaia; Martín-Martín, Natalia; Fernandez-Ruiz, Sonia; Sutherland, James D; Clasquin, Michelle; Tomas-Cortazar, Julen; Jimenez, Jose; Torres, Ines; Quang, Phong; Ximenez-Embun, Pilar; Bago, Ruzica; Ugalde-Olano, Aitziber; Loizaga-Iriarte, Ana; Lacasa-Viscasillas, Isabel; Unda, Miguel; Torrano, Verónica; Cabrera, Diana; van Liempd, Sebastiaan M; Cendon, Ylenia; Castro, Elena; Murray, Stuart; Revandkar, Ajinkya; Alimonti, Andrea; Zhang, Yinan; Barnett, Amelia; Lein, Gina; Pirman, David; Cortazar, Ana R; Arreal, Leire; Prudkin, Ludmila; Astobiza, Ianire; Valcarcel-Jimenez, Lorea; Zuñiga-García, Patricia; Fernandez-Dominguez, Itziar; Piva, Marco; Caro-Maldonado, Alfredo; Sánchez-Mosquera, Pilar; Castillo-Martín, Mireia; Serra, Violeta; Beraza, Naiara; Gentilella, Antonio; Thomas, George; Azkargorta, Mikel; Elortza, Felix; Farràs, Rosa; Olmos, David; Efeyan, Alejo; Anguita, Juan; Muñoz, Javier; Falcón-Pérez, Juan M; Barrio, Rosa; Macarulla, Teresa; Mato, Jose M; Martinez-Chantar, Maria L; Cordon-Cardo, Carlos; Aransay, Ana M; Marks, Kevin; Baselga, José; Tabernero, Josep; Nuciforo, Paolo; Manning, Brendan D; Marjon, Katya; Carracedo, Arkaitz

    2017-07-06

    Activation of the PTEN-PI3K-mTORC1 pathway consolidates metabolic programs that sustain cancer cell growth and proliferation. Here we show that mechanistic target of rapamycin complex 1 (mTORC1) regulates polyamine dynamics, a metabolic route that is essential for oncogenicity. By using integrative metabolomics in a mouse model and human biopsies of prostate cancer, we identify alterations in tumours affecting the production of decarboxylated S-adenosylmethionine (dcSAM) and polyamine synthesis. Mechanistically, this metabolic rewiring stems from mTORC1-dependent regulation of S-adenosylmethionine decarboxylase 1 (AMD1) stability. This novel molecular regulation is validated in mouse and human cancer specimens. AMD1 is upregulated in human prostate cancer with activated mTORC1. Conversely, samples from a clinical trial with the mTORC1 inhibitor everolimus exhibit a predominant decrease in AMD1 immunoreactivity that is associated with a decrease in proliferation, in line with the requirement of dcSAM production for oncogenicity. These findings provide fundamental information about the complex regulatory landscape controlled by mTORC1 to integrate and translate growth signals into an oncogenic metabolic program.

  15. Molecular mechanism of AMD3100 antagonism in the CXCR4 receptor: transfer of binding site to the CXCR3 receptor

    DEFF Research Database (Denmark)

    Rosenkilde, Mette M; Gerlach, Lars-Ole; Jakobsen, Janus S

    2004-01-01

    AMD3100 is a symmetric bicyclam, prototype non-peptide antagonist of the CXCR4 chemokine receptor. Mutational substitutions at 16 positions located in TM-III, -IV, -V, -VI, and -VII lining the main ligand-binding pocket of the CXCR4 receptor identified three acid residues: Asp(171) (AspIV:20), Asp......, respectively. Metal ion binding in the cyclam rings of AMD3100 increased its dependence on Asp(262) and provided a tighter molecular map of the binding site, where borderline mutational hits became clear hits for the Zn(II)-loaded analog. The proposed binding site for AMD3100 was confirmed by a gradual build...... that AMD3100 binds through interactions with essentially only three acidic anchor-point residues, two of which are located at one end and the third at the opposite end of the main ligand-binding pocket of the CXCR4 receptor. We suggest that non-peptide antagonists with, for example, improved oral...

  16. Inhibition of CXCR4 activity with AMD3100 decreases invasion of human colorectal cancer cells in vitro

    Institute of Scientific and Technical Information of China (English)

    Ji-Kun Li; Liang Yu; Yun Shen; Li-Sheng Zhou; Yi-Cheng Wang; Jian-Hai Zhang

    2008-01-01

    AIM: To investigate the effect and mechanism of blockade of the CXC chemokine receptor-4 (CXCR4) signaling pathway by AMD3100, a small non-peptide CXCR4 inhibitor, on invasion and metastasis of colorectal cancer cells in vitro.METHODS: Human colorectal cancer cell line SW480 was treated with AMD3100 at different final concentrations.3-(4,5-dimethylthiazole-2-yl)-2.5-dipheny-ltetrazolium bromide (MTT) assay was used to detect the effect of AMD3100 on cell proliferation. The invasion ability of SW480 cells was determined by cell invasion assay kit.In the presence of AMD3100, the CXCL12-mediated migratory response of SW480 cells was tested by classical chemotaxis assays. RT-PCR analysis and Western blotting were used to detect the expression of vascular endothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2)and -9 (MMP-9) in SW480 cells.RESULTS: Cell viability was significantly suppressed by AMD3100 in a dose-dependent manner. AMD3100 (100and 1000 ng/mL) significantly inhibited the invasion ability of SW480 cells. Treatment with AMD3100markedly reduced the expression of VEGF and MMP-9but not MMP-2 in SW480 cells.CONCLUSION: The CXCL12/CXCR4 system is an important mediator of proliferation and invasion of CXCR4-expressing colorectal cancer cells, AMD3100inhibited invasion and metastasis activity of the colorectal cancer cell line SW480 through down-regulation of VEGF and MMP-9 expression.

  17. Short-term intermittent administration of CXCR4 antagonist AMD3100 facilitates myocardial repair in experimental myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Yuechen Luo; Xiaoning Zhao; Xin Zhou; Wenjie Ji; Ling Zhang; Tao Luo; Hongrnei Liu

    2013-01-01

    The binding of the stromal cell-derived factor-1α (SDF-1α)to the cysteine (C)-X-C motif chemokine receptor 4 (CXCR4) has emerged as a key signal for stem and progenitor cells trafficking to the circulation from the bone marrow.Our aim was to investigate the role of daily intermittent administration of AMD3100 (a specific reversible CXCR4 receptor antagonist) during the healing process after myocardial infarction (MI).Wistar rats were subjected to MI and AMD3100 was injected intraperitoneally after surgery.SDF-1α mRNA expression was measured by real-time polymerase chain reaction.Histology changes were analyzed with immunofluorescence,Masson's trichrome staining,and wheat germ agglutinin.The number of leukocytes in peripheral blood was measured by complete blood cell count analysis.The activities of matrix metalloproteinase-2/9 (MMP-2/9) were determined by gelatin zymography.The expression level of SDF-1αmRNA in the infarcted tissue was enhanced rapidly (6 h),peaked at 24 h,and then declined to the normal level at 7days post-MI.AMD3100 further enhanced the increase of SDF-1α in infarct area.Increased leukocytes were observed in AMD3100-treated groups.The mobilization of c-kit+ stem/progenitor cells and enhanced neovascularization were augmented by AMD3100.Additionally,AMD3100 improved ventricular remodeling,which was revealed by the decrease of infarct size,viable cardiomyocyte cross-sectional area and left ventricle (LV) expansion index,and the increase of LV free wall thickness.The activities of MMP-2/9 were up-regulated by AMD3100.In conclusion,short-term intermittent administration of AMD3100 could accelerate the wound healing process in experimental MI and be a potential therapy for the treatment of MI.

  18. Microglia in the Outer Retina and their Relevance to Pathogenesis of Age-Related Macular Degeneration (AMD)

    OpenAIRE

    2012-01-01

    Age-related macular degeneration (AMD), the largest cause of legal blindness in the elderly in the Western world, is a disease whose pathogenesis is incompletely understood and for which therapeutic challenges remain. The etiology of AMD is thought to involve chronic neuroinflammation of the retina but the details of relevant cellular mechanisms are still not fully understood. Retinal microglia are the primary resident immune cell in the retina and are normally absent from the outer retina, t...

  19. Proteomics of vitreous humor of patients with exudative age-related macular degeneration.

    Directory of Open Access Journals (Sweden)

    Michael Janusz Koss

    Full Text Available BACKGROUND: There is absence of specific biomarkers and an incomplete understanding of the pathophysiology of exudative age-related macular degeneration (AMD. METHODS AND FINDINGS: Eighty-eight vitreous samples (73 from patients with treatment naïve AMD and 15 control samples from patients with idiopathic floaters were analyzed with capillary electrophoresis coupled to mass spectrometry in this retrospective case series to define potential candidate protein markers of AMD. Nineteen proteins were found to be upregulated in vitreous of AMD patients. Most of the proteins were plasma derived and involved in biological (ion transport, acute phase inflammatory reaction, and blood coagulation. A number of proteins have not been previously associated to AMD including alpha-1-antitrypsin, fibrinogen alpha chain and prostaglandin H2-D isomerase. Alpha-1-antitrypsin was validated in vitreous of an independent set of AMD patients using Western blot analysis. Further systems biology analysis of the data indicated that the observed proteomic changes may reflect upregulation of immune response and complement activity. CONCLUSIONS: Proteome analysis of vitreous samples from patients with AMD, which underwent an intravitreal combination therapy including a core vitrectomy, steroids and bevacizumab, revealed apparent AMD-specific proteomic changes. The identified AMD-associated proteins provide some insight into the pathophysiological changes associated with AMD.

  20. CXCR4 Inhibition with AMD3100 Sensitizes Prostate Cancer to Docetaxel Chemotherapy

    Directory of Open Access Journals (Sweden)

    Urszula M. Domanska

    2012-08-01

    Full Text Available Several in vitro and in vivo models have revealed the key role of CXCR4/CXCL12 axis in tumor-stroma interactions. Stromal cells present in the tumor microenvironment express high levels of CXCL12 protein, directly stimulating proliferation and migration of CXCR4-expressing cancer cells. This specific prosurvival influence of stromal cells on tumor cells is thought to protect them from cytotoxic chemotherapy and is postulated as a possible explanation for the minimal residual disease in hematological and solid cancers. Therefore, CXCR4/CXCL12 signaling is an attractive therapeutic target in cancer, as proven in preclinical leukemia mouse models, where CXCR4 inhibition sensitized cancer cells to conventional chemotherapy. This study investigates whether inhibition of CXCR4 with the specific inhibitor AMD3100 sensitizes human prostate cancer cells to docetaxel. We showed that both mouse and human stromal cell lines have a protective effect on PC3-luc cells by promoting their survival after chemotherapy. Furthermore, we demonstrated that AMD3100 sensitizes PC3-luc cells to docetaxel. In a subcutaneous xenograft mouse model of human prostate carcinoma, we showed that a combination of docetaxel and AMD3100 exerts increased antitumor effect compared with docetaxel alone. We concluded that CXCR4 inhibition chemosensitizes prostate cancer cells, both in vitro and in vivo. To explore the relevance of these findings, we analyzed CXCR4 expression levels in human prostate cancer samples. We found that cancer cells present in bone metastatic lesions express higher CXCR4 levels relative to the cells present in primary tumors and lymph node metastatic lesions. These findings underscore the potential of CXCR4 inhibitors as chemosensitizing agents.

  1. Simulation of atmospheric mercury depletion events (AMDEs) during polar springtime using the MECCA box model

    Science.gov (United States)

    Xie, Z.-Q.; Sander, R.; Pöschl, U.; Slemr, F.

    2008-12-01

    Atmospheric mercury depletion events (AMDEs) during polar springtime are closely correlated with bromine-catalyzed tropospheric ozone depletion events (ODEs). To study gas- and aqueous-phase reaction kinetics and speciation of mercury during AMDEs, we have included mercury chemistry into the box model MECCA (Module Efficiently Calculating the Chemistry of the Atmosphere), which enables dynamic simulation of bromine activation and ODEs. We found that the reaction of Hg with Br atoms dominates the loss of gaseous elemental mercury (GEM). To explain the experimentally observed synchronous depletion of GEM and O3, the reaction rate of Hg+BrO has to be much lower than that of Hg+Br. The synchronicity is best reproduced with rate coefficients at the lower limit of the literature values for both reactions, i.e. kHg+Br≍3×10-13 and kHg+BrO≤1×10-15 cm3 molecule-1 s-1, respectively. Throughout the simulated AMDEs, \\chem{BrHgOBr} was the most abundant reactive mercury species, both in the gas phase and in the aqueous phase. The aqueous-phase concentrations of BrHgOBr, HgBr2, and HgCl2 were several orders of magnitude larger than that of Hg(SO3)22-. Considering chlorine chemistry outside depletion events (i.e. without bromine activation), the concentration of total divalent mercury in sea-salt aerosol particles (mostly HgCl42-) was much higher than in dilute aqueous droplets (mostly Hg(SO3)22-), and did not exhibit a diurnal cycle (no correlation with HO2 radicals).

  2. CXCR4 antagonist AMD3100 attenuates colonic damage in mice with experimental colitis

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To investigate the effects of the chemokine stromal cell-derived factor-1(CXCL12) receptor(CXCR4) antagonist AMD3100 on colonic inflammation and epithelial barrier in dextran sulfate sodium(DSS)-induced colitis in mice.METHODS:Experimental colitis was induced by administration of 5% DSS for 7 d,and assays performed on intestinal segments from the ileocecal valve to the anus.Colonic morphology was examined by hematoxylin and eosin staining.Colonic cytokines were determined by enzyme-linked immunosorbent ...

  3. Ub-library of Atomic Masses and Nuclear Ground States Deformations (CENPL.AMD)

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The atomic mass is one of basic data of a nuclear. There are the atomic masses in all nuclear reaction model formulas and motion equations. For any reaction calculations atomic masses are basic data for getting binding energies or Q-values. In some applications, it is important also to have atomic masses even for exotic nuclei quite far from the valley of stability. In addition, nuclear ground state deformations and abundance values are also requisite in the nuclear data calculations. For this purpose, A data file on atomic masses and nuclear ground states deformations (AMD) were constructed, which

  4. AMD3100 combined with triptolide inhibit proliferation, invasion and metastasis and induce apoptosis of human U2OS osteosarcoma cells.

    Science.gov (United States)

    Jiang, Chunming; Fang, Xiang; Zhang, Hongxu; Wang, Xuepeng; Li, Maoqiang; Jiang, Wu; Tian, Fei; Zhu, Liulong; Bian, Zhenyu

    2017-02-01

    Osteosarcoma (OS) mainly occurs in children and adolescents, and has a high propensity for lung metastasis. Little is known about the role of SDF-1/CXCR4 axis in OS progression. AMD3100 is a specific CXCR4 antagonist. Triptolide can induce apoptosis and proliferation inhibition in various cancer cell lines. This work aimed to investigate the effects of AMD3100 plus triptolide on the proliferation, apoptosis, invasion and metastasis of OS cells. The expression levels of SDF-1 and CXCR4 in five OS cell lines was analyzed by qRT-PCR, western blotting and ELISA assays. The effect of AMD3100 and triptolide on the proliferation, apoptosis and invasion of U2OS cells was evaluated by CCK-8, flow cytometry and transwell assay, respectively. Orthotopic intra-tibial growth and lung metastasis mouse model of OS were employed to evaluate the inhibition effect of AMD3100 and triptolide on primary OS growth and lung metastasis. CXCR4 protein expression was detected in HOS-8603, MG-63, U2OS and 143B but not Saos2 cells, and all these cell lines expressed SDF-1. AMD3100 plus triptolide induced proliferation inhibition and apoptosis of U2OS cells, which was attributed to the downregulation of c-Myc, survivin, cyclin D1 and increased cleaved caspase-3 and PARP. AMD3100 and triptolide also suppressed SDF-1 induced invasion of CXCR4+ U2OS cells, which was validated by decreased expression of MMP-2 and 9, VEGF, m-Calpain and β-catenin. Moreover, the phosphorylation levels of Erk1/2, Akt and STAT3, as well as the nuclear translocation and phosphorylation of NF-κB p65 in U2OS cells were also reduced by AMD3100 and triptolide. In vivo, AMD3100 and triptolide significantly reduced primary tumor growth and lung metastasis of U2OS cells. AMD3100 combined with triptolide can reduce proliferation and metastasis, and induce apoptosis of U2OS cells, which may be related to the Erk1/2, Akt, STAT3 and NF-κB pathways. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Effect of In Vitro Exposure of Corticosteroid Drugs, Conventionally Used in AMD Treatment, on Mesenchymal Stem Cells

    Science.gov (United States)

    Nuzzi, Raffaele; Gunetti, Monica; Rustichelli, Deborah; Roagna, Barbara; Fronticelli Bardelli, Francesca; Fagioli, Franca; Ferrero, Ivana

    2012-01-01

    Age-related macular degeneration (AMD) is a leading cause of legal blindness in individuals over 60 years of age, characterized by the dysfunction of retinal pigmented epithelium cells, specifically in the macular area. Despite several treatment options, AMD therapy remains difficult, especially for exudative AMD. Multipotent mesenchymal stem cells (MSCs), with great plasticity and immunomodulant properties, are a promising cell source for cellular therapy and tissue engineering. We evaluated the effects of steroid drugs, often used to treat AMD, in association with MSCs, in view of a possible application together to treat AMD. Morphology, viability, growth kinetics, and immunophenotype were evaluated on healthy donors' MSCs, treated with triamcinolone acetonide, alcohol-free triamcinolone acetonide, micronized intravitreal triamcinolone and dexamethasone at different concentrations, and in a human retinal pigment epithelial cell line supernatant (ARPE-19). The morphological analysis of MSCs in their standard medium showed a negative correlation with drug concentrations, due to the numerous crystals. Dexamethasone was the least toxic corticosteroid used in this study. ARPE-19 seemed to help cells preserve the typical MSC morphology. In conclusion, this in vitro study demonstrated that high doses of corticosteroid drugs have a negative effect on MSCs, reduced in the presence of a conditioned media. PMID:22693520

  6. Effect of In Vitro Exposure of Corticosteroid Drugs, Conventionally Used in AMD Treatment, on Mesenchymal Stem Cells

    Directory of Open Access Journals (Sweden)

    Raffaele Nuzzi

    2012-01-01

    Full Text Available Age-related macular degeneration (AMD is a leading cause of legal blindness in individuals over 60 years of age, characterized by the dysfunction of retinal pigmented epithelium cells, specifically in the macular area. Despite several treatment options, AMD therapy remains difficult, especially for exudative AMD. Multipotent mesenchymal stem cells (MSCs, with great plasticity and immunomodulant properties, are a promising cell source for cellular therapy and tissue engineering. We evaluated the effects of steroid drugs, often used to treat AMD, in association with MSCs, in view of a possible application together to treat AMD. Morphology, viability, growth kinetics, and immunophenotype were evaluated on healthy donors’ MSCs, treated with triamcinolone acetonide, alcohol-free triamcinolone acetonide, micronized intravitreal triamcinolone and dexamethasone at different concentrations, and in a human retinal pigment epithelial cell line supernatant (ARPE-19. The morphological analysis of MSCs in their standard medium showed a negative correlation with drug concentrations, due to the numerous crystals. Dexamethasone was the least toxic corticosteroid used in this study. ARPE-19 seemed to help cells preserve the typical MSC morphology. In conclusion, this in vitro study demonstrated that high doses of corticosteroid drugs have a negative effect on MSCs, reduced in the presence of a conditioned media.

  7. Identifying the Presence of AMD-Derived Soil CO2 in Field Investigations Using Isotope Ratios

    Directory of Open Access Journals (Sweden)

    Kwame Awuah-Offei

    2016-03-01

    Full Text Available Recent incidents of hazardous accumulations of CO2 in homes on or adjacent to reclaimed mine land have been shown to be linked to neutralization reactions between acidic mine drainage and carbonate material. An efficient and economic method is necessary to identify the presence of acid mine drainage- (AMD- derived CO2 on reclaimed mine land, prior to construction. One approach to identify the presence of AMD-derived CO2 is to characterize stable carbon isotope ratios of soil CO2. To do so, a viable method is necessary to acquire soil gas samples for isotope ratio analysis. This paper presents preliminary investigations of the effectiveness of two methods of acquiring gas samples (sampling during soil flux measurements and using slam bar for isotope analysis. The results indicate that direct soil gas sampling is cheaper and provides better results. Neither method is adequate without accounting for temporal effects due to changing gas transport mechanisms. These results have significant implications for safe post-mining land uses and future investigations of leakages from geologic carbon sequestration sites.

  8. PHMB: Utilización del apósito de espuma antimicrobiana (AMD KendallTM (PHMB 0,5% en el tratamiento de las heridas crónicas PHMB: The role ok KendallTM AMD Antimicrobial Foam Dressing (0.5% PHMB in the treatment of wounds

    Directory of Open Access Journals (Sweden)

    John Timmons

    2010-03-01

    Full Text Available Abordamos la parte más problemática del tratamiento de las heridas crónicas o agudas, de acuerdo con los profesionales especializados es la infección de la herida. La sobrecarga bacteriana puede retardar la curación de la herida y disminuir la calidad del paciente como consecuencia del aumento del dolor, del exudado y del posible mal olor. Se han recopilado casos clínicos durante los últimos 6 meses en una unidad especializada en el cuidado de heridas de los hospitales Doncaster y Bassetlaw, RU. Estos casos ilustran la variedad de tipos de herida que pueden tratarse con éxito con el nuevo apósito de Espuma antimicrobiano KendallTM AMD (PHMB 0,5%. Se pudo concluir que el apósito de Espuma KendallTM AMD actúa bien como antimicrobiano y como producto de vendaje moderno. Su utilización disminuye la carga bacteriana al tiempo que consigue la absorción del exudado y el mantenimiento de un ambiente óptimo para la curación de la herida.The most troublesome part of wound healing according to the care practitioners is the Wound infection. The presence of excess bacteria in the wound can lead to delayed healing that lead to a reduced quality of life for the patient due to increased pain, higher exudates levels and potential malodor. The following patient case report have been collated over the past six months in a specialist wound care clinic in Doncaster and Bassetlaw, UK. These cases illustrate the range of wound types that have been successfully treated with the new KendallTM AMD Antimicrobial Foam dressing (PHMB 0,5%. The conclusion was that KendallTM AMD Foam dressing functions well as an antimicrobial and a modern wound dressing product. This resulted in consistent lowering of the wound bioburden, absorption of exudates and maintenance of an optimal wound healing environment.

  9. AMD 系统主动控制控制器设计方法研究%Research on AMD system active control controller design method

    Institute of Scientific and Technical Information of China (English)

    刘泳伶

    2015-01-01

    介绍了AMD主动控制系统的减震原理,基于经典线性最优控制算法,采用Wilson-θ法来求位移时程曲线,并利用matlab编程对一个框架剪切模型计算其在地震作用下采用主动控制前后的弹性时程反应分析,同时进行了对比,表现出了主动控制的显著效果。%This paper introduced the shock absorption principle of AMD active control system,based on classical linear optimal control algorithm, using Wilson-θ method to get the displacement time history curve,and using the matlab programming analyzed the elastic time history response to a frame shear model calculation under earthquake using active control before and after,and has carried on the contrast,showed the significant effect of active control.

  10. The UK Neovascular AMD Database Report 3: inter-centre variation in visual acuity outcomes and establishing real-world measures of care.

    Science.gov (United States)

    Liew, G; Lee, A Y; Zarranz-Ventura, J; Stratton, I; Bunce, C; Chakravarthy, U; Lee, C S; Keane, P A; Sim, D A; Akerele, T; McKibbin, M; Downey, L; Natha, S; Bailey, C; Khan, R; Antcliff, R; Armstrong, S; Varma, A; Kumar, V; Tsaloumas, M; Mandal, K; Egan, C; Johnston, R L; Tufail, A

    2016-11-01

    PurposeInternational variations in visual acuity (VA) outcomes of eyes treated for neovascular age-related macular degeneration (nAMD) are well-documented, but intra-country inter-centre regional variations are not known. These data are important for national quality outcome indicators. We aimed to determine intra-country and inter-centre regional variations in outcomes for treatment of nAMD.Patients and methodsProspective multicentre national database study of 13 UK centres that treated patients according to a set protocol (three loading doses, followed by Pro-Re-Nata retreatment). A total of 5811 treatment naive eyes of 5205 patients received a total of 36 206 ranibizumab injections over 12 months.ResultsMean starting VA between centres varied from 48.9 to 59.9 ETDRS letters. Mean inter-centre VA change from baseline to 12 months varied from +6.9 letters to -0.6 letters (mean of +2.5 letters). The proportion of eyes achieving VA of 70 letters or more varied between 21.9 and 48.7% at 12 months. Median number of injections (visits) at each centre varied from 5 to 8 (9 to 12), with an overall median of 6 (11). Age, starting VA, number of injections, and visits, but not gender were significantly associated with variation in these VA outcomes (Peven after adjusting for these factors.ConclusionThere are modest differences in VA outcomes between centres in the UK. These differences are influenced, but not completely explained, by factors such as patient age, starting VA, number of injections, and visits. These data provide an indication of the VA outcomes that are achievable in real-world settings.

  11. CXCR4 antagonist AMD3100 ameliorates thyroid damage in autoimmune thyroiditis in NOD.H‑2h⁴ mice.

    Science.gov (United States)

    Liu, Xin; Mao, Jinyuan; Han, Cheng; Peng, Shiqiao; Li, Chenyan; Jin, Ting; Fan, Chenling; Shan, Zhongyan; Teng, Weiping

    2016-04-01

    CXC chemokine ligand 12 (CXCL12) and its receptor, CXC chemokine receptor 4 (CXCR4), are upregulated in mice with autoimmune thyroid diseases. However, whether this interaction is involved in the pathophysiology of autoimmune thyroiditis (AIT) remains to be elucidated. In the present study, the effects of the CXCR4 antagonist, AMD3100, in an iodine‑induced autoimmune thyroiditis model were investigated. NOD.H‑2h4 mice were randomly separated into a control, AIT and AIT+AMD3100 groups. The mice were fed with 0.05% sodium iodide water for 8 weeks to induce AIT. The AMD3100‑treated mice were administered with the CXCR4 antagonist at a dose of 10 mg/kg intraperitoneally three times a week during the experimental period. The percentages of CD19+interleukin (IL)10+ B cells and CD4+IL10+ T cells, and the mRNA expression levels of IL10 in the splenocytes were reduced in the AIT group, compared with the control group, however, they increased following AMD3100 treatment, compared with the untreated AIT group. The percentages of CD4+ T cells, CD8+ T cells, CD19+ B cells and CD8+ interferon (IFN)γ+ T cells, and the mRNA expression levels of IFNγ increased in the AIT group, compared with the control group, however, these were reduced in the AMD3100 group, compared with the AIT group. The AMD3100‑treated mice also had lower serum thyroglobulin antibody titers and reduced lymphocytic infiltration in the thyroid, compared with the untreated AIT mice. These results suggested that inhibition of this chemokine axis may offer potential as a therapeutic target for the treatment of AIT.

  12. Simulation of atmospheric mercury depletion events (AMDEs during polar springtime using the MECCA box model

    Directory of Open Access Journals (Sweden)

    Z.-Q. Xie

    2008-12-01

    Full Text Available Atmospheric mercury depletion events (AMDEs during polar springtime are closely correlated with bromine-catalyzed tropospheric ozone depletion events (ODEs. To study gas- and aqueous-phase reaction kinetics and speciation of mercury during AMDEs, we have included mercury chemistry into the box model MECCA (Module Efficiently Calculating the Chemistry of the Atmosphere, which enables dynamic simulation of bromine activation and ODEs.

    We found that the reaction of Hg with Br atoms dominates the loss of gaseous elemental mercury (GEM. To explain the experimentally observed synchronous depletion of GEM and O3, the reaction rate of Hg+BrO has to be much lower than that of Hg+Br. The synchronicity is best reproduced with rate coefficients at the lower limit of the literature values for both reactions, i.e. kHg+Br≈3×10−13 and kHg+BrO≤1×10−15 cm3 molecule−1 s−1, respectively.

    Throughout the simulated AMDEs, chem{BrHgOBr} was the most abundant reactive mercury species, both in the gas phase and in the aqueous phase. The aqueous-phase concentrations of BrHgOBr, HgBr2, and HgCl2 were several orders of magnitude larger than that of Hg(SO322−.

    Considering chlorine chemistry outside depletion events (i.e. without bromine activation, the concentration of total divalent mercury in sea-salt aerosol particles (mostly HgCl42− was much higher than in dilute aqueous droplets (mostly Hg(SO322−, and did not exhibit a diurnal cycle (no correlation with HO2 radicals.

  13. The role of chemical and physical watershed processes in the remediation of AMD impacted streams

    Science.gov (United States)

    Lopez, D. A. L.; Kruse, N.; Bowman, J.

    2016-12-01

    Thousands of miles of streams in the United States are impacted by acid mine drainage (AMD) produced by the exploitation of metal and coal mines. Several methods of remediation are used to improve the water quality and recover the diversity in the aquatic life. One of these methods is the addition of alkaline materials to the stream to neutralize the water, precipitate minerals of heavy metals, and rise the pH. Parameters that are usually considered to determine the load of alkalinity to remediate the water include the acidity and flow of the source(s), and concentration of heavy metals. However, recent studies in AMD remediated streams in SE Ohio suggest that the evolution of the water and sediment chemistry along the stream after remediation is also important, and than that evolution depends no only in the added alkalinity but also in the physical and chemical characteristics of the impacted stream. Retention of precipitated fine-grained sediments is important to improve the physical environment for the aquatic life downstream. If sediment retention ponds cannot be constructed, the occurrence of areas where sediments can be deposited and stored is determined by the topographic gradient of the stream. A detailed high-resolution profile of the stream should be constructed to identify regions where the sediments can be retained. The addition of water, dissolved and suspended matter from tributaries to the main stem should also be considered. Tributaries can provide additional alkalinity or acidity to the stream helping to the remediation process or making it more difficult. Groundwater discharges to the stream can also provide either additional alkalinity or acidity to the stream, affecting the chemical budget. These additions from surface and/or groundwater can play an important role in stream recovery. A budget of alkalinity, acidity, and other chemical species along the impacted stream can provide important information to predict the effect of alkaline additions

  14. Simulation of atmospheric mercury depletion events (AMDEs during polar springtime using the MECCA box model

    Directory of Open Access Journals (Sweden)

    Z.-Q. Xie

    2008-07-01

    Full Text Available Atmospheric mercury depletion events (AMDEs during polar springtime are closely correlated with bromine-catalyzed tropospheric ozone depletion events (ODEs. To study gas- and aqueous-phase reaction kinetics and speciation of mercury during AMDEs, we have included mercury chemistry into the box model MECCA (Module Efficiently Calculating the Chemistry of the Atmosphere, which enables dynamic simulation of bromine activation and ODEs.

    We found that the reaction of Hg with Br atoms dominates the loss of gaseous elemental mercury (GEM. To explain the experimentally observed synchronous destruction of Hg and O3, the reaction rate of Hg+BrO has to be much lower than that of Hg+Br. The synchronicity is best reproduced with rate coefficients at the lower limit of the literature values for both reactions, i.e. kHg+Br≈3×10-13 and kHg+BrO≤1×10-15cm3 mol-1 s-1, respectively.

    Throughout the simulated AMDEs, BrHgOBr was the most abundant reactive mercury species, both in the gas phase and in the aqueous phase. The aqueous phase concentrations of BrHgOBr, HgBr2, and HgCl2 were several orders of magnitude larger than that of Hg(SO32-2.

    Considering chlorine chemistry outside depletion events (i.e. without bromine activation, the concentration of total divalent mercury in sea-salt aerosol particles (mostly HgCl2 was much higher than in dilute aqueous droplets (mostly Hg(SO32-2, and did not exhibit a diurnal cycle (no correlation with HO2 radicals.

  15. Multi-surface segmentation of OCT images with AMD using sparse high order potentials.

    Science.gov (United States)

    Oliveira, Jorge; Pereira, Sérgio; Gonçalves, Luís; Ferreira, Manuel; Silva, Carlos A

    2017-01-01

    In age-related macular degeneration (AMD), the quantification of drusen is important because it is correlated with the evolution of the disease to an advanced stage. Therefore, we propose an algorithm based on a multi-surface framework for the segmentation of the limiting boundaries of drusen: the inner boundary of the retinal pigment epithelium + drusen complex (IRPEDC) and the Bruch's membrane (BM). Several segmentation methods have been considerably successful in segmenting retinal layers of healthy retinas in optical coherence tomography (OCT) images. These methods are successful because they incorporate prior information and regularization. Nonetheless, these factors tend to hinder the segmentation for diseased retinas. The proposed algorithm takes into account the presence of drusen and geographic atrophy (GA) related to AMD by excluding prior information and regularization just valid for healthy regions. However, even with this algorithm, prior information and regularization still cause the oversmoothing of drusen in some locations. Thus, we propose the integration of local shape prior in the form of a sparse high order potentials (SHOPs) into the algorithm to reduce the oversmoothing of drusen. The proposed algorithm was evaluated in a public database. The mean unsigned errors, relative to the average of two experts, for the inner limiting membrane (ILM), IRPEDC and BM were 2.94±2.69, 5.53±5.66 and 4.00±4.00 µm, respectively. Drusen areas measurements were evaluated, relative to the average of two expert graders, by the mean absolute area difference and overlap ratio, which were 1579.7 ± 2106.8 µm(2) and 0.78 ± 0.11, respectively.

  16. 老年黄斑变性的药物治疗%Pharmacological therapy in age-related macular degeneration (AMD)

    Institute of Scientific and Technical Information of China (English)

    Yan-Hong Zou; George C.Y.Chiou

    2005-01-01

    for certain forms of neovascular AMD. Anecortave acetate,as a synthetic derivative of cortisol, might stabilize vision in patients with predominantly classic subfoveal choroidal neovascularization (CNV) for up to 6mo through subtenon juxtascleral depot application. Intravitreous injection of VEGF aptamer stabilized or improved vision in 87.5% of patients with subfoveal CNV 3mo after treatment. Malfunction of choroidal blood flow is found in early stage of AMD. Elevation of intravascular pressure is the crucial hemodynamic factor in age-related macular degeneration, resulting in a decrease of the blood flow of choriocapillaries. Chain reactions are triggered which lead to retinal pigment epithelium (RPE) degeneration,Bruch's membrane breakdown, CNV formation, AMD and blindness in the end. Therefore, specific drugs that can increase the choroidal blood flow could be very useful to prevent the AMD from developing and worsening. Although most of them are still in the experimental stage,it is hopeful to find a way to treat AMD at the early stage and to prevent the disease to be triggered and developed.

  17. Durable response of glioblastoma to adjuvant therapy consisting of temozolomide and a weekly dose of AMD3100 (plerixafor), a CXCR4 inhibitor, together with lapatinib, metformin and niacinamide

    Science.gov (United States)

    Rios, Adan; Hsu, Sigmund H.; Blanco, Angel; Buryanek, Jamie; Day, Arthur L.; McGuire, Mary F.; Brown, Robert E.

    2016-01-01

    Glioblastoma multiforme (GBM) is a CNS (central nervous system) malignancy with a low cure rate. Median time to progression after standard treatment is 7 months and median overall survival is 15 months [1]. Post-treatment vasculogenesis promoted by recruitment of bone marrow derived cells (BMDCs, CD11b+ myelomonocytes) is one of main mechanisms of GBM resistance to initial chemoradiotherapy treatment [2]. Local secretion of SDF-1, cognate ligand of BMDCs CXCR4 receptors attracts BMDCs to the post-radiation tumor site.[3]. This SDF-1 hypoxia-dependent effect can be blocked by AMD3100 (plerixafor) [4]. We report a GBM case treated after chemo- radiotherapy with plerixafor and a combination of an mTOR, a Sirt1 and an EGFRvIII inhibitor. After one year temozolomide and the EGFRvIII inhibitor were stopped. Plerixafor, and the MTOR and Sirt-1 inhibitors were continued. He is in clinical and radiologic remission 30 months from the initiation of his adjuvant treatment. To our knowledge, this is the first report of a patient treated for over two years with a CXCR4 inhibitor (plerixafor), as part of his adjuvant treatment. We believe there is sufficient experimental evidence to consider AMD3100 (plerixafor) part of the adjuvant treatment of GBM. Significance The adjuvant inhibition of GBM vasculogenesis(a process different from local angiogenesis) by specifically blocking the migration of BMDCs to the primary tumor site with inhibitors of the CXCR4/SDF-1 axis represents a potential novel therapeutic approach to GBM. There is significant pre-clinical evidence and validation for its use as demonstrated in a patient derived tumor xenograft model of GBM. Together with other specific anti-tumoral therapies, the active inhibition of vasculogenesis in the adjuvant treatment of GBM is deserving of further exploration. PMID:27489862

  18. Determinants of visual acuity outcomes in eyes with neovascular AMD treated with anti-VEGF agents: an instrumental variable analysis of the AURA study.

    Science.gov (United States)

    Holz, F G; Tadayoni, R; Beatty, S; Berger, A R; Cereda, M G; Hykin, P; Staurenghi, G; Wittrup-Jensen, K; Nilsson, J; Kim, K; Sivaprasad, S

    2016-08-01

    PurposeTo identify the strongest variable(s) linked with the number of ranibizumab injections and outcomes in AURA, and to identify ways to improve outcomes using this association.MethodsAURA was a large observational study that monitored visual acuity over a 2-year period in patients with neovascular age-related macular degeneration (AMD) who received ranibizumab injections. Baseline characteristics, resource use, and outcomes were analyzed using an instrumental variable approach and regression analysis.ResultsData were analyzed from 2227 patients enrolled in AURA. Optical coherence tomography (OCT) and ophthalmoscopy were the most common diagnostic tests used, and this combination was the strongest instrumental variable. Use of OCT and ophthalmoscopy affected the number of injections given and resulted in an increase in visual acuity gains from baseline of 17.6 letters in year 1 and 2.5 letters in year 2. Regression models using the instrumental variable (OCT and ophthalmoscopy combined) showed that ≥5.1 (95% CI: 3.3-11.4) ranibizumab injections were needed to maintain visual acuity from baseline to year 1 and ≥8.3 (95% CI: 5.3-18.8) injections were needed to maintain visual acuity from year 1 to year 2. To gain ≥15 letters, ≥7.9 (95% CI: 5.1-17.5) ranibizumab injections would be needed in year 1 and ≥16.1 (95% CI: 10.3-36.4) injections would be needed over 2 years.ConclusionsThese findings highlight the role that regular monitoring plays in guiding neovascular AMD therapy and they showed that the number of ranibizumab injections needed to maintain visual acuity is higher than that administered in AURA.

  19. Study Evaluating AMD3100 for Transplantation of Sibling Donor Stem Cells in Patients With Hematological Malignancies

    Science.gov (United States)

    2013-08-09

    Leukemia, Myeloid, Acute; Leukemia, Myelogenous, Chronic; Leukemia, Lymphoblastic, Acute; Lymphocytic Leukemia, Chronic; Myelodysplastic Syndromes; Multiple Myeloma; Lymphoma, Non-Hodgkin; Hodgkin Disease

  20. Fast calculation of computer-generated-hologram on AMD HD5000 series GPU and OpenCL

    National Research Council Canada - National Science Library

    Shimobaba, Tomoyoshi; Ito, Tomoyoshi; Masuda, Nobuyuki; Ichihashi, Yasuyuki; Takada, Naoki

    2010-01-01

    ...) made by AMD and its new software development environment, OpenCL. Using a RV870 GPU and OpenCL, we can calculate 1,920 x 1,024 resolution of a CGH from a 3D object consisting of 1,024 points in 30 milli-seconds...

  1. Archaeal amd bacterial community composition of a pristine coastal aquifer in Doñana National Park, Spain

    OpenAIRE

    López Archilla, Ana Isabel; Moreira, David; Velasco, Sergio; López García, Purificación

    2007-01-01

    This is an electronic version of an article published in Aquatic Microbial Ecology. López Archilla, A.I. et al. Archaeal amd bacterial community composition of a pristine coastal aquifer in Doñana National Park, Spain. Aquatic Microbial Ecology 47 (2007): 123-139

  2. Role of antioxidant enzymes and small molecular weight antioxidants in the pathogenesis of age-related macular degeneration (AMD).

    Science.gov (United States)

    Tokarz, Paulina; Kaarniranta, Kai; Blasiak, Janusz

    2013-10-01

    Cells in aerobic condition are constantly exposed to reactive oxygen species (ROS), which may induce damage to biomolecules, including proteins, nucleic acids and lipids. In normal circumstances, the amount of ROS is counterbalanced by cellular antioxidant defence, with its main components-antioxidant enzymes, DNA repair and small molecular weight antioxidants. An imbalance between the production and neutralization of ROS by antioxidant defence is associated with oxidative stress, which plays an important role in the pathogenesis of many age-related and degenerative diseases, including age-related macular degeneration (AMD), affecting the macula-the central part of the retina. The retina is especially prone to oxidative stress due to high oxygen pressure and exposure to UV and blue light promoting ROS generation. Because oxidative stress has an established role in AMD pathogenesis, proper functioning of antioxidant defence may be crucial for the occurrence and progression of this disease. Antioxidant enzymes play a major role in ROS scavenging and changes of their expression or/and activity are reported to be associated with AMD. Therefore, the enzymes in the retina along with their genes may constitute a perspective target in AMD prevention and therapy.

  3. The potential of selected macroalgal species for treatment of AMD at different pH ranges in temperate regions

    CSIR Research Space (South Africa)

    Oberholster, Paul J

    2014-09-01

    Full Text Available -1 Water research Vol. 60, pp 82-92 The potential of selected macroalgal species for treatment of AMD at different pH ranges in temperate regions Paul J. Oberholster a,b, Po-Hsun Cheng a,c, Anna-Maria Botha c,*, Bettina Genthe a a CSIR Natural...

  4. Evolutionary-based Design and Control of Geometry Aims for AMD-manufacturing of Ti-6Al-4V Parts

    Science.gov (United States)

    Möller, Mauritz; Baramsky, Nicolaj; Ewald, Ake; Emmelmann, Claus; Schlattmann, Josef

    Additive Metal Deposition (AMD) is an additive manufacturing process building parts based on a nozzle-fed powder by laser assisted solidification. The AMD technology offers unique advantages for the production of near net-shape parts. In contrast to the powder bed-based technologies it provides a high productivity grade. Today AMD lacks reproducible process strategies manufacturing large parts in narrow tolerances. The building height of a single layer and the geometrical shape of a whole part alter progressively with increasing part dimensions - consecutively leading to a higher effort in the manufacturing-process development for such parts. To reduce this effort, in this paper first an iterative identification of optimal process parameters is performed by following an evolutionary algorithm under varied BC. Based on the geometry-related parameter sets, tolerances are defined. The process strategies and tolerances are validated for a prototype application considering the defined quality aims. Finally the results are discussed and summarized in an a-priori process design guideline for AMD Ti6Al4V-parts.

  5. The influence of CXCR4 inhibitor with Bortezomib on the proliferation of human lymphoma cell line Ramos%CXCR4抑制剂 AMD3100联合硼替佐米对人淋巴瘤细胞株 Ramos 增殖、凋亡的影响

    Institute of Scientific and Technical Information of China (English)

    丁晓蓉; 喻晓娟; 李进; 于伟勇; 何敬东

    2016-01-01

    Objective To investigate the synergistic effects of CXCR4 inhibitors AMD3100 and Bortezomib on apoptosis of lymphoma cell lines Ramos. Methods ①The detection of CXCR4 and NF - κB on bone marrow mononuclear cells of lymphoma patients;②The cells were trea-ted with AMD3100,Bortezomib,AMD3100 combined with Bortezomib,respectively. The proliferation was estimated by CCK - 8,the cell apopto-sis was analysed by flow cytometry,the expression level of NF - κB,Bcl - 2,Bcl - xl,c - IAP1 and Caspase - 3 were measured by Western blot. Results ①The CXCR4 and NF - κB were both highly expressed in bone marrow mononuclear cells of lymphoma patients. ②Both AMD3100 and Bortezomib can inhibit the proliferation and promote apoptosis of Ramos cell,the effect showed dosage dependent manner,AMD3100 and Borte-zomib had the synergy effects( P ﹤ 0. 05). ③The expression level of NF - κB,Bcl - 2,Bcl - xl and c - IAP1 were lower in the single drug and combination groups,but the expression of Caspase - 3 was in the different way. Conclusion AMD3100 and Bortezomib has synergistic effect in the proliferation and apoptosis of Ramos cell line,the mechanism of the effects may be down - regulated the expression level of NF - κB,Bcl - 2, Bcl - xl,c - IAP1and up - regulated the expression of Caspase - 3.%目的:探讨 CXCR4抑制剂 AMD3100、硼替佐米对人淋巴瘤细胞株 Ramos 协同诱导凋亡作用。方法①检测淋巴瘤患者骨髓单个核细胞中 CXCR4及核因子κB(NF -κB)表达水平;②AMD3100、硼替佐米单用以及联合用药分别处理 Ramos 细胞,利用 CCK -8法检测细胞增殖;利用流式细胞术检测细胞凋亡;Wester blot 检测 NF -κB、Bcl -2、Bcl - xl、c - IAP1及 Caspase -3表达水平。结果①淋巴瘤患者骨髓单个核细胞中 CXCR4、NF -κB 表达增高;②AMD3100、硼替佐米作用 Ramos 细胞后,随着药物浓度的增加,对细胞增殖的抑制作用逐渐增强、凋亡增加

  6. [Chronic central serous chorioretinopathy (cCSC): differential diagnosis to choroidal neovascularisation (CNV) secondary to age-related macular degeneration (AMD)].

    Science.gov (United States)

    Inhoffen, W; Ziemssen, F; Bartz-Schmidt, K U

    2012-09-01

    Central neurosensory detachments (NSD) with time-dependent height constitute a disease called central serous chorioretinopathy (CSC), if not arising from uveitis, choroidal neovascularisations (CNV) or leaking retinal vessels. In 10 % of these patients, CSC develops into a chronic disease with recurrent NSD, atrophy of photoreceptors and severe drop in visual acuity. This review article summarises recent progress in understanding this disease and its appearance in funduscopy, FLA, ICG, OCT, autofluorescence as well as its progress, therapy and possible development into secondary CNV. The provided examples illustrate the progression of acute CSC into chronic CSC and with CNV over years. The different appearance of polypoidal choroidal vasculopathy (PCV) in ICG and some of the signs of atypical chronic CSC are discussed. To distinguish between cCSC and wet AMD--both exhibiting leakage in FLA--typical signs are helpful, e.g., "gravitational tracks", retinal precipitates and missing drusen. However, in small lesions, it may be difficult or almost impossible to ensure the correct diagnosis of the underlying disease. The same holds for occult and classic secondary CNV in cCSC vs. CNV in AMD, where photodynamic therapy (PDT) can be successful only in cCSC-CNV and in cCSC without CNV. Corticosteroids often lead to further impairment, even in cases of atypical cCSC, when frequently misdiagnosed as uveitis. As a duration of NSD of more than 4 months is suspected to induce an impairment of photoreceptors, regular examinations are necessary not only in chronic CSC but also after acute CSC (as this form can develop into chronic CSC), while effective therapies are available to resolve the NSD (PDT, anti-VEGF).

  7. A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration (nAMD) in Australia and the United Kingdom.

    Science.gov (United States)

    Johnston, Robert L; Carius, Hans-Joachim; Skelly, Adrian; Ferreira, Alberto; Milnes, Fran; Mitchell, Paul

    2017-03-01

    Neovascular age-related macular degeneration (nAMD) is the leading cause of vision loss among persons aged 65 years and older. Anti-vascular endothelial growth factor (anti-VEGF) treatment is the recommended standard of care. The current study compares the effectiveness of ranibizumab in routine clinical practice in two countries that generally apply two different treatment regimens, treat-and-extend (T&E) in Australia or pro re nata (PRN) in the UK. This retrospective, comparative, non-randomised cohort study is based on patients' data from electronic medical record (EMR) databases in Australia and the UK. Treatment regimens were defined based on location, with Australia as a proxy for analysing T&E and UK as a proxy for analysing PRN. The study included patients with a diagnosis of nAMD who started treatment with ranibizumab between January 2009 and July 2014. A total of 647 eyes of 570 patients in Australia and 3187 eyes of 2755 patients in the UK with complete 12-months follow-up were analysed. Baseline patient characteristics were comparable between the two cohorts. After 1 year of treatment, T&E-treated eyes achieved higher mean (±SE) visual acuity (VA) gains (5.00 ± 0.54 letters [95% confidence interval (CI) 3.93-6.06]) than PRN-treated eyes [3.04 ± 0.24 letters (95% CI 2.57-3.51); difference in means 2.07 ± 0.69 (95% CI 0.73-3.41), p < 0.001]. Non-inferiority of T&E compared to PRN was concluded based on the change in mean visual acuity gains at 12 months. Over the 12-month follow-up, T&E-treated eyes received a higher mean [±standard deviation (SD)] number of injections (9.29 ± 2.43) than PRN-treated eyes (6.04 ± 2.19) (p < 0.0001). Australian patients had a lower mean (±SD) number of total clinic visits (10.29 ± 2.90) than UK patients (11.47 ± 2.93) (p < 0.0001). The higher injection frequency in the T&E cohort may account for the trend toward improved vision. Novartis Pharma AG, Basel, Switzerland.

  8. Characterizing the hydrological system in Rosia Montana mining area (Romania) for AMD mitigation

    Science.gov (United States)

    Cozma, Alexandra; Baciu, Calin; Olenici, Adriana; Brahaita, Dorian; Pop, Cristian; Lazar, Laura; Roba, Carmen; Popita, Gabriela

    2015-04-01

    Keywords: mining, AMD mitigation, isotopic analyses, Romania Rosia Montana is one of the most important European gold fields, with a long history of mining. The extraction of gold started on site during the Roman age, and the mining operations that spanned over almost two millennia have produced a visible environmental footprint. More than 140 km of mining galleries are documented by historical sources and recent surveys. Water streams are the main vectors spreading the pollution outside the mining area. The main streams, Rosia, Corna, and Saliste, tributaries of Abruzel River are significantly impacted by the acid waters issued by adits, exposed rock surfaces, or rock waste heaps, and tailings depots. Low contamination has been observed in the streams outside the mining area, artificial ponds, and shallow groundwater. Excepting the shallow groundwater system that can be sampled in domestic wells and some springs, the circulation of groundwater is largely unknown. An important amount of the infiltration water is channelled through galleries. The waters sampled at the galleries outlets have low pH, generally between 2 and 3, and very high content of heavy metals. A systematic approach based on monthly sampling and chemical analyses, and isotopic measurements, has been initiated, in order to better understand the underground itinerary of water and the chemical transformations that occur. A sampling network of 28 water points, including streams, ponds, dug wells, springs, and gallery outlets has been setup. Beyond producing a water circulation model in the mining area, the main purpose of the research is to identify ways of decreasing the acid water production and to design low cost techniques for the AMD mitigation. The deposit still hosts about 300 tonnes of gold, and 1600 tonnes of silver. A new large scale mining project is currently under permitting. Cost-effective solutions for the water treatment would be beneficial, especially for the post-mining stage of any

  9. Interest of MIBG scintigraphy in screening for pheochromocytoma in patients with medullary thyroid carcinoma; Interet de la scintigraphie a la MIBG dans le depistage des pheochromocytomes chez les patients atteints d`un cancer medullaire de la thyroide

    Energy Technology Data Exchange (ETDEWEB)

    Bonnin, F.; Lumbroso, J.; Schlumberger, M.; Megnigbeto, A.; Tenenbaum, F.; Leclere, J.; Travagli, J.P.; Gardet, P.; Parmentier, C. [Centre de Lutte Contre le Cancer Gustave-Roussy, 94 - Villejuif (France)

    1995-12-31

    Adrenal medullary disease (AMD) is clinically silent in most patients with medullary thyroid carcinoma (MTC). During 16 years, a series of 174 MTC patients was screened yearly for AMD. Metaiodobenzylguanidine (MIBG) scans were performed in 54 cases (21 at diagnosis and 33 during the follow up of MTC) either systematically (43 cases) or in patients with biological or ultrasonographic signs of AMD (11 cases). AMD was discovered in ten patients: five patients were already known to have a type II multiple endocrine neoplasia (MEN-2); in five patients previously considered as having either a sporadic (four cases) or a familial type of isolated MTC (one case), the occurrence of AMD led to diagnose a MEN-2 a syndrome. In three cases, AMD was bilateral. MIBG scan were performed in nine of the ten patients with AMD. No false positive MIBG scan was observed in the series. All patients with positive MIBG scan had either elevated excretion of catecholamines and derivates. MIBG scan had a sensitivity of 0.9 and specificity of 1. MIBG should not be used as a screening test. In particular, MIBG scan should not be performed systematically neither at diagnosis nor during follow-up. But, in cases with suspicion of AMD, it provides important complementary functional information. (authors). 15 refs., 3 tabs., 2 figs.

  10. Long-term efficacy of empirical chronic amiodarone therapy in patients with sustained ventricular tachyarrhythmia and structural heart disease.

    Science.gov (United States)

    Aiba, Takeshi; Kurita, Takashi; Taguchi, Atsushi; Shimizu, Wataru; Suyama, Kazuhiro; Aihara, Naohiko; Kamakura, Shiro

    2002-04-01

    The efficacy of empirical chronic oral amiodarone therapy in 129 patients with sustained ventricular tachyarrhythmia (VTNVF) and structural heart disease is evaluated. Twenty-nine patients were treated with class I drugs and monitored by electrophysiological study (EPS) and Holter electrocardiogram (ECG) (class I). The remaining 100 non-responders to the class I drugs were treated with oral amiodarone, of whom 70 were tolerant (AMD+) and 30 were intolerant (AMD-). Patients were followed up to 36 months. The primary and secondary end-points were recurrence of VT/VF and hypothetical death, respectively; whereby, hypothetical death was defined as actual death and the event of rapid VT.VF (heart rate >240beats/min) in patients with an implantable cardioverter defibrillator. Class I and AMD+ patients showed a better prognosis than AMD- patients. The VT/VF event free at 36 months in class I (64.8%) and AMD+ (56.1%) patients were significantly higher than that in AMD- (27.2%) (pAMD+ (83.6%) patients were significantly higher than that in AMD- (57.0%) (pdisease.

  11. Chinese Medicine for Eye Diseases: Principles of Treatment of Age Related Macular Degeneration-AMD%Chinese Medicine for Eye Diseases:Principles of Treatment of Age Related Macular Degeneration-AMD

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ The AMD causes a deterioration of the central field of vision of the human eye caused by loss of function of the macula. The macula is the central part of the retina, the part that receives the most freely detailed information since it contains a considerable number of daylight sensitive and colour sensitive photoreceptor cells. People with little skin pigments like European people are more frequently affected than people from the Asian continent for example. Three quarters of the people who are affected by AMD suffer from the dry form of macular degeneration which means lack of fluid or dehydration of the back part of the eye. There is no effective treatment to be known so far.

  12. Integration of the APC framework with AMD's Fab25 factory system

    Science.gov (United States)

    Bushman, Scott; Campbell, William J.; Miller, Michael L.

    1999-09-01

    This paper discusses the integration and development of advanced process control technologies with AMD's Fab25 factory systems using the Advance Process Control Framework. The Framework is an open software architecture that allows the integration of existing factory systems, such as the manufacturing execution systems, configurable equipment interfaces, recipe management systems, metrology tools, process tools, and add-on sensors, into a system which provides advanced process control specific functionality. The Advanced Process Control Framework project was formulated to enable effective integration of Advanced Process Control applications into a semiconductor facility to improve manufacturing productivity and product yields. The main communication link between the factory system and the Framework is the Configurable Equipment Interface. It interfaces through a specialized component in the framework, the Machine Interface, which converts the factory system communication protocol, ISIS, to the Framework protocol, CORBA. The Framework is a distributed architecture that uses CORBA as a communication protocol between specialized components. A generalized example of how the Framework is integrated into the semiconductor facility is provided, as well as a description of the overall architecture used for process control strategy development. The main development language, Tcl/Tk, provides for increased development and deployment over traditional coding methods.

  13. Mutations at the CXCR4 interaction sites for AMD3100 influence anti-CXCR4 antibody binding and HIV-1 entry

    DEFF Research Database (Denmark)

    Hatse, Sigrid; Princen, Katrien; Vermeire, Kurt

    2003-01-01

    different anti-CXCR4 monoclonal antibodies as well as the infectivity of diverse human immunodeficiency virus type 1 (HIV-1) strains and clinical isolates. Mutation of Asp(262) strongly decreased the coreceptor efficiency of CXCR4 for wild-type but not for AMD3100-resistant HIV-1 NL4.3. Thus, resistance...... of HIV-1 NL4.3 to AMD3100 is associated with a decreased dependence of the viral gp120 on Asp(262) of CXCR4, pointing to a different mode of interaction of wild-type versus AMD3100-resistant virus with CXCR4....

  14. Treatment of combined acid mine drainage (AMD)--flotation circuit effluents from copper mine via Fenton's process.

    Science.gov (United States)

    Mahiroglu, Ayse; Tarlan-Yel, Esra; Sevimli, Mehmet Faik

    2009-07-30

    The treatability of a copper mine wastewater, including heavy metals, AMD, as well as flotation chemicals, with Fenton process was investigated. Fenton process seems advantageous for this treatment, because of Fe(2+) content and low pH of AMD. First, optimum Fe(2+) condition under constant H(2)O(2) was determined, and initial Fe(2+) content of AMD was found sufficient (120 mg/L for removal of chemical oxygen demand (COD) of 6125 mg/L). In the second step, without any additional Fe(2+), optimum H(2)O(2) dosage was determined as 40 mg/L. Fe(2+)/H(2)O(2) molar ratio of 1.8 was enough to achieve the best treatment performance. In all trials, initial pH of AMD was 4.8 and pH adjustment was not performed. Utilization of existing pH and Fe(2+), low H(2)O(2) requirements, and up to 98% treatment performances in COD, turbidity, color, Cu(2+), Zn(2+) made the proposed treatment system promising. Since the reaction occurs stepwise, a two-step kinetic model was applied and calculated theoretical maximum removal rate was consistent to experimental one, which validates the applied model. For the optimum molar ratio (1.8), 140 mL/L sludge of high density (1.094 g/mL), high settling velocity (0.16 cm/s) with low specific resistance (3.15 x 10(8)m/kg) was obtained. High reaction rates and easily dewaterable sludge characteristics also made the proposed method advantageous.

  15. Gene-environment interaction in progression of AMD: the CFH gene, smoking and exposure to chronic infection.

    Science.gov (United States)

    Baird, Paul N; Robman, Luba D; Richardson, Andrea J; Dimitrov, Peter N; Tikellis, Gabriella; McCarty, Catherine A; Guymer, Robyn H

    2008-05-01

    A number of risk factors including the complement factor H (CFH) gene, smoking and Chlamydia pneumoniae have been associated with age-related macular degeneration (AMD). However, the mechanisms underlying how these risk factors might be involved in disease progression and disease aetiology is poorly understood. A cohort series of 233 individuals followed for AMD progression over a mean period of 7 years underwent a full eye examination, blood was taken for DNA and antibody titre and individuals completed a standard medical and general questionnaire. Y402H variants of the CFH gene were assessed with disease progression as well as examination of interaction between Y402H variants and smoking and Y402H variants and the pathogen C. pneumoniae. The CC risk genotype of Y402H was significantly associated with increased AMD progression [odds ratio (OR) 2.43, 95% confidence interval (95% CI) 1.07-5.49] as was smoking (OR 2.28, 95% CI 1.26-4.12). However, the risk of progression was greatly increased to almost 12-fold (OR 11.8, 95% CI 2.1-65.8) when, in addition to having the C risk allele, subjects also presented with the upper tertile of antibodies to the bacterial pathogen C. pneumoniae compared with those with the T allele of Y402H and the lowest antibody tertile. This demonstrates for the first time the existence of a gene environment-interaction between pathogenic load of C. pneumoniae and the CFH gene in the aetiology of AMD.

  16. Aflibercept in wet AMD beyond the first year of treatment: recommendations by an expert roundtable panel.

    Science.gov (United States)

    McKibbin, M; Devonport, H; Gale, R; Gavin, M; Lotery, A; Mahmood, S; Patel, P J; Ross, A; Sivaprasad, S; Talks, J; Walters, G

    2015-07-01

    This paper provides expert recommendations on administration of aflibercept in wet age-related macular degeneration (AMD) after Year 1 (Y1), based on a roundtable discussion held in London, UK in November 2014. The goals of treatment after Y1 are to maintain visual and anatomical gains whilst minimising treatment burden and using resources effectively. The treatment decision should be made at the seventh injection visit (assuming the label has been followed) in Y1, and three approaches are proposed: (a) eyes with active disease on imaging/examination but with stable visual acuity (VA) at the end of Y1 should continue with fixed 8-weekly dosing; (b) eyes with inactive disease on imaging/examination and stable VA should be managed using a 'treat and extend' (T&E) regimen. T&E involves treating and then extending the interval until the next treatment, by 2-week intervals, to a maximum of 12 weeks, provided the disease remains inactive. If there is new evidence of disease activity, treatment is administered and the interval to the next treatment shortened; and (c) if there has been no disease activity for ≥3 consecutive visits, a trial of monitoring without treatment may be appropriate, initiated at the end of Y1 or at any time during Y2. Where possible, VA testing, OCT imaging and injection should be performed at the same visit. The second eye should be monitored to detect fellow eye involvement. In bilateral disease, the re-treatment interval should be driven by the better-seeing eye or, if the VA is similar, the eye with the more active disease.

  17. HuR-targeted nanotherapy in combination with AMD3100 suppresses CXCR4 expression, cell growth, migration, and invasion in lung cancer

    Science.gov (United States)

    Muralidharan, Ranganayaki; Panneerselvam, Janani; Chen, Allshine; Zhao, Yan Daniel; Munshi, Anupama; Ramesh, Rajagopal

    2015-01-01

    The CXCR4 chemokine receptor plays an important role in cancer cell metastasis. The CXCR4 antagonist, AMD3100, has limited efficacy in controlling metastasis. HuR, an RNA-binding protein, regulates CXCR4 in cancer cells. We therefore investigated whether targeting HuR using a siRNA-based nanoparticle plus AMD3100 would suppress CXCR4 and inhibit lung cancer metastasis. We treated human H1299 lung cancer cell with HuR-specific siRNA contained in a folate-targeted lipid nanoparticle (HuR-FNP) plus AMD3100, and compared this with AMD3100 alone, HuR-FNP alone and no treatment. HuR-FNP plus AMD3100 treatment produced a G1 phase cell-cycle arrest and reduced cell viability above and beyond the effects of AMD3100 alone. HuR and CXCR4 mRNA and protein expression levels were markedly reduced in all treatment groups. Phosphorylated (p) AKTS473 protein was also reduced. P27 protein expression increased with HuR-FNP and combination treatment. Promoter-based reporter studies showed that the combination inhibited CXCR4 promoter activity more than did either treatment alone. Cell migration and invasion was significantly reduced with all treatment; the combination provided the most inhibition. Reduced matrix metalloprotease (MMP) -2 and -9 expression was associated with reduced invasion in all treatment groups. Thus, we found that combined HuR and CXCR4 targeting effectively controlled lung cancer metastasis. PMID:26494555

  18. Hydrogeochemical features of surface water and groundwater contaminated with acid mine drainage (AMD) in coal mining areas: a case study in southern Brazil.

    Science.gov (United States)

    Galhardi, Juliana Aparecida; Bonotto, Daniel Marcos

    2016-09-01

    Effects of acid mine drainage (AMD) were investigated in surface waters (Laranjinha River and Ribeirão das Pedras stream) and groundwaters from a coal mining area sampled in two different seasons at Figueira city, Paraná State, Brazil. The spatial data distribution indicated that the acid effluents favor the chemical elements leaching and transport from the tailings pile into the superficial water bodies or aquifers, modifying their quality. The acid groundwaters in both sampling periods (dry: pH 2.94-6.04; rainy: pH 3.25-6.63) were probably due to the AMD generation and infiltration, after the oxidation of sulfide minerals. Such acid effluents cause an increase of the solubilization rate of metals, mainly iron and aluminum, contributing to both groundwater and surface water contamination. Sulfate in high levels is a result of waters' pollution due to AMD. In some cases, high sulfate and low iron contents, associated with less acidic pH values, could indicate that AMD, previously generated, is nowadays being neutralized. The chemistry of the waters affected by AMD is controlled by the pH, sulfide minerals' oxidation, oxygen, iron content, and microbial activity. It is also influenced by seasonal variations that allow the occurrence of dissolution processes and the concentration of some chemical elements. Under the perspective of the waters' quality evaluation, the parameters such as conductivity, dissolved sodium, and sulfate concentrations acted as AMD indicators of groundwaters and surface waters affected by acid effluents.

  19. HuR-targeted nanotherapy in combination with AMD3100 suppresses CXCR4 expression, cell growth, migration and invasion in lung cancer.

    Science.gov (United States)

    Muralidharan, R; Panneerselvam, J; Chen, A; Zhao, Y D; Munshi, A; Ramesh, R

    2015-12-01

    The CXCR4 chemokine receptor has an important role in cancer cell metastasis. The CXCR4 antagonist, AMD3100, has limited efficacy in controlling metastasis. HuR, an RNA-binding protein, regulates CXCR4 in cancer cells. We therefore investigated whether targeting HuR using a siRNA-based nanoparticle plus AMD3100 would suppress CXCR4 and inhibit lung cancer metastasis. We treated human H1299 lung cancer cells with HuR-specific siRNA contained in a folate-targeted lipid nanoparticle (HuR-FNP) plus AMD3100, and compared this with AMD3100 alone, HuR-FNP alone and no treatment. HuR-FNP plus AMD3100 treatment produced a G1 phase cell cycle arrest and reduced cell viability above and beyond the effects of AMD3100 alone. HuR and CXCR4 mRNA and protein expression levels were markedly reduced in all treatment groups. Phosphorylated (p) AKT(S473) protein was also reduced. P27 protein expression increased with HuR-FNP and combination treatment. Promoter-based reporter studies showed that the combination inhibited CXCR4 promoter activity more than did either treatment alone. Cell migration and invasion was significantly reduced with all treatments; the combination provided the most inhibition. Reduced matrix metalloprotease (MMP)-2 and -9 expression was associated with reduced invasion in all treatment groups. Thus, we found that combined HuR and CXCR4 targeting effectively controlled lung cancer metastasis.

  20. Early treatment of acute submacular haemorrhage secondary to wet AMD using intravitreal tissue plasminogen activator, C3F8, and an anti-VEGF agent.

    Science.gov (United States)

    de Silva, S R; Bindra, M S

    2016-07-01

    PurposeAcute submacular haemorrhage secondary to wet age-related macular degeneration (AMD) has a poor prognosis for which there is currently no 'gold standard' treatment. We evaluated the efficacy of early treatment using intravitreal triple therapy of tissue plasminogen activator (tPA), expansile gas, and an anti-VEGF agent.MethodsThis retrospective case series included eight patients presenting with acute submacular haemorrhage involving the fovea. All patients received treatment with 50 μg (0.05 ml) tPA, 0.3 ml 100% perfluoropropane (C3F8), and an anti-VEGF agent (0.05 mg Ranibizumab or 1.25 mg Bevacizumab in 0.05 ml) administered via intravitreal injection. An anterior chamber paracentesis post injection or vitreous tap was performed before injection to prevent retinal vascular occlusion secondary to raised intra-ocular pressure. Outcomes assessed were visual acuity, change in macular morphology, and complications.ResultsPatients presented promptly with delay between symptom onset and clinic review being 1.9±0.6 days (mean±SD). Treatment was delivered quickly with interval from presentation to treatment being 1.1±1.2 days. Symptom onset to treatment was 3.0±1.0 days. Subfoveal haemorrhage was effectively displaced in all patients. LogMAR visual acuity improved from 1.67±0.47 at presentation to 0.63±0.33 at final follow-up (Pvisual acuity in this series of patients who presented soon after symptom onset. Treatment was well tolerated in this group of elderly and potentially frail patients.

  1. Nuclear kinesis, neurite sprouting and abnormal axonal projections of cone photoreceptors in the aged and AMD-afflicted human retina.

    Science.gov (United States)

    Pow, David V; Sullivan, Robert K P

    2007-05-01

    Tissues often respond to damage by recapitulating developmental programs. We have investigated whether anatomical signs of developmental recapitulation are evident in cone photoreceptors of the aged and AMD-afflicted human retina. Radial migration of cell nuclei mediated by microtubules is a characteristic feature of cells in the developing retina. Similarly, neurite outgrowth is a feature of developing neurons. We have examined whether nuclear kinesis and neurite outgrowth from cone photoreceptors is evident. Calbindin-positive cone photoreceptor nuclei are normally positioned as a single layer of somata at the outer border of the outer nuclear layer. In AMD-afflicted retinae, many nuclei are translocated, with some somata abutting the outer plexiform layer (OPL) and others outside the outer limiting membrane whilst many nuclei are present at intermediate levels. The axonal processes of many cones were also aberrant, displaying tortuous pathways as they projected to the OPL, with occasional evidence for bifurcation at points where the axon changed direction. We suggest that tangential extension of collateral neurites and the rapid retraction of the original process may give rise to the tortuous axonal projections observed. Since microtubules are key mediators of both neurite extension and nuclear kinesis we examined expression of microtubule associated protein 2 (MAP2) which is an important regulator of neurite extension. The strong expression of MAP2 observed in those cells with aberrant morphologies supports the notion that abnormal microtubule-mediated remodelling events are present in the AMD retina and to a lesser extent in normal aged retinas, allowing cone photoreceptors to recapitulate two key features of development.

  2. Polonium behaviour in reservoirs potentially affected by acid mine drainage (AMD) in the Iberian Pyrite Belt (SW of Spain).

    Science.gov (United States)

    Blasco, M; Gázquez, M J; Pérez-Moreno, S M; Grande, J A; Valente, T; Santisteban, M; de la Torre, M L; Bolívar, J P

    2016-02-01

    The province of Huelva is one of the areas most affected by acid mine drainage (AMD) in the world, which can produce big enhancements and fractionations in the waters affected by AMD. There are very few studies on this issue, and none on polonium-210. Twenty-two water reservoirs were sampled, and the (210)Po was measured in both dissolution and particulate phases. The (210)Po concentrations in the waters were in the same order of magnitude to those ones for unperturbed systems, although the data published to particulate matter are very scarce. A mean value and standard uncertainty for (210)Po of 0.25 ± 0.03 mBq L(-1) in the dissolved matter, and 62 ± 9 mBq g(-1) in the particulate matter can be established as base line for the reservoirs of the Huelva area. The distribution coefficients (kd) range from 10(4) to 10(6) L kg(-1), in agreement to the found ones by other authors for the case of neutral waters, but being the lowest values for the more acidic reservoirs. It has been also found that (210)Po has a high tendency to be associated to the particulate matter for neutral-alkaline waters, however, under extreme acid conditions (pH < 3), increases the Po tendency to be associated to the dissolved phase. Therefore, the main conclusion obtained in this work is that AMD has no a significant influence on the total activity concentration of (210)Po in the waters of reservoirs, but the acidity has a clear influence on its distribution between both dissolved and the particulate phases. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Fast calculation of computer-generated-hologram on AMD HD5000 series GPU and OpenCL

    CERN Document Server

    Shimobaba, Tomoyoshi; Masuda, Nobuyuki; Ichihashi, Yasuyuki; Takada, Naoki

    2010-01-01

    In this paper, we report fast calculation of a computer-generated-hologram using a new architecture of the HD5000 series GPU (RV870) made by AMD and its new software development environment, OpenCL. Using a RV870 GPU and OpenCL, we can calculate 1,920 * 1,024 resolution of a CGH from a 3D object consisting of 1,024 points in 30 milli-seconds. The calculation speed realizes a speed approximately two times faster than that of a GPU made by NVIDIA.

  4. Fast calculation of computer-generated-hologram on AMD HD5000 series GPU and OpenCL.

    Science.gov (United States)

    Shimobaba, Tomoyoshi; Ito, Tomoyoshi; Masuda, Nobuyuki; Ichihashi, Yasuyuki; Takada, Naoki

    2010-05-10

    In this paper, we report fast calculation of a computer-generated-hologram using a new architecture of the HD5000 series GPU (RV870) made by AMD and its new software development environment, OpenCL. Using a RV870 GPU and OpenCL, we can calculate 1,920 x 1,024 resolution of a CGH from a 3D object consisting of 1,024 points in 30 milli-seconds. The calculation speed realizes a speed approximately two times faster than that of a GPU made by NVIDIA. (c) 2010 Optical Society of America.

  5. Small, hard macular drusen and peripheral drusen: associations with AMD genotypes in the Inter99 Eye Study

    DEFF Research Database (Denmark)

    Munch, Inger Christine; Ek, Jakob; Kessel, Line;

    2010-01-01

    PURPOSE: To study associations of small, hard macular drusen and peripheral drusen with genotypes associated with age-related macular degeneration (AMD). METHODS: Digital grayscale fundus photographs recorded in red-free illumination were graded for the presence of drusen in 1107 subjects aged 30...... were associated with CFHY402H (odds ratio [OR], 4.3; 95% confidence interval [95% CI], 1.4-13, for CC versus TT genotypes) as was macular drusen >63 microm (OR, 1.9; 95% CI, 1.1-3.1, for CC versus TT genotypes). Macular drusen >63 microm were associated with the presence of 20 or more small, hard...

  6. Understanding age-related macular degeneration (AMD): relationships between the photoreceptor/retinal pigment epithelium/Bruch's membrane/choriocapillaris complex.

    Science.gov (United States)

    Bhutto, Imran; Lutty, Gerard

    2012-08-01

    There is a mutualistic symbiotic relationship between the components of the photoreceptor/retinal pigment epithelium (RPE)/Bruch's membrane (BrMb)/choriocapillaris (CC) complex that is lost in AMD. Which component in the photoreceptor/RPE/BrMb/CC complex is affected first appears to depend on the type of AMD. In atrophic AMD (~85-90% of cases), it appears that large confluent drusen formation and hyperpigmentation (presumably dysfunction in RPE) are the initial insult and the resorption of these drusen and loss of RPE (hypopigmentation) can be predictive for progression of geographic atrophy (GA). The death and dysfunction of photoreceptors and CC appear to be secondary events to loss in RPE. In neovascular AMD (~10-15% of cases), the loss of choroidal vasculature may be the initial insult to the complex. Loss of CC with an intact RPE monolayer in wet AMD has been observed. This may be due to reduction in blood supply because of large vessel stenosis. Furthermore, the environment of the CC, basement membrane and intercapillary septa, is a proinflammatory milieu with accumulation of complement components as well as proinflammatory molecules like CRP during AMD. In this toxic milieu, CC die or become dysfunction making adjacent RPE hypoxic. These hypoxic cells then produce angiogenic substances like VEGF that stimulate growth of new vessels from CC, resulting in choroidal neovascularization (CNV). The loss of CC might also be a stimulus for drusen formation since the disposal system for retinal debris and exocytosed material from RPE would be limited. Ultimately, the photoreceptors die of lack of nutrients, leakage of serum components from the neovascularization, and scar formation. Therefore, the mutualistic symbiotic relationship within the photoreceptor/RPE/BrMb/CC complex is lost in both forms of AMD. Loss of this functionally integrated relationship results in death and dysfunction of all of the components in the complex.

  7. Microglia in the mouse retina alter the structure and function of retinal pigmented epithelial cells: a potential cellular interaction relevant to AMD.

    Directory of Open Access Journals (Sweden)

    Wenxin Ma

    Full Text Available BACKGROUND: Age-related macular degeneration (AMD is a leading cause of legal blindness in the elderly in the industrialized word. While the immune system in the retina is likely to be important in AMD pathogenesis, the cell biology underlying the disease is incompletely understood. Clinical and basic science studies have implicated alterations in the retinal pigment epithelium (RPE layer as a locus of early change. Also, retinal microglia, the resident immune cells of the retina, have been observed to translocate from their normal position in the inner retina to accumulate in the subretinal space close to the RPE layer in AMD eyes and in animal models of AMD. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we examined the effects of retinal microglia on RPE cells using 1 an in vitro model where activated retinal microglia are co-cultured with primary RPE cells, and 2 an in vivo mouse model where retinal microglia are transplanted into the subretinal space. We found that retinal microglia induced in RPE cells 1 changes in RPE structure and distribution, 2 increased expression and secretion of pro-inflammatory, chemotactic, and pro-angiogenic molecules, and 3 increased extent of in vivo choroidal neovascularization in the subretinal space. CONCLUSIONS/SIGNIFICANCE: These findings share similarities with important pathological features found in AMD and suggest the relevance of microglia-RPE interactions in AMD pathogenesis. We speculate that the migration of retinal microglia into the subretinal space in early stages of the disease induces significant changes in RPE cells that perpetuate further microglial accumulation, increase inflammation in the outer retina, and fosters an environment conducive for the formation of neovascular changes responsible for much of vision loss in advanced AMD.

  8. CXCR4 antagonist AMD3100 reverses the neurogenesis promoted by enriched environment and suppresses long-term seizure activity in adult rats of temporal lobe epilepsy.

    Science.gov (United States)

    Zhou, Zhike; Liu, Tingting; Sun, Xiaoyu; Mu, Xiaopeng; Zhu, Gang; Xiao, Ting; Zhao, Mei; Zhao, Chuansheng

    2017-03-30

    It has been showed that enriched environment (EE) enhances the hippocampal neurogenesis and improves the cognitive impairments, accompanied by the increased expressions of stromal cell-derived factor-1 (SDF-1) in adult rats of temporal lobe epilepsy (TLE). We examined whether the enhanced neurogenesis and improved cognitive functions induced by EE following seizures were mediated by SDF-1/CXCR4 pathway. Therefore, we investigated the effects of the EE combined with CXCR4 antagonist AMD3100 on neurogenesis, cognitive functions and the long-term seizure activity in the TLE model. Adult rats were randomly assigned as control rats, rats treated with EE, rats subjected to status epilepticus (SE), post-SE rats treated with EE, AMD3100 or EE combined with AMD3100 respectively. We used immunofluorescence staining to analyze the hippocampal neurogenesis and Nissl staining to evaluate hippocampal damage. Electroencephalography was used to measure the frequency and mean duration of spontaneous seizures. Cognitive function was evaluated by Morris water maze test. EE treatment significantly, as well as improved cognitive impairments and decreased long-term seizure activity, and that these effects might be mediated through SDF-1/CXCR4 pathway during the chronic stage of TLE. Although AMD3100 reversed the effect of EE on neurogenesis, it did not abolish the cognitive improvement induced by EE following seizures. More importantly, EE combined with AMD3100 treatment significantly suppressed long-term seizure activity, which provided promising evidences to treat TLE.

  9. V3-independent competitive resistance of a dual-X4 HIV-1 to the CXCR4 inhibitor AMD3100.

    Directory of Open Access Journals (Sweden)

    Yosuke Maeda

    Full Text Available A CXCR4 inhibitor-resistant HIV-1 was isolated from a dual-X4 HIV-1 in vitro. The resistant variant displayed competitive resistance to the CXCR4 inhibitor AMD3100, indicating that the resistant variant had a higher affinity for CXCR4 than that of the wild-type HIV-1. Amino acid sequence analyses revealed that the resistant variant harbored amino acid substitutions in the V2, C2, and C4 regions, but no remarkable changes in the V3 loop. Site-directed mutagenesis confirmed that the changes in the C2 and C4 regions were principally involved in the reduced sensitivity to AMD3100. Furthermore, the change in the C4 region was associated with increased sensitivity to soluble CD4, and profoundly enhanced the entry efficiency of the virus. Therefore, it is likely that the resistant variant acquired the higher affinity for CD4/CXCR4 by the changes in non-V3 regions. Taken together, a CXCR4 inhibitor-resistant HIV-1 can evolve using a non-V3 pathway.

  10. Analysis of rare variants in the C3 gene in patients with age-related macular degeneration.

    Directory of Open Access Journals (Sweden)

    Maheswara R Duvvari

    Full Text Available Age-related macular degeneration (AMD is a progressive retinal disorder affecting over 33 million people worldwide. Genome-wide association studies (GWASs for AMD identified common variants at 19 loci accounting for 15-65% of the heritability and it has been hypothesized that the missing heritability may be attributed to rare variants with large effect sizes. Common variants in the complement component 3 (C3 gene have been associated with AMD and recently a rare C3 variant (Lys155Gln was identified which exerts a large effect on AMD susceptibility independent of the common variants. To explore whether additional rare variants in the C3 gene are associated with AMD, we sequenced all coding exons in 84 unrelated AMD cases. Subsequently, we genotyped all identified variants in 1474 AMD cases and 2258 controls. Additionally, because of the known genetic overlap between AMD and atypical hemolytic uremic syndrome (aHUS, we genotyped two recurrent aHUS-associated C3 mutations in the entire cohort. Overall, we identified three rare variants (Lys65Gln (P=0.04, Arg735Trp (OR=17.4, 95% CI=2.2-136; P=0.0003, and Ser1619Arg (OR=5.2, 95% CI=1.0-25; P=0.05 at the C3 locus that are associated with AMD in our EUGENDA cohort. However, the Arg735Trp and Ser1619Arg variants were not found to be associated with AMD in the Rotterdam Study. The Lys65Gln variant was only identified in patients from Nijmegen, the Netherlands, and thus may represent a region-specific AMD risk variant.

  11. Human progenitor cells rapidly mobilized by AMD3100 repopulate NOD/SCID mice with increased frequency in comparison to cells from the same donor mobilized by granulocyte colony stimulating factor

    DEFF Research Database (Denmark)

    Hess, David A; Bonde, Jesper; Craft, Timothy P

    2007-01-01

    AMD3100 inhibits the interaction between SDF-1 and CXCR4, and rapidly mobilizes hematopoietic progenitors for clinical transplantation. However, the repopulating function of human cells mobilized with AMD3100 has not been characterized in comparison to cells mobilized with granulocyte-colony stim......AMD3100 inhibits the interaction between SDF-1 and CXCR4, and rapidly mobilizes hematopoietic progenitors for clinical transplantation. However, the repopulating function of human cells mobilized with AMD3100 has not been characterized in comparison to cells mobilized with granulocyte...

  12. Suppression of dualtropic human immunodeficiency virus type 1 by the CXCR4 antagonist AMD3100 is associated with efficiency of CXCR4 use and baseline virus composition.

    Science.gov (United States)

    Fransen, Signe; Bridger, Gary; Whitcomb, Jeannette M; Toma, Jonathan; Stawiski, Eric; Parkin, Neil; Petropoulos, Christos J; Huang, Wei

    2008-07-01

    In a phase I/II evaluation of the CXCR4 antagonist AMD3100, human immunodeficiency virus RNA levels were significantly reduced in a single study subject who harbored CXCR4 (X4)-tropic virus, but not in subjects who harbored either dual/mixed (DM)-tropic or CCR5 (R5)-tropic virus (C. W. Hendrix et al., J. Acquir. Immune Defic. Syndr. 37:1253-1262, 2004). In this study, we analyzed the envelope clones of DM-tropic virus in baseline and treated virus populations from 14 subjects. Ten subjects exhibited significant reductions in CXCR4-mediated infectivity after 10 days of AMD3100 therapy relative to baseline (X4 suppressor group), while four subjects had no reduction of CXCR4-mediated infectivity (X4 nonsuppressor group). The baseline viruses of the X4 suppressor group infected CXCR4-expressing cells less efficiently than those of the X4 nonsuppressor group. Clonal analysis indicated that the baseline viruses from the X4 suppressor group contained a higher proportion of R5-tropic variants mixed with CXCR4-using variants, while the X4 nonsuppressor group was enriched for CXCR4-using variants. AMD3100 suppressed X4-tropic variants in all subjects studied, but not all dualtropic variants. Furthermore, dualtropic variants that used CXCR4 efficiently were suppressed by AMD3100, while dualtropic variants that used CXCR4 poorly were not. This study demonstrated that AMD3100 has the ability to suppress both X4-tropic and certain dualtropic variants in vivo. The suppression of CXCR4-using variants by AMD3100 is dependent on both the tropism composition of the virus population and the efficiency of CXCR4 usage of individual variants.

  13. Use of steel slag to neutralize acid mine drainage (AMD in sulfidic material from a uranium mine

    Directory of Open Access Journals (Sweden)

    Camila Marcon de Carvalho Leite

    2013-06-01

    Full Text Available Acid Mine Drainage (AMD is one of the main environmental impacts caused by mining. Thus, innovative mitigation strategies should be exploited, to neutralize acidity and prevent mobilization of trace elements in AMD. The use of industrial byproducts has been considered an economically and environmentally effective alternative to remediate acid mine drainage. Therefore, the objective of this study was to evaluate the use of steel slag to mitigate acid mine drainage in a sulfidic material from a uranium mine, as an alternative to the use of limestone. Thus, increasing doses of two neutralizing agents were applied to a sulfidic material from the uranium mine Osamu Utsumi in Caldas, Minas Gerais State. A steel slag from the company ArcelorMittal Tubarão and a commercial limestone were used as neutralizing agents. The experiment was conducted in leaching columns, arranged in a completely randomized, [(2 x 3 + 1] factorial design, consisting of two neutralizing agents, three doses and one control, in three replications, totaling 21 experimental units. Electrical conductivity (EC, pH and the concentrations of Al, As, Ca, Cd, Cu, Fe, Mn, Ni, S, Se, and Zn were evaluated in the leached solutions. The trace element concentration was evaluated by ICP-OES. Furthermore, the CO2 emission was measured at the top of the leaching columns by capturing in NaOH solution and titration with HCl, in the presence of BaCl2. An increase in the pH of the leachate was observed for both neutralizing agents, with slightly higher values for steel slag. The EC was lower at the higher lime dose at an early stage of the experiment, and CO2 emission was greater with the use of limestone compared to steel slag. A decrease in trace element mobilization in the presence of both neutralizing agents was also observed. Therefore, the results showed that the use of steel slag is a suitable alternative to mitigate AMD, with the advantage of reducing CO2 emissions to the atmosphere

  14. AMD-associated genes encoding stress-activated MAPK pathway constituents are identified by interval-based enrichment analysis.

    Directory of Open Access Journals (Sweden)

    John Paul SanGiovanni

    Full Text Available PURPOSE: To determine whether common DNA sequence variants within groups of genes encoding elements of stress-activated mitogen-activated protein kinase (MAPK signaling pathways are, in aggregate, associated with advanced AMD (AAMD. METHODS: We used meta-regression and exact testing methods to identify AAMD-associated SNPs in 1177 people with AAMD and 1024 AMD-free elderly peers from 3 large-scale genotyping projects on the molecular genetics of AMD. SNPs spanning independent AAMD-associated genomic intervals were examined with a multi-locus-testing method (INRICH for enrichment within five sets of genes encoding constituents of stress-activated MAPK signaling cascades. RESULTS: Four-of-five pathway gene sets showed enrichment with AAMD-associated SNPs; findings persisted after adjustment for multiple testing in two. Strongest enrichment signals (P = 0.006 existed in a c-Jun N-terminal kinase (JNK/MAPK cascade (Science Signaling, STKE CMP_10827. In this pathway, seven independent AAMD-associated regions were resident in 6 of 25 genes examined. These included sequence variants in: 1 three MAP kinase kinase kinases (MAP3K4, MAP3K5, MAP3K9 that phosphorylate and activate the MAP kinase kinases MAP2K4 and MAP2K7 (molecules that phosphorylate threonine and tyrosine residues within the activation loop of JNK; 2 a target of MAP2K7 (JNK3A1 that activates complexes involved in transcriptional regulation of stress related genes influencing cell proliferation, apoptosis, motility, metabolism and DNA repair; and 3 NR2C2, a transcription factor activated by JNK1A1 (a drugable molecule influencing retinal cell viability in model systems. We also observed AAMD-related sequence variants resident in genes encoding PPP3CA (a drugable molecule that inactivates MAP3K5, and two genes (TGFB2, TGFBR2 encoding factors involved in MAPK sensing of growth factors/cytokines. CONCLUSIONS: Linkage disequilibrium (LD-independent genomic enrichment analysis yielded

  15. Quality of life in patients with age-related macular degeneration: impact of the condition and benefits of treatment.

    Science.gov (United States)

    Slakter, Jason S; Stur, Michael

    2005-01-01

    Age-related macular degeneration (AMD) is a chronic, progressive, degenerative disease of the macula and is the leading cause of central vision loss among elderly people in the western world. Traditionally, clinical studies of AMD have described the impact of AMD, and treatments for AMD, in terms of the patient's visual acuity. However, visual acuity alone does not provide information about a patient's perception of his or her quality of life. Researchers have used a variety of instruments to measure quality of life. Several studies have shown that AMD can severely impair quality of life and that increasing vision loss is associated with increasing impairment of quality of life and frequently causes depression. Interestingly, patients with only one eye affected may become more depressed than those with both eyes affected, possibly because of uncertainty surrounding future vision loss in patients with one eye affected and a greater acceptance of the condition in those with both eyes affected. Studies also have provided some information on the possible quality of life benefits of therapy for AMD. By incorporating measurements of quality of life into the design of future prospective studies, clinical researchers may be able to obtain more comprehensive data on the impact of AMD on patients and the relative benefits of different therapies.

  16. Predictive Factors in OCT Analysis for Visual Outcome in Exudative AMD

    OpenAIRE

    Maria-Andreea Gamulescu; Georgios Panagakis; Carmen Theek; Horst Helbig

    2012-01-01

    Background. Reliable predictive factors for therapy outcome may enable treating physicians to counsel their patients more efficiently concerning probability of improvement or time point of discontinuation of a certain therapy. Methods. This is a retrospective analysis of 87 patients with exudative age-related macular degeneration who received three monthly intravitreal ranibizumab injections. Visual acuity before initiation of intravitreal therapy and 4–6 weeks after last intravitreal injecti...

  17. A human apoB100 transgenic mouse expresses human apoB100 in the RPE and develops features of early AMD

    DEFF Research Database (Denmark)

    Fujihara, Masashi; Bartels, Emil; Nielsen, Lars B

    2009-01-01

    changes consistent with early human AMD including loss of basal infoldings and accumulation of cytoplasmic vacuoles in the RPE, and basal laminar deposits containing long-spacing collagen and heterogeneous debris in Bruch membrane of apoB100 mice. In apoB100 mice given a high-fat diet, basal linear...

  18. Prevalence of depression and its effect on disability in patients with age-related macular degeneration

    OpenAIRE

    Banerjee Anindya; Kumar Suresh; Kulhara Parmanand; Gupta Amod

    2008-01-01

    Aims: To estimate depression in patients with age-related macular degeneration (AMD) and study the relationships among depression, visual acuity, and disability. Materials and Methods: It was a cross-sectional study with consecutive sampling (n = 53) of patients with AMD aged 50 years and above attending the retina clinic of a tertiary care hospital in North India. Depression, general disability and vision-specific disability were assessed in subjects meeting selection criteria. Assessment...

  19. Caregiver Burden in Patients Receiving Ranibizumab Therapy for Neovascular Age Related Macular Degeneration

    OpenAIRE

    Rishma Gohil; Roxanne Crosby-Nwaobi; Angus Forbes; Ben Burton; Phil Hykin; Sobha Sivaprasad

    2015-01-01

    Purpose To assess the caregiver burden and factors determining the burden in patients receiving ranibizumab therapy for neovascular AMD (nAMD). Methods This is a cross-sectional questionnaire survey of 250 matched patient caregiver dyads across three large ophthalmic treatment centres in United Kingdom. The primary outcome was the subjective caregiver burden measured using caregiver reaction assessment scale (CRA). Objective caregiver burden was determined by the caregiver tasks and level of ...

  20. Increased Expression of CD200 on Circulating CD11b+ Monocytes in Patients with Neovascular Age-related Macular Degeneration

    DEFF Research Database (Denmark)

    Singh, Amardeep; Falk, Mads K; Hviid, Thomas V F

    2013-01-01

    , and detailed retinal imaging was performed: fundus autofluorescence imaging, digital color fundoscopy, and spectral-domain optical coherence tomography. Fluorescein and indocyanine green angiography were performed in patients with suspected neovascular AMD. Visual acuity was measured in both eyes. Fresh venous...... was observed in controls with healthy eyes, but not in patients with neovascular AMD. We did not find any differences in CD200 and CD200R expression between patients with subretinal fibrosis and patients without subretinal fibrosis. CONCLUSIONS: The surface expression of CD200 on circulating CD11b+ monocytes...... was found to be increased in patients with neovascular AMD compared with controls with healthy eyes. This novel finding supports the notion that altered regulation of the inflammatory response plays an integral role in the pathogenesis of AMD. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary...

  1. Physical activity patterns in patients with early and late age-related macular degeneration

    DEFF Research Database (Denmark)

    Subhi, Yousif; Sørensen, Torben Lykke

    2016-01-01

    best-corrected visual acuity in the best-seeing and the worse-seeing eye was associated with less engagement in physical activities that would work up sweat and a lower number of steps taken daily. Patients with bilateral vision loss from late AMD engaged in physical activities that were more......INTRODUCTION: Age-related macular degeneration (AMD) leads to visual impairment that affects visual functioning and thereby the ability to be physically active. We investigated physical activity patterns in patients with AMD. METHODS: Patients with early and late AMD and elderly controls were...... recruited for this hospital-based cross-sectional study. All participants had their best-corrected visual acuity measured and were interviewed about their physical activity based on questions that covered regular physical activity, physical activity that would work up sweat, climbing the stairs and time...

  2. Physical activity patterns in patients with early and late age-related macular degeneration

    DEFF Research Database (Denmark)

    Subhi, Yousif; Sørensen, Torben Lykke

    2016-01-01

    best-corrected visual acuity in the best-seeing and the worse-seeing eye was associated with less engagement in physical activities that would work up sweat and a lower number of steps taken daily. Patients with bilateral vision loss from late AMD engaged in physical activities that were more......INTRODUCTION: Age-related macular degeneration (AMD) leads to visual impairment that affects visual functioning and thereby the ability to be physically active. We investigated physical activity patterns in patients with AMD. METHODS: Patients with early and late AMD and elderly controls were...... recruited for this hospital-based cross-sectional study. All participants had their best-corrected visual acuity measured and were interviewed about their physical activity based on questions that covered regular physical activity, physical activity that would work up sweat, climbing the stairs and time...

  3. Ranibizumab for the treatment of wet AMD: a summary of real-world studies.

    Science.gov (United States)

    Chong, V

    2016-02-01

    Data from real-world studies of ranibizumab in neovascular (wet) age-related macular degeneration suggest that outcomes in clinical practice fail to match those seen in clinical trials. These real-world studies follow treatment regimens that differ from the fixed dosing used in the pivotal clinical trial programme. To better understand the effectiveness of ranibizumab in clinical practice, we conducted a comprehensive evaluation of 12-month outcomes reported in peer-reviewed 'real-world' publications. Key measures included in our analysis were mean change in visual acuity (VA) and the proportion of patients gaining ≥15 letters or losing ≤15 letters. Twenty studies were eligible for inclusion in our study, with 18 358 eyes having sufficient data for analysis of 12-month outcomes. Mean baseline VA ranged from 48.8 to 61.6 Early Treatment Diabetic Retinopathy Study letters. Mean change in VA was between -2.0 and +5.5 letters, with a grand mean of +2.9±3.2, and a weighted mean (adjusted for the number of eyes in the study) of +1.95. Eleven studies reported that 19±7.5 (mean value) of patients gained ≥15 letters, while in 12 studies the mean percentage of patient losing ≤15 letters was 89±6.5%. Our comprehensive analysis of real-world ranibizumab study data confirm that patient outcomes are considerably poorer than those reported in randomised control trials of both fixed and pro re nata regimens.

  4. A 4-Year Longitudinal Study of 555 Patients Treated with Ranibizumab for Neovascular Age-related Macular Degeneration

    DEFF Research Database (Denmark)

    Rasmussen, Annette; Bloch, Sara B; Fuchs, Josefine;

    2013-01-01

    To investigate the visual outcome, pattern of discontinuation, ocular complications, and mortality of patients treated with a variable ranibizumab dosing regimen for neovascular age-related macular degeneration (AMD) for 4 years....

  5. Possible role of Rhodotorula sp. in the formation of jarosite in the AMD environment of Muskau Arch, Poland

    Science.gov (United States)

    Jakus, Natalia; Chlebicki, Andrzej; Bożęcki, Piotr; Manecki, Maciej

    2016-04-01

    The Muskau Arch is situated in the west of Poland and in the east of Germany. This region is a belt formed by push and frontal moraines during the Middle-Polish (Riss) glaciation, especially during the Wartanian glaciation. The occurrence of glacier caused folding and forming the glacitectonic type of lignit deposits which were mined for over 150 years. Both open pit and underground mining methods has exposed metal sulfides (mainly pyrite) to air and water causing bio-oxidation. Due to this process the acidity of many reservoirs have increased significantly (pH values between 2 and 4). As a consequence of changes in the environment, new mineral phases precipitated from highly acid waters rich in, among others, various forms of Fe and S. Precipitation of ochreous minerals such as schwertmannite, goethite and jarosite was partly catalyzed by many various acidophilic and acid-tolerant microorganisms: bacteria, archaea and probably yeasts. Jarosite KFe33+(OH)6(SO4)2 can be precipitated both in abiotic conditions and as a by-product of the activity of living organisms. The example of biomineralization induced by fungi Purpureocillium lilacinum in similar AMD environment of Rio Tinto is reported (Oggerin et al, 2014). Recently, jarosite is also considered as a possible biosignature of life on Mars. The assessment of microbial participation in formation of jarosite is an elementary step in geomicrobiological and astrobiological research. Isolated by us Rhodotorula sp. is an unicellular pigmented yeast. Fungi from the genus Rhodotorula F.C. Harrison belong to Sporidiobolalas part of phylum Basidiomycota. They are common environmental inhabitants. Some species, known from Rio Tinto, can live in extreme acidic soils at pH of about 2 (Lopez-Archila et al, 2004). For the first time, authors isolated strain Rhodotorula sp. from surface precipitates in Ł ęknica region (Muskau Arch). This ochreous precipitate contains jarosite. The yeast might be an important factor in indirect

  6. Computerized evaluation of deambulatory pattern before and after visual rehabilitation treatment performed with biofeedback in visually impaired patients suffering from macular degeneration

    OpenAIRE

    Fernanda Pacella; Raffaele Migliorini; Alessandro Segnalini; Enzo Agostinelli; Sara Di Pillo; Gianpaolo Smaldone; Mauro Salducci; Elena Pacella

    2016-01-01

    Aims: The aim of this study was double: the primary endpoint was to evaluate the efficacy of visual rehabilitation of visually impaired patients with macular degeneration (AMD). The secondary endpoint was to assess the effect of rehabilitation treatment on the ambulatory pattern using a computerized evaluation of walking, focusing the attention on space-time parameters that are influenced in patients with visual impairment. Methods: 10 patients with AMD were enrolled, 6 males and 4 female...

  7. Evaluation of 10 AMD Associated Polymorphisms as a Cause of Choroidal Neovascularization in Highly Myopic Eyes

    Science.gov (United States)

    Anter, Jaouad; Bezunartea, Jaione; Hernandez-Sanchez, Maria; García-García, Laura; Alonso, Elena; Ruiz-Moreno, Jose María; Araiz-Iribarren, Javier; Fernandez-Robredo, Patricia; García-Layana, Alfredo

    2016-01-01

    Choroidal neovascularization (CNV) commonly occurs in age related macular degeneration and pathological myopia patients. In this study we conducted a case-control prospective study including 431 participants. The aim of this study was to determine the potential association between 10 single nucleotide polymorphisms (SNPs) located in 4 different genetic regions (CFI, COL8A1, LIPC, and APOE), and choroidal neovascularization in age-related macular degeneration and the development of choroidal neovascularization in highly myopic eyes of a Caucasian population. Univariate and multivariate logistic regression analysis adjusted for age, sex and hypertension was performed for each allele, genotype and haplotype frequency analysis. We found that in the univariate analysis that both single-nucleotide polymorphisms in COL8A1 gene (rs13095226 and rs669676) together with age, sex and hypertension were significantly associated with myopic CNV development in Spanish patients (p0.05); however, analysis of the axial length between genotypes of rs13095226 revealed an important influence of COL8A1 in the development of CNV in high myopia. Furthermore we conducted a meta-analysis of COL8A1, CFI and LIPC genes SNPs (rs669676, rs10033900 and rs10468017) and found that only rs669676 of these SNPs were associated with high myopia neovascularization. PMID:27643879

  8. The rs2071559 AA VEGFR-2 Genotype Frequency Is Significantly Lower in Neovascular Age-Related Macular Degeneration Patients

    Directory of Open Access Journals (Sweden)

    Stefano Lazzeri

    2012-01-01

    Full Text Available In this prospective, case-control genetic study, 120 consecutive neovascular age-related macular degeneration (AMD cases and 78 controls were enrolled. Two SNPs (rs2071559 and rs1870377 of VEGF-A receptor-2 (VEGFR-2 gene were analyzed with the technique of Real-Time PCR to investigate a genetic link between AMD and VEGFR-2 gene polymorphisms in Italian patients. The frequency of the VEGFR-2 genotype rs2071559 AA was significantly lower (18.33% in patients with AMD than in the control subjects (34.62%; P=0.0095, chi-square test; Pcorr=0.038; OR=0.42, 95% CI 0.22 to 0.82. In conclusion, although with the limitations of a small sample size and the few SNPs studied, this study demonstrates a lower frequency of VEGFR-2 rs2071559 AA genotype in an AMD patient population, suggesting future studies on the role VEGFR-2 SNPs.

  9. The rs2071559 AA VEGFR-2 genotype frequency is significantly lower in neovascular age-related macular degeneration patients.

    Science.gov (United States)

    Lazzeri, Stefano; Orlandi, Paola; Figus, Michele; Fioravanti, Anna; Cascio, Elisa; Di Desidero, Teresa; Agosta, Elisa; Canu, Bastianina; Sartini, Maria Sole; Danesi, Romano; Nardi, Marco; Bocci, Guido

    2012-01-01

    In this prospective, case-control genetic study, 120 consecutive neovascular age-related macular degeneration (AMD) cases and 78 controls were enrolled. Two SNPs (rs2071559 and rs1870377) of VEGF-A receptor-2 (VEGFR-2) gene were analyzed with the technique of Real-Time PCR to investigate a genetic link between AMD and VEGFR-2 gene polymorphisms in Italian patients. The frequency of the VEGFR-2 genotype rs2071559 AA was significantly lower (18.33%) in patients with AMD than in the control subjects (34.62%; P = 0.0095, chi-square test; P(corr) = 0.038; OR = 0.42, 95% CI 0.22 to 0.82). In conclusion, although with the limitations of a small sample size and the few SNPs studied, this study demonstrates a lower frequency of VEGFR-2 rs2071559 AA genotype in an AMD patient population, suggesting future studies on the role VEGFR-2 SNPs.

  10. Impact of AMD on water quality in critical watershed in the Hudson River drainage basin: Phillips Mine, Hudson Highlands, New York

    Science.gov (United States)

    Gilchrist, Sivajini; Gates, Alexander; Szabo, Zoltan; Lamothe, Paul J.

    2009-03-01

    A sulfur and trace element enriched U-Th-laced tailings pile at the abandoned Phillips Mine in Garrison, New York, releases acid mine drainage (AMD, generally pH AMD evaporation during dry periods concentrates solid phase trace metals and sulfate, forming melanterite (FeSO4·7H2O) on sulfide-rich tailings surfaces. Wet periods dissolve these concentrates/precipitates, releasing stored acidity and trace metals into the CMB. Sediments along CMB are enriched in iron hydroxides which act as sinks for metals, indicating progressive sequestration that correlates with dilution and sharp rise in pH when mine water mixes with tributaries. Seasonal variations in metal concentrations were partly attributable to dissolution of the efflorescent salts with their sorbed metals and additional metals from surging acidic seepage induced by precipitation.

  11. Design and Implementation of an AMD-Based PC Clustering Computing System%基于AMD PC的机群计算系统的设计与实现

    Institute of Scientific and Technical Information of China (English)

    孙功星; 顾明

    2004-01-01

    文章介绍了一个基于AMD PC的机群计算系统,它由30个计算节点、1个数据服务器及1个登录服务器组成,总共64个CPU,数据服务器使用千兆网络的连接.这个计算系统是用于LHC(Large Hadron Collider)的Monte Carlo模拟以及羊八井中日合作项目的数据分析、Monte Carlo模拟等.由于Monte Carlo模拟部分对计算能力的要求很高,而数据分析部分则对I/O能力的要求很高,因此系统必须兼顾这两个方面的要求.由于物理数据的产生和物理数据的分析是事例间无关的,所以系统使用批作业处理方式.该文选择NASA开发的自由软件PBS作为批作业管理系统.测试结果表明,系统SPEC2000的SPECint和SPECfp值分别为38976和35008,I/O的读写能力分别为62.34MB/s和56.50MB/s,具有很好的性能价格比.

  12. Machine learning based detection of age-related macular degeneration (AMD) and diabetic macular edema (DME) from optical coherence tomography (OCT) images

    OpenAIRE

    Wang, Yu; Zhang, Yaonan; Yao, Zhaomin; Zhao, Ruixue; Zhou, Fengfeng

    2016-01-01

    Non-lethal macular diseases greatly impact patients’ life quality, and will cause vision loss at the late stages. Visual inspection of the optical coherence tomography (OCT) images by the experienced clinicians is the main diagnosis technique. We proposed a computer-aided diagnosis (CAD) model to discriminate age-related macular degeneration (AMD), diabetic macular edema (DME) and healthy macula. The linear configuration pattern (LCP) based features of the OCT images were screened by the Corr...

  13. REE behavior and effect factors in AMD-type acidic groundwater at sulfide tailings pond, BS nickel mine, W.A.

    Institute of Scientific and Technical Information of China (English)

    LEI Liang-qi; SONG Ci-an; XIE Xiang-li; LI Yan-hong

    2008-01-01

    AMD(Acid Mine Drainage)-type acidic groundwater (pH<4) from oxidizing sulfide tailings in BS nickel mine (Western Australia) is of higher total rare earth element(REE) contents and Ce enrichment (PAAS normalization), different from setting groundwater (pH>6.5, with lower total REE contents, Ce depletion). While the AMD contaminated groundwater (pH=4.0-6.5) around tailings pond is characterized by transition from acidic to setting groundwater in total REE content, and associated with Ce depletion (like setting groundwater). The light REE in all type groundwater shows up depletion, but its depleted extent in acidic groundwater is more remarkable. This work indicates that REE behavior in AMD-type acidic groundwater is controlled mainly by pH value and metal (Al, Mn and Fe) contents. And the critical pH value that affects REE behavior in ground acidic water would be 4, lower than the previous value (pH=5) that has been believed prevalently in surface acidic waters. The pH could affect REE behavior in groundwater by controlling the solubility of metal (Al, Mn and Fe) hydroxides and the valence of cerium. Finally, light REE depletion in acidic groundwater may due to element affinity. High content Al (affinity with heavy REE) and low content Fe (affinity with light REE) may lead to heavy REE enrichment while light REE relative depletion in water.

  14. Application of the SWAT model to an AMD-affected river (Meca River, SW Spain). Estimation of transported pollutant load

    Science.gov (United States)

    Galván, L.; Olías, M.; Fernandez de Villarán, R.; Domingo Santos, J. M.; Nieto, J. M.; Sarmiento, A. M.; Cánovas, C. R.

    2009-10-01

    SummaryThe Meca River is highly contaminated by acid mine drainage coming from the Tharsis mining district, belonging to the Iberian Pyrite Belt. This river is regulated by the Sancho reservoir (58 hm 3), with a pH close to 4.2. In this work, the load transported by the Meca River to the Sancho reservoir has been assessed. Due to the lack of streamflow data, the hydrological behaviour of the Meca River basin has been simulated using the SWAT model. The model has been calibrated against registered daily inflows of the Sancho reservoir (1982-2000), excluding the hydrological years 2000/2001 and 2001/2002 that were kept for the validation. The results were satisfactory; the evaluation coefficients for monthly calibration were: r = 0.85 (Pearson's correlation coefficient), NSE = 0.83 (Nash-Sutcliffe coefficient) and DV = 1.08 (runoff volume deviation). The main uncertainty was the calibration during low water because of the poor accuracy in the measurement of the inputs to the reservoir in these conditions. Discharge and dissolved concentration relationships for different elements were obtained from hydrochemical samplings, which allowed us to estimate the element pollutant load transported to the reservoir: 418 ton/year of Al, 8024 ton/year of SO 4, 121 ton/year of Zn, etc. Based on these loads, concentrations in the reservoir were calculated for some elements. Apart from Mn and Sr, good adjustment between calculated and measured values was observed (±20% for Ca, Co, Li, Mg, Na, Ni, Zn and SO 4). Capsule: Hydrological model combined with water quality data show how pollution by AMD can generate huge loads of contaminants acidifying streams and reservoirs.

  15. The potential of selected macroalgal species for treatment of AMD at different pH ranges in temperate regions.

    Science.gov (United States)

    Oberholster, Paul J; Cheng, Po-Hsun; Botha, Anna-Maria; Genthe, Bettina

    2014-09-01

    The metal bioaccumulation potential of selected macroalgae species at different pH ranges was study for usage as part of a possible secondary passive acid mine drainage (AMD) treatment technology in algae ponds. Two separate studies were conducted to determine the suitability of macroalgae for passive treatment when metabolic processes in macrophytes and microorganisms in constructed wetlands decrease during winter months. In the field study, the bioconcentration of metals (mg/kg dry weight) measured in the benthic macroalgae mats was in the following order: site 1. Oedogonium crassum Al > Fe > Mn > Zn; site 2. Klebsormidium klebsii, Al > Fe > Mn > Zn; site 3. Microspora tumidula, Fe > Al > Mn > Zn and site 4. M. tumidula, Fe > Mn > Al > Zn. In the laboratory study, cultured macroalgae K. klebsii, O. crassum and M. tumidula isolated from the field sampling sites were exposed to three different pH values (3, 5 and 7), while bioaccumulation of the metals, Al, Fe, Mn and Zn and glutathione S-transferase (GST) activity were measured in the different selected algae species at a constant water temperature of 14 °C. Bioaccumulation of Al was the highest for O. crassum followed by K. klebsii and M. tumidula (p < 0.0001). From the study it was evident that the highest metal bioaccumulation occurred in the macroalgae O. crassum at all three tested pH values under constant low water temperature.

  16. Convergence of linkage, gene expression and association data demonstrates the influence of the RAR-related orphan receptor alpha (RORA) gene on neovascular AMD: A systems biology based approach

    Science.gov (United States)

    Silveira, Alexandra C.; Morrison, Margaux A.; Ji, Fei; Xu, Haiyan; Reinecke, James B.; Adams, Scott M.; Arneberg, Trevor M.; Janssian, Maria; Lee, Joo-Eun; Yuan, Yang; Schaumberg, Debra A.; Kotoula, Maria G.; Tsironi, Evangeline E.; Tsiloulis, Aristoteles N.; Chatzoulis, Dimitrios Z.; Miller, Joan W.; Kim, Ivana K.; Hageman, Gregory H.; Farrer, Lindsay A.; Haider, Neena B.; DeAngelis, Margaret M.

    2009-01-01

    To identify novel genes and pathways associated with AMD, we performed microarray gene expression and linkage analysis which implicated the candidate gene, retinoic acid receptor-related orphan receptor alpha (RORA, 15q). Subsequent genotyping of 159 RORA single nucleotide polymorphisms (SNPs) in a family-based cohort, followed by replication in an unrelated case-control cohort, demonstrated that SNPs and haplotypes located in intron 1 were significantly associated with neovascular AMD risk in both cohorts. This is the first report demonstrating a possible role for RORA, a receptor for cholesterol, in the pathophysiology of AMD. Moreover, we found a significant interaction between RORA and the ARMS2/HTRA1 locus suggesting a novel pathway underlying AMD pathophysiology. PMID:19786043

  17. Dysregulation of CXCR3 expression on peripheral blood leukocytes in patients with neovascular age-related macular degeneration

    DEFF Research Database (Denmark)

    Falk, Mads Krüger; Singh, Amardeep; Faber, Carsten;

    2014-01-01

    Purpose: The chemokine receptor CXCR3 has been strongly related to inhibition of angiogenesis. The purpose of this study was to investigate the association between expression of CXCR3 on peripheral blood leukocytes and Age-related Wet Macular Degeneration (AMD). Furthermore, we measured the plasma...... concentration of the chemokines CXCL9-11. Methods: The study group consisted of patients with AMD attending our department. Patients referred for other reasons than AMD were enrolled as control persons. The expression of CXCR3 on T-cells and the plasma concentration of CXCL9-11 were measured using flow...... cytometry. Results: We looked at all CD8+ T-cells expressing CXCR3 and found a significant lower percentage of these cells in the neovascular AMD group compared to the age-matched control group (p=0.05). When dividing the CD8+ cells in functional groups according to their expression of CXCR3, we found...

  18. AMD3100 reduces CXCR4-mediated survival and metastasis of osteosarcoma by inhibiting JNK and Akt, but not p38 or Erk1/2, pathways in in vitro and mouse experiments.

    Science.gov (United States)

    Liao, Yu-Xin; Fu, Ze-Ze; Zhou, Cheng-Hao; Shan, Lian-Cheng; Wang, Zhuo-Ying; Yin, Fei; Zheng, Long-Po; Hua, Ying-Qi; Cai, Zheng-Dong

    2015-07-01

    Osteosarcoma (OS) has an unfavorable prognosis and tends to metastasize to lung tissue. Although the CXCL12-CXCR4 axis appears to affect progression and metastasis in numerous tumors, its mechanism and downstream pathways in OS remain unclear. We used western blotting and flow cytometry to detect CXCR4 and CXCR7 expression in two OS cell lines (LM8 and Dunn). An MTT assay was used to evaluate the effects of CXCL12 and AMD3100, a specific CXCR4 antagonist, on cell viability. Flow cytometry was utilized to analyze changes in apoptosis induced by serum deprivation following treatment with CXCL12 and AMD3100. A Transwell assay was used to assess cell migration in response to CXCL12 and AMD3100. Western blotting was performed to identify the phosphorylation of signaling molecules (JNK, c-Jun, Akt, p38 and Erk1/2) and expression of caspase-3 and -8, and PARP. Mouse models were employed to evaluate AMD3100 inhibition of primary OS growth and lung metastasis in vivo. CXCR4 expression was detected in LM8 but not Dunn cells, and neither cell line expressed CXCR7. The addition of CXCL12 induced the survival and migration of serum-starved CXCR4+ LM8 cells activating JNK and Akt pathways, which were abrogated by adding AMD3100. However, similar results were not observed in CXCR4- Dunn cells. CXCL12 protected LM8, but not Dunn cells, from apoptosis induced by serum deprivation by suppressing PARP cleavage, which was partly reversed by AMD3100. In a mouse model, AMD3100 reduced primary tumor growth and lung metastasis compared with the controls. Thus, the CXCL12-CXCR4 axis regulated OS survival and metastasis through the JNK and Akt pathways, and blocking them with AMD3100 was found to be a potential OS treatment.

  19. [Therapeutic approach in patients with age-related macular degeneration and cataract].

    Science.gov (United States)

    Tomi, Anca; Moldoveanu, A; Marin, Irina

    2011-01-01

    Management of the patient with coexisting cataract and AMD presents unique challenges to the cataract surgeon, the retina specialist, and the patient. A common clinical scenario is the patient in whom both the cataract and macular pathology appear to be contributing to decreased visual acuity. As with any surgery, the expectations from cataract removal must be evaluated thoroughly and understood clearly by both the patient and the cataract surgeon. Most patients with AMD who undergo cataract surgery feel that the surgery is worthwhile, and they report improvement of visual function and quality of life. In patients with mild AMD, improvement in central visual acuity and attainment of driving vision are realistic and achievable goals. In an eye with central disciform scarring or geographic atrophy there may be potential for improvement in color discrimination, contrast, or clarity of peripheral vision. In cases of dense cataract obscuring macular detail, cataract removal may be necessary to allow for adequate biomicroscopy and angiography, especially in an eye that may be at high risk for the development of choroidal neovascularization. It is often challenging to estimate the relative impact on visual impairment made by the lens opacities and the macular changes and the benefits and risks of cataract surgery in eyes with AMD should be carefully evaluated. Is cataract surgery justified in these patients? Does cataract surgery aggravate AMD in some patients?

  20. Analysis of the results of multifocal electroretinogram and optical coherence tomography in diagnosis and monitoring of patients with age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Ait Ahmed Кh.

    2014-06-01

    Full Text Available Purpose: to study the correlation between the results of the macular area responses by multifocal-electroretinog-raphy (mf-ERG and the retina thickness obtained by the spectralis optical coherence tomography (ОСТ in patients with age-related macular degeneration (AMD. Material and methods. 28 patients (32 eyes where enrolled in the main group. The control group was up to 10 patients without any AMD's pathological sign in retina. All patients were examined by the optical coherence tomography (ОСТ and multifocal electroretinography (mf-ERG. Results. The data showed a high level of negative correlation between the retinal thickness and electrical amplitudes of the fovea. With the group of "dry" AMD the rise of the macular thickness (drusen not over 290 urn showed a moderate reduction of the amplitude on mf-ERG The group with "wet" AMD showed that a higher rise of the retinal thickness (edema, fibrosis of the macular zone negatively influences the bio-electrical activity of this area and this fact was confirmed by a considerable decline of the amplitude on the mf-ERG. Conclusion. The AMD's pathological changes that have been observed by ОСТ are objectively confirmed by mf-ERG. The mf-ERG in supplement of ОСТ can be used as an important element in the complex studies and objectively monitoring of patients with AMD.

  1. The Mitochondria-Targeted Antioxidant SkQ1 Downregulates Aryl Hydrocarbon Receptor-Dependent Genes in the Retina of OXYS Rats with AMD-Like Retinopathy

    Directory of Open Access Journals (Sweden)

    M. L. Perepechaeva

    2014-01-01

    Full Text Available The mitochondria-targeted antioxidant SkQ1 is a novel drug thought to retard development of age-related diseases. It has been shown that SkQ1 reduces clinical signs of retinopathy in senescence-accelerated OXYS rats, which are a known animal model of human age-related macular degeneration (AMD. The aim of this work was to test whether SkQ1 affects transcriptional activity of AhR (aryl hydrocarbon receptor and Nrf2 (nuclear factor erythroid 2-related factor 2, which are considered as AMD-associated genes in the retina of OXYS and Wistar rats. Our results showed that only AhR and AhR-dependent genes were sensitive to SkQ1. Dietary supplementation with SkQ1 decreased the AhR mRNA level in both OXYS and Wistar rats. At baseline, the retinal Cyp1a1 mRNA level was lower in OXYS rats. SkQ1 supplementation decreased the Cyp1a1 mRNA level in Wistar rats, but this level remained unchanged in OXYS rats. Baseline Cyp1a2 and Cyp1b1 mRNA expression was stronger in OXYS than in Wistar rats. In the OXYS strain, Cyp1a2 and Cyp1b1 mRNA levels decreased as a result of SkQ1 supplementation. These data suggest that the Cyp1a2 and Cyp1b1 enzymes are involved in the pathogenesis of AMD-like retinopathy of OXYS rats and are possible therapeutic targets of SkQ1.

  2. A Candidate Gene Association Study Identifies DAPL1 as a Female-Specific Susceptibility Locus for Age-Related Macular Degeneration (AMD).

    Science.gov (United States)

    Grassmann, Felix; Friedrich, Ulrike; Fauser, Sascha; Schick, Tina; Milenkovic, Andrea; Schulz, Heidi L; von Strachwitz, Claudia N; Bettecken, Thomas; Lichtner, Peter; Meitinger, Thomas; Arend, Nicole; Wolf, Armin; Haritoglou, Christos; Rudolph, Guenther; Chakravarthy, Usha; Silvestri, Giuliana; McKay, Gareth J; Freitag-Wolf, Sandra; Krawczak, Michael; Smith, R Theodore; Merriam, John C; Merriam, Joanna E; Allikmets, Rando; Heid, Iris M; Weber, Bernhard H F

    2015-06-01

    Age-related macular degeneration (AMD) is the leading cause of blindness among white caucasians over the age of 50 years with a prevalence rate expected to increase markedly with an anticipated increase in the life span of the world population. To further expand our knowledge of the genetic architecture of the disease, we pursued a candidate gene approach assessing 25 genes and a total of 109 variants. Of these, synonymous single nucleotide polymorphism (SNP) rs17810398 located in death-associated protein-like 1 (DAPL1) was found to be associated with AMD in a joint analysis of 3,229 cases and 2,835 controls from five studies [combined PADJ = 1.15 × 10(-6), OR 1.332 (1.187-1.496)]. This association was characterized by a highly significant sex difference (Pdiff = 0.0032) in that it was clearly confined to females with genome-wide significance [PADJ = 2.62 × 10(-8), OR 1.541 (1.324-1.796); males: PADJ = 0.382, OR 1.084 (0.905-1.298)]. By targeted resequencing of risk and non-risk associated haplotypes in the DAPL1 locus, we identified additional potentially functional risk variants, namely a common 897-bp deletion and a SNP predicted to affect a putative binding site of an exonic splicing enhancer. We show that the risk haplotype correlates with a reduced retinal transcript level of two, less frequent, non-canonical DAPL1 isoforms. DAPL1 plays a role in epithelial differentiation and may be involved in apoptotic processes thereby suggesting a possible novel pathway in AMD pathogenesis.

  3. Estimation of antioxidants dietary intake in wet age-related macular degeneration patients

    Directory of Open Access Journals (Sweden)

    María del Mar Bibiloni

    2014-04-01

    Full Text Available Aims: The aim of this study was to estimate the intake of antioxidant nutrients in wet age-related macular degeneration (AMD patients, a degenerative and progressive disorder of the macula, which is the central part of the retina, associated with central vision loss. Methods: A sample (n = 52, 78.9 ± 6.6 years old, 40.4% females and 59.6% males of patients diagnosed of AMD was interviewed. Anthropometric measurements, two 24-h recalls, a semi-quantitative food frequency questionnaire and a general questionnaire incorporating questions related to socio-demographic and lifestyle variables were used. Results: Most of wet AMD patients showed inadequate antioxidant nutrient intake (< 2/3 of Recommended Dietary Intake, RDI, and more than 60% of patients showed serious deficient intake (< 1/3 RDI of lutein and zeaxanthin. Most consumed antioxidant rich foods only represented low contributions to antioxidant intake. Although adiposity is a factor risk for AMD progression; the fat and saturated fatty acids (SFA intake of study participants were higher than the recommendations; the prevalence of overweight was 61.9% men and 58.1% in women; and 83% of patients (90.5% men and 77.4% women showed fat mass over the cut-off limits. Conclusions: The food pattern of wet AMD patients should be improved by means of an increase in the consumption of antioxidant rich foods, and a decrease in SFA rich foods.

  4. Impact of AMD on water quality in critical watershed in the Hudson River drainage basin: Phillips Mine, Hudson Highlands, New York

    Science.gov (United States)

    Gilchrist, S.; Gates, A.; Szabo, Z.; Lamothe, P.J.

    2009-01-01

    A sulfur and trace element enriched U-Th-laced tailings pile at the abandoned Phillips Mine in Garrison, New York, releases acid mine drainage (AMD, generally pH iron hydroxides which act as sinks for metals, indicating progressive sequestration that correlates with dilution and sharp rise in pH when mine water mixes with tributaries. Seasonal variations in metal concentrations were partly attributable to dissolution of the efflorescent salts with their sorbed metals and additional metals from surging acidic seepage induced by precipitation.

  5. Prevalence and Risk Factors of Early-Stage Age-Related Macular Degeneration in Patients Examined at a Health Promotion Center in Korea

    OpenAIRE

    Moon, Byung Gil; Joe, Soo Geun; Hwang, Jong-Uk; Kim, Hong Kyu; Choe, Jaewon; Yoon, Young Hee

    2012-01-01

    We evaluated the prevalence and risk factors for early age-related macular degeneration (AMD) in Koreans 50 yr of age or older who were examined at a single health promotion center. We retrospectively reviewed the records of 10,449 subjects who visited the center over a 6-month period. Fundus photography was performed on all subjects, and systematic risk factor analysis was conducted using a structured questionnaire. All patients (n = 322) were initially diagnosed with drusen or early AMD usi...

  6. Improved AMD counters quicky type to achieve a level of 0.2 log derivative mSv output in counts refills; Mejora de la AMD en contadores tipo quicky para conseguir un nivel derivado de registro de 0,2 mSV en contajes de salida en recargas

    Energy Technology Data Exchange (ETDEWEB)

    Bravp Perez-Tinao, B.; Marchena Gonzalez, P.; Sollet Danudo, E.

    2011-07-01

    To ensure that no worker receives contract exposed by internal exposure dose computed not exceed 1 mSv / year, the Nuclear Security Council requested the Spanish nuclear power plants and Tecnatom that in 2010 would ensure a level derived from registration in internal dosimetry counts refills output equal to or less than 0.2 mSv, which represented a reduction of AMD computers.

  7. Rehabilitation Approaches in Macular Degeneration Patients.

    Science.gov (United States)

    Maniglia, Marcello; Cottereau, Benoit R; Soler, Vincent; Trotter, Yves

    2016-01-01

    Age related macular degeneration (AMD) is a visual disease that affects elderly population. It entails a progressive loss of central vision whose consequences are dramatic for the patient's quality of life. Current rehabilitation programs are restricted to technical aids based on visual devices. They only temporarily improve specific visual functions such as reading skills. Considering the rapid increase of the aging population worldwide, it is crucial to intensify clinical research on AMD in order to develop simple and efficient methods that improve the patient's visual performances in many different contexts. One very promising approach to face this challenge is based on perceptual learning (PL). Through intensive practice, PL can induce neural plasticity in sensory cortices and result in long-lasting enhancements for various perceptual tasks in both normal and visually impaired populations. A growing number of studies showed how appropriate PL protocols improve visual functions in visual disorders, namely amblyopia, presbyopia or myopia. In order to successfully apply these approaches to more severe conditions such as AMD, numerous challenges have to be overcome. Indeed, the overall elderly age of patients and the reduced cortical surface that is devoted to peripheral vision potentially limit neural plasticity in this population. In addition, ocular fixation becomes much less stable because patients have to rely on peripheral fixation spots outside the scotoma whose size keeps on evolving. The aim of this review article is to discuss the recent literature on this topic and to offer a unified approach for developing new rehabilitation programs of AMD using PL. We argue that with an appropriate experimental and training protocol that is adapted to each patient needs, PL can offer fascinating opportunities for the development of simple, non-expensive rehabilitation approaches a large spectrum of visual functions in AMD patients.

  8. Estimation of antioxidants dietary intake in wet age-related macular degeneration patients.

    Science.gov (United States)

    Bibiloni, Maria del Mar; Zapata, Maria Elisa; Aragón, Juan A; Pons, Antoni; Olea, José Luis; Tur, Josep A

    2014-04-01

    The aim of this study was to estimate the intake of antioxidant nutrients in wet age-related macular degeneration (AMD) patients, a degenerative and progressive disorder of the macula, which is the central part of the retina, associated with central vision loss. A sample (n = 52, 78.9 ± 6.6 years old, 40.4% females and 59.6% males) of patients diagnosed of AMD was interviewed. Anthropometric measurements, two 24- h recalls, a semi-quantitative food frequency questionnaire and a general questionnaire incorporating questions related to socio-demographic and lifestyle variables were used. Most of wet AMD patients showed inadequate antioxidant nutrient intake (foods only represented low contributions to antioxidant intake. Although adiposity is a factor risk for AMD progression; the fat and saturated fatty acids (SFA) intake of study participants were higher than the recommendations; the prevalence of overweight was 61.9% men and 58.1% in women; and 83% of patients (90.5% men and 77.4% women) showed fat mass over the cut-off limits. The food pattern of wet AMD patients should be improved by means of an increase in the consumption of antioxidant rich foods, and a decrease in SFA rich foods.L. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. A Reduced-Order Controller Considering High-Order Modal Information of High-Rise Buildings for AMD Control System with Time-Delay

    Directory of Open Access Journals (Sweden)

    Zuo-Hua Li

    2017-01-01

    Full Text Available Time-delays of control force calculation, data acquisition, and actuator response will degrade the performance of Active Mass Damper (AMD control systems. To reduce the influence, model reduction method is used to deal with the original controlled structure. However, during the procedure, the related hierarchy information of small eigenvalues will be directly discorded. As a result, the reduced-order model ignores the information of high-order mode, which will reduce the design accuracy of an AMD control system. In this paper, a new reduced-order controller based on the improved Balanced Truncation (BT method is designed to reduce the calculation time and to retain the abandoned high-order modal information. It includes high-order natural frequency, damping ratio, and vibration modal information of the original structure. Then, a control gain design method based on Guaranteed Cost Control (GCC algorithm is presented to eliminate the adverse effects of data acquisition and actuator response time-delays in the design process of the reduced-order controller. To verify its effectiveness, the proposed methodology is applied to a numerical example of a ten-storey frame and an experiment of a single-span four-storey steel frame. Both numerical and experimental results demonstrate that the reduced-order controller with GCC algorithm has an excellent control effect; meanwhile it can compensate time-delays effectively.

  10. Genome-wide analysis of single nucleotide polymorphisms in patients with atrophic age-related macular degeneration in oldest old Han Chinese.

    Science.gov (United States)

    Zhou, T Q; Guan, H J; Hu, J Y

    2015-12-21

    The aim of this study was to identify disease-associated loci in oldest old Han Chinese with atrophic age-related macular degeneration (AMD). This genome-wide association study (GWAS) only included oldest old (≥95 years old) subjects in Rugao County, China. Thirty atrophic AMD patients and 47 age-matched non-AMD controls were enrolled. The study subjects underwent a complete ophthalmic examination. Genomic DNA was extracted from peripheral blood samples. Single nucleotide polymorphisms (SNPs) were scanned by Genome-Wide Human Mapping SNP 6.0 Arrays and GeneChip Scanner 3000 7G. The results were read and analyzed by the Affymetrix Genotyping Console software. We filtered out the SNPs with a no-call rate ≥10%, MAF P old Han Chinese population. This finding may lead to new strategies for screening of atrophic AMD for Han Chinese.

  11. Rehabilitation Approaches in Macular Degeneration Patients

    Science.gov (United States)

    Maniglia, Marcello; Cottereau, Benoit R.; Soler, Vincent; Trotter, Yves

    2016-01-01

    Age related macular degeneration (AMD) is a visual disease that affects elderly population. It entails a progressive loss of central vision whose consequences are dramatic for the patient’s quality of life. Current rehabilitation programs are restricted to technical aids based on visual devices. They only temporarily improve specific visual functions such as reading skills. Considering the rapid increase of the aging population worldwide, it is crucial to intensify clinical research on AMD in order to develop simple and efficient methods that improve the patient’s visual performances in many different contexts. One very promising approach to face this challenge is based on perceptual learning (PL). Through intensive practice, PL can induce neural plasticity in sensory cortices and result in long-lasting enhancements for various perceptual tasks in both normal and visually impaired populations. A growing number of studies showed how appropriate PL protocols improve visual functions in visual disorders, namely amblyopia, presbyopia or myopia. In order to successfully apply these approaches to more severe conditions such as AMD, numerous challenges have to be overcome. Indeed, the overall elderly age of patients and the reduced cortical surface that is devoted to peripheral vision potentially limit neural plasticity in this population. In addition, ocular fixation becomes much less stable because patients have to rely on peripheral fixation spots outside the scotoma whose size keeps on evolving. The aim of this review article is to discuss the recent literature on this topic and to offer a unified approach for developing new rehabilitation programs of AMD using PL. We argue that with an appropriate experimental and training protocol that is adapted to each patient needs, PL can offer fascinating opportunities for the development of simple, non-expensive rehabilitation approaches a large spectrum of visual functions in AMD patients. PMID:28082876

  12. Single-site Baseline and Short-term Outcomes of Clinical Characteristics and Life Quality Evaluation of Chinese Wet Age-related Macular Degeneration Patients in Routine Clinical Practice

    OpenAIRE

    Li-Li Wang; Wen-Jia Liu; Hai-Yun Liu; Xun Xu

    2015-01-01

    Background: Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss among the older population. In China, treatment of age-related ocular diseases is becoming a priority in eye care services. This study was to investigate the clinical characteristics and quality of life of Chinese patients with wet AMD and current treatment types, to evaluate short-term gains in different treatments, and to investigate associations between visual function and vision-related qua...

  13. TU-F-CAMPUS-T-02: Monte Carlo Evaluation of Kilovoltage Radiosurgery with AuNPs for Age Related Macular Degeneration (AMD)

    Energy Technology Data Exchange (ETDEWEB)

    Brivio, D; Zygmanski, P [Brigham & Women’s Hospital, Boston, MA (United States); Sajo, E [Univ Massachusetts Lowell, Lowell, MA (United States); Makrigiorgos, G [Dana Farber Cancer Institute, Boston, MA (United States); Ngwa, W [Harvard Medical School, Boston, MA (United States)

    2015-06-15

    Purpose: To evaluate the benefit of gold nanoparticles (AuNP) in radiosurgery of Age related Macular Degeneration (AMD) using Monte Carlo (MC) simulation. AMD disease causes vision loss due to a leaky vasculature of the endothelial cells. Radiosurgical therapy aims to destroy this vasculature while minimizing the delivered dose to healthy tissues of the eye. AuNP known to enhance local dose have been targeted to the macular choroidal endothelial cells to increase the therapeutic efficacy. Methods: Dose enhancement ratio (DER) in macula endothelial cells due to a thin layer of AuNP has been calculated by a MC radiation transport simulation. AuNP layer (10–100nm) has been placed on the bottom of the macula at 2.4cm depth in a water parallelepiped 3×3×6cm3. This layer has been modeled considering various concentrations of AuNP ranging from 5.5–200mg per gram of endothelial cell (volume 10×10×2um3). The x-ray source is 100kVp 4mm diameter beam tilted 0°-30° with respect to the lens. Results: DER in endothelial cell for AuNP concentration of 31mg/g (shown experimentally feasible) and 10–100nm sizes is about 1.8. Tilting 4mm-beam does not reduce the enhancement but allows to avoid the surrounding tissues. Dose distribution in the AuNP vicinity has a significant increase within 30um, peaked at AuNP interface. DER inside and outside of the irradiation 4mm-field are the same while the actual delivered dose is more than one order of magnitude lower outside the field. Compared to 100kVp, usage of filtered spectra with enhanced flux in the region 20keV-40keV shows further increase of DER by about 20%. Dose to the neighboring organs such as retina/optic nerve are reduced accordingly. Conclusion: The results of this MC simulation provide further confirmation of the potential to enhance DER with AuNP from previous analytical calculations. This study provides impetus to improve treatment effectiveness of AMD disease with radiotherapy.

  14. Improving patient outcomes: role of the primary care optometrist in the early diagnosis and management of age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Liu L

    2013-02-01

    Full Text Available Lei Liu, Mark SwansonSchool of Optometry, University of Alabama at Birmingham, Birmingham, AL, USAAbstract: Not long ago, the management of age-related macular degeneration (AMD was confined to rehabilitating whatever vision had not been damaged by the disease. The recent successes of the anti-vascular endothelial growth factor agents and the antioxidant clinical trials have revolutionized AMD treatment. For the first time, there is realistic hope that the progression of AMD can be slowed down or stopped and near normal vision can be preserved. Developments in new vision tests, imaging modalities, and genetic testing have greatly improved the chance of detecting the onset of AMD and choroidal neovascularization. However, because the current treatments still cannot revive degenerated retinal cells, the best patient outcome that can be achieved is early detection of the disease and application of the appropriate treatment before too much retinal damage has occurred. The opportunities and challenges offered by the new treatment options and disease detection methods have redefined the role of primary care optometrists in AMD management. This review of literature and practice guidelines demonstrates that, in addition to the traditional roles of refraction and visual rehabilitation, the unique position of optometrists as the first-line eye-care providers has allowed them to play an important role in the early detection of AMD, patient education, lifestyle-change counseling, disease monitoring and referral, and nutrition supplement counseling. The active participation of primary care optometrists in the shared care of AMD management is likely to result in great improvement in patient outcomes. Optometrists also need to improve their competence in these areas to meet the new challenges. Although primary care optometrists have always managed patients with AMD, their role in managing this sight-threatening disease has not been adequately documented. In

  15. Efficacy of the drug Vitalux Plus of patients with dry form of age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    I. R. Gazizova

    2014-07-01

    Full Text Available Purpose: To analyze the data, visometry and the thickness of the fovea, patients with dry form of age-related macular degeneration (AMD after dosing Vitalux Plus.Methods: We observed 25 patients with dry form of AMD. Visometry and optical coherence tomography of the macula was assessed at 1 and 3 months after treatment Vitalux Plus.Results: In the study group according to visometry and optical coherence tomography was found a positive trend. In the course of our research in 65.3 % of the thickness of the fovea increased, probably by increasing the layer of pigment epithelium. Improvement in the layer of pigment epithelium was observed mainly in patients with early-stage AMD, and in this group also found improvement in visual acuity and more motivated to treatment and further outpatient observation.Conclusion: During the observation period, all patients with dry form of AMD, the stabilization of visual acuity. In the main group on the background of the drug Vitalux Plus objective indicators showed improvement according to retinal optical coherence tomography.In the analysis of the results showed a positive therapeutic effect in patients Vitalux Plus, especially with early dry form of AMD.

  16. Efficacy of the drug Vitalux Plus of patients with dry form of age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    I. R. Gazizova

    2013-01-01

    Full Text Available Purpose: To analyze the data, visometry and the thickness of the fovea, patients with dry form of age-related macular degeneration (AMD after dosing Vitalux Plus.Methods: We observed 25 patients with dry form of AMD. Visometry and optical coherence tomography of the macula was assessed at 1 and 3 months after treatment Vitalux Plus.Results: In the study group according to visometry and optical coherence tomography was found a positive trend. In the course of our research in 65.3 % of the thickness of the fovea increased, probably by increasing the layer of pigment epithelium. Improvement in the layer of pigment epithelium was observed mainly in patients with early-stage AMD, and in this group also found improvement in visual acuity and more motivated to treatment and further outpatient observation.Conclusion: During the observation period, all patients with dry form of AMD, the stabilization of visual acuity. In the main group on the background of the drug Vitalux Plus objective indicators showed improvement according to retinal optical coherence tomography.In the analysis of the results showed a positive therapeutic effect in patients Vitalux Plus, especially with early dry form of AMD.

  17. Comparative study between a spectral domain and a high-speed single-beam swept source OCTA system for identifying choroidal neovascularization in AMD

    Science.gov (United States)

    Told, R.; Ginner, L.; Hecht, A.; Sacu, S.; Leitgeb, R.; Pollreisz, A.; Schmidt-Erfurth, U.

    2016-12-01

    This comparative study between a SD- and SS-OCTA system for visualizing neovascular patterns in AMD, also assessed the influence of cataract on OCTA imaging. 25 eyes with active CNV (AMD) were documented by FA, ICGA and SD-OCT. Two OCTA devices were used: A custom built SS-OCTA (1050 nm, 400,000 A-scans/s, 5 × 5 mm, no image segmentation); AngioVue (OptoVue, CA, USA) SD-OCTA (840 nm, 70.000 A-scans/s, 3 × 3 mm, SSADA technology). Two retina experts graded CNV types and vascular patterns. Cataract influence on OCTA image quality was reported for the superficial retinal plexus (6 eyes). The SS-OCTA prototype showed more CNV lesions compared to the SD-OCTA system (p = 0.01). Overall sensitivity of SD- and SS-OCTA systems to detect CNV lesions was.32 and.68, respectively. The SS-OCTA system was able to detect discrete lesion characteristics better than the SD-OCTA. No significant difference was found in the ability to identify CNV in treatment-naïve eyes. There was no significant influence of cataract. The SS-OCTA prototype detected CNV-associated vascular patterns more reliably than the SD-OCTA system. This is attributed to the SS-OCTA system’s longer center wavelength and higher A-scan rate yielding higher definition and contrast of small neovascular structures. The SS-OCTA system used showed no advantage regarding cataract influence.

  18. Prevalence of depression, anxiety, adjustment disorders, and somatoform disorders in patients with age-related macular degeneration in Germany

    Science.gov (United States)

    Jacob, Louis; Spiess, Alexandra; Kostev, Karel

    2017-01-01

    Aims: The purpose of this study was to analyze the prevalence of depression, anxiety, adjustment disorders, and somatoform disorders in patients diagnosed with age-related macular degeneration (AMD) in Germany. Methods: This study included 7,580 patients between the ages of 40 and 90 diagnosed with AMD between January 2011 and December 2014 in 1,072 primary care practices (index date). The last follow-up was in July 2016. We also included 7,580 controls without AMD, which were matched (1:1) to the AMD cases by age, sex, type of health insurance (private or statutory), physician, and Charlson comorbidity score as a generic marker of comorbidity. The outcome of the study was the prevalence of depression, anxiety, adjustment disorders, and somatoform disorders recorded in the database between the index date and the end of follow-up. Results: The mean age among subjects was 75.7 years (SD=10.1 years), 34.0% were men, and 7.8% had private health insurance coverage. The Charlson comorbidity index was 2.0 (SD=1.8). Depression was the most frequent disease (33.7% in AMD patients versus 27.3% in controls), followed by somatoform disorders (19.6% and 16.7%), adjustment disorders (14.8% and 10.5%), and anxiety disorders (11.7% and 8.2%). Depression (OR=1.37, 95% CI: 1.27–1.47), anxiety (OR=1.50, 95% CI: 1.35–1.67), adjustment disorders (OR=1.50, 95% CI: 1.36–1.65), and somatoform disorders (OR=1.22, 95% CI: 1.12–1.32) were all positively associated with AMD. Conclusion: Overall, a significant association was found between AMD and depression, anxiety, adjustment disorders, and somatoform disorders.

  19. Quality of diabetes care predicts the development of cardiovascular events: results of the AMD-QUASAR study.

    Science.gov (United States)

    Rossi, Maria C E; Lucisano, Giuseppe; Comaschi, Marco; Coscelli, Carlo; Cucinotta, Domenico; Di Blasi, Patrizia; Bader, Giovanni; Pellegrini, Fabio; Valentini, Umberto; Vespasiani, Giacomo; Nicolucci, Antonio

    2011-02-01

    The QUASAR (Quality Assessment Score and Cardiovascular Outcomes in Italian Diabetes Patients) study aimed to assess whether a quality-of-care summary score predicted the development of cardiovascular (CV) events in patients with type 2 diabetes. In 67 diabetes clinics, data on randomly selected patients were extracted from electronic medical records. The score was calculated using process and outcome indicators based on monitoring, targets, and treatment of A1C, blood pressure, LDL cholesterol, and microalbuminuria. The score ranged from 0 to 40. Overall, 5,181 patients were analyzed; 477 (9.2%) patients developed a CV event after a median follow-up of 28 months. The incidence rate (per 1,000 person-years) of CV events was 62.4 in patients with a score of 25. Multilevel analysis, adjusted for clustering and case-mix, showed that the risk to develop a new CV event was 84% higher in patients with a score of 25. Mean quality score varied across centers from 16.5 ± 7.5 to 29.1 ± 6.3. When the score was tested as the dependent variable, it emerged that 18% of the variance in the score could be attributed to setting characteristics. Our study documented a close relationship between quality of diabetes care and long-term outcomes. A simple score can be used to monitor quality of care and compare the performance of different centers/physicians.

  20. THE MACULAR HOLE AFTER INTRAVITREAL INJECTIONS OF RANIBIZUMAB IN A PATIENT WITH EXUDATIVE AGE-RELATED MACULAR DEGENERATION – A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Magdalena Kal

    2013-11-01

    Full Text Available There are two forms of age-related macular degeneration (AMD, the dry one and the exudative one. The exudative form of AMD can be treated using repeated intravitreal injections of antibodies against vascular endothelial growth factor (VEGF. Optical coherence tomography (OCT of the retina is a standard examination in monitoring patients treated with ranibizumab due to an exudative form of AMD. VEGF plays a key role in the development of choroidal neovascularization in the exudative form of AMD. The subject-matter of our observation was to present the development of the macular hole after treatment of the exudative form of AMD through repeated intravitreal injections of ranibizumab. Ranibizumab is an antibody against VEGF. This substance is registered for the treatment of the exudative form of AMD. Ranibizumab may produce focal sites with traction forces on the surface of the retina during the contraction of the choroidal neovascular membrane. Both of these effects may cause contraction and delamination of the retina causing the macular hole to form.

  1. Comparing the effectiveness of bevacizumab to ranibizumab in patients with exudative age-related macular degeneration. The BRAMD study

    NARCIS (Netherlands)

    A.M.E. Schauwvlieghe; G. Dijkman; J.M.M. Hooymans (Johanna); F.D. Verbraak; C. Hoyng (Carel); M.G.W. Dijkgraaf (Marcel); T. Peto (Tünde); J.R. Vingerling (Hans); R.O. Schlingemann (Reinier)

    2016-01-01

    textabstractPurpose: To compare the effectiveness of bevacizumab and ranibizumab in the treatment of exudative age-related macular degeneration (AMD). Design: Multicentre, randomized, controlled, double-masked clinical trial in 327 patients. The noninferiority margin was 4 letters. Patients: Patient

  2. Comparing the Effectiveness of Bevacizumab to Ranibizumab in Patients with Exudative Age-Related Macular Degeneration. The BRAMD Study

    NARCIS (Netherlands)

    Schauwvlieghe, A M E; Dijkman, G; Hooymans, J M; Verbraak, F D; Hoyng, C B; Dijkgraaf, M G W; Peto, T; Vingerling, J R; Schlingemann, R O

    2016-01-01

    PURPOSE: To compare the effectiveness of bevacizumab and ranibizumab in the treatment of exudative age-related macular degeneration (AMD). DESIGN: Multicentre, randomized, controlled, double-masked clinical trial in 327 patients. The non-inferiority margin was 4 letters. PATIENTS: Patients ≥ 60 year

  3. Comparing the Effectiveness of Bevacizumab to Ranibizumab in Patients with Exudative Age-Related Macular Degeneration. The BRAMD Study

    NARCIS (Netherlands)

    Schauwvlieghe, A.M.; Dijkman, G.; Hooymans, J.M.; Verbraak, F.D.; Hoyng, C.B.; Dijkgraaf, M.G.; Peto, T.; Vingerling, J.R.; Schlingemann, R.O.

    2016-01-01

    PURPOSE: To compare the effectiveness of bevacizumab and ranibizumab in the treatment of exudative age-related macular degeneration (AMD). DESIGN: Multicentre, randomized, controlled, double-masked clinical trial in 327 patients. The non-inferiority margin was 4 letters. PATIENTS: Patients >/= 60

  4. Mutation of Asp(171) and Asp(262) of the chemokine receptor CXCR4 impairs its coreceptor function for human immunodeficiency virus-1 entry and abrogates the antagonistic activity of AMD3100

    DEFF Research Database (Denmark)

    Hatse, S; Princen, K; Gerlach, L O

    2001-01-01

    by substitution of Asp(171) and/or Asp(262) by neutral asparagine residue(s). Both aspartates, but most particularly Asp(262), also proved essential for the anti-HIV-1 activity of AMD3100 against the viruses NL4.3, IIIB, and HE. In contrast, substitution of His(281) by a neutral alanine potentiated...

  5. Predicting Non-response to Ranibizumab in Patients with Neovascular Age-related Macular Degeneration

    NARCIS (Netherlands)

    Asten, F. van; Rovers, M.M.; Lechanteur, Y.T.E.; Smailhodzic, D.; Muether, P.S.; Chen, J.; Hollander, A.I. den; Fauser, S.; Hoyng, C.B.; Wilt, G.J. van der; Klevering, B.J.

    2014-01-01

    Abstract Purpose: To validate known and determine new predictors of non-response to ranibizumab in patients with neovascular age-related macular degeneration (AMD) and to incorporate these factors into a prediction rule. METHODS: This multicenter, observational cohort study included 391 patients tre

  6. Anxiety and depression in patients with advanced macular degeneration: current perspectives

    Directory of Open Access Journals (Sweden)

    Cimarolli VR

    2015-12-01

    Full Text Available Verena R Cimarolli,1 Robin J Casten,2 Barry W Rovner,3–5 Vera Heyl,6 Silvia Sörensen,7,8 Amy Horowitz9 1Research Institute on Aging, Jewish Home Lifecare, New York, NY, USA; 2Department of Psychiatry and Human Behavior, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA; 3Department of Neurology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA; 4Department of Psychiatry, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA; 5Department of Ophthalmology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA; 6Institute of Special Education, University of Education, Heidelberg, Germany; 7Warner School of Education and Human Development, University of Rochester, Rochester, NY, USA; 8Department of Ophthalmology, Flaum Eye Institute, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; 9Graduate School of Social Service, Fordham University, New York, NY, USA Abstract: Age-related macular degeneration (AMD – despite advances in prevention and medical treatment options – remains prevalent among older adults, often resulting in functional losses that negatively affect the mental health of older adults. In particular, the prevalence of both anxiety and depression in patients with AMD is high. Along with medical treatment options, low vision rehabilitation and AMD-specific behavioral and self-management programs have been developed and have demonstrated effectiveness in improving the mental health of AMD patients. This article reviews the prevalence of anxiety and depression in patients with advanced AMD, discusses potential mechanisms accounting for the development of depression and anxiety in AMD patients, presents the state-of the-art of available interventions for addressing anxiety and depression in AMD patients, and delineates recommendations for eye care professionals regarding how to

  7. α-Lipoic Acid Treatment Improves Vision-Related Quality of Life in Patients with Dry Age-Related Macular Degeneration.

    Science.gov (United States)

    Tao, Yuan; Jiang, Pengfei; Wei, Yuhua; Wang, Ping; Sun, Xiaoling; Wang, Hong

    2016-01-01

    Dry form of age-related macular degeneration (AMD) constitutes 90% of AMD cases, and it is characterized by the formation of drusen under the retina and the slow breakdown of the light-sensing cells in the macula, which causes a gradual loss of central vision. Since oxidative stress is involved in the pathogenesis of dry AMD, α-lipoic acid (LA) with antioxidant properties was selected, and its effect on anti-oxidative markers and visual quality in patients with dry AMD was assessed. A total of 100 dry AMD patients (60-83 years old) were randomly assigned to LA treatment group (n = 50) and placebo control group (n = 50). We measured the serum superoxide dismutase (SOD) activity, an important marker of antioxidant defense, best-corrected visual acuity (BCVA), contrast sensitivity, and Chinese-Version Low Vision Quality of Life (CLVQOL) before and after LA or placebo intervention. Pearson correlation coefficients were calculated to explore the relationship between contrast sensitivity values and CLVQOL scores. There was a statistically significant increase in serum SOD activity after LA intervention. The CLVQOL score was improved significantly after LA treatment. The contrast sensitivity measured at middle and low spatial frequency was significantly higher after LA treatment. CLVQOL scores were positively correlated with contrast sensitivity at low spatial frequency (3 cyc/degree) in LA-treated group. These results indicate that LA treatment improves vision-related quality of life in patients with dry AMD probably by increasing antioxidant activity. Thus, LA can be regarded as a promising agent for the treatment of AMD.

  8. Avaliação de desempenho e consumo energético para configurações de Wavefront pools de uma GPU AMD

    Directory of Open Access Journals (Sweden)

    Ariel Gustavo Zuquello

    2016-07-01

    Full Text Available O uso de sistemas heterogêneos CPU-GPU para atender à crescente demanda por aplicações com grande paralelismo de dados resulta na necessidade de estudar e avaliar tais arquiteturas para melhorá-las continuamente. Neste artigo foram feitas simulações da execução de uma suíte de benchmark em uma GPU AMD ATI RadeonTM HD 7970, de modo a avaliar o impacto sobre o desempenho e o consumo energético quando alterado o número de Wavefront Pools presentes em cada compute unit da GPU, que é 4 por padrão. O resultado mais significante evidencia um aumento de velocidade de cerca de 5,7% para a configuração com duas Wavefront Pools em conjunto com um aumento no consumo de energia de cerca de 5,1%. Todavia, as outras configurações avaliadas também representam opções para diferentes tipos de necessidades, conforme a categoria de demanda computacional.Palavras-chave: Sistemas heterogêneos. Simulações. Desempenho.Performance evaluation and energy consumption for settings of Wavefront pools of a GPU AMDAbstractThe use of CPU-GPU heterogeneous systems to meet the growing demand for applications with large data parallelism results in the need to study and evaluate these architectures in order to improve them continuously. In this paper we made simulations of running a benchmark suite on an AMD GPU ATI RadeonTM HD 7970 in order to assess the impact on performance and power consumption when tuning the number of Wavefront Pools present in each GPU compute unit, which is 4 by default. The most significant result shows a speedup of about 5.7% for configuration with two Wavefront Pools in conjunction with an increase of about 5.1% in the energy consumption. However, the other evaluated configuration also represent options for different kinds of needs, according to   the  computational demand.Keyworks: Heterogeneous systems. Simulation. Performance.

  9. Definition of redox and pH influence in the AMD mine system using a fuzzy qualitative tool (Iberian Pyrite Belt, SW Spain).

    Science.gov (United States)

    de la Torre, M L; Grande, J A; Valente, T; Perez-Ostalé, E; Santisteban, M; Aroba, J; Ramos, I

    2016-03-01

    Poderosa Mine is an abandoned pyrite mine, located in the Iberian Pyrite Belt which pours its acid mine drainage (AMD) waters into the Odiel river (South-West Spain). This work focuses on establishing possible reasons for interdependence between the potential redox and pH, with the load of metals and sulfates, as well as a set of variables that define the physical chemistry of the water-conductivity, temperature, TDS, and dissolved oxygen-transported by a channel from Poderosa mine affected by acid mine drainage, through the use of techniques of artificial intelligence: fuzzy logic and data mining. The sampling campaign was carried out in May of 2012. There were a total of 16 sites, the first inside the tunnel and the last at the mouth of the river Odiel, with a distance of approximately 10 m between each pair of measuring stations. While the tools of classical statistics, which are widely used in this context, prove useful for defining proximity ratios between variables based on Pearson's correlations, in addition to making it easier to handle large volumes of data and producing easier-to-understand graphs, the use of fuzzy logic tools and data mining results in better definition of the variations produced by external stimuli on the set of variables. This tool is adaptable and can be extrapolated to any system polluted by acid mine drainage using simple, intuitive reasoning.

  10. Bevacizumab Injection in Patients with Age-Related Macular Degeneration Associated with Poor Initial Visual Acuity

    OpenAIRE

    Leila El Matri; Rym Bouraoui; Ahmed Chebil; Fedra Kort; Mejda Bouladi; Rym Limaiem; Hana Landoulsi

    2012-01-01

    Purpose. To evaluate functional and anatomic effects of intravitreal bevacizumab in patients with neovascular AMD and initial low visual acuity. Methods. Retrospective case series of 38 eyes with neovascular AMD and initial visual acuity of 20/200 or less, treated with intravitreal bevacizumab injection. Results. Mean followup was 14.1 months ± 7 . 1 (range: 5 to 24 months). Mean logMAR vision at baseline was 1.38 logMAR ± 0 . 3 3 , at 6 months was 1.14 logMAR ± 0 . 3 7 ( = 0 . 0 0 1 ) and ...

  11. Role of SDF-1 (CXCL12) in regulating hematopoietic stem and progenitor cells traffic into the liver during extramedullary hematopoiesis induced by G-CSF, AMD3100 and PHZ.

    Science.gov (United States)

    Mendt, Mayela; Cardier, Jose E

    2015-12-01

    The stromal cell derived factor 1 (SDF-1/CXCL12) plays an essential role in the homing of hematopoietic stem and progenitor cells (HSPCs) to bone marrow (BM). It is not known whether SDF-1 may also regulate the homing of HSPCs to the liver during extramedullary hematopoiesis (EMH). Here, we investigated the possible role of SDF-1 in attracting HSPCs to the liver during experimental EMH induced by the hematopoietic mobilizers G-CSF, AMD3100 and phenylhydrazine (PHZ). Mice treated with G-CSF, AMD3100 and PHZ showed a significant increase in the expression of SDF-1 in the liver sinusoidal endothelial cells (LSECs) microenvironments. Liver from mice treated with the hematopoietic mobilizers showed HSPCs located adjacent to the LSEC microenvironments, expressing high levels of SDF-1. An inverse relationship was found between the hepatic SDF-1 levels and those in the BM. In vitro, LSEC monolayers induced the migration of HSPCs, and this effect was significantly reduced by AMD3100. In conclusion, our results provide the first evidence showing that SDF-1 expressed by LSEC can be a major player in the recruitment of HSPCs to the liver during EMH induced by hematopoietic mobilizers.

  12. 抗血管内皮生发因子治疗后湿性AMD患者的OCT特征与视力相关性分析%Correlation between macular structure and visual outcome following anti-VEGF therapy in wet AMD: a spectral domain optical coherence tomography study

    Institute of Scientific and Technical Information of China (English)

    胡旭颋; 丁小燕; 李加青; 雷蕾; 马伟; 袁玲; 梁小玲; 唐仕波

    2010-01-01

    Objective To evaluate the macular structure following anti-VEGF therapy in wet AMD patients and to study the correlation of structural findings with visual acuity outcomes, using spectral domain optical coherence tomography (SD-OCT). Methods Thirty-two cases (32 eyes) with wet AMD after anti-VEGF therapy were included in the study.Ophthalmic examination included best-corrected visual acuity (BCVA), dilated fundus examination and OCT imaging 5-6 months after anti-VEGF therapy.Macular thickness and volume were calculated for morphologic parameters of interest including fovea thickness (FT), central subfield thickness (CST), cube volume (CV), cube average thickness (CAT), subretinal fluid (SRF), intraretinal fluid (IRF), CNV membrane thickness (CNVMT) before and after manually identification of fovea.The correlation between BCVA and OCT parameters were investigated.Results Increased CST was correlated with decreased visual acuity (r =0.447, P=0.019), both pre- and post- manually correction.The association was stronger after manually correction if compared with that before correction.No statistically significant association was detected between BCVA and FT, CA and CAT pre- and post-correction.Decreased visual acuity was also correlated with the presence of the IRF and thicker CNV membrane in the macular region.Con- clusions The manually-corrected CST is strongly correlated with BCVA after anti-VEGF therapy in wet AMD patients. Because of the poor visual function and central fixation in these patients due to the complex macular lesions, manually correction of fovea in OCT analysis is definitely necessary in AMD patients.%目的 评价湿性年龄相关性黄斑变性(AMD)患者抗血管内皮生长因子(VEGF)治疗后术眼OCT参数与视力之间的相关性.方法 32例32只眼湿性AMD患者接受抗VEGF治疗后5-6月,记录患者最佳矫正视力,同一天进行频域OCT扫描,对黄斑中心凹厚度(FT),黄斑中心区厚度(CST),黄斑区容积(CV),黄斑区

  13. A Modified Nottingham Prognostic Index for Breast Cancer Patients Diagnosed in Denmark 1978-1994

    DEFF Research Database (Denmark)

    Rostgaard, Klaus; Mouridsen, Henning T.; Væth, Michael;

    2001-01-01

    Stage of disease is a predictor of breast cancer survival. We used data from the Danish Cancer Register amd the Daniish Breast Cancer Cooperative Group to study stage distribution in 0-69-years-old Danish breast cancer patients diagnosed in 1978-1994. We constructed a modified Nottingham Prognostic...

  14. Short-term Outcomes of Saffron Supplementation in Patients with Age-related Macular Degeneration: A Double-blind, Placebo-controlled, Randomized Trial

    Science.gov (United States)

    LASHAY, Alireza; SADOUGH, Gholamreza; ASHRAFI, Elham; LASHAY, Mohammadreza; MOVASSAT, Morteza; AKHONDZADEH, Shahin

    2016-01-01

    In modern pharmacological medicine, saffron is used for various purposes due to its antioxidant effect. This study evaluated retinal function after treatment with saffron supplementation during a follow-up period of 6 months to provide further insight into the efficacy and safety considerations of this treatment. Sixty patients with wet or dry age-related macular degeneration (AMD) were randomly assigned to receive oral saffron 30 mg/d or placebo supplementation for 6 months. Optical coherence tomography (OCT), electroretinography (ERG), fluorescein angiography, and visual acuity testing were performed at baseline and 3 and 6 months after treatment. The main outcome measures were OCT, ERG amplitude, and implicit time. Six months after treatment, no statistically significant decrease in OCT results was observed between the groups with dry AMD (P = 0.282). However, there was a statistically significant increase in ERG results between the groups at 3 months after treatment (P = 0.027). In addition, there was a significant decrease in OCT results between groups with wet AMD at the follow-up (P = 0.05). Finally, there was a significant increase in ERG findings between the groups with wet AMD at 3 months after treatment (P = 0.01), but these changes decreased at 6 months after treatment (P = 0.213). Daily supplementation with 30 mg of saffron for 6 months may result in a mid-term, significant improvement in retinal function in patients with AMD. PMID:28289690

  15. Application of Spectralis OCT in conbercept treatment of AMD%Spectralis OCT在康柏西普治疗AMD随访中的应用

    Institute of Scientific and Technical Information of China (English)

    叶瑞珍; 徐建峰

    2016-01-01

    目的 回顾性研究康柏西普玻璃体腔注射治疗年龄相关性黄斑变性(AMD)前后黄斑区视网膜结构的变化.方法 选取2015年2月至2015年3月就诊泉州解放军180医院眼科医院确诊为AMD的患者10例(12只眼),行康柏西普眼用注射液玻璃体内腔注射治疗.采用Spectralis OCT观察治疗前和治疗后1周、1个月患者黄斑水肿视网膜厚度及黄斑区视网膜结构变化情况.结果 治疗后1个月内的短期随诊观察,6位患者的最佳矫正视力均有不同程度提高,与治疗前相比,差异有统计学意义(P<0.05).所获得的黄斑区视网膜厚度在治疗1个月后均较治疗前变薄,差异有统计学意义(P<0.O1).治疗1个月后,黄斑区视网膜各层结构均有不同程度的好转.结论 Spectralis OCT的Eye Tracking技术可在随访时精确定位视网膜同一点进行重复扫描,在AMD治疗随访中有独特的优势.

  16. Observation on the quality of life before and after the injection of antiangiogenic drug in the vitreous cavity of patients with wet age-related macular degeneration

    Institute of Scientific and Technical Information of China (English)

    Dan-Dan Wang; Pei-Ying Xu; Tian-Yu Wang; Xiao-Xia Chen; Qing Peng

    2015-01-01

    Objective:To explore the vision-related quality of life(VRQL) before and after the injection of antiangiogenic drug into the vitreous cavity of patients with wet age-related macular degeneration(AMD).Methods:The 2000 edition of the Visual Functioning Questionnaire 25 that was issued by the National Eye Institute was applied,and the VRQL evaluation was conducted on the initially diagnosed patients with wet-AMD before and after the injection of ranibizumab into the vitreous cavity.Results:Among the wet-AMD patients,patients with better distance visual acuity before the intravitreal injection had a lower VFQ-25 score.After the vitreous cavity injection,the VFQ-25 questionnaire score was related to patient care and education from the doctors and nurses;specifically,the better the nursing,the higher the score.Conclusions:Before the vitreous cavity injection,the degree of distance visual acuity is an important factor affecting the VRQL of wet-AMD patients.In addition,patient care and education from the doctors and nurses toward patients during the pre-,intra-and post-operation of the intravitreal injection are also important factors affecting the VRQL.

  17. IFN-alpha antibodies in patients with age-related macular degeneration treated with recombinant human IFN-alpha2a

    DEFF Research Database (Denmark)

    Ross, Christian; Engler, Claus Bødker; Sander, Birgit

    2002-01-01

    We tested for development of binding and neutralizing antibodies to interferon-alpha (IFN-alpha) during IFN-alpha2a therapy of patients with age-related macular degeneration (AMD) of the eyes. Antibodies were investigated retrospectively in sera of 34 patients treated with 3 x 10(6) IU IFN-alpha2...

  18. Blood Pressure Drugs and AMD

    Science.gov (United States)

    ... disease. The researchers also found that taking oral beta blockers such as Tenormin and Lopressor was associated with ... disease. Among those who were not taking oral beta blockers an estimated 0.5 percent developed signs of ...

  19. Visual Performance in Patients with Neovascular Age-Related Macular Degeneration Undergoing Treatment with Intravitreal Ranibizumab

    Directory of Open Access Journals (Sweden)

    Sarah Sabour-Pickett

    2013-01-01

    Full Text Available Purpose. To assess visual function and its response to serial intravitreal ranibizumab (Lucentis, Genentech in patients with neovascular age-related macular degeneration (nv-AMD. Methods. Forty-seven eyes of 47 patients with nv-AMD, and corrected distance visual acuity (CDVA logMAR 0.7 or better, undergoing intravitreal injections of ranibizumab, were enrolled into this prospective study. Visual function was assessed using a range of psychophysical tests, while mean foveal thickness (MFT was determined by optical coherence tomography (OCT. Results. Group mean (±sd MFT reduced significantly from baseline (233 (±59 to exit (205 (±40 (P=0.001. CDVA exhibited no change between baseline and exit visits (P=0.48 and P=0.31, resp.. Measures of visual function that did exhibit statistically significant improvements (P<0.05 for all included reading acuity, reading speed, mesopic and photopic contrast sensitivity (CS, mesopic and photopic glare disability (GD, and retinotopic ocular sensitivity (ROS at all eccentricities. Conclusion. Eyes with nv-AMD undergoing intravitreal ranibizumab injections exhibit improvements in many parameters of visual function. Outcome measures other than CDVA, such as CS, GD, and ROS, should not only be considered in the design of studies investigating nv-AMD, but also in treatment and retreatment strategies for patients with the condition.

  20. Visual performance in patients with neovascular age-related macular degeneration undergoing treatment with intravitreal ranibizumab.

    Science.gov (United States)

    Sabour-Pickett, Sarah; Loughman, James; Nolan, John M; Stack, Jim; Pesudovs, Konrad; Meagher, Katherine A; Beatty, Stephen

    2013-01-01

    Purpose. To assess visual function and its response to serial intravitreal ranibizumab (Lucentis, Genentech) in patients with neovascular age-related macular degeneration (nv-AMD). Methods. Forty-seven eyes of 47 patients with nv-AMD, and corrected distance visual acuity (CDVA) logMAR 0.7 or better, undergoing intravitreal injections of ranibizumab, were enrolled into this prospective study. Visual function was assessed using a range of psychophysical tests, while mean foveal thickness (MFT) was determined by optical coherence tomography (OCT). Results. Group mean (±sd) MFT reduced significantly from baseline (233 (±59)) to exit (205 (±40)) (P = 0.001). CDVA exhibited no change between baseline and exit visits (P = 0.48 and P = 0.31, resp.). Measures of visual function that did exhibit statistically significant improvements (P disability (GD), and retinotopic ocular sensitivity (ROS) at all eccentricities. Conclusion. Eyes with nv-AMD undergoing intravitreal ranibizumab injections exhibit improvements in many parameters of visual function. Outcome measures other than CDVA, such as CS, GD, and ROS, should not only be considered in the design of studies investigating nv-AMD, but also in treatment and retreatment strategies for patients with the condition.

  1. Experiences of patients undergoing anti-VEGF treatment for neovascular age-related macular degeneration: a systematic review.

    Science.gov (United States)

    Boyle, Jessica; Vukicevic, Meri; Koklanis, Konstandina; Itsiopoulos, Catherine

    2015-01-01

    Current therapy to slow disease progression in patients with neovascular age-related macular degeneration (AMD) often entails intra-vitreal injection of an anti-vascular endothelial growth factor (VEGF) agent, that begins with a three-month loading phase of four weekly injections followed by regular monthly visits with clinician-determined re-treatment. The effects of AMD on quality of life and visual function have been extensively reported in the literature, however, less is known about the burden imposed on patients by the arduous and often indefinite treatment schedule which habitually follows a diagnosis of wet AMD. To date, no systematic review has been conducted of research investigating patients' experiences of anti-VEGF treatment for AMD. A systematic search of the Embase, Medline, PsycINFO and PubMed electronic databases was undertaken to identify all studies between January 2004 and December 2013, published in the English language and involving human participants. A hand-search of an additional four journals was conducted. Ten articles were identified for inclusion in this review. A critical appraisal was undertaken using the Critical Appraisal Skills Programme Qualitative Research Checklist and the results synthesised to form a narrative review. Few studies to date have investigated patients' experiences of treatment for AMD. These studies have focused primarily on patients' experiences of the injection procedure with respect to pain and anxiety. Anticipated discomfort is often greater than actual discomfort experienced during intra-vitreal injection. However, different stages of the treatment procedure produce varying levels of patient discomfort. No one method of anaesthesia has consistently been shown to be more effective in reducing discomfort associated with treatment. Common reasons underlying patient apprehension surrounding treatment include the thought of having an injection, fear of losing eyesight and fear of the unknown. Whilst these studies

  2. Lower cognitive function in patients with age-related macular degeneration: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhou LX

    2016-02-01

    Full Text Available Li-Xiao Zhou,1 Cheng-Lin Sun,1 Li-Juan Wei,1 Zhi-Min Gu,1 Liang Lv,1 Yalong Dang21Department of Ophthalmology, The Fifth Affiliated Hospital of Zhengzhou University, 2Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of ChinaObjective: To investigate the cognitive impairment in patients with age-related macular degeneration (AMD.Methods: Relevant articles were identified through a search of the following electronic databases through October 2015, without language restriction: 1 PubMed; 2 the Cochrane Library; 3 EMBASE; 4 ScienceDirect. Meta-analysis was conducted using STATA 12.0 software. Standardized mean differences with corresponding 95% confidence intervals were calculated. All of the included studies met the following four criteria: 1 the study design was a case–control or randomized controlled trial (RCT study; 2 the study investigated cognitive function in the patient with AMD; 3 the diagnoses of AMD must be provided; 4 there were sufficient scores data to extract for evaluating cognitive function between cases and controls. The Newcastle–Ottawa Scale criteria were used to assess the methodological quality of the studies.Results: Of the initial 278 literatures, only six case–control and one RCT studies met all of the inclusion criteria. A total of 794 AMD patients and 1,227 controls were included in this study. Five studies were performed with mini-mental state examination (MMSE, two studies with animal fluency, two studies with trail making test (TMT-A and -B, one study with Mini-Cog. Results of the meta-analysis revealed lower cognitive function test scores in patients with AMD, especially with MMSE and Mini-Cog test (P≤0.001 for all. The results also showed that differences in the TMT-A (except AMD [total] vs controls and TMT-B test had no statistical significance (P>0.01. The Newcastle–Ottawa Scale score was ≥5 for all of the included studies. Based on the

  3. Functional and structural brain modifications induced by oculomotor training in patients with age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Katharina eRosengarth

    2013-07-01

    Full Text Available Patients with age-related macular degeneration (AMD are reliant on their peripheral visual field. Oculomotor training can help them to find the best area on intact peripheral retina and to efficiently stabilize eccentric fixation. In this study nine patients with AMD were trained over a period of six months using oculomotor training protocols to improve fixation stability. They were followed over an additional period of six months, where they completed an auditory memory training as a sham training. In this cross-over design five patients started with the sham training and four with the oculomotor training. Seven healthy age-matched subjects, who did not take part in any training procedure, served as controls. During the six months of training the AMD subjects and the control group took part in three functional and structural magnetic resonance imaging (MRI sessions to assess training-related changes in the brain function and structure. The sham-training phase was accompanied by two more fMRI measurements, resulting in five MRI sessions at intervals of three months for all participants. Despite substantial variability in the training effects, on average, AMD patients benefited from the training measurements as indexed by significant improvements in their fixation stability, visual acuity and reading speed. The patients showed a significant positive correlation between brain activation changes and improvements in fixation stability in the visual cortex during training. These correlations were less pronounced on the long-term after training had ceased. We also found a significant increase in gray and white matter in the posterior cerebellum after training in the patient group. Our results show that functional and structural brain changes can be associated, at least on the short-term, with benefits of oculomotor and/or reading training in patients with central scotomata resulting from AMD.

  4. Study on life of quality and influencing factors in patients with age-related macular degeneration%老年性黄斑变性患者的生活质量及影响因素的研究

    Institute of Scientific and Technical Information of China (English)

    熊艳华; 池晨; 刘汉忠

    2008-01-01

    目的 探讨老年性黄斑变性(AMD)的生活质量及影响因素.方法 采用中文版低视力者生活质量量表(CLVQOL)对105例AMD患者的生活质量进行评价.结果 AMD患者的生活质量得分普遍下降,尤以AMD病程的增加、AMD渗出增多、教育水平的降低、不良遵医行为以及有无婚姻支持较为突出;不同程度的视力损害严重影响着患者的生活质量得分;多因素逐步直线回归显示:生活质量的得分与视力、AMD病程的长短、有无婚姻支持及遵医行为有关;差异均有统计学意义(P<0.05).结论 在保护AMD患者视功能的同时,要重视社会,婚姻支持,做好健康教育和心理指导.%Objective To explore the life of quality and the influencing factors in patients with age-related maeular degeneration (AMD). Methods CLVQOL (Chinese Low Vision's Quality Of Life) was used to evaluate the life of quality in 105 AMD patients. Results The score of life quality of AMD patients generally declined, especially among the patients having the following factors, the progression of AMD, the increase of exudation of AMD, low level of education, bad compliance to doctor' s instructions, and whether the patient had or had not a marriage support ( P < 0. 05 ). Various degrees of vision damages in the patients heavily influenced the score of quality of life (P <0. 05). The gradual regression lines of multiple factors showed that the score of quality of life was related to the vision, the time of AMD disease, whether the patient had or had no marriage support, and the compliance to doctor' s prescription (P < 0. 05). Conclusions It needs to pay attention to the protection of the vision function of the AMD patients, and at the same time, it needs to stress the social support, the marriage support, as well as health education and mental guidelines.

  5. Observation on the quality of life before and after the injection of antiangiogenic drug in the vitreous cavity of patients with wet age-related macular de-generation

    Institute of Scientific and Technical Information of China (English)

    Dan-Dan Wang; Pei-Ying Xu; Tian-Yu Wang; Xiao-Xia Chen; Qing Peng

    2015-01-01

    Objective: To explore the vision-related quality of life ( VRQL) before and after the injection of antiangiogenic drug into the vitreous cavity of patients with wet age-related macular degeneration ( AMD) . Methods: The 2000 edition of the Visual Functioning Questionnaire 25 that was issued by the Na-tional Eye Institute was applied, and the VRQL evaluation was conducted on the initially diagnosed patients with wet-AMD before and after the injection of ranibizumab into the vitreous cavity. Results: Among the wet-AMD patients, patients with better distance visual acuity before the in-travitreal injection had a lower VFQ-25 score. After the vitreous cavity injection, the VFQ-25 questionnaire score was related to patient care and education from the doctors and nurses; specific-ally, the better the nursing, the higher the score. Conclusions: Before the vitreous cavity injection, the degree of distance visual acuity is an im-portant factor affecting the VRQL of wet-AMD patients. In addition, patient care and education from the doctors and nurses toward patients during the pre-, intra-and post-operation of the intrav-itreal injection are also important factors affecting the VRQL.

  6. Single-site Baseline and Short-term Outcomes of Clinical Characteristics and Life Quality Evaluation of Chinese Wet Age-related Macular Degeneration Patients in Routine Clinical Practice

    Directory of Open Access Journals (Sweden)

    Li-Li Wang

    2015-01-01

    Conclusions: Patients treated with IVT ranibizumab experienced better vision improvement at short-term follow-up. The Chinese version of the NEI VFQ-25 is a valid and reliable tool for assessing the VRQoL of Chinese wet AMD patients.

  7. Current smoking is associated with a poor visual acuity improvement after intravitreal ranibizumab therapy in patients with exudative age-related macular degeneration.

    Science.gov (United States)

    Lee, Sangmoon; Song, Su Jeong; Yu, Hyeong Gon

    2013-05-01

    In this study, the risk factors that may influence visual improvement after intravitreal ranibizumab (IVR) treatment for exudative age-related macular degeneration (AMD) were examined. From 2008 to 2012, 420 patients (448 eyes) with exudative AMD were prospectively registered at Seoul National University Hospital. From this group of patients, 125 eyes were included in this study. All patients were treated with 3 consecutive IVR injections. The visual acuity (VA) was evaluated at baseline and 1 month after the third ranibizumab injection. To evaluate the risk factors associated with VA improvement after IVR, patient demographic data and systemic risk factors were analyzed. Patients were divided into a poor VA improvement group and a good VA improvement group, with reference to the median visual improvement in all eyes. Among 125 eyes, 66 eyes (52.8%) were included in the responder group and 59 eyes (47.2%) in the non-responder group. The median VA improvement after 3 monthly ranibizumab injections was -0.05 logMAR. Multivariate analyses revealed that current smoking (adjusted OR, 7.540; 95% CI, 1.732-32.823) was independently associated with poor VA improvement after IVR treatment for exudative AMD. In conclusion, cigarette smoking is an independent risk factor for lower VA gains with IVR treatment for exudative AMD.

  8. Repeatability of contrast sensitivity testing in patients with age-related macular degeneration, glaucoma, and cataract

    Directory of Open Access Journals (Sweden)

    Selcuk Kara

    Full Text Available ABSTRACT Purpose: To analyze the intrasession and intersession repeatability of contrast sensitivity (CS measurements in patients with glaucoma, cataract, or age-related macular degeneration (AMD and healthy controls. Methods: CS measurements were performed using the OPTEC-Functional Vision Analyzer (FVA, which uses a standardized and closed (view-in system. Measurements for patients with glaucoma, cataract, or AMD and healthy controls were repeated within 30 minutes (intrasession and during two sessions (intersession, separated by one week to one month. Test-retest reliability and correlation were measured using the intraclass correlation coefficient (ICC and coefficient of repeatability (COR. Results: Ninety subjects (90 eyes with visual acuity of 0.17 logMAR or higher in the cataract group or 0.00 logMAR in the other groups were included. During the first session, the ICC values were 0.87, 0.90, 0.76, and 0.69, and COR values were 0.24, 0.20, 0.38, and 0.25 for the control, glaucoma, cataract, and AMD groups, respectively. The reliability scores significantly improved during the second session, except in the glaucoma group. There was an acceptable floor effect and no ceiling effect at higher frequencies in the glaucoma and AMD groups. Conclusion: In subjects with good visual acuity, the FVA system is useful for evaluating CS and demonstrates good repeatability, as shown by ICC and COR. Because there is no ceiling effect, this system is beneficial for evaluation of early changes in CS, particularly in patients with glaucoma or AMD.

  9. A 2-Year, Phase IV, Multicentre, Observational Study of Ranibizumab 0.5 mg in Patients with Neovascular Age-Related Macular Degeneration in Routine Clinical Practice: The EPICOHORT Study

    Directory of Open Access Journals (Sweden)

    Sergio Pagliarini

    2014-01-01

    Full Text Available Purpose. To assess the safety profile of ranibizumab 0.5 mg in patients with neovascular age-related macular degeneration (nAMD in routine clinical practice. Methods. This 2-year, multicentre, observational study was conducted to capture real-world early practice and outcomes across Europe, shortly after European licensing of ranibizumab for nAMD. Being observational in nature, the study did not impose diagnostic/therapeutic interventions/visit schedule. Patients were to be treated as per the EU summary of product characteristics (SmPC in effect during the study. Key outcome measures were incidence of selected adverse events (AEs, treatment exposure, bilateral treatment, compliance to the EU SmPC, and best-corrected visual acuity (BCVA over 2 years. Results. 755 of 770 patients received treatment. Ranibizumab was generally well tolerated with low incidence of selected AEs (0%–1.9%. Patients received 6.2 (mean injections and 133 patients received bilateral treatment over 2 years. Protocol deviation to treatment compliance was reported in majority of patients. The observed decline in mean BCVA (Month 12, +1.5; Month 24, –1.3 letters may be associated with undertreatment as suggested by BCVA subgroup analysis. Conclusion. The EPICOHORT study conducted in routine clinical practice reinforces the well-established safety profile of ranibizumab in nAMD. In early European practice it appeared that the nAMD patients were undertreated.

  10. PHMB: Utilización del apósito de espuma antimicrobiana (AMD KendallTM (PHMB 0,5% en el tratamiento de las heridas crónicas

    Directory of Open Access Journals (Sweden)

    John Timmons

    Full Text Available Abordamos la parte más problemática del tratamiento de las heridas crónicas o agudas, de acuerdo con los profesionales especializados es la infección de la herida. La sobrecarga bacteriana puede retardar la curación de la herida y disminuir la calidad del paciente como consecuencia del aumento del dolor, del exudado y del posible mal olor. Se han recopilado casos clínicos durante los últimos 6 meses en una unidad especializada en el cuidado de heridas de los hospitales Doncaster y Bassetlaw, RU. Estos casos ilustran la variedad de tipos de herida que pueden tratarse con éxito con el nuevo apósito de Espuma antimicrobiano KendallTM AMD (PHMB 0,5%. Se pudo concluir que el apósito de Espuma KendallTM AMD actúa bien como antimicrobiano y como producto de vendaje moderno. Su utilización disminuye la carga bacteriana al tiempo que consigue la absorción del exudado y el mantenimiento de un ambiente óptimo para la curación de la herida.

  11. Genetic predictive biomarkers of anti-VEGF treatment response in patients with neovascular age-related macular degeneration.

    Science.gov (United States)

    Fauser, Sascha; Lambrou, George N

    2015-01-01

    Anti-vascular endothelial growth factor (anti-VEGF) therapies for neovascular age-related macular degeneration (nAMD) have proven efficacy at a study-population level, although individual patient responses vary, with most of the patients responding well to anti-VEGF therapies, while a few respond poorly. The pathogenesis of AMD is known to have a genetic component, but it is unclear if any particular genotype can predict response to anti-VEGF therapy. With the advent of less expensive genotyping technology, there have been numerous studies within this area. Here we analyze potential biomarker candidates identified that could be used in a clinical setting to predict response to anti-VEGF treatment of nAMD. We analyze single nucleotide polymorphisms (SNPs) identified from 39 publications. The SNPs that appeared to be of most importance fell into two main groups: those previously associated with AMD pathogenesis and those within the signaling pathway targeted by anti-VEGF therapies. A number of small studies found evidence supporting an association between anti-VEGF treatment response and two SNPs, CFH rs1061170 and VEGFA rs699947, but results from randomized controlled trials found no such association. It is possible that, in the future, the cumulative effect of several high-risk SNPs may prove useful in a clinical setting and that other genetic biomarkers may emerge.

  12. Long-term longitudinal study of patients treated with ranibizumab for neovascular age-related macular degeneration

    DEFF Research Database (Denmark)

    Rasmussen, Annette; Sander, Birgit

    2014-01-01

    2 years, and the number of patients followed for 4 years or longer is small. The results of studies show that the majority of patients with nv-AMD can preserve visual acuity compared with baseline, subgroups reveal large variations in visual benefit. Approximately 20-30% of patients seem to respond...... of patients with nv-AMD can preserve visual acuity and expect long-term treatment beyond 2 years. Ocular complications and systemic adverse events remain few....... poorly to the treatment, and 20% obtain a condition with inactivity and good results. The majority of patients will need continuous active treatment. Long-term decline of visual acuity reflects the natural progression of the disease, however, insufficient treatment cannot be excluded leaving a potential...

  13. Effect of Supplemental Lutein and Zeaxanthin on Serum, Macular Pigmentation, and Visual Performance in Patients with Early Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Yang-Mu Huang

    2015-01-01

    Full Text Available Purpose. To compare the 2-year effect of multiple doses of lutein/zeaxanthin on serum, macular pigmentation, and visual performance on patients with early age-related macular degeneration (AMD. Methods. In this randomized, double-blinded, and placebo-controlled trial, 112 early AMD patients randomly received either 10 mg lutein, 20 mg lutein, a combination of lutein (10 mg and zeaxanthin (10 mg, or placebo daily for 2 years. Serum concentration of lutein/zeaxanthin, macular pigment optical density (MPOD, visual functions including best-spectacle corrected visual acuity (BCVA, contrast sensitivity (CS, flash recovery time (FRT, and vision-related quality of life (VFQ25 was quantified. Results. Serum lutein concentration and MPOD significantly increased in all the active treatment groups. Supplementation with 20 mg lutein was the most effective in increasing MPOD and CS at 3 cycles/degree for the first 48 weeks. However, they both significantly increased to the same peak value following supplementation with either 10 mg or 20 mg lutein during the intervention. No statistical changes of BCVA or FRT were observed during the trial. Conclusions. Long-term lutein supplementation could increase serum lutein concentration, MPOD, and visual sensitivities of early AMD patients. 10 mg lutein daily might be an advisable long-term dosage for early AMD treatment.

  14. Cataract surgery in patients with neovascular age-related macular degeneration

    DEFF Research Database (Denmark)

    Kessel, Line; Koefoed Theil, Pernille; Lykke Sørensen, Torben;

    2016-01-01

    being treated with a median of 10 (range 3-36) anti-VEGF injections for neovascular AMD. Visual acuity improved by a mean of 7.1 [95% confidence interval (CI) 4.6-9.6] ETDRS letters in the first 6 months after cataract surgery. The need of anti-VEGF injections did not change after cataract surgery...... in electronic databases managing anti-VEGF injections and cataract surgery. We compared Early Treatment of Diabetic Retinopathy Study (ETDRS) visual acuity and frequency of anti-VEGF injections before and after cataract surgery. RESULTS: We identified 89 eyes from 89 patients who had cataract surgery after...... AMD. Cataract surgery was not associated with an increased need for anti-VEGF treatment and patients who were in active anti-VEGF treatment had better visual outcomes than patients who had cataract surgery after long injection-free periods....

  15. Mutation of Asp(171) and Asp(262) of the chemokine receptor CXCR4 impairs its coreceptor function for human immunodeficiency virus-1 entry and abrogates the antagonistic activity of AMD3100

    DEFF Research Database (Denmark)

    Hatse, S; Princen, K; Gerlach, L O

    2001-01-01

    by substitution of Asp(171) and/or Asp(262) by neutral asparagine residue(s). Both aspartates, but most particularly Asp(262), also proved essential for the anti-HIV-1 activity of AMD3100 against the viruses NL4.3, IIIB, and HE. In contrast, substitution of His(281) by a neutral alanine potentiated...... the antagonistic and antiviral effects of the compound in the different assay systems. Importantly, compared with the wild-type receptor, CXCR4[D262N] was much less effective, whereas CXCR4[D171N,D262N] completely failed as a coreceptor for infection by HIV-1 NL4.3. Thus, the negatively charged aspartate residues...

  16. 基于LQG/LTR方法的结构振动AMD控制Benchmark模型仿真分析%Simulation of Structure Vibration AMD Control Benchmark Model Base on LQG/LTR Method

    Institute of Scientific and Technical Information of China (English)

    杜永峰; 曹志峰; 孙玉萍

    2006-01-01

    LQG/LTR方法是基于回路传输恢复技术的LQG方法的简称,该方法是为了克服一般的LQG方法稳定裕量低发展而来,该控制方法的优越性已在土木工程结构振动控制领域得到了初步体现,文中主要是结合AMD 控制Benchmark模型,对该控制方法在传感器正常工作时和几种失效情况下的控制效果进行仿真分析,仿真结果表明该控制方法具有很好的控制效果并同时兼具较好的稳定性和鲁棒性.

  17. Prevalence of depression and its effect on disability in patients with age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Banerjee Anindya

    2008-01-01

    Full Text Available Aims: To estimate depression in patients with age-related macular degeneration (AMD and study the relationships among depression, visual acuity, and disability. Materials and Methods: It was a cross-sectional study with consecutive sampling (n = 53 of patients with AMD aged 50 years and above attending the retina clinic of a tertiary care hospital in North India. Depression, general disability and vision-specific disability were assessed in subjects meeting selection criteria. Assessments were done using the fourth edition of Diagnostic and Statistical Manual of mental disorders (DSM- IV Geriatric Depression Scale (GDS, Structured Clinical Interview for DSM-IV Axis -I Disorders, Clinical Version (SCID-CV, World Health Organization Disability Assessment Schedule-II (WHODAS-II and Daily Living Tasks dependent on Vision scale (DLTV. Non-parametric correlation analyses and regression analyses were performed. Results: Out of 53 participants, 26.4% (n = 14 met DSM-IV criteria for the diagnosis of depressive disorder. Depressed patients had significantly greater levels of general and vision-specific disability than non-depressed patients. General disability was predicted better by depression and vision-specific disability than by visual acuity. Conclusion: Depression is a major concern in patients with AMD and contributes more to disability than visual impairment.

  18. Evaluation of cardiovascular biomarkers in patients with age-related wet macular degeneration

    Directory of Open Access Journals (Sweden)

    Keles S

    2014-08-01

    Full Text Available Sadullah Keles,1 Orhan Ates,1 Baki Kartal,2 Hamit Hakan Alp,3 Metin Ekinci,4 Erdinc Ceylan,2 Osman Ondas,5 Eren Arpali,2 Semih Dogan,6 Kenan Yildirim,7 Mevlut Sait Keles8 1Department of Ophthalmology, School of Medicine, Ataturk University, Erzurum, Turkey; 2Department of Ophthalmology, Regional Training and Research Hospital, Erzurum, Turkey; 3Department of Biochemistry, School of Medicine, Yuzuncu Yil University, Van, Turkey; 4Department of Ophthalmology, School of Medicine, Kafkas University, Kars, Turkey; 5Department of Ophthalmology, Erbaa Government Hospital, Tokat, Turkey; 6Department of Ophthalmology, Kolan Hospital, Istanbul, Turkey; 7Department of Ophthalmology, Igdir Government Hospital, Igdir, Turkey; 8Department of Biochemistry, School of Medicine, Ataturk University, Erzurum, Turkey Aim: To evaluate levels of homocysteine, asymmetric dimethylarginine (ADMA, and nitric oxide (NO, as well as activity of endothelial NO synthase (eNOS, in patients with age-related macular degeneration (AMD.Methods: The levels of homocysteine, ADMA, and NO and activity of eNOS in patients who were diagnosed with wet AMD by fundus fluorescein angiography (n=30 were compared to a control group with no retinal pathology (n=30.Results: Levels of homocysteine and ADMA were found to be significantly higher in the wet AMD group than in the control group (P<0.001, whereas NO levels and eNOS activity were higher in the control group (P<0.001. In the wet AMD group, we detected a 2.64- and 0.33-fold increase in the levels of ADMA and homocysteine, respectively, and a 0.49- and 2.41-fold decrease in the eNOS activity and NO level, respectively.Conclusion: Elevated levels of homocysteine and ADMA were observed in patients with wet AMD. Increased ADMA may be responsible for the diminished eNOS activity found in these patients, which in turn contributes to the decrease in NO levels, which likely plays a role in the pathogenesis of AMD. Keywords: age-related macular

  19. Treatment of neovascular age-related macular degeneration in patients with diabetes

    Directory of Open Access Journals (Sweden)

    Michael Cummings

    2008-06-01

    Full Text Available Michael Cummings1, José Cunha-Vaz21Academic Department of Diabetes and Endocrinology, Queen Alexandra Hospital, Portsmouth, UK; 2Department of Ophthalmology, University Hospital of Coimbra, Centre of Ophthalmology, Institute of Biomedical Research on Light and Image, Faculty of Medicine, University of Coimbra, and Association for Innovation and Biomedical Research on Light and Image, Coimbra, PortugalAbstract: The number of patients with type 2 diabetes continues to rise; an anticipated 300 million people will be affected by 2025. The immense social and economic burden of the condition is exacerbated by the initial asymptomatic nature of type 2 diabetes, resulting in a high prevalence of micro- and macrovascular complications at presentation. Diabetic retinopathy, one of the potential microvascular complications associated with diabetes, and neovascular age-related macular degeneration (AMD are the two most frequent retinal degenerative diseases, and are responsible for the majority of blindness due to retinal disease. Both conditions predominantly affect the central macula, and are associated with the presence of retinal edema and an aggressive inflammatory repair process that accelerates disease progression. The associated retinal edema and the inflammatory repair process are directly involved in the breakdown of the blood-retinal barrier (BRB. Yet, the underlying alterations to the BRB caused by the diseases are very different. The coexistence of the two conditions appears to be relatively uncommon, suggesting that diabetes may even protect patients from developing neovascular AMD. However, it is thought that the inflammatory repair responses associated with diabetic retinopathy and neovascular AMD may be cumulative and, in patients affected by both, could result in chronic diffuse cystoid edema. Treatment considerations in such patients should, therefore, include the role of retinal edema and the increased susceptibility of patients with

  20. Caregiver Burden in Patients Receiving Ranibizumab Therapy for Neovascular Age Related Macular Degeneration.

    Directory of Open Access Journals (Sweden)

    Rishma Gohil

    Full Text Available To assess the caregiver burden and factors determining the burden in patients receiving ranibizumab therapy for neovascular AMD (nAMD.This is a cross-sectional questionnaire survey of 250 matched patient caregiver dyads across three large ophthalmic treatment centres in United Kingdom. The primary outcome was the subjective caregiver burden measured using caregiver reaction assessment scale (CRA. Objective caregiver burden was determined by the caregiver tasks and level of care provided. The factors that may predict the caregiver burden such as the patient's visual acuity of the better eye and vision related quality of life, demographics, satisfaction and support provided by the healthcare and the health status of the dyads were also collected and assessed in a hierarchical regression model.The mean CRA score was 3.2±0.5, similar to the score reported by caregivers for atrial fibrillation who require regular hospital appointments for monitoring their thromboprophylaxis. Caregiver tasks including accompanying for hospital appointments for eye treatment and patient's visual acuity in the better eye were the biggest contributors to the caregiver burden hierarchical model explaining 18% and 11% of the variance respectively.Ranibizumab therapy for nAMD is associated with significant caregiver burden. Both disease impact and treatment frequency contributed to the overall burden.

  1. Treatment of peripheral arterial disease in diabetes: a consensus of the Italian Societies of Diabetes (SID, AMD), Radiology (SIRM) and Vascular Endovascular Surgery (SICVE).

    Science.gov (United States)

    Aiello, A; Anichini, R; Brocco, E; Caravaggi, C; Chiavetta, A; Cioni, R; Da Ros, R; De Feo, M E; Ferraresi, R; Florio, F; Gargiulo, M; Galzerano, G; Gandini, R; Giurato, L; Graziani, L; Mancini, L; Manzi, M; Modugno, P; Setacci, C; Uccioli, L

    2014-04-01

    Diabetic foot (DF) is a chronic and highly disabling complication of diabetes. The prevalence of peripheral arterial disease (PAD) is high in diabetic patients and, associated or not with peripheral neuropathy (PN), can be found in 50% of cases of DF. It is worth pointing out that the number of major amputations in diabetic patients is still very high. Many PAD diabetic patients are not revascularised due to lack of technical expertise or, even worse, negative beliefs because of poor experience. This despite the progress obtained in the techniques of distal revascularisation that nowadays allow to reopen distal arteries of the leg and foot. Italy has one of the lowest prevalence rates of major amputations in Europe, and has a long tradition in the field of limb salvage by means of an aggressive approach in debridement, antibiotic therapy and distal revascularisation. Therefore, we believe it is appropriate to produce a consensus document concerning the treatment of PAD and limb salvage in diabetic patients, based on the Italian experience in this field, to share with the scientific community.

  2. Italian Association of Clinical Endocrinologists (AME) & Italian Association of Clinical Diabetologists (AMD) Position Statement : Diabetes mellitus and thyroid disorders: recommendations for clinical practice.

    Science.gov (United States)

    Guastamacchia, Edoardo; Triggiani, Vincenzo; Aglialoro, Alberto; Aiello, Antimo; Ianni, Lucia; Maccario, Mauro; Zini, Michele; Giorda, Carlo; Guglielmi, Rinaldo; Betterle, Corrado; Attanasio, Roberto; Borretta, Giorgio; Garofalo, Piernicola; Papini, Enrico; Castello, Roberto; Ceriello, Antonio

    2015-06-01

    Thyroid disease and diabetes mellitus, the most common disorders in endocrine practice, are not infrequently associated in the same subject. An altered thyroid function may affect glucose tolerance and worsen metabolic control in patients with diabetes. Thyrotoxicosis increases the risk of hyperglycemic emergencies, while a clinically relevant hypothyroidism may have a detrimental effect on glycemic control in diabetic patients. The association of alterations in thyroid function with diabetes mellitus may adversely affect the risk of cardiovascular and microvascular complications resulting from diabetes. Moreover, the treatments used for both diabetes and thyroid disease, respectively, can impact one other. Finally, multinodular goiter, but not thyroid carcinoma, was shown to be more prevalent in type 2 diabetes mellitus. Aim of the present Position Statement is to focus on the evidence concerning the association of thyroid disease and diabetes mellitus and to provide some practical suggestions for an updated clinical management.

  3. Plasma Triglycerides and HDL-C Levels Predict the Development of Diabetic Kidney Disease in Subjects With Type 2 Diabetes: The AMD Annals Initiative.

    Science.gov (United States)

    Russo, Giuseppina T; De Cosmo, Salvatore; Viazzi, Francesca; Pacilli, Antonio; Ceriello, Antonio; Genovese, Stefano; Guida, Pietro; Giorda, Carlo; Cucinotta, Domenico; Pontremoli, Roberto; Fioretto, Paola

    2016-12-01

    Despite the achievement of blood glucose, blood pressure, and LDL cholesterol (LDL-C) targets, the risk for diabetic kidney disease (DKD) remains high among patients with type 2 diabetes. This observational retrospective study investigated whether diabetic dyslipidemia-that is, high triglyceride (TG) and/or low HDL cholesterol (HDL-C) levels-contributes to this high residual risk for DKD. Among a total of 47,177 patients attending Italian diabetes centers, 15,362 patients with a baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m(2), normoalbuminuria, and LDL-C ≤130 mg/dL completing a 4-year follow-up were analyzed. The primary outcome was the incidence of DKD, defined as either low eGFR (30% and/or albuminuria. Overall, 12.8% developed low eGFR, 7.6% an eGFR reduction >30%, 23.2% albuminuria, and 4% albuminuria and either eGFR 30%. TG ≥150 mg/dL increased the risk of low eGFR by 26%, of an eGFR reduction >30% by 29%, of albuminuria by 19%, and of developing one abnormality by 35%. HDL-C 30%, with a 24% higher risk of developing albuminuria and a 44% risk of developing one abnormality. These associations remained significant when TG and HDL-C concentrations were examined as continuous variables and were only attenuated by multivariate adjustment for numerous confounders. In a large population of outpatients with diabetes, low HDL-C and high TG levels were independent risk factors for the development of DKD over 4 years. © 2016 by the American Diabetes Association.

  4. Patients

    African Journals Online (AJOL)

    Items 1 - 7 ... Results: The mean age for patient group is 65.6 years while for controls it is 30.3 years. ... result in large number of population in old ages ... Originally the American Urological Asso- .... age distribution and study results in this study.

  5. Long-Term Visual Outcome in Wet Age-Related Macular Degeneration Patients Depending on the Number of Ranibizumab Injections

    Directory of Open Access Journals (Sweden)

    Pilar Calvo

    2015-01-01

    Full Text Available Purpose. To analyse the visual outcome in wet age-related macular degeneration (AMD patients depending on the number of ranibizumab injections. Methods. 51 naïve wet AMD patients were retrospectively recorded. Visual acuity (VA, central retinal thickness (CRT measured with spectral domain (SD optical coherence tomography (OCT, and number of intravitreal injections were compared at 6, 12, 18, 24, 30, and 36 months of follow-up. Kaplan-Meier survival rates (SRs based on VA outcomes were calculated depending on the number of ranibizumab injections performed. Results. VA improved compared with baseline at 6 and 12 months (P0.05. CRT measured with Cirrus OCT decreased (P<0.001 at all time points analysed. The mean number of injections received was 6.98±3.69. At 36 months, Kaplan-Meier SR was 76.5% (the proportion of patients without a decrease in vision of more than 0.3 logMAR units. VA remained stable (≤0.01 logMAR units or improved in 62.7%. Within this group, SR was 92.9% in those who received 7 or more injections versus 51.4% receiving <7 treatments (P=0.008; log-rank test. Conclusion. Better VA outcomes were found in stable wet AMD patients after 3 years of follow-up if they received ≥7 ranibizumab injections.

  6. Single-site Baseline and Short-term Outcomes of Clinical Characteristics and Life Quality Evaluation of Chinese Wet Age-related Macular Degeneration Patients in Routine Clinical Practice

    Institute of Scientific and Technical Information of China (English)

    Li-Li Wang; Wen-Jia Liu; Hai-Yun Liu; Xun Xu

    2015-01-01

    Background:Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss among the older population.In China,treatment of age-related ocular diseases is becoming a priority in eye care services.This study was to investigate the clinical characteristics and quality of life of Chinese patients with wet AMD and current treatment types,to evaluate short-term gains in different treatments,and to investigate associations between visual function and vision-related quality of life (VRQoL).Methods:A prospective,observational,noninterventional study was conducted.Basic data were collected from patients with clinical diagnoses of wet AMD before clinical assessments at baseline.VRQoL was measured with the Chinese version of the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25).Correlations of the NEI VFQ-25 subscale scores with best-corrected visual acuity (BCVA) and between-group differences were analyzed.Results:A total of 80 wet AMD patients were enrolled,with the mean age of 68.40 years.About one-quarter ofwetAMD patients received intravitreal (IVT) ranibizumab treatment,and 67% of them were treated on apro re nata basis.The visual acuity of patients treated with IVT ranibizumab at month 3 after treatment was significantly increased,whereas patients treated with traditional Chinese medicine achieved no significant improvement.Cronbach's α for the NEI VFQ-25 subscales ranged from 0.697 to 0.843.Eight subscale and overall composite scores were moderately correlated with the BCVA of the better-seeing eye.Significant differences in the overall NEI VFQ-25 scores and other subscales were observed between patients with BCVA in the better-seeing eye of less than 50 letters and the others.Conclusions:Patients treated with IVT ranibizumab experienced better vision improvement at short-term follow-up.The Chinese version of the NEI VFQ-25 is a valid and reliable tool for assessing the VRQoL of Chinese wet AMD patients.

  7. Single-site Baseline and Short-term Outcomes of Clinical Characteristics and Life Quality Evaluation of Chinese Wet Age-related Macular Degeneration Patients in Routine Clinical Practice

    Science.gov (United States)

    Wang, Li-Li; Liu, Wen-Jia; Liu, Hai-Yun; Xu, Xun

    2015-01-01

    Background: Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss among the older population. In China, treatment of age-related ocular diseases is becoming a priority in eye care services. This study was to investigate the clinical characteristics and quality of life of Chinese patients with wet AMD and current treatment types, to evaluate short-term gains in different treatments, and to investigate associations between visual function and vision-related quality of life (VRQoL). Methods: A prospective, observational, noninterventional study was conducted. Basic data were collected from patients with clinical diagnoses of wet AMD before clinical assessments at baseline. VRQoL was measured with the Chinese version of the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Correlations of the NEI VFQ-25 subscale scores with best-corrected visual acuity (BCVA) and between-group differences were analyzed. Results: A total of 80 wet AMD patients were enrolled, with the mean age of 68.40 years. About one-quarter of wet AMD patients received intravitreal (IVT) ranibizumab treatment, and 67% of them were treated on a pro re nata basis. The visual acuity of patients treated with IVT ranibizumab at month 3 after treatment was significantly increased, whereas patients treated with traditional Chinese medicine achieved no significant improvement. Cronbach's α for the NEI VFQ-25 subscales ranged from 0.697 to 0.843. Eight subscale and overall composite scores were moderately correlated with the BCVA of the better-seeing eye. Significant differences in the overall NEI VFQ-25 scores and other subscales were observed between patients with BCVA in the better-seeing eye of less than 50 letters and the others. Conclusions: Patients treated with IVT ranibizumab experienced better vision improvement at short-term follow-up. The Chinese version of the NEI VFQ-25 is a valid and reliable tool for assessing the VRQoL of Chinese wet AMD

  8. Bevacizumab Injection in Patients with Age-Related Macular Degeneration Associated with Poor Initial Visual Acuity

    Directory of Open Access Journals (Sweden)

    Leila El Matri

    2012-01-01

    Full Text Available Purpose. To evaluate functional and anatomic effects of intravitreal bevacizumab in patients with neovascular AMD and initial low visual acuity. Methods. Retrospective case series of 38 eyes with neovascular AMD and initial visual acuity of 20/200 or less, treated with intravitreal bevacizumab injection. Results. Mean followup was 14.1 months ±7.1 (range: 5 to 24 months. Mean logMAR vision at baseline was 1.38 logMAR ±0.33, at 6 months was 1.14 logMAR ±0.37 (=0.001 and at 12 months was 1.22 logMar ±0.33 (=0.004. Mean baseline central retinal thickness was 431 μm ±159.7 at 6 months was 293.43 μm  ±122.79 (=10−4 and at 12 months was 293.1 μm  ±130 (=0.004. Visual acuity improved in both patients with or without prior PDT treatment. Conclusions. Intravitreal bevacizumab injection may increase the chance of visual acuity gain in neovascular AMD even in cases with initial low visual acuity.

  9. Bevacizumab injection in patients with age-related macular degeneration associated with poor initial visual acuity.

    Science.gov (United States)

    El Matri, Leila; Bouraoui, Rym; Chebil, Ahmed; Kort, Fedra; Bouladi, Mejda; Limaiem, Rym; Landoulsi, Hana

    2012-01-01

    Purpose. To evaluate functional and anatomic effects of intravitreal bevacizumab in patients with neovascular AMD and initial low visual acuity. Methods. Retrospective case series of 38 eyes with neovascular AMD and initial visual acuity of 20/200 or less, treated with intravitreal bevacizumab injection. Results. Mean followup was 14.1 months ±  7.1 (range: 5 to 24 months). Mean logMAR vision at baseline was 1.38 logMAR ±  0.33, at 6 months was 1.14 logMAR ±  0.37 (P = 0.001) and at 12 months was 1.22 logMar ±  0.33 (P = 0.004). Mean baseline central retinal thickness was 431 μm ±  159.7 at 6 months was 293.43 μm  ±  122.79 (P = 10(-4)) and at 12 months was 293.1 μm  ±  130 (P = 0.004). Visual acuity improved in both patients with or without prior PDT treatment. Conclusions. Intravitreal bevacizumab injection may increase the chance of visual acuity gain in neovascular AMD even in cases with initial low visual acuity.

  10. Anosognosia in patients with acute hemispheric ischemic stroke

    Directory of Open Access Journals (Sweden)

    V. N. Grigoryeva

    2016-01-01

    Full Text Available Objective: to investigate the frequency of anosognosia (a deficit of self-awareness, its anatomic correlates associated with other neuropsychological and neurological disorders in acute hemispheric ischemic stroke (IS.Patients and methods 150 patients (83 men and 67 women; mean age, 63.0±9.3 years with acute hemispheric IS were examined. All the patients underwent neurological, neuroimaging, and neuropsychological (by the procedure described by A.R. Luria examinations. neuropsychological investigations. Anosognosia was diagnosed using the Dysexecutive Questionnaire (DEX and the authors' procedure involving a scale to measure impaired self-rating of motor abilities and a scale to measure impaired self-rating of cognitive abilities in everyday life.Results and discussion. In the acute period of hemispheric IS, reduced self-awareness of motor and cognitive abilities was noted in 14% of the patients and unawareness of only cognitive abilities was recorded in 15%. Patients with anosognosia and cognitive dysfunction (ACD and those with anosognosia and motor dysfunction (AMD had right-sided hemispheric IS more frequently (76% while this was not found in patients with isolated ACD. The development of anosognosia for paralysis and paresis was favored by the large sizes of an ischemic focus that involved a few lobes in the posterior regions of the brain although no lesions were found in the anosognosia-specific anatomical regions. ACD and AMD proved to be associated with unilateral spatial and tactile neglect and obvious regulatory dysfunction. 

  11. Focus Groups in Elderly Ophthalmologic Patients: Setting the Stage for Quantitative Preference Elicitation.

    Science.gov (United States)

    Danner, Marion; Vennedey, Vera; Hiligsmann, Mickaël; Fauser, Sascha; Stock, Stephanie

    2016-02-01

    Patients suffering from age-related macular degeneration (AMD) are rarely actively involved in decision-making, despite facing preference-sensitive treatment decisions. This paper presents a qualitative study to prepare quantitative preference elicitation in AMD patients. The aims of this study were (1) to gain familiarity with and learn about the special requirements of the AMD patient population for quantitative data collection; and (2) to select/refine patient-relevant treatment attributes and levels, and gain insights into preference structures. Semi-structured focus group interviews were performed. An interview guide including preselected categories in the form of seven potentially patient-relevant treatment attributes was followed. To identify the most patient-relevant treatment attributes, a ranking exercise was performed. Deductive content analyses were done by two independent reviewers for each attribute to derive subcategories (potential levels of attributes) and depict preference trends. The focus group interviews included 21 patients. The interviews revealed that quantitative preference surveys in this population will have to be interviewer assisted to make the survey feasible for patients. The five most patient-relevant attributes were the effect on visual function [ranking score (RS): 139], injection frequency (RS: 101), approval status (RS: 83), side effects (RS: 79), and monitoring frequency (RS: 76). Attribute and level refinement was based on patients' statements. Preference trends and dependencies between attributes informed the quantitative instrument design. This study suggests that qualitative research is a very helpful step to prepare the design and administration of quantitative preference elicitation instruments. It especially facilitated familiarization with the target population and its preferences, and it supported attribute/level refinement.

  12. Macular morphology and response to ranibizumab treatment in patients with wet age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Dervenis N

    2016-06-01

    Full Text Available Nikolaos Dervenis, Saad Younis Western Eye Hospital, Imperial College Healthcare NHS Trust, London, UK Purpose: The purpose of this study was to assess whether specific characteristics of spectral domain optical coherence tomography (SD-OCT affect structural and functional outcomes and number of injections needed in ranibizumab (0.05 mL of 10 mg/mL Lucentis solution-treated wet age-related macular degeneration (AMD patients. Patients and methods: This retrospective case series included 62 newly diagnosed wet AMD patients treated with three monthly intravitreal ranibizumab injections followed by monthly follow-up and pro re nata retreatment. The presence of dome-shaped pigment epithelial detachment (PED, disruption of the retinal pigment epithelium (RPE, and subretinal and intraretinal fluid was associated with changes in Early Treatment of Diabetic Retinopathy Study visual acuity, central macular thickness (CMT, and number of injections needed during the 6-month follow-up. Results: The presence of PED was associated with lower values of CMT at presentation (399 µm [±132 µm] vs 310 µm [±51 µm], P=0.005. The presence of RPE disruption was associated with worse visual acuity in month 6 (0.36 [±0.22] vs 0.61 [0.45], P=0.027 and fewer injections (4.23 [±0.92] vs 3.55 [±0.60], P=0.007. The presence of intraretinal fluid at presentation was associated with worse visual acuity outcomes in month 4 (P=0.045 but not in month 6. Conclusion: The dome-shaped PED was associated with lower CMT at presentation, but it did not affect response to treatment. RPE disruption was associated with worse functional outcomes with fewer injections. Intraretinal fluid at presentation may suggest delayed response to treatment. Individualized SD-OCT analysis could lead to individualized approach to wet AMD patients. SD-OCT can offer imaging biomarkers to assess the prognosis of anti-VEGF treatment in AMD patients. Keywords: AMD, spectral domain optical

  13. [Overexpression of B7-1 amd B7-2 by LFA-1 positive lymphocytes in chronic inflammatory bowel diseases].

    Science.gov (United States)

    Isbert, C; Germer, C T; Albrecht, D; Thomsen-Mund, K; Schuppan, D; Buhr, H J

    1998-01-01

    The B7/CD28 pathway is essential for initiating antigen-specific T-cell activation. LFA-1 (CD11a/CD18) is required for sufficient migration into inflammatory tissue. The aim of this study was to evaluate the role of B7 and LFA-1 in inflammatory bowel disease. Immunohistological single and double staining (PAP/APAAP) with monoclonal antibodies against HLA I/II, CD4, CD8, CD28, B7-1, B7-2, LFA-1 and CD68 were performed in tissue samples from patients with crohn's disease (n = 15), ulcerative colitis (n = 14), colorectal carcinoma (n = 5) and FAP (n = 3). The expression of B7-1 and B7-2 was generally much higher in ulcerative colitis and crohn's disease than in colorectal carcinoma and FAP. In crohn's disease multinucleated gigant cells in the granulomas express B7-1 and B7-2. Double staining showed a higher B7-1/B7-2 coexpression for CD4+ than for CD8+ T cells. In colitis ulcerosa and crohn's disease LFA-1 positive leucocytes showed a high coexpression of B7-1 and B7-2 in contrast to CD68 positive macrophages. These data suggest that overexpression of B7-1 and B7-2 on LFA-1 positive Leucocyts seems to play an important role in the pathogenesis of inflammatory bowel disease.

  14. Resveratrol Based Oral Nutritional Supplement Produces Long-Term Beneficial Effects on Structure and Visual Function in Human Patients

    Directory of Open Access Journals (Sweden)

    Stuart Richer

    2014-10-01

    Full Text Available Background: Longevinex® (L/RV is a low dose hormetic over-the-counter (OTC oral resveratrol (RV based matrix of red wine solids, vitamin D3 and inositol hexaphosphate (IP6 with established bioavailability, safety, and short-term efficacy against the earliest signs of human atherosclerosis, murine cardiac reperfusion injury, clinical retinal neovascularization, and stem cell survival. We previously reported our short-term findings for dry and wet age-related macular degeneration (AMD patients. Today we report long term (two to three year clinical efficacy. Methods: We treated three patients including a patient with an AMD treatment resistant variant (polypoidal retinal vasculature disease. We evaluated two clinical measures of ocular structure (fundus autofluorescent imaging and spectral domain optical coherence extended depth choroidal imaging and qualitatively appraised changes in macular pigment volume. We further evaluated three clinical measures of visual function (Snellen visual acuity, contrast sensitivity, and glare recovery to a cone photo-stress stimulus. Results: We observed broad bilateral improvements in ocular structure and function over a long time period, opposite to what might be expected due to aging and the natural progression of the patient’s pathophysiology. No side effects were observed. Conclusions: These three cases demonstrate that application of epigenetics has long-term efficacy against AMD retinal disease, when the retinal specialist has exhausted other therapeutic modalities.

  15. Visual outcomes of age-related macular degeneration patients undergoing intravitreal ranibizumab monotherapy in an urban population

    Directory of Open Access Journals (Sweden)

    Basheer K

    2015-05-01

    Full Text Available Khadijah Basheer, Evelyn Mensah, Tina Khanam, Neda Minakaran Ophthalmology Department, Central Middlesex Hospital, London, UK Aim: To compare the visual outcomes of an urban population with age-related macular degeneration (AMD undergoing ranibizumab monotherapy to the results from major clinical trials.Procedures: Prospective data was collected from 164 wet AMD patients receiving intravitreal ranibizumab. Visual acuities were obtained with the Early Treatment Diabetic Retinopathy Study chart. All patients underwent a loading phase of three monthly treatments of ranibizumab. Patients were monitored monthly using a retreatment criterion. Treatment was further individualized by sequentially lengthening follow-up intervals when stable.Results: At 12 and 24 months, respectively, the percentage of eyes that maintained vision was 91% and 88.6%. We found that 20.3% of eyes had improved vision at 12 months and 20% at 24 months. At 12 months, 8.3% of eyes’ vision worsened and 12% worsened at 24 months.Conclusion: Individualized ranibizumab monotherapy is effective in preserving vision in wet AMD and follows the same trends as the pivotal trials. Keywords: visual acuity, comparison of age-related macular degeneration treatment trials, choroidal neovascular membrane

  16. Assessing quality of life in the treatment of patients with age-related macular degeneration: clinical research findings and recommendations for clinical practice

    Directory of Open Access Journals (Sweden)

    Yuzawa M

    2013-07-01

    Full Text Available Mitsuko Yuzawa,1 Kyoko Fujita,1 Erika Tanaka,2 Edward C Y Wang21Department of Ophthalmology, Nihon University School of Medicine, Surugadai, Kanda, Chiyoda-ku, Tokyo, Japan; 2Health Economics and Outcomes Research, Bayer Yakuhin Ltd, Marunouchi, Chiyoda-ku, Tokyo, JapanBackground: The importance of incorporating quality-of-life (QoL assessments into medical practice is growing as health care practice shifts from a “disease-based” to a “patient-centered” model. The prevalence of age-related macular degeneration (AMD is increasing in today’s aging population. The purpose of this paper is: (1 to discuss, by reviewing the current literature, the impact of AMD on patients’ QoL and the utility of QoL assessments in evaluating the impact of AMD and its treatment; and (2 to make a recommendation for incorporating QoL into clinical practice.Methods: We conducted a PubMed and an open Internet search to identify publications on the measurement of QoL in AMD, as well as the impact of AMD and the effect of treatment on QoL. A total of 28 articles were selected.Results: AMD has been found to cause a severity-dependent decrement in QoL that is comparable to systemic diseases such as cancer, ischemic heart disease, and stroke. QoL impairment manifests as greater social dependence, difficulty with daily living, higher rates of clinical depression, increased risk of falls, premature admission to nursing homes, and suicide. The National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25 is the most widely used eye disease-specific QoL instrument in AMD. It has been shown to correlate significantly with visual acuity (VA. QoL reflects aspects of AMD including psychological well-being, functional capacity, and the ability to perform patients’ valued activities, which are not captured by a single, numerical VA score.Conclusion: The literature shows that the adverse impact of AMD on QoL is comparable to serious systemic disease. Eye disease

  17. Clinical effect of Conbercept to improve visual acuity of patients with wet age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Zhen-Liu Zhu

    2015-11-01

    Full Text Available AIM:To observe the clinical effect of conbercept to improve visual acuity of patients with wet age-related macular degeneration(wAMD. METHODS:Seventy patients(70 eyeswith wAMD were selected and divided into study group and control group according to different therapies. The control group received intravitreal injection of triamcinolone acetonide. The study group adopted the intravitreal injection with conbercept. Uncorrected visual acuity, the score of reading ability, the central macular thickness(CMTand the macular pigment optical density of two groups before and after treatment was observed. RESULTS: the visual acuity of study group was 0.47±0.11 and 0.60±0.14 respectively at 6mo and 1a after treatments, those of control group were 0.27±0.09 and 0.30±0.15. The differences between the two groups at the two points were statistically significant(PPPCONCLUSION:The intravitreal injection with conbercept has a favorable clinical effect on the treatment of wAMD, Which can greatly improve the uncorrected visual acuity and is worthy promotion.

  18. The utility of using customized heterochromatic flicker photometry (cHFP) to measure macular pigment in patients with age-related macular degeneration

    OpenAIRE

    Stringham, J.M; Hammond, BR; Nolan, John,; Wooten, BR; Mammen, A.; Smollen, W

    2008-01-01

    The purpose of this study was to assess the utility and validity of using customized heterochromatic flicker photometry (cHFP) to measure macular pigment optical density (MPOD) in patients with intermediate stages of age-related macular degeneration (AMD). The measurement procedure was optimized to accommodate individual differences in temporal vision related to age, disease, or other factors. The validity criteria were based on the similarity of the spectral absorption curves to ex vivo curv...

  19. Treatment satisfaction of patients undergoing ranibizumab therapy for neovascular age-related macular degeneration in a real-life setting

    Directory of Open Access Journals (Sweden)

    Gohil R

    2016-05-01

    Full Text Available Rishma Gohil,1,2 Roxanne Crosby-Nwaobi,1,2 Angus Forbes,2 Ben J Burton,3 Philip Hykin,1 Sobha Sivaprasad1,4 1National Institute for Health Research Moorfields Biomedical Research Centre, London, 2Diabetes Nursing, King’s College London, London, 3Ophthalmology Department, James Paget University Hospital, Great Yarmouth, 4Laser and Retinal Research Unit, King’s College Hospital, London, UK Context: Treatment satisfaction with a loading phase of monthly injections for 3 months followed by a pro-re-nata regimen of ranibizumab in neovascular age-related macular degeneration (nAMD remains unclear.Aims: The aim was to evaluate the treatment satisfaction of persons with nAMD treated with ranibizumab in a real-life setting.Settings and design: A cross-sectional study was conducted across three eye clinics within the National Health Service in the UK, where treatment is provided free at point of contact.Materials and methods: A total of 250 patients were selected randomly for the study. Treatment satisfaction was assessed using the Macular Treatment Satisfaction Questionnaire. Data were collected on satisfaction of the service provided (Client Service Questionnaire-8 and the patients’ demographic and quality of life and treatment history. Factors governing treatment questionnaire were determined.Results: The most important factors that determined the satisfaction were the service provided at the clinic (Client Service Questionnaire-8, health-related quality of life (EQ-5D-3L, and duration of AMD. Visual acuity changes were rated as less important than one would have expected.Conclusion: The study result suggested that treatment satisfaction for nAMD was governed by the perception of being reviewed and injected regularly over a long period of time than the actual change in visual acuity from the treatment. Keyword: macular treatment satisfaction questionnaire, patient related outcome measure, treatment history, quality of life 

  20. The AFCRL Lunar amd Planetary Research Branch

    Science.gov (United States)

    Price, Stephan D.

    2011-07-01

    The Lunar and Planetary research program led by Dr John (Jack) Salisbury in the 1960s at the United States Air Force Cambridge Research Laboratories (AFCRL) investigated the surface characteristics of Solar System bodies. The Branch was one of the first groups to measure the infrared spectra of likely surface materials in the laboratory under appropriate vacuum and temperature conditions. The spectral atlases created from the results were then compared to photometric and spectral measurements obtained from ground- and balloon-based telescopes to infer the mineral compositions and physical conditions of the regoliths of the Moon, Mars and asteroids. Starting from scratch, the Branch initially sponsored observations of other groups while its in-house facilities were being constructed. The earliest contracted efforts include the spatially-resolved mapping of the Moon in the first half of the 1960s by Richard W. Shorthill and John W. Saari of the Boeing Scientific Research Laboratories in Seattle. This effort ultimately produced isophotal and isothermal contour maps of the Moon during a lunation and time-resolved thermal images of the eclipsed Moon. The Branch also sponsored probe rocket-based experiments flown by Riccardo Giacconi and his group at American Science and Engineering Inc. that produced the first observations of X-ray stars in 1962 and later the first interferometric measurement of the ozone and C02 emission in the upper atmosphere. The Branch also made early use of balloon-based measurements. This was a singular set of experiments, as these observations are among the very few mid-infrared astronomical measurements obtained from a balloon platform. Notable results of the AFCRL balloon flights were the mid-infrared spectra of the spatially-resolved Moon obtained with the University of Denver mid-infrared spectrometer on the Branch's balloon-borne 61-cm telescope during a 1968 flight. These observations remain among the best available. Salisbury also funded John Strong at the Johns Hopkins University for several near-infrared experiments which created a bit of a stir by detecting water vapor and ice high in the atmosphere of Venus. Once lunar geology transitioned from remote sensing to hands-on geology with the lunar landings, the Branch turned its attention to quantifying the thermal spectral emission from planets for their use as possible infrared calibration sources. The Branch and its research were phased out in 1976 when the program was terminated with the reorganization of AFCRL into the Air Force Geophysics Laboratory (AFGL).

  1. Microprocesadores AMD: pasado, presente y futuro

    Directory of Open Access Journals (Sweden)

    Reynaldo Hernández Perdomo

    2005-01-01

    Full Text Available La evolución de la humanidad y en particular de la electrónica de los últimos años ha estado basada en los constantes avances en la fabricación de chips. Los circuitos integrados se han ido incorporando a todo los que nos rodea hasta el punto de que la vida sin ellos parece imposible. El microprocesador es uno de los logros más sobresalientes del siglo XX. Esas son palabras atrevidas, y hace un cuarto de siglo tal afirmación habría parecido absurda. Pero cada año, el microprocesador se acerca más al centro de nuestras vidas, forjándose un sitio en el núcleo de una máquina tras otra. Su presencia ha comenzado a cambiar la forma en que percibimos el mundo e incluso a nosotros mismos. Cada vez se hace más difícil pasar por alto el microprocesador como otro simple producto en una larga línea de innovaciones tecnológicas. No obstante que reconocemos la penetración del microprocesador en nuestras vidas, ya estamos creciendo indiferentes a la presencia de esos miles de máquinas diminutas que nos encontramos sin saberlo todos los días. Así que, antes de que se integre de manera demasiado imperceptible en nuestra diaria existencia, es el momento de celebrar al microprocesador y la revolución que ha originado, para apreciar el milagro que es en realidad cada uno de esos chips de silicio diminutos y meditar acerca de su significado para nuestras vidas y las de nuestros descendientes.

  2. Hot Flashes amd Night Sweats (PDQ)

    Science.gov (United States)

    ... Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training at ... remedies for hot flashes. These include dong quai , milk thistle , red clover , licorice root extract , and chaste ...

  3. Neutralisation treatment of AMD at affordable cost

    African Journals Online (AJOL)

    2012-06-11

    Jun 11, 2012 ... ment of sludge produced during treatment of acid mine water. Zinck (2006) has ... MBO and Mintek Ettringite processes, can produce drinking water from ..... from the paper industry (SAPPI); an alternative source will be mined ...

  4. Kirurgisk behandling af aldersrelateret makuladegeneration (AMD)?

    DEFF Research Database (Denmark)

    Kiilgaard, Jens Folke

    2001-01-01

    oftalmologi, aldersrelateret makuladegeneration, transplantation, grise, øjne, kirurgisk udvikling......oftalmologi, aldersrelateret makuladegeneration, transplantation, grise, øjne, kirurgisk udvikling...

  5. CFH Y402H and ARMS2 A69S Polymorphisms and Oral Supplementation with Docosahexaenoic Acid in Neovascular Age-Related Macular Degeneration Patients: The NAT2 Study.

    Directory of Open Access Journals (Sweden)

    Bénédicte M J Merle

    Full Text Available Genetic susceptibility could be modified by environmental factors and may also influence differential responses to treatments for age-related macular degeneration (AMD. We investigated whether genotype could influence response to docosahexaenoic acid (DHA-supplementation in the occurrence of choroidal new vessels (CNV.The Nutritional AMD Treatment 2 (NAT2 study was a randomized, placebo-controlled, double-blind, parallel, comparative study, including 250 patients aged 55 to 85 years with early lesions of age-related maculopathy, visual acuity better than 0.4 Logarithm of Minimum Angle of Resolution units in the study eye and neovascular AMD in the fellow eye. Patients were randomized at baseline to receive either 3 daily fish-oil capsules, each containing 280 mg DHA, 90 mg EPA and 2 mg Vitamin E, or placebo.Patients carrying the risk allele (C for CFH Y402H had no statistically significant increased risk for developing CNV in the study eye (Hazard Ratio (HR=0.97; 95% Confidence Interval (CI: 0.54-1.76 for heterozygous and HR=1.29; 95%CI: 0.69-2.40 for homozygous. Patients carrying the risk allele (T for ARMS2 A69S had no statistically significant increased risk for developing CNV in the study eye (HR=1.68; 95%CI: 0.91-3.12 for heterozygous and HR=1.78; 95%CI: 0.90-3.52 for homozygous. A significant interaction was observed between CFH Y402H and DHA-supplementation (p=0.01. We showed a protective effect of DHA-supplementation among homozygous non-risk patients. Among these patients, occurrence of CNV was 38.2% in placebo group versus 16.7% in DHA group (p=0.008.These results suggest that a genetic predisposition to AMD conferred by the CFH Y402H variant limits the benefit provided by DHA supplementation.ISRCTN registry 98246501.

  6. Perceptual learning in patients with macular degeneration

    Directory of Open Access Journals (Sweden)

    Tina ePlank

    2014-10-01

    Full Text Available Patients with age-related macular degeneration (AMD or hereditary macular dystrophies (JMD rely on an efficient use of their peripheral visual field. We trained eight AMD and five JMD patients to perform a texture-discrimination task (TDT at their preferred retinal locus (PRL used for fixation. Six training sessions of approximately one hour duration were conducted over a period of approximately 3 weeks. Before, during and after training twelve patients and twelve age-matched controls (the data from two controls had to be discarded later took part in three functional magnetic resonance imaging (fMRI sessions to assess training-related changes in the BOLD response in early visual cortex. Patients benefited from the training measurements as indexed by significant decrease (p=.001 in the stimulus onset asynchrony (SOA between the presentation of the texture target on background and the visual mask, and in a significant location specific effect of the PRL with respect to hit rate (p=.014. The following trends were observed: (i Improvement in Vernier acuity for an eccentric line-bisection task; (ii positive correlation between the development of BOLD signals in early visual cortex and initial fixation stability (r=0.531; (iii positive correlation between the increase in task performance and initial fixation stability (r=0.730. The first two trends were non-significant, whereas the third trend was significant at p=.014, Bonferroni corrected. Consequently, our exploratory study suggests that training on the TDT can enhance eccentric vision in patients with central vision loss. This enhancement is accompanied by a modest alteration in the BOLD response in early visual cortex.

  7. Perceptual Speech Assessment After Anterior Maxillary Distraction in Patients With Cleft Maxillary Hypoplasia.

    Science.gov (United States)

    Richardson, Sunil; Seelan, Nikkie S; Selvaraj, Dhivakar; Khandeparker, Rakshit V; Gnanamony, Sangeetha

    2016-06-01

    To assess speech outcomes after anterior maxillary distraction (AMD) in patients with cleft-related maxillary hypoplasia. Fifty-eight patients at least 10 years old with cleft-related maxillary hypoplasia were included in this study irrespective of gender, type of cleft lip and palate, and amount of required advancement. AMD was carried out in all patients using a tooth-borne palatal distractor by a single oral and maxillofacial surgeon. Perceptual speech assessment was performed by 2 speech language pathologists preoperatively, before placement of the distractor device, and 6 months postoperatively using the scoring system of Perkins et al (Plast Reconstr Surg 116:72, 2005); the system evaluates velopharyngeal insufficiency (VPI), resonance, nasal air emission, articulation errors, and intelligibility. The data obtained were tabulated and subjected to statistical analysis using Wilcoxon signed rank test. A P value less than .05 was considered significant. Eight patients were lost to follow-up. At 6-month follow-up, improvements of 62% (n = 31), 64% (n = 32), 50% (n = 25), 68% (n = 34), and 70% (n = 35) in VPI, resonance, nasal air emission, articulation, and intelligibility, respectively, were observed, with worsening of all parameters in 1 patient (2%). The results for all tested parameters were highly significant (P ≤ .001). AMD offers a substantial improvement in speech for all 5 parameters of perceptual speech assessment. Copyright © 2016 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Quality of Life with Macular Degeneration Is Not as Dark as It May Seem: Patients' Perceptions of the MacDQoL Questionnaire.

    Science.gov (United States)

    Ord, Lisa M; Wright, JoAnne; DeAngelis, Margaret M; Feehan, Michael

    2015-09-22

    To determine the perceived relevance and value of an individualized measure of the impact of macular degeneration on quality of life (QoL) for elderly people with Age-Related Macular Degeneration (AMD) in the USA, through the assessment of the suitability of the measure's domains and by gaining a deeper insight into the impact of AMD on patients' QoL vis-á-vis these domains, community-dwelling older adults in the metropolitan Salt Lake City, Utah area were interviewed using the macular degeneration on quality of life (MacDQoL) instrument. Participants felt that the MacDQoL was a relevant instrument for use in this US study population, though it could be improved by adding items pertaining to transportation, and independent driving, in particular, as an important QoL indicator. The emerging theme from analysis of the respondent's commentary was that, in spite of AMD, these respondents were committed to engage in, and enjoy life. This is an important concept for clinicians and those who offer support programs to integrate into their care planning and reinforce in messaging to patients with the condition.

  9. Correlations between M-CHARTS and PHP findings and subjective perception of metamorphopsia in patients with macular diseases.

    Science.gov (United States)

    Arimura, Eiko; Matsumoto, Chota; Nomoto, Hiroki; Hashimoto, Shigeki; Takada, Sonoko; Okuyama, Sachiko; Shimomura, Yoshikazu

    2011-01-05

    To assess the correlations between a patient's subjective perception of metamorphopsia and the clinical measurements of metamorphopsia by M-CHARTS and PreView PHP (PHP). The authors designed a 10-item questionnaire focusing on the symptoms of metamorphopsia and verified its validity with a Rasch analysis. M-CHARTS measured the minimum visual angle of a dotted line needed to detect metamorphopsia, and PHP used the hyperacuity function for detection. Subjects were 39 patients with idiopathic epiretinal membrane (ERM), 22 patients with idiopathic macular hole (M-hole), 19 patients with age-related macular degeneration (AMD), and 51 healthy controls. Rasch analysis suggested the elimination of one question. The nine-item questionnaire score significantly correlated to the M-CHARTS score in ERM (r = 0.59; P = 0.0004) but not in M-hole and to the PHP result in AMD (r = -0.29; P = 0.04) but not in ERM. Eighty percent of ERM patients with greater horizontal M-CHARTS score subjectively perceived horizontal metamorphopsia more often. M-CHARTS showed better sensitivities than PHP in both ERM (89% vs. 42%) and AMD (74% vs. 68%) and better specificity (100% vs. 71%) in healthy controls. Rasch analysis indicated that the present form of the questionnaire is better suited for moderate to severe cases of metamorphopsia than for mild cases. The questionnaire appears to be a valid assessment of patient subjective perception of metamorphopsia and can be used to supplement the clinical measurements of metamorphopsia by M-CHARTS and PHP in patients with macular diseases.

  10. Balance training and visual rehabilitation of age-related macular degeneration patients.

    Science.gov (United States)

    Radvay, Xavier; Duhoux, Stéphanie; Koenig-Supiot, Françoise; Vital-Durand, François

    2007-01-01

    Patients with Age-Related Macular Degeneration (AMD) experience a large scotoma precluding central vision. In addition, 2/3 of these patients present visuomotor and balance deficits resulting in clumsiness and increased risk of falls. On the basis of previous work demonstrating that visual, vestibular and somatosensory functions involved in balance control can be rehabilitated by training, we attempted to improve these functions by balance training. We measured the impact of balance training on several visuomotor functions and reading speed. We compared balance status of 54 AMD patients to 55 normal controls. Sixteen of these patients and 14 controls subsequently received balance training sessions on a postural platform (Multitest) stressing sensorimotor coordination by selectively inhibiting or disturbing either, visual, vestibular or somatosensory input. Producing a conflict between two inputs reinforces the use of the third. We assessed postural sway, pointing accuracy, reading performance and, for the patients, the effect of low vision training and balance training on the shift from several spontaneous Preferred Retinal Loci (PRLs) to one or more Trained Retinal Loci (TRL). Even after a limited number of sessions of cross-modal balance training, the results show a significant improvement for the vestibular input and fixation stability. A decrease of visual dependency was observed only in the control group. Apart from these improvements, pointing accuracy and reading speed were not significantly improved compared to controls, leading to the conclusion that more training sessions may be necessary to gain more significant improvement of visuo-motor functions.

  11. The evaluation of reading performance with minnesota low vision reading charts in patients with age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Deniz Altinbay

    2016-01-01

    Full Text Available Purpose: To evaluate the reading performance using the Minnesota low vision reading (MNREAD charts, of patients with age-related macular degeneration (AMD who use low vision aid (LVA devices. Materials and Methods: This prospective study enrolled 27 patients with AMD. Distance visual acuity (VA was evaluated with a distance chart designed for patients with low vision. Near vision and reading performance were evaluated with the Turkish version of the MNREAD charts. Unaided vision and vision with LVA devices and high spherical add near glasses was measured. P <0.05 was considered statistically significant. Results: The mean unaided near VA was 1.05 ± 0.27 log of the minimum angle of resolution (LogMAR. The mean VA with the LVA devices was 0.71 ± 0.41 LogMAR. Reading acuity ranged between 1.15 and 0.21 LogMAR, critical print size was between − 1.2 and 0.2 LogMAR. Maximum reading speeds were between 0 and 103 words/min. The cases are divided into groups in terms of reading speed according to age, gender, diagnosis, and education. Reading speed was negatively correlated to increasing age. Conclusion: MNREAD reading charts can be used to evaluate reading performance in patients with AMD with low vision. The outcomes of the present study indicate that optical correction is adequate for near VA requirements in this patient population. However, optical correction was inadequate for improving reading performance. Appropriate rehabilitation programs can be used to increase reading speed.

  12. Association of Apolipoprotein E Alleles with Susceptibility to Age-Related Macular Degeneration in Iranian Patients

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    Mohammad Askari

    2015-04-01

    Conclusion: The results show a moderate positive association between APOE &epsilon2 and AMD, but current data does not show any role for APOE &epsilon4 in protection from AMD. However, more studies are required to reveal the possible role of APOE in the pathogenesis of AMD.

  13. Reliability and reproducibility of spectral and time domain optical coherence tomography images before and after correction for patients with age-related macular degeneration [v2; ref status: indexed, http://f1000r.es/50m

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    Mohammad A. Sadiq

    2015-03-01

    Full Text Available Purpose: To evaluate the reproducibility and reliability of optical coherence tomography scans obtained using the time domain (TD-OCT StratusTM OCT, and the Spectral Domain (SD-OCT SpectralisTM and CirrusTM OCT devices before and after manual correction in eyes with either Neovascular (NV-AMD or Non-Neovascular (NNV-AMD age-related macular degeneration. Design: Prospective observational study. Methods: Setting: University-based retina practice. Patients: Thirty-six patients (50 eyes with NV-AMD or NNV-AMD. Procedure: OCT scans were taken simultaneously using one TD-OCT and two SD-OCT devices. Main Outcome Measures: Macular thickness measurements were assessed before and after correction of the algorithm by constructing Bland-Altman plots for agreement and calculating intraclass correlation coefficients (ICCs and coefficients of repeatability (COR to evaluate intraclass repeatability. Results: Spectralis had the highest number of images needing manual correction.  All machines had high ICCs, with Spectralis having the highest.  Also, Bland-Altman plots indicated that there was low agreement between Cirrus™ and Stratus™, Spectralis™ and Stratus™, while there was good agreement between the Cirrus™ and Spectralis™.  The CORs were lowest for SpectralisTM and similar and higher for CirrusTM and StratusTM.  Agreement, CORs, and ICCs generally improved after manual correction, but only minimally.  Conclusion: Agreement is low between devices, except between both SD-OCT machines.  Manual correction tends to improve results.

  14. Functional impact of treatment with ranibizumab under a reactive strategy in patients with neovascular age-related macular degeneration.

    Science.gov (United States)

    Gallego-Pinazo, R; Dolz-Marco, R; Andreu-Fenoll, M; Farrés, J; Monclús, L

    2017-03-01

    To analyse the functional recovery using a pro re nata (PRN) dosing strategy with intravitreal injections of ranibizumab for patients with neovascular age-related macular degeneration (AMD). An observational, retrospective, single-centre study, was conducted on patients with neovascular AMD managed with a PRN strategy with ranibizumab, and were followed-up for a minimum of 18 months. Sociodemographic and clinical data were collected from medical records. The percentage of visual acuity (VA) recovered after losing 5 or more letters was calculated taking into account the previous visit, as well as considering the best VA recorded prior to the retreament. The analysis included 128 patients. The mean (SD) follow-up period was 18.9 (2.3) months. The mean (SD) elapsed days between onset of symptoms and diagnosis, and between prescription and administration of treatment was 50.2 (57.4) and 10.9 (16.0), respectively. Only 108 patients were prescribed ranibizumab after losing 5 or more letters of VA. The mean (SD) VA recovery compared to the previous VA was 70.3% (114.4). On the other hand, the mean (SD) VA recovery when considering the best VA registered before the retreatment was 43.5% (112.9), with 59.4% of re-treatments having a VA recovery below 75%, and with 11.7% not presenting any VA recovery. A PRN dosing strategy with intravitreal ranibizumab for neovascular AMD may not be efficient in preserving and/or recovering VA in the long-term, due to a cumulative irreversible VA loss. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Availability of resources for patients with wet age-related macular degeneration. Optimal study].

    Science.gov (United States)

    Casaroli-Marano, R; Roura, M

    2013-08-01

    The aim of the study was to assess the availability of resources for patients with wet age-related macular degeneration (wAMD) in current clinical practice. Observational, cross-sectional and multicenter study. Eligible subjects were ≥ 18 years old, with primary/secondary active subfoveal AMD-related choroidal neovascularization diagnosed 12-18 months prior to inclusion in the study. A total of 266 patients were included (39 centers). The mean age (SD) was 76.1 (8.1) years, of whom 55.6% were female. According to the investigator assessment a median (Q1-Q3) of 20.0 (10.0-50.0) patients were visited weekly. A mean of 100.0 (45.0-250.0) were currently under treatment mainly performed in operating rooms (61.5%). Centers had 1.0 (1.0-2.0) operating rooms available for treatment 2.0 (2.0-5.0) days/week. In 74.4% they were located on different floors/buildings from ophthalmology services. Waiting time until visit was 40.0 (30.0-60.0) min, and duration of treatment was 20.0 (15.0-50.0) min. The time between request until medical visit was 20.0 (15.0-30.0) days, and from diagnosis to treatment was 7.0 (5.0-10.0) days. Clinicians considered there was insufficient staff for examinations (84.6%), and treatment (46.2%). About 30.8% and 20.5% mentioned lack of diagnostic tools, such as optical coherence tomography and fluorescein angiography. More resources for diagnosis and treatment of wAMD are required. These results, together with the current policy of reducing the budget in the Spanish Health System, could lead to possible delays in the diagnosis and treatment of wAMD. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  16. Clinical Features and Course of Patients with Peripheral Exudative Hemorrhagic Chorioretinopathy

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    Zafer Cebeci

    2016-10-01

    Full Text Available Objectives: To evaluate the clinical characteristics of patients who were followed in our clinic with the diagnosis of peripheral exudative hemorrhagic chorioretinopathy (PEHC. Materials and Methods: Medical records of 12 patients who were diagnosed with PEHC in İstanbul University İstanbul Faculty of Medicine, Department of Ophthalmology between July 2006 and June 2014 were reviewed retrospectively. Results: This study included 21 eyes of 12 patients. Four (33.3% of the patients were male and 8 (66.7% were female and ages ranged between 73 and 89 years. Eight (66.7% of the patients were referred to us with the diagnosis of choroidal mass. Unilateral involvement was found in 3 and bilateral involvement in 9 patients. Temporal quadrants were involved in all eyes. Fifteen eyes (71.4% had subretinal hemorrhage and hemorrhagic/serous retinal pigment epithelial detachment, 11 (52.4% had lipid exudation, 5 (23.8% had chronic retinal pigment epithelium alterations, 2 (9.5% had subretinal fibrosis and 1 (4.8% had vitreous hemorrhage. PEHC lesions were accompanied by drusen in 11 eyes (52.4%, geographic atrophy in 2 eyes (9.5%, and choroidal neovascularization scar in 2 eyes (9.5%. Treatment was done in both eyes of a patient for lesions which threatened the macula, in a patient with bilateral macular edema and in a patient with vitreous hemorrhage. The remaining eyes were followed-up without any treatment because the lesions did not threaten the macula and they showed no progression during follow-up. Conclusion: PEHC is a degenerative disease of peripheral retina that is seen in older patients, and signs of age-related macular degeneration (AMD may accompany this pathology. Especially in patients with AMD findings, the peripheral retina must be evaluated carefully for existing PEHC lesions.

  17. The utility of using customized heterochromatic flicker photometry (cHFP) to measure macular pigment in patients with age-related macular degeneration.

    Science.gov (United States)

    Stringham, J M; Hammond, B R; Nolan, J M; Wooten, B R; Mammen, A; Smollon, W; Snodderly, D M

    2008-11-01

    The purpose of this study was to assess the utility and validity of using customized heterochromatic flicker photometry (cHFP) to measure macular pigment optical density (MPOD) in patients with intermediate stages of age-related macular degeneration (AMD). The measurement procedure was optimized to accommodate individual differences in temporal vision related to age, disease, or other factors. The validity criteria were based on the similarity of the spectral absorption curves to ex vivo curves of lutein and zeaxanthin and the similarity of spatial density profiles to those measured in subjects without retinal disease. Macular pigment optical density (MPOD) spatial profiles were measured with an LED-based macular densitometer; spectral absorption curves were measured with a 3-channel Maxwellian view system including a monochromator. All patients were characterized via clinical exams and all but 2 subjects from whom data were obtained had masked grading of color fundus photographs using the Wisconsin Age-Related Maculopathy Grading System. Most of the patients were in AREDS category 2 (27%) or 3 (57%). Patients with visual acuity as poor as 20/80 were included, and could perform the task as long as they could see the stimulus. Eighty-one percent of the patients screened were able to perform the cHFP task, and data were obtained from 30 AMD patients. Spatial profiles of MPOD were measured in 19 subjects who could see the stimulus at all tested loci. These profiles were highly similar to those that have been measured with HFP in subjects without retinal disease. The average shape of the spectral absorption curves for the AMD subjects corresponded well to an ex vivo template. These data support both the utility and validity of the cHFP method for measuring MPOD in subjects with intermediate stages of AMD. The ability to measure the retinal response to nutritional intervention is of practical importance for monitoring patients being supplemented with lutein and

  18. The results of diagnostic and treatment of patients with diabetic retinopathy and age-related macular degeneration at a diabetes type 2.

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    I. V. Vorobyova

    2014-01-01

    Full Text Available Purpose: Explore the changing clinical and functional and morphological changes of the retina against application of angiogenesis inhibitor in patients with diabetes type 2 with comorbidity fundus: diabetic retinopathy (DR and agerelated macular degeneration (AMD.Patients and Methods. In the main study group included 22 patients (22 eyes with type 2 diabetes with combined fundus pathology DR and AMD. All patients before and after intravitreal injection of an angiogenesis inhibitor ranibizumab (Lucentis, Novartis was assessed visual acuity, macular thickness and macular morphology based on the results of OCT, the retinal sensitivity according to the data of microperimetry (MAIA. The control group study included 30 people (15 healthy and 15 with type 2 diabetes without DR.Results. When comparing the main group with the control group was revealed that visual acuity in the main group (0,27±0,05 was significantly lower than in the control group (0,8±0,01, p <0.05; retinal thickness was significantly higher in the control group, and the retinal sensitivity was significantly lower. On the background of intravitreal injection of ranibizumab all patients with DR and AMD had significantly increase in visual acuity on average by 37 % (from 0,27±0,05 before treatment to 0,37±0,05 after treatment, a significantly reduction of macular thickness in 9 out of 9 areas, including the fovea centralis, an average of 32.6 % and increase retinal sensitivity by 24 % (from 11,75±1,68 (dB to 14,58±1,68 (dB, (p <0.05. The correlations were found between visual acuity and retinal thickness, as well as between visual acuity and retinal sensitivity of the macula, before treatment r = –0,26, p <0.01 and r = 0,7 p <0.01, respectively, after treatment with r = –0,14, p <0.01 and r = 0,64, p <0.01, respectively. Conclusions. Intravitreal injection of angiogenesis inhibitor ranibizumab to patients with comorbidity fundus DR and AMD on a background of

  19. The results of diagnostic and treatment of patients with diabetic retinopathy and age-related macular degeneration at a diabetes type 2.

    Directory of Open Access Journals (Sweden)

    I. V. Vorobyova

    2014-10-01

    Full Text Available Purpose: Explore the changing clinical and functional and morphological changes of the retina against application of angiogenesis inhibitor in patients with diabetes type 2 with comorbidity fundus: diabetic retinopathy (DR and agerelated macular degeneration (AMD.Patients and Methods. In the main study group included 22 patients (22 eyes with type 2 diabetes with combined fundus pathology DR and AMD. All patients before and after intravitreal injection of an angiogenesis inhibitor ranibizumab (Lucentis, Novartis was assessed visual acuity, macular thickness and macular morphology based on the results of OCT, the retinal sensitivity according to the data of microperimetry (MAIA. The control group study included 30 people (15 healthy and 15 with type 2 diabetes without DR.Results. When comparing the main group with the control group was revealed that visual acuity in the main group (0,27±0,05 was significantly lower than in the control group (0,8±0,01, p <0.05; retinal thickness was significantly higher in the control group, and the retinal sensitivity was significantly lower. On the background of intravitreal injection of ranibizumab all patients with DR and AMD had significantly increase in visual acuity on average by 37 % (from 0,27±0,05 before treatment to 0,37±0,05 after treatment, a significantly reduction of macular thickness in 9 out of 9 areas, including the fovea centralis, an average of 32.6 % and increase retinal sensitivity by 24 % (from 11,75±1,68 (dB to 14,58±1,68 (dB, (p <0.05. The correlations were found between visual acuity and retinal thickness, as well as between visual acuity and retinal sensitivity of the macula, before treatment r = –0,26, p <0.01 and r = 0,7 p <0.01, respectively, after treatment with r = –0,14, p <0.01 and r = 0,64, p <0.01, respectively. Conclusions. Intravitreal injection of angiogenesis inhibitor ranibizumab to patients with comorbidity fundus DR and AMD on a background of

  20. SU5416 induces premature senescence in endothelial progenitor cells from patients with age-related macular degeneration

    Science.gov (United States)

    Berna, Marc J.; Kunst, Frank; Wege, Henning; Strunnikova, Natalya V.; Gordiyenko, Natalya; Grierson, Rebecca; Richard, Gisbert; Csaky, Karl G.

    2011-01-01

    Purpose We recently demonstrated increased frequency and growth potential of late outgrowth endothelial progenitor cells (OECs) in patients with neovascular age-related macular degeneration (nvAMD). This study investigated the effects of short- and long-term in vitro inhibition of vascular endothelial growth factor (VEGF) Receptor-2 (VEGFR-2) signaling by SU5416 and other inhibitors of the VEGF signaling pathway in OECs. Methods OECs, from the peripheral blood of patients with nvAMD, and human umbilical vein endothelial cells were grown in the presence of SU5416, other VEGFR-2 tyrosine kinase inhibitors (TKIs), and inhibitors of phosphatidylinositol 3′-Kinase (PI3K)/protein kinase B (Akt) and protein kinase C (PKC) in complete angiogenic medium. Apotosis was assessed after 48 h using the fluorescein isothiocyanate Annexin V method. Cell counts were performed for 10 days, and features of senescence were analyzed using senescence-associated β-galactosidase staining, the telomeric repeat amplification protocol for telomerase activity, Southern blot analysis for mean telomere length, flow cytometric analysis for cell-cycle arrest, and western blot for p53 and p21. Control OECs, cells treated for 7 days with inhibitors, as well as naturally senescent OECs were analyzed for expression of different endothelial antigens, including VEGFR-2 and the receptor for stromal cell-derived factor 1, chemokine receptor 4 (CXCR-4). Migration in vitro to VEGF and stromal cell-derived factor 1 of OECs was assessed. Results SU5416, other VEGFR-2 TKIs, and inhibitors of PI3K, Akt, and PKC induced apoptosis, inhibited long-term proliferation, reduced telomerase activity, and induced premature senescence and cell-cycle arrest in OECs as well as in human umbilical vein endothelial cells. Naturally senescent cells and cells rendered senescent by VEGFR-2 TKIs had reduced VEGFR-2 and CXCR-4 expression and demonstrated reduced migratory ability to VEGF. Conclusions This study demonstrates

  1. SU-E-T-16: A Comparison of Expected Dwell Times and Dose Variations for NAMD Patients Treated with An Episcleral Brachytherapy Device

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, R [Univ Arizona, Tucson, AZ (United States); Patel, P; Balaggan, K; Restori, M; Ilginis, T [Moorfields Eye Hospital, London (United Kingdom); Drew, M; McGovern, M; Vitali, J; Marsteller, L [Salutaris Medical Devices, Inc., Tucson, AZ (United States)

    2015-06-15

    Purpose: To evaluate the variations in dwell times and doses expected when using an episcleral brachytherapy device for treatment of neovascular agerelated macular degeneration (n-AMD) based on accurate imaging modalities Methods: Data from 40 eyes from 40 subjects with known n- AMD acquired through the Distance of Choroid Study (DOCS) conducted at Moorfields Eye Hospital was used to determine the target depth; the distance from the outer scleral surface of the eye, through the choroid, to the apex of the choroidal neovascularization (CNV). Each subject underwent, in triplicate, enhanced-depth Spectral Domain Optical Coherence Tomography (SD-OCT), Swept Source Optical Coherence Tomography, (SS-OCT) and Ocular Ultrasound (O-US). These data are the most comprehensive and accurate measurements of the dimensions of the CNV and adjacent layers of the eye for this cohort of patients. During treatment of n-AMD, patients receive a dose of 24Gy to the apex at the target depth. Using the percentage depth dose for a Sr-90 episcleral brachytherapy device, dwell times and doses to the apex were computed to determine the expected variations. Results: The mean target depth and the 95% confidence interval (CI) determined by combining O-US with SD-OCT were 1326 (956,1696)µm and with SS-OCT were 1332 (970,1693)µm. The calculated corresponding mean dwell times and 95% (CI) were 334 (223,445)s and 335 (226,445)s for SD-OCT and SS-OCT determined depths, respectively. The corresponding mean apex dose and 95% (CI) were 24 (35.9,18.0)Gy (SD-OCT) and 24 (35.6,18.1)Gy (SS-OCT). Conclusion: For episcleral brachytherapy treatment of n-AMD, using a patient population average target depth for treatment planning is inadequate, resulting in dose variations of a factor of approximately two over the 95% CI and larger variations for a nontrivial segment of the population. Each patient should have individualized imaging studies to determine the target depth for use in the dwell time calculation

  2. Development of Patients' Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Jennifer [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); D' Alimonte, Laura [Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Angus, Jan [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Paszat, Larry [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Metcalfe, Kelly [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Whelan, Tim [Department of Radiation Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario (Canada); Llewellyn-Thomas, Hilary [Department of Community and Family Medicine, The Center of Informed Choice, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH (Lebanon); Warner, Eiran [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Franssen, Edmee [Consultant Statistician, Faculty of Medicine, University of Toronto, Toronto, Ontario (Canada); Szumacher, Ewa, E-mail: Ewa.Szumacher@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2012-09-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be

  3. Who benefits from CBT for insomnia in primary care? Important patient selection and trial design lessons from longitudinal results of the Lifestyles trial.

    Science.gov (United States)

    McCurry, Susan M; Shortreed, Susan M; Von Korff, Michael; Balderson, Benjamin H; Baker, Laura D; Rybarczyk, Bruce D; Vitiello, Michael V

    2014-02-01

    Evaluate long-term effects of group interventions on sleep and pain outcomes in a primary care population of older adults with osteoarthritis pain and sleep disturbance. Double-blind, cluster-randomized controlled trial with 18-mo follow-up. Group Health and University of Washington, Seattle, WA, from 2009 to 2011. Three hundred sixty-seven adults age 60 y and older, with osteoarthritis pain and insomnia symptoms. Six weekly sessions of group cognitive behavioral therapy for insomnia and pain (CBT-PI), pain alone (CBT-P), and education-only control (EOC) delivered in patients' primary care clinics. There were no significant differences between treatment groups in sleep outcomes at 18 mo. This is a change from published significant 9-mo follow-up results for insomnia severity (Insomnia Severity Index) and sleep efficiency. There were no significant treatment differences in pain at either follow-up. Post hoc analyses of participants with greater insomnia and pain severity at baseline (n = 98) showed significant (P = 0.01) 18-mo reductions in pain comparing CBT-PI versus CBT-P (adjusted mean difference [AMD] = -1.29 [95% confidence interval (CI): -2.24,-0.33]). Moderate, albeit nonsignificant, CBT-PI versus EOC treatment effects for insomnia severity (AMD = -1.43 [95% CI: -4.71, 1.86]) and sleep efficiency (AMD = 2.50 [95% CI: -5.04, 10.05]) were also observed. Possible trial design and methodological considerations that may have affected results are discussed. Results suggest patients with higher levels of comorbid pain and insomnia may be most likely to experience sustained benefit from cognitive behavioral therapy interventions over time, and inclusion of insomnia treatment may yield more clinically meaningful improvements than cognitive behavioral therapy for pain alone. clinicaltrials.gov identifier: NCT01142349.

  4. [Respiratory system elastance and resistance measured by proportional assist ventilation in patients with respiratory muscle weakness].

    Science.gov (United States)

    Oya, Yasushi; Ogawa, Masafumi; Kawai, Mitsuru

    2004-01-01

    Non-invasive ventilatory therapy has prolonged survival of myopathy patients with hypoventilation. Efficacy of non-invasive ventilation depends on both elastance and resistance of the respiratory system. Although these parameters are important in the prescription of respiratory management, conventional respiratory function test does not show the appropriate answer in patients with severe respiratory muscle weakness. In muscular dystrophy, muscle tends to be shortened due to its fibrosis, when muscle becomes atrophic and weak; fibrosis of respiratory muscle tissues presumably causes high thoracic elastance. We evaluated the total respiratory system elastance and resistance during proportional assist ventilation (PAV) in myopathy patients. In PAV with 100% assist, using BiPAP Vision ventilator, airway pressure exceeds 20 cmH2O or tidal volume exceeds 1.5 liter (run-away phenomenon) when the volume assist or the flow assist is higher than the individual elastance or the resistance, respectively. Twenty myopathy patients with ventilatory failure and 7 healthy controls were evaluated, including 7 patients with Duchenne muscular dystrophy (DMD), 2 patients with congenital myopathy (CM), 1 patient with limb-girdle muscular dystrophy (LG), 6 patients with myotonic dystrophy (MyD) and 4 patients with acid maltase deficiency (AMD). Seventeen patients used a nasal mask and 3 patients had a tracheostomy tube. Fifteen patients used a pressure-preset ventilator, and 3 patients used a volume-preset ventilator. In all patients with DMD, CM and LG, respiratory system elastance was higher than 20 (cmH2O/L) and than in all patients with AMD and MyD except 1 MyD patient. Follow-up measurement after half a or one year showed increase of respiratory system elastance in 2 DMD patients and 1 CM patient, but almost no change in 3 AMD patients. The elastance measured during PAV was consistent with the clinical impression of muscle shortening. One exceptional MyD patient showed extremely

  5. Rehabilitation Approaches in Macular Degeneration Patients

    OpenAIRE

    Maniglia, Marcello; Benoit R Cottereau; Soler, Vincent; Trotter, Yves

    2016-01-01

    Age related macular degeneration (AMD) is a visual disease that affects elderly population. It entails a progressive loss of central vision whose consequences are dramatic for the patient’s quality of life. Current rehabilitation programs are restricted to technical aids based on visual devices. They only temporarily improve specific visual functions such as reading skills. Considering the rapid increase of the aging population worldwide, it is crucial to intensify clinical research on AMD in...

  6. Intravitreal injections: what do patients prefer? Analysis of patient's satisfaction and preferences about where to perform intravitreal injections.

    Science.gov (United States)

    Rodríguez Ramírez, M; del Barrio Manso, M I; Martín Sánchez, M D

    2014-12-01

    To analyse satisfaction and patient preferences on the location where they receive an intravitreal injection. A survey was conducted with the intention of analysing these patients who attended the macula clinic and have been intervened using an intravitreal injection at least once in the day hospital or in the theatre setting, comparing both locations. The majority of the interviewed patients preferred the day hospital (50.0 versus 37.5%), mostly because of the comfort and the quick service. In patients with severe age-related macular degeneration (AMD) the option is reversed. The overall satisfaction level was positive in both cases (with 87.5% of patients satisfied or very satisfied in the day hospital and 91.1% in the theatre setting). Through the analysis of different aspects of clinical care the assessment was the same or superior for 75.0% of these patients, except in the waiting time. There were no cases of endophthalmitis. In general, patients prefer the clinical intervention in the consulting room than in the theatre setting because of the quicker service. There are several characteristics that can influence this choice and should be taken into account. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  7. [ANMCO/ISS/AMD/ANCE/ARCA/FADOI/GICR-IACPR/SICI-GISE/SIBioC/SIC/SICOA/SID/SIF/SIMEU/SIMG/SIMI/SISA Consensus document. Hypercholesterolemia and cardiovascular risk: diagnostic and therapeutic pathways in Italy].

    Science.gov (United States)

    Gulizia, Michele Massimo; Colivicchi, Furio; Ricciardi, Gualtiero; Giampaoli, Simona; Maggioni, Aldo Pietro; Averna, Maurizio; Graziani, Maria Stella; Ceriotti, Ferruccio; Mugelli, Alessandro; Rossi, Francesco; Medea, Gerardo; Parretti, Damiano; Abrignani, Maurizio Giuseppe; Arca, Marcello; Filardi, Pasquale Perrone; Perticone, Francesco; Catapano, Alberico; Griffo, Raffaele; Nardi, Federico; Riccio, Carmine; Di Lenarda, Andrea; Scherillo, Marino; Musacchio, Nicoletta; Panno, Antonio Vittorio; Zito, Giovanni Battista; Campanini, Mauro; Bolognese, Leonardo; Faggiano, Pompilio Massimo; Musumeci, Giuseppe; Pusineri, Enrico; Ciaccio, Marcello; Bonora, Enzo; Cantelli Forti, Giorgio; Ruggieri, Maria Pia; Cricelli, Claudio; Romeo, Francesco; Ferrari, Roberto; Maseri, Attilio

    2016-06-01

    Atherosclerotic cardiovascular disease still represents the leading cause of death in western countries. A wealth of scientific evidence demonstrates that increased blood cholesterol levels have a major impact on the outbreak and progression of atherosclerotic plaques. Moreover, several cholesterol-lowering pharmacological agents, including statins and ezetimibe, have proven effective in improving clinical outcomes. This document is focused on the clinical management of hypercholesterolemia and has been conceived by 16 Italian medical associations with the support of the Italian National Institute of Health. The authors have considered with particular attention the role of hypercholesterolemia in the genesis of atherosclerotic cardiovascular disease. Besides, the implications of high cholesterol levels in the definition of the individual cardiovascular risk profile have been carefully analyzed, while all available therapeutic options for blood cholesterol reduction and cardiovascular risk mitigation have been considered. Finally, this document outlines the diagnostic and therapeutic pathways for the clinical management of patients with hypercholesterolemia.

  8. ANMCO/ISS/AMD/ANCE/ARCA/FADOI/GICR-IACPR/SICI-GISE/SIBioC/SIC/SICOA/SID/SIF/SIMEU/SIMG/SIMI/SISA Joint Consensus Document on cholesterol and cardiovascular risk: diagnostic–therapeutic pathway in Italy

    Science.gov (United States)

    Colivicchi, Furio; Ricciardi, Gualtiero; Giampaoli, Simona; Maggioni, Aldo Pietro; Averna, Maurizio; Graziani, Maria Stella; Ceriotti, Ferruccio; Mugelli, Alessandro; Rossi, Francesco; Medea, Gerardo; Parretti, Damiano; Abrignani, Maurizio Giuseppe; Arca, Marcello; Perrone Filardi, Pasquale; Perticone, Francesco; Catapano, Alberico; Griffo, Raffaele; Nardi, Federico; Riccio, Carmine; Di Lenarda, Andrea; Scherillo, Marino; Musacchio, Nicoletta; Panno, Antonio Vittorio; Zito, Giovanni Battista; Campanini, Mauro; Bolognese, Leonardo; Faggiano, Pompilio Massimo; Musumeci, Giuseppe; Pusineri, Enrico; Ciaccio, Marcello; Bonora, Enzo; Cantelli Forti, Giorgio; Ruggieri, Maria Pia; Cricelli, Claudio; Romeo, Francesco; Ferrari, Roberto; Maseri, Attilio

    2017-01-01

    Abstract Atherosclerotic cardiovascular disease still represents the leading cause of death in Western countries. A wealth of scientific evidence demonstrates that increased blood cholesterol levels have a major impact on the outbreak and progression of atherosclerotic plaques. Moreover, several cholesterol-lowering pharmacological agents, including statins and ezetimibe, have proved effective in improving clinical outcomes. This document focuses on the clinical management of hypercholesterolaemia and has been conceived by 16 Italian medical associations with the support of the Italian National Institute of Health. The authors discuss in detail the role of hypercholesterolaemia in the genesis of atherosclerotic cardiovascular disease. In addition, the implications for high cholesterol levels in the definition of the individual cardiovascular risk profile have been carefully analysed, while all available therapeutic options for blood cholesterol reduction and cardiovascular risk mitigation have been explored. Finally, this document outlines the diagnostic and therapeutic pathways for the clinical management of patients with hypercholesterolaemia. PMID:28751833

  9. ANMCO/ISS/AMD/ANCE/ARCA/FADOI/GICR-IACPR/SICI-GISE/SIBioC/SIC/SICOA/SID/SIF/SIMEU/SIMG/SIMI/SISA Joint Consensus Document on cholesterol and cardiovascular risk: diagnostic-therapeutic pathway in Italy.

    Science.gov (United States)

    Gulizia, Michele Massimo; Colivicchi, Furio; Ricciardi, Gualtiero; Giampaoli, Simona; Maggioni, Aldo Pietro; Averna, Maurizio; Graziani, Maria Stella; Ceriotti, Ferruccio; Mugelli, Alessandro; Rossi, Francesco; Medea, Gerardo; Parretti, Damiano; Abrignani, Maurizio Giuseppe; Arca, Marcello; Perrone Filardi, Pasquale; Perticone, Francesco; Catapano, Alberico; Griffo, Raffaele; Nardi, Federico; Riccio, Carmine; Di Lenarda, Andrea; Scherillo, Marino; Musacchio, Nicoletta; Panno, Antonio Vittorio; Zito, Giovanni Battista; Campanini, Mauro; Bolognese, Leonardo; Faggiano, Pompilio Massimo; Musumeci, Giuseppe; Pusineri, Enrico; Ciaccio, Marcello; Bonora, Enzo; Cantelli Forti, Giorgio; Ruggieri, Maria Pia; Cricelli, Claudio; Romeo, Francesco; Ferrari, Roberto; Maseri, Attilio

    2017-05-01

    Atherosclerotic cardiovascular disease still represents the leading cause of death in Western countries. A wealth of scientific evidence demonstrates that increased blood cholesterol levels have a major impact on the outbreak and progression of atherosclerotic plaques. Moreover, several cholesterol-lowering pharmacological agents, including statins and ezetimibe, have proved effective in improving clinical outcomes. This document focuses on the clinical management of hypercholesterolaemia and has been conceived by 16 Italian medical associations with the support of the Italian National Institute of Health. The authors discuss in detail the role of hypercholesterolaemia in the genesis of atherosclerotic cardiovascular disease. In addition, the implications for high cholesterol levels in the definition of the individual cardiovascular risk profile have been carefully analysed, while all available therapeutic options for blood cholesterol reduction and cardiovascular risk mitigation have been explored. Finally, this document outlines the diagnostic and therapeutic pathways for the clinical management of patients with hypercholesterolaemia.

  10. Assessment of effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    V. V. Neroev

    2014-07-01

    Full Text Available Purpose: To evaluate the effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular agerelatedmacular degeneration (AMD.Methods: 35 patients with wet AMD undergone intravitreal 0.5 mg ranibizumab injection. Color Doppler Imaging (CDI and dopplerographywere used to measure hemodynamic parameters including the peak systolic velocity (Vsyst, cm / s, end-diastolic velocity (V diast, cm / s, and resistance index (RI of blood flow in the central retinal artery (CRA, the short posterior ciliary arteries (PCA, and the ophthalmic artery (OA. All patients were examined before and after injection on day 1‑7 and 30 day during the 3‑month follow up period.Results: Before intravitreal injection Vsyst was decreased in short PCA (p<0.05, RI in CRA and in short PCA significantly increased in comparison with normal index in same vessels. The peak systolic velocity in OA, in CRA and in short PCA was not significantly changed. After second injection resistance index in CRA and in short PCA was normalized.Conclusion: There was not impairment of ocular blood flow in retinal and choroidal after monthly intravitreal injection of ranibizumab during the 3‑month follow up period.

  11. Assessment of effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    V. V. Neroev

    2013-01-01

    Full Text Available Purpose: To evaluate the effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular agerelatedmacular degeneration (AMD.Methods: 35 patients with wet AMD undergone intravitreal 0.5 mg ranibizumab injection. Color Doppler Imaging (CDI and dopplerographywere used to measure hemodynamic parameters including the peak systolic velocity (Vsyst, cm / s, end-diastolic velocity (V diast, cm / s, and resistance index (RI of blood flow in the central retinal artery (CRA, the short posterior ciliary arteries (PCA, and the ophthalmic artery (OA. All patients were examined before and after injection on day 1‑7 and 30 day during the 3‑month follow up period.Results: Before intravitreal injection Vsyst was decreased in short PCA (p<0.05, RI in CRA and in short PCA significantly increased in comparison with normal index in same vessels. The peak systolic velocity in OA, in CRA and in short PCA was not significantly changed. After second injection resistance index in CRA and in short PCA was normalized.Conclusion: There was not impairment of ocular blood flow in retinal and choroidal after monthly intravitreal injection of ranibizumab during the 3‑month follow up period.

  12. Health resource utilization and the economic burden of patients with wet age-related macular degeneration in Thailand

    Directory of Open Access Journals (Sweden)

    Piyameth Dilokthornsakul

    2014-02-01

    Full Text Available AIM:To determine healthcare resource utilization and the economic burden associated with wet age-related macular degeneration (AMD in ThailandMETHODS:This study included patients diagnosed with wet AMD that were 60 years old or older, and had best corrected visual acuity (BCVA measured at least two times during the follow-up period. We excluded patients having other eye diseases. Two separate sub-studies were conducted. The first sub-study was a retrospective cohort study; electronic medical charts were reviewed to estimate the direct medical costs. The second sub-study was a cross-sectional survey estimating the direct non-medical costs based on face-to-face interviews using a structured questionnaire. For the first sub-study, direct medical costs, including the cost of drugs, laboratory, procedures, and other treatments were obtained. For the second sub-study, direct non-medical costs, e.g. transportation, food, accessories, home renovation, and caregiver costs, were obtained from face-to-face interviews with patients and/or caregivers.RESULTS: For the first sub-study, sixty-four medical records were reviewed. The annual average number of medical visits was 11.1±6.0. The average direct medical costs were $3 604±4 530 per year. No statistically-significant differences of the average direct medical costs among the BCVA groups were detected (P=0.98. Drug costs accounted for 77% of total direct medical costs. For direct non-medical costs, 67 patients were included. Forty-eight patients (71.6% required the accompaniment of a person during the out-patient visit. Seventeen patients (25.4% required a caregiver at home. The average direct non-medical cost was $2 927±6 560 per year. There were no statistically-significant differences in the average costs among the BCVA groups (P=0.74. Care-giver cost accounted for 87% of direct non-medical costs.CONCLUSION: Our study indicates that wet AMD is associated with a substantial economic burden, especially

  13. Epidemiology and quality of life of patients with age-related macular degeneration.

    Science.gov (United States)

    Synek, Svatopluk; Vojniković, Bozo; Pahor, Dana

    2010-04-01

    It is well known that age-related macular degeneration (AMD), besides glaucoma and diabetic retinopathy, represents a major cause of low vision and blindness throughout the world. In this study, specific causal factors of AMD are analyzed, emphasizing the causal role and effects of sunlight, no matter which part of its spectrum, in a longer exposition through life. The accent is also put on the influence of lifestyle as well as vitamin and antioxidants supplementation in development or prevention of AMD.

  14. A pharmacogenetics study to predict outcome in patients receiving anti-VEGF therapy in age related macular degeneration

    Directory of Open Access Journals (Sweden)

    Kitchens JW

    2013-10-01

    Full Text Available John W Kitchens,1,* Nawal Kassem,2,* William Wood,1 Thomas W Stone,1 Rick Isernhagen,1 Edward Wood,1 Brad A Hancock,2 Milan Radovich,2,4 Josh Waymire,4 Lang Li,3,4 Bryan P Schneider2,41Ophthalmology, Retina Associates of Kentucky, Lexington, KY; 2Department of Medicine, Divisions of Hematology/Oncology, 3Biostatistics, 4Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA *These authors contributed equallyPurpose: To ascertain whether single nucleotide polymorphisms (SNPs in the Vascular Endothelial Growth factor (VEGFA, Complement Factor H (CFH, and LOC387715 genes could predict outcome to anti-VEGF therapy for patients with age related macular degeneration (AMD.Methods: Patients with “wet” AMD were identified by chart review. Baseline optical coherence tomography (OCT and visual acuity (VA data, and at least 6 months of clinical follow up after 3 initial monthly injections of bevacizumab or ranibizumab were required for inclusion. Based on OCT and VA, patients were categorized into two possible clinical outcomes: (a responders and (b non-responders. DNA was extracted from saliva and genotyped for candidate SNPs in the VEGFA, LOC387715, and CFH genes. Clinical outcomes were statistically compared to patient genotypes.Results: 101 patients were recruited, and one eye from each patient was included in the analysis. 97% of samples were successfully genotyped for all SNPs. We found a statistically significant association between the LOC387715 A69S TT genotype and outcome based on OCT.Conclusion: Genetic variation may be associated with outcome in patients receiving anti-VEGF therapy.Keywords: age related macular degeneration, ARMS2, bevacizumab, complement factor H (CFH, LOC387715, ranibizumab, single nucleotide polymorphisms, vascular endothelial growth factor

  15. Bevacizumab vs ranibizumab for neovascular age-related macular degeneration in Chinese patients

    Directory of Open Access Journals (Sweden)

    Zhe-Li Liu

    2013-04-01

    Full Text Available AIM:To compare the clinical efficacy of intravitreal injections of bevacizumab and ranibizumab for treating Chinese patients with neovascular age-related macular degeneration (AMD. METHODS: Among 60 Chinese patients with exudative AMD (60 eyes, 28 received intravitreal bevacizumab injections (1.25mg and 32 received intravitreal ranibizumab injections (0.5mg, once a month for 3 months and were followed for a total of 6 months. Monthly optical coherence tomography (OCT was used to determine whether the patients received additional treatments during the follow-up. We compared the baseline and 6-month follow-up values of mean best-corrected visual acuity (BCVA and central retinal thickness (CRT in both groups of patients. We also compared the occurrence of adverse events. RESULTS:At the 6-month follow-up, the mean BCVA (logMAR of the bevacizumab and ranibizumab treatment groups improved from the baseline measurements of 0.72±0.23 and 0.73±0.22 to 0.47±0.14 and 0.45±0.20, respectively (P<0.05 for both groups. However, the change was not significantly different between the two groups. As evaluated by OCT, CRT decreased from 366.71±34.72μm and 352±36.9μm at baseline to 250.86±41.51μm and 243.22±41.38μm in the bevacizumab and ranibizumab groups, respectively (P<0.05 for both groups. However, the change was not significantly different between the two groups. There were no severe local adverse reactions or systemic adverse events. CONCLUSION:Intravitreal bevacizumab and ranibizumab have equivalent effects on BCVA and CRT and appeare safe over the short-term.

  16. Computational assessment of effective dose and patient specific doses for kilovoltage stereotactic radiosurgery of wet age-related macular degeneration

    Science.gov (United States)

    Hanlon, Justin Mitchell

    Age-related macular degeneration (AMD) is a leading cause of vision loss and a major health problem for people over the age of 50 in industrialized nations. The current standard of care, ranibizumab, is used to help slow and in some cases stabilize the process of AMD, but requires frequent invasive injections into the eye. Interest continues for stereotactic radiosurgery (SRS), an option that provides a non-invasive treatment for the wet form of AMD, through the development of the IRay(TM) (Oraya Therapeutics, Inc., Newark, CA). The goal of this modality is to destroy choroidal neovascularization beneath the pigment epithelium via delivery of three 100 kVp photon beams entering through the sclera and overlapping on the macula delivering up to 24 Gy of therapeutic dose over a span of approximately 5 minutes. The divergent x-ray beams targeting the fovea are robotically positioned and the eye is gently immobilized by a suction-enabled contact lens. Device development requires assessment of patient effective dose, reference patient mean absorbed doses to radiosensitive tissues, and patient specific doses to the lens and optic nerve. A series of head phantoms, including both reference and patient specific, was derived from CT data and employed in conjunction with the MCNPX 2.5.0 radiation transport code to simulate treatment and evaluate absorbed doses to potential tissues-at-risk. The reference phantoms were used to evaluate effective dose and mean absorbed doses to several radiosensitive tissues. The optic nerve was modeled with changeable positions based on individual patient variability seen in a review of head CT scans gathered. Patient specific phantoms were used to determine the effect of varying anatomy and gaze. The results showed that absorbed doses to the non-targeted tissues were below the threshold levels for serious complications; specifically the development of radiogenic cataracts and radiation induced optic neuropathy (RON). The effective dose

  17. [Progression of treatment and researches in dry age related macular degeneration].

    Science.gov (United States)

    Zhang, Kaiyan; Tang, Shibo

    2015-03-01

    Age related macular degeneration (AMD) is the leading cause of blindness and visual disability among old patients in Europe and North America. AMD has been divided into two broad clinical categories depending on whether there is a presence of abnormal neovascularization: neovascular (exudative or wet) AMD and dry (or geographic atrophic) AMD. VEGF has been understood as a pathogenesis of wet AMD which allows us to get breakthroughs in treatment. While the progression of dry AMD treatment is very slow because the lack of pathogenesis, no acute loss of vision, and without appropriate standards for treatment. This review tries to introduce about the recent researches and progressions for dry AMD treatment.

  18. Comparison of visual acuity in macular degeneration patients measured with snellen and early treatment diabetic retinopathy study charts.

    Science.gov (United States)

    Falkenstein, Iryna A; Cochran, Denine E; Azen, Stanley P; Dustin, Laurie; Tammewar, Ajay M; Kozak, Igor; Freeman, William R

    2008-02-01

    To compare the measurements of visual acuity (VA) results measured with Snellen and Early Treatment Diabetic Retinopathy Study (ETDRS) charts in eyes with and without age-related macular degeneration (AMD). Cross-sectional study. One hundred four participants (190 eyes) selected from a university retina practice; 80 participants (142 eyes) had some degree of AMD. Visual acuity was measured in each patient using standard procedure with both Snellen and ETDRS charts in random order. Statistical analysis of the results was performed. Difference in VA measured by both charts in logarithm of minimal angle of resolution (logMAR) notations. Overall, the mean Snellen VA was 0.78 logMAR (= 20/120), and the mean ETDRS VA in the same eye was 0.54 logMAR (= 20/70; P20/30). On average, 20/200 on Snellen was 20/95 on ETDRS (>3 lines difference), and 20/30 on Snellen was 20/25 on ETDRS (Snellen and ETDRS charts, and it was more pronounced in the group with poor vision. The ETDRS measurements yielded better VA, particularly in participants with vision Snellen charts) with outcomes from clinical trials (which typically measure VA using ETDRS charts).

  19. CHANGES IN VISION-RELATED QUALITY OF LIFE FOLLOWING LUTEIN SUPPLEMENTS IN EARLY AGE-RELATED MACULAR DEGENERATION PATIENTS%叶黄素干预对早期老年黄斑变性患者生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    马乐; 闫少芳; 黄旸木; 窦宏亮; 林晓明

    2012-01-01

    目的 研究叶黄素干预对早期老年黄斑变性(aged-related macular degeneration,AMD)患者生活质量的影响.方法 采用随机双盲空白对照法,将108名早期AMD患者随机分为叶黄素低剂量组、叶黄素高剂量组、叶黄素/玉米黄素混合干预组和安慰剂对照组,连续服药48 w.于服药0 w及48 w,进行一般情况、膳食营养摄入状况、最佳矫正视力和视功能相关生存质量测定.结果 早期AMD患者整体健康状况、总体视力及近距离活动能力显著下降,且总体视力、近距离活动能力分别与矫正视力呈显著正相关.服用叶黄素后最佳矫正视力和视力得分较用药前呈上升趋势;叶黄素/玉米黄素混合用药组近距离活动能力得分较服药前显著提高(P<0.05).基线视力、活动受限程度分别与其在用药期间的改变呈负相关.结论 叶黄素干预可提高早期AMD患者视力水平,并显著改善其近距离活动能力,提示叶黄素对早期AMD患者生活质量具有一定的保护作用.%Objectives To investigate the changes in vision-related quality of life following lutein supplements in patients with early age-related macular degeneration (AMD). Method One hudred and eight early AMD patients were randomly divided into low dosage lutein group, high dosage lutein group, lutein/zeaxanthin group, and placebo group. Patients took lutein and lutein/zeaxanthin compound supplements for 48 w. The levels of general characteristics, dietary intakes, letters of best corrected visual acuity and vision-related quality of life were measured at week 0 and 48. Results The general health, general vision acuity, and near activities of early AMD patients declined significantly. The best corrected visual acuity had significantly positive relationship with general vision acuity and near activities. The best corrected visual acuity and general vision acuity were improved in lutein supplementation groups, whereas significant increase of

  20. Two-year outcomes of pro re nata ranibizumab monotherapy for exudative age-related macular degeneration in Japanese patients

    Directory of Open Access Journals (Sweden)

    Yamamoto A

    2013-04-01

    Full Text Available Akiko Yamamoto,1 Annabelle A Okada,1 Atsuhiko Sugitani,1,2 Daisuke Kunita,1 Tosho Rii,1 Reiji Yokota1 1Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology, Kugayama Hospital, Tokyo, Japan Purpose: To describe outcomes of intravitreal ranibizumab using a pro re nata regimen for treatment-naive exudative age-related macular degeneration (AMD, in Japanese patients over the first 2 years. Methods: Clinical records were retrospectively reviewed of 48 eyes of 48 patients with treatment-naive exudative AMD who underwent intravitreal ranibizumab therapy. After three monthly injections (induction, patients were examined monthly, and subsequent injections were performed as needed (pro re nata for any residual activity, by fundus biomicroscopy and imaging studies, regardless of severity. Results: Twenty-nine (60% of the patients were men, and 19 (40% were women; the mean age was 76.1 years. Of the 48 eyes evaluated, 17 (35% had findings consistent with polypoidal choroidal vasculopathy, and five (10% with retinal angiomatous proliferation. A mean of 6.0 ranibizumab injections were given in the first year, 3.5 in the second year, and 9.5 over the 2-year period. The best-corrected visual acuity (logarithm of minimum angle of resolution improved significantly, from 0.35 at baseline to 0.21 at 12 months (P < 0.01, and remained stable at 0.21 at 24 months (P < 0.01. The mean central macular thickness decreased significantly, from 355.4 µm at baseline to 237.9 µm at 12 months (P < 0.01 and 247.7 µm at 24 months (P < 0.01. Conclusion: Improved visual acuity and decreased central macular thickness were observed and maintained over a 2-year period, in a Japanese population receiving 3 monthly induction injections followed by a pro re nata regimen of ranibizumab for exudative AMD. Keywords: optical coherence tomography, polypoidal choroidal vasculopathy, retinal angiomatous proliferation

  1. 富饶之地AMD Richland APU解读

    Institute of Scientific and Technical Information of China (English)

    RIC

    2013-01-01

    AMD于近日发布了旗下的第三代APU产品,代号为“Richland”的新APU。在AMD官方宣传中,首发用于移动版本的新的APU性能更好、频率更高,功耗表现和上代产品基本相当,是笔记本电脑产品的最为合适的选择。除了移动产品外,业内还流出了AMD新桌面版APU的发布计划。那么这些消息都有哪些值得关注的地方呢?本文就为你进行详细的解读吧!

  2. 富饶之地AMD Richland APU解读

    Institute of Scientific and Technical Information of China (English)

    RIC

    2013-01-01

      AMD于近日发布了旗下的第三代APU产品,代号为“Richland”的新APU。在AMD官方宣传中,首发用于移动版本的新的APU性能更好、频率更高,功耗表现和上代产品基本相当,是笔记本电脑产品的最为合适的选择。除了移动产品外,业内还流出了AMD新桌面版APU的发布计划。那么这些消息都有哪些值得关注的地方呢?本文就为你进行详细的解读吧!

  3. Relationship between Oxidative Stress, Circadian Rhythms, and AMD

    Science.gov (United States)

    Fanjul-Moles, María Luisa; López-Riquelme, Germán Octavio

    2016-01-01

    This work reviews concepts regarding oxidative stress and the mechanisms by which endogenous and exogenous factors produce reactive oxygen species (ROS). It also surveys the relationships between oxidative stress, circadian rhythms, and retinal damage in humans, particularly those related to light and photodamage. In the first section, the production of ROS by different cell organelles and biomolecules and the antioxidant mechanisms that antagonize this damage are reviewed. The second section includes a brief review of circadian clocks and their relationship with the cellular redox state. In the third part of this work, the relationship between retinal damage and ROS is described. The last part of this work focuses on retinal degenerative pathology, age-related macular degeneration, and the relationships between this pathology, ROS, and light. Finally, the possible interactions between the retinal pigment epithelium (RPE), circadian rhythms, and this pathology are discussed. PMID:26885250

  4. Hardware Virtualization Support In INTEL, AMD And IBM Power Processors

    CERN Document Server

    Biswas, Kamanashis

    2009-01-01

    At present, the mostly used and developed mechanism is hardware virtualization which provides a common platform to run multiple operating systems and applications in independent partitions. More precisely, it is all about resource virtualization as the term hardware virtualization is emphasized. In this paper, the aim is to find out the advantages and limitations of current virtualization techniques, analyze their cost and performance and also depict which forthcoming hardware virtualization techniques will able to provide efficient solutions for multiprocessor operating systems. This is done by making a methodical literature survey and statistical analysis of the benchmark reports provided by SPEC (Standard Performance Evaluation Corporation) and TPC (Transaction processing Performance Council). Finally, this paper presents the current aspects of hardware virtualization which will help the IT managers of the large organizations to take effective decision while choosing server with virtualization support. Aga...

  5. Fixation stability and implication for multifocal electroretinography in patients with neovascular age-related macular degeneration after anti-VEGF treatment

    DEFF Research Database (Denmark)

    Pedersen, Karen Bjerg; Sjølie, Anne Katrin; Vestergaard, Anders Højslet;

    2016-01-01

    was at baseline, 3 and 6 months negatively correlated to visual acuity (VA) (rbaseline = −0.65, r3 months = −0.60, and r6 months = −0.66 respectively, p ... reduced due to poor fixation as a large number of patients may use a fixation area of more than 5 deg2. Fixation monitoring during recording as well as interpretation of results should be performed with care, especially in patients with poor visual acuity.......Purpose: To quantify fixation stability in patients with neovascular age-related macular degeneration (nAMD) at baseline, 3 and 6 months after anti-vascular endothelial growth factor (anti-VEGF) treatment and furthermore asses the implications of an unsteady fixation for multifocal...

  6. An in silico model of retinal cholesterol dynamics (RCD model): insights into the pathophysiology of dry AMD[S

    Science.gov (United States)

    Zekavat, Seyedeh Maryam; Lu, James; Maugeais, Cyrille; Mazer, Norman A.

    2017-01-01

    We developed an in silico mathematical model of retinal cholesterol (Ch) dynamics (RCD) to quantify the physiological rate of Ch turnover in the rod outer segment (ROS), the lipoprotein transport mechanisms by which Ch enters and leaves the outer retina, and the rates of drusen growth and macrophage-mediated clearance in dry age-related macular degeneration. Based on existing experimental data and mechanistic hypotheses, we estimated the Ch turnover rate in the ROS to be 1–6 pg/mm2/min, dependent on the rate of Ch recycling in the outer retina, and found comparable rates for LDL receptor-mediated endocytosis of Ch by the retinal pigment epithelium (RPE), ABCA1-mediated Ch transport from the RPE to the outer retina, ABCA1-mediated Ch efflux from the RPE to the choroid, and the secretion of 70 nm ApoB-Ch particles from the RPE. The drusen growth rate is predicted to increase from 0.7 to 4.2 μm/year in proportion to the flux of ApoB-Ch particles. The rapid regression of drusen may be explained by macrophage-mediated clearance if the macrophage density reaches ∼3,500 cells/mm2. The RCD model quantifies retinal Ch dynamics and suggests that retinal Ch turnover and recycling, ApoB-Ch particle efflux, and macrophage-mediated clearance may explain the dynamics of drusen growth and regression. PMID:28442497

  7. The design and implementation of a study to investigate the effectiveness of community vs hospital eye service follow-up for patients with neovascular age-related macular degeneration with quiescent disease.

    Science.gov (United States)

    Taylor, J; Scott, L J; Rogers, C A; Muldrew, A; O'Reilly, D; Wordsworth, S; Mills, N; Hogg, R; Violato, M; Harding, S P; Peto, T; Townsend, D; Chakravarthy, U; Reeves, B C

    2016-01-01

    IntroductionStandard treatment for neovascular age-related macular degeneration (nAMD) is intravitreal injections of anti-VEGF drugs. Following multiple injections, nAMD lesions often become quiescent but there is a high risk of reactivation, and regular review by hospital ophthalmologists is the norm. The present trial examines the feasibility of community optometrists making lesion reactivation decisions.MethodsThe Effectiveness of Community vs Hospital Eye Service (ECHoES) trial is a virtual trial; lesion reactivation decisions were made about vignettes that comprised clinical data, colour fundus photographs, and optical coherence tomograms displayed on a web-based platform. Participants were either hospital ophthalmologists or community optometrists. All participants were provided with webinar training on the disease, its management, and assessment of the retinal imaging outputs. In a balanced design, 96 participants each assessed 42 vignettes; a total of 288 vignettes were assessed seven times by each professional group.The primary outcome is a participant's judgement of lesion reactivation compared with a reference standard. Secondary outcomes are the frequency of sight threatening errors; judgements about specific lesion components; participant-rated confidence in their decisions about the primary outcome; cost effectiveness of follow-up by optometrists rather than ophthalmologists.DiscussionThis trial addresses an important question for the NHS, namely whether, with appropriate training, community optometrists can make retreatment decisions for patients with nAMD to the same standard as hospital ophthalmologists. The trial employed a novel approach as participation was entirely through a web-based application; the trial required very few resources compared with those that would have been needed for a conventional randomised controlled clinical trial.

  8. The macular degeneration and aging study: Design and research protocol of a randomized trial for a psychosocial intervention with macular degeneration patients.

    Science.gov (United States)

    Sörensen, Silvia; White, Katherine; Mak, Wingyun; Zanibbi, Katherine; Tang, Wan; O'Hearn, Amanda; Hegel, Mark T

    2015-05-01

    Age-related Macular Degeneration (AMD) is the leading cause of irreversible and predictable blindness among older adults with serious physical and mental health consequences. Visual impairment is associated with negative future outlook and depression and has serious consequences for older adults' quality of life and, by way of depression, on long-term survival. Psychosocial interventions have the potential to alleviate and prevent depression symptoms among older AMD patients. We describe the protocol of the Macular Degeneration and Aging Study, a randomized clinical trial of a psychosocial Preventive Problem-Solving Intervention. The intervention is aimed at enhancing well-being and future planning among older adults with macular degeneration by increasing preparation for future care. Adequate randomization and therapeutic fidelity were achieved. Current retention rates were acceptable, given the vulnerability of the population. Acceptability (adherence and satisfaction) was high. Given the high public health significance and impact on quality of life among older adults with vision loss, this protocol contributes a valid test of a promising intervention for maintaining mental and physical health in this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Clinical experience with fixed bimonthly aflibercept dosing in treatment-experienced patients with neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Khanani AM

    2015-07-01

    Full Text Available Arshad M Khanani Sierra Eye Associates, Reno, NV, USA Purpose: To evaluate the durability of fixed bimonthly dosing of intravitreal aflibercept for neovascular age-related macular degeneration.Methods: Records of 16 patients were retrospectively reviewed. Patients received three initial 2.0 mg monthly doses of aflibercept then 8-weekly doses according to the product label. Best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study [ETDRS] letters, central macular thickness, fluid on optical coherence tomography, and pigment epithelial detachment (PED were measured.Results: Prior to starting aflibercept, 13 patients had subretinal fluid (SRF, five had intraretinal fluid (IRF, four had PED, and baseline visual acuity (VA was 62 approximate ETDRS letters. Following the monthly dosing, seven patients had no improvement or decreased VA, ten patients still had SRF/IRF, and PED had worsened in one patient. At Visit 4, an average of 6.8 weeks after Visit 3, VA had decreased in seven patients, SRF/IRF had increased in 12 patients, and PED had returned in all patients who initially responded. Based on the presence of fluid after the initial monthly injections, 12 patients could not be extended to fixed bimonthly dosing.Conclusion: This case series adds to the growing body of evidence on the need for flexible dosing schedules for the personalized treatment of neovascular age-related macular degeneration. Keywords: age-related macular degeneration, AMD, bimonthly, regimen, aflibercept, case studies, retinal fluid

  10. Prevalence and progression of visual impairment in patients newly diagnosed with clinical type 2 diabetes: a 6-year follow up study.

    Science.gov (United States)

    de Fine Olivarius, Niels; Siersma, Volkert; Almind, Gitte Juul; Nielsen, Niels Vesti

    2011-02-04

    Many diabetic patients fear visual loss as the worst consequence of diabetes. In most studies the main eye pathology is assigned as the cause of visual impairment. This study analysed a broad range of possible ocular and non-ocular predictors of visual impairment prospectively in patients newly diagnosed with clinical type 2 diabetes. Data were from a population-based cohort of 1,241 persons newly diagnosed with clinical, often symptomatic type 2 diabetes aged ≥ 40 years. After 6 years, 807 patients were followed up. Standard eye examinations were done by practising ophthalmologists. At diabetes diagnosis median age was 65.5 years. Over 6 years, the prevalence of blindness (visual acuity of best seeing eye ≤ 0.1) rose from 0.9% (11/1,241) to 2.4% (19/807) and the prevalence of moderate visual impairment (> 0.1; < 0.5) rose from 5.4% (67/1,241) to 6.7% (54/807). The incidence (95% confidence interval) of blindness was 40.2 (25.3-63.8) per 10,000 patient-years. Baseline predictors of level of visual acuity (age, age-related macular degeneration (AMD), cataract, living alone, low self-rated health, and sedentary life-style) and speed of continued visual loss (age, AMD, diabetic retinopathy (DR), cataract, living alone, and high fasting triglycerides) were identified. In a comprehensive assessment of predictors of visual impairment, even in a health care system allowing self-referral to free eye examinations, treatable eye pathologies such as DR and cataract emerge together with age as the most notable predictors of continued visual loss after diabetes diagnosis. Our results underline the importance of eliminating barriers to efficient eye care by increasing patients' and primary care practitioners' awareness of the necessity of regular eye examinations and timely surgical treatment.

  11. Macular Degeneration Partnership

    Science.gov (United States)

    ... Original + Font Size – Home About AMD Dry AMD Wet AMD Experience AMD Living with AMD Take Charge Improve ... Newsletter Warm Line Amsler Grid Research Dry AMD Wet AMD Other AMD Research News AMD Update AMD Update ...

  12. Improving patient outcomes: role of the primary care optometrist in the early diagnosis and management of age-related macular degeneration

    OpenAIRE

    Liu L.; Swanson M

    2013-01-01

    Lei Liu, Mark SwansonSchool of Optometry, University of Alabama at Birmingham, Birmingham, AL, USAAbstract: Not long ago, the management of age-related macular degeneration (AMD) was confined to rehabilitating whatever vision had not been damaged by the disease. The recent successes of the anti-vascular endothelial growth factor agents and the antioxidant clinical trials have revolutionized AMD treatment. For the first time, there is realistic hope that the progression of AMD can be slowed do...

  13. Switching to aflibercept among patients with treatment-resistant neovascular age-related macular degeneration: a systematic review with meta-analysis

    Science.gov (United States)

    Spooner, Kimberly; Hong, Thomas; Wijeyakumar, Wijeyanthy; Chang, Andrew A

    2017-01-01

    Purpose To systematically review anatomical and functional outcomes subsequent to switching from bevacizumab/ranibizumab to aflibercept monotherapy in patients with treatment-resistant neovascular age-related macular degeneration (nAMD). Design Systematic review and meta-analysis. Methods Medline, PubMed, Embase, and Cochrane databases were searched up to July 2016 for available scientific literature which met inclusion criteria. Eligible studies reported visual and anatomical outcomes with at least 6 months of follow-up among patients with nAMD and persistent or resistant exudative fluid despite previous anti-vascular endothelial growth factor (VEGF) therapy (bevacizumab and/or ranibizumab) and were switched to aflibercept monotherapy. Mean changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were pooled using random-effects models with 95% confidence intervals (CIs). Results Of 82 papers reviewed, 28 studies met inclusion criteria of this review. Pooled results showed a small mean improvement in BCVA at 6 and 12 months following switching (1.11 letters, 95% CI −0.25 to 2.46, P=0.17 and 0.63 letters, 95% CI −0.26 to 1.52, P=0.17, respectively). There was a significant improvement in mean CRT following switching (−61.90 µm, 95% CI −77.10 to −46.80, P<0.001 and −50.00 µm, 95% CI −63.20 to −36.80, P<0.001 at 6 and 12 months, respectively). Conclusion Pooled analysis demonstrated significantly improved anatomical outcomes; however, visual function remained stable, having a comparable effect to other anti-VEGF agents in preservation of vision. These patients had poorly responsive chronic disease with limited potential for visual recovery. Switching to aflibercept with frequent monitoring may be a suitable option for patients who have developed treatment resistance.

  14. Vision-related quality of life and related factors in patients with age-related macular degeneration%年龄相关性黄斑变性患者视觉相关生存质量变化及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    刘晓静; 邹海东; 吴星伟

    2012-01-01

    目的 调查年龄相关性黄斑变性(AMD)患者视觉相关生存质量(VRQoL)的变化,并分析相关的影响因素.方法 收集上海交通大学附属第一人民医院眼科门诊就诊的AMD患者(AMD组)和非AMD患者(对照组)各88例,采用中文版低视力者生存质量量表(CLVQOL)评估两组患者的VRQoL.计算两组患者CLVQOL总得分以及各维度(远视力、移动和光感维度、调节能力维度、读和精细工作维度、日常生活能力维度)得分,分析其与单眼logMAR视力和双眼平均视力(WMAR)的相关性.结果 AMD组CLVQOL总得分均值为(96.18 ±20.35)分,显著低于对照组的(106.53±12.75)分,两组间比较差异有统计学意义(P<0.01).除日常生活能力维度外,AMD组其他维度的CLVQOL得分均显著低于对照组,差异有统计学意义(P<0.01).AMD组CLVQOL总得分和各维度得分与较佳眼远视力和WMAR相关性均较高,两者相关系数相近.除读和精细工作维度外,较佳眼远视力是影响AMD患者CLVQOL各维度得分和总得分的首要独立因素;WMAR是影响读和精细工作维度得分的首要独立因素.结论 AMD患者VRQoL较低,保存较佳眼视力可能是减少AMD患者VRQoL下降的途径之一.%Objective To investigate the vision-related quality of life ( VRQoL) and related factors in patients with age-related macular degeneration ( AMD). Methods Eighty-eight patients with AMD (AMD group) and 88 patients with non-AMD diseases (control group) diagnosed at Department of Ophthalmology, the First People's Hospital affiliated to Shanghai Jiaotong University were selected, and Chinese version Low Vision Quality of Life Questionnaire ( CLVQOL) was employed to evaluate VRQoL in both groups. The total score of CLVQOL and scores of each scale of CLVQOL ( scale of distant visual acuity, motion and light perception, scale of adjustment ability, scale of reading and fine work and scale of daily living)were calculated, and their correlations with

  15. Limited availability of childhood overweightand obesity treatment programmes in Danish paediatric departments

    DEFF Research Database (Denmark)

    Eg, Marianne; Cortes, Dina; Johansen, Anders

    2016-01-01

    INTRODUCTION: Age-related macular degeneration (AMD) leads to visual impairment that affects visual functioning and thereby the ability to be physically active. We investigated physical activity patterns in patients with AMD. METHODS: Patients with early and late AMD and elderly controls were rec...

  16. Comparative Study of Nifekalant Versus Amiodarone for Shock-Resistant Ventricular Fibrillation in Out-of-Hospital Cardiopulmonary Arrest Patients

    NARCIS (Netherlands)

    M. Amino; K. Yoshioka; T. Opthof; S. Morita; S. Uemura; K. Tamura; T. Fukushima; S. Higami; H. Otsuka; K. Akieda; M. Shima; D. Fujibayashi; T. Hashida; S. Inokuchi; I. Kodama; T. Tanabe

    2010-01-01

    Background: In Japan, intravenous nifekalant ( NIF) was often used for direct current cardioversion-resistant ventricular fibrillation (VF), until the use of intravenous amiodarone (AMD) was approved in 2007. The defibrillatory efficacy of NIF and AMD has thus far not been compared for resuscitation

  17. A level-set method for pathology segmentation in fluorescein angiograms and en face retinal images of patients with age-related macular degeneration

    Science.gov (United States)

    Mohammad, Fatimah; Ansari, Rashid; Shahidi, Mahnaz

    2013-03-01

    The visibility and continuity of the inner segment outer segment (ISOS) junction layer of the photoreceptors on spectral domain optical coherence tomography images is known to be related to visual acuity in patients with age-related macular degeneration (AMD). Automatic detection and segmentation of lesions and pathologies in retinal images is crucial for the screening, diagnosis, and follow-up of patients with retinal diseases. One of the challenges of using the classical level-set algorithms for segmentation involves the placement of the initial contour. Manually defining the contour or randomly placing it in the image may lead to segmentation of erroneous structures. It is important to be able to automatically define the contour by using information provided by image features. We explored a level-set method which is based on the classical Chan-Vese model and which utilizes image feature information for automatic contour placement for the segmentation of pathologies in fluorescein angiograms and en face retinal images of the ISOS layer. This was accomplished by exploiting a priori knowledge of the shape and intensity distribution allowing the use of projection profiles to detect the presence of pathologies that are characterized by intensity differences with surrounding areas in retinal images. We first tested our method by applying it to fluorescein angiograms. We then applied our method to en face retinal images of patients with AMD. The experimental results included demonstrate that the proposed method provided a quick and improved outcome as compared to the classical Chan-Vese method in which the initial contour is randomly placed, thus indicating the potential to provide a more accurate and detailed view of changes in pathologies due to disease progression and treatment.

  18. Patient - patient interaction

    DEFF Research Database (Denmark)

    Birkelund, Regner; Søndergaard Larsen, Lene

    2013-01-01

    Aim:  The aim of this study is to provide an understanding of the significance of hospitalized patients’ interpersonal interaction with fellow patients in an infectious disease ward in a large Danish hospital. Method:  A qualitative approach was selected using participant observation and semi...... subcategories representing significance of patients’ interaction with fellow patients. Results:  The qualitative analysis resulted in two main categories: (i) Caring for fellow patients and (ii) Sharing illness information with fellow patients. Each of the main categories was elucidated through several...... subcategories. Our findings clearly showed that interpersonal interaction with fellow patients was of utmost importance when it came to care and support and when they needed information about their illness. Typically, the interpersonal interaction was experienced as giving and referred to in positive terms...

  19. The stereotypical molecular cascade in neovascular age-related macular degeneration: the role of dynamic reciprocity.

    Science.gov (United States)

    Kent, D

    2015-11-01

    This review summarises our current understanding of the molecular basis of subretinal neovascularisation (SRNV) in age-related macular degeneration (AMD). The term neovascular AMD (NVAMD) is derived from the dominant early clinical features of haemorrhage, fluid, and lipid in the subretinal space (SRS) and the historical role of fluorescein angiography in detecting the presence of NV tissue. However, at the cellular level, SRNV resembles an aberrant but stereotypical tissue repair response that incorporates both an early inflammatory phase and a late fibrotic phase in addition to the neovascular (NV) component that dominates the early clinical presentation. This review will seek not only to highlight the important molecules involved in each of these components but to demonstrate that the development of SRNV has its origins in the earliest events in non-NV AMD pathogenesis. Current evidence suggests that this early-stage pathogenesis is characterised by complement-mediated immune dysregulation, leading to a state of chronic inflammation in the retinal pigment epithelium/Bruch's membrane/choriocapillaris complex. These initial events can be seamlessly and inextricably linked to late-stage development of SRNV in AMD by the process of dynamic reciprocity (DyR), the ongoing bidirectional communication between cells, and their surrounding matrix. Moreover, this correlation between disease onset and eventual outcome is reflected in the temporal and spatial correlation between chronic inflammation, NV, and fibrosis within the reparative microenvironment of the SRS. In summary, the downstream consequences of the earliest dysfunctional molecular events in AMD can result in the late-stage entity we recognize clinically as SRNV and is characterized by a spectrum of predictable, related, and stereotypical processes referred to as DyR.

  20. Patients' tolerance of bimanual lid retraction versus a metal speculum for intravitreal injections

    Directory of Open Access Journals (Sweden)

    Alattas K

    2016-09-01

    Full Text Available Khadijah Alattas Department of Ophthalmology, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Objective: To compare patients’ acceptance of and correlate their pain level for bimanual versus metal speculum fixation in intravitreal injections. Design: Prospective analysis. Participants: Seventy-three eyes of 56 patients. Methods: A questionnaire indicating patients’ discomfort and pain grading immediately after intravitreal injections using either bimanual fixation or metal speculum fixation (Barraquer Wire Speculum. Results: Fifty-six patients who underwent intravitreal injections were enrolled in this study for various conditions. Patients’ overall pain and discomfort were as follows, right eye – bimanual was 0.3 on our grading scale with a standard deviation of 0.54, right eye – metal was 1.6 on our grading scale with a standard deviation of 1.5, left eye – bimanual was 0.41 on our grading scale with a standard deviation of 0.87, and left eye – metal was 1.91 on our grading scale with a standard deviation of 1.14 (P=0.003. Conclusion: Patients who underwent bimanual fixation had a much more comfortable experience with less pain in comparison to patients who underwent metal speculum fixation. Keywords: AMD, diabetic retionpathy, Avastin, eye injection

  1. A case of polypoidal choroidal vasculopathy. Periphery is equally important for such patients

    Directory of Open Access Journals (Sweden)

    Dimitrios A Karagiannis

    2009-06-01

    Full Text Available Dimitrios A Karagiannis, Vasilios Soublis, Artemios Kandarakis1st Ophthalmology Department of Ophthalmiatrio Eye Hospital of Athens, Athens, GreeceBackground: To report a case of peripheral polypoidal choroidal vasculopathy (PCV which was treated successfully.Methods: Interventional case report. Best-corrected visual acuity measurements (BCVA, slit-lamp examination, fundus biomicroscopy, fluorescein angiography (FFA, and indocyanine green angiography (ICGA were performed at baseline examination and during the follow-up period. The patient underwent ICGA-guided argon laser to treat the active polyps. Results: An 82-year-old Caucasian man presented complaining of sudden deterioration of peripheral vision in his left eye (LE. His previous ocular history was associated with advanced age-related macular degeneration (AMD involving both eyes (BE. Fundus examination revealed macular scars in BE and a large hemorrhagic pigment epithelial detachment (PED temporal to the macula in the LE. ICGA revealed active polyps at the margins of the PED. The patient underwent ICGA-guided argon laser to treat the active polyps. Six months post-laser, the patient regained his peripheral vision with resolution of the hemorrhagic PED and remains stable until now, one year after treatment.Conclusions: Appropriate treatment and regular follow-up is important in patients with PCV and peripheral lesions even if central vision is lost.Keywords: argon laser, peripheral vision, polypoidal choroidal vasculopathy

  2. Autophagy regulating kinases as potential therapeutic targets for age-related macular degeneration.

    Science.gov (United States)

    Kaarniranta, Kai; Kauppinen, Anu; Blasiak, Janusz; Salminen, Antero

    2012-11-01

    Age-related macular degeneration (AMD) is the leading cause of central vision loss in the elderly in the developed countries. The number of AMD patients will double during the next decades due to increasing number of aged people. Chronic oxidative stress, inflammation and accumulation of protein-rich deposits both in the retinal pigment epithelium lysosomes and under the retinal pigment epithelium herald the onset of AMD. The disease can be divided into dry and wet AMD forms. The dry form of the disease is more prevalent accounting for up to 90% of all cases. Continued intraocular injections are the current treatment strategy to prevent progression of wet AMD. It is a major challenge to develop new drugs that could prevent or at least ease the symptoms of the increasing population of AMD patients. Since AMD pathology is clearly associated with accumulated protein deposits, the autophagy clearance system might represent a potential future therapeutic target for AMD as is thoroughly discussed here.

  3. Applying theories and interventions from behavioral medicine to understand and reduce visual field variability in patients with vision loss.

    Science.gov (United States)

    Rozanski, Collin; Haythornthwaite, Jennifer A; Dagnelie, Gislin; Bittner, Ava K

    2014-08-01

    Visual field (VF) test results are often unreliable in visually impaired patients, but continue to be a cornerstone of clinical trials and play a vital role in clinical decision making since they are the primary method to determine patients' functional vision loss or progression. Currently, patients are typically asked to perform VF tasks with minimal instruction or consideration of their psychological experience during the test. The gradual loss of vision due to retinal diseases, such as retinitis pigmentosa (RP), age-related macular degeneration (AMD), or glaucoma can contribute to the experience of negative psychosocial states, such as anxiety, stress, and depression, as well as diminished quality of life. We hypothesize that VF testing elicits test performance anxiety and perception of functional losses of vision, which induces distracting negative thoughts that result in increased VF test variability. Resources for processing and responding to vision-related information may be diverted from task-relevant VF stimuli to task-irrelevant ones, such as internal worry and test anxiety, thereby resulting in VF test performance decrements. We present a theoretical model to support the hypothesis that VF variability is linked to patients' negative thoughts during VF testing. This conceptual framework provides a basis for the development of coping strategies and mindfulness-based interventions to be evaluated in future research aimed at improving psychosocial states and VF reliability in visually-impaired patients. It would be highly significant to intervene by modifying negative thoughts during VF testing to reduce test variability in glaucoma patients who are progressively losing vision to a blinding eye disease, but whose vision loss has not been accurately identified and treated early enough due to variable VF results. In clinical trials of potential interventions for RP and non-neovascular AMD, reducing VF variability would effectively increase the precision for

  4. Smoking and Age-Related Macular Degeneration: Review and Update

    Science.gov (United States)

    Velilla, Sara; García-Medina, José Javier; García-Layana, Alfredo; Pons-Vázquez, Sheila; Pinazo-Durán, M. Dolores; Gómez-Ulla, Francisco; Arévalo, J. Fernando; Díaz-Llopis, Manuel; Gallego-Pinazo, Roberto

    2013-01-01

    Age-related macular degeneration (AMD) is one of the main socioeconomical health issues worldwide. AMD has a multifactorial etiology with a variety of risk factors. Smoking is the most important modifiable risk factor for AMD development and progression. The present review summarizes the epidemiological studies evaluating the association between smoking and AMD, the mechanisms through which smoking induces damage to the chorioretinal tissues, and the relevance of advising patients to quit smoking for their visual health. PMID:24368940

  5. Cost effectiveness of treatments for wet age-related macular degeneration

    OpenAIRE

    Mitchell, Paul; Annemans, Lieven; White, Richard; Gallagher, Meghan; Thomas, Simu

    2011-01-01

    Age-related macular degeneration (AMD) is a leading cause of blindness in people aged >= 50 years. Wet AMD in particular has a major impact on patient quality of life and imposes substantial burdens on healthcare systems. This systematic review examined the cost-effectiveness data for current therapeutic options for wet AMD. PubMed and EMBASE databases were searched for all articles reporting original cost-effectiveness analyses of wet AMD treatments. The Centre for Reviews and Dissemination ...

  6. Cost Effectiveness of Treatments for Wet Age-Related Macular Degeneration

    OpenAIRE

    Paul Mitchell; Lieven Annemans; Richard White; Meghan Gallagher; Simu Thomas

    2011-01-01

    Age-related macular degeneration (AMD) is a leading cause of blindness in people aged ≥50 years. Wet AMD in particular has a major impact on patient quality of life and imposes substantial burdens on healthcare systems. This systematic review examined the cost-effectiveness data for current therapeutic options for wet AMD. PubMed and EMBASE databases were searched for all articles reporting original cost-effectiveness analyses of wet AMD treatments. The Centre for Reviews and Dissemination an...

  7. Smoking and Age-Related Macular Degeneration: Review and Update

    Directory of Open Access Journals (Sweden)

    Sara Velilla

    2013-01-01

    Full Text Available Age-related macular degeneration (AMD is one of the main socioeconomical health issues worldwide. AMD has a multifactorial etiology with a variety of risk factors. Smoking is the most important modifiable risk factor for AMD development and progression. The present review summarizes the epidemiological studies evaluating the association between smoking and AMD, the mechanisms through which smoking induces damage to the chorioretinal tissues, and the relevance of advising patients to quit smoking for their visual health.

  8. Comparison of Progression Rate of Retinal Pigment Epithelium Loss in Patients with Neovascular Age-Related Macular Degeneration Treated with Ranibizumab and Aflibercept

    Directory of Open Access Journals (Sweden)

    Juliana Wons

    2017-01-01

    Full Text Available Purpose. Retinal pigment epithelium (RPE loss in neovascular age-related macular degeneration (nAMD seem to have a linear progression but might be influenced by the treatment. The purpose of the study is the comparison of RPE loss over three years in patients treated with intravitreal ranibizumab to patients who were switched to aflibercept. Methods. A retrospective analysis with 96 eyes switched to aflibercept was conducted. The progression rate of RPE loss was evaluated in patients who showed atrophy one year prior to switch (n=17 or on switch date (n=19. The RPE loss was evaluated by spectral domain optical coherence tomography (SD-OCT. Further, 22 eyes from patients treated with ranibizumab were compared. Results. The median yearly progression of RPE loss after square root transformation showed no significant difference in the year prior to switch compared to the year after switch (p=0.854. In patients who received only ranibizumab, the median yearly progression of RPE loss was 0.15 mm/y, for aflibercept patients, 0.13 mm/y. This difference was not statistically significant (p=0.172. Conclusions. There seems to be a linear progression rate of RPE loss in patients treated with ranibizumab as well as in patients with aflibercept. No significant increase of progression rate was found after switch to aflibercept.

  9. Evaluation of contrast sensitivity and other visual function outcomes in neovascular age-related macular degeneration patients after treatment switch to aflibercept from ranibizumab.

    Science.gov (United States)

    Nixon, Donald R; Flinn, Nicholas Ap

    2017-01-01

    This study evaluated visual function and anatomic and vision-related quality-of-life outcomes in recalcitrant neovascular age-related macular degeneration (AMD) subjects switched to aflibercept (Eylea(®)) from ranibizumab (Lucentis(®)). In a single-center study conducted in Barrie, ON, 40 patients with persistent fluid despite previous ranibizumab treatment were switched to aflibercept with 3 consecutive monthly doses. Main outcome measure was mean change from baseline to week 12 in Pelli-Robson contrast sensitivity (CS). Secondary outcomes were mean change in best corrected visual acuity (BCVA), central retinal thickness (CRT), and National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) score. A two-sided paired t-test was used in the statistical data analysis to compare the means of continuous variables. Forty-nine eyes (baseline visual acuity [VA] >6/120) were evaluated. Ranibizumab injections (mean ± standard deviation [SD] 28.2±22.1 [range 3-86]) were administered prior to treatment switch. Mean CS improved from 1.32 at baseline to 1.40 log units at week 12. VA was stable throughout. Mean CRT decreased from 354 µm at baseline to 332 µm at week 12 (-22 µm, P=0.004). Twenty-six (65%) patients experienced an overall improvement in NEI VFQ-25 score. Interestingly, a correlation was observed between improvement in log CS and CRT change (P=0.000046). Contrast sensitivity improved statistically and significantly, and CRT decreased from baseline to week 12 after a switch to aflibercept from ranibizumab. Analysis of CS as an independent outcome end point in neovascular AMD treatment switch studies may provide a more complete understanding of visual response.

  10. [Urgent action needed to raise public awareness of age-related macular degeneration in China].

    Science.gov (United States)

    Chen, You-xin

    2009-05-01

    Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. The impact of AMD to the economics, society and the patients are huge. However, the awareness of AMD is alarmingly low. Even in developed countries, the awareness of AMD is below 30%. In terms of the risk factors of AMD, the awareness is also quite low, e.g., only 32% were aware of the causal link between smoking and AMD. Although cataract is the leading cause of the blindness in China, as the economic and social progress, as the coming of the aging society, as people pursuing higher quality of life, AMD will become a unignoring public health problem. Thus, it is urgent to take action now to increase the public awareness of AMD.

  11. Choroid, Haller's, and Sattler's layer thickness in intermediate age-related macular degeneration with and without fellow neovascular eyes.

    Science.gov (United States)

    Esmaeelpour, Marieh; Ansari-Shahrezaei, Siamak; Glittenberg, Carl; Nemetz, Susanne; Kraus, Martin F; Hornegger, Joachim; Fujimoto, James G; Drexler, Wolfgang; Binder, Susanne

    2014-07-22

    To analyze choroidal, Sattler's, and Haller's layer thickness maps in age-related macular degeneration (AMD) patients having eyes with bilateral large drusen and pigment changes (intermediate AMD), in patients having intermediate AMD eyes with neovascular fellow eyes (nAMD), and in healthy subjects using three-dimensional (3D) 1060-nm optical coherence tomography (OCT). Automatically generated choroidal thickness (ChT), retinal thickness, and Sattler's and Haller's layer thickness maps were statistically analyzed in 67 subjects consisting of intermediate AMD (n = 21), intermediate AMD (n = 22) with fellow nAMD eyes (n = 22), and healthy eyes (n = 24) with no age and axial eye length difference between groups of eyes (P > 0.05, ANOVA). Eyes were imaged by a prototype high-speed (60,000 A-scans/s) spectral-domain 3D 1060-nm OCT over a 36° × 36° field of view. The mean ± SD (μm) subfoveal ChT for healthy subjects and for bilateral intermediate AMD, unilateral intermediate AMD, and their nAMD fellow eyes was 259 ± 95 and 222 ± 98, 149 ± 60, and 171 ± 78, respectively. Choroidal thickness maps demonstrated significant submacular thinning in unilateral intermediate AMD in comparison to healthy and bilateral intermediate AMD eyes (P choroid and its sublayers, there was no difference between the intermediate AMD eyes and their fellow nAMD eyes (paired testing, P choroidal imaging visualized significant changes in choroidal, Sattler's, and Haller's layer thickness in relation to the progression of AMD. This may be important for understanding the choroidopathy in the pathophysiology of AMD. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  12. Epidemiology and Quality of Life of Patients with Age-Related Macular Degeneration

    OpenAIRE

    Synek, Svatopluk; Vojniković, Božo; Pahor, Đana

    2010-01-01

    It is well known that age-related macular degeneration (AMD), besides glaucoma and diabetic retinopathy, represents a major cause of low vision and blindness throughout the world. In this study, specific causal factors of AMD are analyzed, emphasizing the causal role and effects of sunlight, no matter which part of its spectrum, in a longer exposition through life. The accent is also put on the influence of lifestyle as well as vitamin and antioxidants supplementation in development or preven...

  13. Applying Theories and Interventions from Behavioral Medicine to Understand and Reduce Visual Field Variability in Patients with Vision Loss

    Science.gov (United States)

    Rozanski, Collin; Haythornthwaite, Jennifer A.; Dagnelie, Gislin; Bittner, Ava K.

    2014-01-01

    Visual field (VF) test results are often unreliable in visually impaired patients, but continue to be a cornerstone of clinical trials and play a vital role in clinical decision making since they are the primary method to determine patients’ functional vision loss or progression. Currently, patients are typically asked to perform VF tasks with minimal instruction or consideration of their psychological experience during the test. The gradual loss of vision due to retinal diseases, such as retinitis pigmentosa (RP), age-related macular degeneration (AMD), or glaucoma can contribute to the experience of negative psychosocial states, such as anxiety, stress, and depression, as well as diminished quality of life. We hypothesize that VF testing elicits test performance anxiety and perception of functional losses of vision, which induces distracting negative thoughts that result in increased VF test variability. Resources for processing and responding to vision-related information may be diverted from task-relevant VF stimuli to task-irrelevant ones, such as internal worry and test anxiety, thereby resulting in VF test performance decrements. We present a theoretical model to support the hypothesis that VF variability is linked to patients’ negative thoughts during VF testing. This conceptual framework provides a basis for the development of coping strategies and mindfulness-based interventions to be evaluated in future research aimed at improving psychosocial states and VF reliability in visually-impaired patients. It would be highly significant to intervene by modifying negative thoughts during VF testing to reduce test variability in glaucoma patients who are progressively losing vision to a blinding eye disease, but whose vision loss has not been accurately identified and treated early enough due to variable VF results. In clinical trials of potential interventions for RP and non-neovascular AMD, reducing VF variability would effectively increase the precision

  14. New developments in age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Lyndon da Cruz

    2008-09-01

    Full Text Available The World Health Organization (WHO estimates that over 3 million people (9% of global blindness are blinded by age-related macular degeneration (AMD. AMD affects people over the age of 55. There are two main types of AMD, dry and wet. In dry AMD, patients slowly lose vision through progressive atrophy of the macular tissue. Wet, or exudative, AMD, is associated with new blood vessels called subretinal neovascular membranes (or SRNVM and affected patients lose vision more rapidly due to fluid leakage and haemorrhage at the macula.

  15. Patient Empowerment

    Science.gov (United States)

    ... ONS Journals Research Medical Advisors Young Investigator Award Patient Empowerment What’s Empowerment? Patients and families have rights, ... organizations for your type of cancer. Contact Your Patient Organization The Kidney Cancer Association (KCA) serves kidney ...

  16. Patient Rights

    Science.gov (United States)

    As a patient, you have certain rights. Some are guaranteed by federal law, such as the right to get a copy ... them private. Many states have additional laws protecting patients, and healthcare facilities often have a patient bill ...

  17. Patient satisfaction

    Directory of Open Access Journals (Sweden)

    Bhanu Prakash

    2010-01-01

    Full Text Available Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of doctors and hospitals. This article discusses as to how to ensure patient satisfaction in dermatological practice.

  18. Comparing the Effectiveness of Bevacizumab to Ranibizumab in Patients with Exudative Age-Related Macular Degeneration. The BRAMD Study.

    Directory of Open Access Journals (Sweden)

    A M E Schauwvlieghe

    Full Text Available To compare the effectiveness of bevacizumab and ranibizumab in the treatment of exudative age-related macular degeneration (AMD.Multicentre, randomized, controlled, double-masked clinical trial in 327 patients. The non-inferiority margin was 4 letters.Patients ≥ 60 years of age with primary or recurrent sub- or juxtafoveal choroidal neovascularization (CNV secondary to AMD with a total area of CNV < 12 disc areas and a best corrected visual acuity (BCVA score between 20 and 78 letters on an EDTRS like chart in the study eye.Monthly intravitreal injections with 1.25 mg bevacizumab or 0.5 mg ranibizumab were given during one year. Intention to treat with last observation carried forward analysis was performed.Primary outcome was the change in BCVA in the study eye from baseline to 12 months.The mean gain in BCVA was 5.1 (±14.1 letters in the bevacizumab group (n = 161 and 6.4 (±12.2 letters in the ranibizumab group (n = 166 (p = 0.37. The lower limit of the 95% confidence interval of the difference in BCVA gain was 3.72. The response to bevacizumab was more varied; 24% of patients showed a gain of ≥15 letters, 11% a loss of ≥15 letters and 65% a gain or loss < 15 letters compared to 19%, 5% and 76% respectively for ranibizumab (p = 0.038. No significant differences in absolute CRT and CRT change (p = 0.13 or in the presence of subretinal or intraretinal fluid (p = 0.14 and 0.10, respectively were observed. However, the presence of any fluid on SD-OCT (subretinal and/or intraretinal differed significantly (p = 0.020, with definite fluid on SD-OCT in 45% of the patients for bevacizumab versus 31% for ranibizumab. The occurrence of serious adverse events and adverse events was similar, with 34 SAEs and 256 AEs in the bevacizumab group and 37 SAEs and 299 AEs in the ranibizumab group (p = 0.87 and p = 0.48, respectively.Bevacizumab was not inferior to ranibizumab. The response to bevacizumab was more varied with higher percentages of both

  19. Macular atrophy in patients with long-term anti-VEGF treatment for neovascular age-related macular degeneration.

    Science.gov (United States)

    Munk, Marion R; Ceklic, Lala; Ebneter, Andreas; Huf, Wolfgang; Wolf, Sebastian; Zinkernagel, Martin S

    2016-12-01

    To identify the prevalence and progression of macular atrophy (MA) in neovascular age-related macular degeneration (AMD) patients under long-term anti-vascular endothelial growth factor (VEGF) therapy and to determine risk factors. This retrospective study included patients with neovascular AMD and ≥30 anti-VEGF injections. Macular atrophy (MA) was measured using near infrared and spectral-domain optical coherence tomography (SD-OCT). Yearly growth rate was estimated using square-root transformation to adjust for baseline area and allow for linearization of growth rate. Multiple regression with Akaike information criterion (AIC) as model selection criterion was used to estimate the influence of various parameters on MA area. Forty-nine eyes (47 patients, mean age 77 ± 14) were included with a mean of 48 ± 13 intravitreal anti-VEGF injections (ranibizumab:37 ± 11, aflibercept:11 ± 6, mean number of injections/year 8 ± 2.1) over a mean treatment period of 6.2 ± 1.3 years (range 4-8.5). Mean best-corrected visual acuity improved from 57 ± 17 letters at baseline (= treatment start) to 60 ± 16 letters at last follow-up. The MA prevalence within and outside the choroidal neovascularization (CNV) border at initial measurement was 45% and increased to 74%. Mean MA area increased from 1.8 ± 2.7 mm(2) within and 0.5 ± 0.98 mm(2) outside the CNV boundary to 2.7 ± 3.4 mm(2) and 1.7 ± 1.8 mm(2) , respectively. Multivariate regression determined posterior vitreous detachment (PVD) and presence/development of intraretinal cysts (IRCs) as significant factors for total MA size (R(2) = 0.16, p = 0.02). Macular atrophy (MA) area outside the CNV border was best explained by the presence of reticular pseudodrusen (RPD) and IRC (R(2) = 0.24, p = 0.02). A majority of patients show MA after long-term anti-VEGF treatment. Reticular pseudodrusen (RPD), IRC and PVD but not number of injections or treatment duration seem to be associated with the

  20. An Immunologic Study on Age-related Macular Degeneration

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    Forty-one patients with age-related macular degeneration(AMD) were detected for serum autoantibodies against normal humanretinal protein by means of Western immunoblot analysis.Twenty-sevenout of the 41 patients showed positive response,with a rate of 66 percent.The positive rate of antiretinal antibody in the AMD patients wassignificantly higher than that in normal controls (18%) and in patients withother retinal diseases (24%) (p<0.0005).These antiretinal antibodies fromthe AMD patients partly reacted...

  1. Inferring diagnosis and trajectory of wet age-related macular degeneration from OCT imagery of retina

    Science.gov (United States)

    Irvine, John M.; Ghadar, Nastaran; Duncan, Steve; Floyd, David; O'Dowd, David; Lin, Kristie; Chang, Tom

    2017-03-01

    Quantitative biomarkers for assessing the presence, severity, and progression of age-related macular degeneration (AMD) would benefit research, diagnosis, and treatment. This paper explores development of quantitative biomarkers derived from OCT imagery of the retina. OCT images for approximately 75 patients with Wet AMD, Dry AMD, and no AMD (healthy eyes) were analyzed to identify image features indicative of the patients' conditions. OCT image features provide a statistical characterization of the retina. Healthy eyes exhibit a layered structure, whereas chaotic patterns indicate the deterioration associated with AMD. Our approach uses wavelet and Frangi filtering, combined with statistical features that do not rely on image segmentation, to assess patient conditions. Classification analysis indicates clear separability of Wet AMD from other conditions, including Dry AMD and healthy retinas. The probability of correct classification of was 95.7%, as determined from cross validation. Similar classification analysis predicts the response of Wet AMD patients to treatment, as measured by the Best Corrected Visual Acuity (BCVA). A statistical model predicts BCVA from the imagery features with R2 = 0.846. Initial analysis of OCT imagery indicates that imagery-derived features can provide useful biomarkers for characterization and quantification of AMD: Accurate assessment of Wet AMD compared to other conditions; image-based prediction of outcome for Wet AMD treatment; and features derived from the OCT imagery accurately predict BCVA; unlike many methods in the literature, our techniques do not rely on segmentation of the OCT image. Next steps include larger scale testing and validation.

  2. Influence of Phacoemulsification on the Visual Function and Life Quality of Patients With Cataract Complicated With Age-related Macular Degeneration%晶状体超声乳化联合人工晶体植入术对合并年龄相关黄斑变性的白内障患者视功能和生存质量的影响

    Institute of Scientific and Technical Information of China (English)

    邵玉红; 陈肖; 赵海岚; 吴苗琴

    2015-01-01

    提高视力、改善VF和QOL的有效手段,且AMD早中期患者术后效果优于AMD晚期患者,并未发现AMD晚期进展率提高。%Objective To investigate the influence of phacoemulsification on the visual function and life quality of patients with age-related cataract complicated with age-related macular degeneration( AMD ). Methods We enrolled 710 patients with age-related cataract who received treatment in Zhejiang Provincial People′s Hospital from July 2009 to December 2013. We assigned the subjects who had age-related cataract with AMD that could be clearly diagnosed by stage and didn′t received any eye operation in the past two years into group A(n=239);we assigned the subjects who had age-related cataract with AMD that could be clearly diagnosed by stage,and underwent phacoemulsification into group B(n=163);we assigned the subjects who had age-related cataract without AMD and underwent phacoemulsification into group C(n=308). logMAR,VF and QOL assessments were made at baseline( one week before surgery for group B and group C)and two years later. Results The three groups were significantly different(P0. 05)in the rate of progressing into advance AMD. In group C,AMD occurred in 12 subjects,among which 10 subjects( 3. 2%) were in early or middle stage, 2 subjects ( 0. 6%) were in advanced stage. Conclusion Phacoemulsification is effective in improving eyesight,VF and QOL in patients with age-related cataract complicated with AMD. Phacoemulsification during the early or middle stage of AMD is more effective than that during the advance stage,and no increase in the rate of progressing into advanced stage is found after surgery.

  3. HTRA1 variant confers similar risks to geographic atrophy and neovascular age-related macular degeneration.

    Science.gov (United States)

    Cameron, D Joshua; Yang, Zhenglin; Gibbs, Daniel; Chen, Haoyu; Kaminoh, Yuuki; Jorgensen, Adam; Zeng, Jiexi; Luo, Ling; Brinton, Eric; Brinton, Gregory; Brand, John M; Bernstein, Paul S; Zabriskie, Norman A; Tang, Shibo; Constantine, Ryan; Tong, Zongzhong; Zhang, Kang

    2007-05-02

    Age-related macular degeneration (AMD) is the most common cause of irreversible visual impairment in the developed world. The two forms of advanced AMD, geographic atrophy (GA) and choroidal neovascularization (wet AMD), represent two types of degenerative processes in the macula that lead to loss of central vision. Soft confluent drusen, characterized by deposits in macula without visual loss are considered a precursor of advanced AMD. A single nucleotide polymorphism, rs11200638, in the promoter of HTRA1 has been shown to increases the risk for wet AMD. However, its impact on soft confluent drusen and GA or the relationship between them is unclear. To better understand the role the HTRA1 polymorphism plays in AMD subtypes, we genotyped an expanded Utah population with 658 patients having advanced AMD or soft confluent drusen and 294 normal controls and found that the rs11200638 was significantly associated with GA. This association remains significant conditional on LOC387715 rs10490924. In addition, rs11200638 was significantly associated with soft confluent drusen, which are strongly immunolabeled with HTRA1 antibody in an AMD eye with GA similar to wet AMD. Two-locus analyses were performed for CFH Y402H variant at 1q31 and the HTRA1 polymorphism. Together CFH and HTRA1 risk variants increase the odds of having AMD by more than 40 times. These findings expand the role of HTRA1 in AMD. Understanding the underlying molecular mechanism will provide an important insight in pathogenesis of AMD.

  4. Patient opinion

    DEFF Research Database (Denmark)

    Zurita, Laura; Nøhr, Christian

    2004-01-01

    The paper is based upon a case study and aims to provide information abouit patients values and communication that will be useful in the design of more patient friendly health system.......The paper is based upon a case study and aims to provide information abouit patients values and communication that will be useful in the design of more patient friendly health system....

  5. Evaluation of Stress urinary incontinence among non pregnant female patients in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Shraddha Agarwal

    2016-03-01

    Full Text Available Background: Urinary incontinence has been defined by the international continence society as a condition in which involuntary loss of urine is a social or hygienic problem and is objectively demonstrable. Stress urinary incontinence is the most common form of transurethral urinary incontinence in women. Objective: To study the probable etiological factors in diagnosed cases of Stress urinary incontinence among non pregnant female patients attending outpatient department of Gynecology in SMIMER, Surat and to evaluate the cure rate of non-surgical and surgical treatment among them. Method:This study was conducted in the department of Obst amd Gynec, SMIMER, Surat from May2010 to december2012. Non pregnant patients demonstrating SUI with full bladder were included in the study. Total 40 patients were studied. Observation: Out of 40 cases 32 (80% cases belonged to the age group of 40 to 59 years, 22 (55% were in peri-menopausal age group and the median parity of the patients was 3. Other important observation was that 29(54.7% patients had associated utero-vaginal prolapse with SUI and maximum had third degree prolapsed. Both non-surgical and surgical treatment was offered to patients with good results. Conclusion: This study indicates that SUI is quite common in peri-menopausal age group, it has strong association with multi parity and UV prolapse. Non-surgical management is still the acceptable mode of treatment. The TVT-O appears to be safe and effective surgical treatment for SUI. [Natl J Med Res 2016; 6(1.000: 73-76

  6. Designing and testing scene enhancement algorithms for patients with retina degenerative disorders

    Directory of Open Access Journals (Sweden)

    Downes Susan M

    2010-06-01

    Full Text Available Abstract Background Retina degenerative disorders represent the primary cause of blindness in UK and in the developed world. In particular, Age Related Macular Degeneration (AMD and Retina Pigmentosa (RP diseases are of interest to this study. We have therefore created new image processing algorithms for enhancing the visual scenes for them. Methods In this paper we present three novel image enhancement techniques aimed at enhancing the remaining visual information for patients suffering from retina dystrophies. Currently, the only effective way to test novel technology for visual enhancement is to undergo testing on large numbers of patients. To test our techniques, we have therefore built a retinal image processing model and compared the results to data from patient testing. In particular we focus on the ability of our image processing techniques to achieve improved face detection and enhanced edge perception. Results Results from our model are compared to actual data obtained from testing the performance of these algorithms on 27 patients with an average visual acuity of 0.63 and an average contrast sensitivity of 1.22. Results show that Tinted Reduced Outlined Nature (TRON and Edge Overlaying algorithms are most beneficial for dynamic scenes such as motion detection. Image Cartoonization was most beneficial for spatial feature detection such as face detection. Patient's stated that they would most like to see Cartoonized images for use in daily life. Conclusions Results obtained from our retinal model and from patients show that there is potential for these image processing techniques to improve visual function amongst the visually impaired community. In addition our methodology using face detection and efficiency of perceived edges in determining potential benefit derived from different image enhancement algorithms could also prove to be useful in quantitatively assessing algorithms in future studies.

  7. Computerized evaluation of deambulatory pattern before and after visual rehabilitation treatment performed with biofeedback in visually impaired patients suffering from macular degeneration

    Directory of Open Access Journals (Sweden)

    Fernanda Pacella

    2016-09-01

    Full Text Available Aims: The aim of this study was double: the primary endpoint was to evaluate the efficacy of visual rehabilitation of visually impaired patients with macular degeneration (AMD. The secondary endpoint was to assess the effect of rehabilitation treatment on the ambulatory pattern using a computerized evaluation of walking, focusing the attention on space-time parameters that are influenced in patients with visual impairment. Methods: 10 patients with AMD were enrolled, 6 males and 4 females, and examined 15 eyes, at Department of Sense Organs, Faculty of Medicine and Dentistry Sapienza University of Rome, Italy. Visual rehabilitation was carried out with the use of a microperimeter MP1 using the examination of biofeedback. Patients are asked to move their eyes in coordination with an audible feedback that alerts the patient when he is setting properly the fixation target previously selected. All patients were subjected to 10 sessions lasting 15 minutes each for each eye, 1 time per week. The best corrected visual acuity (BCVA was assessed by far with the ETDRS optotype IN LOG MAR, and by close to 25 cm by adding + 4 ball (addition to near to the BCVA. For each eye the PB ( print body on the distance of 25 cm was measured; It fixation stability for 30 seconds was examined by microperimeter. Gait Analysis was performed with system ELITE BTS SpA (Milan, Italy. Results: At the end of the rehabilitation treatment with biofeedback it was found a marked improvement in BCVA. The BCVA before the rehabilitation treatment was ETDRS 12 LETTERS = 0.86 logMAR. At the end of the visual rehabilitation 16 LETTERS = 0.78 logMAR. The near visual acuity presented a decrease of the printer body measurement (PB and a statistically significant improvement in the fixation stability. Analysis of the spatial and temporal parameters of gait cycle, aimed at assessing the global aspects of gait (speed, rhythm, symmetry, fluidity, dynamic balance showed no significant changes

  8. CXCR4 inhibitors could benefit to HER2 but not to triple-negative breast cancer patients.

    Science.gov (United States)

    Lefort, S; Thuleau, A; Kieffer, Y; Sirven, P; Bieche, I; Marangoni, E; Vincent-Salomon, A; Mechta-Grigoriou, F

    2017-03-02

    The CXCR4 receptor and its ligand CXCL12 (also named stromal cell-derived factor 1, SDF1) have a critical role in chemotaxis and homing, key steps in cancer metastasis. Although myofibroblasts expressing CXCL12 are associated with the presence of axillary metastases in HER2 breast cancers (BC), the therapeutic interest of targeting CXCR4/CXCL12 axis in the different BC subtypes remains unclear. Here, we investigate this question by testing antitumor activity of CXCR4 inhibitors in patient-derived xenografts (PDX), which faithfully reproduce human tumor properties. We observed that two CXCR4 inhibitors, AMD3100 and TN14003, efficiently impair tumor growth and metastasis dissemination in both Herceptin-sensitive and Herceptin-resistant HER2 BC. Conversely, blocking CXCR4/CXCL12 pathway in triple-negative (TN) BC does not reduce tumor growth, and can even increase metastatic spread. Moreover, although CXCR4 inhibitors significantly reduce myofibroblast content in all BC subtypes, they decrease angiogenesis only in HER2 BC. Thus, our findings suggest that targeting CXCR4 could provide some therapeutic interest for HER2 BC patients, whereas it has no impact or could even be detrimental for TN BC patients.

  9. CXCR4 inhibitors could benefit to HER2 but not to triple-negative breast cancer patients

    Science.gov (United States)

    Lefort, S; Thuleau, A; Kieffer, Y; Sirven, P; Bieche, I; Marangoni, E; Vincent-Salomon, A; Mechta-Grigoriou, F

    2017-01-01

    The CXCR4 receptor and its ligand CXCL12 (also named stromal cell-derived factor 1, SDF1) have a critical role in chemotaxis and homing, key steps in cancer metastasis. Although myofibroblasts expressing CXCL12 are associated with the presence of axillary metastases in HER2 breast cancers (BC), the therapeutic interest of targeting CXCR4/CXCL12 axis in the different BC subtypes remains unclear. Here, we investigate this question by testing antitumor activity of CXCR4 inhibitors in patient-derived xenografts (PDX), which faithfully reproduce human tumor properties. We observed that two CXCR4 inhibitors, AMD3100 and TN14003, efficiently impair tumor growth and metastasis dissemination in both Herceptin-sensitive and Herceptin-resistant HER2 BC. Conversely, blocking CXCR4/CXCL12 pathway in triple-negative (TN) BC does not reduce tumor growth, and can even increase metastatic spread. Moreover, although CXCR4 inhibitors significantly reduce myofibroblast content in all BC subtypes, they decrease angiogenesis only in HER2 BC. Thus, our findings suggest that targeting CXCR4 could provide some therapeutic interest for HER2 BC patients, whereas it has no impact or could even be detrimental for TN BC patients. PMID:27669438

  10. Efficacy of aflibercept on exudative age-related macular degeneration in patients exhibiting complete ranibizumab resistance and tachyphylaxis

    Directory of Open Access Journals (Sweden)

    Gokcen Gokce

    Full Text Available ABSTRACT Purpose: The present study compared the efficacy of aflibercept for neovascular age-related macular degeneration (NV-AMD in patients with complete ranibizumab resistance and tachyphylaxis. Methods: Forty-four eyes of 38 neovascular age-related macular degeneration patients were evaluated. Eyes were divided into a complete resistance group (n=23 eyes and tachyphylaxis group (n=21 eyes. Results: After three injections, eight (38.1% patients in the tachyphylaxis group and nine (39.1% in the complete resistance group presented with macular dryness. After the first injection of aflibercept, the mean visual acuity improved significantly in the tachyphylaxis group (p=0.018 but remained unchanged in the complete resistance group (p=0.37. There was a non-significant trend towards improved mean visual acuity in both groups after the second and third injections relative to the acuity at the final visit for ranibizumab treatment. In the tachyphylaxis group, the presence of subfoveal pigmented epithelium detachment (PED decreased significantly after intravitreal aflibercept treatment. Conclusions: Although treatment with aflibercept yielded generally positive anatomical results in both groups, no significant increase in visual acuity was achieved.

  11. Prognostic phenotypic and genotypic factors associated with photodynamic therapy response in patients with age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Tsuchihashi T

    2014-12-01

    Full Text Available Takashi Tsuchihashi,1 Keisuke Mori,1 Kuniko Horie-Inoue,2 Yasushi Okazaki,3 Takuya Awata,4,5 Satoshi Inoue,2 Shin Yoneya1 1Department of Ophthalmology, 2Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 3Division of Translational Research, Research Center for Genomic Medicine, 4Division of Endocrinology and Diabetes, Department of Medicine, 5Division of RI Laboratory, Biomedical Research Center, Saitama Medical University, Iruma, Saitama, Japan Background: This study aimed to demonstrate the phenotypic and genotypic factors associated with photodynamic therapy (PDT for age-related macular degeneration (AMD.Methods: The study included 149 patients with exudative AMD treated by PDT. Eight phenotypic factors and ten genotypic factors for three single nucleotide polymorphisms (SNPs; rs800292, rs1061170, rs1410996 in the complement factor H (CFH gene, rs 11200638-SNP in the high temperature requirement A-1 (HTRA1 gene, two SNPs (rs699947, rs2010963 in the vascular endothelial growth factor (VEGF gene, and four SNPs (rs12948385, rs12150053, rs9913583, rs1136287 in the pigment epithelium-derived factor (PEDF gene were evaluated. Results: A significant association with best-corrected visual acuity change was demonstrated in the greatest linear dimension, presence or absence of pigment epithelial detachment, and HTRA1-rs11200638 genotype statistically (P=3.67×10-4, 1.95×10-2, 1.24×10-3, respectively. Best-corrected visual acuity in patients with AA genotype of HTRA1-rs11200638 significantly decreased compared with that in patients with GG genotype (P=1.33×10-3. Logistic regression analyses demonstrated HTRA1-rs11200638 genotype was most strongly associated with best-corrected visual acuity outcome from baseline at 12 months after photodynamic therapy (P=4.60×10-3; odds ratio 2.363; 95% confidence interval 1.303–4.285.Conclusion: The HTRA1

  12. Individualized Treatment of Neovascular Age-Related Macular Degeneration: What are Patients Gaining? Or Losing?

    Directory of Open Access Journals (Sweden)

    Michael W. Stewart

    2015-05-01

    Full Text Available The widespread use of drugs that bind diffusible vascular endothelial growth factor (VEGF has revolutionized the treatment of neovascular age-related macular degeneration (AMD. The pivotal ranibizumab and aflibercept registration trials featured monthly intravitreal injections for 12 months, during which visual acuities and macular edema rapidly improved for the first 3 months and modest gains or stabilization continued until the primary endpoint. In many subsequent trials, patients were evaluated monthly and treated as-needed (PRN according to the results of visual acuity (VA testing, fundus examinations and optical coherence tomography scans. Compared to monthly-treated control groups, PRN treated patients require fewer injections during the first year but they also experience smaller VA gains (1–3 letters. A small number of prospective trials that directly compared monthly with PRN therapy showed that VA gains with discontinuous therapy lag slightly behind those achieved with monthly injections. Physicians recognize that monthly office visits with frequent intraocular injections challenge patients’ compliance, accrue high drug and professional service costs, and clog office schedules with frequently returning patients. To decrease the numbers of both office visits and anti-VEGF injections without sacrificing VA gains, physicians have embraced the treat-and-extend strategy. Treat-and-extend has not been studied as rigorously as PRN but it has become popular among both vitreoretinal specialists and patients. Despite the possible risks associated with discontinuous therapy (decreased VA and increased macular fluid, most physicians individualize treatment (PRN or treat-and-extend for the majority of their patients. This review chapter explores the many advantages of individualized therapy, while balancing these against suboptimal responses due to the decreased frequency of anti-VEGF injections.

  13. Patient life

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    2004-01-01

    Background: The hypothesis for the study is that the informal relationships amongst patients during hospitalisation have more influence on wellbeing, understanding of own illnesses and recovery than we until now have recognised in nursing. Aim: The purpose is to describe patients' experiences of ...... knowledge and better understanding about patients' lives would give nurses and other professionals more scope to identify and oblige patient needs and preferences during hospitalisation and in planning nursing care....

  14. The Potential Importance of Detection of Neovascular Age-Related Macular Degeneration When Visual Acuity Is Relatively Good.

    Science.gov (United States)

    Ho, Allen C; Albini, Thomas A; Brown, David M; Boyer, David S; Regillo, Carl D; Heier, Jeffrey S

    2017-03-01

    The advent of anti-vascular endothelial growth factor treatment has changed the prognosis for patients with neovascular age-related macular degeneration (nvAMD). The ability to stabilize or improve vision with these treatments is a major step in enabling patients to continue to function at the highest possible level. Many studies have demonstrated that the better the visual acuity (VA) is at the time of treatment initiation, the higher the likelihood that VA will be better during at least the following 2 years; as such, detection of nvAMD when VA is relatively good is important. Data on the VA of patients with intermediate AMD and VA at the time of nvAMD diagnosis suggest that patients are typically losing an average of 3 to 5 lines of vision and possibly more between the time that intermediate AMD progresses to nvAMD and the diagnosis of nvAMD is made. The average patient may have nvAMD for 6 to 12 months before diagnosis and treatment initiation. Current efforts in management of nvAMD are primarily aimed at optimizing anti-vascular endothelial growth factor treatments that have the potential to improve VA outcomes by a magnitude of letters. Additional tools or other efforts to identify patients with nvAMD before substantial vision loss has occurred may reduce the amount of visual loss sustained with anti-vascular endothelial growth factor therapy, and have the potential to improve VA outcomes substantially.

  15. Superoxide Dismutase1 Levels in North Indian Population with Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Akshay Anand

    2013-01-01

    Full Text Available Aim. The aim of the study was to estimate the levels of superoxide dismutase1 (SOD1 in patients of age-related macular degeneration (AMD and examine the role of oxidative stress, smoking, hypertension, and other factors involved in the pathogenesis of AMD. Methods. 115 AMD patients and 61 healthy controls were recruited for this study. Serum SOD1 levels were determined by ELISA and were correlated to various risk factors. Logistic regression model of authenticity, by considering SOD1 as independent variable, has been developed along with ROC curve. Results. The SOD1 levels were significantly higher in AMD patients as compared to those of the controls. The difference was not significant for wet and dry AMD. However, the difference was significant between wet AMD subtypes. Nonsignificance of the Hosmer-Lemeshow goodness of fit statistic (χ2=10.516, df=8, P=0.231 indicates the appropriateness of logistic regression model to predict AMD. Conclusion. Oxidative stress in AMD patients may mount compensatory response resulting in increased levels of SOD1 in AMD patients. To predict the risk of AMD on the basis of SOD1, a logistic regression model shows authenticity of 78%, and area under the ROC curve (0.827, P=.0001 with less standard error of 0.033 coupled with 95% confidence interval of 0.762–0.891 further validates the model.

  16. Survey of 2 768 venerable aged patients with visual disorder%高龄老人视力障碍2768例调查

    Institute of Scientific and Technical Information of China (English)

    王兆艳; 崔霞; 李星星; 王玮

    2003-01-01

    目的通过对 2 768例 80岁以上老年人行眼部检查,探讨影响高龄老年人视力的主要致病因素.方法 1999- 01/2002- 04对眼科会诊的 2 768例( 5 536眼) 80岁以上老年人行眼科常规查体,对矫正视力低于 1.0者行视野、眼底荧光血管造影( fundus fluorescein angiography,FFA)、吲哚青绿脉络膜血管造影( indocyanine green angiography ,ICGA)、光学相干断层扫描( optical coherence tomography ,OCT)等检查,找出病因.结果患白内障者为 5 536眼( 100.00%),患老年性黄斑变性( aged-related macular degeneration,AMD)者为 1 982眼 (35.72% ),剥脱综合征 (pseudoexfoliation syndrome,PXS)为 1 550眼( 28.03%),青光眼 177眼( 3.22%),单纯性视神经萎缩 133眼( 2.43%).影响视力的主要原因依次是白内障、老年性黄斑变性、青光眼、视神经萎缩.结论高龄老年人眼部疾病明显增多,白内障和老年性黄斑变性是影响视力的主要病因.%Aim To investigate the main diseases affecting visual acuity in venerable aged patients.Methods 2 768 patients ( 5 536 eyes) over 80 years old were performed ocular examinations, and patients whose vision less than 1.0 were carried out slit-lamp,direct or indirect ophthalmoscope, fundus fluorescein angiography(FFA),indocyanine green angiography (ICGA) or optical coherence tomography(OCT) examinations to find out the causes.Results 5 536 eyes (100% ) had caught cataract,1 982 eyes (35.72% ) had caught aged-related macular degeneration (AMD),1 550 eyes (28.03% ) caught pseudoexfoliation syndrome (PXS),177 eyes (3.22% ) glaucoma,133 eyes (2.43% )simple optic atrophy.The main diseases that affect vision were cataract,aged-related macular degeneration, glaucoma and optic atrophy.Conclusion Ocular diseases in venerable aged patients have great increase,while cataract and aged-related macular degeneration are the main disease affecting vision.

  17. Switching to aflibercept among patients with treatment-resistant neovascular age-related macular degeneration: a systematic review with meta-analysis

    Directory of Open Access Journals (Sweden)

    Spooner K

    2017-01-01

    Full Text Available Kimberly Spooner,1–3 Thomas Hong,1,2 Wijeyanthy Wijeyakumar,1–3 Andrew A Chang1–3 1Sydney Retina Clinic & Day Surgery, 2Sydney Institute of Vision Science, Sydney, 3Save Sight Institute, Department of Ophthalmology, University of Sydney, Camperdown, NSW, Australia Purpose: To systematically review anatomical and functional outcomes subsequent to switching from bevacizumab/ranibizumab to aflibercept monotherapy in patients with treatment-resistant neovascular age-related macular degeneration (nAMD. Design: Systematic review and meta-analysis. Methods: Medline, PubMed, Embase, and Cochrane databases were searched up to July 2016 for available scientific literature which met inclusion criteria. Eligible studies reported visual and anatomical outcomes with at least 6 months of follow-up among patients with nAMD and persistent or resistant exudative fluid despite previous anti-vascular endothelial growth factor (VEGF therapy (bevacizumab and/or ranibizumab and were switched to aflibercept monotherapy. Mean changes in best-corrected visual acuity (BCVA and central retinal thickness (CRT were pooled using random-effects models with 95% confidence intervals (CIs. Results: Of 82 papers reviewed, 28 studies met inclusion criteria of this review. Pooled results showed a small mean improvement in BCVA at 6 and 12 months following switching (1.11 letters, 95% CI -0.25 to 2.46, P=0.17 and 0.63 letters, 95% CI -0.26 to 1.52, P=0.17, respectively. There was a significant improvement in mean CRT following switching (-61.90 µm, 95% CI -77.10 to -46.80, P<0.001 and -50.00 µm, 95% CI -63.20 to -36.80, P<0.001 at 6 and 12 months, respectively. Conclusion: Pooled analysis demonstrated significantly improved anatomical outcomes; however, visual function remained stable, having a comparable effect to other anti-VEGF agents in preservation of vision. These patients had poorly responsive chronic disease with limited potential for visual recovery. Switching to

  18. Three-year follow-up of visual outcome and quality of life in patients with age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Rung L

    2013-02-01

    Full Text Available Lena Rung,1 Monica Lövestam-Adrian21Department of Ophthalmology, Helsingborg Hospital, Helsingborg, 2Department of Ophthalmology, Lund University, Skåne University Hospital, Malmö, SwedenBackground: The purpose of this study was to evaluate the visual outcome and self-reported vision-targeted health status in patients treated with intravitreal ranibizumab for wet age-related macular degeneration (AMD.Methods: A total of 51 eyes from 50 patients aged 76 ± 7 years, with wet AMD not previously treated, were included in this prospective study. Best corrected visual acuity was examined using Early Treatment Diabetic Research Study charts and near vision reading. All patients underwent an ophthalmological examination, including fluorescein and indocyanine green angiography (occult cases and optical coherence tomography. The Visual Function Questionnaire test was completed before and 37 ± 7 months after the start of intravitreal injections.Results: The patients received a mean number of 7.8 ± 5.0 (range 2–22 injections. One month after the third intravitreal injection, significant improvement was seen in both visual acuity (53 ± 14 to 61 ± 14 letter, P = 0.001 and near vision (17 ± 9 to 11 ± 8 points, P = 0.001. During follow-up, mean visual acuity decreased from 53 ± 14 to 44 ± 24 letters (P = 0.011, and near vision decreased from 17 ± 9 to 20 ± 11 points (P = 0.048. Despite visual impairment, the quality of life test revealed no significant decrease in mental health (P = 0.529 or ability to read a newspaper (P = 0.21, but a decrease in distance activities (reading street signs, steps, going to the theater from 57 ± 27 to 46 ± 31 points (P = 0.007 was documented.Conclusion: Decreased visual acuity was related to a decrease in self-reported visual function for distance activities, while mental health items, such as worrying, were not influenced.Keywords: visual outcome, quality of life, age-related macular degeneration

  19. Application of AMDS&ADS in Phone Antenna Design%AMDS&ADS在手机天线初期设计仿真中的应用

    Institute of Scientific and Technical Information of China (English)

    郝卫东; 熊邺; 王磊; 姚颖

    2009-01-01

    本文简要介绍了一款实物手机天线的初期设计(mockup),同时用AMDS和ADS软件进行协同仿真,得到的仿真和模拟测试结果基本一致,并进一步对该天线在整机中的性能作出评估,极大地缩短了的设计周期,降低了风险.这说明AMDS对天线复杂的电磁仿真可以得到非常接近实际的结果,是一种理想的3D天线分析仿真工具,对天线设计具有很好的指导意义.

  20. Age-related macular degeneration: economic burden and value-based medicine analysis.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C; Stein, Joshua D; Roth, Zachary; Campanella, Joseph; Beauchamp, George R

    2005-06-01

    It can be estimated that 17,100 new cases of neovascular (wet) AMD and 180,000 new cases of geographic-atrophy (dry) AMD occur in Canada annually. In addition to having a devastating effect on patients' lives, the condition causes significant adverse consequences for the economy. The deleterious effect of AMD on quality of life is markedly underestimated by ophthalmologists who treat patients with AMD, by non-ophthalmic physicians and by the public. In fact, patients with different degrees of severity of AMD have a perceived impairment of their quality of life that is 96% to 750% greater than the impairment estimated by treating ophthalmologists. Mild AMD causes a 17% decrease in the quality of life of the average patient, a decrease similar to that encountered with symptomatic human immunodeficiency virus infection or moderate cardiac angina. Moderate AMD produces a 40% decrease in quality of life, a decrease similar to that associated with permanent renal dialysis or severe cardiac angina. Very severe AMD causes a 63% decrement in quality of life, a decrease similar to that encountered with advanced prostatic cancer with uncontrollable pain or a severe stroke that leaves a person bedridden, incontinent and requiring constant nursing care. The adverse economic consequences of AMD include an annual $2.6 billion negative impact on Canada's gross domestic product. The return on investment is high for both current AMD therapies and research into new treatment modalities.

  1. What do we know about the experience of age related macular degeneration? A systematic review and meta-synthesis of qualitative research.

    Science.gov (United States)

    Bennion, Amy E; Shaw, Rachel L; Gibson, Jonathan M

    2012-09-01

    Age Related Macular Degeneration (AMD) is the leading cause of registerable blindness with a high medical and societal cost burden. Much of the research examining experiences of living with AMD has been conducted independently with small sample sizes and has failed to impact on practice. Meta-synthesis of qualitative research can improve the understanding of the experience of living with AMD by drawing together findings of qualitative studies. This article presents a systematic review and meta-synthesis of qualitative studies investigating the experience of AMD (literature searched up to April 2012; published studies identified range from 1996 to 2009). The review highlights themes relating to: functional limitations, adaptation and independence; feelings about the future with vision impairment; interaction with the health service; social engagement; disclosure; and the emotional impacts of living with AMD. Attention to the experience of living with AMD can help us to better understand the needs of patients. This meta-synthesis aimed to bring together the findings of qualitative research studies and highlights important areas for consideration when caring for patients with AMD. Our findings suggest that a holistic approach to service provision and support for AMD is needed which takes into account individuals' needs and experiences when coping with and adjusting to living with AMD. This support should aim to reduce stigma, increase social engagement, and develop the psychological resources of patients with AMD.

  2. Indium-111 antimyosin antibody imaging and thallium-201 imaging. A comparative myocardial scintigraphic study using single-photon emission computed tomography in patients with myocarditis and dilated cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Takehiko; Matsumori, Akira; Nohara, Ryuji; Konishi, Junji; Sasayama, Shigetake [Kyoto Univ. (Japan). Faculty of Medicine; Tamaki, Nagara

    1997-10-01

    Indium-111 antimyosin antibody imaging (a tracer of myocardial necrosis) and thallium-201 imaging (a tracer of myocardial perfusion) were compared in patients with myocarditis and dilated cardiomyopathy. The distribution of each tracer and antimyosin/thallium-201 overlapping were evaluated with single-photon emission computed tomography (SPECT). Scintigraphic data were classified into 5 patterns according to the distribution of both images and were compared with histologic findings of endomyocardial biopsy: AM-D, intense and diffuse antimyosin uptake and no perfusion abnormality (active myocarditis); AM-L, localized antimyosin uptake and no perfusion abnormality (active myocarditis); HM, no antimyosin uptake with or without perfusion abnormality (healed myocarditis); DCM-NH, diffuse antimyosin uptake and inhomogeneous thallium-201 uptake (dilated cardiomyopathy); DCM-PD, diffuse or localized antimyosin uptake and myocardial perfusion defect(s) (dilated cardiomyopathy). Patients with dilated-phase hypertrophic cardiomyopathy were frequently found in the DCM-PD group. Taken together, comparative antimyosin/thallium-201 SPECT images are useful for evaluating the activity of myocarditis and ongoing myocardial damage even in areas with no perfusion in patients with dilated cardiomyopathy. (author)

  3. Inherited Retinal Degenerative Disease Clinical Trial Network

    Science.gov (United States)

    2012-10-01

    We studied a diverse group of 185 eyes with maculopathy including geographic atrophy and dry AMD with visual acuities between 19. 20 20/16 and...studied 36 eyes from 18 patients with non-exudative AMD with visual acuity between 20/16 and 20/160. Spectral domain-OCT or simultaneous OCT scans...that disruption of the photoreceptor IS/OS junction is a statistically significant predictor of poor visual acuity among patients with ERM, dry AMD

  4. Cost-effectiveness of anti-oxidant vitamins plus zinc treatment to prevent the progression of intermediate age-related macular degeneration. A Singapore perspective

    OpenAIRE

    Saxena, Nakul; George, Pradeep Paul; Heng, Bee Hoon; Lim, Tock Han; Yong, Shao Onn

    2015-01-01

    Purpose: To determine if providing high dose anti-oxidant vitamins and zinc treatment age-related eye disease study (AREDS formulation) to patients with intermediate age-related macular degeneration (AMD) aged 40–79 years from Singapore is cost-effective in preventing progression to wet AMD. Methods: A hypothetical cohort of category 3 and 4 AMD patients from Singapore was followed for 5 calendar years to determine the number of patients who would progress to wet AMD given the following treat...

  5. Cost-effectiveness of anti-oxidant vitamins plus zinc treatment to prevent the progression of intermediate age-related macular degeneration. A Singapore perspective

    OpenAIRE

    Nakul Saxena; Pradeep Paul George; Bee Hoon Heng; Tock Han Lim; Shao Onn Yong

    2015-01-01

    Purpose: To determine if providing high dose anti-oxidant vitamins and zinc treatment age-related eye disease study (AREDS formulation) to patients with intermediate age-related macular degeneration (AMD) aged 40-79 years from Singapore is cost-effective in preventing progression to wet AMD. Methods: A hypothetical cohort of category 3 and 4 AMD patients from Singapore was followed for 5 calendar years to determine the number of patients who would progress to wet AMD given the following treat...

  6. Patient empowerment

    DEFF Research Database (Denmark)

    Eskildsen, Nanna Bjerg; Joergensen, Clara Ruebner; Thomsen, Thora Grothe

    2017-01-01

    assessing empowerment from the user perspective. The aim of this review was to identify questionnaires and subscales measuring empowerment and manifestations of empowerment among cancer patients. MATERIALS AND METHODS: We conducted a systematic search of the PubMed, PsycINFO and CINAHL databases......BACKGROUND: There is an increased attention to and demand for patient empowerment in cancer treatment and follow-up programs. Patient empowerment has been defined as feeling in control of or having mastery in relation to cancer and cancer care. This calls for properly developed questionnaires....... Empowerment and multiple search terms associated with empowerment were included. We included peer-reviewed articles published in English, which described questionnaires measuring empowerment or manifestations of empowerment in a cancer setting. In addition, the questionnaire had to be a patient...

  7. chemotherapy patients

    Directory of Open Access Journals (Sweden)

    Katarzyna Augustyniuk

    2016-02-01

    Full Text Available Background . Complementary and alternative medicine (CAM practices for cancer have become popular among oncology patients. An increasing interest in alternative medicine can be explained by the inefficiency of conventional treatment, dissatisfaction with treating patients like objects, and the will to use all available treatment methods. Objectives . The authors assessed how often patients use CAM methods, and which of them are most popular. Material and methods . The study was conducted in Military Hospital no. 109 and the Independent Public Clinical Hospital no. 1 in Szczecin among 100 chemotherapy patients. This survey-based study was performed using an original questionnaire. Results. Most respondents (68% did not use alternative methods to fight the disease. The most popular treatment methods were: herbal medicine (50%, alternative medicine preparations (38% and diet (25%, and the least common: hypnosis (3% and aromatherapy (3%. Analyzed sociodemographic factors had no effects on a choice of a CAM method. Patients obtained information about CAM methods mainly from the Internet (40%, medical staff (37% and literature (31%. Conclusions . 1. Using CAM by patients receiving chemotherapy for neoplasms is quite a common phenomenon. 2. CAM were more often chosen by women. Neither the duration of the disease nor sociodemographic data had effects on making the decision to use CAM methods. 3. The most popular CAM were: herbal medicine, alternative medicine preparations, and diet. 4. Cancer patients should receive special support from nurses and doctors as well as other members of the therapeutic team. Oncology patients should never be left on their own so that they were forced to seek help and support in therapies unconfirmed by scientific investigation.

  8. chemotherapy patients

    Directory of Open Access Journals (Sweden)

    Katarzyna Augustyniuk

    2016-02-01

    Full Text Available Background . Complementary and alternative medicine (CAM practices for cancer have become popular among oncology patients. An increasing interest in alternative medicine can be explained by the inefficiency of conventional treatment, dissatisfaction with treating patients like objects, and the will to use all available treatment methods. Objectives . The authors assessed how often patients use CAM methods, and which of them are most popular. Material and methods . The study was conducted in Military Hospital no. 109 and the Independent Public Clinical Hospital no. 1 in Szczecin among 100 chemotherapy patients. This survey-based study was performed using an original questionnaire. Results. Most respondents (68% did not use alternative methods to fight the disease. The most popular treatment methods were: herbal medicine (50%, alternative medicine preparations (38% and diet (25%, and the least common: hypnosis (3% and aromatherapy (3%. Analyzed sociodemographic factors had no effects on a choice of a CAM method. Patients obtained information about CAM methods mainly from the Internet (40%, medical staff (37% and literature (31%. Conclusions . 1. Using CAM by patients receiving chemotherapy for neoplasms is quite a common phenomenon. 2. CAM were more often chosen by women. Neither the duration of the disease nor sociodemographic data had effects on making the decision to use CAM methods. 3. The most popular CAM were: herbal medicine, alternative medicine preparations, and diet. 4. Cancer patients should receive special support from nurses and doctors as well as other members of the therapeutic team. Oncology patients should never be left on their own so that they were forced to seek help and support in therapies unconfirmed by scientific investigation.

  9. A thermographic study on eyes affected by Age-related Macular Degeneration: Comparison among various forms of the pathology and analysis of risk factors

    Science.gov (United States)

    Matteoli, Sara; Finocchio, Lucia; Biagini, Ilaria; Giacomelli, Giovanni; Sodi, Andrea; Corvi, Andrea; Virgili, Gianni; Rizzo, Stanislao

    2016-05-01

    The aims of this study are to investigate (1) the ocular thermographic profiles in eyes affected by Age related Macular Degeneration (AMD) and age-matched controls to detect possible hemodynamic abnormalities that could be involved in the pathogenesis of the disease, (2) whether any risk factors associated with the disease could affect the development of a form of AMD rather than another. Thirty-four eyes with Age-Related Maculopathy (ARM), 41 eyes with dry AMD, 60 eyes affected by wet AMD, and 74 eyes with fibrotic AMD were included in the study. The control group consisted of 48 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, systemic diseases and a body temperature higher than 37.5 °C. A total of 210 eyes without pupil dilation were investigated by infrared thermography (FLIR A320). The Ocular Surface Temperature (OST) of five ocular areas was calculated by means of an image processing technique from the infrared images. Two-sample t-test, one-way ANOVA test and multivariate analysis were used for statistical analyses. ANOVA analyses showed no significant differences among AMD groups (P-value > 0.05), however, OST in AMD patients was significantly lower than in controls (P-value wet AMD instead of dry AMD. Infrared thermography may be a helpful, non-invasive and not time-consuming method to be used in the management of patients with this common degenerative maculopathy.

  10. The vitreomacular interface in different types of age-related macular degeneration

    Science.gov (United States)

    El-Hifnawy, Mohamed Abd ElMonaem; Ibrahim, Hisham Ali; Gomaa, Amir Ramadan; Elmasry, Mohamed A

    2017-01-01

    AIM To evaluate the vitreomacular interface in cases with wet age-related macular degeneration (AMD) and to compare them to eyes with dry AMD and normal eyes. METHODS This was a cross-sectional comparative study that included 87 eyes with wet AMD, 42 eyes with dry AMD and 40 eyes without AMD as a control group. Optical coherence tomography (OCT) examination was performed for all patients to assess the vitreomacular interface. RESULTS In the wet AMD group, 34.5% of cases had vitreomacular adhesion (VMA). Only 14.3% of dry AMD cases and 10% of control cases had VMA. There was a significant difference between the control group and the wet AMD group (P=0.004) as well as the dry and wet AMD group (P=0.017). There was also a significant difference between the incidence of VMA in patients with subretinal choroidal neovascularization (CNV, type 1) and intraretinal CNV (type 2 or type 3) (P=0.020). CONCLUSION There is an association between posterior vitreous attachment and AMD. There is also an increased incidence of VMA with intra-retinal CNV. PMID:28251084

  11. Prevalence and determinants of age related macular degeneration in north Indian city of Dehradun, Uttarakhand

    Directory of Open Access Journals (Sweden)

    Megha Luthra

    2014-09-01

    Full Text Available Introduction: Age-related macular degeneration (AMD is among the fourth leading cause of blindness in India after cataract, refractive errors and glaucoma. Aim and Objective: To find out magnitude and determinants of blinding AMD among patients presenting at a tertiary level eye care centre in Dehradun with this condition. Material and methods: This was a study of eye patients above age 45 years seen from July 2010 to October 2013. After taking preliminary information, optometrist noted the best-corrected vision. Ophthalmologists examined eyes using a slit-lamp bio-microscope. AMD was confirmed by fluorescein angiography and optical coherence tomography. The age, sex, history of smoking, sun exposure, family history of AMD, diet, body mass index (BMI, history of hypertension, dyslipidemia and diabetes were noted.  Results: Of the 14,698 patients seen, 221 had AMD (dry or wet in at least one eye, the overall proportion of AMD being 1.50%. Of all AMD patients, 103 had blinding wet AMD (46.61%.Further analysis revealed that old age (71-80 years, male sex and history of hypertension, diabetes etc were significant risk factors of  wet AMD. Of the 221 patients with AMD, nearly a third, that is 71 patients (32.13% had visual acuity of better eye < 3/60, which was taken as criteria for blindness. Conclusions: AMD does not seem to be a problem of public health magnitude in the study area. Age, being male, history of hypertension, diabetes etc are significant risk factors for wet AMD.

  12. 视感知觉学习对年龄相关性黄斑变性患者黄斑光敏度影响研究%Visual perception learning effect on macular light sensitivity on the patients with age-related macular degeneration

    Institute of Scientific and Technical Information of China (English)

    李小丹; 李慧丽; 余海; 傅燕

    2015-01-01

    Objective To discuss the visual perception leaming of Age-related macular degeneration (AMD) patients and the effect of visual acuity of macular light sensitivity.Methods Applied visual perception learning system perception training to AMD patients on central vision loss depending on the sense of visual stimulation,contrast sensitivity,visual identification.Using Humphrey type 750 field analyzer analyzing 5 degrees central of macular light sensitivity,to detect the affected eye fixation state and retinal light sensitivity,and to analyze and establish the possible position of the eccentric fixation.Results Twenty cases of AMD patients (25 eyes) with AMD underwent visual perception training,the mean visual after 3 months training was (0.59±0.18) LogMAR,that was improved than ones before visual training (0.67±0.21) LogMAR,but no statistically significant on difference (P > 0.05).After 3 months training,the photosensitivity of right eye macula in each quadrant and the left eye except the nasal quadrant of each quadrant of the outer was slightly improved,the retina photosensitivity on superior temporal quadrant of the right eye and the left upper quadrant of the nose was increased by a big margin,but photosensitivity quadrant differences before and after treatment was not statistically significant (P >0.05).Conclusions AMD patients with central vision loss have poor fixation stability,can form a relatively stable eccentric fixation through rehabilitation training that can be as far as possible to retain its residual visual function,to play an effective application of its vision.%目的 探讨视感知觉学习对年龄相关性黄斑变性(AMD)患者视力及黄斑光敏度的影响.方法 临床病例回顾性系列研究.对2012年10月至2014年6月在重庆市中医院眼科,应用视感知觉学习系统对中心视力缺失的AMD患者进行视觉刺激、对比敏感度、视觉辨识等三项视感知觉训练,采用Humphrey 750

  13. Identification of Chlamydia pneumoniae within human choroidal neovascular membranes secondary to age-related macular degeneration.

    Science.gov (United States)

    Kalayoglu, Murat V; Bula, Deisy; Arroyo, Jorge; Gragoudas, Evangelos S; D'Amico, Donald; Miller, Joan W

    2005-11-01

    Age-related macular degeneration (AMD) is a leading cause of blindness in the United States, and increasing evidence suggests that it is an inflammatory disease. The prokaryotic obligate intracellular pathogen Chlamydia pneumoniae is emerging as a novel risk factor in cardiovascular disease, and recent sero-epidemiological data suggest that C. pneumoniae infection is also associated with AMD. In this study, we examined choroidal neovascular membrane (CNV) tissue from patients with neovascular AMD for the presence of C. pneumoniae and determined whether the pathogen can dysregulate the function of key cell types in ways that can cause neovascular AMD. Nine CNV removed from patients with neovascular AMD were examined for the presence of C. pneumoniae by immunohistochemistry (IHC) and polymerase chain reaction (PCR); in addition, we performed PCR on nine non-AMD eyes, and IHC on five non-AMD CNV, seven non-AMD eyes, and one internal limiting membrane specimen. Finally, human monocyte-derived macrophages and retinal pigment epithelial (RPE) cells were exposed to C. pneumoniae and assayed in vitro for the production of pro-angiogenic immunomodulators (VEGF, IL-8, and MCP-1). C. pneumoniae was detected in four of nine AMD CNV by IHC and two of nine AMD CNV by PCR, induced VEGF production by human macrophages, and increased production of IL-8 and MCP-1 by RPE cells. In contrast, none of the 22 non-AMD specimens showed evidence for C. pneumoniae. These data indicate that a pathogen capable of inducing chronic inflammation and pro-angiogenic cytokines can be detected in some AMD CNV, and suggest that infection may contribute to the pathogenesis of AMD.

  14. Patient life

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    2004-01-01

    , treatment, and staff members will be attended to. A specific focus on contrasting experiences is made in order to enhance a better understanding of patients' interactions. Methods: I explore patients' social interactions in their day-to-day lives in two adult surgical units at a University Hospital......-interviews. The material will consist of field-notes, interviews, and audio-video recordings of interactions between patients. The material will be analysed with inspiration from Mattingly's ideas of narrative, drawing on the work of Ricoeur's term of emplotment developed through considering the narrative structures...... of fiction and history. Especially her way of bringing the term emplotment directly into the area of social action, I find inspiring. Conclusions:The study is ongoing. Yet it is not clear in what perspectives the findings will be interpreted, but age, body, gender, time and space might be relevant. More...

  15. Alterations in Circulating Immune Cells in Neovascular Age-Related Macular Degeneration.

    Science.gov (United States)

    Lechner, Judith; Chen, Mei; Hogg, Ruth E; Toth, Levente; Silvestri, Giuliana; Chakravarthy, Usha; Xu, Heping

    2015-11-17

    Neovascular age-related macular degeneration (nAMD) is the leading cause of irreversible blindness in developed countries. Recent advances have highlighted the essential role of inflammation in the development of the disease. In addition to local retinal chronic inflammatory response, systemic immune alterations have also been observed in AMD patients. In this study we investigated the association between the frequency of circulating leukocyte populations and the prevalence as well as clinical presentations of nAMD. Leukocyte subsets of 103 nAMD patients (most of them were receiving anti-VEGF therapy prior to enrolment) and 26 controls were analysed by flow cytometry by relative cell size, granularity and surface markers. Circulating CD11b(+) cells and CD16(hi)HLA-DR(-) neutrophils were significantly increased (P = 0.015 and 0.009 respectively) in nAMD when compared to controls. The percentage of circulating CD4(+) T-cells was reduced in nAMD patients without subretinal fibrosis (P = 0.026) compared to patients with subretinal fibrosis. There was no correlation between the percentage of circulating leukocytes and the responsiveness to anti-VEGF therapy in nAMD patients. Our results suggest that higher levels of circulating CD11b(+) cells and neutrophils are associated with nAMD and that reduced levels of CD4(+) T-cells are associated with the absence of subretinal fibrosis in nAMD.

  16. SDF-1对糖尿病外周血EPCs功能的影响及其与PI3K/AKT信号通路的关系%Effects of Stromal Cell-Derived-Factor-1 on Endothelial Progenitor Cells of Peripheral Blood and Their Relationship with PI3K/AKT Signal Transduction Pathway in Patients with Diabetes

    Institute of Scientific and Technical Information of China (English)

    黎金凤; 林安华; 邓颖; 霍亚南; 刘精东; 吴明斌; 王晨秀

    2014-01-01

    Objective To observe the effects of stromal cell-derived-factor-1(SDF-1) on the function of endotheli⁃al progenitor cells(EPCs)of peripheral blood in patients with diabetes, and to discuss the effects of PI3K/AKT signaling path⁃way on the role of SDF-1 in EPCs. Methods The peripheral blood samples (30 mL) were collected in 10 diabetes patients (DM group) and 10 healthy controls (HC group). (1) The 100μg/L SDF-1 was added in intervention group. EGM-2MV was added in non-intervention group. The Boyden chamber and in vitro angiogenesis kit were used to analyze the migration and in vitro angiogenesis of EPCs. (2) Cultured EPCs were divided into blank control group, 1μg/L SDF-1 group, 10μg/L SDF-1 group, 100μg/L SDF-1 group, pure AMD3100 group and 100μg/L SDF-1+AMD3100 group. AKT protein expression lev⁃els of endothelial progenitor cells were detected by Western blot assay in each group. Results (1) Without intervention with SDF-1, EPCs’migration and angiogenesis ability were lower in DM group than those in HC group. After intervention with SDF-1, the migration and angiogenesis ability were enhanced in two groups, but the increased level was higher in DM group than that of HC group. (2) Under the same concentration, AKT protein expression level was significantly lower in DM group than that in HC group (P<0.01). AKT protein expression levels were increased with the increased levels of SDF-1 in DM group and HC group (P<0.05). AKT protein expression was significantly lower in 100μg/L SDF-1+AMD3100 group than that of 100μg/L SDF-1 group (P<0.05). Conclusion SDF-1 can increase the chemotactic migration and angiogenesis ability of EPCs in peripheral blood, especially for patients with diabetes. The effects of SDF-1 on EPCs were related to the PI3K/AKT signaling pathway.%目的:观察基质细胞衍生因子-1(SDF-1)对糖尿病外周血内皮祖细胞(EPCs)功能的影响,探讨SDF-1对EPCs的影响是否与PI3K/AKT信号通路有关。方法采集

  17. Patient safety

    African Journals Online (AJOL)

    406 CME Nov/Dec 2012 Vol. 30 No. 11 ... The message remains the same: around 10% of all patients ... error rates in healthcare in South Africa, no real data exist. ... so as technology progresses. The medical .... top priority and they will include it in planning and .... Reason J. Managing the risks of organisational accidents.

  18. diabetic patients

    Directory of Open Access Journals (Sweden)

    Mehraban Falahati

    2016-09-01

    candiduria and female gender, high FBS and urine glucose, uncontrolled diabetes (HbA1c ≥8, and acidic urine pH (P<0.05. Conclusion: Considering the high incidence rate of candiduria in diabetic patients, control of diabetes, predisposing factors, and causal relationships between diabetes and candiduria should be highlighted.

  19. Quantification of visual field loss in age-related macular degeneration.

    Directory of Open Access Journals (Sweden)

    Jennifer H Acton

    Full Text Available BACKGROUND: An evaluation of standard automated perimetry (SAP and short wavelength automated perimetry (SWAP for the central 10-2 visual field test procedure in patients with age-related macular degeneration (AMD is presented in order to determine methods of quantifying the central sensitivity loss in patients at various stages of AMD. METHODS: 10-2 SAP and SWAP Humphrey visual fields and stereoscopic fundus photographs were collected in 27 eyes of 27 patients with AMD and 22 eyes of 22 normal subjects. RESULTS: Mean Deviation and Pattern Standard Deviation (PSD varied significantly with stage of disease in SAP (both p<0.001 and SWAP (both p<0.001, but post hoc analysis revealed overlap of functional values among stages. In SWAP, indices of focal loss were more sensitive to detecting differences in AMD from normal. SWAP defects were greater in depth and area than those in SAP. Central sensitivity (within 1° changed by -3.9 and -4.9 dB per stage in SAP and SWAP, respectively. Based on defect maps, an AMD Severity Index was derived. CONCLUSIONS: Global indices of focal loss were more sensitive to detecting early stage AMD from normal. The SWAP sensitivity decline with advancing stage of AMD was greater than in SAP. A new AMD Severity Index quantifies visual field defects on a continuous scale. Although not all patients are suitable for SWAP examinations, it is of value as a tool in research studies of visual loss in AMD.

  20. Depression in Age-Related Macular Degeneration

    OpenAIRE

    Casten,Robin; Rovner,Barry

    2008-01-01

    Age-related macular degeneration (AMD) is a major cause of disability in the elderly, substantially degrades the quality of their lives, and is a risk factor for depression. Rates of depression in AMD are substantially greater than those found in the general population of older people, and are on par with those of other chronic and disabling diseases. This article discusses the effect of depression on vision-related disability in patients with AMD, suggests methods for screening for depressio...

  1. 45岁以上黄斑区神经上皮脱离患者疾病类型分析%Types of macular neuroepithelial detachment in patients aged above 45 years

    Institute of Scientific and Technical Information of China (English)

    曹绪胜; 周海英; 张风; 周辉

    2009-01-01

    Objective To observe the of macular serous neuroepithelial detachment and the necessary auxiliary examination methods for the diagnosis.Methods The clinical data of 46 patients (49 eyes) aged above 45 years with macular serous neuroepithelial detachment who have been diagnosed by binocular indirect ophthalmoscope and optical coherence tomography (OCT) were retrospectively analyzed.All the patients had undergone fundus fluorescein angiography (FFA) and indocyanine angiography (ICGA),and the diagnosis was established based on the results of FFA,ICGA and OCT.Results In these 46 patients (49 eyes),central serous chorioretinopathy (CSC) was found in 31 (34 eyes,69.4%),age-related macular degeneration (AMD) was found in 12 (12 eyes,24.5%),and polypoidal choroidal vasculopathy (PCV) was found in 3 (3 eyes,6.9%).In the 34 eyes with CSC,12 eyes (35.3%) had typical CSC and 22 eyes (64.7%) had chronic CSC.If the 12 eyes with AMD,9 eyes (75%) had occult CNV,2 eyes (16.7%) had minimally classic CNV,and 1 eye had classic CNV.Conclusions The causes of serous macular neuroepithelial detachment in patients aged above 45 years are complex;ICGA may help to establish the definitive diagnosis of chronic CSC,occult CNVO and PCV should be considered.%目的 观察45岁以上患者发生黄斑区浆液性神经上皮脱离的疾病类型,探讨疾病诊断必要的辅助检查方法.方法 对年龄在45岁以上,双目间接检眼镜检查结合光相十断层扫描(OCT)确诊为黄斑区浆液性神经上皮脱离患者46例49只眼的临床资料进行同顾性分析.所有患者均接受荧光素眼底血管造影(FFA)、吲哚青绿血管造影(ICGA)检查.结合 FFA、ICGA和OCT检查做出诊断.结果 中心性浆液性脉络膜视网膜病变(CSC)31例34只眼,占所有患者的69.4%.其中,9例12只眼呈典型CSC表现,占CSC患者的35.3%;22例22只眼为慢性CSC,占CSC患者的64.7%.渗出型老年性黄斑变性(AMD)12例12只眼,占所有患者的24.5%.其中隐匿型9

  2. Cover design for radioactive and AMD-producing mine waste in the Ronneburg area, eastern Thuringia.

    Science.gov (United States)

    Gatzweiler, R; Jahn, S; Neubert, G; Paul, M

    2001-01-01

    At the former uranium mining site of Ronneburg, large scale underground and open pit mining for nearly 40 years resulted in a production of about 113,000 tonnes of uranium and about 200 million cubic metres of mine waste. In their present state, these materials cause risks to human health and strong environmental impacts and therefore demand remedial action. The remediation options available are relocation of mine spoil into the open pit and on site remediation by landscaping/contouring, placement of a cover and revegetation. A suitable vegetated cover system combined with a surface water drainage system provides long-term stability against erosion and reduces acid generation thereby meeting the main remediation objectives which are long-term reduction of radiological exposure and contaminant emissions and recultivation. The design of the cover system includes the evaluation of geotechnical, radiological, hydrological, geochemical and ecological criteria and models. The optimized overall model for the cover system has to comply with general conditions as, e.g. economic efficiency, public acceptance and sustainability. Most critical elements for the long-term performance of the cover system designed for the Beerwalde dump are the barrier system and its long-term integrity and a largely self-sustainable vegetation.

  3. 代号,Richland AMD A1O-6800K APU首发测试

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    2011年,Llano APU诞生,融合独显核心的设计开辟了一条创新的处理器发展之路。2012年,TrinityAPU出世,让APU彻底扛起了AMD在处理器市场的自卫反击战大旗。转眼就到了2013年,按照APU一年一换代的进程,AMD在这个6月又将APU再次进化,

  4. Assessment of a career development program for executive amd mid-level managers

    Science.gov (United States)

    Swanson, James R., Sr.

    1994-01-01

    This project sought to validate the competencies required of mid-level and executive managers at the Kennedy Space Center (KSC), in order to enable an assessment of the Resident Management Education Program (RMEP). Forty (40) statements describing management competencies were presented to a sample of 37 KSC managers, who judged each as essential, useful but not essential, or not needed at each of two management levels. A content validity ratio (CVR) was calculated for each competency statement at the two management levels. There was general agreement on the validity of 36 or the 40 competency statements. Based on the content validity ratios and comments from respondents, recommendations for improvement of the RMEP were made.

  5. Evaluation of Tillandsia capillaris Ruiz amd Pav. f. capillaris as biomonitor of atmospheric pollution in Argentina

    Energy Technology Data Exchange (ETDEWEB)

    Pignata, M.L. [Univ. Nacional de Cordoba, Cordoba (Argentina). Facultad de Ciencias Exactas, Fisicas y Naturales]|[Instituto Multidisciplinario de Biologia Vegetal (IMBIV-UNC), Cordoba (Argentina); Wannaz, E.D.; Martinez, M.S.; Caminotti, G. [Univ. Nacional de Cordoba, Cordoba (Argentina). Facultad de Ciencias Exactas, Fisicas y Naturales

    2002-07-01

    The behaviour of Tillandsia capillaris Ruiz and Pav. f. capillaris, when exposed to atmospheric pollutants, was assessed by measuring chemical parameters indicating foliar damage and the contents of some heavy metals. Samples were transplanted to three sites in the City of Cordoba and were collected back after 15, 30, 60 and 90 days of exposure. At the same time, samples coming from the collection site were analyzed for each of said exposure times. Chlorophylls, hydroperoxy conjugated dienes, water contents, malondialdehyde, sulfur, Cu, Pb, Ni, Co, Mn, Zn and Fe were measured in the samples. A Foliar Damage Index was calculated from some of these parameters. (orig.)

  6. 龙虎斗:打破AMD A8的“神话”

    Institute of Scientific and Technical Information of China (English)

    刻录光盘

    2011-01-01

    早在2010年初,AMD就开始为旗下的融合平台“Lynx”造势,在经历了1年多的宣传以后,发布了A8系列APU和对应的A75/A55芯片组,这套融合平台确实有着比较优异的性能,但是不是就真的如AMD宣传所说,在同等定位的区间内是完全没有敌手的?让我们用评测的数据说话。

  7. Potencial de reutilización industrial de residuos asociados al tratamiento de AMD

    OpenAIRE

    Valente, Teresa Maria Fernandes; Antunes, M.; Pamplona, J; Grande, J.A.; De la Torre, M. L.; Santistebán, M.; Cruzado, M.

    2012-01-01

    "1st International Congress on Water, Waste and Energy Management " Los sistemas pasivos para el tratamiento de aguas de mina son especialmente apropiados para el caso de drenaje ácido de minas abandonadas. Las ventajas de los tratamientos pasivos surgen del principio de atenuación natural. Este trabajo presenta las propiedades del lodo formado por la neutralización en un tratamiento pasivo construido para tratar AMO procedente de una mina abandonada de Au (planta Jales en Portugal). El...

  8. 横扫GTX460!AMD Radeon HD6000系列探究

    Institute of Scientific and Technical Information of China (English)

    现代计算机评测室

    2010-01-01

    @@ 自从Fermi架构一出,真假DX11之战便打响了,基于Fermi的GTX480/470由于功耗问题并没在市场上占优,不过经过数月的炮制,NVIDIA放出重量级产品GTX460.基于GF104的GTX460经过晶体管上的改良,使其在游戏渲染效能得到很好的提升.由于该卡是面向高端性价比游戏市场,因此霎时间成了NVIDIA扭转Fermi尴尬局面的明星.

  9. amdSYM, a new dominant recyclable marker cassette for Saccharomyces cerevisiae

    NARCIS (Netherlands)

    Solis-Escalante, D.; Kuijpers, N.G.A.; Bongaerts, N.; Bolat, I.; Bosman, L.; Pronk, J.T.; Daran, J.M.; Daran-Lapujade, P.A.S.

    2012-01-01

    Despite the large collection of selectable marker genes available for Saccharomyces cerevisiae, marker availability can still present a hurdle when dozens of genetic manipulations are required. Recyclable markers, counterselectable cassettes that can be removed from the targeted genome after use, ar

  10. Interactive Image Analysis in Age-related Macular Degeneration (AMD) and Stargardt Disease (STGD).

    Science.gov (United States)

    Smith, R Theodore; Lee, Noah; Chen, Jian; Busuioc, Mihai; Laine, Andrew F

    2008-10-26

    The literature of the last three decades is replete with automatic methods for retinal image analysis. Acceptance has been limited due to post-processing or tuning requirements that may be just as time consuming as the original manual methods. The point of view herein is that by taking advantage of the human visual system and expert knowledge from the outset, the promised efficiencies of digital methods can be achieved in practice as well as in theory. Thus, simple labeling of regions of interest that is accepted and easily performed in a few moments by the human can provide enormous advantage to an already well-developed algorithm. Three examples are provided: drusen segmentation, image registration, and geographic atrophy segmentation, with applications to disease understanding.

  11. Efficacy and tolerability of switching to a dual therapy with darunavir/ritonavir plus raltegravir in HIV-infected patients with HIV-1 RNA ≤50 cp/mL.

    Science.gov (United States)

    Madeddu, Giordano; Rusconi, Stefano; Cozzi-Lepri, Alessandro; Di Giambenedetto, Simona; Bonora, Stefano; Carbone, Alessia; De Luca, Andrea; Gianotti, Nicola; Di Biagio, Antonio; Antinori, Andrea

    2017-08-01

    Nucleos(t)ide reverse transcriptase inhibitors (NRTI) toxicity may represent a threat for long-term success of combined antiretroviral therapy. Some studies have suggested a possible improvement of NRTI-related toxicity after switching to NRTI-sparing regimens. We aimed to explore the efficacy and tolerability of switching to darunavir/ritonavir (DRV/r) plus raltegravir (RAL) while having a viral load (VL) ≤50 copies/mL in the clinical setting. Treatment-experienced HIV 1-infected patients enrolled in the ICONA Foundation Study cohort were included if they switched their current regimen to DRV/r + RAL with a HIV-RNA ≤50 copies/mL. Different definitions of virological failure (VF) and treatment failure (TF) were employed. Kaplan-Meier curves and Cox regression models were performed to estimate time to event probability. We included 72 HIV-infected patients, 22 (31%) of these were female, 31 (43%) men who have sex with men (MSM) amd 15 (21%) had hepatitis co-infections. Median age was 44 (IQR: 35-50) years amd CD4 count was 389 (IQR 283-606) cells/mmc. Median follow-up time for TF was 24 (IQR 9-31) months. Twenty-five discontinuations occurred (60% simplifications); only 2 (8%) were toxicity-driven (lipid elevations). The probability of VF (confirmed VL >50 copies/mL) was estimated at 7% [95% confidence interval (CI) 1-13%] by 12 and 9% (95% CI 2-16%) by 24 months. When considering TF, we found a probability of stop/intensification/single VL > 200 copies/mL of 13% (95% CI 1-17%) and 22% (95% CI 11-33%) by 12 and 24 months. Female gender (adjusted relative hazard, ARH = 0.10; 95% CI 0.01-0.74; p = 0.024) and older age (AHR = 0.50 per 10 years older; 95% CI 0.25-0.99; p = 0.045) were associated with a lower risk of TF. A previous PI failure was strongly associated with TF (AHR = 52.6, 95% CI 3.6-779; p = 0.004). DRV/r + RAL is a valuable NRTI-sparing option, especially in female and older patients, with a relatively low risk of VF and good

  12. Prevalence and nature of adverse medical device events in hospitalized children.

    Science.gov (United States)

    Brady, Patrick W; Varadarajan, Kartik; Peterson, Laura E; Lannon, Carole; Gross, Thomas

    2013-07-01

    Our objective was to describe the prevalence and nature of adverse medical device events (AMDEs) in tertiary care children's hospitals. In our retrospective cohort study of patients at 44 children's hospitals in the Pediatric Health Information System (PHIS), we included all inpatient stays with an AMDE-related diagnosis from January 1, 2004 to December 31, 2011. We identified AMDEs by diagnoses that specified a device in their definition. We included events present on admission as well as those complicating hospital stays. We described the characteristics of these admissions and patients, and stratified analysis by device category and presence of a complex chronic condition. Of 4,115,755 admissions in the PHIS database during the study period, 136,465 (3.3%) had at least 1 AMDE. Vascular access and nervous system devices together represented 44.4% of pediatric AMDE admissions. The majority (75.5%) of AMDE admissions were of children with complex chronic conditions. The most common age group was patients aged 2 years or less at the time of their first AMDE-related admission. AMDEs occur commonly in a population cared for in tertiary children's hospitals. Research to more specifically delineate AMDEs and their predictors are next steps to understand and improve device safety in children.

  13. Preferential Hyperacuity Perimeter (PreView PHP) for detecting choroidal neovascularization study.

    Science.gov (United States)

    Alster, Yair; Bressler, Neil M; Bressler, Susan B; Brimacombe, Judith A; Crompton, R Michael; Duh, Yi-Jing; Gabel, Veit-Peter; Heier, Jeffrey S; Ip, Michael S; Loewenstein, Anat; Packo, Kirk H; Stur, Michael; Toaff, Techiya

    2005-10-01

    To assess the ability of the Preferential Hyperacuity Perimeter (PreView PHP; Carl Zeiss Meditec, Dublin, CA) to detect recent-onset choroidal neovascularization (CNV) resulting from age-related macular degeneration (AMD) and to differentiate it from an intermediate stage of AMD. Prospective, comparative, concurrent, nonrandomized, multicenter study. Eligible participants' study eyes had a corrected visual acuity of 20/160 or better and either untreated CNV from AMD diagnosed within the last 60 days or an intermediate stage of AMD. After obtaining consent, visual acuity with habitual correction, masked PHP testing, stereoscopic color fundus photography, and fluorescein angiography were performed. Photographs and angiograms were evaluated by graders masked to diagnosis and PHP results. The reading center's diagnosis determined if the patient was categorized as having intermediate AMD or neovascular AMD. A successful study outcome was defined a priori as a sensitivity of at least 80% and a specificity of at least 80%. Of 185 patients who gave consent to be enrolled, 11 (6%) had PHP results judged to be unreliable. An additional 52 were not included because they did not meet all eligibility criteria. Of the remaining 122 patients, 57 had an intermediate stage of AMD and 65 had neovascular AMD. The sensitivity to detect newly diagnosed CNV using PHP testing was 82% (95% confidence interval [CI], 70%-90%). The specificity to differentiate newly diagnosed CNV from the intermediate stage of AMD using PHP testing was 88% (95% CI, 76%-95%). Preferential Hyperacuity Perimeter testing can detect recent-onset CNV resulting from AMD and can differentiate it from an intermediate stage of AMD with high sensitivity and specificity. These data suggest that monitoring with PHP should detect most cases of CNV of recent onset with few false-positive results at a stage when treatment usually would be beneficial. Thus, this monitoring should be considered in the management of the

  14. Association analysis of genetic and environmental risk factors in the cuticular drusen subtype of age-related macular degeneration.

    NARCIS (Netherlands)

    Ven, J.P.H. van de; Smailhodzic, D.; Boon, C.J.F.; Fauser, S.; Groenewoud, J.M.M.; Chong, N.V.; Hoyng, C.B.; Klevering, B.J.; Hollander, A.I. den

    2012-01-01

    PURPOSE: To assess the association of gender, cigarette smoking, body-mass index, and nine genetic risk variants with cuticular drusen (CD), a well recognized subtype of age-related macular degeneration (AMD). METHODS: A total of 757 patients with AMD, including 217 patients with CD, and 553 control

  15. Clinical characteristics of familial and sporadic age-related macular degeneration: differences and similarities

    NARCIS (Netherlands)

    Saksens, N.T.M.; Kersten, E.; Groenewoud, J.M.M.; Grinsven, M.J.J.P. van; Ven, J.P.H. van de; Sanchez, C.I.; Schick, T.; Fauser, S.; Hollander, A.I. den; Hoyng, C.B.; Boon, C.J.F.

    2014-01-01

    PURPOSE: We describe the differences and similarities in clinical characteristics and phenotype of familial and sporadic patients with age-related macular degeneration (AMD). METHODS: We evaluated data of 1828 AMD patients and 1715 controls enrolled in the European Genetic Database. All subjects

  16. Clinical characteristics of familial and sporadic age-related macular degeneration: differences and similarities

    NARCIS (Netherlands)

    Saksens, N.T.M.; Kersten, E.; Groenewoud, J.M.M.; Grinsven, M.J.J.P. van; Ven, J.P.H. van de; Sanchez, C.I.; Schick, T.; Fauser, S.; Hollander, A.I. den; Hoyng, C.B.; Boon, C.J.F.

    2014-01-01

    PURPOSE: We describe the differences and similarities in clinical characteristics and phenotype of familial and sporadic patients with age-related macular degeneration (AMD). METHODS: We evaluated data of 1828 AMD patients and 1715 controls enrolled in the European Genetic Database. All subjects und

  17. Optical coherence tomography and multifocal electroretinography of patients with advanced neovascular age-related macular degeneration before, during, and after treatment with ranibizumab

    Directory of Open Access Journals (Sweden)

    Izabela Negrão Frota de Almeida

    2015-04-01

    Full Text Available Purpose: To evaluate retinal morphology and function of patients with advanced neovascular age-related macular degeneration (AMD before, during, and after treatment with ranibizumab. Methods: Twenty-one eyes diagnosed with advanced AMD were studied with optical coherence tomography (OCT and multifocal electroretinography (mfERG. Three intravitreal injections of ranibizumab were administered at 1-month intervals. Evaluations were performed before the first injection (D0 and at 30 (D30, 60 (D60, and 90 days (D90 after the first injection and compared to an age-matched control group (n=21 eyes. Results: The thickness of macular retinal layers increased before treatment due to the presence of intraretinal fluid. A thick retinal pigment epithelium-choriocapillaris complex (RPE-CC suggested the presence of choroidal neovascular membrane. Intraretinal edema decreased after treatment (P<0.01, but persisting RPE-CC thickness resulted in a subretinal scar. Three different annular retinal areas were studied with mfERG (from center to periphery: rings R1, R2, and R3. The amplitude of the first negative component (N1 decreased in R1, R2, and R3 at D30, D60, and D90 when compared with that in controls (P<0.05; the N1 implicit time was delayed in R3 at D30 (P<0.05. The amplitude of the first positive component (P1 was reduced in R1 and R2 at D30, D60, and D90 when compared with that in controls (P<0.01; the P1 implicit time was delayed in R1 at D0 and D60 (P<0.05, in R2 at D0, D30, and D90 (P<0.01, and in R3 at D30 and D60 (P<0.05. Conclusion: Ranibizumab reduces intraretinal edema, even in advanced cases. Central macular activity appeared to increase after the initiation of treatment, improving over time.

  18. Genetics of immunological and inflammatory components in age-related macular degeneration.

    Science.gov (United States)

    Tuo, Jingsheng; Grob, Seanna; Zhang, Kang; Chan, Chi-Chao

    2012-02-01

    Age-related macular degeneration (AMD), affecting 30 to 50 million elder individuals worldwide, is a disease affecting the macular retina and choroid that can lead to irreversible central vision loss and blindness. Recent findings support a role for immunologic processes in AMD pathogenesis, including generation of inflammatory related molecules in the Bruch's membrane, recruitment of macrophages, complement activation, microglial activation and accumulation in the macular lesions. Pro-inflammatory effects of chronic inflammation and oxidative stress can result in abnormal retinal pigment epithelium, photoreceptor atrophy and choroidal neovascularization. The associations of immunological and inflammatory genes, in particular the genes related to innate immunity with AMD support the involvement of various immunological pathways in the AMD pathogenesis. We review the literature on the involvements of inflammatory genes in AMD, highlight recent genetic discoveries, and discuss the potential application of such knowledge in the management of patients with AMD.

  19. Polymorphisms of complement genes and ARMS2/HTRAI in patients with age-related macular degeneration in Ningxia, China%中国宁夏地区年龄相关性黄斑变性患者的补体基因和ARMS2/HTRA1基因多态性分析

    Institute of Scientific and Technical Information of China (English)

    李武靓; 庄文娟; 李慧平; 刘雅妮; 哈少平; 盛迅伦

    2015-01-01

    Background Age-related macular degeneration (AMD) is the main cause of irreversible loss of central vision in old population.The incidence of AMD is increasing year by year,but the mechanism is not clearly understood.Objective This study was to investigate the association between genetic variants and the risk of AMD in Ningxia population.Methods This study was approved by Ethic Committee of Ningxia People's Hospital and complied with the Helsinki Declaration.Written informed consent was obtained from each subject.One hundred and fifty patients with AMD and 145 ethnicity-and gender-matched controls were recruited in Ningxia Eye Hospital from January 2012 to March 2013.All individuals underwent comprehensive eye examinations and genomic DNA was prepared from peripheral blood.The single nucleotide polymorphisms (SNPs) of 8 susceptibility loci in four candidate genes,including complement factor H (CFH),complement factor B (CFB),age-related maculopathy susceptibility 2 (ARMS2) and high temperature required factor A1 (HTRA1),were genotyped with Mass Array and MALDI-TOF technique by Sequenom platform.The distribution of genotype was tested for Hardy-Weinberge equilibrium (HWE).The differences of genotype distribution of allele and haplotype frequencies were compared between patients and controls using chi-squared test and the P value was significant at < 0.006 level after correction of age,and the relationship of genotype distribution with AMD was evaluated by Logistic regression analysis.Measures of linkage disequilibrium (LD) was carried out by Haploview.Results All the genetypes met HWE.Seven SNPs were found to be different in the genotypic distributions and allele frequencies between patients and normal controls (all at P< 0.05),however,after Bonferroni correction,the differences of only four SNPs were significant between the patients and controls in the genotype and allele distributions,including the SNPs of rs10737680 and rs1410996 in CFH gene,the SNP of rs

  20. Nutritional Modulation of Age-Related Macular Degeneration

    OpenAIRE

    Weikel, Karen A; Taylor, Allen

    2012-01-01

    Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly worldwide. It affects 30–50 million individuals and clinical hallmarks of AMD are observed in at least one third of persons over the age of 75 in industrialized countries (Gehrs et al., 2006). Costs associated with AMD are in excess of $340 billion US (American-Health-Assistance-Foundation, 2012). The majority of AMD patients in the United States are not eligible for clinical treatments (Biarnes et al., 20...

  1. Cost-effectiveness of anti-oxidant vitamins plus zinc treatment to prevent the progression of intermediate age-related macular degeneration. A Singapore perspective.

    Science.gov (United States)

    Saxena, Nakul; George, Pradeep Paul; Heng, Bee Hoon; Lim, Tock Han; Yong, Shao Onn

    2015-06-01

    To determine if providing high dose anti-oxidant vitamins and zinc treatment age-related eye disease study (AREDS formulation) to patients with intermediate age-related macular degeneration (AMD) aged 40-79 years from Singapore is cost-effective in preventing progression to wet AMD. A hypothetical cohort of category 3 and 4 AMD patients from Singapore was followed for 5 calendar years to determine the number of patients who would progress to wet AMD given the following treatment scenarios: (a) AREDS formulation or placebo followed by ranibizumab (as needed) for wet AMD. (b) AREDS formulation or placebo followed by bevacizumab (monthly) for wet AMD. (c) AREDS formulation or placebo followed by aflibercept (VIEW I and II trial treatment regimen). Costs were estimated for the above scenarios from the providers' perspective, and cost-effectiveness was measured by cost per disability-adjusted life year (DALY) averted with a disability weight of 0.22 for wet AMD. The costs were discounted at an annual rate of 3%. Over 5400 patients could be prevented from progressing to wet AMD cumulatively if AREDS formulation were prescribed. AREDS formulation followed by ranibizumab was cost-effective compared to placebo-ranibizumab or placebo-aflibercept combinations (cost per DALY averted: SGD$23,662.3 and SGD$21,138.8, respectively). However, bevacizumab (monthly injections) alone was more cost-effective compared to AREDS formulation followed by bevacizumab. Prophylactic treatment with AREDS formulation for intermediate AMD patients followed by ranibizumab or for patients who progressed to wet AMD was found to be cost-effective. These findings have implications for intermediate AMD screening, treatment and healthcare planning in Singapore.

  2. Cost-effectiveness of anti-oxidant vitamins plus zinc treatment to prevent the progression of intermediate age-related macular degeneration. A Singapore perspective

    Directory of Open Access Journals (Sweden)

    Nakul Saxena

    2015-01-01

    Full Text Available Purpose: To determine if providing high dose anti-oxidant vitamins and zinc treatment age-related eye disease study (AREDS formulation to patients with intermediate age-related macular degeneration (AMD aged 40-79 years from Singapore is cost-effective in preventing progression to wet AMD. Methods: A hypothetical cohort of category 3 and 4 AMD patients from Singapore was followed for 5 calendar years to determine the number of patients who would progress to wet AMD given the following treatment scenarios: (a AREDS formulation or placebo followed by ranibizumab (as needed for wet AMD. (b AREDS formulation or placebo followed by bevacizumab (monthly for wet AMD. (c AREDS formulation or placebo followed by aflibercept (VIEW I and II trial treatment regimen. Costs were estimated for the above scenarios from the providers′ perspective, and cost-effectiveness was measured by cost per disability-adjusted life year (DALY averted with a disability weight of 0.22 for wet AMD. The costs were discounted at an annual rate of 3%. Results: Over 5400 patients could be prevented from progressing to wet AMD cumulatively if AREDS formulation were prescribed. AREDS formulation followed by ranibizumab was cost-effective compared to placebo-ranibizumab or placebo-aflibercept combinations (cost per DALY averted: SGD$23,662.3 and SGD$21,138.8, respectively. However, bevacizumab (monthly injections alone was more cost-effective compared to AREDS formulation followed by bevacizumab. Conclusion: Prophylactic treatment with AREDS formulation for intermediate AMD patients followed by ranibizumab or for patients who progressed to wet AMD was found to be cost-effective. These findings have implications for intermediate AMD screening, treatment and healthcare planning in Singapore.

  3. Long-term (60-month results for the implantable miniature telescope: efficacy and safety outcomes stratified by age in patients with end-stage age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Boyer D

    2015-06-01

    Full Text Available David Boyer,1 K Bailey Freund,2 Carl Regillo,3 Marc H Levy,4 Sumit Garg5 1Retina-Vitreous Associates Medical Group, Beverly Hills, CA, 2Vitreous-Retina-Macula Consultants of New York, New York, NY; 3Wills Eye Institute, Philadelphia, PA, 4Sarasota Retina Institute, Sarasota, FL, 5The Gavin Herbert Eye Institute (University of California, Irvine Irvine, CA, USA Background: The purpose of this study was to evaluate the long-term results of an implantable miniature telescope (IMT in patients with bilateral, end-stage, age-related macular degeneration (AMD.Methods: A prospective, open-label, multicenter clinical trial with fellow eye controls enrolled 217 patients (mean age 76 years with AMD and moderate-to-profound bilateral central visual acuity loss (20/80–20/800 resulting from untreatable geographic atrophy, disciform scars, or both. A subgroup analysis was performed with stratification for age (patient age 65 to <75 years [group 1; n=70] and patient age ≥75 years [group 2; n=127], with a comparative evaluation of change in best-corrected distance visual acuity (BCDVA, quality of life, ocular complications from surgery, adverse events, and endothelial cell density (ECD. Follow-up in an extension study was 60 months.Results: Data were available for 22, 38, and 31 patients in group 1 and 42, 46, and 32 patients in group 2 at 36, 48, and 60 months, respectively. Mean BCDVA improvement from baseline to 60 months was 2.41±2.69 lines in all patients (n=76, with 2.64±2.55 lines in group 1 and 2.09±2.88 lines in group 2. Quality of life scores were significantly higher in group 1. The most common significant surgery-related ocular complications in group 1 were iritis >30 days after surgery (7/70; 10% and persistent corneal edema (3/70; 4.3%; and in group 2 were a decrease in BCDVA in the implanted eye or IMT removal (10/127 each; 7.9%, corneal edema >30 days after surgery (9/127; 7.1%, and persistent corneal edema (6/127; 4.7%. Significant

  4. Complement component C5a Promotes Expression of IL-22 and IL-17 from Human T cells and its Implication in Age-related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Klein Michael L

    2011-07-01

    Full Text Available Abstract Background Age related macular degeneration (AMD is the leading cause of irreversible blindness in elderly populations worldwide. Inflammation, among many factors, has been suggested to play an important role in AMD pathogenesis. Recent studies have demonstrated a strong genetic association between AMD and complement factor H (CFH, the down-regulatory factor of complement activation. Elevated levels of complement activating molecules including complement component 5a (C5a have been found in the serum of AMD patients. Our aim is to study whether C5a can impact human T cells and its implication in AMD. Methods Human peripheral blood mononuclear cells (PBMCs were isolated from the blood of exudative form of AMD patients using a Ficoll gradient centrifugation protocol. Intracellular staining and enzyme-linked immunosorbent assays were used to measure protein expression. Apoptotic cells were detected by staining of cells with the annexin-V and TUNEL technology and analyzed by a FACS Caliber flow cytometer. SNP genotyping was analyzed by TaqMan genotyping assay using the Real-time PCR system 7500. Results We show that C5a promotes interleukin (IL-22 and IL-17 expression by human CD4+ T cells. This effect is dependent on B7, IL-1β and IL-6 expression from monocytes. We have also found that C5a could protect human CD4+ cells from undergoing apoptosis. Importantly, consistent with a role of C5a in promoting IL-22 and IL-17 expression, significant elevation in IL-22 and IL-17 levels was found in AMD patients as compared to non-AMD controls. Conclusions Our results support the notion that C5a may be one of the factors contributing to the elevated serum IL-22 and IL-17 levels in AMD patients. The possible involvement of IL-22 and IL-17 in the inflammation that contributes to AMD may herald a new approach to treat AMD.

  5. [Patient advice].

    Science.gov (United States)

    Lucio-Villegas Menéndez, M Eulalia; González, Laura López; Gutiérrez Pérez, M Isabel; Lluch, Natalia Aresté; Morató Agustí, M Luisa; Cachafeiro, Santiago Pérez

    2014-05-01

    In wound care, knowing what to do is as important as knowing what not to do. The first step is to evaluate the severity of the lesion and to know whether it is necessary to attend a health center or not. If the wound is simple, the recommended course of action is cleansing with serum or water after washing one's hands, followed by wound disinfection with the most appropriate antiseptic. Antiseptics not should be used for wound cleansing (physiological serum or tap water should be used) or for wound healing with granulation tissue. Equally, antiseptics should not be used in the ear or near the eyes; if there is accidental application, the eye should be washed in abundant water. Povidone iodine should not be used in pregnant women, nor should iodine preparations be used in neonates, in patients with thyroid alterations or in those allergic to iodine. Currently, merbromine/mercurochrome is not used because of its mercury content. Before an antiseptic is applied, all inorganic residues (foreign bodies) and dead tissue should be removed; detritus, slough, purulent exudate, scabs… This will aid healing and the action of antiseptics, since they become inactive in the presence of organic material. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  6. Patients' preferences for patient-centered communication

    DEFF Research Database (Denmark)

    Lau, Sofie Rosenlund; Christensen, Søren Troels; Andreasen T., Jesper

    2013-01-01

    To investigate patients' preferences for patient-centered communication (PCC) in the encounter with healthcare professionals in an outpatient department in rural Sierra Leone.......To investigate patients' preferences for patient-centered communication (PCC) in the encounter with healthcare professionals in an outpatient department in rural Sierra Leone....

  7. Ocular Surface Temperature in Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Andrea Sodi

    2014-01-01

    Full Text Available Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320. The ocular surface temperature (OST of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value >0.272. OST in AMD patients was significantly lower than in controls (P>0.05. Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD.

  8. Do Nutritional Supplements Have a Role in Age Macular Degeneration Prevention?

    Science.gov (United States)

    Pinazo-Durán, Maria D.; Gómez-Ulla, Francisco; Arias, Luis; Araiz, Javier; Casaroli-Marano, Ricardo; Gallego-Pinazo, Roberto; García-Medina, Jose J.; López-Gálvez, Maria Isabel; Manzanas, Lucía; Salas, Anna; Zapata, Miguel; Diaz-Llopis, Manuel; García-Layana, Alfredo

    2014-01-01

    Purpose. To review the proposed pathogenic mechanisms of age macular degeneration (AMD), as well as the role of antioxidants (AOX) and omega-3 fatty acids (ω-3) supplements in AMD prevention. Materials and Methods. Current knowledge on the cellular/molecular mechanisms of AMD and the epidemiologic/experimental studies on the effects of AOX and ω-3 were addressed all together with the scientific evidence and the personal opinion of professionals involved in the Retina Group of the OFTARED (Spain). Results. High dietary intakes of ω-3 and macular pigments lutein/zeaxanthin are associated with lower risk of prevalence and incidence in AMD. The Age-Related Eye Disease study (AREDS) showed a beneficial effect of high doses of vitamins C, E, beta-carotene, and zinc/copper in reducing the rate of progression to advanced AMD in patients with intermediate AMD or with one-sided late AMD. The AREDS-2 study has shown that lutein and zeaxanthin may substitute beta-carotene because of its potential relationship with increased lung cancer incidence. Conclusion. Research has proved that elder people with poor diets, especially with low AOX and ω-3 micronutrients intake and subsequently having low plasmatic levels, are more prone to developing AMD. Micronutrient supplementation enhances antioxidant defense and healthy eyes and might prevent/retard/modify AMD. PMID:24672708

  9. Do Nutritional Supplements Have a Role in Age Macular Degeneration Prevention?

    Directory of Open Access Journals (Sweden)

    Maria D. Pinazo-Durán

    2014-01-01

    Full Text Available Purpose. To review the proposed pathogenic mechanisms of age macular degeneration (AMD, as well as the role of antioxidants (AOX and omega-3 fatty acids (ω-3 supplements in AMD prevention. Materials and Methods. Current knowledge on the cellular/molecular mechanisms of AMD and the epidemiologic/experimental studies on the effects of AOX and ω-3 were addressed all together with the scientific evidence and the personal opinion of professionals involved in the Retina Group of the OFTARED (Spain. Results. High dietary intakes of ω-3 and macular pigments lutein/zeaxanthin are associated with lower risk of prevalence and incidence in AMD. The Age-Related Eye Disease study (AREDS showed a beneficial effect of high doses of vitamins C, E, beta-carotene, and zinc/copper in reducing the rate of progression to advanced AMD in patients with intermediate AMD or with one-sided late AMD. The AREDS-2 study has shown that lutein and zeaxanthin may substitute beta-carotene because of its potential relationship with increased lung cancer incidence. Conclusion. Research has proved that elder people with poor diets, especially with low AOX and ω-3 micronutrients intake and subsequently having low plasmatic levels, are more prone to developing AMD. Micronutrient supplementation enhances antioxidant defense and healthy eyes and might prevent/retard/modify AMD.

  10. Do nutritional supplements have a role in age macular degeneration prevention?

    Science.gov (United States)

    Pinazo-Durán, Maria D; Gómez-Ulla, Francisco; Arias, Luis; Araiz, Javier; Casaroli-Marano, Ricardo; Gallego-Pinazo, Roberto; García-Medina, Jose J; López-Gálvez, Maria Isabel; Manzanas, Lucía; Salas, Anna; Zapata, Miguel; Diaz-Llopis, Manuel; García-Layana, Alfredo

    2014-01-01

    Purpose. To review the proposed pathogenic mechanisms of age macular degeneration (AMD), as well as the role of antioxidants (AOX) and omega-3 fatty acids ( ω -3) supplements in AMD prevention. Materials and Methods. Current knowledge on the cellular/molecular mechanisms of AMD and the epidemiologic/experimental studies on the effects of AOX and ω -3 were addressed all together with the scientific evidence and the personal opinion of professionals involved in the Retina Group of the OFTARED (Spain). Results. High dietary intakes of ω -3 and macular pigments lutein/zeaxanthin are associated with lower risk of prevalence and incidence in AMD. The Age-Related Eye Disease study (AREDS) showed a beneficial effect of high doses of vitamins C, E, beta-carotene, and zinc/copper in reducing the rate of progression to advanced AMD in patients with intermediate AMD or with one-sided late AMD. The AREDS-2 study has shown that lutein and zeaxanthin may substitute beta-carotene because of its potential relationship with increased lung cancer incidence. Conclusion. Research has proved that elder people with poor diets, especially with low AOX and ω -3 micronutrients intake and subsequently having low plasmatic levels, are more prone to developing AMD. Micronutrient supplementation enhances antioxidant defense and healthy eyes and might prevent/retard/modify AMD.

  11. Residual abilities in age-related macular degeneration to process spatial frequencies during natural scene categorization.

    Science.gov (United States)

    Musel, Benoit; Hera, Ruxandra; Chokron, Sylvie; Alleysson, David; Chiquet, Christophe; Romanet, Jean-Paul; Guyader, Nathalie; Peyrin, Carole

    2011-11-01

    Age-related macular degeneration (AMD) is characterized by a central vision loss. We explored the relationship between the retinal lesions in AMD patients and the processing of spatial frequencies in natural scene categorization. Since the lesion on the retina is central, we expected preservation of low spatial frequency (LSF) processing and the impairment of high spatial frequency (HSF) processing. We conducted two experiments that differed in the set of scene stimuli used and their exposure duration. Twelve AMD patients and 12 healthy age-matched participants in Experiment 1 and 10 different AMD patients and 10 healthy age-matched participants in Experiment 2 performed categorization tasks of natural scenes (Indoors vs. Outdoors) filtered in LSF and HSF. Experiment 1 revealed that AMD patients made more no-responses to categorize HSF than LSF scenes, irrespective of the scene category. In addition, AMD patients had longer reaction times to categorize HSF than LSF scenes only for indoors. Healthy participants' performance was not differentially affected by spatial frequency content of the scenes. In Experiment 2, AMD patients demonstrated the same pattern of errors as in Experiment 1. Furthermore, AMD patients had longer reaction times to categorize HSF than LSF scenes, irrespective of the scene category. Again, spatial frequency processing was equivalent for healthy participants. The present findings point to a specific deficit in the processing of HSF information contained in photographs of natural scenes in AMD patients. The processing of LSF information is relatively preserved. Moreover, the fact that the deficit is more important when categorizing HSF indoors, may lead to new perspectives for rehabilitation procedures in AMD.

  12. Genetic, behavioral, and sociodemographic risk factors for second eye progression in age-related macular degeneration

    NARCIS (Netherlands)

    Lechanteur, Y.T.; Ven, J.P. van de; Smailhodzic, D.; Boon, C.J.F.; Klevering, B.J.; Fauser, S.; Groenewoud, J.M.; Wilt, G.J. van der; Hollander, A.I. den; Hoyng, C.B.

    2012-01-01

    PURPOSE: This study was conducted to investigate the correlation of genetic, sociodemographic, and behavioral risk factors with second eye progression to end-stage AMD. METHODS: One hundred and eight patients with end-stage AMD in one or both eyes were included in a retrospective time-to-event analy

  13. The Relationship between Neovascular Age-Related Macular Degeneration and Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Harun Çakmak

    2013-01-01

    Full Text Available Purpose. To evaluate association between erectile dysfunction (ED and neovascular age-related macular degeneration (AMD. Methods. 195 men enrolled in this cross-sectional study. 90 of them had neovascular AMD and 105 of them were healthy volunteers. The International Index of Erectile Function (IIEF questionnaire’s erectile function (EF domain was used to assess ED. The patients in the study and control groups were statistically compared according to visual acuity, EF score, and body mass index. Results. The mean ages were 62 (54.5–73 and 60 (54–68, in the neovascular AMD and control groups, respectively. The total EF scores were 9 (6–16 in neovascular AMD and 18 (9.5–27 in control group. The results of IIEF questionnaire on neovascular AMD patients revealed that 85 men (94.4% had some degree of ED, whereas 68 men (64.8% had some degree of ED on control group. Patients with neovascular AMD had a significantly higher incidence of ED than control patients (. There was a significant association between ED and neovascular AMD (. Conclusions. Our results suggested that neovascular AMD has a high association with ED.

  14. Leucine 7-proline 7 polymorphism in the signal peptide of neuropeptide Y is not a risk factor for exudative age-related macular degeneration.

    Science.gov (United States)

    Kaarniranta, Kai; Holopainen, Juha M; Karvonen, Matti K; Koulu, Markku; Kallio, Jaana; Pesonen, Ullamari; Teräsvirta, Markku; Uusitalo, Hannu; Immonen, Ilkka

    2007-03-01

    Because of the regulatory role of neuropeptide Y (NPY) in angiogenesis, we set out to determine the presence of the leucine 7-proline 7 (Leu7Pro) polymorphism in exudative age-related macular degeneration (AMD) patients and to analyse its implications. Genotype analysis of the Leu7Pro polymorphism in the signal peptide region of the human prepro-NPY was performed in blood samples from exudative AMD patients (n = 240) and control subjects (n = 79). In all, 11% of exudative AMD patients and 14% of control subjects exhibited the NPY signal peptide Leu7Pro polymorphism. There were no statistically significant differences in Leu7Pro polymorphism frequency between the exudative AMD and control cases, as analysed by Fisher's exact two-sided test. Leu7Pro polymorphism in the signal peptide region of the human prepro-NPY is not a risk factor for exudative AMD.

  15. Patient notes

    Directory of Open Access Journals (Sweden)

    Pádraig Ó Tuama

    2017-05-01

    Full Text Available Here’s the thing. While I have my asthma under control and my sleeping is no worse than usual, I am still near the uaigh. That’s the word for grave in Irish, and it’s also part of the word for loneliness. I’m near one or the other, or both. There was a time when my health was the only thing I talked about, and my friends from that time ask me now, and I remember that that was the person I was; when health was a fear, because pain was my first language. But what’s really bothering me is the way I use the possessive when it comes to my asthma, my insomnia, my thinning hair, my symptoms. It makes me think I think I am these things. Am I? I wilt therefore I am? If they are me, where will I go if I lose them? I remember when I learned the word ontology – the study of the nature of being. If I am sad, is sad me? If sad is me then what happens when someone treats my sadness? If we were all speaking Irish we would say that sadness is on me. But we’re not. Because when I was five I asked where English came from and my parents introduced me to stair. If we all spoke Irish we would say stair instead of history. But we speak English, mostly, and so stair is relegated to something we use to get up or down, never a story. Did you know that I carry my people’s history in my bones? People didn’t believe me when I said that but then scientists wrote about it, and discovered what was already there — inherited in the blood, the bones, the DNA, the genomes, the chromosomes, like thinning curly hair, like weak lungs, like poetry, like insomnia — and it’s all the rage now, that codified stairstory inside us. Once when I was waiting on a trolley I kept on trying to get up even though I knew I’d fall down. So they put an orderly to mind me. Well, he was there to restrain me, but I didn’t mind. He was young and eager to be seen to be good with patients. I asked him how long his shift had been and he said it was his first. After a bit of this

  16. Achieving patient satisfaction: resolving patient complaints.

    Science.gov (United States)

    Oxler, K F

    1997-07-01

    Patients demand to be active participants on and partners with the health care team to design their care regimen. Patients bring unique perceptions and expectations and use these to evaluate service quality and satisfaction. If customer satisfaction is not achieved and a patient complaint results, staff must have the skills to respond and launch a service recovery program. Service recovery, when done with style and panache, can retain loyal customers. Achieving patient satisfaction and resolving patient complaints require commitment from top leadership and commitment from providers to dedicate the time to understand their patients' needs.

  17. Evaluation of choroidal thickness in cases with age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Erkan Unsal

    2014-09-01

    Full Text Available AIM: To compare subfoveal choroidal thickness(SFCTbetween cases with non-neovascular age-related macular degeneration(AMDand neovascular AMD by optical coherence tomography(OCTand to evaluate the contribution of choroidal thickness(CTmeasurements to the understanding of pathogenesis of neovascularization in AMD.METHODS: Fourty-eigth eyes of 24 patients who had neovascular AMD in one eye and non-neovascular AMD in the other eye were included in this retrospective, cross- sectional study as study group. Forty eyes of healthy,age and axial length matched individuals were selected as the control group. Eyes with drusen and/or pigmentary changes were included in the non-neovascular AMD subgroup. Eyes with subretinal or intraretinal fluid and/orlipid exudation due to the choroidal neovascularization were included in the neovascular AMD subgroup. OCT measurements were performed with RTVue 100-2(V 5.1, Optovue, Fremont, CA, USAperpendicularly from the outer part of the hyperreflective line(retinal pigment epithelial layerto the line corresponding to the choroido- scleral junction. Choroidal thickness was measured at 7 different points, 500μm intervals up to 1500μm temporal and nasal to the fovea in the study group and compared statistically between subgroups.RESULTS: The mean age of patients was 72.4±8.97(60- 82y. The mean age of healthy individuals was 71.2±8.8(58-81y. Mean SFCT of neovascular AMD group were significantly thicker than non-neovascular AMD group(PP>0.05. In neovascular AMD group, there was a statistically significant difference between the mean SFCT and the mean temporal-nasal choroid thickness(PCONCLUSION: Choroidal thickness measurements with OCT device can make a contribution to the understanding the phatophysiology of AMD and large prospective studies should be conducted to understand why SFCT was thicker in neovascular AMD.

  18. Pharmacist-Patient Interaction and Patient Expectations

    Science.gov (United States)

    DeSimone, Edward M.; And Others

    1977-01-01

    The nature of the professional interaction between the pharmacist and the patient was explored, with data collected from 3,743 questions asked of 16 pharmacists during an 8-week period. Factors that might affect the nature of the pharmacist-patient interaction are identified along with a cognitive-based profile of patient wants. (LBH)

  19. [New insights into the underestimated impairment of quality of life in age-related macular degeneration - a review of the literature].

    Science.gov (United States)

    Meyer-Ruesenberg, B; Richard, G

    2010-08-01

    Different forms of age-related macular degeneration (AMD) can lead to massive visual impairment up to blindness. Therefore, AMD has a high impact on patients' daily life and causes restrictions of their psychological well-being, autonomy and mobility. These restrictions influence their quality of life. It is difficult to define the term "quality of life". It consists of different aspects that can be measured with psychometric tests. Besides the general health status and the psychological well-being, the vision-specific functional status plays a central role for determining the quality of life of AMD patients. To compare the impact of different diseases on the quality of life, the utility analysis has been developed. It demonstrates the relevance of AMD for patients and shows that its impact on patients' life is comparable to those of other systemic diseases like carcinoma or HIV. The impairment of patients' quality of life by AMD is often underestimated by their attending ophthalmologists. Different medical treatments have influenced the quality of life of AMD patients. However, there is still a large group that cannot be treated. These patients benefit from rehabilitation with low vision aids or psychosocial interventions. Further clinical trials at a high evidence level using valid and comparable psychometric tests are necessary to improve the therapy for and the rehabilitation of AMD patients and to increase their quality of life.

  20. Age-related macular degeneration: genetic and environmental factors of disease.

    Science.gov (United States)

    Chen, Yuhong; Bedell, Matthew; Zhang, Kang

    2010-10-01

    Age-related macular degeneration (AMD) is the most common cause of visual impairment among the elderly in developed countries, and its prevalence is thus increasing as the population ages; however, treatment options remain limited because the etiology and pathogenesis of AMD are incompletely defined. Recently, much progress has been made in gene discovery and mechanistic studies, which clearly indicate that AMD involves the interaction of multiple genetic and environmental factors. The identification of genes that have a substantial impact on the risk for AMD is not only facilitating the diagnosis and screening of populations at risk but is also elucidating key molecular pathways of pathogenesis. Pharmacogenetic studies of treatment responsiveness among patients with the "wet" form of AMD are increasingly proving to be clinically relevant; pharmacogenetic approaches hold great promise for both identifying patients with the best chance for vision recovery as well as tailoring individualized therapies.

  1. Patient Treatment Tracking Chart

    Science.gov (United States)

    ... ZIP code here Hepatitis C Treatment Tracking Chart Patient Treatment Tracking Chart Patient Treatment Tracking Chart Sample Chart This chart is ... this website Submit Share this page Related Resource Patient Treatment Tutorial return to top CONNECT Veterans Crisis ...

  2. Patient Assessment File (PAF)

    Data.gov (United States)

    Department of Veterans Affairs — The Patient Assessment File (PAF) database compiles the results of the Patient Assessment Instrument (PAI) questionnaire filled out for intermediate care Veterans...

  3. [Patient education in France].

    Science.gov (United States)

    Bertrand, Dominique

    2011-10-01

    Patient education is an increasingly important component of therapeutic strategies, especially for chronic illnesses, which currently affect about 12% of the French population and will undoubtedly increase in coming years. Patient education aims to enhance patients' personal responsibility and participation in their therapeutic management and quality of life. Article 84 of French health legislation passed in 2009 inscribes patient education in the Public Health Code for the first time. It distinguishes personalized therapeutic education, patient accompaniment, and learning programs. Direct links between patients and drug companies are prohibited. However, the notion of patient accompaniment remains to be defined, along with the evaluation of patient education, funding sources and practical modalities.

  4. Nutritional modulation of age-related macular degeneration.

    Science.gov (United States)

    Weikel, Karen A; Chiu, Chung-Jung; Taylor, Allen

    2012-08-01

    Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly worldwide. It affects 30-50 million individuals and clinical hallmarks of AMD are observed in at least one third of persons over the age of 75 in industrialized countries (Gehrs et al., 2006). Costs associated with AMD are in excess of $340 billion US (American-Health-Assistance-Foundation, 2012). The majority of AMD patients in the United States are not eligible for clinical treatments (Biarnes et al., 2011; Klein et al., 2011). Preventive interventions through dietary modulation are attractive strategies because many studies suggest a benefit of micro- and macronutrients with respect to AMD, as well as other age-related debilities, and with few, if any, adverse effects (Chiu, 2011). Preservation of vision would enhance quality of life for millions of elderly people, and alleviate the personal and public health financial burden of AMD (Frick et al., 2007; Wood et al., 2011). Observational studies indicate that maintaining adequate levels of omega-3 fatty acids (i.e. with 2 servings/week of fish) or a low glycemic index diet may be particularly beneficial for early AMD and that higher levels of carotenoids may be protective, most probably, against neovascular AMD. Intervention trials are needed to better understand the full effect of these nutrients and/or combinations of nutrients on retinal health. Analyses that describe effects of a nutrient on onset and/or progress of AMD are valuable because they indicate the value of a nutrient to arrest AMD at the early stages. This comprehensive summary provides essential information about the value of nutrients with regard to diminishing risk for onset or progress of AMD and can serve as a guide until data from ongoing intervention trials are available.

  5. Stem cell based therapies for age-related macular degeneration: The promises and the challenges.

    Science.gov (United States)

    Nazari, Hossein; Zhang, Li; Zhu, Danhong; Chader, Gerald J; Falabella, Paulo; Stefanini, Francisco; Rowland, Teisha; Clegg, Dennis O; Kashani, Amir H; Hinton, David R; Humayun, Mark S

    2015-09-01

    Age-related macular degeneration (AMD) is the leading cause of blindness among the elderly in developed countries. AMD is classified as either neovascular (NV-AMD) or non-neovascular (NNV-AMD). Cumulative damage to the retinal pigment epithelium, Bruch's membrane, and choriocapillaris leads to dysfunction and loss of RPE cells. This causes degeneration of the overlying photoreceptors and consequential vision loss in advanced NNV-AMD (Geographic Atrophy). In NV-AMD, abnormal growth of capillaries under the retina and RPE, which leads to hemorrhage and fluid leakage, is the main cause of photoreceptor damage. Although a number of drugs (e.g., anti-VEGF) are in use for NV-AMD, there is currently no treatment for advanced NNV-AMD. However, replacing dead or dysfunctional RPE with healthy RPE has been shown to rescue dying photoreceptors and improve vision in animal models of retinal degeneration and possibly in AMD patients. Differentiation of RPE from human embryonic stem cells (hESC-RPE) and from induced pluripotent stem cells (iPSC-RPE) has created a potentially unlimited source for replacing dead or dying RPE. Such cells have been shown to incorporate into the degenerating retina and result in anatomic and functional improvement. However, major ethical, regulatory, safety, and technical challenges have yet to be overcome before stem cell-based therapies can be used in standard treatments. This review outlines the current knowledge surrounding the application of hESC-RPE and iPSC-RPE in AMD. Following an introduction on the pathogenesis and available treatments of AMD, methods to generate stem cell-derived RPE, immune reaction against such cells, and approaches to deliver desired cells into the eye will be explored along with broader issues of efficacy and safety. Lastly, strategies to improve these stem cell-based treatments will be discussed.

  6. Transfer Out Patient Not Abandon The Patient

    Directory of Open Access Journals (Sweden)

    Deepak Gupta

    2015-12-01

    Full Text Available Physician-patient relationship is unique in some aspects and not-so-unique in other aspects when compared to other human interactions. Until-unless for the sake of health promotional activities, this relationship is almost always conceived in the times of human sufferings and consequently culminated when those sufferings have subsided as well as sought out happiness has ensued/been achieved. However, not all physician-patient relationships follow the normal course and/or meet the natural ends. These abnormal relationships are not inconsequential in terms of numbers and/or their effects (short-term and long term on both patients and physicians. Every country has its own baggage in the wake of why, how and what about these abnormal ends to physician-patient relationships; however, the most common causes are the patients’ inability to pay their medical bills, the conflicting goals of physicians and their patients in regards to patients’ sufferings’ management and finally the behavioral issues (patients’ and/or physicians’ interfering these relationships. Irrespective of any cause, the physicians should never forget that the patient can always discharge their physicians and discontinue their relationship with their physicians without any reason (until unless the physicians deem those patients either incapable/non-consentable to do so and/or potential threat to their own personal safety or other people’s safety. Contrarily, physicians can also discharge patients from their care but cannot abandon these patients (1-3 which mean that physicians have to ensure their discharged patients either are referred to or have sought another physician within appropriate time frame post-relationship-discontinuation. Each country has their own medico-legal liabilities that vary in terms of penalties imposed; however, irrespective of the feared legal concerns, the physicians should not forget that ethical essence of medicine is the art of healing that

  7. The generation of induced pluripotent stem cells for macular degeneration as a drug screening platform: identification of curcumin as a protective agent for retinal pigment epithelial cells against oxidative stress

    Directory of Open Access Journals (Sweden)

    Yun-Ching eChang

    2014-08-01

    Full Text Available Age-related macular degeneration (AMD is one retinal aging process that may lead to irreversible vision loss in the elderly. Its pathogenesis remains unclear, but oxidative stress inducing retinal pigment epithelial (RPE cells damage is perhaps responsible for the aging sequence of retina and may play an important role in macular degeneration. In this study, we have reprogrammed T cells from patients with dry type AMD into induced pluripotent stem cells (iPSCs via integration-free episomal vectors and differentiated them into RPE cells that were used as an expandable platform for investigating pathogenesis of the AMD and in-vitro drug screening. These patient-derived RPEs with the AMD-associated background (AMD-RPEs exhibited reduced antioxidant ability, compared with normal RPE cells. Among several screened candidate drugs, curcumin caused most significant reduction of ROS in AMD-RPEs. Pre-treatment of curcumin protected these AMD-RPEs from H2O2-induced cell death and also increased the cytoprotective effect against the oxidative stress of H2O2 through the reduction of ROS levels. In addition, curcumin with its versatile activities modulated the expression of many oxidative stress-regulating genes such as PDGF, VEGF, IGFBP-2, HO1, SOD2 and GPX1. Our findings indicated that the RPE cells derived from AMD patients have decreased antioxidative defense, making RPE cells more susceptible to oxidative damage and thereby leading to AMD formation. Curcumin represented an ideal drug that can effectively restore the neuronal functions in AMD patient-derived RPE cells, rendering this drug an effective option for macular degeneration therapy and an agent against aging-associated oxidative stress.

  8. Copy number variation of age-related macular degeneration relevant genes in the Korean population.

    Directory of Open Access Journals (Sweden)

    Jung Hyun Park

    Full Text Available PURPOSE: Studies that analyzed single nucleotide polymorphisms (SNP in various genes have shown that genetic factors are strongly associated with age-related macular degeneration (AMD susceptibility. Copy number variation (CNV may be an additional type of genetic variation that contributes to AMD pathogenesis. This study investigated CNV in 4 AMD-relevant genes in Korean AMD patients and control subjects. METHODS: Four CNV candidate regions located in AMD-relevant genes (VEGFA, ARMS2/HTRA1, CFH and VLDLR, were selected based on the outcomes of our previous study which elucidated common CNVs in the Asian populations. Real-time PCR based TaqMan Copy Number Assays were performed on CNV candidates in 273 AMD patients and 257 control subjects. RESULTS: The predicted copy number (PCN, 0, 1, 2 or 3+ of each region was called using the CopyCaller program. All candidate genes except ARMS2/HTRA1 showed CNV in at least one individual, in which losses of VEGFA and VLDLR represent novel findings in the Asian population. When the frequencies of PCN were compared, only the gain in VLDLR showed significant differences between AMD patients and control subjects (p = 0.025. Comparisons of the raw copy values (RCV revealed that 3 of 4 candidate genes showed significant differences (2.03 vs. 1.92 for VEGFA, p<0.01; 2.01 vs. 1.97 for CFH, p<0.01; 1.97 vs. 2.01, p<0.01 for ARMS2/HTRA1. CONCLUSION: CNVs located in AMD-relevant genes may be associated with AMD susceptibility. Further investigations encompassing larger patient cohorts are needed to elucidate the role of CNV in AMD pathogenesis.

  9. Ranibizumab: the evidence of its therapeutic value in neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Peter K. Kaiser

    2008-07-01

    Full Text Available Peter K. KaiserCole Eye Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USAIntroduction: Neovascular age-related macular degeneration (AMD is the leading cause of severe, irreversible visual impairment in people over 60 years of age. Neovascular AMD is characterized by abnormal growth of blood vessels under the retina, specifically the macula. These vessels leak blood and fluids, damaging the retina and its photoreceptors, resulting in permanent loss of central vision. Vascular endothelial growth factor-A (VEGF-A has been shown to play a critical role in the pathogenesis of neovascular AMD. In the US, ranibizumab, a VEGF-A blocker, is approved and indicated for the treatment of patients with neovascular AMD.Aims: To review the clinical evidence for ranibizumab in the treatment of neovascular AMD.Evidence review: Phase III clinical trial data have established ranibizumab as a safe and well-tolerated treatment for neovascular AMD. Monthly intravitreal injections of ranibizumab result in a statistically significantly greater proportion of patients losing <15 letters of visual acuity (VA and statistically significant increases in the mean number of letters gained compared with controls. Anatomically, ranibizumab results in stabilization in the mean area of choroidal neovascularization (CNV and statistically significant reductions in the mean area of leakage compared with controls. Although there is limited economic evidence available, ranibizumab therapy for neovascular AMD appears to deliver a significant degree of value gain in terms of quality of life when compared with other neovascular AMD interventions.Place in therapy: Clinical evidence establishes ranibizumab as a first-line therapy option for virtually all treatable neovascular AMD patients. Updating neovascular AMD treatment guidelines to reflect the evidence base for ranibizumab as a preferred first-line therapy would be beneficial for physicians in making informed treatment

  10. Comparison of vision-related quality of life in primary open-angle glaucoma and dry-type age-related macular degeneration.

    Science.gov (United States)

    Karadeniz Ugurlu, S; Kocakaya Altundal, A E; Altin Ekin, M

    2017-03-01

    PurposeTo compare quality of life (QoL) in patients with primary open-angle glaucoma (POAG) and dry-type age-related macular degeneration (AMD) with similar best-corrected visual acuity.MethodsAge-, sex-, and visual acuity-matched POAG and dry AMD patients were included in the study. Each patient performed 24-2 and 10-2 SITA standard visual field tests. Contrast sensitivity was evaluated with CSV-1000 HGT instrument. The 25 item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) was used to analyze QoL. Overall and subscale scores were converted to scores between 0 and 100, the higher scores indicating better vision-related QoL.ResultsOverall NEI-VFQ-25 scores were 86.44 and 84.66 in glaucoma and AMD groups, respectively (P=0.244). The highest scores were obtained in 'vision-related dependency' subgroup in glaucoma and 'color and peripheral vision' in AMD group, whereas the lowest scores were noted 'in peripheral vision' in both glaucoma and AMD patients. Glaucoma patients had significantly lower scores in ocular pain, color vision, and peripheral vision subgroups compared with the AMD group, whereas AMD patients had lower scores in near and distance vision activities, vision-related social activity, and dependency subgroups. Contrast sensitivity results and mean defect values showed correlation with NEI-VFQ-25 scores in both groups.ConclusionsGlaucoma and AMD patients with similar visual acuity experienced similar overall impairment in QoL. However, glaucoma patients described more difficulty with peripheral vision and ocular pain, whereas AMD patients complained more about near and distance vision and dependency items.

  11. Elevated high-density lipoprotein cholesterol and age-related macular degeneration: the Alienor study.

    Directory of Open Access Journals (Sweden)

    Audrey Cougnard-Grégoire

    Full Text Available BACKGROUND: Lipid metabolism and particularly high-density lipoprotein (HDL may be involved in the pathogenic mechanism of age-related macular degeneration (AMD. However, conflicting results have been reported in the associations of AMD with plasma HDL and other lipids, which may be confounded by the recently reported associations of AMD with HDL-related genes. We explored the association of AMD with plasma lipid levels and lipid-lowering medication use, taking into account most of HDL-related genes associated with AMD. METHODS: The Alienor study is a population-based study on age-related eye diseases performed in 963 elderly residents of Bordeaux (France. AMD was graded from non mydriatic color retinal photographs in three exclusive stages: no AMD (n = 430 subjects, 938 eyes; large soft distinct drusen and/or large soft indistinct drusen and/or reticular drusen and/or pigmentary abnormalities (early AMD, n = 176, 247; late AMD (n = 40, 61. Associations of AMD with plasma lipids (HDL, total cholesterol (TC, Low-density lipoprotein (LDL, and triglycerides (TG were estimated using Generalized Estimating Equation logistic regressions. Statistical analyses included 646 subjects with complete data. RESULTS: After multivariate adjustment for age, sex, educational level, smoking, BMI, lipid-lowering medication use, cardiovascular disease and diabetes, and for all relevant genetic polymorphisms (ApoE2, ApoE4, CFH Y402H, ARMS2 A69S, LIPC rs10468017, LIPC rs493258, LPL rs12678919, ABCA1 rs1883025 and CETP rs3764261, higher HDL was significantly associated with an increased risk of early (OR = 2.45, 95%CI: 1.54-3.90; P = 0.0002 and any AMD (OR = 2.29, 95%CI: 1.46-3.59; P = 0.0003. Association with late AMD was far from statistical significance (OR = 1.58, 95%CI: 0.48-5.17; p = 0.45. No associations were found for any stage of AMD with TC, LDL and TG levels, statin or fibrate drug use. CONCLUSIONS: This study suggests that elderly patients with high HDL

  12. Progress on retinal image analysis for age related macular degeneration.

    Science.gov (United States)