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ABSTRACT: To compare the discriminating ability of corneal elevation generated by a dual Scheimpflug analyzer calculated with different reference surfaces for distinguishing normal corneas from those with keratoconus and subclinical keratoconus.
A total of 391 eyes of 208 patients were prospectively enrolled in the study and divided into three groups: 167 eyes of 113 patients with keratoconus, 47 contralateral topographically normal eyes of patients with clinically evident keratoconus in the fellow eye, and 177 eyes of 95 refractive surgery candidates with normal corneas. All eyes were measured with a dual Scheimpflug analyzer (GALILEI Analyzer; Ziemer Ophthalmic Systems AG, Port, Switzerland). Maximum elevation values were recorded within the central 5-mm diameter in both anterior and posterior elevation maps. Discriminating ability of corneal elevation measurements obtained by best-fit toric and aspheric (BFTA) and best-fit sphere (BFS) reference surfaces were compared by receiver operator characteristic (ROC) curves.
ROC curve analysis showed that corneal elevation measured by BFTA had a significantly better ability than with BFS for distinguishing normal corneas from those with keratoconus and forme fruste keratoconus (P = .01). Posterior elevation measured by BFTA had a significantly higher predictive accuracy for forme fruste keratoconus than anterior elevation with an area under ROC curves of 0.88 and 0.80, respectively (P = .01). The sensitivity and specificity achieved with the maximum posterior elevation for detecting keratoconus and forme fruste keratoconus were 99% and 99% for keratoconus and 82% and 80% for forme fruste keratoconus with the cut-off value at 16 and 13 μm, respectively.
The ability to discriminate between normal cornea and forme fruste keratoconus with elevation parameters was significantly improved by using BFTA instead of BFS reference surface.[J Refract Surg. 2013;29(4):274-281.].
Journal of refractive surgery (Thorofare, N.J.: 1995) 04/2013; 29(4):274-81. · 2.54 Impact Factor
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Bénédicte M J Merle,
Marie-Noëlle Delyfer,
Jean-François Korobelnik,
Marie-Bénédicte Rougier,
Florence Malet,
Catherine Féart,
Mélanie Le Goff,
Evelyne Peuchant,
Luc Letenneur,
Jean-François Dartigues, Joseph Colin,
Pascale Barberger-Gateau,
Cécile Delcourt
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ABSTRACT: High dietary intakes of n3 (Ω3) PUFA and fish have been consistently associated with a decreased risk for age-related macular degeneration (AMD). We assessed the associations of late AMD with plasma n3 PUFA, a nutritional biomarker of n3 PUFA status. The Antioxydants Lipides Essentiels Nutrition et Maladies Occulaires (Alienor) Study is a prospective, population-based study on nutrition and age-related eye diseases performed in 963 residents of Bordeaux (France) aged ≥73 y. Participants had a first eye examination in 2006-2008 and were followed for 31 mo on average. Plasma fatty acids were measured by GC from fasting blood samples collected in 1999-2001. AMD was graded from non-mydriatic color retinal photographs at all examinations and spectral domain optical coherence tomography at follow-up. After adjustment for age, gender, smoking, education, physical activity, plasma HDL-cholesterol, plasma TGs, CFH Y402H, apoE4, and ARMS2 A69S polymorphisms, and follow-up time, high plasma total n3 PUFA was associated with a reduced risk for late AMD [OR = 0.62 for 1-SD increase (95% CI: 0.44-0.88); P = 0.008]. Associations were similar for plasma 18:3n3 [OR = 0.62 (95% CI: 0.43-0.88); P = 0.008] and n3 long-chain PUFA [OR = 0.65 (95% CI: 0.46-0.92); P = 0.01]. This study gives further support to the potential role of n3 PUFAs in the prevention of late AMD and highlights the necessity of randomized clinical trials to determine more accurately the value of n3 PUFAs as a means of reducing AMD incidence.
Journal of Nutrition 02/2013; · 3.92 Impact Factor
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ABSTRACT: PURPOSE: To explore the association of age-related macular degeneration (AMD) with long-term average blood pressure (BP) parameters, including pulse pressure (PP). Methods: The Alienor study is a population-based study on age-related eye diseases in 963 residents of Bordeaux (France), aged 73 years or more. AMD was graded from non mydriatic color retinal photographs, in three exclusive stages: no AMD (1015 eyes); large soft distinct drusen and/or large soft indistinct drusen and/or reticular drusen and/or pigmentary abnormalities (early AMD, 276 eyes); late AMD (66 eyes). BP parameters were measured at 4 occasions over a 7-year period. PP was defined as systolic BP minus diastolic BP. Associations of AMD with blood pressure parameters were estimated using Generalized Estimating Equation logistic regressions. Statistical analyses included 702 subjects (1357 eyes) with complete data. Results: After adjustment for age, gender, educational level, smoking, body mass index, plasma HDL- and LDL-cholesterol, CFH Y402H, ApoE2, ApoE4 and ARMS2 A69S polymorphisms, elevated PP was significantly associated with an increased risk of late AMD (OR=1.37 for a 10 mmHg-increase, 95 % confidence interval (CI): [1.03-1.82]). Associations were similar for late atrophic and late neovascular AMD (OR= 1.39 [1.01-1.92], p=0.04 and OR= 1.43 [0.90-2.23], p=0.13, respectively). Association with early AMD was in the same direction but did not reach statistical significance (OR=1.12, 95% CI: 0.98-1.28). Early and late AMD were not significantly associated with systolic or diastolic blood pressure, hypertension or use of anti-hypertensive medications. Conclusions: This study suggests that high pulse pressure may be associated with increased risk for AMD.
Investigative ophthalmology & visual science 02/2013; · 3.43 Impact Factor
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Sihem Lazreg,
Nicolas Mesplié,
Delphine Praud,
Cécile Delcourt,
Heykel Kamoun,
Mohamed Chahbi,
Sandy Leoni-Mesplié,
David Smadja,
William Trattler,
David Touboul, Joseph Colin
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ABSTRACT: PURPOSE: To determine whether corneal thickness and rigidity vary between French and North African refractive surgery candidates. SETTING: Three clinics in North Africa and 1 hospital in France. DESIGN: Cross-sectional study. METHODS: In part 1, the central corneal thickness (CCT) in North African patients and French patients having preoperative examinations was retrospectively compared. In part 2, the biomechanical properties of the corneas in the 2 groups were prospectively compared. Comparisons were performed using the Student t and chi-square tests and multivariate linear and logistic regression. RESULTS: The retrospective study comprised 1662 patients from North Africa and 221 patients from France and the prospective study, 249 and 110, respectively. After adjustment for sex, age, and steepest keratometry, the mean CCT was statistically significantly thinner in North African patients (P<.0001). More than one fourth of North African patients had corneas thinner than 500 μm (28.9% versus 7.7% of French patients). Of patients with thin corneas, the mean corneal resistance factor (CRF) was statistically significantly lower in North African patients (P<.0001); there was no significant difference in corneal hysteresis. This remained true after adjustment for CCT (CCT-adjusted difference in CRF between groups: -0.78; range -1.27 to -0.28; P=.002). CONCLUSION: Corneas were thinner in North African patients than in French patients, and the CRF was different even when CCT was taken into accounted. More research is needed to determine whether these differences are associated with an additional risk for ectasia after laser in situ keratomileusis. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
Journal of cataract and refractive surgery 01/2013; · 2.75 Impact Factor
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ABSTRACT: To compare early corneal healing following conventional, transepithelial, and accelerated corneal collagen cross-linking (CXL) protocols.
Twenty-four patients with progressive keratoconus were divided into three groups to receive conventional, transepithelial, or accelerated CXL. In vivo corneal confocal microscopy was performed on each patient preoperatively and at 1, 3, and 6 months postoperatively.
Closure of the epithelial wound was complete 3 days following conventional and accelerated CXL. The subbasal nerve plexus was essentially obliterated immediately following conventional and accelerated CXL, and virtually no nerve fibers had regenerated by 6 months. The anterior stroma showed significant changes 1 month following conventional CXL; these changes were similar but more pronounced following accelerated CXL. Observed stromal changes included complete obliteration of keratocytes, increased tissue reflectivity, a honeycomb-like appearance, and circular lacunae. Some recovery of keratocyte density was noted after 6 months. These changes were less pronounced in the mid-stroma, and there were no apparent changes to the posterior stroma or endothelium. The cornea appeared to be unaltered following transepithelial CXL.
In vivo corneal confocal microscopy analysis of the postoperative impact of CXL on the cornea revealed clear differences among conventional, accelerated, and transepithelial CXL protocols. Accelerated CXL had a greater impact than conventional CXL on the anterior cornea, whereas transepithelial CXL did not appear to alter corneal morphology.
Journal of refractive surgery (Thorofare, N.J.: 1995) 11/2012; 28(11):769-76. · 2.54 Impact Factor
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ABSTRACT: Purpose: To evaluate the corneal thickness and curvature of myopic and patients with keratoconus from two countries. Methods: This cross-sectional study was conducted at Cabinet Opale, Fort de France, French West Indies and University Hospital of Bordeaux, France. Corneal thickness and curvature were assessed in 170 keratoconic eyes of 89 residents of the French Caribbean Islands (FCI) and 159 keratoconic eyes of 91 residents of the Aquitaine region of southwest France. A group of age-matched keratoconus-free patients who had been referred for refractive surgery owing to myopia (173 FCI [173 eyes; 87 individuals] and Aquitaine [181 eyes; 93 individuals]) were also assessed. Results: The mean age at keratoconus diagnosis was significantly higher among FCI than Aquitaine residents (p = 0.009). The mean keratometric (Km) reading was statistically higher for keratoconic FCI than Aquitaine patients, at 48.06 versus 46.21 diopters (p = 0.001). This difference was more pronounced among patients aged >40 years than those ≤40 years (p = 0.009). Patients with keratoconus showed no significant difference in mean central corneal thickness and thinnest corneal point values, irrespective of region. Myopic individuals from the FCI, however, had significantly lower mean central corneal thickness and thinnest corneal point measurements than Aquitaine myopics, irrespective of age group (p ≤ 0.0008). Conclusion: The corneas of patients with keratoconus of African-Caribbean and Caucasian origins are of similar thickness. Myopic African-Caribbean patients referred for refractive surgery tend to present with thinner corneas than Caucasians.
Acta ophthalmologica 08/2012; · 2.44 Impact Factor
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Archives of ophthalmology 08/2012; 130(8):1077-8. · 3.86 Impact Factor
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ABSTRACT: To evaluate the incidence of glistenings in a large series of consecutive eyes with a blue light-filtering hydrophobic acrylic intraocular lens (IOL) and the relationship with parameters such as age, sex, follow-up length, and corrected distance visual acuity (CDVA).
Service d'Ophtalmologie, Centre Hospitalier et Universitaire Bordeaux, Bordeaux, France.
Cross-sectional study.
This study included 111 eyes of 74 patients (age range 33 to 86 years). All cases had cataract surgery with Acrysof SN60WF monofocal IOL implantation and had a routine postoperative examination between March 2011 and June 2011. The incidence and severity of glistenings were evaluated with the slitlamp. Also evaluated was their relationship with age, sex, follow-up length, IOL power, and CDVA. Glistenings were subjectively graded (0 = absent; 1 = moderate; 2 = dense).
Glistenings occurred in 96 eyes (86.5%). Glistenings were of grade 1 severity in 45 eyes (40.5%) and of grade 2 severity in 51 eyes (45.9%). The follow-up was significantly longer in eyes with grade 2 glistenings (P ≤ .01). A limited, but significant, correlation was found between glistening severity and length of follow-up (r = 0.32, P<.01). Although there was a trend toward decreased visual acuities at higher glistening grades (r = 0.22, P = .01), there were no significant differences in CDVA between the glistening severity groups (P = .14).
Glistenings were common in eyes with the blue light-filtering hydrophobic acrylic IOL and increased over time.
No author has a financial or proprietary interest in any material or method mentioned.
Journal of cataract and refractive surgery 07/2012; 38(7):1140-6. · 2.75 Impact Factor
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ABSTRACT: We report the case of a highly myopic patient who developed severe bilateral endothelial cell loss following implantation of 2 angle-supported anterior chamber pIOL models, the Acrysof Cachet and the GBR (currently off the market). FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
Journal of cataract and refractive surgery 07/2012; 38(7):1288-92. · 2.75 Impact Factor
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ABSTRACT: To define the contribution of the corneal epithelium in corneal topography in keratoconus and discuss the implications regarding combined topography-guided photorefractive keratectomy and corneal collagen crosslinking (CXL).
French National Reference Center for Keratoconus, Bordeaux, France.
Case series.
Specular topographies were performed before and immediately after epithelial removal during conventional CXL surgery in patients with keratoconus.
The study included 1 eye with forme fruste keratoconus, 4 eyes in Krumeich stage I, and 3 eyes in stage II. The mean simulated maximum keratometry (K) increased by 2.87 diopters (D) after epithelial removal. The mean effective refractive power increased by a mean of 4.01 D and the astigmatic refractive power, by a mean of 2.17 D. The difference in mean axis deviation was not significant. The mean inferior-superior ratio irregularity index increased 1.51 units. All K and refractive readings except astigmatic refractive axis were significantly increased after epithelial removal. All regularity indices increased significantly without the epithelium. The amplitude of variations in K readings made it difficult to predict the refractive changes after custom laser photoablation based on epithelial-based topography.
The astigmatism refractive axis did not change significantly; therefore, this axis could be useful for astigmatic corrections, whereas the spherical component would not be useful. Topographic changes after epithelial removal can be important but not intuitive in keratoconus eyes. This should be considered in custom topography-guided photoablation strategies when attempting to correct refractive errors at the time of CXL.
Journal of cataract and refractive surgery 06/2012; 38(6):1043-9. · 2.75 Impact Factor
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ABSTRACT: To evaluate the long-term rate of progression of keratoconus in eyes implanted with Intacs (Addition Technology Inc) at 5-year follow-up.
Data of 105 eyes from 85 patients who had undergone consecutive Intacs implantation between January 2001 and December 2005 were studied retrospectively for progression of keratoconus. Progression of keratoconus was defined as an increase in steep keratometry (K) of ≥ 1.00 diopter (D) over 4 years between 1- and 5-year follow-up. All eyes were categorized into three subgroups: eyes with documented preoperative progression (change in steep K ≥ 1.00 D over 12 months preoperatively), eyes with documented absence of preoperative progression, and eyes with no record of preoperative progression.
Ninety-two eyes were available for analysis. Overall, 91.3% (84/92) of eyes demonstrated no progression between 1- and 5-year follow-up. In the sub-group analysis, 92.9% (52/56) of eyes with documented preoperative progression demonstrated no progression. Additionally, no statistically significant differences were noted in mean steep, flat, and average keratometry; manifest refraction spherical equivalent; and uncorrected and corrected distance visual acuity (P>.05) between 1- and 5-year follow-up.
Results of our study demonstrate the long-term stability of refractive and topographic outcomes following Intacs implantation in eyes with keratoconus. The finding that 92.9% of eyes with progressive keratoconus did not progress postoperatively indicates that Intacs implantation may be a potential therapeutic option to halt progressive keratoconus.
Journal of refractive surgery (Thorofare, N.J.: 1995) 05/2012; 28(6):392-6. · 2.54 Impact Factor
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ABSTRACT: To assess the severity of keratoconus at diagnosis and its scalability over a period of 2 years in children compared to adults.
A retrospective monocentric study was conducted in the National Reference Center for Keratoconus, Bordeaux (France), between October 1997 and November 2010.
In total, 216 patients were studied, comprising 49 patients (22.7%) aged ≤ 15 and 167 patients (77.3%) aged ≥ 27 years at diagnosis, who were seen within 2 years of diagnosis. Severity at diagnosis was assessed using Krumeich's classification, and the scalability criteria of the US Food and Drug Administration (2010) were used. Student t tests and χ(2) tests were performed to compare the 2 groups.
Keratoconus in children was significantly more severe at diagnosis, with 27.8% being stage 4 vs 7.8% of adults (P < .0001). In addition, ophthalmoscopic signs were more frequent in children (42.9% vs 29.5%, P = .05), while mean values of maximum, average, and minimum keratometry as well as simulated keratometric astigmatism were higher (P < .0001, P = .0002, P = .0005, and P = .001, respectively). After diagnosis, keratoconus did not evolve more frequently in children. However, in the case of progression, keratoconus evolved faster in children, with significant differences in the spherical equivalent and maximum and minimum keratometry (P = .03, P = .02, P = .04, respectively).
At diagnosis, keratoconus is often more advanced in children than in adults, with faster disease progression. Early detection and close monitoring are therefore crucial in young patients.
American journal of ophthalmology 04/2012; 154(1):56-62.e1. · 3.83 Impact Factor
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ABSTRACT: To evaluate retrospectively the outcomes of a case series of deep anterior lamellar keratoplasties by air dissection (DALK-AD) using the big bubble (BB) technique, in the surgical treatment of keratoconus (KC).
Forty-four consecutive keratoplasties of 42 patients for KC were performed at the French National Reference Center for KC from January 2008 to June 2010 by the same surgeon with the aim of systematically performing DALK-AD with the BB technique. The outcomes of the DALK-AD not converted to penetrating keratoplasty were analyzed, and a learning curve was established to successfully achieve the DALK-AD using the BB technique.
Thirty-two DALK-AD procedures were successfully performed among 44 consecutively operated keratoplasties, with 12 being converted to penetrating keratoplasty during the surgical procedure. At 12 months, the mean best-corrected logarithm of the minimum angle of resolution visual acuity was 0.88 ± 0.14 with 93.3% seeing best-corrected visual acuity ≥ 20/30 and 100% seeing best-corrected visual acuity ≥ 20/40. The mean gain of visual acuity in logarithm of the minimum angle of resolution lines at 6 and 12 months was 6.12 ± 3.97 (P < 0.0001) and 6.94 ± 4.18 (P < 0.005), respectively. The rate for intraoperative and postoperative complications was 31.8% and 4.5%, respectively.
Despite a learning period needed to successfully perform deep lamellar anterior keratoplasty with the BB technique, this approach is safe and provides very good visual outcomes when adequate baring of Descemet membrane is achieved. The learning curve showed that complications related to this technique decrease significantly after the first 10 cases.
Cornea 04/2012; 31(8):859-63. · 1.73 Impact Factor
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ABSTRACT: To report refractive, topographic, and biomechanical outcomes, efficiency, and safety of corneal collagen crosslinking (CXL) 1, 3, 6, and 12 months after treatment.
National Reference Centre for Keratoconus, Bordeaux and Toulouse, France.
Case series.
This retrospective uncontrolled double-center study comprised eyes with progressive keratoconus. Uncorrected distance visual acuity, corrected distance visual acuity (CDVA), corneal pachymetry, endothelial cell count, and corneal hysteresis and corneal resistance factor were evaluated at baseline and at 1, 3, 6, and 12 months.
One hundred forty-two eyes were enrolled in the study. At 6 months, the CDVA had stabilized in 53 eyes (48.1%), improved in 36 eyes (32.7%), and decreased in 18 eyes (16.3%). At 12 months, the CDVA had stabilized in 31 eyes (47.6%), improved in 26 eyes (40.0%), and decreased in 8 eyes (12%). At 6 months, keratoconus progression had stopped in 51 eyes (49.03%) and the maximum keratometry (K) value had decreased by more than 1.0 diopter (D) in 37 eyes (35.5%); it continued to progress in 16 eyes (15.3%). At 12 months, keratoconus progression had stopped in 42 eyes (68.8%) and the maximum K value had decreased by more than 2.0 D in 13 eyes (21.3%). The complication rate with loss of vision was 3.5%.
Ultraviolet-A light associated with riboflavin CXL is an efficient procedure to stabilize and improve progressive keratoconus. The results reinforce previous studies highlighting the efficacy and safety of the procedure. A large prospective randomized clinical trial is needed.
Journal of cataract and refractive surgery 12/2011; 37(12):2137-43. · 2.75 Impact Factor
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ABSTRACT: To estimate the ability of the Ocular Response Analyzer parameters to aid in the diagnosis of keratoconus in pre-laser in situ keratomileusis (LASIK) patients.
Department of Ophthalmology, Bordeaux 2 University, Bordeaux Cedex, France.
Evaluation of diagnostic test.
This study compared eyes with mild stages of keratoconus (study group) with preoperative eyes that later had LASIK (control group). Corneas with a central thickness within 500 to 600 μm were targeted. The biomechanical measurements were acquired, and 12 parameters were analyzed after extraction from the signal data.
The study group comprised 103 eyes and the control group, 97 eyes. The mean corneal hysteresis (CH) was 9.2 mm Hg in study eyes and 10.1 mm Hg in control eyes and the mean corneal resistance factor (CRF), 8.9 mm Hg and 10.6 mm Hg, respectively. For a threshold of 9.6, CH had a sensitivity of 66% with a specificity of 67%. For a threshold of 9.7, the CRF had a sensitivity of 72% and a specificity of 77%. For 6 biomechanical parameters, the probability that a patient would present with keratoconus was 3 in 1000 if 1 parameter was over the chosen threshold.
If 1 of 6 parameters were over a chosen threshold, the probability that a patient would present with keratoconus would be almost 3 in 1000 instead of 9 in 1000 in a LASIK surgery cohort. Despite low sensitivity and specificity, some parameters provided by the corneal analyzer offered high negative likelihood ratios and deserve more study with bigger samples.
Journal of cataract and refractive surgery 12/2011; 37(12):2144-50. · 2.75 Impact Factor
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ABSTRACT: We describe a case of a 52-year-old man in whom the appearance of an air bubble developed, trapped within the Descemet membrane (DM), that occurred during a planned deep anterior lamellar keratoplasty using the "big bubble" technique. This situation can occur because Descemet membrane's anatomic structure can be opened by the gas dissection; this complication may result in unanticipated results during and after this type of surgery. Surgeons should be aware of this specific risk, so they will recognize it when it occurs. Optical coherence tomography (OCT) imaging and surgical management are presented.
Cornea 11/2011; 31(2):191-3. · 1.73 Impact Factor
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ABSTRACT: To assess glistenings in AcrySof (Alcon Laboratories Inc) intraocular lenses (IOLs), to quantify any effects of glistenings on the visual function of patients with healthy eyes, and to investigate whether glistenings were associated with demographic or lens characteristics.
Case files from a consecutive series of healthy eyes were retrospectively analyzed. Subjective glistening grades were investigated for associations with the following parameters: contrast sensitivity, corrected distance visual acuity (CDVA), intraocular light scattering (measured by C-Quant [Oculus Optikgeräte GmbH]), posterior capsule opacification, demographic characteristics, lens power, and duration of pseudophakia. The subjective grading method was compared to objective software-based quantitation of glistenings.
The study cohort included 97 eyes from 65 patients with a mean age of 65 ± 11 years. Mean follow-up was 18 ± 17 months. Glistening grades did not vary by duration of pseudophakia (P=.19), although study design limited confidence in this result. Glistening grades had no associations with lens power (P=.41), intraocular light scattering (P=.31), logMAR CDVA (P=.64), contrast sensitivity at any spatial frequency (all P ≥.22), or with any other parameter under investigation. The software-based assessment confirmed the validity of the subjective grading method: glistening grades correlated with vacuoles/mm(2) (P<.0001) and mean values for vacuoles/mm(2) were statistically significant for each glistening grade (all P ≤.004).
In healthy eyes, glistening grade was not associated with contrast sensitivity, CDVA, intraocular light scatter, or any lens or demographic characteristics that were investigated.
Journal of refractive surgery (Thorofare, N.J.: 1995) 07/2011; 27(12):869-75. · 2.54 Impact Factor
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Cornea 06/2011; 30(9):1068; author reply 1068-9. · 1.73 Impact Factor
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Bénédicte Merle,
Marie-Noëlle Delyfer,
Jean-François Korobelnik,
Marie-Bénédicte Rougier, Joseph Colin,
Florence Malet,
Catherine Féart,
Mélanie Le Goff,
Jean-François Dartigues,
Pascale Barberger-Gateau,
Cécile Delcourt
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ABSTRACT: Previous studies have suggested a lower risk for age-related maculopathy (ARM) in subjects with high dietary intake of long-chain omega-3 polyunsaturated fatty acids (PUFA). The authors report the associations of ARM with past dietary intakes in French elderly subjects.
The Alienor Study is a population-based epidemiologic study on nutrition and age-related eye diseases performed in residents of Bordeaux 73 years of age and older. Six hundred sixty-six subjects (1289 eyes) with complete data were included in the analyses. ARM was classified from retinal photographs taken in 2006 to 2008 in five exclusive stages: late neovascular ARM (n = 21 subjects, 29 eyes); late atrophic ARM (n = 19 subjects, 33 eyes); large soft indistinct drusen and/or reticular drusen and/or large distinct drusen with pigment abnormalities (early ARM2, n = 67 subjects, 100 eyes); large soft distinct drusen alone or pigment abnormalities alone (early ARM1, n = 119 subjects, 163 eyes); and no ARM (n = 440 subjects, 964 eyes). Dietary intakes were estimated from a 24-hour dietary recall performed by dieticians (2001-2002). Associations were estimated using logistic Generalized Estimating Equation.
After multivariate adjustment, subjects with high intake of long-chain omega-3 PUFA showed a decreased risk for early ARM1 (odds ratio [OR], 0.83; 95% confidence interval [95% CI], 0.71-0.98; P = 0.03) and late neovascular ARM (OR, 0.26; 95% CI, 0.08-0.83; P = 0.02). Associations with late atrophic ARM were in the same direction but did not reach statistical significance (OR, 0.74; 95% CI, 0.52-1.06; P = 0.10). Overall, high intakes of long-chain omega-3 PUFA were associated with reduced risk for late ARM (OR, 0.59; 95% CI, 0.39-0.88; P = 0.01).
These results confirm a decreased risk for ARM in subjects with high intake of long-chain omega-3 PUFA.
Investigative ophthalmology & visual science 06/2011; 52(8):6004-11. · 3.43 Impact Factor
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ABSTRACT: To assess the associations of complement factor H (CFH) Y402H polymorphism and smoking with specific features of early AMD (type, location, and area).
The ALIENOR study is a population-based study of age-related eye diseases in 963 residents of Bordeaux (France), aged 73 years or more. AMD features were graded from nonmydriatic color retinal photographs. CFH Y402H was genotyped by using DNA extracted from blood. Statistical analyses included 796 subjects with complete data.
CFH CC genotype was strongly associated with late neovascular AMD (OR, 6.0; 95% confidence interval [CI], 1.5-23.5) but not with late atrophic AMD (OR, 0.9; 95% CI, 0.2-4.3). Among early characteristics, it was associated with central soft drusen (within 500 μm of the fovea), whether of intermediate (63-125 μm; OR, 2.7; 95% CI, 1.5-4.8), or large (>125 μm; OR, 5.9; 95% CI, 2.2-15.7) size, but not with pericentral soft drusen (500-3000 μm from the fovea). It was also strongly associated with a large central area of soft drusen (OR, 5.7; 95% CI, 1.7-19.2). Similarly, heavy smoking (>20 pack-years) was strongly associated with central large drusen (OR, 3.9; 95% CI, 1.6-9.6) and a large central area of drusen (OR, 3.5; 95% CI, 1.2-10.0), but not with pericentral soft drusen. By contrast, both CFH CC and smoking tended to be more strongly associated with pericentral pigmentary abnormalities.
Location of abnormalities, together with type and area, may prove useful for the identification of subjects at high risk for late AMD.
Investigative ophthalmology & visual science 06/2011; 52(8):5955-62. · 3.43 Impact Factor
