PURPOSE To assess whether smoking status affects 1-year visual outcomes in eyes treated with vascular endothelial growth factor inhibitors for neovascular age-related macular degeneration. METH-ODS Retrospective analysis of data from a prospectively designed, multicenter, observational database. Nine hundred and eighty seven treatment-naive eyes of patients with neovascular age-related macular degeneration were tracked by the Fight Retinal Blindness! outcome registry in Australia, New Zealand, Singapore, and Switzerland who had documented smoking status at baseline and commenced vascular endothelial growth factor inhibitor therapy from January 2006 to December 2016. Generalized additive models were used to display visual acuity results. RESULTS There was a significant difference in mean improvement in visual acuity at 12 months between nonsmokers, ex-smokers, and current smokers (7.7 vs. 6.1 vs. 3.5 letters of change; P = 0.046) among patients who completed 12 months of treatment when adjusted for age, baseline visual acuity, and choroidal neovascular membrane lesion type and nested for practice. There was no significant difference in the median number of injections over 12 months of treatment by smoking status. Current smokers were a mean of 6.2 years younger than nonsmokers when they started treatment (P < 0.001). CONCLUSION This study found inferior 12-month visual outcomes in patients who continued to smoke while receiving vascular endothelial growth factor inhibitor therapy for neovascular age-related macular degeneration.
Functional paragangliomas are rare neuroendocrine tumours that secrete
catecholamines and are infrequently found in the mediastinum. We report a case
of a young male with symptoms of catecholamine excess and a personal and family
history of the paraganglioma predisposing succinate dehydrogenase subunit B
mutation. The lesion had anatomical intrapericardial juxtaposition to important
cardiac anatomy and posed the significant challenge of dissection at surgery.
The lesion was successfully resected via sternotomy on cardiopulmonary bypass
and confirmed histopathologically as paraganglioma. Intrapericardial
paraganglioma is rare and treatment is difficult and time critical considering
the proximity of cardiac anatomy as well as malignant potential.
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