Macular thickness and volume in the elderly: A systematic review

Subhi, Yousif; Forshaw, Thomas Richard Johansen; Sørensen, Torben Lykke

doi:10.1016/j.arr.2016.05.013

Cited by 36 publications

(36 citation statements)

References 59 publications

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“…These findings on cellular level may not necessarily have a clinical significant impact on a broader level as seen in the VIEW studies [8]. However, considering that RPE with age becomes more fragile and develops a more potent VEGF response [23–26], patients aged ≥90 years may constitute a group where the aging process of RPE is at its utmost and where the pharmacokinetic differences between Aflibercept and Ranibizumab give rise to clinically measureable differences. However, the differences between Aflibercept and Ranibizumab on CRT had a small effect size in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Macula undergoes a range of changes [23]. The number of retinal pigment epithelium (RPE) cells decreases while the number of photoreceptors remains relatively stable [24].…”

Section: Introductionmentioning

confidence: 99%

“…These aged and stressed RPE cells develop a higher VEGF response [26]. Taken together, increasing age leads to increased fragility of the macula [23], which we speculate may be a part of the reason for why the oldest individuals experience worse treatment response.…”

Section: Introductionmentioning

confidence: 99%

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Neovascular Age-Related Macular Degeneration in the Very Old (≥90 Years): Epidemiology, Adherence to Treatment, and Comparison of Efficacy

Subhi

Sørensen

2017

Journal of Ophthalmology

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Purpose To investigate neovascular age-related macular degeneration (AMD) in patients aged ≥90 years from several perspectives for a comprehensive overview: prevalence, presenting characteristics, treatment adherence, reasons for discontinuation, and efficacy of antivascular endothelial growth factor (VEGF) treatment comparing Ranibizumab and Aflibercept. Methods In this retrospective chart review, we determined the prevalence and presenting characteristics by reviewing all data for patients referred to our department with treatment-naïve neovascular AMD. By looking at historical cohorts, we determined adherence to treatment, reasons for discontinuation, and treatment outcomes after loading dose, 12 months, and 24 months. Results Patients aged ≥90 years constituted 7% of the patients. Treatment was discontinued in 51%, primarily because of death and treatment burden. Mean change in best-corrected visual acuity was 3.2, 1.5, and −2.2 ETDRS letters at 4, 12, and 24 months, respectively. Aflibercept was superior to Ranibizumab in visual and anatomic outcomes. After two years of treatment, patients losing ≥15 ETDRS letters made up 19% in the Aflibercept group and 26% in the Ranibizumab group. Conclusions We propose that the very old patients with neovascular AMD may constitute a distinctive group warranting special attention and possibilities for individualized therapy. Possible differences between anti-VEGF agents need further investigations.

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Section: Discussionmentioning

confidence: 99%

“…Macula undergoes a range of changes [23]. The number of retinal pigment epithelium (RPE) cells decreases while the number of photoreceptors remains relatively stable [24].…”

Section: Introductionmentioning

confidence: 99%

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Neovascular Age-Related Macular Degeneration in the Very Old (≥90 Years): Epidemiology, Adherence to Treatment, and Comparison of Efficacy

Subhi

Sørensen

2017

Journal of Ophthalmology

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“…These findings are in line with our observations in humans in vivo . The RPE-BM complex does not seem to increase outside of the foveal minimum and there may even be a decrease with age in the more peripheral areas of the macula [14,26]. …”

Section: Discussionmentioning

confidence: 99%

“…Relationships between the thickness of the photoreceptor layer or the RPE layer with age, sex, and lifestyle factors were investigated using linear regression models. When studying aging, we adjusted values for gender by including it as an independent co-variate since studies suggest gender differences [14]. When studying influence of lifestyle factors, we adjusted values for both age and gender.…”

Section: Methodsmentioning

confidence: 99%

Effect of aging and lifestyle on photoreceptors and retinal pigment epithelium: cross-sectional study in a healthy Danish population

Harris

Subhi

Sørensen

2017

Pathobiology of Aging & Age-related Diseases

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Photoreceptors and their supporting retinal pigment epithelium constitute the key functional parts of the retina. Here, a study was undertaken to show how aging and lifestyle factors affect the photoreceptor layer and the retinal pigment epithelium and Bruch’s membrane complex (RPE-BM) in vivo in a healthy Danish population using spectral-domain optical coherence tomography. This was a cross-sectional study of healthy humans aged ≥50 years. All participants were interviewed for medical history and lifestyle factors. Maculae of all participants were scanned using spectral-domain optical coherence tomography. The thickness of the photoreceptor layer and the RPE-BM was measured on one eye from each participant. In 150 eyes of 150 participants, it was found that aging was associated with a decrease in the thickness of the photoreceptor layer (−0.143 μm/year, P = 0.031) and an increase in the thickness of the RPE-BM layer (0.100 μm/year, P = 0.029) at the foveal minimum. Regarding lifestyle factors, alcohol intake or BMI were not associated with any significant trend, but physical inactivity and smoking had effects on the photoreceptor layer (decreased thickness) and the RPE-BM layer (increased thickness) indicating an accelerated aging process of the macula. Taken together, aging affects photoreceptors and the RPE-BM, and these aging trends are accelerated in smokers and the physically inactive.

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Risk of age‐related macular degeneration in aspirin users and non‐aspirin users: A population‐based cohort study in Taiwan

Lee

Yang

Cheng

2020

Pharmacoepidemiology and Drug

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BackgroundThe association between cardioprotective aspirin and risk of age‐related macular degeneration (AMD) is still controversial up to date. We aimed to analyze the risk of AMD between aspirin users and non‐aspirin users.MethodThis was a retrospective cohort study by using claims data from the National Health Insurance Research Database. Patients aged more than 45 years old who initiated aspirin during 2002 to 2012 were followed till 2013. We first selected an age and sex‐matched cohort, then identified aspirin users and non‐aspirin users as propensity score‐matched cohort. Cox proportional hazard regression model was applied to compare their hazards and 95% confidence intervals. Incidence of newly developed AMD, neovascular AMD, and other‐AMD was calculated.ResultsWe identified 204 085 regular aspirin users and 478 048 non‐aspirin users from our datasets. The univariate HR was 2.85 (95% CI, 2.75‐2.96), and the multivariate HR was 2.54 (95% CI, 2.44‐2.65). In the PS‐matched cohort, the HR was 2.38 (95% CI, 2.25‐2.52). The incidence of aspirin users for AMD risk was 11.95 per 1000 person‐year, while the incidence of non‐aspirin users was only 3.92 per 1000 person‐year.ConclusionPatients with regular use of aspirin had higher risk in developing AMD compared to non‐aspirin users and suggest to have regular visual acuity and funduscopic examination.

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Macular thickness and volume in the elderly: A systematic review

Cited by 36 publications

References 59 publications

Neovascular Age-Related Macular Degeneration in the Very Old (≥90 Years): Epidemiology, Adherence to Treatment, and Comparison of Efficacy

Neovascular Age-Related Macular Degeneration in the Very Old (≥90 Years): Epidemiology, Adherence to Treatment, and Comparison of Efficacy

Effect of aging and lifestyle on photoreceptors and retinal pigment epithelium: cross-sectional study in a healthy Danish population

Risk of age‐related macular degeneration in aspirin users and non‐aspirin users: A population‐based cohort study in Taiwan

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