Pub Date : 2023-01-01DOI: 10.1177/20406223231170146
Jinze Zhang, Viacheslav Mazlin, Keyi Fei, Albert Claude Boccara, Jin Yuan, Peng Xiao
Ocular imaging plays an irreplaceable role in the evaluation of eye diseases. Developing cellular-resolution ophthalmic imaging technique for more accurate and effective diagnosis and pathogenesis analysis of ocular diseases is a hot topic in the cross-cutting areas of ophthalmology and imaging. Currently, ocular imaging with traditional optical coherence tomography (OCT) is limited in lateral resolution and thus can hardly resolve cellular structures. Conventional OCT technology obtains ultra-high resolution at the expense of a certain imaging range and cannot achieve full field of view imaging. In the early years, Time-domain full-field OCT (TD-FF-OCT) has been mainly used for ex vivo ophthalmic tissue studies, limited by the low speed and low full-well capacity of existing two-dimensional (2D) cameras. The recent improvements in system design opened new imaging possibilities for in vivo applications thanks to its distinctive optical properties of TD-FF-OCT such as a spatial resolution almost insensitive to aberrations, and the possibility to control the curvature of the optical slice. This review also attempts to look at the future directions of TD-FF-OCT evolution, for example, the potential transfer of the functional-imaging dynamic TD-FF-OCT from the ex vivo into in vivo use and its expected benefit in basic and clinical ophthalmic research. Through non-invasive, wide-field, and cellular-resolution imaging, TD-FF-OCT has great potential to be the next-generation imaging modality to improve our understanding of human eye physiology and pathology.
{"title":"Time-domain full-field optical coherence tomography (TD-FF-OCT) in ophthalmic imaging.","authors":"Jinze Zhang, Viacheslav Mazlin, Keyi Fei, Albert Claude Boccara, Jin Yuan, Peng Xiao","doi":"10.1177/20406223231170146","DOIUrl":"https://doi.org/10.1177/20406223231170146","url":null,"abstract":"<p><p>Ocular imaging plays an irreplaceable role in the evaluation of eye diseases. Developing cellular-resolution ophthalmic imaging technique for more accurate and effective diagnosis and pathogenesis analysis of ocular diseases is a hot topic in the cross-cutting areas of ophthalmology and imaging. Currently, ocular imaging with traditional optical coherence tomography (OCT) is limited in lateral resolution and thus can hardly resolve cellular structures. Conventional OCT technology obtains ultra-high resolution at the expense of a certain imaging range and cannot achieve full field of view imaging. In the early years, Time-domain full-field OCT (TD-FF-OCT) has been mainly used for <i>ex vivo</i> ophthalmic tissue studies, limited by the low speed and low full-well capacity of existing two-dimensional (2D) cameras. The recent improvements in system design opened new imaging possibilities for <i>in vivo</i> applications thanks to its distinctive optical properties of TD-FF-OCT such as a spatial resolution almost insensitive to aberrations, and the possibility to control the curvature of the optical slice. This review also attempts to look at the future directions of TD-FF-OCT evolution, for example, the potential transfer of the functional-imaging dynamic TD-FF-OCT from the <i>ex vivo</i> into <i>in vivo</i> use and its expected benefit in basic and clinical ophthalmic research. Through non-invasive, wide-field, and cellular-resolution imaging, TD-FF-OCT has great potential to be the next-generation imaging modality to improve our understanding of human eye physiology and pathology.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/1e/10.1177_20406223231170146.PMC10161339.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10644888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1177/20406223231173896
Guishuang Wang, Hong Zhao, Lei Sun, Gang Wan, Wen Xie
Background: Metabolic-associated fatty liver disease (MAFLD) has become an important cause of liver cancer. The current understanding of MAFLD-related liver cancer is not sufficient, however.
Objective: The objective of this study was to investigate the clinical and metabolic characteristics of inpatients with MAFLD-related liver cancer.
Design: This is a cross-sectional investigation.
Methods: An investigation was conducted to collect the cases of hepatic malignant tumor hospitalized in Beijing Ditan Hospital, Capital Medical University from 1 January 2010 to December 31 2019. The basic information, medical history, laboratory examination results, and imaging examination results of 273 patients diagnosed with MAFLD-related liver cancer were recorded. The general information and metabolic characteristics of patients with MAFLD-related liver cancer were analyzed.
Results: In total, 5958 patients were diagnosed with hepatic malignant tumor. Among them, liver cancer due to other causes accounted for 6.19% (369/5958), MAFLD-related liver cancer was diagnosed in 273 cases of them. From 2010 to 2019, MAFLD-related liver cancer showed an increasing trend. Among 273 patients with MAFLD-related liver cancer, 60.07% were male, 66.30% were ⩾60 years old, and 43.22% had cirrhosis. The 273 patients were comprised by 38 patients with evidence of fatty liver and 235 patients without evidence of fatty liver. There was no significant difference in the proportions of sex, age, overweight/obesity, type 2 diabetes, and the presence of ⩾2 metabolic-related factors between the two groups. In the group without evidence of fatty liver, 47.23% patients had cirrhosis, which was significantly higher than 18.42% in the group with evidence of fatty liver (p < 0.001).
Conclusion: MAFLD-related liver cancer should be considered in liver cancer patients with metabolic risk factors. Half of MAFLD-related liver cancer occurred in the absence of cirrhosis.
{"title":"Clinical characteristics of hospitalized patients with metabolic-associated fatty liver disease-related liver cancer: data from a single center, 2010-2019.","authors":"Guishuang Wang, Hong Zhao, Lei Sun, Gang Wan, Wen Xie","doi":"10.1177/20406223231173896","DOIUrl":"https://doi.org/10.1177/20406223231173896","url":null,"abstract":"<p><strong>Background: </strong>Metabolic-associated fatty liver disease (MAFLD) has become an important cause of liver cancer. The current understanding of MAFLD-related liver cancer is not sufficient, however.</p><p><strong>Objective: </strong>The objective of this study was to investigate the clinical and metabolic characteristics of inpatients with MAFLD-related liver cancer.</p><p><strong>Design: </strong>This is a cross-sectional investigation.</p><p><strong>Methods: </strong>An investigation was conducted to collect the cases of hepatic malignant tumor hospitalized in Beijing Ditan Hospital, Capital Medical University from 1 January 2010 to December 31 2019. The basic information, medical history, laboratory examination results, and imaging examination results of 273 patients diagnosed with MAFLD-related liver cancer were recorded. The general information and metabolic characteristics of patients with MAFLD-related liver cancer were analyzed.</p><p><strong>Results: </strong>In total, 5958 patients were diagnosed with hepatic malignant tumor. Among them, liver cancer due to other causes accounted for 6.19% (369/5958), MAFLD-related liver cancer was diagnosed in 273 cases of them. From 2010 to 2019, MAFLD-related liver cancer showed an increasing trend. Among 273 patients with MAFLD-related liver cancer, 60.07% were male, 66.30% were ⩾60 years old, and 43.22% had cirrhosis. The 273 patients were comprised by 38 patients with evidence of fatty liver and 235 patients without evidence of fatty liver. There was no significant difference in the proportions of sex, age, overweight/obesity, type 2 diabetes, and the presence of ⩾2 metabolic-related factors between the two groups. In the group without evidence of fatty liver, 47.23% patients had cirrhosis, which was significantly higher than 18.42% in the group with evidence of fatty liver (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>MAFLD-related liver cancer should be considered in liver cancer patients with metabolic risk factors. Half of MAFLD-related liver cancer occurred in the absence of cirrhosis.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/7c/10.1177_20406223231173896.PMC10278433.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10664077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Corneal fluorescein sodium staining is a valuable diagnostic method for various ocular surface diseases. However, the examination results are highly dependent on the subjective experience of ophthalmologists.
Objectives: To develop an artificial intelligence system based on deep learning to provide an accurate quantitative assessment of sodium fluorescein staining score and the size of cornea epithelial patchy defect.
Design: A prospective study.
Methods: We proposed an artificial intelligence system for automatically evaluating corneal staining scores and accurately measuring patchy corneal epithelial defects based on corneal fluorescein sodium staining images. The design incorporates two segmentation models and a classification model to forecast and assess the stained images. Meanwhile, we compare the evaluation findings from the system with ophthalmologists with varying expertise.
Results: For the segmentation task of cornea boundary and cornea epithelial patchy defect area, our proposed method can achieve the performance of dice similarity coefficient (DSC) is 0.98/0.97 and Hausdorff distance (HD) is 3.60/8.39, respectively, when compared with the manually labeled gold standard. This method significantly outperforms the four leading algorithms (Unet, Unet++, Swin-Unet, and TransUnet). For the classification task, our algorithm achieves the best performance in accuracy, recall, and F1-score, which are 91.2%, 78.6%, and 79.2%, respectively. The performance of our developed system exceeds seven different approaches (Inception, ShuffleNet, Xception, EfficientNet_B7, DenseNet, ResNet, and VIT) in classification tasks. In addition, three ophthalmologists were selected to rate corneal staining images. The results showed that the performance of our artificial intelligence system significantly outperformed the junior doctors.
Conclusion: The system offers a promising automated assessment method for corneal fluorescein staining, decreasing incorrect evaluations caused by ophthalmologists' subjective variance and limited knowledge.
{"title":"AES-CSFS: an automatic evaluation system for corneal sodium fluorescein staining based on deep learning.","authors":"Shaopan Wang, Jiezhou He, Xin He, Yuwen Liu, Xiang Lin, Changsheng Xu, Linfangzi Zhu, Jie Kang, Yuqian Wang, Yong Li, Shujia Guo, Yunuo Zhang, Zhiming Luo, Zuguo Liu","doi":"10.1177/20406223221148266","DOIUrl":"https://doi.org/10.1177/20406223221148266","url":null,"abstract":"<p><strong>Background: </strong>Corneal fluorescein sodium staining is a valuable diagnostic method for various ocular surface diseases. However, the examination results are highly dependent on the subjective experience of ophthalmologists.</p><p><strong>Objectives: </strong>To develop an artificial intelligence system based on deep learning to provide an accurate quantitative assessment of sodium fluorescein staining score and the size of cornea epithelial patchy defect.</p><p><strong>Design: </strong>A prospective study.</p><p><strong>Methods: </strong>We proposed an artificial intelligence system for automatically evaluating corneal staining scores and accurately measuring patchy corneal epithelial defects based on corneal fluorescein sodium staining images. The design incorporates two segmentation models and a classification model to forecast and assess the stained images. Meanwhile, we compare the evaluation findings from the system with ophthalmologists with varying expertise.</p><p><strong>Results: </strong>For the segmentation task of cornea boundary and cornea epithelial patchy defect area, our proposed method can achieve the performance of dice similarity coefficient (DSC) is 0.98/0.97 and Hausdorff distance (HD) is 3.60/8.39, respectively, when compared with the manually labeled gold standard. This method significantly outperforms the four leading algorithms (Unet, Unet++, Swin-Unet, and TransUnet). For the classification task, our algorithm achieves the best performance in accuracy, recall, and F1-score, which are 91.2%, 78.6%, and 79.2%, respectively. The performance of our developed system exceeds seven different approaches (Inception, ShuffleNet, Xception, EfficientNet_B7, DenseNet, ResNet, and VIT) in classification tasks. In addition, three ophthalmologists were selected to rate corneal staining images. The results showed that the performance of our artificial intelligence system significantly outperformed the junior doctors.</p><p><strong>Conclusion: </strong>The system offers a promising automated assessment method for corneal fluorescein staining, decreasing incorrect evaluations caused by ophthalmologists' subjective variance and limited knowledge.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/e0/10.1177_20406223221148266.PMC9926379.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The prevalence of 'low bone mineral density (BMD)' in Type 2 diabetes (T2DM), especially stratified by body mass index, is seldom reported. The relation of the euthyroid range and low BMD in T2DM remains to be further elucidated.
Objectives: We aim to investigate the thyroid hormones' impact on BMD among euthyroid patients with T2DM.
Design and methods: A total of 1452 hospitalized T2DM patients with normal thyroid function (43.6% males aged over 50 and 56.4% postmenopausal females) were enrolled in this cross-sectional study. BMD was measured at lumbar spine by GE lunar dual-energy X-ray absorptiometry system, and 'low BMD' was defined as T-score <-1.0 SD. The prevalence of 'low BMD' was compared between obese and nonobese (body mass index < 25 kg/m2) groups for both sexes, and the relation of low BMD and free T4 quartiles was explored by multiple logistic regression.
Results: The general prevalence of 'low BMD' was 12.3% for male patients aged over 50 (15.5% in the nonobese group and 8.0% in the obese group) and 49.8% for postmenopausal females (56.7% in the nonobese group and 48.9% in the obese group). After adjustment in multiple linear regression, free T4 level remained significantly related to decreased BMD in nonobese male subgroup. Multiple logistic regression revealed that BMD of the highest free T4 quartile (1.12-1.48 ng/dL) decreased significantly than other three quartiles after adjusting for confounding factors including age, body mass index, serum calcium and creatinine level, fasting glucose, alkaline phosphatase, glycosylated hemoglobin, total cholesterol, and smoking history (OR = 2.724, 95% CI = 1.085-6.840, p = 0.033). No significant relation was found in obese male or postmenopausal female groups.
Conclusion: High-normal free T4 is a potential independent risk factor for 'low BMD' in nonobese male T2DM patients aged over 50. Close attention should be paid to thyroid function profile, even within normal range, in nonobese men with underlying higher fracture risks on diabetes status.
背景:2型糖尿病(T2DM)中“低骨密度(BMD)”的患病率,特别是按体重指数分层,很少有报道。T2DM患者甲状腺功能正常范围与低骨密度的关系有待进一步研究。目的:探讨甲状腺激素对正常甲状腺功能的T2DM患者骨密度的影响。设计与方法:本横断面研究共纳入1452例甲状腺功能正常的住院T2DM患者(50岁以上男性43.6%,绝经后女性56.4%)。采用GE月相双能x线骨密度仪测量腰椎骨密度,将“低骨密度”定义为男女T-score 2组,采用多元logistic回归探讨低骨密度与游离T4四分位数的关系。结果:50岁以上男性患者的总体“低骨密度”患病率为12.3%(非肥胖组15.5%,肥胖组8.0%),绝经后女性患者的总体“低骨密度”患病率为49.8%(非肥胖组56.7%,肥胖组48.9%)。经多元线性回归调整后,非肥胖男性亚组游离T4水平与BMD降低仍有显著相关性。多元logistic回归分析显示,在校正年龄、体重指数、血钙和肌酐水平、空腹血糖、碱性磷酸酶、糖化血红蛋白、总胆固醇、吸烟史等混杂因素后,游离T4最高四分位数的骨密度(1.12 ~ 1.48 ng/dL)显著低于其他四分位数(OR = 2.724, 95% CI = 1.085 ~ 6.840, p = 0.033)。在肥胖男性或绝经后女性组中未发现显著相关性。结论:高正常游离T4是50岁以上非肥胖男性T2DM患者“低BMD”的潜在独立危险因素。应密切关注甲状腺功能概况,即使在正常范围内,非肥胖男性潜在的骨折风险较高的糖尿病状态。
{"title":"High-normal free thyroxine level is related with decreased bone mineral density in nonobese male patients with type 2 diabetes over 50 years old.","authors":"Hanxin Zhao, Dike Shi, Guoxing Wang, Yu Ruan, Xiaocheng Feng, ChengFang Jia, Qingqing Wang, Xuehong Dong","doi":"10.1177/20406223231195627","DOIUrl":"https://doi.org/10.1177/20406223231195627","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of 'low bone mineral density (BMD)' in Type 2 diabetes (T2DM), especially stratified by body mass index, is seldom reported. The relation of the euthyroid range and low BMD in T2DM remains to be further elucidated.</p><p><strong>Objectives: </strong>We aim to investigate the thyroid hormones' impact on BMD among euthyroid patients with T2DM.</p><p><strong>Design and methods: </strong>A total of 1452 hospitalized T2DM patients with normal thyroid function (43.6% males aged over 50 and 56.4% postmenopausal females) were enrolled in this cross-sectional study. BMD was measured at lumbar spine by GE lunar dual-energy X-ray absorptiometry system, and 'low BMD' was defined as <i>T</i>-score <-1.0 SD. The prevalence of 'low BMD' was compared between obese and nonobese (body mass index < 25 kg/m<sup>2</sup>) groups for both sexes, and the relation of low BMD and free T4 quartiles was explored by multiple logistic regression.</p><p><strong>Results: </strong>The general prevalence of 'low BMD' was 12.3% for male patients aged over 50 (15.5% in the nonobese group and 8.0% in the obese group) and 49.8% for postmenopausal females (56.7% in the nonobese group and 48.9% in the obese group). After adjustment in multiple linear regression, free T4 level remained significantly related to decreased BMD in nonobese male subgroup. Multiple logistic regression revealed that BMD of the highest free T4 quartile (1.12-1.48 ng/dL) decreased significantly than other three quartiles after adjusting for confounding factors including age, body mass index, serum calcium and creatinine level, fasting glucose, alkaline phosphatase, glycosylated hemoglobin, total cholesterol, and smoking history (OR = 2.724, 95% CI = 1.085-6.840, <i>p</i> = 0.033). No significant relation was found in obese male or postmenopausal female groups.</p><p><strong>Conclusion: </strong>High-normal free T4 is a potential independent risk factor for 'low BMD' in nonobese male T2DM patients aged over 50. Close attention should be paid to thyroid function profile, even within normal range, in nonobese men with underlying higher fracture risks on diabetes status.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/f0/10.1177_20406223231195627.PMC10472831.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1177/20406223231152785
Constanze Jonak, Isolde Göttfried, Sylvia Perl-Convalexius, Barbara Gruber, Martina Schütz-Bergmayr, Igor Vujic, Wolfgang Weger, Nikolaus Schicher, Lydia Semlin, Margit Hemetsberger, Myriam Cordey, Paul Sator
Background: Apremilast, an oral phosphodiesterase 4 inhibitor, is approved in the European Union for the treatment of moderate-to-severe chronic plaque psoriasis in adult patients refractory or contraindicated to or intolerant of other systemic therapies.
Objectives: The APPRECIATE study assessed apremilast use in real-world practice and its clinical value to physicians and patients. APPRECIATE was a multinational, observational, retrospective, cross-sectional study.
Methods: Apremilast effectiveness at 6 (±1) months was assessed on the basis of psoriasis severity and health-related quality-of-life scores and treatment satisfaction using physician/patient-reported outcomes, respectively. We report the Austrian cohort of 72 patients.
Results: At 6 (±1) months, three-quarters of patients remained on apremilast, while physicians and patients reported treatment benefits across all psoriasis symptoms and manifestations. Of patients, the majority were satisfied with their treatment and achieved treatment goals considered most relevant. Patients' and physicians' perceptions of treatment effectiveness were aligned, and health-related quality-of-life scores indicated an improvement in the majority of patients. Apremilast tolerability was consistent with the known safety profile.
Conclusions: Among psoriasis patients receiving apremilast in Austria, improvement in clinical outcomes were observed and satisfaction with apremilast treatment among patients and physicians was high.
{"title":"Characteristics and outcomes of patients with psoriasis treated with apremilast in the real-world in Austria - results the APPRECIATE study.","authors":"Constanze Jonak, Isolde Göttfried, Sylvia Perl-Convalexius, Barbara Gruber, Martina Schütz-Bergmayr, Igor Vujic, Wolfgang Weger, Nikolaus Schicher, Lydia Semlin, Margit Hemetsberger, Myriam Cordey, Paul Sator","doi":"10.1177/20406223231152785","DOIUrl":"https://doi.org/10.1177/20406223231152785","url":null,"abstract":"<p><strong>Background: </strong>Apremilast, an oral phosphodiesterase 4 inhibitor, is approved in the European Union for the treatment of moderate-to-severe chronic plaque psoriasis in adult patients refractory or contraindicated to or intolerant of other systemic therapies.</p><p><strong>Objectives: </strong>The APPRECIATE study assessed apremilast use in real-world practice and its clinical value to physicians and patients. APPRECIATE was a multinational, observational, retrospective, cross-sectional study.</p><p><strong>Methods: </strong>Apremilast effectiveness at 6 (±1) months was assessed on the basis of psoriasis severity and health-related quality-of-life scores and treatment satisfaction using physician/patient-reported outcomes, respectively. We report the Austrian cohort of 72 patients.</p><p><strong>Results: </strong>At 6 (±1) months, three-quarters of patients remained on apremilast, while physicians and patients reported treatment benefits across all psoriasis symptoms and manifestations. Of patients, the majority were satisfied with their treatment and achieved treatment goals considered most relevant. Patients' and physicians' perceptions of treatment effectiveness were aligned, and health-related quality-of-life scores indicated an improvement in the majority of patients. Apremilast tolerability was consistent with the known safety profile.</p><p><strong>Conclusions: </strong>Among psoriasis patients receiving apremilast in Austria, improvement in clinical outcomes were observed and satisfaction with apremilast treatment among patients and physicians was high.</p><p><strong>Registration: </strong>ClinicalTrials.gov NCT02740218.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/b6/10.1177_20406223231152785.PMC9909071.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9275284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Metformin is a potent antiglycemic agent, but its importance has receded owing to the launch of novel antidiabetic medications. The benefit of metformin includes not only blood sugar control but also anti-inflammation, autophagy activation, and neuroprotection. This study investigated the risk of cardiovascular disease (CVD) in people with type II diabetes mellitus (T2DM) who adhered to metformin after adding on a second-line antiglycemic agent.
Objectives: The purpose of this study was to investigate the benefits of metformin in CVD prevention in patients with T2DM.
Design: We designed the study by comparing the incident rate of CVD events in patients with T2DM who received metformin continually and who ceased metformin during 2002-2014.
Methods: Medical information was obtained from the National Health Insurance Research Database, and patients with T2DM receiving second-line antiglycemic agents were categorized into metformin-adherent and nonadherent groups according to prescription claims. The study outcomes were the incidence of CVD hospitalization, including stroke (ischemic and hemorrhagic) and myocardial infarction (MI).
Results: A total of 31,384 patients with T2DM constituted the metformin-adherent group and were 1:1 matched to nonadherent patients. Metformin adherence was associated with a lower risk of hospitalization due to stroke [adjusted hazard ratio (aHR) = 0.51, 95% confidence interval (CI): 0.43-0.59, p < 0.001] and MI (aHR = 0.47, 95% CI: 0.43-0.53, p < 0.001). The risk reduction persisted in both ischemic and hemorrhagic strokes. Our subgroup analysis revealed that the protective effect on stroke and MI hospitalization persisted in metformin-adherent patients, both sexes, patients aged ⩽65 or >65 years, and patients with or without concurrent insulin treatment.
Conclusions: This study revealed that metformin adherence in patients with T2DM who required a first-line treatment may reduce the risk of subsequent CVD. Despite the availability of numerous novel antiglycemic agents, metformin adherence by patients who require a combination of antiglycemic agents provides an additional benefit of CVD protection.
背景:二甲双胍是一种有效的降糖药,但由于新型降糖药的推出,其重要性已经下降。二甲双胍的益处不仅包括血糖控制,还包括抗炎症、自噬激活和神经保护。本研究调查了2型糖尿病(T2DM)患者在添加二线降糖药后坚持使用二甲双胍的心血管疾病(CVD)的风险。目的:本研究的目的是探讨二甲双胍在预防T2DM患者心血管疾病方面的益处。设计:我们通过比较2002-2014年期间持续接受二甲双胍治疗和停止使用二甲双胍治疗的T2DM患者的心血管事件发生率来设计这项研究。方法:从国家健康保险研究数据库获取医疗信息,根据处方要求将接受二线降糖药治疗的T2DM患者分为二甲双胍依从组和非依从组。研究结果是CVD住院的发生率,包括卒中(缺血性和出血性)和心肌梗死(MI)。结果:31,384例T2DM患者构成二甲双胍粘附组,与未粘附组1:1匹配。二甲双胍依从性与卒中住院风险降低相关[校正风险比(aHR) = 0.51, 95%可信区间(CI): 0.43-0.59, p < 65岁,患者是否同时接受胰岛素治疗]。结论:本研究表明,需要一线治疗的T2DM患者坚持服用二甲双胍可能会降低随后发生CVD的风险。尽管有许多新的降糖药可用,但需要联合降糖药的患者坚持使用二甲双胍可提供额外的心血管疾病保护益处。
{"title":"Metformin adherence and the risk of cardiovascular disease: a population-based cohort study.","authors":"Shun-Fan Yu, Chien-Tai Hong, Wan-Ting Chen, Lung Chan, Li-Nien Chien","doi":"10.1177/20406223231163115","DOIUrl":"https://doi.org/10.1177/20406223231163115","url":null,"abstract":"<p><strong>Background: </strong>Metformin is a potent antiglycemic agent, but its importance has receded owing to the launch of novel antidiabetic medications. The benefit of metformin includes not only blood sugar control but also anti-inflammation, autophagy activation, and neuroprotection. This study investigated the risk of cardiovascular disease (CVD) in people with type II diabetes mellitus (T2DM) who adhered to metformin after adding on a second-line antiglycemic agent.</p><p><strong>Objectives: </strong>The purpose of this study was to investigate the benefits of metformin in CVD prevention in patients with T2DM.</p><p><strong>Design: </strong>We designed the study by comparing the incident rate of CVD events in patients with T2DM who received metformin continually and who ceased metformin during 2002-2014.</p><p><strong>Methods: </strong>Medical information was obtained from the National Health Insurance Research Database, and patients with T2DM receiving second-line antiglycemic agents were categorized into metformin-adherent and nonadherent groups according to prescription claims. The study outcomes were the incidence of CVD hospitalization, including stroke (ischemic and hemorrhagic) and myocardial infarction (MI).</p><p><strong>Results: </strong>A total of 31,384 patients with T2DM constituted the metformin-adherent group and were 1:1 matched to nonadherent patients. Metformin adherence was associated with a lower risk of hospitalization due to stroke [adjusted hazard ratio (aHR) = 0.51, 95% confidence interval (CI): 0.43-0.59, <i>p</i> < 0.001] and MI (aHR = 0.47, 95% CI: 0.43-0.53, <i>p</i> < 0.001). The risk reduction persisted in both ischemic and hemorrhagic strokes. Our subgroup analysis revealed that the protective effect on stroke and MI hospitalization persisted in metformin-adherent patients, both sexes, patients aged ⩽65 or >65 years, and patients with or without concurrent insulin treatment.</p><p><strong>Conclusions: </strong>This study revealed that metformin adherence in patients with T2DM who required a first-line treatment may reduce the risk of subsequent CVD. Despite the availability of numerous novel antiglycemic agents, metformin adherence by patients who require a combination of antiglycemic agents provides an additional benefit of CVD protection.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/1e/10.1177_20406223231163115.PMC10084537.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9358943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The ciliary muscle plays a role in changing the shape of the crystalline lens to maintain the clear retinal image during near work. Studying the dynamic changes of the ciliary muscle during accommodation is necessary for understanding the mechanism of presbyopia. Optical coherence tomography (OCT) has been frequently used to image the ciliary muscle and its changes during accommodation in vivo. However, the segmentation process is cumbersome and time-consuming due to the large image data sets and the impact of low imaging quality. Objectives: This study aimed to establish a fully automatic method for segmenting and quantifying the ciliary muscle on the basis of optical coherence tomography (OCT) images. Design: A perspective cross-sectional study. Methods: In this study, 3500 signed images were used to develop a deep learning system. A novel deep learning algorithm was created from the widely used U-net and a full-resolution residual network to realize automatic segmentation and quantification of the ciliary muscle. Finally, the algorithm-predicted results and manual annotation were compared. Results: For segmentation performed by the system, the total mean pixel value difference (PVD) was 1.12, and the Dice coefficient, intersection over union (IoU), and sensitivity values were 93.8%, 88.7%, and 93.9%, respectively. The performance of the system was comparable with that of experienced specialists. The system could also successfully segment ciliary muscle images and quantify ciliary muscle thickness changes during accommodation. Conclusion: We developed an automatic segmentation framework for the ciliary muscle that can be used to analyze the morphological parameters of the ciliary muscle and its dynamic changes during accommodation.
背景:睫状肌在近距离工作时改变晶状体的形状以维持清晰的视网膜图像中起作用。研究睫状肌在调节过程中的动态变化,对了解老花眼的发生机制是必要的。光学相干断层扫描(OCT)经常被用来成像睫状肌及其在体内调节过程中的变化。然而,由于图像数据量大、成像质量低的影响,分割过程繁琐且耗时。目的:建立一种基于光学相干断层扫描(OCT)图像的睫状肌全自动分割和定量方法。设计:透视横断面研究。方法:本研究使用3500张签名图像开发深度学习系统。基于广泛使用的U-net和全分辨率残差网络,提出了一种新的深度学习算法,实现了纤毛肌的自动分割和量化。最后,对算法预测结果和人工标注结果进行了比较。结果:该系统分割的总平均像素值差(PVD)为1.12,Dice系数、intersection over union (IoU)和灵敏度分别为93.8%、88.7%和93.9%。该系统的性能可与经验丰富的专家相媲美。该系统还可以成功分割睫状肌图像,量化调节过程中睫状肌厚度的变化。结论:开发了睫状肌自动分割框架,可用于分析调节过程中睫状肌形态学参数及其动态变化。
{"title":"CMS-NET: deep learning algorithm to segment and quantify the ciliary muscle in swept-source optical coherence tomography images.","authors":"Wen Chen, Xiangle Yu, Yiru Ye, Hebei Gao, Xinyuan Cao, Guangqing Lin, Riyan Zhang, Zixuan Li, Xinmin Wang, Yuheng Zhou, Meixiao Shen, Yilei Shao","doi":"10.1177/20406223231159616","DOIUrl":"https://doi.org/10.1177/20406223231159616","url":null,"abstract":"Background: The ciliary muscle plays a role in changing the shape of the crystalline lens to maintain the clear retinal image during near work. Studying the dynamic changes of the ciliary muscle during accommodation is necessary for understanding the mechanism of presbyopia. Optical coherence tomography (OCT) has been frequently used to image the ciliary muscle and its changes during accommodation in vivo. However, the segmentation process is cumbersome and time-consuming due to the large image data sets and the impact of low imaging quality. Objectives: This study aimed to establish a fully automatic method for segmenting and quantifying the ciliary muscle on the basis of optical coherence tomography (OCT) images. Design: A perspective cross-sectional study. Methods: In this study, 3500 signed images were used to develop a deep learning system. A novel deep learning algorithm was created from the widely used U-net and a full-resolution residual network to realize automatic segmentation and quantification of the ciliary muscle. Finally, the algorithm-predicted results and manual annotation were compared. Results: For segmentation performed by the system, the total mean pixel value difference (PVD) was 1.12, and the Dice coefficient, intersection over union (IoU), and sensitivity values were 93.8%, 88.7%, and 93.9%, respectively. The performance of the system was comparable with that of experienced specialists. The system could also successfully segment ciliary muscle images and quantify ciliary muscle thickness changes during accommodation. Conclusion: We developed an automatic segmentation framework for the ciliary muscle that can be used to analyze the morphological parameters of the ciliary muscle and its dynamic changes during accommodation.","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/29/10.1177_20406223231159616.PMC10017933.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9146781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1177/20406223231168754
Yao Wang, Wan Liu, Jiu Chen, Jianling Bai, Hao Yu, Hongxia Ma, Jiang Rao, Guangxu Xu
Background: Which noninvasive brain stimulation (NIBS) treatment - transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS) - is more beneficial for stroke patients' cognitive rehabilitation is still up for debate.
Objectives: Our goal is to provide an overview of the research on the effectiveness and safety of various NIBS protocols.
Design: Systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs).
Methods: This NMA compared any active NIBS versus sham stimulation in adult stroke survivors to enhance cognitive function, with a focus on global cognitive function (GCF), attention, memory, and executive function (EF) using the databases MEDLINE, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. The NMA statistical approach was built on a frequency framework. The effect size was estimated by the standardized mean difference (SMD) and a 95% confidence interval (CI). We compiled a relative ranking of the competing interventions based on their surface under the cumulative ranking curve (SUCRA).
Results: NMA showed that high-frequency repeated TMS (HF-rTMS) improved GCF compared with sham stimulation (SMD = 1.95; 95% CI: 0.47-3.43), while dual-tDCS improved memory performance versus sham stimulation significantly (SMD = 6.38; 95% CI: 3.51-9.25). However, various NIBS stimulation protocols revealed no significant impact on enhancing attention, executive function, or activities of daily living. There was no significant difference between the active stimulation protocols for TMS and tDCS and sham stimulation in terms of safety. Subgroup analysis demonstrated an effect favoring activation site of the left dorsolateral prefrontal cortex (DLPFC) (SUCRA = 89.1) for enhancing GCF and bilateral DLPFC (SUCRA = 99.9) stimulation for enhancing memory performance.
Conclusion: The HF-rTMS over the left DLPFC appears to be the most promising NIBS therapeutic option for improving global cognitive performance after stroke, according to a comparison of numerous NIBS protocols. Furthermore, for patients with post-stroke memory impairment, dual-tDCS over bilateral DLPFC may be more advantageous than other NIBS protocols. Both tDCS and TMS are reasonably safe.
{"title":"Comparative efficacy of different noninvasive brain stimulation therapies for recovery of global cognitive function, attention, memory, and executive function after stroke: a network meta-analysis of randomized controlled trials.","authors":"Yao Wang, Wan Liu, Jiu Chen, Jianling Bai, Hao Yu, Hongxia Ma, Jiang Rao, Guangxu Xu","doi":"10.1177/20406223231168754","DOIUrl":"https://doi.org/10.1177/20406223231168754","url":null,"abstract":"<p><strong>Background: </strong>Which noninvasive brain stimulation (NIBS) treatment - transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS) - is more beneficial for stroke patients' cognitive rehabilitation is still up for debate.</p><p><strong>Objectives: </strong>Our goal is to provide an overview of the research on the effectiveness and safety of various NIBS protocols.</p><p><strong>Design: </strong>Systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>This NMA compared any active NIBS <i>versus</i> sham stimulation in adult stroke survivors to enhance cognitive function, with a focus on global cognitive function (GCF), attention, memory, and executive function (EF) using the databases MEDLINE, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. The NMA statistical approach was built on a frequency framework. The effect size was estimated by the standardized mean difference (SMD) and a 95% confidence interval (CI). We compiled a relative ranking of the competing interventions based on their surface under the cumulative ranking curve (SUCRA).</p><p><strong>Results: </strong>NMA showed that high-frequency repeated TMS (HF-rTMS) improved GCF compared with sham stimulation (SMD = 1.95; 95% CI: 0.47-3.43), while dual-tDCS improved memory performance <i>versus</i> sham stimulation significantly (SMD = 6.38; 95% CI: 3.51-9.25). However, various NIBS stimulation protocols revealed no significant impact on enhancing attention, executive function, or activities of daily living. There was no significant difference between the active stimulation protocols for TMS and tDCS and sham stimulation in terms of safety. Subgroup analysis demonstrated an effect favoring activation site of the left dorsolateral prefrontal cortex (DLPFC) (SUCRA = 89.1) for enhancing GCF and bilateral DLPFC (SUCRA = 99.9) stimulation for enhancing memory performance.</p><p><strong>Conclusion: </strong>The HF-rTMS over the left DLPFC appears to be the most promising NIBS therapeutic option for improving global cognitive performance after stroke, according to a comparison of numerous NIBS protocols. Furthermore, for patients with post-stroke memory impairment, dual-tDCS over bilateral DLPFC may be more advantageous than other NIBS protocols. Both tDCS and TMS are reasonably safe.</p><p><strong>Registration: </strong>PROSPERO ID: CRD42022304865.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/9b/10.1177_20406223231168754.PMC10272674.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10301167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Patients with incidental eosinophilia is becoming increasingly common in clinical practice. But it remains challenging to diagnose and treat owing to its complex etiology. The awareness of physicians and the strategies of diagnosis and treatment toward eosinophilia are still unclear.
Objective: We aimed to evaluate attention, diagnosis, treatment, and awareness of eosinophilia among physicians, as well as factors influencing clinical practice, and to find ways to improve the efficacy of this disease.
Design: This is a cross-sectional survey.
Methods: A cross-sectional study was conducted from 1 to 4 June 2021 in a tertiary hospital. Self-administered and validated electronic questionnaire was used to investigate the attention toward eosinophilia, the strategies of diagnosis and treatment, and the awareness in physicians.
Results: A total of 607 valid questionnaires were collected, with a response rate of 84.5%. Among the responders, 65.4% of physicians claimed to be familiar with patients with eosinophilia but only 11.0% of them had read the relevant guidelines or expert consensus. Among 207 physicians who had ever diagnosed patients with eosinophilia, only 19.4% had performed detailed examinations. The accuracy of awareness questions was 1.6-53.5%, and only 26.5% of physicians had high levels of awareness. An increase in the awareness level of up to 2.82 folds was seen among physicians with factors such as job title, encountering patients with eosinophilia, linking patients' conditions to peripheral blood eosinophil count, and paying attention to guidelines.
Conclusion: This study highlighted the importance of raising awareness and knowledge of eosinophilia among physicians in China. More works on education about eosinophilia guideline are needed, which may help physicians make decision with more benefits to patients.
{"title":"Eosinophilia attention, diagnosis, treatment, and awareness in physicians: a cross-sectional survey.","authors":"Bigui Chen, Yu Fu, Zhufeng Wang, Qiuping Rong, Qingling Zhang, Jiaxing Xie, Xuetao Kong, Mei Jiang","doi":"10.1177/20406223221146938","DOIUrl":"https://doi.org/10.1177/20406223221146938","url":null,"abstract":"<p><strong>Background: </strong>Patients with incidental eosinophilia is becoming increasingly common in clinical practice. But it remains challenging to diagnose and treat owing to its complex etiology. The awareness of physicians and the strategies of diagnosis and treatment toward eosinophilia are still unclear.</p><p><strong>Objective: </strong>We aimed to evaluate attention, diagnosis, treatment, and awareness of eosinophilia among physicians, as well as factors influencing clinical practice, and to find ways to improve the efficacy of this disease.</p><p><strong>Design: </strong>This is a cross-sectional survey.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from 1 to 4 June 2021 in a tertiary hospital. Self-administered and validated electronic questionnaire was used to investigate the attention toward eosinophilia, the strategies of diagnosis and treatment, and the awareness in physicians.</p><p><strong>Results: </strong>A total of 607 valid questionnaires were collected, with a response rate of 84.5%. Among the responders, 65.4% of physicians claimed to be familiar with patients with eosinophilia but only 11.0% of them had read the relevant guidelines or expert consensus. Among 207 physicians who had ever diagnosed patients with eosinophilia, only 19.4% had performed detailed examinations. The accuracy of awareness questions was 1.6-53.5%, and only 26.5% of physicians had high levels of awareness. An increase in the awareness level of up to 2.82 folds was seen among physicians with factors such as job title, encountering patients with eosinophilia, linking patients' conditions to peripheral blood eosinophil count, and paying attention to guidelines.</p><p><strong>Conclusion: </strong>This study highlighted the importance of raising awareness and knowledge of eosinophilia among physicians in China. More works on education about eosinophilia guideline are needed, which may help physicians make decision with more benefits to patients.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/a2/10.1177_20406223221146938.PMC9880572.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9150268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1177/20406223221146721
Ying Huang, Weiwei Zheng, Zuhua Sun, Shenghai Huang, Bing Lin
Objectives: To explore the optical coherence tomography (OCT) biomarkers to predict the transition to chronic central serous chorioretinopathy (cCSC) after retinal laser photocoagulation.
Methods: Patients enrolled in this study were from a 12-week clinical trial comparing the efficacy and safety of subthreshold micropulse laser (SML) with threshold conventional laser (TCL) for CSC and had extended follow-up for more than 1 year. They were divided into two groups, transited to cCSC group (cCSC group) and did not transited to cCSC group (non-cCSC group) according to fundus examination at the extended follow-up. Collect the best-corrected visual acuity (BCVA) and OCT characteristics of patients at baseline and 12 weeks after laser treatment.
Results: Twenty-seven patients were enrolled (42.6 ± 7.7 years old), and duration of follow-up was 178.9 ± 88.8 (57.0-312.0) weeks. Nine patients (33.3%) were assigned to cCSC group, and the other 18 patients (66.7%) were assigned to the non-cCSC group. Twelve weeks after the laser treatment, subretinal fluid (SRF) of 15 patients (83.3%) in non-cCSC group and 5 patients (55.6%) in cCSC group absorbed completely; the height of SRF had statistical difference between two groups (p = 0.035); rough RPE was less common in cCSC group (p = 0.030); hyper reflective mass (HRM) was more common in cCSC group (p = 0.024); more number of hyper reflective foci (HRF) in outer segment of photoreceptor layer were detected in cCSC group (p = 0.035). From baseline to 12 weeks after laser treatment, the number of HRF in outer segment photoreceptor layer did not change significantly in cCSC group (p = 0.665) but decreased significantly in non-cCSC group (p = 0.000). A total of five patients suffered binocular CSC, three of them in the non-cCSC group occurred later than the other two in the cCSC group (129.9-278.3 weeks vs 96.1-114.9 weeks after baseline).
Conclusion: SRF, rough RPE, HRM, and number of HRF in outer segment photoreceptor layer 12 weeks after laser treatment, and change in the number of HRF in outer segment photoreceptor layer from baseline to 12 weeks after laser treatment may predict the transition to cCSC.
{"title":"Optical coherence tomography biomarkers as predictors of transition to chronic central serous chorioretinopathy after retinal laser photocoagulation.","authors":"Ying Huang, Weiwei Zheng, Zuhua Sun, Shenghai Huang, Bing Lin","doi":"10.1177/20406223221146721","DOIUrl":"https://doi.org/10.1177/20406223221146721","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the optical coherence tomography (OCT) biomarkers to predict the transition to chronic central serous chorioretinopathy (cCSC) after retinal laser photocoagulation.</p><p><strong>Methods: </strong>Patients enrolled in this study were from a 12-week clinical trial comparing the efficacy and safety of subthreshold micropulse laser (SML) with threshold conventional laser (TCL) for CSC and had extended follow-up for more than 1 year. They were divided into two groups, transited to cCSC group (cCSC group) and did not transited to cCSC group (non-cCSC group) according to fundus examination at the extended follow-up. Collect the best-corrected visual acuity (BCVA) and OCT characteristics of patients at baseline and 12 weeks after laser treatment.</p><p><strong>Results: </strong>Twenty-seven patients were enrolled (42.6 ± 7.7 years old), and duration of follow-up was 178.9 ± 88.8 (57.0-312.0) weeks. Nine patients (33.3%) were assigned to cCSC group, and the other 18 patients (66.7%) were assigned to the non-cCSC group. Twelve weeks after the laser treatment, subretinal fluid (SRF) of 15 patients (83.3%) in non-cCSC group and 5 patients (55.6%) in cCSC group absorbed completely; the height of SRF had statistical difference between two groups (<i>p</i> = 0.035); rough RPE was less common in cCSC group (<i>p</i> = 0.030); hyper reflective mass (HRM) was more common in cCSC group (<i>p</i> = 0.024); more number of hyper reflective foci (HRF) in outer segment of photoreceptor layer were detected in cCSC group (<i>p</i> = 0.035). From baseline to 12 weeks after laser treatment, the number of HRF in outer segment photoreceptor layer did not change significantly in cCSC group (<i>p</i> = 0.665) but decreased significantly in non-cCSC group (<i>p</i> = 0.000). A total of five patients suffered binocular CSC, three of them in the non-cCSC group occurred later than the other two in the cCSC group (129.9-278.3 weeks <i>vs</i> 96.1-114.9 weeks after baseline).</p><p><strong>Conclusion: </strong>SRF, rough RPE, HRM, and number of HRF in outer segment photoreceptor layer 12 weeks after laser treatment, and change in the number of HRF in outer segment photoreceptor layer from baseline to 12 weeks after laser treatment may predict the transition to cCSC.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/0c/10.1177_20406223221146721.PMC9871971.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10625588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}