Search

Purpose: To evaluate the disease burden of age‐related macular degeneration (AMD) and to evaluate the risk factors of disability‐adjusted life years (DALY) caused by AMD. Methods: Country‐specific DALY number, rate and age‐standardized rate of AMD were acquired from the Global Burden of Disease Study 2017 database. The Socio‐demographic Index (SDI), Human Development Index (HDI), Inequality‐adjusted Human Development Index (IA‐HDI) and other related data were obtained from published data or shared databases. Regression analysis was conducted to evaluate the correlations between the potential risk factors and the age‐standardized DALY rate of AMD. Results: The DALY number doubled from 1990 to 2017, and DALY rate increased from 4.73 (95% CI: 3.19–6.54) to 6.95 (95% CI: 4.76–9.54). However, change was small after standardizing. Females tended to have severer burden. Disability‐adjusted life years (DALY) rates were correlated to annual PM2.5 concentration, gross domestic product (GDP) per capita, population with at least some secondary education (secondary education), glaucoma prevalence and gross national income (GNI) per capita. In SDI model, glaucoma, GDP, healthcare access and quality index (HAQ) and secondary education were associated with disease burden (p < 0.001). In IA‐HDI model, cataract, glaucoma, PM2.5, GDP and secondary education were correlated to DALY rates (p < 0.001). In model included four components of HDI, glaucoma, PM2.5, GDP, secondary education, expected years of schooling and life expectancy at birth were associated (p < 0.001). Conclusion: Being female, older age, poor socioeconomic status and less educated are associated with a heavier disease burden of AMD. These findings would provide a basic understanding for policy making on AMD prevention and treatment. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article by S. Blindbaek and J. Grauslund regarding the prophylactic treatment of retinal breaks.

Purpose To measure the levels of vascular endothelial growth factor ( VEGF) in aqueous humor in patients with unilateral acute primary angle closure ( APAC) and retinal oxygen saturation ( SO2) after trabeculectomy. Methods Twelve patients, with unilateral trabeculectomy-required APAC, were recruited as the study group. Aqueous humor samples were collected prospectively for every subject. VEGF concentrations were analysed via enzyme-linked immunosorbent assay ( ELISA), and retinal SO2 was measured using oximeter (Reykjavik, Iceland) at 1 month after trabeculectomy. Results In the APAC eyes, the mean aqueous humor concentration of VEGF was 388.4 ± 260.1 pg/ml and positively correlated with preoperative intraocular pressure ( ρ = 0.658, p = 0.020). In the normal controls, the mean SO2 levels in the larger arterioles and venules were 93.0 ± 5.9% and 59.5 ± 5.4% and the arteriovenous [A-V] difference was 33.5 ± 6.3%. In the study group, the arteriolar SO2 at 1 month after surgery (97.6 ± 19.4%, p = 0.147) did not differ significantly from the values in the control group. However, the mean venular SO2 was significantly lower than the control eyes (50.0 ± 9.1% versus 59.5 ± 5.4%, p = 0.004), and a remarkable increased A-V difference (47.6 ± 22.7% versus 33.5 ± 6.3%) was found in the APAC eyes (p = 0.037). Conclusions Lower venular SO2 and increased A-V difference existed in the APAC eyes after surgery, and it is possible that the saturation was even lower during the attack. Together with the elevated VEGF concentrations in aqueous humor, these provided indirect evidence that ocular hypoxia was constantly present during APAC attack. [ABSTRACT FROM AUTHOR]