Association between the retinal vascular network with Singapore "I" Vessel Assessment (SIVA) software, cardiovascular history and risk factors in the elderly: The Montrachet study, population-based study.

PURPOSE: To identify patterns summarizing the retinal vascular network in the elderly and to investigate the relationship of these vascular patterns with cardiovascular history. METHODS: We conducted a population-based study, the Montrachet study (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases), in participants older than 75 years. The history of cardiovascular disease and a score-based estimation of their 10-year risk of cardiovascular mortality (Heart SCORE) were collected. Retinal vascular network analysis was performed by means of Singapore "I" Vessel Assessment (SIVA) software. Principal component analysis was used to condense the information contained in the high number of variables provided and to identify independent retinal vascular patterns. RESULTS: Overall, 1069 photographs (1069 participants) were reviewed with SIVA software. The mean age was 80.0 ± 3.8 years. We extracted three vascular patterns summarizing 41.3% of the vascular information. The most clinically relevant pattern, Sparse vascular network, accounted for 17.4% of the total variance. It corresponded to a lower density in the vascular network and higher variability in vessel width. Diabetic participants with hypoglycemic treatment had a sparser vascular network pattern than subjects without such treatment (odds ratio, [OR], 1.68; 95% CI, 1.04-2.72; P = 0.04). Participants with no history of cardiovascular disease who had a sparser vascular network were associated with a higher Heart SCORE (OR, 1.76; 95% CI, 1.08-2.25; P = 0.02). CONCLUSIONS: Three vascular patterns were identified. The Sparse vascular network pattern was associated with having a higher risk profile for cardiovascular mortality risk at 10 years.

Dry eye disease in the elderly in a French population-based study (the Montrachet study: Maculopathy, Optic Nerve, nuTRition, neurovAsCular and HEarT diseases): Prevalence and associated factors.

PURPOSE: To estimate the prevalence of dry eye disease (DED) in the elderly and to describe systemic and ocular factors associated with DED in a population-based study, the Montrachet (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases) study. METHODS: Dry eye symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. A self-reported history of dry eye symptoms and artificial tear use were also recorded. Every participant underwent an ophthalmic evaluation, which included the Schirmer test without anesthesia (Schirmer I), tear film breakup time (TFBUT) measurement, and fluorescein corneal staining evaluation. RESULTS: A total of 1045 subjects were included in the study. The mean age was 82.2 ± 3.8 years. The prevalence of DED according to symptoms, signs, or both was 34.4% [95% confidence interval ({CI)} 31.5-37.2], 34.5% [95% CI 31.6-37.3] and 13.0% [95% CI 10.9-15.0], respectively. Compared with men, women were more likely to self-report DED and artificial tear use, more often displayed an OSDI >22, and more often suffered from subjective and definite DED. In multivariate analysis, associated factors with definite DED were an educational level of short secondary school (to age 15 years), best-corrected visual acuity <20/60, dark iris color, systemic hypertension, and anxiolytic agent and antihistamine eye drop use. CONCLUSION: Dry eye disease is a major ophthalmologic condition with a high prevalence among the elderly. We report well-documented factors associated with DED and new associations deserving further investigation.

Spatial Distribution of Macular Pigment in an Elderly French Population: The Montrachet Study.

PURPOSE: We describe the spatial distribution and cross-sectional associations with physical and lifestyle attributes. METHODS: The participants of the Montrachet (Maculopathy Optic Nerve, nuTRition neurovAsCular and HEarT) study underwent an exhaustive ophthalmologic examination, including optical coherence tomography, to measure retinal thickness. The spatial distribution of macular pigment optical density (MPOD) defined as a ring-like, intermediate or no-ring pattern, was assessed by means of the two-wavelength autofluorescence technique. Blood samples were taken to measure plasma lutein and zeaxanthin using high performance liquid chromatography (HPLC). RESULTS: We studied 635 subjects with good-quality MPOD measurements. The mean age was 82.0 ± 3.4 years. A ring-like structure was found in 109 (17.2%) participants. Participants with a ring-like spatial distribution had a thinner macula in the central subfield (P < 0.001). In multivariate analysis, individuals never protecting themselves from sunlight and with dark iris color were less likely to present a ring-like than a no-ring spatial distribution (P = 0.033 and P = 0.013, respectively). Only in males were lutein plasma levels higher in ring-like and intermediate MPOD profiles than in no-ring structures (odds ratio [OR] = 1.59 for 100 additional µg; 95% confidence interval [CI] = 1.16-2.18 and OR = 1.64; 95% CI, 1.17-2.28). CONCLUSIONS: In this population-based study, individuals never protecting themselves from sunlight, and with dark iris color and a thinner macula were less prone to displaying a ring-like MPOD spatial distribution.

Relationships of Macular Pigment Optical Density With Plasma Lutein, Zeaxanthin, and Diet in an Elderly Population: The Montrachet Study.

PURPOSE: To investigate the association of macular pigment optical density (MPOD) with plasma lutein, zeaxanthin, and diet in an elderly population. METHODS: We conducted a population-based study, the Montrachet (Maculopathy Optic Nerve, nuTRition neurovAsCular, and HEarT disease) study, in subjects older than 75 years. The MPOD was measured by means of the two-wavelength autofluorescence technique. Plasma lutein and zeaxanthin were measured in fasting blood samples using HPLC. Food frequency consumption was assessed with self-reported food frequency questionnaires. RESULTS: Overall, 433 healthy participants (62.1% females) were included. Mean age was 82.0 ± 3.6 years. Mean MPOD at 0.5° eccentricity was 0.57 ± 0.25 density units (DU) and was higher in women than in men (0.59 ± 0.25 vs. 0.53 ± 0.25, P = 0.017). The MPOD was lower in alcohol consumers than in non-alcohol consumers (0.55 ± 0.25 vs. 0.61 ± 0.25, P = 0.016). Median plasma lutein and zeaxanthin levels were 281.4 µg/L and 20.0 µg/L, respectively, and were higher in women (P = 0.010 and P = 0.003, respectively). The MPOD was positively correlated with plasma lutein and zeaxanthin (r = 0.10, P = 0.030 and r = 0.11, P = 0.027, respectively). A higher consumption of squash was associated with higher plasma lutein and zeaxanthin. Adjusting for confounders and diet revealed that MPOD was weakly associated with plasma lutein in nonsmokers (ß = 0.11, P = 0.021). CONCLUSIONS: This study suggests that plasma lutein is associated with MPOD after taking into account potential confounding factors in an elderly population.

Outcome of early monoarthritis: a followup study.

OBJECTIVE: To evaluate clinical, laboratory, and radiological features and outcomes in patients with monoarthritis (MA), identified in a cohort of patients with early arthritis. METHODS: A cohort of 270 patients with undiagnosed arthritis of less than 1 year's duration was divided into 3 groups: single episode of MA (MA, n = 27), MA with a history of patient-reported arthritis (MA + past, n = 23), and oligo- or polyarthritis (OA/PA, n = 220). At 6-month intervals, all patients underwent a standardized examination, radiographs, and standard laboratory tests including rheumatoid factors (RF), antiperinuclear factor (APF), antikeratin antibody (AKA), anticyclic citrullinated peptide antibody (anti-CCP), antinuclear antibodies, and HLA-AB-DR typing. After a median followup of 30 months, the diagnosis was evaluated by a hospital-based rheumatologist. RESULTS: Age and sex did not differ across the 3 groups. Knee involvement was more common in the MA group than in the MA + past group (p < 0.03), whereas hand and metatarsophalangeal involvement was less common (p < 0.03 and p < 0.0001, respectively). RF and anti-CCP were less often positive in the MA group than in the MA + past group (p < 0.02 and p < 0.001, respectively) and the OA/PA group (p < 0.02 and p < 0.03). No patient in the MA group received a diagnosis of rheumatoid arthritis (RA). RA was less common and disease modifying antirheumatic drugs were prescribed less often in the MA group than in the other 2 groups (p < 0.0001 for both comparisons). CONCLUSION: The MA group was clearly different from the other groups, with a favorable outcome and no risk of progression to RA.