Co-Prevalence of Alzheimer's Disease and Age-Related Macular Degeneration Established by Histopathologic Diagnosis.

BACKGROUND: Previous epidemiologic studies have suggested an association between AMD and AD, and several therapeutic agents are being developed based on this principle. However, prior studies have provided conflicting results due in part to their reliance on clinical diagnoses that are not based on gold-standard histopathology. OBJECTIVE: To use histopathologic standards for diagnosis in order to determine the co-prevalence of AD among patients with and without AMD. METHODS: This is a cross-sectional study of 157 autopsy ocular specimens from patients with and without AMD that were greater than 75 years of age at death. Sarks staging was used to document the severity of AMD, and Braak and Braak staging was used to assess the severity of AD in corresponding brain specimens. The prevalence of AD within different severities of AMD was determined using univariable and multivariable logistic regression. RESULTS: 58% of autopsy eyes had AMD. The prevalence of AD was lower in AMD subjects (63%) compared to non-AMD subjects (73%), even when grouped by severity (all p > 0.15). The likelihood of AD was significantly less in AMD subjects, even after adjusting for age and sex in multivariable analysis (OR 0.47, p = 0.049). CONCLUSION: Histopathologic diagnoses fail to support an increase in prevalence of AD among subjects with AMD, even when disease severity is considered.

Bilateral Myelinated Retinal Nerve Fibers Associated With Bilateral Vitreous Cysts and Solitary Vasoproliferative Tumor: A New Syndrome.

The authors report a case of a 57-year-old male with high myopia, extensive bilateral myelination of the retinal nerve fiber layer, bilateral vitreous cysts, and a solitary vasoproliferative tumor in the right eye. He underwent pars plana vitrectomy and multiple transpupillary thermotherapy treatments for recurrent vitreous hemorrhages and subretinal exudation from the vasoproliferative tumor. To the authors' knowledge, this is the first description of this constellation of findings and suggests this represents a new syndrome. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:356-359.].

Complications of Uveitis: The Northern California Epidemiology of Uveitis Study.

PURPOSE: To describe the uveitis complications in a large, community-based cohort. METHODS: Retrospective, community-based, cross-sectional cohort study analyzing complications and associations with complications. RESULTS: A total of 844 cases of uveitis were found; 342 were new-onset, and 462 were prior-onset. In total, 29.5% of patients were affected by one or more complications associated with age, gender, course, and anatomic location of uveitis. Visual loss was experienced by 19.1% of patients and was associated with age, course of disease, and anatomic location of uveitis. Of the patients who developed glaucoma or elevated intraocular pressure over 30 mmHg, 3.9% (n = 33) were related solely to uveitis; 5.2% (n = 44) had an unclear or combined mechanism; and 1.8% (n = 15) were related solely to steroid response. Cystoid macular edema was associated with course of disease and anatomic location of uveitis. CONCLUSIONS: Complications affect a significant portion of uveitis patients, and are often associated with demographic and clinical factors.

Associations with retinal vascular occlusions in a diverse, urban population.

PURPOSE: Retinal vascular occlusions can lead to sudden and permanent visual impairment or blindness. Few epidemiological studies on retinal vascular occlusions have been conducted, especially on diverse populations. METHODS: This is a retrospective case-control study of all incident retinal vascular occlusions occurring during a three and one-half year study period at Montefiore Medical Center, capturing all potential cases by diagnosis codes. Patients with retinal venous occlusions (RVO) and retinal arterial occlusions (RAO) were analyzed separately and compared to age-matched control groups. RESULTS: All potential charts (n = 700) were reviewed, confirming 214 RVO and 35 RAO incident cases. In multivariable analyses, RVO was associated with type 2 diabetes mellitus (OR 2.41, p < 0.001), history of cerebrovascular accident (OR 2.14, p = 0.011), hypertension (OR 1.83, p = 0.004), glaucoma (OR 6.91, p < 0.001), black race (OR 3.72, p < 0.001), and male gender (OR 2.19 p < 0.001). RAO was significantly associated with current and former smoking combined (OR 8.95, p = 0.021) and male gender (OR 2.56, p = 0.038). CONCLUSION: Cardiovascular risk factors and glaucoma are reaffirmed as significant predictors of retinal vascular occlusions in a diverse patient population. Retinal vascular occlusions are more common in certain races and ethnicities, and further study into this may help identify high-risk individuals based on demographics.