Abstract
Purpose Retinal vein occlusion (RVO) is the second most common retinal vascular disease and a major cause of visual impairment. In this study, we aimed to observe whether RVO cases have different antibody profiles as a new potential risk factor and whether a conversion of retinal vein occlusion (RVO) to neovascular glaucoma (NVG), one of the major complications, is occurring within a 5-year timeframe. Methods We performed a nested case-control study (1 : 4) within the Gutenberg Health Study (GHS), a population-based, prospective cohort study in the Rhine-Main Region of Germany including 15,010 participants. RVO subjects (n = 59) were identified by grading of fundus photographs. Optic nerves of RVO subjects and age- and sex-matched controls (n = 229) at baseline and their follow-up examination after 5 years were analyzed for glaucomatous alterations. Of all RVO subjects and controls, serum autoantibody profiles were measured using in-house manufactured antigen-antibody microarrays. Results Of the 59 RVO patients, 3 patients (5%) showed glaucomatous optic disc alterations at baseline, whereas no new glaucoma case was detected at 5-year follow-up. Four of the autoantibodies measured (against dermcidin, neurotrophin-3, superoxide dismutase 1, and signal recognition particle 14 kDa protein) were significantly increased in the serum of RVO patients (p < 0.001). Multivariable conditional logistic regression analysis showed that 3 of these 4 antibodies were independent of cardiovascular risk factors. Conclusions We found several autoantibodies associated with RVO, targeting proteins and structures possibly involved in RVO pathogenesis.
Highlights
Retinal vein occlusion (RVO) is the second most common retinal vascular disease and a major cause of visual impairment [1, 2]. e prevalence of RVO in the German population is 0.4%, and men are 1.7 times more frequently affected than women according to the population-based Gutenberg Health Study (GHS) [3]
neovascular glaucoma (NVG) is mainly caused by severe posterior segment ischemia, commonly due to proliferative diabetic retinopathy, central retinal vein occlusion (CRVO), and branch retinal vein occlusion (BRVO), as well as ocular ischemic syndrome [10, 11], next to many other less common causes of NVG. ose with nonischemic CRVO are at risk, as up to 30% can convert to ischemic CRVO in the following 3 years after the incidence of RVO [8] the numbers vary here from 18.6% to 30% depending on the study
Using data from the GHS, a population-based, prospective cohort study was conducted in Germany with a total of 15,010 participants, and this study aims to analyze the proportion of glaucoma in general and possible conversion to NVG in subjects with RVO
Summary
Retinal vein occlusion (RVO) is the second most common retinal vascular disease and a major cause of visual impairment [1, 2]. e prevalence of RVO in the German population is 0.4%, and men are 1.7 times more frequently affected than women according to the population-based Gutenberg Health Study (GHS) [3]. Cardiovascular disease, certain coagulopathies, and ophthalmic parameters have been identified as risk factors for RVO [4]. Other factors such as alterations of cytokines, involvement of endothelin, and other inflammatory regulators are supposed to play a role in RVO, especially for the development of macular edema after RVO [5,6,7]. Of all CRVO cases, approximately 20% are of the ischemic type [8] and potentially threatened to develop neovascular glaucoma (NVG). NVG is characterized by iris and angle neovascularization, accompanied by aqueous humor outflow obstruction, resulting in sudden and severely elevated intraocular pressure (IOP). NVG is mainly caused by severe posterior segment ischemia, commonly due to proliferative diabetic retinopathy, CRVO, and BRVO, as well as ocular ischemic syndrome [10, 11], next to many other less common causes of NVG. ose with nonischemic CRVO are at risk, as up to 30% can convert to ischemic CRVO in the following 3 years after the incidence of RVO [8] the numbers vary here from 18.6% to 30% depending on the study
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