Szemészet, 2006 (143. évfolyam, 1-4. szám)

2006-12-01 / 4. szám

143. évfolyam (2006) Supplementum I.

39

Relationship between age-related macular degeneration and Chlamydia pneumoniae seropositivity in patients with coronary artery disease

A. Facskó,1 В. Újhelyi,1 A Nagy,1 J. Deák,2 I. Édes3

1University of Szeged: Department of Opthalmology 2University of Debrecen, Institute of Clinical Microbiology 3University of Szeged: Institute of Cardiology

Background: Age-related macular degeneration (AMD) is a leading cause of blindness in the developed countries. Many risk factors have been established, but the aetiopathological background is still not completely clear. Hypertension and atherosclerosis are in the mainstream of research to find a correlation between AMD and internal diseases. Based on seroepidemiological studies, Chlamydia pneumoniae has been suspected to play a role in atherosclerosis.

Aim: to find possible correlations between Chlamydia pneumoniae infection, the blood circulation of the posterior pole of the fundus or macular region, and the progression of the patients’ coronary artery disease (CAD).

Patients and methods: 157 patients were enrolled in the study (84 male, 76 female, age 69.21 years, SD10.06). The patients were in three groups. Group 1. (CAD group) comprised 57 patients with CAD (proven by coronarography). They underwent a complete ophthalmic examination, as well as fluorescein angiography. Group 2., consisting of 47 patients with AMD, and Group 3., 56 cataract patients (as controls), were also tested. Three types of Chlamydia seropositivities (C. psittaci, C. trachomatis, C. pneumoniae) were examined in all 157 patients using the MIF (microimmunofluorescence) method (Focus Technologies, Cypress, USA) to determine immunoglobulin levels (IgM and IgG). Statistical analysis was carried out by means of Chi-square analysis; a level of p<0.05 was regarded as statistically significant.

Results: In the CAD group (Group 1.) the IgM level of C. pneumoniae was negative in 98.2% of patients, but the IgG level was positive in 52.6%. In the AMD group (Group 2.) the results were similar to Group 1.: IgM level was negative in 95.7% and IgG level was positive in 59.7%. In the control group (Group 3.) the seropositivity level of IgM was detected as negative in 92.8% and the IgG level was positive in 69.6% of subjects. Between the three groups there was no statistically significant difference in C. pneumoniae seropositivity (IgM, IgG); in fact, the highest seropositivity level of IgG was detected in the control group. AMD was found among the CAD patients in 31.2% of individuals.

Conclusion: The results of the study do not support the assumption that chronic C. pneumoniae infection plays a role in the development of AMD. Incipient (silent) AMD was found to occur frequently in patients with CAD. (Supported by the Hungarian National Scientific Research Fund, Grant ref. T038348)

Inter-session reproducibility of retinal nerve fibre layer thickness measurements by GDx-VCC in healthy and glaucomatous eyes

Anna Fantin, Stefano Da Pozzo, Marco Paoloni, Giuseppe Ravalico

University of Trieste (Italy), Eye Clinic

Aim: to assess the inter-session reproducibility of retinal nerve fibre layer (RNFL) thickness measurements made using scanning laser polarimetry with variable corneal compensation (GDx-VCC), in a sample of healthy subjects and glaucoma patients.

Methods: One eye from each of 29 healthy and 29 glaucomatous subjects was selected and underwent a GDx-VCC RNFL scan (baseline measurement). The test was repeated by the same operator one week later. The glaucoma diagnosis relied on the presence of a reproducible defect in automated perimetry. The GDx-VCC parameters considered were those available on printout page 1, namely: TSNIT Average (TSNIT Avg), TSNIT SD, Superior Average (SA), Inferior Average (IA), and Nerve Fiber Index (NFI). Reproducibility was assessed by calculating the coefficients of variation (CoV) and intra-class correlation coefficients (ICC), separately for the two subject groups and for each parameter. The proportion of eyes with an inter-session difference of more than 5% in the thickness parameters was also calculated.