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Biomedical subjects

Louis R Pasquale

Publications and source records attributed to Louis R Pasquale.

8 recordsLinked to original sources
PubMed2026

Can we identify people with Alzheimer's disease from examination of the eye? A bidirectional Mendelian randomization (MR) study.

BACKGROUND: Neurodegeneration in Alzheimer's disease (AD) is thought to be driven by amyloid-beta and tau deposition in the cerebral vasculature and brain. As the eye is an extension of the central nervous system, this study aimed to determine which neurovascular and neuroretinal changes in the eye are caused by AD rather than associations of the disease. METHODS: Bidirectional two-sample univariable and multivariable Mendelian randomization (MR) methods were applied. Instrumental variables were derived from genome-wide association studies (GWAS) of AD and the following ocular features: thickness measurements of central macula (MT), retinal nerve fibre layer (mRNFL), ganglion cell-inner plexiform layer (mGCIPL), outer nuclear layer (ONL), inner segment layer (IS), and outer segment (OS) from macular region OCT scans; arteriolar tortuosity (AT), venular tortuosity (VT), venular width (VW), fractal dimension (FD), vertical cup-to-disc ratio (VCDR), optic cup area (OCA), and optic disc area (ODA) derived from other imaging methods. RESULTS: There was strong evidence that genetic liability to AD affected the retinal vasculature by specifically increasing AT (β = 0.007;95%CI=0.002,0.011;p-value=0.005) in UK Biobank participants (n=52,798). AD may influence the mRNFL (β=-0.047,95%CI=-0.119,0.023,p-value=0.18) and mGCIPL (β=-0.061;95%CI=-0.14,0.025,p-value=0.16) of the inner retina and OS layer (β = 0.044;95%CI=-0.0001,0.08;p-value=0.05) but the evidence was weak. Multivariable MR analysis showed that a causal relationship between optic disc area and AD (OR=0.76;95%CI=0.62,0.93,p-value=0.009) was probably mediated by refractive error. CONCLUSION: Early cerebrovascular signs of AD may be detected by examination of the eye. Further investigation is required to determine the clinical utility of eye screening for dementia.

Humans↗
PubMed2003

Antioxidant intake and primary open-angle glaucoma: a prospective study.

The relation between dietary antioxidant intake and primary open-angle glaucoma risk was examined in participants aged over 40 years in the Nurses' Health Study (n = 76,200) and the Health Professionals Follow-up Study (n = 40,284). They were followed biennially from 1980 and 1986, respectively, to 1996, during periods when they received an eye examination. Dietary intakes were measured repeatedly from 1980 in the Nurses' Health Study and from 1986 in the Health Professionals Follow-up Study using validated food frequency questionnaires. The authors analyzed 474 self-reported glaucoma cases confirmed by medical chart review to have primary open-angle glaucoma with visual field loss. The authors used Cox proportional hazards models for cohort-specific multivariate analyses, and results were pooled using random effects models. The pooled multivariate rate ratios for primary open-angle glaucoma comparing the highest versus lowest quintile of cumulative updated intake were 1.17 (95% confidence interval (CI): 0.87, 1.58) for alpha-carotene, 1.10 (95% CI: 0.82, 1.48) for beta-carotene, 0.95 (95% CI: 0.70, 1.29) for beta-cryptoxanthin, 0.82 (95% CI: 0.60, 1.12) for lycopene, 0.92 (95% CI: 0.69, 1.24) for lutein/zeaxanthin, 1.05 (95% CI: 0.59, 1.89) for vitamin C, 0.97 (95% CI: 0.62, 1.52) for vitamin E, and 1.11 (95% CI: 0.82, 1.51) for vitamin A. In conclusion, the authors did not observe any strong associations between antioxidant consumption and the risk of primary open-angle glaucoma.

Adult↗
PubMed2003

Scanning laser polarimetry of edematous and atrophic optic nerve heads.

OBJECTIVE: To determine if scanning laser polarimetry (SLP) measures form birefringence of the retinal nerve fiber layer (RNFL). METHODS: Consecutive patients with either acute unilateral disc edema or chronic diffuse unilateral disc atrophy underwent SLP using the GDx Nerve Fiber Analyzer (Laser Diagnostic Technologies Inc, San Diego, Calif). The former group had peripapillary RNFL edema, presumably with no change in form birefringence elements, while the latter had optic nerve atrophy, presumably with a loss of birefringence elements in the RNFL. A subset of patients with acute unilateral disc edema who subsequently developed disc atrophy had repeated SLP at 6 months. Intereye and intertest comparisons of 6 SLP parameters representative of RNFL thickness were performed using the paired t test. RESULTS: In the acute unilateral disc edema group (n = 28), none of the SLP parameters were significantly increased in affected vs fellow eyes. In the chronic unilateral disc atrophy group (n = 30), all SLP parameters were significantly decreased in affected vs fellow eyes (P<.001). Patients with disc edema who had a follow-up SLP demonstrated significant declines of all parameters in the affected eyes (P<.007) but no change in SLP parameters in unaffected eyes. CONCLUSION: Scanning laser polarimetry measures form birefringence properties of the RNFL, but not necessarily the RNFL thickness.

Acute Disease↗
PubMed2003

Dermatochalasis causing apparent bitemporal hemianopsia.

We describe a previously unreported cause of apparent bitemporal hemianopsia. Three patients with bilateral dermatochalasis underwent Humphrey visual field (HVF) testing in anticipation of corrective blepharoplasty. Unexpectedly, the HVF showed bitemporal hemianopsia in each case, prompting magnetic resonance imaging of the brain in one case. The scan was negative. The HVF tests were repeated with the upper eyelids taped in elevation, and were normal. We conclude that the bitemporal hemianopic defects in our patients resulted from the testing strategy employed by the HVF analyzer software to measure the visual field. Reasons for these artifactual results are discussed. Clinicians should be aware of this uncommon cause of bitemporal hemianopic visual field defects.

Aged↗
PubMedDate not supplied

Surgical management of glaucoma in pseudophakic patients.

Pseudophakic patients that require surgical management of glaucoma have many of the same options as phakic patients. Considerations when performing incisional glaucoma surgery (trabeculectomy with adjunctive antimetabolites and glaucoma drainage device implantation) and laser glaucoma surgery (laser trabeculoplasty and laser cyclophotocoagulation) in pseudophakic patients are reviewed here. The decision to operate and the choice of surgical procedure must be individualized for each patient.

Ciliary Body↗
PubMedDate not supplied

Cystoid macular edema in aphakia and pseudophakia after use of prostaglandin analogs.

Prostaglandin analogs are powerful ocular hypotensive agents that may also be associated with a breakdown of the blood-retinal barrier and cystoid macular edema. The association is evident in pseudophakic or aphakic patients. This paper presents a case of unilateral latanoprost-associated clinical cystoid macular edema in a bilaterally pseudophakic patient; the only difference between the two eyes was the presence of a capsulotomy in the affected eye. We review the literature concerning prostaglandin analog-associated cystoid macular edema, as well as the evidence for prostaglandin analog-associated breakdown of the blood-retinal barrier. Although some evidence is suggestive of a connection between prostaglandin analogs and cystoid macular edema, many questions concerning the complex physiology of prostanoids remain. Until our understanding of these issues is more advanced, judicious use of prostaglandin analogs in patients at risk for cystoid macular edema would be prudent.

Aged↗