Author: Marina Karliychuk (Ukraine)
Co-authors: Serhii Pinchuk, Artem Urazov
Purpose
Aging is the main trigger of vitreous degeneration and posterior vitreous detachment (PVD) is the inevitable result of this condition in humans. PVD consists of a number of phases occurring in a specific order. This physiological process can be affected negatively by several disorders, such as inflammation, trauma, and tumor, which result in the formation of anteroposterior and tangential contractile forces. The aim was to analyze the relationship of individual components of metabolic syndrome (MS) and their combinations on the vitreomacular traction syndrome (VMTS) incidence.
Setting/Venue
Bukovinian State Medical University, Eye Microsurgery Center `Vash Zir`
Methods
The study included 38 patients (52 eyes) (17 women (27 eyes) and 21 men (25 eyes)) aged 45 to 67 years (mean 57.4 ± 5.5 years) with presence of MS components, and without ophthalmoscopically visible diagnostic signs of any retinopathy, and 35 healthy patients (44 eyes) without presence of MS components. The diagnostic criteria for metabolic syndrome components in this age group were central obesity (waist circumference ≥94 cm for males and ≥80 cm for females, or body mass index>30kg/m2), hypertriglyceridemia (≥1.7 mmoL/L; ≥150 mg/dL), high blood glucose (≥5.6 mmoL/L; ≥100 mg/dL), high blood pressure (≥130 mmHg systolic or ≥85 mmHg diastolic), or low high-density lipoprotein (HDL) cholesterol levels (<1.03 mmoL/L (<40 mg/dL) in males and <1.29 mmoL/L (<50 mg/dL) in females). Coexistence of additional ocular pathologies, such as retinal vascular diseases, retinal break, intraocular tumor, chronic ocular medication, the history of uveitis, retinal surgery, a history of steroid use, or any ocular medication, and ocular trauma were considered as exclusion criteria. In addition to standard ophthalmological examinations, optical coherence tomography of the retina (RTVue-100, Optovue, USA) in the area of the macula was performed to determine the presence of VMTS.
Results
It was found that in persons with a combination of hyperglycemia on an empty stomach and hypertriglyceridemia the incidence of VMTS was significantly higher as compared with persons without MS components (67.3% and 13.6% respectively, p<0.05). In persons with a combination of elevated blood pressure, obesity and low HDL cholesterol levels there was a pronounced tendency to higher incidence of VMTS as compared to persons without these factors (28.8% and 13.6%, p=0.078). In the analysis of MS components and their combinations, it was found that VMTS was observed more often in presence of the combination of MS components such as hyperglycemia on an empty stomach and hypertriglyceridemia. Through different etiologies, astrocytes, myofibroblasts, and fibrocytes are known to play a key role in the occurrence of contraction in VMTS, yet the primary triggering mechanism of this process remains unclear. Takahashi H. et al. revealed that the levels of numerous inflammatory cytokines are affected by the presence of PVD. We think that MS components such as hyperglycemia and hypertriglyceridemia may play critical roles in the development of inflammatory cascades and are associated with chronic inflammation.
Conlusions
Studies have shown an interconnection of combination of metabolic syndrome components such as hyperglycemia and hypertriglyceridemia with incidence of vitreomacular traction syndrome.
Financial Disclosure
No
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