Risk factors for choroidal neovascularization in young patients: A case-control study
| Autor: | Janet T. Derosa, Richard F. Spaide, John A. Sorenson, Lawrence A. Yannuzzi, M. Fotino, Michael Marmor |
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| Rok vydání: | 1995 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Adolescent Fundus Oculi Presumed ocular histoplasmosis syndrome Eye disease New York Human leukocyte antigen Histoplasmosis Neovascularization HLA Antigens Risk Factors Physiology (medical) Histoplasma medicine Humans Child Skin Tests Neovascularization Pathologic biology Choroid business.industry Histocompatibility Testing Case-control study Histoplasmin Middle Aged medicine.disease biology.organism_classification Sensory Systems Ophthalmology Choroidal neovascularization Case-Control Studies Female medicine.symptom business Eye Infections Fungal |
| Zdroj: | Documenta Ophthalmologica. 91:207-222 |
| ISSN: | 1573-2622 0012-4486 |
| DOI: | 10.1007/bf01204172 |
| Popis: | A pair-matched, case-control design was used to study exposure to Histoplasma capsulatum and other environmental factors, and to determine various host characteristics including human leukocyte antigen (HLA) typings in 94 young patients with macular choroidal neovascularization (CNV) and in 94 controls with other eye diseases. Patients with two types of retinal patterns were studied: Type I, or those with CNV with one or no chorioretinal atrophic spots in the posterior pole or periphery (n = 51), and Type II, or those with CNV and 2 or more chorioretinal atrophic spots (n = 43). Our purpose was to explore whether these two variants of idiopathic CNV have different and distinguishable epidemiologies which may or may not be related to prior exposure to Histoplasma. We found that histoplasmin skin tests were negative in all but two Type I cases. The combination of the HLA-B7 and HLA-DR2 markers (but not either marker alone) was significantly increased in Type I cases. Among Type II cases, HLA-B7, HLA-DR2, HLA-DQ1, a positive histoplasmin skin test, myopic refractive error, prior residence in a histoplasmosis endemic area, occupations involving exposure to animals, and hypertension were all significantly increased. Histoplasmin skin test responses were positive in 18 Type II cases (45%). In the multivariate analysis, only DR2 and the combined presence of DQ1 and a positive histoplasmin skin test remained predictive of Type II disease. Our findings suggest that histoplasmin sensitivity is associated with some, but not all, cases of Type II disease. However, histoplasmin sensitivity appears to have no relationship to Type I disease. HLA factors may play a role in both disease types, possibly by producing a modified immune response to Histoplasma and/or other unidentified agents. |
| Databáze: | OpenAIRE |
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