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Ma Y, Shao M, Li S, Lei Y, Cao W, Sun X. The association between airborne particulate matter (PM 2.5) exposure level and primary open-angle glaucoma. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 283:116752. [PMID: 39053180 DOI: 10.1016/j.ecoenv.2024.116752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/10/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024]
Abstract
The eye is vulnerable to the adverse effects of air pollution. Previous experimental study found that fine particulate matter (PM2.5) had a direct toxic effect on intraocular tissues. However, clinical evidence for the impact of air pollutants exposure on functional and structural changes in glaucoma remains scarce. A total of 120 patients with primary open-angle glaucoma (POAG) who met the inclusion criteria were included in this retrospective study. The standardized ophthalmic examination, such as intraocular pressure (IOP), visual field, optical coherence tomography, and comprehensive physical examination, were performed. The air pollution data, including PM2.5 concentration and air quality index (AQI), were collected. PM2.5 and AQI for the day of the medical examination, as well as one month, and three months before the medical examination date, were investigated. In our results, higher average exposure levels for one-month and three-month, were associated with increased IOP (r=0.229, P=0.013; r=0.204, P=0.028, respectively) and decreased visual field mean sensitivity (MS) (r=-0.212, P=0.037; r=-0.305, P=0.002, respectively). PM2.5 concentrations for the day of the medical examination was not significantly associated with ocular parameters. In multiple linear regression analysis adjusted for demographic and clinical factors, higher PM2.5 exposure for one month was associated with elevated IOP (P=0.040, β=0.173, 95 %CI=0.008-0.337). We also found an association between PM2.5 and MS (one-month exposure: β=-0.160, P=0.029; three-month exposure: β=-0.238, P=0.002). The logistic regression analysis found that three-month average PM2.5 exposure level was significantly associated with the disease severity (β=0.043, P=0.025, 95 %CI=1.005-1.084). In conclusion, this study is the first to investigate the relationship between air pollution and detailed ocular parameters of POAG patients in Shanghai over a three-year period, and to explore the effects of different exposure times of PM2.5 on glaucoma. This study found that PM2.5 exposure was correlated with elevated IOP and decreased MS. The one-month PM2.5 exposure level had the most significant effects on IOP. The three-month PM2.5 exposure level was an independent risk factor for POAG severity. Current evidence suggests there may be an association between PM2.5 exposure and POAG.
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Affiliation(s)
- Yi Ma
- Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - Mingxi Shao
- Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Shengjie Li
- Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - Yuan Lei
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 20031, China
| | - Wenjun Cao
- Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China.
| | - Xinghuai Sun
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai 200032, China; NHC Key laboratory of Myopia and Related Eye Diseases, Shanghai 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 20031, China
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Kolovos A, Hassall MM, Siggs OM, Souzeau E, Craig JE. Polygenic Risk Scores Driving Clinical Change in Glaucoma. Annu Rev Genomics Hum Genet 2024; 25:287-308. [PMID: 38599222 DOI: 10.1146/annurev-genom-121222-105817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Glaucoma is a clinically heterogeneous disease and the world's leading cause of irreversible blindness. Therapeutic intervention can prevent blindness but relies on early diagnosis, and current clinical risk factors are limited in their ability to predict who will develop sight-threatening glaucoma. The high heritability of glaucoma makes it an ideal substrate for genetic risk prediction, with the bulk of risk being polygenic in nature. Here, we summarize the foundations of glaucoma genetic risk, the development of polygenic risk prediction instruments, and emerging opportunities for genetic risk stratification. Although challenges remain, genetic risk stratification will significantly improve glaucoma screening and management.
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Affiliation(s)
- Antonia Kolovos
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia; , , ,
| | - Mark M Hassall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia; , , ,
| | - Owen M Siggs
- Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia;
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia; , , ,
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia; , , ,
| | - Jamie E Craig
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia; , , ,
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Lai C, Chuang LH, Lai CC, Liu CF, Yang JW, Chen HSL. Longitudinal changes in optical coherence tomography angiography characteristics in normal-tension glaucoma with or without high myopia. Acta Ophthalmol 2024; 102:e762-e773. [PMID: 38279584 DOI: 10.1111/aos.16644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
PURPOSE To evaluate the structural, microvascular, and functional progression of normal tension glaucoma (NTG) with or without high myopia by examining longitudinal changes in optical coherence tomography angiography (OCTA) and visual field (VF) parameters. METHODS We evaluated 61 NTG eyes and classified 25 of the eyes with axial lengths (ALs) of ≥26 mm as highly myopic. We assessed the rate of change in OCTA parameters, namely radial peripapillary capillary (RPC) vessel density (VD), parafovea VD, deep parafovea VD, retinal nerve fibre layer (RNFL) thickness, and ganglion cell complex thickness. We evaluated the correlation of the rate of change in OCTA parameters with VF loss and AL. RESULTS Among the 61 NTG eyes, rates of loss of RPC VD, parafovea VD, deep parafovea VD, and RNFL thickness were significantly different from zero despite the nonsignificant rate of change in VF mean deviation (MD). Changes in these OCTA parameters did not differ significantly in highly myopic NTG eyes. The rate of change in VF MD was significantly correlated with the rate of change in parafovea VD in highly myopic and non-highly myopic NTG eyes. In highly myopic NTG eyes, AL was negatively correlated with the rates of loss of RNFL thickness, VF MD, and VF PSD. CONCLUSION NTG eyes with a relatively stable VF exhibited loss of VD and RNFL thickness. VF progression in NTG was correlated with decreasing parafovea VD, indicating a structure-function correlation. Greater AL may indicate faster VF loss and RNFL thinning in highly myopic NTG eyes.
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Affiliation(s)
- Chin Lai
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Lan-Hsin Chuang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chun Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Fu Liu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ju-Wen Yang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Henry S L Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
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Tellakula A, M MD, Cyriac RV. A Cross-Sectional Study on Knowledge, Awareness, Self-Care Practices About Glaucoma Among Doctors in South India. Cureus 2024; 16:e62043. [PMID: 38859946 PMCID: PMC11163388 DOI: 10.7759/cureus.62043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 06/12/2024] Open
Abstract
Introduction Glaucoma is the major cause of irreversible blindness worldwide. Glaucoma affects the optic nerve head in the posterior segment of the eye and the defects lead to permanent blindness if left untreated. Poor knowledge about this disease is strongly correlated with delayed diagnosis. This study aimed to evaluate doctors' knowledge and self-care practices about glaucoma at a tertiary care hospital in Chennai, presuming that healthcare professionals constitute an effective conduit between the population at risk and ophthalmologists. Methods We carried out this cross-sectional survey among 252 doctors practicing allopathic medicine in a tertiary care hospital in Chennai from July 2022 to December 2022. We have collected 252 samples by simple random sampling method. We have excluded doctors who have a degree in ophthalmology or practicing it. The data collection was interview-based using a pre-designed, structured questionnaire that contained questions on sociodemographic characteristics age, gender, and specialty in medicine. It also included questions assessing knowledge and self-care practices about glaucoma among doctors of various specialties other than ophthalmology. We entered the collected data into Microsoft Excel (Microsoft Corporation, Redmond, WA), cleaned it, and analyzed it using SPSS version 16. Results The mean age of the doctors was 33.24 ± 10.90 years in this study. About 132 (52.4%) of the study participants were females. Only 91 (36.1%) of respondents knew that glaucoma may permanently impair vision, but nearly 240 (95.2%) believed that it could be treated. Two hundred seventeen (86.1%) participants were aware that glaucoma runs in families. About 218(86.5%) doctors were aware that glaucoma destroys the optic nerve in the eye, and 171 (67.9%) knew that peripheral vision loss happens before central vision loss. Only 146 (57.9%) of physicians had their eye pressure examined. About 232(92.1%) doctors had their eyes checked routinely. Only 42 (16.7%) of physicians took part in glaucoma awareness campaigns. Nearly 199 (79%) of those surveyed thought it was required to check a patient's family members for glaucoma. We note that among doctors, the knowledge and practice score of correct replies was strongly connected with work experience (P value = 0.035). Conclusion The need for extensive eye health education and information distribution for healthcare workers should be stressed. Teaching the hospital staff about the symptoms and prognosis of this "silent thief of sight" might be a crucial first step in providing preventive ophthalmic treatment.
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Affiliation(s)
- Adithya Tellakula
- Ophthalmology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Meera Devasena M
- Ophthalmology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Rejo Varkey Cyriac
- Ophthalmology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Thattaruthody F, Chauhan N, Choudhary S, Raj S, Pandav SS, Kaushik S. Efficacy of a novel low-cost torchlight transcorneal transillumination for diode laser transscleral cyclophotocoagulation in adult glaucoma. Eur J Ophthalmol 2024:11206721241253305. [PMID: 38710194 DOI: 10.1177/11206721241253305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
PURPOSE To study the outcomes of diode laser transscleral cyclophotocoagulation (TSCPC) with trans-corneal transillumination using a novel low-cost torchlight method in refractory glaucoma. METHODS AND ANALYSIS This prospective interventional study included patients with refractory glaucoma who underwent TSCPC with trans-corneal transillumination (TSCPC-TI) using a novel low-cost torchlight method. Patients completing a minimum 6-month follow-up were analyzed. They were compared to a historical control group of patients who underwent TSCPC without transillumination (TSCPC-No TI) at 6-month follow-up period. We analyzed the mean laser energy delivered, post-laser intraocular pressure (IOP) reduction, number of antiglaucoma medications (AGM), the requirement of retreatment and complications of the procedure in both groups. RESULTS 32 eyes of 29 patients comprised the TSCPC-TI group and were compared with 39 eyes of 37 patients in the TSCPC-No TI group. The TSCPC-TI group required lower energy than the TSCPC-No TI group (46.15 ± 22.8 Vs 80.65 ± 56.1 J p < 0.001). At 6-month follow-up, the TSCPC-TI group required lesser AGM for IOP control (2.33 ± 1.02 vs 3.02 ± 1.32 p = 0.01). There was a significantly reduced dependence of oral acetazolamide in the TSCPC-TI group at 6 months follow-up (15.6% vs 41% p = 0.03%). The success and response rates were 71.8% Vs 23.1%; p < 0.0001 and 87.5% Vs 51.2%; p = 0.001 significantly high in the TSCPC-TI group. The TSCPC-No TI group had a significantly high failure rate (12.5% Vs 48.2% p = 0.001). Hypotony (n = 1) and phthisis (n = 2) were noted TSCPC-No TI group. CONCLUSIONS TSCPC with transillumination with a low-cost torchlight resulted in a more efficient and effective cycloablation than TSCPC without transillumination.
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Affiliation(s)
- Faisal Thattaruthody
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Neha Chauhan
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Choudhary
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Srishti Raj
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Surinder Singh Pandav
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sushmita Kaushik
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Mannaf SMA, Islam MS, Islam MN, Rahman MM, Parvin S, Rahman S, Sarker BKD. Population-based survey of the prevalence and types of glaucoma in Bangladesh. BMJ Open Ophthalmol 2024; 9:e001609. [PMID: 38538147 PMCID: PMC10982763 DOI: 10.1136/bmjophth-2023-001609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND To delineate the epidemiological landscape of glaucoma using a population-based sample representative of Bangladesh. METHODS Using multistage stratified cluster random sampling, households were selected to identify individuals ≥35 years across all 8 divisions of Bangladesh. Sampling frames were derived from the 2011 national census. Fifty-eight study examination sites were set up for comprehensive eye evaluations, including intraocular pressure, gonioscopy and visual field testing when indicated. International Society for Geographic and Epidemiological Ophthalmology definitions were used to define glaucoma and glaucoma suspect cases. RESULTS One hundred forty clusters (89 rural and 51 urban) were randomly selected, and 13 791 residential households were visited. We invited 17 002 individuals ≥35 years for on-site examination, of which 12 000 (71%) complied, with a male-to-female ratio of 1:1. The prevalence of glaucoma was 3.2% (95% CI 2.79% to 3.64%), and glaucoma suspect was 10.1% (95% CI 9.05% to 11.12%). The majority (78%) had primary open-angle glaucoma (POAG), while angle closure was seen in 16%. Of the POAG, 83% (n=251) were normal-tension glaucoma. Multivariable logistic regression showed increasing age (OR=1.01 for every 5-year increment, 95% CI 1 to 1.01) and male gender (OR=1.43, 95% CI 1.15 to 1.77) to be associated with an increased risk of glaucoma. CONCLUSIONS The prevalence of glaucoma in Bangladesh is 3.2% in ≥35-year-old individuals with older men most at risk. Extrapolating the results, we estimate about 2 million patients with glaucoma. Though normal-tension variety was the most common type, caution should be exercised in generalising these results to other populations.
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Affiliation(s)
- Sheikh M A Mannaf
- Ophthalmology, BIRDEM, Dhaka, Bangladesh
- Harun Eye Hospital, Dhaka, Bangladesh
| | | | - M Nazrul Islam
- Ophthalmology, BIRDEM, Dhaka, Bangladesh
- Glaucoma, Bangladesh Eye Hospital & Institute, Dhaka, Bangladesh
| | - Md Mizanur Rahman
- Ophthalmology, Bangladesh Medical College, Dhaka, Dhaka District, Bangladesh
| | - Salma Parvin
- Ophthalmology, Green Life Medical College and Hospital, Dhanmondi, Dhaka, Bangladesh
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Ho K, Bodi NE, Sharma TP. Normal-Tension Glaucoma and Potential Clinical Links to Alzheimer's Disease. J Clin Med 2024; 13:1948. [PMID: 38610712 PMCID: PMC11012506 DOI: 10.3390/jcm13071948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Glaucoma is a group of optic neuropathies and the world's leading cause of irreversible blindness. Normal-tension glaucoma (NTG) is a subtype of glaucoma that is characterized by a typical pattern of peripheral retinal loss, in which the patient's intraocular pressure (IOP) is considered within the normal range (<21 mmHg). Currently, the only targetable risk factor for glaucoma is lowering IOP, and patients with NTG continue to experience visual field loss after IOP-lowering treatments. This demonstrates the need for a better understanding of the pathogenesis of NTG and underlying mechanisms leading to neurodegeneration. Recent studies have found significant connections between NTG and cerebral manifestations, suggesting NTG as a neurodegenerative disease beyond the eye. Gaining a better understanding of NTG can potentially provide new Alzheimer's Disease diagnostics capabilities. This review identifies the epidemiology, current biomarkers, altered fluid dynamics, and cerebral and ocular manifestations to examine connections and discrepancies between the mechanisms of NTG and Alzheimer's Disease.
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Affiliation(s)
- Kathleen Ho
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Nicole E. Bodi
- Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Tasneem P. Sharma
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
- Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
- Stark Neurosciences Research Institute, Indianapolis, IN 46202, USA
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Tirsi A, Gliagias V, Zhu D, Wong B, Gupta R, Park SC, Obstbaum S, Tello C. Correlations between Steady-State Pattern Electroretinogram and Humphrey Visual Field Analyzer Global Indices and Their Associations with Retinal Ganglion Cell Layer-Inner Plexiform Layer Thickness in Glaucoma Suspects. J Ophthalmol 2024; 2024:2443887. [PMID: 38500553 PMCID: PMC10948225 DOI: 10.1155/2024/2443887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/16/2024] [Accepted: 03/01/2024] [Indexed: 03/20/2024] Open
Abstract
Purpose The purpose of this study was to investigate the utility of steady state pattern electroretinogram (ss-PERG) in detecting retinal ganglion cell (RGC) dysfunction in glaucoma suspects (GS) who had normal 24-2 Humphrey Visual Fields (HFA). Materials and Methods This was a prospective cohort study of GS patients who were identified based on optic disc appearance with normal HFAs. Patients received a complete eye examination, standard automated perimetry (SAP), optical coherence tomography (OCT), and ss-PERG measurements. The ss-PERG parameters, Magnitude (Mag), Magnitude D (MagD), and MagD/Mag ratio, were examined, along with their relationships between HFA and OCT measurements. Results Twenty-five patients were included in this study, with a total of 49 eyes. Fifteen eyes had abnormal ss-PERG parameters and when compared to GS eyes with normal ss-PERG parameters, there were significant differences in HFA 24-2, retinal nerve fiber layer (RNFL) thickness, and ganglion cell layer and inner plexiform layer (GCL + IPL) thickness. All ss-PERG parameters were significantly correlated with 24-2 VF mean deviation (MD) and visual field index (VFI), as well as 10-2 VF MD after controlling for age, sex, intraocular pressure, central corneal thickness, and spherical equivalent. When controlled for age, spherical equivalent, and IOP, MagD/Mag ratio significantly contributed to the variance in average GCL + IPL thicknesses, whereas 24-2 VF MD and 10-2 VF MD did not. MagD/Mag ratio also significantly accounted for variance in all macular GCL + IPL sectors, while 10-2 VF MD did not. Conclusions ss-PERG has significant correlations with HFA global indices and was predictive of GCL + IPL thickness in GS patients. Clinical Significance. ss-PERG may serve as a useful functional tool for detecting and measuring RGC dysfunction in GS. It appears to be more sensitive than HFA in the detection of early changes in GCL + IPL thicknesses and may be helpful to use in conjunction with current diagnostic studies to improve the ability of monitoring GS progression.
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Affiliation(s)
- Andrew Tirsi
- Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, New Hyde Park, NY, USA
| | | | - Daniel Zhu
- Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
| | - Benny Wong
- Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
| | - Rohun Gupta
- Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, New Hyde Park, NY, USA
| | - Sung Chul Park
- Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, New Hyde Park, NY, USA
| | - Stephen Obstbaum
- Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, New Hyde Park, NY, USA
| | - Celso Tello
- Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, New Hyde Park, NY, USA
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Chen Z, Shen X, Zhang Y, Yang W, Ye J, Ouyang Z, Zheng G, Yang Y, Yu M. Development and Validation of an Internet-Based Remote Perimeter (Perimouse). Transl Vis Sci Technol 2024; 13:16. [PMID: 38506801 PMCID: PMC10959190 DOI: 10.1167/tvst.13.3.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/13/2024] [Indexed: 03/21/2024] Open
Abstract
Purpose We sought to validate the feasibility of Perimouse, an internet-based remote perimeter that allows for natural fixation and can be performed on most computers via a web page. Methods In this cross-sectional study, Perimouse evaluated the visual field of 45 healthy people and 27 patients with primary open-angle glaucoma on a laptop. Participants used a mouse cursor to locate new dots on the screen that were determined by preset saccade vectors. A "click and confirm" strategy was used to eliminate the unwanted visual search. Dot brightness was either fixed at 12 dB in the suprathreshold program (screening program) or variable in the threshold program. We compared Perimouse outcomes with the Humphrey Field Analyzer (HFA) 24-2 Swedish Interactive Testing Algorithm standard program. Results In the screening program, Perimouse showed moderate to high concordance with HFA. The intraclass coefficient ranged from 0.58 to 0.86 in different areas of Garway-Heath mapping. In the threshold program, normal subjects had threshold ranging from 19 to 16 dB, presenting sensitivity changes according to the "hill of vision". The test-retest difference was 0.09 dB. Habitual spectacle correction and environmental luminance (2-337 lux) had little impact on the central or peripheral threshold (P > 0.05). The correlation between Perimouse and HFA threshold sensitivity was strong (R = 0.950), although Perimouse mean defect was 4.40 dB higher than the HFA mean defect. Conclusions Perimouse is a reliable visual field test that correlates strongly with HFA. It shows potential for population screening and monitoring visual field defects. Translational Relevance Perimouse assesses the visual field using saccade vectors without eye trackers, enhancing its accessibility via a web page.
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Affiliation(s)
- Zidong Chen
- Sun Yat-Sen University, Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Guangzhou, PR China
| | - Xiaoyuan Shen
- Sun Yat-Sen University, Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Guangzhou, PR China
| | - Yuning Zhang
- Sun Yat-Sen University, Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Guangzhou, PR China
| | - Wenxin Yang
- Sun Yat-Sen University, Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Guangzhou, PR China
| | - Jiexin Ye
- Sun Yat-Sen University, School of Computer Science and Engineering, Guangzhou, PR China
| | - Zhiqiang Ouyang
- Sun Yat-Sen University, School of Computer Science and Engineering, Guangzhou, PR China
| | - Guifeng Zheng
- Sun Yat-Sen University, School of Computer Science and Engineering, Guangzhou, PR China
| | - Yangfan Yang
- Sun Yat-Sen University, Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Guangzhou, PR China
| | - Minbin Yu
- Sun Yat-Sen University, Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Guangzhou, PR China
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Richter GM, Takusagawa HL, Sit AJ, Rosdahl JA, Chopra V, Ou Y, Kim SJ, WuDunn D. Trabecular Procedures Combined with Cataract Surgery for Open-Angle Glaucoma: A Report by the American Academy of Ophthalmology. Ophthalmology 2024; 131:370-382. [PMID: 38054909 DOI: 10.1016/j.ophtha.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 12/07/2023] Open
Abstract
PURPOSE To determine the intraocular pressure (IOP) reduction of various trabecular procedures (a form of minimally invasive glaucoma surgery [MIGS]) combined with cataract surgery compared with cataract surgery alone, to compare the safety of the various trabecular procedures, and to highlight patient characteristics that may favor one trabecular procedure over another. METHODS A search of English-language peer-reviewed literature in the PubMed database was initially conducted in February 2021 and updated in April 2023. This yielded 279 articles. Twenty studies met initial inclusion and exclusion criteria and were assessed for quality by the panel methodologist. Of these, 10 were rated level I, 3 were rated level II, and 7 were rated level III. Only the 10 level I randomized controlled trials (RCTs) were included in this assessment, and all were subject to potential industry-sponsorship bias. RESULTS The current analysis focuses on the amount of IOP reduction (in studies that involved medication washout) and on IOP reduction with concurrent medication reduction (in studies that did not involve medication washout). Based on studies that performed a medication washout, adding a trabecular procedure to cataract surgery provided an additional 1.6 to 2.3 mmHg IOP reduction in subjects with hypertensive, mild to moderate open-angle glaucoma (OAG) at 2 years over cataract surgery alone, which itself provided approximately 5.4 to 7.6 mmHg IOP reduction. In other words, adding a trabecular procedure provided an additional 3.8% to 8.9% IOP reduction over cataract surgery alone, which itself provided 21% to 28% IOP reduction. There was no clear benefit of one trabecular procedure over another. Patient-specific considerations that can guide procedure selection include uveitis predisposition, bleeding risk, metal allergy, and narrowing of Schlemm's canal. There are no level I data on the efficacy of trabecular procedures in subjects with pretreatment IOP of 21 mmHg or less. CONCLUSIONS Trabecular procedures combined with cataract surgery provide an additional mild IOP reduction over cataract surgery alone in hypertensive OAG subjects. Additional research should standardize outcome definitions, avoid industry sponsorship bias, and study the efficacy of these procedures in normotensive OAG. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Grace M Richter
- Department of Ophthalmology, Southern California Permanente Medical Group, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California; USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California
| | - Hana L Takusagawa
- VA Eugene Healthcare Center, Eugene, Oregon and Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon
| | - Arthur J Sit
- Mayo Clinic, Department of Ophthalmology, Rochester, Minnesota
| | - Jullia A Rosdahl
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Vikas Chopra
- Doheny Eye Centers UCLA and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Yvonne Ou
- Department of Ophthalmology, University of California San Francisco, San Francisco, California
| | - Stephen J Kim
- Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Darrell WuDunn
- University of Florida College of Medicine-Jacksonville, Department of Ophthalmology, Jacksonville, Florida
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11
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Kaushik M, Tiwari P, Dada T, Dada R. Beyond the optic nerve: Genetics, diagnosis, and promising therapies for glaucoma. Gene 2024; 894:147983. [PMID: 37952746 DOI: 10.1016/j.gene.2023.147983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Abstract
Glaucoma stands as a leading global cause of blindness, affecting millions. It entails optic nerve damage and vision loss, categorized into open-angle and closed-angle glaucoma with subtypes like POAG, ACG, XFG, PCG, PDG, and developmental glaucoma. The pathophysiological and genetic factors behind glaucoma remain partially understood, with past studies linking intraocular pressure (IOP) levels to retinal ganglion cell death. Open-angle glaucoma involves elevated resistance to aqueous outflow via the trabecular meshwork, while angle-closure glaucoma typically sees drainage pathways obstructed by the iris. Genes have been identified for POAG, ACG, XFG, PCG, PDG, and developmental glaucoma, allowing for early-onset detection and the emergence of gene therapy as an effective treatment. Nevertheless, diagnostic and treatment options have their constraints, necessitating large-scale, well-designed studies to deepen our grasp of genetics' role in glaucoma's pathogenesis. This review delves into glaucoma's risk factors, pathophysiology, genetics, diagnosis, and available treatment options, including gene therapy. Additionally, it suggests alternative therapies like yoga and meditation as adjunct treatments for glaucoma prevention. Overall, this review advances our comprehension of the pathophysiology and genetic associations of glaucoma while highlighting the potential of gene therapy as a treatment avenue. Further research is imperative to fully elucidate the genetic mechanisms underpinning glaucoma and to devise effective treatments.
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Affiliation(s)
- Meenakshi Kaushik
- Lab for Molecular Reproduction and Genetics, Department of Anatomy, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - Prabhakar Tiwari
- Lab for Molecular Reproduction and Genetics, Department of Anatomy, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
| | - Tanuj Dada
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Rima Dada
- Lab for Molecular Reproduction and Genetics, Department of Anatomy, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
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12
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Akkaya B. Preparation and characterization of lysozyme loaded cryogel for heavy metal removal. Int J Biol Macromol 2023; 253:127494. [PMID: 37858643 DOI: 10.1016/j.ijbiomac.2023.127494] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/28/2023] [Accepted: 10/15/2023] [Indexed: 10/21/2023]
Abstract
In the present study, monolithic poly(N-isopropylacrylamide-acrylamide)-acrilic acid (poly(npam-aam)-aac) cryogels were made. Swelling tests, SEM, XRD, and ATR-FTIR analyses revealed distinct cryogel and lysozyme-loaded cryogel properties. The equilibrium swelling degree was 6.2 g H2O/g cryogel. The created poly(npam-aam)-aac with pores of 10-100 μm was obviously seen in SEM images. Lysozyme adsorption capacity on poly(npam-aam)-aac was found to be 260 mg/g at pH 7.4 and 40 °C. After that, we used lysozyme adsorbed cryogel for the removal of the model heavy metal ion (cadmium). A series of pH, duration, and ionic strengths were used to conduct Cd2+ adsorption experiments. The results showed that the new adsorbent had a considerable chemical affinity for Cd2+ ions in its ability to bind them under eye ocular conditions (pH 7.4, 32-36 °C, 0,15 M NaCl). The traditional Langmuir adsorption model was the most suitable, achieving maximum uptake of ∼185 mg/g. Chemical adsorption was found to be the rate-controlling step, and the process was also compatible with the pseudo-second-order model. For the treatment of ocular pathologies, the most effective enzyme, lysozyme, must show its function. That is why there is a need for using lysozyme, and lysozyme is selected as a lignad to adsorb heavy metal ions because of its high heavy metal binding affinity. This material could be used for the treatment of ocular pathologies in the future.
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Affiliation(s)
- Birnur Akkaya
- Sivas Cumhuriyet University Science Faculty, Department of Molecular Biology and Genetics, Sivas, Turkey.
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13
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Jayaram H, Kolko M, Friedman DS, Gazzard G. Glaucoma: now and beyond. Lancet 2023; 402:1788-1801. [PMID: 37742700 DOI: 10.1016/s0140-6736(23)01289-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/11/2023] [Accepted: 06/19/2023] [Indexed: 09/26/2023]
Abstract
The glaucomas are a group of conditions leading to irreversible sight loss and characterised by progressive loss of retinal ganglion cells. Although not always elevated, intraocular pressure is the only modifiable risk factor demonstrated by large clinical trials. It remains the leading cause of irreversible blindness, but timely treatment to lower intraocular pressure is effective at slowing the rate of vision loss from glaucoma. Methods for lowering intraocular pressure include laser treatments, topical medications, and surgery. Although modern surgical innovations aim to be less invasive, many have been introduced with little supporting evidence from randomised controlled trials. Many cases remain undiagnosed until the advanced stages of disease due to the limitations of screening and poor access to opportunistic case finding. Future research aims to generate evidence for intraocular pressure-independent neuroprotective treatments, personalised treatment through genetic risk profiling, and exploration of potential advanced cellular and gene therapies.
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Affiliation(s)
- Hari Jayaram
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK; UCL Institute of Ophthalmology, London, UK; National Institute for Health and Care Research Moorfields Biomedical Research Centre, London, UK
| | - Miriam Kolko
- Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark; University of Copenhagen, Department of Drug Design and Pharmacology, Copenhagen, Denmark
| | - David S Friedman
- Massachusetts Eye and Ear Hospital, Glaucoma Center of Excellence, Boston, MA, USA; Harvard University, Boston, MA, USA
| | - Gus Gazzard
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK; UCL Institute of Ophthalmology, London, UK; National Institute for Health and Care Research Moorfields Biomedical Research Centre, London, UK.
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14
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Maheshwari D, Pillai MR, Kanduri S, Nair IJ, Kader MA, Ramakrishnan R. Comparative study of surgical outcomes of twin-site phacotrabeculectomy with mitomycin C in primary open-angle glaucoma versus primary angle-closure glaucoma. Indian J Ophthalmol 2023; 71:3528-3533. [PMID: 37870019 PMCID: PMC10752304 DOI: 10.4103/ijo.ijo_324_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/19/2023] [Accepted: 07/10/2023] [Indexed: 10/24/2023] Open
Abstract
Purpose To compare the surgical outcomes of twin-site phacotrabeculectomy with Mitomycin C (MMC) in primary open-angle glaucoma (POAG) versus primary angle-closure glaucoma (PACG). Methods Prospective, comparative, observational study. Patients with visually significant cataract and primary glaucoma were divided into two groups: POAG and PACG. They underwent twin-site phacotrabeculectomy with MMC and followed up on days 1, 15, 1 month, 6 months, and 12 months. Baseline and follow-up visits were compared to find the differences in intraocular pressure (IOP), antiglaucoma medications (AGM), success rates, anterior chamber depth (ACD), and axial length (AXL). Results There were 50 eyes each in POAG and PACG groups. Mean IOP reduction from baseline to 12 months (21.22 ± 6.0 to 11.40 ± 2.8-POAG group vs 24.16 ± 7.6 to 12.42 ± 3.2-PACG group) was statistically significant in both groups (P < 0.001), but no significant difference between groups (P = 0.095). There was a statistically significant decline in the number of AGM in POAG [1.66 (0.7) to 0.38 (0.7), P < 0.001] and PACG [2.10 (0.7) to 0.70 (0.8), P < 0.001]; the decline was more in POAG (P = 0.012) at last visit. Probability of overall (complete and qualified) success at 12 months postop was 72.0% [95% confidence interval (CI): 57.4-82.4] in PACG and 84.0% (95% CI: 70.5-91.7) in POAG group. There was a significant increase in ACD and a decrease in AXL in both groups (P < 0.001). More interventions were required in the PACG group (38, P = 0.012). Conclusion Phacotrabeculectomy with MMC causes a significant reduction in IOP and improvement in biometric parameters in both POAG and PACG. Patients with PACG required more postoperative interventions, while a lesser number of antiglaucoma medications were needed in POAG patients.
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Affiliation(s)
- Devendra Maheshwari
- Department of Glaucoma, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
| | | | - Swathi Kanduri
- Department of Glaucoma, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
| | - Indu J Nair
- Department of Retina, Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India
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15
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Bhandari G, Bhandari S, Byanju R, Pradhan S, Sah RK, Kandel RP, Thompson IJ, Rotchford AP, West SK, Muñoz B, Stevens VM, Oatts JT, Ou Y, Lietman TM, O’Brien KS, Keenan JD. Relationship Between Intraocular Pressure and Age: A Population-Based Study in Nepal. J Glaucoma 2023; 32:983-988. [PMID: 37670512 PMCID: PMC10840987 DOI: 10.1097/ijg.0000000000002291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/02/2023] [Indexed: 09/07/2023]
Abstract
PRCIS Intraocular pressure (IOP) decreased with age in a population-based study in Nepal, from a mean of 14.1 mm Hg among those 60-64 years old to 13.0 mm Hg among those 80 years old or older. PURPOSE Few studies have assessed the distribution of IOP from the Indian subcontinent, despite its large population and high burden of glaucoma. The objective of this study was to assess the distribution of IOP measurements from adults living in a lowland region of Nepal. METHODS In a population-based cross-sectional study, all individuals aged 60 years and older from an area of lowland Nepal were invited for an IOP assessment with a rebound tonometer. RESULTS Of 160 communities (28,672 people aged ≥60 y) enrolled, 79 (13,808 people aged ≥60 y) were randomly selected for IOP testing. Of those eligible, 10,017 (72.5%) individuals underwent tonometry. Mean IOP decreased monotonically over 5-year age groups, from 14.1 mm Hg (SD: 3.6) among those aged 60-64 years to 13.0 mm Hg (SD: 4.2) among those 80 years or older. The 97.5th percentile IOP measurement was 21.0 mm Hg for all age groups. In adjusted analyses, younger age, self-reported diabetes, and higher population density were each associated with higher IOP, and self-reported cataract surgery was associated with lower IOP. CONCLUSIONS Mean IOP was lower among older individuals in Nepal, consistent with many studies from East Asia and in contrast to many studies from western populations. These results suggest that ethnic background might be a consideration when diagnosing ocular hypertension.
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Affiliation(s)
| | | | | | | | | | | | - Isabel J Thompson
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
| | - Alan P Rotchford
- Department of Ophthalmology, Tennent Institute of Ophthalmology, Gartnavel Hospital, Glasgow, UK
| | - Sheila K West
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Beatriz Muñoz
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Valerie M Stevens
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
| | - Julius T Oatts
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Yvonne Ou
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Thomas M Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Kieran S O’Brien
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Jeremy D Keenan
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
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16
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Liu Y, Yao B, Chen X, Yang X, Liu Y, Xie Z, Chen X, Yuan Z, Wang X, Hu D, Ma X, Gao W, Wang R, Yang Y, Chen S, Zhang J, Song Z, Wang J, Wang J, Pei J, Wang W, Wang M, Gao J, Zhang H, Tan L, Du W, Pan X, Liu G, Du X, Hou X, Gao X, Zhang Z, Shen Z, Wu C, Yan X, Bo S, Sun X, Tang NJ, Zhang C, Yan H. Glaucoma in rural China (the Rural Epidemiology for Glaucoma in China (REG-China)): a national cross-sectional study. Br J Ophthalmol 2023; 107:1458-1466. [PMID: 35840290 DOI: 10.1136/bjo-2021-320754] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/29/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study aimed to investigate the prevalence of glaucoma with associated factors in the rural populations of 10 provinces in China. DESIGN A population-based cross-sectional study. METHODS All participants aged 6 years or older from 10 provinces completed visual acuity testing, slit-lamp examination, ophthalmoscopy and non-contact tonometry. Glaucoma suspects underwent fundus photography, Goldmann applanation tonometry, visual field testing and gonioscopy. Glaucoma was determined according to the International Society of Geographical and Epidemiological Ophthalmology classification scheme. Associations of demographics and medical factors with glaucoma were assessed using multiple logistic regression models. RESULTS From June 2017 to October 2018, 48 398 of 52 041 participants were included in the final analyses. The age-standardised prevalence of glaucoma was 1.7% (95% CI 1.55% to 1.78%) among the participants older than 6 years, which was 2.1% (95% CI 1.93% to 2.23%) in participants aged over 40 years. The constituent ratios of glaucoma were: 44.4% primary angle-closure glaucoma (PACG), 34.7% primary open-angle glaucoma, 2.6% congenital glaucoma and 18.3% other types of glaucoma. Increasing age, smoking, cerebral stroke, type 2 diabetes, higher education (college or more) and higher personal income were significant risk factors for PACG. The unilateral and bilateral blindness rates in the entire study population were 4.692% and 1.068%, respectively. A family history of glaucoma was a significant risk factor for the prevalence of glaucoma and blindness in at least one eye. CONCLUSIONS Rural populations have a high prevalence of glaucoma, which should be included in chronic disease management programmes in China for long-term care.
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Affiliation(s)
- Yuanyuan Liu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Baoqun Yao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China
| | - Yong Liu
- Department of Ophthalmology, Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China
| | - Zhenggao Xie
- Department of Ophthalmology, Subei People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Xiaofeng Chen
- Department of Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Zhigang Yuan
- Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, Shanxi, China
| | - Xingrong Wang
- Department of Ophthalmology, Eye Institute of Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of TCM, Jinan, Shandong, China
| | - Dan Hu
- Department of Ophthalmology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Xiang Ma
- Department of Ophthalmology, Guyuan Municipal People's Hospital, Guyuan, Gansu, China
| | - Weiqi Gao
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Ruifeng Wang
- Department of Ophthalmology, Zhengzhou Second People's Hospital, Zhengzhou, Henan, China
| | - Yuzhong Yang
- Department of Ophthalmology, Beizhen People's Hospital, Jinzhou, Liaoning, China
| | - Song Chen
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingkai Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zuoqing Song
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Junsu Wang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Wang
- Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinyun Pei
- Department of Ophthalmology, Santan Hospital, Tianjin, China
| | - Weijuan Wang
- Department of Ophthalmology, Binhai Hospital of Tianjin Medical University General Hospital, Tianjin, China
| | - Meiyan Wang
- Department of Ophthalmology, Tianjin Haibin People's Hospital, Tianjin, China
| | - Jun Gao
- Department of Ophthalmology, Tianjin Third Central Hospital, Tianjin, China
| | - Hongwen Zhang
- Department of Ophthalmology, Tianjin Jizhou District People's Hospital, Tianjin, China
| | - Lian Tan
- Department of Ophthalmology, Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China
| | - Wei Du
- Department of Ophthalmology, Subei People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Xuehui Pan
- Department of Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Gang Liu
- Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, Shanxi, China
| | - Xiujuan Du
- Department of Ophthalmology, Eye Institute of Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of TCM, Jinan, Shandong, China
| | - Xu Hou
- Department of Ophthalmology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Xin Gao
- Department of Ophthalmology, Guyuan Municipal People's Hospital, Guyuan, Gansu, China
| | - Zhen Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhansheng Shen
- Department of Ophthalmology, Zhengzhou Second People's Hospital, Zhengzhou, Henan, China
| | - Changfu Wu
- Department of Ophthalmology, Beizhen People's Hospital, Jinzhou, Liaoning, China
| | - Xiaochang Yan
- National School of Development, Peking University, Beijing, China
| | - Shaoye Bo
- Department of Supervisory Board, China Foundation for Disabled Persons, Beijing, China
| | - Xinghuai Sun
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Nai-Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China
| | - Chun Zhang
- Department of Ophthalmology, Peking University Eye Center, Third Hospital of Peking University, Beijing, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
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Abdolalizadeh P, Falavarjani KG. The Correlation of Global Burden of Vision Impairment and Ambient Atmospheric Fine Particulate Matter. J Curr Ophthalmol 2023; 35:387-394. [PMID: 39281396 PMCID: PMC11392291 DOI: 10.4103/joco.joco_125_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/16/2023] [Accepted: 11/10/2023] [Indexed: 09/18/2024] Open
Abstract
Purpose To assess the correlation between the worldwide burden of vision impairment (VI) and fine particulate matter (PM) 2.5. Methods In this retrospective cross-sectional study, global and national prevalence and disability-adjusted lost year (DALY) numbers and rates of total VI, glaucoma, cataract, and age-related macular degeneration (AMD) were obtained from the Global Burden of Disease database. The global and national levels of PM2.5 levels were also extracted. The main outcome measures were the correlation of PM2.5 levels with total VI and three ocular diseases in different age, sex, and socioeconomic subgroups. Results In 2019, the worldwide prevalence of total VI and exposure level of PM2.5 was 9.6% (95% uncertainty interval: 8.0-11.3) and 42.5 μg/m3, respectively. The national age-standardized prevalence rates of total VI (r p = 0.52, P < 0.001), glaucoma (r p = 0.65, P < 0.001), AMD (r p = 0.67, P < 0.001), and cataract (r p = 0.44, P < 0.001) have a positive correlation with PM2.5 levels. In addition, the national age-standardized DALY rates of total VI (r p = 0.62, P < 0.001), glaucoma (r p = 0.62, P < 0.001), AMD (r p = 0.54, P < 0.001), and cataract (r p = 0.45, P < 0.001) significantly correlated with PM2.5 levels. The correlations remained significant in different age, sex, and sociodemographic subgroups. Conclusion National prevalence rates of VI and three major ocular diseases correlate significantly with PM2.5 exposure levels, worldwide.
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Affiliation(s)
- Parya Abdolalizadeh
- Department of Ophthalmology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Khalil Ghasemi Falavarjani
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
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Al-Timimi Z, Huang-Lung J, Keay L, Healey P, Yang E, Dunn H. A Systematic Review of Glaucoma Diagnosis in Prevalence Studies and Quality of Reporting. J Glaucoma 2023; 32:874-884. [PMID: 37406297 DOI: 10.1097/ijg.0000000000002248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/19/2023] [Indexed: 07/07/2023]
Abstract
PRCIS This systematic review has revealed that variable definitions of glaucoma continue to be used in prevalence studies, despite the introduction of the International Society of Geographic and Epidemiologic Ophthalmology (ISGEO) criteria. PURPOSE To systematically review diagnostic criteria and examinations performed in glaucoma prevalence studies over time and determine the quality of reporting. Accurate estimates of glaucoma prevalence are crucial to inform resource allocation. However, diagnosis of glaucoma comprises inherently subjective examinations and the cross-sectional nature of prevalence studies precludes monitoring for progression. METHODS A systematic review of PubMed, Embase, Web of Science, and Scopus was performed to examine diagnostic protocols used by glaucoma prevalence studies and evaluate uptake of the ISGEO criteria, introduced in 2002 to standardize glaucoma diagnosis in prevalence studies. Detection bias and compliance with the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) guidelines were evaluated. RESULTS Ten thousand five hundred forty-four articles were identified. After deduplication, 5589 articles were screened, yielding 136 articles pertaining to 123 studies. An absence of data in many countries was identified. Ninety-two percent of studies stated diagnostic criteria, and 62% used the ISGEO criteria since their publication. Weaknesses of the ISGEO criteria were identified. Temporal variations in the performance of various examinations were observed, including heterogeneity in angle assessment. Mean STROBE compliance was 82% (range 59-100%); 72 articles had a low risk of detection bias, 4 had a high risk, and 60 had some concerns. CONCLUSION Heterogeneous diagnostic definitions persist in glaucoma prevalence studies, despite introduction of the ISGEO criteria. Standardization of criteria remains imperative and the development of new criteria represent a valuable opportunity to achieve this goal. In addition, methods of determining diagnoses are poorly reported, suggesting a need for improvement in study conduct and reporting. Accordingly, we propose the Reporting of quality Of GlaUcoma Epidemiological Studies (ROGUES) Checklist. We have also identified a need for further prevalence studies in regions with limited data and to update Australian angle closure glaucoma prevalence. Design and reporting of future studies can be informed by this review's insights into diagnostic protocols previously used.
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Affiliation(s)
- Zayn Al-Timimi
- Rural Clinical School, University of New South Wales, Port Macquarie
| | - Jessie Huang-Lung
- School of Optometry and Vision Science, University of New South Wales, Sydney
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney
| | - Paul Healey
- Clinical Ophthalmology and Eye Health, Westmead Clinical School
| | - Eleanor Yang
- School of Optometry and Vision Science, University of New South Wales, Sydney
| | - Hamish Dunn
- Rural Clinical School, University of New South Wales, Port Macquarie
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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19
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Faroog Z, Faroog S, Zia Zaidi AR. First Assessment of Awareness and Knowledge of Glaucoma Among Citizens of Addu City, Maldives: A Cross-Sectional Study. Cureus 2023; 15:e44931. [PMID: 37818521 PMCID: PMC10560861 DOI: 10.7759/cureus.44931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/12/2023] Open
Abstract
Background Glaucoma is a progressive optic neuropathy characterized by visual field loss and potentially irreversible blindness, which poses a significant global health challenge. The Maldives, renowned for its unique geography and vibrant culture, faces unique challenges in healthcare access and delivery due to its scattered islands. Limited access to specialized healthcare services, coupled with cultural and socioeconomic factors, can contribute to disparities in glaucoma awareness and early detection. Understanding glaucoma awareness is paramount due to its potential impact on public health and the healthcare system. The aim of this study is to assess the awareness and knowledge about glaucoma among the citizens of Addu City, Maldives. Methods A cross-sectional study was conducted among 390 residents of Addu City, Maldives. The online survey questionnaire assessed demographic information, knowledge and awareness of glaucoma, and risk factors associated with the disease. Results The majority of participants (66.9%) had never heard of glaucoma. Among those who had heard of glaucoma, only 22.6% knew that it could cause irreversible blindness. Logistic regression analysis and multivariate analysis showed that age, gender, socioeconomic status, and education level were significantly associated with awareness and knowledge of glaucoma (p<0.05). Conclusion Findings suggest a high likelihood of low awareness and knowledge of glaucoma among residents of Addu City, Maldives. The study highlights the urgent need for policymakers, program implementers, and the health sector to conduct awareness programs in the community and provide facilities for annual eye examinations, as well as to organize systematic screening plans for glaucoma across the Maldives.
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Markeviciute A, Huang-Lung J, Zemaitiene R, Grzybowski A. A Review of Ambient Air Pollution as a Risk Factor for Posterior Segment Ocular Diseases. J Clin Med 2023; 12:jcm12113842. [PMID: 37298038 DOI: 10.3390/jcm12113842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE To review the most recent evidence on the association of ambient air pollution with posterior segment ocular diseases. METHODS A search of the most recently published medical literature was performed in PubMed and Google Scholar on 10 December 2022. Articles published between 2018 and December 2022 were included in this rapid review. Studies that evaluated the association between ambient air pollutants (nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), ozone (O3), particulate matters (PMs), total hydrocarbons (THC), nonmethane hydrocarbons (NMHC), benzene), and ocular posterior segment diseases (glaucoma, age-related macular degeneration (AMD), and retinal vascular diseases) were included. RESULTS Nineteen research articles met the inclusion criteria. Significant associations were found between PM2.5 and glaucoma, including primary open angle, primary angle closure, and normal tension glaucoma. An increased risk of AMD was linked to increased exposure to PM2.5, NO2, and CO. Single studies suggested that increased exposure to PM2.5 and PM10 is associated with diabetic retinopathy; THC and NMHC increased the risk of retinal vein occlusion; and CO, NO2, and PM10 are linked to an increased risk of central retinal artery occlusion. CONCLUSIONS There is increasing evidence that toxic air pollutants have an impact on posterior segment ocular diseases, hence determining it as a potential modifiable risk factor for visual impairment.
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Affiliation(s)
- Agne Markeviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Jessie Huang-Lung
- School of Optometry and Vision Science, University of New South Wales, Sydney 2052, Australia
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, 61-553 Poznan, Poland
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21
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Central corneal thickness and its associations in a Russian population. The Ural eye and Medical Study. Eye (Lond) 2023; 37:705-713. [PMID: 35347290 PMCID: PMC9998395 DOI: 10.1038/s41433-022-02026-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/28/2022] [Accepted: 03/11/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND To assess central corneal thickness (CCT) and its associations in a Russian population. METHODS The population-based Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals. As part of an ophthalmological and general examination, CCT was measured by Scheimflug imaging. RESULTS The study included 5792 (98.2%) participants (age:58.8 ± 10.6 years;range: 40-94 years) with available bilateral CCT measurements. Mean CCT was larger in Russians than non-Russians (549.5 ± 32.8 µm versus 539.2 ± 33.9 µm; P < 0.001). In multivariable analysis, thicker CCT was associated (regression coefficient r:0.43) with younger age (standardized regression coefficient beta:-0.09; non-standardized regression coefficient B:-0.29;95% confidence interval (CI):-0.39,-0.20; P < 0.001), male sex (beta:0.05; B:3.10; 95%CI:1.18,5.03; P = 0.002), urban region of habitation (beta:0.10; B:6.83; 95%CI:4.61, 9.05; P < 0.001), Russian ethnicity (beta:0.04; B:3.48; 95%CI:1.04, 5.91; P = 0.005), higher level of education (beta:0.04; B:0.97;95%CI:0.29,1.66; P = 0.006), higher serum bilirubin concentration (beta:0.05;B:0.15; 95%CI:0.07,0.23;P < 0.001), lower corneal refractive power (beta:-0.09;B:11.92; 95%CI:-2.50,-1.35; P < 0.001), smaller anterior chamber angle (beta:-0.07;B:-0.38;95%CI:-0.52,-0.24;P < 0.001), higher IOP readings (beta:0.38; B:3.47; 95%CI:3.21,3.73; P < 0.001), and higher rise in IOP readings by medical mydriasis (beta:0.07; B:0.88;95%CI:0.54,1.22;P < 0.001). In that model, CCT was not associated with body height (P = 0.14), previous cataract surgery (P = 0.10), axial length (P = 0.18) or prevalence of glaucoma (P = 0.11). The mean inter-eye difference in CCT was 8.52 ± 13.9 µm (median:6.0;95CI:8.16,8.88). A higher inter-eye CCT difference was associated with older age (beta:0.08; B:0.11;95%CI:0.07,0.15; P = 0.01), lower level of education (beta:-0.04;B:-0.34; 95%CI:-0.60,-0.08; P < 0.001) and status after cataract surgery (beta:0.04; B:2.92;95%CI:1.02,4.83; P = 0.003). INTRODUCTION CONCLUSIONS In this ethnically mixed population from Russia with an age of 40+ years, mean CCT (541.7 ± 33.7 µm) was associated with parameters such as younger age, male sex, Russian ethnicity, and higher educational level. These associations may be taken into account when the dependence of IOP readings on CCT are considered. Glaucoma prevalence was unrelated to CCT.
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22
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Zhang A, Wang Q, Yang X, Liu Y, He J, Shan A, Sun N, Liu Q, Yao B, Liang F, Yang Z, Yan X, Bo S, Liu Y, Mao H, Chen X, Tang NJ, Yan H. Impacts of heatwaves and cold spells on glaucoma in rural China: a national cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:47248-47261. [PMID: 36737565 PMCID: PMC10097786 DOI: 10.1007/s11356-023-25591-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023]
Abstract
China faces increasing health risks from climate change. The structure and function of the eye and vision were affected by extreme heat and cold. The study aimed to evaluate the impacts of heatwaves and cold spells on glaucoma. A national cross-sectional study of the Rural Epidemiology for Glaucoma (REG-China) was conducted in ten provinces of China, and 36,081 adults aged 40 years or more were included. Glaucoma signs were assessed via a standard examination. A total of 15 heatwave definitions, based on intensity (95th to 99th percentiles of temperature distribution) and duration (≥2 days, 3 days, and 4 days), were used to quantify heatwave effects, and 6 cold spell definitions were defined based on threshold temperature percentile (5th and 10th) and duration (3 days, 5 days, and 9 days). Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the impacts of heatwaves and cold spells on glaucoma, and the dose-response relationships were assessed using a restricted cubic spline (RCS) model. Subgroup analysis was conducted stratified by gender, age, smoking status, occupation, and family history of glaucoma. The overall prevalence of glaucoma was 2.1% (95% CI 1.94-2.25%). Higher heatwaves were significantly correlated with higher OR of glaucoma, with the OR (95% CI) ranging from 1.014 (1.009, 1.018) to 1.090 (1.065, 1.115) by different definitions. Glaucoma was affected by heatwaves more strongly than by cold spells. The effects of both heatwaves and cold spells were higher in males than females and in smokers than nonsmokers. These results of the present study evoked the attention of prospective research to elucidate the relationship between extreme temperatures and eye diseases.
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Affiliation(s)
- Ai Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Qihua Wang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Ocular Trauma, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China.,Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Yuanyuan Liu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Ocular Trauma, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Jiayu He
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Anqi Shan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Naixiu Sun
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Qianfeng Liu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Baoqun Yao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Ocular Trauma, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Ze Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaochang Yan
- National School of Development, Peking University, Beijing, China
| | - Shaoye Bo
- China Foundation for Disabled Persons, Dongcheng District, Beijing, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Hongjun Mao
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Nai-Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Ocular Trauma, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China. .,School of Medicine, Nankai University, Tianjin, China.
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Lee TE, Kim JS, Yeom SW, Lee MG, Lee JH, Lee HJ. Long-term effects of obstructive sleep apnea and its treatment on open-angle glaucoma: a big-data cohort study. J Clin Sleep Med 2023; 19:339-346. [PMID: 36305582 PMCID: PMC9892736 DOI: 10.5664/jcsm.10334] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 02/04/2023]
Abstract
STUDY OBJECTIVES The relationship between open-angle glaucoma (OAG) and obstructive sleep apnea (OSA) is unclear. The long-term risk for OAG after OSA diagnosis has not been investigated. Therefore, we assessed the risk for OAG among patients with OSA over a 12-year follow-up period using nationwide, population-based data. METHODS The OSA group was randomly selected from among 3.5 million individuals registered with the National Health Insurance Service. The non-OSA group was obtained through propensity score matching considering several variables. The primary endpoint was glaucoma diagnosis. RESULTS The OSA and non-OSA groups both included 6,369 individuals. The overall hazard ratio for OAG in the OSA group was 1.42 (95% confidence interval [CI]: 1.19-1.69). In subgroup analysis, the hazard ratio for OAG was 1.94 (95% CI: 1.57-2.41) for those aged > 60 years, 1.50 (95% CI: 1.20-1.89) for those with diabetes mellitus, 1.53 (95% CI: 1.26-1.86) for those with hypertension, and 0.71 (95% CI: 0.52-0.96) for those with a history of OSA surgery. CONCLUSIONS Over the 12-year follow-up, the risk for OAG increased after OSA diagnosis. Further research will be necessary to determine if treating OSA can mitigate this association. CITATION Lee T-E, Kim JS, Yeom SW, Lee MG, Lee JH, Lee H-J. Long-term effects of obstructive sleep apnea and its treatment on open-angle glaucoma: a big-data cohort study. J Clin Sleep Med. 2023;19(2):339-346.
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Affiliation(s)
- Tae-Eun Lee
- Department of Ophthalmology, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University – Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Jong Seung Kim
- Research Institute of Clinical Medicine of Jeonbuk National University – Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Sang Woo Yeom
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Min Gyu Lee
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Jong Hwan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Haeng-Jin Lee
- Department of Ophthalmology, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University – Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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Awareness and knowledge of glaucoma among visitors of main public hospitals in Damascus, Syria: a cross-sectional study. BMC Ophthalmol 2023; 23:17. [PMID: 36627615 PMCID: PMC9830819 DOI: 10.1186/s12886-022-02766-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/30/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The main way to prevent blindness from Glaucoma is by early detection and diagnosis; and to do so the awareness must be raised among people where Glaucoma is defined as an acquired chronic optic neuropathy characterized by optic disk cupping and visual field loss. Lack of knowledge about this disease is one of the most important reasons that made it develop to advanced stages. Based on that, we conducted scientific research to assess peoples' awareness and knowledge about Glaucoma. After reviewing the literature, it was found that this study is the first in Syria. METHODS We conducted a cross-sectional study in May 2022. The study included participants, who are above 20 years old, from visitors of Al-Mouwasat University Hospital in Damascus, Syria. During one week, Data was gathered according to the questionnaire, which was presented through face-to-face interviews with participants. We have allocated one point (1) to each question. Three levels of knowledge were adopted, namely; weak level from (0) to (3), average level from (4) to (7) and good level from (8) to (11). Associations between participants' demographic and other details were tested using Chi-square test and other tests, and a p-value of < 0.05 was considered significant. RESULTS A total of 500 participants were interviewed. For awareness of Glaucoma, 33.6% of the participants (n = 168) had heard of Glaucoma, and 66.4% hadn't (n = 332). Mean test results for the knowledge of Glaucoma was 1.62 out of 11, and only 8% of participants (n = 40) had a good knowledge of Glaucoma. Education Level, governorate, and department of hospital that the patient came for significantly affected the knowledge of Glaucoma. Moreover, hospital, Ophthalmologists' Clinics, and health staff (M = 5.45) were the better Resource for information than family, relatives, and friends (M = 3.16). Finally, social media and the Internet group had the lowest mean test results (M = 1.23). These test results were significant, with a p-value < 0.001. CONCLUSION The percentage of knowledge and awareness was significantly low. Organized community awareness methods must disseminate more ability to increase the general public's understanding to avoid injury and late diagnosis of Glaucoma.
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Richardson QR, Kumar RS, Ramgopal B, Rackenchath MV, A V SD, Mannil SS, Nagaraj S, Moe CA, Wittberg DM, O'Brien KS, Oatts JT, Stamper RL, Keenan JD. Diagnostic Accuracy of Frequency-Doubling Technology and the Moorfields Motion Displacement Test for Glaucoma. Ophthalmol Glaucoma 2022; 6:239-246. [PMID: 36435449 DOI: 10.1016/j.ogla.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Portable perimetric testing could be useful for community-based glaucoma screening programs. Frequency-doubling technology (FDT) and the Moorfields motion displacement test (MDT) are portable perimeters that have shown promise as potential screening tools for glaucoma. This study's goal was to determine the diagnostic accuracy of FDT and MDT for visual field defects and glaucoma. DESIGN Prospective, cross-sectional, diagnostic accuracy study. PARTICIPANTS A consecutive series of patients aged ≥ 50 years who presented to a glaucoma clinic in South India and had never undergone Humphrey field analyzer (HFA) visual field testing in the past. METHODS Participants underwent 24-2 Swedish Interactive Thresholding Algorithm (SITA) Standard HFA perimetry, FDT perimetry, MDT perimetry, and iPad perimetry using visualFields Easy in random order. Ophthalmologist grades of HFA and optic nerve head photographs were used as reference standards for glaucoma and field defect presence. Receiver operating characteristic curves were constructed to assess the diagnostic accuracy of various parameters for each test. MAIN OUTCOME MEASURES Sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC). RESULTS Overall, 292 eyes from 173 participants were included, with 112 eyes classified as moderate or worse glaucoma. For moderate or worse glaucoma detection, the best parameter on FDT was mean deviation (MD) (AUROC, 0.84; 95% confidence interval [CI], 0.79-0.89) and the best parameter on MDT was global probability of true damage (GPTD) (AUROC, 0.87; 95% CI, 0.82-0.91). When specificity was set to 90%, the sensitivity for detection of moderate or worse glaucoma was 55% (95% CI, 39%-68%) for FDT MD and 62% (95% CI 52%-71%) for MDT GPTD. CONCLUSIONS Frequency-doubling technology and MDT perimetry had fair diagnostic accuracy for glaucoma detection when administered to naïve test takers in this South Indian population. Although not appropriate for use as a sole glaucoma screening test, these perimetric tests may be useful as ancillary tests. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Quintin R Richardson
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Rajesh S Kumar
- Narayana Nethralaya Eye Hospital, Bangalore, India; Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | | | | | - Suria S Mannil
- Narayana Nethralaya Eye Hospital, Bangalore, India; Byers Eye Institute, Stanford University School of Medicine, Stanford, California
| | | | - Caitlin A Moe
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Dionna M Wittberg
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Kieran S O'Brien
- Francis I. Proctor Foundation, University of California, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California
| | - Julius T Oatts
- Department of Ophthalmology, University of California, San Francisco, California
| | - Robert L Stamper
- Department of Ophthalmology, University of California, San Francisco, California
| | - Jeremy D Keenan
- Francis I. Proctor Foundation, University of California, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California.
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George R, Panda S, Vijaya L. Blindness in glaucoma: primary open-angle glaucoma versus primary angle-closure glaucoma-a meta-analysis. Eye (Lond) 2022; 36:2099-2105. [PMID: 34645961 PMCID: PMC9582001 DOI: 10.1038/s41433-021-01802-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/23/2021] [Accepted: 09/30/2021] [Indexed: 11/08/2022] Open
Abstract
AIM To estimate the risk of blindness with primary angle-closure glaucoma (PACG) compared to primary open-angle glaucoma (POAG) in those population-based studies that reported blindness rates for both PACG and POAG. METHOD A systematic search was performed in PubMed for articles published in English between 2000 and 2020 reporting the prevalence of POAG as well as PACG among various ethnic populations. A study was included if it was (1) population-based (2) had published prevalence and blindness rates for both PACG and POAG in the same cohort. (3) Glaucoma was defined as per the International Society for Geographical and Epidemiological Ophthalmology (ISGEO) criteria. The proportion of blindness for both POAG and PACG for each study and the cumulative proportion taking all the studies were calculated. RESULTS We included 23 studies with 78,434 participants. POAG was diagnosed in 1702 persons with 151 (8.9%) blind. There were 724 cases of PACG with 196 (27.0%) blind. The risk ratio of blindness in PACG to POAG varied from 0.73 to 10.6 among the studies. The cumulative risk ratio was 2.39 (95% confidence interval (CI); 1.99, 2.87). Risk ratios for studies including visual field restriction while defining blindness were similar to studies that did not (1.92 vs 2.64, P = 0.11). Risk ratios were also similar for studies that used greater than 2 instead of 3 or more quadrants of iridotrabecular contact to define angle closure (2.79 vs 2.25). CONCLUSION Primary angle-closure disease is more likely to be associated with blindness.
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Affiliation(s)
- Ronnie George
- Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamilnadu, India.
| | - Smita Panda
- Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamilnadu, India
| | - Lingam Vijaya
- Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamilnadu, India
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Pokal U, Swathi N, Rajalakshmi AR, Lokeshmaran A. Comparing retinal sensitivities on blue-on-yellow and green-on-yellow perimetry in glaucoma suspects. Indian J Ophthalmol 2022; 70:3550-3555. [PMID: 36190045 PMCID: PMC9789795 DOI: 10.4103/ijo.ijo_944_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To compare the retinal sensitivities between the blue-on-yellow perimetry (BYP)/short-wavelength automated perimetry (SWAP) and green-on-yellow perimetry (GYP) among patients with and without nuclear sclerosis among glaucoma suspects. Methods After ophthalmic examination, patients were subjected to two perimetric tests: BYP and GYP. The visual field (VF) parameters were compared between the two perimeters (p < 0.05 was considered significant). Results Fifty-five eyes of 39 patients with a mean age of 60.53 ± 9.70 years were included in the study. Twenty-one eyes had clear lens or pseudophakia. Twenty-six eyes had lower grades of nuclear sclerosis (NO2NC2, NO3NC3) and eight eyes had higher grades of cataract (NO4NC4, NO5NC5). The mean retinal sensitivity (RS) in BYP was 22.08 ± 5.02 (dB) and in GYP was 23.84 ± 5.50 (dB) (p = 0.08). The mean defect in BYP was -2.56 ± 4.40 (dB) and in GYP was -3.24 ± 5.05 (dB), pattern standard deviation (PSD) in BYP was 3.65 ± 1.91 (dB) and in GYP was 3.83 ± 1.99 (dB), and foveal threshold (FT) was 24.20 ± 4.32 (dB) in BYP and 28.10 ± 4.50 (dB) in GYP. The two perimeters showed good agreement by the Bland-Altman plot for all parameters. Fourteen eyes showed perimetric changes suggestive of glaucoma by BYP. In these, GYP had a sensitivity of 92.86% (95% CI of 66.13% to 99.82%) and specificity of 95.12% (95% CI of 83.47% to 99.40%). Conclusion BYP and GYP show good agreement. They are comparable in clear media as well as in different grades of nuclear sclerosis. GYP showed good sensitivity and specificity compared to BYP.
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Affiliation(s)
- Upasana Pokal
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India
| | - N Swathi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India,Correspondence to: Dr. Swathi N, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India. E-mail:
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India
| | - A Lokeshmaran
- Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India
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Saravanan S, Negiloni K, Asokan R. Assessment of knowledge, attitude, and practice of glaucoma among different cadres of optometrists. Indian J Ophthalmol 2022; 70:2014-2019. [PMID: 35647971 PMCID: PMC9359232 DOI: 10.4103/ijo.ijo_3168_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: To assess the level of knowledge, attitude, and clinical practice of glaucoma among optometry students and optometry practitioners with different years of clinical experience and academic background. Methods: A survey with 20 questions on knowledge, attitude, and practice (KAP) of glaucoma was prepared and self-administered to optometry students and optometry practitioners practicing in an eye hospital/clinic/optical with varied years of clinical experience and education qualification. Results: Among the 558 participants, 57% were optometry practitioners and 43% were students. The knowledge scores among optometry practitioners increased significantly with an increase in the years of clinical experience (P < 0.001). Participants with master’s degrees scored higher than participants with bachelor’s degrees (P = 0.12). There was no statistically significant difference in knowledge scores based on the type of clinical practice - hospital, private practice, or optical (P = 0.39). Practicing optometrists who performed slit-lamp examination, gonioscopy, IOP measurements, and disc evaluation for the detection of glaucoma had significantly higher knowledge scores than those who did not perform these tests in their practice (P < 0.05). A positive attitude toward glaucoma learning through workshops and hands-on training was reported by optometrists and students. Conclusion: Knowledge about glaucoma was good among optometrists and optometry students and was better among those who handled the diagnostics. All the optometrists had a positive attitude toward enhancing their practice through proper training.
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Affiliation(s)
- Sowmya Saravanan
- Glaucoma Projects, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Kalpa Negiloni
- Glaucoma Projects, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Rashima Asokan
- Glaucoma Projects, Medical Research Foundation, Chennai, Tamil Nadu, India
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Wang Z, Wiggs JL, Aung T, Khawaja AP, Khor CC. The genetic basis for adult onset glaucoma: Recent advances and future directions. Prog Retin Eye Res 2022; 90:101066. [PMID: 35589495 DOI: 10.1016/j.preteyeres.2022.101066] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 11/26/2022]
Abstract
Glaucoma, a diverse group of eye disorders that results in the degeneration of retinal ganglion cells, is the world's leading cause of irreversible blindness. Apart from age and ancestry, the major risk factor for glaucoma is increased intraocular pressure (IOP). In primary open-angle glaucoma (POAG), the anterior chamber angle is open but there is resistance to aqueous outflow. In primary angle-closure glaucoma (PACG), crowding of the anterior chamber angle due to anatomical alterations impede aqueous drainage through the angle. In exfoliation syndrome and exfoliation glaucoma, deposition of white flaky material throughout the anterior chamber directly interfere with aqueous outflow. Observational studies have established that there is a strong hereditable component for glaucoma onset and progression. Indeed, a succession of genome wide association studies (GWAS) that were centered upon single nucleotide polymorphisms (SNP) have yielded more than a hundred genetic markers associated with glaucoma risk. However, a shortcoming of GWAS studies is the difficulty in identifying the actual effector genes responsible for disease pathogenesis. Building on the foundation laid by GWAS studies, research groups have recently begun to perform whole exome-sequencing to evaluate the contribution of protein-changing, coding sequence genetic variants to glaucoma risk. The adoption of this technology in both large population-based studies as well as family studies are revealing the presence of novel, protein-changing genetic variants that could enrich our understanding of the pathogenesis of glaucoma. This review will cover recent advances in the genetics of primary open-angle glaucoma, primary angle-closure glaucoma and exfoliation glaucoma, which collectively make up the vast majority of all glaucoma cases in the world today. We will discuss how recent advances in research methodology have uncovered new risk genes, and how follow up biological investigations could be undertaken in order to define how the risk encoded by a genetic sequence variant comes into play in patients. We will also hypothesise how data arising from characterising these genetic variants could be utilized to predict glaucoma risk and the manner in which new therapeutic strategies might be informed.
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Affiliation(s)
- Zhenxun Wang
- Duke-NUS Medical School, Singapore; Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Tin Aung
- Duke-NUS Medical School, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Chiea Chuen Khor
- Duke-NUS Medical School, Singapore; Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
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The performance of iPad-based noise-field perimeter versus Humphrey Field Analyser in detecting glaucomatous visual field loss. Eye (Lond) 2022; 36:800-811. [PMID: 33879855 PMCID: PMC8056996 DOI: 10.1038/s41433-021-01541-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 02/28/2021] [Accepted: 04/06/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND To conduct a preliminary evaluation of the feasibility of visual field fast (VFF), a free iPad-based noise-field perimeter, in detecting glaucomatous scotomas versus the clinical-standard Humphrey visual field (HVF) test. VFF confronts subjects with a screen of flickering stimulus, allowing the immediate perception of scotomas. METHODS This was a cross-sectional observational study of 66 glaucoma patients (66 eyes) and 30 healthy controls (30 eyes). All patients had no other visual field disorders. VFF was compared against HVF in terms of whole field and quadrants for the following: (1) correspondence in scotoma detection. (2) Agreement and correlation of the scotoma size (percentage of abnormal visual field area). (3) Test duration. Other domains tested included: (1) correlation of VFF scotoma area with the severity of visual field loss on HVF (mean deviation, MD; visual field index, VFI). (2) Repeatability of VFF. (3) Patient descriptors of scotomas. RESULTS Using HVF pattern deviation plot as a reference, VFF detected 52/57 (91.2%) of glaucoma subjects with 1 false-positive (control) (kappa = 0.86). 146/184 (79.3%) of abnormal quadrants (visual field defect present) were localized and 23/157 (14.6%) healthy quadrants were falsely identified as abnormal (kappa = 0.61). VFF underestimated scotoma area as compared to HVF (21.0% versus 44.0%, p < 0.01) but correlated positively (r = 0.268, p = 0.044) with HVF area and negatively with VFI (r = -0.340, p = 0.01) and MD (r = -0.398, p < 0.01). Using HVF total deviation plot as reference, VFF's glaucoma detection rate remained unchanged (kappa = 0.86) with similar quadrant detection (kappa = 0.68). However, a greater underestimation of scotoma area was observed (21.0% versus 85.4%, p < 0.01). VFF's quantitative repeatability was excellent for whole field (intraclass correlation coefficient, ICC: 0.96; p < 0.0001) and quadrants (ICC: 0.82-0.96; all p < 0.001). Qualitatively, 35/37 (94.6%) of subjects reported reduced luminance and flicker in scotomas, with similar morphologies on retests. VFF is faster than HVF SITA-Standard in glaucoma (3.60 ± 1.85 min versus 6.92 ± 1.12 min, p < 0.01) and control (1.12 ± 0.486 min versus 5.16 ± 0.727 min, p < 0.01). CONCLUSION This early model of VFF accurately detected scotomas with high repeatability. However, its accuracy in localizing and quantifying the scotoma can be improved. Considering its portability and cost-effectiveness, VFF demonstrated potential as a general screening tool for moderate-to-severe glaucoma.
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Leung DYL, Tham CC. Normal-tension glaucoma: Current concepts and approaches-A review. Clin Exp Ophthalmol 2022; 50:247-259. [PMID: 35040248 DOI: 10.1111/ceo.14043] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/09/2022] [Accepted: 01/11/2022] [Indexed: 12/19/2022]
Abstract
Normal tension glaucoma (NTG) has remained a challenging disease. We review, from an epidemiological perspective, why we should redefine normality, act earlier at lower pre-treatment intraocular pressure (IOP) level, and the role of ocular perfusion pressures, noting that perfusion is affected by defective vascular bed autoregulation and endothelial dysfunction. The correlation of silent cerebral infarcts (SCI) and NTG may indicate that NTG belongs to a wider spectrum of small vessel diseases (SVD), with its main pathology being also on vascular endothelium. Epidemiological studies also suggested that vascular geometry, such as fractal dimension, may affect perfusion efficiency, occurrence of SCI, SVD and glaucoma. Artificial intelligence with deep learning, may help predicting NTG progression from vascular geometry. Finally, we review latest evidence on the role of minimally-invasive glaucoma surgery, lasers, and newer drugs. We conclude that IOP is not the only modifiable risk factors as, many vascular risk factors are readily modifiable.
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Affiliation(s)
- Dexter Y L Leung
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong SAR, China
- Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China
| | - Clement C Tham
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong SAR, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China
- Lam Kin Chung . Jet King-Shing Ho Glaucoma Treatment and Research Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
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Chen X, Zhong YL, Chen Q, Tao YJ, Yang WY, Niu ZQ, Zhong H, Cun Q. Knowledge of glaucoma and associated factors among primary glaucoma patients in Kunming, China. BMC Ophthalmol 2022; 22:95. [PMID: 35227222 PMCID: PMC8886968 DOI: 10.1186/s12886-022-02322-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background To investigate the level of knowledge, attitude, and practices about glaucoma and associated factors among primary glaucoma patients in Kunming, China. Methods A hospital-based study was conducted on 93 patients from the First Affiliated Hospital of Kunming Medical University. Interviewer-administered questionnaires were used to collect data after written informed consent. Data were analyzed by SPSS 19.0. Univariate and multivariate logistic regression models were used to identify factors. A Chi-square test was used to analyze the association between knowledge of glaucoma and medication compliance, Mann–Whitney U test was performed to assess the relationship between knowledge of glaucoma and quality of life in patients with glaucoma. P-value < 0.05 was considered statistically significant. Results Among 93 patients, 55 (59.14%) were aware of glaucoma, 48 (51.61%) had good knowledge of glaucoma, while 45 (48.39%) had poor knowledge. Younger age and duration of glaucoma were associated positively with knowledge of glaucoma. 87 (93.54%) patients got knowledge of their disease from doctors. 79.17% of respondents could use all the anti-glaucoma medications on time, out of which 54.17% had good knowledge of glaucoma while 25.00% had poor knowledge of glaucoma. 30.56% of respondents used to stop anti-glaucoma medications on their own out of which only 9.72% had good knowledge of glaucoma while 20.83% had poor knowledge of glaucoma. Patients with good knowledge of glaucoma had lower scores on the Glaucoma Quality of Life-15 questionnaire. Thus, the compliance to anti-glaucoma medications and glaucoma-related quality of life were better in patients with good knowledge. Conclusions The level of knowledge of glaucoma among patients in Kunming is relatively low. Improving knowledge with suitable content for patients through effective multiple means such as the mass media rather than relying only on ophthalmologists may be a veritable first step in combating blindness from glaucoma and enhancing patients' quality of life. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02322-0.
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Affiliation(s)
- Xi Chen
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, China.,Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu Province, China
| | - Yun-Long Zhong
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, China
| | - Qin Chen
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu Province, China
| | - Yi-Jin Tao
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, China
| | - Wen-Yan Yang
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, China
| | - Zhi-Qiang Niu
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, China
| | - Hua Zhong
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, China
| | - Qing Cun
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, China.
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Rewri P, Ali W. Erroneous assumption of ocular hypertension in patients with elevated intraocular pressure. Indian J Ophthalmol 2022; 70:564-568. [PMID: 35086238 PMCID: PMC9024004 DOI: 10.4103/ijo.ijo_938_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Purpose: To determine the proportion of erroneously assumed ocular hypertension (OHT) among referred patients of elevated intraocular pressure (IOP) seen in glaucoma clinic of a teaching hospital in Northern India. Methods: Retrospective review of case records of referred, diagnosed patients of OHT or unspecified glaucoma seen between January 2019 and March 2020. Using an algorithmic clinical approach, including gonioscopy, Goldmann applanation tonometry (GAT), and pachymetry, underlying cause for elevated-IOP was amended and proportion of erroneously assumed OHT was calculated. Results: Of 276 patients diagnosed either as OHT or unspecified glaucoma before being seen at our glaucoma clinic, 44 (16%) had IOP within normal range (10–21 mmHg) on GAT. In 97 (35%) cases elevated-IOP was associated with angle closure. The central corneal thickness (CCT) was >550 μm in 39 (14%) patients with elevated-IOP. The proportion of erroneously assumed OHT was 70% in this study. Conclusion: The elevated-IOP does not imply with OHT unless evident through comprehensive clinical examination and appropriate investigations.
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Affiliation(s)
- Parveen Rewri
- Glauco`ma Services, Department of Ophthalmology, Maharaja Agrasen Medical College, Agroha, Hisar, Haryana, India
| | - Wazid Ali
- Glaucoma Services, Department of Ophthalmology, Maharaja Agrasen Medical College, Agroha, Hisar, Haryana, India
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Rekha PS, Jaseena K. Agreement of gonioscopy and anterior segment-optical coherence tomography in the assessment of the anterior chamber angle: A cross-sectional study. KERALA JOURNAL OF OPHTHALMOLOGY 2022. [DOI: 10.4103/kjo.kjo_91_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Wu J, Hao J, Du Y, Cao K, Lin C, Sun R, Xie Y, Wang N. The Association between Myopia and Primary Open-Angle Glaucoma: A Systematic Review and Meta-Analysis. Ophthalmic Res 2021; 65:387-397. [PMID: 34883495 DOI: 10.1159/000520468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/25/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies identified myopia as a risk factor for primary open-angle glaucoma (POAG). However, recent studies have shown different results, the definitive relationship between myopia and POAG remains controversial. OBJECTIVES To investigate the relationship between myopia and POAG. METHODS Published articles were searched from PubMed, Embase, and Scopus databases between 1970 and 2020. A pooled analysis of the ORs was performed using a random-effects model. RESULTS Data on the association between myopia and POAG, were obtained from 16 cross sectional studies, and the pooled OR was 2.26 (95% confidence interval [CI], 1.77 - 2.89, P < 0.001) in random effects model (I2 = 86%; P < 0.01). For the relationship of myopia and POAG progression, data from seven longitudinal cohort studies were included and the pooled OR was 0.85 (95% CI, 0.73 - 0.99, P = 0.042) in the random-effects model (I2 = 88%; P < 0.01). CONCLUSION Our findings demonstrated that myopia may be a risk factor associated with POAG and a possible protective factor for POAG progression. It may due to myopia with the presence of a lamina cribrosa defect slow down the visual field loss also POAG progression, further research for underlying mechanisms is still needed.
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Affiliation(s)
- Jian Wu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
| | - Jie Hao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing, China
| | - Yifan Du
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing, China
| | - Caixia Lin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
| | - Runzhou Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
| | - Yuan Xie
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing, China
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Kumar RS, Ramgopal B, Rackenchath MV, A V SD, Mannil SS, Nagaraj S, Moe CA, Wittberg DM, O'Brien KS, Stamper RL, Keenan JD. Comparison of Structural, Functional, Tonometric, and Visual Acuity Testing for Glaucoma: A Prospective Diagnostic Accuracy Study. Ophthalmol Glaucoma 2021; 5:345-352. [PMID: 34547504 DOI: 10.1016/j.ogla.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE To determine the diagnostic accuracy of potential screening tests for moderate to advanced glaucoma. DESIGN Prospective diagnostic test accuracy study. PARTICIPANTS The study enrolled a consecutive series of patients aged ≥50 years who presented to a glaucoma clinic in South India without ever having received automated visual field testing. METHODS All participants underwent 8 index tests: OCT of the peripapillary retinal nerve fiber layer, optic disc photography, Moorfield's Motion Displacement Test (MDT), frequency doubling technique perimetry, noncontact tonometry, pneumatonometry, presenting visual acuity, and best-corrected visual acuity. Participants also underwent stereoscopic photographs and Humphrey visual fields, which were used by 2 ophthalmologists to arrive at the reference standard diagnosis of moderate to advanced glaucoma. MAIN OUTCOME MEASURES Sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. RESULTS A total of 217 people were enrolled; 321 eyes from 180 participants had all tests performed. Of these, 127 eyes (40%) were classified as having moderate to advanced glaucoma. Among the 8 tests, OCT best optimized sensitivity (84%, 95% confidence interval [CI], 76-90) and specificity (75%, 95% CI, 68-81). Moorfield's Motion Displacement Test was the best perimetric test, with a sensitivity of 91% (95% CI, 85-96) and specificity of 53% (95% CI, 44-61). Pressure and vision tests were not sensitive (e.g., sensitivity of 16%, 95% CI, 9-23 for noncontact tonometry and 23%, 95% CI, 15-31 for best-corrected visual acuity). Moorfield's Motion Displacement Test identified 16 of 127 eyes (13%) with glaucoma that were not captured by OCT, but also had false-positive results in 65 of 194 eyes (34%) without glaucoma that OCT correctly classified as negative. CONCLUSIONS OCT had moderate sensitivity and fair specificity for diagnosing moderate to advanced glaucoma and should be prioritized during an initial assessment for glaucoma.
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Affiliation(s)
- Rajesh S Kumar
- Narayana Nethralaya Eye Hospital, Bangalore, India; Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - B Ramgopal
- Narayana Nethralaya Eye Hospital, Bangalore, India
| | | | | | - Suria S Mannil
- Narayana Nethralaya Eye Hospital, Bangalore, India; Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Byers Eye Institute, Stanford University School of Medicine, Stanford, California
| | | | - Caitlin A Moe
- Francis I Proctor Foundation, University of California, San Francisco, California
| | - Dionna M Wittberg
- Francis I Proctor Foundation, University of California, San Francisco, California
| | - Kieran S O'Brien
- Francis I Proctor Foundation, University of California, San Francisco, California
| | - Robert L Stamper
- Department of Ophthalmology, University of California, San Francisco, California
| | - Jeremy D Keenan
- Francis I Proctor Foundation, University of California, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California.
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Mastropasqua L, D’Aloisio R, Mastrocola A, Perna F, Cerino L, Cerbara L, Cruciani F, Toto L. Epidemiological Surveillance of Eye Disease and People Awareness in the Abruzzo Region, Italy. MEDICINA-LITHUANIA 2021; 57:medicina57090978. [PMID: 34577901 PMCID: PMC8465192 DOI: 10.3390/medicina57090978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
Background and Objectives: Vision impairments and related blindness are major public health problems. The prevalence of eye disease and barriers to optimal care markedly vary among different geographic areas. In the Abruzzo region (central Italy), an epidemiological surveillance on the state of ocular health in the population aged over 50 years was performed in 2019. Materials and Methods: Participants were sampled to be representative of the region’s inhabitants. Data were collected through a telephone interview and an eye examination. Prevalence of cataract, glaucoma, retinopathy, and maculopathy was assessed. The Cohen’s kappa (k) was used to measure the agreement between the presence of eye disease and awareness of the disease by the participants. Results: Overall, 983 people with a mean age of 66.0 ± 9.5 years were included in the study. The prevalence of cataracts, glaucoma, maculopathy, and retinopathy was 52.6%, 5.3%, 5.6%, and 29.1%, respectively. Among the total of the affected people, those aware of their condition were 21.8% (k = 0.12, slight agreement) for cataract, 65.4% (k = 0.78, substantial agreement) for glaucoma, 7.1% (k = 0.10, slight agreement) for maculopathy, and 0% for retinopathy (k = −0.004, agreement lower than that expected by chance). Refractive defects were corrected in the vast majority of participants. Conclusion: In the Abruzzo region, about two thirds of citizens aged 50 years or over suffer from cataract, glaucoma, retinopathy, or maculopathy, which are recognized as leading causes of blindness. Many people with eye disease do not know they have it. These data can be used by clinicians and policymakers to undertake clinical, political, and social actions.
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Affiliation(s)
- Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
| | - Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
- Correspondence:
| | - Alessandra Mastrocola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
| | - Fabiana Perna
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
- Italian National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired-WHOCC, IAPB Italy Onlus-FPG IRCCS, 00185 Roma, Italy;
| | - Luca Cerino
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
| | - Loredana Cerbara
- Institute for Research on Population and Social Policies, Italian National Research Council (CNR-IRPPS), 00185 Rome, Italy;
| | - Filippo Cruciani
- Italian National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired-WHOCC, IAPB Italy Onlus-FPG IRCCS, 00185 Roma, Italy;
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
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Shah MH, Kumaran M, Chermakani P, Kader MA, Ramakrishnan R, Krishnadas SR, Devarajan B, Sundaresan P. Whole-exome sequencing identifies multiple pathogenic variants in a large South Indian family with primary open-angle glaucoma. Indian J Ophthalmol 2021; 69:2461-2468. [PMID: 34427245 PMCID: PMC8544095 DOI: 10.4103/ijo.ijo_3301_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: To identify the pathogenic variants associated with primary open-angle glaucoma (POAG) using whole-exome sequencing (WES) data of a large South Indian family. Methods: We recruited a large five-generation South Indian family (n = 84) with a positive family history of POAG (n = 19). All study participants had a comprehensive ocular evaluation. We performed WES for 16 samples (nine POAG and seven unaffected controls) since Sanger sequencing of the POAG candidate genes (MYOC, OPTN, and TBK1) showed no genetic variation. We used an in-house pipeline for prioritizing the pathogenic variants based on their segregation among the POAG individual. Results: We identified one novel and five low-frequency pathogenic variants with consistent co-segregation in all affected individuals. The variant c.G3719A in RPGR-interacting domain of RPGRIP1 that segregated heterozygously with the six POAG cases is distinct from variants causing photoreceptor dystrophies, reported affecting the RPGR protein complex signaling in primary cilia. The cilia in trabecular meshwork (TM) cells has been reported to mediate the intraocular pressure (IOP) sensation. Furthermore, we identified a novel c.A1295G variant in Rho guanine nucleotide exchange factors Gene 40 (ARHGEF40) and a likely pathogenic variant in the RPGR gene, suggesting that they may alter the RhoA activity essential for IOP regulation. Conclusion: Our study supports that low-frequency pathogenic variants in multiple genes and pathways probably affect Primary Open Angle Glaucoma’s pathogenesis in the large South Indian family. Furthermore, it requires larger case-controls to perform family-based association tests and to strengthen our analysis.
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Affiliation(s)
- Mohd Hussain Shah
- Department of Genetics, Aravind Medical Research Foundation, Madurai, India
| | - Manojkumar Kumaran
- Department of Bioinformatics, Aravind Medical Research Foundation, Madurai; School of Chemical and Biotechnology, SASTRA (Deemed to be University), Thanjavur, India
| | - Prakash Chermakani
- Department of Genetics, Aravind Medical Research Foundation; Department of Molecular Biology, Alagappa University, Karaikudi, Tamil Nadu, India
| | | | - R Ramakrishnan
- Glaucoma Clinic, Aravind Eye Hospital, Tirunelveli, India
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Zhang N, Wang J, Li Y, Jiang B. Prevalence of primary open angle glaucoma in the last 20 years: a meta-analysis and systematic review. Sci Rep 2021; 11:13762. [PMID: 34215769 PMCID: PMC8253788 DOI: 10.1038/s41598-021-92971-w] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/19/2021] [Indexed: 12/16/2022] Open
Abstract
Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness in the world and is influenced by various sociodemographic factors. This meta-analysis aims to determine the worldwide prevalence of POAG in the adult general population for the last 20 years, and explore variation in prevalence by age, gender and geographical location. An electronic literature search was performed using the PubMed, Embase, and Web of Science databases. Population-based cross-sectional or cohort studies published in the last 20 years (2000–2020) that reported prevalence of POAG were recruited. Relevant studies meeting defined eligibility criteria were selected and reviewed systematically by meta-analysis. The prevalence of POAG was analyzed according to various risk factors. A random effect model was used for the meta-analysis. Fifty publications with a total of 198,259 subjects were included in this meta-analysis. The worldwide overall prevalence of POAG was 2.4% (95% CI 2.0 ~ 2.8%). The prevalence increases with age. Men are found to be more susceptible to POAG than women (RR 1.28, p < 0.01). Africa is found to have the highest prevalence of POAG (4.0%) among all continents. The current estimated global population of POAG is 68.56 million (95% CI 59.99 ~ 79.98). POAG is a worldwide vision threatening disease with high prevalence for the last 20 years. The population-based prevalence of POAG varies widely across individual studies, due to variations in risk factors of age, gender, and population geographic location.
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Affiliation(s)
- Nan Zhang
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Jiaxing Wang
- Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Ying Li
- Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Bing Jiang
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China. .,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China.
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Alqahtani SM, Bakarman MA, Almanjoumi A, Alzahrani SH. Awareness and knowledge about glaucoma among patients visiting the screening clinic in Jeddah Eye Hospital, Saudi Arabia. Int J Ophthalmol 2021; 14:887-895. [PMID: 34150545 DOI: 10.18240/ijo.2021.06.15] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 06/10/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To explore levels and determinants of awareness and knowledge about glaucoma among patients. METHODS This was a cross-sectional study that included adult patients from October to the end of December 2018. A semi-structured questionnaire was designed by the researchers to measure the levels of awareness and knowledge about 18 basic information about glaucoma. The sheet was divided into 4 domains: types of glaucoma, risk factors, clinical features, and management. A knowledge score (KS, range=0-18) was calculated, with higher scores indicating higher levels. RESULTS A total of 383 patients responded to the questionnaire, 61.9% males, mean±SD age was 38.5±12.94 years old, and 61.6% had a university degree or higher. Of them, 6.3% and 23.2% reported personal and family history of glaucoma, respectively. The most frequently reported source of information about glaucoma was another person with glaucoma (28.2%), followed by physicians (24.8%) and TV (19.6%). Knowledge by item ranged from 3.1% to 82.5% correctness rate, while KS showed mean=5.91 and median=5; and reliability testing of the knowledge scale showed Cronbach's alpha=0.782. Higher KS were found among respondents with higher educational level (P=0.036), diabetes history (P=0.025), and personal (P<0.001) and family (P<0.001) history of glaucoma. CONCLUSION This study reveals low awareness and knowledge levels about glaucoma among the attendees of a local eye care hospital, where several misconceptions about disease risk factors, clinical features, and management are identified.
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Affiliation(s)
| | - Marwan A Bakarman
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdul Aziz University, Jeddah 21589, Saudi Arabia
| | - Ahmed Almanjoumi
- Ophthalmology Department, Faculty of Medicine, King Abdulaziz University, Jeddah 22234, Saudi Arabia
| | - Sami H Alzahrani
- Family Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah 22431, Saudi Arabia
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Bhuiyan A, Govindaiah A, Smith RT. An Artificial-Intelligence- and Telemedicine-Based Screening Tool to Identify Glaucoma Suspects from Color Fundus Imaging. J Ophthalmol 2021; 2021:6694784. [PMID: 34136281 PMCID: PMC8179760 DOI: 10.1155/2021/6694784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/11/2021] [Indexed: 10/26/2022] Open
Abstract
RESULTS The system achieved an accuracy of 89.67% (sensitivity, 83.33%; specificity, 93.89%; and AUC, 0.93). For external validation, the Retinal Fundus Image Database for Glaucoma Analysis dataset, which has 638 gradable quality images, was used. Here, the model achieved an accuracy of 83.54% (sensitivity, 80.11%; specificity, 84.96%; and AUC, 0.85). CONCLUSIONS Having demonstrated an accurate and fully automated glaucoma-suspect screening system that can be deployed on telemedicine platforms, we plan prospective trials to determine the feasibility of the system in primary-care settings.
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Affiliation(s)
- Alauddin Bhuiyan
- iHealthscreen Inc., New York, NY, USA
- New York Eye and Ear Infirmary, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - R. Theodore Smith
- New York Eye and Ear Infirmary, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Sharma R, Sharma A. Corneal anthropology: Ethnicity-based central corneal thickness measurements in managing corneal disorders. Indian J Ophthalmol 2021; 69:1338. [PMID: 33913899 PMCID: PMC8186617 DOI: 10.4103/ijo.ijo_385_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Kalyani VK, Bharucha KM, Goyal N, Deshpande MM. Comparison of diagnostic ability of standard automated perimetry, short wavelength automated perimetry, retinal nerve fiber layer thickness analysis and ganglion cell layer thickness analysis in early detection of glaucoma. Indian J Ophthalmol 2021; 69:1108-1112. [PMID: 33913843 PMCID: PMC8186634 DOI: 10.4103/ijo.ijo_2409_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose: The aim of this study was to compare the diagnostic ability of macular ganglion cell layer (GCL) analysis using spectral domain optical coherence tomography against retinal nerve fiber layer analysis (RNFL), short-wavelength automated perimetry (SWAP), and standard automated perimetry (SAP) in early detection of glaucoma. Methods: Participants fulfilling the inclusion criteria were consecutively enrolled from the glaucoma clinic of tertiary care eye hospital in Western India from November 2015 to October 2016. The subjects underwent a detailed evaluation by trained glaucoma specialists. On suspicion of glaucoma, the patients underwent SAP, SWAP, and SD-OCT for GCL and RNFL analysis. Results: There were 91 patients in total of which experts classified 54 eyes into GON and 37 eyes into nonglaucomatous group. Sensitivity of SAP (42.59%) was significantly lower (P < 0.05) than that of average GCL thickness (79.63%) and average RNFL thickness (72.22%). Specificity and positive LR of SWAP (97.3% and 19.19, respectively) and SAP (94.6% and 7.88, respectively) were greater than those of GCL (81.08% and 4.21) and RNFL (67.57% and 2.23) parameters. Negative LR of average GCL thickness (0.25) was superior to that of average RNFL thickness (0.411), SWAP (0.495), and SAP (0.607). Conclusion: Macular GCL parameters perform better than RNFL parameters in patients with early glaucomatous damage. There is superior ability of SWAP over SAP in detecting glaucomatous changes in glaucoma suspect group. GCL thickness analysis has higher sensitivity and negative likelihood ratio, whereas SWAP had higher specificity and positive likelihood ratio. Thus, combining both tests can lead to better diagnostic ability for early glaucomatous damage.
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Affiliation(s)
- V Ks Kalyani
- PBMA's H.V. Desai Eye Hospital, Pune, Maharashtra, India
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Visual field-based grading of disease severity in newly diagnosed primary open angle glaucoma patients presenting to a tertiary eye care centre in India. Int Ophthalmol 2021; 41:3135-3143. [PMID: 33966145 DOI: 10.1007/s10792-021-01878-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/22/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the severity of primary open angle glaucoma (POAG) at presentation using visual field analysis and its relationship to demographic and ocular factors in patients presenting to a tertiary eye care centre. DESIGN Cross-sectional study. METHODS Newly diagnosed POAG patients were classified as early, moderate, or severe stage in the worse eye based on the Humphrey visual field testing using Hodapp-Parrish-Andersons criteria. The groups were compared for differences in demographics and ocular characteristics. Statistical analysis was done using STATA 14.1 (Texas, USA). RESULTS The average age of 71 eligible patients was 60.04 ± 9.53 years, and the cohort had 29.5% females. Among the subjects, 19 (26.7%) had early, 24 (33.3%) had moderate and 28 (38.89%) had severe POAG at presentation. There was no statistically significant difference among different stages of glaucoma with respect to age and sex groups. No statistical association was found with education, occupation status, presenting complaints, family history of glaucoma, or systemic diseases between the different stages of severity. 5.6% with severe disease presented with a relative afferent pupillary defect (RAPD). The mean intraocular pressure (IOP) in the severe stage was 22.54 ± 5.27 mmHg, which was not statistically higher than the other groups (P = 0.726). CONCLUSIONS Newly diagnosed POAG patients predominantly present at moderate or severe stage of disease, reflecting either the asymptomatic nature of the disease or a lack of access to vision care services. Existing screening programmes need to be improved, with special attention to women and individuals less than 50 years of age.
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Da Soh Z, Yu M, Betzler BK, Majithia S, Thakur S, Tham YC, Wong TY, Aung T, Friedman DS, Cheng CY. The Global Extent of Undetected Glaucoma in Adults: A Systematic Review and Meta-analysis. Ophthalmology 2021; 128:1393-1404. [PMID: 33865875 DOI: 10.1016/j.ophtha.2021.04.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 01/30/2023] Open
Abstract
TOPIC Glaucoma is the leading cause of irreversible blindness, despite having good prognosis with early treatment. We evaluated the global extent of undetected glaucoma and the factors associated with it in this systematic review and meta-analysis. CLINICAL RELEVANCE Undetected glaucoma increases the risk of vision impairment, which leads to detrimental effects on the quality-of-life and socioeconomic well-being of those affected. Detailed information on the extent and factors associated with undetected glaucoma aid in the development of public health interventions. METHODS We conducted a systematic review and meta-analysis of population-based studies published between January 1, 1990, and June 1, 2020. Article search was conducted in online databases (PubMED, Web-of-Science), grey literatures (OpenGrey), and nongovernment organization reports. Our outcome measure was the proportion of glaucoma cases that were undetected previously. Manifest glaucoma included any form of glaucoma reported in the original studies and may include primary open-angle glaucoma (POAG), primary angle-closure-glaucoma, secondary glaucoma, or a combination thereof. Undetected glaucoma was defined as glaucoma cases that were undetected prior to diagnosis in the respective study. Random-effect meta-analysis was used to estimate the pooled proportion of undetected glaucoma. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology guidelines in our study. RESULTS We identified 61 articles from 55 population-based studies (n = 189 359 participants; n = 6949 manifest glaucoma). Globally, more than half of all glaucoma cases were undetected previously on average in each geographical region. Africa (odds ratio [OR], 12.70; 95% confidence interval [CI], 4.91-32.86) and Asia (OR, 3.41; 95% CI, 1.63-7.16) showed higher odds of undetected glaucoma as compared with Europe. Countries with low Human Development Index (HDI; <0.55) showed a higher proportion of undetected manifest glaucoma as compared with countries of medium to very high HDI (≥0.55; all P < 0.001). In 2020, 43.78 million POAG cases were projected to be undetected, of which 76.7% were in Africa and Asia. DISCUSSION Undetected glaucoma is highly prevalent across diverse communities worldwide and more common in Africa and Asia. Strategies to improve detection are needed to prevent excess visual disability and blindness resulting from glaucoma.
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Affiliation(s)
- Zhi Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Marco Yu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Bjorn Kaijun Betzler
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Republic of Singapore
| | - David S Friedman
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Republic of Singapore.
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Ramesh SV, George R, Raju P, Sachi D, Sunil G, Vijaya L. Perimetric severity in hospital‐based and population‐based glaucoma patients. Clin Exp Optom 2021; 93:349-53. [DOI: 10.1111/j.1444-0938.2010.00505.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- S Ve Ramesh
- Glaucoma Project, Vision Research Foundation, Sankara Nethralaya, Chennai, India
E‐mail:
| | - Ronnie George
- Glaucoma Project, Vision Research Foundation, Sankara Nethralaya, Chennai, India
E‐mail:
| | - Prema Raju
- Glaucoma Project, Vision Research Foundation, Sankara Nethralaya, Chennai, India
E‐mail:
| | - Devi Sachi
- Glaucoma Project, Vision Research Foundation, Sankara Nethralaya, Chennai, India
E‐mail:
| | - Gt Sunil
- Glaucoma Project, Vision Research Foundation, Sankara Nethralaya, Chennai, India
E‐mail:
| | - Lingam Vijaya
- Glaucoma Project, Vision Research Foundation, Sankara Nethralaya, Chennai, India
E‐mail:
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Venkataraman P, Chandran P, Faheem M, Arunaachalam V, Aboobacker N, Raman GV. Assessment of glaucoma referral letter for quality and accuracy among patients referred to a tertiary eye care center. Indian J Ophthalmol 2021; 68:471-474. [PMID: 32057005 PMCID: PMC7043183 DOI: 10.4103/ijo.ijo_914_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose: To assess the quality and accuracy of glaucoma referrals from ophthalmologist. Methods: Retrospective review of patients chart with referral letter to a tertiary glaucoma center between January and December 2017. Patients aged <16 years, lens-induced glaucoma, uveitic glaucoma, and glaucoma following retinal and corneal surgery were excluded. Results: A total of 184 patients referred by 55 ophthalmologists were included. Mean patient age (SD) was 57.8 ± 14 years. Intraocular pressure was not documented in the referral letter in 113 (61%) patients, gonioscopy in 174 (95%) patients, disc findings in 149 (81%) patients, and visual fields in 175 (95%) patients. Thirteen (37%) of the 35 patients referred as open angle glaucoma were found to have angle closure glaucoma. Pseudoexfoliation glaucoma was diagnosed in 29 (16%) patients, of which 18 were missed by the referring ophthalmologist. Conclusion: In our study >90% of referral letter did not have the essential parameters. A standard template for glaucoma referral is suggested, which will help the patient to get better transfer of care.
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Affiliation(s)
| | - Premanand Chandran
- Department of Glaucoma, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | - Mohamed Faheem
- Department of Glaucoma, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | | | - Nabeed Aboobacker
- Department of Glaucoma, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | - Ganesh V Raman
- Department of Glaucoma, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
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Sun HY, Luo CW, Chiang YW, Li KLYYC, Ho YC, Lee SS, Chen WY, Chen CJ, Kuan YH. Association Between PM 2.5 Exposure Level and Primary Open-Angle Glaucoma in Taiwanese Adults: A Nested Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041714. [PMID: 33578928 PMCID: PMC7916685 DOI: 10.3390/ijerph18041714] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 12/18/2022]
Abstract
Primary open-angle glaucoma (POAG) is the most common type of glaucoma. However, little is known about POAG in adults and exposure to air pollution. The current study aims to investigate whether exposure to particulate matter with a mass median aerodynamic diameter of ≤2.5 μm (PM2.5) is associated with POAG diagnosis. Patient data were obtained from the Longitudinal Health Insurance Database 2010 (LHID2010) of Taiwan for the 2008–2013 period. PM2.5 concentration data, collected from the Ambient Air Quality Monitoring Network established by the Environmental Protection Administration of Taiwan, were categorized into four groups according to World Health Organization (WHO) exposure standards for PM2.5. We estimated the odds ratios (ORs) and 95% CIs for risk factors for POAG with logistic regression. The OR of per WHO standard level increase was 1.193 (95% CI 1.050–1.356). Compared with the normal level, the OR of WHO 2.0 level was 1.668 (95% CI 1.045–2.663, P < 0.05). After excluding confounding risk factors for POAG in this study, we determined that increased PM2.5 exposure is related to POAG risk (ORs > 1, P < 0.05). In this study, PM2.5 was an independent factor associated with open-angle glaucoma. Further research is required to better understand the mechanisms connecting PM2.5 and open-angle glaucoma.
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Affiliation(s)
- Han-Yin Sun
- Department of Optometry, Chung Shan Medical University, Taichung 40201, Taiwan;
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Ci-Wen Luo
- Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-W.L.)
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Yun-Wei Chiang
- Department of life sciences, National Chung-Hsing University, Taichung 402204, Taiwan;
| | - Kun-Lin Yeh Yi-Ching Li
- Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-W.L.)
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Department of Veterinary Medicine, National Chung Hsing University, Taichung 402204, Taiwan;
| | - Yung-Chung Ho
- School of Medical Applied Chemistry, Chung Shan Medical University, Taichung 40201, Taiwan;
| | - Shiuan-Shinn Lee
- School of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan;
| | - Wen-Ying Chen
- Department of Veterinary Medicine, National Chung Hsing University, Taichung 402204, Taiwan;
| | - Chun-Jung Chen
- Department of Education and Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Yu-Hsiang Kuan
- Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-W.L.)
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Correspondence: ; Tel.: +886-4-24730022
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Sesar I, Pušić-Sesar A, Jurišić D, Sesar A, Merdžo I, Ćavar I. HEALTH-RELATED QUALITY OF LIFE IN PRIMARY OPEN-ANGLE GLAUCOMA PATIENTS. Acta Clin Croat 2020; 59:623-631. [PMID: 34285433 PMCID: PMC8253074 DOI: 10.20471/acc.2020.59.04.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 11/29/2020] [Indexed: 11/28/2022] Open
Abstract
The purpose of this research was to evaluate the relationship between general health-related quality of life (GHRQL) and sociodemographic factors in primary open-angle glaucoma (POAG) patients. A prospective cross-sectional study included 207 glaucoma patients. GHRQL was determined via two self-administered questionnaires: the 36-Item Short Form Survey (SF-36) and the EuroQol-5D (EQ-5D) questionnaire. Male and 50- to 69-year-old glaucoma patients, followed by patients who regularly used antiglaucoma therapy and those without progression of glaucoma reported a significantly higher quality of life as measured by the EQ-5D index and the EQ-5D visual analog scale (VAS) (p<0.05 all). Similarly, the Physical Component Summary (PCS) and Mental Component Summary (MCS) of SF-36 had significantly higher values for these patients (p<0.05 all). Furthermore, glaucoma patients with higher education and economic status, glaucoma patients who lived in rural areas, and those who were married achieved higher scores on EQ-5D and SF-36. In conclusion, progression of the disease, female sex, older age, lower education and economic status, urban area and unmarried status negatively affect quality of life in glaucoma patients.
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Affiliation(s)
| | - Anita Pušić-Sesar
- 1Department of Ophthalmology, Mostar University Hospital, Mostar, Bosnia and Herzegovina; 2Department of Physiology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Darija Jurišić
- 1Department of Ophthalmology, Mostar University Hospital, Mostar, Bosnia and Herzegovina; 2Department of Physiology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Antonio Sesar
- 1Department of Ophthalmology, Mostar University Hospital, Mostar, Bosnia and Herzegovina; 2Department of Physiology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Ivan Merdžo
- 1Department of Ophthalmology, Mostar University Hospital, Mostar, Bosnia and Herzegovina; 2Department of Physiology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Ivan Ćavar
- 1Department of Ophthalmology, Mostar University Hospital, Mostar, Bosnia and Herzegovina; 2Department of Physiology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
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Paul C, Sengupta S, Banerjee S, Choudhury S. Open-angle glaucoma in a rural and urban population in Eastern India-the Hooghly river glaucoma study. Indian J Ophthalmol 2020; 68:371-374. [PMID: 31957731 PMCID: PMC7003608 DOI: 10.4103/ijo.ijo_836_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose Glaucoma is the leading cause of irreversible blindness in the world. The current study aims to estimate prevalence, features, and associations of open angle glaucoma (OAG) in a rural and urban East Indian population. Methods This is a population based cross sectional study with two arms, rural (28 contiguous villages from 13 Gram Panchayats in Balagarh Police Station, Hooghly district) and urban (Kolkata). Individuals residing in the study area aged 40 years and above were included using multistage random cluster sampling. All subjects underwent a detailed ophthalmic examination at our base hospitals including applanation tonometry, ultrasound pachymetry, gonioscopy, and frequency doubling technology perimetry. The primary outcome was the prevalence of POAG (95% CI). Age and gender specific prevalence estimates were calculated. Multiple logistic regressions were used to analyze the risk factors. Results Data from 7128 and 6964 subjects aged 40 years or older from Kolkata city and Hooghly district, respectively were analyzed. In the urban population, 2.10% (95% CI: 1.99-2.21%) had POAG and 0.15% (95% CI: 0.13-0.17%) had secondary OAG. In the rural population, 1.45% (95% CI: 0.59-2.31%) had POAG and 0.10 ± 0.03% (95% CI: 0.07-0.13%) had secondary OAG. Conclusion The study concludes that higher age, higher vertical cup disc ratio (VCDR), and lower central corneal thickness (CCT) are important independent predictors of OAG and emphasizes that increased intraocular pressure (IOP) is not POAG. Gonioscopy, disc evaluation, and screening perimetry need to be incorporated in the detection protocol for glaucoma if we intend to lighten the burden of blindness due to glaucoma.
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