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Mikki N, McCormick I, Mactaggart I. Prevalence of vision impairment, diabetic retinopathy and disability in adults 50+ in the occupied Palestinian territories. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003613. [PMID: 39325759 PMCID: PMC11426490 DOI: 10.1371/journal.pgph.0003613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/24/2024] [Indexed: 09/28/2024]
Abstract
The Rapid Assessment of Avoidable Blindness methodology is a population-based survey of vision impairment among the population 50 and above, with optional modules on diabetes, diabetic retinopathy and disability. The first Rapid Assessment of Avoidable Blindness study in the occupied Palestinian territories (oPt) was conducted in 2008. Prevalence of blindness (50+) was 3.4%. 80% of blindness was avoidable. Between July 2018 and April 2019, we completed a nationally-representative follow up survey in oPt using the Rapid Assessment of Avoidable Blindness methodology including the optional modules. We tested distance visual acuity (presenting and pinhole) using a bespoke mobile data collection application. 4223 Palestinians aged 50 years and above were enumerated, of whom 3847 participated (response rate 91.1%). Prevalence of any vision impairment (presenting vision impairment <6/12 in the better seeing eye), blindness (<3/60), severe vision impairment (<6/60 but ≥3/60), moderate vision impairment (<6/18 but ≥6/60) and mild vision impairment (<6/12 but ≥6/18) were 25.8% (95% confidence interval [CI] 23.8-27.8%), 2.6% (1.9-3.2%), 1.4% (1.0-1.8%), 10.2% (9.1-11.2%) and 11.6% (10.3-12.8%), respectively. Avoidable causes of poor vision accounted for 82.4% of blindness, 83.3% of severe vision impairment, 82.0% of moderate vision impairment and 90.2% of mild vision impairment. Diabetes prevalence (reported or suspected based on random blood glucose ≥200 milligrams/decilitre) was 33.8% (32.1-35.5). Half of diabetes participants had diabetic retinopathy and/or maculopathy. Prevalence of disability (reported functional limitations) was 23.8% (21.0-26.5), and higher in women than men. The prevalence of vision impairment and blindness in oPt compared with 2008 was similar. Prevalence of diabetes, diabetic retinopathy and disability were all high, highlighting key areas for public health prioritization among older adults in oPt.
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Affiliation(s)
- Nahed Mikki
- St. John of Jerusalem Eye Hospital Group, East Jerusalem, Palestine
| | - Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, England
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, England
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2
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Zhang XY, Han C, Yao Y, Wei TT. Current Insights on Mitochondria-Associated Endoplasmic Reticulum Membranes (MAMs) and their significance in the pathophysiology of ocular disorders. Exp Eye Res 2024:110110. [PMID: 39326773 DOI: 10.1016/j.exer.2024.110110] [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: 06/20/2024] [Revised: 09/19/2024] [Accepted: 09/23/2024] [Indexed: 09/28/2024]
Abstract
The intricate interaction network necessary for essential physiological functions underscores the interdependence among eukaryotic cells. Mitochondria-Associated Endoplasmic Reticulum Membranes (MAMs), specialized junctions between mitochondria and the ER, were recently discovered. These junctions participate in various cellular processes, including calcium level regulation, lipid metabolism, mitochondrial integrity maintenance, autophagy, and inflammatory responses via modulating the structure and molecular composition of various cellular components. Therefore, MAMs contribute to the pathophysiology of numerous ocular disorders, including Diabetic Retinopathy (DR), Age-related Macular Degeneration (AMD) and glaucoma. In addition to providing a concise overview of the architectural and functional aspects of MAMs, this review explores the key pathogenetic pathways involving MAMs in the development of several ocular disorders.
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Affiliation(s)
- Xin-Yu Zhang
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Cheng Han
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Yong Yao
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.
| | - Ting-Ting Wei
- Center of Clinical Research, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.
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Soszka-Przepiera E, Krzyścin M, Modrzejewska M. Visual Impairment in Women with Turner Syndrome-A 49-Year Literature Review. J Clin Med 2024; 13:5451. [PMID: 39336938 PMCID: PMC11432107 DOI: 10.3390/jcm13185451] [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: 06/02/2024] [Revised: 08/11/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024] Open
Abstract
Aim: Among the severe organ complications occurring in patients with Turner syndrome (TS), ophthalmic dysmorphia and visual impairment are usually marginalized. There are only a few studies that take into account the prevalence of ophthalmic disorders in female patients with TS. Material and methods: Articles in PubMed, Scholar, and Website were reviewed, considering the prevalence of various ocular disorders in patients with X chromosome deficiency. Current standards for the management of patients with TS in the context of the prevalence of ophthalmic disorders were also analyzed. Results: Identification of visual impairment in people is important because it significantly impairs quality of life (QoL) along with other health problems. QoL affects cognitive and behavioral functioning and significantly increases self-esteem, acceptance of treatment, and, consequently, physical and mental health. Low self-esteem makes patients feel helpless and unable to plan their social development. Patients with TS are relatively more frequently diagnosed with various eye defects compared to the healthy population. Therefore, special attention should be paid to the early assessment of the visual system in people with TS to eliminate any factors that could potentially impair their QoL. Conclusions: Patients with TS should be referred to specialist ophthalmologists, pediatricians, or optometrists for preventive care or early treatment of visual impairment. The authors point out the need for comprehensive ophthalmological examinations as standard management in patients with TS.
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Affiliation(s)
- Ewelina Soszka-Przepiera
- II Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
| | - Mariola Krzyścin
- Pediatric, Adolescent Gynecology Clinic, Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Monika Modrzejewska
- II Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
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Pablo L, Garay-Aramburu G, García Layana A, Fernandez A, Vázquez I, Acebes X, Zulueta J, Balonga D, Salinas-Ortega L, Muñoz Á, Casado Gómez A, Casado MÁ, Salvador J, Bañón-Rodriguez I, Ruíz-Moreno JM. Assessing the economic burden of vision loss and irreversible legal blindness in Spain (2021-2030): a societal perspective. HEALTH ECONOMICS REVIEW 2024; 14:70. [PMID: 39225974 PMCID: PMC11370269 DOI: 10.1186/s13561-024-00546-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE To estimate the economic impact for the society, generated as a consequence of the onset of loss of vision and irreversible legal blindness, for the main ophthalmologic diseases in Spain: glaucoma, diabetic retinopathy (DR), diabetic macular edema (DME), age-related macular degeneration (AMD) and high myopia (HM). METHODS A cost analysis model was developed to estimate the economic burden of glaucoma, DR, DME, AMD and HM over a 10-year time horizon (2021-2030), from a societal perspective in Spain. The epidemiological and economic parameters used in the model were obtained through a literature review. Prevalence, incidence, and progression stages were used to establish the epidemiological flows. Annual costs per patient from publications were included and classified into direct healthcare, direct non-healthcare and indirect costs. Costs from other countries were converted based on purchasing-power-parity (€EUR, PPP). Epidemiological parameters about population and cost results were validated by a panel of experts. All costs were adjusted to euros, 2021 (€, 2021), and using the Consumer Price Index (CPI) of the last 10 years, extrapolated to 2030 euros (€, 2030). RESULTS It was estimated that the total population of patients with the main diseases pathologies (glaucoma, DR, DME, AMD and HM) will increase to 7.99 million patients by 2030, representing an increase of 103%. The total cost by 2030 of all pathologies would amount to 99.8 billion euros. Direct non-healthcare costs account for the largest item (44%), followed by loss of productivity costs (38%), and direct healthcare costs (18%). The pathologies with the highest cumulative costs will be glaucoma (€33.6 billion) and DME (€19.8 billion).The greatest increment costs compared to 2021 will likely be generated by pathologies related to diabetes mellitus, such as DR (703%) and DME (317%). CONCLUSIONS Knowing the costs associated with the pathologies that generate loss of vision and irreversible legal blindness is essential to understand the socioeconomic impact associated with these pathologies. Furthermore, the high cost of treating these diseases makes necessary to coordinate efforts between administrations, together with the support of patient associations, to meet their needs.
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Affiliation(s)
- Luis Pablo
- Ophthalmology Department, University Hospital Miguel Servet, Zaragoza, Spain
| | | | | | - Anxo Fernandez
- Pharmacy Department, SERGAS) and Pharmacology Group, University Clinical Hospital of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), 15706, Santiago de Compostela, Spain
| | | | - Xenia Acebes
- Ophthalmology Department. Assistance Services Area, CATSALUT, Barcelona, Spain
| | | | - Delfina Balonga
- Glaucoma Association of Sufferers and relatives, Madrid, Spain
| | - Laura Salinas-Ortega
- Pharmacoeconomics & Outcomes Research Iberia S. L, Paseo Joaquín Rodrigo 4- letra I, Pozuelo de Alarcón, 28224, Madrid, Spain.
| | - Álvaro Muñoz
- Pharmacoeconomics & Outcomes Research Iberia S. L, Paseo Joaquín Rodrigo 4- letra I, Pozuelo de Alarcón, 28224, Madrid, Spain
| | - Araceli Casado Gómez
- Pharmacoeconomics & Outcomes Research Iberia S. L, Paseo Joaquín Rodrigo 4- letra I, Pozuelo de Alarcón, 28224, Madrid, Spain
| | - Miguel Ángel Casado
- Pharmacoeconomics & Outcomes Research Iberia S. L, Paseo Joaquín Rodrigo 4- letra I, Pozuelo de Alarcón, 28224, Madrid, Spain
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Palencia-Florez DC, Oviedo-Cáceres MP, Giraldo Gallo EA. Cross - cultural adaptation of the Low Vision Quality of life scale. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024:S2173-5794(24)00142-7. [PMID: 39181185 DOI: 10.1016/j.oftale.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 06/16/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION The quality of life related to visual function is a multidimensional construct that complements the functional assessment of patients with low vision. It shows the individual's perception of the course of ocular disease and its treatment within the framework of a value system and a sociocultural context. This clinical-epidemiological outcome is recognized as objective and valuable. METHODOLOGY A content validation study was conducted, which involved translating and back-translating the scale to evaluate semantic, idiomatic, conceptual, and experiential equivalence in the resulting version. The study included the participation of 21 individuals, and a quantitative evaluation was performed using Aiken's V coefficient to analyze the scores assigned in the categories of relevance and experiential capacity. RESULTS The questionnaire presentation was reorganized. The examples were expanded, and some optical aids were mentioned. Additionally, terms were changed to improve comprehension and reduce rudeness. Out of the 25 items, 11 had an Aiken V coefficient of less than 1.0. CONCLUSIONS The obtained version is comparable to the original questionnaire. However, the idiomatic twists specific to the local context emphasize the need for content validation to ensure correct interpretation and contribute to the updating of the scale.
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Affiliation(s)
- D C Palencia-Florez
- Magíster en Epidemiología, Estudiante de Doctorado en Epidemiología y Bioestadística de la Universidad CES, Escuela de Graduados, Grupo de Investigación en Epidemiología y Bioestadística, Medellín, Colombia.
| | - M P Oviedo-Cáceres
- Grupo de Investigación GIESVI, Docente Universidad Santo Tomás, Bucaramanga, Colombia
| | - E A Giraldo Gallo
- Grupo de Investigación en Epidemiología y Bioestadística, Docente Universidad CES, Medellín, Colombia
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Chan VF, Fernandes Martins M, Juma Othman O, Yong AC, Mulewa D, Graham C, Price-Sanchez C, Graham R, Farmer A, Mashayo E, Omar F. Subjective Wellbeing, Work Performance and Lived Experience of Zanzibari Women Entrepreneurs with Uncorrected Functional Presbyopia: A Pre-Post Mixed-Methods Study. Ophthalmic Epidemiol 2024; 31:333-341. [PMID: 37933957 PMCID: PMC11229787 DOI: 10.1080/09286586.2023.2279102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE Uncorrected presbyopia has been shown to reduce Zanzibari women's quality of life. In this mixed-methods study, we examined the subjective wellbeing and self-reported work performance among older women entrepreneurs with functional presbyopia before and shortly after correction, and how poor vision at close distance affected their daily lives. METHODS Women entrepreneurs underwent eye examination to identify those with uncorrected functional presbyopia. Their subjective wellbeing and work performance were both measured in Cantril's ladder. Ready-made glasses were then provided and 30 minutes to an hour later, their subjective wellbeing and work performance was remeasured. Twenty women entrepreneurs were interviewed to understand their lived experience with uncorrected presbyopia. RESULTS Two-hundred-seventeen women entrepreneurs were included in the survey (mean age 51.6 years, SD 8.64). Women entrepreneurs had a mean subjective wellbeing score of 3.32 (SD 1.10) pre-correction and 5.99 (SD 1.13) post-correction (p < .001), and a mean self-rated current work performance score of 4.62 (SD 1.36) before correction and 5.47 (SD 1.35) post-correction (p < .001). One-hundred-and-ninety (87.6%) and 121 women entrepreneurs (55.8%) rated their current subjective wellbeing and work performance scores < 5, respectively. Around 1/4 of women entrepreneurs reported having severe difficulties with near tasks. CONCLUSION Poor vision at a close distance caused by uncorrected functional presbyopia negatively affected economic, physical and psychosocial aspects of women entrepreneurs' lives. Subjective wellbeing and self-reported work productivity scores improved significantly shortly after presbyopia was corrected. More research with longer follow-up is needed to understand the full benefits of correcting presbyopia.
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Affiliation(s)
- Ving Fai Chan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern, Ireland, UK
- Programmes Department, Vision Aid Overseas, London, UK
- College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Michelle Fernandes Martins
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern, Ireland, UK
| | - Omar Juma Othman
- Department of Primary Eye Care Unit, Ministry of Health, Zanzibar, Tanzania
| | - Ai Chee Yong
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern, Ireland, UK
| | | | - Christine Graham
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern, Ireland, UK
| | - Carlos Price-Sanchez
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern, Ireland, UK
| | - Ronnie Graham
- Programmes Department, Vision Aid Overseas, London, UK
| | - Adrianna Farmer
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern, Ireland, UK
| | - Eden Mashayo
- Research Department, Vision Care Foundation, Dar-es-Salaam, Tanzania
| | - Fatma Omar
- Department of Primary Eye Care Unit, Ministry of Health, Zanzibar, Tanzania
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Kong K, Ding X, Wang Y, Xu S, Li G, Wang X, Zhang M, Ni Y, Xu G. Circular RNA expression profile and functional analysis of circUvrag in light-induced photoreceptor degeneration. Clin Exp Ophthalmol 2024; 52:558-575. [PMID: 38282307 DOI: 10.1111/ceo.14355] [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: 04/01/2023] [Revised: 11/18/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Circular RNAs (circRNAs) are implicated in retinal pathophysiology; however, their expression profiles and functions in photoreceptor apoptosis are largely unknown. We explored circRNA-expression profiles and circUvrag (host gene: Uvrag, ultraviolet radiation resistance associated gene) function in light-induced photoreceptor apoptosis. METHODS Sprague-Dawley rats and 661 W photoreceptor cells were exposed to blue light to establish light-induced photoreceptor degeneration. Differentially expressed circRNAs were identified using microarrays. Potential functions of dysregulated circRNAs were analysed using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses. CircUvrag expression and localization were evaluated using quantitative RT-PCR and fluorescence in situ hybridization, respectively. CircUvrag overexpression and knockdown were induced using a plasmid and a small interfering RNA, respectively, and retinal function and structure were assessed using scotopic electroretinography, haematoxylin-eosin staining, and TUNEL staining. Microglial migration was assessed using IBA1 immunostaining. The apoptosis ratio of photoreceptor cells in vitro was detected using flow cytometry. RESULTS We identified 764 differentially expressed circRNAs, which were potentially related with the development of retinal structures, including neurons, dendrites, and synapses, and might participate in nervous-system pathophysiology. Light exposure enriched circUvrag in the cytoplasm of photoreceptors in the outer nuclear layer (ONL). CircUvrag knockdown decreased photoreceptor apoptosis and microglial migration to the ONL after light exposure, preserving ONL thickness and a-wave amplitude. In vitro, circUvrag knockdown inhibited photoreceptor apoptosis, although circUvrag overexpression slightly promoted photoreceptor apoptosis. CONCLUSIONS CircUvrag knockdown attenuated light-induced photoreceptor apoptosis, and might be a potential target in retinal degeneration.
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Affiliation(s)
- Kangjie Kong
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Xinyi Ding
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Yingchao Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Sisi Xu
- Department of Ophthalmology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Gang Li
- Research Center, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Xin Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Meng Zhang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Yingqin Ni
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Gezhi Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Shanghai, China
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Hansen ME, Ibrahim Y, Desai TA, Koval M. Nanostructure-Mediated Transport of Therapeutics through Epithelial Barriers. Int J Mol Sci 2024; 25:7098. [PMID: 39000205 PMCID: PMC11241453 DOI: 10.3390/ijms25137098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/16/2024] Open
Abstract
The ability to precisely treat human disease is facilitated by the sophisticated design of pharmacologic agents. Nanotechnology has emerged as a valuable approach to creating vehicles that can specifically target organ systems, effectively traverse epithelial barriers, and protect agents from premature degradation. In this review, we discuss the molecular basis for epithelial barrier function, focusing on tight junctions, and describe different pathways that drugs can use to cross barrier-forming tissue, including the paracellular route and transcytosis. Unique features of drug delivery applied to different organ systems are addressed: transdermal, ocular, pulmonary, and oral delivery. We also discuss how design elements of different nanoscale systems, such as composition and nanostructured architecture, can be used to specifically enhance transepithelial delivery. The ability to tailor nanoscale drug delivery vehicles to leverage epithelial barrier biology is an emerging theme in the pursuit of facilitating the efficacious delivery of pharmacologic agents.
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Affiliation(s)
- M. Eva Hansen
- University of California Berkeley-University of California San Francisco Graduate Program in Bioengineering, San Francisco, CA 94143, USA;
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Yasmin Ibrahim
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA;
- Graduate Program in Biochemistry, Cell and Developmental Biology, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA 30322, USA
| | - Tejal A. Desai
- University of California Berkeley-University of California San Francisco Graduate Program in Bioengineering, San Francisco, CA 94143, USA;
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA 94143, USA
- School of Engineering, Brown University, Providence, RI 02912, USA
| | - Michael Koval
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA;
- Department of Cell Biology, Emory University School of Medicine, Atlanta, GA 30322, USA
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Powers AM, Patel D, DeAngelis MM, Feng C, Allison K. Risk factors affecting the utilization of eye care services evaluated by the CDC's behavior risk factor surveillance system from 2018 to 2021. Front Public Health 2024; 12:1335427. [PMID: 38915755 PMCID: PMC11194383 DOI: 10.3389/fpubh.2024.1335427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/21/2024] [Indexed: 06/26/2024] Open
Abstract
When thinking about major health concerns in the U.S. and around the world, eye care ranks lower compared to cardiovascular disease, cancer, and diabetes. However, people do not think about the direct connection between diabetes and eye health. Untreated diabetes can lead to visual impairments such as blindness or difficulty seeing. Studies have found that eye health associated with nutrition, occupational exposure, diabetes, high blood pressure, and heart disease are some of the known risk factors. This study aimed to identify the potential risk factors that are associated with visual impairment (VI). The data used for this analysis were obtained from the Centers for Disease Control and Prevention (CDC) - Behavioral Risk Factor Surveillance System (BRFSS) from 2018 to 2021. We found important characteristics, such as the U.S. region, general health perception, employment status, income status, age, and health insurance source, that are associated with VI. Our study confirmed that the common demographical factors including age, race/ethnicity, the U.S. region, and gender are associated with VI. The study also highlights associations with additional risk factors such as health insurance source, general health perceptions, employment status, and income status. Using this information, we can reach out to communities with large numbers of individuals experiencing vision challenges and help educate them on prevention and treatment protocols, thereby effectively addressing VI and blindness challenges within our communities, neighborhoods, and finally, the broader society.
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Affiliation(s)
| | - Deepkumar Patel
- University of San Francisco, San Francisco, CA, United States
| | | | | | - Karen Allison
- University of Rochester, Rochester, NY, United States
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Gai MJ, Reddy V, Xu V, Noori NH, Demory Beckler M. Illuminating Perspectives: Navigating Eye Care Access in Sub-Saharan Africa Through the Social Determinants of Health. Cureus 2024; 16:e61841. [PMID: 38975490 PMCID: PMC11227464 DOI: 10.7759/cureus.61841] [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] [Received: 03/24/2024] [Accepted: 06/06/2024] [Indexed: 07/09/2024] Open
Abstract
Ensuring access to proper eye health services is not only a fundamental human right but also crucial for preserving an individual's quality of life, preventing blindness, and promoting overall well-being. This is especially true in low-income countries like Sub-Saharan Africa (SSA) where recognizing the intricate relationship between access to healthcare and social determinants of health (SDOH ) is crucial to addressing health disparities. The goal of this study was to elucidate and highlight not only the barriers millions face in obtaining eye care but also pave the way for interventions and policies aimed at creating equitable access across diverse populations. To do this, a scoping review was conducted across the Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase, and PubMed databases for studies meeting the search terms and inclusion criteria. The results show that intervention strategies that increase vision care must extend beyond the healthcare sector to address the multifaceted challenges. Collaborating with stakeholders involved in addressing broader livelihood issues, such as food security, education, and SDOH, becomes imperative to ensure comprehensive and sustainable improvements in vision care accessibility in SSA.
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Affiliation(s)
- Mam Jarra Gai
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Varsha Reddy
- College of Osteopathic Medicine, Michigan State University College of Osteopathic Medicine, East Lansing, USA
| | - Vivian Xu
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Neda H Noori
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Michelle Demory Beckler
- Microbiology and Immunology, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
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Swain TA, McGwin G, Girkin CA, Owsley C. Telemedicine Screening for Eye Disorders in Federally Qualified Health Centers: Relationship to Vision-Targeted Health-Related Quality of Life. Telemed J E Health 2024; 30:e2080-e2086. [PMID: 38662523 PMCID: PMC11296149 DOI: 10.1089/tmj.2023.0695] [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: 12/20/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction: Federally Qualified Health Centers (FQHCs) play a crucial role as safety-net primary health care clinics in the United States, serving medically underserved areas and populations. However, eye services are rarely offered at FQHCs. We examined how telemedicine-generated ocular diagnoses impacted vision-targeted health-related quality of life at FQHCs in rural Alabama. Methods: We focused on patients who are at risk for glaucoma. Both visual function and retinal imaging were assessed. The telemedicine vision screening protocol performed by a remote ophthalmologist evaluated eyes for glaucoma, diabetic retinopathy, cataract, age-related macular degeneration, and a measurement of habitual visual acuity. The National Eye Institute Visual Function Questionnaire-9 (VFQ-9) was administered. Results: Using stepwise regression, the best-fitting model for predicting VFQ-9 scores incorporated visual acuity 20/40 or worse, a diabetic retinopathy diagnosis, and sociodemographic variables (gender, transportation, insurance type/status, and employment status). Conclusion: Vision-targeted, health-related quality of life in our FQHC settings was related to the visual acuity impairment and the diagnosis of diabetic retinopathy but was also influenced by a variety of sociodemographic factors.
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Affiliation(s)
- Thomas A. Swain
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gerald McGwin
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christopher A. Girkin
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cynthia Owsley
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Kha R, Macken O, Mitchell P, Liew G, Keay L, Waddell C, Yang E, Do V, Fricke T, Newall J, Gopinath B. The Australian Eye and Ear Health Survey (AEEHS): Study protocol for a population-based cross-sectional study. PLoS One 2024; 19:e0301846. [PMID: 38820367 PMCID: PMC11142534 DOI: 10.1371/journal.pone.0301846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 03/21/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION Vision and hearing impairments are highly prevalent and have a significant impact on physical, psychological and social wellbeing. There is a need for accurate, contemporary national data on the prevalence, risk factors and impacts of vision and hearing loss in Australian adults. OBJECTIVES The Australian Eye and Ear Health Survey (AEEHS) aims to determine the prevalence, risk factors and impacts of vision and hearing loss in both Aboriginal and Torres Strait Islander and non-Indigenous older adults. METHODS AND ANALYSIS The AEEHS is a population-based cross-sectional survey which will include 5,000 participants (3250 non-Indigenous aged 50 years or older and 1750 Aboriginal and Torres Strait Islander people aged 40 years or older) from 30 sites covering urban and rural/regional geographic areas, selected using a multi-stage, random cluster sampling strategy. Questionnaires will be administered to collect data on socio-demographic, medical, ocular and ontological history. The testing battery includes assessment of blood pressure, blood sugar, anthropometry, visual acuity (presenting, unaided, pinhole and best-corrected), refraction, tonometry, slit lamp and dilated eye examination, ocular imaging including optical coherence tomography (OCT), OCT-angiography and retinal photography, and automated visual fields. Audiometry, tympanometry and video otoscopy will also be performed. The primary outcomes are age-standardised prevalence of cause-specific vision and hearing impairment. Secondary outcomes are prevalence of non-blinding eye diseases (including dry eye disease), patterns in health service utilisation, universal health coverage metrics, risk factors for vision and hearing impairment, and impact on quality of life.
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Affiliation(s)
- Richard Kha
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, Westmead, Sydney, NSW, Australia
| | - Oonagh Macken
- Macquarie University Hearing, Faculty of Medicine, Health and Human Sciences, The Australian Hearing Hub, Macquarie University, Macquarie Park, NSW, Australia
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, Westmead, Sydney, NSW, Australia
| | - Gerald Liew
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, Westmead, Sydney, NSW, Australia
| | - Lisa Keay
- School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, Australia
| | | | - Eleanor Yang
- School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, Australia
| | - Vu Do
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, Westmead, Sydney, NSW, Australia
| | - Tim Fricke
- School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, Australia
- Brien Holden Foundation, Sydney, NSW, Australia
| | - John Newall
- School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, Australia
| | - Bamini Gopinath
- School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, Australia
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Wu T, Wang Y, Li Y, Li Y, Jiang X, Li X. The impact of corneal higher-order aberrations on dynamic visual acuity post cataract surgery. Front Neurosci 2024; 18:1321423. [PMID: 38803687 PMCID: PMC11128552 DOI: 10.3389/fnins.2024.1321423] [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] [Received: 10/14/2023] [Accepted: 04/30/2024] [Indexed: 05/29/2024] Open
Abstract
Purpose To explore the influence of corneal higher-order aberrations (HOAs) on dynamic visual acuity (DVA) post cataract surgery. Methods A total of 27 patients with 45 eyes following cataract surgery were included in this study. The postoperative monocular object-moving DVA at the velocity of 20, 40, and 80 degrees per second (dps) were examined at 1 month. The total corneal HOAs were measured with Scheimpflug-based corneal topography. The correlation between postoperative DVA and HOAs was analyzed. Results Significant difference was shown among DVA at different velocities (P < 0.001). The 20 dps DVA was significantly better than 40 (P < 0.001) and 80 (P < 0.001) dps DVA. No significant difference was observed between 40 and 80 dps DVA (P = 0.420). The vertical coma and the root mean square (RMS) of coma (RMScoma) were statistically correlated with 80 dps DVA (P < 0.05). The vertical trefoil, RMStrefoil and total RMSHOA were statistically correlated with 40 and 80 dps DVA (P < 0.05). The spherical aberration was not significantly associated with postoperative DVA (P > 0.05 for all velocites). The multivariate linear regression model revealed that age was a significant influential factor for 20 dps DVA (P = 0.002), and RMStrefoil (4 mm) and age were significantly associated with 40 and 80 dps DVA (P ≤ 0.01). Conclusion The research demonstrated that larger corneal HOAs, especially coma and trefoil aberrations were significantly associated with worse high-speed DVA, but not spherical aberration post cataract surgery.
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Affiliation(s)
- Tingyi Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yuexin Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yuanting Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yuanhong Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xiaodan Jiang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
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Marola OJ, MacLean M, Cossette TL, Diemler CA, Hewes AA, Reagan AM, Skelly DA, Howell GR. Genetic context modulates aging and degeneration in the murine retina. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.16.589625. [PMID: 38659747 PMCID: PMC11042269 DOI: 10.1101/2024.04.16.589625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Age is the principal risk factor for neurodegeneration in both the retina and brain. The retina and brain share many biological properties; thus, insights into retinal aging and degeneration may shed light onto similar processes in the brain. Genetic makeup strongly influences susceptibility to age-related retinal disease. However, studies investigating retinal aging have not sufficiently accounted for genetic diversity. Therefore, examining molecular aging in the retina across different genetic backgrounds will enhance our understanding of human-relevant aging and degeneration in both the retina and brain-potentially improving therapeutic approaches to these debilitating conditions. Methods Transcriptomics and proteomics were employed to elucidate retinal aging signatures in nine genetically diverse mouse strains (C57BL/6J, 129S1/SvlmJ, NZO/HlLtJ, WSB/EiJ, CAST/EiJ, PWK/PhK, NOD/ShiLtJ, A/J, and BALB/cJ) across lifespan. These data predicted human disease-relevant changes in WSB and NZO strains. Accordingly, B6, WSB and NZO mice were subjected to human-relevant in vivo examinations at 4, 8, 12, and/or 18M, including: slit lamp, fundus imaging, optical coherence tomography, fluorescein angiography, and pattern/full-field electroretinography. Retinal morphology, vascular structure, and cell counts were assessed ex vivo. Results We identified common molecular aging signatures across the nine mouse strains, which included genes associated with photoreceptor function and immune activation. Genetic background strongly modulated these aging signatures. Analysis of cell type-specific marker genes predicted age-related loss of photoreceptors and retinal ganglion cells (RGCs) in WSB and NZO, respectively. Fundus exams revealed retinitis pigmentosa-relevant pigmentary abnormalities in WSB retinas and diabetic retinopathy (DR)-relevant cotton wool spots and exudates in NZO retinas. Profound photoreceptor dysfunction and loss were confirmed in WSB. Molecular analyses indicated changes in photoreceptor-specific proteins prior to loss, suggesting photoreceptor-intrinsic dysfunction in WSB. In addition, age-associated RGC dysfunction, loss, and concomitant microvascular dysfunction was observed in NZO mice. Proteomic analyses revealed an early reduction in protective antioxidant processes, which may underlie increased susceptibility to DR-relevant pathology in NZO. Conclusions Genetic context is a strong determinant of retinal aging, and our multi-omics resource can aid in understanding age-related diseases of the eye and brain. Our investigations identified and validated WSB and NZO mice as improved preclinical models relevant to common retinal neurodegenerative diseases.
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Affiliation(s)
| | | | | | - Cory A. Diemler
- The Jackson Laboratory, Bar Harbor, ME 04609, USA
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME 04469, USA
| | | | | | | | - Gareth R. Howell
- The Jackson Laboratory, Bar Harbor, ME 04609, USA
- Sackler School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, MA 02111, USA
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME 04469, USA
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Hadipour Jahromy M, Qomi M, Fazelipour S, Sami N, Faali F, Karimi M, Adhami Moghadam F. Evaluation of curcumin-based ophthalmic nano-emulsion on atropine-induced dry eye in mice. Heliyon 2024; 10:e29009. [PMID: 38601632 PMCID: PMC11004198 DOI: 10.1016/j.heliyon.2024.e29009] [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: 11/14/2023] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024] Open
Abstract
Background One of the most efficient treatments for dry eye syndrome (DES) is to use nanocarriers as a potential delivery system. We aim to evaluate curcumin in a nano emulsion formulation. Methods A new formulation containing 5.5% curcuminoid was used. DLS, Zeta potential, TEM, and HPLC tests were performed to determine the size and morphology. First, 30 mice were selected as atropine-induced dry eye models. Next, 25 mice in 5 groups were treated with the nano emulsion at different doses, and corneal tissues were separated for evaluation. Results The DLS test results were indicative of the particles' stability. Nano curcumin appeared to be thoroughly effective in all groups, with the highest dose showing the most similarity to the healthy control group. Conclusions Curcumin-based nano emulsion eye drop is a promising candidate for DES management. However, further investigation is required to evaluate the possible risks in humans.
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Affiliation(s)
- Mahsa Hadipour Jahromy
- Herbal Pharmacology Research Center, School of Medicine, Dept of Pharmacology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mahnaz Qomi
- Active Pharmaceutical Ingredients Research Center (APIRC), Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Department of Medicinal Chemistry, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Simin Fazelipour
- School of Medicine, Dept of Histology & Anatomy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Nafiseh Sami
- School of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Farzaneh Faali
- School of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mehrnaz Karimi
- Department of Nanotechnology, School of Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Farhad Adhami Moghadam
- School of Medicine, Dept of Ophthalmology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Zhang M, Zhang X, Yang Y, Weng Y, Chen X, Chen Y, Shi Y. Diabetes Distress Among Patients Undergoing Surgery for Diabetic Retinopathy and Associated Factors: A Cross-Sectional Survey. Psychol Res Behav Manag 2024; 17:1451-1461. [PMID: 38590759 PMCID: PMC10999732 DOI: 10.2147/prbm.s455535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/14/2024] [Indexed: 04/10/2024] Open
Abstract
Background Diabetes distress (DD) is a negative emotion related to diabetes management and a predictor of depression; it affects diabetic retinopathy (DR) patients' quality of life and disease outcomes. The prevalence of DD was higher in patients undergoing surgery for DR. However, few studies have been conducted on DD in DR surgery patients. The present study aims to investigate the status of DD in DR surgery patients and identify factors associated with DD. Methods Using a convenience sampling method, 210 DR surgery patients who were admitted to 2 tertiary-level hospitals in Wenzhou City (Zhejiang Province) and Zhengzhou City (Henan Province) from February to June 2023 were selected as research subjects. A questionnaire collecting demographic and disease-related information, the Diabetes Distress Scale, the Summary of Diabetes Self-Management Activities, the Family Care Index Scale, and the Social Support Rating Scale were used to collect data. Statistical analyses included descriptive statistics, t tests, ANOVAs, Pearson's correlation analyses and stepwise multiple linear regression. This study is reported according to the STROBE guidelines. Results In total, 156 out of 210 (74.29%) DR surgery patients experienced DD, with an average score of 2.13±0.63. The results of the stepwise multiple regression analysis showed that residential location, employment status, self-management level, family support, and social support were significantly associated with DD. These variables accounted for 30.6% of the total variation in DD. Conclusions DR surgery patients exhibit moderate levels of distress. Health care professionals should pay attention to DD in DR surgery patients and develop targeted interventions to improve the self-management ability of these patients, increase their family support and social support to reduce their DD levels.
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Affiliation(s)
- Mengyue Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Xiaoxian Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yingrui Yang
- Department of Nursing, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China
| | - Yu Weng
- Department of Nursing, The Eye Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Xiaojun Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yanyan Chen
- Department of Nursing, The Eye Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yinghui Shi
- Department of Nursing, The Eye Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
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Dou N, Li G, Fang D, Zhang S, Liang X, Yu S. Association between choroidopathy and photoreceptors during the early stage of diabetic retinopathy: a cross-sectional study. Graefes Arch Clin Exp Ophthalmol 2024; 262:1121-1129. [PMID: 37999773 DOI: 10.1007/s00417-023-06282-z] [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: 06/18/2023] [Revised: 09/18/2023] [Accepted: 10/12/2023] [Indexed: 11/25/2023] Open
Abstract
PURPOSE To explore the role of choroidopathy in diabetic retinopathy (DR) by investigating the correlation between alterations of choroidal vessel and photoreceptors during the early stage of DR. METHODS We performed a cross-sectional comparison of diabetic patients without DR (NDR group; n=16) and those with mild nonproliferative diabetic retinopathy (NPDR group; n=39). Optical coherence tomography (OCT) images of choroidal vessel alterations and photoreceptor structures were evaluated using the choroidal vascularity index (CVI) and adjusted ellipsoid zone (EZ) reflectivity, respectively. To evaluate the function of cone photoreceptors, the fundamental, harmonic amplitudes, the parameters S and Rmp3 were calculated from the electroretinogram (ERG). These factors were compared between groups. The correlation between the CVI and parameters describing the function and structure of the photoreceptors was evaluated. RESULTS The significant decrease was observed in the CVI in the NPDR group compared to the NDR group (0.67 ± 0.04 vs. 0.70 ± 0.06; p = 0.028), but not in the adjusted EZ reflectivity or ERG parameters. In NPDR group and merging the 2 groups, CVI was moderately positively correlated with the fundamental amplitude obtained by the flicker ERG (NPDR only: r = 0.506; p = 0.001; merge the 2 groups: r = 0.423; p = 0.001), which was regulated by the response of the cone photoreceptors. The CVI was positively and moderately correlated with the logS (NPDR only: r = 0.462; p = 0.003; merge the 2 groups: r = 0.355; p = 0.008), indicating the sensitivity of cone cell light transduction. CONCLUSION Compared to eyes without DR, CVI decreased representing choroidal vascular changes in eyes with mild NPDR. These changes may be related to the functional impairment of cone photoreceptors, especially phototransduction sensitivity, as the DR develops.
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Affiliation(s)
- Ningxin Dou
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, 518040, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Guangyang Li
- Bio-manufacturing Engineering Laboratory, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518000, Guangdong, China
| | - Dong Fang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, 518040, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, 518040, China.
| | - Xiaoling Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China.
| | - Shanshan Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China.
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Taylor C, Awadzi R, Enoch J, Dinah C. Proliferative Sickle Cell Retinopathy: A Patient and a Physician's Perspective on Quality of Life and Quality of Eye Care. Ophthalmol Ther 2024; 13:851-860. [PMID: 38345709 PMCID: PMC10912386 DOI: 10.1007/s40123-024-00893-3] [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: 12/26/2023] [Accepted: 01/19/2024] [Indexed: 03/05/2024] Open
Abstract
The impact of visual impairment in the context of sickle cell disease is poorly understood. Despite the significant advancements over the past three decades in retinal imaging and in the understanding of molecular mechanisms that drive retinal neovascularization, there has been little improvement in the management of proliferative sickle cell retinopathy. This article is co-authored by a patient impacted by proliferative sickle cell retinopathy. She highlights her personal experience of sight loss from proliferative sickle cell retinopathy and the impact on her daily life and mental health. Subsequent to diagnosis and management of proliferative sickle cell retinopathy, she continues to live with irreversible sight loss and provides crucial insight from a patient's perspective into the broad lack of high-quality educational materials online and lack of understanding of the disease within the clinical community. This article aims to provide a strong narrative to emphasize the need for further qualitative and quantitative research in this area, to bring about the holistic step-change required to improve visual outcomes and eyecare for people with sickle cell disease.
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Affiliation(s)
| | - Rossby Awadzi
- London Northwest University Healthcare Trust, London, UK
| | - Jamie Enoch
- School of Health and Psychological Sciences, City, University of London, London, UK
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Pesa J, Choudhry Z, de Courcy J, Barlow S, Chatterton E, Thomas O, Gibson G, Hahn B, Govindarajan R. The impact of myasthenia gravis severity on work and daily activities. Muscle Nerve 2024; 69:428-439. [PMID: 38348518 DOI: 10.1002/mus.28063] [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: 06/26/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION/AIMS People with myasthenia gravis (MG) experience impaired quality of life. However, the impact of MG symptoms on work productivity has not been well-studied. We aimed to evaluate this impact and to examine associations between disease severity and the degree of impairment. METHODS Data were drawn from the Adelphi MG Disease-Specific Programme™, a multinational (USA, France, Germany, Italy, Spain, UK) survey completed by physicians and their patients with MG in 2020. Patient-reported measures included the Work Productivity and Activity Impairment (WPAI): Specific Health Problem questionnaire. RESULTS The WPAI questionnaire was completed by 330 patients. Among those currently employed, the mean percentage of work time missed (absenteeism) was 13.3% (N = 116), percentage impairment of productivity at work (presenteeism) was 26.7% (N = 121), and overall work impairment was 30.0% (N = 110). Across all patients, impairment of non-work-related activities due to health problems (ADL impairment) was 39.2% (N = 330). Regression analysis indicated that impairment differed according to MG Foundation of America (MGFA) class (p = .0147, p < .0001, p < .0001 and p < .0001 for absenteeism, presenteeism, overall work impairment and ADL impairment, respectively). Being MGFA class III/IV was a predictor of presenteeism, overall work impairment and ADL impairment in a predictor model. DISCUSSION Patients with MG experience substantial work impairment particularly those with more severe symptoms, highlighting an important way in which patient quality of life is negatively affected. More effective treatment strategies would enable patients to lead more productive lives and could impact decisions relating to work and career.
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Affiliation(s)
- Jacqueline Pesa
- Janssen Scientific Affairs, LLC, Titusville, New Jersey, USA
| | - Zia Choudhry
- Janssen Scientific Affairs, LLC, Titusville, New Jersey, USA
| | | | | | | | | | | | - Bethan Hahn
- Bethan Hahn Communications, LTD., Macclesfield, UK
| | - Raghav Govindarajan
- HSHS Medical Group Multispecialty Care - St. Elizabeth's, O'Fallon, Illinois, USA
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Mulkutkar M, Damani M, Sawarkar S. Polymeric microneedles for the eye: An overview of advances and ocular applications for minimally invasive drug delivery. Eur J Pharm Biopharm 2024; 197:114209. [PMID: 38336234 DOI: 10.1016/j.ejpb.2024.114209] [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: 10/08/2023] [Revised: 01/29/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024]
Abstract
Ocular drug delivery is challenging due to the presence of tissue barriers and clearance mechanisms. Most widely used topical formulations need frequent application because of poor permeability, short retention, and low bioavailability. Invasive intraocular injections and implants that deliver drugs at the target site are associated with infections, inflammation, and even vision loss post-use. These gaps can be addressed by a delivery platform that can efficiently deliver drug with minimal tissue damage. Microneedles were introduced as a delivery platform for overcoming dermal barriers with minimal tissue damage. After the successful clinical transition of microneedles in the transdermal drug delivery, they are now being extensively studied for ocular applications. The attributes of minimally invasive application and the capability to deliver a wide range of therapeutics make microneedles an attractive candidate for ocular drug delivery. The current manuscript provides a detailed overview of the recent advancements in the field of microneedles for ocular use. This paper reviews research focusing on polymeric microneedles and their pharmaceutical and biopharmaceutical properties. A brief discussion about their clinical translation and regulatory concerns is also covered. The multitude of research articles supports the fact that microneedles are a potential, minimally invasive drug delivery platform for ophthalmic use.
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Affiliation(s)
- Madhura Mulkutkar
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai, India
| | - Mansi Damani
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai, India
| | - Sujata Sawarkar
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai, India.
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Zhang Q, Jiang Y, Deng C, Wang J. Effects and potential mechanisms of exercise and physical activity on eye health and ocular diseases. Front Med (Lausanne) 2024; 11:1353624. [PMID: 38585147 PMCID: PMC10995365 DOI: 10.3389/fmed.2024.1353624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/12/2024] [Indexed: 04/09/2024] Open
Abstract
In the field of eye health, the profound impact of exercise and physical activity on various ocular diseases has become a focal point of attention. This review summarizes and elucidates the positive effects of exercise and physical activities on common ocular diseases, including dry eye disease (DED), cataracts, myopia, glaucoma, diabetic retinopathy (DR), and age-related macular degeneration (AMD). It also catalogues and offers exercise recommendations based on the varying impacts that different types and intensities of physical activities may have on specific eye conditions. Beyond correlations, this review also compiles potential mechanisms through which exercise and physical activity beneficially affect eye health. From mitigating ocular oxidative stress and inflammatory responses, reducing intraocular pressure, enhancing mitochondrial function, to promoting ocular blood circulation and the release of protective factors, the complex biological effects triggered by exercise and physical activities reveal their substantial potential in preventing and even assisting in the treatment of ocular diseases. This review aims not only to foster awareness and appreciation for how exercise and physical activity can improve eye health but also to serve as a catalyst for further exploration into the specific mechanisms and key targets through which exercise impacts ocular health. Such inquiries are crucial for advancing innovative strategies for the treatment of eye diseases, thereby holding significant implications for the development of new therapeutic approaches.
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Affiliation(s)
| | | | - Chaohua Deng
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junming Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Bekollari M, Dettoraki M, Stavrou V, Glotsos D, Liaparinos P. Computer-Aided Discrimination of Glaucoma Patients from Healthy Subjects Using the RETeval Portable Device. Diagnostics (Basel) 2024; 14:349. [PMID: 38396388 PMCID: PMC10888400 DOI: 10.3390/diagnostics14040349] [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: 01/10/2024] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Glaucoma is a chronic, progressive eye disease affecting the optic nerve, which may cause visual damage and blindness. In this study, we present a machine-learning investigation to classify patients with glaucoma (case group) with respect to normal participants (control group). We examined 172 eyes at the Ophthalmology Clinic of the "Elpis" General Hospital of Athens between October 2022 and September 2023. In addition, we investigated the glaucoma classification in terms of the following: (a) eye selection and (b) gender. Our methodology was based on the features extracted via two diagnostic optical systems: (i) conventional optical coherence tomography (OCT) and (ii) a modern RETeval portable device. The machine-learning approach comprised three different classifiers: the Bayesian, the Probabilistic Neural Network (PNN), and Support Vectors Machines (SVMs). For all cases examined, classification accuracy was found to be significantly higher when using the RETeval device with respect to the OCT system, as follows: 14.7% for all participants, 13.4% and 29.3% for eye selection (right and left, respectively), and 25.6% and 22.6% for gender (male and female, respectively). The most efficient classifier was found to be the SVM compared to the PNN and Bayesian classifiers. In summary, all aforementioned comparisons demonstrate that the RETeval device has the advantage over the OCT system for the classification of glaucoma patients by using the machine-learning approach.
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Affiliation(s)
- Marsida Bekollari
- Department of Biomedical Engineering, University of West Attica, Ag. Spyridonos, 12243 Athens, Greece; (M.B.); (D.G.)
| | - Maria Dettoraki
- Department of Ophthalmology, “Elpis” General Hospital, 11522 Athens, Greece
| | - Valentina Stavrou
- Department of Ophthalmology, “Elpis” General Hospital, 11522 Athens, Greece
| | - Dimitris Glotsos
- Department of Biomedical Engineering, University of West Attica, Ag. Spyridonos, 12243 Athens, Greece; (M.B.); (D.G.)
| | - Panagiotis Liaparinos
- Department of Biomedical Engineering, University of West Attica, Ag. Spyridonos, 12243 Athens, Greece; (M.B.); (D.G.)
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23
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Li D, Chan VF, Virgili G, Mavi S, Pundir S, Singh MK, She X, Piyasena P, Clarke M, Whitestone N, Patnaik JL, Xiao B, Cherwek DH, Negash H, O'Connor S, Prakalapakorn SG, Huang H, Wang H, Boswell M, Congdon N. Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Quality of Life in Children: A Systematic Review. Ophthalmology 2024; 131:188-207. [PMID: 37696451 DOI: 10.1016/j.ophtha.2023.09.005] [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: 07/07/2023] [Revised: 08/16/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023] Open
Abstract
TOPIC This review summarizes existing evidence of the impact of vision impairment and ocular morbidity and their treatment on children's quality of life (QoL). CLINICAL RELEVANCE Myopia and strabismus are associated with reduced QoL among children. Surgical treatment of strabismus significantly improves affected children's QoL. METHODS We conducted a systematic review and meta-analysis by screening articles in any language in 9 databases published from inception through August 22, 2022, addressing the impact of vision impairment, ocular morbidity, and their treatment on QoL in children. We reported pooled standardized mean differences (SMDs) using random-effects meta-analysis models. Quality appraisal was performed using Joanna Briggs Institute and National Institutes of Health tools. This study was registered with the International Prospective Register of Systematic Reviews (identifier, CRD42021233323). RESULTS Our search identified 29 118 articles, 44 studies (0.15%) of which were included for analysis that included 32 318 participants from 14 countries between 2005 and 2022. Seventeen observational and 4 interventional studies concerned vision impairment, whereas 10 observational and 13 interventional studies described strabismus and other ocular morbidities. Twenty-one studies were included in the meta-analysis. The QoL scores did not differ between children with and without vision impairment (SMD, -1.04; 95% confidence interval [CI], -2.11 to 0.03; P = 0.06; 9 studies). Myopic children demonstrated significantly lower QoL scores than those with normal vision (SMD, -0.60; 95% CI, -1.09 to -0.11; P = 0.02; 7 studies). Children with strabismus showed a significantly lower QoL score compared with those without (SMD, -1.19; 95% CI, -1.66 to -0.73; P < 0.001; 7 studies). Strabismus surgery significantly improved QoL in children (SMD, 1.36; 95% CI, 0.48-2.23; P < 0.001; 7 studies). No randomized controlled trials (RCTs) concerning refractive error and QoL were identified. Among all included studies, 35 (79.5%) were scored as low to moderate quality; the remaining met all quality appraisal tools criteria. DISCUSSION Reduced QoL was identified in children with myopia and strabismus. Surgical correction of strabismus improves the QoL of affected children, which supports insurance coverage of strabismus surgery. Further studies, especially RCTs, investigating the impact of correction of myopia on QoL are needed. 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)
- Dongfeng Li
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China; Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Ving Fai Chan
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Gianni Virgili
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Department Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Sonia Mavi
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Sheetal Pundir
- Department of Ophthalmology, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Xinshu She
- School of Medicine, Stanford University, Stanford, California
| | - Prabhath Piyasena
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Mike Clarke
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | | | - Jennifer L Patnaik
- Orbis International, New York, New York; Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado
| | - Baixiang Xiao
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Affiliated Eye Hospital of Nanchang University, Nanchang City, China
| | | | | | - Sara O'Connor
- Advanced Center for Eyecare Global, Bakersfield, California
| | - S Grace Prakalapakorn
- Departments of Ophthalmology and Pediatrics, Duke University Medical Center, Durham, North Carolina; Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Huilan Huang
- Shandong First Medical University (Shandong Academy of Medical Science), Jinan, China
| | - Huan Wang
- Centre on China's Economy and Institutions, Stanford University, Stanford, California
| | - Matthew Boswell
- Centre on China's Economy and Institutions, Stanford University, Stanford, California
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Orbis International, New York, New York; Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China.
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24
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Philippin H, Morny EKA, Heinrich SP, Töws I, Maier PC, Guthoff RF, Qureshi BM, Reinhard T, Burton MJ, Finger RP. [Global ophthalmology : Update]. DIE OPHTHALMOLOGIE 2024; 121:157-170. [PMID: 38300260 DOI: 10.1007/s00347-023-01983-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 02/02/2024]
Abstract
The aim of global ophthalmology is to maximize vision, ocular health and functional ability, thereby contributing to overall health and well-being, social inclusion and quality of life of every individual worldwide. Currently, an estimated 1.1 billion people live with visual impairment, 90% of which can be prevented or cured through largely cost-effective interventions. At the same time, 90% of people affected live in regions with insufficient eye health coverage. This challenge drove the World Health Organization (WHO) and a group of nongovernmental organizations to launch "VISION 2020: the Right to Sight", a global campaign which recently concluded after 20 years. The achievements, challenges and lessons learned were identified and incorporated into the current campaign "2030 IN SIGHT".
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Affiliation(s)
- Heiko Philippin
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland.
- International Centre for Eye Health, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HTUK, London, Vereinigtes Königreich.
- CBM Christoffel-Blindenmission Christian Blind Mission, Bensheim, Deutschland.
| | - Enyam K A Morny
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Sven P Heinrich
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
| | - Ingrid Töws
- Institut für Evidenz in der Medizin, Universitätsklinikum und Medizinische Fakultät, Universität Freiburg, Freiburg i. Brsg., Deutschland
| | - Philip C Maier
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
| | - Rudolf F Guthoff
- Klinik und Poliklinik für Augenheilkunde, Universität Rostock, Rostock, Deutschland
| | - Babar M Qureshi
- CBM Christoffel-Blindenmission Christian Blind Mission, Cambridge, Vereinigtes Königreich
| | - Thomas Reinhard
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
| | - Matthew J Burton
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, Vereinigtes Königreich
| | - Robert P Finger
- Augenklinik, Universitätsklinikum Mannheim, Universität Heidelberg, Mannheim, Deutschland
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25
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Zhang K, Cai W, Hu L, Chen S. Generating Retinas through Guided Pluripotent Stem Cell Differentiation and Direct Somatic Cell Reprogramming. Curr Stem Cell Res Ther 2024; 19:1251-1262. [PMID: 37807418 DOI: 10.2174/011574888x255496230923164547] [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: 04/13/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 10/10/2023]
Abstract
Retinal degeneration diseases affect millions of people worldwide but are among the most difficult eye diseases to cure. Studying the mechanisms and developing new therapies for these blinding diseases requires researchers to have access to many retinal cells. In recent years there has been substantial advances in the field of biotechnology in generating retinal cells and even tissues in vitro, either through programmed sequential stem cell differentiation or direct somatic cell lineage reprogramming. The resemblance of these in vitro-generated retinal cells to native cells has been increasingly utilized by researchers. With the help of these in vitro retinal models, we now have a better understanding of human retinas and retinal diseases. Furthermore, these in vitro-generated retinal cells can be used as donor cells which solves a major hurdle in the development of cell replacement therapy for retinal degeneration diseases, while providing a promising option for patients suffering from these diseases. In this review, we summarize the development of pluripotent stem cell-to-retinal cell differentiation methods, the recent advances in generating retinal cells through direct somatic cell reprogramming, and the translational applications of retinal cells generated in vitro. Finally, we discuss the limitations of the current protocols and possible future directions for improvement.
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Affiliation(s)
- Ke Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510623, China
| | - Wenwen Cai
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510623, China
| | - Leyi Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510623, China
| | - Shuyi Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510623, China
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26
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Shree D, Patra CN, Sahoo BM. Applications of Nanotechnology-mediated Herbal Nanosystems for Ophthalmic Drug. Pharm Nanotechnol 2024; 12:229-250. [PMID: 37587812 DOI: 10.2174/2211738511666230816090046] [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: 04/04/2023] [Revised: 06/05/2023] [Accepted: 07/13/2023] [Indexed: 08/18/2023]
Abstract
In recent years, herbal nanomedicines have gained tremendous popularity for novel drug discovery. Nanotechnology has provided several advances in the healthcare sector, emerging several novel nanocarriers that potentiate the bioavailability and therapeutic efficacy of the herbal drug. The recent advances in nanotechnology with accelerated strategies of ophthalmic nanosystems have paved a new path for overcoming the limitations associated with ocular drug delivery systems, such as low bioavailability, poor absorption, stability, and precorneal drug loss. Ophthalmic drug delivery is challenging due to anatomical and physiological barriers. Due to the presence of these barriers, the herbal drug entry into the eyes can be affected when administered by following multiple routes, i.e., topical, injectables, or systemic. However, the advancement of nanotechnology with intelligent systems enables the herbal active constituent to successfully entrap within the system, which is usually difficult to reach employing conventional herbal formulations. Herbal-loaded nanocarrier drug delivery systems demonstrated enhanced herbal drug permeation and prolonged herbal drug delivery. In this current manuscript, an extensive search is conducted for original research papers using databases Viz., PubMed, Google Scholar, Science Direct, Web of Science, etc. Further painstaking efforts are made to compile and update the novel herbal nanocarriers such as liposomes, polymeric nanoparticles, solid lipid nanoparticles, nanostructure lipid carriers, micelles, niosomes, nanoemulsions, dendrimers, etc., which are mostly used for ophthalmic drug delivery system. This article presents a comprehensive survey of diverse applications used for the preventative measures and treatment therapy of varied eye disorders. Further, this article highlights the recent findings that the innovators are exclusively working on ophthalmic nanosystems for herbal drug delivery systems. The nanocarriers are promising drug delivery systems that enable an effective and supreme therapeutic potential circumventing the limitations associated with conventional ocular drug delivery systems. The nanotechnology-based approach is useful to encapsulate the herbal bioactive and prevent them from degradation and therefore providing them for controlled and sustained release with enhanced herbal drug permeation. Extensive research is still being carried out in the field of herbal nanotechnology to design an ophthalmic nanosystem with improved biopharmaceutical properties.
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Affiliation(s)
- Dipthi Shree
- Department of Pharmaceutics, Roland Institute of Pharmaceutical Sciences, Berhampur, 760010, Odisha, India
| | - Chinam Niranjan Patra
- Department of Pharmaceutics, Roland Institute of Pharmaceutical Sciences, Berhampur, 760010, Odisha, India
| | - Biswa Mohan Sahoo
- Department of Pharmaceutical Chemistry, Roland Institute of Pharmaceutical Sciences, Berhampur, 760010, Odisha, India
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27
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Osuagwu UL, Ahaiwe KE, Meribe N, Nkanga ED, Ekpenyong BN, Ibanga AA, Goson PC, Nkanga DG. Quality of life and depression among patients with high myopia in Nigeria: a cross sectional study. Int J Ophthalmol 2023; 16:2071-2081. [PMID: 38111950 PMCID: PMC10700079 DOI: 10.18240/ijo.2023.12.21] [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: 11/23/2022] [Accepted: 09/14/2023] [Indexed: 12/20/2023] Open
Abstract
AIM To evaluate the quality of life (QOL) and level of depression among participants with high myopia in Nigeria and the demographic factors associated with these outcomes. METHODS This cross-sectional study was conducted on 100 adult participants with high myopia (defined as refractive error ≤-5.00 D or worse, and uncorrected visual acuity worse than 6/18 in the better seeing eye) attending ophthalmology centres in Nigeria from 2 October 2021 to 30 August 2022. The means and standard deviations were calculated for each of the four domains of World Health Organization Quality of life scale (WHOQOL-BREF) using the transformed scores. The Beck Depression Inventory (BDI) scale was used to assess the level of depression. RESULTS The highest and the lowest mean scores of WHOQOL-BREF domains were found for the psychological and physical health domains (mean percentage scores were 67.0 [95% confidence intervals (CI) 64.1-68.9] and 55.3 (95%CI 51.8-58.8, P<0.001), respectively. One-way analysis of variance (ANOVA) revealed significant differences in physical health with educational status (higher among those with tertiary education: mean difference 0.9, 95%CI -0.2-2.1; P=0.049), differences in psychological health with working status (higher among those who were working 1.2, 95%CI 0.3-2.1; P=0.012). Also, the result showed a statistically significant association between environmental health and marital status (higher among non-married: 1.7, 95%CI -0.9-2.3; P=0.012) while overall health was associated with place of residence (higher in urban areas: 2.3, 95%CI 1.2-3.5; P=0.024). For depression, one in every nine participants reported major depressive symptom, mostly younger people (aged 16-29 vs 30-49y: 17.0% vs 0, P=0.019), and slightly more women than men (14.3% vs 0, P=0.064). There were significant negative correlations between the depression scores and psychological health (r=-0.48, P<0.001), physical health (r=-0.29, P=0.002), social and relationship (r=-0.49, P<0.001), environmental (r=-0.48, P<0.001) and overall health (r=-0.49, P<0.001). CONCLUSION People with high myopia have a relatively moderate QOL, but poor physical health, particularly the younger age group, and women who are more likely to experience clinically relevant depression. Eye care professionals should consider possible referrals for counselling for people with high myopia.
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Affiliation(s)
- Uchechukwu Levi Osuagwu
- Bathurst Rural Clinical School (BRCS), School of Medicine, Western Sydney University, Bathurst, NSW 2795, Australia
- African Vision Research Institute, University of KwaZulu-Natal Durban, Durban 4001, South Africa
| | - Kelechukwu Enyinnaya Ahaiwe
- Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River State 540281, Nigeria
| | - Nnaemeka Meribe
- Department of Politics, Media and Philosophy, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Elizabeth Dennis Nkanga
- Department of Ophthalmology, Faculty of Clinical Sciences, University of Calabar, Cross River State 540281, Nigeria
| | - Bernadine Nsa Ekpenyong
- Department of Public Health, University of Calabar, Calabar, Cross River State 540281, Nigeria
| | - Affiong Andem Ibanga
- Department of Ophthalmology, Faculty of Clinical Sciences, University of Calabar, Cross River State 540281, Nigeria
| | - Piwuna Christopher Goson
- Department of Psychiatry, College of Health Sciences, University of Jos, Jos, Plateau 930001, Nigeria
| | - Dennis George Nkanga
- Department of Ophthalmology, Faculty of Clinical Sciences, University of Calabar, Cross River State 540281, Nigeria
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28
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Khatami K, Estedlal A, Vali M, Kamalipour A, Mahmoudinezhad G, Nejabat M, Nowroozzadeh MH, Vardanjani HM. Prevalence and secular trends of four causes of blindness and visual impairment in Iran (1990-2019): a comparative study based on the Global Burden of Disease project's data. Int Ophthalmol 2023; 43:4719-4728. [PMID: 37713146 DOI: 10.1007/s10792-023-02872-2] [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: 02/01/2023] [Accepted: 08/26/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE The purpose of this study was to investigate the prevalence of cataracts, refractive disorders, age-related macular disease (AMD), and glaucoma, as well as their trends from 1990 to 2019 in Iran, in comparison with high-middle socio-demographic index (HMSDI) countries and the world, using the Global Burden of Disease (GBD) 2019 study. METHODS The GBD study provided data on the prevalence of blindness and visual impairment (VI), as well as four of their causes including cataracts, refractive disorders, age-related macular disease (AMD), and glaucoma. Using Joinpoint analysis, the annual percent change (APC) was calculated to assess the trend of change in prevalence in each category of diseases from 1990 to 2019, stratified by sex and age, for Iran, HMSDI countries, and the world. RESULTS In 2019, refractive errors and cataracts were the most common causes of blindness and VI for both genders in Iran, HMSDI countries and the world. Iran had a higher age-standardized prevalence in all four categories of ophthalmologic disorders compared to HMSDI countries and the world for both genders in 2019. Additionally, the age-specific prevalence of all four disorders in 2019 was higher in Iran compared to HMSDI countries. However, in terms of trends of prevalence from 1990 to 2019, the rate of reduction for the four ophthalmologic disorders in Iran was higher than in HMSDI and the world for both males and females. Furthermore, Iran had a greater percentage of reduction in prevalence for all age groups in all four disorders compared to HMSDI countries. CONCLUSION The prevalence of cataracts, refractive errors, AMD, and glaucoma in Iran was higher compared to HMSDI countries in 2019 for both sexes and all age groups, but the trends of prevalence for all four disorders from 1990 to 2019 in Iran had a higher slope of reduction compared to HMSDI countries for all ages and sexes.
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Affiliation(s)
- Kiana Khatami
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - AliReza Estedlal
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - AliReza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Mahmood Nejabat
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hossein Molavi Vardanjani
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- MD-MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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29
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Fernández-Vigo JI, Blanco-Darriba D, Etxabe-Avila H, Montolío-Marzo E, Robles-Amor P, Escobar-Moreno MJ, Burgos-Blasco B. Comparative analysis of the quality of life among different retinal diseases. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:633-639. [PMID: 37748684 DOI: 10.1016/j.oftale.2023.07.007] [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: 06/14/2023] [Accepted: 07/26/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE To assess the impact on the quality of life (QoL) among different retinal diseases such as diabetic macular edema (DME), retinal vein occlusion (RVO), pathologic myopia (PM), neovascular age-related macular degeneration (nAMD) and central serous chorioretinopathy (CSC). METHODS A cross-sectional study was carried out in 241 patients, affected by DME (n=44), RVO (n=41), PM (n=34) and nAMD (n=85) receiving intravitreal injections due to the presence of macular edema or choroidal neovascularization. The CSC patients included (n=37) were candidates for laser treatment. The patients included completed the National Eye Visual Functioning Questioning-25 (NEI VFQ-25). Best eye visual acuity (BEVA) was recorded using the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. RESULTS There were significant differences between subgroups for all the domains, except for the general vision in which all scores among diseases ranged from 40.7 to 45.2 out of 100 (P=.436), despite the difference in BEVA (CSC: 86.3±11.9; RVO: 78.5±15.5, DME: 73.3±15.2, nAMD: 72.9±12.6 and PM: 68.5±18.1 letters respectively; P<.001). The lowest VFQ-25 total score was observed in the PM patients (52.1±20.9), followed by nAMD (55.3±20.8), RVO (65.0±22.3), DME (68.6±21.0) and CSC (70.9±16.2). The DME group reported the worst score for general health (38.9±21.4). Mental health and role difficulties were lowest for PM (48.2±28.8 and 48.2±31.9, P<.007). CONCLUSIONS This study reveals the differences in the QoL among DME, RVO, nAMD, PM and CSC, describing the different repercussions that they can suffer, observing a higher impact in PM and nAMD.
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Affiliation(s)
- J I Fernández-Vigo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
| | - D Blanco-Darriba
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - H Etxabe-Avila
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - E Montolío-Marzo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - P Robles-Amor
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - M J Escobar-Moreno
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - B Burgos-Blasco
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
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Newman-Casey PA, Aliancy J, Lu MC, Woodward MA, Hicks PM, Niziol LM, Musch DC, Bicket AK, John D, Killeen O, Wood SD, Johnson L, Kershaw M, Zhang J, Elam AR. Social Deprivation and the Risk of Screening Positive for Glaucoma in the MI-SIGHT Telemedicine-Based Glaucoma Detection Program. Ophthalmology 2023; 130:1053-1065. [PMID: 37211338 PMCID: PMC10527632 DOI: 10.1016/j.ophtha.2023.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/04/2023] [Accepted: 05/15/2023] [Indexed: 05/23/2023] Open
Abstract
PURPOSE To assess whether increased poverty is associated with increased risk of screening positive for glaucoma or suspected glaucoma in a large public screening and intervention program. DESIGN Cross-sectional study from 2020 to 2022. PARTICIPANTS Adults ≥ 18 years old without acute ocular symptoms. METHODS Michigan Screening and Intervention for Glaucoma and eye Health through Telemedicine (MI-SIGHT) program participants' sociodemographic characteristics and area deprivation index (ADI) values were summarized from the clinical sites, which included a free clinic and a Federally Qualified Health Center (FQHC). The ADI, a composite measure of neighborhood deprivation (range, 1-10; 10 is worst deprivation), was assigned on the basis of the participants' addresses. Group comparisons were performed via 2-sample t tests or Wilcoxon Mann-Whitney tests for continuous measures and chi-square tests or Fisher exact tests with Monte Carlo simulation for categorical measures; Holm adjustment was used for multiple comparisons. MAIN OUTCOME MEASURES Risk factors for screening positive for glaucoma or suspected glaucoma. RESULTS Of the 1171 enrolled participants, 1165 (99.5%) completed the screening: 34% at the free clinic and 66% at the FQHC. Participants were on average aged 55.1 ± 14.5 years, 62% were women, 54% self-reported as Black/African-American, 34% White, 10% Hispanic or Latino, and 70% earned < $30 000 annually. The mean ADI was 7.2 ± 3.1. The FQHC had higher (worse) ADI than the free clinic (free clinic: 4.5 ± 2.9, FQHC: 8.5 ± 2.1, P < 0.0001). One-quarter (24%) of participants screened positive for glaucoma or suspected glaucoma. Screening positive for glaucoma or suspected glaucoma was associated with being older (P = 0.01), identifying as Black/African-American (P = 0.0001), having an established eyecare clinician (P = 0.0005), and not driving a personal vehicle to the appointment (P = 0.001), which is a proxy for increased poverty. Participants who screened positive had worse ADI than those who screened negative (7.7 ± 2.8 vs. 7.0 ± 3.2, P = 0.002). A larger percentage of White participants screened positive at the FQHC compared with White participants at the free clinic (21.3% vs. 12.3%, P = 0.01). FQHC White participants had worse ADI than free clinic White participants (7.5 ± 2.5 vs. 3.7 ± 2.7, P < 0.0001). CONCLUSIONS Personal poverty, assessed as not driving a personal vehicle to the appointment, and neighborhood-level poverty were both associated with increased rates of screening positive for glaucoma or suspected glaucoma. 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)
- Paula Anne Newman-Casey
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
| | - Joah Aliancy
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan
| | - Ming-Chen Lu
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan
| | - Maria A Woodward
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Patrice M Hicks
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan
| | - Leslie M Niziol
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan
| | - David C Musch
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Amanda K Bicket
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Denise John
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan
| | - Olivia Killeen
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Sarah D Wood
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan
| | | | | | - Jason Zhang
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan
| | - Angela R Elam
- Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan
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Song R, Huang W, Yang J, Tang X, Huang Y, Chen Y, Zhao M, Hu Q, Du Y. Association of aquaporin-4 antibody-seropositive optic neuritis with vision-related quality of life and depression. Front Neurol 2023; 14:1265170. [PMID: 37840923 PMCID: PMC10575616 DOI: 10.3389/fneur.2023.1265170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Objective Aquaporin-4 (AQP4) antibody-seropositive optic neuritis (AQP4-ON) is one of the most common types of optic neuritis in China. However, the association between AQP4-ON and vision-related quality of life (QoL) and depression remains poorly understood. Methods In this cross-sectional study, 57 patients with optic neuritis were evaluated for their vision-related QoL using a Chinese version of the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) and assessed for depressive symptoms using a Chinese version of the Beck Depression Inventory-II (BDI-II). Data regarding participants' age, sex, visual acuity, and the number of recurrence events were gathered. Linear regression analysis was employed to investigate the relationships between AQP4-ON and vision-related QoL, as well as depression. Results Of the 57 included patients, 28 were AQP4-ON, and 29 were idiopathic optic neuritis (ION). AQP4-ON demonstrated a significant correlation with a decreased VFQ-25 composite score (Mean difference, -11.65 [95% CI, -21.61 to -1.69]; p = 0.023) and an increased BDI-II score (Mean difference, 6.48 [95% CI, 0.25 to 12.71]; p = 0.042) when compared to ION. The BDI-II score was correlated with the VFQ-25 composite score (Spearman ρ = -0.469; p < 0.001) but not with the visual acuity in the worse-seeing eye (Spearman ρ = 0.024; p = 0.860) or in the better-seeing eye (Spearman ρ = -0.039; p = 0.775), bilateral severe visual impairment (Spearman ρ = 0.039; p = 0.772) or the number of recurrence events (Spearman ρ = 0.184; p = 0.171). Conclusion AQP4-positive optic neuritis is associated with a decline in vision-related quality of life as well as an increased likelihood of experiencing depression. It is crucial for clinicians to assess both vision-related QoL and depression in patients with AQP4-positive optic neuritis to provide patient-centered care.
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Affiliation(s)
- Ruitong Song
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wenqiao Huang
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jun Yang
- Department of Ophthalmology, Wuzhou Gongren Hospital, Wuzhou, China
| | - Xueshan Tang
- Department of Ophthalmology, Wuzhou Gongren Hospital, Wuzhou, China
| | - Yihua Huang
- Department of Ophthalmology, Wuming Hospital of Guangxi Medical University, Nanning, China
| | - Yingying Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Mukun Zhao
- Jingliang Eye Hospital, Guangxi Medical University, Nanning, China
| | - Qiuming Hu
- Jingliang Eye Hospital, Guangxi Medical University, Nanning, China
| | - Yi Du
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Lan Q, Xu F, Sun T, Zeng S, Liu Y, Yang T, Li Y, Yao G, Ma B, Tao L, Ma B, Xiao X, Li M, Qi H. Comparison of binocular visual quality in six treatment protocols for bilateral cataract surgery with presbyopia correction: a prospective two-center single-blinded cohort study. Ann Med 2023; 55:2258894. [PMID: 37734409 PMCID: PMC10515669 DOI: 10.1080/07853890.2023.2258894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE To compare the postoperative binocular visual quality in six treatment protocols for bilateral age-related cataract surgery with presbyopia correction for clinical decisions. MATERIALS AND METHODS In this prospective two-center single-blinded cohort study, participants from North or South China who underwent bilateral phacoemulsification and intraocular lens implantation were divided into six protocols: monovision, diffractive bifocal, mixed, refractive bifocal, trifocal, and micro-monovision extended range of vision (EROV). Binocular visual quality was evaluated at 3 months postoperatively, including binocular uncorrected full-range visual acuity, binocular defocus curves (depth of focus [DoF] and area under the curve [AUC]), binocular visual function (fusion function and stereopsis), binocular subjective spectacle independence rates, visual analog scale (VAS) of overall satisfaction, 25-item visual function questionnaire (VFQ-25), and binocular dysphotopsia symptoms. RESULTS Of the 300 enrolled patients, 272 (90.7%; 544 eyes) were analyzed. The trifocal protocol showed excellent binocular full-range visual acuity and the best performance for most DoFs and AUCs. The monovision protocol presented the worst binocular visual quality in most perspectives, especially in convergence, distance, and near stereopsis (p < 0.001). The full-range subjective spectacle independence rates were sorted from highest to lowest as follows: trifocal (84.8%), refractive bifocal (80.9%), EROV (80.0%), mixed (73.3%), diffractive bifocal (65.2%), and monovision (32.6%) protocols, with no statistically significant differences between the former five protocols (p > 0.05). The EROV protocol achieved the highest VAS and VFQ-25 scores. The incidence of postoperative binocular dysphotopsia symptoms was comparable in all protocols. CONCLUSIONS The trifocal protocol showed the best performance, and the monovision protocol presented the worst performance in most perspectives of binocular visual quality for presbyopia correction. The refractive bifocal, mixed, or EROV protocols can provide an approximate performance as a trifocal protocol. Ophthalmologists can customize therapies using different protocols.
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Affiliation(s)
- Qianqian Lan
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Fan Xu
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Tong Sun
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Siming Zeng
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Yiyun Liu
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Tingting Yang
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Yaxin Li
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Gang Yao
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Baikai Ma
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Boping Ma
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Xin Xiao
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Min Li
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Hong Qi
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
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Almazroa A, Almatar H, Alduhayan R, Albalawi M, Alghamdi M, Alhoshan S, Alamri S, Alkanhal N, Alsiwat YJ, Alrabiah S, Aldrgham M, AlSaleh AA, Alsanad HA, Alsomaie B. The Patients' Perspective for the Impact of Late Detection of Ocular Diseases on Quality of Life: A Cross-Sectional Study. CLINICAL OPTOMETRY 2023; 15:191-204. [PMID: 37719025 PMCID: PMC10503557 DOI: 10.2147/opto.s422451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/01/2023] [Indexed: 09/19/2023]
Abstract
Background Late detection of ocular diseases negatively affects patients' quality of life (QoL), encompassing health status, psychological, financial, and social aspects. However, the early detection of eye conditions leads to rapid intervention and avoiding complications, thus preserving the QoL. This study assessed the impact of ocular diseases late detection on patients' QoL at multi-eye clinics based on questionnaire responses. Methods We developed an original Arabic-English questionnaire to assess the QoL of patients with ocular diseases referred from primary and secondary healthcare centers to tertiary hospitals. It covered preliminary data, patient perspectives on having lately detected ocular disease and treatment costs, and the impact of late detection on finances, social life, psychology, health status, and awareness of current initiatives. Logistic regression analysis was used to explore the associations between patient perspectives on having ocular diseases detected at a late stage and its impact on different domains. Multivariate logistic regression was applied with impact types of health status, psychological, financial, and social (dependent variables) and age, income levels, and hospital type (independent variables). Results Three hundred and eighty-eight responded, with 50% experiencing psychological effects, 27% health issues, 23% social impacts, and 23% financial burdens. Two hundred seventeen patients (56%) reported having ocular condition detected in late stage. Logistic regression analysis showed positive association with health status, social well-being, and financial effects (p < 0.05). Multivariate analysis revealed pronounced effects in patients ≤ 50 years, with income \< 5000 SAR, and those visiting private clinics (p < 0.05). The social impact was greater in patients visiting private hospitals. Ninety percent of all patients emphasized the importance of increasing awareness for better QoL. Conclusion Significant associations were found between the late detection of eye diseases and their impact on QoL. Therefore, early detection and increasing patients' awareness of ocular diseases and treatment are essential.
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Affiliation(s)
- Ahmed Almazroa
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hessa Almatar
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Reema Alduhayan
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Maram Albalawi
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mansour Alghamdi
- Department of Optometry and Vision Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Saja Alhoshan
- Department of Ophthalmology, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Suhailah Alamri
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Norah Alkanhal
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Yara J Alsiwat
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Saad Alrabiah
- Department of Ophthalmology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Aldrgham
- Department of Ophthalmology, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint AbdulRahman University, Riyadh, Saudi Arabia
| | | | - Hessa Abdulrahman Alsanad
- Department of Social Planning, College of Social Work, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Barrak Alsomaie
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Vishwakarma P, Sundararaj L, Chavan S, Mondal A, Ranpise D, Sudhir RR, Kumar SGP, Kurian E. Spectacle compliance postcataract surgery significantly improved vision function-related quality of life of adult patients in India: Evidence from a multicenter longitudinal cohort study. Oman J Ophthalmol 2023; 16:500-508. [PMID: 38059111 PMCID: PMC10697246 DOI: 10.4103/ojo.ojo_234_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Cataract is the leading cause of avoidable blindness globally. This study aims to measure the changes in Vision function-related quality of life (VFQoL) before and after cataract surgery and identify the predictors of an improvement in these outcomes. METHODS A multicenter, longitudinal cohort study was conducted. Patients with first eye cataracts were interviewed before and 6 months after cataract surgery. Multiple classification analysis (MCA) was performed to assess variation in the intensities of mean change scores for general function, psychosocial impact, and visual function with select factors. RESULTS A total of 747 participated in the baseline assessment. The 6-month follow-up rate was 86.5%. The mean general function, psychosocial impact, and visual function scores were 35.3 (±8.6), 12.5 (±3.4), and 8.3 (±3) in the baseline and 17 (±5.3), 6 (±2.2) and 3.8 (±1.3) in the follow-up assessments, respectively. In MCA, patients using spectacles postsurgery (β 0.111) and those having a very good postoperative visual acuity (β 0.098) had the most impact on general function. Patients reporting no ocular complaints postsurgery had a relatively higher effect on the psychosocial impact, (β 0.168) and similarly, patients using spectacles postsurgery and those aged 70 and older had the most impact on the visual function scores (β 0.146 and 0.126), respectively. CONCLUSION Cataract surgery is associated with meaningful improvements in vision and VFQoL in general. The determinants of better VFQoL include the usage of spectacles postsurgery. Strategies to further improve patient participation in postoperative review visits are needed for spectacle provision and patient education regarding spectacle use and compliance is imparted during such visits.
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Affiliation(s)
| | | | | | | | | | - Rachapalle Reddi Sudhir
- Department of Preventive Ophthalmology, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
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RaviChandran N, Teo ZL, Ting DSW. Artificial intelligence enabled smart digital eye wearables. Curr Opin Ophthalmol 2023; 34:414-421. [PMID: 37527195 DOI: 10.1097/icu.0000000000000985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
PURPOSE OF REVIEW Smart eyewear is a head-worn wearable device that is evolving as the next phase of ubiquitous wearables. Although their applications in healthcare are being explored, they have the potential to revolutionize teleophthalmology care. This review highlights their applications in ophthalmology care and discusses future scope. RECENT FINDINGS Smart eyewear equips advanced sensors, optical displays, and processing capabilities in a wearable form factor. Rapid technological developments and the integration of artificial intelligence are expanding their reach from consumer space to healthcare applications. This review systematically presents their applications in treating and managing eye-related conditions. This includes remote assessments, real-time monitoring, telehealth consultations, and the facilitation of personalized interventions. They also serve as low-vision assistive devices to help visually impaired, and can aid physicians with operational and surgical tasks. SUMMARY Wearables such as smart eyewear collects rich, continuous, objective, individual-specific data, which is difficult to obtain in a clinical setting. By leveraging sophisticated data processing and artificial intelligence based algorithms, these data can identify at-risk patients, recognize behavioral patterns, and make timely interventions. They promise cost-effective and personalized treatment for vision impairments in an effort to mitigate the global burden of eye-related conditions and aging.
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Affiliation(s)
| | - Zhen Ling Teo
- Singapore National Eye Center, Singapore Eye Research Institute
| | - Daniel S W Ting
- AI and Digital Innovations
- Singapore National Eye Center, Singapore Eye Research Institute
- Duke-NUS Medical School, National University Singapore, Singapore
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Alharthy N, Almotairy R, Aldulhum R, Alghamdi A, Aquil R, Alkharaan G, Alsuwais S, Alshibani A. Knowledge and experience of paramedics concerning patients with hearing and visual disability. BMC Emerg Med 2023; 23:91. [PMID: 37592234 PMCID: PMC10433550 DOI: 10.1186/s12873-023-00866-y] [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: 12/28/2022] [Accepted: 08/08/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND A 2017 nationwide disability survey conducted by the General Authority of Statistics in Saudi Arabia, a sample representing the whole population living in Saudi Arabia, reported that approximately 5% and 2% of the Saudi population suffers from visual or hearing impairments, respectively. Patients with these disabilities find it difficult to convey their medical history and chief complaints to paramedics, causing communication breakdowns that can lead to misinterpretation of patient history, leave medical problems unaddressed, and reduce patient engagement and autonomy. We aimed to assess paramedics' knowledge, attitude, and level of confidence when managing patients with visual or hearing problems. METHODS Descriptive cross-sectional design was used to report the knowledge and experience of paramedics towards patients with hearing/vision disabilities in Saudi Arabia. A validated questionnaire was distributed to our study sample of paramedics in Riyadh, Saudi Arabia between 01, July 2020 and 31, December 2020. Ethical approval was obtained from King Abdullah International Medical Research Center. RESULTS Ninety-seven participants completed the survey. Male paramedics accounted for 77% of the study participants; 24% were Saudi Red Crescent employees, and 57% were 20-25 years old. Most participants encountered 1-5 cases of patients with hearing disability (55%) as well as patients with visual disability (48%) during their career. Taking medical history was a challenge indicated by 42% of the participants, and 30% reported difficulties in explaining procedures. Of the participants, 44% were confident in handling patients with hearing or visual impairment. There was a strong association between participants who indicated higher confidence levels and those who had obtained specific training for patients with hearing or visual impairments. CONCLUSION Assisting patients with hearing or visual impairments is challenging, especially during an emergency. We recommend programs that provide specific training in handling hearing or visually impaired patients to close the communication gap in emergent medical situations handled by paramedics or other emergency medicine doctors and nurses.
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Affiliation(s)
- Nesrin Alharthy
- Pediatrics Emergency Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
| | - Raghad Almotairy
- Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Rahaf Aldulhum
- Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Albatool Alghamdi
- Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Reem Aquil
- Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ghada Alkharaan
- Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sara Alsuwais
- Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdullah Alshibani
- Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Sapowadia A, Ghanbariamin D, Zhou L, Zhou Q, Schmidt T, Tamayol A, Chen Y. Biomaterial Drug Delivery Systems for Prominent Ocular Diseases. Pharmaceutics 2023; 15:1959. [PMID: 37514145 PMCID: PMC10383518 DOI: 10.3390/pharmaceutics15071959] [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: 05/02/2023] [Revised: 06/26/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Ocular diseases, such as age-related macular degeneration (AMD) and glaucoma, have had a profound impact on millions of patients. In the past couple of decades, these diseases have been treated using conventional techniques but have also presented certain challenges and limitations that affect patient experience and outcomes. To address this, biomaterials have been used for ocular drug delivery, and a wide range of systems have been developed. This review will discuss some of the major classes and examples of biomaterials used for the treatment of prominent ocular diseases, including ocular implants (biodegradable and non-biodegradable), nanocarriers (hydrogels, liposomes, nanomicelles, DNA-inspired nanoparticles, and dendrimers), microneedles, and drug-loaded contact lenses. We will also discuss the advantages of these biomaterials over conventional approaches with support from the results of clinical trials that demonstrate their efficacy.
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Affiliation(s)
- Avin Sapowadia
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Delaram Ghanbariamin
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
- Department of Biomedical Engineering, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Libo Zhou
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Qifa Zhou
- Department of Biomedical Engineering and Ophthalmology, University of Southern California, Los Angeles, CA 90089, USA
| | - Tannin Schmidt
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
- Department of Biomedical Engineering, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Ali Tamayol
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
- Department of Biomedical Engineering, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Yupeng Chen
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
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Mohankumar A, Rajan M. Role of hyaluronidase as an adjuvant in local anesthesia for cataract surgery. Indian J Ophthalmol 2023; 71:2649-2655. [PMID: 37417102 PMCID: PMC10491076 DOI: 10.4103/ijo.ijo_2515_22] [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: 10/01/2023] [Revised: 03/07/2023] [Accepted: 03/27/2023] [Indexed: 07/08/2023] Open
Abstract
Cataract surgery ranks among the commonest procedures performed worldwide. Approximately 51% of blindness worldwide is related to cataracts, affecting about 65.2 million people worldwide and more so in developing countries. Over the years, there has been a significant evolution in the surgical techniques of cataract extraction. The advancement in phacoemulsification machines, phaco-tips, and the availability of ophthalmic viscoelastic devices have played a substantial role in cataract surgery such that they are faster and more controlled than before. Similarly, anesthetic techniques in cataract surgery have advanced significantly from retrobulbar, peribulbar, and sub-Tenon's blocks to topical anesthesia. Though topical anesthesia eliminates the possible complications of injectable anesthesia, it is not suitable for use in uncooperative, anxious patients, pediatric age groups, and patients with cognitive disabilities. Hyaluronidase is an enzyme that breaks down hyaluronic acid in the retrobulbar tissue, facilitating uniform diffusion of the anesthetic drug and hastening the onset of anesthesia and akinesia. Hyaluronidase has been used in the last 80 years successfully as an adjuvant in retrobulbar, peribulbar, and sub-Tenon's blocks. Initially, the hyaluronidase enzyme was animal-derived and of bovine and ovine sources. Recombinant human-derived hyaluronidase, which has lesser allergic reactions, impurities, and toxicity, is now available. There is conflicting evidence regarding the efficacy of hyaluronidase as an adjuvant in retrobulbar and peribulbar blocks. This article summarizes a brief review of the literature on the role of hyaluronidase as an adjuvant in local anesthetic blocks in ophthalmic surgeries.
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Affiliation(s)
- Arthi Mohankumar
- Department of Retina and Vitreous, Rajan Eye Care Hospital Pvt Ltd, Chennai, Tamil Nadu, India
| | - Mohan Rajan
- Department of Retina and Vitreous, Rajan Eye Care Hospital Pvt Ltd, Chennai, Tamil Nadu, India
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Mader G, Ghinelli F, Torelli F, Patel C, Masseria C, Dickerson J, Nguyen D, Cantor L. The budget impact of introducing the OMNI® surgical system to a United States health plan for managing mild-to-moderate primary open-angle glaucoma. Expert Rev Pharmacoecon Outcomes Res 2023; 23:805-812. [PMID: 37224422 DOI: 10.1080/14737167.2023.2217357] [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: 12/22/2022] [Revised: 04/25/2023] [Accepted: 05/12/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Minimally invasive glaucoma surgery devices fill an unmet need in the treatment paradigm between topical intraocular pressure medicines and more invasive filtration procedures. This study evaluated the adoption of The OMNI® Surgical System with or without cataract surgery in primary open-angle glaucoma patients. METHODS A budget impact analysis estimated costs before and after adoption of OMNI® to a hypothetical US health plan with 1 million Medicare-covered lives over two years. Model input data were derived from published sources and development of the model included primary research with key opinion leaders and payers. The model compared total annual direct costs for OMNI® versus other treatment options (medications, other minimally invasive surgical procedures, selective laser trabeculoplasty) to calculate budget impact. A one-way sensitivity analysis was conducted to assess parameter uncertainty. RESULTS Increased adoption of OMNI® resulted in budget neutrality over the two years with a decrease in total costs of $35,362. Per member per month incremental costs were $0.00 when used without cataract surgery and yielded cost savings of -$0.01 when used with cataract surgery. Sensitivity analysis confirmed model robustness and identified surgical center fee variability as a key driver of costs. CONCLUSION OMNI® is budgetary efficient from a US payer perspective.
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Affiliation(s)
| | | | | | | | | | - Jaime Dickerson
- Sight Sciences Inc, Menlo Park, CA, USA
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Dan Nguyen
- Mid-Cheshire Hospitals NHS Foundation Trust, Cheshire, UK
| | - Louis Cantor
- Eugene and Marilyn Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
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40
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Singh RP, Welch L, Longo NL, Frese M. Impact of an immersive, interactive medical education initiative on guideline-based retinal disease management knowledge/competence and effectual practice change. BMC Ophthalmol 2023; 23:285. [PMID: 37349689 DOI: 10.1186/s12886-023-03034-9] [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: 02/08/2023] [Accepted: 06/10/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Retinal diseases, including wet or dry age-related macular degeneration, diabetic macular edema, and diabetic retinopathy (DR), are underdiagnosed and undertreated in the United States. Clinical trials support the effectiveness of anti-vascular endothelial growth factor (anti-VEGF) therapies for several retinal conditions, but real-world data suggest underuse by clinicians, resulting in patients experiencing poorer visual outcomes over time. Continuing education (CE) has demonstrated effectiveness at changing practice behaviors, but more research is needed to understand whether CE can help address diagnostic and treatment gaps. METHODS This test and control matched pair analysis examined pre-/post-test knowledge of retinal diseases and guideline-based screening and intervention among 10,786 healthcare practitioners (i.e., retina specialists, ophthalmologists, optometrists, primary care providers, diabetes educators, pharmacists/managed care specialists, and other healthcare providers, such as registered nurses, nurse practitioners, and physician assistants) who participated in a modular, interactive CE initiative. An additional medical claims analysis provided data on practice change, evaluating use of VEGF-A inhibitors among retina specialist and ophthalmologist learners (n = 7,827) pre-/post-education, compared to a matched control group of non-learners. Outcomes were pre-/post-test change in knowledge/competence and clinical change in application of anti-VEGF therapy, as identified by the medical claims analysis. RESULTS Learners significantly improved knowledge/competence scores on early identification and treatment, identifying patients who could benefit from anti-VEGF agents, using guideline-recommended care, recognizing the importance of screening and referral, and recognizing the importance of early detection and care for DR (all P-values = 0.003 to 0.004). Compared with matched controls, learners' incremental total injections for anti-VEGF agents for retinal conditions increased more after the CE intervention (P < 0.001); specifically, there were 18,513 more (new) anti-VEGF injections prescribed versus non-learners (P < 0.001). CONCLUSIONS This modular, interactive, immersive CE initiative resulted in significant knowledge/competence gains among retinal disease care providers and changes in practice-related treatment behaviors (i.e., appropriate consideration and greater incorporation of guideline-recommended anti-VEGF therapies) among participating ophthalmologists and retina specialists compared to matched controls. Future studies will utilize medical claims data to show longitudinal impact of this CE initiative on treatment behavior among specialists and impact on diagnosis and referral rates among optometrists and primary care providers who participate in future programming.
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Affiliation(s)
- Rishi P Singh
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
- Cleveland Clinic Martin Health, Stuart, FL, USA
| | - Lauren Welch
- Med Learning Group, 17th St #4, New York, NY, 10011, USA.
| | - Nicole L Longo
- Med Learning Group, 17th St #4, New York, NY, 10011, USA
| | - Matt Frese
- Med Learning Group, 17th St #4, New York, NY, 10011, USA
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Sharif NA. Elevated Intraocular Pressure and Glaucomatous Optic Neuropathy: Genes to Disease Mechanisms, Therapeutic Drugs, and Gene Therapies. Pharmaceuticals (Basel) 2023; 16:870. [PMID: 37375817 DOI: 10.3390/ph16060870] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
This review article focuses on the pathogenesis of and genetic defects linked with chronic ocular hypertension (cOHT) and glaucoma. The latter ocular disease constitutes a group of ocular degenerative diseases whose hallmark features are damage to the optic nerve, apoptotic demise of retinal ganglion cells, disturbances within the brain regions involved in visual perception and considerable visual impairment that can lead to blindness. Even though a number of pharmaceuticals, surgical and device-based treatments already exist addressing cOHT associated with the most prevalent of the glaucoma types, primary open-angle glaucoma (POAG), they can be improved upon in terms of superior efficacy with reduced side-effects and with longer duration of activity. The linkage of disease pathology to certain genes via genome-wide associated studies are illuminating new approaches to finding novel treatment options for the aforementioned ocular disorders. Gene replacement, gene editing via CRISPR-Cas9, and the use of optogenetic technologies may replace traditional drug-based therapies and/or they may augment existing therapeutics for the treatment of cOHT and POAG in the future.
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Affiliation(s)
- Najam A Sharif
- Eye-APC Duke-NUS Medical School, Singapore 169857, Singapore
- Singapore Eye Research Institute, Singapore 169856, Singapore
- Department of Pharmacology and Neuroscience, University of North Texas Health Sciences Center, Fort Worth, TX 76107, USA
- Department of Pharmacy Sciences, Creighton University, Omaha, NE 68178, USA
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX 77004, USA
- Imperial College of Science and Technology, St. Mary's Campus, London W2 1PG, UK
- Institute of Ophthalmology, University College London, London WC1E 6BT, UK
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Martins MF, Omar F, Othman O, Virgili G, Yong AC, Mulewa D, Graham C, Price-Sanchez C, Graham R, Farmer A, Mashayo E, Chan VF. How does a pair of near-vision spectacle correction empower older Zanzibari craftswomen?: A qualitative study on perception. PLoS One 2023; 18:e0286315. [PMID: 37235560 PMCID: PMC10218727 DOI: 10.1371/journal.pone.0286315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Studies have shown that correcting presbyopia among women could increase short-term income and quality of life. However, it is unclear whether these short-term outcomes translate to long-term empowerment. This is partly due to women's empowerment being under-studied in the eye health field. Hence, we attempted to understand Zanzibari craftswomen's perception of how near-vision spectacle correction could empower them. METHODS Semi-structured interviews were conducted with 24 craftswomen with presbyopia (7 to 21 April 2022), identified from Zanzibari cooperatives using quota and heterogeneity sampling. We included a sample of tailors, beaders/weavers, and potters who were 40 years and older. Directed content analysis was performed on interview transcripts. RESULTS Two themes and seven sub-themes emerged from the data. Craftswomen perceived that at the personal level, near-vision spectacle correction could improve their economic empowerment (better income and savings and buying things for themselves), psychological empowerment (more self-confidence and decision-making), political empowerment (taking up leadership roles), and educational empowerment (acquiring new skills). At a relational level, they perceived that near-vision spectacle correction could bring about economic empowerment (ability to buy things for the family), social empowerment (ability to participate in social activities), and educational empowerment (ability to educate other women). CONCLUSION Older craftswomen perceived that correcting near vision could empower them at personal and relational levels that encompass economic, psychological, social, political and educational empowerment. The findings laid the foundation for future research into eye health and women's empowerment.
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Affiliation(s)
- Michelle Fernandes Martins
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | | | | | - Gianni Virgili
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | - Ai Chee Yong
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | | | - Christine Graham
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | - Carlos Price-Sanchez
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | | | - Adrianna Farmer
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | | | - Ving Fai Chan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
- Vision Action, London, United Kingdom
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Bekollari M, Dettoraki M, Stavrou V, Skouroliakou A, Liaparinos P. Investigating the Structural and Functional Changes in the Optic Nerve in Patients with Early Glaucoma Using the Optical Coherence Tomography (OCT) and RETeval System. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094504. [PMID: 37177707 PMCID: PMC10181589 DOI: 10.3390/s23094504] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/10/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
The present manuscript introduces an investigation of the structural and functional changes in the optic nerve in patients undergoing glaucoma treatment by comparing optical coherence tomography (OCT) measurements and RETeval system parameters. For such a purpose, 140 eyes were examined at the Ophthalmology Clinic of the "Elpis" General Hospital of Athens between October 2022 and April 2023. A total of 59 out of 140 eyes were from patients with early glaucoma under treatment (case group), 63 were healthy eyes (control group) and 18 were excluded. The experimental measurements were statistically analyzed using the SPSS software package. The main outcomes are summarized below: (i) there was no statistical difference between the right and left eye for both groups, (ii) statistical differences were found between age interval subgroups (30-54 and 55-80 years old) for the control group, mainly for the time response part of the RETeval parameters. Such difference was not indicated by the OCT system, and (iii) a statistical difference occurred between the control and case group for both OCT (through the retinal nerve fiber layer-RNFL thickness) and the RETeval parameters (through the photopic negative response-PhNR). RNFL was found to be correlated to b-wave (ms) and W-ratio parameters. In conclusion, the PhNR obtained by the RETeval system could be a valuable supplementary tool for the objective examination of patients with early glaucoma.
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Affiliation(s)
- Marsida Bekollari
- Department of Biomedical Engineering, University of West Attica, Ag. Spyridonos, 12243 Athens, Greece
| | - Maria Dettoraki
- Department of Ophthalmology, "Elpis" General Hospital, 11522 Athens, Greece
| | - Valentina Stavrou
- Department of Ophthalmology, "Elpis" General Hospital, 11522 Athens, Greece
| | - Aikaterini Skouroliakou
- Department of Biomedical Engineering, University of West Attica, Ag. Spyridonos, 12243 Athens, Greece
| | - Panagiotis Liaparinos
- Department of Biomedical Engineering, University of West Attica, Ag. Spyridonos, 12243 Athens, Greece
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Popova LT, Abuzaitoun RO, Fresco DM, Abalem MF, Andrews CA, Musch DC, Ehrlich JR, Jayasundera KT. Positive feedback loop between vision-related anxiety and self-reported visual difficulty. Ophthalmic Genet 2023:1-7. [PMID: 37140038 DOI: 10.1080/13816810.2023.2208211] [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: 05/05/2023]
Abstract
BACKGROUND Patients with Inherited Retinal Diseases typically experience progressive, irreversible vision loss resulting in low vision and blindness. As a result, these patients are at high risk for vision-related disability and psychological distress, including depression and anxiety. Historically, the relationship between self-reported visual difficulty (encompassing metrics of vision-related disability and quality of life, among others) and vision-related anxiety has been regarded as an association and not a causal relationship. As a result, there are limited interventions available that address vision-related anxiety and the psychological and behavioral components of self-reported visual difficulty. MATERIALS AND METHODS We applied the Bradford Hill criteria to evaluate the case for a bidirectional causal relationship between vision-related anxiety and self-reported visual difficulty. RESULTS There is sufficient evidence to satisfy all nine of the Bradford Hill criteria of causality (strength of association, consistency, biological gradient, temporality, experimental evidence, analogy, specificity, plausibility, and coherence) for the relationship between vision-related anxiety and self-reported visual difficulty. CONCLUSIONS The evidence suggests that there is a direct positive feedback loop-a bidirectional causal relationship-between vision-related anxiety and self-reported visual difficulty. More longitudinal research on the relationship between objectively-measured vision impairment, self-reported visual difficulty, and vision-related psychological distress is needed. Additionally, more investigation of potential interventions for vision-related anxiety and visual difficulty is needed.
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Affiliation(s)
- Lilia T Popova
- University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Rebhi O Abuzaitoun
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
| | - David M Fresco
- Department of Psychiatry, University of Michigan Department of Psychiatry, Ann Arbor, Michigan, USA
| | - Maria Fernanda Abalem
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
- Department of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Chris A Andrews
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
| | - David C Musch
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
| | - K Thiran Jayasundera
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
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Mong MA. Vitamin K and the Visual System-A Narrative Review. Nutrients 2023; 15:nu15081948. [PMID: 37111170 PMCID: PMC10143727 DOI: 10.3390/nu15081948] [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: 02/01/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
Vitamin K occupies a unique and often obscured place among its fellow fat-soluble vitamins. Evidence is mounting, however, that vitamin K (VK) may play an important role in the visual system apart from the hepatic carboxylation of hemostatic-related proteins. However, to our knowledge, no review covering the topic has appeared in the medical literature. Recent studies have confirmed that matrix Gla protein (MGP), a vitamin K-dependent protein (VKDP), is essential for the regulation of intraocular pressure in mice. The PREDIMED (Prevención con Dieta Mediterránea) study, a randomized trial involving 5860 adults at risk for cardiovascular disease, demonstrated a 29% reduction in the risk of cataract surgery in participants with the highest tertile of dietary vitamin K1 (PK) intake compared with those with the lowest tertile. However, the specific requirements of the eye and visual system (EVS) for VK, and what might constitute an optimized VK status, is currently unknown and largely unexplored. It is, therefore, the intention of this narrative review to provide an introduction concerning VK and the visual system, review ocular VK biology, and provide some historical context for recent discoveries. Potential opportunities and gaps in current research efforts will be touched upon in the hope of raising awareness and encouraging continued VK-related investigations in this important and highly specialized sensory system.
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Affiliation(s)
- Michael A Mong
- Department of Ophthalmology, Veteran Affairs North Texas Health Care Medical Center, Dallas, TX 75216, USA
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Boto de los Bueis A, de la Fuente M, Montejano-Milner R, del Hierro Zarzuelo A, Vecino E, Acera A. A Pilot Study of a Panel of Ocular Inflammation Biomarkers in Patients with Primary Sjögren’s Syndrome. Curr Issues Mol Biol 2023; 45:2881-2894. [PMID: 37185712 PMCID: PMC10136698 DOI: 10.3390/cimb45040188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
Ocular diseases have a strong impact on individuals, the effects of which extend from milder visual impairment to blindness. Due to this and to their prevalence, these conditions constitute important health, social and economic challenges. Thus, improvements in their early detection and diagnosis will help dampen the impact of these conditions, both on patients and on healthcare systems alike. In this sense, identifying tear biomarkers could establish better non-invasive approaches to diagnose these diseases and to monitor responses to therapy. With this in mind, we developed a solid phase capture assay, based on antibody microarrays, to quantify S100A6, MMP-9 and CST4 in human tear samples, and we used these arrays to study tear samples from healthy controls and patients with Sjögren’s Syndrome, at times concomitant with rheumatoid arthritis. Our results point out that the detection of S100A6 in tear samples seems to be positively correlated to rheumatoid arthritis, consistent with the systemic nature of this autoinflammatory pathology. Thus, we provide evidence that antibody microarrays may potentially help diagnose certain pathologies, possibly paving the way for significant improvements in the future care of these patients.
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Affiliation(s)
| | - Miguel de la Fuente
- Experimental Ophthalmo-Biology Group (GOBE), Department of Cell Biology and Histology, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - Rafael Montejano-Milner
- Ophthalmology Service, Hospital Universitario Príncipe de Asturias, 28805 Alcala de Henares, Spain
| | | | - Elena Vecino
- Experimental Ophthalmo-Biology Group (GOBE), Department of Cell Biology and Histology, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - Arantxa Acera
- Experimental Ophthalmo-Biology Group (GOBE), Department of Cell Biology and Histology, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
- Ikerbasque, Basque Foundation for Science, 48001 Bilbao, Spain
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Kamińska A, Jankowski M, Rejdak MB, Ostrowski J, Rejdak R, Pinkas J. An Online Questionnaire-Based Survey of 1076 Individuals in Poland to Identify the Prevalence of Ophthalmic Symptoms in Autumn 2022. Med Sci Monit 2023; 29:e939622. [PMID: 37009783 PMCID: PMC10037922 DOI: 10.12659/msm.939622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/16/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Vision health affects functioning in society, and the ability to learn and work. Ophthalmic symptoms may be caused by eye diseases, but also by environmental or lifestyle factors. This online questionnaire-based survey aimed to identify the prevalence of ophthalmic symptoms in 1076 individuals in Poland, as well as to identify factors associated with the presence of ophthalmic symptoms. MATERIAL AND METHODS An online questionnaire-based survey was carried out in December 2022 on a representative sample of 1076 adult Poles. Non-probability quota sampling was used. Respondents were asked about the presence of 16 different eye symptoms and vision problems in the last 30 days. The presence of ophthalmic symptoms was self-declared. Data were analyzed with IBM SPSS package version 28. RESULTS More than half of the respondents (57.8%) had at least 1 ophthalmic symptom in the last 30 days. Burning and stinging eyes (21.6%) and dry eyes (18.9%) were the most common ophthalmic symptoms declared by the respondents. Moreover, 21.3% of respondents reported vision deterioration in the last 30 days. Out of 10 different factors analyzed in this study, female gender, living in rural areas or small cities (below 100 000 inhabitants), living with at least 1 other person, having low economic status, having chronic diseases, and wearing spectacles/contact lenses were significantly associated (P.
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Affiliation(s)
- Agnieszka Kamińska
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Janusz Ostrowski
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Robert Rejdak
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
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Zhang M, Zhang C, Chen C, Liu L, Liang Y, Hong Y, Chen Y, Shi Y. The experience of diabetic retinopathy patients during hospital-to-home full-cycle care: A qualitative study. BMC Nurs 2023; 22:58. [PMID: 36869346 PMCID: PMC9983167 DOI: 10.1186/s12912-023-01206-y] [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: 12/13/2022] [Accepted: 02/13/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is one of the major blinding eye diseases worldwide. Psychological, emotional and social problems of DR patients are prominent. The aim of this study is to explore the experiences of patients with different phases of DR from hospital to home based on the "Timing It Right" framework, and to provide a reference for formulating corresponding intervention strategies. METHODS The phenomenological method and semi-structured interviews were used in this study. A total of 40 patients with DR in different phases were recruited from a tertiary eye hospital between April and August 2022. Colaizzi's analysis method was used to analyse the interview data. RESULTS Based on the "Timing It Right" framework, different experiences in five phases of DR before and after Pars Plana Vitrectomy (PPV) were extracted. The patients experienced complicated emotional reactions and inadequate coping skills during the pre-surgery phase, increased uncertainty during the post-surgery phase, insufficient confidence and the decision to change during the discharge preparation phase, eagerness for professional support and moving forward in exploration during the discharge adjustment phase, and courageous acceptance and positive integration during the discharge adaptation phase. CONCLUSION The experiences of DR patients with vitrectomy in different phases of disease are ever-changing, and medical staff should provide personalized support and guidance to help DR patients get through the hard times smoothly and enhance the quality of hospital-family holistic care.
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Affiliation(s)
- Mengyue Zhang
- grid.268099.c0000 0001 0348 3990School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, 325027 Wenzhou, Zhejiang China
| | - ChunHua Zhang
- grid.268099.c0000 0001 0348 3990School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, 325027 Wenzhou, Zhejiang China
| | - Chen Chen
- grid.268099.c0000 0001 0348 3990School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, 325027 Wenzhou, Zhejiang China
| | - Linjie Liu
- grid.414701.7The Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, 325027 Wenzhou, Zhejiang China
| | - Youping Liang
- grid.414701.7The Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, 325027 Wenzhou, Zhejiang China
| | - YiRong Hong
- grid.414701.7The Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, 325027 Wenzhou, Zhejiang China
| | - Yanyan Chen
- The Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China.
| | - Yinghui Shi
- The Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China.
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The influence of the topographic location of geographic atrophy on vision-related quality of life in nonexudative age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2023; 261:699-708. [PMID: 36269402 DOI: 10.1007/s00417-022-05849-6] [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: 07/12/2022] [Revised: 09/17/2022] [Accepted: 09/22/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To examine associations between the topographic distribution of geographic atrophy (GA) and vision-related quality of life (VRQoL). METHODS This study included 237 eyes from 161 participants in the Age-Related Eye Disease Study (AREDS). GA lesions were manually delineated with color fundus photographs obtained by the AREDS Research Group and atrophic area was measured in an Early Treatment Diabetic Retinopathy Study (ETDRS) grid. VRQoL was measured using the National Eye Institute Visual Function Questionnaire (NEI-VFQ). Area of atrophy in the ETDRS grid subfields was correlated with VRQoL by linear regression modeling. RESULTS The average area of atrophy in the better and worse eye was 3.43mm2 and 7.15mm2 respectively. In multivariable analysis, VRQoL was not associated with total area of atrophy in the better eye (β, - 0.53; 95% confidence interval [CI], - 1.11 to 0.05; P = 0.07) or worse eye (β, 0.12; 95% CI, - 0.32 to 0.55; P = 0.59). However, area of atrophy in the central 1-mm-diameter zone of the better eye was significantly associated with VRQoL when the ETDRS subfields were examined individually (β, - 14.57; 95% CI, - 27.12 to - 2.02; P = 0.023), grouped into quadrants (β, - 18.35; 95% CI, - 30.03 to - 6.67; P = 0.002), inner and outer zones (β, - 17.26; 95% CI, - 29.38 to - 5.14; P = 0.006), or vertical and horizontal zones (β, - 18.97; 95% CI, - 30.18 to - 7.77; P = 0.001). CONCLUSION In patients with GA, greater area of atrophy in the central 1-mm-diameter zone of the better eye was independently associated with lower VRQoL, while total area of atrophy in the better or worse eye was not.
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Baumal CR, Sørensen TL, Karcher H, Freitas RL, Becher A, Balez S, Clemens A, Singer M, Kodjikian L. Efficacy and safety of brolucizumab in age-related macular degeneration: A systematic review of real-world studies. Acta Ophthalmol 2023; 101:123-139. [PMID: 36117281 DOI: 10.1111/aos.15242] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/30/2022] [Accepted: 08/19/2022] [Indexed: 12/01/2022]
Abstract
Intravitreally injected anti-vascular endothelial growth factor (anti-VEGF) agents are first-line treatment for neovascular age-related macular degeneration (nAMD). Phase 3 trials demonstrated non-inferiority of anti-VEGF therapy with brolucizumab compared with aflibercept in best corrected visual acuity (BCVA) gains, with superior anatomical outcomes after brolucizumab. The purpose of the review was to summarize real-world efficacy and safety data on brolucizumab in patients with nAMD. The review protocol was registered with PROSPERO (ID: CRD42021290530). We conducted systematic searches in Embase, Medline and key ophthalmology congress websites (19 October 2021). Original reports of efficacy and/or safety in patients receiving brolucizumab to treat nAMD in clinical practice were eligible. The descriptive summary includes reports describing at least 10 brolucizumab-treated eyes. In total, 2907 brolucizumab-treated eyes from 26 studies were included. Outcomes were available for treatment-naive eyes (six studies), eyes switched to brolucizumab from other anti-VEGFs (16 studies), and/or treatment-naive and switch eyes combined (eight studies). Follow-up time points ranged from 4 weeks to 1 year post-brolucizumab initiation. For BCVA, significant improvements compared with brolucizumab initiation were reported in four of six studies in treatment-naive eyes (mean BCVA improvement, range: +3.7 to +11.9 Early Treatment Diabetic Retinopathy Study [ETDRS] letters) and in three of 12 studies in switch eyes (range: +9.0 to +15 ETDRS letters) (all p < 0.05); remaining studies reported no significant post-brolucizumab BCVA changes. For central subfield thickness (CST), improvements post-brolucizumab initiation were reported in all six studies in treatment-naive eyes (mean CST improvement, range: -113.4 to -150.1 μm) and in eight of 11 studies in switch eyes (range: -26 to -185.7 μm) (all p < 0.05). The 14 studies reporting on intraretinal, subretinal and/or total fluid observed improvements post-brolucizumab initiation. The four studies comparing treatment intervals observed extension of the interval between injections after switching to brolucizumab from other anti-VEGFs. Incidence of intraocular inflammation ranged from 0% to 19%. In conclusion, real-world efficacy and safety data concur with brolucizumab pivotal trials. Additionally, reduction of disease activity in anti-VEGF switch eyes was demonstrated by fluid reduction and/or visual acuity gain, along with prolongation of the interval between injections.
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Affiliation(s)
- Caroline R Baumal
- New England Eye Center, Tufts Medical Center, Boston, Massachusetts, USA
| | - Torben Lykke Sørensen
- University of Copenhagen, Copenhagen, Denmark.,Department of Ophthalmology, Zealand University Hospital Roskilde, Roskilde, Denmark
| | | | - Rita L Freitas
- Novartis Farma - Produtos Farmacêuticos, S.A., Porto Salvo, Portugal
| | | | | | - Andreas Clemens
- Novartis Pharma AG, Basel, Switzerland.,Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Singer
- University of Texas Health Science Center and Medical Center Ophthalmology, San Antonio, Texas, USA
| | - Laurent Kodjikian
- University of Lyon and Croix-Rousse University Hospital UCBL, INSA Lyon, CNRS, MATEIS, UMR5510, Hospices Civils de Lyon, Lyon, France
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