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Landsend ECS, von der Lippe C, Mediå L, Miller JU, Berge KE, Sigurdardottir S. Relationship between physical and psychological functioning and health-related quality of life in congenital Aniridia. Acta Ophthalmol 2024; 102:590-599. [PMID: 38131258 DOI: 10.1111/aos.16615] [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: 10/11/2023] [Revised: 11/15/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE Congenital aniridia is a serious eye disease characterized by absence of iris to various degrees. The aims of this study were to investigate health-related quality of life (HRQoL) in adults with aniridia and assess the relationships between HRQoL, psychological status, ocular health and obesity. METHODS Twenty-nine adults with congenital aniridia (48% male, aged 18-79 years) participated. HRQoL was measured with SF-36 and the EQ visual analogue scale (VAS). The physical (PCS) and mental (MCS) component summaries of the SF-36 were calculated with higher scores indicating better HRQoL. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Obesity was assessed with the Patient-Reported Outcomes in Obesity (PROS). Sociodemographic characteristics, genetic variants and ocular and medical health variables were also analysed. RESULTS The participants scored significantly lower in the general health domain of the SF-36 than the general population (65.2 vs. 75.3, p = 0.017). The EQ VAS score was also lower in the aniridia group (64.9 vs. 77.9, p = 0.021). Low PCS score was correlated with presence of ocular pain (p = 0.019), high HADS score (p = 0.017) and high PROS score (p = 0.009). Low MCS score was related to higher educational level (p = 0.038) and high HADS score (p < 0.001). High HADS and PROS scores were both related to low EQ VAS scores. CONCLUSION Adults with congenital aniridia scored worse on certain measures of HRQoL than the general population. Poorer HRQoL was associated with increased symptoms of anxiety, depression and obesity and with presence of ocular pain.
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Affiliation(s)
| | | | - Line Mediå
- Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway
| | | | - Knut Erik Berge
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
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Wu BQ, Kuo HT, Hsu AY, Lin CJ, Lai CT, Tsai YY. The Clinical Efficacy of Different Relaxation Exercises on Intraocular Pressure Reduction: A Meta-Analysis. J Clin Med 2024; 13:2591. [PMID: 38731121 PMCID: PMC11084912 DOI: 10.3390/jcm13092591] [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: 03/27/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Objective: The aim of this study was to synthesize the available evidence on the clinical efficacy of different relaxation exercises on intraocular pressure (IOP) reduction. Methods: A systemic search of PubMed, Embase, Cochrane CENTRAL, and Web of Science was undertaken from the earliest record to 10 April 2024. Peer-reviewed studies that reported on healthy individuals and glaucoma patients engaging in relaxation exercises for at least three weeks were included. The primary outcome was changes in IOP levels from baseline, before the commencement of relaxation exercises, to post-exercise. Our statistical analysis employed a random-effects model, with effect sizes reported using Hedges' g. Results: Twelve studies were included, totaling 764 eyes (mean participant age ranging from 21.07 to 69.50 years). Relaxation exercises significantly reduced IOP, with Hedges' g being -1.276 (95% CI: -1.674 to -0.879) and I2 = 84.4%. Separate subgroup analyses showed that breathing exercises (Hedges' g = -0.860, p < 0.0001), mindfulness-based stress reduction (MBSR) (Hedges' g = -1.79, p < 0.0001), and ocular exercises (Hedges' g = -0.974, p < 0.0001) were associated with reduced IOP levels. The reduction in IOP following the relaxation exercises was found to be associated with baseline IOP either greater than (Hedges' g = -1.473, p < 0.0001) or less than 21 mmHg (Hedges' g = -1.22, p < 0.0001). Furthermore, this effect persisted with follow-up durations of less than (Hedges' g = -1.161, p < 0.0001) and more than one month (Hedges' g = -1.324, p < 0.0001). Conclusions: The current meta-analysis indicates that relaxation exercises can significantly reduce IOP levels. Relaxation exercises are a potential class of novel treatments for glaucoma patients that deserve further evaluation.
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Affiliation(s)
- Bing-Qi Wu
- Department of General Medicine, China Medical University Hospital, Taichung 404, Taiwan; (B.-Q.W.); (H.-T.K.)
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (A.Y.H.); (Y.-Y.T.)
| | - Hou-Ting Kuo
- Department of General Medicine, China Medical University Hospital, Taichung 404, Taiwan; (B.-Q.W.); (H.-T.K.)
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (A.Y.H.); (Y.-Y.T.)
| | - Alan Y. Hsu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (A.Y.H.); (Y.-Y.T.)
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (A.Y.H.); (Y.-Y.T.)
- School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
- Department of Optometry, Asia University, Taichung 413, Taiwan
| | - Chun-Ting Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (A.Y.H.); (Y.-Y.T.)
- School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
- Department of Optometry, Asia University, Taichung 413, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (A.Y.H.); (Y.-Y.T.)
- School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
- Department of Optometry, Asia University, Taichung 413, Taiwan
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Gunay M, Kurt IM, Turk A, Erdol H, Akyol N, Imamoglu HI, Uzlu D. Comparison of clinical outcomes between gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in advanced-stage pseudoexfoliation glaucoma. Graefes Arch Clin Exp Ophthalmol 2024; 262:567-574. [PMID: 37804451 DOI: 10.1007/s00417-023-06246-3] [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: 05/10/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 10/09/2023] Open
Abstract
PURPOSE To compare clinical outcomes between gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) in patients with advanced-stage pseudoexfoliation glaucoma (PEXG). METHODS This comparative study comprised 62 patients who underwent GATT (N = 31) or TRAB (N = 31) for advanced-stage PEXG. Primary outcome was cumulative probability of surgical success at the end of 12-month follow-up. Success was determined as intraocular pressure (IOP) reduction ≥ 30% from baseline, IOP between 6 and 18 mmHg and IOP upper limits for IOP < 15 mmHg and < 12 mmHg, separately. Secondary outcomes were IOP reduction, antiglaucoma medication (AGM) use, and complications in the study. RESULTS Age, sex, cup/disc ratio, mean deviation, pattern standard deviation, and retinal nerve fiber layer thickness did not significantly differ between the groups (p > 0.05 for all). The probability of cumulative surgical success at the end of 12 months was similar between the two groups for IOP < 15 mmHg and < 18 mmHg but significantly higher after TRAB (92.0%) than GATT (82.5%) for IOP < 12 mmHg (log-rank test p = 0.035). Percentage of IOP reduction from baseline was similar between the groups (53.1 ± 18.6% in GATT group and 53.0 ± 16.6% in TRAB group, p = 0.98) at the end of 12 months. No significant difference in the mean number of AGM was present at the 12-month visit (1.3 ± 1.4 in GATT and 1.1 ± 1.4 in TRAB, p = 0.65). CONCLUSION At the end of 12 months, IOP reduction rate was similar between GATT and TRAB. Cumulative surgical success was higher after TRAB than GATT for IOP < 12 mmHg.
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Affiliation(s)
- Murat Gunay
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Farabi Cad, No:10, Trabzon, Turkey.
| | - Ibrahim Mert Kurt
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Farabi Cad, No:10, Trabzon, Turkey
| | - Adem Turk
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Farabi Cad, No:10, Trabzon, Turkey
| | - Hidayet Erdol
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Farabi Cad, No:10, Trabzon, Turkey
| | - Nurettin Akyol
- Department of Ophthalmology, Kuzey Eye Hospital, Trabzon, Turkey
| | | | - Dilek Uzlu
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Farabi Cad, No:10, Trabzon, Turkey
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Radcliffe NM, Shah M, Samuelson TW. Challenging the "Topical Medications-First" Approach to Glaucoma: A Treatment Paradigm in Evolution. Ophthalmol Ther 2023; 12:2823-2839. [PMID: 37855977 PMCID: PMC10640619 DOI: 10.1007/s40123-023-00831-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023] Open
Abstract
Topical glaucoma medications are effective and safe, but they have numerous well-documented limitations that diminish their long-term utility and sustainability. These limitations can include high rates of nonadherence (with associated glaucoma progression), concerning side effects, inconsistent circadian intraocular pressure (IOP) control, complex dosing regimens, difficulty with self-administration, costs, and decreased quality of life. Despite these limitations, topical medications traditionally have been first-line in the glaucoma treatment algorithm, as no other minimally invasive treatment alternatives existed. In recent years, however, novel interventional therapies-including sustained-release drug-delivery platforms, selective laser trabeculoplasty, and micro-invasive glaucoma surgery procedures-have made it possible to intervene earlier without relying on topical medications. As a result, the topical medication-first treatment approach is being reevaluated in an overall shift toward earlier more proactive interventions.
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Affiliation(s)
- Nathan M Radcliffe
- New York Eye Surgery Center, 1101 Pelham Parkway North, Bronx, NY, 10469, USA.
| | - Manjool Shah
- New York University (NYU) Langone Health, New York, NY, USA
| | - Thomas W Samuelson
- Minnesota Eye Consultants, University of Minnesota, Minneapolis, MN, USA
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