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Mohammed BN, Ofori EK, Adekena CN, Amponsah SK, Asare-Anane H, Amanquah SD, Abdul-Rahman M, Amissah-Arthur KN. Levels of anti-insulin antibodies in diabetic retinopathy patients: an observational cross-sectional study. Future Sci OA 2024; 10:FSO982. [PMID: 38817369 PMCID: PMC11137838 DOI: 10.2144/fsoa-2024-0002] [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: 01/01/2024] [Accepted: 02/28/2024] [Indexed: 06/01/2024] Open
Abstract
Aim: This study evaluated the levels of anti-insulin antibodies (AIAs) and the influence of some antidiabetic medications on AIA in diabetes mellitus (DM) patients with retinopathy. Patient & methods: An observational cross-sectional study. Results: A lower titer of AIA IgG was observed in the diabetic retinopathy (DR) and DM-only study categories compared with the control group [DR = 86 (5-560), DM-only = 50 (5-500), versus control = 200 (7-565); p = 0.017]. Taking nifedipine and metformin were negatively correlated (r = -0.32, p = 0.04) with the levels of AIA IgE in the DR group. Conclusion: A decreased titer of circulating AIAs was observed in the DR study category, suggesting that AIA may not contribute to the pathogenesis of DR.
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Affiliation(s)
- Bismark N Mohammed
- Department of Chemical Pathology, University of Ghana Medical School, Accra, Ghana
| | - Emmanuel K Ofori
- Department of Chemical Pathology, University of Ghana Medical School, Accra, Ghana
| | | | - Seth K Amponsah
- Department of Medical Pharmacology, University of Ghana Medical School, Accra, Ghana
| | - Henry Asare-Anane
- Department of Chemical Pathology, University of Ghana Medical School, Accra, Ghana
| | - Seth D Amanquah
- Department of Chemical Pathology, University of Ghana Medical School, Accra, Ghana
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Emami-Naeini P, Garmo V, Boucher N, Fernando R, Menezes A. Maintenance of Vision Needed to Drive after Intravitreal Anti-VEGF Therapy in Patients with Neovascular Age-related Macular Degeneration and Diabetic Macular Edema. Ophthalmol Retina 2024; 8:388-398. [PMID: 37866681 DOI: 10.1016/j.oret.2023.10.010] [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: 05/15/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To evaluate the association between intravitreal anti-VEGF therapy and visual acuity (VA)/driving vision maintenance over 4 years in patients with neovascular age-related macular degeneration (nAMD) or diabetic macular edema (DME). DESIGN Retrospective, observational, clinical practice cohort study using data from the Vestrum Health database. PARTICIPANTS Initial diagnosis (January 1, 2014 to June 30, 2019) of nAMD or DME and ≥ 1 year of treatment/follow-up history. The VA analysis required 4 years of treatment/follow-up history. For the driving vision maintenance analysis, patients required Snellen VA of 20/40 or better at baseline and for ≥ 6 months during year 1 after index intravitreal anti-VEGF treatment in the better-seeing eye. METHODS A loss-of-driving event was the first clinic visit with VA worse than 20/40 sustained for ≥ 6 consecutive months. Kaplan-Meier analyses estimated the probability of maintaining driving vision over 4 years stratified by year-1 injection number. Cox proportional hazard models examined associations between baseline clinical characteristics and year-1 injection frequency and the risk of losing driving vision. MAIN OUTCOME MEASURES Mean change in VA over time and by baseline VA, driving vision maintenance probability over time and stratified by anti-VEGF injection frequency, and baseline factors predictive of driving vision maintenance. RESULTS In year 1, the nAMD and DME cohorts gained 8.5 and 9.5 ETDRS letters, respectively. Between years 1 and 4, patients with nAMD and DME lost 6.6 and 2.7 ETDRS letters, respectively. The probability of maintaining driving vision over 4 years was 56% (nAMD) and 72% (DME); among patients who received 1 to 5, 6 to 7, and ≥ 8 anti-VEGF injections in year 1, corresponding probabilities were 50%, 56%, and 65% (nAMD; P < 0.001) and 63%, 72%, and 77% (DME; P < 0.001). Baseline factors associated with driving vision loss included older age, worse index VA, geographic atrophy (nAMD), and worsening baseline diabetic retinopathy (DME). CONCLUSIONS Older age and worse index VA were risk factors for driving vision loss, whereas a greater year-1 injection number was associated with driving vision maintenance through year 4, supporting early initiation and frequent anti-VEGF injections for maintaining driving vision in nAMD or DME. 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)
- Parisa Emami-Naeini
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, California.
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Chen C, Lan Y, Wang Z, Yan W, Yan X, Han J. Causal effects of diabetic retinopathy on depression, anxiety and bipolar disorder in the European population: a Mendelian randomization study. J Endocrinol Invest 2024; 47:585-592. [PMID: 37598399 DOI: 10.1007/s40618-023-02176-3] [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: 05/30/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE To verify the causal effects of diabetic retinopathy (DR) on depression, anxiety and bipolar disorder (BD). METHODS Mendelian randomization (MR) analysis was performed to identify the causal relationships between DR and depression or anxiety or BD via using DR-related GWAS data (14,584 cases and 176,010 controls), depression-related GWAS data (59,851 cases and 113,154 controls), anxiety-related GWAS data (7016 cases and 14,745 controls) and BD-related GWAS data (41,917 cases and 371,549 controls). The inverse-variance weighted (IVW) model was adopted to estimate the causal relationship. The outcome was expressed as odds ratio (OR) with 95% confidence intervals (CI). RESULTS The MR analysis results presented that DR was causally associated with a significantly increased risk of BD in the European population (IVW, OR = 1.06, 95%CI [1.03, 1.08], P = 2.44 × 10-6), while DR was unable to causally influence the risk of depression (IVW, OR = 1.01, 95%CI [0.99, 1.04], P = 0.32) and anxiety (IVW, OR = 0.97, 95%CI [0.89, 1.06], P = 0.48) in the European population. Subgroup analysis based on BD identified DR causally increased the risk of bipolar I disorder (BD I) but not bipolar II disorder (BD II). Sensitivity analysis results did not show any pleiotropy and heterogeneity in both groups of analyses, indicating that the results were stable and reliable. CONCLUSIONS The results of the current MR analysis indicated a causal relationship between DR and BD in the European population, while there was no causal connection between DR and depression or anxiety. However, further research is needed to confirm these conclusions.
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Affiliation(s)
- C Chen
- Department of Ophthalmology, Tangdu Hospital, The Air Force Military Medical University, 569 Xinsi Rd, Xi'an, 710038, China
- Department of Ophthalmology, The 900th Hospital of Joint Logistic Support Force, PLA (Clinical Medical College of Fujian Medical University, Dongfang Hospital Affiliated to Xiamen University), Fuzhou, 350025, China
| | - Y Lan
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Z Wang
- Department of Thoracic Surgery, Tangdu Hospital, The Air Force Military Medical University, Xi'an, 710038, China
| | - W Yan
- Department of Ophthalmology, The 900th Hospital of Joint Logistic Support Force, PLA (Clinical Medical College of Fujian Medical University, Dongfang Hospital Affiliated to Xiamen University), Fuzhou, 350025, China
| | - X Yan
- Department of Thoracic Surgery, Tangdu Hospital, The Air Force Military Medical University, Xi'an, 710038, China.
| | - J Han
- Department of Ophthalmology, Tangdu Hospital, The Air Force Military Medical University, 569 Xinsi Rd, Xi'an, 710038, China.
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Vujosevic S, Chew E, Labriola L, Sivaprasad S, Lamoureux E. Measuring Quality of Life in Diabetic Retinal Disease: A Narrative Review of Available Patient-Reported Outcome Measures. OPHTHALMOLOGY SCIENCE 2024; 4:100378. [PMID: 37868790 PMCID: PMC10585645 DOI: 10.1016/j.xops.2023.100378] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/21/2023] [Accepted: 08/02/2023] [Indexed: 10/24/2023]
Abstract
Topic Several patient-reported outcome measures (PROMs) are available to measure health-related quality of life (HRQoL) in patients with late-stage clinical diabetic retinal diseases (DRDs). However, an understanding of the psychometric properties of PROMs is needed to assess how they could relate to severity levels of a revised DRD grading system. This narrative review assessed the available generic-, vision-, and DRD-related PROMs used in DRD research and highlights areas for improvement. Clinical Relevance Diabetic retinal disease is a common complication of diabetes and can lead to sight-threatening complications with a devastating effect on HRQoL. Methods The Quality of Life working group is one of 6 working groups organized for the DRD Staging System Update Effort, a project of the Juvenile Diabetes Research Foundation Mary Tyler Moore Vision Initiative. PubMed, Cochrane Library, Embase, and Google Scholar databases were searched using core keywords to retrieve ophthalmology-related review articles, randomized clinical trials, and prospective, observational, and cross-sectional studies in the English language. A detailed review of 12 PROMs (4 QoL questionnaires and 8 utilities) that met a minimum level of evidence (LOE) was conducted. The relevance of each PROM to DRD disease stage and Biomarker Qualification guidelines (Biomarkers, EndpointS, and other Tools) categories was also defined. Results The National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25), Impact of vision impairment-computerized adaptive testing, and Diabetic Retinopathy and Macular Edema Computerized Adaptive Testing System had a LOE of II in detecting change due to late-stage DRD (diabetic macular edema), although several areas for improvement (e.g., psychometrics and generalizability) were identified. Other PROMs, particularly the utilities, had a LOE of III due to cross-sectional evidence in late-stage clinical DRD. Although the NEI VFQ-25 has been the most widely used PROM in late-stage DRD, more work is required to improve its multidimensional structure and other psychometric limitations. No PROM was deemed relevant for subclinical or early/mid-DRD. Conclusion This narrative review found that the most commonly used PROM is NEI VFQ-25, but none meets the ideal psychometric, responsiveness, and clinical setting digital administration requirements that could be included in an updated DRD staging system for diagnosis and monitoring of DRD progression. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Stela Vujosevic
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Eye Clinic, IRCCS MultiMedica, Milan, Italy
| | - Emily Chew
- Division of Epidemiology and Clinical Applications, Clinical Trials Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Leanne Labriola
- Ophthalmology Department, Carle Foundation Hospital, Urbana, Illinois
- Surgery Department, University of Illinois College of Medicine, Urbana, Illinois
| | - Sobha Sivaprasad
- Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, United Kingdom
| | - Ecosse Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore
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Ross E, Alfonso CA. Psychodynamic Psychiatry and the Care of Persons with Vision Loss and Blindness. Psychodyn Psychiatry 2024; 52:1-7. [PMID: 38426754 DOI: 10.1521/pdps.2024.52.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
The authors describe the clinical relevance of the psychiatric concept of bidirectionality when caring for persons with comorbid disorders, and they propose a psychodynamic framework to guide the treatment of persons with vision loss and blindness. Since persons with vision loss have an increased risk of depressive and anxiety disorders, they recommend targeted screening, integrated services, and a biopsychosocial approach to clinical care. The psychoanalytic concept of aphanisis, first described by Ernest Jones and later developed by Lacan and Kohut, is briefly discussed. Common psychotherapy themes in the treatment of persons who experience vision loss from systemic illness include reactivation of memories of past traumas resulting in avoidance, social withdrawal, depressive states, catastrophic thinking, a sense of foreshortened future, anhedonia, and fear of disintegration and invisibility. Psychotherapy also serves to correct negative introjects from ableist societal attitudes.
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Affiliation(s)
- Edward Ross
- Lighthouse Guild International; New York Institute for Psychoanalytic Self-Psychology
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Zhou J, Zhu L, Li Y. Association between the triglyceride glucose index and diabetic retinopathy in type 2 diabetes: a meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1302127. [PMID: 38130393 PMCID: PMC10733479 DOI: 10.3389/fendo.2023.1302127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023] Open
Abstract
The triglyceride-glucose (TyG) index is an accessible and reliable surrogate indicator of insulin resistance and is strongly associated with diabetes. However, its relationship with diabetic retinopathy (DR) remains controversial. This meta-analysis aimed to assess the relationship between the TyG index and the prevalence of DR. Initial studies were searched from PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) electronic databases. The retrieval time range was from the establishment of the database to June 2023. Pooled estimates were derived using a random-effects model and reported as odds ratio (OR) with 95% confidence intervals (CIs). Two researchers independently assessed the methodological quality of the included studies. The Newcastle-Ottawa Quality Scale (NOS) was utilized to assess cohort studies or case-control studies. The Agency for Healthcare Research and Quality (AHRQ) methodology checklist was applied to assess cross-sectional studies. Ten observational studies encompassing 13716 patients with type 2 diabetes were included in the meta-analysis. The results showed that a higher TyG index increased the risk of DR compared with a low TyG index (OR: 2.34, 95% CI: 1.31-4.19, P < 0.05). When the index was analyzed as a continuous variable, consistent results were observed (OR: 1.48, 95% CI: 1.12-1.97, P < 0.005). There was no significant effect on the results of the sensitivity analyses excluding one study at a time (P all < 0.05). A higher TyG index may be associated with an increased prevalence of DR in patients with type 2 diabetes. However, high-quality cohort or case-control studies are needed to further substantiate this evidence. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023432747.
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Affiliation(s)
- Jianlong Zhou
- Department of Traditional Chinese Medicine, People’s Hospital of Deyang City, Deyang, China
| | - Lv Zhu
- Department of Integrative Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yadi Li
- Department of Traditional Chinese Medicine, People’s Hospital of Deyang City, Deyang, China
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Valluru G, Costa A, Klawe J, Liu B, Deobhakta A, Ahmad S. Depression in Individuals With Diabetic Retinopathy in the US National Health and Nutrition Examination Survey, 2005-2008. Am J Ophthalmol 2023; 256:63-69. [PMID: 37495007 DOI: 10.1016/j.ajo.2023.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE To examine the relationship between diabetic retinopathy (DR) and depression in the United States. DESIGN Retrospective, cross-sectional study. METHODS National Health and Nutrition Examination Survey (NHANES) participants between 2005 and 2008 (ages 40-85 years) were included. Prevalence of major depression among DR stages as determined by retinal imaging was estimated. Multivariable models assessed associations between depression and DR. RESULTS Depression was more common in those with moderate to severe DR (16%) than in those with no DR (7%), mild nonproliferative diabetic retinopathy (NPDR, 6%), or proliferative DR (5%). In a model with DR stages that adjusted for demographic factors, there was an association between moderate to severe DR and depression (odds ratio [OR], 2.46, 95% CI, 1.03-5.85). CONCLUSIONS Depression was more prevalent in those with moderate to severe NPDR than in those with no DR, mild NPDR, or proliferative DR. This relationship is statistically significant after adjustment for demographic factors.
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Affiliation(s)
- Girish Valluru
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA (G.V., A.C., J.K., A.D., S.A.).
| | - Allen Costa
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA (G.V., A.C., J.K., A.D., S.A.)
| | - Janek Klawe
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA (G.V., A.C., J.K., A.D., S.A.)
| | - Bian Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA (B.L.)
| | - Avnish Deobhakta
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA (G.V., A.C., J.K., A.D., S.A.)
| | - Sumayya Ahmad
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA (G.V., A.C., J.K., A.D., S.A.)
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Saitakis G, Roukas D, Hatziagelaki E, Efstathiou V, Theodossiadis P, Rizos E. Evaluation of Quality of Life and Emotional Disturbances in Patients with Diabetic Retinopathy. Eur J Investig Health Psychol Educ 2023; 13:2516-2528. [PMID: 37998065 PMCID: PMC10670728 DOI: 10.3390/ejihpe13110175] [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: 09/16/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
Diabetes has detrimental effects on many organs, including the kidneys, heart, and the central nervous system, with ophthalmic involvement and Diabetic Retinopathy (DR), specifically, being among the most severe and prominent consequences. Diabetic Retinopathy and especially advanced stages of the disease, have a crucial impact on patients' quality of life and emotional status. In this context, emotional imbalance, psychological side effects and comorbidities, like anxiety disorders, could emerge, deteriorating the patients' condition further. A number of questionnaires can be employed in the evaluation of the potential impact of Diabetic Retinopathy on patients' quality of life, including the Beck Anxiety Inventory (BAI) and The National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). PURPOSE The purpose of this study was to evaluate the association of Diabetic Retinopathy (DR) and diabetic macular edema with vision-related quality of life, as well as the potential association between the disease's severity, emotional status of patients and the manifestation of anxiety and psychological features. RESULTS Patients with fundoscopic findings had significantly lower scores in all VFQ-25 subscales, indicating worse quality of life in comparison to patients without DR. Severity of DR, greater levels of anxiety, daily sitting time, unemployment and lower education level, were all found to be significantly, negatively associated with a worse quality of life. Regarding emotional status, more years of suffering from diabetes, treatment with insulin and the hours being idle per day were associated with an increased burden of anxiety. In addition, the presence of a concomitant disease, findings in fundoscopy, diabetic macular edema and treatment with anti-VEFG injections, as well as the number of doses, were significantly associated with greater anxiety. Multivariate analysis showed that having Severe Non-Proliferative Diabetic Retinopathy or having Proliferative Diabetic Retinopathy and receiving insulin therapy (alone or in combination with another treatment), were significantly associated with higher levels of anxiety. CONCLUSION The well-established impact of DR on the patients' well-being, quality of life and emotional status render DR and CME prevention, stabilization or delaying progression as a necessity in order to protect patients from developing psychiatric symptoms. On the other hand, the speculated bi-directional association between emotional problems and DR progression highlights the importance of acknowledging and dealing with psychological issues with the aim of delaying DR progression.
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Affiliation(s)
- George Saitakis
- Second Department of Ophthalmology, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece
| | - Dimitrios Roukas
- Department of Psychiatry, 417 VA (NIMITS) Hospital, 11521 Athens, Greece;
| | - Erifili Hatziagelaki
- Research Institute and Diabetes Center, Second Department of Internal Medicine-Propaedeutic, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece
| | - Vasiliki Efstathiou
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Medical School of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece; (V.E.); (E.R.)
| | - Panagiotis Theodossiadis
- Second Department of Ophthalmology, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Medical School of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece; (V.E.); (E.R.)
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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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Bouhout S, Hébert M, Jakubowska W, Jaworski L, Freeman EE, Aubin MJ. Impact of the COVID-19 Pandemic on Mental Health among Patients with Chronic Ocular Conditions. Vision (Basel) 2023; 7:49. [PMID: 37489328 PMCID: PMC10366822 DOI: 10.3390/vision7030049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023] Open
Abstract
The COVID-19 pandemic had significant impacts on the mental and visual health of patients. This cross-sectional, survey-based, multicentric study evaluates the state of mental and visual health among patients with chronic ocular diseases such as glaucoma, neovascular age-related macular degeneration, diabetic retinopathy, or chronic uveitis during the lockdown period of the COVID-19 pandemic. Mental health was assessed using three questionnaires: the Patient Health Questionnaire-9 (PHQ-9), the Impact of Event Scale-Revised (IES-R), and the National Eye Institute Visual Function Questionnaire-25 (VFQ-25). A total of 145 patients completed the questionnaires. The PHQ-9 showed that most respondents (n = 89, 61%) had none or minimal depressive symptoms, while 31 (21%) had mild depressive symptoms, 19 (13%) had moderate depressive symptoms, 5 (3%) had moderately severe depressive symptoms, and 1 (1%) had severe depressive symptoms. Regarding stress surrounding the pandemic, the median IES-R showed mild distress in 16 (11%), moderate distress in 7 (5%), and severe distress in 4 (3%). The COVID-19 pandemic lockdowns had a negative impact on patients' mental health with close to 20% of the patients reporting at least moderately depressive symptoms and 19% reporting at least mildly distressful symptoms.
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Affiliation(s)
- Soumaya Bouhout
- Department of Ophthalmology, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Mélanie Hébert
- Department of Ophthalmology, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Weronika Jakubowska
- Department of Ophthalmology, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Laurence Jaworski
- Department of Ophthalmology, Université de Montréal, Montréal, QC H3T 1J4, Canada
- University Ophthalmology Center, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC H2X 3E4, Canada
| | - Ellen E Freeman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
- Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada
| | - Marie-Josée Aubin
- Department of Ophthalmology, Université de Montréal, Montréal, QC H3T 1J4, Canada
- University Ophthalmology Center, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île-de-Montréal-Hôpital Maisonneuve-Rosemont, Montréal, QC H1T 2M4, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, QC H3T 1J4, Canada
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Shughoury A, Bhatwadekar A, Jusufbegovic D, Hajrasouliha A, Ciulla TA. The evolving therapeutic landscape of diabetic retinopathy. Expert Opin Biol Ther 2023; 23:969-985. [PMID: 37578843 PMCID: PMC10592121 DOI: 10.1080/14712598.2023.2247987] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/30/2023] [Accepted: 08/11/2023] [Indexed: 08/16/2023]
Abstract
INTRODUCTION Diabetic retinopathy (DR) is a leading cause of blindness worldwide. Recent decades have seen rapid progress in the management of diabetic eye disease, evolving from pituitary ablation to photocoagulation and intravitreal pharmacotherapy. The advent of effective intravitreal drugs inhibiting vascular endothelial growth factor (VEGF) marked a new era in DR therapy. Sustained innovation has since produced several promising biologics targeting angiogenesis, inflammation, oxidative stress, and neurodegeneration. AREAS COVERED This review surveys traditional, contemporary, and emerging therapeutics for DR, with an emphasis on anti-VEGF therapies, receptor tyrosine kinase inhibitors, angiopoietin-Tie2 pathway inhibitors, integrin pathway inhibitors, gene therapy 'biofactory' approaches, and novel systemic therapies. Some of these investigational therapies are being delivered intravitreally via sustained release technologies for extended durability. Other investigational agents are being delivered non-invasively via topical and systemic routes. These strategies hold promise for early and long-lasting treatment of DR. EXPERT OPINION The evolving therapeutic landscape of DR is rapidly expanding our toolkit for the effective and durable treatment of blinding eye disease. However, further research is required to validate the efficacy of novel therapeutics and characterize real world outcomes.
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Affiliation(s)
- Aumer Shughoury
- Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA 46202
| | - Ashay Bhatwadekar
- Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA 46202
| | - Denis Jusufbegovic
- Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA 46202
| | - Amir Hajrasouliha
- Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA 46202
| | - Thomas A Ciulla
- Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA 46202
- Midwest Eye Institute, Indianapolis, IN, USA 46290
- Clearside Biomedical, Inc., Alpharetta, GA, USA 30005
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12
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Sandvik SA, Sundling V, Lagali N. Methods for evaluation of corneal nerve fibres in diabetes mellitus by in vivo confocal microscopy: a scoping review protocol. BMJ Open 2023; 13:e070017. [PMID: 37045576 PMCID: PMC10106056 DOI: 10.1136/bmjopen-2022-070017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
INTRODUCTION Globally, 422 million people have diabetes. Late complications of diabetes are blindness, kidney failure, heart attack, stroke and lower limb amputation. The prevalence of diabetic peripheral neuropathy and diabetic retinopathy is 50% and 35%, respectively. In vivo confocal microscopy (IVCM) is a rapid, non-invasive method to evaluate subbasal corneal nerve fibres, which are small fibres of the peripheral nervous system. Corneal nerve fibre changes can be a marker of diabetic peripheral neuropathy. There is currently no gold-standard procedure for IVCM imaging, image processing or quantitative analysis of the corneal nerve fibres in the subbasal plexus. This protocol describes a scoping review to map, summarise and critically evaluate current methods used with IVCM evaluation in people with diabetes mellitus. METHODS The scoping review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping review. A comprehensive search of the literature will be conducted in MEDLINE, Embase, Cochrane, Scopus and Web of Science. The search strategy will include terms related to IVCM, diabetes and corneal nerve fibres. We will set inclusion and exclusion criteria prior to the search, and two reviewers will screen titles and abstracts independently. One reviewer will full text read eligible articles and chart data from the studies. A descriptive summary of the methods used in imaging, image processing and quantitative analysis of peripheral corneal nerve fibres by IVCM will be written. ETHICS AND DISSEMINATION Ethical approval is not required since this is a scoping review based on previously published articles. The findings will be published in a scientific peer-reviewed journal.
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Affiliation(s)
- Siv Aaseth Sandvik
- Department of Optometry, Radiology and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | - Vibeke Sundling
- Department of Optometry, Radiology and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | - Neil Lagali
- Department of Biomedical and Clinical Sciences, Linkopings universitet, Linkoping, Sweden
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Rofail D, Sherman S, Hartford C, Levine A, Baldasaro J, Marquis P, Rao R, Do DV. Development and Preliminary Validation of an Instrument to Measure Symptoms and Impacts in Patients with Proliferative Diabetic Retinopathy. Adv Ther 2023; 40:1773-1786. [PMID: 36848017 PMCID: PMC9969934 DOI: 10.1007/s12325-023-02447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/27/2023] [Indexed: 03/01/2023]
Abstract
INTRODUCTION Following a review of patient-reported outcome (PRO) instruments in the literature, existing PRO instruments may not adequately capture the experience of receiving treatment for proliferative diabetic retinopathy (PDR). Therefore, this study aimed to develop a de novo instrument to comprehensively assess the patient experience of PDR. METHODS This qualitative, mixed-methods study comprised item generation for the Diabetic Retinopathy-Patient Experience Questionnaire (DR-PEQ), content validation in patients with PDR, and preliminary Rasch measurement theory (RMT) analyses. Adult patients with diabetes mellitus and PDR who received aflibercept and/or panretinal photocoagulation within 6 months of study initiation were eligible for participation. The preliminary DR-PEQ comprised four scales: Daily Activities, Emotional Impact, Social Impact, and Vision Problems. DR-PEQ items were generated using existing knowledge of patient experiences in PDR and conceptual gaps identified from existing PRO instruments. Patients indicated the level of difficulty conducting daily activities and frequency experiencing emotional impacts, social impacts, and vision problems attributed to diabetic retinopathy and its treatment in the past 7 days. Content validity was evaluated in two rounds of in-depth, semi-structured patient interviews. Measurement properties were investigated via RMT analyses. RESULTS The preliminary DR-PEQ comprised 72 items. Overall, mean (SD) patient age was 53.7 (14.7) years. Forty patients completed the first interview; of these, 30 completed the second interview. Patients reported that the DR-PEQ was easily understood and relevant to their experience. Minor revisions, including removal of the Social Impact scale and addition of a Treatment Experience scale, were implemented to generate 85 items spanning four scales: Daily Activities, Emotional Impact, Vision Problems, and Treatment Experience. RMT analyses provided preliminary evidence that the DR-PEQ performed as intended. CONCLUSION The DR-PEQ evaluated a broad spectrum of symptoms, functional impacts, and treatment experiences relevant to patients with PDR. Additional analyses are warranted to evaluate psychometric properties in a larger patient population.
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Affiliation(s)
- Diana Rofail
- Regeneron Pharmaceuticals, Inc., 1 Rockwood Road, Sleepy Hollow, NY, 10591, USA.
| | - Steven Sherman
- Regeneron Pharmaceuticals, Inc., 1 Rockwood Road, Sleepy Hollow, NY, 10591, USA
| | | | - Adele Levine
- Modus Outcomes, a Division of THREAD, Cambridge, MA, USA
- Center for the Evaluation of Value and Risk in Health, Boston, MA, USA
| | | | | | - Rohini Rao
- Regeneron Pharmaceuticals, Inc., 1 Rockwood Road, Sleepy Hollow, NY, 10591, USA
| | - Diana V Do
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
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Almpanidou S, Almaliotis D, Karamitopoulos L, Topouzis F, Konstas AG, Labiris G, Dardavesis T, Fountoulakis KN, Chatzisavvas KC, Karampatakis V. Development and Validation of the Life for Low Vision Questionnaire (LIFE4LVQ) Using Rasch Analysis: A Questionnaire Evaluating Ability and Independence. J Clin Med 2023; 12:jcm12072549. [PMID: 37048633 PMCID: PMC10095134 DOI: 10.3390/jcm12072549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/24/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Low vision (LV) has a substantial impact on an individual’s daily functionality and patient-reported outcome measures (PROMs) are increasingly incorporated into the evaluation of this problem. The objective of this study was to describe the design of the new “Life for Low Vision Questionnaire (LIFE4LVQ)”, as a measure of daily functionality in LV and to explore its psychometric properties. A total of 294 participants completed the LIFE4LVQ and the data were subjected to Rasch analysis to determine the psychometric properties of the questionnaire, including response category ordering, item fit statistics, principal component analysis, precision, differential item functioning, and targeting. Test–retest reliability was evaluated with an interval of three weeks and intraclass correlation coefficients (ICC) were used. The correlation between the questionnaire score and Best Corrected Visual Acuity (BCVA) was examined using Spearman’s correlation coefficient. Rasch analysis revealed that for most items the infit and outfit mean square fit values were close to 1, both for the whole scale and its subscales (ability and independence). The separation index for person measures was 5.18 with a reliability of 0.96, indicating good discriminant ability and adequate model fit. Five response categories were found for all items. The ICC was 0.96 (p < 0.001; 95% CI, 0.93–0.98), suggesting excellent repeatability of the measure. Poorer BCVA was significantly associated with worse scores (rho = 0.559, p < 0.001), indicating excellent convergent validity. The functional, 40-item LIFE4LVQ proved to be a reliable and valid tool that effectively measures the impact of LV on ability and independence.
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Affiliation(s)
- Stavroula Almpanidou
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6946777213
| | - Diamantis Almaliotis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Leonidas Karamitopoulos
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Fotios Topouzis
- 1st Department of Ophthalmology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | | | - Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
| | - Theodoros Dardavesis
- Department of Hygiene, Social-Preventative Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Konstantinos N. Fountoulakis
- Third Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Konstantinos Ch. Chatzisavvas
- mSensis S.A., VEPE Technopolis, Bld C2, 55535 Thessaloniki, Greece
- Department of Electrical and Computer Engineering, University of Western Macedonia, ZEP Campus Kozani, 50100 Kozani, Greece
| | - Vasileios Karampatakis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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The Patient Experience with Diabetic Retinopathy: Qualitative Analysis of Patients with Proliferative Diabetic Retinopathy. Ophthalmol Ther 2023; 12:431-446. [PMID: 36460939 PMCID: PMC9834467 DOI: 10.1007/s40123-022-00614-8] [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: 09/19/2022] [Accepted: 11/06/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Few qualitative studies have explored the patient experience of daily life with proliferative diabetic retinopathy (PDR) and associated treatments. Herein, a conceptual model was developed to comprehensively examine symptoms, functional impacts, and treatment experiences in PDR. METHODS A qualitative, mixed-methods study comprising a literature search and semi-structured interviews with clinicians and patients was conducted. Published literature and online patient resources were searched to identify concepts relevant to patients, including symptoms, functional impacts, and treatment experiences of PDR. Semi-structured interviews with experienced clinicians were conducted to identify symptoms and impacts reported by patients with PDR and to receive feedback regarding concepts identified from the literature search. A preliminary conceptual model was then developed based on findings from the literature search and clinician interviews. Patients with PDR participated in two rounds of semi-structured interviews to identify additional concepts relevant to the patient experience in PDR and associated treatments, which informed revisions to the conceptual model. Saturation of patient interviews was assessed. RESULTS Findings from the literature search and clinician interviews yielded 109 concepts that were included in a preliminary conceptual model with three overarching domains: symptoms, impacts, and managing the disease. Clinicians confirmed concepts identified from the literature search. During interviews, patients reported a broad spectrum of symptoms (e.g., red vision); functional impacts relating to activities of daily living (e.g., reading), emotional functioning (e.g., loss of independence), and social functioning (e.g., problems recognizing faces); and treatment experiences (e.g., improves eye problems, no change) associated with PDR. Additional concepts elicited in patient interviews informed revisions to the conceptual model. Saturation was achieved in the patient sample. CONCLUSIONS A wide variety of symptoms, functional impacts, and treatment experiences that significantly affect health-related quality of life were identified in patients with PDR. These insights are critical for understanding PDR symptomology and assessing treatment response.
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Shen Y, Chen Y, Huang S, Yao X, Kanwar YS, Zhan M. The Association between Symptoms of Depression and Anxiety, Quality of Life, and Diabetic Kidney Disease among Chinese Adults: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:475. [PMID: 36612797 PMCID: PMC9819882 DOI: 10.3390/ijerph20010475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 06/17/2023]
Abstract
Depression and anxiety are common comorbid symptoms among patients with diabetic kidney disease (DKD). Little is known about the influence of poor psychological conditions on the disease progression and quality of life (QOL) in DKD patients. This study aimed to investigate the prevalence of, and risk factors for, depression and anxiety in Chinese DKD patients, and to analyze their impact on the renal function, proteinuria, and QOL. A total of 620 adult patients with Type 2 diabetes and DKD being treated at a tertiary hospital in East China were recruited. Depression and anxiety symptoms were assessed by the Zung Self-Rating Depression Scale and Anxiety Scale. Among the DKD participants, 41.3% had symptoms of depression and 45.0% had anxiety symptoms. A poor education, physical inactivity, stroke, low serum albumin, CKD stage 3-4, macroalbuminuria, and a poor QOL were independent risk factors for depression in the DKD patients. Whereas a higher education, physical inactivity, diabetic retinopathy and neuropathy, low hemoglobin, CKD stage 3-4, and a poor QOL were risk factors for anxiety. Depression and anxiety scores among the DKD patients were negatively correlated with the eGFR and QOL scores. Moreover, depression and anxiety symptoms were independent risk factors for DKD patients with CKD stage 3-4 and a poor QOL. Our findings suggest a high prevalence of depression and anxiety among Chinese DKD patients, and the severity of psychological symptoms is closely linked to the deterioration of renal function and the QOL. The early screening and intervention of psychopathological disorders is thus strongly recommended for improving the QOL and clinical outcomes among DKD patients.
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Affiliation(s)
- Yan Shen
- School of Medicine, Ningbo University, Ningbo 315000, China
| | - Yi Chen
- School of Medicine, Ningbo University, Ningbo 315000, China
| | - Shichun Huang
- School of Medicine, Ningbo University, Ningbo 315000, China
| | - Xuejie Yao
- Department of Medicine, Ningbo First Hospital, Zhejiang University, Ningbo 315000, China
| | - Yashpal S. Kanwar
- Department of Pathology, Northwestern University, Chicago, IL 60611, USA
- Department of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Ming Zhan
- Department of Medicine, Ningbo First Hospital, Zhejiang University, Ningbo 315000, China
- China Health Institute, University of Nottingham Ningbo China, Ningbo 315100, China
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17
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Ma Q, Zhou J, Yang Z, Xue Y, Xie X, Li T, Yang Y. Mingmu Xiaoyao granules regulate the PI3K/Akt/mTOR signaling pathway to reduce anxiety and depression and reverse retinal abnormalities in rats. Front Pharmacol 2022; 13:1003614. [PMID: 36278192 PMCID: PMC9579374 DOI: 10.3389/fphar.2022.1003614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/20/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: To investigate the effects of Mingmu Xiaoyao granules (MMXY) on the morphology and function of the retina and the mechanism of PI3K/Akt/mTOR pathway-related proteins in rats with anxiety and depression induced by chronic unpredictable mild stress (CUMS). Methods: Fifty-two male Sprague Dawley rats were randomly allocated to either a control (n = 14) or a simulated CUMS group (n = 38). The CUMS model was established successfully at 4 weeks. Six rats in each group were randomly selected to be sacrificed and their retinas isolated for histological examination. At 5 weeks, rats in the CUMS group were randomly allocated to the following groups: Model (CUMS + pure water), MMXY-H (CUMS + MMXY 7.2 g/kg/d), MMXY-L (CUMS + MMXY 3.6 g/kg/d), and CBZ (CUMS + Carbamazepine 20 mg/kg/d), with eight rats in each group. All rats were given the relevant intervention once a day. At 12 weeks, sucrose preference and open field tests were performed to evaluate the anxiety and depression status of rats. In live rats, optical coherence tomography angiography was used to measure retinal thickness and blood flow, while electroretinograms (ERGs) and visual evoked potentials (VEPs) were used to evaluate retinal function. The next day, the specimens were sacrificed for serological, histological, immunofluorescence, Western blot and transmission electron microscopy examinations to explore the mechanism of MMXY in CUMS rats. Results: MMXY improved the anxiety and depression-like behavior of rats. Results of optical coherence tomography angiography showed that MMXY improved retinal inner thickness and blood flow in CUMS rats. MMXY improved the amplitude of a- and b-waves in the scotopic and photopic ERG, as well as N2 and P2 peak time and amplitude in the flash-VEP in CUMS rats. Retinal histological staining and transmission electron microscopy showed that MMXY reversed retinal morphology and ultrastructure in CUMS rats. MMXY reduced the expression of Beclin1 and LC3I/II proteins, regulated the PI3K/Akt/mTOR pathway, inhibited autophagy, and had a protective effect on the retina in CUMS rats. Conclusion: MMXY may effectively improve retinal morphology and function as well as anxiety and depression-like behaviors in CUMS rats by regulating the PI3K/Akt/mTOR signaling pathway.
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Affiliation(s)
- Qiuyan Ma
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Ophthalmology Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jian Zhou
- Ophthalmology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ziyi Yang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yuxin Xue
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Xinran Xie
- Ophthalmology Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
- Beijing Institute of Traditional Chinese Medicine, Beijing, China
| | - Tiejun Li
- Ophthalmology Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yingxin Yang
- Ophthalmology Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
- *Correspondence: Yingxin Yang,
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Crooke A, Martínez-Alberquilla I, Madrid-Costa D, Ruiz-Alcocer J. Presbyopia: An outstanding and global opportunity for early detection of pre-frailty and frailty states. Front Med (Lausanne) 2022; 9:968262. [PMID: 36267611 PMCID: PMC9576860 DOI: 10.3389/fmed.2022.968262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Almudena Crooke
- Department of Biochemistry and Molecular Biology, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain,Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain,*Correspondence: Almudena Crooke
| | - Irene Martínez-Alberquilla
- Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain,Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - David Madrid-Costa
- Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain,Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Ruiz-Alcocer
- Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain,Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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Inverso H, Moore HR, Lupini F, Wang CH, Streisand R, Shomaker LB, Mackey ER. Mindfulness-Based Interventions: Focus on Pediatric Type 1 and Type 2 Diabetes. Curr Diab Rep 2022; 22:493-500. [PMID: 35984566 DOI: 10.1007/s11892-022-01492-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Mindfulness-based interventions (MBIs) focus on promoting nonjudgmental, purposeful awareness of the present experience, and they include specific components such as body scan, meditation, and breathing techniques for healthier coping with stress and reduced negative affect. In adult populations with chronic illness (e.g., type 1 diabetes [T1D], type 2 diabetes [T2D], overweight), MBIs have been shown to improve psychosocial outcomes with some improvements in health outcomes as well. Youth with T1D/T2D frequently experience heightened depression as well as diabetes distress, which are associated with less frequent blood glucose monitoring, insulin administration, and nutrition oversight. Thus, MBIs have potential to alleviate psychosocial distress in youth with T1D/T2D and also improve health outcomes. This paper is a review of the literature on potential psychosocial and health benefits of MBIs for youth with T1D/T2D. RECENT FINDINGS Among youth with T1D/T2D, MBIs have been shown to reduce symptoms of depression and diabetes distress. Improvements in health outcomes, such as A1c, have been inconsistent across studies. Although research on the efficacy of MBIs to improve psychosocial and health outcomes in youth with T1D/T2D is promising, this area of study is in its early stages. Future investigation of MBIs in youth with T1D and T2D is warranted, recognizing that these are heterogeneous groups with potential benefit of specifically tailored interventions.
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Affiliation(s)
- Hailey Inverso
- Center for Translational Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC, 20010, USA
| | - Hailey R Moore
- Center for Translational Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC, 20010, USA
| | - Francesca Lupini
- Center for Translational Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC, 20010, USA
| | - Christine H Wang
- Center for Translational Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC, 20010, USA
| | - Randi Streisand
- Center for Translational Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC, 20010, USA
- The George Washington University School of Medicine, Washington, DC, USA
| | - Lauren B Shomaker
- Colorado State University, Fort Collins, CO, USA
- Children's Hospital Colorado/University of Colorado Anschutz, Aurora, CO, USA
- Colorado School of Public Health, Fort Collins and Aurora, CO, USA
| | - Eleanor R Mackey
- Center for Translational Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC, 20010, USA.
- The George Washington University School of Medicine, Washington, DC, USA.
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20
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Elbarky A. Effectiveness and tolerability of the fluocinolone acetonide implant in patients with diabetic macular edema in the UAE: 24 and 36-month outcomes. Eur J Ophthalmol 2022; 33:11206721221128671. [PMID: 36168254 DOI: 10.1177/11206721221128671] [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: 11/15/2022]
Abstract
INTRODUCTION The effectiveness and safety of the fluocinolone acetonide (FAc) implant was evaluated at Month 24 and, in some sustained for up to 36 months, in patients with diabetic macular edema (DME) and a pseudophakic lens treated in the UAE following prior anti-vascular endothelial growth factor and dexamethasone (DEX) implant. METHODS This was a retrospective, observational audit study conducted between September 2017-September 2020 in which 22 patients were treated with the FAc implant and outcomes monitored for up to 36 months. Effectiveness outcomes were: best-corrected visual acuity (BVCA) and central macular thickness (CMT). Safety was assessed by monitoring intraocular pressure (IOP). All outcomes were measured at Months 1, 3, 6, 12, 24, and 36. RESULTS Significant improvements in mean BCVA were observed versus baseline from Month 1, which were maintained up to Month 24 (P < 0.0001 versus baseline). In all five patients completing 36 months follow-up, the improvements in BVCA were maintained through to Month 36 P < 0.005 versus baseline. Similarly, mean CMT improved versus baseline at Month 1 through to Month 24 (P < 0.0001 versus baseline), with significant improvements also noted in the 5 patients completing 36 months follow-up (P < 0.005 versus baseline). An IOP rise to 32 mmHg was observed in one eye, but returned to normal values at next measure. Five eyes required IOP lowering drops and one required IOP-lowering surgical intervention. CONCLUSION The FAc intravitreal implant is effective for 24 months, and sustained for 36 months, in a UAE population previously treated with a DEX implant, with tolerability profile in-line with previous reports.
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Affiliation(s)
- Ahmed Elbarky
- 37532Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, Egypt
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21
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Sun XJ, Zhang GH, Guo CM, Zhou ZY, Niu YL, Wang L, Dou GR. Associations between psycho-behavioral risk factors and diabetic retinopathy: NHANES (2005-2018). Front Public Health 2022; 10:966714. [PMID: 36187629 PMCID: PMC9521717 DOI: 10.3389/fpubh.2022.966714] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/19/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Diabetes mellitus (DM) and diabetic retinopathy (DR) increase the global burden. Since their pathogenesis is complex, it is necessary to use the biopsychosocial model to discover the most effective strategies. The study is aimed to investigate the psycho-behavioral factors of DR and confirm the discrepancies from previous studies. Research design and methods The study comprised seven cycles of cross-sectional data of the National Health and Nutrition Examination Survey (NHANES) from 2005-2006 to 2017-2018. Samples of DM were selected from this complex multi-stage probability sample and divided into the non-DR and DR groups, where 4,426 samples represented 18,990,825 individuals after weighting. This study comprehensively explored the biological, social, and psychological risk factors of DR, among which the biological factors included blood pressure, blood routine, HbA1c%, blood glucose, the duration of DM, family history, comorbidities, and treatment methods. Social aspects include gender, education, income, insurance, smoking, drinking, sleep habits, and recreational activities. The Patient Health Questionnaire-9 (PHQ-9) was used to assess the psychological state. Taylor series regression was used to examine the connection between factors and DR. Results Men accounted for 55.5% of the DR group (P = 0.0174). Lymphocyte count, insulin treatment, heart failure, stroke, liver condition, and renal failure showed significant differences in DR (P < 0.05). The incidence of depression in DR was 40.5%. Mild to moderate depression [odds ratio was associated with DR [(OR) = 1.37, 95% confidence interval (CI): 1.06-1.79], but there was no statistical difference in severe depression (OR = 1.34, 95% CI: 0.83-2.17). Although ≤ 6 h of sleep was associated with DR (OR = 1.38, 95% CI: 1.01-1.88), we found no statistical differences in alcohol consumption, recreational activities, or sedentary time between the two groups in our current study (P > 0.05). Conclusions The biological risk factors of DR are significant. It showed that stroke is associated with DR, and retinal exams have the potential value as a screening tool for the brain. Besides, psycho-behavioral risk factors of DR should also be paid attention. Our study highlights that mild and moderate depression and ≤6 h of sleep are distinguishably associated with DM complicated with DR. It indicates that psycho-behavioral risk factors confer a vital influence on diabetic health care and DR.
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Affiliation(s)
- Xiao-Jia Sun
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Guo-Heng Zhang
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Chang-Mei Guo
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zi-Yi Zhou
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ya-Li Niu
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ling Wang
- Department of Health Statistics, Faculty of Preventive Medicine, Fourth Military Medical University, Xi'an, China,Ling Wang
| | - Guo-Rui Dou
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China,*Correspondence: Guo-Rui Dou
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Increased probability of mood disorders after age-related macular degeneration: a population-based cohort study. Sci Rep 2022; 12:15222. [PMID: 36075924 PMCID: PMC9458640 DOI: 10.1038/s41598-022-19429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/29/2022] [Indexed: 11/08/2022] Open
Abstract
We aim to investigate the association of mood disorders with age-related macular degeneration (AMD). This retrospective cohort study used data from 2000 and 2016 from National Health Insurance Research Database (NHIRD) in Taiwan. Patients with AMD diagnosis formed the exposed group, and an age- and sex-matched group without AMD served as the nonexposed group. Main outcomes were the incidence of mood disorders including psychological counseling, behavior therapy, sleep or anxiety-related disorders, and major depressive disorders (MDDs) in the exposed and non-exposed groups. The Cox proportional hazard regression analysis was used to evaluate the incidence and adjusted hazard ratio (aHR) of mood disorders. A total of 5916 and 11,832 individuals with and without AMD were enrolled into the exposed and nonexposed groups. There were 1017 (17.19%) and 1366 (11.54%) episodes of mood disorders occurred in the exposed and nonexposed groups, respectively. The aHRs of any psychological counseling, behavioral therapy, sleep or anxiety-related disorders, and MDD were significantly higher in patients with AMD than in those without AMD (all P < 0.05). Besides, patients with dry-AMD, participants aged 50-70 years, and women with AMD had a higher incidence of mood disorders (all P < 0.05) than did non-AMD individuals, patients > 70 years, and women without AMD. In conclusion, AMD occurrence leads to an increased rate of mood disorders, particularly among those with dry-AMD, middle aged participants (aged 50-70), and women.
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Déniz-García A, Díaz-Artiles A, Saavedra P, Alvarado-Martel D, Wägner AM, Boronat M. Impact of anxiety, depression and disease-related distress on long-term glycaemic variability among subjects with Type 1 diabetes mellitus. BMC Endocr Disord 2022; 22:122. [PMID: 35546667 PMCID: PMC9092877 DOI: 10.1186/s12902-022-01013-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anxiety, depression, and disease-related distress are linked to worse overall glycaemic control, in terms of HbA1c. This study was aimed to evaluate whether traits of these emotional disorders are associated with long-term glycaemic variability in subjects with Type 1 diabetes. METHODS Longitudinal retrospective study. Six-year HbA1c data (2014-2019) from 411 subjects with Type 1 diabetes who had participated in a previous study to design a diabetes-specific quality of life questionnaire in the year 2014 were included. Scores for Spanish versions of the Hospital Anxiety and Depression Scale (HADS) and Problem Areas in Diabetes (PAID) scale were obtained at baseline, along with sociodemographic and clinical data. Long-term glycaemic variability was measured as the coefficient of variation of HbA1c (HbA1c-CV). The association between HADS and PAID scores and HbA1c-CV was analysed with Spearman correlations and multiple regression models, both linear and additive, including other covariates (age, sex, diabetes duration time, type of treatment, baseline HbA1c, use of anxiolytic or antidepressant drugs, education level and employment status). RESULTS Scores of depression, anxiety and distress were positively and significantly correlated to HbA1c-CV in univariate analyses. Multiple regression study demonstrated an independent association only for diabetes distress score (p < 0.001). Age, diabetes duration time, baseline HbA1c, education level and employment status were also significantly associated with HbA1c-CV. However, when subjects were analyzed separately in two age groups, distress scores were associated with HbA1c-CV only among those aged 25 years or older, while anxiety scores, but not distress, were associated with HbA1c-CV among those younger than 25 years. CONCLUSIONS Psychological factors, particularly disease-related distress and anxiety, are associated with long-term glycaemic variability in subjects with Type 1 diabetes.
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Affiliation(s)
- Alejandro Déniz-García
- Section of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Avenida Marítima del Sur, s/n. 35016, Las Palmas de Gran Canaria, Spain
- Institute of Biomedical and Health Research, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Alba Díaz-Artiles
- Section of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Avenida Marítima del Sur, s/n. 35016, Las Palmas de Gran Canaria, Spain
| | - Pedro Saavedra
- Mathematics Department, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Dácil Alvarado-Martel
- Institute of Biomedical and Health Research, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Ana M Wägner
- Section of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Avenida Marítima del Sur, s/n. 35016, Las Palmas de Gran Canaria, Spain
- Institute of Biomedical and Health Research, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Mauro Boronat
- Section of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Avenida Marítima del Sur, s/n. 35016, Las Palmas de Gran Canaria, Spain.
- Institute of Biomedical and Health Research, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
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Lundeen EA, Saydah S, Ehrlich JR, Saaddine J. Self-Reported Vision Impairment and Psychological Distress in U.S. Adults. Ophthalmic Epidemiol 2022; 29:171-181. [PMID: 33896341 PMCID: PMC10949979 DOI: 10.1080/09286586.2021.1918177] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Examine the relationship between vision impairment and psychological distress in adults ≥18 years. METHODS Using the 2016-2017 cross-sectional, U.S. National Health Interview Survey, we analyzed self-reported data (n = 57,644) on: Kessler psychological distress scores; general vision impairment (GVI), defined as difficulty seeing even when wearing glasses or contacts; and visual function impairment (VFI), measured using six visual function questions. Multinomial logistic regression was used to estimate adjusted odds ratios (aOR) for mild/moderate and serious psychological distress, by GVI and VFI status, and identify predictors of psychological distress among those with GVI or VFI. RESULTS Among adults, 10.6% (95% CI: 10.2, 11.0) had GVI; 11.6% (CI: 11.1, 12.0) had VFI. One in four adults with GVI had psychological distress (14.9% [CI: 13.8, 16.0] reported mild/moderate and 11.2% [CI: 10.2, 12.3] reported serious). Individuals with GVI, versus those without, had higher odds of mild/moderate (aOR = 2.24; CI: 2.00, 2.52) and serious (aOR = 3.41; CI: 2.96, 3.93) psychological distress; VFI had similar findings. Among adults with GVI, odds of serious psychological distress were higher for those aged 18-39 (aOR = 4.46; CI: 2.89, 6.90) or 40-64 (aOR = 6.09; CI: 4.33, 8.57) versus ≥65 years; smokers (aOR = 2.45; CI: 1.88, 3.18) versus non-smokers; physically inactive (aOR = 1.61; CI: 1.22, 2.11) versus active; and with arthritis (aOR = 2.18; CI: 1.66, 2.87) or chronic obstructive pulmonary disease (aOR = 1.65; CI: 1.15, 2.37) versus without. CONCLUSION Adults with self-reported vision impairment had higher odds of psychological distress. These findings may inform screening interventions to address psychological distress, particularly among younger working-age adults vision impairment.
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Affiliation(s)
- Elizabeth A Lundeen
- Division of Diabetes Translation (DDT, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Sharon Saydah
- Division of Diabetes Translation (DDT, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
| | - Jinan Saaddine
- Division of Diabetes Translation (DDT, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
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25
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Shu R, Liu C, Liang H, Liang Y. Potential mediators of the relationship between vision impairment and self-rated health in older adults: A comparison between long-term care insurance claimants in residential care institutions versus those living in the community. Geriatr Nurs 2022; 44:259-265. [DOI: 10.1016/j.gerinurse.2022.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 01/24/2023]
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26
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Lee CY, Chen HC, Huang JY, Lai CC, Yang SF, Wu WC. Elevated risk of mood disorders after the occurrence of recurrent retinal detachment: a population-based cohort study. Ophthalmologica 2022; 245:249-257. [PMID: 35026763 DOI: 10.1159/000521290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 12/01/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To investigate the risk of mood disorders in patients who experienced retinal detachment (RD) by using the National Health Insurance Research Database in Taiwan. METHODS Participants with a diagnosis of RD were regarded as the study group, and an age- and sex-matched group without a diagnosis of RD served as the control group. The outcomes related to mood disorders after RD included (1) psychiatric outpatient department visits; (2) behavioural therapy; (3) sleep or anxiety-related disorders; and (4) major depressive disorder (MDD). RESULTS A total of 4,129 participants diagnosed with RD and 16,516 non-RD individuals were enrolled in the study. There were no significant differences in the four mood disorder-related outcomes between the study and control groups. However, the patients with recurrent RD who received more than two treatments and female patients with RD who needed surgical treatment showed a higher probability of developing MDD than did the non-RD subjects (incidence rate: 0.96 versus 0.36; adjusted hazard ratio (aHR): 2.382, 95% CI: 1.032-5.496, log-rank P= 0.0325; and aHR: 6.895, 95% CI: 1.659-28.656, log-rank P= 0.0060, respectively). CONCLUSION Patients with recurrent RD and multiple surgeries and females with RD who needed surgical treatment were at greater risk for developing MDD.
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Affiliation(s)
- Chia-Yi Lee
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chi-Chun Lai
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shun-Fa Yang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
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27
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Um YH, Kim TW, Jeong JH, Hong SC, Seo HJ, Han KD. Association Between Diabetic Retinopathy and Insomnia Risk: A Nationwide Population-Based Study. Front Endocrinol (Lausanne) 2022; 13:939251. [PMID: 35909567 PMCID: PMC9333090 DOI: 10.3389/fendo.2022.939251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies have suggested a close link between sleep disturbances and diabetic retinopathy (DR). However, to date, no confirmatory findings have been reported. We aimed to explore the risk of insomnia in DR by considering demographic factors and diabetes mellitus (DM)-related variables. METHODS A nationwide population-based cohort of 2,206,619 patients with type 2 diabetes from the Korean National Insurance Service Database was followed up for insomnia incidence. DR, non-proliferative DR (NPDR), and proliferative DR (PDR) were defined according to ICD-10 codes. The interactive effects of sex, age, and DM-related variables were analyzed to evaluate their impact on insomnia risk in DR. RESULTS Compared with the non-DR group, insomnia risk was increased in the DR [(adjusted hazard ratio (aHR): 1.125, 95% confidence interval (CI):1.108-1.142), NPDR (aHR:1.117, 95% CI:1.099-1.134), and PDR (aHR:1.205, 95% CI: 1.156-1.256), even after controlling for comorbidities, lifestyle factors, and DM-related variables. The men and youngest age groups (<40 years) were most vulnerable to insomnia risk. Sex, age, DM duration, and chronic kidney disease (CKD) status exerted interactive effects with DR status in increasing the insomnia risk. In the PDR group, sex, age, DM duration, insulin therapy status, and CKD status exerted interactive effects that increased the risk of insomnia. CONCLUSION Insomnia risk is significantly higher in patients with DR, and clinical attention is warranted.
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Tae-Won Kim
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Seung-Chul Hong
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Ho-Jun Seo
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- *Correspondence: Ho-Jun Seo, ; Kyung-Do Han,
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
- *Correspondence: Ho-Jun Seo, ; Kyung-Do Han,
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28
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Li S, Liu H, Zhu X. The effect of psychotherapy on anxiety, depression, and quality of life in patients with diabetic retinopathy: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2021; 100:e28386. [PMID: 34941170 PMCID: PMC8702293 DOI: 10.1097/md.0000000000028386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is one of the common microvascular complications in diabetic patients, which is characterized by progressive development and often leads to irreversible visual impairment. More seriously, DR patients suffer great psychological stress due to impaired visual function and reduced self-care ability such as anxiety and depression, which seriously affect the quality of life of patients. In recent years, various psychological therapies have been applied to alleviate anxiety, depression, and quality of life in DR patients, which have achieved positive results. However, the effectiveness and safety of different psychological therapies are unclear. This study aims to assess the effects of psychotherapy on anxiety, depression, and quality of life in DR patients through a network meta-analysis. METHODS All randomized controlled trials (RCTs) on the effects of psychotherapy on anxiety, depression, and quality of life in patients with DR published before 30 November 30, 2021, will be searched in the PubMed, EMBASE, Cochrane Register of Controlled Trials, Web of Science, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, Wanfang, and China Biomedical Literature Database. There will have no restrictions on publication status and language. Two researchers will be independently responsible for RCT screening, data extraction, and quality evaluation. All statistical analyses will be performed using Stata 14.0 and R 4.1.2. RESULTS The results of this meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION This study will provide comprehensive and reliable evidence-based references for elucidating the efficacy of psychotherapy on anxiety, depression, and quality of life in DR patients. ETHICS AND DISSEMINATION Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/K8T27.
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Affiliation(s)
- Suiping Li
- Department of Endocrinology, Zhuzhou Central Hospital, Zhuzhou, Hunan Province, China
| | - Hong Liu
- Department of Endocrinology, Zhuzhou Central Hospital, Zhuzhou, Hunan Province, China
| | - Xian Zhu
- Department of Nuclear Medicine, Zhuzhou Central Hospital, Zhuzhou, Hunan Province, China
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29
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Sakamoto T, Shimura M, Kitano S, Ohji M, Ogura Y, Yamashita H, Suzaki M, Mori K, Ohashi Y, Yap PS, Kaneko T, Ishibashi T. Impact on visual acuity and psychological outcomes of ranibizumab and subsequent treatment for diabetic macular oedema in Japan (MERCURY). Graefes Arch Clin Exp Ophthalmol 2021; 260:477-487. [PMID: 34477927 PMCID: PMC8786783 DOI: 10.1007/s00417-021-05308-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/17/2021] [Accepted: 06/29/2021] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The MERCURY study aimed to evaluate the effects on visual acuity and psychological symptoms, and safety, of ranibizumab and subsequent treatment in patients with diabetic macular oedema (DME) and impaired visual acuity (VA). We report data from the prespecified 12-month interim analysis. METHODS This was a 24-month, phase 4, open-label, single-arm, prospective, observational study conducted at 20 specialised retinal centres in Japan. Participants were 209 patients with DME and impaired VA, not previously treated with either intravitreal or systemic anti-vascular endothelial growth factor (anti-VEGF) agents, who initiated ranibizumab 0.5 mg per investigator discretion. Following ranibizumab administration, patients were treated per routine clinical practice. Other treatments were allowed. The main outcome measure was the mean change in best-corrected VA (BCVA) in logarithmic minimum angle of resolution (logMAR) from baseline to month 12. An exploratory objective was to assess patients' psychological status using the Hospital Anxiety and Depression Scale (HADS). RESULTS The mean ± standard deviation BCVA at baseline was 0.43 ± 0.39 logMAR. The mean number of injections of ranibizumab and anti-VEGF agents from baseline to month 11 was 3.2 ± 2.0 and 3.6 ± 2.4, respectively. The BCVA change from baseline to 12 months was - 0.08 ± 0.34 logMAR (p = 0.011), showing a significant improvement; the HADS-anxiety score also decreased significantly (p = 0.001) and the depression score decreased numerically (p = 0.080). CONCLUSION MERCURY study data confirm the effectiveness of real-world treatment initiated with ranibizumab in Japanese patients with DME. In addition, treatment was able to positively influence anxiety via VA improvement.
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Affiliation(s)
- Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Masahiko Shimura
- Department of Ophthalmology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | | | - Masahito Ohji
- Department of Ophthalmology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Yuichiro Ogura
- Department of Ophthalmology and Visual Science, Nagoya City University, Nagoya, Aichi, Japan
| | - Hidetoshi Yamashita
- Department of Ophthalmology and Visual Sciences, Yamagata University, Yamagata, Japan
| | - Makoto Suzaki
- Medical Division, Novartis Pharma K.K., Tokyo, Japan
| | - Kimie Mori
- Medical Division, Novartis Pharma K.K., Tokyo, Japan
| | - Yohei Ohashi
- Medical Division, Novartis Pharma K.K., Tokyo, Japan
| | - Poh Sin Yap
- Novartis Corporation (M) Sdn. Bhd., Selangor, Malaysia
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30
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Assi L, Chamseddine F, Ibrahim P, Sabbagh H, Rosman L, Congdon N, Evans J, Ramke J, Kuper H, Burton MJ, Ehrlich JR, Swenor BK. A Global Assessment of Eye Health and Quality of Life: A Systematic Review of Systematic Reviews. JAMA Ophthalmol 2021; 139:526-541. [PMID: 33576772 PMCID: PMC7881366 DOI: 10.1001/jamaophthalmol.2021.0146] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Question What is the association between vision impairment, eye diseases, or ophthalmic interventions and quality of life? Findings In this cross-sectional study, vision impairment and eye diseases were associated with lower quality of life. More than half of the ophthalmic interventions included had a positive association with quality of life. Meaning The associations of quality of life with vision impairment and the improvements in quality of life with ophthalmic interventions support efforts to improve access to ophthalmic treatments globally to reach the millions of people affected by eye disease each year. Importance More than 1 billion people worldwide have vision impairment or blindness from potentially preventable or correctable causes. Quality of life, an important measure of physical, emotional, and social well-being, appears to be negatively associated with vision impairment, and increasingly, ophthalmic interventions are being assessed for their association with quality of life. Objective To examine the association between vision impairment or eye disease and quality of life, and the outcome of ophthalmic interventions on quality of life globally and across the life span, through an umbrella review or systematic review of systematic reviews. Evidence Review The electronic databases MEDLINE, Ovid, Embase, Cochrane Database of Systematic Reviews, Proquest Dissertations, and Theses Global were searched from inception through June 29, 2020, using a comprehensive search strategy. Systematic reviews addressing vision impairment, eye disease, or ophthalmic interventions and quantitatively or qualitatively assessing health-related, vision-related, or disease-specific quality of life were included. Article screening, quality appraisal, and data extraction were performed by 4 reviewers working independently and in duplicate. The Joanna Briggs Institute critical appraisal and data extraction forms for umbrella reviews were used. Findings Nine systematic reviews evaluated the association between quality of life and vision impairment, age-related macular degeneration, glaucoma, diabetic retinopathy, or mendelian eye conditions (including retinitis pigmentosa). Of these, 5 were reviews of quantitative observational studies, 3 were reviews of qualitative studies, and 1 was a review of qualitative and quantitative studies. All found an association between vision impairment and lower quality of life. Sixty systematic reviews addressed at least 1 ophthalmic intervention in association with quality of life. Overall, 33 unique interventions were investigated, of which 25 were found to improve quality of life compared with baseline measurements or a group receiving no intervention. These interventions included timely cataract surgery, anti–vascular endothelial growth factor therapy for age-related macular degeneration, and macular edema. Conclusions and Relevance There is a consistent association between vision impairment, eye diseases, and reduced quality of life. These findings support pursuing ophthalmic interventions, such as timely cataract surgery and anti–vascular endothelial growth factor therapy, for common retinal diseases, where indicated, to improve quality of life for millions of people globally each year.
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Affiliation(s)
- Lama Assi
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Fatimah Chamseddine
- Clinical Research Institute, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Perla Ibrahim
- Department of Ophthalmology, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Hadi Sabbagh
- Department of Ophthalmology, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Lori Rosman
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences, Belfast, United Kingdom.,Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jennifer Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.,School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Bonnielin K Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Akuffo KO, Sewpaul R, Darrah S, Dukhi N, Kumah DB, Agyei-Manu E, Addo EK, Asare AK, Osei Duah I, Reddy P. Vision loss, vision difficulty and psychological distress in South Africa: results from SANHANES-1. BMC Psychol 2021; 9:66. [PMID: 33926560 PMCID: PMC8082762 DOI: 10.1186/s40359-021-00558-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Psychological distress in vision impairments and blindness is a complex issue and a major public health concern. Sudden adjustments in routine lifestyle and career aspirations in such persons culminate in and/or aggravate their level of stress. Yet, psychological distress in persons with visual difficulties and vision loss in South Africa is poorly understood. We investigated the association between psychological distress and self-reported vision difficulties as well as clinician-assessed vision loss using data from the South African National Health and Nutrition Examination Survey (SANHANES-1). Methods Data was analysed on participants aged ≥ 15 years who participated in the SANHANES-1 clinical examinations and interviews. Data on demographic, socio-economic, and health status variables were gathered using a structured questionnaire. Psychological distress was assessed using the Kessler psychological distress scale (K10). Vision assessment was conducted by clinicians adhering to standard protocols as well as by participants’ subjective response to vision-related questions. Vision loss was defined as presenting visual acuity worse than Snellen 6/12 in the better eye. Bivariate and multiple logistic regressions were used to examine the association between vision parameters and psychological distress. Results The analytic sample comprised 6859 participants with mean age of 38.4 years (60.8% females). The prevalence of psychological distress was 19.9%. After adjusting for demographics, socioeconomic, health risk and eye care variables, self-reported myopia (mild adjusted odds ratio [AOR] = 1.9, 95% CI 1.3–2.7; moderate AOR = 2.4, 95% CI 1.6–3.7; severe AOR = 3.6, 95% CI 1.8–7.3) and self-reported hyperopia (mild AOR = 1.7, 95% CI 1.2–2.5; moderate AOR = 2.4, 95% CI 1.5–3.8; severe AOR = 3.5, 95% CI 1.8–6.8) were significantly associated with psychological distress. While psychological distress was higher in patients with clinician assessed vision loss than those with normal vision, the association was not statistically significant after adjusting for confounders (AOR: 1.0, 95% CI 0.7–1.4). Conclusions Persons who self-reported vision difficulty experienced a higher prevalence of psychological distress. Therefore, comprehensive psychological care is needed for patients with eye disease or vision difficulties as part of a governmental strategy to provide mental health care for all South Africans.
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Affiliation(s)
- Kwadwo Owusu Akuffo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Ronel Sewpaul
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - Samson Darrah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Natisha Dukhi
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - David Ben Kumah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eldad Agyei-Manu
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Usher Institute for Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Emmanuel Kofi Addo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Ophthalmology and Visual Sciences, Moran Eye Centre, University of Utah, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA
| | - Akosua Kesewah Asare
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - Isaiah Osei Duah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Priscilla Reddy
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa.,Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
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Yang Q, Shao Q, Xu Q, Shi H, Li L. Art Therapy Alleviates the Levels of Depression and Blood Glucose in Diabetic Patients: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:639626. [PMID: 33776864 PMCID: PMC7994617 DOI: 10.3389/fpsyg.2021.639626] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/18/2021] [Indexed: 12/18/2022] Open
Abstract
Objective: To systematically analyze the effects of art therapy on the levels of depression, anxiety, blood glucose, and glycated hemoglobin in diabetic patients. Methods: We searched Cochrane Library, PubMed, Embase, and ClinicalTrials.gov databases from inception to January 24, 2021. The language of publication was limited to English. Randomized controlled trials (RCTs) that used art therapy to improve mental disorders in diabetic patients were involved. After selection of eligible studies, data were extracted, including the first author's full-name, year of publication, the first author's country of residence, number of intervention and control groups, the mean age of participants, method of intervention, duration of follow-up, and outcome measures. Assessment of quality of the included studies and data extraction were independently carried out by two researchers. RevMan 5.3 software was used to perform statistical analysis. Results: A total of 396 samples from five studies were included, and the eligible studies were RCTs with a parallel design. Methods of art therapy included music therapy and painting therapy. The results showed that compared with the control group, art therapy could positively affect the levels of depression [standardized mean difference (SMD), −1.36; 95% confidence interval (CI), (−1.63, −1.09); P < 0.00001] and blood glucose in diabetic patients [mean difference (MD), −0.90; 95% CI, (−1.03, −0.77); P < 0.0001], while it had no influence on the levels of anxiety [SMD, −0.31; 95% CI, (−0.93, 0.31); P = 0.32] and glycated hemoglobin [MD, 0.22; 95% CI, (−0.02, 0.46); P = 0.07]. Conclusion: Art therapy may have significant effects on the levels of depression and blood glucose for diabetic patients.
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Affiliation(s)
- Qingqi Yang
- Department of Dermatology, Air Force Medical Center, Beijing, China
| | - Qunhui Shao
- Department of Cardiovascular Medicine, People's Hospital of Zhongwei, Zhongwei, China
| | - Qiang Xu
- Department of Health Management Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Hui Shi
- Department of Health Management Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Lin Li
- Department of Health Management Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
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Elbarky AM. Effectiveness and tolerability of the fluocinolone acetonide implant in patients with diabetic macular edema in UAE: 12-Month results. Eur J Ophthalmol 2021; 31:3196-3202. [PMID: 33426902 DOI: 10.1177/1120672120982948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION To evaluate 12-month outcomes following fluocinolone acetonide (FAc 0.2 μg/day) implant in pseudophakic patients with diabetic macular edema (DME) that persists or recurs despite previous treatment with anti-vascular endothelial growth factors (anti-VEGF) and dexamethasone implant (DEX) in a UAE population. METHODS A retrospective, observational, single-center, 12-month audit study, where 22 pseudophakic eyes (22 patients) with DME were treated with the FAc intravitreal implant according to licensed UAE indications. Outcome measurements at baseline and at months 1, 3, 6, and 12 included best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP). RESULTS Post-FAc implantation, mean BCVA significantly improved at 1, 3, and 12 months (+10.4 ± 16.1, +22.8 ± 13.6, and +25.5 ± 13.0 letters, respectively; p < 0.0001), with 86% of eyes gaining ⩾15 letters at month 12. Similarly, CMT reduced significantly at month 1, and stabilized thereafter at months 3-12 (-171.5 ± 72.5 µm, -240.9 ± 74.2 µm, and -246.2 ± 93.4 µm, respectively; p < 0.0001). By month 12, 64% (n = 14/22) of eyes had a CMT below 300 µm. Only 1 eye had an IOP ⩾ 21 mmHg at baseline and month 12. Five eyes required IOP lowering drops and 1 required IOP-lowering surgical intervention. CONCLUSION In pseudophakic patients with DME FAc implant provide a substantial functional and anatomical benefits for up to 12 months.
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Affiliation(s)
- Ahmed Mohammed Elbarky
- Faculty of Medicine, Benha University, Benha, Egypt.,Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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Weng N, Li K, Lan H, Zhang T, Zhang X, Gui Y, Fu X, Liu Q. Evaluation of the reliability and validity of Functional Assessment Of Chronic Illness Therapy-Spiritual Well-Being-Expanded in elderly patients with chronic orthopaedic diseases. Psychogeriatrics 2021; 21:32-41. [PMID: 33179396 DOI: 10.1111/psyg.12624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 08/20/2020] [Accepted: 09/08/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The Functional Assessment Of Chronic Illness Therapy-Spiritual Well-Being-Expanded (FACIT-Sp-Ex) scale can simultaneously evaluate the quality of life and spiritual health level of patients with chronic orthopaedic diseases. We performed the FACIT-Sp-Ex scale in Chinese, and tested its reliability and validity in patients with chronic orthopaedic diseases. METHODS There were 249 patients with chronic orthopaedic diseases who were selected for the questionnaire survey. AMOS 23.0 and SPSS 25.0 were used for statistical analysis to calculate the reliability and validity of the Chinese version of the scale. RESULTS The Chinese version of FACIT-Sp-Ex scale showed that root mean square error of approximation (RMSEA) was 0.06. Cronbach's alpha coefficient was 0.83, the subscale was 0.72 ~ 0.82. The meaning, peace, relational subscales and total scale of the FACIT-Sp-Ex were negatively correlated with hospital anxiety and depression scale (HADS) and positively correlated with health-related quality of life (HRQOL). All four subdomains were inversely associated with HADS anxiety symptoms, the peace and relational subscales were inversely associated with HADS depressive symptoms. Elderly female patients score higher than male patients in faith subscale. The highest-scoring disease in FACIT-Sp-Ex faith scale was osteoarthritis, which in FACIT-Sp-Ex total scale are piriformis syndrome and osteoarthritis. CONCLUSION The Chinese version of FACIT-Sp-Ex scale has good reliability and validity, which can be used as an evaluation tool for the spiritual status and quality of life of Chinese elderly chronic orthopaedic patients.
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Affiliation(s)
- Nengyuan Weng
- First Knee Trauma Ward, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Kainan Li
- Department of Orthopedics, the Affiliated Hospital of Chengdu University, Chengdu, China
| | - Hai Lan
- Department of Orthopedics, the Affiliated Hospital of Chengdu University, Chengdu, China
| | - Tao Zhang
- First Knee Trauma Ward, Tianjin Hospital, Tianjin University, Tianjin, China
| | | | - Yongxia Gui
- Centre for Mental Health Research and Education, Henan University of Economics and Law, Zhengzhou, China
| | - Xuefei Fu
- First Knee Trauma Ward, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Qixin Liu
- First Knee Trauma Ward, Tianjin Hospital, Tianjin University, Tianjin, China
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Marmamula S, Mitchell W, Zebardast N, Locascio J, Barrenkala NR, Kumbham TR, Modepalli SB, Khanna RC, Friedman DS. Impact of Vision Loss on Visual Function Among Elderly Residents in the "Home for the Aged" in India: The Hyderabad Ocular Morbidity in Elderly Study. Transl Vis Sci Technol 2020; 9:11. [PMID: 33344055 PMCID: PMC7726582 DOI: 10.1167/tvst.9.13.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/18/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to report the association between visual impairment (VI) and self-reported visual difficulty among the elderly in residential care using the Indian Vision Functioning Questionnaire (IND-VFQ-33) psychometrically validated questionnaire. Methods Participants aged ≥ 60 years were recruited from 41 homes in Hyderabad in South India. All participants underwent detailed eye examination and interviews. Self-reported visual function was assessed using the IND-VFQ-33 questionnaire. Factor Analysis and Item Response Theory (IRT) models were used for analysis. Multivariable regression models were used to investigate associations between derived global difficulty scores versus severity and causes of VI. Presenting visual acuity worse than 6/18 in the better eye was considered as VI. Results In total, 867 elderly participants completed the INDVFQ-33. Two latent traits ("daily activities" and "visual symptoms") were identified on factor analysis, each with uniquely loading questions. Participants with VI reported significantly higher daily activities difficulty (6 points higher) and visual symptoms difficulty (1.7 points higher) than those without VI (P < 0.05). Those with cataract reported the highest daily activities and visual symptoms difficulty (7.6 points and 2.2 points higher, respectively, P < 0.05). Greater severity of VI was associated with increased self-reported difficulty for both factors, and for all causes of VI. Conclusions We present a psychometrically validated visual questionnaire particularly suited to older adults in residential homes. We show a significant association between cause/severity of VI and difficulty with daily activities and visual symptoms after adjusting for sociodemographic and medical factors. Translational Relevance Understanding the impact of vision loss on visual functions in the elderly will help in planning and resource allocation for developing early intervention programs for the elderly.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
- Wellcome Trust/Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - William Mitchell
- Massachusetts Eye and Ear, Harvard Medical School, Harvard Medical School, Department of Ophthalmology, Boston, MA, USA
| | - Nazlee Zebardast
- Massachusetts Eye and Ear, Harvard Medical School, Harvard Medical School, Department of Ophthalmology, Boston, MA, USA
| | | | - Navya Rekha Barrenkala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit C. Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - David S. Friedman
- Massachusetts Eye and Ear, Harvard Medical School, Harvard Medical School, Department of Ophthalmology, Boston, MA, USA
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Fenwick EK, Man REK, Gan ATL, Aravindhan A, Tey CS, Soon HJT, Ting DSW, Yeo SIY, Lee SY, Tan G, Wong TY, Lamoureux EL. Validation of a New Diabetic Retinopathy Knowledge and Attitudes Questionnaire in People with Diabetic Retinopathy and Diabetic Macular Edema. Transl Vis Sci Technol 2020; 9:32. [PMID: 33062395 PMCID: PMC7533728 DOI: 10.1167/tvst.9.10.32] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/21/2020] [Indexed: 12/31/2022] Open
Abstract
Purpose A validated questionnaire assessing diabetic retinopathy (DR)- and diabetic macular edema (DME)-related knowledge (K) and attitudes (A) is lacking. We developed and validated the Diabetic Retinopathy Knowledge and Attitudes (DRKA) questionnaire and explored the association between K and A and the self-reported difficulty accessing DR-related information (hereafter referred to as Access). Methods In this mixed-methods study, eight focus groups with 36 people with DR or DME (mean age, 60.1 ± 8.0 years; 53% male) were conducted to develop content (phase 1). In phase 2, we conducted 10 cognitive interviews to refine item phrasing. In phase 3, we administered 28-item K and nine-item A pilot questionnaires to 200 purposively recruited DR/DME patients (mean age, 59.0 ± 10.6 years; 59% male). The psychometric properties of DRKA were assessed using Rasch and classical methods. The association between K and A and DR-related Access was assessed using univariable linear regression of mean K/A scores against Access. Results Following Rasch-guided amendments, the final 22-item K and nine-item A scales demonstrated adequate psychometric properties, although precision remained borderline. The scales displayed excellent discriminant validity, with K/A scores increasing as education level increased. Compared to those with low scores, those with high K/A scores were more likely to report better access to DR-related information, with K scores of 0.99 ± 0.86 for no difficulty; 0.79 ± 1.05 for a little difficulty; and 0.24 ± 0.85 for moderate or worse difficulty (P < 0.001). Conclusions The psychometrically robust 31-item DRKA questionnaire can measure DR- and DME-related knowledge and attitudes. Translational Relevance The DRKA questionnaire may be useful for interventions to improve DR-related knowledge and attitudes and, in turn, optimize health behaviors and health literacy.
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Affiliation(s)
- Eva K Fenwick
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Ryan E K Man
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Alfred T L Gan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Amudha Aravindhan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Ching Siong Tey
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | | | - Daniel S W Ting
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - San I Y Yeo
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Shu Yen Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Gavin Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
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Kawada T. Food addiction and psycho-physiological condition in patients with type 2 diabetes. Acta Diabetol 2020; 57:1271-1272. [PMID: 32725415 DOI: 10.1007/s00592-020-01583-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8602, Japan.
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Kawada T. Diabetic Retinopathy and Depression: A Risk Assessment. PSYCHOSOMATICS 2020; 62:S0033-3182(20)30257-7. [PMID: 34756366 DOI: 10.1016/j.psym.2020.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
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Fajnkuchen F, Delyfer MN, Conrath J, Baillif S, Mrejen S, Srour M, Bellamy JP, Dupas B, Lecleire-Collet A, Meillon C, Bonicel P, Hobeika M, Giocanti-Aurégan A. Expectations and fears of patients with diabetes and macular edema treated by intravitreal injections. Acta Diabetol 2020; 57:1081-1091. [PMID: 32274583 DOI: 10.1007/s00592-020-01513-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/06/2020] [Indexed: 01/19/2023]
Abstract
AIMS Clinical outcomes of diabetic macular edema (DME) have been widely described, but data on diabetic retinopathy perceptions by diabetes patients are limited. The aim of this survey was to explore the lived experience, knowledge, fears and expectations about disease, and treatment in patients with diabetes and macular edema treated with intravitreal injections (IVTI) and to characterize patient profiles. METHODS Cross-sectional survey including a preliminary qualitative phase (20 patients with DME, treated or treatment-naive, 5 female and 15 male, age 36-74 years) followed by a quantitative survey (116 patients treated with IVTI for DME). Data ASKIA Analyze (version 5.3.3.5) was used for descriptive statistics, and R software (version 3.4.1) for multiple correspondence analysis. RESULTS The qualitative phase identified the wording used by patients and information helpful to propose modalities of response in the quantitative phase. In the quantitative survey (116 patients, mean age 66.6 years), most patients were treated with anti-vascular endothelial growth factor. Overall, 71.9% reported that the disease negatively affected their daily activities and 33.1% considered that regular visits to the ophthalmologist were disrupting their life. Treatment expectations differed significantly between patients in terms of disease experience (visit and injection schedules), fears and feelings, and relationship with physicians, allowing three patient profiles to be identified: "Worried" patients (n = 45) felt isolated and were worried about the need for repeated treatment and possible side effects. They were mainly active men aged < 60 with type I diabetes (T1D) and DME diagnosed for > 2 years; "Curious" patients (n = 21) experienced insufficient support and requested more information on their disease and existing treatments. They were mainly single women aged 60-69 years; "Passive" patients (n = 50) felt sufficiently informed by their ophthalmologist and were not concerned by DME. They were older (mean age: 70 years) and mainly type 2 diabetic men. CONCLUSIONS Patients with diabetes and macular edema treated with IVTI form a heterogeneous group regarding fears and expectations. Different patient profiles were identified and need to be confirmed in larger studies. A better understanding of psychological profiles may optimize compliance of diabetic patients.
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Affiliation(s)
- Franck Fajnkuchen
- Ophthalmology Department, Hôpital Avicenne and University Paris 13, Bobigny, Paris, France
- Centre d'Imagerie et de Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Marie-Noëlle Delyfer
- Department of Ophthalmology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - John Conrath
- Centre Monticelli Paradis d'Ophtalmologie, Marseille, France
| | | | - Sarah Mrejen
- Centre d'Imagerie et de Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
- Department of Ophthalmology, XV-XX Ophthalmology National Hospital Center, Paris, France
| | - Mayer Srour
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Université de Paris Est Créteil, Créteil, France
| | | | - Benedicte Dupas
- Ophthalmology Department, Hôpital Lariboisière, Université Paris 7, Paris, France
| | | | - Cyril Meillon
- Department of Ophthalmology, University Hospital, Dijon, France
| | - Pierre Bonicel
- Department of Ophthalmology, Orléans Hospital, Orléans, France
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40
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Assi L, Rosman L, Chamseddine F, Ibrahim P, Sabbagh H, Congdon N, Evans J, Ramke J, Kuper H, Burton MJ, Ehrlich JR, Swenor BK. Eye health and quality of life: an umbrella review protocol. BMJ Open 2020; 10:e037648. [PMID: 32868362 PMCID: PMC7462163 DOI: 10.1136/bmjopen-2020-037648] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Vision impairment and eye disease are major global health concerns and have been associated with increased morbidity and mortality, and lower quality of life. Quality of life, whether generic, vision-specific or disease-specific, is an important measure of the impact of eye health on people's daily activities, well-being and visual function, and is increasingly used to evaluate the impact of ophthalmic interventions and new devices. While many studies and reviews have examined the relationship between vision or eye health and quality of life across different contexts, there has yet to be a synthesis of the impact of vision impairment, eye disease and ophthalmic interventions on quality of life globally and across the lifespan. METHODS AND ANALYSIS An umbrella review of systematic reviews will be conducted to address these two questions: (1) What is the association of vision impairment and eye disease with quality of life? (2) What is the impact of ophthalmic interventions on quality of life? A search of related literature will be performed on the 11 February 2020 in Medline Ovid, Embase.com, Cochrane Database of Systematic Reviews, Proquest Dissertations and Theses Global, and the grey literature, and repeated at the synthesis stage. Title/abstract and full-text screening, methodological quality assessment and data extraction will be conducted by reviewers working independently and in duplicate. Assessment of methodological quality and data extraction will be performed using Joanna Briggs Institute standard forms. Findings from the systematic reviews and their methodological quality will be summarised qualitatively in the text and using tables. ETHICS AND DISSEMINATION No ethical approval is required. Results of this umbrella review will be published in a peer-reviewed journal and summarised in the Lancet Global Health Commission on Global Eye Health. TRIAL REGISTRATION NUMBER This protocol was registered in the Open Science Framework Registries (https://osf.io/qhv9g/).
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Affiliation(s)
- Lama Assi
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lori Rosman
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Fatimah Chamseddine
- Clinical Research Institute, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Perla Ibrahim
- Department of Ophthalmology, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Hadi Sabbagh
- Department of Ophthalmology, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences, Belfast, UK
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Jennifer Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- Cornea & External Eye Disease, Moorfields Eye Hospital, London, UK
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Bonnielin K Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Fenwick EK, Barnard J, Gan A, Loe BS, Khadka J, Pesudovs K, Man R, Lee SY, Tan G, Wong TY, Lamoureux EL. Computerized Adaptive Tests: Efficient and Precise Assessment of the Patient-Centered Impact of Diabetic Retinopathy. Transl Vis Sci Technol 2020; 9:3. [PMID: 32832210 PMCID: PMC7414626 DOI: 10.1167/tvst.9.7.3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 02/21/2020] [Indexed: 01/26/2023] Open
Abstract
Purpose Evaluate efficiency, precision, and validity of RetCAT, which comprises ten diabetic retinopathy (DR) quality of life (QoL) computerized adaptive tests (CATs). Methods In this cross-sectional clinical study, 183 English and/or Mandarin-speaking participants with DR (mean age ± standard deviation [SD] 56.4 ± 11.9 years; 38% proliferative DR [worse eye]) were recruited from retinal clinics in Singapore. Participants answered the RetCAT tests (Symptoms, Activity Limitation, Mobility, Emotional, Health Concerns, Social, Convenience, Economic, Driving, and Lighting), which were capped at seven items each, and other questionnaires, and underwent eye tests. Our primary evaluation focused on RetCAT efficiency (i.e. standard error of measurement [SEM] ± SD achieved and time needed to complete each CAT). Secondary evaluations included an assessment of RetCAT's test precision and validity. Results Mean SEM across all RetCAT tests was 0.351, ranging from 0.272 ± 0.130 for Economic to 0.484 ± 0.130 for Emotional. Four tests (Mobility, Social, Convenience, and Driving) had a high level of measurement error. The median time to take each RetCAT test was 1.79 minutes, ranging from 1.12 (IQR [interquartile range] 1.63) for Driving to 3.28 (IQR 2.52) for Activity Limitation. Test precision was highest for participants at the most impaired end of the spectrum. Most RetCAT tests displayed expected correlations with other scales (convergent/divergent validity) and were sensitive to DR and/or vision impairment severity levels (criterion validity). Conclusions RetCAT can provide efficient, precise, and valid measurement of DR-related QoL impact. Future application of RetCAT will employ a stopping rule based on SE rather than number of items to ensure that all tests can detect meaningful differences in person abilities. Responsiveness of RetCAT to treatment interventions must also be determined. Translational Relevance RetCAT may be useful for measuring the patient-centered impact of DR severity and disease progression and evaluating the effectiveness of new therapies.
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Affiliation(s)
- Eva K Fenwick
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore.,Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - John Barnard
- Excel Psychological & Educational Consultancy, Melbourne, Australia.,School of Medical Sciences, University of Sydney, Sydney, Australia
| | - Alfred Gan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Bao Sheng Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - Jyoti Khadka
- Institute for Choice, University of South Australia, Adelaide, Australia.,Registry of Older South Australians, South Australian Health and Medical Research Institute, Adelaide, Australia.,Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Konrad Pesudovs
- University of New South Wales, Sydney, Australia.,Anglia Ruskin University, Cambridge, UK
| | - Ryan Man
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Shu Yen Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Gavin Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore.,Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
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