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Lin B, Xu M, Chen LL, Li DK. A study exploring the causal relationship between glaucoma and anxiety disorders. Front Med (Lausanne) 2024; 11:1410607. [PMID: 39170036 PMCID: PMC11335643 DOI: 10.3389/fmed.2024.1410607] [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: 04/01/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024] Open
Abstract
Background Glaucoma, a leading cause of global blindness, is characterized by optic nerve damage and visual field loss. Previous studies have suggested a potential association between glaucoma and anxiety disorders. However, the causal relationship between these two conditions remains unclear. Methods In this study, we conducted a Mendelian Randomization analysis to investigate the causal relationship between glaucoma and anxiety disorders. We sourced Genome-Wide Association Study (GWAS) datasets for glaucoma and anxiety with the largest sample sizes from the Integrative Epidemiology Unit OpenGWAS (IEU OpenGWAS) project website. Instrumental variables were selected based on specific criteria, and statistical analyses were performed using the R programming language. Results After filtering and merging the datasets, a total of 60 Single Nucleotide Polymorphisms (SNPs) were obtained for analysis. Regression models were applied to assess the causal relationship between glaucoma and anxiety disorders. The results from all four methods indicated that glaucoma does not cause anxiety disorders (p > 0.05). Conclusion Through rigorous Mendelian Randomization analysis, our findings indicate that glaucoma is not a causative factor for anxiety, with minimal influence from confounding factors in this study. These findings enhance our understanding of the relationship between glaucoma and anxiety.
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Affiliation(s)
- Bin Lin
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Meng Xu
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Long-long Chen
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Dong-kan Li
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
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Barak Özer A, Eröz P. Evaluation of Depression Levels in Patients With Primary Open-Angle Glaucoma Using the Geriatric Depression Scale. Cureus 2024; 16:e64162. [PMID: 39119439 PMCID: PMC11309073 DOI: 10.7759/cureus.64162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Glaucoma is a chronic disease that can lead to severe visual impairment and blindness. Methods The study included 91 primary open-angle glaucoma patients aged 60 years and older (group 1) and 83 healthy controls (group 2) with similar age and gender distribution. The duration of the disease, the number of anti-glaucomatous drops used daily, and visual field parameters were recorded. All participants then underwent a comprehensive mental status examination by a psychiatrist and were administered the Geriatric Depression Scale (GDS). Results In Group 1, the mean duration of glaucoma was 10.2±6.0 years, and the mean number of drops used per day was 2.91±1.47 drops/day. According to visual field (24-2) data, the mean mean deviation (MD) was -7.76±4.78 dB and the mean pattern standard deviation (PSD) was 5.14±2.60 dB. According to the classification based on MD, 33 (36.3%) patients were in the early stage, 36 (39.5%) in the intermediate stage, and 22 (24.2%) in the advanced stage. The mean best-corrected visual acuity (BCVA) was 0.85±0.38 logMAR in group 1 and 0.34±0.19 logMAR in group 2. The mean GDS scores were 13.7±7.23 points in group 1 and 3.61±1.71 points in group 2. There were statistically significant differences between the groups in terms of BCVA and GDS scores (p=0.039 and p<0.001, respectively). Conclusion In conclusion, it is important that ophthalmologists provide adequate information about glaucoma to prevent the development of depression in patients with glaucoma. This information may protect patients from uncertainty. A multidisciplinary approach in the management of glaucoma, a chronic and vision-threatening disease, can positively affect patients' compliance with follow-up and treatment, increase the quality of healthcare, and improve treatment responses.
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Affiliation(s)
- Ayşegül Barak Özer
- Psychiatry, Niğde Ömer Halisdemir University Training and Research Hospital, Niğde, TUR
| | - Pınar Eröz
- Ophthalmology, Tarsus State Hospital, Mersin, TUR
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Li T, Zhang WM, Wang J, Liu BJ, Gao Q, Zhang J, Qian HD, Pan JY, Liu M, Huang Q, Fang AW, Zhang Q, Gong XH, Cui RZ, Liang YB, Lu QK, Wu WC, Chi ZL. Circulating Small Extracellular Vesicles Involved in Systemic Regulation Respond to RGC Degeneration in Glaucoma. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2309307. [PMID: 38923329 DOI: 10.1002/advs.202309307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 05/14/2024] [Indexed: 06/28/2024]
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide and is characterized by progressive retinal ganglion cell (RGC) degeneration and vision loss. Since irreversible neurodegeneration occurs before diagnosable, early diagnosis and effective neuroprotection are critical for glaucoma management. Small extracellular vesicles (sEVs) are demonstrated to be potential novel biomarkers and therapeutics for a variety of diseases. In this study, it is found that intravitreal injection of circulating plasma-derived sEVs (PDEV) from glaucoma patients ameliorated retinal degeneration in chronic ocular hypertension (COH) mice. Moreover, it is found that PDEV-miR-29s are significantly upregulated in glaucoma patients and are associated with visual field defects in progressed glaucoma. Subsequently, in vivo and in vitro experiments are conducted to investigate the possible function of miR-29s in RGC pathophysiology. It is showed that the overexpression of miR-29b-3p effectively prevents RGC degeneration in COH mice and promotes the neuronal differentiation of human induced pluripotent stem cells (hiPSCs). Interestingly, engineered sEVs with sufficient miR-29b-3p delivery exhibit more effective RGC protection and neuronal differentiation efficiency. Thus, elevated PDEV-miR-29s may imply systemic regulation to prevent RGC degeneration in glaucoma patients. This study provides new insights into PDEV-based glaucoma diagnosis and therapeutic strategies for neurodegenerative diseases.
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Affiliation(s)
- Tong Li
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Wen-Meng Zhang
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Jie Wang
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Bai-Jing Liu
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Qiao Gao
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Jing Zhang
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Hai-Dong Qian
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Jun-Yi Pan
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Ming Liu
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Qing Huang
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Ai-Wu Fang
- National Clinical Research Center for Ocular Diseases, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Qi Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Xian-Hui Gong
- National Clinical Research Center for Ocular Diseases, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Ren-Zhe Cui
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji, 136200, China
| | - Yuan-Bo Liang
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Qin-Kang Lu
- Department of Ophthalmology, Yinzhou People's Hospital, Medical School of Ningbo University, Ningbo, 315040, China
| | - Wen-Can Wu
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Zai-Long Chi
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
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Kopilaš V, Kopilaš M. Quality of life and mental health status of glaucoma patients. Front Med (Lausanne) 2024; 11:1402604. [PMID: 38887669 PMCID: PMC11180758 DOI: 10.3389/fmed.2024.1402604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/24/2024] [Indexed: 06/20/2024] Open
Abstract
Introduction Glaucoma, a leading cause of irreversible blindness worldwide, poses significant challenges to patients' quality of life (QOL) and mental well-being. Methods This study aimed to investigate the complex interplay between clinical, demographic, and psychological factors and their impact on QOL among patients diagnosed with glaucoma. A cohort of 201 glaucoma patients, with a mean age of 70 years, participated in the study. Results Descriptive analyses revealed that participants reported living with a glaucoma diagnosis for an average of 13.38 years, highlighting the chronic nature of the disease in the cohort. Comorbidity was shown to be in close relationship with QOL, where with additional health problems have lower QOL scores (M = 34.86, SD = 18.25), as well as higher levels of anxiety (M = 10.64, SD = 5.38) and depression (M = 13.42, SD = 7.37). Correlation analyses further unveiled robust associations between clinical characteristics and psychological outcomes, with lower visual acuity strongly correlated with reduced QOL (rR = -0.74, pR < 0.001; rL = -0.78, pL < 0.001) and higher levels of anxiety and depression. Additionally, longer duration of glaucoma diagnosis was moderately associated with poorer QOL (r = 0.56, p < 0.001) and increased psychological distress, highlighting the cumulative burden of living with the disease over time. Mediation analyses indicated that duration of diagnosis partially mediated the relationship between depression and QOL, as well as anxiety and QOL, suggesting that the prolonged experience of living with glaucoma may exacerbate the impact of psychological distress on QOL. Discussion These findings underscore the importance of holistic patient care approaches that address both the physical and psychological aspects of glaucoma to improve patient outcomes and enhance overall well-being.
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Affiliation(s)
- Vanja Kopilaš
- Faculty of Croatian Studies, University of Zagreb, Zagreb, Croatia
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5
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Wang Y, Li C, Liu L, Yang Y, He X, Li G, Zheng X, Ren Y, Zhao H, Du Z, Jiang J, Kuang Y, Jia F, Yu H, Yang X. Association of Retinal Neurovascular Impairment with Disease Severity in Patients with Major Depressive Disorder: An Optical Coherence Tomography Angiography Study. Psychol Res Behav Manag 2024; 17:1573-1585. [PMID: 38617578 PMCID: PMC11015850 DOI: 10.2147/prbm.s443146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/27/2024] [Indexed: 04/16/2024] Open
Abstract
Background Identifying the fundus objective biomarkers for the major depressive disorders (MDD) may help promote mental health. The aim of this study was to evaluate retinal neurovascular changes and further investigate their association with disease severity in MDD. Methods This cross-sectional study conducted in the hospital enrolled patients with MDD and healthy controls.The retinal neurovascular parameters for all subjects, including vessel density (VD), thickness of ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL), and optic nerve head (ONH) eg are automatically calculated by the software in optical coherence tomography angiography (OCTA). The severity of MDD including depressive symptoms, anxiety, cognition, and insomnia was assessed by Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Scale (HAMA), Montreal Cognitive Assessment (MoCA), and Insomnia Severity Index (ISI) respectively. Results This study included 74 MDD patients (n=74 eyes) and 60 healthy controls (HCs) (n=60 eyes). MDD patients showed significantly decreased VD of superficial and deep capillary plexus, thickness of GCC and RNFL, and volume of ONH (all p<0.05) and increased vertical cup-to-disc ratio and global loss volume (GLV) (all p<0.05) compared to HCs. Positive associations were found between HAMD scores and cup area (r=0.30, p=0.035), cup volume (r=0.31, p=0.029), and disc area (r=0.33, p=0.020) as well as ISI scores and RNFL thickness (r=0.34, p=0.047). Conclusion We found the retinal neurovascular impairment and its association with disease severity in MDD patients. OCTA showed promise as a potential complementary assessment tool for MDD.
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Affiliation(s)
- Yan Wang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Cong Li
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Lei Liu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Yuan Yang
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Xue He
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Gang Li
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Xianzhen Zheng
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Yun Ren
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- Shantou University Medical College, Shantou, People’s Republic of China
| | - Hanpeng Zhao
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China
| | - Zhenchao Du
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- Shantou University Medical College, Shantou, People’s Republic of China
| | - Jianrong Jiang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China
| | - Yu Kuang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Fujun Jia
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Honghua Yu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Xiaohong Yang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
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Maheshwari D, Pillai MR, George Koshy TN, Nagdev N, Gunaselvi DR, Uduman MS, Kader MA, Ramakrishnan R. Glaucoma awareness, anxiety and its impact on patients undergoing visual field testing and optical coherence tomography. Eur J Ophthalmol 2024:11206721241243105. [PMID: 38533557 DOI: 10.1177/11206721241243105] [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: 03/28/2024]
Abstract
PURPOSE To assess the effect of Glaucoma awareness, knowledge, and anxiety on patients under visual field analysis by Humphrey's visual field analyzer (HFA) and optical coherence tomography(OCT). METHODS This prospective comparative cohort study included glaucoma patients undergoing HFA (Group A)(n = 150) and OCT(Group B) (n = 150). Each group consisted of 75 newly diagnosed patients and 75 patients who were on follow-up. Participants completed State trait anxiety inventory form Y2(STAI) before and after the test to assess pre-test and intra-test anxiety. Another validated and structured questionnaire was used to assess patient awareness and knowledge of glaucoma. Anxiety scores were used to make correlations and comparisons between the two groups and also against visual field reliability indices. The impact of awareness on anxiety scores and its correlation with reliability indices were also determined. RESULTS Overall pretest and intratest anxiety scores in patients undergoing HFA were 52.39(9.5) and 52.45(8.6)and OCT 53.04(8.0) and 53.83(8.2) respectively.Pretest anxiety was less in follow-up patients of both groups(Group A-51.04,Group B-52.72).There was no statistically significant difference between the groups(pretest p = 0.52,Intratest p = 0.15). Anxiety score was found to be significantly high in female participants(54.07,p = 0.01)and those without awareness(p < 0.001). Patients with education of graduation and above in group B had significantly lower anxiety scores(p = 0.007). CONCLUSION Anxiety levels induced by both diagnostic modalities HFA and OCT appear to be similar and it does not affect the reliability indices.Anxiety score was higher in female participants and participants lacking disease awareness.
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Affiliation(s)
- Devendra Maheshwari
- Department of Glaucoma, Aravind Eye Hospital & PG Institute of Ophthalmology, Tirunelveli, India
| | - Madhavi Ramanatha Pillai
- Department of Glaucoma, Aravind Eye Hospital & PG Institute of Ophthalmology, Tirunelveli, India
| | | | - Nimrita Nagdev
- Department of Glaucoma, Aravind Eye Hospital & PG Institute of Ophthalmology, Tirunelveli, India
| | - D Ranitha Gunaselvi
- Glaucoma services, Aravind Eye Hospital& PG Institute of Ophthalmology, Tirunelveli, India
| | | | - Mohideen Abdul Kader
- Department of Glaucoma, Services, Aravind Eye Hospital & PG Institute of Ophthalmology, Tirunelveli, India
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Ramesh PV, Morya AK, Azad A, Pannerselvam P, Devadas AK, Gopalakrishnan ST, Ramesh SV, Aradhya AK. Navigating the intersection of psychiatry and ophthalmology: A comprehensive review of depression and anxiety management in glaucoma patients. World J Psychiatry 2024; 14:362-369. [PMID: 38617979 PMCID: PMC11008383 DOI: 10.5498/wjp.v14.i3.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/28/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
Glaucoma, a prevalent and debilitating eye disease, has long been associated with vision impairment and blindness. However, recent research has shed light on the often-underestimated psychological dimensions of this condition. Anxiety and depression, two pervasive psychiatric comorbidities, have been increasingly recognized among glaucoma patients. This comprehensive review aims to explore the intricate relationship between psychiatry and ophthalmology, in the context of managing depression and anxiety in glaucoma patients. By meticulously examining peer-reviewed literature, we synthesize current knowledge on the prevalence, risk factors, and underlying mechanisms of anxiety and depression in glaucoma. The evidence reveals that glaucoma patients face an elevated risk of experiencing these mood disorders. Factors such as progressive vision loss, complex medication regimens, and the fear of further visual deterioration contribute to their vulnerability. Moreover, we delve into the bidirectional relationship between glaucoma and mood disorders, shedding light on the complex interplay between ocular and emotional health. Our review investigates the implications of anxiety and depression on glaucoma management, including their potential impact on treatment adherence, disease progression, and overall quality of life. We also explore the neurobiological pathways linking glaucoma and mood disorders, providing a foundation for future research and potential therapeutic interventions. In conclusion, recognizing the psychological burden carried by glaucoma patients is essential for holistic and patient-centered care. This review underscores the pressing need for integrated approaches that bring together ophthalmological and psychiatric expertise to optimize the well-being of individuals facing the challenges of glaucoma. By addressing anxiety and depression in glaucoma care, healthcare providers can enhance the overall quality of life for these patients, ultimately leading to improved outcomes and a brighter future for those affected by this condition. This review offers valuable insight for healthcare practitioners and researchers, providing a concise overview of key topics and research in the field of managing depression and anxiety in glaucoma patients.
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Affiliation(s)
- Prasanna Venkatesh Ramesh
- Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Arvind Kumar Morya
- Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
| | - Ashik Azad
- Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Pavithra Pannerselvam
- Junior Resident, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Aji Kunnath Devadas
- Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | | | - Shruthy Vaishali Ramesh
- Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Ajanya K Aradhya
- Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
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8
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Zhang X, Liang Y, Huang Y, Liu S, Li Q, Wang S, Wu G, Du Z, Wang Y, Wang J, Hu Y, Zang S, Hu Y, Shang X, Zhang X, Zhang L, Brown A, Zhu Z, He M, Yu H. Evaluation of the Observational Associations and Shared Genetics Between Glaucoma With Depression and Anxiety. Invest Ophthalmol Vis Sci 2024; 65:12. [PMID: 38466289 PMCID: PMC10929750 DOI: 10.1167/iovs.65.3.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/29/2024] [Indexed: 03/12/2024] Open
Abstract
Purpose Glaucoma, a leading cause of blindness worldwide, is suspected to exhibit a notable association with psychological disturbances. This study aimed to investigate epidemiological associations and explore shared genetic architecture between glaucoma and mental traits, including depression and anxiety. Methods Multivariable logistic regression and Cox proportional hazards regression models were employed to investigate longitudinal associations based on UK Biobank. A stepwise approach was used to explore the shared genetic architecture. First, linkage disequilibrium score regression inferred global genetic correlations. Second, MiXeR analysis quantified the number of shared causal variants. Third, specific shared loci were detected through conditional/conjunctional false discovery rate (condFDR/conjFDR) analysis and characterized for biological insights. Finally, two-sample Mendelian randomization (MR) was conducted to investigate bidirectional causal associations. Results Glaucoma was significantly associated with elevated risks of hospitalized depression (hazard ratio [HR] = 1.54; 95% confidence interval [CI], 1.01-2.34) and anxiety (HR = 2.61; 95% CI, 1.70-4.01) compared to healthy controls. Despite the absence of global genetic correlations, MiXeR analysis revealed 300 variants shared between glaucoma and depression, and 500 variants shared between glaucoma and anxiety. Subsequent condFDR/conjFDR analysis discovered 906 single-nucleotide polymorphisms (SNPs) jointly associated with glaucoma and depression and two associated with glaucoma and anxiety. The MR analysis did not support robust causal associations but indicated the existence of pleiotropic genetic variants influencing both glaucoma and depression. Conclusions Our study enhances the existing epidemiological evidence and underscores the polygenic overlap between glaucoma and mental traits. This observation suggests a correlation shaped by pleiotropic genetic variants rather than being indicative of direct causal relationships.
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Affiliation(s)
- Xiayin Zhang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yingying Liang
- Department of Ophthalmology, Guangzhou First People's Hospital, Guangzhou, China
| | - Yu Huang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- Division of Population Health and Genomics, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom
| | - Shunming Liu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Qinyi Li
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Shan Wang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Guanrong Wu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Zijing Du
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yaxin Wang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Jinghui Wang
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Haikou, China
| | - Yunyan Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Siwen Zang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yijun Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Xianwen Shang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Xueli Zhang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Lei Zhang
- Clinical Medical Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
- Artificial Intelligence and Modelling in Epidemiology Program, Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Andrew Brown
- Division of Population Health and Genomics, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Mingguang He
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Honghua Yu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou, China
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9
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Gc K, Mahalingam K, Gupta V, Angmo D, Gupta S, Dada T. Stress and Allostatic Load in Patients With Primary Open Angle Glaucoma. J Glaucoma 2024; 33:87-93. [PMID: 37974317 DOI: 10.1097/ijg.0000000000002332] [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: 08/10/2023] [Accepted: 10/15/2023] [Indexed: 11/19/2023]
Abstract
PRCIS This study evaluated the allostatic load (AL) in primary open angle glaucoma (POAG) patients and reported that the AL score was significantly higher in glaucoma patients compared with age-matched controls. PURPOSE To evaluate the AL in patients with POAG. METHODS This case-control study comprised 50 POAG (glaucoma patients) and 50 age-matched controls without glaucoma (controls). AL was estimated based on 13 variables: systolic blood pressure (BP), diastolic BP, homocysteine, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, body mass index, serum cortisol, glycosylated hemoglobin, albumin, creatinine clearance, and C-reactive protein. High-risk thresholds were determined based on biological cutoffs of each biomarker. One point was assigned for each biomarker reading above cutoff and were summated to obtain AL score; score ≥4 was considered high. RESULTS Mean age of glaucoma patients was 60.82±6.26 and 60.14±6.72 years in controls ( P =0.602). All components of AL score (except C-reactive protein) had higher values in glaucoma patients. There was a statistically significant difference in homocysteine ( P =0.001), total cholesterol ( P =0.037), high-density lipoprotein ( P =0.005), and glycosylated hemoglobin ( P =0.003). Mean AL score was 4.68±2.09 in glaucoma patients and 3.32±1.34 in controls ( P <0.001). There was significant association of high AL score with older age ( P =0.006), low socioeconomic status ( P =0.020), and glaucoma severity ( P =0.001). Negative correlation was seen between AL and retinal nerve fiber layer thickness (Right Eye: r =-0.37, P <0.001; Left Eye: r =-0.298, P <0.001) and visual field mean deviation (Right Eye: r =-0.469, P <0.001; Left Eye: r =-0.520, P <0.001). CONCLUSIONS Glaucoma patients exhibited allostatic overload indicating physiological dysregulation to chronic stress although additional research is required to establish causality. A holistic approach with lifestyle modifications to reduce chronic stress should be an integral part of managing glaucoma patients as it would serve both to possibly reduce or prevent disease progression and improve overall health outcomes.
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Affiliation(s)
- Kiran Gc
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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10
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Emmerich G, Wiek J, Höfling J. [Life satisfaction in patients with chronic glaucoma-An overview]. DIE OPHTHALMOLOGIE 2024; 121:4-10. [PMID: 37737336 DOI: 10.1007/s00347-023-01925-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 09/23/2023]
Abstract
How do patients perceive fear and psychological challenges emerging from a chronic disease and how does this influence their commitment to treatment? Treating patients suffering from glaucoma requires not only medical knowledge but also empathy, communication skills and a positive valuing doctor-patient relationship, thus, having a good eye for the challenges in the treatment of patients with glaucoma. Supplementary, a method and a case study for the measurement of satisfaction with life in patients with glaucoma is introduced. The results and the benefits of an individual evaluation and analysis of the results with each patient are discussed in this article. To make the patients aware of possible psychological challenges and to address possible solutions, ophthalmologists should use and analyze questionnaires with their patients individually. The relationship to the patient and a valuing guidance of the patient are essential to the promotion of the effectiveness of treatment and adherence of the patient.
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Affiliation(s)
- Gabriele Emmerich
- Praxis an der Lichtwiese, Ohlystrasse 52, 64285, Darmstadt, Deutschland.
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11
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Huang H, Dai Y, Sun X, Fang Y. The Outbreak of Acute Primary Angle-Closure Cases During the COVID-19 Omicron Variant Pandemic at a Tertiary Eye Center in Shanghai. Clin Ophthalmol 2023; 17:4009-4019. [PMID: 38162694 PMCID: PMC10757803 DOI: 10.2147/opth.s440740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose This study aimed to investigate the outbreak of acute primary angle-closure (APAC) during the COVID-19 Omicron variant pandemic in Shanghai. Methods This single-center retrospective observational study included all newly diagnosed patients with APAC in Eye, Ear, Nose, and Throat Hospital of Fudan University from December 15, 2022, to January 14, 2023 (pandemic group) during the COVID-19 pandemic of Omicron Variant, and from November 15, 2021, to February 14, 2022 (control group) when the infection rate of COVID-19 is very low in Shanghai. Demographic features, intraocular pressure, axial length, anterior chamber depth, lens thickness and pupil diameter were compared between the two groups. Results A total of 223 patients (261 eyes) were included in the pandemic group and 75 patients (82 eyes) in the control group. The number of APAC patients and eyes in the pandemic group is 8.92-fold and 9.55-fold of the monthly average number in the control group. The onset dates of acute angle-closure were mainly between December 17 and December 31, 2022. In the pandemic group, 72.65% of patients with APAC had a recent COVID-19 infection. Among the COVID-19-positive patients, 72% suffered APAC attacks within 24h of the occurrence of COVID-19 symptoms and 92% within 3 days. The pandemic group showed a longer time from symptoms to treatment and larger pupil diameter than the control group (7.92 ± 6.14 vs 3.63 ± 2.93 days, p = 0.006; 4.53 ± 1.17 vs 3.78 ± 1.24 mm, p = 0.003, respectively). Conclusion An outbreak of APAC attack was observed in our eye center during the COVID-19 Omicron variant pandemic in Shanghai. There may be a correlation between the onset of APAC and new COVID-19 Omicron variant infection, but the exact reason needs to be investigated further.
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Affiliation(s)
- Haili Huang
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, People’s Republic of China
| | - Yi Dai
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, People’s Republic of China
| | - Xinghuai Sun
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, People’s Republic of China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, 200032, People’s Republic of China
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, 200031, People’s Republic of China
| | - Yuan Fang
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, People’s Republic of China
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12
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Hua Y, Lu H, Dai J, Zhou Y, Zhou W, Wang A, Chen Y, Liang Y. Self-management challenges and support needs among patients with primary glaucoma: a qualitative study. BMC Nurs 2023; 22:426. [PMID: 37957705 PMCID: PMC10644434 DOI: 10.1186/s12912-023-01527-y] [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] [Accepted: 09/22/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Self-management plays an important role in the disease management of glaucoma patients. The effectiveness of the program can be improved by assessing the patient's perspective and needs to tailor self-management support. Most studies have focused on assessing one of these self-management behaviours, such as medication adherence, and there is a lack of systematic assessment of the support needs and challenges of self-management for patients with glaucoma. Therefore, in this study, we conducted an in-depth investigation into the self-management challenges and support needs of patients with primary glaucoma, providing a basis for nursing staff to implement self-management support. METHOD The phenomenological method and semistructured interviews were used in this study. A total of 20 patients with primary glaucoma were recruited between June and December 2022. Colaizzi's analysis method was used to analyse the interview data. RESULTS Challenges for patients include becoming an expert in glaucoma, managing negative emotions, adapting to daily life changes and resuming social activities. To address these challenges, four themes of patient self-management support needs were identified: (1) health information support, (2) social support, (3) psychological support, and (4) daily living support. CONCLUSION Patients with primary glaucoma experience varying degrees of challenge in dealing with medical, emotional, and social aspects. Comprehending the support needs of patients, healthcare professionals should deliver targeted, personalized and comprehensive self-management interventions to enhance their capacity of patients to perform self-management and improve their quality of life.
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Affiliation(s)
- Yiting Hua
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Hujie Lu
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Jingyao Dai
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Yewei Zhou
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Wenzhe Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Aisun Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Yanyan Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China.
| | - Youping Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China.
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13
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Baek SU, Kim JS, Kim DW, Ha A, Kim YK. Association between psychological vulnerability and glaucoma progression: Protocol for a multicenter prospective cohort study in South Korea. PLoS One 2023; 18:e0292599. [PMID: 37816064 PMCID: PMC10564137 DOI: 10.1371/journal.pone.0292599] [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: 06/20/2023] [Accepted: 09/19/2023] [Indexed: 10/12/2023] Open
Abstract
INTRODUCTION Mental health is a significant concern for patients diagnosed with glaucoma, as visual impairment can have a profound impact on psychological well-being. Conversely, psychological vulnerability in glaucoma patients can negatively influence treatment adherence to ocular hypotensive therapy, thereby potentially exacerbating disease progression in a vicious cycle. The study protocol proposed herein aims to explore the impact of psychological states such as anxiety, depression, and stress on both medication adherence and progression of glaucoma. MATERIALS AND METHODS This study is to be a prospective multicenter study conducted at four tertiary medical centers. Patients recently diagnosed with glaucoma and not yet treated will be enrolled. Anxiety, depression, and stress scales will be administered at baseline, one year, and two years, along with glaucomatous assessments to be performed every six months. Validated questionnaires (Generalized Anxiety Disorder Assessment [GAD-7], Patient Health Questionnaire [PHQ-9], and Perceived Stress Scale-10 [PSS-10]) will assess anxiety, depression, and stress, respectively. The primary objective is to correlate post-diagnosis psychological status with medication adherence and disease progression. The effects of pre- and post-diagnosis changes in anxiety, depression, and stress on disease progression will be analyzed. Kaplan-Meier survival analysis and logistic regression will be performed to identify clinical characteristics associated with increased risk of developing anxiety, depression, and stress in glaucoma patients.
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Affiliation(s)
- Sung Uk Baek
- Department of Ophthalmology, Hallym University College of Medicine, Anyang, Korea
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jin-Soo Kim
- Department of Ophthalmology, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Dai Woo Kim
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Ahnul Ha
- Department of Ophthalmology, Jeju National University Hospital, Jeju-si, Korea
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju-si, Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- EyeLight Data Science Laboratory, Seoul, Korea
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14
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Poostchi A, Kastner A, Konstantakopoulou E, Gazzard G, Jayaram H. Clinical risk stratification in glaucoma. Eye (Lond) 2023; 37:3121-3127. [PMID: 36918628 PMCID: PMC10013986 DOI: 10.1038/s41433-023-02480-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/30/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023] Open
Abstract
Glaucoma is the leading cause of preventable sight loss in the United Kingdom and the provision of timely glaucoma care has been highlighted as a significant challenge in recent years. Following a recent high-profile investigation, The Healthcare Safety Investigation Branch recommended the validation of risk stratification models to safeguard the vision-related quality of life of glaucoma patients. There continues to be no nationally agreed evidence-based risk stratification model for glaucoma care across the United Kingdom. Some models have used simple measures of disease staging such as visual field mean deviation as surrogates for risk, but more refined, individualised risk stratification models should include factors related to both visual impairment and visual disability. Candidate tools should also incorporate both ocular and systemic co-morbidities, rate of disease progression, visual needs and driving status and undergo clinical refinement and validation to justify implementation. The disruption to routine glaucoma care caused by the COVID-19 pandemic has only highlighted the importance of such risk stratification models and has accelerated their development, application and evaluation. This review aims to critically appraise the available evidence underpinning current approaches for glaucoma risk stratification and to discuss how these may be applied to contemporary glaucoma care within the United Kingdom. Further research will be essential to justify and validate the utility of glaucoma risk stratification models in everyday clinical practice.
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Affiliation(s)
- Ali Poostchi
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Alan Kastner
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Evgenia Konstantakopoulou
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- UCL Institute of Ophthalmology, London, UK
- NIHR Moorfields Biomedical Research Centre, London, UK
- Division of Optics and Optometry, University of West Attica, Athens, Greece
| | - Gus Gazzard
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- UCL Institute of Ophthalmology, London, UK
- NIHR Moorfields Biomedical Research Centre, London, UK
| | - Hari Jayaram
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
- UCL Institute of Ophthalmology, London, UK.
- NIHR Moorfields Biomedical Research Centre, London, UK.
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15
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Latif K, Nishida T, Moghimi S, Weinreb RN. Quality of life in glaucoma. Graefes Arch Clin Exp Ophthalmol 2023; 261:3023-3030. [PMID: 37017741 DOI: 10.1007/s00417-023-06050-z] [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: 12/03/2022] [Revised: 03/07/2023] [Accepted: 03/24/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND An essential goal of glaucoma management is to prevent a patient's visual impairment that compromises their health-related quality of life (QOL). The disease itself, in addition to the medical or surgical treatment, can have a large impact on one's life. We aim to briefly review and evaluate aspects of QOL in glaucoma. METHODS The PubMed database was utilized for the literature examination of this review. Keywords that were searched included glaucoma, quality of life, vision-related QOL (VRQOL), quality of life questionnaire, and glaucoma therapy. RESULTS The main topics identified and analyzed during the literature review stages include factors affecting VRQOL, the assessment of VRQOL using questionnaires, QOL in early and severe glaucoma, glaucoma and activities of daily living, glaucoma treatments, and new advances in clinically assessing QOL. The study findings indicate a relationship between the deterioration of visual field and the quality of life. The investigation shows that visual loss can result in a range of daily life challenges, which include compromised mental health status and difficulties with driving, reading, and recognizing people. CONCLUSION Glaucoma-induced visual field loss can significantly impact different aspects of patients' life, and several methods exist for evaluating changes in quality of life. Quality of life assessments have their limitations as they are subjective. As potential future steps, we suggest exploring technological advancements such as virtual reality to improve patient care and outcomes.
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Affiliation(s)
- Kareem Latif
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Takashi Nishida
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA.
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA
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16
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Groff ML, Choi B, Lin T, Mcllraith I, Hutnik C, Malvankar-Mehta MS. Anxiety, depression, and sleep-related outcomes of glaucoma patients: systematic review and meta-analysis. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:346-355. [PMID: 35305959 DOI: 10.1016/j.jcjo.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 02/07/2022] [Accepted: 02/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study aims to synthesize data quantifying the prevalence and severity of common psychological conditions in patients with glaucoma. DESIGN Systematic review and meta-analysis. METHODS Databases including Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane Library, Web of Science, Open Grey, and ProQuest Theses and dissertations were searched. Two reviewers independently assessed and screened all studies, followed by quality assessment of included studies using the modified Downs and Black checklist. Data were pooled using fixed-effect and random-effects models. RESULTS Of 2067 studies identified by the search strategy, 57 passed full-text screening, and 45 studies (4 995 538 subjects) were eligible for analysis. Overall, the prevalence of depression (effect size [ES] = 0.19, 95% CI 0.16-0.23; n = 31), anxiety (ES = 0.25, 95% CI 0.21-0.30; n = 18), and sleep disorders (ES = 0.47, 95% CI 0.26-0.68; n = 7) were high in patients with glaucoma. Similarly, symptomatic measurements of depression (standardized mean difference [SMD] = 0.46, 95% CI 0.19-0.73), anxiety (SMD = 0.44, 95% CI 0.08-0.81), and sleep quality (SMD = 0.72, 95% CI 0.22-1.21) were significant in glaucoma patients. CONCLUSIONS A higher prevalence and severity of depression, anxiety, and sleep disorders was experienced in patients with glaucoma compared with patients without glaucoma. Caregivers as well as health care providers may need to be aware of unique psychological and social stressors placed on glaucoma patients.
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Affiliation(s)
- Michael Lee Groff
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Bohmyi Choi
- Faculty of Medicine, University of Ottawa, Ottawa, ON
| | - Tony Lin
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Ian Mcllraith
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Cindy Hutnik
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Monali S Malvankar-Mehta
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON; Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON.
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17
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Kolko M, Gazzard G, Baudouin C, Beier S, Brignole-Baudouin F, Cvenkel B, Fineide F, Hedengran A, Hommer A, Jespersen E, Messmer EM, Murthy R, Sullivan AG, Tatham AJ, Utheim TP, Vittrup M, Sullivan DA. Impact of glaucoma medications on the ocular surface and how ocular surface disease can influence glaucoma treatment. Ocul Surf 2023; 29:456-468. [PMID: 37302545 DOI: 10.1016/j.jtos.2023.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/13/2023]
Affiliation(s)
- Miriam Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark; Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Gus Gazzard
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK; UCL Institute of Ophthalmology, London, UK; NIHR-Moorfields Biomedical Research Centre, London, UK
| | - Christophe Baudouin
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; Université Paris-Saclay, Versailles-Saint-Quentin-en-Yvelines, Paris, France; Institut de la Vision, Sorbonne Université, Paris, France
| | - Sofie Beier
- Royal Danish Academy - Architecture, Design, Conservation, Copenhagen, Denmark
| | - Françoise Brignole-Baudouin
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; Institut de la Vision, Sorbonne Université, Paris, France; Faculté de Pharmacie, Paris Cité université, Paris, France
| | - Barbara Cvenkel
- Department of Ophthalmology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Fredrik Fineide
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Anne Hedengran
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark; Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Anton Hommer
- Department of Ophthalmology, HERA Hospital, Vienna, Austria
| | | | | | | | | | - Andrew J Tatham
- Princess Alexandra Eye Pavilion and Department of Ophthalmology, University of Edinburgh, Edinburgh, UK
| | - Tor Paaske Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
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18
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Ferry F, Rosato M, Leavey G. Severe mental illness and ophthalmic health: A linked administrative data study. PLoS One 2023; 18:e0286860. [PMID: 37285337 DOI: 10.1371/journal.pone.0286860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/24/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND While evidence has emerged highlighting the potential benefits of the eye as a window to the central nervous system, research on severe mental illness (SMI) and eye health is rare. AIMS We examine the association of SMI with a range of ophthalmic health outcomes, and whether any relationship is modified by age. METHODS We used linked administrative data from general practitioner (GP), hospital and ophthalmic records to examine receipt of any Health and Social Care (HSC) eye-test; and (based on eligibility recorded for a sight test) any glaucoma, any diabetes, and any blindness among the Northern Ireland (NI) hospital population between January 2015 and November 2019 (N = 798,564). RESULTS When compared with non-SMI patients, those with SMI recorded a higher prevalence of having had a sight test, diabetes, and blindness. In fully adjusted logistic regression models, higher likelihood of an eye-test and diabetes (OR = 1.71: 95%CI = 1.63, 1.79 and OR = 1.29: 1.19, 1.40 respectively); and lower likelihood of glaucoma remained (OR = 0.69: 0.53, 0.90). Amongst persons with SMI there was evidence that the likelihood of having had an eye-test was lower in the older age-groups. CONCLUSION Our study provides new evidence on ophthalmic health inequalities associated with SMI. While the study has immediate relevance to its NI context, we believe it is generalizable to wider UK health concerns. We emphasize the need for more research of this type, using large linkable electronic administrative databases to further our understanding of both health inequalities associated with SMI and poor eye health, and health outcomes in general.
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Affiliation(s)
- Finola Ferry
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Northern Ireland, United Kingdom
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Coleraine, Northern Ireland, United Kingdom
| | - Michael Rosato
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Northern Ireland, United Kingdom
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Coleraine, Northern Ireland, United Kingdom
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Northern Ireland, United Kingdom
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Coleraine, Northern Ireland, United Kingdom
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Gubin D, Neroev V, Malishevskaya T, Kolomeichuk S, Cornelissen G, Yuzhakova N, Vlasova A, Weinert D. Depression scores are associated with retinal ganglion cells loss. J Affect Disord 2023; 333:290-296. [PMID: 37084971 DOI: 10.1016/j.jad.2023.04.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/27/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Light is a known factor affecting mood and the circadian system. Light deficit is linked to deteriorated transduction of photic information to the brain, and reduced amplitude of the perceived circadian light signaling. Retinal ganglion cells (RGCs) loss due to advanced glaucoma can be a factor compromising light perception, with consequences for circadian rhythms, sleep and mood. This study aimed to estimate associations of RGCs loss with a depression score by multiple regression, accounting for other features of glaucoma. METHODS One hundred and fifteen patients diagnosed with primary open-angle glaucoma completed the Beck Depression Inventory II questionnaire. The damage to their RGCs was assessed by high-definition optical coherence tomography (HD-OCT) and their function by pattern electroretinogram (PERG). On fifteen of these patients, 24-h salivary melatonin patterns were determined under light-controlled laboratory conditions, and analysis of eight clock related gene polymorphisms was performed. RESULTS Backward stepwise multiple regression revealed that the BDI score was the strongest factor that was most closely associated with the HD-OCT-based percentage of global RGCs loss (standardized coefficient, b* = 0.784, p < 0.001), surpassing other related factors, including age, intraocular pressure, visual field loss, and PERG amplitude. A high BDI score was associated with the GNβ3 825C > T polymorphism (dbSNP rs5443). LIMITATIONS This study did not specifically address damage to intrinsically photoreceptive RGCs. The gene study is based on a limited number of volunteers. CONCLUSIONS Depression scores are strongly associated with RGCs loss, increasing abruptly above a threshold of 15 %, supporting the hypothesis that RGCs loss in advanced glaucoma may affect non-visual photic transduction and lead to mood disturbances.
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Affiliation(s)
- Denis Gubin
- Laboratory for Chronobiology and Chronomedicine, Research Institute of Biomedicine and Biomedical Technologies, Medical University, 625023 Tyumen, Russia; Department of Biology, Medical University, 625023 Tyumen, Russia; Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia.
| | - Vladimir Neroev
- Helmholz National Medical Research Center of Eye Diseases, Moscow, Russia.
| | | | - Sergey Kolomeichuk
- Laboratory for Genomics, Metabolomics and Proteomics, Research Institute of Biomedicine and Biomedical Technologies, Medical University, 625023 Tyumen, Russia; Laboratory of Genetics, Institute of Biology, Karelian Scientific Center of RAS, Petrozavodsk, Russia; Tyumen State Medical University, Tyumen, Russia
| | - Germaine Cornelissen
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, USA.
| | - Natalia Yuzhakova
- Laboratory for Genomics, Metabolomics and Proteomics, Research Institute of Biomedicine and Biomedical Technologies, Medical University, 625023 Tyumen, Russia.
| | - Anastasia Vlasova
- State Autonomous Health Care Institution Tyumen Regional Ophthalmological Dispensary, 625048, Tyumen, Russia
| | - Dietmar Weinert
- Institute of Biology/Zoology, Martin Luther University, Halle-Wittenberg, Germany.
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20
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Delavar A, Bu JJ, Radha Saseendrakumar B, Weinreb RN, Baxter SL. Mental health and social support among glaucoma patients enrolled in the NIH All of Us COVID-19 Participant Experience (COPE) survey. BMC Ophthalmol 2023; 23:63. [PMID: 36782129 PMCID: PMC9923653 DOI: 10.1186/s12886-023-02771-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 01/04/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic created many challenges for our society. In this study, we explore how measures of mental health, coping strategies, and social support during the pandemic varied by glaucoma status. METHODS A cohort of patients aged 40 and over enrolled in the NIH All of Us Research Program, a nationwide longitudinal cohort, who answered the COVID-19 Participant Experience (COPE) survey was obtained. We analyzed several measures of mental health, coping strategies, and social support used during the early stages of the COVID-19 pandemic. Surveys were recurring and answered from May 2020 to February 2021. Demographics and the most recently answered survey responses were obtained and stratified by glaucoma status. Pearson's Chi-squared tests and multivariable logistic regressions adjusting for age, gender, race, ethnicity, and income were used to generate p-values, odds ratios (ORs) and 95% confidence intervals (CIs) between outcome measures and glaucoma status. RESULTS Of 42,484 patients who responded to All of Us COPE survey items, 2912 (6.9%) had a diagnosis of glaucoma. On Pearson's Chi-squared tests glaucoma patients were less likely to report drinking alcohol (P = 0.003), eating more food than usual (P = 0.004), and using marijuana (P = 0.006) to cope with social distancing than those without a diagnosis of glaucoma. Further, glaucoma patients had lower rates of probable mild, moderate, or severe depression as calculated by Patient Health Questionnaire-9 (PHQ-9) scores (P < 0.001) and had lower rates of reporting some or a lot of stress from social distancing (P < 0.001). However, glaucoma patients were less likely to report having someone to help prepare meals (P = 0.005) or help with daily chores (P = 0.003) if they became sick with COVID-19. In multivariable logistic regression analyses adjusting for confounding factors, no differences were found for measures of mental health or social support. CONCLUSIONS Glaucoma patients did not fare worse on many measures of mental health and coping strategies during the early stages of the COVID-19 pandemic compared those without glaucoma. However, a substantial proportion of glaucoma patients still endorsed stress, social isolation, and probable depression, representing challenges for disease management.
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Affiliation(s)
- Arash Delavar
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
| | - Jennifer J. Bu
- grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
| | - Bharanidharan Radha Saseendrakumar
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
| | - Robert N. Weinreb
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Sally L. Baxter
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
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21
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Tian Y, Li M, Zhang S, Hu J, Wu H, Wan M, Xue J, Wang L, Xiao H, Zhou G, Wang K, Liu Q. Microglia activation in the hippocampus mediates retinal degeneration-induced depressive-like behaviors via the NLRP3/IL-1β pathway. Brain Res Bull 2023; 192:70-79. [PMID: 36332880 DOI: 10.1016/j.brainresbull.2022.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/24/2022] [Accepted: 10/31/2022] [Indexed: 11/13/2022]
Abstract
Epidemiological studies have shown that patients with glaucoma are more prone to depression, but the mechanism of comorbid depression in patients with glaucoma remains unknown. Excessive neuroinflammation has been shown to participate in glaucoma-induced retinal degeneration and hippocampal neural apoptosis in depression. However, little research has been conducted to determine whether neuroinflammation contributes to glaucoma-induced depression. Since the degeneration of retinal ganglion cells is a hallmark of glaucoma, we investigated the role of microglia-induced neuroinflammation in retinal degeneration-induced depression and its potential mechanism. An N-methyl-D-aspartate (NMDA)-induced retinal degeneration model was established, and behavioral tests were conducted at 3, 7, 14, and 21 days after retinal degeneration. After tissue collection, we used immunohistochemistry to assess the activation of microglia and real-time polymerase chain reaction to measure the levels of pro-inflammatory cytokines and the NOD-, LRR-, and pyrin-domain containing protein 3 (NLRP3) inflammasome. The mice exhibited depressive-like behaviors 14 and 21 days after retinal degeneration, based on the open field test, tail suspension test, and forced swimming test. Mice also displayed a lower body weight gain than the control group. In addition, microglial activation was observed in the hippocampus. Microglial proliferation was first observed in the dentate gyrus on day 3, while the number of microglia in cornu ammonis 1 grew the most. Moreover, not only was the expression of pro-inflammatory cytokines, including interleukin-1β, interleukin-18, and interleukin-6 promoted, but the messenger ribonucleic acid levels of the NLRP3 inflammasome were also increased. In conclusion, our research shows that NMDA-induced retinal degeneration can induce depressive-like behaviors, which may be attributed to hippocampal neuroinflammation.
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Affiliation(s)
- Yi Tian
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China; Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - Meihui Li
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Shanshan Zhang
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Juntao Hu
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Haoran Wu
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Mitchell Wan
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Jingxin Xue
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Leilei Wang
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Honglei Xiao
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Guomin Zhou
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China; Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention of Shanghai, Shanghai, China.
| | - Kaidi Wang
- Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China.
| | - Qiong Liu
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China; Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention of Shanghai, Shanghai, China.
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22
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Tang L, Chen L, Ye C, Zheng J, Zhou Y, Tao Y, Huang Q, Wang X, Shang X, Pan X, Congdon N, Liang Y. Population-based associations between progression of normal-tension glaucoma and Yang-deficient constitution among Chinese persons. Br J Ophthalmol 2023; 107:37-42. [PMID: 34362777 PMCID: PMC9763230 DOI: 10.1136/bjophthalmol-2021-319210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/23/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To explore the association between constitution types as defined by traditional Chinese medicine (TCM) and risk for normal-tension glaucoma (NTG). DESIGN Population-based cohort study. METHODS Persons were identified in a population cohort aged ≥30 years with NTG, defined as having an untreated mean intraocular pressure measurement ≤21 mm Hg over six separate occasions, with no single reading >24 mm Hg (as in the Collaborative Normal Tension Glaucoma Study). The Body Constitution in Traditional Chinese Medicine Questionnaire was used to assess each participant's TCM constitution types. The association between various constitutions and visual field progression according to Early Manifest Glaucoma Trial criteria was assessed using Cox regression HR models. RESULTS Among 142 participants (245 eyes), 23 persons (17.6%) and 25 eyes (10.2%) progressed, over a mean (SD) follow-up duration of 3.49 (0.99) years. Progression rates were highest in participants with Yang-deficient constitution (n=19, 13.4%), among whom 7 (36.8%) exhibited worsening fields. After adjusting for sex, age, central corneal thickness, retinal nerve fibre layer thickness and mean deviation on visual field testing, Yang-deficient constitution (HR 4.63, 95% CI 1.77 to 12.1, p=0.002) and higher mean intraocular pressure during follow-up (HR 1.25, 95% CI 1.01 to 1.56, p=0.044) were associated with field progression. CONCLUSIONS Yang-deficient constitution and higher intraocular pressure are risk factors for visual field progression in NTG patients. Yang deficiency is characterised by abnormal vasoregulation, and these results may be consistent with prior studies linking NTG progression to Raynaud's phenomenon and migraine.
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Affiliation(s)
- Lewei Tang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Liang Chen
- Wenzhou Medical University Second Affiliated Hospital, Wenzhou, China
| | - Cong Ye
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Jingwei Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Yi Zhou
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Yan Tao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Qiangjie Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Xiaoyan Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Xiao Shang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Xiafei Pan
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Nathan Congdon
- Centre for Public Health, Queen’s University Belfast, Belfast, UK,ORBIS International, New York, New York, USA
| | - Yuanbo Liang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China .,National Clinical Research Center for Ocular Diseases, Wenzhou, China
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23
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Klauke S, Sondocie C, Fine I. The impact of low vision on social function: The potential importance of lost visual social cues. JOURNAL OF OPTOMETRY 2023; 16:3-11. [PMID: 35568628 PMCID: PMC9811370 DOI: 10.1016/j.optom.2022.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/09/2022] [Accepted: 03/06/2022] [Indexed: 05/06/2023]
Abstract
Visual cues usually play a vital role in social interaction. As well as being the primary cue for identifying other people, visual cues also provide crucial non-verbal social information via both facial expressions and body language. One consequence of vision loss is the need to rely on non-visual cues during social interaction. Although verbal cues can carry a significant amount of information, this information is often not available to an untrained listener. Here, we review the current literature examining potential ways that the loss of social information due to vision loss might impact social functioning. A large number of studies suggest that low vision and blindness is a risk factor for anxiety and depression. This relationship has been attributed to multiple factors, including anxiety about disease progression, and impairments to quality of life that include difficulties reading, and a lack of access to work and social activities. However, our review suggests a potential additional contributing factor to reduced quality of life that has been hitherto overlooked: blindness may make it more difficult to effectively engage in social interactions, due to a loss of visual information. The current literature suggests it might be worth considering training in voice discrimination and/or recognition when carrying out rehabilitative training in late blind individuals.
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Affiliation(s)
| | - Chloe Sondocie
- Department of Psychology, University of Washington, Seattle, USA
| | - Ione Fine
- Department of Psychology, University of Washington, Seattle, USA.
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24
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Zhou W, Lin H, Ren Y, Lin H, Liang Y, Chen Y, Zhang S. Mental health and self-management in glaucoma patients during the COVID-19 pandemic: a cross-sectional study in China. BMC Ophthalmol 2022; 22:474. [PMID: 36474185 PMCID: PMC9727872 DOI: 10.1186/s12886-022-02695-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To investigate mental health and self-management in glaucoma patients during the COVID-19 pandemic in China and to describe the correlation between anxiety, depression, glaucoma, and self-management. METHODS This cross-sectional study included glaucoma patients who enrolled in the case management platform and completed an online survey. The survey included the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Glaucoma Self-Management Questionnaire (GSMQ). RESULTS Among 109 glaucoma patients enrolled in this study, the proportions of patients suffering from depression and anxiety during the COVID-19 pandemic were 26.6% and 20.2%, respectively. A statistical association was found between depression and self-management behaviour in these glaucoma patients (r = -0.247, P = 0.010). The self-management scores in patients less than 35 years were lower than those in patients aged 35-60 years (P = 0.046). The scores of body function promotion in men were lower than those in women (P = 0.048). Patients with primary school education and below had lower scores in the medical management of disease than those with either middle school education (P = 0.032) or community college education or higher (P = 0.022). CONCLUSION A high proportion of anxiety and depression was found in glaucoma patients during the COVID-19 pandemic. Better self-management behaviour was associated with stronger mental health regulation. It is important to help glaucoma patients improve their self-management behaviours, especially for young men with low educational levels.
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Affiliation(s)
- Wenzhe Zhou
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Haishuang Lin
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China ,grid.268099.c0000 0001 0348 3990Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Yanhan Ren
- grid.168645.80000 0001 0742 0364University of Massachusetts Medical School, Worcester, USA
| | - Hao Lin
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Youping Liang
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Yanyan Chen
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Shaodan Zhang
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
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25
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Wang Y, Chen L, Cai F, Gao J, Ouyang F, Chen Y, Yin M, Hua C, Zeng X. Altered functional connectivity of the thalamus in primary angle-closure glaucoma patients: A resting-state fMRI study. Front Neurol 2022; 13:1015758. [PMID: 36277918 PMCID: PMC9583913 DOI: 10.3389/fneur.2022.1015758] [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: 08/11/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Background and objectives Glaucoma is one of the leading irreversible causes of blindness worldwide, and previous studies have shown that there is abnormal functional connectivity (FC) in the visual cortex of glaucoma patients. The thalamus is a relay nucleus for visual signals; however, it is not yet clear how the FC of the thalamus is altered in glaucoma. This study investigated the alterations in thalamic FC in patients with primary angle-closure glaucoma (PACG) by using resting-state functional MRI (rs-fMRI). We hypothesized that PACG patients have abnormal FC between the thalamus and visual as well as extravisual brain regions. Methods Clinically confirmed PACG patients and age- and gender-matched healthy controls (HCs) were evaluated by T1 anatomical and functional MRI on a 3 T scanner. Thirty-four PACG patients and 33 HCs were included in the rs-fMRI analysis. All PACG patients underwent complete ophthalmological examinations; included retinal nerve fiber layer thickness (RNFLT), intraocular pressure (IOP), average cup-to-disc ratio (A-C/D), and vertical cup-to-disc ratio (V-C/D). After the MRI data were preprocessed, the bilateral thalamus was chosen as the seed point; and the differences in resting-state FC between groups were evaluated. The brain regions that significantly differed between PACG patients and HCs were identified, and the correlations were then evaluated between the FC coefficients of these regions and clinical variables. Results Compared with the HCs, the PACG patients showed decreased FC between the bilateral thalamus and right transverse temporal gyrus, between the bilateral thalamus and left anterior cingulate cortex, and between the left thalamus and left insula. Concurrently, increased FC was found between the bilateral thalamus and left superior frontal gyrus in PACG patients. The FC between the bilateral thalamus and left superior frontal gyrus was positively correlated with RNFLT and negatively correlated with the A-C/D and V-C/D. The FC between the left thalamus and left insula was negatively correlated with IOP. Conclusion Extensive abnormal resting-state functional connections between the thalamus and visual and extravisual brain areas were found in PACG patients, and there were certain correlations with clinical variables, suggesting that abnormal thalamic FC plays an important role in the progression of PACG.
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Affiliation(s)
- Yuanyuan Wang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linglong Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Fengqin Cai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Junwei Gao
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Ouyang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ye Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Mingxue Yin
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Chengpeng Hua
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Xianjun Zeng
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26
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Berchuck SI, Jammal AA, Page D, Somers TJ, Medeiros FA. A Framework for Automating Psychiatric Distress Screening in Ophthalmology Clinics Using an EHR-Derived AI Algorithm. Transl Vis Sci Technol 2022; 11:6. [PMID: 36180026 PMCID: PMC9547354 DOI: 10.1167/tvst.11.10.6] [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: 06/28/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose In patients with ophthalmic disorders, psychosocial risk factors play an important role in morbidity and mortality. Proper and early psychiatric screening can result in prompt intervention and mitigate its impact. Because screening is resource intensive, we developed a framework for automating screening using an electronic health record (EHR)-derived artificial intelligence (AI) algorithm. Methods Subjects came from the Duke Ophthalmic Registry, a retrospective EHR database for the Duke Eye Center. Inclusion criteria included at least two encounters and a minimum of 1 year of follow-up. Presence of distress was defined at the encounter level using a computable phenotype. Risk factors included available EHR history. At each encounter, risk factors were used to discriminate psychiatric status. Model performance was evaluated using area under the receiver operating characteristic (ROC) curve and area under the precision-recall curve (PR AUC). Variable importance was presented using odds ratios (ORs). Results Our cohort included 358,135 encounters from 40,326 patients with an average of nine encounters per patient over 4 years. The ROC and PR AUC were 0.91 and 0.55, respectively. Of the top 25 predictors, the majority were related to existing distress, but some indicated stressful conditions, including chemotherapy (OR = 1.36), esophageal disorders (OR = 1.31), central pain syndrome (OR = 1.25), and headaches (OR = 1.24). Conclusions Psychiatric distress in ophthalmology patients can be monitored passively using an AI algorithm trained on existing EHR data. Translational Relevance When paired with an effective referral and treatment program, such algorithms may improve health outcomes in ophthalmology.
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Affiliation(s)
| | - Alessandro A. Jammal
- Duke Eye Center and Department of Ophthalmology, Duke University, Durham, NC, USA
| | - David Page
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Felipe A. Medeiros
- Duke Eye Center and Department of Ophthalmology, Duke University, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
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27
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Duong AT, Van Tassel SH. Depression and Glaucoma: A Review and Considerations for Researchers and Providers. Int Ophthalmol Clin 2022; 62:39-44. [PMID: 36170220 DOI: 10.1097/iio.0000000000000441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Dada T, Verma S, Gagrani M, Bhartiya S, Chauhan N, Satpute K, Sharma N. Ocular and Systemic Factors Associated with Glaucoma. J Curr Glaucoma Pract 2022; 16:179-191. [PMID: 36793269 PMCID: PMC9905876 DOI: 10.5005/jp-journals-10078-1383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/14/2022] [Indexed: 01/25/2023] Open
Abstract
Glaucoma is one of the leading causes of irreversible blindness in the world. Although numerous factors have been implicated in the pathogenesis of glaucoma, the main focus of management still remains lowering the intraocular pressure (IOP) by medical or surgical therapy. However, a major challenge is that many glaucoma patients continue to progress despite good control of IOP. In this regard, the importance of other coexisting factors that may contribute to disease progression needs to be explored. Ophthalmologists need to be aware of ocular risk factors and the impact of systemic diseases and their medications, along with lifestyle modifications on the course of glaucomatous optic neuropathy and adopt a holistic approach in treating the eye as well as the patient to alleviate the suffering from glaucoma in a comprehensive manner. How to cite this article Dada T, Verma S, Gagrani M, et al. Ocular and Systemic Factors associated with Glaucoma. J Curr Glaucoma Pract 2022;16(3):179-191.
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Affiliation(s)
- Tanuj Dada
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Saurabh Verma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Meghal Gagrani
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Shibal Bhartiya
- Senior consultant, Department of Opthalmology, fortis memorial research institute, Gurugram, Haryana, India
| | - Nidhi Chauhan
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Kanchan Satpute
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Ha YW, Jang H, Koh SB, Noh Y, Lee SK, Seo SW, Cho J, Kim C. Reduced brain subcortical volumes in patients with glaucoma: a pilot neuroimaging study using the region-of-interest-based approach. BMC Neurol 2022; 22:277. [PMID: 35879747 PMCID: PMC9310417 DOI: 10.1186/s12883-022-02807-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/19/2022] [Indexed: 11/19/2022] Open
Abstract
Background While numerous neuroimaging studies have demonstrated that glaucoma is associated with smaller volumes of the visual cortices in the brain, only a few studies have linked glaucoma with brain structures beyond the visual cortices. Therefore, the objective of this study was to compare brain imaging markers and neuropsychological performance between individuals with and without glaucoma. Methods We identified 64 individuals with glaucoma and randomly selected 128 age-, sex-, and education level-matched individuals without glaucoma from a community-based cohort. The study participants underwent 3 T brain magnetic resonance imaging and neuropsychological assessment battery. Regional cortical thickness and subcortical volume were estimated from the brain images of the participants. We used a linear mixed model after adjusting for potential confounding variables. Results Cortical thickness in the occipital lobe was significantly smaller in individuals with glaucoma than in the matched individuals (β = − 0.04 mm, P = 0.014). This did not remain significant after adjusting for cardiovascular risk factors (β = − 0.02 mm, P = 0.67). Individuals with glaucoma had smaller volumes of the thalamus (β = − 212.8 mm3, P = 0.028), caudate (β = − 170.0 mm3, P = 0.029), putamen (β = − 151.4 mm3, P = 0.051), pallidum (β = − 103.6 mm3, P = 0.007), hippocampus (β = − 141.4 mm3, P = 0.026), and amygdala (β = − 87.9 mm3, P = 0.018) compared with those without glaucoma. Among neuropsychological battery tests, only the Stroop color reading test score was significantly lower in individuals with glaucoma compared with those without glaucoma (β = − 0.44, P = 0.038). Conclusions We found that glaucoma was associated with smaller volumes of the thalamus, caudate, putamen, pallidum, amygdala, and hippocampus. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02807-x.
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Affiliation(s)
- Yae Won Ha
- Department of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Heeseon Jang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Young Noh
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seung-Koo Lee
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jaelim Cho
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Republic of Korea. .,Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Lešin Gaćina D, Jandroković S, Vidas Pauk S, Škegro I, Bošković J, Tomić M, Pupić-Bakrač A, Vlašić D. The medication adherence among glaucoma patients during the coronavirus disease 2019 pandemic in Croatia. Eur J Ophthalmol 2022; 33:333-340. [PMID: 35791501 PMCID: PMC9260194 DOI: 10.1177/11206721221112150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE This study aimed to evaluate the level of treatment adherence and identify predictors of adherence in glaucoma patients during the coronavirus disease 2019 (COVID-19) pandemic in Zagreb, Croatia. METHODS The cross-sectional study was conducted among primary open-angle glaucoma (POAG) patients at the Department of Ophthalmology, University Hospital Centre Zagreb, between 1st April 2020 and 1st April 2021. The sociodemographic data, clinical, and drug information were recorded. The treatment adherence was assessed through a self-administered questionnaire, the Culig Adherence Scale (CAS). Statistical analyses were performed using TIBCO Statistica™ 14.0.0. RESULTS 113 POAG patients (48M/65F) with a mean age of 65.89 ± 8.53 years were included in this study. According to the CAS, only 39.8% of patients adhered to topical glaucoma treatment. Educational level was positively related to adherence to treatment (p = 0.022). The main predictors for adherence were the patients' positive attitude towards the drug's effect, family support, and good relationship with the healthcare providers (p < 0.05, respectively). The majority of patients stated forgetfulness as the main reason for skipping drug dosing. CONCLUSIONS Non-adherence to treatment was prevalent among patients with POAG during the COVID-19 pandemic in Zagreb, Croatia. Personal beliefs and attitudes towards treatment, family support, and patient-healthcare provider relationship were significant predictors of adherence. Special consideration should be given to the whole health system-level strategies targeting the adherence to treatment, especially in crises, in order to achieve positive therapeutic outcomes.The study protocol was registered in the DRKS - German Clinical Trials Register, DRKS-ID: DRKS00022081.
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Affiliation(s)
- Dina Lešin Gaćina
- Department of Ophthalmology, Zagreb
University Hospital Center, Zagreb, Croatia,Dina Lešin Gaćina, Department of
Ophthalmology, Zagreb University Hospital Center, Kišpatićeva 12, 10 000 Zagreb,
Croatia.
| | - Sonja Jandroković
- Department of Ophthalmology, Zagreb
University Hospital Center, Zagreb, Croatia,University of Zagreb, School of
Medicine, Zagreb, Croatia
| | - Sania Vidas Pauk
- Department of Ophthalmology, Zagreb
University Hospital Center, Zagreb, Croatia
| | - Ivan Škegro
- Department of Ophthalmology, Zagreb
University Hospital Center, Zagreb, Croatia,University of Zagreb, School of
Medicine, Zagreb, Croatia
| | | | - Martina Tomić
- Department of Ophthalmology, Vuk
Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur
University Hospital, Zagreb, Croatia
| | - Ana Pupić-Bakrač
- Department of Ophthalmology, Zadar General Hospital, Zadar, Croatia
| | - Domagoj Vlašić
- Department of Ophthalmology, Dubrovnik General Hospital, Dubrovnik, Croatia
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Bioinformatic Prioritization and Functional Annotation of GWAS-Based Candidate Genes for Primary Open-Angle Glaucoma. Genes (Basel) 2022; 13:genes13061055. [PMID: 35741817 PMCID: PMC9222386 DOI: 10.3390/genes13061055] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 12/19/2022] Open
Abstract
Background: Primary open-angle glaucoma (POAG) is the most prevalent glaucoma subtype, but its exact etiology is still unknown. In this study, we aimed to prioritize the most likely ‘causal’ genes and identify functional characteristics and underlying biological pathways of POAG candidate genes. Methods: We used the results of a large POAG genome-wide association analysis study from GERA and UK Biobank cohorts. First, we performed systematic gene-prioritization analyses based on: (i) nearest genes; (ii) nonsynonymous single-nucleotide polymorphisms; (iii) co-regulation analysis; (iv) transcriptome-wide association studies; and (v) epigenomic data. Next, we performed functional enrichment analyses to find overrepresented functional pathways and tissues. Results: We identified 142 prioritized genes, of which 64 were novel for POAG. BICC1, AFAP1, and ABCA1 were the most highly prioritized genes based on four or more lines of evidence. The most significant pathways were related to extracellular matrix turnover, transforming growth factor-β, blood vessel development, and retinoic acid receptor signaling. Ocular tissues such as sclera and trabecular meshwork showed enrichment in prioritized gene expression (>1.5 fold). We found pleiotropy of POAG with intraocular pressure and optic-disc parameters, as well as genetic correlation with hypertension and diabetes-related eye disease. Conclusions: Our findings contribute to a better understanding of the molecular mechanisms underlying glaucoma pathogenesis and have prioritized many novel candidate genes for functional follow-up studies.
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Glaucoma – risk factors and current challenges in the diagnosis of a leading cause of visual impairment. Maturitas 2022; 163:15-22. [DOI: 10.1016/j.maturitas.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/01/2022] [Accepted: 05/09/2022] [Indexed: 11/21/2022]
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33
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Lee JS, Park S, Seong GJ, Kim CY, Lee SY, Choi W, Bae HW. Long-term Intraocular Pressure Fluctuation Is a Risk Factor for Visual Field Progression in Advanced Glaucoma. J Glaucoma 2022; 31:310-316. [PMID: 35283440 DOI: 10.1097/ijg.0000000000002011] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/23/2022] [Indexed: 11/25/2022]
Abstract
PRCIS Intraocular pressure (IOP) fluctuations increase the risk of visual field progression of primary open-angle glaucoma (POAG) in the advanced stage even when IOP is maintained low on average. PURPOSE The purpose of this study was to identify risk factors associated with the progression of visual field defect in patients with advanced POAG. MATERIALS AND METHODS A retrospective review of medical records was conducted to identify patients who met the Hodapp-Parrish-Anderson criteria for advanced POAG. A total of 122 eyes of 122 patients had undergone IOP measurement with Goldmann applanation tonometer, standard automated perimetry, Cirrus optical coherence tomography, and fundus photography at 6-month intervals. Visual field progression was defined as the deterioration of a minimum of 3 visual field locations more than baseline at 5% levels in 4 consecutive visual fields with 24-2 SITA testing. RESULTS Thirty-six eyes of 122 eyes (29.5%, 51.9±13.9 y old) showed visual field progression during 100.7±44.2 months of follow-up. The progression group showed greater long-term IOP fluctuations (2.6±1.4 mm Hg) than the no progression group (53.5±13.5 y; 2.0±1.0 mm Hg, P=0.008). Disc hemorrhage was detected more frequently in the progression group (40.5% vs. 17.4%, P=0.005). Multivariate Cox regression analysis revealed long-term IOP fluctuations [hazard ratio (HR)=2.567, 95% confidence interval (CI): 1.327-5.370, P=0.012] and disc hemorrhage (HR=2.351, 95% CI: 1.120-4.931, P=0.024) to be independent risk factors of visual field progression. Patients who showed both disc hemorrhage and long-term IOP fluctuations were at greater risks of progression (HR=2.675, 95% CI: 1.072-6.457, P=0.035). CONCLUSIONS Long-term IOP fluctuations and disc hemorrhage are independent and additive risk factors of visual field progression in advanced glaucoma even at low IOPs. Patients in whom these risk factors are identified require close monitoring and vigorous treatment.
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Affiliation(s)
- Jihei Sara Lee
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine
| | - Sungeun Park
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine
| | - Gong Je Seong
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine
| | - Chan Yun Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine
| | - Sang Yeop Lee
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine
- Department of Ophthalmology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Wungrak Choi
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine
| | - Hyoung Won Bae
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine
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Anatomical Evidence for the Neural Connection from the Emotional Brain to Autonomic Innervation in the Anterior Chamber Structures of the Eye. Curr Med Sci 2022; 42:417-425. [PMID: 35366148 DOI: 10.1007/s11596-022-2571-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/09/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Previous studies have shown that the autonomic nervous system (ANS), which can be affected by emotions, is important in the occurrence or progression of glaucoma. The autonomic innervation distributed in the anterior chamber (AC) structures might play an efferent role in the neural regulation of intraocular pressure (IOP). This study aimed to investigate the anatomic neural connection from the emotional brain to autonomic innervation in the AC. METHODS A retrograde trans-multisynaptic pseudorabies virus encoded with an enhanced green fluorescent protein (PRV531) and non-trans-synaptic tracer FAST Dil were injected into the right eye of mice, respectively. Fluorescent localization in the emotional brain and preganglionic nuclei was studied. Five and a half days after PRV531 injection into the right AC, fluorescent signals were observed in several emotional brain regions, including the amygdala, agranular insular cortex, lateral septal nuclei, periaqueductal gray, and hypothalamus. Autonomic preganglionic nuclei, including Edinger-Westphal nucleus, superior salivatory nucleus, and intermediolateral nucleus, were labeled using PRV531. RESULTS The sensory trigeminal nuclei were not labeled using PRV531. The fluorescence signals in the nuclei mentioned above showed bilateral distribution, primarily on the ipsilateral side. Seven days after injecting FAST Dil into the AC, we observed no FAST Dil-labeled neurons in the central nervous system. CONCLUSION Our results indicate a neural connection from the emotional brain to autonomic innervation in the AC, which provides anatomical support for the emotional influence of IOP via the ANS.
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35
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DeCarlo AA, Hammes N, Johnson PL, Shekhar A, Samuels BC. Dual Orexin Receptor Antagonist Attenuates Increases in IOP, ICP, and Translaminar Pressure Difference After Stimulation of the Hypothalamus in Rats. Invest Ophthalmol Vis Sci 2022; 63:1. [PMID: 35234838 PMCID: PMC8899853 DOI: 10.1167/iovs.63.3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Intraocular pressure (IOP) remains the only modifiable risk factor for glaucoma progression. Our previous discovery that stimulation of nuclei within the hypothalamus can modulate IOP, intracranial pressure (ICP), and translaminar pressure difference (TLPD) fluctuations led us to investigate this pathway further. Our purpose was to determine the role of orexin neurons, primarily located in the dorsomedial hypothalamus (DMH) and perifornical (PeF) regions of the hypothalamus, in modulating these pressures. METHODS Sprague Dawley rats were pretreated systemically with a dual orexin receptor antagonist (DORA-12) at 30 mg/Kg (n = 8), 10 mg/Kg (n = 8), or vehicle control (n = 8). The IOP, ICP, heart rate (HR), and mean arterial pressure (MAP) were recorded prior to and following excitation of the DMH/PeF using microinjection of the gamma-aminobutyric acid (GABA)A receptor antagonist bicuculline methiodide (BMI). RESULTS Administration of the DORA at 30 mg/Kg significantly attenuated peak IOP by 5.2 ± 3.6 mm Hg (P = 0.007). During the peak response period (8-40 minutes), the area under the curve (AUC) for the 30 mg/Kg DORA cohort was significantly lower than the control cohort during the same period (P = 0.04). IOP responses for peak AUC versus DORA dose, from 0 to 30 mg/Kg, were linear (R2 = 0.18, P = 0.04). The ICP responses during the peak response period (4-16 minutes) versus DORA dose were also linear (R2 = 0.24, P = 0.014). Pretreatment with DORA significantly decreased AUC for the TLPD following stimulation of the DMH/PeF (10 mg/kg, P = 0.045 and 30 mg/kg, P = 0.015). CONCLUSIONS DORAs have the potential to attenuate asynchronous changes in IOP and in ICP and to lessen the extent of TLPDs that may result from central nervous system (CNS) activation.
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Affiliation(s)
- Arthur A. DeCarlo
- University of Alabama at Birmingham, Department of Ophthalmology and Visual Sciences, Birmingham, Alabama, United States
| | - Nathan Hammes
- Indiana University School of Medicine, Department of Ophthalmology, Indianapolis, Indiana, United States,Microsoft Corporation, Redmond, Washington, United States
| | - Philip L. Johnson
- Indiana University School of Medicine, Department of Anatomy, Cell Biology, and Physiology, Indianapolis, Indiana, United States
| | - Anantha Shekhar
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, United States
| | - Brian C. Samuels
- University of Alabama at Birmingham, Department of Ophthalmology and Visual Sciences, Birmingham, Alabama, United States
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36
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McCullagh D, Puls N, Beaconsfield M, Dempster M, Jackson J, Williams M. Psychological aspects of living with an artificial eye. Orbit 2022; 41:745-750. [PMID: 35226567 DOI: 10.1080/01676830.2021.2013505] [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: 10/19/2022]
Abstract
PURPOSE Artificial eye clinics address physical and aesthetic aspects of orbital prostheses, but psychological effects may not be formally addressed. In general, without effective coping mechanisms, stress can lead to anxiety and depression. This study aims to determine, in the context of having an artificial eye, whether coping strategies, as well as perception of illness and other demographic and clinical variables are associated with anxiety or depression. METHODS Consecutive patients attending two artificial eye clinics were invited to participate in this audit. Participants completed questionnaires: HADS, Brief IPQ and Brief COPE. Variables with a correlation coefficient of ≥0.2 with anxiety or depression were included in regression modeling. The extent to which the participants' emotional and cognitive representations of their artificial eye related to feelings of anxiety and depression was determined. RESULTS In the cohort of 208, clinically significant anxiety was present in 29.5% and clinically significant depression was present in 8.4%. Perceptions of the impact of the artificial eye and self-blame as a coping strategy were correlated with anxiety. Depression levels were higher when participants believed that their artificial eye had a greater impact on their life, when they lived alone, and when they used substances as a coping strategy. CONCLUSION Significant levels of anxiety exist in those living with artificial eyes, with various coping strategies used. Addressing this and offering alternative coping strategies may improve patient well being and overall satisfaction.
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Affiliation(s)
- Donal McCullagh
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, UK
| | - Nicholas Puls
- Ocular Prosthetics Department, Moorfields Eye Hospital, London, UK
| | | | | | - Jonathan Jackson
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, UK
| | - Michael Williams
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, UK.,School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, UK
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Wu N, Kong X, Sun X. Anxiety and depression in Chinese patients with glaucoma and its correlations with vision-related quality of life and visual function indices: a cross-sectional study. BMJ Open 2022; 12:e046194. [PMID: 35190403 PMCID: PMC8860023 DOI: 10.1136/bmjopen-2020-046194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To investigate anxiety and depression in patients with glaucoma and its correlations with vision-related quality of life (VR-QoL) and visual function indices. DESIGN A hospital-based, cross-sectional study. SETTING Shanghai, China PARTICIPANTS: The Hospital Anxiety and Depression Scale and the 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) were administered to 446 Chinese patients with glaucoma to assess their psychological disorders, namely anxiety and depression, and VR-QoL, respectively. OUTCOME MEASURES Sociodemographic and clinical data were collected at the same time. Multivariate linear regression analysis was carried out to investigate the associations between VR-QoL, visual function indices and psychological disorders. Standardised partial regression analysis was used to identify the variable mostly indicative in evaluating psychological burdens. RESULTS The prevalence of anxiety and depression in Chinese patients with glaucoma was 12.11% and 25.78%, respectively. Most of the subscales and the composite score of NEI VFQ-25 were negatively associated with each parameter of anxiety and depression after adjusting for sociodemographic and clinical variables. For visual function indices, only the best-corrected visual acuity of both eyes was correlated with anxiety after adjustment. Standardised partial regression analysis further showed VR-QoL, but not the objective visual function indices, was mostly relevant to psychological disturbances. CONCLUSIONS Anxiety and depression were common in Chinese patients with glaucoma. Self-reported VR-QoL was beneficial in assessing psychological status of patients with glaucoma, while objective visual function indices provide little hint on it.
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Affiliation(s)
- Na Wu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xiangmei Kong
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xinghuai Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Ulhaq ZS, Soraya GV, Dewi NA, Wulandari LR. The prevalence of anxiety symptoms and disorders among ophthalmic disease patients. Ther Adv Ophthalmol 2022; 14:25158414221090100. [PMID: 35464342 PMCID: PMC9021519 DOI: 10.1177/25158414221090100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/09/2022] [Indexed: 12/26/2022] Open
Abstract
Background: Progressive and irreversible vision loss has been shown to place a patient at risk of mental health problems such as anxiety. However, the reported prevalence of anxiety symptoms and disorders among eye disease patients vary across studies. Thus, this study aims to clarify the estimated prevalence of anxiety symptoms and disorders among ophthalmic disease patients. Methods: Relevant studies on the prevalence of anxiety symptoms and disorders among eye disease patients were collected through international databases, PubMed, Scopus, and Web of Science. A random-effects model was used to determine the pooled prevalence of anxiety symptoms and disorders among ophthalmic disease patients. Results: The 95 included studies yielded a pooled prevalence of 31.2% patients with anxiety symptoms and 19.0% with anxiety disorders among subjects with ophthalmic disease. Pediatric patients were more anxious (58.6%) than adults (29%). Anxiety symptoms were most prevalent in uveitis (53.5%), followed by dry eye disease (DED, 37.2%), retinitis pigmentosa (RP, 36.5%), diabetic retinopathy (DR, 31.3%), glaucoma (30.7%), myopia (24.7%), age-related macular degeneration (AMD, 21.6%), and cataract (21.2%) patients. Anxiety disorders were most prevalent in thyroid eye disease (TED, 28.9%), followed by glaucoma (22.2%) and DED (11.4%). When compared with healthy controls, there was a twofold increase on the prevalence of anxiety symptoms (OR = 1.912, 95% CI 1.463–2.5, p < 0.001) and anxiety disorders (OR = 2.281, 95% CI 1.168–4.454, p = 0.016). Conclusion: Anxiety symptoms and disorders are common problems associated with ophthalmic disease patients. Thus, comprehensive and appropriate treatments are necessary for treating anxiety symptoms and disorders among ophthalmic disease patients.
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Affiliation(s)
- Zulvikar Syambani Ulhaq
- Research Center for Pre-Clinical and Clinical Medicine, National Research and Innovation Agency Republic of Indonesia, Cibinong, Indonesia
| | - Gita Vita Soraya
- Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Nadia Artha Dewi
- Department of Ophthalmology, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Lely Retno Wulandari
- Department of Ophthalmology, Faculty of Medicine, Brawijaya University, Malang, Indonesia
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Quality of Life in Adults with Childhood Glaucoma: An Interview Study. Ophthalmol Glaucoma 2021; 5:325-336. [PMID: 34562634 DOI: 10.1016/j.ogla.2021.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/25/2021] [Accepted: 09/15/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To explore and report on the quality-of-life (QoL) issues encountered by adults with childhood glaucoma. DESIGN Exploratory qualitative study. PARTICIPANTS Forty-seven participants with childhood glaucoma (defined as disease onset <18 years) recruited from the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG). METHODS A qualitative research methodology (interpretive phenomenology) was applied, and data were collected through semistructured in-depth interviews. NVivo-12 software (QSR International Pty Ltd) was used to inductively analyze and code data to identify QoL themes pertinent to the cohort studied. MAIN OUTCOME MEASURES Quality-of-life themes and subthemes. RESULTS Mean participant age was 40.0 ± 15.3 years, and 55% of participants were female. We identified 10 QoL themes pertinent to adults living with childhood glaucoma. Coping strategies and emotional well-being were the most prominent themes. Maladaptive coping strategies, including treatment nonadherence, were observed more commonly in individuals aged <40 years and those without a vision impairment or reviewed less regularly. Emotional well-being was affected by feelings of being misunderstood because of the rarity of the condition, being self-conscious of physical manifestations of the disease, and anxiety related to possible disease progression and vision loss. The effect of childhood glaucoma on family planning formed a novel QoL theme and included worry for their child to inherit the condition and an inability to fulfill parental duties. This often led to genetic counseling-seeking behaviors. Mobility issues were infrequently experienced. CONCLUSIONS Childhood glaucoma poses a substantial impact to the emotional well-being of adults with the condition, which is mediated by the use of coping strategies. Genetic counseling and family planning options may be important. This study supports the development of a childhood glaucoma-specific patient-reported outcome measure for assessment of the psychosocial impact of childhood glaucoma in adults.
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40
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Berchuck SI, Jammal AA, Mukherjee S, Somers TJ, Medeiros FA. Impact of anxiety and depression on progression to glaucoma among glaucoma suspects. Br J Ophthalmol 2021; 105:1244-1249. [PMID: 32862132 PMCID: PMC9924953 DOI: 10.1136/bjophthalmol-2020-316617] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/24/2020] [Accepted: 08/01/2020] [Indexed: 01/12/2023]
Abstract
AIMS To assess the impact of anxiety and depression in the risk of converting to glaucoma in a cohort of glaucoma suspects followed over time. METHODS The study included a retrospective cohort of subjects with diagnosis of glaucoma suspect at baseline, extracted from the Duke Glaucoma Registry. The presence of anxiety and depression was defined based on electronic health records billing codes, medical history and problem list. Univariable and multivariable Cox proportional hazards models were used to obtain HRs for the risk of converting to glaucoma over time. Multivariable models were adjusted for age, gender, race, intraocular pressure measurements over time and disease severity at baseline. RESULTS A total of 3259 glaucoma suspects followed for an average of 3.60 (2.05) years were included in our cohort, of which 911 (28%) were diagnosed with glaucoma during follow-up. Prevalence of anxiety and depression were 32% and 33%, respectively. Diagnoses of anxiety, or concomitant anxiety and depression were significantly associated with risk of converting to glaucoma over time, with adjusted HRs (95% CI) of 1.16 (1.01, 1.33) and 1.27 (1.07, 1.50), respectively. CONCLUSION A history of anxiety or both anxiety and depression in glaucoma suspects was associated with developing glaucoma during follow-up.
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Affiliation(s)
- Samuel I. Berchuck
- Department of Statistical Science and Forge, Duke University, Durham, North Carolina, USA,Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Alessandro A. Jammal
- Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Sayan Mukherjee
- Departments of Statistical Science, Mathematics, Computer Science, Biostatistics & Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Felipe A. Medeiros
- Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina, USA
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Poleon S, Racette L, Fifolt M, Schoenberger-Godwin YM, Abu SL, Twa MD. Patient and Provider Perspectives on Glaucoma Treatment Adherence: A Delphi Study in Urban Alabama. Optom Vis Sci 2021; 98:1085-1093. [PMID: 34524213 PMCID: PMC8505131 DOI: 10.1097/opx.0000000000001776] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/30/2021] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Patients with glaucoma and providers recognized perceived treatment efficacy, patient-provider relationship, psychological stress, instillation skill, good quality of life, and forgetfulness as key determinants of glaucoma adherence. This shared insight could help shape the development of clinical and behavioral interventions for addressing treatment barriers and improving adherence. PURPOSE Despite their impact on adherence in glaucoma, sociobehavioral factors may not be adequately explored during clinical consultations. We aimed to elicit consensus between patients and providers around key determinants of adherence and hypothesized that patients would place greater emphasis on sociobehavioral factors compared with providers. METHODS A two-round Delphi survey was used to assess treatment beliefs, barriers, facilitators, motivators, and needs among 18 patients with glaucoma and providers. In round 1, agreement with 46 statements was scored on a 5-point Likert scale (strongly disagree to strongly agree). Statements with which 80% or more of panelists agreed reached consensus and advanced to round 2, where participants were asked to prioritize them based on their importance to treatment. RESULTS There was consensus regarding the influence of perceived treatment efficacy, good provider relationship, good quality of life, psychological stress, glaucoma knowledge, instillation skill, and forgetfulness on glaucoma adherence. For statements that failed to reach consensus, the Bonferroni-corrected Mann-Whitney U test revealed that the greatest differences between patients and providers pertained to regimen complexity (provider median, 4 [interquartile range {IQR}, 1]; patient median, 1.5 [IQR, 1]; P = .002), instillation skill (providers, 4 [IQR, 0.5]; patients, 2 [IQR, 1]; P = .001), and low motivation (providers, 3 [IQR, 2.25]; patients, 1 [IQR, 0]; P = .003). CONCLUSIONS Although patients and providers prioritized sociobehavioral factors as key determinants of adherence, disagreement between these groups was observed in other areas. Continued juxtaposition of patient and provider perspectives could spotlight underexplored areas and guide the development of successful interventions for improving adherence.
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Affiliation(s)
- Shervonne Poleon
- Department of Optometry and Vision Science, University of Alabama at Birmingham School of Optometry, Birmingham, Alabama
| | - Lyne Racette
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Matthew Fifolt
- Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama
| | - Yu-Mei Schoenberger-Godwin
- Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Sampson Listowell Abu
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Michael D. Twa
- University of Houston College of Optometry, Houston, Texas
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Tan Z, Tung TH, Xu SQ, Chen PE, Chien CW, Jiang B. Personality types of patients with glaucoma: A systematic review of observational studies. Medicine (Baltimore) 2021; 100:e25914. [PMID: 34114987 PMCID: PMC8202580 DOI: 10.1097/md.0000000000025914] [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: 08/12/2020] [Accepted: 04/21/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES To synthesize recent empirical research on the association between personality and glaucoma among this sub-population. METHODS PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Scopus and ScienceDirect databases were searched to identify eligible studies published between January 1950 and March 2019 in any language. The quality of included observational studies was assessed using an 11-item checklist which was recommended by Agency for Healthcare Research and Quality (AHRQ). After using the checklist, 12 papers are included into the systematic review. RESULTS There are some differences on the studies about the negative personality of glaucoma patients. In spite of these differences, most included studies significantly showed that glaucoma patients tend to or do have some specific personality. CONCLUSION The extant research could demonstrate that glaucoma patients tend to have some negative personality in some extent. Future studies are needed to provide more convincing support to personality of glaucoma patients.
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Affiliation(s)
- Zhenyan Tan
- Institute for Hospital Management, Tsinghua University, Shenzhen Campus
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang
| | - Shi-Qing Xu
- Institute for Hospital Management, Tsinghua University, Shenzhen Campus
| | - Pei-En Chen
- Taiwan Association of Health Industry Management and Development
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsinghua University, Shenzhen Campus
| | - Bo Jiang
- Department of Ophthalmology, Maoming People's Hospital, Maoming, Guangdong Province, China
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Østergaard Madsen H, Hageman I, Kolko M, Lund-Andersen H, Martiny K, Ba-Ali S. Seasonal variation in neurohormones, mood and sleep in patients with primary open angle glaucoma - implications of the ipRGC-system. Chronobiol Int 2021; 38:1421-1431. [PMID: 34112046 DOI: 10.1080/07420528.2021.1931275] [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: 10/21/2022]
Abstract
Primary open angle glaucoma is associated with an increased risk of mood and sleep disorders. These adversities have been suggested to relate to a disrupted function of the intrinsically photosensitive retinal ganglion cells (ipRGCs). The ipRGCs are key components in the nonvisual photoreceptive system that mediates light effects on mood, sleep and circadian rhythm. We assessed the diurnal hormone levels, pupillary responses and mood and sleep under seasons with different photoperiods in 24 patients with glaucoma and 24 age- and sex-matched healthy controls to investigate responses to naturalistic seasonal changes in daylight. The patients had moderate-to-advanced glaucoma with substantial visual field defects and reductions in the ipRGC-mediated pupillary responses (p < .001). In winter, compared with summer, patients with glaucoma had higher daytime melatonin concentration (p < .001) and lower nighttime cortisol (p = .002). In winter, the daytime melatonin level was inversely correlated with the ipRGC-mediated pupillary responses in the control group (p = .04). In the control group, there were no significant changes in hormone levels between seasons or any correlations between neurohormone levels and the ipRGC-mediated responses. The two groups showed a similar response to season with lower depression scores in summer compared with winter. In between-group comparison, the nocturnal melatonin level (area under curve from 20:00 h to 08:00 h) in summer was lower in glaucoma compared with controls (p = .03). In winter, nocturnal cortisol (at 04:00 h) was lower (p = .004) and daytime cortisol (12:00 h and 16:00 h) was higher (p = .007) in glaucoma compared with controls. In conclusion, we found that patients with glaucoma displayed a seasonal variation in diurnal hormone levels that was not present in healthy controls. Such neurohormonal changes may contribute to the increased risk of mood and sleep disorders seen in patients with glaucoma.
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Affiliation(s)
| | - Ida Hageman
- Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Miriam Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.,Department of Ophthalmology, Rigshospitalet-Glostrup Hospital, Copenhagen, Denmark
| | - Henrik Lund-Andersen
- Department of Ophthalmology, Rigshospitalet-Glostrup Hospital, Copenhagen, Denmark
| | - Klaus Martiny
- Mental Health Center Copenhagen, Copenhagen, Denmark
| | - Shakoor Ba-Ali
- Department of Ophthalmology, Rigshospitalet-Glostrup Hospital, Copenhagen, Denmark
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Tilahun MM, Yibekal BT, Kerebih H, Ayele FA. Prevalence of common mental disorders and associated factors among adults with Glaucoma attending University of Gondar comprehensive specialized hospital tertiary eye care and training center, Northwest, Ethiopia 2020. PLoS One 2021; 16:e0252064. [PMID: 34015012 PMCID: PMC8136648 DOI: 10.1371/journal.pone.0252064] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/07/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study aimed to assess the prevalence of common mental disorders and associated factors among adults with glaucoma at Gondar university comprehensive specialized hospital tertiary eye care and training center. Glaucoma predisposes patients to common mental problems and leads to wasteful, costly and inefficient use of medical services and complications of the diagnoses. So, determining the level and factors associated with common mental disorders among glaucoma patient would help to improve and integrate comprehensive ophthalmic services which address common mental disorder in a follow-up visit. METHODS An institution-based cross-sectional study was conducted on 495 glaucoma patients selected by using systematic random sampling. Data were collected through face-to-face interview and chart review. Self-reported questionnaire (SRQ-20) was used to assess the presence of common mental disorders. Binary logistic regression analysis was done to identify factors associated with common mental disorders. Variables with P<0.05 were considered as factors significantly associated with common mental disorders. RESULT Four hundred sixty-eight patients were included in this study with a response rate of 94.54%. The mean age of the participant was 58 ± 14.11 years. The prevalence of common mental disorders was found to be 29.5% (95% CI 25.4-33.3). Female sex (AOR = 3.79, 95% CI: 1.66-8.62) (p-value = 0.001), average monthly income of less than 1200 birr (AOR = 6.05 95% CI: 2.26-16.22) (p-value = 0.001), poor level of social support (AOR = 17.39 95% CI: 7.79-38.82) (p-value = 0.001), moderate and high risk of alcohol use (AOR = 10.42 95%CI: 2.74-39.54) (p-value = 0.001), presence of chronic medical illness (AOR = 3.85 95% CI: 2.07-7.16) (p-value = 0.001), receiving both drug and surgical treatment (AOR = 2.50, 95%CI: 1.30-4.83) (p-value = 0.006) and presence of systemic carbonic anhydrase inhibitors use (AOR = 3.16, 95%CI: 1.65-6.06) (p-value = 0.001) were significantly associated with increased level of common mental disorders. CONCLUSION Significant numbers of glaucoma patients have CMD and found significantly associated with socio-economic, ocular and systemic clinical factors. Therefore, the integration of psychosocial care into the current treatment of patients with glaucoma would have a significant advantage to help these patients.
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Affiliation(s)
- Mikias Mered Tilahun
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive specialized hospital, Gondar Town, Ethiopia
| | - Betelhem Temesgen Yibekal
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive specialized hospital, Gondar Town, Ethiopia
| | - Habtamu Kerebih
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive Specialized Hospital, Gondar Town, Ethiopia
| | - Fisseha Ademassu Ayele
- Department of Ophthalmology, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive Specialized Hospital, Gondar Town, Ethiopia
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Stamatiou ME, Kazantzis D, Theodossiadis P, Chatziralli I. Depression in glaucoma patients: A review of the literature. Semin Ophthalmol 2021; 37:29-35. [PMID: 33822676 DOI: 10.1080/08820538.2021.1903945] [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] [Indexed: 01/10/2023]
Abstract
Purpose: The purpose of this review was to evaluate the association between glaucoma and depression and to identify possible risk factors for depressive symptoms in glaucoma patients.Methods: A total of 587 abstracts were screened and 32 studies were deemed eligible for inclusion in this review.Results: An association of glaucoma and depression was found, while advanced disease stage, older age, female sex and faster visual loss progression were recognized as potential risk factors for depression in patients with glaucoma.Conclusions: Our findings may have important clinical significance, such as alerting ophthalmologists to implement a multidisciplinary approach in patients with glaucoma. Further research is needed to examine this association in different types of glaucoma and try to investigate the underlying pathophysiological mechanisms to establish a causal inference between glaucoma and depression.
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46
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Effect of depressive symptom and depressive disorder on glaucoma incidence in elderly. Sci Rep 2021; 11:5888. [PMID: 33723349 PMCID: PMC7961135 DOI: 10.1038/s41598-021-85380-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 02/18/2021] [Indexed: 12/27/2022] Open
Abstract
Although depression and glaucoma share several common pathophysiology, the risk of glaucoma in patients with depression has not been reported. Thus, we investigated the effect of depressive symptom and depressive disorder on glaucoma incidence. In this nationwide population-based cohort study, all subjects receiving the National Screening Program at the age of 66 during 2009-2014 were included. These subjects were divided into depression group and no depression group based on subjective depressive symptoms and clinically diagnosed depressive disorder and were tracked until 2017 for development of glaucoma. Of the 922,769 subjects included in the study, 191,636 (20.77%) subjects were categorized as depression group. Subjects with depression showed increased hazard of developing glaucoma (adjusted HR = 1.12[95% confidence interval (CI), 1.09-1.15]) than those without depression. The risk of glaucoma increased sequentially from those with no depression to those with subjective depressive symptom (adjusted HR = 1.09[95% CI, 1.06-1.13]), those with clinically diagnosed depressive disorder (adjusted HR = 1.23[95% CI, 1.14-1.32]), and those with both subjective depressive symptom and clinically diagnosed depressive disorder (adjusted HR = 1.36[95% CI, 1.22-1.52]). Our analyses suggest that individuals with depression had a greater risk of developing glaucoma than those without depression. Subjective depressive symptoms and clinically diagnosed depressive disorder independently and synergistically increased the risk of glaucoma incidence.
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47
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Le P, Nguyen M, Vu T, Dao DP, Olson D, Zhang AY. Anxiety and Depression in Patients With Retinitis Pigmentosa. JOURNAL OF VITREORETINAL DISEASES 2021; 5:114-120. [PMID: 37009075 PMCID: PMC9979061 DOI: 10.1177/2474126420936455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE Retinitis pigmentosa (RP) is a chronic progressive disease with no curative treatments. Understanding the variables involved with improving patients' quality of life is important in managing this population. The literature investigating the relationship of anxiety and depression with RP relies on the analysis of smaller subset populations of patients with RP, and no study has quantified the effect size of the potential association. This study aims to elucidate and quantify the association between RP, anxiety, and depression. METHODS A retrospective case-control study was conducted of 6 093 833 medical records within the University of North Carolina Hospital and outpatient clinic system from July 1, 2004, to August 30, 2019. Patients with a diagnosis of RP, anxiety, and depression were identified within the Carolina Data Warehouse for Health by International Classification of Diseases, Ninth and Tenth Revision codes. RESULTS From the base population of 6 093 833 patients' medical records, 690 patients were diagnosed with RP, 253 065 with anxiety, and 232 541 with depression. Patients with RP have an odds ratio, adjusted for sex and age, of 4.915 (95% CI, 4.035-5.987) for having comorbid anxiety, 5.609 (95% CI, 4.622-6.807) for comorbid depression, and 4.130 (95% CI, 3.187-5.353) for comorbid anxiety and depression. CONCLUSIONS Patients with RP have a higher prevalence of anxiety and depression, with increased odds of approximately 5 to 6 times for also carrying a diagnosis of anxiety or depression and about 4 times for carrying diagnoses of anxiety and depression compared with the general population.
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Affiliation(s)
- Patrick Le
- School of Medicine, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Michelle Nguyen
- School of Medicine, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Thoai Vu
- Department of Ophthalmology, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Diem-Phuong Dao
- School of Medicine, Virginia Commonwealth
University, Richmond, VA, USA
| | - Daniel Olson
- Department of Ophthalmology, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Alice Yang Zhang
- Department of Ophthalmology, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
- Alice Yang Zhang, MD, Department of
Ophthalmology, University of North Carolina at Chapel Hill, 2226 Nelson Hwy,
Suite 200, Chapel Hill, NC 27517, USA.
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Holló G, Sándor NG, Kóthy P, Géczy A. Influence of painless one-eye blindness on depression, anxiety and quality of life in glaucoma patients with a normal fellow eye. BMC Ophthalmol 2021; 21:89. [PMID: 33596863 PMCID: PMC7891029 DOI: 10.1186/s12886-021-01845-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background For clinical practice it is important to evaluate and compare anxiety, depression and quality of life of glaucoma patients with painless one-eye blindness and a normal fellow eye to unaffected age-matched individuals from a similar environment. Methods Twenty-eight stable glaucoma patients (age, mean ± SD: 69.0 ± 13.3 years) with one normal and one painless blind eye, and 26 controls (age: 67.0 ± 14.0 years) completed the standard Hungarian adaptations of the Beck Depression Inventory, Beck Anxiety Inventory, Spielberger-Trait Anxiety Inventory, Hopelessness Scale, and Quality of Life Questionnaire SF-36 with the assistance of trained psychologist interviewers within 3 months after a detailed ophthalmological examination. Results The groups did not differ in age, gender distribution, number of children, grandchildren and people in their household (p ≥ 0.235). The best corrected visual acuity (BCVA) of the diseased eye was minimal (median: 0.00), while BCVA of their better eye (median: 1.0) did not differ from that of the control group (p ≥ 0.694). Compared to the control group, the patients’ scores were significantly higher for depression (p ≤ 0.01), cognitive and psychophysiological symptoms of anxiety (p ≤ 0.05) and hopelessness (p ≤ 0.013), and lower (worse) for physical function, vitality, general health and bodily pain (p ≤ 0.045). No difference was found between the groups for mental health, physical role functioning, emotional role functioning and social role functioning (p ≥ 0.117). Conclusion Our results show that patients with glaucoma-related one-eye blindness may require regular psychological support even when the visual performance of the fellow eye is fully maintained on the long run, and the patients’ everyday functioning is normal.
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Affiliation(s)
- Gábor Holló
- Department of Ophthalmology, Semmelweis University, Mária u. 39, Budapest, 1085, Hungary.
| | - Nikolett Gabriella Sándor
- Department of Personality and Clinical Psychology, Pázmány Péter Catholic University, Institute of Psychology, Budapest, Hungary.,Doctoral School of Psychology, University of Pécs, Pécs, Hungary
| | - Péter Kóthy
- Department of Ophthalmology, Semmelweis University, Mária u. 39, Budapest, 1085, Hungary
| | - Anna Géczy
- Department of Personality and Clinical Psychology, Pázmány Péter Catholic University, Institute of Psychology, Budapest, Hungary
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Yang X, Sun NN, Zhao ZN, He SX, Zhang M, Zhang DD, Yu XW, Zhang JM, Fan ZG. Coinheritance of OLFM2 and SIX6 variants in a Chinese family with juvenile-onset primary open-angle glaucoma: A case report. World J Clin Cases 2021; 9:697-706. [PMID: 33553411 PMCID: PMC7829722 DOI: 10.12998/wjcc.v9.i3.697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/26/2020] [Accepted: 12/06/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Juvenile-onset primary open-angle glaucoma (JOAG), characterized by severe elevation of intraocular pressure and optic neuropathy prior to the age of 40, is a rare subtype of primary open-angle glaucoma. Several genetic mutations have been associated with JOAG.
CASE SUMMARY The proband patient was a young male, diagnosed with primary open-angle glaucoma at the age of 27. The patient and his unaffected parents who have been excluded from classic genetic mutations for primary open-angle glaucoma were included to explore for other possible genetic variants through whole genome sequencing and bioinformatics analysis. In this trio, we found two heterozygous variants inherited from the parents in the proband: c.281G>A, p.Arg94His in OLFM2 and c.177C>G, p.Ile59Met in SIX6. Both genetic mutations are predicted through bioinformatics analysis to replace evolutionary conserved amino acids, therefore rendering a pathogenic effect on proteins. In contrast, very low frequencies for these genetic mutations were recorded in most common control databases.
CONCLUSION This is the first report on coinherited mutations of OLFM2 and SIX6 in a JOAG family, which shows the complexity of JOAG inheritance. Large-scale clinical screening and molecular functional investigations on these coinherited mutations are imperative to improve our understanding of the development of JOAG.
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Affiliation(s)
- Xue Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Nan-Nan Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Zhen-Ni Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Shu-Xiang He
- Guangzhou KingMed Diagnostics Group Co., Ltd, Guangzhou 510060, Guangdong Province, China
| | - Miao Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Dan-Dan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Xiao-Wei Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jia-Min Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Zhi-Gang Fan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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50
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Shin DY, Jung KI, Park HYL, Park CK. The effect of anxiety and depression on progression of glaucoma. Sci Rep 2021; 11:1769. [PMID: 33469104 PMCID: PMC7815884 DOI: 10.1038/s41598-021-81512-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/07/2021] [Indexed: 02/08/2023] Open
Abstract
Glaucoma is considered a chronic disease that requires lifelong management. Chronic diseases are known to be highly associated with psychological disturbances such as depression and anxiety. There have also been many studies on association between anxiety or depression and glaucoma. The majority of these studies explained that the glaucoma diagnosis causes anxiety or depression. However, It is also necessary to evaluate whether the psychological disturbance itself affect glaucoma. Therefore, we investigated the association of anxiety and depression with glaucoma progression, and elucidate mechanisms underlying that. We included 251 eyes with open angle glaucoma who were followed up for at least 2 years in this retrospective case-control study. The Beck Anxiety Inventory (BAI) and Beck Depressive Inventory-II (BDI-II) were used to assess anxiety and depression in glaucoma patients. Patients were classified into groups (high-anxiety group; HA-G, low-anxiety group; LA-G, high-depression group; HD-G, low-depression group; LD-G) according to their score on the BAI or BDI-II (separately). In logistic regression analysis, disc hemorrhage, peak intraocular pressure (IOP) and RNFL thickness loss rate were significantly associated with high anxiety (p = 0.017, p = 0.046, p = 0.026). RNFL thinning rate and disc hemorrhage were significant factors associated with anxiety in multivariate models (p = 0.015, p = 0.019). Multivariate linear regression analysis showed a significant positive correlation between the rate of RNFL thickness loss and BAI score (B = 0.058; 95% confidential interval = 0.020-0.097; p = 0.003), and RNFL loss and IOP fluctuation (B = 0.092; 95% confidential interval = 0.030-0.154; p = 0.004). For the depression scale, visual field mean deviation and heart rate variability were significantly associated with high depression in multivariate logistic regression analysis (p = 0.003, p = 0.006). We suggest that anxiety increase the risk of glaucoma progression and they are also associated with IOP profile and disc hemorrhage.
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Affiliation(s)
- Da Young Shin
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Kyoung In Jung
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Hae Young Lopilly Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Chan Kee Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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