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Abdulazim DO, Fadel MR, Yassin BM, Magdy M, Eissa BM. Ocular Damage Index, Ocular Pain and Subjective Visual Rating in Patients with Behçet's Uveitis: A Study of Impact on Health-Related Quality of Life. Ocul Immunol Inflamm 2024:1-8. [PMID: 39012760 DOI: 10.1080/09273948.2024.2375020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/26/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE The aim of our study is to assess subjective disease burden parameters (SVR and OP) as well as objective ones (BCVA and ODI) as predictors of HRQoL in Egyptian patients with BD uveitis. METHODS Ninety-six patients with BD uveitis were recruited in this cross-sectional study from the Rheumatology Department, Cairo University Hospital. HRQoL was assessed using RAND-36 item health survey 1.0, subjective visual rating (SVR) was measured on a 6-point Likert scale. Ocular pain (OP) was rated on a numeric rating scale. The Ocular Damage Index (ODI) was calculated using the ocular domain of the BD damage index. Linear regression was performed to determine predictors of HRQoL metrics. RESULTS SVR predicted Vitality (β = 0.15, p = 0.004), Emotional Well-being (EW) (β = 0.13, p = 0.005), General Health (β = 0.18, p = 0.012) and Mental Component Summary (β = 0.22, p = 0.002). OP predicted Social Function (β = -3.18 p < 0.001), General Health (β = -1.55, p = 0.004), Physical Component Summary (β = -2.00, p = 0.007) and Mental Component Summary (β = -1.53, p = 0.005). BCVA predicted Physical Function (β = 31.1, p = 0.02) and Emotional Well-being (β = 7.94, p = 0.01). ODI failed to predict any HRQoL metrics. ODI was independent predictor of legal blindness adjusted for uveitis duration and severity. Legally blind patients had worse HRQoL metrics than patients with better vision. CONCLUSION In BD uveitis patients, subjective disease burden parameters were more informative about HRQoL metrics than objective ones. Longitudinal studies are needed to elucidate the utility of ODI as an outcome measure in BD uveitis. PRECIS In Behcet's uveitis patients, health-related quality of life was related to visual outcome, ocular pain, and subjective visual rating. Ocular damage was an independent predictor of legal blindness, adjusted for uveitis duration and severity.
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Affiliation(s)
- Dina O Abdulazim
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mariam Raouf Fadel
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Bassant Mahmoud Yassin
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa Magdy
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Basma M Eissa
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt
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Zhang Y, Cheng Y, Liang Y, Shao M, Chen A. Based on the relationship between anxiety of existential meaninglessness, hope level, and fear of progression, explored the effect of preoperative nursing with Orem theory in the senile cataract population. Front Psychol 2024; 15:1358229. [PMID: 38800682 PMCID: PMC11117140 DOI: 10.3389/fpsyg.2024.1358229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/10/2024] [Indexed: 05/29/2024] Open
Abstract
Background Cataracts, characterized by a decrease in vision due to the clouding of the lens, can progress to blindness in advanced stages. The rising incidence of cataract cases has led to a significant number of patients experiencing negative emotions associated with vision loss, thereby diminishing their quality of life. In clinical practice, it is imperative for healthcare professionals to consider the psychological well-being of cataract patients. Currently, there is a scarcity of research focusing on psychological evaluations, such as assessing feelings of meaninglessness among individuals with cataracts. Objective This study aims to investigate the factors influencing the anxiety of existential meaninglessness and to explore the relationships among existential anxiety, Herth hope index levels and fear of progression in the elderly cataract-affected population. Additionally, it evaluates the effectiveness of Orem's nursing care strategies. Methods Utilizing a sociodemographic questionnaire, the Existential Meaninglessness Anxiety Scale (EM-A), Herth Hope Index Level Scale, and the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), this research employed convenience sampling for a cross-sectional and intervention study. The retrospective study sample comprised 1,029 individuals, while the intervention study included 317. The intervention design assessed psychological changes in existential meaninglessness following Orem's preoperative nursing interventions. Multiple linear regression analysis was employed to ascertain the determinants of EM-A within the population of elderly patients with senile cataracts. Pearson correlation analysis elucidated the relationship between EM-A, levels of hope, and the FoP-Q-SF among this demographic. Subsequent investigations, utilizing a t-test, evaluated the effects by comparing the data before and after the implementation of the interventions. Results The correlation between EM-A, hope levels, and FoP-Q-SF was statistically significant (p < 0.05). Factors such as age, education level, alcohol consumption habits, hope levels, and FoP-Q-SF scores significantly affected EM-A scores (p < 0.05). Orem's nursing framework significantly reduced existential anxiety (p < 0.05). Conclusion Among elderly patients with cataracts, existential anxiety was generally moderate. Hope levels and fear of progression were closely associated with the EM-A. The novel Orem preoperative care model effectively addresses clinical issues. In clinical practice, it is crucial to address psychological problems and enhance patients' quality of life.
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Affiliation(s)
| | | | | | | | - Aiai Chen
- Ningbo Eye Institute, Ningbo Eye Hospital, Wenzhou Medical University, Ningbo, China
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Zhao DX, Quintero M, Mihailovic A, Akpek E, Karakus S, Guo L, Ramulu PY. Utilizing visual symptoms to distinguish dry eye from glaucoma, cataract, and suspect glaucoma patients: a cross-sectional study. BMC Ophthalmol 2024; 24:16. [PMID: 38195490 PMCID: PMC10775660 DOI: 10.1186/s12886-023-03219-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/13/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND The diagnosis of dry eye and other common ophthalmological conditions can be supported using patient reported symptoms, which is increasingly useful in contexts such as telemedicine. We aim to ascertain visual symptoms that differentiate dry eye from cataract, glaucoma, or glaucoma suspects. METHODS Adults with dry eye, glaucoma, cataract, and suspected glaucoma (controls) completed a questionnaire to rate the frequency and severity of 28 visual symptoms. Univariate, followed by multivariable logistic regression with backward stepwise selection (p < 0.05), determined the individual symptoms and set of symptoms best distinguishing dry eye from each of the other conditions. RESULTS Mean age of 353 patients (94 glaucoma suspect controls, 79 glaucoma, 84 cataract, and 96 dry eye) was 64.1 years (SD = 14.1); 67% were female and 68% White. Dry eye patients reported more frequent light sensitivity (OR = 15.0, 95% CI = 6.3-35.7) and spots in vision (OR = 2.8, 95% CI = 1.2-6.3) compared to glaucoma suspect controls. Compared to glaucoma patients, dry eye patients experienced more frequent light sensitivity (OR = 9.2, 95% CI = 2.0-41.7), but less frequent poor peripheral vision (OR = 0.2, 95% CI = 0.06-0.7), difference in vision between eyes (OR = 0.09, 95% CI = 0.01-0.7), and missing patches of vision (OR = 0.06, 95% CI = 0.009-0.3). Compared to cataract patients, dry eye patients reported more frequent spots in vision (OR = 4.5, 95% CI = 1.5-13.4) and vision variability across the week (OR = 4.7, 95% CI = 1.2-17.7) and were less likely to report worsening vision (OR = 0.1, 95% CI = 0.03-0.4) and blindness (OR = 0.1, 95% CI = 0.02-0.8). CONCLUSION Visual symptoms may serve as a complementary tool to distinguish dry eye from various ocular conditions, though the symptoms that best distinguish dry eye differ across comparisons. Differentiating how patients visually perceive common eye diseases may be used in a variety of clinical settings to rule out specific conditions.
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Affiliation(s)
- David X Zhao
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | | | | | - Esen Akpek
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Sezen Karakus
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Lee Guo
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Pradeep Y Ramulu
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA.
- Wilmer Eye Institute, Johns Hopkins Medical Institutions, 600 N. Wolfe St., Wilmer 129, Baltimore, MD, 21287, USA.
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Tagle CA, Chen JW, Mistry J, Fernandez D, Neeki CC, Dong F, Neeki MM. A role of point-of-care ultrasound in the emergency department diagnosis of vision loss due to traumatic cataract. Int J Emerg Med 2023; 16:78. [PMID: 37919646 PMCID: PMC10623738 DOI: 10.1186/s12245-023-00558-1] [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: 08/29/2023] [Accepted: 10/26/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Ocular complaints, including acute or subacute vision loss, are commonly encountered in emergency departments (ED). These potentially time-sensitive complaints are difficult to diagnose and evaluate without adequate, specialized equipment and expertise. Additionally, a thorough evaluation often requires a more extensive and specialized physical exam, imaging, and ophthalmologic consultation, all of which may not be readily available in the acute setting. CASE PRESENTATION This case report presented a patient in the emergency department with the chief complaint of vision loss. Point-of-care ultrasound (POCUS) using the 10-MHz-linear-array probe, in the ocular setting, demonstrated calcification of the lens, a finding consistent with cataract in the right eye. CONCLUSIONS The use of POCUS can expedite the accurate identification of vision threatening pathology, such as cataracts, and streamline ED disposition and plan of care.
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Affiliation(s)
- Christian A Tagle
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA, USA
| | - Joe W Chen
- California University of Science and Medicine, Colton, CA, USA
| | - Jamshid Mistry
- California University of Science and Medicine, Colton, CA, USA
- Department of Emergency Medicine, Arrowhead Regional Medical Center, 400 N. Pepper Ave, Suite # 107, Colton, CA, USA
| | - Danny Fernandez
- Department of Emergency Medicine, Arrowhead Regional Medical Center, 400 N. Pepper Ave, Suite # 107, Colton, CA, USA
| | - Cameron C Neeki
- Department of Emergency Medicine, Arrowhead Regional Medical Center, 400 N. Pepper Ave, Suite # 107, Colton, CA, USA
| | - Fanglong Dong
- Department of Emergency Medicine, Arrowhead Regional Medical Center, 400 N. Pepper Ave, Suite # 107, Colton, CA, USA
| | - Michael M Neeki
- California University of Science and Medicine, Colton, CA, USA.
- Department of Emergency Medicine, Arrowhead Regional Medical Center, 400 N. Pepper Ave, Suite # 107, Colton, CA, USA.
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Rechuan MM, Vaz JC, Marques FDAP, Azulay DR. Ophthalmological complications related to the use of microfocused ultrasound in the periocular region and face. An Bras Dermatol 2023; 98:863-864. [PMID: 37357116 PMCID: PMC10589498 DOI: 10.1016/j.abd.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/08/2021] [Accepted: 12/13/2021] [Indexed: 06/27/2023] Open
Affiliation(s)
- Mariana Marques Rechuan
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Jordana Cezar Vaz
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - David Rubem Azulay
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Stanford P. Cataracts: the essentials for patient care. Br J Community Nurs 2023; 28:230-236. [PMID: 37130710 DOI: 10.12968/bjcn.2023.28.5.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
It is estimated that over 2.2 billion people globally have a visual impairment. Cataract is one such form of impairment, which can be surgically corrected. However, disruptions in ophthalmic services due to the pandemic have resulted in long wait times-estimated to take up to 5 years to clear. Considering these issues, there is no doubt that individuals affected by the condition will be negatively impacted. In this article, Penelope Stanford provides information on the anatomy and altered physiology of the crystalline lens, and informs on the essentials of patient care.
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Affiliation(s)
- Penelope Stanford
- Senior Lecturer Adult Nursing, University of Manchester; Chair RCN Ophthalmic Nursing Forum
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Dammak A, Pastrana C, Martin-Gil A, Carpena-Torres C, Peral Cerda A, Simovart M, Alarma P, Huete-Toral F, Carracedo G. Oxidative Stress in the Anterior Ocular Diseases: Diagnostic and Treatment. Biomedicines 2023; 11:biomedicines11020292. [PMID: 36830827 PMCID: PMC9952931 DOI: 10.3390/biomedicines11020292] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
The eye is a metabolically active structure, constantly exposed to solar radiations making its structure vulnerable to the high burden of reactive oxygen species (ROS), presenting many molecular interactions. The biomolecular cascade modification is caused especially in diseases of the ocular surface, cornea, conjunctiva, uvea, and lens. In fact, the injury in the anterior segment of the eye takes its origin from the perturbation of the pro-oxidant/antioxidant balance and leads to increased oxidative damage, especially when the first line of antioxidant defence weakens with age. Furthermore, oxidative stress is related to mitochondrial dysfunction, DNA damage, lipid peroxidation, protein modification, apoptosis, and inflammation, which are involved in anterior ocular disease progression such as dry eye, keratoconus, uveitis, and cataract. The different pathologies are interconnected through various mechanisms such as inflammation, oxidative stress making the diagnostics more relevant in early stages. The end point of the molecular pathway is the release of different antioxidant biomarkers offering the potential of predictive diagnostics of the pathology. In this review, we have analysed the oxidative stress and inflammatory processes in the front of the eye to provide a better understanding of the pathomechanism, the importance of biomarkers for the diagnosis of eye diseases, and the recent treatment of anterior ocular diseases.
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Luo J, Chen X, Yang Y, Liu Y, Feng Y, Chen G. Association of MTHFR C667T Polymorphism, Homocysteine, and B Vitamins with Senile Cataract. J Nutr Sci Vitaminol (Tokyo) 2023; 69:136-144. [PMID: 37121723 DOI: 10.3177/jnsv.69.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Senile cataract has become the leading cause of visual impairment and even blindness in the world, but there are few reports on its relationship with methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms. This study is aimed to investigate the correlation between MTHFR gene polymorphisms or its enzyme metabolites and senile cataract. From January 2019 to June 2020, 663 patients with senile cataract at the Mianyang Central Hospital were enrolled as the observation group, and 646 healthy subjects were randomly selected as the control group. MTHFR gene polymorphisms (i.e., CC, CT, or TT genotypes) and serum homocysteine (HCY), folic acid (FOL), vitamin B12 (VitB12), and vitamin B6 (VitB6) levels were detected. The mutation rate of MTHFR C677T and HCY levels in the observation group were significantly higher than those in the control group, whereas FOL, VitB12, and VitB6 were significantly lower. With an increase in the MTHFR C677T mutation, HCY showed an upward trend, whereas FOL and VitB12 showed a decreasing trend in both the observation and control groups. Multiple logistic regression analysis showed that HCY and FOL were associated with senile cataract and MTHFR mutations; VitB12 was only associated with senile cataract. Compared to that with the CC genotype, CT and TT genotypes were associated with an increased senile cataract risk. Monitoring MTHFR gene polymorphisms and changes in serum HCY, FOL, and VitB12 levels could provide references in predicting senile cataract.
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Affiliation(s)
- Jun Luo
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Xiaohong Chen
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Yuwei Yang
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Yunbing Liu
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Yue Feng
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Gang Chen
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
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Oliveira NN, Ikegami ÉM, Oliveira NGN, Tavares DMDS. Fatores associados à incapacidade funcional de idosos com catarata: revisão integrativa. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2021. [DOI: 10.1590/1981-22562022025.220076.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Resumo Objetivo identificar as evidências científicas disponíveis na literatura sobre os fatores associados à incapacidade funcional de idosos com catarata. Métodos revisão integrativa da literatura realizada nas bases de dados PubMed, Web of Science, LILACS e CINAHL. Incluíram-se os artigos originais que responderam à questão norteadora: quais as evidências científicas sobre os fatores associados à incapacidade funcional de idosos com catarata? Resultados foram incluídos seis artigos, a maioria foi publicada a partir do ano 2000 (n=4) e realizada na América (n=3). Predominaram os estudos do tipo longitudinal (n=3) com nível de evidência IV, e transversal (n=3) com nível de evidência VI, e que realizaram análise de caminhos (n=3). Com base nos achados, emergiram três categorias temáticas: características demográficas; relacionadas à saúde ocular, física e mental, e comportamentais. Conclusão a incapacidade funcional de idosos com catarata pode ser resultante de características demográficas, relacionadas à saúde ocular, física e mental, e comportamentais.
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