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Rusciano D, Russo C. The Therapeutic Trip of Melatonin Eye Drops: From the Ocular Surface to the Retina. Pharmaceuticals (Basel) 2024; 17:441. [PMID: 38675402 PMCID: PMC11054783 DOI: 10.3390/ph17040441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/18/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Melatonin is a ubiquitous molecule found in living organisms, ranging from bacteria to plants and mammals. It possesses various properties, partly due to its robust antioxidant nature and partly owed to its specific interaction with melatonin receptors present in almost all tissues. Melatonin regulates different physiological functions and contributes to the homeostasis of the entire organism. In the human eye, a small amount of melatonin is also present, produced by cells in the anterior segment and the posterior pole, including the retina. In the eye, melatonin may provide antioxidant protection along with regulating physiological functions of ocular tissues, including intraocular pressure (IOP). Therefore, it is conceivable that the exogenous topical administration of sufficiently high amounts of melatonin to the eye could be beneficial in several instances: for the treatment of eye pathologies like glaucoma, due to the IOP-lowering and neuroprotection effects of melatonin; for the prevention of other dysfunctions, such as dry eye and refractive defects (cataract and myopia) mainly due to its antioxidant properties; for diabetic retinopathy due to its metabolic influence and neuroprotective effects; for macular degeneration due to the antioxidant and neuroprotective properties; and for uveitis, mostly owing to anti-inflammatory and immunomodulatory properties. This paper reviews the scientific evidence supporting the use of melatonin in different ocular districts. Moreover, it provides data suggesting that the topical administration of melatonin as eye drops is a real possibility, utilizing nanotechnological formulations that could improve its solubility and permeation through the eye. This way, its distribution and concentration in different ocular tissues may support its pleiotropic therapeutic effects.
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Affiliation(s)
- Dario Rusciano
- Fidia Research Centre, c/o University of Catania, Via Santa Sofia 89, 95123 Catania, Italy
| | - Cristina Russo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 89, 95123 Catania, Italy;
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Rodriguez NG, Claici AO, Ramos-Castaneda JA, González-Zamora J, Bilbao-Malavé V, de la Puente M, Fernandez-Robredo P, Garzón-Parra SJ, Garza-Leon M, Recalde S. Conjunctival ultraviolet autofluorescence as a biomarker of outdoor exposure in myopia: a systematic review and meta-analysis. Sci Rep 2024; 14:1097. [PMID: 38212604 PMCID: PMC10784576 DOI: 10.1038/s41598-024-51417-9] [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: 09/12/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
Outdoor exposure is considered the primary modifiable risk factor in preventing the development of myopia. This effect is thought to be attributed to the light-induced synthesis and release of dopamine in the retina. However, until recent years, there was no objective quantifiable method available to measure the association between time spent outdoors and myopia. It is only recently that the conjunctival ultraviolet autofluorescence (CUVAF) area, serving as a biomarker for sun exposure, has begun to be utilized in numerous studies. To provide a comprehensive summary of the relevant evidence pertaining to the association between the CUVAF area and myopia across different geographic regions and age groups, a systematic review and meta-analysis were conducted. The search encompassed multiple databases, including MEDLINE, SCIENCE DIRECT, GOOGLE SCHOLAR, WEB OF SCIENCE, and SCOPUS, and utilized specific search terms such as "conjunctival ultraviolet autofluorescence", "CUVAF", "UVAF", "objective marker of ocular sun exposure", "myopia", "degenerative myopia", and "high myopia". The bibliographic research included papers published between the years 2006 and 2022. A total of 4051 records were initially identified, and after duplicates were removed, 49 articles underwent full-text review. Nine articles were included in the systematic review. These studies covered myopia and outdoor exposure across different regions (Australia, Europe and India) with a total population of 3615 individuals. They found that myopes generally had smaller CUVAF areas compared to non-myopes. The meta-analysis confirmed this, revealing statistically smaller CUVAF areas in myopic patients, with a mean difference of - 3.30 mm2 (95% CI - 5.53; - 1.06). Additionally, some studies showed a positive correlation between more outdoor exposure and larger CUVAF areas. In terms of outdoor exposure time, myopic patients reported less time outdoors than non-myopic individuals, with a mean difference of - 3.38 h/week (95% CI - 4.66; - 2.09). Overall, these findings highlight the connection between outdoor exposure, CUVAF area and myopia, with regional variations playing a significant role. The results of this meta-analysis validate CUVAF as a quantitative method to objectively measure outdoor exposure in relation with myopia development.
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Grants
- 01/0022-23 Doctoral fellowship funded by Miniciencias Bogotá, Colombia.
- PI20/00251 Instituto de Salud Carlos III through the project Co-funded by European Regional Development Fund "A way to make Europe"
- CUN 2019 Multiópticas
- (RD21/0017/0027) Redes de Investigación Cooperativa Orientadas al Resultado en Salud (RICORS) de Terapias avanzadas , Enfermedades Inflamatorias and Enfermedades vasculares cerebrales , Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III
- (RD21/0002/0010) Redes de Investigación Cooperativa Orientadas al Resultado en Salud (RICORS) de Terapias avanzadas , Enfermedades Inflamatorias and Enfermedades vasculares cerebrales , Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III
- (RD21/0006/0008) Redes de Investigación Cooperativa Orientadas al Resultado en Salud (RICORS) de Terapias avanzadas , Enfermedades Inflamatorias and Enfermedades vasculares cerebrales , Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III
- 01-20/21 Fundación Jesús Gangoiti Barrera
- Instituto de Salud Carlos III through the project Co-funded by European Regional Development Fund “A way to make Europe”
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Affiliation(s)
- Natali Gutierrez Rodriguez
- Grupo de Investigación en Optometría-Facultad de Optometría de la Universidad Antonio Nariño, Bogotá, Colombia
| | - Aura Ortega Claici
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain
- Faculty of Medicine, Universidad de Navarra, Pamplona, Spain
| | - Jorge A Ramos-Castaneda
- Research Group Innovación y Cuidado, Faculty of Nursing, Universidad Antonio Nariño, Neiva, Colombia
| | - Jorge González-Zamora
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain
- Department of Ophthalmology, Clínica Universidad de Navarra, Madrid, Spain
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
| | - Valentina Bilbao-Malavé
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain
- Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain
| | - Miriam de la Puente
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain
- Department of Ophthalmology, Clínica Universidad de Navarra, Madrid, Spain
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
| | - Patricia Fernandez-Robredo
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain
- Department of Ophthalmology, Clínica Universidad de Navarra, Madrid, Spain
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
| | - Sandra Johanna Garzón-Parra
- Grupo de Investigación en Optometría-Facultad de Optometría de la Universidad Antonio Nariño, Bogotá, Colombia
| | - Manuel Garza-Leon
- Clinical Science Department, Science of Health Division, University of Monterrey, San Pedro Garza García, Nuevo León, México
| | - Sergio Recalde
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain.
- Department of Ophthalmology, Clínica Universidad de Navarra, Madrid, Spain.
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain.
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Hussain A, Gopalakrishnan A, Scott H, Seby C, Tang V, Ostrin L, Chakraborty R. Associations between systemic melatonin and human myopia: A systematic review. Ophthalmic Physiol Opt 2023; 43:1478-1490. [PMID: 37568264 DOI: 10.1111/opo.13214] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023]
Abstract
PURPOSE Experimental models have implicated the role of melatonin circadian rhythm disruption in refractive error development. Recent studies have examined melatonin concentration and its diurnal patterns on refractive error with equivocal results. This systematic review aimed to summarise the literature on melatonin circadian rhythms in myopia. RECENT FINDINGS PubMed, EMBASE, Web of Science, Scopus, ProQuest Central, LILACS, Cochrane and Medline databases were searched for papers between January 2010 and December 2022 using defined search terms. Seven studies measured melatonin and circadian rhythms in three biological fluids (blood serum, saliva and urine) in both myopes and non-myopes. Morning melatonin concentrations derived from blood serum varied significantly between studies in individuals aged 10-30 years, with a maximum of 89.45 pg/mL and a minimum of 5.43 pg/mL using liquid chromatography and mass spectrometry. The diurnal variation of salivary melatonin was not significantly different between myopes and emmetropes when measured every 4 h for 24 h and quantified with enzyme-linked immunosorbent assay. Significantly elevated salivary melatonin concentrations were reported in myopes compared with emmetropes, aged 18-30 years when measured hourly from evening until their habitual bedtime using liquid chromatography. However, the relationship between dim light melatonin onset and refractive group was inconsistent between studies. The 6-sulphatoxymelatonin concentration derived from overnight urine volume, measured using a double antibody radioimmunoassay, was found to be significantly lower in myopes (29.17 pg/mL) than emmetropes (42.51 pg/mL). SUMMARY The role of melatonin concentration and rhythm in myopia has not been studied extensively. This systematic review confirms conflicting findings across studies, with potential relationships existing. Future studies with uniform methodological approaches are required to ascertain the causal relationship between melatonin dysregulation and myopia in humans.
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Affiliation(s)
- Azfira Hussain
- Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Aparna Gopalakrishnan
- Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Hannah Scott
- Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, South Australia, Australia
| | - Chris Seby
- Caring Futures Institute, Myopia and Visual Development Lab, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Victoria Tang
- Caring Futures Institute, Myopia and Visual Development Lab, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Lisa Ostrin
- College of Optometry, University of Houston, Houston, Texas, USA
| | - Ranjay Chakraborty
- Caring Futures Institute, Myopia and Visual Development Lab, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Fulton JM, Flanagan SC, Sittlington JJ, Cobice D, Dobbin S, McCullough SJ, Orr G, Richardson P, Saunders KJ. A Cross-Sectional Study of Myopia and Morning Melatonin Status in Northern Irish Adolescent Children. J Ophthalmol 2023; 2023:7961623. [PMID: 37946723 PMCID: PMC10632006 DOI: 10.1155/2023/7961623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023] Open
Abstract
Purpose Previous studies have demonstrated an association between melatonin status and both refractive error and axial length in young adult myopes. This study aimed to determine if this relationship extends to a younger adolescent cohort. Methods Healthy children aged 12-15 years provided morning saliva samples before attending Ulster University (55°N) for cycloplegic autorefraction and axial length measures. Participants completed questionnaires describing recent sleep habits and physical activity. Salivary melatonin was quantified using high-performance liquid chromatography-tandem mass spectrometry. Data collection for all participants occurred over a 1-week period (April 2021). Results Seventy participants aged 14.3 (95% CI: 14.2-14.5) years were categorised by spherical equivalent refraction [SER] (range: -5.38DS to +1.88DS) into two groups; myopic SER ≤ -0.50DS (n = 22) or nonmyopic -0.50DS < SER ≤ +2.00DS (n = 48). Median morning salivary melatonin levels were 4.52 pg/ml (95% CI: 2.60-6.02) and 4.89 pg/ml (95% CI: 3.18-5.66) for myopic and nonmyopic subjects, respectively, and did not differ significantly between refractive groups (P = 0.91). Melatonin levels were not significantly correlated with SER, axial length, sleep, or activity scores (Spearman's rank, all P > 0.39). Higher levels of physical activity were associated with higher sleep quality (Spearman's rank, ρ = -0.28, P = 0.02). Conclusion The present study found no significant relationship between morning salivary melatonin levels and refractive error or axial length in young adolescents. This contrasts with outcomes from a previous study of adults with comparable methodology, season of data collection, and geographical location. Prospective studies are needed to understand the discrepancies between adult and childhood findings and evaluate whether melatonin levels in childhood are indicative of an increased risk for future onset of myopia and/or faster axial growth trajectories and myopia progression in established myopes. Future work should opt for a comprehensive dim-light melatonin onset protocol to determine circadian phase.
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Affiliation(s)
- Jane M. Fulton
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sarah C. Flanagan
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Julie J. Sittlington
- Nutrition Innovation Centre for Food and Health (NICHE), Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Diego Cobice
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sara Dobbin
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sara J. McCullough
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Gareth Orr
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Patrick Richardson
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Kathryn J. Saunders
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
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Rajasingam P, Shaw A, Davis B, Alonso-Caneiro D, Hamwood J, Collins M. The association between conjunctival and scleral thickness and ocular surface ultraviolet autofluorescence. Sci Rep 2023; 13:7931. [PMID: 37193731 DOI: 10.1038/s41598-023-35062-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/11/2023] [Indexed: 05/18/2023] Open
Abstract
Ultraviolet autofluorescence (UVAF) imaging is used to visualise ocular surface changes due to sunlight exposure and so is considered to be a biomarker for UV damage. The conjunctival and scleral thicknesses of participants with and without ocular surface UVAF were measured to examine the UVAF associated tissue thicknesses. The presence of UVAF on the ocular surface was associated with significant differences in tissue thickness including thinner conjunctival epitheliums and thicker scleras but predominantly thickening of the conjunctival stroma. Participants were also classified into four groups according to the presence and absence of UVAF on both the temporal and nasal conjunctivas. It was noted that for those that had only nasal UVAF, the temporal conjunctival stroma was significantly thicker even without the presence of UVAF. Some participants with temporal UVAF had signs of pinguecula observed with slit lamp examination and some had OCT SLO enface imaging darkening. These findings highlight the potential of techniques other than slit lamp examination, including tissue thickness measurement and UVAF photography, in the detection of early UV-related changes to the ocular surface.
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Affiliation(s)
- Pryntha Rajasingam
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Alyra Shaw
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
| | - Brett Davis
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Jared Hamwood
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Michael Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
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Bilbao-Malavé V, González-Zamora J, Gándara E, de la Puente M, Escriche E, Bezunartea J, Marizkurrena A, Alonso E, Hernández M, Fernández-Robredo P, Sáenz de Viteri M, Barrio-Barrio J, García-Layana A, Recalde S. A Cross-Sectional Observational Study of the Relationship between Outdoor Exposure and Myopia in University Students, Measured by Conjunctival Ultraviolet Autofluorescence (CUVAF). J Clin Med 2022; 11:jcm11154264. [PMID: 35893353 PMCID: PMC9331436 DOI: 10.3390/jcm11154264] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 11/28/2022] Open
Abstract
Myopia is the most common refractive error worldwide. This cannot be explained by genetic factors alone, therefore, environmental factors may play an important role. Hence, the main objective of this study was to analyse whether outdoor exposure could exert a protective effect against the development of myopia in a cohort of young adults and to investigate ultraviolet autofluorescence (CUVAF), as a biomarker of time spent outdoors. A cross-sectional observational study was carried out using two cohorts. A total of 208 participants were recruited, 156 medical students and 52 environmental science students. The data showed that 66.66% of the medical students were myopic, while 50% of the environmental science students were myopic (p = 0.021). Environmental science students spent significantly more hours per week doing outdoor activities than medical students (p < 0.0001), but there was no significant difference with respect to near work activities between them. In both cohorts, the degree of myopia was inversely associated with CUVAF, and a statistically significant positive correlation was observed between spherical equivalent and CUVAF (Pearson’s r = 0.248). In conclusion, outdoor activities could reduce the onset and progression of myopia not only in children, but also in young adults. In addition, CUVAF represents an objective, non-invasive biomarker of outdoor exposure that is inversely associated with myopia.
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Affiliation(s)
- Valentina Bilbao-Malavé
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, 31008 Pamplona, Spain
| | - Jorge González-Zamora
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, 31008 Pamplona, Spain
| | - Elsa Gándara
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
| | - Miriam de la Puente
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, 31008 Pamplona, Spain
| | - Elena Escriche
- Faculty of Medicine, Universidad de Navarra, 31008 Pamplona, Spain;
| | - Jaione Bezunartea
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Navarra Institute for Health Research, IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa en Salud (RD16/0008/0011), Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ainara Marizkurrena
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
| | - Elena Alonso
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research, IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa en Salud (RD16/0008/0011), Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Hernández
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research, IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa en Salud (RD16/0008/0011), Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Patricia Fernández-Robredo
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research, IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa en Salud (RD16/0008/0011), Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-948-425600 (ext. 6499-6290)
| | - Manuel Sáenz de Viteri
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research, IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa en Salud (RD16/0008/0011), Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jesús Barrio-Barrio
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research, IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa en Salud (RD16/0008/0011), Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alfredo García-Layana
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research, IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa en Salud (RD16/0008/0011), Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Sergio Recalde
- Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (V.B.-M.); (J.G.-Z.); (E.G.); (M.d.l.P.); (J.B.); (A.M.); (E.A.); (M.H.); (M.S.d.V.); (J.B.-B.); (A.G.-L.); (S.R.)
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research, IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa en Salud (RD16/0008/0011), Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, 28029 Madrid, Spain
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Wadhwani M, Vashist P, Singh SS, Gupta V, Gupta N, Saxena R. Myopia prevalence in a population-based childhood visual impairment study in North India - CHVI-2. Indian J Ophthalmol 2022; 70:939-943. [PMID: 35225546 PMCID: PMC9114607 DOI: 10.4103/ijo.ijo_974_21] [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: 11/29/2022] Open
Abstract
Purpose: The aim of the study was to determine the prevalence of myopia at the community level. Methods: A population-based, cross-sectional study was planned in 40 clusters among children identified with subnormal vision in the urban community of Delhi. House-to-house visits were conducted for visual acuity screening of 20,000 children aged 0–15 years using age appropriate visual acuity charts. All the children with visual acuity of < 6/12 in any eye in the age group between 3 and 15 years and inability to follow light in age group 0–3 years were referred for detailed ophthalmic examination. Results: A total of 13,572 (64.7%) children belonged to the age group of 6–15 years. Of these, a total of 507 (3.7%) were found to be having myopia (spherical equivalent of -0.50 DS or worse in one or both eyes) with positive association with higher age groups. Conclusion: The estimated prevalence of myopia is 3.7%; the proportion of uncorrected myopia was 45%, which reflects that refractive error services need to be improved further.
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Affiliation(s)
| | - Praveen Vashist
- Community Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Suraj Senjam Singh
- Community Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Vivek Gupta
- Community Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Noopur Gupta
- Cornea and Anterior Segment, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Rohit Saxena
- Neurophthalmology and Strabismus, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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Lingham G, Kugelman J, Charng J, Lee SS, Yazar S, McKnight CM, Coroneo MT, Lucas RM, Brown H, Stevenson LJ, Mackey DA, Alonso-Caneiro D. Conjunctival ultraviolet autofluorescence area decreases with age and sunglasses use. Br J Ophthalmol 2021; 107:614-620. [PMID: 34815236 DOI: 10.1136/bjophthalmol-2021-320284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/06/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Conjunctival ultraviolet autofluorescence (CUVAF) is a method of detecting conjunctival damage related to ultraviolet radiation exposure. In cross-sectional studies, CUVAF area is positively associated with self-reported time spent outdoors and pterygium and negatively associated with myopia; however, longitudinal studies are scarce. AIMS To use a novel deep learning-based tool to assess 8-year change in CUVAF area in young adults, investigate factors associated with this change and identify the number of new onset pterygia. METHODS A deep learning-based CUVAF tool was developed to measure CUVAF area. CUVAF area and pterygium status were assessed at three study visits: baseline (participants were approximately 20 years old) and at 7-year and 8-year follow-ups. Participants self-reported sun protection behaviours and ocular history. RESULTS CUVAF data were available for 1497 participants from at least one study visit; 633 (43%) participants had complete CUVAF data. Mean CUVAF areas at baseline and the 7-year and 8-year follow-ups were 48.4, 39.3 and 37.7 mm2, respectively. There was a decrease in mean CUVAF area over time (change in total CUVAF area=-0.96 mm2 per year (95% CI: -1.07 to -0.86)). For participants who wore sunglasses ≥1/2 of the time, CUVAF area decreased by an additional -0.42 mm2 per year (95% CI: -0.72 to -0.12) on average. Fourteen (1.5%) participants developed a pterygium. CONCLUSIONS In this young adult cohort, CUVAF area declined over an 8-year period. Wearing sunglasses was associated with a faster reduction in CUVAF area. Deep learning-based models can assist in accurate and efficient measurement of CUVAF area.
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Affiliation(s)
- Gareth Lingham
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Jason Kugelman
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jason Charng
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Samantha Sy Lee
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia.,Garvan-Weizmann Centre for Cellular Genomics, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Charlotte M McKnight
- Ophthalmology, St John of God Health Care, West Perth, Western Australia, Australia
| | - Minas T Coroneo
- Department of Ophthalmology, University of New South Wales, Sydney, New South Wales, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Holly Brown
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Louis J Stevenson
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - David Alonso-Caneiro
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Leng L, Zhang J, Xie S, Ding W, Ji R, Tian Y, Long K, Yu H, Guo Z. Effect of Sunshine Duration on Myopia in Primary School Students from Northern and Southern China. Int J Gen Med 2021; 14:4913-4922. [PMID: 34483681 PMCID: PMC8409785 DOI: 10.2147/ijgm.s328281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background To assess the current myopia prevalence rate and evaluate the effect of sunshine duration on myopia among primary school students in the north and south of China. Methods This prospective cross-sectional study pooled data from 9171 primary school students (grades from 1 to 6) from four cities in the north and south of China. National Geomatics Center of China (NGCC) and China Meteorological Administration provided data about altitude, latitude, longitude, average annual temperature, and average annual sunshine duration. Non-cycloplegic refraction was recorded, and prevalence rates in primary school students and factors associated with myopia were analyzed. Univariate and multivariate logistic regression models were used to determine the independent association of risk factors of myopia. Results The overall myopia prevalence was 28.0%, from 7.5% to 50.6% for first and sixth grades, respectively. Low, moderate and high myopia significantly increased with school grades from 7.30% to 35.0%, 0.3% to 13.60% and 0.00% to 1.9%, respectively. Multiple regression analysis revealed that longer average cumulative daylight hours were connected to lower myopia prevalence in primary school students (OR, 0.721; 95% CI, [0.593–0.877]; P=0.001), whereas girls and higher grade was independently associated with higher myopia prevalence (girls: β=0.189; OR, 1.208; 95% CI, [1.052–1.387]; P=0.007; higher grade: β=0.502; OR, 1.652; 95% CI, [1.580–1.726]; P<0.001). Conclusion This study demonstrated that myopia was highly prevalent in southern Chinese cities over northern ones, linked to shorter light exposure, higher education level, and female gender. Such findings reinforced the beneficial impact of daylight exposure with a protective role against myopia development.
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Affiliation(s)
- Lin Leng
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, People's Republic of China
| | - Jiafan Zhang
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, People's Republic of China
| | - Sen Xie
- Department of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong Province, People's Republic of China
| | - Wenzhi Ding
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, People's Republic of China
| | - Rongyuan Ji
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, People's Republic of China
| | - Yuyin Tian
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, People's Republic of China
| | - Keli Long
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, People's Republic of China
| | - Hongliang Yu
- Department of Ophthalmology, Shenyang Eye Docloud Internet Hospital, Shenyang, 110000, Liaoning Province, People's Republic of China
| | - Zhen Guo
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, People's Republic of China
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Hussain A, Gopalakrishnan A, Muthuvel B, Hussaindeen JR, Narayanasamy A, Sivaraman V. Young adults with myopia have lower concentrations of neuromodulators-dopamine and melatonin in serum and tear. Exp Eye Res 2021; 209:108684. [PMID: 34175263 DOI: 10.1016/j.exer.2021.108684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/24/2022]
Abstract
The purpose of this experimental case-control study was to explore the association between myopia and concentration of dopamine and melatonin in serum and tear fluid among young myopic adults, compared to age matched non-myopic controls. Healthy myopic adults with Spherical equivalent refraction (SER) of ≤ -0.50 D to -6.00 D and emmetropic adults were included in the study. All participants underwent comprehensive eye examination and ocular biometric measures that included-axial length and corneal radii. Insomnia symptom questionnaire (ISQ) was used to screen the symptoms associated with the diagnostic criteria for primary insomnia. Morning serum and tear concentration of dopamine and melatonin were collected and was quantified using High performance liquid chromatography. A total number of 40 participants, 21 myopes and 19 controls, with a median (IQR) age of myopes 24 [21-34] years and controls 24 [20-29] years were studied. The Median [IQR] of SER was -2.00[-6.25-(-0.50)] D and 0 [(-0.50)-0.25] D for myopes and controls respectively. Myopes were found to have significantly lower concentration of serum dopamine (Median [IQR]) 190 [50-342] ng/mL compared to controls (Median [IQR]) 411 [84-717] ng/mL (U = 88, p < 0.002). Likewise, myopes showed significantly lower serum melatonin concentration of 40 [20-169] ng/mL compared to controls 203 [22-539] ng/mL (U = 88.50, p < 0.001). Myopes exhibited lower concentration of tear dopamine 101 [8-188] ng/mL compared to controls 136 [25-451] ng/mL (U = 103, p < 0.05). Likewise, myopes showed significantly lower tear melatonin concentration 6 [2-18] ng/mL compared to controls 9 [2-23] ng/mL (U = 104, p < 0.05). Both serum dopamine (r = 0.419, p < 0.05) and melatonin (r = 0.323, p < 0.05) showed significant positive association with increase in spherical equivalent refraction (SER). The observed changes in the decreased concentration of Dopamine and Melatonin among young adult myopes and its association with refraction indicates the role of altered circadian rhythm in the human myopia mechanism.
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Affiliation(s)
- Azfira Hussain
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India
| | - Aparna Gopalakrishnan
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India; Faculty of Health, School of Medicine, Deakin University, Australia
| | - Bharathselvi Muthuvel
- R.S.Mehta Jain Department of Biochemistry and Cell Biology, Vision Research Foundation, Sankara Nethralaya, Chennai, India
| | | | - Angayarkanni Narayanasamy
- R.S.Mehta Jain Department of Biochemistry and Cell Biology, Vision Research Foundation, Sankara Nethralaya, Chennai, India
| | - Viswanathan Sivaraman
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India.
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