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Farzanfar A, Lockett-Ruiz V, Navarro R, Koppen C, Rozema JJ. The influence of variations in ocular biometric and optical parameters on differences in refractive error. Ophthalmic Physiol Opt 2024; 44:1000-1009. [PMID: 38666416 DOI: 10.1111/opo.13318] [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: 09/23/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE To present a paraxial method to estimate the influence of variations in ocular biometry on changes in refractive error (S) at a population level and apply this method to literature data. METHODS Error propagation was applied to two methods of eye modelling, referred to as the simple method and the matrix method. The simple method defines S as the difference between the axial power and the whole-eye power, while the matrix method uses more accurate ray transfer matrices. These methods were applied to literature data, containing the mean ocular biometry data from the SyntEyes model, as well as populations of premature infants with or without retinopathy, full-term infants, school children and healthy and diabetic adults. RESULTS Applying these equations to 1000 SyntEyes showed that changes in axial length provided the most important contribution to the variations in refractive error (57%-64%), followed by lens power/gradient index power (16%-31%) and the anterior corneal radius of curvature (10%-13%). All other components of the eye contributed <4%. For young children, the largest contributions were made by variations in axial length, lens and corneal power for the simple method (67%, 23% and 8%, respectively) and by variations in axial length, gradient lens power and anterior corneal curvature for the matrix method (55%, 21% and 14%, respectively). During myopisation, the influence of variations in axial length increased from 54.5% to 73.4%, while changes in corneal power decreased from 9.82% to 6.32%. Similarly, for the other data sets, the largest contribution was related to axial length. CONCLUSIONS This analysis confirms that the changes in ocular refraction were mostly associated with variations in axial length, lens and corneal power. The relative contributions of the latter two varied, depending on the particular population.
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Affiliation(s)
- Arezoo Farzanfar
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Veronica Lockett-Ruiz
- INMA, Consejo Superior de Investigaciones Científicas & Universidad de Zaragoza, Zaragoza, Spain
| | - Rafael Navarro
- INMA, Consejo Superior de Investigaciones Científicas & Universidad de Zaragoza, Zaragoza, Spain
| | - Carina Koppen
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Jos J Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
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Xu R, Zheng J, Liu L, Zhang W. Effects of inflammation on myopia: evidence and potential mechanisms. Front Immunol 2023; 14:1260592. [PMID: 37849748 PMCID: PMC10577208 DOI: 10.3389/fimmu.2023.1260592] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023] Open
Abstract
As the most common type of refractive error, myopia has become one of the leading causes of visual impairment. With the increasing prevalence of myopia, there is a growing need to better understand the factors involved in its development. Inflammation, one of the most fundamental pathophysiological processes in humans, is a rapid response triggered by harmful stimuli and conditions. Although controlled inflammatory responses are necessary, over-activated inflammation is the common soil for many diseases. The impact of inflammation on myopia has received rising attention in recent years. Elevated inflammation may contribute to myopia progression either directly or indirectly by inducing scleral remodeling, and myopia development may also increase ocular inflammation. This article provides a comprehensive review of the interplay between inflammation and myopia and the potential biological mechanisms, which may present new targets for understanding the pathology of myopia and developing myopia therapies.
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Affiliation(s)
- Ran Xu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Zheng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Wenqiu Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
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Bryl A, Mrugacz M, Falkowski M, Zorena K. A Mediterranean Diet May Be Protective in the Development of Diabetic Retinopathy. Int J Mol Sci 2023; 24:11145. [PMID: 37446322 DOI: 10.3390/ijms241311145] [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: 06/15/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
The Mediterranean diet is recognized as one of the healthiest available dietary patterns. This perception results from its beneficial effects on the cardiovascular system and, also, on hypertension, diabetes, and cancer compared with other diets. Its impact on the course of diabetes is assessed in the available scientific literature; however, little information is available about its impact on diabetic retinopathy. The MD is characterized mainly by the consumption of fish, seafood, foods of plant origin, and fresh fruit and vegetables. It is also recommended to consume legumes, which are a source of folic acid, magnesium, iron, and dietary fiber. High consumption of nuts and unrefined grains is also recommended in the MD. Marine fish provide polyunsaturated acids from the omega-3 group. Olive oil plays a very important role, especially olive oil obtained from mechanical pressing. Additionally, olive oil contains vitamins E, K, and polyphenols. Polyphenols, which are present in a diverse range of vegetables, fruits, and seeds, have the ability to decrease oxidative stress, inflammation, and insulin resistance. Resveratrol is naturally found in grape skins and seeds, as well as in peanuts and berries, and is a constituent of red wine. Resveratrol can inhibit increased vascular leakage and loss of pericytes and regulate the level of VEGF protein in the retina, thus inhibiting the development of DR. Consumption of fruits, vegetables, fish, and olive oil may be correlated with a lower risk of diabetic retinopathy. This paper presents the definition of the Mediterranean diet and its influence on the course of diabetes and diabetic retinopathy.
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Affiliation(s)
- Anna Bryl
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Małgorzata Mrugacz
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Mariusz Falkowski
- PhD Studies, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Katarzyna Zorena
- Department of Immunobiology and Environmental Microbiology, Medical University of Gdansk, 80-211 Gdansk, Poland
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Chaurasiya RK, Gupta A. Comments on: Does myopia decrease the risk of diabetic retinopathy in both type-1 and type-2 diabetes mellitus? Indian J Ophthalmol 2023; 71:2319-2320. [PMID: 37203001 PMCID: PMC10391486 DOI: 10.4103/ijo.ijo_2991_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Ritesh Kumar Chaurasiya
- Department of Optometry and Vision Sciences, C L Gupta Eye Institute, Ramganga Vihar Phase - II (Extn), Moradabad, Uttar Pradesh, India
| | - Akansha Gupta
- Department of Optometry and Vision Sciences, C L Gupta Eye Institute, Ramganga Vihar Phase - II (Extn), Moradabad, Uttar Pradesh, India
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Lin Z, Wen L, Li D, Moonasar N, Zhai G, Wang Y, Wang FH, Liang YB. Refractive Error in a Chinese Population with Type 2 Diabetes: A Report from the Fushun Diabetic Retinopathy Cohort Study. Ophthalmic Epidemiol 2023; 30:38-45. [PMID: 35188061 DOI: 10.1080/09286586.2022.2031228] [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 To describe the prevalence and risk factors for refractive errors in a northeastern Chinese population with type 2 diabetes. METHODS Subjects (age ≥30 years) from a community-based study, the Fushun Diabetic Retinopathy Cohort Study, were enrolled. All subjects underwent comprehensive ocular examinations, including autorefraction. Myopia, high myopia, and hyperopia were defined as a spherical equivalent (SE) of the right eye <-0.5 diopter (D), <-5.0D, and >0.5D, respectively. Astigmatism was defined as cylinder <-0.5D in a minus cylinder prescription. Anisometropia was defined as a difference of SE >1.0D between two eyes. RESULTS A total of 1929 participants (790 males, 41.0%) were enrolled. The age and gender standardized prevalence of myopia, high myopia, hyperopia, astigmatism, and anisometropia were 43.1% (95% confidence interval [CI]: 40.9%-45.3%), 8.5% (95% CI: 7.3%-9.8%), 21.5% (95% CI: 19.7%-23.4%), 61.0% (95% CI: 58.9%-63.2%), and 17.2% (95% CI: 15.5%-18.9%), respectively. Advancing age was associated with a higher frequency of hyperopia, astigmatism, and anisometropia, as opposed to a lower frequency of myopia. Female (adjusted odds ratio [aOR], 1.27; 95% CI, 1.02-1.57) participants, higher intraocular pressure (aOR, 1.03; 95% CI, 1.00-1.07), and lenticular opacity (aOR, 1.53; 95% CI, 1.20-1.94) were also found to be associated with myopia. Long duration of diabetes (>15 years) was found to be a significant factor for astigmatism (aOR, 1.62; 95% CI, 1.15-2.27) and anisometropia (aOR, 1.87; 95% CI, 1.29-2.71). CONCLUSION Nearly two-thirds of participants with type 2 diabetes had a refractive error. Age is a common factor with different types of refractive errors.
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Affiliation(s)
- Zhong Lin
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Liang Wen
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Dong Li
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | | | - Gang Zhai
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Yu Wang
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Feng Hua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Yuan Bo Liang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
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Xu Q, Zhang F, Li J, Liu J, Zhu R, Yu J, Xu X. Association of maternal diabetes during pregnancy with visual acuity development in offspring: a prospective cohort study. Acta Diabetol 2022; 59:1461-1468. [PMID: 35941247 DOI: 10.1007/s00592-022-01933-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 06/29/2022] [Indexed: 11/01/2022]
Abstract
AIMS We aimed to investigate the association between maternal diabetes before or during pregnancy and visual acuity development in offspring at 1 and 4 years old. METHODS This prospective cohort study comprised 301 individuals born in 2015-2017. Those who had maternal diabetes during or before pregnancy (type 1 diabetes, type 2 diabetes and gestational diabetes) were investigated. Two visual examinations were routinely performed on children relatively at the age of 1 at physical examination and at the age of 4 at admission to school to assess the possible effects of gestational exposure to diabetes on the visual system of the offspring. RESULTS Data were collected on children aged 1 and 4, which consisted of 173 children of mothers exposed to diabetes and 128 children of mothers without diabetes). We found no significant association between maternal diabetes during pregnancy and visual acuity development in 1-year-old offspring. At 4 years old, the incidence of amblyopia and strabismus was similar in both groups. Prenatal exposure to maternal diabetes was associated with a 171% increased risk of high RE: OR 2.71 (95% CI 1.08, 6.81), p < 0.05. Astigmatism (13.3% vs 5.5%) was found to be significantly more prevalent in children born to mothers with GD than in the controls (p = 0.025 in both groups). Moreover, offspring exposed to PGDM had a higher overall risk of high RE than those exposed to GDM during pregnancy (25.0% vs 17.4%). We further found that in the offspring of diabetic mothers, the risk of high RE was significantly increased among children who were female or who spent more time using electronic devices daily. CONCLUSIONS Our findings suggest that maternal diabetes during pregnancy is associated with an increased risk of high RE in offspring. Regular ophthalmological screening should be advised to offspring of mothers with diabetes diagnosed before or during pregnancy.
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Affiliation(s)
- Qinwen Xu
- Medicine School of Nantong University, Nantong, China
| | - Feng Zhang
- Medicine School of Nantong University, Nantong, China
| | - Jingyu Li
- Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong, China
| | - Jin Liu
- Medicine School of Nantong University, Nantong, China
| | - Ruilin Zhu
- Medicine School of Nantong University, Nantong, China
| | - Jie Yu
- Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong, China
| | - Xujuan Xu
- Affiliated Hospital of Nantong University, Nantong, China.
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Rozema JJ, Khan A, Atchison DA. Modelling ocular ageing in adults with well-controlled type I diabetes. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100048. [PMID: 37846385 PMCID: PMC10577873 DOI: 10.1016/j.aopr.2022.100048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/03/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2023]
Abstract
Purpose To develop a paraxial eye model based on a previously collected cohort of adults with well-controlled type 1 diabetes mellitus (DM1) and a limited range of refractive errors. Methods The study used the previously published biometric data of 72 participants (Age: 41.5 ± 12.4 years) with DM1. Measurements included objective refraction, anterior and posterior corneal radii of curvatures, and internal distances. Moreover, phakometry was used to determine the lens radii of curvature and lens equivalent indices, from which the lens powers were calculated. A multivariate linear regression was performed for each biometric parameter with respect to current age (Age), the time since the onset of diabetes (Tdb), and current levels of glycated hemoglobin (HbA1c). The vitreous chamber depth was determined from other distances, and lens equivalent index was chosen to balance the models. These were compared with an existing model for non-diabetic eyes. Results Some dependent parameters were not affected by the independent variables (spherical equivalent, anterior corneal radius of curvature, central corneal thickness), some were affected by time since onset (the lens radii of curvatures, anterior chamber depth) and others were affected by both age and time since onset (posterior corneal radius of curvature, lens thickness, axial length). None of the dependent parameters were affected by current levels of HbA1c. Conclusions The proposed model accurately describes the age-related changes in the eyes of people with DM1. In this description the age of diabetes onset plays an important role, especially if the diabetes onset occurred during childhood.
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Affiliation(s)
- Jos J. Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Adnan Khan
- Research Division, Weill Cornell Medicine – Qatar, Doha, Qatar
- Faculty of Health Sciences, Khyber Medical University, Peshawar, Pakistan
| | - David A. Atchison
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Australia
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Gil A, Hernández CS, Nam AS, Varadaraj V, Durr NJ, Lim D, Dave SR, Lage E. Predicting subjective refraction with dynamic retinal image quality analysis. Sci Rep 2022; 12:3714. [PMID: 35260664 PMCID: PMC8904625 DOI: 10.1038/s41598-022-07786-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/22/2022] [Indexed: 01/13/2023] Open
Abstract
The aim of this work is to evaluate the performance of a novel algorithm that combines dynamic wavefront aberrometry data and descriptors of the retinal image quality from objective autorefractor measurements to predict subjective refraction. We conducted a retrospective study of the prediction accuracy and precision of the novel algorithm compared to standard search-based retinal image quality optimization algorithms. Dynamic measurements from 34 adult patients were taken with a handheld wavefront autorefractor and static data was obtained with a high-end desktop wavefront aberrometer. The search-based algorithms did not significantly improve the results of the desktop system, while the dynamic approach was able to simultaneously reduce the standard deviation (up to a 15% for reduction of spherical equivalent power) and the mean bias error of the predictions (up to 80% reduction of spherical equivalent power) for the handheld aberrometer. These results suggest that dynamic retinal image analysis can substantially improve the accuracy and precision of the portable wavefront autorefractor relative to subjective refraction.
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Affiliation(s)
- Andrea Gil
- Department of Electronics and Communications Technology, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,PlenOptika, Inc., Boston, MA, USA
| | - Carlos S Hernández
- Department of Electronics and Communications Technology, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,PlenOptika, Inc., Boston, MA, USA
| | | | - Varshini Varadaraj
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicholas J Durr
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Eduardo Lage
- Department of Electronics and Communications Technology, Universidad Autónoma de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain. .,PlenOptika, Inc., Boston, MA, USA.
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Pseudomyopia: A Review. Vision (Basel) 2022; 6:vision6010017. [PMID: 35324602 PMCID: PMC8950661 DOI: 10.3390/vision6010017] [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: 12/19/2021] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 12/02/2022] Open
Abstract
This review has identified evidence about pseudomyopia as the result of an increase in ocular refractive power due to an overstimulation of the eye’s accommodative mechanism. It cannot be confused with the term “secondary myopia”, which includes transient myopic shifts caused by lenticular refractive index changes and myopia associated with systemic syndromes. The aim was to synthesize the literature on qualitative evidence about pseudomyopia in terms that clarify its pathophysiology, clinical presentation, assessment and diagnosis and treatment. A comprehensive literature search of PubMed and the Scopus database was carried out for articles published up to November 2021, without a data limit. This review was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Following inclusion and exclusion criteria, a total of 54 studies were included in the qualitative synthesis. The terms pseudomyopia and accommodation spasm have been found in most of the studies reviewed. The review has warned that although there is agreement on the assessment and diagnosis of the condition, there is no consensus on its management, and the literature describes a range of treatment.
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Martínez-Blanco AM, Cantor EJ, Valencia-Peña C. Prevalence and risk factors for primary angle-closure disease spectrum: The Colombian glaucoma study. Eur J Ophthalmol 2021; 32:11206721211060153. [PMID: 34796746 DOI: 10.1177/11206721211060153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To estimate the prevalence and risk factors associated with the primary angle-closure disease spectrum in participants of the Colombian Glaucoma Study. METHODS A cross-sectional study in subjects older than 50 years with a diagnosis of diabetes mellitus or/and systemic hypertension was conducted in Colombia to estimate glaucoma prevalence. This study included 1749 patients and classified them using gonioscopy into either open-angle or primary angle-closure disease spectrum groups. The patients in the primary angle-closure disease spectrum group were then subdivided into the following categories: primary angle-closure suspect, primary angle-closure, and primary angle-closure glaucoma. A logistic regression model was carried out to identify factors related to the primary angle-closure disease spectrum, including age, sex, height, and refraction. RESULTS The prevalence of primary angle-closure disease spectrum was 19.3% (338) (95% CI: 17.5-21.2). The prevalence of primary angle-closure suspect, primary angle-closure, and primary angle-closure glaucoma was 8.0% (140) (95% CI: 6.8-9.4), 10.1% (176) (95% CI: 8.7-11.6), and 1.2% (22) (95% CI: 0.8-1.9), respectively. In the multivariate analysis, advanced age (+80 years), female sex, and high hyperopia (p = 0.000, 0.021, and 0.001, respectively) were identified as independent factors related to the primary angle-closure disease spectrum. CONCLUSION A high prevalence of primary angle-closure disease spectrum was found in Colombian patients with a diagnosis of diabetes mellitus or/and systemic hypertension, especially primary angle-closure and primary angle-closure glaucoma. Age, female sex, and high hyperopia were identified as risk factors for the primary angle-closure disease spectrum.
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Affiliation(s)
- Alexander M Martínez-Blanco
- Ophthalmology Programme, 28006Universidad del Valle, Cali, Colombia
- VISOC, group Universidad del Valle, Cali, Colombia
- Department of Ophthalmology, Hospital Universitario del Valle, Cali, Colombia
- Department of Ophthalmology, Clinica Imbanaco Grupo Quirón Salud, Cali, Colombia
| | - Erika J Cantor
- Ophthalmology Programme, 28006Universidad del Valle, Cali, Colombia
| | - Claudia Valencia-Peña
- Ophthalmology Programme, 28006Universidad del Valle, Cali, Colombia
- VISOC, group Universidad del Valle, Cali, Colombia
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Du J, Li J, Liu X, Liu H, Obel C, Shen H, Hu Z, Yu Y. Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide population-based cohort study. Diabetologia 2021; 64:2466-2477. [PMID: 34401952 DOI: 10.1007/s00125-021-05526-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS We aimed to investigate the associations between maternal diabetes before or during pregnancy and the risk of high refractive error (RE) in offspring until the age of 25 years. METHODS This nationwide register-based cohort study comprised 2,470,580 individuals born in 1977-2016. The exposure was maternal diabetes during or before pregnancy (type 1 diabetes, type 2 diabetes and gestational diabetes). Cox regression was used to examine the association between maternal diabetes and the risk of high RE in offspring from birth until the age of 25 years, adjusting for multiple potential confounders. RESULTS During up to 25 years of follow-up, 553 offspring of mothers with diabetes and 19,695 offspring of mothers without diabetes were diagnosed with high RE. Prenatal exposure to maternal diabetes was associated with a 39% increased risk of high RE: HR 1.39 (95% CI 1.28, 1.51), p < 0.001; standardised cumulative incidence in unexposed offspring at 25 years of age 1.18% (95% CI 1.16%, 1.19%); cumulative incidence difference 0.72% (95% CI 0.51%, 0.94%). The elevated risks were observed for hypermetropia (HR 1.37 [95% CI 1.24, 1.51], p < 0.001), myopia (HR 1.34 [95% CI 1.08, 1.66], p = 0.007) and astigmatism (HR 1.58 [95% CI 1.29, 1.92], p < 0.001). The increased risks were more pronounced among offspring of mothers with diabetic complications (HR 2.05 [95% CI 1.60, 2.64], p < 0.001), compared with those of mothers with diabetes but no diabetic complications (HR 1.18 [95% CI 1.02, 1.37], p = 0.030). CONCLUSIONS/INTERPRETATION Our findings suggest that maternal diabetes during pregnancy is associated with an increased risk of high RE in offspring, in particular among those of mothers with diabetic complications. Early ophthalmological screening should be recommended in offspring of mothers with diabetes diagnosed before or during pregnancy.
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Affiliation(s)
- Jiangbo Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Jiong Li
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Xiaoqin Liu
- NCRR-National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Hu Liu
- Department of Ophthalmology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Carsten Obel
- Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Hongbing Shen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
| | - Yongfu Yu
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
- The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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Benassaia E, Riveline JP, Routier E, Barreau E, Robert C. Refractive changes during immunotherapy: Think diabetes! Eur J Cancer 2021; 158:15-16. [PMID: 34634540 DOI: 10.1016/j.ejca.2021.07.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 07/22/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Erwin Benassaia
- Oncodermatology Service, Department of Medicine, Gustave Roussy, Villejuif, France
| | - Jean-Pierre Riveline
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 Rue Ambroise Paré, Paris, 75010, France; Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France; Université de Paris, Paris, France
| | - Emilie Routier
- Oncodermatology Service, Department of Medicine, Gustave Roussy, Villejuif, France
| | - Emmanuel Barreau
- Department of Ophthalmology, Hôpital Universitaire Bicêtre, Le Kremlin Bicêtre, France
| | - Caroline Robert
- Oncodermatology Service, Department of Medicine, Gustave Roussy, Villejuif, France; University of Paris-Saclay, Le Kremlin-Bicêtre, France.
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Feldman-Billard S, Dupas B. Eye disorders other than diabetic retinopathy in patients with diabetes. DIABETES & METABOLISM 2021; 47:101279. [PMID: 34534696 DOI: 10.1016/j.diabet.2021.101279] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/18/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
AIM While diabetic retinopathy is the most specific complication of chronic hyperglycaemia, numerous other ocular conditions also can involve the eyes of people with diabetes. Cataract, glaucoma, age-related macular degeneration, retinal vascular occlusion, and acute ischaemic optic neuropathy combine to impair vision in people with diabetes, especially when they are old. This report provides a critical analysis and an overview of the current knowledge of the main ocular disorders (excluding diabetic retinopathy) and their association in patients with diabetes. METHODS A literature search strategy was conducted for all English-language literature with a systematic review of key references until 2021. RESULTS Patients with diabetes have a high-to-moderate increased risk for most of the usual ocular disorders we reviewed with the exception of age-related macular degeneration. Exposure to chronic hyperglycaemia promotes the development of many eye disorders while acute glucose changes are involved in refractive disorders, diabetic papillopathy and acute cataract. CONCLUSION Diabetes, beyond diabetic retinopathy, increases the risk of numerous eye disorders leading to low vision with implications for daily diabetes management. Even in the absence of clearly demonstrated benefit from glucose control in all eye conditions, achieving good glycaemic control and adherence to diabetes treatment will likely help avoid an additional risk of visual impairment in people with diabetes. In perspective, interesting findings suggesting a preventive effect of metformin use on age-related macular degeneration occurrence justify further studies.
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Affiliation(s)
- Sylvie Feldman-Billard
- Service de Médecine Interne, CHNO des Quinze-Vingts, 28 rue de Charenton, 75571 Paris Cedex 12, France.
| | - Bénédicte Dupas
- Centre Ophtalmologique Sorbonne Saint-Michel, Paris, France; Service d'Ophtalmologie, Hôpital Lariboisière, Paris, France
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Associations of refractive errors and retinal changes measured by optical coherence tomography: A systematic review and meta-analysis. Surv Ophthalmol 2021; 67:591-607. [PMID: 34343537 DOI: 10.1016/j.survophthal.2021.07.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/15/2022]
Abstract
Studies reporting alteration in retinal thickness using optical coherence tomography (OCT) have been performed in different populations with various degrees of refractive error, producing inconsistent results. Therefore, we performed a meta-analysis to evaluate the alterations in retinal OCT measurements in myopic and hyperopic patients compared to controls. Evaluation of different retinal layers' thickness may have significance for developing novel approaches for preventing, diagnosing, and treating refractive errors and their complications. We searched PubMed and EMBASE to identify articles that reported OCT measurements of different retinal layers and regions, including macular, foveal, parafoveal, perifoveal, foveolar, ganglion cell complex (GCC), retinal nerve fiber layer (RNFL), peripapillary retinal nerve fiber layer (pRNFL), and ganglion cell and inner plexiform layer (GC-IPL) thickness in addition to macular volume, and optic disc area in myopes and hyperopes comparing their differences with controls. We applied either a fixed-effects or random-effects model for the meta-analysis of these differences based on the assessed heterogeneity level. Furthermore, subgroup analyses and metaregression, as well as publication bias and quality assessment, were conducted for the eligible studies. Forty-seven studies with a total of 12223 eyes, including 8600 cases and 3623 non-cases, are included in this meta-analysis. Our results showed that, in comparison to controls, highly myopic eyes had a significantly lower value for mean macular thickness, macular GCC, macular GC-IPL, parafoveal, perifoveal, foveal, foveolar, RNFL, and pRNFL thickness. Compared to controls, moderately myopic eyes showed a significantly thinner mean macular GCC layer and pRNFL. On the other hand, hyperopic eyes had significantly thicker average pRNFL than controls. Several other significant differences were also observed in various regional analyses. The findings of the current study affirm the retinal OCT measurement differences between myopic and hyperopic eyes compared to controls, emphasizing OCT measurements' advantages as potential biomarkers of ocular pathologies.
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Lin HT, Zheng CM, Fang YA, Liu JC, Wu YC, Chang YH, Chen JT, Liang CM, Chang TJ, Zheng JQ, Tai MC, Lin YF. Prevalence and risk factors for myopia in Taiwanese diabetes mellitus patients: a multicenter case-control study in Taiwan. Sci Rep 2021; 11:8195. [PMID: 33854140 PMCID: PMC8046800 DOI: 10.1038/s41598-021-87499-y] [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] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 03/30/2021] [Indexed: 11/09/2022] Open
Abstract
This population-based retrospective cohort study investigated the prevalence of myopia among patients with Type 1 and Type 2 diabetes mellitus (DM) and evaluate risk factors for myopia in these groups. Records from 2000 to 2012 with at least one year of follow-up from the Taiwan National Health Insurance Research Database were included. This study included 35,538 patients with DM and 71,076 patients without DM. Patients with DM had a significantly higher adjusted hazard ratio for myopia in all age groups and both sexes compared with patients without DM. The subgroup analysis results revealed that the rates of myopia and astigmatism were significantly higher among patients with DM compared with patients without DM aged < 60 years. However, the rates of high myopia or myopia progression to high myopia did not differ significantly between the two groups. These findings indicate that DM is a critical risk factor for myopia and astigmatism among patients aged < 60 years. Therefore, active surveillance and earlier treatment of myopia are critical for patients with DM.
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Affiliation(s)
- Hsin-Ting Lin
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Cai-Mei Zheng
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan
| | - Yu-Ann Fang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ju-Chi Liu
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yun-Chun Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yun-Hsiang Chang
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jiann-Torng Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chang-Min Liang
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Tian-Jong Chang
- Department of Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jing-Quan Zheng
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Critical Care Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ming-Cheng Tai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yuh-Feng Lin
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Internal Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
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16
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Guo X, Swenor BK, Goldstein JE. Association of Visual Acuity Improvement With Uncorrected Refractive Error in Patients New to Low Vision Clinics. JAMA Ophthalmol 2020; 138:765-771. [PMID: 32437505 DOI: 10.1001/jamaophthalmol.2020.1677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance There is substantial socioeconomic and individual burden from uncorrected refractive error (URE) and chronic ocular disease. Understanding the association of visual acuity (VA) reduction with URE and the adults most likely to benefit from refraction may help support clinical decision-making in ophthalmologic care and maximize patient outcomes. Objectives To assess the magnitude of VA improvement associated with URE among adults under ophthalmic care who obtain low vision rehabilitation (LVR) services and identify the characteristics of the patients who are most likely to experience improvement. Design, Setting, and Participants This retrospective case series assessed patients 20 years or older who were new to the LVR clinics from August 1, 2013, to December 31, 2015, and who had habitual VA between 20/40 and counting fingers (not including) and underwent refraction. Data analysis was performed from April 4, 2018, to December 20, 2019. Exposures Patient demographics and clinical data, including habitual and refraction VA, refraction, and disease diagnosis. Habitual VA was categorized as mild (VA worse than 20/40 and at least 20/60), moderate (VA worse than 20/60 and better than 20/200), severe (VA 20/200 or worse and better than 20/500), and profound (VA 20/500 or worse) vision impairment (VI). Main Outcomes and Measures At least 2-line VA improvement and any VA improvement (≥1-line) by refraction. Results Among the 2923 patients new to LVR clinics, 1773 (mean [SD] age, 70 [18.2] years; 1069 [60.3%] female) were included in these analyses. The mean habitual VA was 20/100 (mean [SD], 0.67 [0.36] logMAR). At least 2-line improvement was observed in 493 patients (27.8%), and any VA improvement was seen in 1023 patients (57.7%). At least 2-line improvement was observed in 54 patients (34.8%) with corneal disorders and was more likely seen among patients aged 40 to <65 years compared with those aged 20 to <40 years (odds ratio [OR], 1.57; 95% CI, 1.02-2.41), African American patients compared with white patients (OR, 1.41; 95% CI, 1.08-1.85), or patients with moderate VI compared with mild VI (OR, 1.36; 95% CI, 1.07-1.72). Conclusions and Relevance The findings suggest that URE is prevalent among patients with ocular disease and accessing LVR and that refractive evaluation should be considered for patients with ocular disease and reduced VA, especially working-age adults aged 40 to <65 years, African American patients, and those with moderate VI.
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Affiliation(s)
- Xinxing Guo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Bonnielin K Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Judith E Goldstein
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Beato JN, Esteves-Leandro J, Reis D, Matos R, Falcão M, Rosas V, Carneiro Â, Falcão-Reis F. Agreement between IOLMaster ® 500 and Pentacam ® HR for keratometry assessment in type 2 diabetic and non-diabetic patients. Int J Ophthalmol 2020; 13:920-926. [PMID: 32566503 DOI: 10.18240/ijo.2020.06.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/27/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate inter-device agreement of anterior keratometry obtained by the IOLMaster® 500 and Pentacam® HR in type 2 diabetic and non-diabetic patients. METHODS Corneal measurements were sequentially performed in 60 diabetes mellitus (DM) and 48 age and sex-matched controls undergoing cataract surgery. Variables recorded included flat and steep keratometry, mean keratometry (Km), astigmatism magnitude, axis location, J0 and J45 components. Bland-Altman plots and intraclass correlation coefficients were used for examination of agreement. Subgroup analyses were performed for astigmatism magnitude, diabetes duration, hemoglobin A1c (HbA1c) levels and diabetic retinopathy (DR) stage. RESULTS Agreement for Km and astigmatism magnitude were considered good and moderate, with 95% limits of agreement (LoA) of -1.09 to 1.23 diopters (D) and -0.83 to 0.86 D in DM group, respectively; and -0.59 to 0.72 D and -0.98 to 0.75 D in non-DM group, respectively. In contrast, the 95% LoA for corneal axis exceeded the clinically relevant margins in both groups. In the total sample, only 41 eyes (38%) had a smaller than 5-degree difference. Diabetes duration, HbA1c levels and DR stage were not found to significantly affect agreement. Logistic regression showed that higher corneal power (P=0.021) and astigmatism magnitude (P=0.011) were associated with a decreased risk of having a difference in axis location greater than 10-degrees. CONCLUSION In both groups, IOLMaster and Pentacam agree well for corneal power and moderately for astigmatism. However, axis location disagreement is frequent in eyes with flatter corneas and small amounts of astigmatism.
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Affiliation(s)
- João N Beato
- Department of Ophthalmology, São João Hospital, Porto 4200-319, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| | | | - David Reis
- Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| | - Rita Matos
- Department of Ophthalmology, São João Hospital, Porto 4200-319, Portugal
| | - Manuel Falcão
- Department of Ophthalmology, São João Hospital, Porto 4200-319, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| | - Vítor Rosas
- Department of Ophthalmology, São João Hospital, Porto 4200-319, Portugal
| | - Ângela Carneiro
- Department of Ophthalmology, São João Hospital, Porto 4200-319, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| | - Fernando Falcão-Reis
- Department of Ophthalmology, São João Hospital, Porto 4200-319, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
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