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Fink PB, Wheeler AR, Smith WR, Brant-Zawadzki G, Lieberman JR, McIntosh SE, Van Tilburg C, Wedmore IS, Windsor JS, Hofmeyr R, Weber D. Wilderness Medical Society Clinical Practice Guidelines for the Treatment of Acute Pain in Austere Environments: 2024 Update. Wilderness Environ Med 2024; 35:198-218. [PMID: 38651342 DOI: 10.1177/10806032241248422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the management of pain in austere environments. Recommendations are graded based on the quality of supporting evidence as defined by criteria put forth by the American College of Chest Physicians. This is an update of the 2014 version of the "WMS Practice Guidelines for the Treatment of Acute Pain in Remote Environments" published in Wilderness & Environmental Medicine 2014; 25:41-49.
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Affiliation(s)
- Patrick B Fink
- Department of Emergency Medicine, University of Utah, Salt Lake City, UT
| | - Albert R Wheeler
- Department of Emergency Medicine, St. John's Health, Jackson, WY
| | - William R Smith
- Department of Emergency Medicine, St. John's Health, Jackson, WY
| | | | | | - Scott E McIntosh
- Department of Emergency Medicine, University of Utah, Salt Lake City, UT
| | | | - Ian S Wedmore
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | | | - Ross Hofmeyr
- Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
| | - David Weber
- Mountain Rescue Collective, LLC, Park City, UT
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Moe MC, Özmert E, Baudouin C, Binadra A, Crafoord S, Jo Y, Kiratli H, Moore M, Pitsiladis YP, Rolle U, Tan B, Yanik Ö, Budgett R, Erdener U, Steffen K, Engbretsen L. International Olympic Committee (IOC) consensus paper on sports-related ophthalmology issues in elite sports. BMJ Open Sport Exerc Med 2023; 9:e001644. [PMID: 37485004 PMCID: PMC10357794 DOI: 10.1136/bmjsem-2023-001644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Vision plays an important role in an athletes' success. In sports, nearly 80% of perceptual input is visual, and eye health and sports medicine are closely intertwined fields of utmost importance to athletes. The physical nature of sports activities renders individuals more prone to various eye injuries than the general population. Ocular trauma can lead to lifelong sequelae, and impaired vision requires careful follow-up and management. Apart from injuries, athletes may also experience vision problems that can hamper their performance, including blurred vision, double vision, and light sensitivity. The interdisciplinary nature of sports medicine necessitates collaboration between sports medicine professionals and ophthalmologists. Through such collaborations, athletes can receive appropriate eye care, education on proper eye protection and guidance on adopting good eye health practices. If any inconspicuous symptoms are not detected and treated promptly, athletes may acquire systemic injuries because of defective vision, preventing them from achieving high level athletic performance in competitions. The protection of the elite athlete is the responsibility of all of us in sports medicine. To advance a more unified, evidence-informed approach to ophthalmic health assessment and management in athletes and as relevant for sports medicine physicians, the International Olympic Committee Consensus Group aims for a critical evaluation of the current state of the science and practice of ophthalmologic issues and illness in high-level sports, and present recommendations for a unified approach to this important issue.
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Affiliation(s)
- Morten Carstens Moe
- Department of Ophthalmology, Oslo University Hospital Ullevaal, Oslo, Norway
| | - Emin Özmert
- Ophthalmology, Ankara University Faculty of Medicine, Ankara, Türkiye
- Department of Ophthalmology, Vehbi Koç Eye Hospital, Ankara, Türkiye
| | - Christophe Baudouin
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital & Vision Institute, Paris, France
| | - Abhinav Binadra
- Medical & Scientific, International Olympic Committee, Lausanne, Switzerland
| | - Sven Crafoord
- Faculty of Medicine and Health, Department of Ophthalmology, Örebro University Hospital, Orebro, Sweden
| | - Young Jo
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, South Korea
| | - Hayyam Kiratli
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Türkiye
| | - Melita Moore
- Physical Medicine and Rehabilitation, University of California Davis Medical Center, Sacramento, California, USA
| | - Yannis P Pitsiladis
- School of Sport and Health Sciences, University of Brighton, Eastbourne, UK
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
| | - Udo Rolle
- Department of Paediatric Surgery and Paediatric Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt/M, Germany
| | - Ben Tan
- SingHealth Duke-NUS Sport & Exercise Medicine Centre, Singapore
| | - Özge Yanik
- Ophthalmology, Ankara University Faculty of Medicine, Ankara, Türkiye
- Department of Ophthalmology, Vehbi Koç Eye Hospital, Ankara, Türkiye
| | - Richard Budgett
- Medical & Scientific, International Olympic Committee, Lausanne, Switzerland
| | - Ugur Erdener
- Medical & Scientific, International Olympic Committee, Lausanne, Switzerland
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Türkiye
- World Archery, Lausanne, Switzerland
| | - Kathrin Steffen
- Oslo Sports Trauma Center, Institute of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Lars Engbretsen
- Medical & Scientific, International Olympic Committee, Lausanne, Switzerland
- Oslo Sports Trauma Center, Institute of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Division of Orthopaedic Surgery, University of Oslo Faculty of Medicine, Oslo, Norway
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3
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Lee JJ, Forristal MT, Harney F, Flaherty GT. Eye disease and international travel: a critical literature review and practical recommendations. J Travel Med 2023; 30:taad068. [PMID: 37191043 PMCID: PMC10289526 DOI: 10.1093/jtm/taad068] [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: 04/19/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/17/2023]
Abstract
RATIONALE FOR REVIEW Eye diseases pose a significant public health and economic burden, particularly for travellers exposed to ocular hazards who may lack access to specialist eye care. This article offers an evidence-based review for travel-health practitioners, with a particular emphasis on ocular infections and trauma that are more prevalent among travellers. Providing an overview of these issues will allow travel health practitioners to comprehensively address ophthalmic considerations of travel. METHODS A systematic literature search was conducted on PubMed and Embase electronic databases, using keywords related to travel medicine and ophthalmology. Inclusion was based on the relevant contribution to epidemiology, aetiology, diagnostics, management and long-term consequences of travel-related eye conditions. The data were analysed using narrative synthesis. KEY FINDINGS This literature review highlighted that various travel-related eye conditions may occur. Travellers should be aware of the risk of travel-related ocular complications, which can arise from ocular infections, high-risk activities, high altitude and space travel. The economic and logistical challenges associated with medical tourism for ophthalmic procedures are discussed. For travellers with pre-existing eye conditions or visual impairment, careful planning may be needed to promote eye health and ensure safety of travel. CONCLUSIONS Travel medicine practitioners should have a comprehensive understanding of the major ocular risks associated with overseas travel, including eye infections, eye injuries and solar eye damage. Further research in this area can enhance overall wellness and alleviate the burden of ocular diseases on travellers. Evidence-based guidelines based on research can also improve the quality of care and prevent long-term vision problems.
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Affiliation(s)
- Jay Jun Lee
- Department of Ophthalmology, University Hospital Galway, Galway, Ireland
- Department of Ophthalmology, Temple Street Children’s University Hospital, Dublin, Ireland
| | - Mark T Forristal
- Department of Ophthalmology, University Hospital Galway, Galway, Ireland
| | - Fiona Harney
- Department of Ophthalmology, University Hospital Galway, Galway, Ireland
- School of Medicine, University of Galway, Galway, Ireland
| | - Gerard T Flaherty
- School of Medicine, University of Galway, Galway, Ireland
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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Rauchman SH, Locke B, Albert J, De Leon J, Peltier MR, Reiss AB. Toxic External Exposure Leading to Ocular Surface Injury. Vision (Basel) 2023; 7:vision7020032. [PMID: 37092465 PMCID: PMC10123707 DOI: 10.3390/vision7020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/30/2023] [Accepted: 04/01/2023] [Indexed: 04/07/2023] Open
Abstract
The surface of the eye is directly exposed to the external environment, protected only by a thin tear film, and may therefore be damaged by contact with ambient particulate matter, liquids, aerosols, or vapors. In the workplace or home, the eye is subject to accidental or incidental exposure to cleaning products and pesticides. Organic matter may enter the eye and cause infection. Ocular surface damage can trigger a range of symptoms such as itch, discharge, hyperemia, photophobia, blurred vision, and foreign body sensation. Toxin exposure can be assessed clinically in multiple ways, including via measurement of tear production, slit-lamp examination, corneal staining, and conjunctival staining. At the cellular level, environmental toxins can cause oxidative damage, apoptosis of corneal and conjunctival cells, cell senescence, and impaired motility. Outcomes range from transient and reversible with complete healing to severe and sight-compromising structural changes. Classically, evaluation of tolerance and safety was carried out using live animal testing; however, new in vitro and computer-based, in silico modes are superseding the gold standard Draize test. This review examines how environmental features such as pollutants, temperature, and seasonality affect the ocular surface. Chemical burns to the eye are considered, and approaches to protect the ocular surface are detailed.
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Affiliation(s)
| | - Brandon Locke
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
| | - Jacqueline Albert
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
| | - Joshua De Leon
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
| | - Morgan R. Peltier
- Department of Psychiatry and Behavioral Health, Jersey Shore University Medical Center, Neptune, NJ 07753, USA
| | - Allison B. Reiss
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
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Stapleton F, Abad JC, Barabino S, Burnett A, Iyer G, Lekhanont K, Li T, Liu Y, Navas A, Obinwanne CJ, Qureshi R, Roshandel D, Sahin A, Shih K, Tichenor A, Jones L. TFOS lifestyle: Impact of societal challenges on the ocular surface. Ocul Surf 2023; 28:165-199. [PMID: 37062429 PMCID: PMC10102706 DOI: 10.1016/j.jtos.2023.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Societal factors associated with ocular surface diseases were mapped using a framework to characterize the relationship between the individual, their health and environment. The impact of the COVID-19 pandemic and mitigating factors on ocular surface diseases were considered in a systematic review. Age and sex effects were generally well-characterized for inflammatory, infectious, autoimmune and trauma-related conditions. Sex and gender, through biological, socio-economic, and cultural factors impact the prevalence and severity of disease, access to, and use of, care. Genetic factors, race, smoking and co-morbidities are generally well characterized, with interdependencies with geographical, employment and socioeconomic factors. Living and working conditions include employment, education, water and sanitation, poverty and socioeconomic class. Employment type and hobbies are associated with eye trauma and burns. Regional, global socio-economic, cultural and environmental conditions, include remoteness, geography, seasonality, availability of and access to services. Violence associated with war, acid attacks and domestic violence are associated with traumatic injuries. The impacts of conflict, pandemic and climate are exacerbated by decreased food security, access to health services and workers. Digital technology can impact diseases through physical and mental health effects and access to health information and services. The COVID-19 pandemic and related mitigating strategies are mostly associated with an increased risk of developing new or worsening existing ocular surface diseases. Societal factors impact the type and severity of ocular surface diseases, although there is considerable interdependence between factors. The overlay of the digital environment, natural disasters, conflict and the pandemic have modified access to services in some regions.
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Affiliation(s)
- Fiona Stapleton
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia.
| | - Juan Carlos Abad
- Department of Ophthalmology, Antioquia Ophthalmology Clinic-Clofan, Medellin, Antioquia, Colombia
| | - Stefano Barabino
- ASST Fatebenefratelli-Sacco, Ospedale L. Sacco-University of Milan, Milan, Italy
| | - Anthea Burnett
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
| | - Geetha Iyer
- C. J. Shah Cornea Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Kaevalin Lekhanont
- Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tianjing Li
- Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Yang Liu
- Ophthalmology Department, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Alejandro Navas
- Conde de Valenciana, National Autonomous University of Mexico UNAM, Mexico City, Mexico
| | | | - Riaz Qureshi
- Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Danial Roshandel
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA, Australia
| | - Afsun Sahin
- Department of Ophthalmology, Koc University Medical School, İstanbul, Turkey
| | - Kendrick Shih
- Department of Ophthalmology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Anna Tichenor
- School of Optometry, Indiana University, Bloomington, IN, USA
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
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Mohibbullah M, Haque MN, Sohag AAM, Hossain MT, Zahan MS, Uddin MJ, Hannan MA, Moon IS, Choi JS. A Systematic Review on Marine Algae-Derived Fucoxanthin: An Update of Pharmacological Insights. Mar Drugs 2022; 20:279. [PMID: 35621930 PMCID: PMC9146768 DOI: 10.3390/md20050279] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 12/12/2022] Open
Abstract
Fucoxanthin, belonging to the xanthophyll class of carotenoids, is a natural antioxidant pigment of marine algae, including brown macroalgae and diatoms. It represents 10% of the total carotenoids in nature. The plethora of scientific evidence supports the potential benefits of nutraceutical and pharmaceutical uses of fucoxanthin for boosting human health and disease management. Due to its unique chemical structure and action as a single compound with multi-targets of health effects, it has attracted mounting attention from the scientific community, resulting in an escalated number of scientific publications from January 2017 to February 2022. Fucoxanthin has remained the most popular option for anti-cancer and anti-tumor activity, followed by protection against inflammatory, oxidative stress-related, nervous system, obesity, hepatic, diabetic, kidney, cardiac, skin, respiratory and microbial diseases, in a variety of model systems. Despite much pharmacological evidence from in vitro and in vivo findings, fucoxanthin in clinical research is still not satisfactory, because only one clinical study on obesity management was reported in the last five years. Additionally, pharmacokinetics, safety, toxicity, functional stability, and clinical perspective of fucoxanthin are substantially addressed. Nevertheless, fucoxanthin and its derivatives are shown to be safe, non-toxic, and readily available upon administration. This review will provide pharmacological insights into fucoxanthin, underlying the diverse molecular mechanisms of health benefits. However, it requires more activity-oriented translational research in humans before it can be used as a multi-target drug.
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Affiliation(s)
- Md. Mohibbullah
- Department of Fishing and Post Harvest Technology, Sher-e-Bangla Agricultural University, Sher-e-Bangla Nagar, Dhaka 1207, Bangladesh;
- Seafood Research Center, Silla University, #605, Advanced Seafood Processing Complex, Wonyang-ro, Amnam-dong, Seo-gu, Busan 49277, Korea
- Department of Food Biotechnology, Division of Bioindustry, College of Medical and Life Sciences, Silla University, Busan 46958, Korea
| | - Md. Nazmul Haque
- Department of Anatomy, College of Medicine, Dongguk University, Gyeongju 38066, Korea; (M.N.H.); (I.S.M.)
- Department of Fisheries Biology and Genetics, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh
| | - Abdullah Al Mamun Sohag
- Department of Biochemistry and Molecular Biology, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh; (A.A.M.S.); (M.T.H.); (M.A.H.)
| | - Md. Tahmeed Hossain
- Department of Biochemistry and Molecular Biology, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh; (A.A.M.S.); (M.T.H.); (M.A.H.)
| | - Md. Sarwar Zahan
- ABEx Bio-Research Center, East Azampur, Dhaka 1230, Bangladesh; (M.S.Z.); (M.J.U.)
| | - Md. Jamal Uddin
- ABEx Bio-Research Center, East Azampur, Dhaka 1230, Bangladesh; (M.S.Z.); (M.J.U.)
| | - Md. Abdul Hannan
- Department of Biochemistry and Molecular Biology, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh; (A.A.M.S.); (M.T.H.); (M.A.H.)
| | - Il Soo Moon
- Department of Anatomy, College of Medicine, Dongguk University, Gyeongju 38066, Korea; (M.N.H.); (I.S.M.)
| | - Jae-Suk Choi
- Seafood Research Center, Silla University, #605, Advanced Seafood Processing Complex, Wonyang-ro, Amnam-dong, Seo-gu, Busan 49277, Korea
- Department of Food Biotechnology, Division of Bioindustry, College of Medical and Life Sciences, Silla University, Busan 46958, Korea
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Volatier T, Schumacher B, Cursiefen C, Notara M. UV Protection in the Cornea: Failure and Rescue. BIOLOGY 2022; 11:biology11020278. [PMID: 35205145 PMCID: PMC8868636 DOI: 10.3390/biology11020278] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 01/07/2023]
Abstract
Simple Summary The sun is a deadly laser, and its damaging rays harm exposed tissues such as our skin and eyes. The skin’s protection and repair mechanisms are well understood and utilized in therapeutic approaches while the eye lacks such complete understanding of its defenses and therefore often lacks therapeutic support in most cases. The aim here was to document the similarities and differences between the two tissues as well as understand where current research stands on ocular, particularly corneal, ultraviolet protection. The objective is to identify what mechanisms may be best suited for future investigation and valuable therapeutic approaches. Abstract Ultraviolet (UV) irradiation induces DNA lesions in all directly exposed tissues. In the human body, two tissues are chronically exposed to UV: the skin and the cornea. The most frequent UV-induced DNA lesions are cyclobutane pyrimidine dimers (CPDs) that can lead to apoptosis or induce tumorigenesis. Lacking the protective pigmentation of the skin, the transparent cornea is particularly dependent on nucleotide excision repair (NER) to remove UV-induced DNA lesions. The DNA damage response also triggers intracellular autophagy mechanisms to remove damaged material in the cornea; these mechanisms are poorly understood despite their noted involvement in UV-related diseases. Therapeutic solutions involving xenogenic DNA-repair enzymes such as T4 endonuclease V or photolyases exist and are widely distributed for dermatological use. The corneal field lacks a similar set of tools to address DNA-lesions in photovulnerable patients, such as those with genetic disorders or recently transplanted tissue.
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Affiliation(s)
- Thomas Volatier
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 62, 50937 Cologne, Germany; (C.C.); (M.N.)
- Correspondence:
| | - Björn Schumacher
- Cologne Excellence Cluster for Cellular Stress Responses, Aging-Associated Diseases (CECAD) and Center for Molecular Medicine (CMMC), University of Cologne, Joseph-Stelzmann-Strasse 26, 50931 Cologne, Germany;
| | - Claus Cursiefen
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 62, 50937 Cologne, Germany; (C.C.); (M.N.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 21, 50931 Cologne, Germany
| | - Maria Notara
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 62, 50937 Cologne, Germany; (C.C.); (M.N.)
- Cologne Excellence Cluster for Cellular Stress Responses, Aging-Associated Diseases (CECAD) and Center for Molecular Medicine (CMMC), University of Cologne, Joseph-Stelzmann-Strasse 26, 50931 Cologne, Germany;
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Yu H, Xu M, Zhao Y, Li J, Wu W, Feng Y. COVID-19 Changed Prevalence, Disease Spectrum and Management Strategies of Ocular Trauma. Front Med (Lausanne) 2022; 8:774493. [PMID: 35083239 PMCID: PMC8784966 DOI: 10.3389/fmed.2021.774493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the health of people around the world and has reshaped social behaviors and clinical practice. The purpose of this perspective is to provide epidemiologists and clinicians with information about how the spectrum of ocular trauma diseases changed, as well as to optimize management for improving patient prognosis during this crisis. Analysis of current studies revealed that the prevalence of eye trauma decreased overall, with a trend of delayed medical treatment during the COVID-19 era. Irregular epidemic prevention and control measures, unprotected home activities, and unusual mental states are the main causes of ocular trauma. Strategies for reducing morbidity are also discussed, including popularizing the use norms of prevention and control supplies, taking heed to the safety of family activities, highlighting the special status of child protection, and paying attention to previous case data to implement region-specific precautions. The procedure of ophthalmological emergency and outpatient management should also be optimized, and mental health should be emphasized during this pandemic.
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Affiliation(s)
- Haozhe Yu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Minhui Xu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Yue Zhao
- Institute of Medical Education, Peking University, Beijing, China
| | - Jingyi Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Wenyu Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Yun Feng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
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9
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Castellani JW, Eglin CM, Ikäheimo TM, Montgomery H, Paal P, Tipton MJ. ACSM Expert Consensus Statement: Injury Prevention and Exercise Performance during Cold-Weather Exercise. Curr Sports Med Rep 2021; 20:594-607. [PMID: 34752434 DOI: 10.1249/jsr.0000000000000907] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
ABSTRACT Cold injury can result from exercising at low temperatures and can impair exercise performance or cause lifelong debility or death. This consensus statement provides up-to-date information on the pathogenesis, nature, impacts, prevention, and treatment of the most common cold injuries.
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Affiliation(s)
- John W Castellani
- United States Army Research Institute of Environmental Medicine, Thermal and Mountain Medicine Division, Natick, MA
| | - Clare M Eglin
- University of Portsmouth, School of Sport, Health and Exercise Science, Portsmouth, United Kingdom
| | | | - Hugh Montgomery
- University College London, Centre for Human Health and Performance, London, United Kingdom
| | - Peter Paal
- Hospitallers Brothers Hospital, Anaesthesiology and Intensive Care Medicine, Salzburg, Austria
| | - Michael J Tipton
- University of Portsmouth, School of Sport, Health and Exercise Science, Portsmouth, United Kingdom
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10
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Angyal Á, Pénzes Z, Alimohammadi S, Horváth D, Takács L, Vereb G, Zsebik B, Bíró T, Tóth KF, Lisztes E, Tóth BI, Oláh A, Szöllősi AG. Anandamide Concentration-Dependently Modulates Toll-Like Receptor 3 Agonism or UVB-Induced Inflammatory Response of Human Corneal Epithelial Cells. Int J Mol Sci 2021; 22:7776. [PMID: 34360541 PMCID: PMC8346008 DOI: 10.3390/ijms22157776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 01/22/2023] Open
Abstract
Photodamage-induced and viral keratitis could benefit from treatment with novel nonsteroid anti-inflammatory agents. Therefore, we determined whether human corneal epithelial cells (HCECs) express members of the endocannabinoid system (ECS), and examined how the endocannabinoid anandamide (AEA, N-arachidonoyl ethanolamine) influences the Toll-like receptor 3 (TLR3) agonism- or UVB irradiation-induced inflammatory response of these cells. Other than confirming the presence of cannabinoid receptors, we show that endocannabinoid synthesizing and catabolizing enzymes are also expressed in HCECs in vitro, as well as in the epithelial layer of the human cornea in situ, proving that they are one possible source of endocannabinoids. p(I:C) and UVB irradiation was effective in promoting the transcription and secretion of inflammatory cytokines. Surprisingly, when applied alone in 100 nM and 10 μM, AEA also resulted in increased pro-inflammatory cytokine production. Importantly, AEA further increased levels of these cytokines in the UVB model, whereas its lower concentration partially prevented the transcriptional effect of p(I:C), while not decreasing the p(I:C)-induced cytokine release. HCECs express the enzymatic machinery required to produce endocannabinoids both in vitro and in situ. Moreover, our data show that, despite earlier reports about the anti-inflammatory potential of AEA in murine cornea, its effects on the immune phenotype of human corneal epithelium may be more complex and context dependent.
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Affiliation(s)
- Ágnes Angyal
- Department of Physiology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (Á.A.); (K.F.T.); (E.L.); (B.I.T.); (A.O.)
- Doctoral School of Molecular Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (Z.P.); (S.A.); (D.H.)
| | - Zsófia Pénzes
- Doctoral School of Molecular Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (Z.P.); (S.A.); (D.H.)
- Department of Immunology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary;
| | - Shahrzad Alimohammadi
- Doctoral School of Molecular Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (Z.P.); (S.A.); (D.H.)
- Department of Immunology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary;
| | - Dorottya Horváth
- Doctoral School of Molecular Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (Z.P.); (S.A.); (D.H.)
- Department of Immunology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary;
| | - Lili Takács
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary;
| | - György Vereb
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (G.V.); (B.Z.)
- MTA-DE Cell Biology and Signaling Research Group, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary
- Faculty of Pharmacy, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary
| | - Barbara Zsebik
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (G.V.); (B.Z.)
- MTA-DE Cell Biology and Signaling Research Group, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary
| | - Tamás Bíró
- Department of Immunology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary;
- Monasterium Laboratory Skin & Hair Research Solutions, Mendelstraße 17, 48149 Münster, Germany
| | - Kinga Fanni Tóth
- Department of Physiology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (Á.A.); (K.F.T.); (E.L.); (B.I.T.); (A.O.)
- Doctoral School of Molecular Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (Z.P.); (S.A.); (D.H.)
- Department of Immunology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary;
| | - Erika Lisztes
- Department of Physiology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (Á.A.); (K.F.T.); (E.L.); (B.I.T.); (A.O.)
| | - Balázs István Tóth
- Department of Physiology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (Á.A.); (K.F.T.); (E.L.); (B.I.T.); (A.O.)
| | - Attila Oláh
- Department of Physiology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary; (Á.A.); (K.F.T.); (E.L.); (B.I.T.); (A.O.)
| | - Attila Gábor Szöllősi
- Department of Immunology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, 4032 Debrecen, Hungary;
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Wang Y, Lou J, Ji Y, Wang Z. Increased photokeratitis during the coronavirus disease 2019 pandemic: Clinical and epidemiological features and preventive measures. Medicine (Baltimore) 2021; 100:e26343. [PMID: 34128883 PMCID: PMC8213321 DOI: 10.1097/md.0000000000026343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 05/28/2021] [Indexed: 01/04/2023] Open
Abstract
An increased incidence of photokeratitis has occurred during the coronavirus disease 2019 (COVID-19) pandemic due to improper and unprotected use of ultraviolet lamps. Here, we summarize the clinical and epidemiological features of this increased incidence of photokeratitis and share advice in using health education to prevent it.We collected data from patients diagnosed with photokeratitis from October 7, 2019 to December 1, 2019, and from February 17, 2020 to April 12, 2020, and compared the frequency of onset, site of ultraviolet radiation (UVR) exposure, reason for exposure, exposure time, and recovery time. We also implemented and evaluated multiple measures of public health education to prevent increased disease.After the COVID-19 outbreak, the frequency of onset of photokeratitis increased significantly, especially among young women. The main reason for UVR exposure changed from welding to disinfection. The incidence sites varied, and the exposure time was longer. As a result, patients needed a longer time to recover. Positive health education was an useful and convenient measure to prevent the disease.While the COVID-19 pandemic is ongoing, more attention should be paid to public health and implement positive measures to prevent photokeratitis.
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Affiliation(s)
| | - Jing Lou
- Suzhou Dushuhu Public Hospital, Suzhou, Jiangsu, China
| | - Ye Ji
- The First Affiliated Hospital of Soochow University
| | - ZhenYu Wang
- The First Affiliated Hospital of Soochow University
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12
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Rubeshkumar P, Ponnaiah M, Prakash SV, Balasubramanian R, Somasundaram S, Premkumar B, Gounder KK, Murhekar MV. An outbreak of bilateral photokeratitis and eyelid erythema following exposure to an artificial source of ultraviolet radiation, Tamil Nadu, India, 2018. Environ Epidemiol 2020; 4:e118. [PMID: 33778353 PMCID: PMC7941794 DOI: 10.1097/ee9.0000000000000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 08/28/2020] [Indexed: 11/25/2022] Open
Abstract
Metal halide lights (MHLs) emit ultraviolet radiation (UVR) and should be used with enclosed fixtures. We investigated a cluster of blurred vision in a locality in South India reported among light music event attendees to identify risk factors. METHODS We searched for attendees with any eye-related symptoms by door-to-door. We described cases by time, place, and person and inspected the environment to generate a hypothesis. We followed-up the cohort of the attendees to examine the hypothesis of exposure to MHL as the cause of the outbreak. We computed relative risk (RR) and 95% confidence interval (CI) by comparing attack rates among attendees by seating location and duration of exposure. RESULTS Of the total 500 attendees, we could interview 319 (64%) and 89% (284/319) attendees developed bilateral photokeratitis (median age = 24 years [range: 2-80 years]). Attack rate was higher among female (92% [172/189]) than male (85% [110/130]). Attack rate among those seated within 12 meters from dais was higher (95% [241/253]) than the rest (65% [43/66]; RR = 1.5; 95% CI = 1.2, 1.7) and attack rate was higher among those continuously exposed to MHL (97% [268/277]) than others (38% [16/42]; RR = 2.5; 95% CI = 1.7, 3.7). The duration of exposure was associated with increased risk of bilateral photokeratitis (χ2 test for linear trend = 74; P < 0.00001). During the environmental inspection, we identified the use of MHL with a broken outer envelope. CONCLUSIONS Photokeratitis was associated with exposure to UVR from MHL with a broken outer envelope. We recommended the usage of MHL along with enclosed fixtures.
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Affiliation(s)
- Polani Rubeshkumar
- Field Epidemiology Training Programme (FETP), ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
- Directorate of Public Health & Preventive Medicine, Tamil Nadu, India
| | - Manickam Ponnaiah
- Field Epidemiology Training Programme (FETP), ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - S. Varun Prakash
- Directorate of Public Health & Preventive Medicine, Tamil Nadu, India
| | | | | | | | | | - Manoj V. Murhekar
- Field Epidemiology Training Programme (FETP), ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
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13
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Sengillo JD, Kunkler AL, Medert C, Fowler B, Shoji M, Pirakitikulr N, Patel N, Yannuzzi NA, Verkade AJ, Miller D, Sliney DH, Parel JM, Amescua G. UV-Photokeratitis Associated with Germicidal Lamps Purchased during the COVID-19 Pandemic. Ocul Immunol Inflamm 2020; 29:76-80. [PMID: 33215961 DOI: 10.1080/09273948.2020.1834587] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE To report photokeratitis caused by the improper use of germicidal lamps purchased during the COVID-19 pandemic. METHODS Case series. RESULTS Seven patients presented with acute ocular surface pain after exposure to UV-emitting germicidal lamps. Visual acuity was 20/30 or better in 13 of 14 eyes (93%). Anterior segment examination revealed varying degrees of conjunctival injection and diffusely distributed punctate epithelial erosions (PEEs) in every patient. No intraocular inflammation was identified across the cohort and all fundus examinations were normal. Treatment varied by provider and included artificial tears alone or in combination with antibiotic ointments and/or topical steroids. Five patients were followed via telehealth, one patient returned for an in-office visit, and one patient was lost to follow-up. Five of six patients endorsed complete resolution of symptoms within 2-3 days. CONCLUSIONS Patients should follow manufacturer recommendations when using UV-emitting germicidal lamps and avoid direct exposure to the ocular surface.
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Affiliation(s)
- Jesse D Sengillo
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Anne L Kunkler
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Charles Medert
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Benjamin Fowler
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Marissa Shoji
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Nathan Pirakitikulr
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Nimesh Patel
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Nicolas A Yannuzzi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Angela J Verkade
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Darlene Miller
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - David H Sliney
- Department of Environmental Science and Engineering, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Jean-Marie Parel
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Guillermo Amescua
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
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Gouveia RM, Connon CJ. Biomechanical Modulation Therapy-A Stem Cell Therapy Without Stem Cells for the Treatment of Severe Ocular Burns. Transl Vis Sci Technol 2020; 9:5. [PMID: 33240564 PMCID: PMC7671857 DOI: 10.1167/tvst.9.12.5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/07/2020] [Indexed: 12/16/2022] Open
Abstract
Ocular injuries caused by chemical and thermal burns are often unmanageable and frequently result in disfigurement, corneal haze/opacification, and vision loss. Currently, a considerable number of surgical and pharmacological approaches are available to treat such injuries at either an acute or a chronic stage. However, these existing interventions are mainly directed at (and limited to) suppressing corneal inflammation and neovascularization while promoting re-epithelialization. Reconstruction of the ocular surface represents a suitable but last-option recourse in cases where epithelial healing is severely impaired, such as due to limbal stem cell deficiency. In this concise review, we discuss how biomechanical modulation therapy (BMT) may represent a more effective approach to promoting the regeneration of ocular tissues affected by burn injuries via restoration of the limbal stem cell niche. Specifically, the scientific basis supporting this new therapeutic modality is described, along with our growing understanding of the role that tissue biomechanics plays in stem cell fate and function. The potential impact of BMT as a future treatment option for the management of injuries affecting tissue compliance is also further discussed.
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Affiliation(s)
- Ricardo M Gouveia
- Biosciences Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Che J Connon
- Biosciences Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Newcastle upon Tyne, UK
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15
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Jaki Mekjavic P, Tipton MJ, Mekjavic IB. The eye in extreme environments. Exp Physiol 2020; 106:52-64. [DOI: 10.1113/ep088594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/05/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Polona Jaki Mekjavic
- University Medical Centre Ljubljana Eye Clinic Ljubljana Slovenia
- Faculty of Medicine University of Ljubljana Ljubljana Slovenia
- Department of Automation Biocybernetics and Robotics Jozef Stefan Institute Ljubljana Slovenia
| | - Michael J. Tipton
- School of Sport Health and Exercise Science University of Portsmouth Portsmouth UK
| | - Igor B Mekjavic
- Department of Automation Biocybernetics and Robotics Jozef Stefan Institute Ljubljana Slovenia
- Department of Biomedical Physiology and Kinesiology Simon Fraser University Burnaby British Columbia Canada
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16
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Rubeshkumar PC, Manickam P, Anandhi D, Senthil Kumar S, Rita Hepsi Rani M, Premkumar B, Karumana Gounder K. An outbreak of bilateral photokeratitis among an indoor school event attendees attributable to unshielded mercury vapour and metal halide lights, Eruvadi village, Tirunelveli, Tamil Nadu, South India, 2018. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2019.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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17
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Izadi M, Jonaidi-Jafari N, Pourazizi M, Alemzadeh-Ansari MH, Hoseinpourfard MJ. Photokeratitis induced by ultraviolet radiation in travelers: A major health problem. J Postgrad Med 2019; 64:40-46. [PMID: 29067921 PMCID: PMC5820813 DOI: 10.4103/jpgm.jpgm_52_17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Ultraviolet (UV) irradiation is one of the several environmental hazards that may cause inflammatory reactions in ocular tissues, especially the cornea. One of the important factors that affect how much ultraviolet radiation (UVR) humans are exposed to is travel. Hence, traveling is considered to include a more acute UVR effect, and ophthalmologists frequently evaluate and manage the ocular manifestations of UV irradiation, including UV-induced keratitis. The purpose of this paper is to provide an evidence-based analysis of the clinical effect of UVR in ocular tissues. An extensive review of English literature was performed to gather all available articles from the National Library of Medicine PubMed database of the National Institute of Health, the Ovid MEDLINE database, Scopus, and ScienceDirect that had studied the effect of UVR on the eye and its complications, between January 1970 and June 2014. The results show that UVR at 300 nm causes apoptosis in all three layers of the cornea and induces keratitis. Apoptosis in all layers of the cornea occurs 5 h after exposure. The effect of UVR intensity on the eye can be linked to numerous factors, including solar elevation, time of day, season, hemisphere, clouds and haze, atmospheric scattering, atmospheric ozone, latitude, altitude, longitudinal changes, climate, ground reflection, and geographic directions. The most important factor affecting UVR reaching the earth's surface is solar elevation. Currently, people do not have great concern over eye protection. The methods of protection against UVR include avoiding direct sunlight exposure, using UVR-blocking eyewear (sunglasses or contact lenses), and wearing hats. Hence, by identifying UVR intensity factors, eye protection factors, and public education, especially in travelers, methods for safe traveling can be identified.
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Affiliation(s)
- M Izadi
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - N Jonaidi-Jafari
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - M Pourazizi
- Cancer Research Center, Semnan University of Medical Sciences, Semnan; Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M H Alemzadeh-Ansari
- Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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18
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Fuchs endothelial corneal dystrophy and corneal endothelial diseases: East meets West. Eye (Lond) 2019; 34:427-441. [PMID: 31267087 DOI: 10.1038/s41433-019-0497-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 04/21/2019] [Accepted: 04/27/2019] [Indexed: 12/13/2022] Open
Abstract
Fuchs endothelial corneal dystrophy (FECD) is amongst one of the most common indications for endothelial keratoplasty worldwide. Despite being originally described among Caucasians, it is now known to be prevalent among a large number of populations, including Asians. While the FECD phenotype is classically described as that of central guttate and pigment deposits associated with corneal endothelial dysfunction, there are subtle yet important differences in how FECD and its phenocopies may present in Caucasians vs Asians. Such differences are paralled by genotypic variations and disease management preferences which appear to be geographically and ethnically delineated. This article provides a succinct review of such differences, with a focus on diagnostic and management issues which may be encountered by ophthalmologists practicing in the different geographic regions, when evaluating a patient with FECD.
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19
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Huang Y, Shi C, Li J. The protective effect of zeaxanthin on human limbal and conjunctival epithelial cells against UV-induced cell death and oxidative stress. Int J Ophthalmol 2019; 12:369-374. [PMID: 30918802 DOI: 10.18240/ijo.2019.03.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 12/18/2018] [Indexed: 01/30/2023] Open
Abstract
AIM To explore the protective effect of zeaxanthin on human limbal and conjunctival epithelial cells against UV-radiation and excessive oxidative stress. METHODS Human limbal and conjunctival epithelial cells were isolated from cadaver and cultured in vitro. They were challenged with UVB radiation and H2O2 with and without zeaxanthin pretreatment. Cell viability, p38 and c-JUN NH(2)-terminal kinase (JNK) phosphorylation, IL-6, IL-8 and MCP-1 secretion and malondialdehyde (MDA) content were measured. RESULTS Zeaxanthin had no measurable cytotoxicity on limbal or conjunctival epithelial cells when used at concentrations of 5 µg/mL and below. At 30 mJ/cm2 UVB, the pretreatment of zeaxanthin increased the percentage of live cells from 50% to 69% (P=0.01) and from 66% to 75% (P=0.05) for limbal and conjunctival epithelial cells, respectively. The concentrations of IL-6, IL-8 and MCP-1 in the culture medium reduced to 66% (for IL-6 and MCP-1) and 56% (for IL-8) of the levels without zeaxanthin. This was accompanied by reduced p38 and JNK protein phosphorylation. Pretreatment of zeaxanthin also reduced intracellular MDA content caused by H2O2 stimulation from 0.86 µmol/L to 0.52 µmol/L (P=0.02) in limbal epithelial cells and from 0.96 µmol/L to 0.56 µmol/L in conjunctival epithelial cells (P=0.03). However, zeaxanthin did not have significant effect on H2O2-induced cell death in limbal or conjunctival epithelial cells. CONCLUSION Zeaxanthin is an effective reagent in reducing the detrimental effect of UV-radiation and oxidative stress on ocular surface epithelial cells.
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Affiliation(s)
- Yue Huang
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.,Department of Ophthalmology, Xinhua Hospital, Chong Ming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 202150, China
| | - Chun Shi
- Department of Ophthalmology, Jiangwan Hospital of Hongkou District, Shanghai 200434, China
| | - Jing Li
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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20
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Chen SJ, Lee CJ, Lin TB, Peng HY, Liu HJ, Chen YS, Tseng KW. Protective Effects of Fucoxanthin on Ultraviolet B-Induced Corneal Denervation and Inflammatory Pain in a Rat Model. Mar Drugs 2019; 17:md17030152. [PMID: 30841522 PMCID: PMC6471339 DOI: 10.3390/md17030152] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 01/04/2023] Open
Abstract
Fucoxanthin is a carotenoid with many pharmaceutical properties that is found in brown seaweed. However, the effects of fucoxanthin on corneal innervation and intense eye pain have not been extensively examined. To clarify the protective roles and underlying mechanisms of fucoxanthin on ocular lesions, we investigated the beneficial effects and mechanisms by which fucoxanthin ameliorates ultraviolet B (UVB)-induced corneal denervation and trigeminal pain. Treatment with fucoxanthin enhanced the expression of nuclear factor erythroid 2-related factor 2 in the cornea. Inhibition of typical denervation and epithelial exfoliation in the cornea were observed in rats treated with fucoxanthin following UVB-induced nerve disorders. Moreover, the active phosphorylated form of p38 MAP kinase (pp38) and the number of glial fibrillary acidic protein (GFAP)-positive neural cells were significantly reduced. Decreased expression of neuron-selective transient receptor potential vanilloid type 1 (TRPV1) in the trigeminal ganglia neurons was also demonstrated in rats treated with fucoxanthin after UVB-induced keratitis. Symptoms of inflammatory pain, including difficulty in opening the eyes and eye wipe behaviour, were also reduced in fucoxanthin-treated groups. Pre-treatment with fucoxanthin may protect the eyes from denervation and inhibit trigeminal pain in UVB-induced photokeratitis models.
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Affiliation(s)
- Shiu-Jau Chen
- Department of Neurosurgery, Mackay Memorial Hospital, Taipei 10449, Taiwan.
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan.
| | - Ching-Ju Lee
- Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei 24213, Taiwan.
- Department of Business Administration, National Taipei University, New Taipei 24741, Taiwan.
| | - Tzer-Bin Lin
- Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11049, Taiwan.
| | - Hsien-Yu Peng
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan.
| | - Hsiang-Jui Liu
- Department of Optometry, Mackay Junior College of Medicine, Nursing and Management, New Taipei 11260, Taiwan.
| | - Yu-Shan Chen
- Department of Business Administration, National Taipei University, New Taipei 24741, Taiwan.
| | - Kuang-Wen Tseng
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan.
- School of Life Science, National Taiwan Normal University, Taipei 10610, Taiwan.
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21
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Notara M, Behboudifard S, Kluth MA, Maßlo C, Ganss C, Frank MH, Schumacher B, Cursiefen C. UV light-blocking contact lenses protect against short-term UVB-induced limbal stem cell niche damage and inflammation. Sci Rep 2018; 8:12564. [PMID: 30135547 PMCID: PMC6105637 DOI: 10.1038/s41598-018-30021-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 07/16/2018] [Indexed: 11/09/2022] Open
Abstract
UVB irradiation has been linked to pathogenesis of pterygium, a conjunctival tumor growing onto transparent cornea, the windscreen of the eye. Due to corneal anatomy, ambient UVB irradiation is amplified at the stem cell-containing nasal limbus. The aim of this study was to analyse the effect of a UV-blocking contact lens (UVBCL, senofilcon A, Class 1 UV blocker) on limbal epithelial cells and fibroblasts under UVB irradiation compared to a non-UVB-blocking contact lens. UVBCL prevented UVB-induced DNA damage (as assessed by cyclobutane pyrimidine dimer immunostaining) as well as a decrease in proliferation and scratch wound closure rate of both limbal epithelial and fibroblast cells. Similarly, UVBCL protected limbal epithelial cells from UVB-induced loss of their phenotype in terms of colony forming efficiency and stem cell marker expression (ABCB5, P63α, integrin β1) compared to controls. Moreover, with UVBCL pro-inflammatory cytokines such as TNFα and MCP1 remained unchanged. These data demonstrate the significance of UV-protection in preserving the limbal niche in response to at least short-term UVB. Our data support the use of UVBCL in protecting limbal niche cells, especially after limbal stem cell transplantation and in patients after pterygium surgery, to help prevent recurrences.
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Affiliation(s)
- M Notara
- Department of Ophthalmology, University of Cologne, Cologne, Germany.
| | - S Behboudifard
- Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - M A Kluth
- TICEBA GmbH, Im Neuenheimer Feld 517, Heidelberg, Germany
- RHEACELL GmbH & Co. KG, Im Neuenheimer Feld 517, Heidelberg, Germany
| | - C Maßlo
- TICEBA GmbH, Im Neuenheimer Feld 517, Heidelberg, Germany
- RHEACELL GmbH & Co. KG, Im Neuenheimer Feld 517, Heidelberg, Germany
| | - C Ganss
- TICEBA GmbH, Im Neuenheimer Feld 517, Heidelberg, Germany
- RHEACELL GmbH & Co. KG, Im Neuenheimer Feld 517, Heidelberg, Germany
| | - M H Frank
- Transplant Research Program, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
- School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - B Schumacher
- Institute for Genome Stability in Ageing and Disease, CECAD Research Center, Joseph-Stelzmann-Str. 26, 50931, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMK), University of Cologne, Cologne, Germany
| | - C Cursiefen
- Department of Ophthalmology, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMK), University of Cologne, Cologne, Germany
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22
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Indications and Outcomes of Helicopter Rescue Missions in Alpine Mountain Huts: A Retrospective Study. High Alt Med Biol 2017; 18:355-362. [DOI: 10.1089/ham.2017.0051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Laggner M, Pollreisz A, Schmidinger G, Schmidt-Erfurth U, Chen YT. Autophagy mediates cell cycle response by regulating nucleocytoplasmic transport of PAX6 in limbal stem cells under ultraviolet-A stress. PLoS One 2017; 12:e0180868. [PMID: 28700649 PMCID: PMC5507275 DOI: 10.1371/journal.pone.0180868] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 06/22/2017] [Indexed: 01/09/2023] Open
Abstract
Limbal stem cells (LSC) account for homeostasis and regeneration of corneal epithelium. Solar ultraviolet A (UVA) is the major source causing oxidative damage in the ocular surface. Autophagy, a lysosomal degradation mechanism, is essential for physiologic function and stress defense of stem cells. PAX6, a master transcription factor governing corneal homeostasis by regulating cell cycle and cell fate of LSC, responds to oxidative stress by nucleocytoplasmic shuttling. Impaired autophagy and deregulated PAX6 have been reported in oxidative stress-related ocular surface disorders. We hypothesize a functional role for autophagy and PAX6 in LSC’s stress response to UVA. Therefore, human LSC colonies were irradiated with a sub-lethal dose of UVA and autophagic activity and intracellular reactive oxygen species (ROS) were measured by CYTO-ID assay and CM-H2DCFDA live staining, respectively. Following UVA irradiation, the percentage of autophagic cells significantly increased in LSC colonies while intracellular ROS levels remained unaffected. siRNA-mediated knockdown (KD) of ATG7 abolished UVA-induced autophagy and led to an excessive accumulation of ROS. Upon UVA exposure, LSCs displayed nuclear-to-cytoplasmic translocation of PAX6, while ATG7KD or antioxidant pretreatment largely attenuated the intracellular trafficking event. Immunofluorescence showing downregulation of proliferative marker PCNA and induction of cell cycle regulator p21 indicates cell cycle arrest in UVA-irradiated LSC. Abolishing autophagy, adenoviral-assisted restoration of nuclear PAX6 or antioxidant pretreatment abrogated the UVA-induced cell cycle arrest. Adenoviral expression of an ectopic PAX gene, PAX7, did not affect UVA cell cycle response. Furthermore, knocking down PAX6 attenuated the cell cycle progression of irradiated ATG7KD LSC by de-repressing p21 expression. Collectively, our data suggest a crosstalk between autophagy and PAX6 in regulating cell cycle response of ocular progenitors under UVA stress. Autophagy deficiency leads to impaired intracellular trafficking of PAX6, perturbed redox balance and uncurbed cell cycle progression in UVA-stressed LSCs. The coupling of autophagic machinery and PAX6 in cell cycle regulation represents an attractive therapeutic target for hyperproliferative ocular surface disorders associated with solar radiation.
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Affiliation(s)
- Maria Laggner
- Department of Ophthalmology & Optometry, Medical University of Vienna, Vienna, Austria
| | - Andreas Pollreisz
- Department of Ophthalmology & Optometry, Medical University of Vienna, Vienna, Austria
| | - Gerald Schmidinger
- Department of Ophthalmology & Optometry, Medical University of Vienna, Vienna, Austria
| | | | - Ying-Ting Chen
- Department of Ophthalmology & Optometry, Medical University of Vienna, Vienna, Austria
- * E-mail:
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Gilani CJ, Yang A, Yonkers M, Boysen-Osborn M. Differentiating Urgent and Emergent Causes of Acute Red Eye for the Emergency Physician. West J Emerg Med 2017; 18:509-517. [PMID: 28435504 PMCID: PMC5391903 DOI: 10.5811/westjem.2016.12.31798] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 12/30/2016] [Indexed: 11/22/2022] Open
Abstract
Patients commonly present with an acute red eye to the emergency department (ED). It is important to distinguish between benign and sight-threatening diagnoses. Here we provide a comprehensive overview on the acute red eye in the ED.
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Affiliation(s)
| | - Allen Yang
- Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, California
| | - Marc Yonkers
- University of California, Irvine, Medical Center, Gavin Herbert Eye Institute, Department of Ophthalmology, Irvine, California
| | - Megan Boysen-Osborn
- University of California, Irvine, Medical Center, Department of Emergency Medicine, Orange, California
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Fan C, Zhao Y, Yu Q, Yin W, Liu H, Lin J, Yang T, Fan M, Gesang L, Zhang J. Reversible Brain Abnormalities in People Without Signs of Mountain Sickness During High-Altitude Exposure. Sci Rep 2016; 6:33596. [PMID: 27633944 PMCID: PMC5025655 DOI: 10.1038/srep33596] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 08/30/2016] [Indexed: 01/23/2023] Open
Abstract
A large proportion of lowlanders ascending to high-altitude (HA) show no signs of mountain sickness. Whether their brains have indeed suffered from HA environment and the persistent sequelae after return to lowland remain unknown. Thirty-one sea-level college students, who had a 30-day teaching on Qinghai-Tibet plateau underwent MRI scans before, during, and two months after HA exposure. Brain volume, cortical structures, and white matter microstructure were measured. Besides, serum neuron-specific enolase (NSE), C-reactive protein, and interleukin-6 and neuropsychiatric behaviors were tested. After 30-day HA exposure, the gray and white matter volumes and cortical surface areas significantly increased, with cortical thicknesses and curvatures changed in a wide spread regions; Anisotropy decreased with diffusivities increased in multiple sites of white matter tracts. Two months after HA exposure, cortical measurements returned to basal level. However, increased anisotropy with decreased diffusivities was observed. Behaviors and serum inflammatory factor did not significant changed during three time-point tests. NSE significantly decreased during HA but increased after HA exposure. Results suggest brain swelling occurred in people without neurological signs at HA, but no negative sequelae in cortical structures and neuropsychiatric functions were left after the return to lowlands. Reoxygenation changed white matter microstructure.
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Affiliation(s)
- Cunxiu Fan
- Department of Physiology, Medical College of Xiamen University, Xiamen 361102, Fujian, China
| | - Yuhua Zhao
- Institute of high altitude medicine, Tibet Autonomous Region People’s Hospital, Lasa 850000, Tibet Autonomous Region, China
| | - Qian Yu
- Department of Physiology, Medical College of Xiamen University, Xiamen 361102, Fujian, China
| | - Wu Yin
- Department of Radiology, Tibet Autonomous Region People’s Hospital, Lasa 850000, Tibet Autonomous Region, China
| | - Haipeng Liu
- Department of Radiology, Tibet Autonomous Region People’s Hospital, Lasa 850000, Tibet Autonomous Region, China
| | - Jianzhong Lin
- Magnetic Resonance Center, Zhongshan Hospital Xiamen University, Xiamen 361004, Fujian, China
| | - Tianhe Yang
- Magnetic Resonance Center, Zhongshan Hospital Xiamen University, Xiamen 361004, Fujian, China
| | - Ming Fan
- Department of Brain Protection and Plasticity, Institute of Basic Medical Sciences, Beijing 100850, China
| | - Luobu Gesang
- Institute of high altitude medicine, Tibet Autonomous Region People’s Hospital, Lasa 850000, Tibet Autonomous Region, China
| | - Jiaxing Zhang
- Department of Physiology, Medical College of Xiamen University, Xiamen 361102, Fujian, China
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