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Dhawale KK, Tidake P. Cataract Surgery and Mental Health: A Comprehensive Review on Outcomes in the Elderly. Cureus 2024; 16:e65469. [PMID: 39188457 PMCID: PMC11346754 DOI: 10.7759/cureus.65469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 07/26/2024] [Indexed: 08/28/2024] Open
Abstract
Cataract surgery is a widely performed and highly effective procedure that significantly improves vision in elderly patients. This narrative review examines the impact of cataract surgery on mental health outcomes in the elderly, focusing on conditions such as depression, anxiety, and cognitive decline. The review highlights the prevalence of cataracts in older adults and the importance of mental health in this demographic, emphasizing the interconnectedness of visual and mental health. Improved vision following cataract surgery has been associated with enhanced quality of life, increased independence, and better psychological well-being. Mechanisms linking visual improvement to mental health benefits include biological pathways, psychosocial factors, and overall health improvements. However, socioeconomic factors, access to healthcare, and patient education play crucial roles in achieving positive outcomes. This review also compares cataract surgery with other interventions, providing a cost-benefit analysis and discussing the long-term sustainability of mental health benefits. Practice recommendations include pre-surgical mental health screening, integrative care approaches, and guidelines for postoperative care focusing on mental health. The review concludes with suggestions for future research to further explore the relationship between cataract surgery and mental health in the elderly, aiming to enhance clinical practice and public health strategies.
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Affiliation(s)
- Kasturi K Dhawale
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pravin Tidake
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Wang S, Du Z, Lai C, Seth I, Wang Y, Huang Y, Fang Y, Liao H, Hu Y, Yu H, Zhang X. The association between cataract surgery and mental health in older adults: a review. Int J Surg 2024; 110:2300-2312. [PMID: 38668662 PMCID: PMC11020056 DOI: 10.1097/js9.0000000000001105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/08/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Although cataract surgery has been proposed as a potentially modifiable protective factor for enhancing emotional well-being in cataract patients, studies examining the relationship between anxiety or depression and cataract surgery have yielded inconsistent findings. This review summarizes existing evidence to establish whether cataract surgery is associated with depression and anxiety in older adults. METHODS A literature search was conducted across PubMed, Medline, Web of Science, and Embase databases. An initial screening by abstracts and titles was performed, followed by a review and assessment of the methodological quality of the relevant full papers, and final inclusion of 44 studies were deemed eligible for inclusion in this review. RESULTS Among 44 included studies, 36 studies (81.8%) were observational studies concerning the association of cataract surgery or cataracts with anxiety or depression, four studies (9.1%) were interventional studies, and four studies (9.1%) were reviews. Cataract surgery notably enhances the mental health of individuals with impaired vision. However, the multifaceted nature of psychological well-being, influenced by various factors, suggests that cataract surgery may not address all aspects comprehensively. Additionally, preoperative anxiety and depression significantly impact cataract surgery outcomes. CONCLUSION Vision impairment in older adults is closely associated with increased symptoms of depression and anxiety. While surgical intervention for cataracts improves these symptoms, it might be less effective for mental disorders with multifactorial causes. Notably, anxiety or depression poses challenges to successful preoperative and intraoperative cataract surgeries.
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Affiliation(s)
- Shan Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Zijing Du
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Chunran Lai
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Ishith Seth
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
| | - Yaxin Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Yu Huang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
| | - Ying Fang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Huiyi Liao
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Image Analysis and Application, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences
| | - Xiayin Zhang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
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Gerbutavicius R, Merle DA, Wolf A, Dimopoulos S, Kortuem KU, Kortuem FC. User Friendliness and Perioperative Guidance Benefits of a Cataract Surgery Education App: Randomized Controlled Trial. JMIR Form Res 2024; 8:e55742. [PMID: 38551619 PMCID: PMC11015376 DOI: 10.2196/55742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Cataract surgeries are among the most performed surgeries worldwide. A thorough patient education is essential to inform patients about the perioperative process and postoperative target results concerning the intraocular lens and objectives for visual outcomes. However, addressing all relevant aspects and questions is time-consuming. Mobile apps can facilitate this process for both patients and physicians and thus be beneficial. However, the success of such an app depends on its user friendliness and acceptance by patients. OBJECTIVE This study aimed to evaluate the user friendliness and acceptance of a cataract surgery education app on mobile devices among patients undergoing cataract surgery, the characteristics of patients who benefit the most from app use, and the influence of the app on patient satisfaction with treatment. METHODS All patients who underwent cataract surgery at an ophthalmological practice from August 2020 to July 2021 were invited to participate in this randomized controlled trial. Out of 493 invited patients, 297 (60.2%) were enrolled in this study. Patients were randomized into 3 different groups. Half of the patients were offered to participate in Group 1 with use of the "Patient Journey" app. However, if they decided not to use the app, they were included in Group 2 (app denial). The other half of the patients were included in Group 3 (control) with no use of the app and with information provided conventionally. The app provided general information on the ophthalmological center, surgeons, cataract, and treatment options. Different questionnaires were used in all 3 groups to evaluate satisfaction with the perioperative process. Group 1 evaluated the app. Demographic characteristics, such as age, gender, and educational degree, were assessed. RESULTS Group 1 included 77 patients (median age 69 years). Group 2 included 61 patients, and their median age was higher (median age 79 years). Group 3 included 159 patients (median age 74 years). There was no difference in satisfaction with the perioperative process and clinic between the 3 groups. Almost all app users appreciated the digital details provided for the organization and the information on the surgery. Age did not play a major role in appreciation of the app. Female patients tended to appreciate the information provided more than male patients. Patients who did not have a higher university degree experienced more benefits from the informational content of the app and were the most satisfied with the information. However, male patients and academics were in general more aware of technology and handled the app more easily. CONCLUSIONS The app showed high user friendliness and acceptance, and could particularly benefit specific patient groups. App users demonstrated a noninferior high satisfaction with the treatment in the ophthalmological center in comparison with patients who were informed about the surgery only conventionally.
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Affiliation(s)
- Rokas Gerbutavicius
- Department for Ophthalmology, University of Tuebingen, Tuebingen, Germany
- University Eye Hospital, University of Ulm, Ulm, Germany
| | - David A Merle
- Department for Ophthalmology, University of Tuebingen, Tuebingen, Germany
- Institute for Ophthalmic Research, Center for Ophthalmology, University of Tuebingen, Tuebingen, Germany
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | - Armin Wolf
- University Eye Hospital, University of Ulm, Ulm, Germany
| | | | - Karsten Ulrich Kortuem
- University Eye Hospital, University of Ulm, Ulm, Germany
- Augenarztpraxis Dres. Kortuem, Ludwigsburg, Germany
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Vishwakarma P, Sundararaj L, Chavan S, Mondal A, Ranpise D, Sudhir RR, Kumar SGP, Kurian E. Spectacle compliance postcataract surgery significantly improved vision function-related quality of life of adult patients in India: Evidence from a multicenter longitudinal cohort study. Oman J Ophthalmol 2023; 16:500-508. [PMID: 38059111 PMCID: PMC10697246 DOI: 10.4103/ojo.ojo_234_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Cataract is the leading cause of avoidable blindness globally. This study aims to measure the changes in Vision function-related quality of life (VFQoL) before and after cataract surgery and identify the predictors of an improvement in these outcomes. METHODS A multicenter, longitudinal cohort study was conducted. Patients with first eye cataracts were interviewed before and 6 months after cataract surgery. Multiple classification analysis (MCA) was performed to assess variation in the intensities of mean change scores for general function, psychosocial impact, and visual function with select factors. RESULTS A total of 747 participated in the baseline assessment. The 6-month follow-up rate was 86.5%. The mean general function, psychosocial impact, and visual function scores were 35.3 (±8.6), 12.5 (±3.4), and 8.3 (±3) in the baseline and 17 (±5.3), 6 (±2.2) and 3.8 (±1.3) in the follow-up assessments, respectively. In MCA, patients using spectacles postsurgery (β 0.111) and those having a very good postoperative visual acuity (β 0.098) had the most impact on general function. Patients reporting no ocular complaints postsurgery had a relatively higher effect on the psychosocial impact, (β 0.168) and similarly, patients using spectacles postsurgery and those aged 70 and older had the most impact on the visual function scores (β 0.146 and 0.126), respectively. CONCLUSION Cataract surgery is associated with meaningful improvements in vision and VFQoL in general. The determinants of better VFQoL include the usage of spectacles postsurgery. Strategies to further improve patient participation in postoperative review visits are needed for spectacle provision and patient education regarding spectacle use and compliance is imparted during such visits.
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Affiliation(s)
| | | | | | | | | | - Rachapalle Reddi Sudhir
- Department of Preventive Ophthalmology, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Harutyunyan T, Giloyan A, Petrosyan V. Health-Related Quality of Life after Cataract Surgery in Armenia: A Cross-Sectional Survey. Healthcare (Basel) 2023; 11:2429. [PMID: 37685463 PMCID: PMC10487762 DOI: 10.3390/healthcare11172429] [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: 06/12/2023] [Revised: 08/14/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
Cataract surgery helps to enhance visual function and improve the quality of life of cataract patients. The present study assessed visual outcomes and explored health-related quality of life (HRQoL) and factors associated with it following cataract surgery in Armenia. An interviewer-administered survey along with the ophthalmologic examination was conducted among 248 patients. It explored socio-demographic characteristics, use of eye care services, smoking status, comorbidities, and receiving and giving social support. A Short Form Health Survey (SF-36) was used to measure HRQoL. Simple and multivariable linear regression was used for the analysis. About 72.8% of examined eyes had good visual outcomes, while 17.7% had borderline outcomes. Poor visual outcomes were detected in 9.5% of the eyes. The mean composite SF-36 score for physical health was 50.8, while the mean composite score for mental health was 49.9. Gender, socioeconomic status, having a non-communicable disease, and receiving and giving tangible social support were significantly associated with SF-36 physical component in the adjusted analysis, while the variables which demonstrated significant association with the mental component included socioeconomic status, having a non-communicable disease, and giving tangible support. The visual outcome after cataract surgery in Armenian patients is below WHO-recommended standards. The quality of ophthalmological surgical care should be monitored to maximize the visual outcome in Armenian patients, with a focus on women, patients with poor socioeconomic status, and those with non-communicable diseases.
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Affiliation(s)
- Tsovinar Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan 0019, Armenia; (A.G.); (V.P.)
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Deng R, Zhu Z, Han X, Shang X, He M, Xu G, Chen Z, Fan H. Evaluation of Systemic Medications Associated With Surgically Treated Cataract Among US Adults. Am J Ophthalmol 2023; 249:126-136. [PMID: 36646239 DOI: 10.1016/j.ajo.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/24/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023]
Abstract
PURPOSE To comprehensively determine the associations between systemic medications and surgically treated cataract in the US population. DESIGNS Retrospective cross-sectional study. METHODS Participants aged ≥40 years from the 1999-2008 National Health and Nutrition Examination Survey (NHANES) were included. Surgically treated cataract was defined as cataract requiring a procedure. Data on prescription drug use over the past 30 days were collected via home interviews. Drug categories for ophthalmic indications and those prescribed in less than 0.5% of the participants were excluded from the analysis. Separate logistic regression models were used to explore associations between each drug category and surgically treated cataract. The Benjamin-Hochberg procedure was used to control the false discovery rate. RESULTS A total of 14,931 were included in the present analysis. The weighted prevalence of surgically treated cataract was 9.6% (n=2010). We identified 20 drug categories that had significant associations with surgically treated cataract, of which 8 associations remained statistically significant after further adjustment for pertinent comorbidities. The 3 drug categories with the highest odds ratio (OR) values were tricyclic antidepressants (OR, 2.21; 95% CI, 1.38-3.51; P = .001), insulin (OR, 2.13; 95% CI, 1.48-3.07; P = 9.41×10-5) and group III antiarrhythmic agents (OR, 2.00; 95% CI, 1.25-3.19; P = .004). The use of sex hormone combinations among women reduced the risk of having surgically treated cataract (OR, 0.011; 95% CI, 0.001-0.089; P = 5.98×10-5). Dose-response relationships were observed for all 8 drug categories. CONCLUSIONS Our comprehensive evaluation provides new knowledge on the complex relationships between systemic medications and surgically treated cataract.
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Affiliation(s)
- Ruidong Deng
- From the Department of Ophthalmology, Huizhou Central People's Hospital (R.D., G.X., Z.C., H.F.), Huizhou, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Z.Z., X.H., X.S., M.H.), Guangzhou, China; Ophthalmology, Department of Surgery, University of Melbourne (Z.Z., M.H.), Melbourne, Australia
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Z.Z., X.H., X.S., M.H.), Guangzhou, China
| | - Xianwen Shang
- Ophthalmology, Department of Surgery, University of Melbourne (Z.Z., M.H.), Melbourne, Australia
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Z.Z., X.H., X.S., M.H.), Guangzhou, China; Ophthalmology, Department of Surgery, University of Melbourne (Z.Z., M.H.), Melbourne, Australia
| | - Guihua Xu
- From the Department of Ophthalmology, Huizhou Central People's Hospital (R.D., G.X., Z.C., H.F.), Huizhou, China
| | - Zilin Chen
- From the Department of Ophthalmology, Huizhou Central People's Hospital (R.D., G.X., Z.C., H.F.), Huizhou, China
| | - Huiya Fan
- From the Department of Ophthalmology, Huizhou Central People's Hospital (R.D., G.X., Z.C., H.F.), Huizhou, China.
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Sankarananthan R, Prasad S, Shekhar M, Narendran S, Balakrishnan L, Rathinam SR. Outcomes of cataract surgery in patients with Human Immunodeficiency Virus infection in a developing country. Int Ophthalmol 2022; 43:1601-1609. [PMID: 36273361 DOI: 10.1007/s10792-022-02559-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To report the outcomes of cataract surgery in patients with Human Immunodeficiency Virus (HIV) infection. Setting Tertiary care ophthalmic hospital DESIGN: Retrospective study METHODS: This study included all eyes of patients with known HIV infection undergoing cataract surgery with a minimum follow-up of 6 months between January 2017 and December 2020. Patients who underwent combined surgeries and pediatric patients were excluded from analysis. Data were retrieved from electronic medical records and we documented demographics, history, detailed anterior and posterior segment examination, pre-operative grade and type of cataract, type of surgery done, its complication and post-operative course. All these parameters were recorded at the baseline visit and at 1 month and 6 months postoperatively. RESULTS One hundred and twenty nine eyes of 107 HIV infected patients that underwent cataract surgery were evaluated. Mature cataract was seen in 31% of the eyes. Features of HIV related uveitis/retinitis were seen in 21 (16.2%) eyes. Phacoemulsification was performed in 44 (34.1%) eyes while manual small incision cataract surgery (MSICS) was done in 85 (65.9%) eyes. Intra-operative complications were encountered in 4 (3.1%) eyes. At the final follow-up, there was a significant improvement in median corrected distance visual acuity (CDVA) from LogMAR 1.08 (5/60) at baseline to LogMAR 0 (6/6) at 6 months follow-up. CONCLUSION Patients with HIV infection usually present early and with advanced cataracts. Visual outcomes after cataract surgery are generally good but affected by presence of prior HIV related uveitis or retinitis.
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Affiliation(s)
- R Sankarananthan
- Department of Intraocular Lens and Cataract Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India
| | - Senthil Prasad
- Department of Intraocular Lens and Cataract Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India
| | - Madhu Shekhar
- Department of Intraocular Lens and Cataract Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India.
| | - Siddharth Narendran
- Department of Intraocular Lens and Cataract Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Coimbatore, India
| | | | - S R Rathinam
- Department of Uvea Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India
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Kutzner BL, Ring M, Michelson G. [Binocular vision training for professional athletes]. Ophthalmologe 2022; 119:721-729. [PMID: 35107596 DOI: 10.1007/s00347-022-01574-x] [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: 07/08/2021] [Revised: 01/01/2022] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Optimal visual abilities including stereo acuity seem to be an important issue in sports. There is increasing evidence that stereo acuity can be sustainably improved by digital vision training even for people with good stereo acuity. STUDY DESIGN AND TEST METHODS In this study 31 male and female tennis players (professionals, young professionals, coaches and former professionals) completed at least 6 training units each with 192 dynamic stereoscopic tasks (N = 1152) within 6 weeks including a 4-option test with different levels of difficulty on a 3D screen at a distance of 5 m. The parameter reaction time and correctness at 15-300 arcseconds was determined. For a more precise representation of the reaction time improvement as a function of the difficulty level, the parameter reaction time increase per stereo disparity reduction (ReST) was defined. RESULTS Reaction time to 15 arcsecond stimuli significantly decreased from 3.9 s to 1.6 s (59%) as a result of digital vision training. The correctness at 30 arcsecond stimuli significantly increased by 23%. DISCUSSION The observed improvement in reaction time during vision training did not result in decreasing correctness when answering the visual questions. This represents an overall improvement in stereo vision. CONCLUSION Dynamic visual training over 6 weeks improves stereoscopic performance including stereo acuity, response time and correctness.
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Affiliation(s)
- Benedikt L Kutzner
- Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Deutschland.
| | - Matthias Ring
- Department Artificial Intelligence in Biomedical Engineering (AIBE), Lehrstuhl für Maschinelles Lernen und Datenanalytik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Carl-Thiersch-Str. 2b, 91052, Erlangen, Deutschland.
| | - Georg Michelson
- Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Deutschland.
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Sánchez RF, García-Guerra CE, Martínez-Roda JA, de Paul AG, Issolio LA, Pujol J. Implementation of the Frequency Scatter Index in Clinical Commercially Available Double-pass Systems. Curr Eye Res 2021; 47:391-398. [PMID: 34738850 DOI: 10.1080/02713683.2021.2002908] [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
A previous work has reported a methodology to quantify intraocular scattering using a high sensitivity double-pass instrument with a robust index, the frequency scatter index. The purpose of our study was to evaluate an adaptation of the frequency scatter index for use in clinical double-pass systems. A prospective observational study was carried out in a group of patients with nuclear cataracts (n = 52) and in a control group (n = 11) using conventional double-pass systems. The frequency scatter index and the objective scatter index were used to assess the scattering. The Spearman coefficient was calculated to assess the correlation between both indexes, obtained from the double-pass images. Simultaneous measurements were performed with a double-pass and with a Hartmann-Shack wavefront sensor in the control group. The root-mean-square wavefront error and the full width at half maximum of the double-pass image were used to quantify the residual aberrations introduced by the variations in pupil size and retinal eccentricity. Measurement in eyes with different grades of cataracts shows a strong correlation (ρ = 0.929, p < .0001) between the frequency scatter index and the objective scatter index. A certain degree of correlation was observed between the objective scatter index and the root-mean-square and between the objective scatter index and the full width at half maximum, both for measurements with a different pupillary diameter and with a different retinal eccentricity (p < .05). No relationship was observed between the frequency scatter index and the root-mean-square or between the frequency scatter index and the full width at half maximum (p > .05). We have introduced and evaluated an adaptation of a methodology proposed recently for the measurement of intraocular scattering using the double-pass technique with a robust index, which is less affected by ocular aberrations. The frequency scatter index can be applied to conventional double-pass instruments available in clinical environments.
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Affiliation(s)
- Roberto F Sánchez
- Instituto de Investigación en Luz, Ambiente y Visión, CONICET-UNT, Tucumán, Argentina
| | - Carlos E García-Guerra
- Centre de Desenvolupament de Sensors, Instrumentació i Sistemes, Universitat Politecnica de Catalunya, Barcelona, España
| | - Joan A Martínez-Roda
- Centre de Desenvolupament de Sensors, Instrumentació i Sistemes, Universitat Politecnica de Catalunya, Barcelona, España
| | - Aníbal G de Paul
- Instituto de Investigación en Luz, Ambiente y Visión, CONICET-UNT, Tucumán, Argentina
| | - Luis A Issolio
- Instituto de Investigación en Luz, Ambiente y Visión, CONICET-UNT, Tucumán, Argentina.,Departamento de Luminotecnia, Luz y Visión, Universidad Nacional de Tucumán, Tucumán, Argentina
| | - Jaume Pujol
- Centre de Desenvolupament de Sensors, Instrumentació i Sistemes, Universitat Politecnica de Catalunya, Barcelona, España
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Mehta H. Management of Cataract in Patients with Age-Related Macular Degeneration. J Clin Med 2021; 10:2538. [PMID: 34201114 PMCID: PMC8228734 DOI: 10.3390/jcm10122538] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022] Open
Abstract
Cataract and age-related macular degeneration (AMD) are two of the most common eye diseases of aging. This review addresses the pre-operative, intra-operative, and post-operative considerations in managing cataract in patients with age-related macular degeneration. Surgery for visually significant cataracts in patients with AMD can substantially improve the quality of life and reduce the risk of falls. Pre-operative optical coherence tomography is now recommended where possible to identify pre-existing macula disease. Careful counselling of patients is required before cataract surgery, especially with respect to the expected visual outcome, intraocular lens choice and potential risks of surgery. Real-world data has suggested 6 months of intravitreal anti-VEGF therapy for neovascular AMD before cataract surgery is compatible with optimum long-term visual outcomes. Patients receiving intravitreal therapy for neovascular AMD should be advised of the slightly higher risk of intraoperative complications and the surgeon should be prepared to manage these during the operation. During cataract surgery, unnecessary light exposure should be avoided to reduce phototoxicity. Careful planning of intravitreal therapy for neovascular AMD just before cataract surgery allows the eye greater recovery time in the post-operative period before further planned intravitreal therapy.
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Affiliation(s)
- Hemal Mehta
- Save Sight Registries, University of Sydney, Sydney, NSW 2000, Australia;
- Strathfield Retina Clinic, Strathfield, Sydney, NSW 2135, Australia
- Ophthalmology Department, Royal Free London NHS Foundation Trust, London NW3 2QG, UK
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Chen AX, Haueisen A, Rasendran C, Hom GL, Conti TF, Conti FF, Greenlee TE, Briskin IN, Bena JF, Singh RP, Talcott KE. Visual outcomes following cataract surgery in age-related macular degeneration patients. Can J Ophthalmol 2021; 56:348-354. [PMID: 33609442 DOI: 10.1016/j.jcjo.2021.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate visual acuity (VA) outcomes, prognostic factors, and changes in disease severity in patients with age-related macular degeneration (AMD) undergoing cataract surgery. DESIGN Retrospective cohort study PARTICIPANTS: Patients with AMD or healthy control patients who underwent cataract surgery between 2012 and 2017. METHODS Eyes were categorized into 3 AMD groups-intermediate AMD (iAMD), fovea-involving geographic atrophy (GA), neovascular AMD (nAMD)-and 3 preoperative VA-matched control groups (iAMDc), fovea-involving geographic atrophy control (GAc), neovaascular AMD control (nAMDc). RESULTS We compared 216 iAMD, 35 GA, and 184 nAMD eyes with 130, 31, and 129 controls. At postoperative month 12 (POM12), VA increased significantly in iAMD and nAMD (+10.1 ± 14.5 and +9.7 ± 18.9 letters, p < 0.001), but not in GA (p = 0.68). All control groups showed significant VA gains (iAMDc: +17.1 ± 9.7, GAc: +30 ± 12.9, and nAMDc: +26.4 ± 15.6 letters, p < 0.001). For AMD groups, POM12 VA and gain in VA were significantly lower than that of controls (p < 0.01), and better preoperative VA predicted smaller VA gains (p ≤ 0.007). Longer duration of AMD in iAMD, ellipsoid zone disruption in nAMD, and lower central subfield thickness in GA were associated with poorer VA outcomes (p < 0.05). Development of nAMD occurred in 8 iAMD eyes and was associated with longer duration of disease (p = 0.001). For nAMD eyes, injection frequency did not vary between the 12-month pre- and postoperative periods (p = 0.051). CONCLUSIONS Cataract surgery improves VA for patients with iAMD and nAMD, albeit not to the level of those without retinal pathology. Preoperative VA, AMD duration, and optical coherence tomography parameters may be important prognostic factors for cataract surgery in patients with AMD.
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Affiliation(s)
- Andrew X Chen
- Case Western Reserve University School of Medicine, Cleveland, Ohio; Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | | | | | - Grant L Hom
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Thais F Conti
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Felipe F Conti
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Tyler E Greenlee
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Isaac N Briskin
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
| | - James F Bena
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Rishi P Singh
- Case Western Reserve University School of Medicine, Cleveland, Ohio; Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Katherine E Talcott
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
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12
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Deardorff WJ, Sloane RJ, Pavon JM, Hastings SN, Whitson HE. Hospitalization Risk Among Older Adults with Sensory Impairments: Development of a Prognostic Model. J Am Geriatr Soc 2020; 68:2650-2655. [PMID: 32852787 DOI: 10.1111/jgs.16800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/21/2020] [Accepted: 08/03/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To develop a prognostic model for hospital admissions over a 1-year period among community-dwelling older adults with self-reported hearing and/or vision impairments based on readily obtainable clinical predictors. DESIGN Retrospective cohort study. SETTING Medicare Current Beneficiary Survey from 1999 to 2006. PARTICIPANTS Community-dwelling Medicare beneficiaries, aged 65 years and older, with self-reported hearing and/or vision impairment (N = 15,999). MEASUREMENTS The primary outcome was any hospital admission over a predefined 1-year study period. Candidate predictors included demographic factors, prior healthcare utilization, comorbidities, functional impairment, and patient-level factors. We analyzed the association of all candidate predictors with any hospital admission over the 1-year study period using multivariable logistic regression. The final model was created using a penalized regression method known as the least absolute shrinkage and selection operator. Model performance was assessed by discrimination (concordance statistic (c-statistic)) and calibration (evaluated graphically). Internal validation was performed via bootstrapping, and results were adjusted for overoptimism. RESULTS Of the 15,999 participants, the mean age was 78 years and 55% were female. A total of 2,567 participants (16.0%) had at least one hospital admission in the 1-year study period. The final model included seven variables independently associated with hospitalization: number of inpatient admissions in the previous year, number of emergency department visits in the previous year, activities of daily living difficulty score, poor self-rated health, and self-reported history of myocardial infarction, stroke, and nonskin cancer. The c-statistic of the final model was 0.717. The optimism-corrected c-statistic after bootstrap internal validation was 0.716. A calibration plot suggested that the model tended to overestimate risk among patients at the highest risk for hospitalization. CONCLUSION This prognostic model can help identify which community-dwelling older adults with sensory impairments are at highest risk for hospitalization and may inform allocation of healthcare resources.
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Affiliation(s)
- William J Deardorff
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Richard J Sloane
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina
| | - Juliessa M Pavon
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina.,Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina.,Geriatrics Research Education and Clinical Center, Durham Veterans Affairs Health Care System, Durham, North Carolina
| | - Susan N Hastings
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina.,Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina.,Geriatrics Research Education and Clinical Center, Durham Veterans Affairs Health Care System, Durham, North Carolina.,Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Heather E Whitson
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina.,Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina.,Geriatrics Research Education and Clinical Center, Durham Veterans Affairs Health Care System, Durham, North Carolina.,Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
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Aggarwal S, Knight DK, Shumway CL, Wade M, Crow RW. Visual acuity after cataract surgery in patients with optic neuropathies. Acta Ophthalmol 2019; 97:e514-e518. [PMID: 30511418 DOI: 10.1111/aos.13959] [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: 05/09/2018] [Accepted: 09/27/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare visual acuity outcomes of cataract surgery between patients with and without non-glaucomatous optic neuropathies. METHODS Retrospective case-control study of patients with and without optic neuropathies who underwent cataract surgery from 2010 to 2017. For all eyes, the last preoperative best corrected visual acuity (BCVA) and first BCVA greater than 1 month postoperatively (to ensure sustained refractive stabilization) were recorded in logarithm of the minimum angle of resolution (logMAR) units. RESULTS Thirty patients (42 eyes) with optic neuropathies and 30 control patients (42 eyes) underwent uncomplicated cataract surgery. The mean age at surgery was significantly younger in the optic neuropathy group (64 versus 71.2 years, p < 0.01). The mean improvement in visual acuity in the optic neuropathy group was 0.4 ± 0.6 logMAR units (roughly 4 Snellen lines) from 0.7 ± 0.8 units preoperatively to 0.3 ± 0.5 postoperatively. Between the cases and controls, there was no significant difference in preoperative BCVA (p = 0.48), postoperative BCVA (p = 0.42), or the mean improvement in BCVA (p = 0.82). When stratified by optic neuropathy subtype, patients with optic neuropathies secondary to multiple sclerosis (n = 12) or non-arteritic ischaemic optic neuropathy (n = 11) had significant improvement in BCVA postoperatively (p < 0.01 and p = 0.03, respectively). CONCLUSION Contrary to what may be expected from such a severe ocular comorbidity, our data suggest that the mean BCVA improvement after cataract surgery in patients with non-glaucomatous optic neuropathies was comparable to that of control patients. Cataract surgery may be performed in patients with both optic neuropathies and advanced cataracts with a reasonable preoperative expectation that visual acuity improvement can be significant.
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Affiliation(s)
- Sahil Aggarwal
- University of California Irvine School of Medicine Irvine CA USA
| | - Darren K. Knight
- Gavin Herbert Eye Institute UC Irvine School of Medicine Irvine CA USA
| | - Caleb L. Shumway
- University of California Irvine School of Medicine Irvine CA USA
| | - Matthew Wade
- Gavin Herbert Eye Institute UC Irvine School of Medicine Irvine CA USA
| | - Robert W. Crow
- Gavin Herbert Eye Institute UC Irvine School of Medicine Irvine CA USA
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Hwang JS, Lee YP, Bae SH, Kim HK, Yi K, Shin YJ. Utility of the optical quality analysis system for decision-making in cataract surgery. BMC Ophthalmol 2018; 18:231. [PMID: 30176839 PMCID: PMC6122688 DOI: 10.1186/s12886-018-0904-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 08/28/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND A cataract is a common cause of vision impairment that requires surgery in older subjects. The Optical Quality Analysis System (OQAS, Visiometrics SL, Terrassa, Spain) assesses the optical quality of the eye in cataract patients. This study shows the role of the optical quality evaluation system for decision-making in cataract surgery. We investigated the clinical utility of the OQAS for decision-making in cataract surgery. METHODS Sixty-seven eyes from 67 patients undergoing cataract surgery and 109 eyes from 109 control subjects were compared. The best corrected visual acuity (BCVA) was measured. The objective scatter index (OSI), modulation transfer function (MTF), Strehl ratio, predicted visual acuity (PVA) 100%, PVA 20%, and PVA 10% were measured using the OQAS. The sensitivity and specificity of the different parameters were analyzed using the receiver operating characteristic (ROC) curve. The main parameters measured were sensitivity and specificity. RESULTS The BCVA, OSI, PVA 100%, PVA 20%, and PVA 10% were higher in the cataract group compared to those in the control group, while the MTF and Strehl ratios were lower (p < 0.001 for all). ROC analysis showed that the OSI had the largest area under the curve and that the sensitivity and specificity of the OSI were 83.9 and 84.6%, respectively, at the optimal cut-off point of 2.35. CONCLUSION The MTF, OSI, Strehl ratio, PVA 100%, PVA 20% and PVA 10% may be useful parameters for preoperative decision-making in cataract surgery. The OSI appears to be the most effective parameter for this purpose.
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Affiliation(s)
- Jin Sun Hwang
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea
| | - Yoon Pyo Lee
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea
| | - Seok Hyun Bae
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea
| | - Ha Kyoung Kim
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea
| | - Kayoung Yi
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea
| | - Young Joo Shin
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea.
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Bains SK, Chapman K, Bright S, Senan A, Kadhim M, Slijepcevic P. Effects of ionizing radiation on telomere length and telomerase activity in cultured human lens epithelium cells. Int J Radiat Biol 2018; 95:54-63. [PMID: 29667481 DOI: 10.1080/09553002.2018.1466066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To investigate the effects of ionizing radiation on telomere length and telomerase activity in human lens epithelial cells. There are studies suggesting evidence of telomere length in association with opacity of the lens; however, these studies have been conducted on Canine Lens cells. Our study was designed to understand further the effects of different doses of ionizing radiation on telomere length and telomerase activity in cultured human lens epithelium cells from three Donors. MATERIALS AND METHODS For this study, embryonic human lens epithelial (HLE) cells from three donors, obtained commercially were cultured. Telomere length and telomerase activity were measured after each passage until cells stopped growing in culture. This was repeated on irradiated (0.001 Gy, 0.01 Gy, 0.02 Gy, 0.1 Gy, 1 Gy and 2 Gy) cells. DNA damage response using the H2AX and telomere dysfunction foci assays were also examined at 30 mins, 24 hours, 48 hours and 72 hours postirradiation. RESULTS AND CONCLUSION We have demonstrated genetic changes in telomere length and oxidative stress, which may be relevant to cataractogenesis. Our study shows that in control cells telomere length increases as passage increases. We have also demonstrated that telomere length increases at higher doses of 1.0 Gy and 2.0 Gy. However, telomerase activity decreases dose dependently and as passages increase. These results are not conclusive and further studies ex vivo measuring lens opacity and telomere length in the model would be beneficial in a bigger cohort, hence confirming a link between telomere length, cataractogenesis and genetic factors.
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Affiliation(s)
- Savneet Kaur Bains
- a Department of Life Sciences , Brunel University London , Uxbridge , UK.,b Department of Biological and Medical Sciences , Oxford Brookes University , Oxford , UK
| | - Kim Chapman
- b Department of Biological and Medical Sciences , Oxford Brookes University , Oxford , UK.,c Oxford Institute of Nursing , Oxford Brookes University , Oxford , UK
| | - Scott Bright
- b Department of Biological and Medical Sciences , Oxford Brookes University , Oxford , UK.,d Department of Radiation Physics , University of Texas, MD Anderson Cancer Center , Houston , TX , USA
| | - Anish Senan
- b Department of Biological and Medical Sciences , Oxford Brookes University , Oxford , UK
| | - Munira Kadhim
- b Department of Biological and Medical Sciences , Oxford Brookes University , Oxford , UK
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Singh RP, Staurenghi G, Pollack A, Adewale A, Walker TM, Sager D, Lehmann R. Efficacy of nepafenac ophthalmic suspension 0.1% in improving clinical outcomes following cataract surgery in patients with diabetes: an analysis of two randomized studies. Clin Ophthalmol 2017; 11:1021-1029. [PMID: 28603408 PMCID: PMC5457150 DOI: 10.2147/opth.s132030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To assess the efficacy of nepafenac 0.1% ophthalmic suspension in improving the clinical outcomes following cataract surgery (CS) in patients with nonproliferative diabetic retinopathy. METHODS In two similar multicenter, randomized studies, patients received either nepafenac 0.1% or vehicle, instilled three times daily starting a day prior to surgery and continuing for 90 days postoperatively. A post hoc analysis of these two studies was conducted to assess 1) the likelihood for development of postoperative macular edema (ME), based on the percentage of patients who developed ME (≥30% increase from preoperative baseline in central subfield macular thickness) within 90 days following CS and 2) best-corrected visual acuity (BCVA) endpoints, including the percentage of patients with a BCVA improvement of ≥15 letters from preoperative baseline to Day 14 and maintained through Day 90. Results for individual studies and their pooled estimates (only visual acuity endpoints) are reported. Primary inference was based on odds ratio (OR). RESULTS This post hoc analysis included 411 patients (nepafenac 0.1%: 205; vehicle: 206). The incidence of postoperative ME within 90 days of CS was notably lower in the nepafenac-treated patients than in vehicle-treated patients (study 1: 3.2% vs 16.7%; OR =0.2, 95% confidence interval [CI] =0.1, 0.5, P=0.001; study 2: 5.0% vs 17.5%; OR =0.2, 95% CI =0.1, 0.8, P=0.018). A higher percentage of nepafenac-treated patients than vehicle-treated patients gained ≥15 letters from preoperative baseline to Day 14, which was maintained through Day 90 (study 1: 38.4% vs 21.4%; OR =2.4, 95% CI =1.4, 4.2, P=0.003; study 2: 35.0% vs 25.0%; OR =1.6, 95% CI =0.8, 3.2, P=0.172; pooled: 37.1% vs 22.8%; OR =2.0, 95% CI =1.3, 3.1, P=0.001). The odds of >5-letter and >10-letter loss in BCVA from postoperative Day 7 were higher in vehicle-treated than in nepafenac-treated patients. CONCLUSION These results support the clinical benefit of prophylactic use of nepafenac 0.1% for reducing the risk of postoperative ME and for improvement in BCVA outcomes following CS in patients with nonproliferative diabetic retinopathy.
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Affiliation(s)
- Rishi P Singh
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Giovanni Staurenghi
- Department of Biomedical and Clinical Science Luigi Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Ayala Pollack
- Ophthalmology Department, Kaplan Medical Center, Rehovot, Israel
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Abstract
PURPOSE To assess the construct validity and responsiveness of the EuroQoL-5D (EQ-5D) instrument in Asian patients undergoing cataract surgery in Singapore. METHODS In this prospective study, English- or Chinese-speaking patients (n = 216) completed the EQ-5D and the VF-14 questionnaires before and 3 months after they underwent cataract surgery. The impact of cataracts on patients was assessed using two standard gamble (SG) questions before surgery. Construct validity of the EQ-5D index and the visual analog scale (VAS) was assessed by examining their correlation with the VF-14 and SG scores. Responsiveness of the EQ-5D was compared with that of the VF-14 in terms of the magnitude of score change associated with cataract surgery. RESULTS We found that the EQ-5D index correlated with VF-14, SG (death), and SG (blindness) (Pearson r = 0.30, 0.23 and 0.24, respectively; p < 0.01). In contrast, we found no correlation between the EQ-VAS, VF-14, and SG scores. The mean EQ-5D index (difference, 0.06; effect size, 0.35) and VF-14 score (difference, 1.75; effect size, 0.97) of patients improved after cataract surgery (p < 0.0001). CONCLUSIONS Our study demonstrated that the EQ-5D utility index is a valid and responsive outcome measure for evaluating the impact of cataract surgery in our Asian population. However, the implications of using the generic EQ-5D instrument to assess the cost-effectiveness of surgical interventions for visual impairment require further investigation.
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Wang CW, Chan CLW, Chi I. Overview of Quality of Life Research in Older People with Visual Impairment. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/aar.2014.32014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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