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Dong Y, Wang A. Health Management Service Models for the Elderly with Visual Impairment: A Scoping Review. J Multidiscip Healthc 2024; 17:2239-2250. [PMID: 38751666 PMCID: PMC11095522 DOI: 10.2147/jmdh.s463894] [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] [Received: 03/07/2024] [Accepted: 05/04/2024] [Indexed: 05/18/2024] Open
Abstract
Background The incidence of visual impairment(VI) in older people is gradually increasing. This review aimed to summarise the evidence on existing health management models and strategies for older adults with VI to improve health-related and vision-related quality of life (QoL) in older people. Methods Based on the framework of the scoping review methodology of Arksey and O'Malley (2005), a comprehensive literature search of relevant literature published between January 2010 and June 2022 in PubMed, CINAHL, EMBASE, Web of Science, Cochrane Library, CNKI, VIP, Wanfang database, Sinomed and the grey literature. Results Finally, 31 articles were included. The health management model had a multidisciplinary team low vision rehabilitation model, medical consortium two-way management model, low vision community comprehensive rehabilitation model, medical consortium-family contract service model, screening-referral-follow-up model, and three-level low vision care model. The health management strategy covers nine aspects, the combination of multi-element strategies is feasible, and network information technology has also shown positive results. Conclusion In the future, under the Internet and hierarchical management model, we should provide demand-based personalized support to rationalize and scientifically achieve hierarchical management and improve resource utilization efficiency and eye health outcomes.
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Affiliation(s)
- Yu Dong
- The First Hospital of China Medical University, Shenyang, People’s Republic of China
| | - Aiping Wang
- The First Hospital of China Medical University, Shenyang, People’s Republic of China
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Chen XY, Wu QR, Xie MY, Zhang D, Zhang C. Bibliometric analysis of research relating to refractive cataract surgery over a 20-year period: from 2003 to 2022. Int J Ophthalmol 2023; 16:1692-1701. [PMID: 37854386 PMCID: PMC10559026 DOI: 10.18240/ijo.2023.10.20] [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: 04/10/2023] [Accepted: 08/01/2023] [Indexed: 10/20/2023] Open
Abstract
AIM To investigate the research trend on refractive cataract surgery, compare the contributions of different countries, institutions, journals, and authors in the past 20y, and explore its potential research hotspots. METHODS All publications were extracted relating to refractive cataract surgery from 2003 to 2022 from Web of Science. Document types were limited to original articles and reviews, and the language was limited to English. Quantitatively and qualitatively of the publications were analyzed through Microsoft Excel and GraphPad Prism. VOSviewer and CiteSpace were used for bibliometric and visualized analysis. RESULTS A total of 2090 publications were enrolled. The United States contributed the most publications (434, 20.8%), followed by China (345, 16.5%) and England (163, 7.80%). Publications from the United States were cited more frequently (9552 citations) with the highest H-index of 48. China ranked second in the total number of publications, the papers were not cited that frequently (3237 citations), and the H-index ranked sixth (H-index=29). Journal of Cataract and Refractive Surgery published the most papers (333, 15.9%), and the University of London had the highest number of publications (75, 3.59%). Dick HB from Germany published the most papers. Corneal astigmatism-related research, cataract surgery method-related research, postoperative visual-quality relate to research, and postoperative complications-relate research are the hotspots in this field. The most significant limitation was that the database was updated frequently and the latest publications were not included. CONCLUSION The bibliometric analysis shows a brief summarization of the contribution of the authors, institutions, countries, and journals. Corneal astigmatism, cataract surgery method, postoperative visual-quality and postoperative complications related researches have become the emerging hotspots, which can give a direction in the future researches.
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Affiliation(s)
- Xiao-Yong Chen
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Qian-Ru Wu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Min-Yue Xie
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Di Zhang
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Chun Zhang
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
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Wu TH, Jiang B, Liu WM, Li JQ, Song ZY, Lu PR. Time trends and gender disparities of Chinese cataract burden and their predictions. Int J Ophthalmol 2023; 16:1527-1534. [PMID: 37724286 PMCID: PMC10475628 DOI: 10.18240/ijo.2023.09.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/05/2023] [Indexed: 09/20/2023] Open
Abstract
AIM To evaluate the trends and changes in the number and rates of disability-adjusted life years (DALYs) and prevalence of cataract in China between 1990 and 2019, and to predict the trends of cataract burden from 2020 to 2030. METHODS The Global Burden of Diseases (GBD) database was employed to collect the data on DALYs and the prevalence of cataract in China, which was distinguished by age and sex during the past three decades from 1990 to 2019, and then changes in the number and rates of cataract from 2020 to 2030 were predicted. All data were analyzed by the R program (version 4.2.2) and GraphPad Prism 9.0 statistics software. RESULTS The number of DALYs of cataract increased from 449 322.84 in 1990 to 1 087 987.61 in 2019, number of cataract cases increased from 5 607 600.94 in 1990 to 18 142 568.96 in 2019. The age-standardized DALY rates (ASDR) generally increased slightly [estimated annual percentage change (EAPC=0.1; 95%CI: -0.24 to 0.45), age-standardized prevalence rates (ASPR) also increased (EAPC=0.88; 95%CI: 0.6 to 1.15). Cataract burden increased with age and female gender. Among the causes of cataract, air pollution was the most important, followed by smoking, high fasting plasma glucose, and high body mass index (BMI). The burden of cataract is predicted to grow persistently from 2020 to 2030, the number of DALYs and prevalence for cataract will rise to 2 336 431 and 43 698 620 respectively by 2030, the ASDR is predicted to be 85/100 000 and ASPR will be 1586/100 000 in 2030, females will still be at greater risk of suffering from cataract than males. CONCLUSION The burden of cataract in China kept rising from 1990 to 2019. Increasing age and female gender are risk factors for cataract. Air pollution, smoking, high fasting plasma glucose, and high BMI are associated with cataract. The burden of cataract in China will gradually increase from 2020 to 2030, the elderly women in particular need attention. Our results may be of help for providing reference strategies to reduce cataract burden in the near future.
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Affiliation(s)
- Tian-Hong Wu
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Bo Jiang
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Wei-Ming Liu
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Jian-Qing Li
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Zi-Yue Song
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Pei-Rong Lu
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
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Song X, Zhou J, Zhang G, Jia S, Yuan J, Hu K, Liu X, Zeng M, Wang Z, Tan B, Lu X, Lin A, Hu X, Xuan J. The impact of preloaded intraocular lens implantation system (TECNIS iTec®) in routine cataract surgery in China: a time-motion analysis. BMC Ophthalmol 2023; 23:126. [PMID: 36978039 PMCID: PMC10045151 DOI: 10.1186/s12886-023-02858-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE To evaluate the impact on surgical efficiency and labor time cost of preloaded intraocular lens (IOL) implantation system compared with manual IOL implantation system in age-related cataract surgery in China. METHODS This study was an observational, multicenter, prospective time-motion analysis. IOL preparation time, operation time, cleaning time, number and cost of cataract surgeries in eight participating hospitals were collected. The linear mixed model was used to explore factors associated with the difference in operation time between the preloaded IOL implantation system and the manual IOL implantation system. A time-motion model was constructed to convert the operation time cost saved by using preloaded IOL into economic benefits from hospital and social perspective, respectively. RESULTS There were 2,591 cases included in the study (preloaded IOL: 1,591 cases; manual IOL: 1,000 cases). The preloaded IOL implantation system was significant time-saving in both preparation time and operation time compared to the manual IOL implantation system (25.48s vs. 47.04s, P < 0.001 and 353.84s vs. 367.46s, P = 0.004, respectively). An average total of 35.18s can be saved by using preloaded IOL per procedure. The results of linear mixed model showed that the type of IOL was the main factor leading to the difference in preparation time between preloaded IOL and manual IOL implantation system. By switching from manual IOL to preloaded IOL, the model projected additional 392 surgeries can be performed each year and an increase in revenue of $565,282 per hospital, a 9% increase from hospital perspective. And the annual productivity loss saved by using preloaded IOL was $3,006 in eight hospitals from perspective of society. CONCLUSION Compared with manual IOL implantation system, the preloaded IOL implantation system reduces lens preparation time and operation time, which increases potential surgical volume and revenue, and reduces the loss of work productivity. This study provides real-world evidence to support the advantages of the preloaded IOL implantation system in improving efficiency of ophthalmic surgery in China.
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Affiliation(s)
- Xudong Song
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
| | | | | | - Songbai Jia
- The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun Yuan
- Zhengzhou Second Hospital, Zhengzhou, China
| | - Ke Hu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | | | - Mingbing Zeng
- Hainan Branch of Zhongshan Ophthalmic Hospital, Hainan, China
| | - Zhenyu Wang
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Baoying Tan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-sen University, Guangzhou, China
| | - Xingwei Lu
- Health Economic Research Institute, School of Pharmacy, Sun Yat-sen University, Guangzhou, China
| | - Ailing Lin
- Health Economic Research Institute, School of Pharmacy, Sun Yat-sen University, Guangzhou, China
| | - Xiaohan Hu
- Health Economic Research Institute, School of Pharmacy, Sun Yat-sen University, Guangzhou, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-sen University, Guangzhou, China
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Wang YX, Kang GJ, Zhou J, Chen Y, Peng ZH. The Effect of Psychological Intervention on the Visual Quality of Patients with a Diffractive Multifocal Intraocular Lens Implant. Klin Monbl Augenheilkd 2023; 240:697-704. [PMID: 36216355 DOI: 10.1055/a-1957-8114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE This study aimed to investigate the effect of psychological intervention on the visual quality of patients with a diffractive multifocal intraocular lens implant and its possible mechanism. METHODS Eighty-nine patients undergoing age-related cataract surgery were enrolled in the study at the Affiliated Hospital of Southwest Medical University between December 2015 and July 2017. They were randomly divided into two groups: multiple focus M1 group (n = 45) and multiple focus M2 group (n = 40). The M1 group was only given routine preoperative health education, treatment, and evaluation, while the M2 group also received psychological intervention. RESULTS After treatment, there was no statistical difference in the uncorrected distance and near visual acuity, corrected distance and near visual acuity, or the vision and near removal rate in either of the two groups (p > 0.05). However, postoperative glare was lower in the M2 group (p < 0.05), and patient satisfaction was higher in the M2 group (p < 0.05). The M2 group had a more obvious improvement in the Symptom Checklist-90 score (p < 0.05), the serum interleukin-6 (IL-6) was lower, and the serum brain-derived neurotrophic factor (BDNF) was higher in the M2 group (p < 0.05). In addition, serum IL-6 had a negative correlation with the depression score, and serum BDNF also showed a negative correlation with the anxiety score (p < 0.05). CONCLUSIONS Psychological intervention improved the stress state of patients with age-related cataracts and diffractive multifocal intraocular lens implants, reduced the level of inflammatory factors in the body, improved the level of BDNF, reduced postoperative visual interference, and improved postoperative satisfaction.
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Affiliation(s)
- Yan-Xi Wang
- Ophthalmology, Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Gang-Jin Kang
- Ophthalmology, Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Juan Zhou
- Ophthalmology, Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Ying Chen
- Ophthalmology, Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Zheng-Hong Peng
- Physical Examination Center, Affiliated Hospital of Southwest Medical University, Sichuan, China
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Hong Y, Wu J, Sun Y, Zhang S, Lu Y, Ji Y. ceRNA network construction and identification of hub genes as novel therapeutic targets for age-related cataracts using bioinformatics. PeerJ 2023; 11:e15054. [PMID: 36987450 PMCID: PMC10040182 DOI: 10.7717/peerj.15054] [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: 09/21/2022] [Accepted: 02/21/2023] [Indexed: 03/30/2023] Open
Abstract
Background The aim of this study is to investigate the genetic and epigenetic mechanisms involved in the pathogenesis of age-related cataract (ARC). Methods We obtained the transcriptome datafile of th ree ARC samples and three healthy, age-matched samples and used differential expression analyses to identify the differentially expressed genes (DEGs). The differential lncRNA-associated competing endogenous (ceRNA) network, and the protein-protein network (PPI) were constructed using Cytoscape and STRING. Cluster analyses were performed to identify the underlying molecular mechanisms of the hub genes affecting ARC progression. To verify the immune status of the ARC patients, immune-associated analyses were also conducted. Results The PPI network identified the FOXO1 gene as the hub gene with the highest score, as calculated by the Maximal Clique Centrality (MCC) algorithm. The ceRNA network identified lncRNAs H19, XIST, TTTY14, and MEG3 and hub genes FOXO1, NOTCH3, CDK6, SPRY2, and CA2 as playing key roles in regulating the pathogenesis of ARC. Additionally, the identified hub genes showed no significant correlation with an immune response but were highly correlated with cell metabolism, including cysteine, methionine, and galactose. Discussion The findings of this study may provide clues toward ARC pathogenic mechanisms and may be of significance for future therapeutic research.
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Affiliation(s)
- Yingying Hong
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Jiawen Wu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yang Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Shenghai Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yinghong Ji
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
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Li YQ, Wang Q, Liu R, Li GA, He JL, Huang F, Zhou YF. Associations of exposure to multiple metals with the risk of age-related cataract in Anhui, China: a case-control study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:4680-4693. [PMID: 35972654 DOI: 10.1007/s11356-022-22494-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
It's well-known that multiple metal elements can lead to the change of oxidative stress response levels in vivo. However, their relationship with age-related cataract (ARC) had not been well studied. We designed a case-control study including 210 individuals with ARC and 210 matched control group. The metal levels in their urine specimens were measured using graphite furnace atomic absorption spectrometry (GFAAS) and inductively coupled plasma optical emission spectrometry (ICP-OES). Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to select representative metals into the multi-element model and reduce dimension. Multivariate logic analysis and Bayesian kernel machine regression (BKMR) were subsequently used to explore the association of ARC risk with multiple metal elements. We found that magnesium (Mg), chromium (Cr), arsenic (As), manganese (Mn), and selenium (Se) were positively associated with ARC in the single-element model. The multiple exposure model indicated a positive association between Mg and As, in which the OR in their highest quartile were 3.32 (95% CI: 1.24-8.89) and 7.09 (95% CI: 2.56-19.63). The BKMR model also showed the effect of As increased monotonically with its increasing concentration, and high levels of Mg and As had a significant positive effect on ARC risk. In conclusion, we found that exposure to multiple metals was associated with increased ARC risk. Further research is needed to verify these findings in the future.
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Affiliation(s)
- Yan-Qing Li
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, 230022, Anhui, China
| | - Qian Wang
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, 230022, Anhui, China
| | - Ran Liu
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, 230022, Anhui, China
| | - Guo-Ao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jia-Liu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Yan-Feng Zhou
- Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei, 230022, Anhui, China.
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The Relationship between Nutrient Intake and Cataracts in the Older Adult Population of Korea. Nutrients 2022; 14:nu14234962. [PMID: 36500992 PMCID: PMC9739297 DOI: 10.3390/nu14234962] [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: 10/04/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
Cataracts are a prevalent ophthalmic disease worldwide, and research on the risk factors for cataracts occurrence is actively being conducted. This study aimed to investigate the relationship between nutrient intake and cataracts in the older adult population in Korea. We analyzed data from Korean adults over the age of 60 years (cataract: 2137, non-cataract: 3497) using the Korean National Health and Nutrition Examination Survey. We performed univariate simple and multiple logistic regressions, adjusting for socio-demographic, medical history, and lifestyle, to identify the associations between nutrient intake and cataracts. A higher intake of vitamin B1 in the male group was associated with a lower incidence of cataracts. A lower intake of polyunsaturated fatty acids and vitamin A, and a higher intake of vitamin B2 in the female group were associated with a higher incidence of cataracts. Our study demonstrated that polyunsaturated fatty acids, vitamin A, and vitamin B2 could affect the incidence of cataracts according to sex. The findings could be used to control nutrient intake for cataract prevention.
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Li Y, Hu QR, Li XX, Hu YH, Wang B, Qin XY, Ren T. Visual acuity of urban and rural adults in a coastal province of southern China: the Fujian Eye Study. Int J Ophthalmol 2022; 15:1157-1164. [PMID: 35919332 DOI: 10.18240/ijo.2022.07.17] [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: 07/05/2021] [Accepted: 01/26/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the vision status and sociodemographic associations of visual acuity (VA) in an urban and rural population in a coastal province of southern China. METHODS The Fujian Eye Study, a population-based cross-sectional study, was performed from May 2018 to October 2019. Totally 10 044 participants over 50 years old from all nine cities in Fujian Province were enrolled, and underwent a questionnaire and a series of standard physical and ocular examinations. VA was measured by E Standard Logarithmic Visual Acuity Chart (GB 11533-1989). Data was double entered with EpiData v3.1 for data collation and Stata/SE statistical software v15.1 was used to analyze the data. RESULTS Totally 8211 (81.8%) participants were finally included and were divided into urban populations (4678 subjects), rural populations (n=3533), coastal residents (n=6434), and inland residents (1777 subjects); 4836 participants were female. The mean age was 64.39±8.87y (median 64y; range 50-98y). The mean presenting VA was 0.61±0.30 (0.23±0.27 logMAR), and the mean best corrected visual acuity (BCVA) was 0.82±0.28 (0.08±0.19 logMAR). In the multiple regression analysis, BCVA was significantly correlated with several socioeconomic and biologic factors, including age (P<0.001), education level (P<0.001), income (P=0.005), rural residency (P<0.001), inland residency (P=0.001) and refractive error (P<0.001), while sex (P=0.194) was independent with BCVA. CONCLUSION Accessible services and eye health policies targeting the elderly, people with high myopia and people living in rural or inland areas are needed.
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Affiliation(s)
- Yang Li
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen 361003, Fujian Province, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China
| | - Qin-Rui Hu
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen 361003, Fujian Province, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China
| | - Xiao-Xin Li
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen 361003, Fujian Province, China.,Department of Ophthalmology, Peking University People's Hospital, Beijing 100044, China
| | - Yong-Hua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China
| | - Bin Wang
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen 361003, Fujian Province, China
| | - Xue-Ying Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China
| | - Tao Ren
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China
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10
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Xiang Y, Jiang H, Zhao L, Liu Q, Lin H. Delays in Seeking Medical Services in Elderly Patients With Senile Cataract. Front Psychol 2022; 13:930726. [PMID: 35903737 PMCID: PMC9314650 DOI: 10.3389/fpsyg.2022.930726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Delay in seeking medical services is common in elderly populations, which leads to disease progression and life difficulty. This study aims to assess the prevalence of delay in medical visits and treatment and define associated effects and factors in patients with senile cataract, which may help obtain a better understanding of late-life psychopathology and provide the basis for interventions. Patients aged more than 60 years were prospectively recruited in Zhongshan Ophthalmic Center (ZOC). All participants were diagnosed with binocular senile cataract and decided to have primary surgery in ZOC. The distributions of the popularity of delaying outpatient visits and treatment, the degrees of visual impairment, the influences on quality of life, and the reasons for delaying treatment among participants were accessed by the descriptive statistics. Factors associated with the perceptions of cataract treatment were accessed using a binary logistic regression model. A total of 400 senile patients aged from 60 to 94 years were enrolled. At diagnosis, 82 (20.5%) participants had a low vision with monocular acuity of both eyes below 0.05. All participants have felt that their normal lives were affected, and 64 (16%) participants felt that their lives were affected severely. Only 17 (4.25%) participants have sought for medical services immediately after feeling vision loss, and 294 (73.50%) participants have felt vision loss since a year ago before seeking medical help. A total of 298 (74.50%) participants have delayed the surgery time, and 229 (57.25%) patients delayed it for more than 12 months. There were 147 (36.75%) participants delaying surgery on account of no knowledge about it and 114 (28.50%) participants delaying surgery because of fear. There are a high proportion of elderly patients with senile cataract delaying their outpatient visits and surgery treatment, whose normal lives were severely affected. Increasing medical service propaganda about cataract and other common diseases in elderly populations would probably be helpful for improving perceptions of diseases and decreasing medical delays. Public needs to draw more attention to the healthy and medical status of the elderly ocular patients.
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Affiliation(s)
- Yifan Xiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Haofeng Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lanqin Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Qiong Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Center for Precision Medicine, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Haotian Lin,
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11
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Lu Y, Xiao F, Wang Y, Wang Z, Liu D, Hong F. Prevalence of Helicobacter pylori in Non-Cardia Gastric Cancer in China: A Systematic Review and Meta-Analysis. Front Oncol 2022; 12:850389. [PMID: 35592678 PMCID: PMC9111517 DOI: 10.3389/fonc.2022.850389] [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: 01/07/2022] [Accepted: 03/30/2022] [Indexed: 01/30/2023] Open
Abstract
Non-cardia gastric cancer was significantly associated with Helicobacter pylori (H. pylori) infection. Reducing H. pylori prevalence was an important prevention strategy for non-cardia gastric cancer. However, national-level data on the H. pylori prevalence in non-cardia gastric cancer were limited in China. Therefore, we conducted this study to estimate the pooled prevalence of H. pylori in non-cardia gastric cancer in China. We searched PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang, and VIP Database for Chinese Technical Periodicals for studies reporting H. pylori prevalence in non-cardia gastric cancer in China which were published before September 1, 2021. Pooled prevalence was calculated using a random-effect model. Subgroup analysis and meta-regression were used to explore the potential sources of heterogeneity. Egger’s test and funnel plot were used to assess publication bias. A total number of 55 studies with 5324 cases of non-cardia gastric cancer were included in this study. The pooled prevalence of H. pylori in non-cardia gastric cancer in China was 66.5% (95%CI: 62%-71%, I2=93.8%, P<0.0001). In subgroup analysis, a significant difference in the prevalence of H. pylori in non-cardia gastric cancer was noted when stratified by geographic region of China (P=0.0112). The highest H. pylori prevalence (78.9%, 95%CI: 69.9%-87.8%) was noted in Northwest China and the lowest (53.1%, 95%CI: 38.9%-67.3%) was in North China. In meta-regression, a significant association between H. pylori prevalence and geographic region was found, while type of sample, H. pylori testing method, diagnosis period, detection timing, type of study design, quality grade, publication year, and sample size were not associated with the prevalence of H. pylori in non-cardia gastric cancer (P>0.05). A large proportion of non-cardia gastric cancers were associated with H. pylori infection in China, emphasizing the possible benefits of H. pylori eradication for the prevention and control of non-cardia gastric cancer.
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Affiliation(s)
- Yong Lu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Fei Xiao
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Yuan Wang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Zhenyu Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Di Liu
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Feng Hong
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
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Xu J, Chen X, Wang H, Yao K. Safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: A meta-analysis and systematic review. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100027. [PMID: 37846222 PMCID: PMC10577854 DOI: 10.1016/j.aopr.2022.100027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/08/2022] [Accepted: 02/08/2022] [Indexed: 10/18/2023]
Abstract
Purpose To compare the complications of femtosecond laser-assisted cataract surgery (FLACS) with those of conventional phacoemulsification surgery (CPS) for age-related cataracts. Methods PubMed, Cochrane Library, and EMBASE were systematically searched for studies comparing FLACS and CPS. Outcomes were operative complications, including the intraoperative capsule tear, postoperative corneal edema, macular edema, uncontrolled IOP, etc. The effect measures were weighted with odds ratios with 95% CIs. Results Nineteen RCTs and 18 cohort studies, including 24,806 eyes (11,375 of the FLACS group and 13,431 of the CPS group), were identified. There were no significant differences between the two groups in anterior capsule tear, corneal edema, macular edema, uncontrolled IOP, vitreous loss, posterior vitreous detachment, etc. Posterior capsule tear rate showed a significantly lower in RCT subgroups (P = 0.04) and without differences in total (P = 0.63). Significant differences were observed in the incidence of descemet membrane tear/trauma (P = 0.02) and IFIS/iris trauma (P = 0.04. Additionally, The FLACS specific complications showed a significantly higher rate of miosis (P < 0.0001), corneal epithelial defect (P = 0.001), corneal haze (P = 0.002), and subconjunctival hemorrhage (P = 0.01). Conclusions FLACS maintains the same safety compared with CPS in terms of all intraoperative and postoperative complications. Although FLACS did show a statistically significant difference for several FLACS specific complications, it would not influence the visual outcome and heal itself.
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Affiliation(s)
| | | | | | - Ke Yao
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China
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Al-Namaeh M. Common causes of visual impairment in the elderly. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2022; 10:191-200. [PMID: 37641654 PMCID: PMC10460237 DOI: 10.51329/mehdiophthal1438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 10/24/2021] [Indexed: 08/31/2023]
Abstract
Background Aging is not a disease; rather, it is a process. As people age, visual impairment (VI) becomes more common. In 2010, the overall prevalence rate of vision impairment in all races was 25.66% in individuals aged ≥ 80 years, according to the estimate of the National Eye Institute at the National Institutes of Health. This review aimed to address the common causes of VI in the elderly. Methods In this narrative review, an electronic search of the PubMed/MEDLINE database was conducted using "visual impairment" and "elderly" for the period between January 2010 and April 2021, to include randomized clinical trials and observational studies concerning VI in the elderly. The selected time period was chosen to provide an updated review. Results The search yielded 2955 articles published over the period of more than 11 years. The relevant randomized clinical trials or observational studies were included and reviewed. Cataracts, refractive errors, open-angle glaucoma, age-related macular degeneration, and diabetic retinopathy were the most common age-related ocular disorders leading to VI if untreated in the elderly. The loss of visual acuity can adversely affect quality of life in the elderly. Difficulty with activities of daily living related to VI can lead to social isolation, depression, and anxiety. Loss of vision in the elderly is linked to an increased risk of falls, hip fracture, depression, and poor quality of life. Conclusions The most common causes of VI in the elderly are cataracts and refractive errors. VI in most ocular diseases is more prevalent in women than in men due to longer lifespan. The overall prevalence of the main causes of VI in the elderly is expected to increase; therefore, health policymakers should consider this when planning for the health-enhancement program of the population.
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Analysis of Lens Thickness Distribution Based on Swept-Source Optical Coherence Tomography (SS-OCT). J Ophthalmol 2022; 2021:4717996. [PMID: 35003790 PMCID: PMC8736696 DOI: 10.1155/2021/4717996] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/12/2021] [Accepted: 12/14/2021] [Indexed: 11/25/2022] Open
Abstract
Objective This study aimed to analyze the distribution of lens thickness (LT) and its associations in age-related cataract patients based on swept-source optical coherence tomography (SS-OCT). Methods This cross-sectional study included 59,726 Chinese age-related cataract patients. Only right-eye data were included in the study. Repeated measures of ocular parameters were performed using an IOL Master 700 device. The distributions of ocular biometric data including anterior chamber depth (ACD), LT, axial length (AL), central corneal thickness (CCT), white-to-white (WTW), and mean keratometry (MK) and their associations with age were assessed. The anterior segment (AS) was measured as the sum of CCT, ACD, and LT, while the vitreous chamber depth (VCD) was calculated as the difference between AL and AS. The values of LT : AL, AS : AL, and VCD : AL in different AL groups and their changes are the main outcome measures used to observe the proportion of the anterior and posterior segments of the eye. Results Biometric data were available for 59,726 individuals. The mean age was 68.81 years (range = 40–100); 40.62% were male and 59.38% were female. Mean anterior chamber depth (ACD) was 3.02 ± 0.44 mm, mean LT was 4.51 ± 0.44 mm, mean axial length (AL) was 23.89 ± 1.92 mm, mean central corneal thickness (CCT) was 0.53 ± 0.03 mm, mean white-to-white (WTW) was 11.64 ± 0.44 mm, and mean keratometry (MK) was 44.27 ± 1.65 diopter. Female patients had shorter AL, shallower ACD, smaller CCT and WTW, decreased LT, and steeper corneas (p < 0.005). ACD revealed the strongest negative correlation (p ≤ 0.001, r = –0.682) with LT. Age (p ≤ 0.001, r = 0.348) showed a moderate positive correlation, whereas MK (p < 0.05, r = 0.011), CCT (p ≤ 0.001, r = 0.041) had a weak positive correlation and WTW (p ≤ 0.001, r = –0.034) had a weak negative correlation with LT. A nonlinear correlation was found between LT and AL. LT increased with age in both males and females. LT changed variably in eyes with AL less than 27 mm, LT decreased as AL increased, then LT gradually increased as AL increased in extremely long and extra-long eyes (p ≤ 0.001). LT : AL and AS : AL decreased as AL increased, VCD : AL gradually increased as AL increased in highly myopic eyes, and VCD : AL increased by about 0.01 for every 1 mm increase in AL. Conclusions Among Chinese age-related cataract patients, we found LT to have the strongest relation with ACD. The lens was thicker in elderly patients and women. The correlation between LT and AL is not a simple negative correlation; with the increase of age, LT decreases first and then increases. The proportion of VCD is constantly rising with the elongation of AL.
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Na KS, Jung SK, Jung Y, Han K, Lee J, Paik JS, Yang SW. Association between age-related cataract and blepharoptosis in Korean adults: a population-based study. Sci Rep 2022; 12:389. [PMID: 35013495 PMCID: PMC8748712 DOI: 10.1038/s41598-021-04381-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022] Open
Abstract
Cataract and blepharoptosis are both commonly encountered ophthalmic problems in older adults. Since they share similar risk factors, it is plausible that there may be an association between the two conditions. We examined data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2010–2012 to determine if there is an association between age-related cataract and blepharoptosis. Multivariable adjusted logistic regression analysis was conducted to examine the odds ratio (OR) and 95% confidence interval (CI) for association of each specific type of cataract with presence of blepharoptosis. Of the 10,387 eligible participants, 4782 (46.0%) had cataract and 1419 (15.8%) had blepharoptosis. There were more participants with blepharoptosis in the cataract group, compared with those in the no cataract group. After adjusting for potential confounders, participants with blepharoptosis had a higher risk of total cataract (OR: 1.557, 95% CI 1.201–2.019) and nuclear subtype cataract (OR: 1.305, 95% CI 1.050–1.620). Blepharoptosis was associated with significantly higher odds of cataract in obese participants when compared with non-obese participants (p for interaction = 0.0236). Our study revealed a positive association between age-related cataract and blepharoptosis; it suggests that thorough ophthalmic assessment is needed when assessing patients who are planning cataract or blepharoptosis surgery.
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Affiliation(s)
- Kyung-Sun Na
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
| | - Su-Kyung Jung
- Eyeclinic, Center for Clinical Center, National Cancer Center, Goyang-si, South Korea
| | - Younhea Jung
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jiyoung Lee
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
| | - Ji-Sun Paik
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea.
| | - Suk-Woo Yang
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Chang SW, Wu WL. Age affects intraocular lens attributes preference in cataract surgery. Taiwan J Ophthalmol 2021; 11:280-286. [PMID: 34703744 PMCID: PMC8493983 DOI: 10.4103/tjo.tjo_20_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/15/2020] [Indexed: 01/19/2023] Open
Abstract
PURPOSE The aim of this study is to analyze the effects of age on intraocular lens (IOL) attributes preference. MATERIALS AND METHODS We enrolled 4213 eyes that underwent smooth phacoemulsification and IOL implantation between January 2005 and June 2018. Patients were subdivided into six groups according to their ages, i.e.,≤40, 41-50, 51-60, 61-70, 71-80, and ≥ 81 years old. The difference in preference of IOL attributes regarding age, gender, and year of surgery was analyzed separately. The analyzed IOL attributes included asphericity, astigmatism-correction, presbyopia-correction, and blue-blocking function. RESULTS The patients averaged 68.3 ± 11.6 years old at the time of surgery. There was no significant difference in age between males and females. There were 1980 patients (47.0%) selected aspheric IOL, 822 patients (19.5%) selected multifocal (MF) IOL, 93 patients (2.2%) selected toric IOL, and 859 patients (20.4%) selected blue-blocking IOL. Adoption of aspheric and MF IOL increased significantly during the study (P < 0.001 for both attributes). There were more young patients selected aspheric and MF IOL (P < 0.001 for both), and the change in the trend of adoption over the years was also most significant in the young group (P < 0.001 for both). The proportion of patients that selected blue-blocking IOL decreased significantly after 2011 (P < 0.001). There was no gender preference in aspheric, MF, and toric IOL selection. However, there were more male patients selected blue-blocking IOL (P = 0.018). CONCLUSION The adoption of IOLs with emerging technologies increased significantly over the years. Younger adults tended to adopt advanced technology IOL more than the older ones.
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Affiliation(s)
- Shu-Wen Chang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taipei, Taiwan.,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wan-Lin Wu
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taipei, Taiwan
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Zhong J, Wang W, Wang H, Huang J, Li T, Chen J, Chen W, Yuan J, Chen W. Distribution and determinants of hospital efficiency and relative productivity in county-level hospitals in rural China: an observational study. BMJ Open 2021; 11:e042326. [PMID: 34215595 PMCID: PMC8256740 DOI: 10.1136/bmjopen-2020-042326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Cataract surgery is very important to prevent blindness, but its productivity and efficiency in China are unknown. Our study aimed to evaluate the geographical distribution of cataract surgeons and prospectively identify the factors associated with the increased productivity in cataract surgery and efficiency in outpatient ophthalmic services in rural Chinese hospitals. METHODS Data were prospectively collated from various hospital datasets and the census registered by the geographical unit county. Prior to mapping, the geographical location data of counties were cross-linked with the equivalent ophthalmologist and service output data to create categories and map multiple data attributes. Descriptive statistical analyses were performed to characterise the data stratified by county. Linear regression analyses were used to explore the factors associated with the increased productivity/efficiency. RESULTS The ophthalmologists, surgical productivity of ophthalmologists and outpatient efficacy of ophthalmologists significantly varied across counties. During the period between 2016 and 2018, the median (IQR) change in surgical productivity of and outpatient efficacy of ophthalmologists were 31.627 (-3.33 to 29.94) and 118.08 (-132.30 to 740.89). In the simple regression analysis for predictors of a high productivity change, only the increased number of phaco machine had statistical significance (p=0.003). In addition, only the gross domestic product per capita in 2016 was associated with an increased improvement in efficiency of outpatient services (p=0.008). CONCLUSIONS This study demonstrated that the ophthalmologist productivity and the efficiency of outpatient services were unequally geographically distributed, and their predictors were identified. Further studies to elucidate the extent of the problem and improve the health service delivery models are required.
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Affiliation(s)
- Jing Zhong
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Wei Wang
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Hongxi Wang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Jingjing Huang
- Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tao Li
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Jingjing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jin Yuan
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Weirong Chen
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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Chan KH, Yan M, Bennett DA, Guo Y, Chen Y, Yang L, Lv J, Yu C, Pei P, Lu Y, Li L, Du H, Lam KBH, Chen Z. Long-term solid fuel use and risks of major eye diseases in China: A population-based cohort study of 486,532 adults. PLoS Med 2021; 18:e1003716. [PMID: 34324491 PMCID: PMC8321372 DOI: 10.1371/journal.pmed.1003716] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 06/29/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Over 3.5 billion individuals worldwide are exposed to household air pollution from solid fuel use. There is limited evidence from cohort studies on associations of solid fuel use with risks of major eye diseases, which cause substantial disease and economic burden globally. METHODS AND FINDINGS The China Kadoorie Biobank recruited 512,715 adults aged 30 to 79 years from 10 areas across China during 2004 to 2008. Cooking frequency and primary fuel types in the 3 most recent residences were assessed by a questionnaire. During median (IQR) 10.1 (9.2 to 11.1) years of follow-up, electronic linkages to national health insurance databases identified 4,877 incident conjunctiva disorders, 13,408 cataracts, 1,583 disorders of sclera, cornea, iris, and ciliary body (DSCIC), and 1,534 cases of glaucoma. Logistic regression yielded odds ratios (ORs) for each disease associated with long-term use of solid fuels (i.e., coal or wood) compared to clean fuels (i.e., gas or electricity) for cooking, with adjustment for age at baseline, birth cohort, sex, study area, education, occupation, alcohol intake, smoking, environmental tobacco smoke, cookstove ventilation, heating fuel exposure, body mass index, prevalent diabetes, self-reported general health, and length of recall period. After excluding participants with missing or unreliable exposure data, 486,532 participants (mean baseline age 52.0 [SD 10.7] years; 59.1% women) were analysed. Overall, 71% of participants cooked regularly throughout the recall period, of whom 48% used solid fuels consistently. Compared with clean fuel users, solid fuel users had adjusted ORs of 1.32 (1.07 to 1.37, p < 0.001) for conjunctiva disorders, 1.17 (1.08 to 1.26, p < 0.001) for cataracts, 1.35 (1.10 to 1.66, p = 0.0046) for DSCIC, and 0.95 (0.76 to 1.18, p = 0.62) for glaucoma. Switching from solid to clean fuels was associated with smaller elevated risks (over long-term clean fuel users) than nonswitching, with adjusted ORs of 1.21 (1.07 to 1.37, p < 0.001), 1.05 (0.98 to 1.12, p = 0.17), and 1.21 (0.97 to 1.50, p = 0.088) for conjunctiva disorders, cataracts, and DSCIC, respectively. The adjusted ORs for the eye diseases were broadly similar in solid fuel users regardless of ventilation status. The main limitations of this study include the lack of baseline eye disease assessment, the use of self-reported cooking frequency and fuel types for exposure assessment, the risk of bias from delayed diagnosis (particularly for cataracts), and potential residual confounding from unmeasured factors (e.g., sunlight exposure). CONCLUSIONS Among Chinese adults, long-term solid fuel use for cooking was associated with higher risks of not only conjunctiva disorders but also cataracts and other more severe eye diseases. Switching to clean fuels appeared to mitigate the risks, underscoring the global health importance of promoting universal access to clean fuels.
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Affiliation(s)
- Ka Hung Chan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
- Oxford British Heart Foundation Centre of Research Excellence, University of Oxford, United Kingdom
| | - Mingshu Yan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Derrick A. Bennett
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, United Kingdom
| | - Yu Guo
- Chinese Academy of Medical Science, Beijing, China
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Pei Pei
- Chinese Academy of Medical Science, Beijing, China
| | - Yan Lu
- NCD Prevention and Control Department, Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Huaidong Du
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Kin Bong Hubert Lam
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
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Gu Y, Yao K, Fu Q. Lens regeneration: scientific discoveries and clinical possibilities. Mol Biol Rep 2021; 48:4911-4923. [PMID: 34143397 DOI: 10.1007/s11033-021-06489-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/08/2021] [Indexed: 12/11/2022]
Abstract
In the process of exploring new methods for cataract treatment, lens regeneration is an ideal strategy for effectively restoring accommodative vision and avoiding postoperative complications and has great clinical potential. Lens regeneration, which is not a simple repetition of lens development, depends on the complex regulatory network comprising the FGF, BMP/TGF-β, Notch, and Wnt signaling pathways. Current research mainly focuses on in situ and in vitro lens regeneration. On the one hand, the possibility of the autologous stem cell in situ regeneration of functional lenses has been confirmed; on the other hand, both embryonic stem cells and induced pluripotent stem cells have been induced into lentoid bodies in vitro which are similar to the natural lens to a certain extent. This article will briefly summarize the regulatory mechanisms of lens development, describe the recent progress of lens regeneration, explore the key molecular signaling pathways, and, more importantly, discuss the prospects and challenges of their clinical applications to provide reference for clinical transformations.
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Affiliation(s)
- Yuzhou Gu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, 310009, Zhejiang Province, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, China. .,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, 310009, Zhejiang Province, China.
| | - Qiuli Fu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, China. .,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, 310009, Zhejiang Province, China.
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20
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Zou M, Guo D, Chen A, Young CA, Li Y, Zheng D, Jin G. Prevalence of visual impairment among older Chinese population: A systematic review and meta-analysis. J Glob Health 2021; 11:08004. [PMID: 33981412 PMCID: PMC8088771 DOI: 10.7189/jogh.11.08004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background To evaluate the prevalence of visual impairment (VI) among elderly Chinese population. Methods All population-based studies on VI prevalence among elderly Chinese populations were searched and only studies with clear definitions of diagnosis were selected. Meta-analysis methods were used to estimate the pooled prevalence and its 95% confidence interval (95%CI) of moderate and severe visual impairment (MSVI) and blindness both by presenting visual acuity (PVA) and best corrected visual acuity (BCVA). Subgroup analysis of gender, district, geographical location, age, education level and examined year were also conducted. Results 72 studies with 465 039 individuals were included and analyzed. Using PVA, the pooled prevalence of MSVI is 10.9% (95% CI = 9.4%-12.6%) and blindness is 2.2% (95% CI = 1.8%-2.8%), while prevalence of MSVI and blindness by BCVA was 5.4% (95% CI = 4.6%-6.2%) and 2.2% (95% CI = 1.9%-2.5%), respectively. Females, rural residents, older age and lower educational level were risk factors for MSVI and blindness. Conclusions VI causes a great health burden among Chinese populations, particularly affecting female subjects, subjects dwelling in rural area, older subjects and subjects with lower educational level.
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Affiliation(s)
- Minjie Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Dongwei Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Aiming Chen
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Charlotte Aimee Young
- Department of Ophthalmology, Third Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, China
| | - Yi Li
- Department of Applied Biology and Chemical Technology, Hong Kong Polytechnic University, Hongkong, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Fikrie A, Mariam YG, Amaje E, Bekele H. Knowledge about cataract and associated factors among adults in Yirgalem town, Sidama National Regional State, southern Ethiopia, 2020: a community based cross sectional study design. BMC Ophthalmol 2021; 21:79. [PMID: 33568076 PMCID: PMC7877085 DOI: 10.1186/s12886-021-01844-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/28/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Globally, at least 1 billion people have a vision impairment that could have been easily prevented or easily treated. Cataract is the leading preventable and most treatable causes of blindness and bilateral low vision among adults. Despite being the leading cause of preventable and most treatable blindness, the lack of knowledge about the disease and its option of treatment is still a major barrier in reducing the blindness owing to cataract in the developing countries particularly in Ethiopia. Hence, the aim of this study is to determine the level of knowledge about cataract and associated factors among adults in Yirgalem Town, Sidama National Regional State, Southern Ethiopia, 2020. METHODS A community-based cross-sectional study design was conducted among randomly selected 599 adult's age 18 years and above from May 10-30, 2020. A multi-stage sampling technique was used to select the study participants. Data were collected using pre-tested and structured face-to-face interview questionnaires. The collected data were entered to Epi data version 3.1 and then exported to SPSS version 21 for analysis. Bi-variable and multivariable logistic regression was used to identify associated factors of knowledge about cataract. Adjusted Odds Ratio (AOR) together with 95% Confidence Interval (CI) was used to declare the statistical association between dependent and independent variables. RESULTS Of the total study participants, 379 (64.7%), [(95% CI: 60.7-68.6%)] of them had good knowledge about cataract. Age (≥40 years) [AOR = 2.29(95% CI 1.18-4.44)], Elementary school completed [AOR = 2.31(95% CI 1.30-4.10)], High school & above [AOR = 5.55(95% CI 2.81-10.89)], governmental and non-governmental employed [AOR = 5.62 (95% CI 2.78-11.38)], Merchant [AOR = 1.72(95% CI 1.03-2.88)], Positive Attitude [AOR = 3.85(95% CI 2.94-6.47)] were positively significantly associated with knowledge about cataract. Whereas, rural residence [AOR = 0.19 (95% CI: 0.12-0.31)] was negatively associated with knowledge about cataract. CONCLUSIONS More than one third of the participants still had poor knowledge about cataract. This implies that health facilities should be engaged and raises the awareness of the community and empowers people about eye care needs.
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Affiliation(s)
- Anteneh Fikrie
- School of Public Health, College of Health and Medical Sciences, Bule Hora University, PO. Box 144, Bule Hora, Ethiopia. .,Public Health Department, Pharma College Hawassa Campus, P.O.B. 67, Hawassa, Ethiopia.
| | - Yonatan G Mariam
- Public Health Department, Pharma College Hawassa Campus, P.O.B. 67, Hawassa, Ethiopia
| | - Elias Amaje
- School of Public Health, College of Health and Medical Sciences, Bule Hora University, PO. Box 144, Bule Hora, Ethiopia
| | - Henok Bekele
- Public Health Department, Pharma College Hawassa Campus, P.O.B. 67, Hawassa, Ethiopia.,Malaria prevention, Control and Elimination Technical Advisory in South Nation Nationalities Peoples Regional State, Southern Ethiopia, Hawassa, Ethiopia
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22
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Addo EK, Akuffo KO, Sewpaul R, Dukhi N, Agyei-Manu E, Asare AK, Kumah DB, Awuni M, Reddy P. Prevalence and associated factors of vision loss in the South African National Health and Nutrition Examination Survey (SANHANES-1). BMC Ophthalmol 2021; 21:1. [PMID: 33386075 PMCID: PMC7775629 DOI: 10.1186/s12886-020-01714-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/02/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Vision loss is a major public health concern that significantly affects developing countries, including South Africa. Although existing literature have reported on the prevalence, causes, and impact of vision loss on the quality of life of affected individuals (children and adults) in parts of South Africa, there is no evidence of the prevalence and associated factors of vision loss in the general population. Hence, this study aimed to determine the prevalence of vision loss and its associated factors in South Africa using a population-based survey. METHODS Secondary analyses were conducted using data from the South African National Health and Nutrition Examination Survey (SANHANES-1), a population-based national health survey conducted from 2011 to 2012. Vision loss was defined as presenting visual acuity (PVA) worse than Snellen 6/12 in the better eye. Visual acuity was assessed by clinicians and participants' subjective response to vision-related questions. Univariate and multiple logistic regression models were used to examine the association of the independent variables with vision loss. RESULTS The analytic sample comprised 4346 individuals with a mean age of 39.1 years. Female sex accounted for 55.6% of the participants. The prevalence of vision loss among participants was 9.2% (95% CI: 7.7-10.9). Older age (45-54 years, OR = 2.99, p < 0.001; 55-64 years, OR = 5.78, p < 0.001 and ≥ 65 years, OR = 5.12, p < 0.001), female sex (OR = 1.50, p = 0.016), and previous diabetes diagnosis (OR = 2.28, p = 0.001) were significantly associated with increased odds of vision loss. Further, secondary school education (OR = 0.71, p = 0.031), white ethnicity (OR = 0.11, p = 0.007), residing in Mpumalanga province (OR = 0.12, p < 0.001) and having never had an eye examination (OR = 0.56, p = 0.003) were significantly associated with reduced odds of vision loss. CONCLUSION Almost one in ten participants had vision loss. Adopting strategies targeted at reducing barriers to the utilization of eye care services will promote early detection and management of blinding conditions, and thereby, decrease the burden of vision loss in South Africa.
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Affiliation(s)
- Emmanuel Kofi Addo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Ophthalmology and Visual Sciences, John A. Moran Eye Centre, University of Utah, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA
| | - Kwadwo Owusu Akuffo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Ronel Sewpaul
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - Natisha Dukhi
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - Eldad Agyei-Manu
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Usher Institute for Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Akosua Kesewah Asare
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David Ben Kumah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Moses Awuni
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Priscilla Reddy
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa.,Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
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Li P, Yu H, Zhang G, Kang L, Qin B, Cao Y, Luo J, Chen X, Wang Y, Qin M, Wu J, Huang Y, Zou X, Guan H, Wang Y. Identification and Characterization of N6-Methyladenosine CircRNAs and Methyltransferases in the Lens Epithelium Cells From Age-Related Cataract. Invest Ophthalmol Vis Sci 2021; 61:13. [PMID: 32761139 PMCID: PMC7441297 DOI: 10.1167/iovs.61.10.13] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose To explore the involvement of N6-methyladenosine (m6A) modification in circular RNAs (circRNAs) and relevant methyltransferases in the lesion of lens epithelium cells (LECs) under the circumstances of age-related cataract (ARC). Methods LECs were collected from normal subjects and patients with cortical type of ARC (ARCC). M6A-tagged circRNAs and circRNAs expression were analyzed by m6A-modified RNA immunoprecipitation sequencing (m6A-RIP-seq) and RNA sequencing (RNA-seq). Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were used to predict possible functions of the m6A-circRNAs. Expression of m6A-related methyltransferase and demethytransferase was measured by quantitative real-time polymerase chain reaction. Expression and location of AlkB homolog 5 RNA demethylase (ALKBH5), a key component of m6A demethytransferase, were determined by Western blot and immunostaining. Results All 4646 m6A peaks within circRNAs had different abundances, with 2472 enriched and 2174 subdued. The level of m6A abundance in total circRNAs was decreased in the LECs from ARCCs in comparison with the controls. We also found that the expression of highly m6A-tagged circRNAs was mostly decreased in comparison with non-m6A-tagged circRNAs. The bioinformatics analysis predicted the potential functions of m6A modified circRNAs and the relevant pathways that may be associated with m6A modified circRNAs. Among five major methyltransferases, ALKBH5 was significantly upregulated in LECs of ARCCs. Conclusions Our data provided novel evidence regarding the involvement of circRNAs m6A modifications in ARC. The altered expression of methyltransferases in lens tissue might selectively change the epigenetic profile of lens genome through regulating genes that host the circRNAs, thus enhance the susceptibility to ARC. The results might provide a new insight in the molecular target of ARC pathogenesis.
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Xie J, Zhu Y, Fan Y, Xie L, Xie R, Huang F, Cao L. Association between extreme heat and hospital admissions for cataract patients in Hefei, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:45381-45389. [PMID: 32789637 PMCID: PMC7686207 DOI: 10.1007/s11356-020-10402-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
Cataract is the first cause of blindness and the major cause of visual impairment worldwide. Under conditions of global warming, researchers have begun to give attention to the influence of increasing temperature on cataract patients. Our paper aimed to investigate the association between extreme heat and hospital admissions for cataract in Hefei, China. Based on data from the New Rural Cooperative Medical System and National Meteorological Information Center, we used a generalized additive model and a distributed lag nonlinear model to examine the relationship between extreme heat and hospitalizations for cataract, with consideration of cumulative and lagged effects. When current mean temperature was above 28 °C, each 1 °C rise was associated with a 4% decrease in the number of cataract admissions (RR = 0.96, 95% CI = 0.94-0.98). The cumulative relative risk over 11 days of lag was the lowest, which indicated that every 1 °C increase in mean temperature above 28 °C was associated with a 19% decrease in the number of hospital admissions for cataract (RR = 0.81, 95% CI = 0.75-0.88). In subgroup analyses, the negative association between extreme heat and hospital admissions for cataract was stronger among patients who were not admitted to provincial-level hospitals. In conclusion, this paper found that extreme heat was negatively associated with cataract hospitalizations in Hefei, providing useful information for hospitals and policymakers.
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Affiliation(s)
- Jingui Xie
- School of Management, Technical University of Munich, Bildungscampus 9, 74076 Heilbronn, Germany
| | - Yongjian Zhu
- School of Management, University of Science and Technology of China, 96 Jin Zhai Road, Bao He District, Hefei, 230026 Anhui People’s Republic of China
| | - Yiming Fan
- School of Management, University of Science and Technology of China, 96 Jin Zhai Road, Bao He District, Hefei, 230026 Anhui People’s Republic of China
| | - Linbo Xie
- Anhui Health College, 9 Xue Yuan Road, Jiao Yu Yuan District, Chizhou, 247099 Anhui People’s Republic of China
| | - Ruijin Xie
- Anhui Health College, 9 Xue Yuan Road, Jiao Yu Yuan District, Chizhou, 247099 Anhui People’s Republic of China
| | - Fengming Huang
- The First Affiliated Hospital of University of Science and Technology of China, 17 Lu Jiang Road, Lu Yang District, Hefei, 230001 Anhui People’s Republic of China
| | - Liqing Cao
- The First Affiliated Hospital of University of Science and Technology of China, 17 Lu Jiang Road, Lu Yang District, Hefei, 230001 Anhui People’s Republic of China
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25
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Wu Y, Yan H, Yan W. Preloaded vs manually loaded IOL delivery systems in cataract surgery in the largest ambulatory surgery center of northwestern China: an efficiency analysis. BMC Ophthalmol 2020; 20:469. [PMID: 33261575 PMCID: PMC7708187 DOI: 10.1186/s12886-020-01721-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the efficiency of preloaded vs manually loaded IOL (P-IOL vs M-IOL, respectively) delivery systems in cataract surgery in the largest ambulatory surgery center of Northwestern China. METHODS A total of 200 cases were included in this prospective, observational study. Time and motion data were collected in a one- or two-operating room (1-OR or 2-OR, respectively) scenario. A model of the efficiency and revenue implications of introducing a preloaded delivery system for IOLs in cataract surgery was used to estimate the changes in cataract throughput and hospital revenue through transitioning from the M-IOL delivery system to the P-IOL system. RESULTS In the 1-OR scenario, the mean total case time was 16.9 min using P-IOL, which was a 7.7% reduction compared with M-IOL (P < 0.01). In the 2-OR scenario, the mean total surgeon time was 10.8 min using P-IOL, which was a 7.8% reduction compared with M-IOL (P < 0.05). By switching from M-IOL to P-IOL, annual throughput will increase by 5.2% (960 cases) in the 1-OR scenario and 7.7% (1440 cases) in the 2-OR scenario, accompany by an increase in revenue of approx. 284,352 USD in the 1-OR scenario and approx. 426,528 USD in the 2-OR scenario. CONCLUSION This report is the first of a comparison of two IOL delivery systems in China using different settings in the scenario. IOL delivery with preloaded systems is time saving in both the 1-OR scenario and the 2-OR scenario. Moreover, switching from the M-IOL delivery system to the P-IOL system holds potential to increase cataract throughput and hospital revenue.
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Affiliation(s)
- Yazhen Wu
- Xi'an Fourth Hospital, Shaanxi Eye Hospital, Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University, Xi'an, 710004, Shaanxi Province, China
| | - Hong Yan
- Xi'an Fourth Hospital, Shaanxi Eye Hospital, Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University, Xi'an, 710004, Shaanxi Province, China.
| | - Weijia Yan
- Department of Ophthalmology, University of Heidelberg, 69120, Heidelberg, Germany
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26
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The Association between Socioeconomic Factors and Visual Function among Patients with Age-Related Cataracts. J Ophthalmol 2020; 2020:7236214. [PMID: 33335783 PMCID: PMC7722637 DOI: 10.1155/2020/7236214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/25/2020] [Accepted: 10/30/2020] [Indexed: 01/19/2023] Open
Abstract
Background With the development of the economy, socioeconomic factors, such as inequalities in the status of regional economies and the subsequent effects on health systems, have influenced the status of health. We explored the association between age-related cataracts and socioeconomic indicators, including the regional economy, health systems, and energy industries. Methods This was a prospective, multicenter, Chinese population-based, cross-sectional study. A total of 830 participants from seven centers were enrolled. Data on the best-corrected visual acuity (BCVA), Lens Opacities Classification System III (LOCS III) score, Visual Function Index-14 (VF-14) score, total and subscale scores of the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), per capita disposable income (PCDI), medical resource-related indicators, and investments in the energy industry were obtained. Associations among these parameters were analyzed. Results The PCDI ranking was correlated with the VF-14 score (R = -0.426, P < 0.01), total score of NEI-VFQ-25 (r = -0.500, P < 0.01), and BCVA (r = 0.278, P < 0.01). The number of health agencies (r1 = 0.267, r2 = -0.303, r3 = -0.291,), practicing or assistant practicing doctors (r1 = -0.283, r2 = 0.427, r3 = 0.502,), registered nurses (r1 = -0.289, r2 = 0.409, r3 = 0.469, P < 0.01), and health technicians (r1 = -0.278, r2 = 0.426, r3 = 0.500, P < 0.01) per 10,000 of the population was each correlated with the BCVA, VF-14 score, and total score of NEI-VFQ-25, respectively. Health expenditure per capita was correlated with the VF-14 score (r = 0.287, P < 0.01) and total score of NEI-VFQ-25 (r = 0.459, P < 0.01). The LOCS III P score was correlated with investments in the energy industry (r = 0.485, P < 0.001). Conclusions Patients in higher economic regions with greater medical resources show a greater demand to undergo cataract surgery at a better subjective and objective visual function. The energy industry has a significant effect on cataracts, especially the posterior subcapsular cataract, and thus more attention should be paid to people in regions with abundant energy industries.
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27
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Liu YX, Li B, Wu KR, Tang LY, Lin Q, Li QH, Yuan Q, Shi WQ, Liang RB, Ge QM, Shao Y. Altered white matter integrity in patients with monocular blindness: A diffusion tensor imaging and tract-based spatial statistics study. Brain Behav 2020; 10:e01720. [PMID: 32558355 PMCID: PMC7428480 DOI: 10.1002/brb3.1720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Visual deprivation can lead to abnormal and plastic changes in the brain's visual system and other systems. Although the secondary changes of gray matter in patients have been well studied, the study of white matter is rare. In fact, subtle changes in white matter may be revealed by diffusion tensor imaging, and tract-based spatial statistics can be used to analyze DTI image data. PURPOSE In the present study, diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS) were used to investigate abnormal structural changes in the white matter (WM) of patients with monocular blindness (MB). METHODS We recruited 16 healthy controls (HC) (fourteen males and two females) and 16 patients (fifteen males and one female) with right-eye blindness (without differences in left-eye vision). All patients were of similar age. Data acquisition was performed using magnetic resonance imaging (MRI) and DTI. Voxel-based whole brain comparisons of fractional anisotropy (FA) and radial diffusivity (RD) of WM fibers in patients and HC were performed using the TBSS method. The mean FA and RD values for altered brain regions in MB patients were analyzed via the receiver operating characteristic (ROC) curve. Correlation analysis was performed to investigate the relationships between the average FA (RD) value of the whole brain and anxiety score, depression score, and visual function questionnaire score in MB patients. RESULTS In MB patients, the mean FA of the whole brain was decreased versus HC. Moreover, the FA values of the corpus callosum, the corona radiata, the posterior thalamic radiation, and the right retrolenticular part of internal capsule were significantly decreased. In addition, the average RD value of the whole brain in MB patients was higher than that observed in HC. The mean FA and RD values of brain regions were analyzed using the ROC curve, and the results showed that the area under the ROC curve was more accurate. Furthermore, the average FA and RD values of the whole brain were significantly correlated with anxiety score, depression score, and visual function-related quality of life score. CONCLUSION DTI and TBSS may be useful in examining abnormal spontaneous alterations in the WM of MB patients. The observed changes in FA and RD values may imply the larvaceous neurological mechanism involved in MB.
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Affiliation(s)
- Yu-Xin Liu
- Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Biao Li
- Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Kang-Rui Wu
- Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li-Ying Tang
- Department of Ophthalmology, Xiang'an Hospital of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Eye Institute of Xiamen University, Xiamen University School of Medicine, Xiamen, China
| | - Qi Lin
- Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qing-Hai Li
- Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qing Yuan
- Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wen-Qing Shi
- Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Rong-Bin Liang
- Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qian-Min Ge
- Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yi Shao
- Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, The First Affiliated Hospital of Nanchang University, Nanchang, China
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28
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MicroRNA-182-5p protects human lens epithelial cells against oxidative stress-induced apoptosis by inhibiting NOX4 and p38 MAPK signalling. BMC Ophthalmol 2020; 20:233. [PMID: 32552665 PMCID: PMC7301500 DOI: 10.1186/s12886-020-01489-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/28/2020] [Indexed: 02/06/2023] Open
Abstract
Background MicroRNAs (miRNAs) are abnormally expressed in various ocular diseases, including age-related cataract. However, the role of miR-182-5p in the progression of age-related cataract remains unclear. Methods The expression of miR-182-5p in HLE-B3 cells was detected by qRT-PCR. HLE-B3 cells were transfected with miR-182-5p mimics. CCK-8, EdU, flow cytometry, 2′,7′-dichlorodihydrofluorescein diacetate, JC-1 kit, and western blot were used to assess the cell viability, proliferation, apoptosis, reactive oxygen species (ROS) level, mitochondrial membrane potential (MMP), and protein expression, respectively, in vitro. The relationship between miR-182-5p and NOX4 was confirmed using the dual-luciferase reporter gene analysis. Results We found that miR-182-5p expression was significantly decreased by the H2O2 exposure. Overexpression of miR-182-5p promoted cell proliferation and inhibited ROS production and apoptosis in H2O2-induced HLE-B3 cells. Moreover, p-p-38, p-ERK, and p-JNK were up-regulated in H2O2-treated HLE-B3 cells, and overexpression of miR-182-5p reversed the effects of H2O2 on HLE-B3 cells. In addition, dual-luciferase reporter assay substantiated that NOX4 was a direct target and downregulated by miR-182-5p. Conclusions We concluded that miR-182-5p inhibited lens epithelial cells apoptosis through regulating NOX4 and p38 MAPK signaling, providing a novel biomarker for treatment of age-related cataract.
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Bernhard GH, Neale RE, Barnes PW, Neale PJ, Zepp RG, Wilson SR, Andrady AL, Bais AF, McKenzie RL, Aucamp PJ, Young PJ, Liley JB, Lucas RM, Yazar S, Rhodes LE, Byrne SN, Hollestein LM, Olsen CM, Young AR, Robson TM, Bornman JF, Jansen MAK, Robinson SA, Ballaré CL, Williamson CE, Rose KC, Banaszak AT, Häder DP, Hylander S, Wängberg SÅ, Austin AT, Hou WC, Paul ND, Madronich S, Sulzberger B, Solomon KR, Li H, Schikowski T, Longstreth J, Pandey KK, Heikkilä AM, White CC. Environmental effects of stratospheric ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2019. Photochem Photobiol Sci 2020; 19:542-584. [PMID: 32364555 PMCID: PMC7442302 DOI: 10.1039/d0pp90011g] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/24/2022]
Abstract
This assessment, by the United Nations Environment Programme (UNEP) Environmental Effects Assessment Panel (EEAP), one of three Panels informing the Parties to the Montreal Protocol, provides an update, since our previous extensive assessment (Photochem. Photobiol. Sci., 2019, 18, 595-828), of recent findings of current and projected interactive environmental effects of ultraviolet (UV) radiation, stratospheric ozone, and climate change. These effects include those on human health, air quality, terrestrial and aquatic ecosystems, biogeochemical cycles, and materials used in construction and other services. The present update evaluates further evidence of the consequences of human activity on climate change that are altering the exposure of organisms and ecosystems to UV radiation. This in turn reveals the interactive effects of many climate change factors with UV radiation that have implications for the atmosphere, feedbacks, contaminant fate and transport, organismal responses, and many outdoor materials including plastics, wood, and fabrics. The universal ratification of the Montreal Protocol, signed by 197 countries, has led to the regulation and phase-out of chemicals that deplete the stratospheric ozone layer. Although this treaty has had unprecedented success in protecting the ozone layer, and hence all life on Earth from damaging UV radiation, it is also making a substantial contribution to reducing climate warming because many of the chemicals under this treaty are greenhouse gases.
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Affiliation(s)
- G H Bernhard
- Biospherical Instruments Inc., San Diego, California, USA
| | - R E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - P W Barnes
- Biological Sciences and Environment Program, Loyola University, New Orleans, USA
| | - P J Neale
- Smithsonian Environmental Research Center, Edgewater, Maryland, USA
| | - R G Zepp
- United States Environmental Protection Agency, Athens, Georgia, USA
| | - S R Wilson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - A L Andrady
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - A F Bais
- Department of Physics, Aristotle University of Thessaloniki, Greece
| | - R L McKenzie
- National Institute of Water & Atmospheric Research, Lauder, Central Otago, New Zealand
| | - P J Aucamp
- Ptersa Environmental Consultants, Faerie Glen, South Africa
| | - P J Young
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - J B Liley
- National Institute of Water & Atmospheric Research, Lauder, Central Otago, New Zealand
| | - R M Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - S Yazar
- Garvan Institute of Medical Research, Sydney, Australia
| | - L E Rhodes
- Faculty of Biology Medicine and Health, University of Manchester, and Salford Royal Hospital, Manchester, UK
| | - S N Byrne
- School of Medical Sciences, University of Sydney, Sydney, Australia
| | - L M Hollestein
- Erasmus MC, University Medical Center Rotterdam, Manchester, The Netherlands
| | - C M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - A R Young
- St John's Institute of Dermatology, King's College, London, London, UK
| | - T M Robson
- Organismal & Evolutionary Biology, Viikki Plant Science Centre, University of Helsinki, Helsinki, Finland
| | - J F Bornman
- Food Futures Institute, Murdoch University, Perth, Australia.
| | - M A K Jansen
- School of Biological, Earth and Environmental Sciences, University College Cork, Cork, Ireland
| | - S A Robinson
- Centre for Sustainable Ecosystem Solutions, University of Wollongong, Wollongong, Australia
| | - C L Ballaré
- Faculty of Agronomy and IFEVA-CONICET, University of Buenos Aires, Buenos Aires, Argentina
| | - C E Williamson
- Department of Biology, Miami University, Oxford, Ohio, USA
| | - K C Rose
- Department of Biological Sciences, Rensselaer Polytechnic Institute, Troy, New York, USA
| | - A T Banaszak
- Unidad Académica de Sistemas Arrecifales, Universidad Nacional Autónoma de México, Puerto Morelos, Mexico
| | - D -P Häder
- Department of Biology, Friedrich-Alexander University, Möhrendorf, Germany
| | - S Hylander
- Centre for Ecology and Evolution in Microbial Model Systems, Linnaeus University, Kalmar, Sweden
| | - S -Å Wängberg
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - A T Austin
- Faculty of Agronomy and IFEVA-CONICET, University of Buenos Aires, Buenos Aires, Argentina
| | - W -C Hou
- Department of Environmental Engineering, National Cheng Kung University, Tainan City, Taiwan, China
| | - N D Paul
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - S Madronich
- National Center for Atmospheric Research, Boulder, Colorado, USA
| | - B Sulzberger
- Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - K R Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, Canada
| | - H Li
- Institute of Atmospheric Environment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - T Schikowski
- Research Group of Environmental Epidemiology, Leibniz Institute of Environmental Medicine, Düsseldorf, Germany
| | - J Longstreth
- Institute for Global Risk Research, Bethesda, Maryland, USA
| | - K K Pandey
- Institute of Wood Science and Technology, Bengaluru, India
| | - A M Heikkilä
- Finnish Meteorological Institute, Helsinki, Finland
| | - C C White
- , 5409 Mohican Rd, Bethesda, Maryland, USA
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Scorcia V, Soda M, Lucisano A, Lanza M, Giannaccare G. A Preliminary Comparative Study of Visual Performance Between Two Newly Commercially Available Monofocal Intraocular Lenses Implanted During Cataract Surgery. Clin Ophthalmol 2020; 14:831-835. [PMID: 32214794 PMCID: PMC7083640 DOI: 10.2147/opth.s246319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 02/27/2020] [Indexed: 01/06/2023] Open
Abstract
Purpose To compare visual outcomes of two newly developed monofocal intraocular lenses (IOLs) (I-Stream H and CT Lucia 211P) implanted in patients undergoing surgery for senile cataract. Methods This prospective, comparative, single-center, randomized study included 94 eyes of 94 patients undergoing cataract surgery. Patients were randomized to receive the implantation of I-Stream H IOL (Group 1) or CT Lucia 211P IOL (Group 2). Each patient underwent a complete ocular examination before (V0), 1 month (V1), 3 months (V2) and 6 months (V3) after surgery, including visual acuity testing, objective refraction, slit-lamp biomicroscopy, contrast sensitivity testing and visual function index questionnaire (VF-14). Results After surgery, a significant increase of best-corrected visual acuity (BCVA), CS and VF-14 and a significant decrease of SE were detected in both groups at each time point compared to baseline (always p<0.01). No significant differences in the postoperative increase of BCVA (p=0.12), CS (p=0.21) and VF-14 (p=0.31) and decrease of SE (p=0.08) were detected comparing patients from Group 1 and Group 2 at V3. Mean and median prediction error, as well as absolute prediction error values, did not significantly differ between the two groups (p>0.05). Eyes with an actual refraction within 0.25, 0.50 and 1 D were 53.1%, 85.1% and 100% for Group 1 and 55.3%, 87.2% and 100% for Group 2 (p>0.05). Conclusion I-Stream H and CT Lucia 211P allowed a satisfied recovery of visual function after senile cataract surgery; both IOLs were shown to have similar outcomes of visual performance.
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Affiliation(s)
- Vincenzo Scorcia
- Department of Ophthalmology, University Magna Græcia, Catanzaro, Italy
| | - Mauro Soda
- Department of Ophthalmology, University Magna Græcia, Catanzaro, Italy
| | - Andrea Lucisano
- Department of Ophthalmology, University Magna Græcia, Catanzaro, Italy
| | - Michele Lanza
- Multidisciplinary Department of Medical, Surgical and Dental Specialities, Università della Campania "Luigi Vanvitelli", Naples, Italy
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Chen H, Shao ZM, Yu KD, Xu GZ. Association of adjuvant aromatase inhibitor with cataract risk in postmenopausal women with breast cancer. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:342. [PMID: 32355786 PMCID: PMC7186723 DOI: 10.21037/atm.2020.02.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Aromatase inhibitor (AI) is a cornerstone drug for endocrine therapy of postmenopausal hormone receptor-positive breast cancer. The relationship between AI medication and subsequent cataract risk is yet inconclusive. Methods A total of 1,697 postmenopausal, early-staged, and hormone receptor-positive breast cancer patients from the prospectively-maintained database of the Breast Surgery Department at Fudan University Shanghai Cancer Center were included, with 542 patients received no endocrine therapy and 1,155 treated with AI only. We explored the influence the use of AI or not and the duration of AI on the subsequent incidence of cataract. Results A total of 146 (8.6%) cataracts were observed in the whole study population. The incidence of cataract is highly related to age, with incidence of cataract in patients <50 years old, 50-60 years, ≥60 years was 2.9%, 6.9%, and 13.3%, respectively (P<0.001). There was no significant relationship between adjuvant AI use and cataract (7.4% in no endocrine group vs. 9.2% in the AI group) with an adjusted hazard ratio of 1.20 (95% confidence interval: 0.8-1.7, P=0.30). The incidence of cataract in patients with long-term AI (more than 5 years) could be high up to 14.7%, but without statistical significance compared to those the shorter duration (P=0.52). Conclusions There is no significant association between use of AI and cataract in postmenopausal breast cancer patients. Of note, age is an important risk factor for cataract and it is necessary to surveil the eye health in postmenopausal elderly women.
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Affiliation(s)
- Han Chen
- Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Zhi-Ming Shao
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Ke-Da Yu
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Ge-Zhi Xu
- Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
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Cho MC, Kim RB, Ahn JY, Yoo WS, Kim SJ. Aqueous humor and serum 25-Hydroxyvitamin D levels in patients with cataracts. BMC Ophthalmol 2020; 20:6. [PMID: 31906919 PMCID: PMC6945656 DOI: 10.1186/s12886-019-1293-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 12/27/2019] [Indexed: 12/20/2022] Open
Abstract
Background Serum 25-hydroxyvitamin D (25 (OH) D) levels are associated with various pathologic ocular conditions. Few studies have assessed 25 (OH) D concentrations in non-serum specimens, and none to date has assessed 25 (OH) D concentrations in human aqueous humor and their association with ocular diseases. This study investigated the possible correlations between 25 (OH) D concentrations in aqueous humor and serum and whether vitamin D concentrations in aqueous humor were associated with cataract. Methods This study prospectively enrolled 136 patients, including 87 with senile cataract and 49 with diabetic cataract, who underwent cataract surgery from January to November 2017. 25 (OH) D was measured in aqueous humor and serum specimens collected from all patients, and their correlation was analyzed statistically. Clinical and laboratory data, including the results of ophthalmologic examinations, were compared in the two groups of cataract patients. Results No correlation was observed between 25 (OH) D concentrations in aqueous humor and serum (P = 0.381). 25 (OH) D concentrations in aqueous humor were significantly higher in patients with diabetic than senile cataract (P = 0.006). Multivariate logistic regression analysis showed that the adjusted odds ratio for diabetic cataract for the highest compared with the lowest quartile of 25 (OH) D concentration in aqueous humor was 4.36 ng/ml (95% confidence interval [CI]: 1.33–14.34 ng/ml; P = 0.015). Multivariate linear regression analysis showed that 25(OH) D concentration in aqueous humor was 2.68 ng/ml (95% CI: 0.34–5.01 ng/ml; P = 0.025) higher in patients with diabetic than senile cataract. Conclusions 25(OH) D concentrations in aqueous humor and serum did not correlate with each other. Higher 25(OH) D level in aqueous humor was associated with diabetic cataract. These findings suggest that studies of vitamin D levels in patients with ocular conditions should include measurements of vitamin D levels in aqueous humor.
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Affiliation(s)
- Min-Chul Cho
- Department of Laboratory Medicine, Gyeongsang National University Hospital and Gyeongsang National University College of Medicine, Jinju, South Korea.,Institute of Health Science, Gyeongsang National University, Jinju, South Korea
| | - Rock-Bum Kim
- Department of Preventive Medicine, Gyeongsang National University Hospital and Gyeongsang National University College of Medicine, Jinju, South Korea
| | - Ja-Young Ahn
- Department of Ophthalmology, Gyeongsang National University Hospital and Gyeongsang National University College of Medicine, 79 Gangnam-ro, Jinju-si, Gyeongsangnam-do, 52727, South Korea
| | - Woong-Sun Yoo
- Institute of Health Science, Gyeongsang National University, Jinju, South Korea.,Department of Ophthalmology, Gyeongsang National University Hospital and Gyeongsang National University College of Medicine, 79 Gangnam-ro, Jinju-si, Gyeongsangnam-do, 52727, South Korea
| | - Seong-Jae Kim
- Institute of Health Science, Gyeongsang National University, Jinju, South Korea. .,Department of Ophthalmology, Gyeongsang National University Hospital and Gyeongsang National University College of Medicine, 79 Gangnam-ro, Jinju-si, Gyeongsangnam-do, 52727, South Korea.
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Lu WL, Shen PC, Lee CH, Su YT, Chen LM. High Risk of Early Cataracts in Young Type 1 Diabetes Group: A Nationwide Cohort Study. Int J Endocrinol 2020; 2020:8160256. [PMID: 33133186 PMCID: PMC7568800 DOI: 10.1155/2020/8160256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/28/2020] [Accepted: 09/18/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Chronic hyperglycemia in type 1 diabetes (T1D) patients results in ocular problems over time, but only a few studies emphasized on cataracts. AIM To evaluate the epidemiology of cataracts in the T1D population. METHOD A two-part study was conducted using data from the National Health Insurance Research Database in Taiwan. Information from the Longitudinal Health Insurance Database (LHID) was served as a template of the general population. In the first part, a total of 3,622 T1D cases registered between 1998 and 2007 were enrolled and compared with a matched group from the LHID. For identifying risk factors of cataracts in the T1D population in the second part, a total of 9032 T1D cases registered between 1998 and 2013 were included. RESULT Compared to the LHID, the hazard ratio (HR) of cataracts in the T1D group was 5.81 (95% CI 4.60-7.33), and the HR was higher in females (6.29, 95% CI 4.63-8.55). The peak incidence of cataracts occurred between age 20 and 29 in the T1D group, while in the LHID, it was after 60. The overall incidence of cataracts in the T1D group was 9.1%. In T1D patients with cataracts, they were found with higher rates of associated diabetic complications. CONCLUSION Compared to the nondiabetic population, cataracts seemed more rampant and premature in T1D patients, especially those of female gender. Early ophthalmologic examination should be considered in T1D patients.
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Affiliation(s)
- Wen-Li Lu
- Division of Genetics and Metabolism, Children's Hospital of China Medical University, Taichung, Taiwan
| | - Po-Chih Shen
- Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chen-Hao Lee
- Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Tsun Su
- Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Li-Min Chen
- Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
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Clinical Role of Epigenetics and Network Analysis in Eye Diseases: A Translational Science Review. J Ophthalmol 2019; 2019:2424956. [PMID: 31976085 PMCID: PMC6959156 DOI: 10.1155/2019/2424956] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/18/2019] [Accepted: 12/09/2019] [Indexed: 12/22/2022] Open
Abstract
Network medicine is a molecular-bioinformatic approach analyzing gene-gene interactions that can perturb the human interactome. This review focuses on epigenetic changes involved in several ocular diseases, such as DNA methylation, histone and nonhistone post-translational modifications, and noncoding RNA regulators. Although changes in aberrant DNA methylation play a major role in the pathogenesis of most ocular diseases, histone modifications are seldom investigated. Hypermethylation in TGM-2 and hypomethylation in MMP-2/CD24 promoter genes may play a crucial role in pterygium development; hypermethylation in regulatory regions of GSTP1 and OGG1 genes appear to be diagnostic biomarkers of cataract; hypomethylation of TGF-β1 promoter may trigger glaucoma onset; hypermethylation of the LOXL1 gene might be associated with pseudoexfoliation syndrome. A large panel of upregulated micro-RNAs (miRNAs), including hsa-hsa-miR-494, hsa-let-7e, hsa-miR-513-1, hsa-miR-513-2, hsa-miR-518c, hsa-miR-129-1, hsa-miR-129-2, hsa-miR-198, hsa-miR-492, hsa-miR-498, hsa-miR-320, hsa-miR-503, and hsa-miR-373, ∗ may have a putative role in the development of retinoblastoma. Hypermethylation of H3K4 and hypomethylation of H3K27 at the TGFBIp locus are putative pathogenic mechanisms involved in corneal dystrophies. Determining how, where, and when specific epigenetic changes trigger ocular diseases may provide useful clinical biomarkers for their prevention, diagnosis, and management, as well as innovative drug targets. PF-04523655, a 19-nucleotide methylated double-stranded siRNA targeting the RTP80 gene, showed a dose-related improvement in best-corrected visual acuity (BCVA) in patients affected by diabetic macular edema. The observed results support a clinical network-based research program aimed to clarify the role of epigenetic regulators in the development of ocular diseases and personalized therapy.
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Cui Z, Meng X, Feng H, Zhuang S, Liu Z, Zhu T, Ye K, Xing Y, Sun C, Zhou F, Tian Y. Estimation and projection about the standardized prevalence of osteoporosis in mainland China. Arch Osteoporos 2019; 15:2. [PMID: 31811461 DOI: 10.1007/s11657-019-0670-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 11/08/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED We performed a systematic analysis of the standardized prevalence of osteoporosis in mainland China from 1990 to 2050. INTRODUCTION Osteoporosis is the most common bone disease. We aimed to investigate the standardized prevalence of osteoporosis in mainland China at the national and regional levels, with projections until 2050. METHODS A comprehensive literature search was performed in PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and CBM-SinoMed. We constructed resample sets to calculate the standardized prevalence in each study. Multilevel mixed-effects logistic regression was used to estimate the age-specific and sex-specific prevalence. The United Nations Population Division (UNPD) data and regional population data from the fifth and sixth censuses in mainland China were used to estimate and project the national and regional prevalence of osteoporosis. RESULTS The standardized prevalence of osteoporosis ranged from 5.04% (2.12~11.34%) to 7.46% (3.13~16.32%) in males aged ≥ 50 years and from 26.28% (15.38~40.40%) to 39.19% (25.74~53.95%) in females aged ≥ 50 years from 1990 to 2050. Moreover, we did not find a significant difference in the standardized prevalence among three geographic regions (Central China, West China, and East China). CONCLUSION We found that osteoporosis is a serious public health challenge in mainland China. The findings in our study add insight into the epidemiology of osteoporosis and would be beneficial for the prevention and treatment of osteoporosis in mainland China.
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Affiliation(s)
- Zhiyong Cui
- Department of Orthopedic Surgery, Peking University Third Hospital, No 49 Huayuan Road, Haidian District, Beijing, China.,Peking University Health Science Center, Beijing, China
| | - Xiangyu Meng
- Department of Urology, Wuhan University Zhongnan Hospital, Wuhan, Hubei, China
| | - Hui Feng
- Department of Orthopedic Surgery, Peking University Third Hospital, No 49 Huayuan Road, Haidian District, Beijing, China
| | - Siying Zhuang
- Wuhan University School of Medicine, Wuhan, Hubei, China
| | - Zhaorui Liu
- Peking University Sixth Hospital, Beijing, China
| | - Tengjiao Zhu
- Department of Orthopedic Surgery, Peking University Third Hospital, No 49 Huayuan Road, Haidian District, Beijing, China.,Department of Orthopedic Surgery, Peking University International Hospital, Beijing, China
| | - Kaifeng Ye
- Department of Orthopedic Surgery, Peking University Third Hospital, No 49 Huayuan Road, Haidian District, Beijing, China.,Peking University Health Science Center, Beijing, China
| | - Yong Xing
- Department of Orthopedic Surgery, Peking University Third Hospital, No 49 Huayuan Road, Haidian District, Beijing, China.,Peking University Health Science Center, Beijing, China
| | - Chuan Sun
- Department of Orthopedic Surgery, Peking University Third Hospital, No 49 Huayuan Road, Haidian District, Beijing, China.,Peking University Health Science Center, Beijing, China
| | - Fang Zhou
- Department of Orthopedic Surgery, Peking University Third Hospital, No 49 Huayuan Road, Haidian District, Beijing, China
| | - Yun Tian
- Department of Orthopedic Surgery, Peking University Third Hospital, No 49 Huayuan Road, Haidian District, Beijing, China.
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Wu X, Huang Y, Liu Z, Lai W, Long E, Zhang K, Jiang J, Lin D, Chen K, Yu T, Wu D, Li C, Chen Y, Zou M, Chen C, Zhu Y, Guo C, Zhang X, Wang R, Yang Y, Xiang Y, Chen L, Liu C, Xiong J, Ge Z, Wang D, Xu G, Du S, Xiao C, Wu J, Zhu K, Nie D, Xu F, Lv J, Chen W, Liu Y, Lin H. Universal artificial intelligence platform for collaborative management of cataracts. Br J Ophthalmol 2019; 103:1553-1560. [PMID: 31481392 PMCID: PMC6855787 DOI: 10.1136/bjophthalmol-2019-314729] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/21/2019] [Accepted: 08/07/2019] [Indexed: 11/24/2022]
Abstract
Purpose To establish and validate a universal artificial intelligence (AI) platform for collaborative management of cataracts involving multilevel clinical scenarios and explored an AI-based medical referral pattern to improve collaborative efficiency and resource coverage. Methods The training and validation datasets were derived from the Chinese Medical Alliance for Artificial Intelligence, covering multilevel healthcare facilities and capture modes. The datasets were labelled using a three-step strategy: (1) capture mode recognition; (2) cataract diagnosis as a normal lens, cataract or a postoperative eye and (3) detection of referable cataracts with respect to aetiology and severity. Moreover, we integrated the cataract AI agent with a real-world multilevel referral pattern involving self-monitoring at home, primary healthcare and specialised hospital services. Results The universal AI platform and multilevel collaborative pattern showed robust diagnostic performance in three-step tasks: (1) capture mode recognition (area under the curve (AUC) 99.28%–99.71%), (2) cataract diagnosis (normal lens, cataract or postoperative eye with AUCs of 99.82%, 99.96% and 99.93% for mydriatic-slit lamp mode and AUCs >99% for other capture modes) and (3) detection of referable cataracts (AUCs >91% in all tests). In the real-world tertiary referral pattern, the agent suggested 30.3% of people be ‘referred’, substantially increasing the ophthalmologist-to-population service ratio by 10.2-fold compared with the traditional pattern. Conclusions The universal AI platform and multilevel collaborative pattern showed robust diagnostic performance and effective service for cataracts. The context of our AI-based medical referral pattern will be extended to other common disease conditions and resource-intensive situations.
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Affiliation(s)
- Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yelin Huang
- Beijing Tulip Partners Technology Co., Ltd, Beijing, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Weiyi Lai
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Erping Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Kai Zhang
- School of Computer Science and Technology, Xidian University, Xi'an, China
| | - Jiewei Jiang
- School of Computer Science and Technology, Xidian University, Xi'an, China
| | - Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Kexin Chen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Tongyong Yu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Dongxuan Wu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Cong Li
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yanyi Chen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Minjie Zou
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Chuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Yi Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Chong Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiayin Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ruixin Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yahan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yifan Xiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lijian Chen
- Beijing Tulip Partners Technology Co., Ltd, Beijing, China
| | - Congxin Liu
- Beijing Tulip Partners Technology Co., Ltd, Beijing, China
| | - Jianhao Xiong
- Beijing Tulip Partners Technology Co., Ltd, Beijing, China
| | - Zongyuan Ge
- Department of Electrical and Computer Systems Engineering, Faculty of Engineering, Monash University, Melbourne, Victoria, Australia
| | | | - Guihua Xu
- Huizhou Municipal Central Hospital, Huizhou, China
| | - Shaolin Du
- Tung Wah Hospital, Sun Yat-sen University, Dongguan, China
| | - Chi Xiao
- Dongguan Guangming Ophthalmic Hospital, Dongguan, China
| | - Jianghao Wu
- Dongguan Guangming Ophthalmic Hospital, Dongguan, China
| | - Ke Zhu
- Kaifeng Eye Hospital, Kaifeng, China
| | - Danyao Nie
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Fan Xu
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jian Lv
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Song P, Xu Y, Zha M, Zhang Y, Rudan I. Global epidemiology of retinal vein occlusion: a systematic review and meta-analysis of prevalence, incidence, and risk factors. J Glob Health 2019; 9:010427. [PMID: 31131101 PMCID: PMC6513508 DOI: 10.7189/jogh.09.010427] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Retinal vein occlusion (RVO) is the second most common retinal vascular disorder that affected 16.4 million people worldwide in 2008. The last decade has seen new epidemiological data on RVO, enabling us to provide a contemporary estimation of RVO epidemiology. Methods We searched PubMed, Medline, Embase, GLOBAL HEALTH, World Health Organization Global Health Library, China National Knowledge Infrastructure for studies that reported prevalence or incidence of RVO in the general population. The age- and sex-specific prevalence of RVO was estimated by a multilevel mixed-effects logistic regression, the incidence of RVO and potential risk factors for RVO were respectively pooled by a random-effects meta-analysis. Results The prevalence of any RVO, branch RVO (BRVO) and central RVO (CRVO) all increased with advanced age, but didn’t differ significantly between sexes. In 2015, the global prevalence of any RVO, BRVO and CRVO in people aged 30-89 years was 0.77% (95% confidence interval CI = 0.55-1.08), 0.64% (95% CI = 0.47-0.87) and 0.13% (95% CI = 0.08-0.21), equivalent to an overall of 28.06 million, 23.38 million and 4.67 million affected people. For any RVO, the pooled five-year cumulative incidence was 0.86% (95% CI = 0.70-1.07) and the pooled ten-year cumulative incidence was 1.63% (95% CI = 1.38-1.92). Hypertension was the strongest risk factor for any RVO, with a meta- odds ratio (OR) of 2.82 (95% CI = 2.12-3.75). Conclusions This study provides an updated summary of RVO epidemiology in the general population. More epidemiological studies worldwide are still needed to better understand the global disease burden of RVO.
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Affiliation(s)
- Peige Song
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Yuehong Xu
- Medical school Southeast University, Nanjing, Jiangsu, China
| | - Mingming Zha
- Medical school Southeast University, Nanjing, Jiangsu, China
| | - Yan Zhang
- Faculty of Life Science and Medicine, Kings College London, London, England, UK
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
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