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Ayoubi M, Cabrera K, Locatelli EV, Felix ER, Galor A. Associations between Corneal Nerve Structure and Function in a Veteran Population. J Clin Med 2024; 13:2513. [PMID: 38731042 DOI: 10.3390/jcm13092513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Background: We evaluate the relationship between corneal nerve structure and function in a veteran population. Methods: 83 veterans (mean age: 55 ± 5 years) seen at the Miami Veterans Affairs (VA) eye clinic were included in this study. Each individual filled out questionnaires to evaluate ocular symptoms (5-Item Dry Eye Questionnaire, DEQ5; Ocular Surface Disease Index, OSDI) and ocular pain (Numerical Rating Scale, NRS; Neuropathic Pain Symptom Inventory modified for the Eye, NPSI-Eye). The individuals also underwent an ocular surface examination that captured functional nerve tests including corneal sensation, corneal staining, and the Schirmer test for tear production. Corneal sub-basal nerve analysis was conducted using in vivo confocal microscopy (IVCM) images with corneal nerve density, length, area, width, and fractal dimension captured. IVCM and functional corneal metrics from the right eye were examined using correlational and linear regression analysis. Results: Most corneal structural metrics were not related to functional metrics, except for weak correlations between various IVCM metrics and tear production. In addition, corneal nerve fiber area was positively related to corneal sensation (r = 0.3, p = 0.01). On linear regression analyses, only the corneal fractal dimension remained significantly related to tear production (β = -0.26, p = 0.02) and only the corneal nerve fiber area remained significantly related to corneal sensation (β = 0.3, p = 0.01). Conclusions: Most corneal nerve structural metrics did not relate to functional metrics in our veteran population, apart from a few weak correlations between structural metrics and tear production. This suggests that using corneal nerve anatomy alone may be insufficient for predicting corneal function.
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Affiliation(s)
- Mohammad Ayoubi
- Surgical and Research Services, Miami Veterans Administration Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA
| | - Kimberly Cabrera
- Surgical and Research Services, Miami Veterans Administration Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA
| | - Elyana Vt Locatelli
- Surgical and Research Services, Miami Veterans Administration Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA
| | - Elizabeth R Felix
- Surgical and Research Services, Miami Veterans Administration Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA
| | - Anat Galor
- Surgical and Research Services, Miami Veterans Administration Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL 33136, USA
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Bashir E, Abdu L, Isyaku M, Habib ZG, Habib SG, Kurawa MS, Hassan S. Ophthalmic Manifestations of Migraine in a Nigerian Tertiary Health Facility. J West Afr Coll Surg 2024; 14:76-82. [PMID: 38486648 PMCID: PMC10936896 DOI: 10.4103/jwas.jwas_80_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/25/2023] [Indexed: 03/17/2024]
Abstract
Background Migraine is a group of headache syndromes, with a prevalence of 5%-25%. Migraine is a complex recurrent headache disorder, often unilateral, throbbing or pulsating in nature aggravated by physical activity, bright light, and loud noises. Symptoms associated with migraine without aura are nausea, anorexia, and varying degrees of ophthalmic problems ranging from visual aura, ocular symptoms, and ophthalmoplegia. Objectives The study determined the pattern and ophthalmic manifestations of migraine in Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods This was an observational cross-sectional study. Ethical clearance was obtained from the research ethical committee of Aminu Kano Teaching Hospital (AKTH). A total of 254 patients diagnosed with migraine using international headache society criteria attending neurology clinic in AKTH were interviewed and examined using a structured questionnaire which captured the biodata, pattern of migraine and ocular symptoms associated with migraine. The data obtained were collated and analysed using Statistical Package for the Social Sciences, version 23. Results Of the 254 patients examined, there were 95 (37.4%) males and 159 (62.6%) females, (M:F = 1:2) with mean age of 28.9 ± 9.7 years. Migraine without aura was the commonest type seen in 55.8% of patients. Most patients had unilateral headaches. About 52.8% and 57.5% had headaches that were throbbing in nature. The headache lasted for 72 h in 48.2% and 48 h in 30.3%. It was triggered by physical stress in 49.6% and lack of sleep in 46.5%. The commonest associated symptom was nausea in 44.9%, tinnitus in 39.0%, and vomiting in 29.1%. While the commonest ocular/visual symptom was photophobia in 76% of patients. Most of the patients had family history of migraine (62.8%). Migraine without aura (MWOA) was found to be significantly associated with female gender (P = 0.001; OR = 2.48; 95% CI: 1.45-4.25). Scotoma, fortifying spectra were significantly associated with migraine with aura (MWA; P = 0.0004; OR = 28.46; 95% CI: 11.53-70.35). Conclusion Migraine is one of the most common types of primary headache. There is a female preponderance. Migraine has significant association with visual disturbances and ocular symptoms.
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Affiliation(s)
- Eiman Bashir
- Department of Ophthalmology, Aminu Kano Teaching Hospital, Kano, Nigeria
- St Helens and Knowsley Teaching Hospital, Health Education England-East Midlands, Leicestershire, United Kingdom
| | - Lawan Abdu
- Department of Ophthalmology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Mohammed Isyaku
- Department of Ophthalmology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Zahraddeen Garba Habib
- Department of Psychiatry, Faculty of Clinical Sciences, College of Health Sciences, Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Saudat Garba Habib
- Department of Ophthalmology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Musbahu Sani Kurawa
- Department of Ophthalmology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Sadiq Hassan
- Department of Ophthalmology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria
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Moideen Sheriff S, Chukwunyelu NK, Ezeafulukwe CJ, Kunnel SS, Hassan OA. A Rare Case of Chronic Photophobia Associated With Oral Vancomycin Therapy: Exploring the Relationship. Cureus 2023; 15:e42145. [PMID: 37602043 PMCID: PMC10438128 DOI: 10.7759/cureus.42145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Vancomycin is a widely used tricyclic glycopeptide antibiotic for treating various Gram-positive infections, including Clostridium difficile colitis. Although considered generally safe, it has been associated with several side effects. In this case report, we highlight a rare adverse effect in which a patient experienced chronic photophobia following treatment with oral vancomycin. This sheds light upon a potential relationship between oral vancomycin therapy and photophobia, emphasizing the need for increased awareness in clinical practice and urging further investigation into this association.
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Affiliation(s)
- Serin Moideen Sheriff
- Department of Emergency Medicine, Lal Bahadur Shastri Hospital, Delhi, IND
- Department of Internal Medicine, Odesa National Medical University, Odessa, UKR
| | | | | | - Sandra S Kunnel
- Department of Internal Medicine, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, IND
| | - Omar A Hassan
- Department of General Medicine, Ondokuz Mayis University, Samsun, TUR
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Shimazaki S, Sato J, Niwa A. Bilateral Eyelid Edema in a Pediatric Patient With COVID-19: A Case Report and Literature Review. Cureus 2023; 15:e40427. [PMID: 37456421 PMCID: PMC10348718 DOI: 10.7759/cureus.40427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is primarily transmitted through the eyes, nose, or mouth. Ophthalmic complications, such as conjunctivitis and dacryoadenitis, have been reported in patients with coronavirus disease 19 (COVID-19). We report the case of an early adolescent girl who presented with bilateral urticarial rashes, eyelid edema, fever, and cough. She was diagnosed with acute dacryoadenitis with SARS-CoV-2 infection confirmed by a nasopharyngeal polymerase chain reaction and clinical investigations. The patient was treated with dexamethasone (3 mg daily) for three days, which resulted in the resolution of fever and urticarial rash, and improvement of eyelid edema. While bilateral upper eyelid edema and acute dacryoadenitis commonly occur in pediatric patients due to Epstein-Barr virus (EBV) infection and Kawasaki disease, they are rarely associated with other diseases. However, ocular symptoms have been reported in 11.4% of patients with COVID-19. In addition, eyelid edema and acute dacryoadenitis have also been reported after COVID-19 messenger RNA (mRNA) vaccination. The underlying mechanisms of these complications are not yet completely understood. Our case highlights the possibility of bilateral eyelid edema in children with COVID-19, which can occur in addition to other viral infections such as EBV.
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Affiliation(s)
- Shunsuke Shimazaki
- Department of Pediatrics, Funabashi Municipal Medical Center, Chiba, JPN
| | - Junichi Sato
- Department of Pediatrics, Funabashi Municipal Medical Center, Chiba, JPN
| | - Atsuko Niwa
- Department of Pediatrics, Funabashi Municipal Medical Center, Chiba, JPN
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Gadain Hassan HA. Computer Vision Syndrome Among Medical Students at the University of Khartoum, Sudan: Prevalence and Associated Factors. Cureus 2023; 15:e38762. [PMID: 37303411 PMCID: PMC10249515 DOI: 10.7759/cureus.38762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Background and aims Regular continuous uninterrupted use of electronic devices, such as smartphones, tablets, and computers, can result in a spectrum of vision-related symptoms known as computer vision syndrome. Students today can readily access information and books on their smartphones and computers, which reduces their reliance on printed texts. Numerous muscle-related and ocular complaints could arise from this. The primary objective of this study was to estimate the prevalence of computer vision syndrome symptoms among medical students at the University of Khartoum and to identify its contributing factors. The secondary objective was to evaluate practices and knowledge related to computer vision syndrome prevention. Methods This study is a facility-based cross-sectional observation aimed at describing medical students' characteristics at the University of Khartoum. The sampling strategy employed was stratified random sampling, and a structured online questionnaire was used to collect the data. A total of 149 students completed the self-administered questionnaire. The questionnaire included questions on sociodemographic data, validated symptoms of computer vision syndrome, and factors associated with the syndrome's development. Data were analyzed using SPSS Statistics (Armonk, NY: IBM Corp.), simple descriptive statistics were calculated, and odds ratios and Pearson's chi-square test were employed to examine and quantify the association between variables. Results Of the 149 participants, 58.4% were female, while males made up 41.6% of the study sample. The prevalence of computer vision syndrome has been found to be 94%, and 72.4% of the students reported experiencing at least three symptoms of computer vision syndrome. Neck and shoulder pain was the most commonly reported symptom (78.5%), followed by headache (70.5%), while the least reported symptom was eye redness (36.2%). The majority of students (81.2%) used electronic devices for five or more hours a day, and the most common posture while using electronic devices was lying down, as reported by 54.4% of the students. A total of 68% of the medical students in this study reported keeping a distance that was shorter than the suggested 40 centimeters from the screen, and only 18.1% were aware of the 20-20-20 rule (every 20 minutes look at an object 20 feet away for 20 seconds). The seating position has been found to be significantly associated with the number of symptoms experienced (p=0.012); sitting with a bent back was 4.6 times more likely to cause more than three symptoms when compared to sitting upright with a straight back (OR=4.643; 95% CI: 1.63-13.21; p=0.004). Conclusion There was a very high prevalence of computer vision syndrome among medical students at the University of Khartoum. Most students had poor awareness and bad practices regarding the safe use of electronic devices. Awareness campaigns to encourage good practices and enable the safe use of computers and other digital devices are strongly recommended.
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Ashikawa Y, Kusunoki Nakamoto F, Sato T, Katsumata J, Bannai T, Seki T, Takeda M, Shiio Y. Successful Treatment of Herpes Zoster Ophthalmicus Complicated by Intense Orbital Inflammation Using Laser Irradiation over the Stellate Ganglion. Intern Med 2023; 62:623-627. [PMID: 35831112 PMCID: PMC10017239 DOI: 10.2169/internalmedicine.9503-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 56-year-old man presented with right-sided headache and ptosis accompanied by a facial skin rash. He was diagnosed with herpes zoster ophthalmicus (HZO). Despite acyclovir and steroid therapy, the ocular symptoms worsened. Magnetic resonance imaging (MRI) revealed severe orbital inflammation and abnormal lesions in the right trigeminal nucleus and tract. The effects of re-administration of intravenous acyclovir and steroid pulse therapy were limited. Laser irradiation of the stellate ganglion (SGL) and high-dose oral prednisolone therapy were effective. Our experience suggests the efficacy of early multimodal treatment, including SGL, in treating ocular symptoms associated with HZO.
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Affiliation(s)
| | | | - Tatsuya Sato
- Department of Neurology, Tokyo Teishin Hospital, Japan
| | | | - Taro Bannai
- Department of Neurology, Tokyo Teishin Hospital, Japan
| | - Tomonari Seki
- Department of Neurology, Tokyo Teishin Hospital, Japan
| | - Masako Takeda
- Department of Anesthesiology, Tokyo Teishin Hospital, Japan
| | - Yasushi Shiio
- Department of Neurology, Tokyo Teishin Hospital, Japan
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Saito M, Nishimura S, Okuyama S, Kubota K, Matsuyama J, Takemura A, Matsushima T, Sakuma H, Watanabe K. Extensive extracranial growth of spheno-orbital meningioma: illustrative case. J Neurosurg Case Lessons 2023; 5:CASE22322. [PMID: 36794729 PMCID: PMC10550608 DOI: 10.3171/case22322] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/14/2022] [Indexed: 02/15/2023]
Abstract
BACKGROUND Spheno-orbital meningioma (SOM) typically presents with a classic triad of symptoms (i.e., proptosis, visual impairment, and ocular paresis), resulting from intraorbital tumor invasion. The authors present a very rare case of SOM in which the chief complaint was swelling of the left temporal region, which, to the best of their knowledge, has not been reported previously. OBSERVATIONS The patient presented with marked extracranial extension to the left temporal region but unremarkable intraorbital extension, even on radiological examination. Physical examination of the patient showed almost no exophthalmos or restriction of left eye movement, consistent with the radiological findings. Four separate meningioma specimens were removed by extraction (i.e., one each from the intracranial, extracranial, and intraorbital segments of the tumor and one from the skull). The World Health Organization grade was 1 and the MIB-1 index was less than 1%, indicating a diagnosis of a benign tumor. LESSONS SOM may be present even in patients with only temporal swelling and few ocular-related symptoms, and detailed imaging evaluations may be required to identify the tumor.
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Affiliation(s)
- Makoto Saito
- Department of Neurosurgery, Southern Tohoku General Hospital, Iwanuma, Japan; and
| | - Shinjitsu Nishimura
- Department of Neurosurgery, Southern Tohoku General Hospital, Iwanuma, Japan; and
| | - Sumito Okuyama
- Department of Neurosurgery, Southern Tohoku General Hospital, Iwanuma, Japan; and
| | - Keiichi Kubota
- Department of Neurosurgery, Southern Tohoku General Hospital, Iwanuma, Japan; and
| | - Junko Matsuyama
- Department of Neurosurgery, Southern Tohoku General Hospital, Iwanuma, Japan; and
| | - Atsuhito Takemura
- Department of Neurosurgery, Southern Tohoku General Hospital, Iwanuma, Japan; and
| | - Tadao Matsushima
- Department of Neurosurgery, Southern Tohoku General Hospital, Iwanuma, Japan; and
| | | | - Kazuo Watanabe
- Neurosurgery, Southern Tohoku General Hospital, Koriyama, Japan
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Abstract
Objectives: The aim of this study was to investigate the prevalence of symptoms of computer vision syndrome (CVS) and identify its associated risk factors among computer-using bank workers in Pakistan. Materials and Methods: This cross-sectional study was conducted on computer-using bank workers. The data collection procedure included a self-administered questionnaire and comprehensive ocular health examination. The prevalence of CVS and its associated risk factors were investigated. The chi-square test was used to study the significance of the association of CVS with potential risk factors. Results: Of 127 participants, 95 (74.8%) were men. Most of the participants (n=53; 41.7%) were in the 30-40 years age group. A total of 101 participants (79.5%) reported any ocular symptom, with burning eyes being the most frequent ocular symptom (77.2%). General body fatigue was the most common non-ocular symptom of CVS (92.9%), followed by headache (83.5%). Out of 127 participants, 71 men and 30 women had some degree of CVS. Female participants had significantly higher risk of CVS than male participants (p=0.01). Total duration of computer use per day and duration of uninterrupted computer use were significantly associated with the occurrence of CVS (p=0.001 and p=0.008, respectively). No significant association was found between CVS and distance from computer screen (p=0.89), frequency of breaks (p=0.18), or font size (p=0.12). Conclusion: A high prevalence of CVS-related symptoms was observed among computer-using bank workers. Non-ocular symptoms associated with computer use were more common than ocular symptoms (92.9% vs. 77.2%).
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Affiliation(s)
- Mufarriq Shah
- Pakistan Institute of Community Ophthalmology, Department of Optometry, Hayatabad Medical Complex Peshawar, Peshawar, Pakistan
| | - Abdul Saboor
- Pakistan Institute of Community Ophthalmology, Department of Optometry, Hayatabad Medical Complex Peshawar, Peshawar, Pakistan
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Muacevic A, Adler JR. Acute Leukemia Presenting in the Pediatric Orbit. Cureus 2022; 14:e29996. [PMID: 36381778 PMCID: PMC9636987 DOI: 10.7759/cureus.29996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 01/25/2023] Open
Abstract
We present a case series to evaluate the clinical features of acute leukemia presenting with primary orbital manifestations. We undertook a retrospective case review of primary orbital presentations of acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL) over a 10-year period at two hospital sites (Hereford County Hospital and Leicester Royal Infirmary). Our case series included four patients - two with AML and two with ALL. Patients were young (mean age of four years and five months) at presentation, all with unilateral disease, and presented with orbital signs. Although there was some confusion with the diagnosis at the time of referral, a suspicion of malignancy was made rapidly once ophthalmic review was initiated. All four cases were diagnosed with the assistance of peripheral blood film and bone marrow biopsy, without the need for orbital biopsy. All four cases had resolution of the orbital mass and remain disease-free.
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Serhan HA, Alma’aitah HW, Irshaidat S, Ameer MA, Asghar MS, Tahir MJ. Ophthalmic manifestations of nutritional deficiencies: A mini review. J Family Med Prim Care 2022; 11:5899-5901. [PMID: 36618247 PMCID: PMC9810943 DOI: 10.4103/jfmpc.jfmpc_790_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/01/2022] [Accepted: 06/07/2022] [Indexed: 11/11/2022] Open
Abstract
Balanced nutrition is crucial for a healthy eye and vision. Many nutritional deficiencies can result in vision impairment. This article reviews the ocular manifestations of vitamin deficiencies, including vitamin A, vitamin B1 and B12, vitamin C, vitamin D, and vitamin E, and minerals such as zinc. It discusses different ophthalmic symptoms and signs, including dry eye disease, corneal xerosis, decreased night vision, subconjunctival hemorrhage, and retinal changes similar to retinitis pigmentosa. We strongly recommend using multi-vitamin supplements for treating many diseases such as age-related macular degeneration.
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Affiliation(s)
| | | | - Sara Irshaidat
- Department of Pediatric, King Hussein Cancer Centre, Amman, Jordan
| | - Muhammad Atif Ameer
- Department of Medicine, University Hospitals Bristol and Weston NHS Foundation Trust, Weston-Super Mare, UK
| | - Muhammad Sohaib Asghar
- Department of Internal Medicine, Dow University of Health Sciences–Ojha Campus, Karachi, Pakistan,Address for correspondence: Dr. Muhammad Sohaib Asghar, Department of Internal Medicine, Dow University Hospital–Ojha Campus, Dow University of Health Sciences, Karachi, Pakistan. B328, Block 6, Gulshan-e-Iqbal, Karachi - 75300, Pakistan. E-mail:
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Niedźwiedź A, Kawa M, Pius-Sadowska E, Kuligowska A, Ziontkowska A, Wrzałek D, Parczewski M, Safranow K, Kozłowski K, Machaliński B, Machalińska A. Evaluating Ocular Symptoms and Tear Film Cytokine Profiles in Symptomatic COVID-19 Patients. J Clin Med 2022; 11:jcm11092647. [PMID: 35566776 PMCID: PMC9105717 DOI: 10.3390/jcm11092647] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 12/23/2022] Open
Abstract
Background: This study investigated the presence and duration of ophthalmic symptoms in the early phase of COVID-19 to assess the corresponding local immune response on the ocular surface. Methods: The study included data from 180 COVID-19 patients and 160 age-matched healthy controls. The main finding was the occurrence of ophthalmological manifestations at the time of admission to the hospital and during the preceding 7 days. Tear film concentrations of TNF-α, IL-1b, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12 p70, GM-CSF, and IFN-γ were determined by a magnetic bead assay. Results: Among the COVID-19 patients, 12.64% had at least one ocular symptom at the time of admission, and 24.14% had symptoms within the preceding 7 days (p < 0.001 vs. controls). We found that the COVID-19 patients complained more frequently about eye tearing (p = 0.04) and eye pain (p = 0.01) than controls. A multivariate analysis of the patients and controls adjusted for age and sex revealed that COVID-19 was an independent factor associated with higher VEGF and IL-10 tear film concentrations (β = +0.13, p = 0.047 and β = +0.34, p < 0.001, respectively) and lower IL-1β, IL-8, and GM-CSF levels (β = −0.25, p < 0.001; β = −0.18, p = 0.004; and β = −0.82, p = 0.0 respectively). Conclusions: SARS-CoV-2 does not attract a strong local response of the conjunctival immune system; therefore, ophthalmic symptoms may not constitute a substantial element in the clinical picture of novel COVID-19 infection.
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Affiliation(s)
- Anna Niedźwiedź
- Department of General Pathology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.N.); (M.K.); (E.P.-S.); (B.M.)
| | - Miłosz Kawa
- Department of General Pathology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.N.); (M.K.); (E.P.-S.); (B.M.)
| | - Ewa Pius-Sadowska
- Department of General Pathology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.N.); (M.K.); (E.P.-S.); (B.M.)
| | - Agnieszka Kuligowska
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.K.); (A.Z.); (D.W.)
| | - Alicja Ziontkowska
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.K.); (A.Z.); (D.W.)
| | - Dawid Wrzałek
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.K.); (A.Z.); (D.W.)
| | - Miłosz Parczewski
- Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Arkońska 4 Street, 71-455 Szczecin, Poland;
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Krzysztof Kozłowski
- Department of Constitutional Law, Faculty of Law and Administration, Jagiellonian University, Bracka 12 Street, 31-005 Krakow, Poland;
| | - Bogusław Machaliński
- Department of General Pathology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.N.); (M.K.); (E.P.-S.); (B.M.)
| | - Anna Machalińska
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.K.); (A.Z.); (D.W.)
- Correspondence: ; Tel.: +48-91-483-86-00
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Li Z, Du K, Chu X, Lv H, Zhang W, Wang Z, Yuan Y, Meng L. TTR Gly83Arg Mutation: Beyond Familial Vitreous Amyloidosis. Front Neurol 2022; 12:821003. [PMID: 35185758 PMCID: PMC8850374 DOI: 10.3389/fneur.2021.821003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Gly83Arg variation is a type of TTR mutation specific to the Chinese population. Patients of hereditary transthyretin amyloidosis (ATTR) with Gly83Arg variation predominantly present with blurred vision and most of these cases are reported by ophthalmologists. There is currently no systematic assessment of extraocular features of ATTR with Gly83Arg variation. METHODS Six patients and two asymptomatic carriers with molecularly confirmed Gly83Arg variation of ATTR from three unrelated families were identified by sequencing the TTR gene. The clinical, electrophysiological, ultrasonic, and pathological data were collected and analyzed. RESULTS This study included six patients and two carriers with TTR Gly83Arg mutation, all of whom came from the Han nationality of China. The average age of onset for the six patients was 39 years, and the course of disease ranged from 5 to 19 years. All the patients started with blurred vision, which was diagnosed as vitreous opacity (VO). Most of the patients developed sensory-motor polyneuropathies over years or even more than a decade (4-15 years) after VO. However, the heterogeneity of peripheral neuropathies among these patients remained large between families. Autonomic impairment also occurred after VO, with varying degrees of abnormalities seen in the associated autonomic assessments. None of the patients had any symptoms of cardiac impairment, but abnormal results were found in examinations. A combined biopsy of the sural nerve and muscle was also performed. Nerve pathology revealed the moderately reduced myelinated nerve fiber density and muscle pathology showed predominant neurogenic impairment accompanied by possible myogenic impairment. CONCLUSIONS This is a detailed account of Gly83Arg mutation-related ATTR, focusing on the extraocular presentations of this special variant in Chinese. Clinical features of this variant are early-onset, ocular involvement predominance, neurological, and cardiac involvement along with the disease, and relatively long survival.
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Affiliation(s)
- Zhenxian Li
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China
| | - Kang Du
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China
| | - Xujun Chu
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China
| | - He Lv
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China
| | - Lingchao Meng
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing, China
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13
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Deiner MS, Seitzman GD, Kaur G, McLeod SD, Chodosh J, Lietman TM, Porco TC. Sustained Reductions in Online Search Interest for Communicable Eye and Other Conditions During the COVID-19 Pandemic: Infodemiology Study. JMIR Infodemiology 2022; 2:e31732. [PMID: 35320981 PMCID: PMC8931841 DOI: 10.2196/31732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/26/2022] [Accepted: 02/16/2022] [Indexed: 12/20/2022]
Abstract
Background In a prior study at the start of the pandemic, we reported reduced numbers of Google searches for the term “conjunctivitis” in the United States in March and April 2020 compared with prior years. As one explanation, we conjectured that reduced information-seeking may have resulted from social distancing reducing contagious conjunctivitis cases. Here, after 1 year of continued implementation of social distancing, we asked if there have been persistent reductions in searches for “conjunctivitis,” and similarly for other communicable disease terms, compared to control terms. Objective The aim of this study was to determine if reduction in searches in the United States for terms related to conjunctivitis and other common communicable diseases occurred in the spring-winter season of the COVID-19 pandemic, and to compare this outcome to searches for terms representing noncommunicable conditions, COVID-19, and to seasonality. Methods Weekly relative search frequency volume data from Google Trends for 68 search terms in English for the United States were obtained for the weeks of March 2011 through February 2021. Terms were classified a priori as 16 terms related to COVID-19, 29 terms representing communicable conditions, and 23 terms representing control noncommunicable conditions. To reduce bias, all analyses were performed while masked to term names, classifications, and locations. To test for the significance of changes during the pandemic, we detrended and compared postpandemic values to those expected based on prepandemic trends, per season, computing one- and two-sided P values. We then compared these P values between term groups using Wilcoxon rank-sum and Fisher exact tests to assess if non-COVID-19 terms representing communicable diseases were more likely to show significant reductions in searches in 2020-2021 than terms not representing such diseases. We also assessed any relationship between a term’s seasonality and a reduced search trend for the term in 2020-2021 seasons. P values were subjected to false discovery rate correction prior to reporting. Data were then unmasked. Results Terms representing conjunctivitis and other communicable conditions showed a sustained reduced search trend in the first 4 seasons of the 2020-2021 COVID-19 pandemic compared to prior years. In comparison, the search for noncommunicable condition terms was significantly less reduced (Wilcoxon and Fisher exact tests, P<.001; summer, autumn, winter). A significant correlation was also found between reduced search for a term in 2020-2021 and seasonality of that term (Theil-Sen, P<.001; summer, autumn, winter). Searches for COVID-19–related conditions were significantly elevated compared to those in prior years, and searches for influenza-related terms were significantly lower than those for prior years in winter 2020-2021 (P<.001). Conclusions We demonstrate the low-cost and unbiased use of online search data to study how a wide range of conditions may be affected by large-scale interventions or events such as social distancing during the COVID-19 pandemic. Our findings support emerging clinical evidence implicating social distancing and the COVID-19 pandemic in the reduction of communicable disease and on ocular conditions.
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Affiliation(s)
- Michael S Deiner
- Francis I Proctor Foundation University of California San Francisco San Francisco, CA United States.,Department of Ophthalmology University of California San Francisco San Francisco, CA United States
| | - Gerami D Seitzman
- Francis I Proctor Foundation University of California San Francisco San Francisco, CA United States.,Department of Ophthalmology University of California San Francisco San Francisco, CA United States
| | - Gurbani Kaur
- School of Medicine University of California San Francisco San Francisco, CA United States
| | - Stephen D McLeod
- Francis I Proctor Foundation University of California San Francisco San Francisco, CA United States.,Department of Ophthalmology University of California San Francisco San Francisco, CA United States
| | - James Chodosh
- Department of Ophthalmology Massachusetts Eye and Ear Harvard Medical School Boston, MA United States
| | - Thomas M Lietman
- Francis I Proctor Foundation University of California San Francisco San Francisco, CA United States.,Department of Ophthalmology University of California San Francisco San Francisco, CA United States.,Department of Epidemiology and Biostatistics Global Health Sciences University of California San Francisco San Francisco, CA United States
| | - Travis C Porco
- Francis I Proctor Foundation University of California San Francisco San Francisco, CA United States.,Department of Ophthalmology University of California San Francisco San Francisco, CA United States.,Department of Epidemiology and Biostatistics Global Health Sciences University of California San Francisco San Francisco, CA United States
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14
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Piromchai P, Pornumnouy W, Saeseow P, Chainansamit S. The minimum effective dose of abobotulinum toxin A injection for allergic rhinitis: A dose-escalation randomized controlled trial. Laryngoscope Investig Otolaryngol 2021; 6:6-12. [PMID: 33614923 PMCID: PMC7883613 DOI: 10.1002/lio2.499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/28/2020] [Accepted: 11/05/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To find the lowest effective injection dose of abobotulinum toxin A (Dysport) for allergic rhinitis. STUDY DESIGN Dose-escalation randomized controlled trial. METHODS We included all patients aged 18 years or older who had persistent allergic rhinitis and positive allergy skin prick test. The patients were randomly allocated to receive 40, 30, or 20 U of abobotulinum toxin A by injection at the inferior turbinate. We followed up on patients for 12 weeks to evaluate nasal symptoms, ocular symptoms, minimum nasal cross-sectional area as measured using acoustic rhinometry, and complications. RESULTS Seventeen patients were included in this study, with 7 receiving 20 U of abobotulinum toxin A and 5 each receiving 30 U and 40 U. Abobotulinum toxin A significantly improved nasal congestion, rhinorrhea, sneezing, and loss of smell at 40 U (P < .05) and nasal congestion, sneezing, and loss of smell at 30 U (P < .05). However, at a dose of 20 U, only nasal congestion and loss of smell improved (P < .05). Nasal patency had also significantly improved two weeks after treatment at doses of 40 and 30 U (P < .05). Complications included epistaxis (11.8%) and nasal dryness (23.5%). CONCLUSION Abobotulinum toxin A at a dose of at least 30 U effectively reduced most nasal symptoms. LEVEL OF EVIDENCE 2. TRIAL REGISTRATION Clinicaltrials.in.th/ TCTR20200526014.
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Affiliation(s)
- Patorn Piromchai
- Department of Otorhinolaryngology, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
| | - Worakit Pornumnouy
- Department of Otorhinolaryngology, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
| | - Patchareeporn Saeseow
- Department of Otorhinolaryngology, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
| | - Seksun Chainansamit
- Department of Otorhinolaryngology, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
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15
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Liu M, Dai C, Lv X, Li B. Letter to the Editor: Are severe COVID-19 patients more susceptible to conjunctivitis? J Med Virol 2020; 92:2394-2395. [PMID: 32470212 PMCID: PMC7283819 DOI: 10.1002/jmv.26084] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/24/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Meng Liu
- School of Basic Medicine, North Sichuan Medical College, Nanchong, China
| | - Cheng Dai
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiaodong Lv
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Binzhong Li
- School of Basic Medicine, North Sichuan Medical College, Nanchong, China
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16
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Amaral R, Bousquet J, Pereira AM, Araújo LM, Sá‐Sousa A, Jacinto T, Almeida R, Delgado L, Fonseca JA. Disentangling the heterogeneity of allergic respiratory diseases by latent class analysis reveals novel phenotypes. Allergy 2019; 74:698-708. [PMID: 30447164 DOI: 10.1111/all.13670] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/23/2018] [Accepted: 11/06/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Refined phenotyping of allergic diseases may unravel novel phenotypes. Conjunctivitis as an independent disorder has never been approached. AIM To identify distinct classes of allergic respiratory diseases using latent class analysis (LCA) and distinguish each class using classification and regression tree (CART) analysis. METHODS Seven hundred and twenty-eight adults from the Portuguese general population study ICAR had a structured medical interview combined with blood collection, skin prick tests, spirometry with bronchodilation, and exhaled nitric oxide. LCA was applied to 19 variables. The CART algorithm selected the most likely variables distinguishing LCA-classes. RESULTS A six-class model was obtained. Class 1 (25%): nonallergic participants without bronchial or ocular symptoms. Classes 2 (22%) and 3 (11%): nasal and ocular (low levels) symptoms without nasal impairment, monosensitized (Class 2) or polysensitized (Class 3). Class 4 (13%): polysensitized participants with high levels of nasal and ocular symptoms, and nasal impairment. Classes 5 (16%) and 6 (14%): high level of nasal, bronchial and ocular symptoms with nasal impairment (non-allergic or polysensitized, respectively). Participants in classes 5 and 6 had more bronchial exacerbations and unscheduled medical visits (P < 0.001). Ocular symptoms were significantly higher in classes with nasal impairment, compared to those without impairment (P < 0.001) or no nasal symptom (P < 0.001). CART highlighted ocular symptoms as the most relevant variable in distinguishing LCA-classes. CONCLUSION Novel severe phenotypes of participants with co-occurrence of ocular, nasal and bronchial symptoms, and exacerbation-prone were identified. The tree algorithm showed the importance of the ocular symptoms in the expression of allergic diseases phenotypes.
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Affiliation(s)
- Rita Amaral
- CINTESIS ‐ Center for Health Technology and Services Research Faculty of Medicine University of Porto Porto Portugal
- Department of Cardiovascular and Respiratory Sciences Porto Health School Porto Portugal
| | - Jean Bousquet
- MACVIA‐France Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site Montpellier France
- INSERM U 1168 VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches Villejuif France
- UMR‐S 1168 Université Versailles St‐Quentin‐en‐Yvelines Montigny le Bretonneux France
- Euforea Brussels Belgium
- Euforea Charité Germany
| | - Ana M. Pereira
- CINTESIS ‐ Center for Health Technology and Services Research Faculty of Medicine University of Porto Porto Portugal
- Allergy Unit Instituto & Hospital CUF Porto Portugal
| | - Luís M. Araújo
- Allergy Unit Instituto & Hospital CUF Porto Portugal
- Basic & Clinical Immunology, Pathology Department Faculdade Medicina da Universidade do Porto Porto Portugal
| | - Ana Sá‐Sousa
- CINTESIS ‐ Center for Health Technology and Services Research Faculty of Medicine University of Porto Porto Portugal
| | - Tiago Jacinto
- CINTESIS ‐ Center for Health Technology and Services Research Faculty of Medicine University of Porto Porto Portugal
- Department of Cardiovascular and Respiratory Sciences Porto Health School Porto Portugal
| | - Rute Almeida
- CINTESIS ‐ Center for Health Technology and Services Research Faculty of Medicine University of Porto Porto Portugal
| | - Luís Delgado
- Allergy Unit Instituto & Hospital CUF Porto Portugal
- Basic & Clinical Immunology, Pathology Department Faculdade Medicina da Universidade do Porto Porto Portugal
| | - Joao A. Fonseca
- CINTESIS ‐ Center for Health Technology and Services Research Faculty of Medicine University of Porto Porto Portugal
- Allergy Unit Instituto & Hospital CUF Porto Portugal
- MEDCIDS Department of Community Medicine, Information, and Health Sciences Faculty of Medicine University of Porto Porto Portugal
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17
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Nowak M, Nowak L, Nowak J, Chaniecki P. [ Ocular symptoms in von Recklinghausen disease]. Pol Merkur Lekarski 2017; 43:287-290. [PMID: 29298970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Von Recklinghausen disease is a genetic disease with autosomal dominant, belonging to the group phakomatoses. In the clinical picture of the disease are skin lesions, eye, bone, intracranial tumors and other cancers of the extracranial location. Due to the high variability of clinical symptoms often diagnosis is delayed in cases of mild expression. The prognosis depends on the location and extent of the change and only symptomatic treatment have a tendency to change regrowth.
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Affiliation(s)
- Mateusz Nowak
- 5th Military Clinical Hospital with Polyclinic in Cracow, Poland
| | - Lidia Nowak
- Private Ophthalmology Practice in Libiąż, Poland
| | | | - Piotr Chaniecki
- 5th Military Clinical Hospital with Polyclinic in Cracow, Poland
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18
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Xu HL, Zhang QC, Hu SQ, You YW, Chen J. [The clinical features of patients with allergic rhinitis of Nantong city in China]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:30-33. [PMID: 29774681 DOI: 10.13201/j.issn.1001-1781.2017.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Indexed: 11/12/2022]
Abstract
Objective:To comprehensively analyze the clinical features of patients with AR by a retrospective study. Method:A total number of 8 102 patients diagnosed with AR were enrolled in Nantong area, and detailed clinical data were documented in all cases. Skin prick tests with standardized aeroallergens were conducted in these patients; The samples were divided into two groups(children and adults group) and the clinical features between two groups were analysed. Result:Children in schoolage were the majority of AR patients in children group. There were 4 581 cases(56.54%) with ocular symptoms, 3 977 cases(49.09%)with lower respiratory tract symptoms. Nasal congestion (97.37%) was the most common symptoms in patients with AR,while eye itching(32.68%) was the most common ocular symptoms in patients with AR, followed by the dacryorrhea(23.57%);and cough(44.72%) was the most common lower respiratory tract symptoms. Dermatophagoides pteronyssinus and dermatophagoides farinae had the highest positivity among all allergens, and the shrimp was the main food allergen. Conclusion:We analyzed the clinical features of patients with AR, that would provide a more scientific basis for prevention,clinical diagnosis, treatment and epidemiological studies for AR.
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Affiliation(s)
- H L Xu
- Department of Otorhinolaryngology Head and Neck Surgery, the Third People's Hospital of Nantong
| | - Q C Zhang
- Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of Nantong University
| | - S Q Hu
- Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of Nantong University
| | - Y W You
- Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of Nantong University
| | - J Chen
- Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of Nantong University
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Kim J, Hwang Y, Kang S, Kim M, Kim TS, Kim J, Seo J, Ahn H, Yoon S, Yun JP, Lee YL, Ham H, Yu HG, Park SK. Association between Exposure to Smartphones and Ocular Health in Adolescents. Ophthalmic Epidemiol 2016; 23:269-76. [PMID: 27254040 DOI: 10.3109/09286586.2015.1136652] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Smartphone use has dramatically increased in recent years. Smartphones may have adverse health effects, particularly on the eyes, because users stare at the screen for a much longer time than they do with ordinary mobile phones. The objective of this study was to elucidate the relationship between smartphone use and ocular symptoms among adolescents. METHODS Information on smartphone use and ocular symptoms (blurring, redness, visual disturbance, secretion, inflammation, lacrimation and dryness) related to eye fatigue and strain from 715 adolescent subjects from three cities in Korea was obtained using a structured questionnaire. Ocular health was scored using number of ocular symptoms. Odds ratios (ORs), 95% confidence intervals (95% CIs) and p-values for ocular symptoms were calculated with binomial and multinomial logistic regression models. RESULTS Higher prevalence rates for ocular symptoms were observed in groups with greater exposure to smartphones (p < 0.05). Longer daily smartphone use was associated with a higher likelihood of having multiple ocular symptoms (5-7 symptoms out of 7 symptoms; p = 0.005). Excessive/intermittent use (>2 hours daily and ≤2 hours continuously) and excessive/persistent use (>2 hours daily and >2 hours continuously) compared to shorter use (<2 hours daily) were associated with multiple ocular symptoms (OR 2.18, 95% CI 1.09-4.39; OR 2.26, 95% CI 1.11-4.57, respectively). A higher lifetime exposure to smartphones was associated with a higher likelihood of having multiple ocular symptoms (OR 3.05, 95% CI 1.51-6.19; p = 0.001). CONCLUSION Increasing exposure to smartphones can have a negative impact on ocular health in adolescents.
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Affiliation(s)
- Joowon Kim
- a Seoul National University College of Medicine , Seoul , Korea
| | - Yunji Hwang
- b Department of Preventive Medicine , Seoul National University College of Medicine , Seoul , Korea.,c Cancer Research Institute, Seoul National University , Seoul , Korea.,d Department of Biomedical Science , Seoul National University Graduate School , Seoul , Korea
| | - Seungheon Kang
- a Seoul National University College of Medicine , Seoul , Korea
| | - Minhye Kim
- a Seoul National University College of Medicine , Seoul , Korea
| | - Tae-Shin Kim
- a Seoul National University College of Medicine , Seoul , Korea
| | - Jay Kim
- a Seoul National University College of Medicine , Seoul , Korea
| | - Jeongmin Seo
- a Seoul National University College of Medicine , Seoul , Korea
| | - Hyojeong Ahn
- a Seoul National University College of Medicine , Seoul , Korea
| | - Sungjoon Yoon
- a Seoul National University College of Medicine , Seoul , Korea
| | - Jun Pil Yun
- a Seoul National University College of Medicine , Seoul , Korea
| | - Yae Lim Lee
- a Seoul National University College of Medicine , Seoul , Korea
| | - Hyunsoo Ham
- a Seoul National University College of Medicine , Seoul , Korea
| | - Hyeong Gon Yu
- e Department of Ophthalmology , Seoul National University , Seoul , Korea
| | - Sue K Park
- b Department of Preventive Medicine , Seoul National University College of Medicine , Seoul , Korea.,c Cancer Research Institute, Seoul National University , Seoul , Korea.,d Department of Biomedical Science , Seoul National University Graduate School , Seoul , Korea
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20
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Nolte H, Maloney J, Nelson HS, Bernstein DI, Lu S, Li Z, Kaur A, Zieglmayer P, Zieglmayer R, Lemell P, Horak F. Onset and dose-related efficacy of house dust mite sublingual immunotherapy tablets in an environmental exposure chamber. J Allergy Clin Immunol 2015; 135:1494-501.e6. [PMID: 25636947 DOI: 10.1016/j.jaci.2014.12.1911] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 11/25/2014] [Accepted: 12/16/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND The magnitude of effect of sublingual immunotherapy for house dust mite (HDM)-induced allergic rhinitis with or without conjunctivitis is uncertain, partly because there are few well-controlled trials with well-defined doses. OBJECTIVE We sought to determine the dose-related efficacy and onset of action of the HDM sublingual immunotherapy tablet MK-8237 (Merck/ALK-Abelló) using the Vienna Challenge Chamber. METHODS In this randomized, double-blind, single-site trial, adults with HDM-induced allergic rhinitis with or without conjunctivitis and with or without asthma (n = 124) received 12 developmental units (DU) of MK-8237, 6 DU of MK-8237, or placebo daily for 24 weeks. Subjects underwent 6-hour exposure challenges at screening and weeks 8, 16, and 24. The total nasal symptom score (TNSS) during chamber challenge at week 24 was the primary end point. The TNSS was the sum of 4 nasal symptom scores (maximum = 12). Total ocular symptom scores (TOSSs; 2 symptoms; maximum = 6) and total symptom scores (TSSs; TSS = TNSS plus TOSS; maximum = 18) were secondary end points. RESULTS Dose- and time-dependent improvements with MK-8237 versus placebo were observed. At week 24, TNSS improvement relative to placebo was 48.6% (95% CI, 35.3% to 60.2%) with 12 DU of MK-8237 and 26.6% (95% CI, 11.2% to 39.6%) with 6 DU of MK-8237. Statistically significant improvements for TNSSs were also observed at weeks 8 (12 DU of MK-8237) and 16 (6 and 12 DU of MK-8237) and for TOSSs and TSSs by both doses at week 24. MK-8237 was well tolerated. No investigator-assessed anaphylactic allergic reactions or reactions requiring epinephrine were observed. CONCLUSIONS MK-8237, 12 DU, reduced nasal and ocular symptoms and exceeded World Allergy Organization-established clinical efficacy criteria (≥20% improvement vs placebo). The onset of action for 12 DU of MK-8237 was week 8. MK-8237, 12 DU, is appropriate for further evaluation to determine the magnitude of effect in an uncontrolled allergen exposure environment.
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Affiliation(s)
| | | | - Harold S Nelson
- Department of Medicine, Division of Allergy and Immunology, National Jewish Health, Denver, Colo
| | - David I Bernstein
- Bernstein Allergy Group and the Division of Allergy and Immunology, University of Cincinnati, Cincinnati, Ohio
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21
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Garg P, Garg R, Prasad R, Mishra AK. A prospective study of ocular toxicity in patients receiving ethambutol as a part of directly observed treatment strategy therapy. Lung India 2015; 32:16-9. [PMID: 25624590 PMCID: PMC4298911 DOI: 10.4103/0970-2113.148428] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND OBJECTIVES India is among the largest countries to implement the revised National Tuberculosis Control Program (RNTCP). This program provides intermittent regimens to the patients, where the doses of isoniazid and ethambutol are more as compared to the daily regimen, which is a cause of concern, particularly with regard to the ocular toxicity of ethambutol. The present study was undertaken to explore the ocular toxicity in the patients registered under the program. MATERIALS AND METHODS This was a prospective single center cohort study of 64 patients of categories I and II, coming to the RNTCP-Directly Observed Treatment Strategy (DOTS) center at a tertiary care referral hospital. The detailed history, best corrected visual acuity, fundus examination, and color vision test were carried out in all patients at the start of treatment and then at the first and second month of treatment. RESULTS Loss in visual acuity from the baseline was noted at the second month follow up in 12 (9.4%) eyes (P = 0.001), visual field defects were seen in eight (6.3%) eyes (P = 0.0412), and optic disc abnormalities were observed in six (4.7%) (P = 0.013) eyes. Color vision abnormalities were noted in 16 (12.6%) eyes (P = 0.003), four eyes showed impairment in red-green color perception, and the others showed impairment in blue-yellow color perception as well. Patients with ocular symptoms were advised to stop ethambutol and they showed improvement in visual acuity after follow up of one to two months. The overall outcome of treatment was not affected by discontinuation of ethambutol in these patients. CONCLUSION Ethambutol when taken according to program could cause ocular toxicity. The early recognition of ocular symptoms is important to prevent unnecessary delay in diagnosis and probable irreversible visual loss.
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Affiliation(s)
- Pragati Garg
- Department of Ophthalmology, Era's Lucknow Medical College, Lucknow, Uttar Pradesh, India
| | - Rajiv Garg
- Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rajendra Prasad
- Department of Pulmonary, Vallabhbhai Patel Chest Institute, Delhi, India
| | - Ashwini Kumar Mishra
- Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
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Aneeza WH, Husain S, Rahman RA, Van Dort D, Abdullah A, Gendeh BS. Efficacy of mometasone furoate and fluticasone furoate on persistent allergic rhinoconjunctivitis. Allergy Rhinol (Providence) 2014; 4:e120-6. [PMID: 24498516 PMCID: PMC3911800 DOI: 10.2500/ar.2013.4.0065] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Allergic rhinoconjunctivitis denotes both nasal and ocular manifestation of allergy, which may be solely treated with intranasal steroid. This study compares the efficacy of mometasone furoate nasal spray (NS) and fluticasone furoate NS in treatment of allergic rhinoconjunctivitis. The secondary objective is to study the severity of baseline ocular symptoms in allergic rhinoconjunctivitis. Seventy-eight patients with allergic rhinoconjunctivitis were assessed subjectively and objectively using twice-daily symptom scores for nasal (reflective total nasal symptom score [rTNSS] and instantaneous TNSS [iTNSS]) and ocular (reflective total ocular symptom score [rTOSS] and instantaneous TOSS [iTOSS]) symptoms, rhinoconjunctivitis quality-of-life questionnaires (RQOLQs), and acoustic rhinometry. All measurements were taken at baseline and at 4 and 8 weeks of treatment. Sixty-three patients who were randomized into the mometasone furoate group (n = 36) and the fluticasone furoate group (n = 27) completed the study. Seventy-six percent of patients had mild ocular symptoms, 20.5% had moderate symptoms, and only 2.6% had severe symptoms at baseline based on the iTOSS; 65.1% had mild nasal symptoms and 3% had severe nasal symptoms. There was significant reduction in the symptom scores after 1 week (p < 0.05). Both groups had significant improvement in RQOLQ scores after 1 month, which further improved at 2 months (p < 0.05). The nasal dimensions also improved in both groups (p < 0.05) but there was no statistically significant difference between groups. Both mometasone furoate and fluticasone furoate are effective as single-modality treatment of allergic rhinoconjunctivitis. The majority of patients manifest mild ocular symptoms that may be solely treated with intranasal steroids.
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Affiliation(s)
- W Hamizan Aneeza
- Departments of Otorhinolaryngology-Head and Neck Surgery, Department of Pharmacology, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Salina Husain
- Departments of Otorhinolaryngology-Head and Neck Surgery, Department of Pharmacology, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Roslenda Abdul Rahman
- Departments of Otorhinolaryngology-Head and Neck Surgery, Department of Pharmacology, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Dexter Van Dort
- Departments of Otorhinolaryngology-Head and Neck Surgery, Department of Pharmacology, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Asma Abdullah
- Departments of Otorhinolaryngology-Head and Neck Surgery, Department of Pharmacology, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Balwant S Gendeh
- Departments of Otorhinolaryngology-Head and Neck Surgery, Department of Pharmacology, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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Andriamanjato HH, Mathenge W, Kalua K, Courtright P, Lewallen S. Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel? Hum Resour Health 2014; 12 Suppl 1:S3. [PMID: 25860992 PMCID: PMC4108919 DOI: 10.1186/1478-4491-12-s1-s3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND The inclusion of primary eye care (PEC) in the scope of services provided by general primary health care (PHC) workers is a 'task shifting' strategy to help increase access to eye care in Africa. PEC training, in theory, teaches PHC workers to recognize specific symptoms and signs and to treat or refer according to these. We tested the sensitivity of these symptoms and signs at identifying significant eye pathology. METHODS Specialized eye care personnel in three African countries evaluated specific symptoms and signs, using a torch alone, in patients who presented to eye clinics. Following this, they conducted a more thorough examination necessary to make a definite diagnosis and manage the patient. The sensitivities and specificities of the symptoms and signs for identifying eyes with conditions requiring referral or threatening sight were calculated. RESULTS Sensitivities of individual symptoms and signs to detect sight threatening pathology ranged from 6.0% to 55.1%; specificities ranged from 8.6 to 98.9. Using a combination of symptoms or signs increased the sensitivity to 80.8 but specificity was 53.2. CONCLUSIONS In this study, the sensitivity and specificity of commonly used symptoms and signs were too low to be useful in guiding PHC workers to accurately identify and refer patients with eye complaints. This raises the question of whether this task shifting strategy is likely to contribute to reducing visual loss or to providing an acceptable quality service.
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Affiliation(s)
| | | | - Khumbo Kalua
- Blantyre Institute for Community Ophthalmology and Ministry of Health, Lions Sight First Eye Hospital, Blantyre, P.O. Box E180 Post Dot Net, Blantyre, Malawi
- Department of Ophthalmology, University of Malawi College of Medicine, P/Bag 360, Blantyre, Malawi
| | - Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology, University of Cape Town, South Africa
- University of Cape Town, Department of Ophthalmology, Groote Schuur Hospital, Cape Town, South Africa
| | - Susan Lewallen
- Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology, University of Cape Town, South Africa
- University of Cape Town, Department of Ophthalmology, Groote Schuur Hospital, Cape Town, South Africa
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Amparo F, Wang H, Emami-Naeini P, Karimian P, Dana R. The Ocular Redness Index: a novel automated method for measuring ocular injection. Invest Ophthalmol Vis Sci 2013; 54:4821-6. [PMID: 23766472 DOI: 10.1167/iovs.13-12217] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To develop and validate a novel automated system to assess ocular redness (OR) in clinical images. METHODS We developed a novel software that quantifies OR in digital images based on a mathematic algorithm using a centesimal continuous scoring scale. Subsequently, we conducted a study to validate the scores obtained with this system by correlating them with those obtained by two physicians using two image-based comparative subjective scales, the Efron and the Validated Bulbar Redness (VBR) grading scales. Additionally, we evaluated the level of clinical agreement between the Ocular Redness Index (ORI) score and the two image-based methods by means of the Bland-Altman analysis. Main outcome measures included correlation and level of agreement between the ORI score, Efron score, and the VBR score. RESULTS One hundred and two clinical photographs of eyes with OR were evaluated. The ORI scores significantly correlated with the scores obtained by the two clinicians using the Efron (Observer 1, R=0.925, P<0.001; Observer 2, R=0.857, P<0.001), and VBR (Observer 1, R=0.830, P<0.001; Observer 2, R=0.821, P<0.001) scales. The Bland-Altman analysis revealed levels of disagreement of up to 30 and 27 units for the ORI-Efron and ORI-VBR score comparisons, respectively. CONCLUSIONS The ORI provides an objective and continuous scale for evaluating ocular injection in an automated manner, and without need for a trained physician for scoring. The ORI may be used as a new alternative for objective OR evaluation in clinics and in clinical trials.
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Affiliation(s)
- Francisco Amparo
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, USA
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Nishiyama M, Nakae K, Yukawa S, Hashimoto T, Inaba G, Mochizuki M, Sakane T. A study of comparison between the nationwide epidemiological survey in 1991 and previous surveys on behçet's disease in Japan. Environ Health Prev Med 1999; 4:130-4. [PMID: 21432185 DOI: 10.1007/BF02932268] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/1999] [Accepted: 07/16/1999] [Indexed: 10/21/2022] Open
Abstract
The 4th nationwide epidemiological survey on Behçet disease (BD), which included all patients with BD at 1,200 hospitals selected at random from 10,081 hospitals in Japan, was carried out by the BD Research Committee of the Ministry of Health and Welfare in 1991 to examine the epidemiological features of BD in Japan by comparing with previous surveys. 3,938 patients from these hospitals were examined by the Japanese diagnostic criteria of BD (JCBD) revised in 1987 and the International criteria for classification of BD (ICBD). Among these 3,938 patients, 622 patients were only suspected of having BD or clinical signs of the disease were unknown, and most of these patients were incompatible with the ICBD. So these patients were excluded from the study of epidemiological features. The average patients age has risen 7-8 years over the last 20 years and the average age of onset in both sexes increased by about 3 years from 1972 to 1991. While a decrease in the sex ratio was seen in the complete-type and the incomplete-type BD without ocular symptoms, a sustained high sex ratio was shown in incomplete-type BD with ocular symptoms. The positive rate of HLA-B51 antigen was 54.9% (men: 56.9%, women: 52.2%) significantly higher than die 15-16% in healthy subjects but it might have been gradually decreasing. Also the clinical course of BD has become too mild for prognosis. According to diese epidemiological features of BD, the clinical manifestation of BD in Japan might have become the Western type of BD.
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Versura P, Profazio V, Campos EC. One month use of Systane improves ocular surface parameters in subjects with moderate symptoms of ocular dryness. Clin Ophthalmol 2011; 2:629-35. [PMID: 19668764 PMCID: PMC2694005 DOI: 10.2147/opth.s3731] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of Systane((R)) Lubricating Eye Drops in improving the symptoms of moderate ocular dryness. METHODS Fifty subjects with moderate symptoms of ocular dryness were enrolled in this open label study. The mean age of subjects was 57.6 +/- 15.4 years. To be eligible, subjects' tear film break-up time (TFBUT) had to be <10 seconds, and subjects had to have at least one ocular discomfort symptom in addition to dryness. Saline was used for a washout period of 3-5 days. Subjects were re-examined, and those continuing to meet the inclusion criteria were dispensed Systane((R)) and re-examined again after 28 days. At each visit, slitlamp examination was conducted, and ocular discomfort symptoms and TFBUT were evaluated. Subjects rated their overall satisfaction at baseline and on the last visit. RESULTS No significant changes in TFBUT or ocular discomfort symptoms were observed after saline use, compared with screening visit. After 28 days of Systane((R)) use there was statistically significant improvement of TFBUT (p = 0.0001) compared with baseline. Subjects experienced significant symptomatic relief for all 6 ocular discomfort symptoms at the endpoint visit. CONCLUSION Systane((R)) effectively relieved the symptoms associated with moderate ocular dryness, with measurable improvement in objective TFBUT, subjective symptoms, and overall satisfaction.
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Affiliation(s)
- Piera Versura
- Department of Surgery and Anesthesiology, Section of Ophthalmology, Alma Mater Studiorum University at Bologna, Bologna, Italy
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