ICG-based laser treatments for ophthalmic diseases: Toward their safe and rapid strategy

The eye is a very important organ, and keratitis, corneal neovascularization, floaters, age-related macular degeneration, and other vision problems have seriously affected people's quality of life. Among the ophthalmic treatments, laser photocoagulations have been proposed and have shown therapeutic effects in clinical settings. However, corneal thinning and bleeding lesions induced by laser damage have led to limit its applications. To treat the issues of traditional hyperthermia treatments, photosensitizers [e.g., indocyanine green (ICG)] have been investigated to increase the therapeutic effects of corneal neovascularization and choroidal neovascularization. In the recent study, with the help of ICG, laser-induced nanobubble was proposed to treat vitreous opacities. The developed strategies could enlarge the effect of laser irradiation and reduce the side effects, so as to expand the scope of laser treatments in clinical ophthalmic diseases.

Development and evaluation of multimodal AI for diagnosis and triage of ophthalmic diseases using ChatGPT and anterior segment images: protocol for a two-stage cross-sectional study

Introduction

Artificial intelligence (AI) technology has made rapid progress for disease diagnosis and triage. In the field of ophthalmic diseases, image-based diagnosis has achieved high accuracy but still encounters limitations due to the lack of medical history. The emergence of ChatGPT enables human-computer interaction, allowing for the development of a multimodal AI system that integrates interactive text and image information.

Objective

To develop a multimodal AI system using ChatGPT and anterior segment images for diagnosing and triaging ophthalmic diseases. To assess the AI system's performance through a two-stage cross-sectional study, starting with silent evaluation and followed by early clinical evaluation in outpatient clinics.

Methods and analysis

Our study will be conducted across three distinct centers in Shanghai, Nanjing, and Suqian. The development of the smartphone-based multimodal AI system will take place in Shanghai with the goal of achieving ≥90% sensitivity and ≥95% specificity for diagnosing and triaging ophthalmic diseases. The first stage of the cross-sectional study will explore the system's performance in Shanghai's outpatient clinics. Medical histories will be collected without patient interaction, and anterior segment images will be captured using slit lamp equipment. This stage aims for ≥85% sensitivity and ≥95% specificity with a sample size of 100 patients. The second stage will take place at three locations, with Shanghai serving as the internal validation dataset, and Nanjing and Suqian as the external validation dataset. Medical history will be collected through patient interviews, and anterior segment images will be captured via smartphone devices. An expert panel will establish reference standards and assess AI accuracy for diagnosis and triage throughout all stages. A one-vs.-rest strategy will be used for data analysis, and a post-hoc power calculation will be performed to evaluate the impact of disease types on AI performance.

Discussion

Our study may provide a user-friendly smartphone-based multimodal AI system for diagnosis and triage of ophthalmic diseases. This innovative system may support early detection of ocular abnormalities, facilitate establishment of a tiered healthcare system, and reduce the burdens on tertiary facilities.

Trial registration

The study was registered in ClinicalTrials.gov on June 25th, 2023 (NCT05930444).

Therapeutic applications of contact lens-based drug delivery systems in ophthalmic diseases

Traditional ophthalmic drugs, such as eye drops, gels and ointments, are accompanied by many problems, including low bioavailability and potential drug side effects. Innovative ophthalmic drug delivery systems have been proposed to overcome the limitations associated with traditional formulations. Recently, contact lens-based drug delivery systems have gained popularity owing to their advantages of sustained drug delivery, prolonged drug retention, improved bioavailability, and few drug side effects. Various methods have been successfully applied to drug-loaded contact lenses and prolonged the drug release time, such as chemical crosslinking, material embedding, molecular imprinting, colloidal nanoparticles, vitamin E modification, drug polymer film/coating, ion ligand polymerization systems, and supercritical fluid technology. Contact lens-based drug delivery systems play an important role in the treatment of multifarious ophthalmic diseases. This review discusses the latest developments in drug-loaded contact lenses for the treatment of ophthalmic diseases, including preparation methods, application in ophthalmic diseases and future prospects.

Novel Role of Molecular Hydrogen: The End of Ophthalmic Diseases?

Molecular hydrogen (H2) is a colorless, odorless, and tasteless gas which displays non-toxic features at high concentrations. H2 can alleviate oxidative damage, reduce inflammatory reactions and inhibit apoptosis cascades, thereby inducing protective and repairing effects on cells. H2 can be transported into the body in the form of H2 gas, hydrogen-rich water (HRW), hydrogen-rich saline (HRS) or H2 produced by intestinal bacteria. Accumulating evidence suggest that H2 is protective against multiple ophthalmic diseases, including cataracts, dry eye disease, diabetic retinopathy (DR) and other fields. In particular, H2 has been tested in the treatment of dry eye disease and corneal endothelial injury in clinical practice. This medical gas has brought hope to patients suffering from blindness. Although H2 has demonstrated promising therapeutic potentials and broad application prospects, further large-scale studies involving more patients are still needed to determine its optimal application mode and dosage. In this paper, we have reviewed the basic characteristics of H2, and its therapeutic effects in ophthalmic diseases. We also focus on the latest progress in the administration approaches and mechanisms underlying these benefits.

A Global Review of Publicly Available Datasets Containing Fundus Images: Characteristics, Barriers to Access, Usability, and Generalizability

This article provides a comprehensive and up-to-date overview of the repositories that contain color fundus images. We analyzed them regarding availability and legality, presented the datasets' characteristics, and identified labeled and unlabeled image sets. This study aimed to complete all publicly available color fundus image datasets to create a central catalog of available color fundus image datasets.

[The social and medical aspects of falls in elderly and senile age under eyesight deficiency]

The aging of population is accompanied by simultaneous increasing of rate of age-associated ophthalmic diseases resulting in vision decreasing. However, visual impairment in elderly and senile age is rarely considered in the epidemiology of falls in these groups. The purpose of the study is to investigate medical social aspects of falls in older age groups with visual impairment. The retrospective methodology was applied to study falls in 4832 elderly and senile patients with visual impairment due to cataract glaucoma, diabetic retinopathy and age-related macular degeneration. The high incidence of falls in men and women aged 80 and older, amounting to 82.6 and 125.7 cases per 1000 of population of corresponding age respectively was established. The falls in elderly patients with low vision is more often registered in case of diabetic retinopathy than of glaucoma, cataract and age-related macular degeneration without significant differences at the age 50-59 years and 60-69 years. The diabetic retinopathy is the most common cause of falls requiring hospitalization in all age groups. To In reducing prevalence of falls and resulted hospitalization, to optimize traumatological care of patients of older age groups, the priority is for early identification and treatment of people with diabetic retinopathy.

Functional Carbon Quantum Dots for Ocular Imaging and Therapeutic Applications

Carbon quantum dots (CDs) are a class of emerging carbonaceous nanomaterials that have received considerable attention due to their excellent fluorescent properties, extremely small size, ability to penetrate cells and tissues, ease of synthesis, surface modification, low cytotoxicity, and superior water dispersion. In light of these properties, CDs are extensively investigated as candidates for bioimaging probes, efficient drug carriers, and disease diagnostics. Functionalized CDs represent a promising therapeutic candidate for ocular diseases. Here, this work reviews the potential use of functionalized CDs in the diagnosis and treatment of eye-related diseases, including the treatment of macular and anterior segment diseases, as well as targeting Aβ amyloids in the retina.

Feature preserving mesh network for semantic segmentation of retinal vasculature to support ophthalmic disease analysis

Introduction

Ophthalmic diseases are approaching an alarming count across the globe. Typically, ophthalmologists depend on manual methods for the analysis of different ophthalmic diseases such as glaucoma, Sickle cell retinopathy (SCR), diabetic retinopathy, and hypertensive retinopathy. All these manual assessments are not reliable, time-consuming, tedious, and prone to error. Therefore, automatic methods are desirable to replace conventional approaches. The accuracy of this segmentation of these vessels using automated approaches directly depends on the quality of fundus images. Retinal vessels are assumed as a potential biomarker for the diagnosis of many ophthalmic diseases. Mostly newly developed ophthalmic diseases contain minor changes in vasculature which is a critical job for the early detection and analysis of disease.

Method

Several artificial intelligence-based methods suggested intelligent solutions for automated retinal vessel detection. However, existing methods exhibited significant limitations in segmentation performance, complexity, and computational efficiency. Specifically, most of the existing methods failed in detecting small vessels owing to vanishing gradient problems. To overcome the stated problems, an intelligence-based automated shallow network with high performance and low cost is designed named Feature Preserving Mesh Network (FPM-Net) for the accurate segmentation of retinal vessels. FPM-Net employs a feature-preserving block that preserves the spatial features and helps in maintaining a better segmentation performance. Similarly, FPM-Net architecture uses a series of feature concatenation that also boosts the overall segmentation performance. Finally, preserved features, low-level input image information, and up-sampled spatial features are aggregated at the final concatenation stage for improved pixel prediction accuracy. The technique is reliable since it performs better on the DRIVE database, CHASE-DB1 database, and STARE dataset.

Results and discussion

Experimental outcomes confirm that FPM-Net outperforms state-of-the-art techniques with superior computational efficiency. In addition, presented results are achieved without using any preprocessing or postprocessing scheme. Our proposed method FPM-Net gives improvement results which can be observed with DRIVE datasets, it gives Se, Sp, and Acc as 0.8285, 0.98270, 0.92920, for CHASE-DB1 dataset 0.8219, 0.9840, 0.9728 and STARE datasets it produces 0.8618, 0.9819 and 0.9727 respectively. Which is a remarkable difference and enhancement as compared to the conventional methods using only 2.45 million trainable parameters.

Application of low-intensity pulsed ultrasound on tissue resident stem cells: Potential for ophthalmic diseases

INTRODUCTION

Tissue-resident stem cells (TRSCs) have the ability to self-renew and differentiate throughout an individual's lifespan, and they utilize both mechanisms to maintain homeostasis and regenerate damaged tissues. Several studies suggest that these stem cells can serve as a potential source for cell-replacement-based therapy by promoting differentiation or expansion. In recent years, low-intensity pulsed ultrasound (LIPUS) has been demonstrated to effectively stimulate stem cell proliferation and differentiation, promote tissue regeneration, and inhibit inflammatory responses.

AIMS

To present a comprehensive overview of current application and mechanism of LIPUS on tissue resident stem cells.

METHODS

We searched PubMed, Web of Science for articles on the effects of LIPUS on tissue resident stem cells and its application.

RESULTS

The LIPUS could modulate cellular activities such as cell viability, proliferation and differentiation of tissue resident stem cells and related cells through various cellular signaling pathways. Currently, LIPUS, as the main therapeutic ultrasound, is being widely used in the treatment of preclinical and clinical diseases.

CONCLUSION

The stem cell research is the hot topic in the biological science, while in recent years, increasing evidence has shown that TRSCs are good targets for LIPUS-regulated regenerative medicine. LIPUS may be a novel and valuable therapeutic approach for the treatment of ophthalmic diseases. How to further improve its efficiency and accuracy, as well as the biological mechanism therein, will be the focus of future research.

Nutraceuticals: A Promising Therapeutic Approach in Ophthalmology

Oxidative stress represents one of the main factors driving the pathophysiology of multiple ophthalmic conditions including presbyopia, cataracts, dry eye disease (DED), glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy (DR). Currently, different studies have demonstrated the role of orally administered nutraceuticals in these diseases. For instance, they have demonstrated to improve lens accommodation in presbyopia, reduce protein aggregation in cataracts, ameliorate tear film stability, break up time, and tear production in dry eye, and participate in the avoidance of retinal neuronal damage and a decrease in intraocular pressure in glaucoma, contribute to the delayed progression of AMD, or in the prevention or treatment of neuronal death in diabetic retinopathy. In this review, we summarized the nutraceuticals which have presented a positive impact in ocular disorders, emphasizing the clinical assays. The characteristics of the different types of nutraceuticals are specified along with the nutraceutical concentration used to achieve a therapeutic outcome in ocular diseases.

N6-Methyladenosine-Modification-Related Ophthalmic Diseases and Potential Therapeutic Strategies

The N6-methyladenosine (m6A) is the most abundant internal modification in advanced eukaryotic mRNAs, and it plays an important role in mRNA metabolism and diverse biological processes. Moreover, m6A modification is dynamically reversible and may reshape gene expression patterns after demethylation induced by drug interventions, which may reverse the occurrence and progression of certain diseases. Although the role of changes in DNA methylation in ophthalmic diseases has been well described, the regulatory role of the m6A modification in ophthalmic diseases is still a new field of study. This paper aims to systematically summarize the latest research progress about m6a-modification-related ophthalmic diseases and potential therapeutic strategies. All English literature relevant to our research was searched in PubMed and CNKI databases, using appropriate keywords. Our study reviews the regulatory role of m6A in ophthalmic diseases. It covers almost all of the reported m6A-related ophthalmic diseases and proposes potential treatment strategies for each disease. This review will provide direction for further research on m6A in ophthalmic diseases and help in the treatment of ophthalmic diseases in the future.

Study on the mechanism of Qiju Dihuang pill in the treatment of ophthalmic diseases based on systems pharmacology

Qiju Dihuang pill is one of the common Traditional Chinese Medicine to treat ophthalmic diseases. In vivo studies have suggested that Qiju Dihuang pill can be used for treating glaucoma, and it can also be used clinically to treat cataract patients. However, the bioactive ingredients and the therapeutic mechanism of Qiju Dihuang pill on treating these ophthalmic diseases remained unclear. Presently, a systems pharmacology approach which combines pharmacokinetic screening, targeted fishing, biological function enrichment, network pharmacology, and molecular docking analysis, was employed. A total of 134 active ingredients with 72 corresponding targets are identified from Qiju Dihuang pill. Additionally, 3 core targets including CHRM1, ESR1, and AR are obtained from the ingredients and drug targets network analysis. Besides, gen ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis reveal 3 important biological pathways, that is, calcium signaling pathway, insulin signaling pathway and Vascular endothelial growth factor signaling pathway. In final, a molecular docking model was constructed to study the interaction mechanism between active components and drug targets at the molecular level. All the findings show that Qiju Dihuang pill achieves therapeutic effects on treating ophthalmic diseases by regulating the crucial targets of the compounds in it. This work not only provides insight into the therapeutic mechanism of herbal medicine in the treatment of ophthalmic diseases from a multiscale perspective, but also offers an effective approach for drug discovery and development of Traditional Chinese Medicine.

Recent Advanced Deep Learning Architectures for Retinal Fluid Segmentation on Optical Coherence Tomography Images

With non-invasive and high-resolution properties, optical coherence tomography (OCT) has been widely used as a retinal imaging modality for the effective diagnosis of ophthalmic diseases. The retinal fluid is often segmented by medical experts as a pivotal biomarker to assist in the clinical diagnosis of age-related macular diseases, diabetic macular edema, and retinal vein occlusion. In recent years, the advanced machine learning methods, such as deep learning paradigms, have attracted more and more attention from academia in the retinal fluid segmentation applications. The automatic retinal fluid segmentation based on deep learning can improve the semantic segmentation accuracy and efficiency of macular change analysis, which has potential clinical implications for ophthalmic pathology detection. This article summarizes several different deep learning paradigms reported in the up-to-date literature for the retinal fluid segmentation in OCT images. The deep learning architectures include the backbone of convolutional neural network (CNN), fully convolutional network (FCN), U-shape network (U-Net), and the other hybrid computational methods. The article also provides a survey on the prevailing OCT image datasets used in recent retinal segmentation investigations. The future perspectives and some potential retinal segmentation directions are discussed in the concluding context.

Diabetic and Hypertensive Retinopathy Screening in Fundus Images Using Artificially Intelligent Shallow Architectures

Retinal blood vessels are considered valuable biomarkers for the detection of diabetic retinopathy, hypertensive retinopathy, and other retinal disorders. Ophthalmologists analyze retinal vasculature by manual segmentation, which is a tedious task. Numerous studies have focused on automatic retinal vasculature segmentation using different methods for ophthalmic disease analysis. However, most of these methods are computationally expensive and lack robustness. This paper proposes two new shallow deep learning architectures: dual-stream fusion network (DSF-Net) and dual-stream aggregation network (DSA-Net) to accurately detect retinal vasculature. The proposed method uses semantic segmentation in raw color fundus images for the screening of diabetic and hypertensive retinopathies. The proposed method's performance is assessed using three publicly available fundus image datasets: Digital Retinal Images for Vessel Extraction (DRIVE), Structured Analysis of Retina (STARE), and Children Heart Health Study in England Database (CHASE-DB1). The experimental results revealed that the proposed method provided superior segmentation performance with accuracy (Acc), sensitivity (SE), specificity (SP), and area under the curve (AUC) of 96.93%, 82.68%, 98.30%, and 98.42% for DRIVE, 97.25%, 82.22%, 98.38%, and 98.15% for CHASE-DB1, and 97.00%, 86.07%, 98.00%, and 98.65% for STARE datasets, respectively. The experimental results also show that the proposed DSA-Net provides higher SE compared to the existing approaches. It means that the proposed method detected the minor vessels and provided the least false negatives, which is extremely important for diagnosis. The proposed method provides an automatic and accurate segmentation mask that can be used to highlight the vessel pixels. This detected vasculature can be utilized to compute the ratio between the vessel and the non-vessel pixels and distinguish between diabetic and hypertensive retinopathies, and morphology can be analyzed for related retinal disorders.

Microbiota and Ocular Diseases

Recent advances have identified significant associations between the composition and function of the gut microbiota and various disorders in organ systems other than the digestive tract. Utilizing next-generation sequencing and multiomics approaches, the microbial community that possibly impacts ocular disease has been identified. This review provides an overview of the literature on approaches to microbiota analysis and the roles of commensal microbes in ophthalmic diseases, including autoimmune uveitis, age-related macular degeneration, glaucoma, and other ocular disorders. In addition, this review discusses the hypothesis of the "gut-eye axis" and evaluates the therapeutic potential of targeting commensal microbiota to alleviate ocular inflammation.

Clinical Application and Efficacy of Silver Drug in Ophthalmology: A Literature Review and New Formulation of EYE Drops with Drug Silver (I) Complex of Metronidazole with Improved Dosage Form

The use of silver preparations in medicine is becoming increasingly popular. The basic aim of this evaluation was to review the literature on the clinical (in vivo) and antibacterial potential of silver preparations in ophthalmic diseases. The second goal was to summarize the results of experimental research on the use of silver preparations in ophthalmology. The third objective was to present a method for stabilizing eye drops containing silver (I) complex. Analysis of the pH stability of the silver (I) complex with metronidazole in the prepared dosage form (eye drops) was carried out. Most silver preparations are clinically used for topical application. Few experimental results indicate the usefulness of intraocular or systemic administration of silver (I) preparations as an alternative or additional therapy in infectious and angiogenic eye diseases. The development of a new formulation increases the stability of the dosage form. New forms of silver (I) products will certainly find application in the treatment of many ophthalmic diseases. One of the most important features of the silver (I) complex is its capacity to break down bacterial resistance. The new eye drops formula can significantly improve comfort of use. Due to their chemical nature, silver (I) compounds are difficult to stabilize, especially in the finished dosage form.

Curcumin Metabolite Tetrahydrocurcumin in the Treatment of Eye Diseases

Curcumin is one of the most valuable natural products due to its pharmacological activities. However, the low bioavailability of curcumin has long been a problem for its medicinal use. Large studies have been conducted to improve the use of curcumin; among these studies, curcumin metabolites have become a relatively new research focus over the past few years. Additionally, accumulating evidence suggests that curcumin or curcuminoid metabolites have similar or better biological activity than the precursor of curcumin. Recent studies focus on the protective role of plasma tetrahydrocurcumin (THC), a main metabolite of curcumin, against tumors and chronic inflammatory diseases. Nevertheless, studies of THC in eye diseases have not yet been conducted. Since ophthalmic conditions play a crucial role in worldwide public health, the prevention and treatment of ophthalmic diseases are of great concern. Therefore, the present study investigated the antioxidative, anti-inflammatory, antiangiogenic, and neuroprotective effects of THC on four major ocular diseases: age-related cataracts, glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR). While this study aimed to show curcumin as a promising potential solution for eye conditions and discusses the involved mechanistic pathways, further work is required for the clinical application of curcumin.

Current Evidence on the Ocular Surface Microbiota and Related Diseases

The ocular surface microbiota refers to the resident non-pathogenic microorganisms that colonize conjunctiva and cornea. Several studies have shown that ocular surface epithelial cells can respond selectively to specific components of ocular pathogenic bacteria by producing pro-inflammatory cytokines and, in contrast, they do not respond to non-pathogenic bacteria, thus supporting the colonization by a real microbiota. However, the analysis of the ocular microbiome composition is essential for understanding the pathophysiology of various ophthalmic diseases. In this scenario, the first studies, which used microbiological culture techniques, reported a less diverse profile of the ocular microbiota compared with that recently discovered using new molecular-based methods. Indeed, until a few years ago, the microbiota of the ocular surface appeared to be dominated by Gram-positive and a few Gram-negative bacteria, as well as some fungal strains. In contrast, genomics has nowadays detected a remarkable diversity in the ocular surface microorganisms. Furthermore, recent studies suggest that the microbiota of other areas of the body, such as the gut and oral microbiota, are involved in the pathophysiology of several ophthalmic diseases. The aim of the present study is to highlight the current evidence on the ocular surface microbiota to better understand it and to investigate its potential role in the development of ophthalmic diseases.

Carbonic anhydrase inhibition and the management of glaucoma: a literature and patent review 2013-2019

Introduction: Glaucoma affects more than 70 million people worldwide. One of the major therapeutic options for its management is based on the inhibition of the metalloenzyme carbonic anhydrases (CAs, EC 4.2.1.1). CA inhibitors (CAIs) diminish ocular hypertension in glaucomatous patients by reducing the rate of bicarbonate formation and thus, the secretion of the aqueous humor. Areas covered: This review is intended to cover the major contributions in terms of patent literature reports for the treatment of ophthalmic diseases by means of CAIs in a time frame spanning from 2013 to date. Expert opinion: The patent literature is dominated by innovative pharmaceutical formulations including a CAI alone or in combination with other therapeutic agents. Very few novelties within drug discovery are currently present and they mainly account for new CAI moieties and classical CAIs merged into scaffolds bearing additional chemical functionalities beneficial for the pharmacological treatment of the disease. It is reasonable to expect that in the near future the so-called 'old drugs' will achieve pharmacological performances in the management of ocular hypertension beyond any expectations and thus open a new era of drug repurposing merely based on material science advancements.

Ocular findings and selected ophthalmic diagnostic tests in a group of young commercially available Guinea and Skinny pigs (Cavia porcellus)

OBJECTIVE

The purpose of this study is to evaluate a group of young commercially available Skinny pigs, to gain information regarding ocular findings in this breed of guinea pig. Comparisons of ocular findings are to be made between Skinny pigs and haired guinea pigs.

ANIMAL STUDIED

Ten haired guinea pigs and ten Skinny pigs were examined.

PROCEDURE

A complete ophthalmic examination including Schirmer tear test-II (STT-II), phenol red thread test (PRTT), rebound tonometry with TonoVet PLUS, Fluorescein and Rose Bengal stain was performed. Microbiology swabs for aerobic bacterial growth were collected from conjunctiva of both eyes prior to the ophthalmic examination.

RESULTS

The ophthalmic examination revealed seven abnormal ocular findings: trichiasis, mucopurulent discharge, hyperemia/chemosis of the conjunctiva, corneal fibrosis, corneal vascularization, and foreign body on the cornea or conjunctiva. Skinny pigs had a significantly higher amount of mucopurulent discharge (P = .0133) and a significantly higher STT-II (P < .001) than haired guinea pigs. Although not significant, trichiasis, keratitis with corneal vascularization, and foreign body presence were more common in Skinny pigs. Significantly more Skinny pigs had Pasteurellaceae isolated from their conjunctiva than haired guinea pigs (P = .0112). Antimicrobial susceptibility for the five Pasteurellaceae organisms isolated revealed susceptibility toward oxytetracycline, tobramycin, ciprofloxacin, and ofloxacin, whereas resistance was found toward erythromycin, trimethoprim-sulfamethoxazole, and moxifloxacin.

CONCLUSION

Young Skinny pigs have a higher risk of Pasteurellaceae-associated conjunctivitis. Oxytetracycline, tobramycin, ciprofloxacin, and ofloxacin were identified as topical antibiotics that may be useful for Pasteurellaceae-associated conjunctivitis in Skinny pigs.

Pattern of ocular morbidities: A cross-sectional study on school-going children in Shillong city

Introduction:

India is plagued by ocular morbidities in school-children. However, there exists paucity of studies, school health check-ups, and health education in the north-eastern region. This study aimed at estimating the prevalence and pattern of various ocular morbidities in school-going children of Shillong.

Methodology:

It was a school-based cross-sectional study done in Shillong, Meghalaya among 540 school-going children from class VI to X. Data were analyzed using SPSS version 23.

Results:

The most common ocular morbidity was refractive error (57.4%) followed by vitamin A deficiency (38.1%), color blindness (3.1%), nevus (3%), manifest squint (2.2%), ptosis (2.2%), conjunctivitis (0.9%), stye (0.4%), etc., There was statistically significant association (P = 0.0192) among the variations of presence of ocular morbidities in the various age groups, among students attending Government or Private schools (P = 0.0430), and socio-economic status (P = 0.012). The prevalence of ocular morbidities was found to have highly significant association with the educational status of both the father (P = 0.0001) and mother (P = 0.001). In addition, the occupational status of the father (P = 0.0472) and the mother (P = 0.0251) were significantly associated with the prevalence too.

Conclusion:

The prevalence of ocular morbidities was found to be much higher than in other places of the country, which may be because of environmental factors and lifestyle combined with a lack of awareness and timely diagnosis and an absence of robust school health program. A regular screening along with specific health education campaigns can go a long way in decreasing the same.

Hyaluronic Acid: Molecular Mechanisms and Therapeutic Trajectory

Hyaluronic acid (also known as hyaluronan or hyaluronate) is naturally found in many tissues and fluids, but more abundantly in articular cartilage and synovial fluid (SF). Hyaluronic acid (HA) content varies widely in different joints and species. HA is a non-sulfated, naturally occurring non-protein glycosaminoglycan (GAG), with distinct physico-chemical properties, produced by synoviocytes, fibroblasts, and chondrocytes. HA has an important role in the biomechanics of normal SF, where it is partially responsible for lubrication and viscoelasticity of the SF. The concentration of HA and its molecular weight (MW) decline as osteoarthritis (OA) progresses with aging. For that reason, HA has been used for more than four decades in the treatment of OA in dogs, horses and humans. HA produces anti-arthritic effects via multiple mechanisms involving receptors, enzymes and other metabolic pathways. HA is also used in the treatment of ophthalmic, dermal, burns, wound repair, and other health conditions. The MW of HA appears to play a critical role in the formulation of the products used in the treatment of diseases. This review provides a mechanism-based rationale for the use of HA in some disease conditions with special reference to OA.

The use of mesenchymal stem cells for the treatment of progressive retinal diseases: a review

Some ocular diseases, such as dystrophies, retinal and macular degeneration, optic nerve atrophy, and Stargardt disease, are progressive and irreversible. In this review, we focus on the use of mesenchymal stem cells (MSCs) in the treatment of these diseases. In animal studies, MSC transplantation significantly delayed retinal degeneration, led to the regeneration of cone cells, and supported the survival of retinal ganglion cells and axon regeneration. In clinical practice, patients with Behcet's disease with retinal vasculitis who received MSC injections experienced a decrease in retinal vasculitis but no improvement in vision acuity. Nonetheless, there is no evidence that MSCs are carcinogenic, and they even reduce the size of tumors in vitro. Furthermore, MSCs do not trigger the immune response.

Ultrasonographic assessment of ophthalmic diseases in low-income countries

We undertook a study between December 2016 and February 2017 on 1637 of 2101 patients with clearly documented findings. These underwent ocular B-scan ultrasonography (USG). Their ages were in the range of 10 days to 92 years; among these patients, 921 (56.26%) were male and 224 (13.68%) were children. Among the adults, 669 (40.86%) patients had anterior segment and 636 (38.85%) had posterior segment pathology. In addition, there were 108 (6.59%) with orbital pathology. Our experience is that USG is an effective, quick, low-cost and non-invasive diagnostic tool for the diagnosis of various ocular and orbital conditions in high patient volume centres (including children and adults) especially where resources are limited.

[The patient-centered approach to providing pharmaceutical care to gerontological patients in ophthalmic practice.]

The article examines the indicators of physical and economic accessibility of pharmaceutical care to patients of older age groups with visual impairment from the perspective of the patient-centered approach. The motives of consumers' behavior when choosing pharmacy organizations and ophthalmic preparations are revealed. The estimation of the consumers' satisfaction with the location of pharmacy organizations and the available in them assortment of medicines for treatment and prevention of eye diseases is given. The consumer perception of the market price of ophthalmic drugs on the Russian pharmaceutical market is represented. It is established that the revealed indicators of accessibility provide an opportunity for a wide choice of medicines for treatment and prevention of eye diseases, taking into account modern methods of pharmacotherapy, individual characteristics of the disease, consumer preferences and financial capabilities of consumers, providing practical implementation of the concept of patient- centered pharmaceutical care for ophthalmic patients of older age groups.

Oxidative stress and its downstream signaling in aging eyes

BACKGROUND

Oxidative stress (OS) and its biomarkers are the biochemical end point of the imbalance between reactive oxygen species (ROS) production and the ability of the antioxidant (AOX) biological systems to fight against oxidative injury.

OBJECTIVE

We reviewed the role of OS and its downstream signaling in aging eyes.

METHODS

A search of the literature and current knowledge on the physiological and pathological mechanisms of OS were revisited in relation to the eyes and the aging process. Most prevalent ocular diseases have been analyzed herein in relation to OS and nutraceutic supplements, such as dry-eye disorders, glaucoma, age-related macular degeneration, and diabetic retinopathy.

RESULTS

Clinical, biochemical, and molecular data from anterior and posterior eye segment diseases point to OS as the common pathogenic mechanism in the majority of these ocular disorders, many of which are pathologies causing visual impairment, blindness, and subsequent loss of life quality. Studies with nutraceutic supplements in aging eye-related pathologies have also been reviewed.

CONCLUSION

OS, nutritional status, and nutraceutic supplements have to be considered within the standards of care of older ophthalmologic patients. OS biomarkers and surrogate end points may help in managing the aging population with ocular diseases.

Application of ultrasound microbubble contrast technology in ophthalmic targeted therapy: literature analysis

AIM

To analyze the application of microbubble contrast technology in the treatment of ophthalmic diseases, mainly analyzing its advantages and existing problems.

METHODS

A total of 30 representative literatures about the application of ultrasound contrast agent in gene targeted therapy at home and abroad were collected, and focusing on sorting out the literature reporting the treatment of ophthalmic diseases with microbubble contrast technology in recent years, then recalling its advantages and problems, finally making reasonable assessment on existing problems and proposing possible solutions to the problems.

RESULTS

DUE TO ITS UNIQUE SAFETY AND EFFICACY, THE TREATMENT OF OPHTHALMIC DISEASES WITH MICROBUBBLE CONTRAST TECHNOLOGY HAS INCREASINGLY DRAWN THE ATTENTION OF CLINICIANS, BUT TWO RELEVANT ISSUES SHOULD BE CONSIDERED: first, the nature of contrast agent and the choice of corresponding ultrasound parameters; second, relative incidence of tissue bleeding, intravascular hemolysis, moderate or severe allergy as well as other side effects.

CONCLUSION

Microbubble may become the carrier of targeted therapy, and as a kind of new non-invasive delivery system, the ultrasound contrast agent has broad application prospects, but its application in ophthalmic research is still in its initial stage and the safety of contrast-enhanced ultrasound still needs further study.

The Rotterdam Study: 2012 objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over a 1,000 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy ). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.

The Rotterdam Study: 2010 objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in close to a 1,000 research articles and reports (see www.epib.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.

A new agent for the treatment of noninfectious uveitis: rationale and design of three LUMINATE (Lux Uveitis Multicenter Investigation of a New Approach to Treatment) trials of steroid-sparing voclosporin

Uveitis is an inflammatory, putative Th1-mediated autoimmune disease that affects various parts of the eye and is a leading cause of visual loss. Currently available therapies are burdened with toxicities and/or lack definitive evidence of efficacy. Voclosporin, a rationally designed novel calcineurin inhibitor, exhibits a favorable safety profile, a strong correlation between pharmacokinetic and pharmacodynamic response, and a wide therapeutic window. The LUMINATE (Lux Uveitis Multicenter Investigation of a New Approach to TrEatment) clinical development program was initiated in 2007 to assess the safety and efficacy of voclosporin for the treatment, maintenance, and control of all forms of noninfectious uveitis. If LUMINATE is successful, voclosporin will become the first Food and Drug Administration-approved corticosteroid-sparing agent for this condition.

Ocular disease in rats: a review

The rat Rattus norvegicus is widely used in experimental work, both providing a rodent model for human ocular disease and as a species for toxicologic screening. In addition, the rat is more and more widely kept as a pet, being both friendly and intelligent. Diagnosis and treatment of ocular disease is important for the welfare of individual animals and whole colonies, but also to ensure that spontaneous disease is not compromising experimental work. Here, ophthalmic conditions are reviewed in order to provide a survey of ocular disease in the rat both for veterinary ophthalmologists and for laboratory animal veterinarians and research workers.