Eye最新文献

Background/objectives: Although polygenic risk scores (PRSs) have been developed for age-related macular degeneration (AMD), it is not known whether these scores are associated with impairment of visual functions in older individuals with healthy macula. We evaluated age-related changes in visual function in people aged 55 years or above with healthy macula and determined the associations of age-related visual function changes with AMD PRS in people with healthy macula.

Subjects/methods: Participants aged 55 years or above with healthy macula and a comparative group of people with early or intermediate AMD from the Northern Ireland Sensory Ageing study were included. 45 SNPs were included for PRS calculation.

Results: A total of 470 participants with healthy macula were included (Beckman grade 0 or 1). The comparator group consisted of participants with early AMD (n = 87) or intermediate AMD (n = 48). All visual functions except metrics of central visual field assessment showed a significant decline with age in adjusted linear regression models. Rod intercept time (RIT) was the only visual function significantly associated with PRS with Beta = 0.12 (95% confidence interval: 0.01-0.23), P = 0.03. A PRS integrated model achieved the highest area under the receiver operating characteristic curve (AUC) of 0.803 (0.732 to 0.874) to distinguish between normal or increased RIT.

Conclusions and relevance: We observed a significant decline in multiple visual functions with increasing age. However, PRS was significantly associated with RIT only, highlighting the genetic association of age-related decline in rod function.

Juvenile-onset Systemic Lupus Erythematosus (JSLE) is a chronic multifactorial autoimmune disease with multiple system involvement, affecting children and adolescents. Ocular manifestations are rare and can range from mild to severe. JSLE impacts quality of life and prognosis. However, the impact JSLE has on children's ocular health remains an underexplored area. This systematic review aims to consolidate existing evidence on ocular manifestations in JSLE. A systematic search of MEDLINE and ScienceDirect was conducted until October 2024. Eligible studies focused on children and adolescents with JSLE presenting ocular symptoms. Joanna Briggs Institute critical appraisal tools for each study were employed for quality assessment. Forty-two studies evaluating ocular manifestations in JSLE patients were included. Among those were 29 case reports and case series with 34 patients in total, 4 cross-sectional studies, with a total of 210 patients, 155 of whom had ocular manifestations, and 9 cohort studies, with a total of 2696 patients enrolled and 212 of them reporting ocular manifestations (7.8%). Results were categorized by affected ocular structures: external, anterior, or posterior segment. Neuro-ophthalmological and drug-induced manifestations were described separately. Retinal involvement was the most often reported. Notable manifestations included dry eye disease, uveitis, vaso-occlusive retinopathy, and corticosteroid-induced cataracts. Ocular symptoms often served as the initial indication of disease onset. Heightened awareness and standardized assessments are necessary for management of ocular manifestations. Further research is needed to comprehensively elucidate the underlying mechanisms and pathogenesis of the disease.

Objectives: To assess global, regional, and national burdens and trends of age-related macular degeneration (AMD) from 1990 to 2021.

Methods: Data from the Global Burden of disease Study 2021(GBD 2021) were used. The primary measurement were prevalent cases, years lived with disability (YLDs), age-standardised prevalence rate (ASPR) and age-standardised YLDs rate (ASYR), categorized by age and sociodemographic index (SDI). Trend analysis was measured by calculating average annual percentage change (AAPC) of ASPR and ASYR.

Results: Globally, the prevalent AMD cases increased to 8,057,520.459 (95% uncertainty interval [UI], 6,705,283.83 to 9,823,237.34) in 2021, with associated YLDs rising to 577,984.5004 (95% UI, 401,188.20 to 797,657.63). AMD burdens varied across regions and countries, as well as level of SDI development. China, India, and the United States of America (USA) were the top three countries with AMD cases. Caribbean regions have significant lower ASPR and ASYR of AMD. The AMD burden peaked between ages 65-69. Females had a significantly higher burden of AMD compared to males. From 1990 to 2021, the global ASPR and ASYR showed downward trend (AAPC = -0.15, 95% confidence interval [CI], -0.19 to -0.12, P < 0.001; AAPC = -0.69, 95% CI, -0.71 to -0.67, P < 0.001) respectively. The USA is the only developed country showed decreasing AAPCs of ASPR and ASYR from 1990 to 2021 but increasing AAPCs of ASPR and ASYR from 2012 to 2021.

Conclusions: AMD burdens increased over 30 years, varying by age, sex, and SDI, guiding global strategies and public health interventions.

Background: Health-related social needs (HRSN), or unmet conditions that are important to maintain health (such as finances and transportation), contribute to vision health disparities. The purpose of this study is to identify the unmet HRSN of ophthalmology clinic patients.

Methods: This retrospective, cross-sectional study examined HRSN survey results from adult patients who checked in for a clinic visit at a tertiary academic eye centre from April 28, 2022, to March 31, 2023. Demographics and visual acuity were extracted from the electronic health record, and their reported HRSNs were evaluated using binary logistic regression.

Results: Of 1413 patients who completed the survey, 194 (13.7%) screened positive for at least one HRSN. The most frequently reported need was food insecurity (99/1303, 7.6%), followed by transportation (68/1340, 5.1%), housing instability (63/1305, 4.8%), financial insecurity (46/1293, 3.6%), and homelessness (10/1330, 0.8%). Patients with at least one reported HRSN were more likely to be Black compared to White (OR 4.03, 95% CI: 2.71-5.96), female compared to male (OR 1.88, 95% CI: 1.34-2.62), and younger than 65 years of age compared to 65 to 75 years (OR 2.35, 95% CI: 1.68-3.37) or older than 75 years (OR 4.62, 95% CI: 2.54-8.16). Presence of at least one HRSN was associated with visual impairment, with greater odds of best-corrected visual acuity worse than 20/40 in the group with HRSN compared to without HRSN (OR 1.55, 95% CI: 1.09-2.19).

Conclusion: Integrating a screening questionnaire in ophthalmology clinics can uncover unaddressed HRSN, enabling resource allocation to mitigate vision health disparities.

Objective: To evaluate if provider characteristics affect attitude toward carbonic anhydrase inhibitors (CAI) prescription for patients with history of sulfonamide antibiotic (SA) hypersensitivity.

Methods: A survey querying providers' attitudes toward CAI prescription in hypothetical patients with prior SA hypersensitivity was distributed to four ophthalmology and optometry organizations. Logistic regression was used to assess the relationship between avoiding CAI and profession, specialty, organizational affiliation, and years in practice.

Results: Of 250 respondents, 27% and 52% would avoid topical and oral CAI, respectively, in patients with prior SA rash and/or urticaria. >90% would avoid oral CAI in patients with prior severe SA hypersensitivity. Respondents with >10 years in practice were more likely to avoid oral CAI in patients with prior SA rash and/or urticaria than those with ≤10 (OR 2.27, p = 0.002). Respondents affiliated with non-glaucoma organizations were more likely to avoid oral CAI in patients with prior SA rash and/or urticaria than those affiliated with glaucoma organizations (p = 0.03). Providers without glaucoma training were more likely to avoid topical CAI in patients with prior SA rash and/or urticaria (p = 0.004) and anaphylaxis (p = 0.01) than glaucoma-trained providers.

Conclusions: Despite no supporting evidence, a significant number of respondents would avoid CAI in patients with prior SA hypersensitivity. Respondents without glaucoma training, no affiliation with a glaucoma organization, and >10 years in practice are more likely to avoid CAI in patients with type I SA hypersensitivity. Providers should be informed of the low cross-reactivity risk between CAI and SA so more patients may benefit from these drugs.