A Comprehensive Review of Leber Hereditary Optic Neuropathy and Its Association with Multiple Sclerosis-Like Phenotypes Known as Harding's Disease.

Leber Hereditary Optic Neuropathy (LHON) stands as a distinctive maternally inherited mitochondrial disorder marked by painless, subacute central vision loss, primarily affecting young males. This review covers the possible relationship between LHON and multiple sclerosis (MS), covering genetic mutations, clinical presentations, imaging findings, and treatment options. LHON is associated with mutations in mitochondrial DNA (mtDNA), notably m.11778G>A, m.3460G>A, and m.14484T>C, affecting complex I subunits. Beyond ocular manifestations, LHON can go beyond the eye into a multi-systemic disorder, showcasing extraocular abnormalities. Clinical presentations, varying in gender prevalence and outcomes, underscore the nature of mitochondrial optic neuropathies. Hypotheses exploring the connection between LHON and MS encompass mitochondrial DNA mutations triggering neurological diseases, immunologically mediated responses inducing demyelination, and the possibility of coincidental diseases. The research on mtDNA mutations among MS patients sheds light on potential associations with specific clinical subgroups, offering a unique perspective into the broader landscape of MS. Imaging findings, ranging from white matter alterations to cerebrospinal fluid biomarkers, further emphasize shared pathological processes between LHON-MS and classical MS. This comprehensive review contributes to the understanding of the complex relationship between LHON and MS.

Detecting seasonal trends in optic neuritis within the Ottawa region.

OBJECTIVE: In this study we aim to determine seasonal patterns underlying optic neuritis (ON) onset that may provide valuable epidemiologic information and help delineate causative or protective factors. DESIGN: Single-centre retrospective chart review. METHODS: A database search of centralized electronic health records was completed using diagnostic codes employed at the Ottawa Eye Institute for data collection. Charts were reviewed for documentation supporting a diagnosis of ON falling into the following categories: multiple sclerosis ON and clinically isolated syndrome ON, myelin oligodendrocyte glycoprotein ON, neuromyelitis optica ON, and idiopathic ON. Date of onset, biological sex, and age were extracted from each chart. Data were analyzed for calculation of frequency by season and overall pooled seasonal trends of all cases of ON. RESULTS: From the 218 included patients with ON, there was no statistically significant seasonal correlation. The overall trend of ON was lowest in winter and spring (22% and 23%, respectively) and highest in summer and fall (28% and 27% respective). Divided further, multiple sclerosis ON or clinically isolated syndrome ON rates (n = 144) were lowest in the spring (21%) and highest in fall (29%); myelin oligodendrocyte glycoprotein ON rates (n = 25) were lowest in winter (16%) and highest in summer and fall (both at 32%); neuromyelitis optica ON rates (n = 16) were lowest in fall (12.5%) and highest in winter and summer (both at 31.25%); and idiopathic ON rates (n = 33) were lowest in fall (18%) and highest in spring (33%). CONCLUSIONS: The overall ON seasonal trend appears to have a predilection for the summer and fall months, which may be explained by warmer weather and viral infections as risk factors for multiple sclerosis relapse during those seasons.

Awareness and Knowledge About Glaucoma in the Western Region of Saudi Arabia: A Population-Based Survey.

Background Glaucoma is a leading cause of irreversible blindness worldwide. This study aimed to assess the Saudi population's levels of awareness and knowledge regarding glaucoma risk factors, symptoms, treatment, and outcomes. Methods A cross-sectional study was conducted among the Glaucoma Awareness Campaign attendees during the World Glaucoma Week (2015-2016). A structured questionnaire was used, and a knowledge score (0-25) was calculated as the sum of all correct answers. Sociodemographic factors, personal and family history of glaucoma, and the presence of risk factors were investigated and analyzed as factors affecting knowledge. Results The study included 1751 participants, with a mean age of 40.23 (SD ±13.86) years; 51.5% were males, 3.7% had glaucoma and 22.6% had a family history of glaucoma. The overall awareness rate was 65.6%, which was moderately higher among females (71.6%), older participants (≥40 years, 69.7%), and highly educated participants (70.6%). Concerning knowledge, 15.4% had fair to good knowledge (score 15-25). Participants with a personal history of glaucoma had relatively greater knowledge regarding glaucoma-specific questions, such as optic nerve damage (p=0.001) and the requirement of lifetime treatment (p<0.001). Conclusion Awareness and knowledge about glaucoma are limited among the Saudi population, regardless of socioeconomic class or educational status. Knowledge about glaucoma should be further promoted to enable early screening and prevention.

Neuro-Ophthalmic Complications of COVID-19 Infection and Vaccination.

The COVID-19 pandemic has led to the identification of new disease phenotypes associated with infection by the SARS-CoV-2 virus. This includes multiple neuro-ophthalmological sequelae, which have been associated with COVID-19 infection and administration of COVID-19 vaccines. Some of these associations have a plausible pathophysiological link to the infection or vaccination but true causation has yet to be established. We review the literature for associations reported between COVID-19 infection or vaccination and neuro-ophthalmic sequelae and review the potential pathophysiological processes that may underlie these associations.

Effects of Face-Mask Use on Dry Eye Disease Evaluated Using Self-Reported Ocular Surface Disease Index Scores: A Cross-Sectional Study on Nurses in Saudi Arabia.

BACKGROUND: Wearing face masks has been an essential part of healthcare workers' lives since the coronavirus disease 2019 (COVID-19) pandemic. This study aims to determine the association between prolonged face mask-wearing and dry eye disorder (DED) among female nurses. METHODS: An online questionnaire-based cross-sectional study was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between May 2021 and February 2022. It covered sociodemographic data, conditions associated with ocular irritation, and questions related to mask-wearing duration. The Ocular Surface Disease Index (OSDI) survey was used to measure DED severity. Binary logistic regression analysis was done and Odd's ratios (OR) with 95% confidence intervals (CI) were reported. RESULTS: A total of 266 female nurses responded to this study. The majority of the sample (71.1%) fell in the normal-mild DED category (OSDI 0-22), while (28.9%) were categorized as the moderate-severe DED category (OSDI >22). We found a significant independent association of dry eye disorder with wearing a mask for >6 hours/day (OR 2.066, 95% CI: 1.083-3.944). Other significant predictors of DED in this study were wearing corrective eyeglasses (OR 2.382, 95% CI: 1.296-4.376) and having rheumatoid arthritis (OR 17.289, 95% CI: 1.794-166.7). CONCLUSION: Wearing a face mask for > 6 hours/day was significantly associated with moderate to severe DED among female nursing staff. Ophthalmologists should be aware of this adverse effect in order to promote ways to relieve this condition.

Retinopathy of prematurity in Saudi Arabia: Exploring maternal risk factors.

PURPOSE: Retinopathy of prematurity (ROP) is a preventable blinding disorder affecting preterm infants. To date, maternal risk factors have not been studied in Saudi Arabia. This study aims to identify possible maternal risk factors for any stage and type 1 ROP. MATERIALS AND METHODS: A total of 295 preterm infants screened for ROP between November 2013 and December 2018 at a Saudi Arabian tertiary-care hospital were included. We included infants with a gestational age ≤ 32 weeks and/or birth weight (BW) ≤1500 g. We analyzed 28 maternal and neonatal risk factors. RESULTS: The incidence of ROP at any stage and Type 1 were 31.9% and 7%, respectively. In the univariate analysis, the only maternal factor associated with any stage of ROP was spontaneous vaginal delivery (P = 0.049), but no maternal factor was an independent risk factor for type 1 ROP. Multivariate logistic regression analysis identified lower BW, lower gestational age and longer neonatal intensive care unit stay as independent risk factors for the development of ROP at any stage (P < 0.05). For Type 1 ROP, lower BW, and intraventricular hemorrhage were significant independent risk factors (P < 0.05). CONCLUSION: The only maternal risk factor related to ROP was spontaneous vaginal delivery, which increased the risk of any stage of ROP. The single most predictive risk factor for any stage of ROP and Type 1 ROP was low BW. These findings emphasize the role of the obstetrician in promoting health care and modifying maternal risk factors to prevent preterm births related to a low BW.