Migraine eye: correlation between migraine and the retina.

Background: Activation of the trigeminal vascular system in migraine releases vasoactive neurotransmitters, causing abnormal vasoconstriction, which may affect the ocular system, leading to retinal damage. The purpose of our study was to determine whether there are differences in each retinal layer between migraine patients and healthy subjects. Methods: A case-control study recruited 38 migraine patients and 38 age- and sex-matched controls. Optical coherence tomography was used to measure the thickness of the peripapillary and macular retinal nerve fiber layer (pRNFL and mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer (INL). Results: The mean ages of the migraine patients and controls were 36.29 ± 9.45 and 36.45 ± 9.27 years, respectively. Thirty-four patients (89.48%) in both groups were female. The mean disability score was 19.63 ± 20.44 (indicating severe disability). The superior-outer INL of migraine patients were thicker than controls. Thickness of the GCL at temporal-outer sector and mRNFL at the superior-outer sector of the headache-side eyes was reduced. However, the INL of the headache-side-eye showed negative correlation with the disability score. This is the first study having found thinning of the GCL and mRNFL of the headache-side eyes. The INL was also thickened in migraines but showed negative correlation with the disability score. Conclusions: Increased INL thickness in migraine patients may result from inflammation. The more severe cases with a high disability score might suffered progressive retinal neuronal loss, resulting in thinner INL than less severe cases.

Chicago sky blue gel for better visualization of Demodex in patients with Demodex blepharitis.

Background: Demodex blepharitis is a common chronic disease. The number of mites is associated with ocular discomfort. The accurate number derived from well-stained specimens is, hence, in favor of diagnosing, monitoring, and determining treatment responses. Methods: A cross-sectional study was conducted between April and July 2022 at the dermatology and ophthalmology clinic, Walailak University, Thailand. Adult participants with clinical suspicion of Demodex blepharitis were recruited. We examined eyelashes under light microscopy to quantify the number of Demodex mites before and after adding CSB gel. The mite counts, evaluated by an untrained investigator and an experienced investigator, were recorded and compared. Results: A total of 30 participants were included for final analysis, among which 25 (83.3%) were female. The median age was 64.0 years (IQR, 61.0-68.0). The median Demodex counts evaluated by the experienced investigator before and after adding CSB gel were 1.0 (IQR, 0.0-1.0) and 2.5 (IQR, 2.0-3.0), respectively (p < 0.001). Moreover, the median Demodex counts evaluated by the untrained investigator before and after adding CSB gel were 1.0 (IQR, 0.0-1.0) and 2.0 (IQR, 1.0-3.0), respectively (p < 0.001). The correlation coefficient between Demodex counts after the addition of CSB counted by the experienced investigator and those counted by the untrained investigator was 0.92 (p < 0.001). CSB gel is a promising product to identify and quantify the number of Demodex mites. The findings supported the consideration of CSB gel as one of the diagnostic stains.

Evidence of Nrf2/Keap1 Signaling Regulation by Mitochodria-Generated Reactive Oxygen Species in RGK1 Cells.

It has been known that reactive oxygen species (ROS) are generated from the mitochondrial electron transport chain (ETC). Majima et al. proved that mitochondrial ROS (mtROS) caused apoptosis for the first time in 1998 (Majima et al. J Biol Chem, 1998). It is speculated that mtROS can move out of the mitochondria and initiate cellular signals in the nucleus. This paper aims to prove this phenomenon by assessing the change in the amount of manganese superoxide dismutase (MnSOD) by MnSOD transfection. Two cell lines of the same genetic background, of which generation of mtROS are different, i.e., the mtROS are more produced in RGK1, than in that of RGM1, were compared to analyze the cellular signals. The results of immunocytochemistry staining showed increase of Nrf2, Keap1, HO-1 and 2, MnSOD, GCL, GST, NQO1, GATA1, GATA3, GATA4, and GATA5 in RGK1 compared to those in RGM1. Transfection of human MnSOD in RGK1 cells showed a decrease of those signal proteins, suggesting mtROS play a role in cellular signals in nucleus.

Mitochondrial oxidative stress, mitochondrial ROS storms in long COVID pathogenesis.

Significance: This review discusses the coronavirus disease 2019 (COVID-19) pathophysiology in the context of diabetes and intracellular reactions by COVID-19, including mitochondrial oxidative stress storms, mitochondrial ROS storms, and long COVID. Recent advances: The long COVID is suffered in ~10% of the COVID-19 patients. Even the virus does not exist, the patients suffer the long COVID for even over a year, This disease could be a mitochondria dysregulation disease. Critical issues: Patients who recover from COVID-19 can develop new or persistent symptoms of multi-organ complications lasting weeks or months, called long COVID. The underlying mechanisms involved in the long COVID is still unclear. Once the symptoms of long COVID persist, they cause significant damage, leading to numerous, persistent symptoms. Future directions: A comprehensive map of the stages and pathogenetic mechanisms related to long COVID and effective drugs to treat and prevent it are required, which will aid the development of future long COVID treatments and symptom relief.

Effects of blue-light-filtering intraocular lenses on contrast sensitivity in patients with glaucoma.

To compare the effects of blue-light-filtering intraocular lenses (BF-IOLs) and conventional ultraviolet-blocking intraocular lenses (UVB-IOLs) on contrast sensitivity in patients with concurrent cataracts and glaucoma. This prospective randomized comparative interventional study enrolled glaucomatous patients with concurrent cataracts scheduled for cataract surgery with IOL implantation at Siriraj Hospital, Bangkok, Thailand, between October 2016 and March 2018. The patients were randomly assigned to receive BF-IOLs or UVB-IOLs. A functional vision analyzer measured contrast sensitivity at spatial frequencies of 1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree (CPD). The contrast sensitivity values of the 2 patient groups were compared at 2 months postoperatively. The study enrolled 42 eyes (21 with primary angle-closure glaucoma and 21 with primary open-angle glaucoma) of 32 patients. Twenty eyes received BF-IOLs, and 22 received UVB-IOLs. Postoperative logarithmic contrast sensitivity (log contrast sensitivity) significantly improved at each spatial frequency in both groups, except for 1.5 CPD. The median postoperative log contrast sensitivity values for the spatial frequencies of 1.5, 3.0, 6.0, 12.0, and 18.0 CPD for the BF-IOL group were 1.6, 1.9, 1.8, 1.4, and 0.6, respectively, compared to 1.4, 1.8, 1.7, 1.2, and 0.8 for the UVB-IOL group. However, the 2 groups had no significant differences in log contrast sensitivity values at each spatial frequency (P = .20, .37, .30, .28, and .68, respectively). Cataract surgery with IOL implantation improved contrast sensitivity in glaucomatous patients. The BF-IOLs and UVB-IOLs showed no statistically significant difference in the postoperative contrast sensitivity achieved at each spatial frequency.

Effectiveness of an online educational video intervention to improve the knowledge and behavior of contact lens care during the COVID-19 pandemic: A pre-test/post-test design.

Objective: To assess the effectiveness of an online educational video in improving contact lens (CL) care knowledge and behavior. Methods: Participants completed a 47-item questionnaire on their CL hygiene knowledge and wear and care behavior. A 5-min CL educational video was shown, and participants completed a post-test. After 2 months, the same questionnaire was used to determine knowledge retention and behavioral changes. Descriptive statistics and McNemar's tests were performed. Results: The mean age of the 132 enrolled participants was 24 years, and 61% were female. The knowledge scores significantly improved after watching the educational video (p < 0.001). Two months after the intervention, the participants reported changes in their hygienic behavior (p < 0.001). Conclusions: Online video-based learning is an effective educational tool for improving the knowledge and behavior of CL care. Practice implications: Patient education via online videos is an innovative and successful strategy that raises awareness, increases patient knowledge, and encourages preventative health behavior to avoid CL-related complications.

Rub and Rinse Contact Lenses Before Wearing as a Protective Regimen Against Contact Lens-Related Eye Infections.

Purpose: Data on contact lens (CL) users in Thailand are limited, and previous reports have mainly focused on young populations. This study aims to determine demographic data, hygienic behaviour, and complications related to the usage of CLs in the general population. Methods: This was a cross-sectional survey conducted from November 2020 to March 2021 using an anonymous questionnaire. Information on the demographic traits of the participants, characteristics of CL use, and CL care behaviours was collected. The responses were summarised and presented as a total behaviour score. Regression analysis was performed to evaluate the potential risk factors for a history of CL-related eye infections. Results: A total of 134 CL wearers were recruited. Of all the participants, 83.58% were female and 16.42% were male. The average age was 31.14±10.69 years old. The total behaviour score showed that 62.69% of the population had good CL behaviour, while 37.31% exhibited poor CL behaviour. More than 50% of participants practised appropriate CL handling. Common unfavourable behaviours (>50%) reported were not using CL care solution to clean the storage case, not rubbing and rinsing the lens before storage, exposure to water during wear, use of makeup around the ocular area, and missing annual eye exams. Other less common but important instances of mishandling included using tap water to clean the lenses, topping off old CL solution, and exceeding the recommended planned-replacement period. However, no behaviours were significantly associated with a history of CL-related eye infections. Rubbing and rinsing CLs before wearing them was found to be a protective factor against a history of eye infections. Conclusion: Rubbing and rinsing CLs before wearing should be mentioned as an additional recommendation for the user.

Bacterial microbiota of the contact lens surface and associated care behaviours.

Introduction: Contact lens (CL) wear has been reported to cause changes to the microbiome of the ocular surface. More insight into the alteration of this microenvironment can help to understand the pathogenesis of CL-related eye infections. Knowledge of the relationship between the CL wearer's behaviours and pathogens would help health care providers focus on each step of proper CL care. This study aims to determine the behaviours that might be associated with the community of bacteria on CL. Methods: A cross-sectional design was performed using anonymous questionnaires to obtain demographic data and assess hygiene practices among volunteering wearers. The CLs used were collected to evaluate the prevalence of pathogenic bacteria associated with ocular infections by PCR and microbiota analysis. Results: The bacterial microbiota study revealed a total of 19 genera and 26 isolated strains from 20 eligible CLs. Enterobacter, Staphylococcus, and Achromobacter were the main genus in this subject population. Staphylococcus pasteuri and Achromobacter agilis were the most common pathogens at 65% and 35%, respectively. Enterobacter mori, a nonpathogenic organism, was found to be the most predominant strain, accounting for 27.51% of the total bacterial constituents. The risk behaviour of CL wear that was significantly associated with A. agilis contamination was cleaning the CL case with tap water (P value = 0.04). Conclusions: This is the first study focusing on the association between the culture selected microbial community on the CL surface and compehensive behavioural characteristics. Environmental contamination was the main source of microbes found on CL surfaces. An emphasis in patient education should be placed on careful handling during the CL care routine and managing the hygiene of the surroundings.

Influence of Contact Lens Materials and Cleaning Procedures on Bacterial Adhesion and Biofilm Formation.

PURPOSE: The present study aimed to compare the existing soft contact lens (CL) materials regarding their influence on bacterial biofilm formation and adhesion susceptibility. Then, the study was designed to investigate the effectiveness of various disinfecting solutions and evaluate the ability of cleaning regimens in terms of anti-bacterial adhesion and biofilm removal on different soft CL materials. METHODS: Bacterial biofilm formation on CLs was evaluated by biomass assay. Adhesion assay and standard plate count were carried out at time-interval periods within 24 h. Various CL disinfecting procedures were assessed for their efficacy to remove biofilm and reduce bacterial adhesion. Scanning electron microscopy (SEM) was performed for the morphological assessment of bacterial biofilm. RESULTS: Printed hydroxyethyl methacrylate (HEMA) CLs significantly demonstrated more biofilm staining and bacterial attachment when compared with non-printed HEMA CLs, while the Filcon II 3 and Nesofilcon A CLs possessed less biofilm biomass and adherent cells. Staphylococcus aureus and Pseudomonas aeruginosa represented the highest biofilm producing bacteria on HEMA-based materials in this study. The disinfecting regimen with the highest efficacy was the two-step system, first using multipurpose disinfecting solution containing edetate disodium and sorbic acid (MPDS+EDSA), followed by soaking in multipurpose solution (MPS). The regimen demonstrated the greatest effect against the pre-formed biofilm and the adhesion activity of S. aureus and P. aeruginosa on the soft CLs. The SEM micrographs confirmed the morphological changes of bacterial biofilm after disinfecting and revealed that the two-step system treated CLs displayed less adherent bacteria. CONCLUSION: HEMA-based soft CLs may facilitate bacterial biofilm formation and adhesion capability. The two-step system was the most effective regimen for biofilm removal, where the soaking period in the disinfecting solution of the no-rub regimen should last more than 6 h to remove pre-formed biofilm.

Multiple Eyelid Signs are Suggestive of Demodex Infestation.

PURPOSE: To determine the signs associated with Demodex infestation in blepharitis patients and the rates of eyelash Demodex colonization among blepharitic patients and healthy individuals in Thailand. PATIENTS AND METHODS: This was a prospective, case-control clinical study. Eighty-three controls and 43 blepharitic patients were consecutively enrolled from Walailak University Hospital. Each patient answered a questionnaire, underwent a complete eye exam, and had four lashes from each eye epilated; eyelashes were directly examined under a light microscope. Ocular signs, including types of eyelash debris (waxy debris, scaly debris, or cylindrical dandruff (CD)), erythema and telangiectasia of the eyelid, were noted. RESULTS: Demodex infestation was observed more frequently among patients with blepharitis than among controls (67.4% in the blepharitis group, 26.5% in the control group, p-value <0.001). The participants with Demodex infestation were 5.7 times more likely to have blepharitis than the controls (odds ratio 5.74; 95% confidence interval 2.57-12.82, p-value <0.001). Clinical signs that were significantly (p-value <0.05) related to demodicosis were lid erythema, lid telangiectasia, and any type of eyelash debris (scaly, waxy, or CD). CONCLUSION: In contrast to previous studies that found only CD to be highly associated with eyelash demodicosis, we found multiple suggestive signs: any kind of debris on eyelashes (scaly, waxy, or CD), eyelid erythema, and eyelid telangiectasia. Approximately one-quarter (26.5%) of the studied population had asymptomatic mite colonization. Demodex infestation should therefore always be on the list of possible etiologies when treating patients with blepharitis or other ocular surface-related problems.