Intraocular pressure modulation with thermal stimuli

ABSTRACT Purpose: This study aimed to determine whether early-stage intraocular pressure can be modulated using a thermal face mask. Methods: In this prospective clinical study, healthy participants were randomized on a 1:1:1 allocation ratio to three mask groups: hypothermic (G1), normothermic (G2), and hyperthermic (G3). After randomization, 108 eyes from 108 participants were submitted to clinical evaluations, including measurement of initial intraocular pressure (T1). The thermal mask was then applied for 10 minutes, followed by a second evaluation of intraocular pressure (T2) and assessment of any side effects. Results: The hypothermic group (G1) showed a significant reduction in mean intraocular pressure between T1 (16.97 ± 2.59 mmHg) and T2 (14.97 ± 2.44 mmHg) (p<0.001). G2 showed no significant pressure difference between T1 (16.50 ± 2.55 mmHg) and T2 (17.00 ± 2.29 mmHg) (p=0.054). G3 showed a significant increase in pressure from T1 (16.53 ± 2.69 mmHg) to T2 (18.58 ± 2.95 mmHg) (p<0.001). At T1, there was no difference between the three study groups (p=0.823), but at T2, the mean values of G3 were significantly higher than those of G1 and G2 (p<0.00). Conclusion: Temperature was shown to significantly modify intraocular pressure. Thermal masks allow the application of temperature in a controlled, reproducible manner. Further studies are needed to assess the duration of these effects and whether they are reproducible in patients with pathologies that affect intraocular pressure.

Outer retinal thinning is associated with brain atrophy in early age-related macular degeneration.

PURPOSE: Both retinal changes and age-related macular degeneration (AMD) have been shown to be associated with Alzheimer's disease and related dementias (ADRD). In AMD, the outer retina is impacted significantly and early, but little is known about its association with cognition or changes in brain morphometry. This study investigates the relationship between retinal and brain morphometry in older adults with early and intermediate age-related macular degeneration (AMD). DESIGN: Cross-sectional study. METHODS: Adults ≥ 70 years with normal, early, and intermediate AMD were recruited from Callahan Eye Hospital Clinics at the University of Alabama at Birmingham. Participants underwent cognitive testing, optical coherence tomography (OCT), and magnetic resonance imaging (MRI). Associations of retinal layer thickness with brain volume and thickness of specific brain regions were evaluated utilizing multivariable linear regression. The relevance of retinal thickness variables in brain volumetrics was quantified using least absolute shrinkage and selection operator (LASSO) regression models. Correlations between demographic variables, cognitive scores, and brain morphometry were evaluated. RESULTS: Participants with thinner outer retina had significantly smaller hippocampus (ß = 0.019, p = 0.022), lower occipital cortex regions of interest (occipital ROIs) thickness (ß = 5.68, p = 0.020), and lower cortical thickness in ADRD-related brain regions (ß = 7.72, p = 0.006). People with thinner total retina had significantly lower occipital ROIs (ß = 3.19, p = 0.009) and ADRD-related brain region (ß = 3.94, p = 0.005) thickness. Outer retinal thickness in the outer Early Treatment of Diabetic Retinopathy Study (ETDRS) ring was the most frequently reported retinal variable associated with brain morphometry on LASSO regression. Total gray matter volume showed positive correlations with education (Pearson's r = 0.30, p = 0.022). CONCLUSION: In older adults with normal retinal aging and early and intermediate AMD, thinner outer retina had specific associations with brain regions primarily involved in vision and cognition, such as lower hippocampal volume and lower thickness of the occipital ROIs and brain regions known to show early structural changes in dementia.

Caffeine and Vision: Effects on the Eye.

Caffeine, commonly found in coffee and tea, affects various aspects of eye health as it blocks adenosine receptors, impacting tear production, intraocular pressure, macular perfusion, and choroidal thickness. However, its connection with eye conditions like glaucoma and cataracts remains uncertain due to conflicting research findings. Some studies suggest potential benefits for cataracts, while others warn against frequent caffeine intake in glaucoma and surgical scenarios due to possible increases in intraocular pressure. Conflicting evidence also exists regarding its effects on dry eye, macular degeneration, myopia/hyperopia, diabetic retinopathy, retinopathy of prematurity, and central serous retinopathy. Caffeine does not seem to be a risk factor for dry eye, although studies have shown that caffeine may offer protection against wet age-related macular degeneration, and the metabolite 7-methylxanthine could be a more promising treatment for myopia. Moreover, caffeine can potentially cause tremors and might hinder surgical performance, especially in less experienced surgeons. Recommendations from experts vary, highlighting the need for further research to fully understand how caffeine affects the eye. Individuals genetically predisposed to glaucoma should be cautious due to the possibility of clinically significant elevations in intraocular pressure with caffeine consumption. For delicate procedures like microsurgery, where tremors can be detrimental, caution should be exercised with caffeine. This review underscores the importance of additional studies to provide clearer insights and prudent recommendations regarding caffeine's impact on eye health.

Associations between vision impairment and eye diseases with dementia, dementia subtypes and cognitive impairment: An umbrella review.

Vision impairment (VI) and eye diseases such as age-related macular degeneration (AMD), diabetic retinopathy (DR), glaucoma and cataract have been reported to be associated with cognitive impairment and dementia, however, to date, very little attempt has been made to collate and synthesizes such literature. Therefore, the aim of this umbrella review is to systematically assesses the credibility and certainty of evidence of associations between vision impairment (VI) and eye diseases with cognitive impairment, dementia and dementia subtypes. We conducted an umbrella review of meta-analyses by screening articles in any language in PubMed, MEDLINE (Ovid), EMBASE, Web of Science, Cochrane CENTRAL and CDSR published from database inception up to May 30, 2024. Quality appraisal of each included original meta-analysis was assessed using A Measurement Tool for Assessing Systematic Reviews 2 (AMSTAR2). The certainty of the evidence was based on statistical significance, study size, heterogeneity, small study effects, prediction intervals (PI), and bias. We followed an a-priori protocol registered with PROSPERO (CRD42024564249). We identified 13 meta-analyses (AMSTAR 2; high accuracy of the findings 1, moderate 10, and low 2) that included 232 original articles based on 99,337,354 participants. Overall, no evidence was highly suggestive or convincing. Suggestive evidence was found for associations between cataract and dementia (equivalent odds ratio [eOR] 1.20, 95 %CI, 1.16-1.25), cataract and Alzheimer's disease (eOR 1.21, 95 %CI, 1.15-1.28), and AMD and Alzheimer's disease (eOR 1.27, 95 %CI, 1.27-1.27). Weak evidence was found for associations between VI and dementia (eOR 1.50, 95 %CI, 1.23-1.84), DR and dementia (eOR 1.33, 95 %CI, 1.17-1.50), cataract and vascular dementia (eOR 1.26, 95 %CI, 1.09-1.45), VI identified by cross-sectional studies and cognitive impairment (eOR 2.37, 95 %CI, 2.31-2.44), and VI identified by objective measures and cognitive impairment (eOR 1.56, 95 %CI, 1.12-2.18). The observed suggestive level of evidence for the relationship between eye disease and dementia (as well as dementia subtypes) suggests that policy and interventions to aid in the prevention and management of eye disease may also aid in the prevention of dementia syndrome. Where the level of evidence is weak, further studies are needed with stronger methodological approaches.

Comparison of food and nutrient intake according to the presence of glaucoma among Korean older adults.

BACKGROUND/OBJECTIVES: The purpose of this study was to compare nutrient intake according to the presence of glaucoma among Korean individuals aged 60 yrs or older and to establish evidence for the necessity of dietary habits and nutritional management in the prevention and management of glaucoma. SUBJECTS/METHODS: The study was conducted on 4,195 older adults aged 60 or older who participated in the Korea National Health and Nutrition Examination Survey in 2017 and 2018. The subjects were classified into glaucoma (n = 186) and non-glaucoma (n = 4,009) groups based on the doctor's diagnosis of glaucoma. Nutrient intake was estimated using a 24-h recall method, and the intake of nutrients between the 2 groups was compared. RESULTS: The comparison of food group and nutrient intake according to the subjects' prevalence of glaucoma showed that the average intake of potatoes and starches was higher in the glaucoma group than in the non-glaucoma group (P = 0.049), whereas the average intake of meat, fish, and shellfish was higher in the non-glaucoma group than in the glaucoma group (P = 0.045, P = 0.018). Additionally, the average intake of omega-3 and vitamin C was higher in the non-glaucoma group than in the glaucoma group (P = 0.022, P = 0.045), while the average intake of niacin was higher in the glaucoma group than in the non-glaucoma group (P = 0.046). CONCLUSION: The intake of meats, fish, and shellfish, omega-3, and vitamin C was higher in the non-glaucoma group than in the glaucoma group. These results suggest that a healthy diet might be necessary for the prevention and management of glaucoma.

Diagnosis of ophthalmologic diseases in canines based on images using neural networks for image segmentation.

The primary challenge in diagnosing ocular diseases in canines based on images lies in developing an accurate and reliable machine learning method capable of effectively segmenting and diagnosing these conditions through image analysis. Addressing this challenge, the study focuses on developing and rigorously evaluating a machine learning model for diagnosing ocular diseases in canines, employing the U-Net neural network architecture as a foundational element of this investigation. Through this extensive evaluation, the authors identified a model that exhibited good reliability, achieving prediction scores with an Intersection over Union (IoU) exceeding 80 %, as measured by the Jaccard index. The research methodology encompassed a systematic exploration of various neural network backbones (VGG, ResNet, Inception, EfficientNet) and the U-Net model, combined with an extensive model selection process and an in-depth analysis of a custom training dataset consisting of historical images of different medical symptoms and diseases in dog eyes. The results indicate a fairly high degree of accuracy in the segmentation and diagnosis of ocular diseases in canines, demonstrating the model's effectiveness in real-world applications. In conclusion, this potentially makes a significant contribution to the field by utilizing advanced machine-learning techniques to develop image-based diagnostic routines in veterinary ophthalmology. This model's successful development and validation offer a promising new tool for veterinarians and pet owners, enhancing early disease detection and improving health outcomes for canine patients.

Impact of social distancing policy on pediatric emergency ophthalmic severity during the coronavirus disease 2019 pandemic.

BACKGROUND: We investigated the impact of social distancing policies (SDPs) on ophthalmic severity in children who underwent emergency ophthalmic referrals during the coronavirus disease 2019 pandemic period. METHODS: We reviewed all children with ophthalmic referrals in a single academic hospital emergency department during the period from February 2017 to December 2019 (prepandemic) or February 2020 to December 2022 (pandemic). Baseline features, diagnosis-based severity, and outcomes were compared between the two periods. The Government Response Stringency Index (GRSI), which ranges from 0 to 100, was used as a surrogate for the intensity of SDPs during the pandemic. Poisson regression was used to quantify the association of the GRSI with the severity. RESULTS: Among 1074 children with ophthalmic referrals, 437 (40.7%) visited during the pandemic. This was 31.4% lower than that during the prepandemic period. In numbers, pandemic-related declines were more modest in high severity than in medium-to-low severity (35.1% vs. 55.0%), and for injury than for illness (28.5% vs. 36.1%). In percentages, high severity increased from 63.3% to 71.3% (p = 0.016). The hospitalization rate increased from 1.7% to 3.9% (p = 0.029). For every 10-point increase in GRSI, there was a 20.0% decrease in high severity (95% confidence interval, 5%-30%). CONCLUSIONS: This study shows an inverse association of SDPs with ophthalmic severity and an increase in severe cases along with consistent flow of injury cases, amid the overall decline in eye-related visits to the emergency department during the pandemic period.

Microbiome as an endocrine organ and its relationship with eye diseases: Effective factors and new targeted approaches.

Microbiome is an endocrine organ that refers to both the complicated biological system of microbial species that colonize our bodies and their genomes and surroundings. Recent studies confirm the connection between the microbiome and eye diseases, which are involved in the pathogenesis of eye diseases, including age-related macular disorders, diabetic retinopathy, glaucoma, retinitis pigmentosa, dry eye, and uveitis. The aim of this review is to investigate the microbiome in relation to eye health. First, a brief introduction of the characteristics of the gut microorganisms terms of composition and work, the role of dysbiosis, the gut microbiome and the eye microbiome in the progression of eye illnesses are highlighted, then the relationship among the microbiome and the function of the immune system and eye diseases, the role of inflammation and aging and the immune system, It has been reviewed and finally, the control and treatment goals of microbiome and eye diseases, the role of food factors and supplements, biotherapy and antibiotics in relation to microbiome and eye health have been reviewed.

The gut-eye axis: the retinal/ocular degenerative diseases and the emergent therapeutic strategies.

The interplay between human microbiota and various physiological systems has garnered significant attention in recent years. The gut microbiota plays a critical role in maintaining physiological homeostasis and influences various aspects of human health, particularly via the gut brain axis. Since 2017, the challenging concept of the gut-retina axis has emerged thanks to a network analysis emphasizing the potential role of the gut microbiota disruption in the development of the age-related macular degeneration and further retinal damages. Many other ocular disorders have been linked to the dysbiosis of the gut microbiota, including uveitis and glaucoma. It has been shown that age related macular degeneration can be prevented or reversed using a diet that induces changes in the gut microbiota. The potential link between the gut microbiota as well as others types of microbiota such as the ocular surface microbiota and the development/progression of age related as well as inherited retinal degenerations and other degenerative eye diseases, has recently been broadened. Therefore, the pathogenesis of several eye diseases has recently been associated with a larger perception called the gut eye axis. This mini-review examines the potential mechanisms underlying the gut eye axis and suggests implications for the management of eye diseases. By understanding the modulation of the gut microbiota and its impact on eye disease, this mini-review provides insight into potential therapeutic interventions and avenues for future research.

Ocular Ultrasound.

Point-of-care ultrasound may be used to assist in the diagnosis of ocular complaints in the emergency department. With the use of a linear probe, the emergency physician can view anterior and posterior chamber structures of the patient's eye and evaluate for signs of pathology.

Current management of inherited retinal degenerations in Portugal (IRD-PT survey).

Inherited retinal dystrophies/degenerations (IRDs) are the leading cause of visual impairment and incurable familial blindness in the Western world. Given the clinical and genetic heterogeneity, establishing a molecular diagnosis is especially relevant. The aim of this study was to perform the first nationwide survey to understand the prevalence and current management of IRDs in Portugal. A response was obtained from 26 healthcare providers (HCP) (76.5% response rate). Only 4 respondents reported not managing IRD patients. Most HCPs (68.1%) reported managing up to 100 patients, while three currently manage between 501 and 1000 patients. Based on the Portuguese population, an estimated IRD prevalence of 0.031%, i.e., about 1 in 3000 individuals, was calculated. In most HCPs (86.3%), most patients are adults, and non-syndromic retinitis pigmentosa is the most frequent diagnosis. Only 4 HCPs currently use the national, web-based IRD registry (IRD-PT). However, all but one respondent expressed interest in participating in such a registry. Genetic testing is available in 54.5%, with 58.3% HCPs reporting solved rates between 61-80%, but 4 to 9 months to get a genetic test result in 83.4% of cases. Based on this survey, the prevalence of biallelic RPE65-associated disease in Portugal is 0.00031%, i.e., approximately 1:300,000 individuals. Data from this study provide vital background information on national differences in the diagnosis and management of IRD patients. Nationwide implementation of the IRD-PT registry should be encouraged and supported to provide population-based reference data and to identify patients eligible for current and future therapies.

Current insights on mitochondria-associated endoplasmic reticulum membranes (MAMs) and their significance in the pathophysiology of ocular disorders.

The intricate interaction network necessary for essential physiological functions underscores the interdependence among eukaryotic cells. Mitochondria-Associated Endoplasmic Reticulum Membranes (MAMs), specialized junctions between mitochondria and the ER, were recently discovered. These junctions participate in various cellular processes, including calcium level regulation, lipid metabolism, mitochondrial integrity maintenance, autophagy, and inflammatory responses via modulating the structure and molecular composition of various cellular components. Therefore, MAMs contribute to the pathophysiology of numerous ocular disorders, including Diabetic Retinopathy (DR), Age-related Macular Degeneration (AMD) and glaucoma. In addition to providing a concise overview of the architectural and functional aspects of MAMs, this review explores the key pathogenetic pathways involving MAMs in the development of several ocular disorders.

[Ocular manifestations of rheumatic diseases]. / Glaznye proyavleniya revmaticheskikh zabolevanii.

Rheumatic diseases are a large group of conditions of various origins, predominantly systemic in nature, with persistent or transient joint syndrome and involvement of other organs and systems, including the eyes. Many rheumatic diseases are characterized by specific types of ocular inflammation, which manifests through its localization, symmetry, and clinical features.

[Alexey Alexeevich Maklakov (19.09.1872-21.03.1918)]. / Aleksei Alekseevich Maklakov (19.09.1872­21.03.1918).

This article commemorates the 150th anniversary of the birth of prominent early 20th-century Russian ophthalmologist Professor Alexey Alekseevich Maklakov of Moscow University and aims to explore his biography, which remains relatively obscure. His scientific, pedagogical, and public activities have not been subjected to comprehensive analysis until now. The study clarifies key dates in his life through examination of archival documents. The biography is further supplemented with new facts concerning his work at the medical faculty of Moscow University.

[Contact lenses as a preferred choice for vision correction in various clinical scenarios with regard to work environment]. / Soczewki kontaktowe jako preferowana metoda korekcji wad refrakcji w wybranych sytuacjach klinicznych z uwzglednieniem wplywu srodowiska pracy.

Amendment to the Regulation of Minister of Labour and Social Policy of 1 December 1998 on safety and occupational hygiene at positions equipped with display monitors, adopted on October 18th, 2023, entered the long-awaited by employees possibility of reimbursement for corrective contact lenses, adjusting the Polish legislation to European directive regulating working conditions with display screen equipment. Contact lenses in many cases of refractive errors can be an alternative to prescription glasses method of correcting the visual impairment. There are however many clinical conditions, in which contact lenses can provide a better corrective effect on visual acuity. The information contained in medical databases of articles and scientific journals (PubMed, Biblioteka Nauki), online publications (Lippincott Journals), books, applicable legal regulations (available in Internetowy System Aktów Prawnych) and guidelines published by organizations and associations (Nofer Institute of Occupational Medicine in Lódz, Occupational Safety and Health Administration, Tear Film & Ocular Surface Society) were analyzed, covering the discussed issues over the years 2000-2023. Non-correction or suboptimal correction of a refractive error can cause a wide variety of troublesome symptoms, such as eye pain, headache, double vision, balance disorders, nausea, disturbances in the perception of the surroundings, contributing to poorer work efficiency, faster fatigue or an increased risk of error. This article, which is a narrative review, aims to present these conditions, as well as provide a brief overview of the types of contact lenses used, complications that may result from their use and contraindications to the use of this type of correction. Med Pr Work Health Saf. 2024;75(4):383-390.

Influencing factors for pediatric eye disorders and health related quality of life: a cross-sectional study in Shanghai, China.

Background: Myopia, strabismus, and ptosis are common pediatric eye diseases, which have a negative impact on children and adolescents in terms of visual function, mental health, and health-related quality of life (HRQoL). Therefore, this study focused on those pediatric eye diseases by analyzing their risk factors and HRQoL for the comprehensive management of myopia, strabismus, and ptosis. Methods: A total of 363 participants (2-18 years old) were included in this study for risk factors analysis of myopia, strabismus, and ptosis. We collected demographic characteristics, lifestyle habits and eye care habits of these children and analyzed them by using univariable and multivariable logistic regression. In addition, we applied the Chinese version of Pediatric Quality of Life Inventory-Version 4.0 (PedsQL 4.0) to assess HRQoL in 256 children with strabismus and ptosis. Univariable and multivariable linear regression models were applied to evaluate potential influencing factors of HRQoL. Results: Of all the participants, 140 had myopia, 127 had strabismus, and 145 had ptosis. Based on the multivariable logistic regression analysis model, we found that the history of parental myopia and daily average near-distance eye usage time were risk factors for myopia, and increased body mass index (BMI) was identified as a risk factor for strabismus and ptosis. Individuals with ptosis possessed decreased HRQoL. The multivariable linear regression model suggested that daily average near-distance eye usage time, light intensity during visual tasks, and daily average sleep duration had potential influences on HRQoL. Conclusion: This is the first study to assess the risk factors and HRQoL of myopia, strabismus, and ptosis together. We identified risk factors for these common pediatric eye diseases to help doctors, parents, and teachers better manage them. Our study discovered that children with eye disorders exhibit a notably diminished HRQoL. Consequently, it emphasizes the necessity for increased social attention and mental health assistance for these children.

Clinical management of eye diseases: carotenoids and their nanoformulations as choice of therapeutics.

Eye diseases, such as age-related macular degeneration (AMD) and diabetic retinopathy (DR), impose a substantial health cost on a worldwide scale. Carotenoids have emerged as intriguing candidates for pharmacological treatment of various disorders. Their therapeutic effectiveness, however, is hindered by poor solubility and vulnerability to degradation. Nanocarriers, such as nanoparticles, liposomes, and micelles, provide a transformational way to overcome these limits. This review explores the pharmacological potential of carotenoids, namely lutein, zeaxanthin, and astaxanthin, to treat several ocular disorders. The main emphasis is on their anti-inflammatory and antioxidant actions, which help to counteract inflammation and oxidative stress, crucial factors in the development of AMD and DR. The review evaluates the significant benefits of nano-formulated carotenoids, such as improved bioavailability, higher cellular absorption, precise administration to particular ocular tissues, and greater biostability, which make them superior to conventional carotenoids. Some clinical studies on the beneficial properties of carotenoids in eye diseases are discussed. Furthermore, safety and regulatory concerns are also taken into account. Ultimately, carotenoids, especially when created in their nano form, have significant potential for safeguarding eyesight and enhancing the overall well-being of several individuals afflicted with vision-endangering eye diseases.