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1.
Eye Contact Lens ; 48(11): 455-459, 2022 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-36083156

RESUMEN

OBJECTIVES: To assess the impact of national affluence on the extent of prescribing of various types of soft contact lenses. METHODS: Using information derived from a large bank of contact lens prescribing data, the relationship between the percentage prescribing of daily disposable, toric, silicone hydrogel, and multifocal contact lenses versus the gross domestic product at purchasing parity per capita (GDP [PPP]) was determined for all countries in which contact lens prescribers returned survey forms relating to greater than 100 contact lens fits between 2017 and 2021, inclusive. RESULTS: Data from 39 countries were analyzed, comprising 94,181 contact lens fits. The relationship between percentage contact lens prescribing versus GDP (PPP) was highly statistically significant for daily disposable lenses (r 2 =0.35, P <0.0001), marginally significant for toric lenses (r 2 =0.08, P =0.06), and not significant for silicone hydrogel lenses (r 2 =0.01, P =0.42) or multifocal lenses (r 2 =0.02, P =0.35). CONCLUSIONS: The rate of prescribing daily disposable contact lenses, and to a lesser extent toric lenses, is related to national affluence. The contact lens industry, practitioners, and governments/regulatory bodies should remain cognizant of this association and, where possible, reduce cost barriers to the purchase of such contact lens products so that they can be prescribed based on important clinical, refraction, and lifestyle considerations.


Asunto(s)
Lentes de Contacto Hidrofílicos , Optometría , Humanos , Prescripciones , Siliconas , Hidrogeles
2.
Diabetes Metab Res Rev ; 37(1): e3361, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32506740

RESUMEN

BACKGROUND: The aetiology of painful diabetic neuropathy is unclear. We have evaluated vitamin D levels in diabetic patients with and without painful neuropathy. METHODS: Forty-three patients with type 1 diabetes and painless (DPN) (n = 20) or painful (PDN) (n = 23) neuropathy and 14 non-diabetic healthy control subjects (C) underwent assessment of neurologic deficits, quantitative sensory testing (QST), electrophysiology, skin biopsy, corneal confocal microscopy (CCM) and measurement of serum 25(OH)D. RESULTS: There were no significant differences for age, BMI, HbA1c , lipids, neurological deficits, QST, electrophysiology, intra-epidermal nerve fibre density (IENFD) and corneal nerve morphology between patients with DPN and PDN. Both positive (hyperalgesia and allodynia) and negative symptoms (paraesthesia and numbness) of diabetic neuropathy were greater in PDN compared with DPN (P = .009 and P = .02, respectively). Serum 25(OH)D levels were significantly lower in PDN (24.0 ± 14.1 ng/mL) compared with DPN (34.6 ± 15.0 ng/mL, P = .01) and controls (34.1 ± 8.6 ng/mL, P = .03). The odds ratio in favour of painful diabetic neuropathy was 9.8 [P = .003 (95% CI, 2.2-76.4)] for vitamin D deficiency (<20 ng/mL) and 4.4 [P = .03 (95% CI, 1.1-19.8)] for vitamin D insufficiency (<30 ng/mL). CONCLUSIONS: This study suggests that vitamin D deficiency and insufficiency are associated with painful diabetic neuropathy.


Asunto(s)
Neuropatías Diabéticas , Deficiencia de Vitamina D , Diabetes Mellitus Tipo 1 , Neuropatías Diabéticas/etiología , Humanos , Deficiencia de Vitamina D/complicaciones
3.
Eur J Neurol ; 28(5): 1745-1751, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33523534

RESUMEN

BACKGROUND AND AIM: Damage to small nociceptive fibres may contribute to painful diabetic neuropathy. We aimed to compare large and small nerve fibre measurements together with skin biopsy and corneal confocal microscopy in patients with type 1 diabetes and painful or painless diabetic neuropathy. METHODS: We have assessed the McGill pain questionnaire, neuropathy disability score, vibration perception threshold, warm and cold sensation thresholds, electrophysiology, corneal confocal microscopy and skin biopsy in participants with type 1 diabetes and painful (n = 41) or painless (n = 50) diabetic neuropathy and control subjects (n = 50). RESULTS: The duration of diabetes, body mass index, glycated haemoglobin (HbA1c), blood pressure and lipid profile did not differ between subjects with painful and painless neuropathy. Neuropathy disability score and vibration perception threshold were higher and sural nerve conduction velocity was lower, but sural nerve amplitude, peroneal nerve amplitude and conduction velocity and cold and warm sensation thresholds did not differ between patients with painful compared to painless diabetic neuropathy. However, intraepidermal nerve fibre density, corneal nerve fibre density, corneal nerve branch density and corneal nerve fibre length were significantly lower in subjects with painful compared to painless diabetic neuropathy. CONCLUSIONS: There is evidence of more severe neuropathy, particularly small fibre damage in the skin and cornea, of patients with painful compared to painless diabetic neuropathy.


Asunto(s)
Diabetes Mellitus Tipo 1 , Neuropatías Diabéticas , Córnea , Diabetes Mellitus Tipo 1/complicaciones , Humanos , Fibras Nerviosas , Dolor
4.
J Peripher Nerv Syst ; 26(1): 49-54, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33236478

RESUMEN

A proportion of individuals with type 1 diabetes mellitus for more than 50 years (medallists) may be protected from developing nephropathy, retinopathy and neuropathy. Detailed neuropathy phenotyping was undertaken in a cohort of 33 medallists aged 63.7 ± 1.4 years with diabetes for 58.5 ± 0.8 years and HbA1c of 65.9 ± 2.1 mmol/mmol. Medallists had a significantly higher HbA1c (P < .001), lower estimated glomerular filtration rate (eGFR) (P = .005) and higher albumin creatinine excretion ratio (ACR) (P = .01), but a lower total cholesterol (P < .001), triacylglycerols (P = .001), low density lipoprotein-cholesterol (P < .001) and higher high density lipoprotein-cholesterol (P = .03), compared to controls. Twenty-four percent of participants were identified as "escapers" without confirmed diabetic neuropathy. They had a lower neuropathy symptom profile (P = .002), vibration perception threshold (P = .02), warm threshold (P = .05), higher peroneal amplitude (P = .005), nerve conduction velocity (P = .03), heart rate variability (P = .001), corneal nerve fibre density (P = 0.001), branch density (P < .001) and length (P = .001), compared to medallists with diabetic neuropathy. Escapers had a shorter duration of diabetes (P = .006), lower alcohol consumption (P = .04), lower total cholesterol (P = .04) and LDL (P = .02), higher eGFR (P = .001) and lower ACR (P < .001). Patients with extreme duration diabetes without diabetic neuropathy have a comparable HbA1c, blood pressure and body mass index, but a more favourable lipid profile and consume less alcohol compared to those with diabetic neuropathy.


Asunto(s)
Presión Sanguínea/fisiología , Índice de Masa Corporal , Diabetes Mellitus Tipo 1/metabolismo , Neuropatías Diabéticas/metabolismo , Hemoglobina Glucada/metabolismo , Lipoproteínas/sangre , Triglicéridos/sangre , Anciano , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/complicaciones , Neuropatías Diabéticas/sangre , Neuropatías Diabéticas/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo
5.
Optom Vis Sci ; 98(9): 1039-1044, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34469928

RESUMEN

SIGNIFICANCE: Identification of the most impactful articles, authors, institutions, countries, and journals in myopia management provides a useful baseline reference for clinicians, researchers, and funding agencies in respect of this emerging field.This work aims to assemble publication metrics for myopia management to identify the most impactful articles, authors, institutions, countries, and journals in this emerging field of research. A search of the titles of articles was undertaken on the Scopus database to identify myopia management-related articles. The 25 most highly cited articles were determined from the total list of 1064 articles found. Rank-order lists by count were assembled for the top 25 in each of four categories: authors, institutions, countries, and journals. A subject-specific myopia management-related h-index (hMM-index) was derived for the entire field, in addition to each of the four categories, to serve as measures of impact in the field. Top 15 lists were generated for each category ranked by hMM-index and tabulated for consideration. An article by Christine Wildsoet and colleagues, describing choroidal and scleral mechanisms of compensation for spectacle lenses in chicks, has generated the most citations (412); Earl Smith is the most impactful author (hMM = 19); the University of Houston produces the most impactful articles (hMM = 31); the United States is the most highly ranked country (hMM = 60); and Optometry and Vision Science is the most impactful journal. Although still in its infancy, myopia management is a topic of emerging interest in the clinical and scientific ophthalmic literature. Impactful authors, institutions, countries, and journals are identified. Optometry is revealed as the leading profession in relation to the publication of myopia management-related articles.


Asunto(s)
Miopía , Optometría , Bibliometría , Humanos , Miopía/diagnóstico , Miopía/terapia , Estados Unidos
6.
Gene Ther ; 26(6): 250-263, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30962537

RESUMEN

Recombinant Adeno-associated viruses (AAVs) are an attractive vector for gene therapy delivery which may be blocked by AAV neutralising antibodies (NAbs). As Type 1 Diabetes (T1DM) is an endocrine disease of immunological origin, it is likely that NAb profiles are altered in the disease. In this study NAb to AAV2, AAV5, AAV6, and AAV8 in 72 subjects with T1DM and 45 non-diabetic patients were measured over a 4-year follow-up period. AAV2 NAb titres were significantly lower in non-diabetic subjects (P = 0.036). The T1DM group had more AAV8 NAb activity at baseline (P = 0.019), whilst after 4 years follow-up the T1DM group displayed developed increased AAV 5 (P = 0.03), 6 (P = 0.03) and 8 (P = 0.002) activity relative to the control group, however, overall AAV5 and 8 NAb levels were very low in patients <40. AAV NAb titre activity and prevalence generally appears higher in T1DM, however, low levels of AAV 5 and 8, particular in younger adult age groups at which T1DM can be targeted, could make these attractive vectors to target the disease.


Asunto(s)
Anticuerpos Neutralizantes/inmunología , Dependovirus/inmunología , Diabetes Mellitus Tipo 1/sangre , Adolescente , Adulto , Anciano , Animales , Anticuerpos Neutralizantes/sangre , Células COS , Chlorocebus aethiops , Diabetes Mellitus Tipo 1/inmunología , Femenino , Técnicas de Transferencia de Gen/efectos adversos , Humanos , Masculino , Persona de Mediana Edad
7.
Diabetologia ; 61(8): 1856-1861, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29869146

RESUMEN

AIMS/HYPOTHESIS: Small cohort studies raise the hypothesis that corneal nerve abnormalities (including corneal nerve fibre length [CNFL]) are valid non-invasive imaging endpoints for diabetic sensorimotor polyneuropathy (DSP). We aimed to establish concurrent validity and diagnostic thresholds in a large cohort of participants with and without DSP. METHODS: Nine hundred and ninety-eight participants from five centres (516 with type 1 diabetes and 482 with type 2 diabetes) underwent CNFL quantification and clinical and electrophysiological examination. AUC and diagnostic thresholds were derived and validated in randomly selected samples using receiver operating characteristic analysis. Sensitivity analyses included latent class models to address the issue of imperfect reference standard. RESULTS: Type 1 and type 2 diabetes subcohorts had mean age of 42 ± 19 and 62 ± 10 years, diabetes duration 21 ± 15 and 12 ± 9 years and DSP prevalence of 31% and 53%, respectively. Derivation AUC for CNFL was 0.77 in type 1 diabetes (p < 0.001) and 0.68 in type 2 diabetes (p < 0.001) and was approximately reproduced in validation sets. The optimal threshold for automated CNFL was 12.5 mm/mm2 in type 1 diabetes and 12.3 mm/mm2 in type 2 diabetes. In the total cohort, a lower threshold value below 8.6 mm/mm2 to rule in DSP and an upper value of 15.3 mm/mm2 to rule out DSP were associated with 88% specificity and 88% sensitivity. CONCLUSIONS/INTERPRETATION: We established the diagnostic validity and common diagnostic thresholds for CNFL in type 1 and type 2 diabetes. Further research must determine to what extent CNFL can be deployed in clinical practice and in clinical trials assessing the efficacy of disease-modifying therapies for DSP.


Asunto(s)
Córnea/diagnóstico por imagen , Neuropatías Diabéticas/diagnóstico por imagen , Microscopía Confocal , Adolescente , Adulto , Anciano , Área Bajo la Curva , Estudios de Cohortes , Estudios Transversales , Diabetes Mellitus Tipo 1/diagnóstico por imagen , Diabetes Mellitus Tipo 2/diagnóstico por imagen , Femenino , Humanos , Cooperación Internacional , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad
8.
Optom Vis Sci ; 95(8): 672-677, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-30063664

RESUMEN

PURPOSE: The purpose of this study was to establish an age-dependent normative range and factors affecting the migration rate of the corneal subbasal nerve plexus in a healthy control population. METHODS: Corneal nerve migration rate was measured in 60 healthy participants grouped by age: A, aged 20 to 39 years (n = 20); B, 40 to 59 years (n = 20); and C, 60 to 79 years (n = 20). Laser-scanning corneal confocal microscopy was performed on the right eye of all participants at baseline and again after 3 weeks. Fully automated software was used to montage the frames. Distinctive nerve landmarks were manually reidentified between the two montages, and a software program was developed to measure the migration of these landmark points to determine corneal nerve migration rate in micrometers per week (µm/wk). RESULTS: The mean ± SD age of all participants in the study was 47.5 ± 15.5 years; 62% of participants were male. The average corneal nerve migration rates of groups A, B, and C were 42.0 ± 14.0, 42.3 ± 15.5, and 42.0 ± 10.8 µm/wk, respectively (P = .99). There was no difference in corneal nerve migration rate between male (41.1 ± 13.5 µm/wk) and female (43.7 ± 13.2 µm/wk) participants (P = .47). There was no significant correlation between age (P = .97), smoking (P = .46), alcohol use (P = .61), and body mass index (P = .49, respectively) with corneal nerve migration rate. However, exercise frequency correlated significantly (P = .04) with corneal nerve migration rate. CONCLUSIONS: Corneal nerve migration rate varies in healthy individuals and is not affected by age, sex, or body mass index but is related to physical activity.


Asunto(s)
Córnea/inervación , Nervio Trigémino/fisiología , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Microscopía Confocal , Persona de Mediana Edad , Estudios Prospectivos , Programas Informáticos , Nervio Trigémino/diagnóstico por imagen , Adulto Joven
9.
Diabetologia ; 60(6): 1094-1101, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-28357503

RESUMEN

AIMS/HYPOTHESIS: The aim of this study was to identify the contribution of small- and large-fibre neuropathy to erectile dysfunction in men with type 1 diabetes mellitus. METHODS: A total of 70 participants (29 without and 41 with erectile dysfunction) with type 1 diabetes and 34 age-matched control participants underwent a comprehensive assessment of large- and small-fibre neuropathy. RESULTS: The prevalence of erectile dysfunction in participants with type 1 diabetes was 58.6%. After adjusting for age, participants with type 1 diabetes and erectile dysfunction had a significantly higher score on the Neuropathy Symptom Profile (mean ± SEM 5.3 ± 0.9 vs 1.8 ± 1.2, p = 0.03), a higher vibration perception threshold (18.3 ± 1.9 vs 10.7 ± 2.4 V, p = 0.02), and a lower sural nerve amplitude (5.0 ± 1.1 vs 11.7 ± 1.5 mV, p = 0.002), peroneal nerve amplitude (2.1 ± 0.4 vs 4.7 ± 0.5 mV, p < 0.001) and peroneal nerve conduction velocity (34.8 ± 1.5 vs 41.9 ± 2.0 m/s, p = 0.01) compared with those without erectile dysfunction. There was also evidence of a marked small-fibre neuropathy with an impaired cold threshold (19.7 ± 1.4°C vs 27.3 ± 1.8°C, p = 0.003), warm threshold (42.9 ± 0.8°C vs 39.0 ± 0.9°C, p = 0.005) and heart rate variability (21.5 ± 3.1 vs 30.0 ± 3.7 beats/min, p = 0.001) and reduced intraepidermal nerve fibre density (2.8 ± 0.7 vs 5.9 ± 0.7/mm, p = 0.008), corneal nerve fibre density (12.6 ± 1.5 vs 23.9 ± 2.0/mm2, p < 0.001), corneal nerve branch density (12.7 ± 2.5 vs 31.6 ± 3.3/mm2, p < 0.001) and corneal nerve fibre length (8.3 ± 0.7 vs 14.5 ± 1.0 mm/mm2, p < 0.001) in participants with type 1 diabetes and erectile dysfunction. Erectile dysfunction correlated significantly with measures of both large- and small-fibre neuropathy. CONCLUSIONS/INTERPRETATION: Small-fibre neuropathy is prominent in patients with type 1 diabetes, and is associated with erectile dysfunction and can be objectively quantified using corneal confocal microscopy. This may allow the identification of patients who are less likely to respond to conventional therapies such as phosphodiesterase type 5 inhibitors.


Asunto(s)
Diabetes Mellitus Tipo 1/fisiopatología , Nefropatías Diabéticas/fisiopatología , Disfunción Eréctil/fisiopatología , Adulto , Estudios Transversales , Humanos , Masculino , Microscopía Confocal , Persona de Mediana Edad
10.
Ophthalmic Physiol Opt ; 37(4): 451-459, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28656669

RESUMEN

PURPOSE: To examine the capability of optical coherence tomography-derived retinal thickness measures in detecting 4-year incident diabetic peripheral neuropathy (DPN). METHODS: 145 eyes of 145 participants with diabetes but no DPN at baseline were examined for incident DPN. HbA1c levels, nephropathy, neuropathy (DPN), cardiovascular measures, and various retinal thickness measures were examined at baseline and after 4 years. Incidence of DPN was defined as newly developed DPN at follow-up. Baseline factors were assessed by univariate and a step-wise multiple logistic regression, and the predictors were examined for diagnostic capabilities. RESULTS: Of the 145 participants without DPN at baseline, 51 had developed DPN when examined after 4 years (35% incidence). Of the ophthalmic variables, the mean (S.D.) of the overall thickness in the parafovea at baseline was 315 (18) µm in the no DPN group and 306 (18) µm in the 'incidence' group, and the differences were significant, p = 0.005. The superior hemisphere parafovea (mean (S.D.): 318 (17) µm vs 310 (20) µm, p = 0.02) and inferior hemisphere parafovea (313 (19) µm vs 302 (18) µm, p = 0.002) were different in the incident DPN group compared with the no DPN group. When adjusted for age, retinal thickness in the parafovea (AUC = 0.65, p = 0.003, 86% sensitivity and 44% specificity at 321 µm criterion), and body mass index or BMI (AUC = 0.65, p = 0.003, 49% sensitivity and 83% specificity at 29.3 kg m-2 criterion) at baseline were significant predictors for 4-year incident DPN. CONCLUSIONS: A lower retinal thickness at the parafovea and a higher BMI can predict 4-year incident neuropathy in patients with diabetes, with acceptable diagnostic accuracies. This OCT-derived measure may serve as a potential ophthalmic marker in the screening of patients at risk of developing DPN.


Asunto(s)
Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Neuropatías Diabéticas/diagnóstico , Retina/patología , Tomografía de Coherencia Óptica/métodos , Adolescente , Adulto , Anciano , Neuropatías Diabéticas/epidemiología , Neuropatías Diabéticas/etiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Queensland/epidemiología , Curva ROC , Factores de Riesgo , Adulto Joven
11.
Optom Vis Sci ; 93(8): 917-24, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27055062

RESUMEN

PURPOSE: To determine if Langerhans cells in the lid wiper are upregulated in contact lens-induced dry eye (CLIDE). METHODS: The lid wiper of one eye of 17 participants with CLIDE (assessed using the CLDEQ-8) and 29 without CLIDE (NO-CLIDE) was examined using a Heidelberg laser scanning confocal microscope after 6 months wear of daily disposable hydrogel contact lenses (Biomedics 1 day Extra). Twenty non-contact-lens-wearing controls were also examined. Langerhans cell density (LCD) in each participant was taken as the mean cell count calculated manually from six clear, randomly selected images of known dimensions. RESULTS: There were significant overall differences in LCD in the lid wiper among the three groups (p < 0.001). LCD was significantly greater in the lid wiper in CLIDE (17 ± 10 cells/mm) compared to controls (8 ± 4 cells/mm) (p < 0.001); however, there was no difference in LCD between NO-CLIDE (10 ± 5 cells/mm) and controls (p = 0.489). LCD was significantly greater in CLIDE than NO-CLIDE (p = 0.002). CONCLUSIONS: Langerhans cells in the lid wiper are upregulated in CLIDE, suggesting an inflammatory component in the etiology of this condition.


Asunto(s)
Lentes de Contacto/efectos adversos , Síndromes de Ojo Seco/patología , Párpados/patología , Células de Langerhans/patología , Adolescente , Adulto , Recuento de Células , Síndromes de Ojo Seco/etiología , Femenino , Humanos , Inflamación/patología , Masculino , Microscopía Confocal , Persona de Mediana Edad , Adulto Joven
13.
Ophthalmic Physiol Opt ; 36(2): 158-66, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26690674

RESUMEN

PURPOSE: To examine the retinal thickness profiles of individuals with and without diabetic retinopathy (DR). METHODS: Full retinal thickness in the central zone, overall and hemisphere thicknesses of the parafovea and perifovea, ganglion cell complex (GCC) thickness and retinal nerve fibre layer (RNFL) thickness were assessed in 185 individuals using spectral domain optical coherence tomography (88 individuals with diabetes but no DR, 55 with DR, and 42 non-diabetic controls). The DR group comprised of 60% of participants with very mild non-proliferative diabetic retinopathy (NPDR) (representing microaneurysms only) and 40% with mild NPDR (hard exudates, cotton-wool spots, and/or mild retinal haemorrhages). Regression analysis was performed to determine the factors associated with retinal tissue thickness, taking into account, age, sex, presence of DR, duration of diabetes, HbA1c levels and type of diabetes. RESULTS: The mean (S.D.) of the overall parafoveal thickness was 306 (16) in the DR group and 314 (14) in the control group (p = 0.02). The mean (S.D.) of the superior hemisphere parafoveal thickness was 309 (16) in the DR group and 318 (14) in the control group (p = 0.02). The mean (S.D.) of the inferior hemisphere parafoveal thickness was 303 (17) in the DR group and 311 (15) in the control group (p = 0.02). There were no significant differences in retinal thickness between groups in the central zone (p = 0.27) or perifovea (p > 0.41). Neither the overall nor the hemisphere RNFL (p > 0.75) and GCC thickness (p > 0.37) were significantly different between the groups. Regression analysis revealed that parafoveal thickness in diabetic individuals was reduced in association with presence of DR (B = -5.9 µm, p = 0.02) and with advancing age (B = -4.5 µm, p = 0.004, for every 10 year increase in age) when adjusted for sex, duration of diabetes, HbA1c levels and type of diabetes. CONCLUSION: The inner macula is thinner in the presence of clinical signs of diabetic retinopathy and is compounded by advancing age. The influence of any macular oedema or that by cotton-wool spots could not be ruled out and may still confound these results.


Asunto(s)
Retinopatía Diabética/patología , Retina/patología , Adulto , Anciano , Estudios de Casos y Controles , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Hemoglobina Glucada/análisis , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Células Ganglionares de la Retina , Factores de Riesgo , Tomografía de Coherencia Óptica
14.
Optom Vis Sci ; 92(7): 758-67, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26101823

RESUMEN

PURPOSE: To document contact lens prescribing patterns in the United States between 2002 and 2014. METHODS: A survey of contact lens prescribing trends was conducted each year between 2002 and 2014, inclusive. Randomly selected contact lens practitioners were asked to provide information relating to 10 consecutive contact lens fits between January and March each year. RESULTS: Over the 13-year survey period, 1650 survey forms were received from US practitioners representing details of 7702 contact lens fits. The mean (±SD) age of lens wearers was 33.6 (±15.2) years, of whom 65.2% were female. Rigid lens new fits decreased from 13.0% in 2002 to 9.4% in 2014. Across this period, silicone hydrogels have replaced mid water contact lens hydrogels as the soft lens material of choice. Toric lenses represented about 25 to 30% of all soft lens fits. Multifocal soft lenses are generally preferred to monovision. Daily disposable lens fits have recently increased, and in 2014, they represented 27.1% of all soft lens fits. Most lenses are prescribed on 1 to 2 weekly or monthly lens replacement regimen. Extended wear remains a minority lens wearing modality. The vast majority of those wearing reusable lenses use multipurpose lens care solutions. Lenses are mostly worn 7 d/wk. CONCLUSIONS: This survey has revealed prescribing trends and preferences in the United States over the past 13 years.


Asunto(s)
Lentes de Contacto Hidrofílicos/tendencias , Pautas de la Práctica en Medicina/tendencias , Prescripciones/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Equipos Desechables/estadística & datos numéricos , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Persona de Mediana Edad , Optometría/estadística & datos numéricos , Ajuste de Prótesis , Encuestas y Cuestionarios , Estados Unidos
15.
Cont Lens Anterior Eye ; : 102259, 2024 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-38951051

RESUMEN

PURPOSE: Daily disposable contact lenses offer numerous benefits in terms of ocular health and wearer convenience. The purpose of this work is to update earlier surveys by describing global trends in daily disposable lens fitting between 2000 and 2023. METHOD: An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023, inclusive. Data relating to 265,106 daily wear soft lens fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of daily disposable lens fitting. RESULTS: Overall, daily disposable lens prescribing increased over time, from 17.1 % of daily wear soft lens fits in 2000 to 46.7 % in 2023 (p < 0.0001). There were significant differences between countries in daily disposable lens prescribing (p < 0.0001), and between the percentage of males fitted with daily disposable lenses, as a proportion of all daily wear soft lenses (37.2 %), compared to females (35.2 %) (p < 0.0001). Daily disposable lens wearers are slightly younger at fitting than reusable soft lens wearers (31.0 vs 31.2 years, respectively) (p < 0.0001), although this difference is not clinically meaningful. Analysis of 50,240 daily wear soft lenses fitted recently (2019-2023) were found to be prescribed for the following replacement frequencies: daily - 47 %; monthly - 42 %; 1-2 weekly - 9 %; and ≥3 monthly - 2 %. CONCLUSION: There has been a substantial increase in daily disposable lens fitting throughout the first 24 years of this century. The gradual nature of this increase is commensurate with the staged introduction of daily disposable lens designs and expanded parameter ranges over the survey period.

16.
Cont Lens Anterior Eye ; : 102276, 2024 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-38997940

RESUMEN

PURPOSE: There have been significant advancements in toric soft contact lens design and manufacturing technology, and increased product availability, over the past half a century. The purpose of this work is to update earlier surveys by describing international trends in toric soft lens fitting between 2000 and 2023, inclusive. METHOD: An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023, inclusive. Data relating to 220,934 standard soft daily wear single vision lens fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of toric soft lens fitting. RESULTS: Overall, toric soft lens prescribing almost doubled over the time-course of this survey, from 24.4 % of standard soft daily wear single vision lens fits in 2000 to 46.2 % in 2023 (p < 0.0001). There were significant differences between countries in toric soft lens prescribing (p < 0.0001). Of all standard soft daily wear single vision contact lenses prescribed to males, 32.0 % were toric soft lenses, compared with 28.7 % for females (p < 0.0001). The mean age of toric soft lens wearers was 30.5 ± 12.5 years, compared to 27.9. ± 12.1 years for spherical soft lens wearers (p < 0.0001). Analysis of 13,582 recent toric soft lens fits (2019-2023, inclusive), in terms of material type and replacement frequency, revealed the following proportions: reusable silicone hydrogel - 51 %; daily disposable silicone hydrogel - 27 %; daily disposable hydrogel - 12 %; and reusable hydrogel - 10 %. CONCLUSION: There has been a substantial increase in toric soft lens fitting throughout the 24 years of this survey, to a point whereby almost all clinically significant astigmatism is being corrected among those wearing standard soft daily wear single vision lenses.

17.
Cont Lens Anterior Eye ; : 102255, 2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38942659

RESUMEN

PURPOSE: Rigid contact lenses have an important role in contact lens practice. The purpose of this work is to update earlier surveys by describing global trends in rigid lens fitting between 2000-2023. METHOD: An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023. Data relating to 342,500 fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of rigid lens fitting, defined as the fitting of any design of a contact lens manufactured in a rigid material. RESULTS: Overall, rigid lens prescribing increased slightly over time, from 14.2 % of lens fits in 2000 to 15.2 % in 2023 (p < 0.0001). However, post-hoc analysis shows that the change over time is best described as a decline between 2000 and 2012, followed by a steady increase subsequently. There were significant differences in rigid lens prescribing between countries (p < 0.0001). The difference between the percentage of males fitted with rigid lenses, as a proportion of all contact lenses (12.7 %), and females (12.0 %) is significant (p < 0.0001), although not clinically meaningful. Rigid lens wearers are older at fitting than soft lens wearers (38.7 vs 31.3 years, respectively) (p < 0.0001). Analysis of 5,994 rigid lens fits prescribed currently (2019-2023) were categorised as: corneal sphere - 30 %; scleral and corneo-scleral - 28 %; corneal myopia control/orthokeratology - 21 %; and corneal complex (including toric, multifocal and monovision) - 16 %. CONCLUSION: There has been a slight increase in rigid lens fitting during the second decade of this century. This increase is apparently due to a 'repurposing' of rigid lenses, with the growth of scleral/corneo-scleral and myopia control/orthokeratology lens fits essentially replacing conventional spherical corneal lens fits.

18.
Cont Lens Anterior Eye ; : 102158, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38631935

RESUMEN

This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice. Current options for contact lens correction of presbyopia include soft simultaneous, rigid translating and rigid simultaneous designs, in addition to monovision. Spectacle options include single vision lenses, bifocal lenses and a range of progressive addition lenses. The comparative performance of both contact lens and spectacle lens options is presented. With a significant proportion of the global population now being presbyopic, this overview is particularly timely and is designed to act as a guide for researchers, industry and eyecare practitioners alike.

19.
Optom Vis Sci ; 90(2): 113-8, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23262991

RESUMEN

PURPOSE: To determine the extent of rigid contact lens fitting worldwide and to characterize the associated demographics and fitting patterns. METHODS: Survey forms were sent to contact lens fitters in up to 40 countries between January and March every year for five consecutive years (2007 to 2011). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Survey data collected between 1996 and 2011 were also analyzed to assess rigid lens fitting trends in seven nations during this period. RESULTS: Data were obtained for 12,230 rigid and 100,670 soft lens fits between 2007 and 2011. Overall, rigid lenses represented 10.8% of all contact lens fits, ranging from 0.2% in Lithuania to 37% in Malaysia. Compared with soft lens fits, rigid lens fits can be characterized as follows: older age (rigid, 37.3 ± 15.0 years; soft, 29.8 ± 12.4 years); fewer spherical and toric fits; more bifocal/multifocal fits; less frequent replacement (rigid, 7%; soft, 85%); and less part-time wear (rigid, 4%; soft, 10%). High-Dk (contact lens oxygen permeability) (36%) and mid-Dk (42%) materials are predominantly used for rigid lens fitting. Orthokeratology represents 11.5% of rigid contact lens fits. There has been a steady decline in rigid lens fitting between 1996 and 2011. CONCLUSIONS: Rigid contact lens prescribing is in decline but still represents approximately 10% of all contact lenses fitted worldwide. It is likely that rigid lenses will remain as a viable, albeit increasingly specialized, form of vision correction.


Asunto(s)
Lentes de Contacto/estadística & datos numéricos , Optometría/estadística & datos numéricos , Vigilancia de la Población/métodos , Prescripciones/estadística & datos numéricos , Errores de Refracción/rehabilitación , Humanos , Estudios Retrospectivos , Encuestas y Cuestionarios
20.
Eye Contact Lens ; 39(2): 132-7, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23392302

RESUMEN

OBJECTIVES: To characterize toric contact lens prescribing worldwide. METHODS: Up to 1,000 survey forms were sent to contact lens fitters in up to 39 countries between January and March every year for 5 consecutive years (2007-2011). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Only data for toric and spherical soft lens fits were analyzed. Survey data collected since 1996 were also analyzed for 7 nations to assess toric lens fitting trends since that time. RESULTS: Data were collected in relation to 21,150 toric fits (25%) and 62,150 spherical fits (75%). Toric prescribing ranged from 6% of lenses in Russia to 48% in Portugal. Compared with spherical fittings, toric fittings can be characterized as follows: older age (29.8 ± 11.4 years vs. 27.6 ± 10.8 years for spherical lenses); men are overrepresented (38% vs. 34%); greater proportion of new fits (39% vs. 32%); use of silicone hydrogel lenses (49% vs. 39%); and lower proportion of daily disposable lenses (14% vs. 28%). There has been a continuous increase in toric lens prescribing between 1996 and 2011. The proportion of toric lens fits was positively related to the gross domestic product at purchasing power parity per capita for year 2011 (r = 0.21; P=0.004). CONCLUSIONS: At the present time, in the majority of countries surveyed, toric soft contact lens prescribing falls short of that required to correct clinically significant astigmatism (≥ 0.75 diopters) in all lens wearers.


Asunto(s)
Astigmatismo/rehabilitación , Lentes de Contacto/estadística & datos numéricos , Optometría/estadística & datos numéricos , Prescripciones/estadística & datos numéricos , Femenino , Humanos , Masculino , Vigilancia de la Población/métodos , Encuestas y Cuestionarios
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