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1.
Int J Mol Sci ; 23(15)2022 Aug 01.
Article in English | MEDLINE | ID: mdl-35955664

ABSTRACT

Retinopathy of prematurity (ROP) is a rare proliferative ocular disorder in preterm infants. Because of the advancements in neonatal care, the incidence of ROP has increased gradually. Now, ROP is one of the leading causes of blindness in children. Preterm infants with immature retinal development are exposed to supplemental oxygen inside an incubator until their cardiopulmonary system is adequately developed. Once they are returned to room air, the relatively low oxygen level stimulates various angiogenesis factors initiating retinal neovascularization. If patients with ROP are not offered adequate and timely treatment, they can experience vision loss that may ultimately lead to permanent blindness. Although laser therapy and anti-vascular endothelial growth factor agents are widely used to treat ROP, they have limitations. Thus, it is important to identify novel therapeutics with minimal adverse effects for the treatment of ROP. To date, various pharmacologic and non-pharmacologic therapies have been assessed as treatments for ROP. In this review, the major molecular factors involved in the pathogenesis of ROP, currently offered therapies, therapies under investigation, and emerging novel therapeutics of ROP are discussed.


Subject(s)
Infant, Premature, Diseases , Retinopathy of Prematurity , Blindness/complications , Blindness/drug therapy , Child , Humans , Infant , Infant, Newborn , Infant, Premature , Oxygen , Retinopathy of Prematurity/drug therapy , Retinopathy of Prematurity/etiology
2.
Ophthalmic Surg Lasers Imaging Retina ; 53(8): 464-467, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35951720

ABSTRACT

We previously reported that planned preterm delivery at 34 weeks gestational age provided an opportunity to treat Norrie disease in the vasoproliferative phase, prevented infantile retinal detachment, and preserved functional vision without further treatment after infancy. Although retinal vascularization did not proceed postnatally, after 8 years of follow-up, the retinas remained attached, and rudimentary foveal development was observed by optical coherence tomography. Best corrected visual acuity gradually improved to 20/80 with both eyes, and visual fields and real-world visual performance were remarkably functional. Global development progressed appropriately, and no long-term sequelae of premature delivery were observed. [Ophthalmic Surg Lasers Imaging Retina 2022;53:464-467.].


Subject(s)
Nervous System Diseases , Premature Birth , Retinal Detachment , Blindness/congenital , Female , Genetic Diseases, X-Linked , Humans , Infant, Newborn , Retinal Degeneration , Retrospective Studies , Spasms, Infantile , Tomography, Optical Coherence/methods , Visual Acuity
3.
BMJ Case Rep ; 15(7)2022 Jul 04.
Article in English | MEDLINE | ID: mdl-35787502

ABSTRACT

Factitious disorder imposed on another, or medical child abuse, has been rarely reported to have primary ocular presentations. We report an unusual and difficult diagnosis of factitious disorder imposed by a mother on her infant resulting in bilateral blindness. An infant was referred with a history of recurrent periorbital cellulitis and sanguineous discharge associated with seizure-like episodes. Symptoms have been going on for more than 14 months, and child had been treated by different physicians from different specialties without a clear ophthalmic diagnosis. The right eye was previously enucleated at an outside hospital for secondary complications of similar symptoms. He was admitted for exhaustive diagnostic tests and multiple surgical treatments, and his hospital stay was complicated with multiple corneal perforations and apnoeic episodes despite optimal treatment. After suspicion of factitious disease, continuous electroencephalography and video monitoring revealed evidence of the mother inflicting physical harm to her child.


Subject(s)
Child Abuse , Factitious Disorders , Blindness , Cellulitis , Child , Factitious Disorders/diagnosis , Female , Hospitalization , Humans , Infant , Male , Mothers
4.
Sci Rep ; 12(1): 11207, 2022 Jul 01.
Article in English | MEDLINE | ID: mdl-35778593

ABSTRACT

To describe the presentation, histopathological characteristics, and management outcomes for corneal myxoma. This one-armed cohort study evaluated histologically confirmed consecutive cases of corneal myxoma. Data were evaluated on demographics, clinical presentation, management, histopathological and immunohistochemical features, and outcomes; visual acuity and corneal clarity. The study sample was comprised of 10 eyes (10 patients). The median age at presentation was 10.5 years. Five eyes had high intraocular pressure, four eyes had decreased distance visual acuity and one eye became discolored. Surgical management included penetrating keratoplasty (8 eyes), phototherapeutic keratectomy (1 eye), and evisceration because of a blind painful eye (1 eye). Postoperative best-corrected distance vision ranged from 20/20 to 20/60 (1 eye), < 20/60 to 20/200 (2 eyes), < 20/200 to 20/400 (1 eye), < 20/200 to light perception (4 eyes) and no light perception (1 eye). The histopathology of these lesions showed typical subepithelial proliferating spindle-shaped cells of mesenchymal origin within a myxoid stroma rich in glycosaminoglycan. The median duration of follow-up was 5 years. Recurrence was observed in an eye that underwent local excision. Corneal myxoma is a rare lesion that is presumably isolated, secondary, and reactive in nature. Surgically management yields reasonably favorable outcomes.


Subject(s)
Myxoma , Photorefractive Keratectomy , Blindness , Cohort Studies , Follow-Up Studies , Humans , Lasers, Excimer/therapeutic use , Myxoma/diagnosis , Myxoma/surgery
5.
BMC Ophthalmol ; 22(1): 298, 2022 Jul 09.
Article in English | MEDLINE | ID: mdl-35810276

ABSTRACT

BACKGROUND: Medical services are still developing in Bhutan. There is no published national report on age-related macular degeneration (AMD). We therefore aim to determine the demographic characteristics and severity of AMD at first presentation among Bhutanese patients attending their recently inaugurated vitreoretinal (VR) clinics over a 3-year national survey, and to inform national health policy to develop suitable health program to prevent AMD-related blindness and visual impairment. METHODS: A retrospective cross-sectional consecutive case series study was conducted on all new AMD cases in Bhutan. If a patient presented with asymmetrical AMD, the eye with more severe AMD was considered. If both the eyes had the same severity one eye was chosen randomly. Collection of demographic data and clinical details including diagnostic testing (fundus photography, OCT and fluorescent angiography) and clinical staging were performed. RESULTS: Of 521 new AMD patients aged 71.9 ± 11.3 years, 306/521 (58.7%) were males (p = 0.005). At their first presentation, 234/521 patients (44.9%) already had late-stage AMD. Importantly, 69/234 patients (29.5%), that is half of total neovascular AMD (nAMD) patients, had disciform scars (DS) which were beyond treatment, and 7/234 patients (3.0%) had geographic atrophy (GA). Seven patients had retinal pigment epithelium tear at presentation. Fourteen of nineteen polypoidal choroidal vasculopathy (PCV) patients were younger than 50 years. CONCLUSIONS: Half of nAMD cases presented as DS not amenable to the treatment. Many potentially treatable nAMD patients had already lost central vision and were legally blind. Young people with PCV losing vision early in life with longer morbidity-affected life and socio-economic burden was concerning. GA and DS cases need visual rehabilitation to improve their QoL. Incorporating a screening program for AMD with effective health education, and maintaining a national AMD Registry, would potentially lower AMD-related blindness and visual impairment.


Subject(s)
Geographic Atrophy , Wet Macular Degeneration , Adolescent , Angiogenesis Inhibitors , Bhutan/epidemiology , Blindness/epidemiology , Blindness/etiology , Cross-Sectional Studies , Female , Fluorescein Angiography , Humans , Male , Quality of Life , Retrospective Studies , Vascular Endothelial Growth Factor A , Vision Disorders , Visual Acuity , Wet Macular Degeneration/diagnosis , Wet Macular Degeneration/epidemiology
6.
BMC Ophthalmol ; 22(1): 312, 2022 Jul 19.
Article in English | MEDLINE | ID: mdl-35850761

ABSTRACT

BACKGROUND: In Ethiopia, refractive error is the second leading cause of vision impairment and the third main cause of blindness. Because refraction services are scarce and difficult to obtain, many people with refractive error live with impaired vision or blindness for the rest of their lives. OBJECTIVE: The primary goal of this study was to determine the prevalence of refractive errors and associated factors among patients who visited Boru Meda Hospital. METHODS: A retrospective cross-sectional study was conducted from April to June 2018, all patients who visited Boru Meda Hospital's secondary eye unit were deemed our source population; the sample frame was the secondary eye unit outpatient departments register. To select samples, simple random sampling was used. Data was entered by using Epi-data version 3 and analysed with Statistical Package for Social Science 20. Tables and graphs were used to display descriptive statistics, and logistic regression was used to examine the relationship between the dependent and independent variables. At p < 0.05, statistical significance was inferred. RESULTS: Refractive error was detected in 42 (18.3%) of study participants. The average age was 46.69 ± 20.77. There were 136 men and 93 women in this group (59.4 and 40.6%, respectively). Myopia was the most frequent refractive defect, accounting for 52.4% of all cases. CONCLUSION & RECOMMENDATION: Refractive error is a widespread problem in our study area that affects people of all age groups. We recommend patients to have screening on regular basis so that refractive anomalies can be detected early.


Subject(s)
Refractive Errors , Adult , Aged , Blindness , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Hospitals , Humans , Male , Middle Aged , Prevalence , Refractive Errors/diagnosis , Refractive Errors/epidemiology , Retrospective Studies , Visual Acuity
7.
Cognition ; 227: 105208, 2022 Oct.
Article in English | MEDLINE | ID: mdl-35792349

ABSTRACT

People tend to think they are not susceptible to change blindness and overestimate their ability to detect salient changes in scenes. Yet, despite their overconfidence, are individuals aware of and able to assess the relative difficulty of such changes? Here, we investigated whether participants' judgements of their ability to detect changes predicted their own change blindness. In Experiment 1, participants completed a standard change blindness task in which they viewed alternating versions of scenes until they detected what changed between the versions. Then, 6 to 7 months later, the same participants viewed the two versions and rated how likely they would be to spot the change. We found that changes rated as more likely to be spotted were detected faster than changes rated as more unlikely to be spotted. These metacognitive judgements continued to predict change blindness when accounting for low-level image properties (i.e., change size and eccentricity). In Experiment 2, we used likelihood ratings from a new group of participants to predict change blindness durations from Experiment 1. We found that there was no advantage to using participants' own metacognitive judgements compared to those from the new group to predict change blindness duration, suggesting that differences among images (rather among individuals) contribute the most to change blindness. Finally, in Experiment 3, we investigated whether metacognitive judgements are based on the semantic similarity between the versions of the scene. One group of participants described the two versions of the scenes, and an independent group rated the similarity between the descriptions. We found that changes rated as more similar were judged as being more difficult to detect than changes rated as less similar; however, semantic similarity (based on linguistic descriptions) did not predict change blindness. These findings reveal that (1) people can rate the relative difficulty of different changes and predict change blindness for different images and (2) metacognitive judgements of change detection likelihood are not fully explained by low-level and semantic image properties.


Subject(s)
Metacognition , Awareness , Blindness , Humans , Judgment , Semantics
8.
Nat Commun ; 13(1): 3853, 2022 Jul 04.
Article in English | MEDLINE | ID: mdl-35788594

ABSTRACT

Electronic visual prostheses, or biomimetic eyes, have shown the feasibility of restoring functional vision in the blind through electrical pulses to initiate neural responses artificially. However, existing visual prostheses predominantly use wired connections or electromagnetic waves for powering and data telemetry, which raises safety concerns or couples inefficiently to miniaturized implant units. Here, we present a flexible ultrasound-induced retinal stimulating piezo-array that can offer an alternative wireless artificial retinal prosthesis approach for evoking visual percepts in blind individuals. The device integrates a two-dimensional piezo-array with 32-pixel stimulating electrodes in a flexible printed circuit board. Each piezo-element can be ultrasonically and individually activated, thus, spatially reconfigurable electronic patterns can be dynamically applied via programmable ultrasound beamlines. As a proof of concept, we demonstrate the ultrasound-induced pattern reconstruction in ex vivo murine retinal tissue, showing the potential of this approach to restore functional, life-enhancing vision in people living with blindness.


Subject(s)
Visual Prosthesis , Animals , Biomimetics , Blindness/therapy , Humans , Mice , Retina/diagnostic imaging , Retina/physiology , Retina/surgery , Vision, Ocular
9.
Sci Rep ; 12(1): 11779, 2022 Jul 11.
Article in English | MEDLINE | ID: mdl-35821044

ABSTRACT

We report prevalence and risk factors for multimorbidity and multi-disability among elderly people in residential care in the Hyderabad region in South India. In total, 1182 elderly (aged ≥ 60) participants were examined in 41 homes for the aged centres. Detailed interviews were conducted by trained personnel to collect personal and demographic information. A questionnaire was used to assess the history of non-communicable diseases and Washington Disability Questionnaire (WDQ) was administered to assess disabilities. The mean age of the participants was 75.0 years (SD 8.8 years; range: 60-108 years), 35.4% were men, 20.3% had no formal education, 60.7% had school education and 19% had higher education. The prevalence of multimorbidity was 37.6% (95% CI: 34.8-40.4). Prevalence of multi-disability was 23.6% (95% CI: 21.2-26.3; n = 270). In total, 857 (72.5%) participants reported using at least one medication for NCDs. Over a third of the elderly in residential care had multimorbidity, and a quarter of them had multi-disability. A holistic health care system that comprises health and wellness coupled with rehabilitation to address disabilities is needed to achieve healthy aging in elderly in homes for the aged in India.


Subject(s)
Disabled Persons , Multimorbidity , Aged , Aged, 80 and over , Blindness , Cross-Sectional Studies , Female , Humans , India/epidemiology , Male , Middle Aged , Morbidity
10.
Comput Intell Neurosci ; 2022: 3193193, 2022.
Article in English | MEDLINE | ID: mdl-35845900

ABSTRACT

The rapid advancement of information technology in today's modern society is contributing to an increase in the general degree of civilization in society. People are pleased with technological progress, but they are also becoming more aware that a major challenge confronting the advancement of social civilization at the moment is determining how to alleviate the difficulties associated with traveling and participating in social activities for the blind, as well as increasing the frequency with which they go out, travel, and participate in other activities. The blindness equipment that is now accessible in China is no longer suitable to meet the needs of blind people, but the growth of smart cities offers an opportunity to change this. Guide devices are crucial among the numerous types of equipment to assist the blind, and in order to better fulfill their various demands, we must upgrade and optimize the existing devices. The Chinese People's Daily highlights some of the key barriers to blind people's access in its 2019 article: random parking that blocks blind lanes; and "snake" and "broken" blind lanes that are not created with blind people's access in mind. In a smart city, accurate placement via smart maps helps alleviate a number of traffic-related issues for blind individuals. In this paper, we propose an intelligent guide device and interactive software to provide a more intelligent way for blind people to travel, which can effectively improve blind people's traffic conditions and make their travel easy, convenient, and safe, reflecting society's concern for blind people.


Subject(s)
Blindness , China , Cities , Humans
11.
PLoS One ; 17(7): e0271736, 2022.
Article in English | MEDLINE | ID: mdl-35862402

ABSTRACT

INTRODUCTION: Avoidable blindness is a significant public health problem in India. Nationally representative RAAB surveys (Rapid Assessment of Avoidable Blindness) are being conducted periodically in the country to know the current status of blindness in the country. The current study describes the findings from the RAAB survey conducted during 2015-19 in India. METHODOLOGY: A cross-sectional, population-based survey was conducted across the entire country among persons aged 50 years and above using RAAB version 6 methodology. Presenting and pinhole visual acuity was recorded followed by lens examination using a torchlight. In order to estimate the prevalence of blindness and visual impairment in overall population in India, district weights were assigned to each of the 31 surveyed districts and the prevalence was standardized using the RAAB software. RESULTS: The overall weighted, age-gender standardized, prevalence of blindness (presenting visual acuity <3/60 in better eye) in population aged ≥50 years was 1.99% (95% CI 1.94%, 2.13%) and of visual impairment (VI) (presenting visual acuity <6/12 in better eye) was 26.68% (95% CI 26.57-27.17%). On multivariate analysis, adjusted odds ratio showed that blindness was associated with age ≥ 80 years (OR = 20.3, 95% CI: 15.6-26.4) and being illiterate (OR = 5.6, 95% CI: 3.6-8.9). Blindness was not found to be significantly associated with either gender or locality. CONCLUSION: The results of the survey demonstrate that currently more than one fourth of persons aged 50 years and above are visually impaired (PVA<6/12 in better eye) in India. The prevalence of blindness among them is 1.99%, and older age and illiteracy are significantly associated with blindness. Major causes of blindness included cataract (66.2%), corneal opacity (CO) (8.2%), cataract surgical complications (7.2%), posterior segment disorders (5.9%) and glaucoma (5.5%). The proportion of blindness and visual impairment that is due to avoidable causes include 92.9% and 97.4% respectively.


Subject(s)
Cataract , Vision, Low , Visually Impaired Persons , Blindness/diagnosis , Blindness/epidemiology , Blindness/etiology , Cataract/complications , Cataract/epidemiology , Cross-Sectional Studies , Humans , India/epidemiology , Prevalence , Vision, Low/etiology
12.
Int J Mol Sci ; 23(15)2022 Jul 24.
Article in English | MEDLINE | ID: mdl-35897728

ABSTRACT

Recent technological development requires new approaches to address the problem of blindness. Such approaches need to be able to ensure that no cells with photosensitive capability remain in the retina. The presented model, Opn4-/- × Pde6brd10/rd10 (O×Rd) double mutant murine, is a combination of a mutation in the Pde6b gene (photoreceptor degeneration) together with a deletion of the Opn4 gene (responsible for the expression of melanopsin in the intrinsically photosensitive retinal ganglion cells). This model has been characterized and compared with those of WT mice and murine animal models displaying both mutations separately. A total loss of pupillary reflex was observed. Likewise, behavioral tests demonstrated loss of rejection to illuminated spaces and a complete decrease in visual acuity (optomotor test). Functional recordings showed an absolute disappearance of various wave components of the full-field and pattern electroretinogram (fERG, pERG). Likewise, visual evoked potential (VEP) could not be recorded. Immunohistochemical staining showed marked degeneration of the outer retinal layers and the absence of melanopsin staining. The combination of both mutations has generated an animal model that does not show any photosensitive element in its retina. This model is a potential tool for the study of new ophthalmological approaches such as optosensitive agents.


Subject(s)
Evoked Potentials, Visual , Retinal Degeneration , Animals , Blindness , Evoked Potentials, Visual/genetics , Mice , Mice, Inbred C57BL , Models, Genetic , Phenotype , Retina/metabolism , Retinal Degeneration/metabolism
13.
Genes (Basel) ; 13(7)2022 Jun 26.
Article in English | MEDLINE | ID: mdl-35885933

ABSTRACT

Stickler syndromes are inherited conditions caused by abnormalities of structural proteins in the eye, inner ear and cartilage. The risk of retinal detachment, particularly due to the development of giant retinal tears, is high. Stickler syndrome is the most common cause of childhood retinal detachment. Although retinal detachment surgery in the general population has a high success rate, outcomes from surgical repair in Stickler syndrome patients are notoriously poor, providing a strong argument for prophylactic intervention. Variable case selection, absence of molecular genetic sub-typing and inconsistent treatment strategies have all contributed to the historic uncertainty regarding the safety and efficacy of prophylactic treatment. This paper reviews the major published clinical studies that have evaluated different methods and strategies for prophylaxis. Based on the current body of literature, there is extremely strong evidence from cohort comparison studies demonstrating the efficacy and safety of prophylactic retinopexy to reduce, but not eliminate, the risk of retinal detachment in Stickler syndrome patients. It is vital that this body of evidence is provided to Stickler syndrome patients, to enable them to make their own fully informed choice about whether to receive prophylaxis for themselves and particularly on behalf of their affected children, to reduce the risk of retinal detachment.


Subject(s)
Arthritis , Connective Tissue Diseases , Craniofacial Abnormalities , Eye Diseases, Hereditary , Osteochondrodysplasias , Retinal Detachment , Arthritis/complications , Arthritis/genetics , Arthritis/surgery , Blindness , Child , Connective Tissue Diseases/complications , Connective Tissue Diseases/genetics , Hearing Loss, Sensorineural , Humans , Retinal Detachment/genetics , Retinal Detachment/surgery
14.
Trends Cogn Sci ; 26(9): 809-819, 2022 Sep.
Article in English | MEDLINE | ID: mdl-35872002

ABSTRACT

Humans routinely miss important information that is 'right in front of our eyes', from overlooking typos in a paper to failing to see a cyclist in an intersection. Recent studies on these 'Looked But Failed To See' (LBFTS) errors point to a common mechanism underlying these failures, whether the missed item was an unexpected gorilla, the clearly defined target of a visual search, or that simple typo. We argue that normal blindness is the by-product of the limited-capacity prediction engine that is our visual system. The processes that evolved to allow us to move through the world with ease are virtually guaranteed to cause us to miss some significant stimuli, especially in important tasks like driving and medical image perception.


Subject(s)
Automobile Driving , Visual Perception , Attention , Blindness , Humans
15.
Eur J Neurosci ; 56(4): 4486-4500, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35792656

ABSTRACT

It is well documented that early sensory loss typically alters brain morphology in the areas associated with the lost sense. However, much less is known about the impact of early sensory loss on the remainder of the sensory regions. Therefore, we investigated whether congenitally blind (CB) individuals show brain alterations in the olfactory system by comparing cortical morphology and olfactory bulb (OB) volume between 16 congenitally blind individuals and 16 sighted matched controls. Our results showed that not only CB blind individuals exhibited smaller OB but also alterations of cortical density in some higher olfactory processing centres, but unchanged cortical thickness. Our current findings suggest that a lifelong absence of visual input leads to morphological alterations in olfactory processing areas.


Subject(s)
Magnetic Resonance Imaging , Smell , Blindness , Humans , Magnetic Resonance Imaging/methods , Olfactory Bulb
16.
BMC Health Serv Res ; 22(1): 945, 2022 Jul 25.
Article in English | MEDLINE | ID: mdl-35879794

ABSTRACT

BACKGROUND: Globally, 19 million children have preventable vision impairment simply because refractive and eye health services are inaccessible to most of them. In Zambia, approximately 50,000 school children need spectacle provision. The School-based Eye Health Programme (SEHP) has been identified worldwide as a proven strategy to address childhood blindness. Given its great benefits, the Zambian government intends to scale up the programme. This scalability assessment aims to identify and evaluate the essential components of an effective SEHP, determine roles, assess existing capacities within user organisations, identify environmental facilitating and inhibiting factors, and estimate the minimum resources necessary for the scaling up and their proposed scale-up strategies. METHODS: Five elements (innovation, user organisation, resource team, environment, and strategies for horizontal and vertical scaling-up) were assessed guided by the ExpandNet-WHO Nine Steps for Developing a Scaling-Up Strategy. Literature review on proven strategies to reduce childhood blindness and the credibility of SEHP implemented in resource-limited settings, document review on the pilot project, questionnaires, and stakeholders' interviews were conducted to collect data for this assessment. Subsequently, twenty questions in the Worksheets for Developing a Scaling-up Strategy were used to report the assessment outcome systematically. RESULTS: Additional components of SEHP incorporated in Zambia's model enhanced the innovation's credibility and relevance. The resource team was relatively competent in the pilot project, and the same team will be employed during the scaling-up. Potential change in political parties, the lack of supply chain, and unstable financial support were identified as inhibiting factors. The objectives of SEHP were aligned with the National Eye Health Strategic Plan 2017-2021, which supports the institutionalisation of the SEHP into the existing School Health and Nutrition Programme. For the pace of expansion, replicating SEHP to another district rather than a province will be more realistic. CONCLUSION: Scaling up a comprehensive SEHP in Zambia is feasible if sufficient funding is available. Additionally, the pace must be adapted to the local context to ensure that every component within the SEHP is intact.


Subject(s)
Blindness , Schools , Child , Health Promotion , Humans , Pilot Projects , Zambia
17.
BMJ Open ; 12(7): e055061, 2022 07 07.
Article in English | MEDLINE | ID: mdl-35798521

ABSTRACT

INTRODUCTION: Globally, diabetic retinopathy (DR) is the leading cause of blindness in working-aged adults. Early detection and treatment of DR is essential for preventing sight loss. Services must be available, accessible and acceptable to patients if we are to ensure they seek such care. OBJECTIVES: To understand patients' knowledge and attitudes towards laser versus antivascular endothelial growth factor (VEGF) injections to treat DR in Vietnam, and to identify factors Vietnamese ophthalmologists consider when making treatment decisions. METHODS: This is a descriptive qualitative study based on semi-structured interviews with 18 patients (12 from Ho Chi Minh City and 6 from Hanoi) plus individual interviews with 24 ophthalmologists working in eye clinics in these cities. Thematic analysis was used to analyse the data. RESULTS: In total, 10/24 (41.7%) ophthalmologists were female, and their median age was 41 years (range 29-69 years). The median age of patients was 56.5 years (range 28-72 years), and 7/18 (38.9%) were female. Briefly, factors that influence DR treatment decisions for ophthalmologists are medical considerations (ie, severity of disease, benefits and risks), availability (ie, treatment and resources) and patient-related factors (ie, costs and adherence). Patient's perceived barriers and facilitators to treatments were based on patient and family related factors (ie, treatment and transportation costs) and previous treatment experiences (ie, positive and negative). Recommendations by all participants included ensuring that both laser and anti-VEGF injections are widely available across the country and controlling costs for patients and the healthcare system. CONCLUSIONS: Reducing DR treatment costs, optimising treatments options, and expanding the network of clinics offering treatment outside metropolitan areas were the main issues raised by participants. These findings can help inform policy changes in Vietnam and may be generalisable to other low-resource settings.


Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Macular Degeneration , Ophthalmologists , Adult , Aged , Blindness/etiology , Blindness/prevention & control , Diabetic Retinopathy/diagnosis , Female , Humans , Male , Middle Aged , Qualitative Research , Vietnam
18.
Indian J Ophthalmol ; 70(7): 2355-2385, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35791117

ABSTRACT

Retinitis pigmentosa (RP) belongs to a group of pigmentary retinopathies. It is the most common form of inherited retinal dystrophy, characterized by progressive degradation of photoreceptors that leads to nyctalopia, and ultimately, complete vision loss. RP is distinguished by the continuous retinal degeneration that progresses from the mid-periphery to the central and peripheral retina. RP was first described and named by Franciscus Cornelius Donders in the year 1857. It is one of the leading causes of bilateral blindness in adults, with an incidence of 1 in 3000 people worldwide. In this review, we are going to focus on the genetic heterogeneity of this disease, which is provided by various inheritance patterns, numerosity of variations and inter-/intra-familial variations based upon penetrance and expressivity. Although over 90 genes have been identified in RP patients, the genetic cause of approximately 50% of RP cases remains unknown. Heterogeneity of RP makes it an extremely complicated ocular impairment. It is so complicated that it is known as "fever of unknown origin". For prognosis and proper management of the disease, it is necessary to understand its genetic heterogeneity so that each phenotype related to the various genetic variations could be treated.


Subject(s)
Retinitis Pigmentosa , Blindness , Humans , Phenotype , Retina , Retinitis Pigmentosa/diagnosis , Retinitis Pigmentosa/genetics
19.
Indian J Ophthalmol ; 70(7): 2397-2400, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35791119

ABSTRACT

Telerehabilitation is a viable option to provide continuum of rehabilitation intervention in situations like the ongoing pandemic. Presently, there is no policy guidelines to the minimum standard of telerehabilitation. This paper describes procedures for telerehabilitation for people with blindness and low vision from the evidence-based practices from a premier eye institute in South India. The suggested guidelines can help develop and replicate similar models of telerehabilitation to reach people in need in difficult situations like COVID 19 pandemic.


Subject(s)
COVID-19 , Telerehabilitation , Vision, Low , Blindness , COVID-19/epidemiology , Humans , India/epidemiology , Vision, Low/rehabilitation
20.
Indian J Ophthalmol ; 70(7): 2533-2538, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35791150

ABSTRACT

Purpose: To describe the clinical presentation and demographic distribution of retinitis pigmentosa (RP) in Laurence-Moon-Bardet-Biedl (LMBB) syndrome patients. Methods: This is a cross-sectional observational hospital-based study wherein 244 patients with RP in LMBB syndrome presenting to our hospital network between March 2012 and October 2020 were included. An electronic medical record database was used for data retrieval. Results: There were 244 patients in total, with a hospital-based prevalence rate of 0.010% or 1000/100,000 population. The mean and median age of patients was 15.22 ± 7.56 and 14 (IQR: 10-18.5) years, respectively, with the majority being in the age group of 11-20 years (133/244 patients; 54.50%). Males were more commonly affected (164 patients; 67.21%), and the majority (182 patients; 74.59%) were students. All 244 patients (100%) complained of defective central vision at presentation. More than one-fourth of the patients had severe visual impairment to blindness at presentation. Prominent retinal feature at presentation was diffuse or widespread retinal pigment epithelial degeneration in all patients. Conclusion: Patients with RP in LMBB syndrome present mainly in the first to second decade of life with severe visual acuity impairment to blindness early in life. It is important to rule out LMBB syndrome in early-onset RP with central visual acuity impairment. On the contrary, all patients diagnosed or suspected with LMBB syndrome systemic features at physician clinic should also be referred for ophthalmic evaluation, low vision assessment, rehabilitation, and vice versa.


Subject(s)
Bardet-Biedl Syndrome , Laurence-Moon Syndrome , Retinitis Pigmentosa , Adolescent , Adult , Blindness , Child , Cross-Sectional Studies , Data Science , Electronic Health Records , Humans , India/epidemiology , Male , Retinitis Pigmentosa/diagnosis , Retinitis Pigmentosa/epidemiology , Young Adult
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