Nanozyme-Cosmetic Contact Lenses for Ocular Surface Disease Prevention.

Efficiently balancing excess reactive oxygen species (ROS) caused by various factors on the ocular surface is a promising strategy for preventing the development of ocular surface diseases (OSDs). Nevertheless, the conventional topical administration of antioxidants is limited in efficacy due to poor absorption, rapid metabolism, and irreversible depletion, which impede their performance. To address this issue, contact lenses embedded with antioxidant nanozymes that can continuously scavenge ROS, thereby providing an excellent preventive effect against OSDs are developed. Specifically, Prussian blue family nanozymes are chosen based on their multiple antioxidant enzyme-like activities and excellent biocompatibility. The diverse range of colors made them promising candidates for the development of cosmetic contact lenses (CCLs) as a substitute for conventional pigments. The efficacy of nanozyme-CCLs is demonstrated in rabbits and rats exposed to a high risk of developing OSDs. These OSDs' prevention nanozyme-CCLs can pave the way for CCLs toward powerful wearable biomedical devices and provide novel strategies for the rational utilization of nanomaterials in clinical practice.

339ª Reunião do Conselho Nacional de Saúde - 15 feb. 2023

Antioxidant Nutraceutical Strategies in the Prevention of Oxidative Stress Related Eye Diseases.

This review aims to discuss the delicate balance between the physiological production of reactive oxygen species and the role of antioxidant nutraceutical molecules in managing radicals in the complex anatomical structure of the eye. Many molecules and enzymes with reducing and antioxidant potential are present in different parts of the eye. Some of these, such as glutathione, N-acetylcysteine, α-lipoic acid, coenzyme Q10, and enzymatic antioxidants, are endogenously produced by the body. Others, such as plant-derived polyphenols and carotenoids, vitamins B2, C, and E, zinc and selenium, and omega-3 polyunsaturated fatty acids, must be obtained through the diet and are considered essential nutrients. When the equilibrium between the production of reactive oxygen species and their scavenging is disrupted, radical generation overwhelms the endogenous antioxidant arsenal, leading to oxidative stress-related eye disorders and aging. Therefore, the roles of antioxidants contained in dietary supplements in preventing oxidative stress-based ocular dysfunctions are also discussed. However, the results of studies investigating the efficacy of antioxidant supplementation have been mixed or inconclusive, indicating a need for future research to highlight the potential of antioxidant molecules and to develop new preventive nutritional strategies.

Linkage between a plant-based diet and age-related eye diseases: a systematic review and meta-analysis.

CONTEXT: An increased risk of age-related eye disease has been observed in individuals lacking a balanced diet. Following a plant-based diet may result in nutritional insufficiencies and negatively affect health if an effort is not made to ensure the consumption of fortified foods or specific supplements. OBJECTIVE: The purpose of this article is to characterize the relationship between plant-based diets and age-related ocular outcomes among adults. DATA SOURCES: A comprehensive literature review was performed using the MEDLINE, Embase, Cochrane, and PubMed databases up until December 19, 2021. STUDY SELECTION: Studies that focused on observed visual changes due to a reduced intake of animal products and that included a minimum of 50 eyes were eligible for inclusion. DATA EXTRACTION: Two levels of screening, quality assessment, and data extraction were conducted by 2 reviewers independently. The 21 studies identified from 814 unique studies progressed to data extraction and 15 were included in the quantitative analysis using STATA 15.0 fixed-effect and random-effect models computed on the basis of heterogeneity. RESULTS: The 15 (n = 51 695 participants) assessed the impact of fish consumption, 8 studies (n = 28 753 participants) analyzed the effect of red meat intake, and 3 studies (n = 7723 participants) assessed the impact of omission of skim milk, poultry, and non-meat animal products and the presence of disease incidence as indicated by age-related macular degeneration or cataract development. Meta-analysis indicated regular consumption of fish (odds ratio [OR], 0.70; 95%CI, 0.62-0.79) and skim milk, poultry, and non-meat animal products (OR, 0.70; 95%CI, 0.61-0.79) reduced the risk of age-related eye disease development among adults. Consumption of red meat (OR, 1.41; 95%CI, 1.07-1.86) may increase the risk of age-related eye disease development. CONCLUSION: A pescatarian diet is associated with the most favorable visual outcomes among adults, whereas consumption of red meat negatively affects ocular health. Results suggest a need for more initiatives promoting a healthy and balanced diet. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021269925.

The Importance of Health Literacy in Addressing Eye Health and Eye Care Disparities.

Disparities in eye health and eye care frequently result from a lack of understanding of ocular diseases and limited use of ophthalmic health services by various populations. The purpose of this article is to describe the principle of health literacy and its central role in enhancing health, and how its absence can result in poorer health outcomes. The article evaluates the current status of health literacy in visual health and disparities that exist among populations. It also explores ways to improve health literacy as a means of reducing disparities in visual health and eye care. Advancing dissemination of health information and enhancing health literacy may help not only to reduce healthcare barriers in the underserved populations but also to lessen visual health disparities.

Seguridad en procedimientos dermatológicos: complicaciones oftalmológicas / Safety in Dermatologic Procedures: Ophthalmologic Complications

Las complicaciones oftalmológicas en las cirugías dermatológicas son poco frecuentes. A pesar de ello, todo cirujano debe tener un conocimiento básico del reconocimiento, la prevención y el tratamiento de las cuatro complicaciones que se abordan en este artículo incluido en la serie «Seguridad en procedimientos dermatológicos». La primera complicación a tratar es el daño ocular por irritantes químicos, una situación habitual dadas las sustancias irritantes empleadas en quirófano y las localizaciones anatómicas donde se puede producir la intervención (región ciliar, región palpebral…). En segundo lugar, se aborda el daño ocular por láser, una complicación donde la prevención (utilización de gafas o lentillas protectoras) a lo largo de toda la intervención es esencial. Otra complicación a tener en cuenta debido a la proximidad de algunas intervenciones quirúrgicas al globo ocular es la punción traumática accidental. En cuarto y último lugar, se abordará el vasoespasmo o embolismo arterial retiniano por fármacos o materiales de relleno. Dicha complicación es infrecuente, pero es recomendable saber reconocerla para realizar un tratamiento precoz evitando una situación de ceguera permanente (AU)

Ophthalmological complications are uncommon in dermatologic surgery. Nonetheless, all surgeons should know the basics of recognizing, preventing, and treating the 4 complications addressed in this article from the series ‘Safety in Dermatologic Procedures’. The first complication that surgeons should be familiar with is eye damage due to chemical irritants. This is a common complication in operating rooms given the presence of irritant substances and the performance of procedures in the eyebrow and eyelid region. The second complication is laser-induced eye damage. In this case, eye protection with safety glasses or eye caps is crucial. The third complication is accidental eyeball perforation, which can occur during certain surgical procedures. The fourth and final complication is retinal artery vasospasm or embolism due to drugs or filler materials. This complication is rare but important to recognize, as early treatment can prevent permanent blindness (AU)

[Translated article] Safety in Dermatologic Procedures: Ophthalmologic Complications / Seguridad en procedimientos dermatológicos: complicaciones oftalmológicas

Ophthalmological complications are uncommon in dermatologic surgery. Nonetheless, all surgeons should know the basics of recognizing, preventing, and treating the 4 complications addressed in this article from the series ‘Safety in Dermatologic Procedures’. The first complication that surgeons should be familiar with is eye damage due to chemical irritants. This is a common complication in operating rooms given the presence of irritant substances and the performance of procedures in the eyebrow and eyelid region. The second complication is laser-induced eye damage. In this case, eye protection with safety glasses or eye caps is crucial. The third complication is accidental eyeball perforation, which can occur during certain surgical procedures. The fourth and final complication is retinal artery vasospasm or embolism due to drugs or filler materials. This complication is rare but important to recognize, as early treatment can prevent permanent blindness (AU)

Las complicaciones oftalmológicas en las cirugías dermatológicas son poco frecuentes. A pesar de ello, todo cirujano debe tener un conocimiento básico del reconocimiento, la prevención y el tratamiento de las cuatro complicaciones que se abordan en este artículo incluido en la serie «Seguridad en procedimientos dermatológicos». La primera complicación a tratar es el daño ocular por irritantes químicos, una situación habitual dadas las sustancias irritantes empleadas en quirófano y las localizaciones anatómicas donde se puede producir la intervención (región ciliar, región palpebral…). En segundo lugar, se aborda el daño ocular por láser, una complicación donde la prevención (utilización de gafas o lentillas protectoras) a lo largo de toda la intervención es esencial. Otra complicación a tener en cuenta debido a la proximidad de algunas intervenciones quirúrgicas al globo ocular es la punción traumática accidental. En cuarto y último lugar, se abordará el vasoespasmo o embolismo arterial retiniano por fármacos o materiales de relleno. Dicha complicación es infrecuente, pero es recomendable saber reconocerla para realizar un tratamiento precoz evitando una situación de ceguera permanente (AU)

Long-Acting Protective Ocular Surface by Instilling Adhesive Dual-Antiviral Nanoparticles.

The eye is susceptible to viral infections, causing severe ocular symptoms or even respiratory diseases. Methods capable of protecting the eye from external viral invasion in a long-term and highly effective way are urgently needed but have been proved to be extremely challenging. Here, a strategy of forming a long-acting protective ocular surface is described by instilling adhesive dual-antiviral nanoparticles. Taking pseudotyped severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a model virus, antiviral agent-loaded nanoparticles are coated with a "double-lock" hybrid cell membrane abundant with integrin-ß1 and angiotensin converting enzyme II (ACE2). After instillation, the presence of integrin-ß1 endows coated nanoparticles with steady adhesion via specific binding to Arg-Gly-Asp sequence on the fibronectin of ocular epithelium, achieving durable retention on the ocular surface. In addition to loaded inhibitors, the exposure of ACE2 can trap SARS-CoV-2 and subsequently neutralize the associated spike protein, playing a dual antiviral effect of the resulting nanoparticles. Adhesive dual-antiviral nanoparticles enabled by coating with a "double-lock" hybrid cell membrane could be a versatile platform for topical long-acting protection against viral infection of the eye.

Management of Key Ocular Adverse Events in Patients Implanted with the Port Delivery System with Ranibizumab.

PURPOSE: To provide strategies for the management of key ocular adverse events (AEs) that may be encountered with the Port Delivery System with ranibizumab (PDS) in practice and provide recommendations that may mitigate such AEs based on clinical trial experiences and considerations from experts in the field. DESIGN: Safety evaluation based on the phase 2 Ladder (NCT02510794) and phase 3 Archway (NCT03677934) trials of the PDS. METHODS: The PDS implant is a permanent, indwelling, and refillable ocular drug delivery system that requires standardized procedural steps for its insertion and refill-exchange procedures, which evolved during the PDS clinical program. We described identified AEs that may arise after implant insertion or refill-exchange procedures, including conjunctival retraction, conjunctival erosion, endophthalmitis, implant dislocation, conjunctival blebs or conjunctival filtering bleb leaks, wound leaks, hypotony, choroidal detachment, vitreous hemorrhage, rhegmatogenous retinal detachment, cataract, and septum dislodgement. RESULTS: Adverse events related to the PDS were well understood, were manageable by trial investigators, and did not prevent patients from achieving optimal outcomes in most cases. CONCLUSIONS: Surgeons using the PDS should be aware of potential ocular AEs and identify them early for optimal management. As with any new surgical procedure, it is important to provide surgeons with appropriate training, ensure adherence to optimal surgical techniques, and continually refine the procedure to mitigate complications and improve outcomes.

Gut Microbiome and Its Influence On Ocular Surface and Ocular Surface Diseases.

ABSTRACT: The gut microbiome plays a substantial immunologic and pathophysiologic role in maintaining the health of the host, and dysregulation of this dynamic ecosystem has been associated with several inflammatory conditions. Many studies have explored the influence of gut microbiota on the ocular surface and whether gut microbiota impact the pathophysiology of ophthalmic conditions. These findings have highlighted the advantages of enhancing gut microbes through probiotics, prebiotics, diet, vitamin supplementations, and fecal microbial transplant in clinical practice. The purpose of this review article was to provide an up-to-date overview of the knowledge on this topic. Further exploration of this area of research is important to help guide new therapeutic targets to develop treatment and prevention of certain ocular surface diseases.

[Chinese expert consensus on prevention and control of COVID-19 eye disease (2022)].

Accumulated evidence has shown that novel coronavirus disease 2019 (COVID-19) could contribute to eye disease during its pandemic, which is called COVID-19 eye disease. Currently, there is a lack of uniform and standardized guidelines for the protection of medical staff in the diagnosis and treatment process. Most ophthalmologists treat this disease according to their clinical experience. Therefore, the experts of the Public Health Ophthalmology Branch of Chinese Preventive Medicine Association have developed this consensus statement after thorough discussions, hoping to provide guiding opinions on the further prevention and control of COVID-19 eye disease in China.

Differential Antimicrobial Efficacy of Preservative-Free Contact Lens Disinfection Systems against Common Ocular Pathogens.

Microbial keratitis is a devastating disease that can cause eye damage and blindness and can be the result of infections by several common ocular pathogens. Importantly, some of these pathogens, such as Acanthamoeba, are particularly unsusceptible to biocides in common contact lens care solutions. Therefore, the disinfection efficacy of preservative-free (PF) disinfection systems against bacteria, fungi, and Acanthamoeba trophozoites and cysts should be assessed as products with the most potential to be efficacious against resistant organisms. PF disinfection systems were analyzed for antimicrobial efficacy. These were the one-step (hydrogen peroxide-based) Clear Care and Clear Care Plus systems and the two-step (povidone-iodine-based) Cleadew system. Stand-alone challenges using bacteria, fungi, and Acanthamoeba were prepared according to the International Standards Organization method 14729. These same challenges were also conducted in the presence of the following contact lenses: Boston RGP, Acuvue Oasys, Biofinity, Ultra, and 2-week PremiO. All challenges were performed at the manufacturer's recommended disinfection time. All preservative-free disinfection systems demonstrated similarly high rates of antimicrobial efficacy when challenged with bacteria or fungi, with or without lenses. However, both Clear Care and Clear Care Plus demonstrated significantly greater disinfection efficacy against Acanthamoeba trophozoites and cysts, with and without lenses (P < 0.05). Cleadew efficacy was impacted by the addition of contact lenses, whereas Clear Care/Clear Care Plus maintained similar efficacies in the absence or presence of lenses. While both hydrogen peroxide and povidone-iodine are highly effective against bacteria and fungi, hydrogen peroxide maintains significantly greater disinfection capabilities than povidone-iodine against all forms of Acanthamoeba. IMPORTANCE Understanding the most efficacious products will allow clinicians to best communicate to patients and consumers the safest products on the market to reduce adverse events, including microbial keratitis, during contact lens use.

Computer Vision Syndrome: Will the Pandemic Lead to Eye Problems for Dentists?

ABSTRACT Over the past year and a half dental education has been conducted primarily online due to the SARS-CoV-2 pandemic. During the pandemic, we have spent many hours a day on our computers, mobile phones, and tablets to gather information and participate in online seminars and classrooms. Health consequences resulting from the overuse of these devices include carpal tunnel syndrome as well as computer vision syndrome (CVS). Computer vision syndrome, also known as digital eye strain, has several associated features such as eye burning, strained vision, dry eye, blurred vision, and associated neck and shoulder pain. Several predisposing factors have been linked with CVS, but often this problem gets ignored. The management of this syndrome is aimed at educating dentists on computer use, position, and the surrounding environment. Considering all this, we must ensure that we spend some time away from these devices every day to avoid any significant vision problems. The objective of preparing this manuscript was to provide a brief overview of the increased prevalence of computer vision syndrome and its associated features.

Largazole Inhibits Ocular Angiogenesis by Modulating the Expression of VEGFR2 and p21.

Ocular angiogenic diseases, characterized by abnormal blood vessel formation in the eye, are the leading cause of blindness. Although Anti-VEGF therapy is the first-line treatment in the market, a substantial number of patients are refractory to it or may develop resistance over time. As uncontrolled proliferation of vascular endothelial cells is one of the characteristic features of pathological neovascularization, we aimed to investigate the role of the class I histone deacetylase (HDAC) inhibitor Largazole, a cyclodepsipeptide from a marine cyanobacterium, in ocular angiogenesis. Our study showed that Largazole strongly inhibits retinal vascular endothelial cell viability, proliferation, and the ability to form tube-like structures. Largazole strongly inhibits the vessel outgrowth from choroidal explants in choroid sprouting assay while it does not affect the quiescent choroidal vasculature. Largazole also inhibits vessel outgrowth from metatarsal bones in metatarsal sprouting assay without affecting pericytes coverage. We further demonstrated a cooperative effect between Largazole and an approved anti-VEGF drug, Alflibercept. Mechanistically, Largazole strongly inhibits the expression of VEGFR2 and leads to an increased expression of cell cycle inhibitor, p21. Taken together, our study provides compelling evidence on the anti-angiogenic role of Largazole that exerts its function through mediating different signaling pathways.

Raising awareness about the unintended consequences of hand sanitiser in children.

The use of hand sanitisers is common practice to prevent the spread of coronavirus disease 2019 (COVID-19). However, the safety thereof requires consideration as this may be hazardous in children. Recent studies have shown that the misuse and increased unsupervised availability of alcohol-based hand sanitisers may result in adverse events in children such as skin irritation, dryness, cracking and peeling. Unintentional or intentional ingestion of hand sanitisers in children under the age of 12 years may occur because of the colour, smell and flavour added to it. Consumption of alcohol in children may result in hypoglycaemia, apnoea and acidosis. This allows the invasion of other bacterial and viral infections. Children may also rub their eyes with sanitised hands and cause ocular injury. Therefore, the use of hand sanitisers in general needs to be revised in both children and adults. Other interventions on lowering the risk of adverse events because of misuse of hand sanitiser should be practised more often. These include promoting washing of hands over sanitisers where possible, training children on how to use hand sanitisers and creating awareness of the dangers if ingested or in contact with the eyes.

[Ocular manifestations of Rheumatic diseases]. / Rheumatische Erkrankungen mit Manifestation am Auge.

Pain in the musculoskeletal system and in the joints is what comes to mind first when people talk about rheumatic diseases. However, rheumatic diseases are multisystem disorders that can affect every organ system. Therefore, ocular manifestations are common and can occur in almost every rheumatic disease. On the one hand, they can even precede musculoskeletal manifestations. On the other hand, they can remain unrecognized without a thorough ophthalmologic examination in some disease entities. Consequently, a close cooperation between medical specialties is warranted, to prevent permanent impairment in vision or consequential damage to organs or joints.The following article thus focuses on the most important ocular manifestations of rheumatic diseases. For example, we address keratoconjunctivitis sicca as a complication in many rheumatic disorders, which include rheumatoid arthritis and, most importantly, Sjogren's syndrome. Furthermore, we cover uveitis and associated diseases such as spondyloarthritis or sarcoidosis. Also, we discuss giant cell arteritis as a rheumatological emergency. All in all, we aim to give a synopsis of clinical presentations, important diagnostic measures, and current therapeutic options of the above-mentioned disorders.

Sunlight exposure in infancy decreases risk of sporadic retinoblastoma, extent of intraocular disease.

BACKGROUND: Prior ecologic studies suggest that UV exposure through sunlight to the retina might contribute to increased retinoblastoma incidence. AIMS: Our study objectives were (1) to examine the relationship between exposure to sunlight during postnatal retinal development (prior to diagnosis of sporadic disease) and the risk of retinoblastoma, and (2) to examine the relationship between sun exposure during postnatal retinal development, and the extent of disease among children with unilateral and bilateral retinoblastoma. METHODS AND RESULTS: We interviewed 511 mothers in the EpiRbMx case-control study about their child's exposure to sunlight during postnatal retinal cell division by examining three time periods prior to Rtb diagnosis coinciding with developmental stages in which outdoor activities vary. Weekly sun exposure was compared by age period, between unilateral (n = 259), bilateral (n = 120), and control (n = 132) children, accounting for two factors affecting UV exposure: residential elevation and reported use of coverings to shield eyes. For cases, association between sunlight exposure and clinical stage was examined by laterality at each age period. After adjusting for maternal education and elevation, sun exposure was lower in cases than controls in all three age periods especially during the first 6 months, and in children 12-23 months whose mothers did not cover their eyes when outdoors. In children diagnosed after 12 months of age, sun exposure during the second year of life (age 12-23 months) appeared inversely correlated (r = -0.25) with more advanced intraocular disease in bilateral Rtb children after adjusting for maternal education, residential elevation, and age of diagnosis (p < .09) consistent with effects of Vitamin D exposure on intraocular spread in earlier transgenic murine models of retinoblastoma, and suggesting potential chemopreventive strategies. CONCLUSION: Sun exposure in early childhood is protective for retinoblastoma and may decrease degree of intraocular spread in children with bilateral Rtb.