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1.
Afr Health Sci ; 22(Spec Issue): 124-132, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36321128

RESUMO

Background: The elderly have an increased risk of developing visual impairment (VI). Due to the increase in life expectancy of individuals in Sub-Saharan Africa, the population of the elderly is projected to increase. It is thus postulated that the prevalence of VI will increase which is currently unknown in Uganda. Objective: To determine the prevalence and risk factors for VI among the elderly at Mulago National Referral Hospital eye clinic in Uganda. Methods: This was a cross-sectional study carried out in 2020 with consecutive enrolment of patients aged 60 years and above. Obtaining history was followed by systemic and ocular examination. Statistical analysis was performed to determine the prevalence and factors associated with VI. Results: Of 346 elderly participants examined, 174 (50.3%) were males and median age was 67 (IQR 63-74). Prevalence of VI was 32.1%. Cataract was the leading cause of blindness 54.1%, followed by refractive error (21.6%), glaucoma (11.7%), and corneal opacities (5.4%). Age (adjusted Prevalence Ratio (aPR): 1.05, 95% CI (1.02, 1.06)), history of diabetes mellitus (aPR 1.46, 95%CI (1.04, 2.05)), history of hypertension (aPR 1.46, 95%CI (1.10, 1.93)), having completed primary level of education (aPR 0.74, 95%CI (0.55, 0.98)) and secondary level of education (aPR 0.47, 95%CI (0.30,0.73)), presence of a cataract at examination (aPR: 2.28, 95%CI (1.66, 3.13)) were statistically significantly associated with VI. Conclusion: In Mulago hospital, the prevalence of VI among the elderly is high with majority of the causes being correctable. We recommend that efforts towards early case identification of causes of VI among the elderly should be a priority.


Assuntos
Catarata , Baixa Visão , Idoso , Masculino , Humanos , Feminino , Estudos Transversais , Prevalência , Uganda/epidemiologia , Acuidade Visual , Baixa Visão/etiologia , Cegueira/etiologia , Fatores de Risco , Encaminhamento e Consulta , Hospitais
3.
BMC Public Health ; 22(1): 2068, 2022 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-36369026

RESUMO

BACKGROUND: To evaluate the global burden of cataracts by year, age, region, gender, and socioeconomic status using disability-adjusted life years (DALYs) and prevalence from the Global Burden of Disease (GBD) study 2019. METHODS: Global, regional, or national DALY numbers, crude DALY rates, and age-standardized DALY rates caused by cataracts, by year, age, and gender, were obtained from the Global Burden of Disease Study 2019. Socio-demographic Index (SDI) as a comprehensive indicator of the national or regional development status of GBD countries in 2019 was obtained from the GBD official website. Kruskal-Wallis test, linear regression, and Pearson correlation analysis were performed to explore the associations between the health burden with socioeconomic levels, Wilcoxon Signed-Rank Test was used to investigate the gender disparity. RESULTS: From 1990 to 2019, global DALY numbers caused by cataracts rose by 91.2%, crude rates increased by 32.2%, while age-standardized rates fell by 11.0%. Globally, age-standardized prevalence and DALYs rates of cataracts peaked in 2017 and 2000, with the prevalence rate of 1283.53 [95% uncertainty interval (UI) 1134.46-1442.93] and DALYs rate of 94.52 (95% UI 67.09-127.24) per 100,000 population, respectively. The burden was expected to decrease to 1232.33 (95% UI 942.33-1522.33) and 91.52 (95% UI 87.11-95.94) by 2050. Southeast Asia had the highest blindness rate caused by cataracts in terms of age-standardized DALY rates (99.87, 95% UI: 67.18-144.25) in 2019. Gender disparity has existed since 1990, with the female being more heavily impacted. This pattern remained with aging among different stages of vision impairments and varied through GBD super regions. Gender difference (females minus males) of age-standardized DALYs (equation: Y = -53.2*X + 50.0, P < 0.001) and prevalence rates (equation: Y = - 492.8*X + 521.6, P < 0.001) was negatively correlated with SDI in linear regression. CONCLUSION: The global health of cataracts is improving but the steady growth in crude DALY rates suggested that health progress does not mean fewer demands for cataracts. Globally, older age, females, and lower socioeconomic status are associated with higher cataract burden. The findings of this study highlight the importance to make gender-sensitive health policies to manage global vision loss caused by cataracts, especially in low SDI regions.


Assuntos
Catarata , Carga Global da Doença , Masculino , Humanos , Feminino , Anos de Vida Ajustados por Qualidade de Vida , Saúde Global , Prevalência , Catarata/epidemiologia , Cegueira/epidemiologia , Cegueira/etiologia
4.
Front Public Health ; 10: 1033495, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36388337

RESUMO

Purpose: This study aimed to provide a comprehensive assessment of burden estimates and the secular trend of blindness and vision loss, as measured by years lived with disability (YLDs), at the global, regional, and national levels. Methods: The age-standardized YLD rates (ASYRs) due to blindness and vision loss and its subtypes, including moderate vision loss, severe vision loss, blindness, and presbyopia, from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends in the ASYRs due to blindness and vision loss. Results: In 2019, the global ASYRs per 100,000 population was 327.98 for blindness and vision loss, specifically, 85.81 for moderate vision loss, 74.86 for severe vision loss, 95.03 for blindness, and 62.27 for presbyopia. From 1990 to 2019, the ASYRs due to blindness and vision loss slightly decreased. Females showed higher ASYRs than males in 2019. The global highest ASYRs were observed in South Asia and sub-Saharan Africa. Negative associations were found between the burden estimates of blindness and vision loss and the sociodemographic index levels. The EAPCs of ASYRs in blindness and vision loss were significantly negatively correlated with the ASYRs in 1990 and positively correlated with human development indices in 2019. Conclusions: Globally, blindness and vision loss continue to cause great losses of healthy life. Reasonable resource allocation and health-service planning are needed for the prevention and early intervention of disabilities caused by vision loss.


Assuntos
Carga Global da Doença , Presbiopia , Masculino , Feminino , Humanos , Anos de Vida Ajustados pela Incapacidade , Saúde Global , Prevalência , Cegueira/epidemiologia , Cegueira/etiologia
5.
Br Dent J ; 233(9): 699, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36369535
6.
Harefuah ; 161(10): 603-605, 2022 Oct.
Artigo em Hebraico | MEDLINE | ID: mdl-36315204

RESUMO

INTRODUCTION: Hypereosinophilic syndrome (HES) is a rare disorder, in which eosinophilic toxins damage capillary and coronary endothelium and neuronal axons, at different target organs; 12% of patients experience stroke as a result of endothelial dysfunction, cardiomyopathy with secondary embolism, hyperviscosity and hypercoagulability. The treatment target is to lower the eosinophil count and shorten its tissue survival time. Supportive care and anticoagulants are given as required. We report a case of myocarditis, respiratory failure and cortical blindness due to rapidly deteriorating HES. The case demonstrates how early recognition and appropriate treatment can reduce tissue toxicity and functional loss due to hypereosinophilic syndrome.


Assuntos
Síndrome Hipereosinofílica , Miocardite , Acidente Vascular Cerebral , Humanos , Síndrome Hipereosinofílica/complicações , Síndrome Hipereosinofílica/diagnóstico , Anticoagulantes , Acidente Vascular Cerebral/complicações , Cegueira/etiologia
7.
Vestn Oftalmol ; 138(5. Vyp. 2): 221-226, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36287159

RESUMO

The most common complication of hemodialysis is blood pressure decrease, which is an ischemic optic neuropathy risk factor. The article presents a case study of sequential bilateral ischemic optic neuropathy with the development of amaurosis as a result of arterial hypotension against the background of programmed hemodialysis. Differential diagnosis in bilateral visual impairment is discussed.


Assuntos
Hipotensão , Neuropatia Óptica Isquêmica , Humanos , Neuropatia Óptica Isquêmica/diagnóstico , Neuropatia Óptica Isquêmica/etiologia , Diálise Renal/efeitos adversos , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Hipotensão/complicações , Cegueira/diagnóstico , Cegueira/etiologia
8.
Kidney360 ; 3(9): 1542-1544, 2022 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-36245648

RESUMO

Background: Diabetes is rising globally and is the most common cause of both end-stage renal disease and blindness. People on hemodialysis have to attend several dialysis appointments per week, which can affect their attendance at diabetic eye screening. In addition, previous literature suggests patients on hemodialysis are more likely to have sight-threatening diabetic eye disease. This study aims to determine attendance at the Diabetic Eye Screening Program in Northern Ireland, diabetic retinopathy severity, and use of handheld retinal imaging in people with diabetes attending hemodialysis units in Northern Ireland. Methods: All patients with diabetes attending hemodialysis clinics regionally were screened and graded by the Diabetic Eye Screening Program in Northern Ireland using a handheld and/or conventional nonmydriatic fundus camera. Results: All eligible people (N=149) were offered a Diabetic Eye Screening Program in Northern Ireland appointment, 132 attended, 34% of whom had not been seen in >3 years and 15% of whom had never attended the Diabetic Eye Screening Program in Northern Ireland despite multiple previous appointments. Altogether, 13% required urgent referral to hospital eye services, which is significantly higher than the national average of 0.4%. Conclusions: Those on hemodialysis are at high risk for sight-threatening diabetic retinopathy. Implementing the Diabetic Eye Screening Program in Northern Ireland in hemodialysis clinics enables timely diagnosis and referral.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Cegueira/etiologia , Retinopatia Diabética/diagnóstico , Humanos , Programas de Rastreamento/efeitos adversos , Irlanda do Norte/epidemiologia , Diálise Renal/efeitos adversos
10.
Indian J Ophthalmol ; 70(11): 3933-3937, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36308130

RESUMO

Purpose: Globally, cataracts have remained the major cause of blindness. Cataract accounts for 62.6% of blindness affecting 9-12 million people. The only treatment for cataracts is surgical removal of cataracts. The surgical procedures include phacoemulsification and extracapsular cataract extraction (ECCE). In India, there is a huge backlog of cataract patients. Phacoemulsification is preferred nowadays for early visual rehabilitation, but in developing countries like ours, where facilities are not widely available, small-incision cataract surgery (SICS) is a cost-effective alternative as no machine is required. Also, it provides early visual rehabilitation as it is sutureless when compared to ECCE. So, manual SICS has emerged as a substitute for phacoemulsification and ECCE. The aim of the study was to evaluate the visual acuity and surgically induced astigmatism in patients more than 40 years of age, undergoing manual SICS with nucleus management by viscoexpression technique. Methods: This was a prospective study that included 50 patients over the age of 40 years undergoing manual SICS at a tertiary health-care center in North India by viscoexpression technique. Only those patients whose functional visual disability could be attributed to cataracts were included in the study. Preoperative and postoperative astigmatism were analyzed in the first, fourth, and sixth weeks. Results: Fifty patients who were undergoing manual SICS were analyzed. Preoperative best-corrected visual acuity (BCVA) and astigmatism were compared to postoperative BCVA and astigmatism. Of 50 patients, 48 (96%) patients were able to gain good vision after 6 weeks. Conclusion: This study showed early visual rehabilitation with less surgically induced astigmatism following manual SICS by viscoexpression technique.


Assuntos
Astigmatismo , Extração de Catarata , Catarata , Facoemulsificação , Ferida Cirúrgica , Humanos , Adulto , Astigmatismo/etiologia , Implante de Lente Intraocular/métodos , Estudos Prospectivos , Complicações Pós-Operatórias/etiologia , Extração de Catarata/efeitos adversos , Facoemulsificação/métodos , Catarata/complicações , Ferida Cirúrgica/complicações , Cegueira/etiologia , Resultado do Tratamento
11.
J Alzheimers Dis ; 89(4): 1193-1202, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36093700

RESUMO

The progressive aging of the population will notably increase the burden of those diseases which leads to a disabling situation, such as Alzheimer's disease (AD) and ophthalmological diseases that cause a visual impairment (VI). Eye diseases that cause a VI raise neuroplastic processes in the parietal lobe. Meanwhile, the aforementioned lobe suffers a severe decline throughout AD. From this perspective, diving deeper into the particularities of the parietal lobe is of paramount importance. In this article, we discuss the functions of the parietal lobe, review the parietal anatomical and pathophysiological peculiarities in AD, and also describe some of the changes in the parietal region that occur after VI. Although the alterations in the hippocampus and the temporal lobe have been well documented in AD, the alterations of the parietal lobe have been less thoroughly explored. Recent neuroimaging studies have revealed that some metabolic and perfusion impairments along with a reduction of the white and grey matter could take place in the parietal lobe during AD. Conversely, it has been speculated that blinding ocular diseases induce a remodeling of the parietal region which is observable through the improvement of the integration of multimodal stimuli and in the increase of the volume of this cortical region. Based on current findings concerning the parietal lobe in both pathologies, we hypothesize that the increased activity of the parietal lobe in people with VI may diminish the neurodegeneration of this brain region in those who are visually impaired by oculardiseases.


Assuntos
Doença de Alzheimer , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/patologia , Cegueira/etiologia , Cegueira/patologia , Humanos , Imageamento por Ressonância Magnética , Lobo Parietal/diagnóstico por imagem , Lobo Parietal/patologia , Lobo Temporal/patologia
14.
Artigo em Inglês | MEDLINE | ID: mdl-36141761

RESUMO

Blindness and visual impairment are part of the global burden of eye disease, with cataract being one of the leading causes of blindness. This study aimed to determine the factors affecting visual acuity (VA) improvement among cataract patients after phacoemulsification surgery in Malaysia. Cataract patients aged over 18 who underwent phacoemulsification surgery between January 2014 and December 2018 were included in this retrospective cohort study. Patients' sociodemographic, comorbidities, surgical, and related complication factors were extracted from the National Eye Database. The outcome was measured by the difference in visual acuity before and after the operation and was categorized as "improved", "no change", and "worse". A total of 180,776 patients were included in the final analysis. Multinomial logistic regression analysis showed "no changes in VA" was significantly higher in patients aged less than 40 years old (OR: 1.66; 95% CI: 1.22, 2.26), patients with ocular comorbidities (OR: 1.65; 95% CI: 1.53, 1.77), patients who had undergone surgery lasting more than 60 min (OR: 1.39; 95% CI: 1.14, 1.69), patients who had surgery without an intraocular lens (IOL) (OR: 1.64; 95% CI: 1.20, 2.26), and patients with postoperative complications (OR: 8.76; 95% CI: 8.13, 9.45). Worsening VA was significantly higher among male patients (OR: 1.11; 95% CI: 1.01, 1.22), patients who had ocular comorbidities (OR: 1.76; 95% CI: 1.59, 1.96), patients who had undergone surgery lasting more than 60 min (OR: 1.94; 95% CI: 1.57, 2.41), patients who had surgery without an IOL (OR: 2.03; 95% CI: 1.48, 2.80), and patients with postoperative complications (OR: 21.46; 95% CI: 19.35, 23.80). The factors impacting "no changes" in and "worsening" of VA after cataract surgery were the following: older age, male gender, ethnicity, ocular comorbidities, surgeon grade, absence of IOL, intraoperative complication, and postoperative problems.


Assuntos
Catarata , Facoemulsificação , Adolescente , Adulto , Cegueira/etiologia , Catarata/epidemiologia , Catarata/etiologia , Humanos , Implante de Lente Intraocular/efeitos adversos , Masculino , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos
16.
Lancet Healthy Longev ; 3(1): e1, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36098281
17.
Niger J Clin Pract ; 25(8): 1211-1215, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35975365

RESUMO

Background: Visual impairment is a global problem. The World Health Organization (WHO) in 2017 estimated that 36 million people were blind and 217 million people had moderate or severe visual impairment. An untreated or undetected eye problem becomes a threat to the general health of the individual, particularly the health of those that lack the basic needs of life. Most blind people live in low-income countries where increasing poverty perpetuates destitution. Aim: This study aimed at determining the prevalence of visual impairment among the destitute in Onitsha metropolis, which would provide a solid database for designing an effective eye care delivery system for them in the state. Subjects and Methods: This was a cross-sectional study of 168 destitute individuals in Onitsha. The study was carried out between June and July 2011. Destitute clusters were randomly selected, and all of the eligible participants were interviewed. Presenting visual acuity (VA) at 6 m, refraction, and anterior and posterior segment evaluation were done. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 16. Results: One hundred sixty-eight destitute individuals-consisting of 93 males (55.4%) and 75 females (44.6%)-were studied, and the age range was 11-78 years with a median age of 45 years. One hundred twenty-nine participants (76.8%) did not have any formal education, all were unemployed, and none had any personal assets or property. Fifty-six participants (33.3%) had ocular disorder. The prevalence of blindness was 12.5% and that of visual impairment was 10.2%. The causes of blindness were glaucoma (6, 28.6%), cataract (5, 23.8%), corneal acuity (5, 23.8%), and empty socket from tumor nucleation and trauma (2, 9.5%). Conclusion: Ocular findings in all eyes of the destitute are similar to that in the eyes of normal individuals. Destitution is an offshoot of health, social, and economic frustration, and therefore requires a comprehensive approach.


Assuntos
Catarata , Baixa Visão , Adolescente , Adulto , Distribuição por Idade , Idoso , Cegueira/epidemiologia , Cegueira/etiologia , Catarata/complicações , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Transtornos da Visão/complicações , Transtornos da Visão/epidemiologia , Baixa Visão/epidemiologia , Baixa Visão/etiologia , Adulto Jovem
18.
Klin Monbl Augenheilkd ; 239(9): 1165-1179, 2022 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-35970191

RESUMO

Corneal blindness affects over 8 million adults and 1.5 million children worldwide, making it one of the top 5 causes of blindness. Depending on the recipient's corneal condition corneal transplantation may not be a viable treatment option. In such seemingly no-alternative situations, keratoprosthesis implantation can be an option in some patients. In terms of numbers, two types of keratoprostheses are currently used: 1. Keratoprostheses with biological haptics made of tooth or tibia bone. 2. The Boston type I-keratoprosthesis. Both types have optics made of PMMA. The most common complication is the formation of an optically disturbing retroprosthetic membrane behind the optic, which can usually be removed with YAG laser. Causes of blindness after keratoprosthesis implantation are glaucoma, endophthalmitis and retinal detachment. The extrusion rate of the Boston type I-keratoprosthesis seems to be higher than after keratoprosthesis implantation with biological haptic. Autoimmunological corneal diseases have increased extrusion rates and higher rates of endophthalmitis when compared to non-autoimmunological diseases. Visual outcomes after keratoprosthesis implantation are potentially very good and usually limited by extracorneal concomitant diseases. Advances in glaucoma diagnostic (OCT, implantation of intraocular pressure sensors), standard glaucoma prophylaxis by medication or surgery, modern retinal surgery and better treatment options in case of extrusion improve the prognosis of keratoprosthesis surgery. Still, the ideal technique for permanent anchoring of artifical optics in biological tissue has yet to be developed.


Assuntos
Órgãos Artificiais , Doenças da Córnea , Endoftalmite , Glaucoma , Adulto , Cegueira/etiologia , Cegueira/prevenção & controle , Cegueira/cirurgia , Criança , Córnea/cirurgia , Doenças da Córnea/diagnóstico , Doenças da Córnea/cirurgia , Endoftalmite/cirurgia , Glaucoma/diagnóstico , Glaucoma/cirurgia , Humanos , Complicações Pós-Operatórias/cirurgia , Próteses e Implantes , Implantação de Prótese/métodos , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual
19.
Nepal J Ophthalmol ; 14(27): 31-38, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35996901

RESUMO

INTRODUCTION: Retinitis Pigmentosa (RP) is a group of diffuse retinal degenerative diseases predominantly affecting the rod and cone photoreceptors. The prevalence of retinitis pigmentosa seen in literature is approximately 1:4000. Retinitis Pigmentosa is one of the the most common causes of blindness in the age group of 20 to 40 years. The objective of this study was to determine the profile of retinitis pigmentosa in Terai and Nepal-India border region considering patients seeking care at a Tertiary level Eye Hospital in the terai region (southern part) of Nepal. MATERIALS AND METHODS: A hospital-based, retrospective study was carried out at R. M. Kedia Eye Hospital. A total of 385 (83 males and 107 females from Nepal and 109 males and 86 females from India) diagnosed patients of Retinitis Pigmentosa were included in the study. Data was collected over a period of eleven years from 2008-2018. RESULTS: Out of 385 diagnosed Retinitis Pigmentosa patients, 192 (49.87%) were male and 193 (50.13%) were female with slightly female predominance. The prevalence of RP seen in our study was 0.03%. About 51% of the patients visited here were from India and nearby border areas/ villages which cover most of the rural areas of India. In this study it was found that 49.34% of the RP cases were from Nepal, of which 43.63% of cases were from Hindu community and 5.71% from Muslim community and about 50.66% cases of RP were from India, of which 37.67% from Hindu and 12.98% from Muslim community. The peak age of presentation of RP was at 30-39 years (29.09%), followed by 20-29 years (26.75%). The common marriage pattern of consanguinity was found in Muslim community in between the first cousins. In this study the hospital record did not show any evaluation for the syndromic disease in the hospital record, though RP is usually non syndromic and there are literatures where many syndromic forms have been identified. CONCLUSION: The prevalence of RP seen in the study was 0.03% (A total of 1101299 sample population of which 385 patients had RP). Since RP is an inherited disease and is one of the non-treatable causes of blindness which runs in the families, a role of counseling to reduce consanguineous marriages should be brought forward to reduce the disease process.


Assuntos
Doenças Retinianas , Retinite Pigmentosa , Adulto , Cegueira/epidemiologia , Cegueira/etiologia , Feminino , Hospitais , Humanos , Masculino , Nepal/epidemiologia , Prevalência , Retinite Pigmentosa/diagnóstico , Retinite Pigmentosa/epidemiologia , Estudos Retrospectivos , Adulto Jovem
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