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The New England Journal of Medicine May 2024
Topics: Female; Humans; Cornea; Corneal Diseases; Middle Aged; Cataract; Vision Disorders
PubMed: 38692294
DOI: 10.1056/NEJMicm2313156 -
Clinical Nutrition (Edinburgh, Scotland) Dec 2023Inflammation is involved in the pathogenesis of cataract, age-related macular degeneration (AMD), and possibly open-angle glaucoma (OAG). We assessed whether the...
BACKGROUND & AIMS
Inflammation is involved in the pathogenesis of cataract, age-related macular degeneration (AMD), and possibly open-angle glaucoma (OAG). We assessed whether the inflammatory potential of diet (quantified using the dietary inflammatory index; DII) affects the incidence of these common blinding age-related eye diseases. Serum inflammation markers were investigated as possible mediators.
METHODS
Participants aged >45 years were selected from the prospective, population-based Rotterdam Study. From 1991 onwards, every 4-5 years, participants underwent extensive eye examinations. At baseline, blood samples and dietary data (using food frequency questionnaires) were collected. The DII was adapted based on the data available. Of the 7436 participants free of eye diseases at baseline, 4036 developed incident eye diseases during follow-up (cataract = 2895, early-intermediate AMD = 891, late AMD = 81, OAG = 169).
RESULTS
The adapted DII (aDII) ranged from -4.26 (i.e., anti-inflammatory) to 4.53 (i.e., pro-inflammatory). A higher aDII was significantly associated with increased inflammation. A higher neutrophil-lymphocyte ratio (NLR) was associated with an increased risk of cataract and AMD. Additionally, complement component 3c (C3c) and systemic immune-inflammation index (SII) were associated with increased risks of cataract and late AMD, respectively. Every point increase in the aDII was associated with a 9% increased risk of cataract (Odds ratio [95% confidence interval]: 1.09 [1.04-1.14]). The NLR and C3c partly mediated this association. We also identified associations of the aDII with risk of AMD (early-intermediate AMD, OR [95% CI]: 1.11 [1.03-1.19]; late AMD, OR [95% CI]: 1.24 [1.02-1.53]). The NLR partly mediated these associations. The aDII was not associated with OAG.
CONCLUSIONS
A pro-inflammatory diet was associated with increased risks of cataract and AMD. Particularly the NLR, a marker of subclinical inflammation, appears to be implicated. These findings are relevant for patients with AMD and substantiate the current recommendations to strive for a healthy lifestyle to prevent blindness.
Topics: Humans; Prospective Studies; Glaucoma, Open-Angle; Diet; Cataract; Inflammation; Macular Degeneration; Biomarkers; Risk Factors; Incidence
PubMed: 37865012
DOI: 10.1016/j.clnu.2023.10.008 -
Journal of Visualized Experiments : JoVE Dec 2023Cataract surgery (CS) is an effective treatment for cataracts, a major cause of visual disability worldwide. However, CS leads to ocular inflammation, and in the long...
Cataract surgery (CS) is an effective treatment for cataracts, a major cause of visual disability worldwide. However, CS leads to ocular inflammation, and in the long term, it can result in posterior capsular opacification (PCO) and/or lens dislocation driven by the post-surgical overgrowth of lens epithelial cells (LECs) and their conversion to myofibroblasts and/or aberrant fiber cells. However, the molecular mechanisms by which CS results in inflammation and PCO are still obscure because most in vitro models do not recapitulate the wound healing response of LECs seen in vivo, while traditional animal models of cataract surgery, such as rabbits, do not allow the genetic manipulation of gene expression to test mechanisms. Recently, our laboratory and others have successfully used genetically modified mice to study the molecular mechanisms that drive the induction of proinflammatory signaling and LEC epithelial to mesenchymal transition, leading to new insight into PCO pathogenesis. Here, we report the established protocol for modeling cataract surgery in mice, which allows for robust transcriptional profiling of the response of LECs to lens fiber cell removal via RNAseq, the evaluation of protein expression by semi-quantitative immunofluorescence, and the use of modern mouse genetics tools to test the function of genes that are hypothesized to participate in the pathogenesis of acute sequelae like inflammation as well as the later conversion of LECs to myofibroblasts and/or aberrant lens fiber cells.
Topics: Animals; Mice; Rabbits; Epithelial-Mesenchymal Transition; Lens, Crystalline; Cataract Extraction; Cataract; Inflammation
PubMed: 38108456
DOI: 10.3791/66050 -
Nutrients Oct 2023Cataract, defined as the opacification of the lens that prevents clear vision, is a leading cause of vision loss and impairment worldwide. Elderly people comprise the... (Review)
Review
Cataract, defined as the opacification of the lens that prevents clear vision, is a leading cause of vision loss and impairment worldwide. Elderly people comprise the highest proportion of those suffering from this eye disease. According to the National Institute of Health (NIH), the risk of developing aged-related cataract (ARC) increases with every decade of life, starting from the age of 40. Despite progress in surgical treatment methods, life-style modifications may be beneficial in prevention or slowing down the progression of ARC. This systematic review aims to summarize studies on the significance of specific nutritional patterns, dietary products, vitamins, minerals, and carotenoids intake in the onset or progression of ARC. In this context, the presented paper thoroughly analyzes 24 articles, following the PRISMA guidelines. The results indicate significant protective effects of various dietary patterns, including the Korean balanced diet, vegetarian diet, "dairy products and vegetables", "traditional", "antioxidant", and "omega-3" patterns. Additionally, the consumption of fruits, vegetables, legumes, nuts, skimmed yoghurt, fish, coffee, and vitamins has shown positive effects on cataract incidence. Therefore, further research seems to be essential to gain a better understanding of these associations and to create uniform dietary recommendations for both the vulnerable population and ARC patients.
Topics: Aged; Animals; Humans; Vitamins; Diet; Cataract; Antioxidants; Vitamin A; Vegetables; Vitamin K
PubMed: 37960238
DOI: 10.3390/nu15214585 -
Nutrients Jul 2023Age is the biggest risk factor for cataracts, and aberrant oxidative modifications are correlated with age-related cataracts, suggesting that proper redox regulation is... (Review)
Review
Age is the biggest risk factor for cataracts, and aberrant oxidative modifications are correlated with age-related cataracts, suggesting that proper redox regulation is important for lens clarity. The lens has very high levels of antioxidants, including ascorbate and glutathione that aid in keeping the lens clear, at least in young animals and humans. We summarize current functional and genetic data supporting the hypothesis that impaired regulation of oxidative stress leads to redox dysregulation and cataract. We will focus on the essential endogenous antioxidant glutathione and the exogenous antioxidant vitamin C/ascorbate. Additionally, gene expression in response to oxidative stress is regulated in part by the transcription factor NRF2 (nuclear factor erythroid 2-related factor 2 [NFE2L2]), thus we will summarize our data regarding cataracts in mice. In this work, we discuss the function and integration of these capacities with the objective of maintaining lens clarity.
Topics: Humans; Animals; Mice; NF-E2-Related Factor 2; Ascorbic Acid; Reactive Oxygen Species; Oxidative Stress; Antioxidants; Glutathione; Oxidation-Reduction; Signal Transduction; Cataract; Vitamins
PubMed: 37571310
DOI: 10.3390/nu15153375 -
International Ophthalmology Clinics Oct 2023
Topics: Humans; Cataract Extraction; Glaucoma; Cataract; Intraocular Pressure
PubMed: 37755448
DOI: 10.1097/IIO.0000000000000481 -
American Journal of Ophthalmology Oct 2023
Topics: Humans; Cataract; Adrenal Cortex Hormones
PubMed: 37393973
DOI: 10.1016/j.ajo.2023.06.022 -
Journal of Binocular Vision and Ocular... Oct 2023Childhood cataract is a complex condition requiring longitudinal care, including early diagnosis, timely referral to a specialist, early surgical intervention, and... (Review)
Review
Childhood cataract is a complex condition requiring longitudinal care, including early diagnosis, timely referral to a specialist, early surgical intervention, and dedicated postoperative care. Adherence to refractive correction and amblyopia therapy are critical for visual rehabilitation, even months to years after the cataract is removed. We review the impact of the social determinants of health on each step in the visual rehabilitation pathway for children with congenital and infantile cataracts. Children from socioeconomically marginalized backgrounds are more likely to experience delays in access to care and utilization of surgical services. They are also less likely to adhere to amblyopia therapy, with corresponding decrements in visual outcomes. Additional sociocultural factors, including parental stress, self-efficacy, and health literacy, pose barriers for these children. Standardizing clinical roles, improving health communication, managing parental stress, and implementing systemic policy changes may alleviate socioeconomic disparities in outcomes for children with cataracts.
Topics: Child; Humans; United States; Cataract Extraction; Amblyopia; Lens Implantation, Intraocular; Cataract; Visual Acuity
PubMed: 37931121
DOI: No ID Found -
Clinical & Experimental Optometry Sep 2023With the increasing use of technology and an emerging need for virtual clinical reviews, particularly following the recent pandemic, it is essential to evaluate the...
CLINICAL RELEVANCE
With the increasing use of technology and an emerging need for virtual clinical reviews, particularly following the recent pandemic, it is essential to evaluate the safety of these clinical tools.
BACKGROUND
This retrospective study aims to determine the safety of virtual follow-up day one after cataract surgery.
METHODS
All patients who underwent cataract surgery at Auckland District Health Board, New Zealand (Aotearoa), and were triaged for telephone review the day after surgery, from 5 November 2018 to 31 January 2020, were eligible. Outcomes measured: presentations to the acute eye clinic prior to the post-operative visit (number and reasons) and complications at the one-month follow-up (persistent inflammation, cystoid macular oedema, raised intra-ocular pressure).
RESULTS
Nine hundred and eighty-seven cataract surgeries were triaged for virtual follow-up over the retrospective study period. Nine hundred and eighty-five cases in 928 patients met the inclusion criteria. The median duration of phone calls was 5 minutes (range 2-30). Prior to the one-month post-operative visit, there were 66 presentations to the acute eye clinic, most commonly due to ocular surface irritation (33.3%) and persisting inflammation (25.8%). At the one-month post-operative review, 110 cases (11.2%) had complications; 62 (6.3%) had persisting inflammation, 46 (4.7%) had cystoid macular oedema, and two (0.2%) had raised intraocular pressure.
CONCLUSIONS
This is the largest study of a virtual day one post-operative follow-up following cataract surgery, and demonstrates that, in carefully selected subjects, virtual follow-up is a safe alternative to a clinic review. This method could significantly reduce healthcare costs and serve to be more efficient and favourable for patients and clinicians.
Topics: Humans; Phacoemulsification; Follow-Up Studies; Macular Edema; Retrospective Studies; Cataract Extraction; Cataract; Inflammation; Telephone
PubMed: 36464321
DOI: 10.1080/08164622.2022.2146482 -
Redox Biology Oct 2023The lens proteome undergoes dramatic composition changes during development and maturation. A defective developmental process leads to congenital cataracts that account...
The lens proteome undergoes dramatic composition changes during development and maturation. A defective developmental process leads to congenital cataracts that account for about 30% of cases of childhood blindness. Gene mutations are associated with approximately 50% of early-onset forms of lens opacity, with the remainder being of unknown etiology. To gain a better understanding of cataractogenesis, we utilized a transgenic mouse model expressing a mutant ubiquitin protein in the lens (K6W-Ub) that recapitulates most of the early pathological changes seen in human congenital cataracts. We performed mass spectrometry-based tandem-mass-tag quantitative proteomics in E15, P1, and P30 control or K6W-Ub lenses. Our analysis identified targets that are required for early normal differentiation steps and altered in cataractous lenses, particularly metabolic pathways involving glutathione and amino acids. Computational molecular phenotyping revealed that glutathione and taurine were spatially altered in the K6W-Ub cataractous lens. High-performance liquid chromatography revealed that both taurine and the ratio of reduced glutathione to oxidized glutathione, two indicators of redox status, were differentially compromised in lens biology. In sum, our research documents that dynamic proteome changes in a mouse model of congenital cataracts impact redox biology in lens. Our findings shed light on the molecular mechanisms associated with congenital cataracts and point out that unbalanced redox status due to reduced levels of taurine and glutathione, metabolites already linked to age-related cataract, could be a major underlying mechanism behind lens opacities that appear early in life.
Topics: Humans; Animals; Mice; Proteome; Glutathione; Disease Models, Animal; Mice, Transgenic; Mutant Proteins; Oxidation-Reduction; Taurine; Cataract
PubMed: 37677999
DOI: 10.1016/j.redox.2023.102869