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Advances in Ophthalmology Practice and... Nov 2021To evaluate the feature of different retinal layer segmentation in neuromyelitis optica spectrum disorders (NMOSD) with spectral-domain optical coherence tomography... (Review)
Review
BACKGROUND
To evaluate the feature of different retinal layer segmentation in neuromyelitis optica spectrum disorders (NMOSD) with spectral-domain optical coherence tomography (SD-OCT) and to compare it with that in multiple sclerosis (MS), healthy controls (HC), and idiopathic optic neuritis (ION).
METHODS
We retrieved four electronic databases, including Pubmed, Embase, Cochrane Library, and Web of Science from inception to September 1st, 2021. A meta-analysis was performed to compare different retinal layer segmentation thicknesses between patients with or without a history of optic neuritis (ON) in NMOSD and the control group, including patients with MS, HC, and ION.
RESULTS
Forty-two studies were included and the interval between the last ON onset and examination was greater than 3 months. Compared with that in HC eyes, the loss of retinal nerve fiber layer (RNFL) and macular ganglion cell and inner plexiform layer (GC-IPL) was serious in NMOSD eye especially after ON. Moreover, compared with that in ION eyes or MS-related-ON eyes, the injury to the peripapillary retinal nerve fiber layer (pRNFL) was severe in NMOSD-related-ON eyes. In addition, the correlation coefficient between pRNFL and prognostic visual acuity was 0.43. However, the one-arm study revealed the inner nuclear layer (INL) was thickened in NMOSD-related-ON eyes compared with HC eyes.
CONCLUSIONS
Inclusion of the RNFL and macular GC-IPL is recommended for monitoring disease progression and attention should be paid to changes in the INL.
PubMed: 37846392
DOI: 10.1016/j.aopr.2021.100007 -
Survey of Ophthalmology 2022Studies reporting alteration in retinal thickness using optical coherence tomography (OCT) have been performed in different populations with various degrees of... (Meta-Analysis)
Meta-Analysis Review
Studies reporting alteration in retinal thickness using optical coherence tomography (OCT) have been performed in different populations with various degrees of refractive error, producing inconsistent results. Therefore, we performed a meta-analysis to evaluate the alterations in retinal OCT measurements in myopic and hyperopic patients compared to controls. Evaluation of different retinal layers' thickness may have significance for developing novel approaches for preventing, diagnosing, and treating refractive errors and their complications. We searched PubMed and EMBASE to identify articles that reported OCT measurements of different retinal layers and regions, including macular, foveal, parafoveal, perifoveal, foveolar, ganglion cell complex (GCC), retinal nerve fiber layer (RNFL), peripapillary retinal nerve fiber layer (pRNFL), and ganglion cell and inner plexiform layer (GC-IPL) thickness in addition to macular volume, and optic disc area in myopes and hyperopes comparing their differences with controls. We applied either a fixed-effects or random-effects model for the meta-analysis of these differences based on the assessed heterogeneity level. Furthermore, subgroup analyses and metaregression, as well as publication bias and quality assessment, were conducted for the eligible studies. Forty-seven studies with a total of 12223 eyes, including 8600 cases and 3623 non-cases, are included in this meta-analysis. Our results showed that, in comparison to controls, highly myopic eyes had a significantly lower value for mean macular thickness, macular GCC, macular GC-IPL, parafoveal, perifoveal, foveal, foveolar, RNFL, and pRNFL thickness. Compared to controls, moderately myopic eyes showed a significantly thinner mean macular GCC layer and pRNFL. On the other hand, hyperopic eyes had significantly thicker average pRNFL than controls. Several other significant differences were also observed in various regional analyses. The findings of the current study affirm the retinal OCT measurement differences between myopic and hyperopic eyes compared to controls, emphasizing OCT measurements' advantages as potential biomarkers of ocular pathologies.
Topics: Humans; Nerve Fibers; Optic Disk; Refractive Errors; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 34343537
DOI: 10.1016/j.survophthal.2021.07.007 -
Frontiers in Medicine 2021This study aimed to assess the differences in the average and sectoral peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell plus inner plexiform layer...
Optical Coherence Tomography Evaluation of Peripapillary and Macular Structure Changes in Pre-perimetric Glaucoma, Early Perimetric Glaucoma, and Ocular Hypertension: A Systematic Review and Meta-Analysis.
This study aimed to assess the differences in the average and sectoral peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell plus inner plexiform layer (mGCIPL), and macular ganglion cell complex (mGCC) thickness using optical coherence tomography (OCT) in patients with pre-perimetric glaucoma (PPG) compared to those with early perimetric glaucoma (EG) and ocular hypertension (OHT). A comprehensive literature search of the PubMed database, the Cochrane Library, and Embase was performed from inception to March 2021. The weighted mean difference (WMD) with the 95% confidence interval (CI) was pooled for continuous outcomes. Twenty-three cross-sectional studies comprising 2,574 eyes (1,101 PPG eyes, 1,233 EG eyes, and 240 OHT eyes) were included in the systematic review and meta-analysis. The pooled results demonstrated that the average pRNFL (WMD = 8.22, 95% CI = 6.32-10.12, < 0.00001), mGCIPL (WMD = 4.83, 95% CI = 3.43-6.23, < 0.00001), and mGCC (WMD = 7.19, 95% CI = 4.52-9.85, < 0.00001) were significantly thinner in patients with EG than in those with PPG. The sectoral thickness of pRNFL, mGCIPL, and mGCC were also significantly lower in the EG eyes. In addition, the average pRNFL and mGCC were significantly thinner in the PPG eyes than those in the OHT eyes (pRNFL: WMD = -8.57, 95% CI = -9.88 to -7.27, < 0.00001; mGCC: WMD = -3.23, 95% CI = -6.03 to -0.44, = 0.02). Similarly, the sectoral pRNFL and mGCC were also significantly thinner in the PPG eyes than those in the OHT eyes. OCT-based measurements of peripapillary and macular structural alterations can be used to distinguish PPG from EG and OHT, which can help understand the pathophysiology of glaucoma at earlier stages. Studies that employ clock hour classification methods and longitudinal studies are needed to verify our findings. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=239798 CRD42021239798.
PubMed: 34277670
DOI: 10.3389/fmed.2021.696004 -
Nutrients Jun 2021Primary open-angle glaucoma (POAG) remains a leading cause of irreversible blindness globally. Recent evidence further substantiates sustained oxidative stress, and...
Primary open-angle glaucoma (POAG) remains a leading cause of irreversible blindness globally. Recent evidence further substantiates sustained oxidative stress, and compromised antioxidant defenses are key drivers in the onset of glaucomatous neurodegeneration. Overwhelming oxidative injury is likely attributed to compounding mitochondrial dysfunction that worsens with age-related processes, causing aberrant formation of free radical species. Thus, a compromised systemic antioxidant capacity exacerbates further oxidative insult in glaucoma, leading to apoptosis, neuroinflammation, and subsequent tissue injury. The purpose of this systematic review is to investigate the neuroprotective benefits of the macular carotenoids lutein, zeaxanthin, and -zeaxanthin on glaucomatous neurodegeneration for the purpose of adjunctive nutraceutical treatment in glaucoma. A comprehensive literature search was conducted in three databases (PubMed, Cochrane Library, and Web of Science) and 20 records were identified for screening. Lutein demonstrated enhanced neuroprotection on retinal ganglion cell survival and preserved synaptic activity. In clinical studies, a protective trend was seen with greater dietary consumption of carotenoids and risk of glaucoma, while greater carotenoid levels in macular pigment were largely associated with improved visual performance in glaucomatous eyes. The data suggest that carotenoid vitamin therapy exerts synergic neuroprotective benefits and has the capacity to serve adjunctive therapy in the management of glaucoma.
Topics: Antioxidants; Carotenoids; Dietary Supplements; Glaucoma, Open-Angle; Humans; Lutein; Macular Pigment; Oxidative Stress; Visual Acuity; Zeaxanthins
PubMed: 34204051
DOI: 10.3390/nu13061949 -
Chronobiology International Oct 2021Blue-blocking glasses, also known as amber glasses, are plastic glasses that primarily block blue light. Blue-blocking glasses have been studied as a sleep intervention...
Blue-blocking glasses, also known as amber glasses, are plastic glasses that primarily block blue light. Blue-blocking glasses have been studied as a sleep intervention for insomnia, delayed sleep-phase disorder, shift work, jet lag, and nonpathologic sleep improvement. Blue-blocking glasses have also been studied as a treatment for bipolar disorder, major depression, and postpartum depression. Blue-blocking glasses improve sleep by inducing dim-light melatonin onset by reducing activation of intrinsically photosensitive retinal ganglion cells (ipRGCs) which are most sensitive to blue light and are a major input for circadian regulation; their mechanism for mood regulation is unclear but may be similar to that of dark therapy for bipolar disorder where patients are kept in darkness for an extended period every night. A systematic search of the scientific literature identified a total of 29 experimental publications involving evening wear of blue-blocking glasses for sleep or mood disorders. These consisted of 16 randomized controlled trials (RCTs) published in journals with a total of 453 patients, 5 uncontrolled trials, 1 case series, 1 case study, and 6 abstracts from conference proceedings. Only 1 case study and 1 RCT were for acutely manic patients but both found substantial decreases in manic symptoms with the use of blue-blocking glasses; these give preliminary clinical evidence of efficacy that makes blue-blocking glasses a high-yield intervention to study for bipolar disorder. Findings in the 3 publications for major depression and postpartum depression were heterogeneous and conflicting as to their efficacy. Out of the 24 publications focusing on sleep, there was substantial evidence for blue-blocking glasses being a successful intervention for reducing sleep onset latency in patients with sleep disorders, jet lag, or variable shift work schedules. Given the well-established biological mechanism and clinical research showing that blue-blocking glasses are effective for inducing sleep, they are a viable intervention to recommend to patients with insomnia or a delayed sleep phase.
Topics: Bipolar Disorder; Circadian Rhythm; Depressive Disorder, Major; Eyeglasses; Female; Humans; Light; Melatonin; Sleep
PubMed: 34030534
DOI: 10.1080/07420528.2021.1930029 -
International Ophthalmology Sep 2021Retinal nerve fiber/ganglion cell layer (RNFL/GCL) thickness measured using optical coherence tomography has been proposed as an ocular biomarker for children with... (Meta-Analysis)
Meta-Analysis Review
The association between attention-deficit/hyperactivity disorder and retinal nerve fiber/ganglion cell layer thickness measured by optical coherence tomography: a systematic review and meta-analysis.
PURPOSE
Retinal nerve fiber/ganglion cell layer (RNFL/GCL) thickness measured using optical coherence tomography has been proposed as an ocular biomarker for children with attention-deficit/hyperactivity disorder (ADHD), but findings varied in different studies. This study aims to determine the association between RNFL/GCL thickness and ADHD in children by systematic review and meta-analysis.
METHODS
We performed a literature search in Embase, PubMed, Medline, Web of Science, and PsycINFO for relevant articles published up to February 29, 2020. All studies with original data comparing RNFL/GCL thickness in ADHD and healthy children were included. The Newcastle Ottawa Scale was used to assess bias risk and quality of evidence. Pooled estimates of the differences in thickness of RNFL or GCL between ADHD and healthy subjects were generated using meta-analysis with a random-effect model due to significant inter-study heterogeneity. Sensitivity analysis was also performed.
RESULTS
We identified four eligible studies involving a total of 164 ADHD and 150 control subjects. Meta-analysis revealed that ADHD in children was associated with a reduction in global RNFL thickness (SMD, - 0.23; 95% CI - 0.46, - 0.01; p = 0.04). The global GCL thickness was examined in two studies with 89 ADHD and 75 control subjects, but the pooled difference in global GCL thickness between ADHD children and controls was not statistically significant (SMD, - 0.34; 95% CI - 1.25, 0.58; p = 0.47).
CONCLUSION
Existing evidence suggests a possible association between ADHD and RNFL thinning in children. In view of the limited number of reports, further studies in large cohorts should be warranted.
Topics: Attention Deficit Disorder with Hyperactivity; Humans; Nerve Fibers; Retina; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 34014463
DOI: 10.1007/s10792-021-01852-8 -
Penetration Enhancers for Topical Drug Delivery to the Ocular Posterior Segment-A Systematic Review.Pharmaceutics Feb 2021There is an unmet clinical need for eye drop formulations to efficiently treat the diseases of the posterior ocular segment by non-invasive topical administration. Here,... (Review)
Review
There is an unmet clinical need for eye drop formulations to efficiently treat the diseases of the posterior ocular segment by non-invasive topical administration. Here, we systematically reviewed the literature on ocular penetration enhancers and their ability to transfer drugs to the posterior segment of the eye in experimental studies. Our aim was to assess which penetration enhancer is the most efficient at delivering drugs to the posterior segment of the eye, when topically applied. We conducted a comprehensive search in three electronic databases (Ovid Embase, Ovid MEDLINE, and PubMed) to identify all the relevant manuscripts reported on ocular penetration enhancers based on the PRISMA guidelines. We identified 6540 records from our primary database search and filtered them per our inclusion/exclusion criteria to select a final list of 14 articles for qualitative synthesis. Of these, 11 studies used cell penetrating peptides (CPPs), 2 used chitosan, and 1 used benzalkonium chloride (BAC) as the penetration enhancer. Cationic and amphipathic CPPs, transactivator of transcription (TAT), and penetratin can be inferred to be the best among all the identified penetration enhancers for drug delivery to the fundus oculi via topical eye drop instillation. Further high-quality experimental studies are required to ascertain their quantitative efficacy.
PubMed: 33670762
DOI: 10.3390/pharmaceutics13020276 -
Neurological Sciences : Official... Mar 2021Migraine is one of the most common disabling diseases in the world. Its recurrent attacks may lead to abnormalities in the structure of the brain and retina. An... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Migraine is one of the most common disabling diseases in the world. Its recurrent attacks may lead to abnormalities in the structure of the brain and retina. An increasing number of studies have investigated retinal nerve fiber layer (RNFL) thickness alterations in migraine by the optical coherence tomography (OCT); however, no consensus has yet reached.
METHOD
We searched Pubmed, Embase, and Web of Science databases to identify studies that investigated RNFL thickness in migraine by OCT measurement and performed a meta-analysis of eligible studies.
RESULTS
Twenty-six studies were included in the meta-analysis, comprising 1530 migraine patients and 1105 healthy controls. The mean RNFL thickness was thinner in the migraine group compared to the control group (SMD =- 0.53). In the subgroup analyses, RNFL thickness were decreased most significantly in the superior (SMD = - 0.71) and inferior (SMD = - 0.63) quadrants among all quadrants. Migraine with aura (SMD = - 0.91) showed a greater effect size of RNFL thickness reduction than migraine without aura (SMD =- 0.47). Spectral-domain OCT (SMD = - 0.55) seems more sensitive to detect RNFL thickness reduction than time-domain OCT (SMD = - 0.44). In addition, age, sex, disease duration, attack frequency, and intraocular pressure were not significantly associated with RNFL thickness.
CONCLUSIONS
The findings from our comprehensive meta-analysis with large datasets strengthen the clinical evidence of the RNFL thickness reduction in migraine. RNFL thickness via spectral-domain OCT measurement demonstrates the potential role in differentiating patients with migraine, especially migraine with aura, from healthy controls.
Topics: Humans; Migraine Disorders; Nerve Fibers; Retina; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 33439389
DOI: 10.1007/s10072-020-04992-4 -
Current Eye Research Aug 2021The optical coherence tomography (OCT) has been used to evaluate the changes of retinal degeneration in patients with diabetic peripheral neuropathy (DPN) in recent... (Meta-Analysis)
Meta-Analysis
PURPOSE
The optical coherence tomography (OCT) has been used to evaluate the changes of retinal degeneration in patients with diabetic peripheral neuropathy (DPN) in recent years, but the results of previous studies were controversial. Therefore, systematic review and meta-analysis were performed to evaluate the degree of retinal neurodegeneration in DPN measured by OCT.
METHODS
A comprehensive search of PubMed, Embase, Web of Science, Scopus, China Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI), VIP, and Wanfang databases were performed to identify studies that evaluate retinal neurodegeneration in DPN by using OCT. The included studies were critically reviewed and meta-analyses were performed to evaluate differences of the OCT-derived parameters between the DPN and non-DPN patients.
RESULTS
Twelve studies were included in the final meta-analysis, involving a total of 1,807 eyes (573 in the DPN group and 1,229 in the non-DPN group). The mean peripapillary retinal nerve fiber layer (pRNFL) thickness was significantly lower in the DPN group than in the non-DPN group (weighted mean difference [WMD] = -8.37 μm; 95% CI: -11.00, -5.74). The reduction of pRNFL thickness was the most pronounced in the inferior quadrant, and the differences in the nasal and temporal quadrants were also statistically significant, with WMD (95% CI) being -4.63 μm (-7.51, -1.76) and -3.92 μm (-6.86, -0.98), respectively. Similar results were observed for macular parameters, with WMD and 95% CI being -1.0 μm (-1.5, -0.5) for macular retinal nerve fiber layer (mRNFL), -2.7 μm (-10.7, -5.3) for macular ganglion cell-inner plexiform layer (mGCIPL), and -2.2 μm (-4.4, -0.04) for macular ganglion cell complex (mGCC), respectively.
CONCLUSIONS
Patients with DPN present with significant retinal neurodegeneration, with reduced pRNFL, mRNFL, mGCIPL, and mGCC thickness. Measurements of OCT parameters may serve as a biomarker for diagnosing and monitoring DPN.
Topics: Diabetic Neuropathies; Humans; Nerve Fibers; Retinal Degeneration; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 33428500
DOI: 10.1080/02713683.2021.1874025 -
Frontiers in Neurology 2020The use of optical coherence tomography (OCT) of the retina to detect inner retinal degeneration is being investigated as a potential biomarker for mild cognitive...
The use of optical coherence tomography (OCT) of the retina to detect inner retinal degeneration is being investigated as a potential biomarker for mild cognitive impairment (MCI) and Alzheimer's disease (AD), and an overwhelming body of evidence indicates that discovery of disease-modifying treatments for AD should be aimed at the pre-dementia clinical stage of AD, i.e., MCI. We aimed to perform a systematic review and meta-analysis on retinal OCT in MCI. We performed a systematic review of the English literature in three databases (PubMed, Embase, and Latindex) for studies that measured retinal thickness using OCT in people with MCI and healthy controls, age 50 or older, between 1 January 2000 and 31 July 2019. Only cohort and case-control studies were reviewed, and independent extraction of quality data and established objective data was performed. We calculated the effect size for studies in the review that met the following criteria: (1) a statistically significant difference between MCI subjects and normal controls for several OCT variables, (2) use of spectral domain OCT, and (3) use of APOSTEL recommendations for OCT reporting. Weighted Hedges' g statistic was used to calculate the pooled effect size for four variables: ( in micrometers (μm), in μm, in μm, and in μm. For variables with high heterogeneity, a multivariate meta-regression was performed. We followed the PRISMA guidelines for systematic reviews. Fifteen articles met the inclusion criteria. A total of 58.9% of MCI patients had statistically significant thinning of the pRNFL compared with normal subjects, while 61.6% of all MCI patients who had macular volume measured had a statistically significant reduction in volume compared with controls, and 50.0% of the macular GCL-IPL complexes measured demonstrated significant thinning in MCI compared with normal controls. Meta-analysis demonstrated a large effect size for decreased macular thickness in MCI subjects compared with normal controls, but there was a substantial heterogeneity for macular thickness results. The other variables did not demonstrate a significant difference and also had substantial heterogeneity. Meta-regression analysis did not reveal an explanation for the heterogeneity. A better understanding of the cause of retina degeneration and longitudinal, standardized studies are needed to determine if optical coherence tomography can be used as a biomarker for mild cognitive impairment due to Alzheimer's disease.
PubMed: 33178120
DOI: 10.3389/fneur.2020.578698