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International Journal of Molecular... Apr 2024Age-related macular degeneration (AMD) is an age-related disorder that is a global public health problem. The non-enzymatic Maillard reaction results in the formation of...
Age-related macular degeneration (AMD) is an age-related disorder that is a global public health problem. The non-enzymatic Maillard reaction results in the formation of advanced glycation end products (AGEs). Accumulation of AGEs in drusen plays a key role in AMD. AGE-reducing drugs may contribute to the prevention and treatment of AGE-related disease. Fructosamine oxidase (FAOD) acts on fructosyl lysine and fructosyl valine. Based upon the published results of fructosamine 3-kinase (FN3K) and FAOD obtained in cataract and presbyopia, we studied ex vivo FAOD treatment as a non-invasive AMD therapy. On glycolaldehyde-treated porcine retinas, FAOD significantly reduced AGE autofluorescence ( = 0.001). FAOD treatment results in a breakdown of AGEs, as evidenced using UV fluorescence, near-infrared microspectroscopy on stained tissue sections of human retina, and gel permeation chromatography. Drusen are accumulations of AGEs that build up between Bruch's membrane and the retinal pigment epithelium. On microscopy slides of human retina affected by AMD, a significant reduction in drusen surface to 45 ± 21% was observed following FAOD treatment. Enzymatic digestion followed by mass spectrometry of fructose- and glucose-based AGEs (produced in vitro) revealed a broader spectrum of substrates for FAOD, as compared to FN3K, including the following: fructosyllysine, carboxymethyllysine, carboxyethyllysine, and imidazolone. In contrast to FN3K digestion, agmatine (4-aminobutyl-guanidine) was formed following FAOD treatment in vitro. The present study highlights the therapeutic potential of FAOD in AMD by repairing glycation-induced damage.
Topics: Macular Degeneration; Humans; Glycation End Products, Advanced; Animals; Swine; Retina; Amino Acid Oxidoreductases
PubMed: 38732004
DOI: 10.3390/ijms25094779 -
Ophthalmology and Therapy Jun 2024The phase 3, randomized, vehicle-controlled, 14-day VIRGO study evaluated the efficacy and safety of twice-daily dosing of pilocarpine hydrochloride ophthalmic solution...
INTRODUCTION
The phase 3, randomized, vehicle-controlled, 14-day VIRGO study evaluated the efficacy and safety of twice-daily dosing of pilocarpine hydrochloride ophthalmic solution 1.25% (Pilo) in presbyopia. On VIRGO exit, a companion study was conducted to assess the patient experience with presbyopia and satisfaction with Pilo.
METHODS
Recruited individuals completed the Presbyopia Patient Satisfaction Questionnaire (PPSQ) plus a three-part exit survey, or a live interview. The PPSQ evaluated respondents' experience with Pilo. Survey parts 1 and 2 evaluated experience managing presbyopia before and during VIRGO, respectively; part 3 assessed future possibilities of using Pilo in real-world situations. The interview further informed the interviewees' experience with presbyopia and Pilo. The primary endpoint was responders (%) in each rating category of the PPSQ items 1-7; the secondary endpoints were summary of categorical (survey) and qualitative (interviews) responses.
RESULTS
The PPSQ and survey included 62 participants who received Pilo (N = 28) or vehicle (N = 34) in VIRGO; the interview included ten participants (Pilo, N = 4; vehicle, N = 6). Per the PPSQ, 64.3% of Pilo users reported vision improvement, including 17.9% with complete improvement; ≥ 46.4% were satisfied/very satisfied with their ability to perform daily activities, see up close unaided, and read in dim light. Among vehicle users, these percentages were 35.3%, 0%, and ≤ 23.5%, respectively. In both subgroups, ≥ 67.9% were interested in using Pilo or Pilo and eyeglasses/contact lenses in the future. Per the interview, vehicle users (n = 6/6) found the eyedrop easy to use but none experienced meaningful near-vision improvements, stopped using other correction method(s) part of the day, were satisfied with the eyedrop, preferred it over their previous correction method(s), or would continue using it if prescribed. Conversely, 75% (n = 3/4) of Pilo users responded positively to each of these six criteria.
CONCLUSIONS
Findings validate the VIRGO results and improve our understanding of the patient experience, demonstrating improved vision and satisfaction with Pilo (vs. vehicle) when performing daily activities.
PubMed: 38662193
DOI: 10.1007/s40123-024-00935-w -
Taiwan Journal of Ophthalmology 2024Lamellar surgeries with SMILE lenticules are an evolving field of refractive surgery. This chapter intends to discuss the reported clinical results of using SMILE...
PURPOSE
Lamellar surgeries with SMILE lenticules are an evolving field of refractive surgery. This chapter intends to discuss the reported clinical results of using SMILE derived lenticules in terms of feasibility, safety and predictability; or the potential management of hyperopia, keratoconus, SMILE ectasia and presbyopia.
MATERIALS AND METHODS
Donor SMILE lenticules were prepared under microscope tocreate doughnut shaped lenticules. For hyperopia, this tissue was then inserted into afemtosecond laser enabled pocket created using VisuMax FS Laser at a depth of 160µm. For ectasia induced by keratoconus and post refractive procedure (SMILE), 0.23% riboflavin dye was instilled into the interface and then lenticule was inserted followed by exposure to UV-A radiation with total energy of 6.3 J.
RESULTS
Spherical equivalent (S.E.) of within ± 0.5 D was observed in 50% (n=21) eyes and within 1 D was seen in 71% eyes treated for hyperopia. A significant increase in the K mean anterior, central corneal thickness, Q-value and corneal aberrations was seen 2 weeks post-op. Clinical improvement in terms of S.E. and uncorrected distance visual acuity in eyes treated for ectasia after keratoconus and post refractive procedure (SMILE) was seen.
CONCLUSION
With the ample availability of SMILE- derived lenticules, researchers are exploring the possibility of using this tissue for the treatment of various refractive and corneal conditions.
PubMed: 38654992
DOI: 10.4103/tjo.TJO-D-23-00171 -
Indian Journal of Ophthalmology May 2024
Topics: Humans; Drug Labeling; Presbyopia; Ophthalmic Solutions
PubMed: 38648444
DOI: 10.4103/IJO.IJO_1476_23 -
Turkish Journal of Ophthalmology Apr 2024To evaluate the clinical results of a new trifocal intraocular lens (IOL) with sinusoidal design by comparing with a traditional trifocal IOL. (Comparative Study)
Comparative Study
OBJECTIVES
To evaluate the clinical results of a new trifocal intraocular lens (IOL) with sinusoidal design by comparing with a traditional trifocal IOL.
MATERIALS AND METHODS
A total of 79 patients undergoing uneventful microincisional cataract surgery with bilateral implantation of one of two types of trifocal IOLs, the Acriva Trinova IOL (VSY) or Acrysof IQ PanOptix IOL (Alcon), were enrolled in this prospective study. Visual and refractive outcomes, contrast sensitivity (CS), and defocus curve were assessed at 3 months after surgery. Patient satisfaction and incidence of photic phenomena were also evaluated.
RESULTS
The number of patients/eyes were 48/96 in the Trinova group and 31/62 in the PanOptix group. There were no significant differences between the groups for monocular and binocular corrected/uncorrected distance or intermediate (at 60 cm) and near visual acuities (VA) postoperatively. The Trinova group had statistically significantly better intermediate VA at 80 cm than the PanOptix group (p<0.05). The CS results of both groups were within the normal limits. In the binocular defocus curve of both IOLs, we observed a peak of good VA at 0.0 diopters defocus and a useful wide range for intermediate distances. The incidence of photic phenomena in the Trinova group was lower at postoperative 1 month (p<0.05) but this difference disappeared at 3 months. A total of 47 patients (97.9%) in the Trinova group and 30 patients (96.7%) in the PanOptix group stated that they would recommend the same IOL.
CONCLUSION
Both trifocal IOLs provide good visual quality outcomes and patient satisfaction.
Topics: Humans; Prospective Studies; Female; Male; Visual Acuity; Aged; Middle Aged; Multifocal Intraocular Lenses; Prosthesis Design; Presbyopia; Refraction, Ocular; Vision, Binocular; Patient Satisfaction; Contrast Sensitivity; Phacoemulsification; Follow-Up Studies; Lens Implantation, Intraocular; Lenses, Intraocular
PubMed: 38644781
DOI: 10.4274/tjo.galenos.2024.27657 -
Korean Journal of Ophthalmology : KJO Jun 2024To investigate the clinical outcomes of new hydrophobic trifocal intraocular lens with hydroxyethyl methacrylate in the Korean population. (Observational Study)
Observational Study
PURPOSE
To investigate the clinical outcomes of new hydrophobic trifocal intraocular lens with hydroxyethyl methacrylate in the Korean population.
METHODS
This prospective, multicenter, and observational study evaluated the clinical outcomes of 80 eyes of 40 patients with age-related cataract underwent cataract surgery using CNWT (Clareon PanOptix). Assessment included monocular and binocular uncorrected distance visual acuity, corrected distance visual acuity, uncorrected intermediate visual acuity (at 60cm), near visual acuity (at 40 and 33 cm), uncorrected defocus curves, questionnaires evaluating photic phenomena, spectacle independence, and spectacle free satisfaction.
RESULTS
At postoperative 3 months, mean uncorrected binocular visual acuities were 0.04, 0.04, 0.03 logarithm of the minimum angle of resolution (logMAR) at far, intermediate, and near distances, respectively. All patients achieved uncorrected binocular visual acuity of 0.2 logMAR or better. Monocular and binocular defocus curve indicated a mean visual acuity of 0.2 logMAR or better at the defocus range of +1.0 to - 3.0 diopters (100 to 33 cm) and +1.0 to - 3.5 diopters (100 to 28 cm). High spectacle independence was observed at all distances, with 37.5% patients reporting photic phenomena.
CONCLUSIONS
The Clareon PanOptix intraocular lens has shown positive clinical outcomes, providing a viable option for cataract surgery. These lenses effectively address patients' visual needs, especially in intermediate and near distance tasks, reducing dependence on glasses.
Topics: Humans; Prospective Studies; Male; Female; Visual Acuity; Aged; Middle Aged; Methacrylates; Treatment Outcome; Prosthesis Design; Vision, Binocular; Follow-Up Studies; Aged, 80 and over; Cataract Extraction; Multifocal Intraocular Lenses; Lenses, Intraocular; Refraction, Ocular; Lens Implantation, Intraocular; Patient Satisfaction; Cataract; Surveys and Questionnaires
PubMed: 38644651
DOI: 10.3341/kjo.2023.0140 -
Contact Lens & Anterior Eye : the... Apr 2024It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power....
It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.
PubMed: 38641525
DOI: 10.1016/j.clae.2024.102156 -
PloS One 2024To determine the effect of sex as a risk factor regarding presbyopia.
PURPOSE
To determine the effect of sex as a risk factor regarding presbyopia.
METHODS
Maximum accommodation was pharmacologically induced (40% cabachol corneal iontophoresis) in 97 rhesus monkeys (49 males and 48 females) ranging in age from 8 to 36 years old. Accommodation was measured by Hartinger coincidence refractometry.
RESULTS
Accommodative amplitude measured refractometrically decreased with age, and the rate of change was not different between males and females (p = 0.827).
CONCLUSIONS
Presbyopia is essentially sex neutral, and no one is spared. There may be modest variations between different populations for various reasons, but essentially it is monotonously predictable. At present there is no biological therapeutic.
Topics: Male; Animals; Female; Macaca mulatta; Presbyopia; Accommodation, Ocular; Aging; Lens, Crystalline
PubMed: 38635668
DOI: 10.1371/journal.pone.0300476 -
Scientific Reports Apr 2024This prospective single-arm study aimed to evaluate the clinical efficacy and safety of a refractive multifocal contact lens for the correction of presbyopia in 22...
This prospective single-arm study aimed to evaluate the clinical efficacy and safety of a refractive multifocal contact lens for the correction of presbyopia in 22 patients. The participants underwent clinical examinations before and 1 week after wearing a refractive multifocal contact lens (OptaCon ZOOM). The primary endpoints were the corrected distance visual acuity (CDVA) and distance-corrected near visual acuity (DCNVA). Defocus curve, contrast sensitivity, and ocular surface disease index (OSDI) were analyzed. A slit-lamp examination was performed for safety analysis. Contact lens comfort and patient satisfaction were assessed using a questionnaire. No significant difference in CDVA was observed before and 1 week after refractive multifocal contact lens use (p = 0.127), whereas DCNVA was significantly improved after 1 week (p < 0.001). The contrast sensitivity was not significantly affected at any spatial frequency under mesopic or photopic conditions. OSDI was significantly increased (p = 0.023). The patient-reported satisfaction scores were 96.2, 91.9, and 85.0 out of 100 at far, intermediate, and near distances, respectively. No significant adverse events were observed. Refractive multifocal contact lenses improved near vision while maintaining distance vision in presbyopic patients, without compromising contrast sensitivity. The study results suggest that OptaCon ZOOM can be considered safe and effective for the correction of presbyopia.
Topics: Humans; Presbyopia; Prospective Studies; Refraction, Ocular; Visual Acuity; Contact Lenses
PubMed: 38632261
DOI: 10.1038/s41598-024-55918-5 -
Contact Lens & Anterior Eye : the... Apr 2024This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses...
This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice. Current options for contact lens correction of presbyopia include soft simultaneous, rigid translating and rigid simultaneous designs, in addition to monovision. Spectacle options include single vision lenses, bifocal lenses and a range of progressive addition lenses. The comparative performance of both contact lens and spectacle lens options is presented. With a significant proportion of the global population now being presbyopic, this overview is particularly timely and is designed to act as a guide for researchers, industry and eyecare practitioners alike.
PubMed: 38631935
DOI: 10.1016/j.clae.2024.102158