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Endocrinology, Diabetes & Metabolism Jul 2024Although risk factors linked to diabetic retinopathy (DR) among patients with Type 2 diabetes mellitus (T2DM) have been extensively studied globally, the specific...
INTRODUCTION
Although risk factors linked to diabetic retinopathy (DR) among patients with Type 2 diabetes mellitus (T2DM) have been extensively studied globally, the specific determinants of these factors in relation to DR in Palestine are presently not well understood.
METHODS
This retrospective cross-sectional study included patients who underwent DR screening with a fundus camera (VersaCam a). The study included patients aged ≥18 with T2DM, excluding those with other types of diabetes or a history of malignancies. Univariable and multivariable logistic regressions were used to identify factors associated with DR.
RESULTS
A total of 1163 patients with T2DM were included in this study. Of these, 211 (18.1%) patients were classified in the DR group, 761 (65.4%) in the no DR group and 191 (16.4%) were ungradable. Among the included patients, 434 (37.3%) were male. A secondary level of education or higher and a BMI ≥30 kg/m, compared with <25 kg/m, were independently and inversely associated with DR, with odds ratios (ORs) of 0.46 (p < 0.001) and 0.58 (p = 0.046), respectively. A 5-year increase in the duration of T2DM correlated with 45% higher odds of having DR (p < 0.001). Patients with DR were more likely to have HbA1c >7%, be physically inactive and use insulin, with ORs of 1.63 (p = 0.02), 2.05 (p < 0.001) and 1.53 (p = 0.03), respectively. Age, gender, occupational status, hypertension and hyperlipidaemia were not independent predictors of DR (p < 0.05).
CONCLUSION
Longer duration of T2DM, HbA1c >7%, physical inactivity and insulin use were all independently associated with the presence of DR. Furthermore, a secondary or higher educational level and obesity demonstrated independent and inverse associations with the development of DR.
Topics: Humans; Male; Diabetes Mellitus, Type 2; Cross-Sectional Studies; Female; Diabetic Retinopathy; Risk Factors; Middle Aged; Retrospective Studies; Arabs; Adult; Aged; Glycated Hemoglobin
PubMed: 38874277
DOI: 10.1002/edm2.494 -
Mathematical Biosciences and... Mar 2024Glaucoma is a chronic neurodegenerative disease that can result in irreversible vision loss if not treated in its early stages. The cup-to-disc ratio is a key criterion...
Glaucoma is a chronic neurodegenerative disease that can result in irreversible vision loss if not treated in its early stages. The cup-to-disc ratio is a key criterion for glaucoma screening and diagnosis, and it is determined by dividing the area of the optic cup (OC) by that of the optic disc (OD) in fundus images. Consequently, the automatic and accurate segmentation of the OC and OD is a pivotal step in glaucoma detection. In recent years, numerous methods have resulted in great success on this task. However, most existing methods either have unsatisfactory segmentation accuracy or high time costs. In this paper, we propose a lightweight deep-learning architecture for the simultaneous segmentation of the OC and OD, where we have adopted fuzzy learning and a multi-layer perceptron to simplify the learning complexity and improve segmentation accuracy. Experimental results demonstrate the superiority of our proposed method as compared to most state-of-the-art approaches in terms of both training time and segmentation accuracy.
Topics: Deep Learning; Humans; Optic Disk; Glaucoma; Algorithms; Fuzzy Logic; Neural Networks, Computer; Image Processing, Computer-Assisted; Reproducibility of Results; Image Interpretation, Computer-Assisted; Fundus Oculi
PubMed: 38872528
DOI: 10.3934/mbe.2024225 -
Scientific Reports Jun 2024To investigate biomarkers of intra-ocular pressure (IOP) decrease after cataract surgery with trabecular washout in pseudo-exfoliative (PEX) glaucoma. A single-center... (Observational Study)
Observational Study
To investigate biomarkers of intra-ocular pressure (IOP) decrease after cataract surgery with trabecular washout in pseudo-exfoliative (PEX) glaucoma. A single-center observational prospective study in PEX glaucoma patients undergoing cataract surgery with trabecular washout (Goniowash) was performed from 2018 to 2021. Age, gender, visual acuity, IOP, endothelial cell count, central corneal thickness, medications, were collected over 16-month follow-up. Multivariable binomial regression models were implemented. 54 eyes (35 subjects) were included. Mean preoperative IOP (IOP) was 15.9 ± 3.5 mmHg. Postoperative IOP reduction was significant at 1-month and throughout follow-up (p < 0.01, respectively). IOP was a predictive biomarker inversely correlated to IOP decrease throughout follow-up (p < 0.001). At 1 and 12 months of follow-up, IOP decrease concerned 31 (57.4%) and 34 (63.0%) eyes with an average IOP decrease of 17.5% (from 17.6 ± 3.1 to 14.3 ± 2.2 mmHg) and 23.0% (from 17.7 ± 2.8 to 13.5 ± 2.6 mmHg), respectively. Performance (AUC) of IOP was 0.85 and 0.94 (p < 0.0001, respectively), with IOP threshold ≥ 15 mmHg for 82.1% and 96.8% sensitivity, 84.2% and 75.0% specificity, 1.84 and 3.91 IOP decrease odds-ratio, respectively. All PEX glaucoma patients with IOP greater than or equal to the average general population IOP were likely to achieve a significant sustainable postoperative IOP decrease.
Topics: Humans; Intraocular Pressure; Male; Female; Aged; Prospective Studies; Cataract Extraction; Biomarkers; Exfoliation Syndrome; Middle Aged; Glaucoma, Open-Angle; Trabecular Meshwork; Aged, 80 and over; Visual Acuity
PubMed: 38866840
DOI: 10.1038/s41598-024-53893-5 -
Frontiers in Cellular Neuroscience 2024Diabetic retinopathy (DR) is a leading cause of blindness and vision impairment worldwide and represents one of the most common complications among diabetic patients....
Diabetic retinopathy (DR) is a leading cause of blindness and vision impairment worldwide and represents one of the most common complications among diabetic patients. Current treatment modalities for DR, including laser photocoagulation, intravitreal injection of corticosteroid, and anti-vascular endothelial growth factor (VEGF) agents, target primarily vascular lesions. However, these approaches are invasive and have several limitations, such as potential loss of visual function, retinal scars and cataract formation, and increased risk of ocular hypertension, vitreous hemorrhage, retinal detachment, and intraocular inflammation. Recent studies have suggested mitochondrial dysfunction as a pivotal factor leading to both the vascular and neural damage in DR. Given that Coenzyme Q10 (CoQ10) is a proven mitochondrial stabilizer with antioxidative properties, this study investigated the effect of CoQ10 eyedrops [in conjunction with vitamin E d-α-tocopheryl poly(ethylene glycol) 1000 succinate (TPGS)] on DR-induced neurodegeneration using a type 2 diabetes mouse model (C57BLKsJ-db/db mice). Utilizing a comprehensive electroretinography protocol, supported by immunohistochemistry, our results revealed that topical application of CoQ10 eyedrops conjugated with vitamin E TPGS produced a neuroprotective effect against diabetic-induced neurodegeneration by preserving the function and histology of various retinal neural cell types. Compared to the control group, mice treated with CoQ10 exhibited thicker outer and inner nuclear layers, higher densities of photoreceptor, cone cell, and rod-bipolar cell dendritic boutons, and reduced glial reactivity and microglial cell density. Additionally, the CoQ10 treatment significantly alleviated retinal levels of MMP-9 and enhanced mitochondrial function. These findings provide further insight into the role of mitochondrial dysfunction in the development of DR and suggest CoQ10 eyedrops, conjugated with vitamin E TPGS, as a potential complementary therapy for DR-related neuropathy.
PubMed: 38863499
DOI: 10.3389/fncel.2024.1404987 -
Actas Espanolas de Psiquiatria Jun 2024Glaucoma is a chronic disease with an insidious onset that often brings severe psychological burden to patients. Therefore, based on a systematic review and... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Glaucoma is a chronic disease with an insidious onset that often brings severe psychological burden to patients. Therefore, based on a systematic review and meta-analysis, we explore the prevalence and severity of depression and anxiety in glaucoma patients, and provide clinically valuable information for medical staff.
METHODS
Computer searches were conducted for relevant studies in PubMed, Embase, ProQuest PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, The Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure, Wanfang Database, and China VIP Database. The search date range was from the establishment of the database to December 2023. Literature was screened and data were extracted. The Cochrane risk of bias assessment tool was used to evaluate the quality of the literature, and RevMan5.4 was used for meta-analysis.
RESULTS
The total sample size of the 15 included studies was 24,334 cases. All included studies were of high quality. The results of the meta-analysis revealed that, compared with control patients without glaucoma, patients with glaucoma were more likely to experience depression and to have more severe depressive symptoms [RR (Relative Risk) = 5.92, 95% CI (Confidence Interva) (3.29, 10.66), p < 0.01]; they were also more likely to experience anxiety and to have more severe anxiety symptoms [RR = 2.99, 95% CI (1.93, 4.64), p < 0.01]. The results of the sensitivity analysis showed that the two studies by Cumurcu E. 2005 and Yochim 2012 were the sources of heterogeneity in the meta-analysis of depression; and the three studies by Mabuchi 2012, Otori 2017, and Yochim 2012 were the sources of heterogeneity in the meta-analysis of anxiety disorders.
CONCLUSION
People with glaucoma are more likely to experience depression and anxiety than people without glaucoma. Medical staff should pay greater attention to patients' emotional problems and help patients improve their quality of life.
Topics: Humans; Glaucoma; Prevalence; Cross-Sectional Studies; Anxiety Disorders; Depression; Depressive Disorder
PubMed: 38863056
DOI: 10.62641/aep.v52i3.1561 -
BMC Ophthalmology Jun 2024Ahmed valve implantation demonstrated an increasing proportion in glaucoma surgery, but predicting the successful maintenance of target intraocular pressure remains a...
BACKGROUND
Ahmed valve implantation demonstrated an increasing proportion in glaucoma surgery, but predicting the successful maintenance of target intraocular pressure remains a challenging task. This study aimed to evaluate the performance of machine learning (ML) in predicting surgical outcomes after Ahmed valve implantation and to assess potential risk factors associated with surgical failure to contribute to improving the success rate.
METHODS
This study used preoperative data of patients who underwent Ahmed valve implantation from 2017 to 2021 at Ajou University Hospital. These datasets included demographic and ophthalmic parameters (dataset A), systemic medical records excluding psychiatric records (dataset B), and psychiatric medications (dataset C). Logistic regression, extreme gradient boosting (XGBoost), and support vector machines were first evaluated using only dataset A. The algorithm with the best performance was selected based on the area under the receiver operating characteristics curve (AUROC). Finally, three additional prediction models were developed using the best performance algorithm, incorporating combinations of multiple datasets to predict surgical outcomes at 1 year.
RESULTS
Among 153 eyes of 133 patients, 131 (85.6%) and 22 (14.4%) eyes were categorized as the success and failure groups, respectively. The XGBoost was shown as the best-performance model with an AUROC value of 0.684, using only dataset A. The final three further prediction models were developed based on the combination of multiple datasets using the XGBoost model. All datasets combinations demonstrated the best performances in terms of AUROC (dataset A + B: 0.782; A + C: 0.773; A + B + C: 0.801). Furthermore, advancing age was a risk factor associated with a higher surgical failure incidence.
CONCLUSIONS
ML provides some predictive value in predicting the outcomes of Ahmed valve implantation at 1 year. ML evaluation revealed advancing age as a common risk factor for surgical failure.
Topics: Humans; Machine Learning; Female; Glaucoma Drainage Implants; Male; Glaucoma; Intraocular Pressure; Middle Aged; Aged; Retrospective Studies; ROC Curve; Adult; Prosthesis Implantation; Risk Factors; Visual Acuity; Treatment Outcome; Aged, 80 and over
PubMed: 38862946
DOI: 10.1186/s12886-024-03510-w -
BMC Ophthalmology Jun 2024Due to the asymptomatic nature of the disease and lack of awareness, most glaucoma patients present for eye examination late, after significant damage of optic nerve...
Awareness of glaucoma among adult patients attending hawassa university comprehensive specialized hospital ophthalmic outpatient department, Sidama, Ethiopia, August 2022.
BACKGROUND
Due to the asymptomatic nature of the disease and lack of awareness, most glaucoma patients present for eye examination late, after significant damage of optic nerve occur. Being aware of glaucoma is important for timely diagnosis of the disease and preventing blindness from it.
OBJECTIVE
The aim of this study was to assess glaucoma awareness and associated factors among adult patients aged 35 and over attending the eye outpatient department.
METHODS
Hospital based cross-sectional study was conducted on 284 adult patients aged 35 and over attending ophthalmic outpatient department from July to August 2022 using systematic random sampling. An interviewer-administered questionnaire was used to collect data. The data were checked for completeness, and then entered to SPSS version 22 software. Descriptive and binary logistic regression analyses were performed. Independent variables with p-value ≤ 0.05 in multivariate logistic regression were considered as statistically significant.
RESULTS
About 284 study participants, of whom 57.75% were male, participated in this study with a response rate of 94.1%. The mean age of the study participants was 53.58 years. Only 39.09%(95% CI: 36.53-41.65) were aware of glaucoma. Age groups 46-50 [AOR; 1.83: 1.18, 2.56] and 51-64 [AOR; 3.21: 2.03, 4.39], having college education or above [AOR; 3.1: 2.20, 6.64], family member with glaucoma [AOR; 5.86:3.25, 8.0], income 6500 ETB [AOR; 2.9: 1.97, 5.00] and previous eye examination [AOR; 2.15: 1.46, 4.05] were factors significantly associated with awareness of glaucoma. The main sources of information were news media, family members with glaucoma and health workers.
CONCLUSION
More than half (60.91%) of adult ophthalmic patients attending HUCSH were unaware of glaucoma and need eye health education concerning glaucoma.
Topics: Humans; Male; Female; Middle Aged; Ethiopia; Cross-Sectional Studies; Glaucoma; Adult; Health Knowledge, Attitudes, Practice; Aged; Surveys and Questionnaires; Hospitals, Special; Ophthalmology; Hospitals, University
PubMed: 38858622
DOI: 10.1186/s12886-024-03517-3 -
PloS One 2024This study aimed to assess the effect of intraocular pressure (IOP) changes on biometry and intraocular lens (IOL) power calculation in patients diagnosed with primary...
This study aimed to assess the effect of intraocular pressure (IOP) changes on biometry and intraocular lens (IOL) power calculation in patients diagnosed with primary open-angle glaucoma (POAG) and ocular hypertension (OHT). This prospective non-randomized cohort study enrolled patients with diagnosed POAG and OHT, presenting with IOP levels exceeding 25 mmHg. Thai Clinical Trials Registry number was TCTR20180912007. Optical biometry, encompassing measurements such as corneal thickness (CCT), keratometry, anterior chamber depth (ACD), and axial length, was conducted before and after IOP reduction. The IOL power was also determined using the SRK/T formula. The main outcomes measured were alterations in biometry and IOL power. Correlations between IOP, biometric parameters, and IOL power were analyzed. In total, 28 eyes were included in the study, with a mean patient age of 65.71±10.2 years. After IOP reduction, all biometric parameters, except CCT and ACD, exhibited a decrease without reaching statistical significance (all p>0.05). Meanwhile, IOL power showed a slight increase of 0.214±0.42 diopters (P = 0.035). The correlation between IOP and biometric parameters was found to be weak. However, there was a moderate correlation between IOP and IOL power (r2 = 0.267). Notably, IOL power tended to increase by more than 0.5 diopters when IOP decreased by more than 10 mmHg (p < 0.001). In conclusion, changes in IOP among patients with POAG and OHT do not significantly impact biometry and IOL power calculations. Nonetheless, it may be prudent to consider a slight adjustment in IOL power when IOP is lowered by more than 10 mmHg.
Topics: Humans; Intraocular Pressure; Glaucoma, Open-Angle; Male; Female; Aged; Middle Aged; Ocular Hypertension; Prospective Studies; Lenses, Intraocular; Biometry
PubMed: 38857282
DOI: 10.1371/journal.pone.0304169 -
BioRxiv : the Preprint Server For... Jun 2024Glaucoma is a neurodegenerative disease that leads to the death of retinal ganglion cells (RGCs). A growing body of literature suggests a role for neuroinflammation in...
Glaucoma is a neurodegenerative disease that leads to the death of retinal ganglion cells (RGCs). A growing body of literature suggests a role for neuroinflammation in RGC death after glaucoma-relevant insults. For instance, it was shown that deficiency of three proinflammatory cytokines, complement component 1, subcomponent q ( ), interleukin 1 alpha ( ), and tumor necrosis factor ( ), resulted in near complete protection of RGCs after two glaucoma-relevant insults, optic nerve injury and ocular hypertension. While TNF and C1Q have been extensively investigated in glaucoma-relevant model systems, the role of IL1A in RGC is not as well defined. Thus, we investigated the direct neurotoxicity of IL1A on RGCs in vivo. Intravitreal injection of IL1A did not result in RGC death at either 14 days or 12 weeks after insult. Consistent with previous studies, TNF injection did not result in significant RGC loss at 14 days but did after 12 weeks. Interestingly, IL1A+TNF resulted in a relatively rapid RGC death, driving significant RGC loss two weeks after injection. JUN activation and SARM1 have been implicated in RGC death in glaucoma and after cytokine insult. Using mice deficient in JUN or SARM1, we show RGC loss after IL1A+TNF insult is JUN-independent and SARM1-dependent. Furthermore, RNA-seq analysis showed that RGC death by SARM1 deficiency does not stop the neuroinflammatory response to IL1A+TNF. These findings indicate that IL1A can potentiate TNF-induced RGC death after combined insult is likely driven by a SARM1-dependent RGC intrinsic signaling pathway.
PubMed: 38854045
DOI: 10.1101/2024.05.28.596328 -
Aging Jun 2024Glaucoma is an optic neurodegenerative disease. Retinal ganglion cells (RGCs) are the fundamental neurons in the trabecular meshwork, and their loss is the main...
BACKGROUND
Glaucoma is an optic neurodegenerative disease. Retinal ganglion cells (RGCs) are the fundamental neurons in the trabecular meshwork, and their loss is the main pathological reason for glaucoma. The present study was to investigate mechanisms that regulate RGCs survival.
METHODS
A mouse model of glaucoma was established by injecting hypertonic saline into the limbal veins. RGCs apoptosis was detected by using flow cytometry. Protein expressions in RGCs in response to DNA damage inducer cisplatin treatment were detected by immunofluorescence and western blot. The expressions of inflammatory cytokines were determined using ELISA and real-time PCR.
RESULTS
In the hypertonic saline-injected mice, we found visual function was impaired followed by the increased expression of γH2AX and activation of cGAS-STING signaling. We found that DNA damage inducer cisplatin treatment incurred significant DNA damage, cell apoptosis, and inflammatory response. Mechanistically, cisplatin treatment triggered activation of the cGAS-STING signaling by disrupting mitochondrial function. Suppression of cGAS-STING ameliorated inflammation and protected visual function in glaucoma mice.
CONCLUSIONS
The data demonstrated that cGAS-STING signaling is activated in the damaged retinal ganglion cells, which is associated with increased inflammatory responses, DNA damage, and mitochondrial dysfunction. Targeting the cGAS-STING signaling pathway represents a potential way to alleviate glaucoma-related visual function.
Topics: Animals; Retinal Ganglion Cells; Nucleotidyltransferases; Glaucoma; Signal Transduction; Membrane Proteins; Mice; DNA Damage; Apoptosis; Cisplatin; Disease Models, Animal; Mice, Inbred C57BL
PubMed: 38848144
DOI: 10.18632/aging.205900