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Telemedicine Journal and E-health : the... Jun 2024The availability and utilization of telehealth services have been rapidly increasing in the past decade, which paved the way for ophthalmological care to be offered...
Assessment of a Telehealth Platform in Evaluating the Urgency of Ophthalmical Consultation in the Middle East and North Africa Region: The Red Flags of Retinal Detachment.
The availability and utilization of telehealth services have been rapidly increasing in the past decade, which paved the way for ophthalmological care to be offered more easily and conveniently. However, the proficiency of telehealth in the context of ophthalmical care still requires further studies to prove its effectiveness. This study examined the proficiency of general practitioners in a telemedicine platform in identifying red flag symptoms, suggestive of retinal detachment, and devising optimal management strategies. Our cross-sectional study used chat-based consultations on Altibbi Telemedicine platform (2018-2023) to study ophthalmical patients presenting with "blurred vision" or "blindness." Those endorsing red flag symptoms were categorized as having "positive symptomatology" and those reporting none as having "negative symptomatology." Management plans were classified as referral or reassuring. Statistical analysis was performed using IBM's Statistical Package for Social Sciences to examine associations between symptomatology and other variables. values below 0.05 were considered statistically significant. Five hundred and fifty ( = 550) patients with a mean age 22.5 ± 13 years were included. Patients expressing positive symptomatology were more likely to be referred relative to those expressing negative symptomatology (81% vs. 61%, < 0.001). No significant difference was found between genders and referral ( = 0.053) or age and referral ( = 0.231). Multivariate regression showed a significant correlation between positive symptoms and referral (adjusted odds ratio [aOR]: 2.0; 95% confidence interval [95% CI]: 1.3-3.3), none between gender (aOR: 1.5; 95% CI: 0.9-2.2) or age (aOR: 1.0; 95% CI: 0.9-1.1) and referral odds. The telemedicine platform studied is effective in referring cases with red flag symptoms to urgent care, regardless of age and gender.
PubMed: 38920007
DOI: 10.1089/tmj.2024.0111 -
Policy Insights From the Behavioral and... Oct 2023Beyond visual function, specialized light-sensitive retinal circuits involving the photopigment melanopsin drive critical aspects of human physiology and behavior,...
Beyond visual function, specialized light-sensitive retinal circuits involving the photopigment melanopsin drive critical aspects of human physiology and behavior, including sleep-wake rhythms, hormone production, mood, and cognition. Fundamental discoveries of visual neurobiology dating back to the 1990s have given rise to strong interest from the lighting industry in optimizing lighting to benefit health. Consequently, evidence-based recommendations, regulations, and policies need to translate current knowledge of neurobiology into practice. Here, reviewing recent advances in understanding of NIF circuits in humans leads to proposed strategies to optimize electric lighting. Highlighted knowledge gaps must be addressed urgently, as well as the challenge of developing personalized, adaptive NIF lighting interventions accounting for complex individual differences in physiology, behavior, and environment. Finally, lighting equity issues appear in the context of marginalized groups, who have traditionally been underserved in research on both fundamental visual processes and applied lighting. Biologically optimal light is a fundamental environmental right.
PubMed: 38919981
DOI: 10.1177/23727322231196896 -
Frontiers in Pediatrics 2024Bardet-Biedl syndrome (BBS) is a rare genetic disorder characterized by retinitis pigmentosa, polydactyly, type 2 diabetes mellitus, and obesity. This case report...
Bardet-Biedl syndrome (BBS) is a rare genetic disorder characterized by retinitis pigmentosa, polydactyly, type 2 diabetes mellitus, and obesity. This case report presents a 19-year-old male from Palestine with BBS, exhibiting delayed diagnosis and variable phenotypic expression. The patient had familial BBS history and presented with obesity, type 2 diabetes mellitus, retinitis pigmentosa, and cryptorchidism. Genetic analysis identified heterozygous missense variants in the gene, yet additional genetic factors may contribute to the phenotype. Renal abnormalities included kidney shrinkage and mild hydronephrosis. Management of this patient involves a multidisciplinary approach with lifestyle modifications, surgical interventions, and supportive care. Early diagnosis, genetic counseling, and regular follow-up are crucial for improving outcomes in BBS. This report highlights diagnostic and therapeutic challenges and underscores the need for further research on this complex disorder.
PubMed: 38919843
DOI: 10.3389/fped.2024.1420684 -
Communicative & Integrative Biology 2024The Dead Sea is unique compared to other extreme halophilic habitats. Its salinity exceeds 34%, and it is getting saltier. The Dead Sea environment is characterized by a... (Review)
Review
The Dead Sea is unique compared to other extreme halophilic habitats. Its salinity exceeds 34%, and it is getting saltier. The Dead Sea environment is characterized by a dominance of divalent cations, with magnesium chloride (MgCl) levels approaching the predicted 2.3 M upper limit for life, an acidic pH of 6.0, and high levels of absorbed ultraviolet radiation. Consequently, only organisms adapted to such a polyextreme environment can survive in the surface, sinkholes, sediments, muds, and underwater springs of the Dead Sea. Metagenomic sequence analysis and amino acid profiling indicated that the Dead Sea is predominantly composed of halophiles that have various adaptation mechanisms and produce metabolites that can be utilized for biotechnological purposes. A variety of products have been obtained from halophilic microorganisms isolated from the Dead Sea, such as antimicrobials, bioplastics, biofuels, extremozymes, retinal proteins, colored pigments, exopolysaccharides, and compatible solutes. These resources find applications in agriculture, food, biofuel production, industry, and bioremediation for the detoxification of wastewater and soil. Utilizing halophiles as a bioprocessing platform offers advantages such as reduced energy consumption, decreased freshwater demand, minimized capital investment, and continuous production.
PubMed: 38919836
DOI: 10.1080/19420889.2024.2369782 -
Clinical Ophthalmology (Auckland, N.Z.) 2024To review the latest surgical advances and evolving clinical use of scleral bio-tissue for reinforcement in the eye and review the published literature on novel surgical... (Review)
Review
The Evolving Surgical Paradigm of Scleral Allograft Bio-Tissue Use in Ophthalmic Surgery: Techniques and Clinical Indications for Ab-Externo and Ab-Interno Scleral Reinforcement.
To review the latest surgical advances and evolving clinical use of scleral bio-tissue for reinforcement in the eye and review the published literature on novel surgical applications of scleral allograft bio-tissue. Conventional surgical procedures for scleral reinforcement using homologous scleral allograft have been traditionally ab-externo interventions comprising of anterior or posterior reinforcement of the sclera for clinical indications such as trauma, scleromalacia, glaucoma drainage device coverage, scleral perforation, buckle repair as well as posterior reinforcement for pathologic myopia and staphyloma. There have been a few novel ab-interno uses of scleral bio-tissue for reinforcement in both retina and glaucoma. Over the last decade, there has been an increase in peer-reviewed publications on scleral reinforcement, reflecting more interest in its clinical applications. With favorable biological and biomechanical properties, scleral allograft may be an ideal substrate for an array of new applications and surgical uses.
PubMed: 38919403
DOI: 10.2147/OPTH.S462719 -
Cureus May 2024Herpes simplex virus (HSV) infection of the cornea, uvea, and retina is the leading infectious cause of blindness worldwide. This study examined the effects of retinoic...
BACKGROUND
Herpes simplex virus (HSV) infection of the cornea, uvea, and retina is the leading infectious cause of blindness worldwide. This study examined the effects of retinoic acid (RA) on the protein levels of interleukin (IL)-17A and IL-23 cytokines with known proinflammatory effects and toll-like receptor 3 (TLR3) messenger RNA (mRNA) expression in retinal pigment epithelial (ARPE-19) cells treated with HSV-1-infected cell protein 0 (ICP0).
METHODOLOGY
We used 3-[4.5-dimethylthiazol-2-yl]-2.5-diphenyl tetrazolium bromide assay to calculate the half maximal inhibitory concentration (IC50) doses of RA and ICP0 in ARPE-19 cells. At the end of 24 hours, protein levels of IL-17A and IL-23 were analyzed using enzyme-linked immunosorbent assay. TLR3 mRNA expression levels were also calculated using reverse transcription-polymerase chain reaction (RT-PCR).
RESULTS
RA administration decreased IL-17A levels, which were elevated by ICP0. The IL-23 levels were similar between the ICP0-treated and control groups, but the difference was significant between the ICP0-treated group and RA+ICP0 combination. These results showed that RA can significantly increase IL-23 levels in the presence of ICP0. Although ICP0 dramatically increased TLR3 mRNA expression compared with that in the control group, the RA+ICP0 combination returned TLR3 mRNA expression to a level similar to that in the control group ( = 0.419).
CONCLUSIONS
RA may potentially neutralize HSV-1 ICP0 negative effects in ARPE-19 cells.
PubMed: 38919217
DOI: 10.7759/cureus.61089 -
Cureus May 2024This report presents a rare case of a central retinal artery occlusion in an eight-year-old girl attributed to an undiagnosed patent ductus arteriosus (PDA). Despite...
This report presents a rare case of a central retinal artery occlusion in an eight-year-old girl attributed to an undiagnosed patent ductus arteriosus (PDA). Despite intensive treatment, the patient's eyesight failed to improve. Cases of central retinal artery occlusion may occur in patients with undiagnosed, small PDA, with only symptomatic treatment being available.
PubMed: 38919210
DOI: 10.7759/cureus.61083 -
Annali Italiani Di Chirurgia 2024Vitrectomy is one of the crucial therapeutic interventions for non-traumatic and non-diabetic retinal diseases. However, the prognosis of patients undergoing this...
AIM
Vitrectomy is one of the crucial therapeutic interventions for non-traumatic and non-diabetic retinal diseases. However, the prognosis of patients undergoing this procedure and the factors affecting prognosis remain to be clarified. The aim of this study was to analyze the prognostic factors of non-traumatic and non-diabetic retinopathy complicated by vitreous hemorrhage.
METHODS
A retrospective study was conducted on 352 patients, including 152 (43.18%) females, who underwent vitrectomy in our hospital from March 2018 to December 2022, divided into Group A (postoperative complications) and Group B (no complications) according to whether complications occurred during postoperative follow-up. General and clinical data of the two groups were collected and compared. Binary logistic regression was used to analyze the main factors affecting prognosis.
RESULTS
All patients were followed up for 12 months. A total of 87 patients had postoperative complications, accounting for 24.72% (87/352), and were classified as Group A. A total of 265 patients who had no postoperative complications, accounting for 75.28% (265/352), were classified as Group B. There were significant differences in preoperative visual acuity, time of surgical intervention, preoperative fundus condition, stage of retinopathy, preoperative intraocular pressure and age between the two groups (p < 0.05), and these indices were identified as independent risk factors affecting the prognosis of patients (odds ratio >1).
CONCLUSIONS
Preoperative visual acuity, time of surgical intervention, preoperative fundus condition, stage of retinopathy, preoperative intraocular pressure and age are all factors affecting the prognosis of patients with non-traumatic and non-diabetic retinopathy while undergoing vitrectomy. Personalized care is required to improve the surgical outcome for these patients.
Topics: Humans; Vitrectomy; Female; Male; Retrospective Studies; Prognosis; Middle Aged; Retinal Diseases; Postoperative Complications; Vitreous Hemorrhage; Risk Factors; Aged; Adult; Visual Acuity; Intraocular Pressure
PubMed: 38918969
DOI: 10.62713/aic.3279 -
Journal of Neuroinflammation Jun 2024The microglia-mediated neuroinflammation have been shown to play a crucial role in the ocular pathological angiogenesis process, but specific immunotherapies for...
The microglia-mediated neuroinflammation have been shown to play a crucial role in the ocular pathological angiogenesis process, but specific immunotherapies for neovascular ocular diseases are still lacking. This study proposed that targeting GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) might be a novel immunotherapy for these angiogenesis diseases. We found a significant upregulation of CGAS and STING genes in the RNA-seq data derived from retinal tissues of the patients with proliferative diabetic retinopathy. In experimental models of ocular angiogenesis including laser-induced choroidal neovascularization (CNV) and oxygen-induced retinopathy (OIR), the cGAS-STING pathway was activated as angiogenesis progressed. Either genetic deletion or pharmacological inhibition of STING resulted in a remarkable suppression of neovascularization in both models. Furthermore, cGAS-STING signaling was specifically activated in myeloid cells, triggering the subsequent RIP1-RIP3-MLKL pathway activation and leading to necroptosis-mediated inflammation. Notably, targeted inhibition of the cGAS-STING pathway with C-176 or SN-011 could significantly suppress pathological angiogenesis in CNV and OIR. Additionally, the combination of C-176 or SN-011 with anti-VEGF therapy led to least angiogenesis, markedly enhancing the anti-angiogenic effectiveness. Together, our findings provide compelling evidence for the importance of the cGAS-STING-necroptosis axis in pathological angiogenesis, highlighting its potential as a promising immunotherapeutic target for treating neovascular ocular diseases.
Topics: Nucleotidyltransferases; Membrane Proteins; Animals; Humans; Mice; Neuroinflammatory Diseases; Mice, Inbred C57BL; Choroidal Neovascularization; Signal Transduction; Mice, Knockout; Diabetic Retinopathy
PubMed: 38918759
DOI: 10.1186/s12974-024-03155-y -
Eye (London, England) Jun 2024Dark adaptation measures photoreceptor recovery following intense light stimulation. Time to recovery reflects retinal function. We describe a novel method of relative...
BACKGROUND/OBJECTIVE
Dark adaptation measures photoreceptor recovery following intense light stimulation. Time to recovery reflects retinal function. We describe a novel method of relative foveal dark adaptation using an iPhone. Data from a small number of healthy subjects were studied to assess reproducibility, effects of age, and consider potential clinical utility.
METHODS
Relative foveal dark adaption was studied in 6 normal subjects across ages from 20 to 81 years and across differing testing conditions. Foveal bleaching is produced by fixating a bright white circle on an iPhone for variable times. After foveal bleaching an annular surround appears to complete a bullseye stimulus with surround initially brighter than centre. As the fovea recovers the centre regains brightness. Relative foveal dark adaptation, the time for the visual anchor to shift from surround to centre, was studied across a range of bleaching times, ages, and testing conditions.
RESULTS
Dispersion of dark adaptation times grows with increasing age. Foveal bleaching for 30 s was as effective as longer times. Testing times with a 30 s bleach were less than 1 min. Foveal dark adaptation was reproducible within each subject and was unaffected by ambient room lighting, pupil size, and light attenuation. Repeat, immediately sequential testing was similarly reproducible except after long bleaching.
CONCLUSIONS
This method of dark adaptation is intuitive, repeatable, and relatively unaffected by testing condition. Testing times are brief, requiring only an iPhone screen positioned at reading distance. Relative foveal dark adaptation may be a useful tool to assess macular health.
PubMed: 38918567
DOI: 10.1038/s41433-024-03201-2