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Journal of Neurology Jul 2022Ophthalmological disorders are common and frequently disabling for people with Parkinson's disease (PD). However, details on the prevalence, severity and impact of... (Observational Study)
Observational Study
BACKGROUND
Ophthalmological disorders are common and frequently disabling for people with Parkinson's disease (PD). However, details on the prevalence, severity and impact of ophthalmological disorders thus far lacking. We aimed to identify PD patients with undetected ophthalmological disorders in a large cross-sectional, observational study.
METHODS
We previously delivered a screening questionnaire to detect ophthalmological symptoms (Visual impairment in PD questionnaire; VIPD-Q) to 848 patients. Here, we report on a subgroup of 102 patients who received complete ophthalmological assessment aimed at identifying clinically relevant ophthalmological diseases, which were classified as either vison-threatening or not. Impact on daily life functioning was measured using the visual functioning-25 questionnaire (VFQ-25) and fall frequency.
RESULTS
Almost all patients (92%) had one or more clinically relevant ophthalmological disorders. Of those, 77% had a potentially vision-threatening disease, while 34% had a potentially treatable ophthalmological disease which impacted on quality of life. The most prevalent ophthalmological disorders were dry eyes (86%), ocular misalignment (50%) and convergence insufficiency (41%). We found a weak but significant association between clinically relevant ophthalmological diseases and both fall frequency (R = 0.15, p = 0.037) and VFQ-25 score (R = 0.15, p = 0.02). The VIPD-Q could not correctly identify patients with relevant ophthalmological disorders.
CONCLUSIONS
Surprisingly, in our study sample, many participants manifested previously undetected ophthalmological diseases, most of which threatened vision, impacted on daily life functioning and were amenable to treatment. Screening for these ophthalmological disorders using a questionnaire asking about symptoms seems insufficient. Instead, episodic ophthalmological assessments should be considered for PD patients, aiming to identify vision-threatening yet treatable diseases.
TRIAL REGISTRATION
Dutch Trial Registration, NL7421.
Topics: Cross-Sectional Studies; Humans; Parkinson Disease; Quality of Life; Vision Disorders; Vision, Ocular
PubMed: 35262759
DOI: 10.1007/s00415-022-11014-0 -
The Cochrane Database of Systematic... May 2018Age-related macular degeneration (AMD) causes progressive and irreversible damage to the retina, resulting in loss of central vision. AMD is the third leading cause of... (Review)
Review
BACKGROUND
Age-related macular degeneration (AMD) causes progressive and irreversible damage to the retina, resulting in loss of central vision. AMD is the third leading cause of irreversible visual impairment worldwide and the leading cause of blindness in industrialized countries. Since AMD is more common in older individuals, the number of affected individuals will increase significantly as the population ages. The implantable miniature telescope (IMT) is an ophthalmic device developed to improve vision in individuals who have lost vision due to AMD. Once implanted, the IMT is used to enlarge objects in the central visual field and focus them onto healthy areas of the retina not affected by AMD, allowing individuals to recognize objects that they otherwise could not see. It is unclear whether and how much the IMT can improve vision in individuals with end-stage AMD.
OBJECTIVES
To assess the effectiveness and safety of the IMT in improving visual acuity and quality of life in people with late or advanced AMD.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 11); Ovid MEDLINE; Embase.com; PubMed; LILACS; AMED; Web of Science Conference Proceedings Citation Index-Science; OpenSIGLE; the metaRegister of Controlled Trials (mRCT) (last searched 27 June 2014); ClinicalTrials.gov; the ICTRP and the US Food and Drug Administration (FDA) Medical Devices database. The date of the search was 2 November 2017, with the exception of mRCT which is no longer in service.
SELECTION CRITERIA
We planned to include randomized controlled trials (RCTs) and quasi-randomized trials that compared the IMT versus no IMT.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed all studies for inclusion, using standard methodological procedures expected by Cochrane.
MAIN RESULTS
Our search yielded 1042 unique records. We removed irrelevant studies after screening titles and abstracts, and evaluated five full-text reports from four studies; three were non-randomized studies. There was one ongoing RCT that compared the OriLens intraocular telescope with standard low vision training in eyes with end-stage AMD. Results for this study are expected in 2020.
AUTHORS' CONCLUSIONS
We found no RCT or quasi-RCT and can draw no conclusion about the effectiveness and safety of the IMT in improving visual acuity in individuals with late or advanced AMD. Since the IMT is typically implanted monocularly based upon which eye has better best-corrected distance visual acuity, randomization between eyes within an individual may not be acceptable. Studies are needed that compare outcomes between individuals randomized to the device versus individuals not implanted, at least during study follow-up, who serve as controls.
Topics: Humans; Macular Degeneration; Miniaturization; Telescopes; Vision Disorders
PubMed: 29847689
DOI: 10.1002/14651858.CD011140.pub2 -
Optometry and Vision Science : Official... Dec 2016: Charles Bonnet Syndrome is a condition where visual hallucinations occur as a result of damage along the visual pathway. Patients with Charles Bonnet Syndrome maintain... (Review)
Review
: Charles Bonnet Syndrome is a condition where visual hallucinations occur as a result of damage along the visual pathway. Patients with Charles Bonnet Syndrome maintain partial or full insight that the hallucinations are not real, absence of psychological conditions, and absence of hallucinations affecting other sensory modalities, while maintaining intact intellectual functioning. Charles Bonnet Syndrome has been well documented in neurologic, geriatric medicine, and psychiatric literature, but there is lack of information in optometric and ophthalmologic literature. Therefore, increased awareness of signs and symptoms associated with Charles Bonnet Syndrome is required among practicing clinicians. This review of the literature will also identify other etiologies of visual hallucinations, pathophysiology of Charles Bonnet Syndrome, and effective management strategies.
Topics: Awareness; Hallucinations; Humans; Syndrome; Vision Disorders
PubMed: 27529611
DOI: 10.1097/OPX.0000000000000959 -
Communications Biology Feb 2021Acquired and inherited retinal disorders are responsible for vision loss in an increasing proportion of individuals worldwide. Photoreceptor (PR) death is central to the... (Review)
Review
Acquired and inherited retinal disorders are responsible for vision loss in an increasing proportion of individuals worldwide. Photoreceptor (PR) death is central to the vision loss individuals experience in these various retinal diseases. Unfortunately, there is a lack of treatment options to prevent PR loss, so an urgent unmet need exists for therapies that improve PR survival and ultimately, vision. The retina is one of the most energy demanding tissues in the body, and this is driven in large part by the metabolic needs of PRs. Recent studies suggest that disruption of nutrient availability and regulation of cell metabolism may be a unifying mechanism in PR death. Understanding retinal cell metabolism and how it is altered in disease has been identified as a priority area of research. The focus of this review is on the recent advances in the understanding of PR metabolism and how it is critical to reduction-oxidation (redox) balance, the outer retinal metabolic ecosystem, and retinal disease. The importance of these metabolic processes is just beginning to be realized and unraveling the metabolic and redox pathways integral to PR health may identify novel targets for neuroprotective strategies that prevent blindness in the heterogenous group of retinal disorders.
Topics: Animals; Cell Death; Cellular Reprogramming; Energy Metabolism; Humans; Metabolome; Metabolomics; Photoreceptor Cells; Retinal Diseases; Vision Disorders; Vision, Ocular
PubMed: 33627778
DOI: 10.1038/s42003-021-01765-3 -
Asia-Pacific Journal of Ophthalmology... 2020The rising popularity of artificial intelligence (AI) in ophthalmology is fuelled by the ever-increasing clinical "big data" that can be used for algorithm development.... (Review)
Review
The rising popularity of artificial intelligence (AI) in ophthalmology is fuelled by the ever-increasing clinical "big data" that can be used for algorithm development. Cataract is one of the leading causes of visual impairment worldwide. However, compared with other major age-related eye diseases, such as diabetic retinopathy, age-related macular degeneration, and glaucoma, AI development in the domain of cataract is still relatively underexplored. In this regard, several previous studies explored algorithms for automated cataract assessment using either slit lamp of color fundus photographs. However, several other study groups proposed or derived new AI-based calculation for pre-cataract surgery intraocular lens power. Along with advancements in digitization of clinical data, data curation for future cataract-related AI developmental work is bound to undergo significant improvements in the foreseeable future. Even though most of these previous studies reported early promising performances, limitations such as lack of robust, high-quality training data, and lack of external validations remain. In the next phase of work, apart from algorithm's performance, it will also be pertinent to evaluate deployment angles, feasibility, efficiency, and cost-effectiveness of these new cataract-related AI systems.
Topics: Artificial Intelligence; Cataract; Cataract Extraction; Diagnostic Techniques, Ophthalmological; Humans; Vision Disorders
PubMed: 32349116
DOI: 10.1097/01.APO.0000656988.16221.04 -
Clinical Medicine (London, England) Mar 2022Visual loss describes temporary or permanent reduction in visual acuity and/or field. Its aetiology is diverse due to the contributions of the different neuro-ophthalmic... (Review)
Review
Visual loss describes temporary or permanent reduction in visual acuity and/or field. Its aetiology is diverse due to the contributions of the different neuro-ophthalmic structures (eye, optic nerve, and brain) to image formation and perception, but may be categorised into ocular causes (corneal, lenticular, vitreoretinal and macular) or optic neuropathies. Clinical evaluation of visual loss relies on thorough history and examination to guide further tests. In this article, we provide a practical overview of visual loss assessment for general physicians.
Topics: Brain; Humans; Optic Nerve Diseases; Physicians; Vision Disorders; Visual Acuity
PubMed: 35304366
DOI: 10.7861/clinmed.2022-0057 -
Clinical & Experimental Optometry Mar 2011Pseudoxanthoma elasticum (PXE), also known as Groenblad syndrome, is an inherited disorder characterised by mineralisation and fragmentation of elastic fibres in a... (Review)
Review
Pseudoxanthoma elasticum (PXE), also known as Groenblad syndrome, is an inherited disorder characterised by mineralisation and fragmentation of elastic fibres in a number of organs including the skin, eyes and arterial blood vessels. The clinical manifestations of PXE centre on three major organ systems: skin, cardiovascular system and the eyes. This review focuses on the ocular manifestations of pseudoxanthoma elasticum, namely, peau d'orange, angioid streaks and choroidal neovascularisation, the clinical course of patients, the diagnostic approaches and current therapeutic strategies, such as laser photocoagulation whether transpupillary thermotherapy or photodynamic therapy, macular translocation surgery and anti-vascular endothelial growth factor treatment.
Topics: Humans; Pseudoxanthoma Elasticum; Retinal Diseases; Vision Disorders; Visual Acuity
PubMed: 21198842
DOI: 10.1111/j.1444-0938.2010.00559.x -
Asia-Pacific Journal of Ophthalmology... 2016The myopia epidemic in Asia is evident because the prevalence of high myopia among young adults is higher among Asian (6.8%-21.6%) compared with non-Asian populations... (Review)
Review
The myopia epidemic in Asia is evident because the prevalence of high myopia among young adults is higher among Asian (6.8%-21.6%) compared with non-Asian populations (2.0%-2.3%). High myopia is linked to pathologic myopia (PM), which may cause irreversible visual impairment (VI). This review will highlight updates on the prevalence of PM and the associated VI from PM. The prevalence of PM among the middle-aged and elderly (0.9%-3.1%) is higher than the prevalence among children and adolescents (<0.2%). The PM lesions detected among older adults include advanced lesions, such as posterior staphyloma, chorioretinal atrophy, lacquer cracks, and Fuchs spot (in descending frequency of occurrence). A relatively high prevalence of PM (8%) was recently reported among highly myopic young adults. As young individuals grow older, the early grades of PM lesions are likely to progress to advanced grades. Two longitudinal changes that occur frequently in PM include the enlargement of beta peripapillary atrophy and the development of chorioretinal atrophy. The lack of longitudinal changes in PM limits the causal inferences of PM. The prevalence of VI attributed to PM seems to be higher among Asian populations compared with Western and European populations. Pathologic myopia is ranked as a more important cause of blindness and low vision in Asian populations compared with Western and European populations. With the lack of effective treatment strategies and poor prognosis, PM threatens the vision health of populations in Asia and worldwide. To control this future epidemic, the prevention of myopia onset and progression is necessary.
Topics: Asia; Global Health; Humans; Myopia, Degenerative; Prevalence; Vision Disorders
PubMed: 27898442
DOI: 10.1097/APO.0000000000000234 -
Deutsches Arzteblatt International Aug 2021
Topics: Blindness; Humans; Hyperferritinemia; Vision Disorders
PubMed: 34612191
DOI: 10.3238/arztebl.m2021.0078 -
Seminars in Pediatric Neurology May 2017Cortical (cerebral) visual impairment (CVI) results from perinatal injury to visual processing structures and pathways of the brain and is the most common cause of... (Review)
Review
Cortical (cerebral) visual impairment (CVI) results from perinatal injury to visual processing structures and pathways of the brain and is the most common cause of severe visual impairment or blindness in children in developed countries. Children with CVI display a wide range of visual deficits including decreased visual acuity, impaired visual field function, as well as impairments in higher-order visual processing and attention. Together, these visual impairments can dramatically influence a child's development and well-being. Given the complex neurologic underpinnings of this condition, CVI is often undiagnosed by eye care practitioners. Furthermore, the neurophysiological basis of CVI in relation to observed visual processing deficits remains poorly understood. Here, we present some of the challenges associated with the clinical assessment and management of individuals with CVI. We discuss how advances in brain imaging are likely to help uncover the underlying neurophysiology of this condition. In particular, we demonstrate how structural and functional neuroimaging approaches can help gain insight into abnormalities of white matter connectivity and cortical activation patterns, respectively. Establishing a connection between how changes within the brain relate to visual impairments in CVI will be important for developing effective rehabilitative and education strategies for individuals living with this condition.
Topics: Brain; Humans; Neural Pathways; Vision Disorders
PubMed: 28941531
DOI: 10.1016/j.spen.2017.04.005