Acquired Vision Loss Research Articles

N-glycosylation of disease-specific haptoglobin for the early screening of diabetic retinopathy.

Diabetic retinopathy (DR), as one of the microvascular complications of diabetes, is a leading cause of acquired vision loss. Most DR cases are detected in the advanced stage through fundoscopy, making molecular biomarkers urgently needed for early diagnosis of DR. Serum disease-specific haptoglobin-β (Hp-β) chains of 100 patients with type 2 diabetes mellitus (T2DM) and 156 T2DM patients with non-proliferative diabetic retinopathy (NPDR) were separated using polyacrylamide gel electrophoresis. After in-gel digestion and enrichment, the intact N-glycopeptides were detected by mass spectrometry. Fucosylation of Hp-β was significantly increased and sialylation of Hp-β was significantly decreased in background DR (BDR, an early-stage DR) patients compared with non-diabetic retinopathy patients (p<0.05) and yielded area under curves (AUCs) of 0.801 and 0.829 in training and validation groups, respectively, which had an advantage over glycated hemoglobin A1c (AUC ≤ 0.691). Moreover, a significant increase in sialylated Hp-β was found in severe NPDR patients compared with BDR patients and yielded an AUC of 0.828 to distinguish severe NPDR from BDR. Changes in Hp-β glycosylation are closely related to DR, and may be used for early diagnosis and screening of DR.

Bioinformatics-based Study on the Effects of Umbilical Cord Mesenchymal Stem Cells on the Aging Retina.

Retinal aging is one of the common public health problems caused by population aging and has become an important cause of acquired vision loss in adults. The aim of this study was to determine the role of human umbilical cord mesenchymal stem cells (hUCMSCs) in delaying retinal ganglion cell (RGC) aging and part of the network of molecular mechanisms involved. A retinal ganglion cell senescence model was established in vitro and treated with UCMSC. Successful establishment of the senescence system was demonstrated using β- galactosidase staining. The ameliorative effect of MSC on senescence was demonstrated using CCK8 cell viability and Annexin V-PI apoptosis staining. The relevant targets of RGC, MSC, and senescence were mainly obtained by searching the GeneCards database. The protein interaction network among the relevant targets was constructed using the String database and Cytoscape, and 10 key target genes were calculated based on the MCC algorithm, based on which Gene ontologies (GO) enrichment and the Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment were performed. Changes in relevant target genes were detected using real-time fluorescence quantitative PCR and the mechanism of action of UCMSC was determined by RNA interference. β-galactosidase staining showed that UCMSC significantly reduced the positive results of RGC. The retinal aging process was alleviated. The bioinformatics screen yielded 201 shared genes. 10 key genes were selected by the MCC algorithm, including vascular endothelial growth factor A (VEGFA), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), albumin (ALB), interleukin- 6 (IL6), tumor necrosis factor (TNF), tumor protein P53 (TP53), insulin (INS), matrix metalloproteinase 9 (MMP9), epidermal growth factor (EGF), interleukin-1β (IL1B), and enrichment to related transferase activity and kinase activity regulated biological processes involved in oxidative stress and inflammation related pathways. In addition, PCR results showed that all the above molecules were altered in expression after UCMSC involvement. This experiment demonstrated the role of UCMSC in delaying retinal ganglion cell senescence and further elucidated that UCMSC may be associated with the activation of VEGFA, TP53, ALB, GAPDH, IL6, IL1B, MMP9 genes and the inhibition of INS, EGF, and TNF in delaying retinal senescence.

Geraniin ameliorates streptozotocin-induced diabetic retinopathy in rats via modulating retinal inflammation and oxidative stress

BackgroundDiabetic retinopathy (DR) is the major complication of diabetes, which causes acquired vision loss in the working-age group population. ObjectiveHere, we planned to address the therapeutic roles of geraniin against the streptozotocin (STZ)-challenged DR in rats MethodologyThe DR was induced in the animals by 60 mg/kg of STZ, and then treated with 25 mg/kg of geraniin for 60 days. Later, bodyweight, food consumption, and blood glucose levels were investigated. The levels of antioxidants, MMP-9, MCP-1, and VEGF, and inflammatory cytokine status were measured using marker-specific kits. The morphometric study was conducted to assess the retinal thickness. The pancreatic tissues were analyzed microscopically. ResultsGeraniin reduced the blood glucose (270.36 ± 81 mg/dL), hemoglobin, and enhanced bodyweight (261.93 ± 72 g)in the DR rats. The antioxidant levels in the STZ-challenged DR rats were substantially improved by geraniin. Geraniin also decreased inflammatory cytokines, MCP-I, MMP-9, and VEGF levels and enhanced the retinal thickness. A histological study demonstrated that geraniin reduced the pancreatic islet cell damage in STZ-induced DR rats. ConclusionOur outcomes witnessed that geraniin reduced retinal inflammation and oxidative stress in the STZ-induced DR rats.

Circulating MicroRNAs as Potential Diagnostic Biomarkers for Diabetic Retinopathy: A Meta-Analysis.

ObjectiveDiabetic retinopathy (DR) is a common diabetic microvascular complication and a major cause of acquired vision loss. Finding effective biomarkers for the early identification and diagnosis of DR is crucial. This study aimed to comprehensively evaluate the accuracy of microRNAs (miRNAs) in the diagnosis of DR via a meta-analysis of previously published diagnostic studies. This study has been registered on the PROSPERO website, with the number CRD42022323238.MethodsWe searched PubMed, Cochrane Library, Embase, Web of Science, China Wanfang database, and China Knowledge Network database to identify relevant articles published from the time of database creation to April 10, 2022. Stata 14.0 software was used to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic ratio (DOR), and area under the summary receiver operating characteristic (ROC) curve to assess the accuracy of miRNAs in the diagnosis of DR. Heterogeneity between studies was assessed using Cochran-Q test and I2 statistic for quantitative analysis. The random-effect model was selected due to significant heterogeneity. Subgroup analysis and regression analysis were also performed to determine the potential sources of heterogeneity.ResultsWe included 25 articles detailing 52 studies with 1987 patients with DR and 1771 non-DR controls. The findings demonstrated overall sensitivity (0.82, 95% CI: 0.78 ~ 0.85), specificity (0.84, 95% CI: 0.81 ~ 0.86), PLR (5.0, 95% CI: 4.2 ~ 5.9), NLR (0.22, 95% CI: 0.18 ~ 0.26), and the area under the summary ROC curve (0.90, 95% CI: 0.87 ~ 0.92). Furthermore, we performed subgroup analysis and found that panels of multiple miRNAs could enhance the pooled sensitivity (sensitivity, specificity, and AUC values were 0.89, 0.87, and 0.94, respectively).ConclusionThe meta-analysis showed that miRNAs can be used as potential diagnostic markers for DR, with high accuracy of diagnoses observed with the detection of miRNAs in plasma and serum.

VEGF-Trap Modulates Retinal Inflammation in the Murine Oxygen-Induced Retinopathy (OIR) Model.

Anti-Vascular Endothelial Growth Factor (VEGF) agents are the first-line treatment for retinal neovascular diseases, which represent the most prevalent causes of acquired vision loss world-wide. VEGF-Trap (Aflibercept, AFL), a recombinant decoy receptor recognizing ligands of both VEGFR-1 and -2, was recently reported to be highly efficient in improving visual acuity and preserving retinal anatomy in individuals affected by diabetic macular edema. However, the precise molecular and cell biological mechanisms underlying the beneficial effects of this novel tool have yet to be elucidated. Using the mouse oxygen-induced retinopathy (OIR) model as a surrogate of retinopathies with sterile post-ischemic inflammation, such as late proliferative diabetic retinopathy (PDR), retinopathy of prematurity (ROP), and diabetic macular edema (DME), we provide evidence that AFL modulates inflammation in response to hypoxia by regulating the morphology of microglial cells, a parameter commonly used as a proxy for changes in their activation state. We show that AFL administration during the hypoxic period of OIR leads to an increased number of ramified Iba1+ microglial cells/macrophages while subsequently limiting the accumulation of these cells in particular retinal layers. Our results suggest that, beyond its well-documented beneficial effects on microvascular regeneration, AFL might exert important modulatory effects on post-ischemic retinal inflammation.

Perspectives on diabetic retinopathy from advanced retinal vascular imaging.

Diabetic retinopathy (DR) is a microvascular complication of diabetes and the most common cause of acquired vision loss in adults worldwide. DR is associated with long-term chronic hyperglycaemia and its detrimental effects on the neurovascular structure and function of the retina. Direct imaging of the retinal vasculature and staging of DR has been traditionally based on fundoscopy and fluorescein angiography, which provide only 2D views of the retina, and in the case of fluorescein angiography, requires an invasive dye injection. In contrast, advanced retinal imaging modalities like optical coherence tomography angiography (OCTA) and adaptive optics (AO) are non-invasive and provide depth-resolved, 3D visualization of retinal vessel structure as well as blood flow. Recent studies utilizing these imaging techniques have shown promise in evaluating quantitative vascular parameters that correlate tightly to clinical DR staging, elucidating functional changes in early diabetes, and monitoring DR treatment response. In this article, we discuss and synthesize the results of advanced retinal imaging studies in DR and their implications for our clinical and pathophysiologic understanding of the disease. Based on the recent literature, we also propose a model to describe the differential changes in vascular structure and flow that have been described on advanced retinal imaging as DR progresses. Future studies of these imaging modalities in larger and more diverse populations, as well as corroboration with histological and functional studies, will be important to further our understanding of DR.

Designing an internet-based intervention for improving wellbeing in people with acquired vision loss: A Delphi consensus study.

Vision impairment (VI) may impact a person's functional ability resulting in a loss of independence, anxiety, depression, social isolation and reduced quality of life. Caregivers also experience similar problems due to the increased burden placed on them. Support to address these difficulties encountered by those with VI and their caregivers may not always be accessible. An internet-based intervention may provide more accessible support. The aim of this study was to obtain consensus regarding the content and accessibility features required to design an internet-based intervention to promote wellbeing for people with VI and their caregivers. A three-round Delphi review was conducted with a panel of 30 stakeholders. Three stakeholder groups were included, namely individuals with vision loss, experts in the field of vision loss and mental health and carers of individuals with vision loss. Conceptual wellbeing ideas were examined in round 1, the intervention modules and module content were proposed in round 2 and refined in round 3. Consensus of 75% or more was reached to include 18 modules into the intervention. These were divided into seven sections: understanding vision loss, emotional wellbeing, functional wellbeing, social wellbeing, physical wellbeing, wellbeing for carers and maintaining wellbeing. The accessibility features deemed most important were font size, colour and contrast options, compatibility with low vision aids and layout of the intervention. The Delphi process positively informed the design of an internet-based intervention for individuals with acquired VI and their caregivers. Suggestions provided by stakeholders should now be incorporated into the intervention. Future evaluation of efficacy and cost-effectiveness of such an intervention are necessary.

Gene expression profile of the murine ischemic retina and its response to Aflibercept (VEGF-Trap)

Ischemic retinal dystrophies are leading causes of acquired vision loss. Although the dysregulated expression of the hypoxia-responsive VEGF-A is a major driver of ischemic retinopathies, implication of additional VEGF-family members in their pathogenesis has led to the development of multivalent anti-angiogenic tools. Designed as a decoy receptor for all ligands of VEGFR1 and VEGFR2, Aflibercept is a potent anti-angiogenic agent. Notwithstanding, the molecular mechanisms mediating Aflibercept’s efficacy remain only partially understood. Here, we used the oxygen-induced retinopathy (OIR) mouse as a model system of pathological retinal vascularization to investigate the transcriptional response of the murine retina to hypoxia and of the OIR retina to Aflibercept. While OIR severely impaired transcriptional changes normally ensuing during retinal development, analysis of gene expression patterns hinted at alterations in leukocyte recruitment during the recovery phase of the OIR protocol. Moreover, the levels of Angiopoietin-2, a major player in the progression of diabetic retinopathy, were elevated in OIR tissues and consistently downregulated by Aflibercept. Notably, GO term, KEGG pathway enrichment, and expression dynamics analyses revealed that, beyond regulating angiogenic processes, Aflibercept also modulated inflammation and supported synaptic transmission. Altogether, our findings delineate novel mechanisms potentially underlying Aflibercept’s efficacy against ischemic retinopathies.

Cerebral Embolism as a Result of Facial Filler Injections: A Literature Review.

BackgroundWith the growth in the popularity of facial filler injections, increased numbers of severe adverse events, such as cerebral embolism, have been reported.ObjectivesThe aim of this article was to summarize the clinical manifestations and proposed mechanisms of filler-induced cerebral embolism (FICE).MethodsA literature review was performed with the search keywords “filler injection,” “hyaluronic acid,” “fat graft,” “cerebral infarction,” “cerebral embolism,” “stroke,” “cerebrovascular infarction,” “disorders of consciousness,” and “hemiplegia.”ResultsAmong the 43 cases of FICE enrolled from 35 articles, 37 patients were female, and 6 were male. Twenty-nine of these patients had received fat grafting, and 12 hyaluronic acid injection. Most FICE patients had been injected in the glabella, followed by the temporal, forehead, and nasal areas. Among 30 patients injected under local anesthesia, 43.33% presented with neurologic symptoms during the procedure. The main symptoms were consciousness disorders and hemiplegia. Most of the embolization sites were in the middle cerebral artery, followed by frontal lobe infarction and anterior cerebral artery infarction. Three patients developed cerebral hemorrhage after embolism. Twenty-six patients presented with newly acquired vision loss. The management for FICE cases included embolectomy, thrombolysis, decompressive craniectomy, antiplatelet/anticoagulant therapy, and symptomatic and nutritional treatment. Nearly half of the patients recovered or exhibited improved neurologic manifestations but not visual loss. Five patients died.ConclusionsFICE is a severe complication following facial filler injection. Careful prevention, timely identification, and treatment are crucial to decreasing the morbidity and mortality of FICE.Level of Evidence: 4

EFFECT OF MRIDWEEKADI KASHAYA SEKA IN RETINAL HAEMORRHAGES ASSOCIATED WITH NON-PROLIFERATIVE DIABETIC RETINOPATHY – A CLINICAL STUDY

Diabetic retinopathy (DR) is a leading cause of acquired vision loss in middle-aged and elderly people globally. In modern science, other than the meticulous control of diabetes there is no proven non-invasive management for the prevention or cure of Diabetic retinopathy.&#x0D; In this study, mild to moderate Non-proliferative diabetic retinopathy (NPDR) with retinal haemorrhages is considered as a Timira (symptomatically) and as Abhishyanda (considering etiopathogenesis) with Kapha-pitta predominance. Mridweekadi kashaya, predominantly Kapha Pitta samana, was selected for the study to be used as Seka. &#x0D; Method: The study design was Interventional- pre and post evaluation without control, sample size fixed as 30 eyes. Mridweekadi kashaya was used as Seka for 21 days, twice daily. Fundus photographs were taken prior to commencement of Seka, on the 22nd day and then on 30th and 60th day after completion of the procedure. Change in extent of retinal hemorrhages were assessed as visualized in Fundus photographs and direct ophthalmoscopy. Change in visual acuity was assessed by LogMar Visual acuity chart and change in contrast sensitivity by Pelli-Robson contrast sensitivity chart consecutively, prior to the treatment, on the 10th day, 22nd day and then on 30th and 60th day after completion of procedure. Statistical analysis was done using Wilcoxon signed rank test and Paired t test according to the variable.&#x0D; Result: Control in retinal haemorrhages associated with NPDR and improvement in visual acuity and contrast sensitivity.&#x0D; Conclusion: Mridweekadi kashaya seka is effective in controlling retinal haemorrhages associated with NPDR.

Factors related to braille reading acquisition among aging braille learners

The prevalence of older adults with acquired vision loss is expected to double by 2050 as life expectancy continues to increase, and reading difficulties remain the most common reason for referral to vision rehabilitation services. Refreshable braille technologies provide expanded access to information in braille, and may be beneficial to older adults who experience age-related declines in tactile acuity. Despite this, very little is known about the impact of aging on braille reading, how reading performance differs between hardcopy and electronic refreshable braille, or whether such technologies would improve training outcomes for older adults who pursue braille training. The goal of this research is to answer fundamental questions about aging on braille reading performance through both traditional and technological methods and to explore whether use of refreshable braille technologies within training interventions would help to better meet the unique needs of a quickly aging population.

AB029. Investigating the link between reduced reading ability and cognitive decline in older adults with acquired vision impairment: a feasibility study

Background: Reading enables us to obtain information, to engage in leisure, educational, business and other activities, and fosters cognitive stimulation. Acquired vision loss can have a negative effect on an individual’s ability to read, and, by extension, reduce overall quality of life. In addition, a growing body of research on the association between reading and cognition has linked a decrease in reading ability with negative changes in cognitive function. Therefore, the purpose of the current study is to test the feasibility of a research protocol that will be used to study the association between reduced reading ability and cognitive impairment, specifically in older adults with acquired vision loss.

AB031. Exploring the facilitators and barriers encountered by adults and seniors with acquired vision loss who pursue braille training

AB031. Exploring the facilitators and barriers encountered by adults and seniors with acquired vision loss who pursue braille training

Imaging and Biomarkers in Diabetic Macular Edema and Diabetic Retinopathy.

Diabetic retinopathy (DR) is the leading cause of acquired vision loss in adults across the globe. Early identification and treatment of patients with DR is paramount for vision preservation. The aim of this review paper is to outline current and new imaging techniques and biomarkers that are valuable for clinical diagnosis and management of DR. Ultrawide field imaging and automated deep learning algorithms are recent advancements on traditional fundus photography and fluorescein angiography. Optical coherence tomography (OCT) and OCT angiography are techniques that image retinal anatomy and vasculature and OCT is routinely used to monitor response to treatment. Many circulating, vitreous, and genetic biomarkers have been studied to facilitate disease detection and development of new treatments. Recent advancements in retinal imaging and identification of promising new biomarkers for DR have the potential to increase detection, risk stratification, and treatment for patients with DR.

Major Depression in Individuals with Visual Impairment, Associations with Characteristics of Vision Loss, and Relation to Life Satisfaction

Background: A predominant focus on middle-aged or elderly has limited most studies of depression in adults with visual impairment (VI). In this cohort of individuals with VI across a broad age spectrum, we aimed to estimate the prevalence of and factors associated with major depression in adults with VI, and to examine its association with life satisfaction. Methods: We performed a cross-sectional interview study of 736 adults with VI who were members of the Norwegian Association of the Blind and Partially Sighted. The members were randomly sampled across four different age strata (years: 18–35, 36–50, 51–65, ≥ 66). Structured telephone interviews were completed in the period between January and May, 2017, collecting data on characteristics of visual impairment, major depression (Patient Health Questionnaire), and life satisfaction (Cantril’s Ladder of Life Satisfaction). Findings: The point prevalence of major depression in different age strata varied between 3.7– 15.8% in women and 2.4–12.9% in men. The estimates were highest in those aged 36–50 years. After controlling for age, gender, and education, major depression was associated with VI occurring quite recently (prevalence ratio (PR): 2.35), having additional impairments (PR: 2.13), and acquired vision loss during adulthood (PR: 2.36). Those who were depressed had lower life satisfaction than those without depression (Adjusted β = −2.40, 95% CI: −2.90, −1.90). Interpretation: High rates of major depression in young and middle-aged adults with VI suggest a need for mental health care professionals with specific expertise on challenges in being visually impaired. Funding Statement: Grants from the European Commission, Directorate - General Humanitarian Aid and Civil Protection (Grant no. ECHO/SUB/2015/718665/PREP17) and from the Norwegian Association of the Blind and Partially Sighted. Declaration of Interests: The authors state: None declared. Ethics Approval Statement: The study was carried out anonymously and, at request, the Regional Committee for Medical and Health Research Ethics required no further formal ethical approval (Reference number: 2016/1615A). All participants provided informed consent for taking part in the study. Study participation was voluntary, and the participants were informed that they could withdraw from the study at any time.

Overview of Risk factors of diabetic macular edema treatment prognosis

Background: Diabetes mellitus (DM) is just one of the world's fastest growing chronic conditions as well as a leading cause of acquired vision loss, diabetic macular edema (DME) is a disease linked to diabetes. Some individuals with diabetes will certainly get a kind of retinopathy-a problem of the retina in the eye. Diabetic retinopathy could progress as well as result in DME (additionally referred to as retinal swelling) that might impact your vision, and is among the most usual reasons for blindness. Objective: In this review we discuss about the most dangerous risk factors during treatment and in daily life, which can worsen the treatment prognosis. Methods: PubMed and Embase database were searched up to July, 2018 for relevant studies that discussing the risk factors of glaucoma. Result: It is clear that the variety of people affected by DM is expanding greatly, as is the variety of patients with problems from DM. Fortunately; the eye symptoms of DME can be identified and managed prior to considerable vision loss happens if patients with DM undergo routine eye tests and much better manage their systemic condition. Conclusion: Close collaboration in between doctors and also ophthalmologists is important in the managing of patients with diabetic retinopathy and also DME. To make certain very early medical diagnosis as well as treatment all diabetic person patients should be screened for diabetic person retinopathy. Control of blood pressure, serum lipids, and also renal function are very important treatments focused on prevention of visual impairment associated with diabetic retinopathy and DME.

Overview of Risk factors of diabetic macular edema treatment prognosis

Background: Diabetes mellitus (DM) is just one of the world's fastest growing chronic conditions as well as a leading cause of acquired vision loss, diabetic macular edema (DME) is a disease linked to diabetes. Some individuals with diabetes will certainly get a kind of retinopathy-a problem of the retina in the eye. Diabetic retinopathy could progress as well as result in DME (additionally referred to as retinal swelling) that might impact your vision, and is among the most usual reasons for blindness. Objective: In this review we discuss about the most dangerous risk factors during treatment and in daily life, which can worsen the treatment prognosis. Methods: PubMed and Embase database were searched up to July, 2018 for relevant studies that discussing the risk factors of glaucoma. Result: It is clear that the variety of people affected by DM is expanding greatly, as is the variety of patients with problems from DM. Fortunately; the eye symptoms of DME can be identified and managed prior to considerable vision loss happens if patients with DM undergo routine eye tests and much better manage their systemic condition. Conclusion: Close collaboration in between doctors and also ophthalmologists is important in the managing of patients with diabetic retinopathy and also DME. To make certain very early medical diagnosis as well as treatment all diabetic person patients should be screened for diabetic person retinopathy. Control of blood pressure, serum lipids, and also renal function are very important treatments focused on prevention of visual impairment associated with diabetic retinopathy and DME.

Perception of blind rehabilitation services among adults with acquired blindness in Nigeria: Attention to functional goals

Like other sub-Saharan African nations, Nigeria has a relatively high proportion of adults with acquired vision loss. This study investigates the impacts of becoming blind in adulthood and how the use of blind rehabilitation services addresses functional needs, supports activities of daily living, and enhances participation in educational, vocational, and community activities. Adopting a qualitative and interpretative approach, we conducted in-depth interviews with eight adult users of blind rehabilitation services. Three broad themes were identified: (1) psycho-emotional responses to vision loss; (2) impacts on participation in education, employment, and community; and (3) positive impact of blind rehabilitation services. Findings are discussed in the context of the international literature, and suggestions that may enhance the blind rehabilitation services are made.

Ocular findings in Zucker Diabetic Fatty rats emphasize the key role of neuroglia degeneration in diabetic retinopathy pathophysiology.

Ocular findings in Zucker Diabetic Fatty rats emphasize the key role of neuroglia degeneration in diabetic retinopathy pathophysiology.

XPress

Although many older adults are active online, certain age-related disabilities, such as late-life vision impairment, make sustaining online participation difficult. Motivated by the need for accessible online spaces for people experiencing vision impairment in older adulthood, we developed xPress, a voice-based online blogging community. Through a 10-week deployment with seven older adults with acquired vision loss, we analyze how this type of online community enables connecting with peers, sharing experiences, and offering social support in new ways. The design of xPress also highlights the importance of human voice in accessible social platforms and reveals expectations around community participation. We discuss designing for age and disability through the lens of intersectionality and offer design considerations for similar voice-based online communities.