Cause Of Visual Impairment Research Articles

Proliferative Diabetic Retinopathy Microenvironment Drives Microglial Polarization and Promotes Angiogenesis and Fibrosis via Cyclooxygenase-2/Prostaglandin E2 Signaling

Diabetic retinopathy (DR) is the leading cause of visual impairment, particularly in the proliferative form (proliferative DR [PDR]). The impact of the PDR microenvironment on microglia, which are the resident immune cells in the central nervous system, and the specific pathological changes it may induce remain unclear. This study aimed to investigate the role of microglia in the progression of PDR under hypoxic and inflammatory conditions. We performed a comprehensive gene expression analysis using human-induced pluripotent stem cell-derived microglia under different stimuli (dimethyloxalylglycine (DMOG), lipopolysaccharide (LPS), and DMOG + LPS) to mimic the hypoxic inflammatory environment characteristic of PDR. Principal component analysis revealed distinct gene expression profiles, with 76 genes synergistically upregulated under combined stimulation. Notably, prostaglandin-endoperoxide synthase 2 (encoding cyclooxygenase (COX)-2) exhibited the most pronounced increase, leading to elevated prostaglandin E2 (PGE2) levels and driving pathological angiogenesis and inflammation via the COX-2/PGE2/PGE receptor 2 signaling axis. Additionally, the upregulation of the fibrogenic genes snail family transcriptional repressor 1 and collagen type I alpha 1 chain suggested a role for microglia in fibrosis. These findings underscore the critical involvement of microglia in PDR and suggest that targeting both the angiogenic and fibrotic pathways may present new therapeutic strategies for managing this condition.

Multiple sclerosis-associated uveitis in Persian population, a multicenter study

PurposeTo report the characteristics of multiple sclerosis-associated uveitis (MSU) among the Persian population. Patients and methodsRetrospective, nonrandomized, multicenter study. Epidemiological characteristics, ocular and neurologic findings, angiographic features, and visual outcomes in MSU were studied. Results92 patients (173 eyes) were included; the mean age at the time of uveitis onset was 35.9 ± 10.9 years (range; 10–60 years), 84.8 % were female, and 88.0 % had bilateral involvement. The anatomical subgroups were isolated anterior uveitis (AU) in 12.0 %, intermediate uveitis (IU) with or without AU in 84.8 % and pure retinal vasculitis in 3.3 % of patients. None of the patients were defined as having posterior or panuveitis. Uveitis had an insidious onset and chronic course in 89.1 % patients and was of granulomatous type in 81.9 %. The diagnosis of MS precedes uveitis onset in 48.8 % patients (range 1 to 35 years, median: 7 years) and was concurrent or after the uveitis onset in 52.2 % patients (range; 1 to 12 years; median: 2 years). Undifferentiated intermediate uveitis was the most common initial diagnosis (30.4 %) before MS establishment. 89.1 % of patients received at least one conventional immunotherapy agent. Peripheral retinal perivascular leakage (81.4 %) and optic disc hyperfluorescence (74.4 %) were the two most common fluorescein angiography (FA) findings The major causes of visual impairment were cataracts (52.7 %), cystoid macular edema (CME) (31.5 %), and optic neuritis (29.2 %). During an average follow-up time of 4.76 ± 3.18 years (range: 1–12 years), visual acuity improved –0.09 logMar/year and most eyes maintain relatively good visual acuity. ConclusionMSU usually presents as chronic granulomatous bilateral IU and less often isolated AU, especially in females. Retinal vasculitis can be a prominent feature. Clinically, it may resemble Undifferentiated intermediate uveitis . In geographical areas where MS is prevalent, the indication of neuroimaging should be expanded and include patients presenting with chronic granulomatous IU or AU especially if accompanied by retinal vasculitis.

PSAT1 is upregulated by METTL3 to attenuate high glucose-induced retinal pigment epithelial cell apoptosis and oxidative stress

BackgroundDiabetic retinopathy (DR) is a major ocular complication of diabetes mellitus, and a significant cause of visual impairment and blindness in adults. Phosphoserine aminotransferase 1 (PSAT1) is an enzyme participating in serine synthesis, which might improve insulin signaling and insulin sensitivity. Furthermore, it has been reported that the m6A methylation in mRNA controls gene expression under many physiological and pathological conditions. Nevertheless, the influences of m6A methylation on PSAT1 expression and DR progression at the molecular level have not been reported.MethodsHigh-glucose (HG) was used to treat human retinal pigment epithelial cells (ARPE-19) to construct a cell injury model. PSAT1 and Methyltransferase-like 3 (METTL3) levels were detected by real-time quantitative polymerase chain reaction (RT-qPCR). PSAT1, B-cell lymphoma-2 (Bcl-2), Bcl-2 related X protein (Bax), and METTL3 protein levels were examined by western blot assay. Cell viability and apoptosis were detected by Cell Counting Kit-8 (CCK-8) and TUNEL assays. Reactive oxygen species (ROS), malondialdehyde (MDA), and Glutathione peroxidase (GSH-Px) levels were examined using special assay kits. Interaction between METTL3 and PSAT1 was verified using methylated RNA immunoprecipitation (MeRIP) and dual-luciferase reporter assay.ResultsPSAT1 and METTL3 levels were decreased in DR patients and HG-treated ARPE-19 cells. Upregulation of PSAT1 might attenuate HG-induced cell viability inhibition and apoptosis and oxidative stress promotion in ARPE-19 cells. Moreover, PSAT1 was identified as a downstream target of METTL3-mediated m6A modification. METTL3 might improve the stability of PSAT1 mRNA via m6A methylation.ConclusionMETTL3 might mitigate HG-induced ARPE-19 cell damage partly by regulating the stability of PSAT1 mRNA, providing a promising therapeutic target for DR.

The Role of Immune Cells and Signaling Pathways in Diabetic Eye Disease: A Comprehensive Review.

Diabetic eye disease (DED) encompasses a range of ocular complications arising from diabetes mellitus, including diabetic retinopathy, diabetic macular edema, diabetic keratopathy, diabetic cataract, and glaucoma. These conditions are leading causes of visual impairments and blindness, especially among working-age adults. Despite advancements in our understanding of DED, its underlying pathophysiological mechanisms remain incompletely understood. Chronic hyperglycemia, oxidative stress, inflammation, and neurodegeneration play central roles in the development and progression of DED, with immune-mediated processes increasingly recognized as key contributors. This review provides a comprehensive examination of the complex interactions between immune cells, inflammatory mediators, and signaling pathways implicated in the pathogenesis of DED. By delving in current research, this review aims to identify potential therapeutic targets, suggesting directions of research for future studies to address the immunopathological aspects of DED.

Predicting vision-threatening diabetic retinopathy in patients with type 2 diabetes mellitus: Systematic review, meta-analysis, and prospective validation study.

Delayed diagnosis and treatment of vision-threatening diabetic retinopathy (VTDR) is a common cause of visual impairment in individuals with type 2 diabetes mellitus (T2DM). Identification of VTDR predictors is the key to early prevention and intervention, but the predictors from previous studies are inconsistent. This study aims to conduct a systematic review and meta-analysis of the existing evidence for VTDR predictors, then to develop a risk prediction model after quantitatively summarising the predictors across studies, and finally to validate the model with two Chinese cohorts. We systematically retrieved cohort studies that reported predictors of VTDR in T2DM patients from PubMed, Ovid, Embase, Scopus, Cochrane Library, Web of Science, and ProQuest from their inception to December 2023. We extracted predictors reported in two or more studies and combined their corresponding relative risk (RRs) using meta-analysis to obtain pooled RRs. We only selected predictors with statistically significant pooled RRs to develop the prediction model. We also prospectively collected two Chinese cohorts of T2DM patients as the validation set and assessed the discrimination and calibration performance of the prediction model by the time-dependent ROC curve and calibration curve. Twenty-one cohort studies involving 622 490 patients with T2DM and 57 107 patients with VTDR were included in the meta-analysis. Age of diabetes onset, duration of diabetes, glycosylated haemoglobin (HbA1c), estimated glomerular filtration rate (eGFR), hypertension, high albuminuria and diabetic treatment were used to construct the prediction model. We validated the model externally in a prospective multicentre cohort of 555 patients with a median follow-up of 52 months (interquartile range = 39-77). The area under the curve (AUC) of the prediction model was all above 0.8 for 3- to 10-year follow-up periods and different cut-off value of each year provided the optimal balance between sensitivity and specificity. The data points of the calibration curves for each year closely surround the corresponding dashed line. The risk prediction model of VTDR has high discrimination and calibration performance based on validation cohorts. Given its demonstrated effectiveness, there is significant potential to expand the utilisation of this model within clinical settings to enhance the detection and management of individuals at high risk of VTDR.

FYCO1 regulates autophagy and senescence via PAK1/p21 in cataract

ARC (Age-related cataract) is one of the leading causes of vision impairment and blindness; however, its pathogenesis remains unclear. FYCO1 (FYVE and coiled-coil domain containing 1) serves as an autophagy adaptor. The present study investigated the role of FYCO1 in cataract. Ultraviolet-B (UVB) irradiation was used to establish a cataract mice model. Hematoxylin and eosin (H&E) assay were used to observe lens morphology. Cell models were constructed by cultivating SRA 01/04 cells with H2O2 and UVB. Cell counting kit-8 (CCK8) and Senescence-associated β-galactosidase (SA-β-Gal) assay were performed to explore proliferation and senescence. The gene and protein expression were assessed by quantitative real-time PCR (qRT-PCR), western blot and immunofluorescence staining. We demonstrated lens structural damage and downregulation of FYCO1 in mice with UVB-induced cataracts. In vitro results revealed a deletion in autophagy levels along with the decrease of FYCO1 expression in human lens epithelial cells (HLECs) after H2O2 treatment, which was confirmed in vivo. The knockout of FYCO1 in the HLECs did not change basal autophagy and senescence but suppressed HLECs response in the induction of both. Further investigation indicated that FYCO1 knockout inhibited senescence and p21 levels by suppressing the expression of p21 activated kinase 1 (PAK1) in cataract cell models. This study has newly characterized the role of FYCO1 in UVB-induced cataracts and in oxidative stress, both of which are associated with ARCs. A novel association between FYCO1 and PAK1/p21 in lens epithelial cell autophagy, senescence, and cataractogenesis also appears to have been established.

Dasatinib and erianin co-loaded ion-responsive in-situ hydrogel for effective treatment of corneal neovascularization

Corneal neovasularization (CNV) is one of the leading causes for visual impairment. Dasatinib is a multi-target tyrosine kinase inhibitor, which can inhibit both platelet derived growth factor receptor and Src family kinases. Erianin exhibits excellent anti-inflammatory and anti-angiogenic effects. In this study, dasatinib and erianin were found to synergically inhibit the proliferation, migration and tube formation of Ea.hy926 cells, the three most important cellular processes of CNV. Next, dasatinib and erianin were co-encapsulated in nanostructured lipid carriers (dasa-eri-NLC), which increased the solubility of dasatinib by about 1790 times, increased the solubility of erianin by about 3 times. To improve its retention time on the ocular surface, dasa-eri-NLC was mixed with gellan gum (dasa-eri-NLC-gel), which achieved a sol-gel transformation when got in contact with tears. The dasa-eri-NLC-gel exhibited good rheological properties with shear thinning properties, extended the ocular residence time by more than 6 times, sustained the drug release, improved the corneal permeability of drug and exhibited good biocompatibility. Finally, the in vivo anti-CNV effect was evaluated in an alkaline burned mouse model of CNV, in which, the dasa-eri-NLC-gel significantly impeded the development and pathological changes of CNV, inhibited the expression of TNF-α, VEGF-A, HIF-1α, Src, pSrc in the cornea. In summary, dasa-eri-NLC-gel safely and efficiently delivered dasatinib and erianin to the cornea and exhibited significantly anti-CNV effect via inhibiting various angiogenesis related cytokines or factors. Dasa-eri-NLC-gel showed a great promise for the treatment of CNV and our study laid a solid foundation for future clinical transformation.

The Use of Artificial Intelligence for Estimating Anterior Chamber Depth from Slit-Lamp Images Developed Using Anterior-Segment Optical Coherence Tomography.

Primary angle closure glaucoma (PACG) is a major cause of visual impairment, particularly in Asia. Although effective screening tools are necessary, the current gold standard is complex and time-consuming, requiring extensive expertise. Artificial intelligence has introduced new opportunities for innovation in ophthalmic imaging. Anterior chamber depth (ACD) is a key risk factor for angle closure and has been suggested as a quick screening parameter for PACG. This study aims to develop an AI algorithm to quantitatively predict ACD from anterior segment photographs captured using a portable smartphone slit-lamp microscope. We retrospectively collected 204,639 frames from 1586 eyes, with ACD values obtained by anterior-segment OCT. We developed two models, (Model 1) diagnosable frame extraction and (Model 2) ACD estimation, using SWSL ResNet as the machine learning model. Model 1 achieved an accuracy of 0.994. Model 2 achieved an MAE of 0.093 ± 0.082 mm, an MSE of 0.123 ± 0.170 mm, and a correlation of R = 0.953. Furthermore, our model's estimation of the risk for angle closure showed a sensitivity of 0.943, specificity of 0.902, and an area under the curve (AUC) of 0.923 (95%CI: 0.878-0.968). We successfully developed a high-performance ACD estimation model, laying the groundwork for predicting other quantitative measurements relevant to PACG screening.

Refractive errors, amblyopia risk factors and vision screening in children aged 7–10 years in Aotearoa New Zealand

ABSTRACT Clinical relevance Vision screening is important for detecting undiagnosed vision conditions that are common in school-aged children. However, current vision screening protocols are poor at detecting vision conditions that are most common in the Aotearoa New Zealand paediatric population. Background Uncorrected refractive error and amblyopia are the most common causes of visual impairment in children. The most appropriate vision screening method depends on the refractive error profile of the population. This study aimed to: estimate the prevalence of refractive errors and amblyopia risk factors among children living in Aotearoa New Zealand; describe previous participation in preschool vision screening and determine the diagnostic accuracy of potential screening methods. Methods Children aged 7–10 years received comprehensive eye examinations, including cycloplegic refraction, in their school. Eye examination results were assessed for refractive error and amblyopia risk factors. The sensitivity and specificity of individual vision tests for detecting any vision conditions was calculated to assess the most effective tests for vision screening. Results Eye examinations were completed for 237 children and cycloplegic refraction data was available for 220 of these children. Significant refractive error (need for glasses) was detected in 23.6% of children (7.7% myopia, 7.7% hyperopia, 15.0% astigmatism). Amblyopia risk factors were detected in 9.1% of children. Preschool vision screening had been completed by 78.5% of children. Distance visual acuity screening alone had a sensitivity of 39% for detecting vision conditions, with addition of the Spot Vision Screener improving sensitivity to 65%. Conclusion Astigmatism is the most frequent refractive error among children aged 7–10 years living in Aotearoa New Zealand. Distance visual acuity screening alone is ineffective in detecting refractive error in children in Aotearoa New Zealand. Further research investigating refractive errors across the paediatric population in Aotearoa New Zealand is required to determine the optimal timing and appropriate protocols for school-aged vision screening.

Changes in Vitreous and Retina in Pathological Myopia

Myopia is the leading cause of visual impairment and its prevalence continues to increase significantly. Pathological myopia affects 1-3% of the general population and is one of the main causes of low vision and blindness worldwide. Myopic vitreopathy associated with pathological myopia essentially represents fibrous vitreous liquefaction, resulting from both hereditary and degenerative processes. In addition, myopic retinopathy, in which axial elongation plays an important role in pathogenesis, has many unique pathologies. In this review, changes in the vitreous and retina in patients with pathological myopia are discussed.

Vision impairment in school students: Results of a school-based study in Qatar

Background: Pediatric vision impairment (VI) has profound implications for a child's development, intellectual skills, and quality of life. The aim of this study was to assess the prevalence of VI among primary and preparatory school students in Qatar. Methods: A school-based cross-sectional study was conducted among students in grades 1, 3, 5, 7, and 9 in Qatar. School nurses conducted visual acuity (VA) measurement using a Snellen chart placed 6 meters away, with an E symbol, in which the 6/6 line is the standard for normal vision. Each student's information was recorded in their electronic health records (government schools, GSs) or in Excel sheets (private schools, PSs). Results: Three hundred and thirty schools participated in this survey, with 99,379 students divided into 45,670 from GSs and 53,709 from PSs. The prevalence of abnormal VA among students was 10.4% in GSs and 12.6% in PSs. There was no significant association between VI and gender or nationality, although VI was higher in grades 5, 7, and 9 but not statistically significant. Furthermore, the proportion of visually impaired students diagnosed with refractive errors and wearing glasses or contact lenses during vision measurement was 14.7% in GSs and 27% in PSs. Conclusion: The study provides comprehensive and baseline data on VI among the school children of Qatar. The vision screening helped in the early detection of VI in one-tenth of the affected students. However, urgent interventions are needed to enhance screening strategies for future studies on the causes of VI.

Epidemiology of Myopia: Prevalence, Risk Factors and Effects of Myopia.

Myopia is the most common cause of visual impairment in children and young adults. In order to assess the consequences for society, it is necessary to know temporal trends in prevalence, incidence and associated factors in childhood and adolescence, as well as the rate of myopia progression, as based on epidemiological research. This paper presents a literature review of publications from 2020 up to March 2024, supplemented by other relevant publications. The prevalence of myopia in children and adolescents in Germany is almost stable and is significantly lower than in Asia. The development of myopia is influenced by outdoor activity, parental myopia, genetics and near work, while insufficient time spent outdoors in childhood is a significant and controllable risk factor for myopia-related complications such as myopic maculopathy, glaucoma, and retinal detachment.

Outcomes of Multidisciplinary Low-Vision Rehabilitation Using Two Questionnaires and the International Classification of Functioning, Disability, and Health

Objective: To evaluate the effectiveness of a low-vision service by using three tools and to identify the specific outcomes obtained from each instrument. Materials and Methods: Patients consecutively visiting the low-vision clinic at Siriraj Hospital, Bangkok, Thailand, were enrolled. The impact of the prescribed rehabilitation on patient quality of life was measured using three tools: the Low-Vision Quality-Of-Life Questionnaire (LVQOL); the generic EuroQol Five-Dimensional Questionnaire (EQ-5D); and the World Health Organization International Classification of Functioning, Disability, and Health (WHO-ICF). Results: Out of the 104 patients recruited, 76 patients (mean age, 53 ± 16.2 years) completed the questionnaires before and after rehabilitation, which was assessed after 5.8 ± 2.0 months. Post-rehabilitation, the time of follow-up, patients had significant improvements in the mean scores of both the LVQOL scores and mean EQ-5D scores compared to before rehabilitation (P < 0.001), with Cohen’s effect sizes of 0.85 and 0.67, respectively. Subgroup analyses by age, severity, and cause of visual impairment also showed significant improvements in the LVQOL (P < 0.05), but not the EQ-5D score in the blindness severity subgroup. The ICF scores also showed significant improvement in most domains, including seeing functions, mobility across different locations, transportation use, meal preparation, economic self-sufficiency, community life, and recreational activities (P < 0.01). Conclusion: Patients with low vision experienced significant improvements following vision rehabilitation, especially in terms of seeing functions and mobility. Evaluation by different questionnaire types could provide additional information. The WHO-ICF was effective in assessing each domain related to activity performance and participation.

Age-related macular degeneration.

Age-related macular degeneration (AMD) is the leading cause of visual impairment in patients age 50 and older, with an estimated 200 million people affected worldwide and a projected 288 million by 2040. This article provides an overview of the epidemiology, risk factors, pathophysiology, clinical manifestations, diagnosis, management, and nursing considerations for AMD to equip nurses with the knowledge to play a crucial role in the early detection of this disease.

Repeated treatment with VEGF receptor inhibitors induces phenotypic changes in endothelial cells and pericytes in the rat retina

Abnormal ocular angiogenesis is a major cause of visual impairment and vision loss in neovascularization-related diseases. Currently, anti-vascular endothelial growth factor (VEGF) drugs are used to treat ocular neovascularization, but repeated injections are needed to maintain their therapeutic effects. However, repeated injection of anti-VEGF drugs may affect the retinal blood vessel phenotype and diminish therapeutic effects. In this study, we aimed to investigate the phenotypic changes in endothelial cells and pericytes caused by the repeated interruption of the VEGF receptor signaling pathway in neonatal rats. KRN633 (10 mg/kg), a VEGF receptor tyrosine kinase inhibitor, was subcutaneously administered on postnatal day (P)-7 and P8 (first round), P14 and P15 (second round), and P21 and P22 (third round). The rat eyes were collected on P7, P9, P14, P16, P21, P23, P28, and P35. Using retinal flat-mount specimens stained with specific markers for vascular endothelial cells, basement membranes, and pericytes, the arteriolar tortuosity, capillary area density, and distribution of pericytes were evaluated. Significant loss of capillaries was observed the day after the first round of KRN633 treatment, after which aggressive angiogenesis occurred, leading to the formation of tortuous arterioles. Rats that completed second and third rounds of KRN633 treatment showed more severe abnormalities in the retinal vasculature than those that only completed first round treatment. Repeated treatment with KRN633 decreased the anti-angiogenic effects but increased the immunoreactivity of α-smooth muscle actin in the pericytes on veins and capillaries. α-Smooth muscle actin expression was inversely correlated to anti-angiogenic effects. Overall, these results revealed that repeated interruption of VEGF receptor signaling pathway altered the phenotypes of endothelial cells and pericytes and induced anti-VEGF drug resistance. Therefore, careful follow-up is necessary when using anti-VEGF drugs to treat abnormal angiogenesis-associated ocular diseases.

Diabetic Retinopathy Diagnosis based on Convolutional Neural Network in the Russian Population: A Multicenter Prospective Study.

Diabetic retinopathy is the most common complication of diabetes mellitus and is one of the leading causes of vision impairment globally, which is also relevant for the Russian Federation. To evaluate the diagnostic efficiency of a convolutional neural network trained for the detection of diabetic retinopathy and estimation of its severity in fundus images of the Russian population. In this cross-sectional multicenter study, the training data set was obtained from an open source and relabeled by a group of independent retina specialists; the sample size was 60,000 eyes. The test sample was recruited prospectively, 1186 fundus photographs of 593 patients were collected. The reference standard was the result of independent grading of the diabetic retinopathy stage by ophthalmologists. Sensitivity and specificity were 95.0% (95% CI; 90.8-96.4) and 96.8% (95% CI; 95.5- 99.0), respectively; positive predictive value - 98.8% (95% CI; 97.6-99.2); negative predictive value - 87.1% (95% CI, 83.4-96.5); accuracy - 95.9% (95% CI; 93.3-97.1); Kappa score - 0.887 (95% CI; 0.839-0.946); F1score - 0.909 (95% CI; 0.870-0.957); area under the ROC-curve - 95.9% (95% CI; 93.3-97.1). There was no statistically significant difference in diagnostic accuracy between the group with isolated diabetic retinopathy and those with hypertensive retinopathy as a concomitant diagnosis. The method for diagnosing DR presented in this article has shown its high accuracy, which is consistent with the existing world analogues, however, this method should prove its clinical efficiency in large multicenter multinational controlled randomized studies, in which the reference diagnostic method would be unified and less subjective than an ophthalmologist.

Awareness, Knowledge, Attitudes, and Practices Regarding Diabetic Retinopathy Among Residents of Jazan City, Saudi Arabia.

Eye diseases, particularly diabetic retinopathy, cataracts, and glaucoma, are significant public health challenges globally, affecting quality of life. Diabetic retinopathy, a common diabetes complication, is a leading cause of visual impairment among working-age adults due to chronic hyperglycemia. Despite treatment advances, awareness of this condition remains low, especially in high-risk populations. This study explores the awareness, knowledge, attitudes, and practices regarding eye health among residents of Jazan City, Saudi Arabia. This cross-sectional study utilized an online survey distributed via social media from August 1 to August 30, 2024. Targeting adults aged 18 and older, the survey assessed demographics, knowledge of eye diseases, and awareness of screening practices. After refining through a pilot test and validation by experts, data were collected anonymously via Google Forms (Google, Mountain View, California, United States) and analyzed using IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States). A total of 424 participants completed the survey, comprising 236 females (55.7%) and 186 males (43.9%), with the majority aged 18-45 years (n=379, 89.4%). Significant knowledge gaps were evident, as 284 participants (67%) were unaware of diabetic retinopathy, with only 138 (32.5%) recognizing the condition. Awareness of treatability was limited; 261 participants (61.6%) were uncertain about available treatment options. Social media (n=112, 26.4%) and family or friends (n=106, 25%) were the primary sources of information regarding eye health. While most participants believed in the necessity of regular eye examinations, many had not undergone such screenings. This study reveals critical gaps in knowledge and awareness of eye diseases, particularly diabetic retinopathy, among residents of Jazan City, Saudi Arabia. Although participants generally recognize the importance of eye health, misconceptions about the causes, risk factors, and treatment options for common eye conditions persist. Targeted public health initiatives and educational interventions are essential to enhance awareness and promote proactive eye health behaviors. Improving understanding and access to eye care services can facilitate the early detection and management of eye diseases, ultimately reducing the burden of visual impairment in the community.

Update on Epidemiologic Trends in Causes of Childhood Blindness and Severe Visual Impairment in East Africa.

The initiative 2030 In Sight and the International Agency for the Prevention of Blindness have developed a plan to mitigate the global burden of preventable sight loss. One priority of this initiative is obtaining population eye health data. East Africa is a region that has historically been plagued by high rates of vision loss, and it is imperative to understand what causes are at play. Two large cross-sectional studies were previously published in 1995 and 2009, reporting the causes of childhood blindness (BL) and severe visual impairment (SVI) in East Africa. An update regarding more recent causes is warranted to better understand the trends of childhood BL/SVI in this region. A search strategy was developed a priori to identify relevant terms and align them with a standardized definition of East Africa. This strategy was then employed across PubMed, Google Scholar, and Scopus, with the yield of the overall search depicted in a Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 flow diagram. In the articles gathered by the search, causes of BL/SVI were typically categorized by anatomy and etiology. Eight articles met the criteria, with data from 6 countries, consisting of 534 cases of childhood BL/SVI. Common anatomic locations identified included the cornea, lens, and whole globe. Among the most common etiologies were corneal scarring/opacity and cataract. Systemic etiologies and disease associations included measles, toxoplasmosis, and prematurity. Presumptive infectious disease and hereditary conditions were also identified as a category, but specific identification of etiologies and genetic diagnosis was largely unavailable. BL/SVI due to the cornea was among the common anatomic sites of disease in our study. The identification of measles as an associated systemic etiology requires further understanding in the context of increased vaccination programs. Multiple articles acknowledged that cataract has become the predominant cause of BL/SVI owing to increased measles vaccination and vitamin A supplementation. Additional research should be conducted to gain a complete understanding of childhood BL/SVI in East Africa, and responses at regional and national levels are likely necessary to address treatable causes of vision impairment.

Serum lipid and lipoprotein profiles and their association with intraocular pressure in primary open-angle glaucoma: an observational cross-sectional study in the Chinese population

BackgroundGlaucoma is a leading cause of vision impairment and permanent blindness. Primary open-angle glaucoma (POAG) is a prominent type of primary glaucoma; however, its cause is difficult to determine. This study aimed to analyze the serum lipid profile of Chinese POAG patients and assess its correlation with intraocular pressure (IOP).MethodsThe study included 1,139, 1,248, and 356 Chinese individuals with POAG, primary angle closure glaucoma (PACG), and controls, respectively. Peripheral whole blood samples were collected at the time of diagnosis. Enzymatic colorimetry was used to determine serum levels of different lipids: high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides, cholesterol, and very low-density lipoproteins (VLDL). Additionally, immunoturbidimetry was used to quantify serum levels of apolipoproteins A (APOA), B (APOB), E (APOE), and lipoprotein A [Lp(a)], while intraocular pressure (IOP) was measured in all patients with POAG.ResultsAfter adjusting for age and sex, patients with POAG exhibited elevated serum levels of VLDL, APOA, and APOE but mitigated cholesterol levels compared with the control participants. Significantly lower serum triglyceride, VLDL, and Lp(a) levels were found in patients with PACG than in control participants. Serum cholesterol (P = 0.019; β = -0.75, 95% confidence interval [CI]: -1.38 – -0.12) and HDL levels (P < 0.001; β = -2.91, 95% CI: -4.58 – -1.25) were inversely linked to IOP in patients with POAG, after adjusting for age, sex, and ocular metrics. In addition, serum Lp(a) levels were correlated with the average IOP (P = 0.023; β = -0.0039, 95% CI: -0.0073 – -0.006) and night peak (P = 0.027; β = -0.0061, 95% CI: -0.0113 – -0.0008) in patients with POAG.ConclusionsSignificantly different serum lipid and lipoprotein profiles were observed in POAG and PACG patients. This study highlighted the differences in serum lipid and lipoprotein levels among Chinese POAG patients and their relationship with IOP and IOP fluctuation. Serum lipid and lipoprotein profiles should be considered while evaluating glaucoma risk.

Advanced Filtering and Enhancement Techniques for Diabetic Retinopathy Image Analysis

Diabetic retinopathy is a leading cause of visual impairment and blindness in diabetes sufferers. Early detection is crucial to prevent severe outcomes. This study presents an image processing method for retinal images to aid early detection. The method involves four steps: image enlargement, preprocessing, enhancement, and convolution. First, an algorithm enlarges the retinal image to increase resolution and reveal finer details. Preprocessing uses a min-max filtering algorithm to reduce noise and improve image quality. Next, specific pixel range enhancement techniques further refine the image and highlight relevant features. Finally, convolution with customized kernels detects and emphasizes areas indicating diabetic retinopathy, such as aneurysms and hemorrhages. Experimental results show improvement in image clarity and detail, enabling more accurate detection of diabetic retinopathy features. The correlation results are as follows: Filtering (0.35275, 0.20157, 0.4345), Enhancement (0.3214, 0.15823 0.34674), and Convolution (0.33542, 0.15758, 0.36826). The proposed algorithm enhances early detection and diagnosis by improving retinal image quality. Future work can optimize the algorithm and validate results with larger datasets, aiming to refine the determination of areas or pixel values relevant to diabetic retinopathy.