Eye Disease In People Research Articles

Assessment of meibomian gland dysfunction and dry eye disease by using novel noninvasive ocular surface analyzer in people with type 2 diabetes

Abstract Objective: To assess meibomian gland dysfunction (MGD) and dry eye disease in people with type 2 diabetes using a novel noninvasive ocular surface analyzer. Materials and Methods: This prospective study was conducted in the Ophthalmology Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, from June to December 2020. MGD is defined as increased lipids and proteins in the meibomian glands, leading to increased severity of dry eye disease symptoms. People with type 2 diabetes underwent an ocular surface examination; lipid layer thickness, noninvasive breakup time, tear meniscus height, grading of meibomian gland loss, and expression of meibum by a noninvasive analyzer. MGD was graded based on minimal to mild, moderate, and marked symptoms and divided into four subtypes. Result: A total of 46 diabetic subjects, 24 (52.2%) were males and 22 (47.8%) were females, with a median age of 55 (50–67.5) and 48 (41.5–55.25) years. Most of the subjects had mild gland opening for both the right and the left eye (50% and 54.3%). MGD score 1 was found in 12 (26.7%) and 11 (24.4%) subjects for the right and the left eye, respectively. Score 2 was observed mostly in the right eye 32 (71.1%) while score 3 was more frequent in the left eye 27 (60%). Notably, the conjunctival and ciliary levels were predominantly normal. Conclusion: Most of the participants had moderate to severe loss of the meibomian gland in both eyes.

THE IMPACT OF WORKING CONDITIONS ON THE OCCURRENCE OF CONJUNCTIVAL AND CORNEAL DISEASES IN MODERN OIL INDUSTRY

The problem of the development of eye diseases in people employed in hazardous industries, including the oil industry, remains relevant in Azerbaijan, as the health protection of the working population is a priority. This paper presents the results of a study on the impact of the severity of working conditions in the modern oil industry of Azerbaijan on the occurrence of conjunctival and cornea diseases. The objective of the study is to assess the working environment at the enterprises of oil and gas production profile of the State Oil Company of the Azerbaijan Republic (SOCAR) in terms of their impact on the occurrence of eye diseases. In total, 1852 employees from 13 SOCAR enterprises, who are willing to voluntarily participate in the study, were selected by random systematic sampling. The research was conducted in 2018-2019. According to the obtained data, 55.5% of workplaces in the enterprises belong to class A (optimal working conditions). However, in such industries as “Oil Rocks” and “Siyazan Oil”, on average, 30% of workplaces belong to a high hazard class C. Conjunctival and corneal pathologies were detected in 33% of all workers during the study. There was a statistically significant difference in the character of the conjunctival and corneal diseases, depending on the severity of working conditions. The percentage of occurrence of dry eye syndrome was significant in all conditions of labour severity and ranged from 65 to 79%. The majority of participants employed in the production group of “Class C – heavy working conditions” had a high incidence of conjunctivitis of various aetiologies (18%). To reduce the occurrence of conjunctival and corneal diseases, it is recommended to adhere to preventive measures for employees working in difficult working environment.

Tear film layers and meibomian gland assessment in patients with type 1 diabetes mellitus using a noninvasive ocular surface analyzer: a cross-sectional case–control study

PurposeTo assess the tear film layers and Meibomian glands by a noninvasive ocular surface analyzer in patients with and without type 1 diabetes mellitus (T1DM).MethodsEighty-eight participants were enrolled in this study: 44 patients with T1DM without diabetic retinopathy, and 44 patients as a control group, between 18 and 49 years old. Limbal and bulbar redness classification, lipid layer thickness (LLT), tear meniscus height (TMH), first and mean noninvasive tear break-up time (FNIBUT and MNIBUT, respectively), and Meibomian glands loss (MGL) were assessment through the ICP Ocular Surface Analyzer (OSA). Schirmer’s I test (SIT), the fluorescein tear break-up time test (TFBUT), OSDI and SPEED questionnaires, and percentage of glycosylated hemoglobin (HbA1c) were also tested.ResultsThe T1DM group showed higher limbal and bulbar redness (p = 0.010) and lower LLT (p < 0.001), TMH (p < 0.001), FNIBUT (p < 0.001), MNIBUT (p < 0.001), SIT (p = 0.001), and TFBUT (p < 0.001) than the control group. A higher percentage of MGL was found in the T1DM group in the upper (p = 0.097) and lower (p < 0.001) eyelids. No significant differences were found in dry eye symptoms across the OSDI and SPEED questionnaires between the two groups.ConclusionPatients with T1DM without signs of retinopathy showed involvement of the mucoaqueous and lipid layers of the tear film, as well as a higher percentage of MGL, using a noninvasive analyzer. Dry eye disease in people with T1DM cannot be ruled out by anamnesis and subjective symptom questionnaires alone; therefore, these patients should undergo regular anterior pole examinations.

Risk Factors for Progression to Referable Diabetic Eye Disease in People With Diabetes Mellitus in Auckland, New Zealand: A 12-Year Retrospective Cohort Analysis.

To evaluate the prevalence and risk factors for the development of any and referable diabetic eye disease in a multi-ethnic New Zealand population with diabetes mellitus attending a regional retinal screening service. Retrospective observational cohort study of people living with diabetes who attended the Auckland Regional Diabetic Retinal Screening Programme 2006-2018 inclusive (n = 41,786). Any retinopathy/maculopathy was present at first screening for 48.2% [95% confidence interval (CI): 45.8%-50.6%] / 37.8% (95% CI: 35.5%- 40.1%) of people with Type 1 and 25% (95% CI: 24.6%-25.4%) / 21.9% (95% CI: 21.5%-22.3%) with Type 2 diabetes. Referable retinopathy at baseline screening was 4.4% (95% CI: 3.6%-5.3%) and 1.6% (95% CI: 1.5%-1.7%) among people with Type 1 and Type 2 diabetes mellitus, respectively. After 4 years, cumulative incidence for referable retinopathy /referable maculopathy was 12/36 per 1000 people with Type 1 and 2.4/16 per 1000 people with Type 2 diabetes. Independent hazards for disease progression varied for the diabetes cohort types but baseline grade, duration of diabetes, and HbA1c were common to all. Referable diabetic eye disease at the first screening and after 4 years of follow-up is uncommon. Lengthening of the screening intervals for people with no or mild diabetic eye disease at first screening assessment could be considered.

Spectrum of eye disorders in diabetes (SPEED) in India: Eye care facility based study. Report # 1. Eye disorders in people with type 2 diabetes mellitus.

Purpose:To document the spectrum of eye diseases in people with type 2 diabetes mellitus (T2DM) reporting to large eye care facilities in India.Methods:The selection of eye care facilities was based on the zone of the country and robustness of the programs. Only people with known T2DM certified by internist, or taking antidiabetes medications, or referred for diabetes related eye diseases were recruited. The analysis included the demographic characteristics, systemic associations, ocular comorbidities, and visual status.Results:People (11,182) with T2DM were recruited in 14 eye care facilities (3 in north, 2 in south central, 4 in south, 2 in west, and 3 in east zone); two were government and 12 were non-government facilities. Hypertension was the commonest systemic association (n = 5500; 49.2%). Diabetic retinopathy (n = 3611; 32.3%) and lens opacities (n = 6407; 57.3%) were the common ocular disorders. One-fifth of eyes (n = 2077; 20.4%) were pseudophakic; 547 (5.4%) eyes had glaucoma and 277 (2.5%) eyes had retinal vascular occlusion. At presentation, 4.5% (n = 502) were blind (visual acuity <3/60 in the better eye) and 9.6% (n = 1077) had moderate to severe visual impairment (visual acuity <6/18-->3/60 in the better eye).Conclusion:People with T2DM presenting at eye clinics in India have high rates of diabetic retinopathy and vision loss. Cataract is a very common occurrence. Advocacy, infrastructure strengthening, and human resource development are the key to address the growing threats of T2DM and eye care in India.

Analysis of Indicators of Primary and Repeated Disability due to Eye Diseases in People of Retirement Age in the Russian Federation and in Moscow

This paper analyzes the dynamics of primary and secondary disability due to eye diseases in people of retirement age in the Russian Federation and Moscow for the period 2007–2016. The main medical and social indicators in disabled people of retirement age are defined. A comparative analysis of primary and repeated disability in the Russian Federation and Moscow is performed.

The Montrachet Study: study design, methodology and analysis of visual acuity and refractive errors in an elderly population.

PurposeTo describe the design of the Montrachet Study (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases) and to report visual acuity and refractive errors in this elderly population.MethodsParticipants were recruited in Dijon (France), from the ongoing population‐based 3C Study. In 2009–2011, 1153 participants from the 3 Cities Study, aged 75 years or more, had an initial eye examination and were scheduled for eye examinations. The eye examination comprised visual acuity, refraction, visual field, ocular surface assessment, photographs and OCT of the macula and the optic disc, measurement of intra‐ocular pressure, central corneal thickness and macular pigment assessment. Information on cardiovascular and neurologic diseases and a large comprehensive database (blood samples, genetic testing, cognitive tests, MRI) were available from the 3C Study.ResultsPresenting visual acuity <20/60 in the better eye was found in 2.3% (95% CI 1.5–3.2) of the participants with no gender differences. Visual impairment increased with age from 1.5% (95% CI 0.3–2.7) for those aged 75–79 years to 5.6% (95% CI 2.9–8.4) for patients 85 years and older (p = 0.0003). Spherical equivalent did not differ between men and women (p = 0.8) and decreased with age whatever the lens status.ConclusionDespite the high prevalence of self‐reported eye diseases in this elderly population, visual impairment was low and increased with age. The Montrachet Study may help to better estimate the prevalence of eye diseases in people over 75 years of age and to seek associations with cardiovascular and neurologic diseases and their potential risk factors.

Dry eye disease in type 2 diabetes mellitus; comparison of the tear osmolarity test with other common diagnostic tests: a diagnostic accuracy study using STARD standard.

BackgroundTo determine the diagnostic performance of tear osmolarity in diagnosis of dry eye disease by using tear lab osmolarity system in people with type 2 diabetes, and to compare it with common diagnostic tests already available in clinical practice.MethodsTwo hundreds forty three people with type 2 diabetes were included. Tear osmolarity was measured with the tear osmolarity system. The 308 mOsm/L cutoff was used to diagnose dry eye disease. The following tests were also performed: Ocular Surface Disease Index (OSDI) questionnaire, Tear Film Break up Time (TFBUT), Schirmer I test, Rose Bengal and Fluorescein staining. The results of these tests were compared to the tear osmolarity measurement.ResultsThe prevalence of dry eye disease detected by the tear osmolarity test was 27.7%. It was as follows for the other common diagnostic tests: OSDI (17.7%), Schirmer I test (33%), TFBUT (41%), Rose Bengal (11%), and Fluorescein staining (4%). Fluorescein staining had the highest specificity (97%). With the cutoff score >12, the positive likelihood ratio for the OSDI questionnaire was the highest (1.78). The sensitivity was poor for all common diagnostic tests. ROC curve analysis could not determine optimal cut offs for the common diagnostic tests.ConclusionsThe available common diagnostic tests underestimate the presence of dry eye disease in people with type 2 diabetes. Moreover, they could not discriminate tear hyperosmolarity from normal. Tear osmolarity could be considered as the best single test for detection of dry eye disease in people with type2 diabetes.

Risk of selected eye diseases in people admitted to hospital for hypertension or diabetes mellitus: record linkage studies

We read with great interest the article by Goldacre et al. 1 The authors conducted a retrospective matched cohort study to measure the association between hypertension or diabetes …

Risk of selected eye diseases in people admitted to hospital for hypertension or diabetes mellitus: record linkage studies

AimsAssociations among hypertension, diabetes mellitus and some ophthalmic diseases are well established; associations with others are more equivocal. The aim was to quantify associations accurately using large epidemiological datasets.MethodsAnalysis of...

Prevalence of major eye diseases and causes of visual impairment in the adult Finnish population: a nationwide population‐based survey

To estimate the prevalence of cataract, glaucoma, age-related maculopathy (ARM) and diabetic retinopathy (DR) in the adult Finnish population. A representative cross-sectional sample of the Finnish population aged 30 years and older. Of the 7979 eligible people, 7413 (93%) were interviewed and/or examined. The interview included self-reported doctor-made diagnoses of cataract, glaucoma, degenerative fundus changes (mainly ARM) or DR. Information on self-reported eye diseases was complemented with data from national registers, and case records were gathered for non-participants and persons with visual acuity (VA) < 0.5 or reporting difficulties in vision or eye diseases without assessed VA. Based on self-reported and/or register-based data the estimated total prevalences of cataract, glaucoma, ARM and DR in the study population were 10%, 5%, 4% and 1%, respectively. All these chronic eye diseases increased with age (p < 0.001). The corresponding prevalences for persons aged 65 and older were 34%, 13%, 12% and 2%, respectively. Cataract and glaucoma were more common in women than in men [odds ratio (OR) 1.55, 95% confidence interval (CI) 1.26-1.91; OR 1.57, 95% CI 1.24-1.98, respectively]. The most prevalent eye diseases in people with visual impairment (VA < or = 0.25) were ARM (37%), unoperated cataract (27%), glaucoma (22%) and DR (7%). The high prevalence of these mainly age-related eye diseases, together with increasing life expectancy, mean that continuous efforts are needed to identify and treat eye diseases in order to maintain patients' quality of life and to alleviate the social and economic burden of serious eye diseases.

Rationale and Methodology for a Population-Based Study of Eye Diseases in Malay People: The Singapore Malay Eye Study (SiMES)

Purpose: Although there are approximately 200 million people of Malay ethnicity living in Asia, the burden and risk factors of blinding eye diseases in this ethnic group are unknown. This study summarizes the rationale and study design of a population-based study of eye diseases among adult Malays in Singapore. Methods: A population-based cross-sectional study of Malays was designed in Singapore. The sampling frame consisted of all Malays aged 40–79 living in designated study areas in southwestern Singapore. From a list of 16,069 names provided by the Ministry of Home Affairs, age-stratified random sampling was used to select 5,600 names (1,400 people from each decade of 40–49, 50–59, 60–69, and 70–79 years). The target sample size for this study was 3,150 persons. Selected individuals were invited to a centralized clinic by letters, telephone calls, and home visits. Participants underwent standardized interview and assessment of blood pressure, anthropometry, presenting and best-corrected visual acuity, subjective refraction, ocular biometry, Goldmann tonometry, slit-lamp biomicroscopy, optic disc imaging, digital lens, and retinal photography. Blood and urine samples were collected for biochemical analyses and further stored for future studies. Selected participants also had gonioscopic examination, visual fields test, and assessment of ankle and brachial blood pressure to detect presence of peripheral vascular disease. Conclusions: This study provides population-based data on the prevalence of and risk factors for age-related eye diseases in people of Malay ethnicity in Singapore. Data from this study allow further understanding of the etiology and impact of eye diseases in this ethnic group.

Risk of incident age-related eye diseases in people with an affected sibling : The Beaver Dam Eye Study.

The purpose of this investigation was to determine whether age-related cataract and maculopathy in older siblings predicts development of the same in younger siblings. A population-based study of age-related eye diseases was conducted in 1988--1990 in Beaver Dam, Wisconsin, and a follow-up examination was performed 5 years later. Diagnoses of age-related eye diseases were assigned on the basis of gradings of study photographs. There were 1,088 people from 488 sibships with at least two siblings who could contribute information for these analyses. The authors computed odds ratios and 95% confidence intervals for developing the specific lesion and identifying it 5 years later if an older sibling had it at baseline. The odds ratios were 1.65 (95% confidence interval (CI): 0.91, 2.99) for nuclear cataract, 1.62 (95% CI: 0.92, 2.85) for cortical cataract, 1.95 (95% CI: 0.48, 7.95) for posterior subcapsular cataract, 1.82 (95% CI: 0.91, 3.66) for soft drusen, 8.18 (95% CI: 3.34, 20.08) for retinal pigment epithelium depigmentation, 3.59 (95% CI: 1.71, 7.57) for increased retinal pigment, and 10.32 (95% CI: 0.83, 128.58) for exudative age-related maculopathy. These findings suggest that strong family determinants of lesions of age-related maculopathy are likely, less so for age-related cataract, which confer risk of the same lesion in a younger sibling.

Knowledge levels of diabetic eye disease in people with diabetes: results of a descriptive survey

An epidemiological questionnaire delivered to patients attending a mobile community based photographic screening unit for detection of diabetic eye disease (n=2386) has yielded demographic, prevalence and knowledge data. The main results of this report focus on the knowledge of eye complications, which show that there is a considerable lack of knowledge in people with diabetes in this area. This paper presents the results of two questions pertaining to knowledge of effects of diabetic eye disease and control of blood glucose levels. Results show that 1021 (42.8%) of responders were aware that diabetes can cause blindness and 1439 (60.3%) were aware that good control of diabetes was very important. Health education strategies need to be developed in order that people with diabetes have the correct information, necessary to make positive cognitive decisions regarding their diabetes management and lifestyle.Trained workers delivered the closed response questions via a structured interview. The coded responses were entered onto an Epi-Info database with measures to limit unreliability and ensure validity. Data were then analysed to present descriptive data and broad recommendations were made on potential effective health education strategies.