Eye Disorders Research Articles

The regulatory role of microRNAs in common eye diseases: A brief review.

MicroRNAs (miRNAs) are highly conserved, small non-coding RNA molecules (∼21 nucleotides) that regulate numerous biological processes, including developmental timing, hematopoiesis, organogenesis, apoptosis, cell differentiation, and proliferation either by mRNA degradation or translation repression. Since eye physiology requires a perfect orchestration of complex regulatory networks, an altered expression of key regulatory molecules such as miRNAs potentially leads to numerous eye disorders. In recent years, comprehensive progress has been made in demonstrating the precise roles of miRNAs, emphasizing their potential use in diagnostic and therapeutic purposes of chronic human diseases. Thus, this review explicitly illustrates the regulatory roles of miRNAs in four common eye disorders, such as cataract, glaucoma, macular degeneration, and uveitis, and their application in disease management.

An Efficient Healthcare Data Mining Approach Using Apriori Algorithm: A Case Study of Eye Disorders in Young Adults

In the public health sector and the field of medicine, the popularity of data mining and its usage in knowledge discovery and databases (KDD) are rising. The growing popularity of data mining has discovered innovative healthcare links to support decision making. For this reason, there is a great possibility to better diagnose patient’s diseases and maintain the quality of healthcare services in hospitals. So, there is an urgent need to make disease diagnosis possible by discovering the hidden patterns from the patients’ history information in developing countries. This work is a step towards how to use the extracted knowledge to enhance the quality of healthcare facilities. In this paper, we have proposed a web-centered hospital information management system (HIMS) that identifies frequent patterns from the data with eye disorder patients using the association rule-based Apriori data mining technique. The proposed framework has the capability to overcome all the key issues and problems in the current hospital information management system regarding data analysis and reporting services. For this purpose, data were collected from more than 1000 university students (China citizens) both online and manually (printed questionnaire). After applying the Apriori algorithm on the collected data, we revealed that almost 140 individuals out of 1035 had myopia (near-sighted disorder), at current age of 22 years, and that there were no male patients found with myopia. We concluded that their clinical relevance and utility can generate favorable results from prospective clinical studies by mapping out the habits or lifestyles that potentially lead to fatal diseases. In the future, we plan to extend this work to fully automate HIMS to help practitioners to diagnose the reasons of various diseases by extracting patient lifestyle patterns.

Incapacity to Work Rate and Disability Rate in Traumatic Eye Disorders

Incapacity to Work Rate and Disability Rate in Traumatic Eye Disorders

Systemic treatment with cigarette smoke extract affects zebrafish visual behaviour, intraocular vasculature morphology and outer segment phagocytosis

Introduction: Cigarette smoking adversely affects multiple aspects of human health including eye disorders such as age-related macular degeneration, cataracts and dry eye disease. However, there remains a knowledge gap in how constituents of cigarette smoke affect vision and retinal biology. We used zebrafish to assess effects of short-term acute exposure to cigarette smoke extract (CSE) on visual behaviour and retinal biology. Methods: Zebrafish larvae with a developed visual system at three days post-fertilization (dpf) were exposed to CSE for 4, 24 or 48 hours. Visual behaviour, hyaloid vasculature morphology, retinal histology, oxidative stress gene expression and outer segment phagocytosis were investigated using visual behavioural optokinetic and visual motor response assays (OKR and VMR), microscopy (light, fluorescence and transmission electron microscopy), and real-time PCR. Results: In zebrafish larvae, 48 hours of CSE treatment resulted in significantly reduced visual behaviour. Larvae treated with 10, 15 or 20 μg/mL CSE showed an average of 13.7, 10.7 or 9.4 saccades per minute, respectively, significantly lower compared with 0.05% DMSO controls (p=0.0093, p=0.0004 and p<0.0001, respectively) that exhibited 19.7 saccades per minute. The diameter of intraocular vessels increased from 4.12 μm in 0.05% DMSO controls to 5.69 μm in the 20 μg/mL CSE-treated larvae (p≤0.0001). Biometry analysis highlighted a significant axial length elongation in 20 μg/mL CSE-treated larvae (216.9 μm, p<0.0001) compared to 0.05% dimethyl sulfoxide (DMSO) controls (205.1 μm). Larvae exposed to 20 μg/mL CSE had significantly (p=0.0002) higher numbers of RPE phagosomes compared to vehicle controls (0.1425 and 0.093 phagosomes/μm RPE, respectively). Conclusions: Zebrafish larvae with a developed visual system display apparent defects in visual behaviour and retinal biology after acute exposure to CSE, establishing a valuable in vivo model to investigate ocular disorders related to cigarette smoke.

Automated segmentation of palpebral fissures from eye videography using a texture fusion neural network

Automated segmentation of palpebral fissures depicted on images of eye videography plays a crucial role in identifying blinks (especially incomplete blinks) and detecting some eye disorders (e.g., dry or tired eyes). To this end, we propose a texture fusion segmentation network (called TF-Net) on the basis of the popular U-Net for automatically segmenting palpebral fissures from eye videography. The proposed network is constructed by defining two novel subtraction convolutional blocks and introducing them into the U-Net. These subtraction blocks are able to suppress motion artifacts and complex background in some degrees and enhance the sensitivity of the proposed network to objects of interest, as compared to the U-Net. Extensive experiments on our collected blink images from eye videography and three public datasets demonstrated that the proposed network obtained, on average, the Dice score (DS), Jaccard similarity (JS), and Hausdorff distance (HD) of 0.9445, 0.9099, and 5.3657, respectively, on the blink image dataset, and 0.8364, 0.7434, and 4.5745 for 14 objects of interest on three public datasets, which surpassed the U-Net and its multiple variants.

Prevalence of Eye and Vision Disorders in the Military Health System, Fiscal Year 2018.

Eye and vision disorders are estimated to impact 7.08 million people in the United States, including 1.62 million under the age of 40. This study uses the Vision and Eye Health Surveillance System (VEHSS) case definitions to assess the burden of eye and vision disorders in a universally insured, nationally representative population. This retrospective, cross-sectional study applied the VEHSS case definitions to TRICARE claims data collected from the Military Health System Data Repository and Defense Enrollment Eligibility Reporting System during 2018. Beneficiaries aged 0-64 years during the fiscal year 2018 were identified with inpatient and outpatient codes matching to the VEHSS diagnostic case definitions, which were organized into 17 categories of eye and vision disorders classified by the ICD-10. Beneficiaries were recorded only once per category but allowed to match to multiple categories. Analyses included descriptive statistics of patient demographics and prevalence of eye disorders. We identified 4,548,897 TRICARE Prime/Plus beneficiaries (54.86% men and 45.14% women), of whom 22.93% were diagnosed with at least one disorder in 2018. Of those with a diagnosis, the majority were men (50.13%), adults (74.91%), and of or sponsored by a senior enlisted rank (57.83%), used as socioeconomic proxy. Disorders of refraction and accommodation were most prevalent, followed by infectious and inflammatory diseases. Potentially preventable and treatable conditions, including amblyopia and strabismus, infectious and inflammatory disease, and diabetic complications, affected up to 22% of those with vision disorders. This study represents the first use of VEHSS measures in a universally insured, socioeconomically diverse population. Identification of potentially treatable or preventable conditions indicates significant opportunity to mitigate the burden of eye and vision disorders in the Military Health System.

Impact of major age-related eye disorders on health-related quality of life assessed by EQ-5D: a systematic review and meta-analysis.

This study is to quantitatively estimate the health-related quality of life (HRQOL) impact of major age-related eye diseases (AREDs) including cataract, glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR) assessed by the EuroQoL Five-Dimensional Questionnaire (EQ-5D). PubMed, Embase, Cochrane Library, and CINAHL were searched until October 20, 2022. Studies were included if they reported the EQ-5D health utility score (HUS) or visual analogue scale (VAS) score of both AREDs patients and healthy controls. The mean difference (MD) in HUS or VAS score between cases and controls and its 95% confidence interval (95%CI) were pooled using the random-effects model. We also performed sensitivity analysis using the leaving-one-out method and subgroup analyses by sample size and race. The prevalence in reporting any problems in the five EQ-5D dimensions was summarized and compared between cases and controls using the Chi-square test. Fifteen articles involving 30,491 participants were included in this review. Pooled estimates indicated reduced HUS in AMD patients (MD = -0.04, 95%CI -0.07, -0.01; P = 0.009), DR patients (MD = -0.03, 95%CI -0.05, -0.01; P = 0.01), and glaucoma patients (MD = -0.06, 95%CI -0.10, -0.01; P = 0.01), compared with the controls. Significantly lower EQ-5D VAS score was also observed in cataract patients (MD = -11.33, 95%CI -13.47, -9.18; P < 0.001) and DR patients (MD = -6.41, 95%CI -10.64, -2.18; P = 0.003). AREDs patients reported usual activities and anxiety/depression problems more frequently than the control group. Our findings confirmed the HRQOL impairment caused by major AREDs including AMD, cataract, DR, and glaucoma. High-quality studies with large sample sizes are warranted to further verify our results.

Extracellular vesicles as a new horizon in the diagnosis and treatment of inflammatory eye diseases: A narrative review of the literature.

Extracellular vesicles include exosomes, microvesicles, and apoptotic bodies. Their cargos contain a diverse variety of lipids, proteins, and nucleic acids that are involved in both normal physiology and pathology of the ocular system. Thus, studying extracellular vesicles may lead to a more comprehensive understanding of the pathogenesis, diagnosis, and even potential treatments for various diseases. The roles of extracellular vesicles in inflammatory eye disorders have been widely investigated in recent years. The term "inflammatory eye diseases" refers to a variety of eye conditions such as inflammation-related diseases, degenerative conditions with remarkable inflammatory components, neuropathy, and tumors. This study presents an overview of extracellular vesicles' and exosomes' pathogenic, diagnostic, and therapeutic values in inflammatory eye diseases, as well as existing and potential challenges.

Final analysis of a post-marketing surveillance study of dabrafenib and trametinib combination therapy in Japanese patients with unresectable malignant melanoma with BRAF V600 mutation.

Targeted therapy with a combination of dabrafenib and trametinib has been developed and widely used for treatment of melanoma. However, data regarding its safety and efficacy in Japanese patients with malignant melanoma are limited. A post-marketing surveillance (PMS) study was conducted to investigate the safety and efficacy of combination therapy in a Japanese clinical setting with a surveillance period of June 2016 to March 2022; 326 patients with unresectable malignant melanoma with BRAF mutation were enrolled. The interim results were published in July 2020. Herein, we report the results of the final analysis based on the data collected until the completion of the PMS study. The safety analysis population included 326 patients, the majority of whom had stage IV disease (79.14%) and Eastern Cooperative Oncology Group performance status 0 or 1 (85.28%). All patients were treated with the approved dose of dabrafenib, while 99.08% were treated with the approved dose of trametinib. Adverse events (AEs) occurred in 282 patients (86.50%) and the major AEs (incidence ≥5%) were pyrexia (47.85%), malignant melanoma (33.44%), hepatic function abnormal (9.82%), rash and blood creatine phosphokinase increased (8.59% each), malaise (6.44%), nausea (5.52%), and diarrhea and rhabdomyolysis (5.21% each). The incidences rates of adverse drug reactions of safety specifications were 45.71% for pyrexia, 15.95% for hepatic impairment, 12.58% for rhabdomyolysis, 4.60% for cardiac disorders, and 3.07% for eye disorders. In the efficacy analysis population of 318 patients, the objective response rate was 58.18% (95% confidence interval [CI] 52.54%-63.66%). The progression-free survival rates at 90, 180, and 360 days were 88.14% (95% CI 84.00%-91.26%), 69.53% (63.85%-74.50%), and 52.07% (45.71%-58.03%), respectively. Consistent with previous interim results, no new safety or efficacy concerns were observed in this final analysis of a PMS study conducted in a Japanese real-world clinical setting.

Knowledge and attitude toward eye disorders in children among pediatricians and family physicians: a survey study

BackgroundVision-related disorders are common in children. Therefore, eye examination and thorough visual assessment by first-contact physicians are crucial in children. This study aimed to evaluate the knowledge of and attitude toward children’s eye disorders among pediatricians and family physicians in the Ministry of National Guard Health Affairs-Western Region (MNGHA-WR) of Saudi Arabia.MethodsIn this observational, cross-sectional study, we used a self-administered, web-based questionnaire. The sample size was calculated to be 148 pediatricians and family physicians (of 240 in total) currently working at MNGHA-WR. The first section of the questionnaire dwelled on demographics, while the second section addressed the physician’s knowledge of and attitude toward commonly encountered ophthalmological pathologies in children. Data collected were entered into Microsoft Excel and then transferred to IBM SPSS version 22 for statistical analysis.ResultsA total of 148 responses (92 family physicians and 56 pediatricians) were received. Most of the participants were residents or staff physicians (n = 105, 70.9%). The mean knowledge score of the respondents was 54.67% ± 14.5%. Participants’ knowledge was further subclassified using Bloom’s original cutoff points into high (n = 4, 2.7%), moderate (n = 53, 35.8%), and low (n = 91, 61.5%) levels of knowledge. Regarding practices, 120 (81%) participants performed ophthalmic examinations; however, only 39 (26.4%) conducted routine examinations as part of every child’s visit. Fundus examinations were performed by 25 (16.9%) physicians. A significant deficiency in knowledge was noted in those with < 1 year of work experience (P = 0.014). Although statistically not significant (P = 0.052), family physicians possessed better knowledge than pediatricians regarding children’s eye disorders. On the contrary, more pediatricians performed eye examinations than family physicians (P = 0.015). The male sex was also associated with higher rates of eye examination (P = 0.033).ConclusionAn unsatisfactory level of knowledge of eye disease among participating doctors was reported. The proportion was significantly higher among residents and staff physicians. Therefore, awareness efforts should be incorporated in both family medicine and pediatrics residency programs to limit the number of cases of ocular disorders going undiagnosed in children.

3D Printing Smart Eyeglass Frames: A Review

Eyeglasses are typical correctors for refractive error eye disorders. They are commonly placed on frames expected to be stylish and durable. Currently, the consumer demand for sustainable and eco-friendly frames is gaining interest, especially since conventional frame manufacturing methods follow a subtraction of large blocks of wasted scrap material. Additive manufacturing (AM) promises better economic feasibility due to reduced tooling, storage, and material costs, as well as enhanced mechanical properties, by inducing nanomaterials and composites. Moreover, synergism between AM and digital design has led to a rising interest in smart or electronic eyeglass frames. This systematic review assesses commercial eyeglass frames that use standard materials with long-lasting resistance, durability, comfort, and versatility with various materials such as metals and polymers. It also explores the design aspects of these eyeglasses and their correlation with the utilization of artificial intelligence trained computer-aided design software. Beyond the appealing eyeglass frame technology, a review of smart frame design, in which electronic sensors and chips are embedded, is also included. Furthermore, this review comprises various applications for 3D printing of frames including commercial and biomedical applications. Other reviewed topics include the side effects, health risks, shortcomings of AM techniques and materials, and void formation inside the matrix that propagates fatigue and shrinkage or density change during solidification.

Topical Losartan: Practical Guidance for Clinical Trials in the Prevention and Treatment of Corneal Scarring Fibrosis and Other Eye Diseases and Disorders.

Losartan is an angiotensin II receptor blocker (ARB) that impedes transforming growth factor (TGF) beta signaling by inhibiting activation of signal transduction molecule extracellular signal-regulated kinase (ERK). Studies supported the efficacy of topical losartan in decreasing scarring fibrosis after rabbit Descemetorhexis, alkali burn, and photorefractive keratectomy injuries, and in case reports of humans with scarring fibrosis after surgical complications. Clinical studies are needed to explore the efficacy and safety of topical losartan in the prevention and treatment of corneal scarring fibrosis, and other eye diseases and disorders where TGF beta has a role in pathophysiology. These include scarring fibrosis associated with corneal trauma, chemical burns, infections, surgical complications, and persistent epithelial defects, as well as conjunctival fibrotic diseases, such as ocular cicatricial pemphigoid and Stevens-Johnson syndrome. Research is also needed to explore the efficacy and safety of topical losartan for hypothesized treatment of transforming growth factor beta-induced (TGFBI)-related corneal dystrophies (Reis-Bu¨cklers corneal dystrophy, lattice corneal dystrophy type 1, and granular corneal dystrophies type 1 and type 2) where deposited mutant protein expression is modulated by TGF beta. Investigations could also explore the efficacy and safety of topical losartan treatments to reduce conjunctival bleb scarring and shunt encapsulation following glaucoma surgical procedures. Losartan and sustained release drug delivery devices could be efficacious in treating intraocular fibrotic diseases. Dosing suggestions and precautions that should be considered in trials of losartan are detailed. Losartan, as an adjuvant to current treatments, has the potential to augment pharmacological therapeutics for many ocular diseases and disorders where TGF beta plays a central role in pathophysiology.

Exploratory Study on Central Sensitization and Bioelectrical Activity of the Selected Masticatory Muscles in Subjects with Myopia

Myopia is one of the most common eye disorders involving abnormal focusing of light rays. The studies recognize the association between the stomatognathic and visual systems. This compound may have a neurological basis associated with disorders such as central sensitization. The main aim of this study was to evaluate the influence of central sensitization on the bioelectrical activity of selected muscles of the masticatory organ in subjects with myopia. Selected masticatory and cervical spine muscles were analyzed using an eight-channel BioEMG III electromyograph. Central sensitization was analyzed using the central sensitization inventory. Statistical analysis revealed significantly higher scores on the central sensitization inventory in subjects with axial myopia compared to subjects without refractive error. Repeated positive correlations were observed in the sternocleidomastoid muscle activity and negative correlations in the digastric muscle activity during open and closed eyes in myopic subjects. Subjects with myopia have an increased score in the central sensitization inventory. The increase in the central sensitization inventory score is connected with the changes within the electromyographic activity of the masticatory and neck muscles. The effect of central sensitization on masticatory muscle activity in myopic subjects requires further study.

A TRANSDISCIPLINARY APPROACH TO THE TREATMENT OF DRY EYE DISEASE IN PATIENTS WITH PSYCHIATRIC DISORDERS

IntroductionDry eye disease (DED) is a multifactorial disease of the tear film and ocular surface representing one of the most common problems in ophthalmological practice and significant public health problem. Characteristic symptoms of DED include gritty, sandy foreign body sensation as well as visual disturbances that have a negative impact on the patient’s daily activities and also affecting patient’s quality of life (QOL).ObjectivesThe objective of this research is to point out the importance of transdisciplinary approach to treatment of dry eye disease in patients with psychiatric disorders.MethodsWe reviewed all current available literature in Pubmed dealing with the topic of connection of dry eye disease and psychiatric disorders.ResultsIn recent years, the relationship between DED and psychiatric disorders has been gaining attention. A number of epidemiological studies have reported a possible association between dry eye and psychiatric disorders showing that the subjective symptoms of dry eye can be affected not only by changes of the tear film and ocular surface but also psychological factors such as anxiety, depression, schizophrenia, post-traumatic stress disorder (PTSP) and subjective happiness. Apart from psychiatric disorders, psychiatric medications are also considered as risk factors for DED due to their influence on the tear film status. The incidence of ocular side effects increases rapidly with the use of polypharmacy, a very common form of treatment used in psychiatry.Mental health disorders may be one of considerable contributing factors for dry eye symptoms and undiagnosed mental health conditions can be an influencing element for unexplained levels of DED symptoms. Depression, anxiety, stress, hypochondriasis, neuroticism, sleep and mood disorders may be associated with the exacerbation of symptoms to degrees that are not consistent with the objective signs related to tear dysfunction as well as changes in the anterior surface of the eye.There is often inconsistency between signs and symptoms of DED, where symptoms often are more related to non-ocular conditions including psychiatric disorders than to tear film parameters. Consequently, in many cases DED may be considered as a psychiatric as well as ophthalmological problem. Psychiatrists and ophthalmologists need to be aware of the potential influence of psychiatric disorders and medications on tear film stability.ConclusionsA detailed medical history, thorough ophthalmological examination and referral to a psychologist or psychiatrist may be essential in the treatment of those patients. In treatment of psychiatric patients, an integrative and transdisciplinary approach will result in better functioning and higher QOL.Disclosure of InterestNone Declared

Shedding light on myopia by studying complete congenital stationary night blindness.

Myopia is the most common eye disorder, caused by heterogeneous genetic and environmental factors. Rare progressive and stationary inherited retinal disorders are often associated with high myopia. Genes implicated in myopia encode proteins involved in a variety of biological processes including eye morphogenesis, extracellular matrix organization, visual perception, circadian rhythms, and retinal signaling. Differentially expressed genes (DEGs) identified in animal models mimicking myopia are helpful in suggesting candidate genes implicated in human myopia. Complete congenital stationary night blindness (cCSNB) in humans and animal models represents an ON-bipolar cell signal transmission defect and is also associated with high myopia. Thus, it represents also an interesting model to identify myopia-related genes, as well as disease mechanisms. While the origin of night blindness is molecularly well established, further research is needed to elucidate the mechanisms of myopia development in subjects with cCSNB. Using whole transcriptome analysis on three different mouse models of cCSNB (in Gpr179-/-, Lrit3-/- and Grm6-/-), we identified novel actors of the retinal signaling cascade, which are also novel candidate genes for myopia. Meta-analysis of our transcriptomic data with published transcriptomic databases and genome-wide association studies from myopia cases led us to propose new biological/cellular processes/mechanisms potentially at the origin of myopia in cCSNB subjects. The results provide a foundation to guide the development of pharmacological myopia therapies.

The epidemiology and disease pattern of pediatric ocular morbidities in Western India: The National Institute of OphthalMology AmBlyopia StUdy in Indian Paediatric EyeS (NIMBUS) study report 1.

To determine the pattern of pediatric ocular morbidities in western India. This was a retrospective longitudinal study that included all consecutive children aged ≤15 years who presented to the outpatient department of a tertiary eye center for the first time. Patient demographics, best-corrected visual acuity (BCVA), and ocular examination data were compiled. Subgroup analysis was also performed based on age group (years): ≤5, 5-10, and >10-15. A total of 11,126 eyes of 5563 children were included in the study. The mean age of the study population was 5.15 (±3.32) years with males (57.07%) being predominant. Approximately half of the patients (50.19%) were under the age of 5 years, followed by those aged 5-10 years (45.1%) and >10-15 years (4.71%). Among the study eyes, the BCVA was ≥20/60 in 58.57%, indeterminable in 35.16%, and <20/60 in 6.71%. The commonest ocular morbidity noted was refractive error (28.97%) followed by allergic conjunctivitis (7.64%) and strabismus (4.95%) in the total study cohort and also after age stratification. Refractive error, allergic conjunctivitis, and strabismus are the major causes of ocular morbidity in pediatric eyes at a tertiary care center. Planning screening programs at the regional and national levels is crucial to decreasing the burden of eye disorders. These programs also need to have a suitable referral mechanism established and be smoothly connected to primary and secondary health-care centers. This will help to assure quality eye care delivery, while also reducing the strain of overworked tertiary centers.

Provision of the Russian population with inpatient ophthalmological&#x0D; medical care

Introduction. The level of provision of the population with bed resources is one of the key indicators of the availability of specialized medical care (SMC). &#x0D; Purpose is to study the provision of the Russian population with specialized ophthalmological medical care, depending on the incidence of eye disorders.&#x0D; Material and methods. The assessment of population provision with specialized ophthalmological medical care was carried out on the base of an analysis of data from federal forms of statistical reporting forms of Russian Federation regions over 2017. Statistical processing of the material included methods of descriptive statistics; calculation of average and relative values. Spearman’s rank correlation method was used to determine the correlation between quantitative variables. &#x0D; Results. The value of indicator of population provision with ophthalmological beds (OB) per 100 thousand of the population: the minimum — 1.8, the maximum — 55.1, the average — 11.9 beds. The average value of the number of days of an OB occupation per year in Russia is 314 ± 33. The average value of the duration of the patient’s stay in the OB is 6.5 ± 1.4 days. The average indicator value of the Russian population general morbidity with the organ of vision and its adnexa diseases is 10,462 ± 3,069 cases per 100 thousand of the population. The rank correlation coefficient of the indicators of the provision of the population with OB and the indicators of eye diseases incidence is 0.05 at p &gt; 0.05. &#x0D; Limitations. The research materials are limited to the results of the analysis of data from federal forms of statistical reporting of Russian Federation regions for 2017.&#x0D; Conclusion. The provision of the population of the Russian Federation regions with ophthalmological beds does not correlate with the incidence rates of eye diseases (r = 0.05 at p &gt; 0.05). For the first time, a comparative assessment of the actual provision of the population of the Russian Federation with ophthalmological beds is given in comparison with the recommended standard: 12 versus 10.7 beds per 100 thousand of the population, respectively. The number of days of occupation of an ophthalmic bed per year was found do not increase with an increase in the average time of hospitalization of an ophthalmic patient, but decreases with a certain degree of probability (r = (–0.25) at p &lt; 0.05).

Roles of non-coding RNAs in eye development and diseases.

The prevalence of ocular disorders is dramatically increasing worldwide, especially those that cause visual impairment and permanent loss of vision, including cataract, glaucoma, age-related macular degeneration, and diabetic retinopathy. Extensive evidence has shown that ncRNAs are key regulators in various biogenesis and biological functions, controlling gene expression related to histogenesis and cell differentiation in ocular tissues. Aberrant expression and function of ncRNA can lead to dysfunction of visual system and mediate progression of eye disorders. Here, we mainly offer an overview of the role of precise modulation of ncRNAs in eye development and function in patients with eye diseases. We also highlight the challenges and future perspectives in conducting ncRNA studies, focusing specifically on the role of ncRNAs that may hold expanded promise for their diagnostic and therapeutic applications in various eye diseases. This article is categorized under: Regulatory RNAs/RNAi/Riboswitches > Regulatory RNAs RNA in Disease and Development > RNA in Disease RNA in Disease and Development > RNA in Development.

Management of Fibroblast Growth Factor Inhibitor Treatment–emergent Adverse Events of Interest in Patients with Locally Advanced or Metastatic Urothelial Carcinoma

BackgroundErdafitinib is indicated for the treatment of adults with locally advanced/metastatic urothelial carcinoma and susceptible FGFR3/2 alterations progressing on/after one or more lines of prior platinum-based chemotherapy. ObjectiveTo better understand the frequency and management of select treatment-emergent adverse events (TEAEs) to enable optimal fibroblast growth factor receptor inhibitor (FGFRi) treatment. Design, setting, and participantsLonger-term efficacy and safety results of the BLC2001 (NCT02365597) trial in patients with locally advanced and unresectable or metastatic urothelial carcinoma were studied. InterventionErdafitinib schedule of 8 mg/d continuous in 28-d cycles, with uptitration to 9 mg/d if serum phosphate level was <5.5 mg/dl and no significant TEAEs occurred. Outcome measurements and statistical analysisAdverse events were graded using National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. The Kaplan-Meier methodology was used for the cumulative incidence of the first onset of TEAEs by grade. Time to resolution of TEAEs was summarized descriptively. Results and limitationsAt data cutoff, the median treatment duration was 5.4 mo among 101 patients receiving erdafitinib. Select TEAEs (total; grade 3) were hyperphosphatemia (78%; 2.0%), stomatitis (59%; 14%), nail events (59%; 15%), non–central serous retinopathy (non-CSR) eye disorders (56%; 5.0%), skin events (55%; 7.9%), diarrhea (55%; 4.0%), and CSR (27%; 4.0%). Select TEAEs were mostly of grade 1 or 2, and were managed effectively with dose modifications, including dose reductions or interruptions, and/or supportive concomitant therapies, resulting in few events leading to treatment discontinuation. Further work is needed to determine whether management is generalizable to the nonprotocol/general population. ConclusionsIdentification of select TEAEs and appropriate management with dose modification and/or concomitant therapies resulted in improvement or resolution of most TEAEs in patients, allowing for continuation of FGFRi treatment to ensure maximum benefit. Patient summaryEarly identification and proactive management are warranted to mitigate or possibly prevent erdafitinib side effects to allow for maximum drug benefit in patients with locally advanced or metastatic bladder cancer.

Long-term variability of human health-related solar ultraviolet-B radiation doses for the 1980s to the end of the 21st century.

Solar ultraviolet-B (UV-B) radiation has played a crucial role in the evolution of life on Earth, and potential changes in its levels could affect the health and functionality of humans and the ecosystems. UV exposure presents both risks and benefits to humans. However, optimal UV-B radiation exposure depends on several environmental and physiological factors and cannot be easily determined. The present document provides a review of the current state of knowledge relative to the effects of UV-B radiation on human health. A brief description of the physical mechanisms that control the levels of solar UV-B radiation at the Earth's surface is provided, with special emphasis on the role of ozone and the importance of the Montreal Protocol. A comprehensive review of studies reporting current trends in levels of surface solar UV-B radiation and projections of future levels reveals the dominant role of climatic changes in the long-term variability of UV-B radiation and its impact on the development of melanomas as well as eye disorders. The review provides strong evidence that despite the success of the Montreal Protocol and the expected ozone recovery, the future evolution of the levels of solar UV-B radiation at the Earth's surface is not certain.