Eye Disorders Research Articles

When noise becomes signal: A study of blink rate using an eye tracker

PurposeAlthough blink rate is considered important for digital eye strain and dry eye conditions, its assessment has been mostly manual. This study aimed at quantifying blink rate automatically using the Eyelink 1000 Plus eye tracker and comparing it with manual counting. Additionally, blink rate was correlated with reading eye movements and reading speed. MethodsThirty participants (mean age 26.8 ± 3.5 years; 19 females) were enrolled. An on-screen reading task for 3 min duration, was repeated 3 times with a 2-min break between the repetitions. During this task, eye movements and blinks were measured through the Eyelink 1000 Plus eye tracker. The blink was also counted manually by the examiner in real time from a video feed. ResultsThe blink rate obtained by the eye tracker (median [Q1, Q3]:11.7 [6.8,15.5] blinks/min) and manual counting (11.6 [7.1, 15.4] blinks/min) were comparable (p > 0.5). No significant correlations were observed between the blink rate and any of the reading eye movement parameters except saccadic amplitude (Spearman's rho, rs = 0.506). No statistically significant correlation was found between the blink rate and reading speed. ConclusionThe Eyelink 1000 Plus eye tracker gives a comparable blink rate compared to that obtained through manual counting. A positive correlation between the blink rate and saccade amplitude could indicate a coupled interaction between the two mechanisms to minimize visual loss during reading. The option of using this tracker to investigate blinks in dry eye and binocular vision disorders can be further explored.

Crosstalk between MIR-96 and IRS/PI3K/AKT/VEGF cascade in hRPE cells; A potential target for preventing diabetic retinopathy.

Regulation of visual system function demands precise gene regulation. Dysregulation of miRNAs, as key regulators of gene expression in retinal cells, contributes to different eye disorders such as diabetic retinopathy (DR), macular edema, and glaucoma. MIR-96, a member of the MIR-183 cluster family, is widely expressed in the retina, and its alteration is associated with neovascular eye diseases. MIR-96 regulates protein cascades in inflammatory and insulin signaling pathways, but further investigation is required to understand its potential effects on related genes. For this purpose, we identified a series of key target genes for MIR-96 based on gene and protein interaction networks and utilized text-mining resources. To examine the MIR-96 impact on candidate gene expression, we overexpressed MIR-96 via adeno-associated virus (AAV)-based plasmids in human retinal pigment epithelial (RPE) cells. Based on Real-Time PCR results, the relative expression of the selected genes responded differently to overexpressed MIR-96. While the expression levels of IRS2, FOXO1, and ERK2 (MAPK1) were significantly decreased, the SERPINF1 gene exhibited high expression simultaneously. pAAV-delivered MIR-96 had no adverse effect on the viability of human RPE cells. The data showed that changes in insulin receptor substrate-2 (IRS2) expression play a role in disrupted retinal insulin signaling and contribute to the development of diabetic complications. Considered collectively, our findings suggest that altered MIR-96 and its impact on IRS/PI3K/AKT/VEGF axis regulation contribute to DR progression. Therefore, further investigation of the IRS/PI3K/AKT/VEGF axis is recommended as a potential target for DR treatment.

Artificial Intelligence (AI) enable advanced and accurate diagnostics eye health station for critical eye conditions

Millions worldwide suffer from various eye conditions such as Diabetic retinopathy, Cataract, Myopia, glaucoma, Age-related eye disorders, and those arising from hypertension. However, the existing healthcare infrastructure often falls short in providing timely intervention and prevention strategies. Many individuals lack access to advanced diagnostic tools and expert medical professionals, leading to undetected or poorly managed eye conditions. Consequently, irreversible damage occurs, diminishing the quality of life for affected individuals and placing a significant burden on healthcare systems. The Eye Health Station work aims to address these challenges by establishing a visionary and comprehensive medical facility dedicated to eye healthcare. Central to our approach is early intervention and prevention. Through the utilization of cutting-edge technology, including advanced imaging and diagnostic tools, we empower our team of seasoned ophthalmologists, optometrists, and medical professionals to deliver precise and timely assessments. Regular screenings and vigilant monitoring enable us to detect eye conditions at their incipient stages, facilitating effective intervention before irreversible damage occurs. Additionally, our commitment extends to personalize treatment plans tailored to each patient's unique needs, ensuring comprehensive and holistic care. By combining state-of-the-art technology with expert medical expertise, the Eye Health Station stands as a beacon of hope, preserving and restoring vision for individuals across all age groups and enhancing their quality of life.

A Randomized Controlled Trial Comparing Thai Facial Massage, Chinese Eye Exercise of Acupoints and Standard Treatment in Patients with Dry Eye Disorders

Dry eye disorder (DED) is a chronic medical condition that requires ongoing treatment, with increasing prevalence worldwide. Traditional Thai eye exercises (TFM) and Chinese eye exercises of acupoints (CEA) are believed to improve ocular health. The objective of this study is to examine the efficacy and potential adverse effects of TFM and CEA in treating DED compared to standard treatment of lid hygiene (STD). In this 12-week single-blind randomized controlled trial, 84 participants aged 20-60 years with mild to moderate DED were recruited from Thammasat University Hospital, Thailand. They were equally divided into three groups: TFM, CEA, and STD (28 participants each). The participants were trained to self-administer treatments at home. The primary outcomes were OSDI scores, SIT, TBUT, and CSS, while the secondary outcomes were ocular tests, including VA and Likert scale, to measure DED-related symptoms. One-way ANOVA and repeated measures (ANOVA) were used to compare results between groups and study visits, respectively; p-values <0.05 were considered statically significant. The post-treatment results showed a gradual improvement of OSDI (p value <0.001), TBUT (p value <0.01), and SIT (p value <0.01) in all groups. CSS improved significantly only in CEA groups (p value <0.05). No significant differences were found between the study groups, except for SIT in week 4 and week 12 when there was a greater reduction of SIT in CEA compared to TFM and STD groups (p < 0.05). No adverse event was observed in all study groups throughout the intervention program. TFM and CEA could be effectively used as alternative treatments for STD without any negative side effects.

Prevalence of chronic postsurgical hypoparathyroidism not adequately controlled: an analysis of a nationwide cohort of 337 patients.

The identification of patients with chronic hypoparathyroidism who are adequately (AC) or not adequately controlled (NAC) has clinical interest, since poor disease control is related to complications and mortality. We aimed to assess the prevalence of NAC patients in a cohort of subjects with postsurgical hypoparathyroidism. We performed a multicenter, retrospective, cohort study including patients from 16 Spanish hospitals with chronic hypoparathyroidism lasting ≥3 years. We analyzed disease control including biochemical profile and clinical wellness. For biochemical assessment we considered three criteria: criterion 1, normal serum calcium, phosphorus and calcium x phosphorus product; criterion 2, the above plus estimated glomerular filtration rate ≥60 ml/min/1.73 m2; and criterion 3, the above plus normal 24-hour urinary calcium excretion. A patient was considered AC if he or she met the biochemical criteria and was clinically well. We included 337 patients with postsurgical hypoparathyroidism (84.3% women, median age 45[36-56] years, median time of follow-up 8.9[6.0-13.0] years). The proportions of NAC patients with criteria 1, 2 and 3 were, respectively, 45.9%, 49.2% and 63.1%. Patients who had dyslipidemia at the time of diagnosis presented a significantly higher risk of NAC disease (criterion 3; OR 7.05[1.44-34.45]; P=0.016). NAC patients (criterion 2) had a higher proportion of subjects with incident chronic kidney disease and eye disorders, and NAC patients (criterion 3) had a higher proportion of incident chronic kidney disease, nephrolithiasis and dyslipidemia than AC patients. The present study shows a strikingly high prevalence of NAC patients in the clinical practice of Spanish endocrinologists. Results suggest that NAC disease might be associated with some prevalent and incident comorbidities.

MicroRNA and Rare Human Diseases

Background: The role of microRNAs (miRNAs) in the pathogenesis of rare genetic disorders has been gradually discovered. MiRNAs, a class of small non-coding RNAs, regulate gene expression by silencing target messenger RNAs (mRNAs). Their biogenesis involves transcription into primary miRNA (pri-miRNA), processing by the DROSHA–DGCR8 (DiGeorge syndrome critical region 8) complex, exportation to the cytoplasm, and further processing by DICER to generate mature miRNAs. These mature miRNAs are incorporated into the RNA-induced silencing complex (RISC), where they modulate gene expression. Methods/Results: The dysregulation of miRNAs is implicated in various Mendelian disorders and familial diseases, including DICER1 syndrome, neurodevelopmental disorders (NDDs), and conditions linked to mutations in miRNA-binding sites. We summarized a few mechanisms how miRNA processing and regulation abnormalities lead to rare genetic disorders. Examples of such genetic diseases include hearing loss associated with MIR96 mutations, eye disorders linked to MIR184 mutations, and skeletal dysplasia involving MIR140 mutations. Conclusions: Understanding these molecular mechanisms is crucial, as miRNA dysregulation is a key factor in the pathogenesis of these conditions, offering significant potential for the diagnosis and potential therapeutic intervention.

Phytochemical Screening of Genus Primula Species Growing in Georgia and Study of their Antioxidant and Anti-inflammatory Potentials

Background: In traditional medicine, species of the genus Primula L. are used to treat various health conditions, such as eye disorders, respiratory infections, headaches, epilepsy, insomnia, as expectorants, and to promote wound healing. Objective: The goal of this article was to evaluate the antioxidant and anti-inflammatory activities of three species from genus Primula L. growing in Georgia: Primula macrocalyx, Primula woronowii and Primula saguramica. Methods: Initially, fractions containing both aerial and underground parts were air-dried, ground, and extracted with 80% ethanol. The extract was then concentrated by condensation and further dried through freeze-drying. Subsequently, additional chromatographic separations were carried out on Diaion HP-20 using solvents such as water, methanol (50% and 100%), and 100% ethyl acetate to isolate the desired fractions. To identify flavonoids and triterpene glycosides, the study employed thin-layer chromatography (TLC) alongside preliminary phytochemical tests. The antioxidant activity of these species was estimated in vitro by cell-free systems using ABTS and DPPH assays. The extracts' anti-inflammatory properties were evaluated using an ex-vivo cell system that isolated neutrophils. The study examined the extracts' impact on reactive oxygen species (ROS) production in neutrophils stimulated with PMA, as well as their effect on the catalytic activity of myeloperoxidase (MPO), a marker of inflammation in neutrophils. Results: Flavonoids and triterpene glycosides were primarily identified in the 50% and 100% methanol (MeOH) fractions of Primula species through TLC and preliminary phytochemical tests. For each experiment, gallic acid and quercetin served as standards at a concentration of 1 mg/ml, while the tested samples were prepared at concentrations of 5 mg/ml. Based on the IC50 findings, P. w 3 exhibits the most potent antioxidant and anti-inflammatory properties, as evidenced by the following indicators: ABTS - IC50=8.51 ± 0.18; DPPH - IC50=34.57 ± 0.47; PMN - IC50=0.68 ± 0.04; SIEFED - IC50=1.49 ± 0.7; and classical IC50=1.89 ± 0.01. Conclusion: Among the tested fractions, only the fraction of the 3 species prepared in MeOH (50%) showed the best dose-dependent antioxidant and anti-inflammatory activities, especially P.w 3 which is probably related to the high flavonoid content found in this species.

Safety analysis of fluoroquinolone drugs in elderly patients over 65 based on FAERS

ABSTRACT Objective This study investigates adverse drug event (ADE) reports from the FAERS related to FQs drugs in patients aged 65 and older. The findings aim to guide the rational clinical use of these drugs in elderly patients. Methods We employed Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR) methods to analyze ADE reports for the representative FQ drugs from Q1 2015 to Q4 2023, covering 36 quarters. Results The analysis identified 6883 ADE cases for ciprofloxacin, 5866 for levofloxacin, 1498 for moxifloxacin, and 317 for ofloxacin. Moxifloxacin showed higher incidences of Cardiac disorders and Psychiatric disorders ADEs (4.01%, 23.11%). Ciprofloxacin and levofloxacin showed higher ADE rates in musculoskeletal and connective tissue diseases (20.18% and 26.97%) compared to moxifloxacin (3.62%) and ofloxacin (9.25%). Additionally, moxifloxacin and ofloxacin showed higher ADE rates for eye disorders (10.61% and 15.03%). Conclusion Different FQs exhibit varying ADE profiles across cardiovascular, vascular and lymphatic, renal and urinary, psychiatric, musculoskeletal and connective tissue, and ocular systems. Patients with underlying systemic diseases should avoid FQs with higher ADE risks for their conditions. Personalized medication plans for elderly patients should also be strengthened.

A Nanogel Formulation of Anti-VEGF Peptide for Ocular Neovascularization Treatment.

Age-related macular degeneration (AMD) is an eye disorder that can lead to visual impairment in elder patients, and current treatments include repeated injections of monoclonal antibody-based antivascular endothelial growth factor (anti-VEGF) agents. This study investigates the potential of a nanoformulation of a peptide anti-VEGF molecule for neovascular AMD. Anti-VEGF peptide HRHTKQRHTALH (HRH), which has high affinity to VEGF-Fc receptor, was used as the bioactive agent to control neovascularization of the retina. The nanoformulation consisting of hyaluronic acid nanogel was generated by incorporating divinyl sulfone and cholesterol to increase the stability and control the size of the nanodrug. The encapsulation efficacy of nanogel was 65%, and drug release was 34.72% at the end of 192 h. Obtained nanogels were efficiently internalized in 15 min by human umbilical vascular endothelial cells (HUVECs) and ARPE-19 cells, and results indicate that nanoformulation is not toxic to ARPE-19 cells, whereas it inhibits HUVEC proliferation owing to anti-VEGF peptide in the nanogel structure. In the coculture experiment in which retinal penetration was modeled, it was observed that the nanogel reached HUVECs and negatively affected their proliferation without disturbing the monolayer of ARPE-19 cells. In vivo experiments with chick chorioallantoic membrane revealed that nanogel formulation has higher antiangiogenesis activity compared to free HRH. Additionally, in an oxygen-induced retinopathy model, the excessive growth of blood vessels was notably suppressed in mice treated with HRH-loaded nanogel. This research indicates that nanogels formulated in this study are promising candidates as a topical treatment for AMD.

ROLE OF PATHYA APATHYA IN NETHRA SWASTHYA (EYE HEALTH)-A RE-VIEW

Since Ayurveda places a high value on both disease prevention and treatment, it is important to preserve health. Through their explanation of Pathya Apathya, the Acharyas have equipped us with the necessary knowledge to prevent and manage lifestyle issues related to eye diseases. Daily observations assessed the effectiveness of specific dietary habits and medications in preventing eye disorders. pathya apathya is used to explain certain parts of daily routine. The word "Chakshu" means "which enlightens the mind about its details and illuminates the objects." The term Chakshushya is crucial when discussing Pathya and Apathya since it is used in classic literature to describe the effects of consuming specific beneficial regimes (Pathya) and nonbeneficial medications and practices (apthya), among other things. Various ahar vargas, which list the qualities of every food item, have been referenced in ancient scriptures. With this understanding, we may choose our meals carefully and follow a daily routine to maintain netra swasthya, or eye health.

Ocular manifestations of various spondyloarthropathies

Eye inflammation has been described as a crucial prominent feature of several rheumatic diseases. Uveitis, conjunctivitis, and episcleritis have been reported in patients with known spondyloarthropathies or may be significant symptoms for the diagnosis of previously undiagnosed spondyloarthropathy. A hospital-based, cross-sectional, observational study was conducted over twenty-one months, from January 2021 to September 2022. Patients aged more than 18 years with a definitive diagnosis of Spondyloarthropathy, attending the Department of Orthopedics outpatient clinics, SGMH, Rewa, were screened for presence of eye disorders. A total of 100 cases were recruited in the study. The mean age of the study group was 34.58 years (female 33.5 years and male 35.6 years) with a majority of cases (72%) in the study group aged between 20 and 39 years. Ankylosing spondyloarthropathy was the most common diagnosis in the study, with 49% cases being diagnosed with it. Patients with Psoriatic arthropathy were also found to have a significant association with foreign body sensation and diminution of vision while ciliary congestion was significantly associated with ankylosing spondylitis. In addition, uveitis was observed to have a statistically significant association with incidence of ankylosing spondylitis. The various manifestations of seronegative spondyloarthropathies include uveitis, which is a potentially blinding complication was noted in 19% of the patients, that needs to be identified early and treated right away to avoid irreparable vision loss.

Congenital retinal eye disorders with poor visual outcome from a developing country: A case series

Congenital eye disorders are an important cause of childhood blindness. They can be due to defective development of ocular tissues during the intrauterine life, which can result from adverse genetic, environmental factors, teratogens, or chromosomal anomalies in the developing embryo. We report three such cases with congenital retinal disorders where even surgical intervention would result in a poor visual outcome. Preconceptional genetic counseling of prospective parents can maximize the chances of the couple having a healthy baby. Premarital counseling for consanguinity and screening for carriers of genetic diseases can help prevent many congenital diseases. Proper diagnosis and early intervention may provide a favourable outcome.

Light-Activated Anti-Vascular Combination Therapy against Choroidal Neovascularization.

Choroidal neovascularization (CNV) underlies the crux of many angiogenic eye disorders. Although medications that target vascular endothelial growth factor (VEGF) are approved for treating CNV, their effectiveness in destroying new blood vessels is limited, and invasive intravitreal administration is required. Additionally, other drugs that destroy established neovessels, such as combretastatin A-4, may have systemic side effects that limit their therapeutic benefits. To overcome these shortcomings, a two-pronged anti-vascular approach is presented for CNV treatment using a photoactivatable nanoparticle system that can release a VEGF receptor inhibitor and a vascular disrupting agent when irradiated with 690nm light. The nanoparticles can be injected intravenously to enable anti-angiogenic and vascular disrupting combination therapy for CNV through light irradiation to the eyes. This approach can potentiate therapeutic effects while maintaining a favorable biosafety profile for choroidal vascular diseases.

Safety profile of levonorgestrel intrauterine system: Analysis of spontaneous reports submitted to FAERS

The levonorgestrel-releasing intrauterine system (LNG-IUS) is an established, long-acting contraceptive option. With the widespread use of the LNG-IUS, drug-reported adverse events (AEs) have also garnered significant attention. In this study, we conducted a real-world analysis using the FDA's Adverse Event Reporting System (FAERS) database to assess the incidence of AEs associated with LNG-IUS use. Data from FAERS spanning from 2004Q1 to 2024Q1 were reviewed, with a focus on reports in which LNG-IUS was the primary suspected and secondary suspect drug. Signal detection was carried out utilizing Standardized MedDRA Queries (SMQ) and Preferred Terms (PT), with reporting odds ratio (ROR), proportional reporting ratio (PRR), and information component (IC) employed to identify Signals of Disproportionate Reporting (SDR) for AEs. A positive SDR was defined when all three methods indicated significance. Analysis of 13 SMQs revealed notable SDRs in ear and eye disorders, cardiac arrhythmias, and lipodystrophy. Of the 61 suspected SDRs identified at the PT level, nearly half were not previously documented in labeling. Key potential signals of AEs associated with LNG-IUS use included increased heart rate, papilledema, idiopathic intracranial hypertension, cervical dysplasia, ruptured ovarian cyst, and uterine embedment and perforation. The findings underscore the importance of signal detection using FAERS data for identifying safety concerns related to LNG-IUS. Long-term observational studies are warranted to confirm and further elucidate these potential safety signals.

The Rise of Ophthalmology as a Specialty: Albrecht von Graefe's Pioneering Contributions.

Albrecht von Graefe (1828-1870) is celebrated as a pivotal figure in the evolution of ophthalmology. He is renowned for his transformative contributions that established the field as a distinct medical specialty separate from general surgery. This biography review delves into von Graefe's pioneering efforts that reshaped ophthalmology, highlighting his innovations and establishing fundamental practices that define modern ophthalmic care. von Graefe's introduction of iridectomy for glaucoma, development of specialized surgical instruments, and advocacy for the use of the ophthalmoscope marked significant advancements in treating eye disorders. Additionally, his role in founding the first ophthalmological society and journal underscored his commitment to creating a structured, scientific approach to the field. Through meticulous examination of his work and its impact, this article underscores how von Graefe's pioneering spirit and dedication fostered the growth of ophthalmology into an independent and respected medical specialty.

Voriconazole-induced central nervous system toxicity: a pharmacovigilance study based on FDA adverse event reporting system (FAERS) database

ABSTRACT Background This study aims to evaluate the relationship between voriconazole (VRC) and central nervous system (CNS) toxicity based on the real world data. Research design and methods The reports of FAERS from January 2004 to March 2022 were included in our study. The CNS toxicity events were identified by using Medical Dictionary for Regulatory Activities terms. Reporting odds ratios corresponding to 95% confidence intervals were employed to quantify the signals of VRC-associated CNS events. Results The overall RORs (95%CI) for psychiatric disorders, nervous system disorders, and eye disorders were 1.84 (1.70, 2.00), 1.09 (1.01, 1.18), and 3.84 (3.48, 4.23), respectively (p < 0.05). The median time to the CNS events of VRC was 1(IQR 0–5) day. Top six signals were macular opacity, chloropsia, scintillating scotoma, toxic optic neuropathy, corneal bleeding, and dyschromatopsia, all of them grouped as eye disorders. Compared with itraconazole, fluconazole, posaconazole, and isavuconazole, VRC shows significant relationship and higher incidence rate of psychiatric disorders, nervous system disorders, and eye disorders, respectively (p < 0.05). Conclusions VRC was significantly associated with the CNS toxicity. Dosing adjustment, model-based individualized treatment project, and the therapeutic drug monitoring-guided individualized medication regime could be good strategies for efficacy improvement and the adverse events of reducing of VRC.

Rationale and design of the BeyeOMARKER study: prospective evaluation of blood- and eye-based biomarkers for early detection of Alzheimer’s disease pathology in the eye clinic

BackgroundAlzheimer’s disease (AD) is a common, complex and multifactorial disease that may require screening across multiple routes of referral to enable early detection and subsequent future implementation of tailored interventions. Blood- and eye-based biomarkers show promise as low-cost, scalable and patient-friendly tools for early AD detection given their ability to provide information on AD pathophysiological changes and manifestations in the retina, respectively. Eye clinics provide an intriguing real-world proof-of-concept setting to evaluate the performance of these potential AD screening tools given the intricate connections between the eye and brain, presumed enrichment for AD pathology in the aging population with eye disorders, and the potential for an accelerated diagnostic pathway for under-recognized patient groups.MethodsThe BeyeOMARKER study is a prospective, observational, longitudinal cohort study aiming to include individuals visiting an eye-clinic. Inclusion criteria entail being ≥ 50 years old and having no prior dementia diagnosis. Excluded eye-conditions include traumatic insults, superficial inflammation, and conditions in surrounding structures of the eye that are not engaged in vision. The BeyeOMARKER cohort (n = 700) will undergo blood collection to assess plasma p-tau217 levels and a brief cognitive screening at the eye clinic. All participants will subsequently be invited for annual longitudinal follow-up including remotely administered cognitive screening and questionnaires. The BeyeOMARKER + cohort (n = 150), consisting of 100 plasma p-tau217 positive participants and 50 matched negative controls selected from the BeyeOMARKER cohort, will additionally undergo Aβ-PET and tau-PET, MRI, retinal imaging including hyperspectral imaging (primary), widefield imaging, optical coherence tomography (OCT) and OCT-Angiography (secondary), and cognitive and cortical vision assessments.ResultsWe aim to implement the current protocol between April 2024 until March 2027. Primary outcomes include the performance of plasma p-tau217 and hyperspectral retinal imaging to detect AD pathology (using Aβ- and tau-PET visual read as reference standard) and to detect cognitive decline. Initial follow-up is ~ 2 years but may be extended with additional funding.ConclusionsWe envision that the BeyeOMARKER study will demonstrate the feasibility of early AD detection based on blood- and eye-based biomarkers in alternative screening settings, and will improve our understanding of the eye-brain connection.Trial registrationThe BeyeOMARKER study (Eudamed CIV ID: CIV-NL-23–09-044086; registration date: 19th of March 2024) is approved by the ethical review board of the Amsterdam UMC.

A Review of Cholinergic Acid's Antioxidant Potential in Age-Related Eye Disorders

Sepsis is a disordered host response to an infection, and one of its hallmarks is organ failure. Mitochondria appear to be a key actor in the chain of events that results in multiple organ failure and potentially death, despite the pathophysiology being complex and little understood. Apart from supplying energy and metabolic intermediates required for immune cell activation and function, mitochondria also impact inflammation and cell death pathways. These two functions of mitochondria influence immunological responses. Crucially, the stability of end organ metabolism and the efficacy of the immune system are both compromised by mitochondrial dysfunction. A hyperinflammatory state and a lack of cellular homeostasis are further consequences of malfunctioning mitochondria, which also contribute to poor clinical outcomes. Hence, strategies to maximize mitochondrial efficiency are necessary since signs of mitochondrial malfunction are evident even in early stages of sepsis. Replacing or repairing damaged mitochondria may therefore aid in the recovery of organ function in sepsis. Toward the conclusion.

Epidemiology of eye diseases in Bangladesh

Bangladesh is densely populated country in South Asia, faces significant challenges in eye health due to various socioeconomic, environmental, and healthcare access factors. Limited access to quality eye care services, poor hygiene practices, prevalence of infectious diseases, and a high burden of non-communicable diseases contribute to the prevalence of eye disorders in the region. This study aims to comprehensively analyze the prevalence, distribution, and risk factors associated with various eye diseases among the population of Bangladesh. A systematic review and meta-analysis were conducted to gather data on the epidemiology of eye diseases in Bangladesh. Published studies, national surveys, and reports from relevant health organizations were reviewed to compile data on the prevalence, distribution, and risk factors of common eye conditions, including cataracts, refractive errors, conjunctivitis, glaucoma, diabetic retinopathy, and age-related macular degeneration. The prevalence of eye diseases in Bangladesh is relatively high, with conditions such as refractive errors, cataracts, glaucoma, and corneal diseases being major concerns. Refractive errors, including myopia, hyperopia, and astigmatism, affect a substantial portion of the population, particularly among children and young adults. Cataracts, a leading cause of blindness worldwide, also pose a significant burden in Bangladesh, with prevalence increasing with age. While the prevalence of glaucoma in Bangladesh is lower compared to some other countries, the condition remains a cause of concern due to its impact on quality of life and the healthcare system. Diabetic retinopathy, a complication of diabetes mellitus, affects the retina and is a leading cause of vision loss and blindness globally in the elderly. In Bangladesh, the rising prevalence of diabetes, fueled by changing lifestyles and an aging population, has contributed to an increasing burden of diabetic retinopathy. Conjunctivitis is prevalent, particularly in densely populated urban areas and rural communities with limited access to clean water and sanitation facilities.Collaborative efforts involving government agencies, healthcare providers, non-governmental organizations, and the community are essential to effectively address the burden of eye diseases in Bangladesh. By implementing preventive measures and improving access to quality eye care services, it is possible to mitigate the impact of these eye diseases and improve visual health outcomes for the population.

Integrative therapeutics for ocular surface disorders.

Integrative medicine techniques are increasingly accepted into the treatment paradigm for many chronic disorders including eye disease. Over 71% of patients, including 67% of those with eye disorders, use some form of Integrative therapy. Physicians should be well versed in evidence-based therapies to know how to refer patients for the best complimentary care. We highlight the most effective integrative therapeutics from different complementary treatment paradigms to offer a framework for approaching therapy in patients with ocular surface disorders (OSDs). Lifestyle and behavioral modifications help a proportion of people with OSDs like dry eye disease and allergic conjunctivitis, which are interrelated disorders. Nutrition and supplementation can also play a role in addressing underlying inflammation and improving OSD symptoms. Acupuncture and traditional herbal medicine may also benefit some patients. New technologies offer innovative treatment pathways in the treatment of OSD but require referral to Ocular Surface Treatment Centers. Integrative treatment approach for OSD incorporates allopathic medicine, traditional remedies and lifestyle behavioral interventions, Ayurveda and herbal medicine, Nutritional Supplements, Homeopathy, Acupuncture and Chinese Medicine. New cutting-edge technologies offer breakthroughs in difficult to treat ocular surface cases. Collaboration between allergy or otolaryngology offices, complementary practitioners, as well as optometrists and ophthalmologists in Ocular Surface Treatment Centers can offer patients new avenues of treatment.