Higher Prevalence Of Cataract Research Articles

Prevalence of Age-Related Cataracts Among Patients Utilizing Eye Services in Cross River State Eye Care Programme, Calabar, Nigeria

Background: Cataract is the leading cause of blindness worldwide. Its prevalence in the area of study needs to be assessed due to the unawareness of older adults, who need to identify the risk factors and access to cataract services. Aims: The study aimed to determine the prevalence of age-related cataracts between 2019 and 2022 among patients attending the Cross River State Eye Care clinic in Calabar, Nigeria. Methods: The study utilized a retrospective research design. The case notes of 200 patients aged 50 years and above who attended the clinic during the period under study were reviewed. Relevant data was extracted from the patients’ folders into a checklist and was analysed using descriptive statistics (frequency and percentage). Chi-square was used to test the hypothesis. Findings: The result of the data analysed showed that most of the study participants (41%) were in the age range of 71 years and above. There were more females (51%) than males in the study. The prevalence of cataracts was 68%. The prevalence rate was higher in females (70.6%) than males (65.3%). A chi-square analysis of the hypothesis showed that the calculated X2 value of 25.92 is far greater than the critical X2 value of 5.99 at a 0.05 level of significance. The null hypothesis was therefore rejected, implying a significant relationship between gender and age-related cataracts. Conclusion: The high prevalence of cataracts recorded in this study highlights the need for nurses to ask about the state of vision of their patients during the initial assessment of all patients on first contact with the health facility. If this is done, patients who complain of decreased vision can be arranged to be evaluated accordingly. Recommendation: Based on these findings, eye screening, health promotion, and health education on the availability and utilization of cataract services should be considered a routine part of healthcare services.

Prevalence of cataract and its contributing factors in Iranian elderly population: the Gilan eye study.

To report the prevalence and the associated factors leading to cataract among the Iranian population living in Gilan Province, Iran. This population-based cross-sectional study was performed from June to November 2014 on 2,975 residents aged ≥ 50 years old living in urban and rural regions of the Gilan Province in Iran. A representative sample of residents in the province was recruited into the study through door-to-door visiting, and baseline data were collected by questionnaire. All participants were referred to the medical center for comprehensive ophthalmic examination, laboratory tests, and blood pressure measurement. Among the population, 2,588 (86.99%) subjects were eligible to be included in this study, categorized either into the cataract or the non-cataract group. The mean age of participants was 62.59 ± 8.92 years, and 57.5% were female. Higher prevalence of cataract was found in individuals of older ages (odds ratio (OR) = 1.13; 95% confidence interval (CI) = 1.10 to 1.16; P < 0.001) and a history of previous ocular surgery (OR = 5.78; 95% CI = 2.28 to 14.63; P < 0.001). At the same time, a lower prevalence of cataract was seen in patients exposed to sunlight for more than 4 h per day (OR = 0.49; 95% CI = 0.32 to 0.73; P = 0.001). Cataract affects 50.50% of the study population, especially those over 80. The mildest form of cataract, grade zero, is the most common. Surgery for cataract has good outcomes. The risk of cataract is higher for those older or who have had eye surgeries. People not affected by cataract tend to be exposed to more sunlight.

Impact of cataract surgery on quality of life in rural areas of Jharkhand: a community based cross-sectional study

Background: Cataract is the leading cause of blindness in India, accounting for approximately 66.2% of all blindness cases and accounting for 71.2% of all visual impairment cases. This study was conducted in 5 blocks of East Singhbhum and Saraikela-Kharsawan districts of Jharkhand to determine burden of cataract and the impact of cataract surgery on quality of life in the rural population. Methods: Community based cross sectional study was conducted between January 2023 to April 2023 among individuals residing in rural areas of Jharkhand using multi-stage sampling with a sample size of 692 individuals. Results: Prevalence of cataract amongst the study population was 23% (159) and there was a statistically significant improvement in the quality-of-life post cataract surgery. Conclusions: High prevalence of cataract increases the burden on existing health care system. Ongoing research and initiatives should focus on improving early detection and referral, providing comprehensive post-operative care to reduce the burden of cataract and improve the quality-of-life outcomes among the individuals.

Age-Related Differences in Ocular Features of a Naturalistic Free-Ranging Population of Rhesus Macaques.

Rhesus macaques (Macaca mulatta) are the premier nonhuman primate model for studying human health and disease. We investigated if age was associated with clinically relevant ocular features in a large cohort of free-ranging rhesus macaques from Cayo Santiago, Puerto Rico. We evaluated 120 rhesus macaques (73 males, 47 females) from 0 to 29 years old (mean ± SD: 12.6 ± 6.4) from September to December 2021. The ophthalmic evaluation included intraocular pressure (IOP) assessment, corneal pachymetry, biomicroscopy, A-scan biometry, automated refraction, and fundus photography after pupil dilation. The associations of age with the outcomes were investigated through multilevel mixed-effects models adjusted for sex and weight. On average, IOP, pachymetry, axial length, and automated refraction spherical equivalent were 18.37 ± 4.68 mmHg, 474.43 ± 32.21 µm, 19.49 ± 1.24 mm, and 0.30 ± 1.70 diopters (D), respectively. Age was significantly associated with pachymetry (β coefficient = -1.20; 95% confidence interval [CI], -2.27 to -0.14; P = 0.026), axial length (β coefficient = 0.03; 95% CI, 0.01 to 0.05; P = 0.002), and spherical equivalent (β coefficient = -0.12; 95% CI, -0.22 to -0.02; P = 0.015). No association was detected between age and IOP. The prevalence of cataracts in either eye was 10.83% (95% CI, 6.34-17.89) and was significantly associated with age (odds ratio [OR] = 1.20; 95% CI, 1.06-1.36; P = 0.004). Retinal drusen in either eye was observed in 15.00% (95% CI, 9.60-22.68) of animals, which was also significantly associated with age (OR = 1.14; 95% CI, 1.02-1.27; P = 0.020). Rhesus macaques exhibit age-related ocular associations similar to those observed in human aging, including decreased corneal thickness, increased axial length, myopic shift, and higher prevalence of cataract and retinal drusen.

Age-related cataract - Prevalence, epidemiological pattern and emerging risk factors in a cross-sectional study from Central India

Purpose: To study the epidemiological pattern, prevalence, types, and correlates of age-related cataracts in a tertiary care center in central India. Methods: This hospital-based single-center cross-sectional study was conducted on 2,621 patients diagnosed with cataracts for 3 years. Data pertaining to demography, socio-economic profile, cataract grading, cataract types, and associated risk factors were evaluated. Statistical analysis using unadjusted odds ratio (OR) and multivariate logistic regression was performed, with P-value <0.05 considered significant with the power of the study being 95%. Results: The commonest age group affected was 60–79 years, closely followed by the 40–59 years age group. The prevalence of nuclear sclerosis (NS), cortical (CC), and posterior subcapsular cataract (PSC) was found to be 65.2% (3,418), 24.6% (1,289), and 43.4% (2,276), respectively. Among mixed cataracts, (NS + PSC) had the highest prevalence of 39.8%. Smokers were found to have 1.17 times higher odds of developing NS than non-smokers. Diabetics had 1.12 times higher odds of developing NS cataracts and 1.04 times higher odds of developing CC. Patients with hypertension showed 1.27 times higher odds of developing NS and 1.32 times higher odds of developing CC. Conclusion: The prevalence of cataracts in the pre-senile age group (<60 years) was found to have increased significantly (35.7%). A higher prevalence of PSC (43.4%) was found in studied subjects, as compared to the data of previous studies. Smoking, diabetes, and hypertension were found to have a positive association with a higher prevalence of cataracts.

Use of Informational Brochures on Knowledge of Cataracts in Rural Ecuador.

Background Cataracts are the leading global cause of preventable blindness. Despite the high prevalence of cataracts in rural Ecuadorian communities, no community-wide educational efforts on the impact of cataract-related blindness have been attempted. This study used an educational brochure to assess individual knowledge of cataract blindness before and after the distribution of the brochure. Methods We conducted electronic surveys with 100 patients over the age of 18 who visited the Fundacion Internacional Buen Samaritano Paul Martel (FIBUSPAM) clinic serving the Chimborazo region of Ecuador. Participation in the study included an introduction and written consent followed by a pre-survey. Every patient was given a brochure. After reviewing the brochure, patients were then asked to complete the same survey again. Each survey question received one mark. Knowledge was considered "good" if the subject correctly answered four out of seven questions and "poor" if they scored ≤3. Results Of the 100 patients, 21 had poor knowledge surrounding cataracts. Cataract awareness was lowest in the group without formal education (50%). In addition, 17 participants demonstrated poor knowledge before the informational brochure was distributed, and all improved to "good" knowledge after. Following brochure distribution, there was an improved knowledge of cataract anatomy (correct answer: 32.9% to 94.6%), treatment of cataracts (80% to 95.9%), cataract symptoms (36.7% to 95.9%), age at risk (88.8% to 97.3%), and relationship to blindness (93.5% to 98.6%). In contrast, overall knowledge of the risk factors for cataracts (46.8% to 37%) and prevention of the onset of the cataract (81.3% to 77%) slightly decreased after the brochure was given. Overall, the increase in the number of correct answers after the brochure was not significant (p = 0.25). Conclusions To our knowledge, this is a rare study to assess the effect of informational brochures on cataract knowledge in rural Ecuador. This study was limited by selection bias and did not look at the long-term recall of knowledge. The results of this study suggest that brochures can improve health awareness; however, brochures alone may not be enough. Additional assessments on the use of oral and visual aids are needed. Health education efforts should go beyond simple brochures and focus on innovative strategies to improve health education and communication efforts.

Menopausal hormone therapy and the risk of cataracts in postmenopausal women in South Korea.

Postmenopausal women have a higher prevalence of cataracts than men of a similar age. This study aimed to evaluate the effects of menopausal hormone therapy (MHT) on lens opacities in postmenopausal women. This retrospective cohort study analysed population-based health insurance data in South Korea collected from 2002 to 2019. To determine the risk factors associated with cataract, postmenopausal women (N= 2,506,271) were grouped according to post-MHT use. The treatment group was further divided into the following subgroups: tibolone, combined oestrogen plus progestin by manufacturer, oral oestrogen, combined oestrogen plus progestin by physician and topical oestrogen groups. The main outcome measure was the prevalence of cataracts. The control group comprised 463,151 postmenopausal women who had never used MHT after menopause, while the treatment group included 228,033 postmenopausal women who had used MHT continuously for at least 6months. The treatment group had a higher incidence of cataracts than the control group based on Cox proportional hazards ratio analysis. Low socioeconomic status and high parity were identified as risk factors for cataracts, and reduced risk of cataracts was associated with living in rural areas and drinking alcohol. Women undergoing post-MHT, including tibolone, had a higher incidence of cataracts. Cataract development should be a concern when examining postmenopausal patients using MHT.

Chronic kidney disease and its association with cataracts-A cross-sectional and longitudinal study.

We aim to explore the association between chronic kidney disease (CKD) and cataracts. A total of 121,380 participants with adequate information collected from 29 community-based recruitment centers since 2008 were analyzed. The association between CKD and self-reported diagnosed cataracts was examined in a cross-sectional cohort and was validated in a longitudinal cohort of 25,263 participants without cataracts at baseline. Of all participants, cataracts occurred in 503/1,947 (26%) and 10,464/119,433 (9%) subjects in the CKD and non-CKD groups, respectively. Multivariate logistic regression showed that CKD was significantly associated with a higher prevalence of self-reported diagnosed cataracts. In the validation cohort, a higher incidence of cataracts was also noted in the CKD group (65/317, 21%) compared to the non-CKD group (1,964/24,252, 8%) during a mean 47-month follow-up. After adjusting for confounders, subjects with CKD had a 1.498-fold higher risk of incident cataracts than those without CKD (95% confidence interval = 1.114 to 2.013, p value = 0.007). We found that CKD was associated with a higher prevalence of cataracts as well as incident cataracts, which suggests CKD patients and their primary physicians should be aware of this disease and can provide a clue for further exploration of the possible mechanisms and treatments.

Menopausal hormone therapy and the risk of cataract in postmenopausal women in South Korea

AbstractPurpose: Postmenopausal women have a higher prevalence of cataract than similar‐aged men. This study aimed to evaluate the effects of menopausal hormone therapy on lens opacity in postmenopausal women.Methods: This retrospective cohort study analysed population‐based health insurance data in South Korea collected from 2002 to 2019. To determine the risk factors associated with cataract, postmenopausal women (N = 2 506 271) were grouped according to postmenopausal hormone therapy use. The treatment group was further divided into the following subgroups: tibolone, combined oestrogen plus progestin by manufacturer, oral oestrogen, combined oestrogen plus progestin by physician, and topical oestrogen groups. The main outcome measure was the prevalence of cataract.Results: The control group comprised 463 151 postmenopausal women who had never used menopausal hormone therapy after menopause, while the treatment group included 228 033 postmenopausal women who had used menopausal hormone therapy continuously for at least 6 months. The treatment group had a higher incidence of cataract than the control group based on Cox proportional hazards ratio analysis. Low socioeconomic status and high parity were identified as risk factors for cataract, and reduced risk of cataract was associated with living in rural areas and drinking.Conclusions: Women undergoing postmenopausal hormone therapy, including tibolone, had a higher incidence of cataract than those who were not. Old age, low socioeconomic status, and high parity were risk factors for cataract. Our findings may help physicians identify postmenopausal women at a greater risk of developing cataract.

Cross-sectional study of the association between asthma and cataract among 40 years and older in the USA

BackgroundThis study is aimed to assess the association between asthma and cataract in a representative sample in the United States.MethodsThe National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States. Ten years (2010-2019) of NHIS were analyzed in this study. Asthma and cataract status were collected from relevant questionnaires among participants aged 40 years and older. Multivariate regression analyses were applied to explore the association between asthma and cataract.ResultsFrom 40,457 participants included, those with asthma had higher prevalence of cataract than those without asthma (29.41% vs 25.87%, p < 0.001). Participants who had asthma had 40% higher odds of cataract compared to those without, after adjusting for potential confounding covariates (Odds Ratio [OR] = 1.40, 95% Confidence Interval [CI]: 1.29-1.52, p < 0.001). When viewing asthma as the outcome, participants who had cataract had 36% higher odds of asthma compared to those without, after adjusting for potential confounding covariates (Odds Ratio [OR] = 1.36, 95% Confidence Interval [CI]: 1.25-1.47, p < 0.001).ConclusionsWith our study, we demonstrated that individuals with asthma were more likely to develop cataract compared with those without asthma. Further RCTs are needed to confirm this potential impact of asthma on cataract and to investigate the underlying mechanisms.

Factors associated with the presence of cataracts in the Peruvian population older than 50 years: a cross-sectional study

Background: Cataracts are a public health problem, especially in low- and middle-income countries, where the greatest limitations of health care systems are observed, making access to treatment difficult. This study aimed to determine the factors associated with the presence of cataracts in adults over 50 years of age in Peru. Methods: A cross-sectional analytical observational study was performed of data from the 2019 Demographic and Family Health Survey (ENDES – acronym in Spanish). The dependent variable was the self-reported diagnosis of cataracts (yes or no). Crude and adjusted prevalence ratios (aPR) were calculated using a generalized linear model of the Poisson family with a log link function to estimate factors associated with self-reported cataract diagnosis. Results: We analyzed the data of 8775 Peruvian adults older than 50 years; 1322 (16.68%) self-reported a diagnosis of cataract. A higher prevalence of having cataracts was associated with being aged 60-69 years (aPR: 1.40; 95% confidence interval (CI): 1.21-1.61) and 70 years and older (aPR: 2.78; 95% CI: 2.44-3.18), identifying as being of native ethnicity (aPR: 1.30; 95% CI: 1.16-1.47), having undergone ophthalmologic evaluation in the last 12 months (aPR: 2.29; 95% CI: 2.07-2.53) and having diabetes mellitus (aPR: 1.30; 95% CI: 1.13-1.51). The prevalence of cataracts was lower in subjects belonging to the poorest wealth quintile (aPR: 0.55; 95% CI: 0.43-0.70) and those with a higher level of education (aPR: 0.74; 95% CI: 0.62-0.88). Conclusions: In Peru, one out of six adults older than 50 years self-reported a diagnosis of cataracts. People older than 60 years, being of native ethnicity, having had a visual acuity evaluation in the last 12 months and having diabetes were associated with a higher prevalence of cataracts. These factors should be considered when implementing strategies for health education, promotion and prevention to ensure access to early ophthalmologic care.

Feed Digestion, Growth and Disease Prevalence in Nile Tilapia (Oreochromis niloticus) Cultured at Different Water Exchange Rates in a Recirculating Aquaculture System

The quality of culture water and the rate of water flow within a culture system can affect fish growth and health. In this study, the effects of different water flow rates on digestion efficiency, growth and welfare of juvenile Nile tilapia (Oreochromis niloticus) (Initial weight: 25.75±0.47 g) were investigated. Fish (15 per tank) were randomly stocked into twelve 150 L thermoplastic tanks of a recirculating aquaculture system and subjected in quadruplicate groups to water flow rates of 50 Lh-1 (Low exchange; LE), 100 Lh-1 (Medium exchange; ME) and 150 Lh-1 (High exchange; HE) for 72 days. Water quality parameters including total ammonia nitrogen, nitrate and alkalinity, dry matter, protein and lipid digestibilities, somatic growth and some welfare indicators including haematology and disease prevelance were monitored. There were no significant differences in growth among the treatments. Higher prevalence of cataract, fin erosion, oral and dermal lesions were observed in the LE and ME treatments indicating compromised welfare. There were no statistical differences among the treatments in terms of nutrient digestibility. This study has shown that culturing Nile tilapia under moderately high water flow rates of at least 100% tank water replacement per hour in RAS ensures good growth and feed utilization.

Reported evidence of vitamin E protection against cataract and glaucoma

Cataract and glaucoma are the major causes of severe visual loss and blindness in older adults. This review article describes the currently available basic and clinical evidence regarding vitamin E protection against these eye diseases in the chronologic order of the publications. Experimental evidence has suggested both that oxidative stress due to the accumulation of free radicals plays a role in the pathogenesis of cataracts and glaucoma and that the process can be prevented or ameliorated by vitamin E. The results of observational studies have been inconsistent regarding the association between blood vitamin E levels and the risk of age-related cataract or glaucoma. Despite the encouraging effects of vitamin E from case series, case-control studies, and cross-sectional studies in humans, the effects on cataract formation and/or progression have not been consistent among prospective and randomized control studies; few randomized control studies have tested the effects of supplemental vitamin E on glaucoma development or progression. Given the high prevalence of cataract and glaucoma in the elderly population, even a modest reduction in the risk for these eye diseases would potentially have a substantial public health impact; however, the potential benefits of vitamin E on cataract or glaucoma remain inconclusive and need to be carefully considered.

Frequency of Eye Changes in Patients of Chronic Kidney Disease

Background: One important and often ignored aspect in treatment of patients of chronic kidney disease (CKD) is screening for eye disorders. There is a need for continuous monitoring and examination, with cooperation from an ophthalmologist, of all dialysis patients with increased risk of vision loss like patients with coexisting diabetes and hypertension. It is not very common to find vision disorders or other anatomical defects of eye which can be directly attributed to kidney diseases. In general, eye disease is found as incidental finding during screening of patients with kidney diseases. Aim: To evaluate the frequency of eye changes in patients of chronic kidney disease. Methods: It was a Cross-sectional descriptive study performed in Department of Medicine and Nephrology Indoor, Fatima Memorial Hospital Lahore. The total duration was 6 months after approval of the project i.e. from 26-12-2019 to 25-06-2020. All patients admitted in the hospital under department of Medicine or Nephrology from 13 to 70 years of age diagnosed as a case of Chronic Kidney Disease as per the Glomerular Filtration Rate (GFR) were recruited for the study. Results: Total cases were 213, 44(20.65%) were from the age group of 13-40, 169(79.35%) were in 41-70 years age group, mean±Standard deviation(SD)was 47.82±8.55years, 114(53.52%) male, 99(46.48%) females, 129(60.56%) had diabetes mellitus, 141(66.19%) had hypertension, mean duration of disease was calculated as 14.23±4.99 months, 41(19.24%) retinal disorder, 79(37.08%) had cataract while 93(43.66%) had no eye disorder, out of 41 cases of retinal disorders, 17(41.46%) had hypertensive retinopathy while 24(58.53%) had diabetic retinopathy. Conclusion: There is a high prevalence of cataract and retinal disorders in chronic kidney disease patients. However our study was limited to single center, more extensive studies with a bigger sample size are needed to validate our results. Keywords: Chronic kidney disease, Eye disorders, Retinal disorders, Cataract, End stage renal diseases

Harm of high LET radiation to the lens of the human eye

The biological effects of ionising radiation vary according to its linear energy transfer (LET) density, with higher LET radiation having stronger biological effects than lower LET radiation at the same absorbed dose. Though we have done more research in the area of radiation effects on the ocular lens, we know little about the effects of high LET on the ocular lens. This article briefly describes the historical changes in the dose limits of the human ocular lens, investigates the epidemiology of high LET radiation eye lens, summarizes various biological experiments of high LET particles, and briefly analyzes the reasons for the high prevalence of cataracts in the plateau. It also discusses the factors that need to be considered in the future research on high LET, aiming to provide valuable information for the future research of high LET eye lens in China. 摘要： 眼晶状体是人体对辐射最敏感的组织之一, 电离辐射的生物效应因其传能线密度 (linear energy transfer, LET) 的不同而不同, 同等吸收剂量条件下, 高 LET 辐射生物效应比低 LET 辐射更强, 尽管目前辐射对眼晶状体的影响这一 领域己经有了较多研宄, 但对于高 LET 对眼晶状体的影响知之甚少。本文简述人眼晶状体剂量限值的历史变化情况, 综述各种高 LET 粒子的生物学实验, 调查高 LET 辐射眼晶状体的流行病学, 简要分析高原白内障高患病率的原因, 并 初步讨论未来研宄高 LET 需要考虑的因素, 旨在为国内今后开展高 LET 辐射对人眼晶状体的研宄提供有价值的信息。

A transcriptomic analysis of diploid and triploid Atlantic salmon lenses with and without cataracts

To avoid negative environmental impacts of escapees and potential inter-breeding with wild populations, the Atlantic salmon farming industry has and continues to extensively test triploid fish that are sterile. However, they often show differences in performance, physiology, behavior and morphology compared to diploid fish, with increased prevalence of vertebral deformities and ocular cataracts as two of the most severe disorders. Here, we investigated the mechanisms behind the higher prevalence of cataracts in triploid salmon, by comparing the transcriptional patterns in lenses of diploid and triploid Atlantic salmon, with and without cataracts. We assembled and characterized the Atlantic salmon lens transcriptome and used RNA-seq to search for the molecular basis for cataract development in triploid fish. Transcriptional screening showed only modest differences in lens mRNA levels in diploid and triploid fish, with few uniquely expressed genes. In total, there were 165 differentially expressed genes (DEGs) between the cataractous diploid and triploid lens. Of these, most were expressed at lower levels in triploid fish. Differential expression was observed for genes encoding proteins with known function in the retina (phototransduction) and proteins associated with repair and compensation mechanisms. The results suggest a higher susceptibility to oxidative stress in triploid lenses, and that mechanisms connected to the ability to handle damaged proteins are differentially affected in cataractous lenses from diploid and triploid salmon.

KLF6 Induces Apoptosis in Human Lens Epithelial Cells Through the ATF4-ATF3-CHOP Axis.

BackgroundMany studies have confirmed that high myopia is related to the high prevalence of cataracts, which results from apoptosis of lens epithelial cells (LECs) due to endoplasmic reticulum stress. Krüppel-like factor 6 (KLF6) is a tumor suppressor that is involved in the regulation of cell proliferation and apoptosis.PurposeIn this study, our purpose was to find the relationship between KLF6-induced apoptosis in LECs and ATF4 (activating transcription factor 4)-ATF3 (activating transcription factor 3)-CHOP (C/EBP homologous protein) signaling pathway.MethodsKLF6, ATF4, ATF3, and CHOP were ectopically expressed using cDNAs subcloned into the pCDNA3.1+ vector. ATF4, ATF3, and CHOP knockdown were performed by small interfering RNA (siRNA). Expression of relative gene was tested using QT-PCR and western-blot. Then, accompanied by UVB stimulation, cell viability was measured by CCK-8 assay; The cell damage was examined by live & dead staining; The apoptotic markers Bax and Bcl-2 were detected by immunoblotting; Quantitative apoptotic levels were measured with the Apoptosis Detection Kit; The expression level of reactive oxygen-free radical (ROS) was analyzed by DCFH-DA` probe.ResultsEctopically expressed ATF4, ATF3, and CHOP-induced apoptosis in cells, whereas ATF4, ATF3, and CHOP knockdown by small interfering RNA (siRNA) blocked KLF6-induced apoptosis. In addition, we determined that ATF4 regulates ATF3 and CHOP expression and that ATF3 silencing reduces CHOP upregulation without changing ATF4 levels; however, ATF4 and ATF3 expression was unaffected by blockade of CHOP, suggesting that KLF6 triggers endoplasmic reticulum stress in LECs by mediating the ATF4-ATF3/CHOP axis. Besides, KLF6 overexpression significantly induced LEC apoptosis under UV radiation, as demonstrated by the elevated Bax/Bcl-2 ratio.ConclusionThe ATF4-ATF3-CHOP pathway plays an important role in KLF6-induced apoptosis in HLECs. Our results increase our understanding of the mechanisms that regulate LEC apoptosis and contribute to the development of a new preventative strategy for cataract.

German claims data analysis to assess impact of different intraocular lenses on posterior capsule opacification and related healthcare costs

AimCataract extraction is one of the most frequent surgeries in Germany. In most cases, the clouded natural lens is replaced by a hydrophobic or hydrophilic acrylic intraocular lens (IOL) implant. The most common long-term complication after cataract surgery is the development of a posterior capsule opacification (PCO). Although no precise real world data are available, published evidence suggests a lower risk for PCO development for hydrophobic acrylic IOLs compared to hydrophilic acrylic IOLs. Therefore, in the present study we assessed real world data on the impact of different IOL material types on the incidence of post-operative PCO treatment.Subject and methodsIn this retrospective study, we included 3,025 patients who underwent cataract extraction and implantation of either an acrylic hydrophobic or hydrophilic IOL in 2010. We assessed clinical outcomes and direct costs in a 4-year follow-up period after cataract surgery from a statutory health insurance (SHI) perspective in Germany.ResultsPCO that required capsulotomies occurred significantly (p < 0.0001) less frequent in patients who had received a hydrophobic IOL (31.57% of 2,078 patients) compared to the group with hydrophilic IOL implants (56.6% of 947 patients) and costs per patient for postoperative treatment in a 4-year follow-up were 50.03 € vs. 87.81 € (i.e. 75% higher in the latter group, p < 0.0001).ConclusionConsidering the high prevalence of cataract, the economic burden associated with adverse effects of cataract extraction is of great relevance for the German SHI. Hydrophobic lenses seem to be superior regarding both medical and economic results.

Prevalence of Steroid-Induced Cataract and Glaucoma in Chronic Obstructive Pulmonary Disease Patients Attending a Tertiary Care Center in India.

Exposure to corticosteroids is known to be associated with an increased risk of cataract and glaucoma. This study was undertaken to determine the prevalence of steroid-induced cataract and glaucoma in patients with chronic obstructive pulmonary disease (COPD) and to assess a dose-response relationship between them. This was a prospective observational study. We identified all COPD patients aged 50 years or older, with minimum steroid exposure of 4 months and on inhaled corticosteroids from March 2014 to March 2015. Average daily dose of inhaled corticosteroids was defined as low (1-250 µg), medium (251-500 µg), and high (501-1000 µg) using fluticasone propionate equivalents. We screened 405 COPD patients, of which 48 were dropouts. We identified 58 cataract and 14 glaucoma patients with a prevalence of 16.24% and 3.92%, respectively. We also observed a dose-response relationship with the highest prevalence of cataract (39.6%) and glaucoma (42.8%) at daily doses of 501-1000 µg fluticasone propionate equivalents. It is evident that higher doses and longer duration of inhaled corticosteroid in COPD patients are associated with a higher prevalence of cataract and glaucoma.

Oestradiol levels and superoxide dismutase activity in age-related cataract: a case-control study.

BackgroundIt has been suggested that the higher prevalence of cataract in women is caused by a withdrawal effect of oestrogen at menopause. In vitro studies have demonstrated protection of serum oestradiol (E2) against oxidative stress through upregulation of antioxidant enzymes, including superoxide dismutase (SOD). The purpose of the present study was to investigate E2 levels and SOD erythrocyte activity in patients with age-related cataract.MethodsThe studied subjects consisted of 103 patients with age-related cataract and 22 controls. Cataracts were classified as nuclear, cortical, or posterior subcapsular. Blood samples were collected and data on smoking, hormonal use, diabetes and age at menarche/menopause was obtained for all individuals. Serum oestradiol analyses were performed with radioimmunoassay (RIA) and SOD activity was measured in erythrocyte lysates.ResultsA negative correlation between age and E2 concentration was seen in a linear regression analysis. No correlation was seen between SOD activity and age or gender and no correlation between E2 levels and SOD activity was found using multiple linear regression. The mean level of E2 for all male subjects was 50.1 ± 16.3 pmol/L, significantly higher compared to 13.8 ± 11.8 pmol/L for postmenopausal women.ConclusionThe present study does not support a role for E2-induced effects on SOD in cataract formation. The findings of higher E2 levels in men than in postmenopausal women may suggest that decreased oestrogen at menopause is partially responsible for the gender-related difference in cataract prevalence. However, the latter can only be verified through prospective randomized trials using hormonal replacement therapy.