Aged Lenses Research Articles

N-formylkynurenine but not kynurenine enters a nucleophile-scavenging branch of the immune-regulatory kynurenine pathway.

Tryptophan catabolism along the kynurenine pathway (KP) mediates key physiological functions ranging from immune tolerance to lens UV protection, but the contributory roles and chemical fates of individual KP metabolites are incompletely understood. This particularly concerns the first KP metabolite, N-formylkynurenine (NFK), canonically viewed as a transient precursor to the downstream kynurenine (KYN). Here, we challenge that canon and show that hydrolytic enzymes act as a rheostat switching NFK's fate between the canonical KP and a novel non-enzymatic branch of tryptophan catabolism. In the physiological environment (37°C, pH 7.4), NFK deaminated into electrophilic NFK-carboxyketoalkene (NFK-CKA), which rapidly (<2min) formed adducts with nucleophiles such as cysteine and glutathione, the key intracellular antioxidants. Serum hydrolases suppressed NFK deamination as they hydrolysed NFK to KYN ∼3 times faster than NFK deaminates. Whilst KYN did not deaminate, its deaminated product (KYN-CKA) rapidly reacted with cysteine but not glutathione. The new NFK transformations of a yet to be discovered function highlight NFK's significance beyond hydrolysis to KYN and suggests the dominance of its chemical transformations over those of KYN. Enzyme compartmentalisation and abundance offer insights into the regulation of non-enzymatic KP metabolite transformations such as KYN involved in immune regulation, protein modification, lens aging or neuropathology.

Artificial intelligence detection of refractive eye diseases using certainty factor and image processing

Refractive errors are defined as an impairment in the eye’s capacity to focus light, resulting in the formation of blurred or unfocused images. These issues arise from alterations in the shape of the cornea, the length of the eyeball, or the aging of the crystalline lens. It is anticipated that the prevalence of visual impairment will increase in conjunction with global population growth. At present, a significant number of countries have not yet accorded sufficient priority to eye health within their healthcare systems. This has resulted in insufficient awareness and reluctance to seek costly specialized care. This study proposes the development of an advanced refractive eye disease detection system with the objective of improving diagnostic accuracy, disseminating disease information, and reducing financial barriers to specialist consultation. The research employs certainty factor (CF) methods and image processing with feature extraction. The initial results demonstrate the potential for identifying specific refractive eye diseases with high certainty through the analysis of symptoms and the examination of photographs of the eye. The proposed approach provides an alternative method for diagnosing refractive eye diseases, which could enhance access to refractive eye care services and reduce the economic burden on patients.

Through the Lens of Age: Using Dog Photographs to Uncover Welfare and Stress

This study evaluated the potential of using dogs’ apparent age, judged from photographs, as a non-invasive tool for assessing their welfare. Traditional welfare assessment methods often rely on behavioral and physiological indicators, which can be resource-intensive and invasive. This research explored whether apparent age, a measure used in humans to predict health and longevity, can also serve as an indicator of welfare in dogs by investigating its association with relative telomere length (RTL), a biomarker of biological aging. Photographs of 60 domestic dogs were evaluated by canine specialists and general volunteers via the citizen science platform Zooniverse. Participants estimated the age of 20 dogs from three different age categories: young (0–2 years), adult (2–5 years), and senior (6+ years). The accuracy of these predictions was compared to the dogs’ chronological ages and RTLs. Generalized linear models were used to assess factors influencing prediction accuracy, including the dogs’ age, sex, and origin. Results indicated that both specialists and volunteers reliably estimated the age of senior dogs, with no significant differences in accuracy between groups. Dogs with accurate apparent age estimates had RTLs matching their chronological age, while those with premature aging signs had shorter RTLs. This suggests apparent age could be a practical, non-invasive welfare assessment tool, offering a potentially accessible method for new welfare assessment protocols.

Introduction: Gothic Age and Ageing

In this introduction to the special issue, the editors sketch the major talking points within the recent turn towards examining Gothic fiction through the lens of age and ageing, and vice versa. They consider how the mode’s concern for the return of the past is readable as an anxious treatment of intergenerational relations, which are shown to contain the potential for coercion and exploitation. Gothic fiction brings to the fore the worrisome significations of old age in global societies that increasingly see age as a matter of productive output. The gothic figure of the vampire in particular reworks the archetypes of the ‘burdensome’ and ‘rapacious elder’, but in all cases (including the child-vampire) gains its threat and appeal from inverting age-based expectations. The mode also purposefully represents old age and ageing as abject or gruesome, foregrounding an uncomfortable possibility famously explored in Simone de Beauvoir’s La Vieillesse (1970); attempts to reverse or annul the ageing process receive similar treatment. The Introduction concludes with an overview of the contributions. Diverse in their subjects, and spanning the mode’s eighteenth-century origins through to its twenty-first century effusions, the essays nonetheless jointly evidence that age and ageing are integral to the form and function of the Gothic.

Lens capsule advanced glycation end products induce senescence in epithelial cells: Implications for secondary cataracts.

Posterior capsule opacification (PCO) is a common complication after cataract surgery. Residual lens epithelial cells (LECs) on the anterior lens capsule, after cataract surgery, migrate to the posterior lens capsule and undergo transdifferentiation into myofibroblast-like cells. Those cells synthesize excessive amounts of extracellular matrix and contribute to fibrosis during PCO. Cellular senescence, a phenomenon that increases with aging, has been implicated in several fibrotic diseases. Here, we have investigated the prevalence of senescent LECs within the lens posterior capsule and the ability of advanced glycation end products (AGEs) in lens capsules to induce senescence, contributing to PCO. Aged lens capsules from pseudophakic human cadaver eyes showed the presence of senescent LECs. In human capsular bags, LECs showed an age-dependent increase in senescence after 28 days of culture. Human LECs cultured on aged lens capsules for 3 days underwent senescence; this effect was not seen in LECs cultured on young lens capsules. Human LECs cultured on an AGE-modified extracellular matrix (ECM-AGEs) showed an AGE-concentration-dependent increase in the expression of senescence markers and reactive oxygen species (ROS) levels. Treatment with a RAGE antagonist and ROS inhibitor reduced the expression of senescence and fibrotic markers. Additionally, conditioned media from ECM-AGEs-treated cells induced the expression of fibrotic markers in naïve LECs. Together, these suggest that AGEs in the capsule induce senescence of LECs, which triggers the mesenchymal transition of neighboring non-senescent LECs and contributes to PCO.

The future of work in an ageing world: Priorities for advancing age equality at work

In an ageing world, age equality is critical for securing the future of work. Yet workplaces have not been designed with demographic ageing in mind, and age discrimination remains prevalent. This article offers a provocation to encourage the use of an age lens when considering the future of work and workplace change. It puts forward suggestions for future research and scholarship, to reframe equality law, and to build a research agenda that helps advance workplace equality for people of all ages.

Rallying Europe: young women and men searching for a life and a future

ABSTRACT The turmoil of the mid-twentieth century saw young people mobilized for action across Europe in an unprecedented manner. Concurrently, against the backdrop of the struggle between democratic and authoritarian projects, war and fragile peace, young people increasingly became a target of state legislation, (mass) organizations and other institutions. From the end of the First World War to the aftermath of the Second World War, Europe witnessed fundamental changes in the social regimes that determined societal power distribution. This special issue approaches the first half of the twentieth century through the lens of age and gender as interdependent categories of analysis. In doing so, the authors reveal how adult perceptions of youth and gender framed young men and women’s lives, as well as their roles in society. Vice versa, the authors explore how these perceptions collided with youth agency, probing the specific age – and gender-related dynamics of empowerment and organization. By zooming in on the concrete young actors and the institutional settings that limited their scope of action, processes of wayward appropriations will be contrasted with institutionalized attempts to control and lead ‘the young’. As such, the authors contribute to a global academic discussion on age, gender, the lifecycle and intersectionality.

Loss of αBa-crystallin, but not αA-crystallin, increases age-related cataract in the zebrafish lens

The vertebrate eye lens is an unusual organ in that most of its cells lack nuclei and the ability to replace aging protein. The small heat shock protein α-crystallins evolved to become key components of this lens, possibly because of their ability to prevent aggregation of aging protein that would otherwise lead to lens opacity. Most vertebrates express two α-crystallins, αA- and αB-crystallin, and mutations in each are linked to human cataract. In a mouse knockout model only the loss of αA-crystallin led to early-stage lens cataract. We have used the zebrafish as a model system to investigate the role of α-crystallins during lens development. Interestingly, while zebrafish express one lens-specific αA-crystallin gene (cryaa), they express two αB-crystallin genes, with one evolving lens specificity (cryaba) and the other retaining the broad expression of its mammalian ortholog (cryabb). In this study we used individual mutant zebrafish lines for all three α-crystallin genes to determine the impact of their loss on age-related cataract. Surprisingly, unlike mouse knockout models, we found that the loss of the αBa-crystallin gene cryaba led to an increase in lens opacity compared to cryaa null fish at 24 months of age. Loss of αA-crystallin did not increase the prevalence of cataract. We also used single cell RNA-Seq and RT-qPCR data to show a shift in the lens expression of zebrafish α-crystallins between 5 and 10 days post fertilization (dpf), with 5 and 6 dpf lenses expressing cryaa almost exclusively, and expression of cryaba and cryabb becoming more prominent after 10 dpf. These data show that cryaa is the primary α-crystallin during early lens development, while the protective role for cryaba becomes more important during lens aging. This study is the first to quantify cataract prevalence in wild-type aging zebrafish, showing that lens opacities develop in approximately 25% of fish by 18 months of age. None of the three α-crystallin mutants showed a compensatory increase in the expression of the remaining two crystallins, or in the abundant βB1-crystallin. Overall, these findings indicate an ontogenetic shift in the functional importance of individual α-crystallins during zebrafish lens development. Our finding that the lens-specific zebrafish αBa-crystallin plays the leading role in preventing age-related cataract adds a new twist to our understanding of vertebrate lens evolution.

Automated Compression Testing of the Ocular Lens.

The biomechanical properties of the ocular lens are essential to its function as a variable power optical element. These properties change dramatically with age in the human lens, resulting in a loss of near vision called presbyopia. However, the mechanisms of these changes remain unknown. Lens compression offers a relatively simple method for assessing the lens' biomechanical stiffness in a qualitative sense and, when coupled with appropriate analytical techniques, can help quantify biomechanical properties. A variety of lens compression tests have been performed to date, including both manual and automated, but these methods inconsistently apply key aspects of biomechanical testing such as preconditioning, loading rates, and time between measurements. This paper describes a fully automated lens compression test wherein a motorized stage is synchronized with a camera to capture the force, displacement, and shape of the lens throughout a preprogrammed loading protocol. A characteristic elastic modulus may then be calculated from these data. While demonstrated here using porcine lenses, the approach is appropriate for the compression of lenses of any species.

Impact of lens autofluorescence and opacification on retinal imaging

BackgroundRetinal imaging, including fundus autofluorescence (FAF), strongly depends on the clearness of the optical media. Lens status is crucial since the ageing lens has both light-blocking and autofluorescence (AF) properties...

Lens Cytoskeleton: An Update on the Etiopathogenesis of Human Cataracts.

A cataract is a loss of the transparency of a normal crystalline lens. Multiple factors, including age as the major risk factor for cataracts, can disturb the transparency of the crystalline lens due to cumulative damage from environmental insults to proteins, particularly crystallins. Lens proteins do not turnover, and crystallins undergo extensive post-translational modifications (PTMs) with age in order to interact with each other and maintain their soluble basis for lens transparency. These PTMs include truncation, oxidation, deamidation, acetylation, phosphorylation, and glycosylation. Cataract formation, apart from protein PTMs, involves protein crosslinking, protein insolubilization, and aggregation. Oxidation is a key feature in age-related cataract formation. Due to the role of genetic and environmental factors, as well as its variable clinical presentation, we consider cataracts to be a multifactorial disease. The preliminary results of our study indicate that proteins implicated in the pathway of a structural constituent of the eye lens (BFSP1, BFSP2, CRYAA, CRYAB, CRYBA, CRYBB, CRYGC, CRYGD, CRYGS, KRTs, and VIM), together with AQP1 and AQP5, may also be involved in lens aging.

Swimming exercise reverses transcriptomic changes in aging mouse lens

BackgroundThe benefits of physical activity for the overall well-being of elderly individuals are well-established, the precise mechanisms through which exercise improves pathological changes in the aging lens have yet to be fully understood.Methods3-month-old C57BL/6J mice comprised young sedentary (YS) group, while aging mice (18-month-old) were divided into aging sedentary (AS) group and aging exercising (AE) group. Mice in AE groups underwent sequential stages of swimming exercise. H&E staining was employed to observe alterations in lens morphology. RNA-seq analysis was utilized to examine transcriptomic changes. Furthermore, qPCR and immunohistochemistry were employed for validation of the results.ResultsAE group showed alleviation of histopathological aging changes in AS group. By GSEA analysis of the transcriptomic changes, swimming exercise significantly downregulated approximately half of the pathways that underwent alterations upon aging, where notable improvements were ‘calcium signaling pathway’, ‘neuroactive ligand receptor interaction’ and ‘cell adhesion molecules’. Furthermore, we revealed a total of 92 differentially expressed genes between the YS and AS groups, of which 10 genes were observed to be mitigated by swimming exercise. The result of qPCR was in consistent with the transcriptome data. We conducted immunohistochemical analysis on Ciart, which was of particular interest due to its dual association as a common aging gene and its significant responsiveness to exercise. The Protein-protein Interaction network of Ciart showed the involvement of the regulation of Rorb and Sptbn5 during the process.ConclusionThe known benefits of exercise could extend to the aging lens and support further investigation into the specific roles of Ciart-related pathways in aging lens.

The α-crystallin Chaperones Undergo a Quasi-ordered Co-aggregation Process in Response to Saturating Client Interaction

Small heat shock proteins (sHSPs) are ATP-independent chaperones vital to cellular proteostasis, preventing protein aggregation events linked to various human diseases including cataract. The α-crystallins, αA-crystallin (αAc) and αB-crystallin (αBc), represent archetypal sHSPs that exhibit complex polydispersed oligomeric assemblies and rapid subunit exchange dynamics. Yet, our understanding of how this plasticity contributes to chaperone function remains poorly understood. Using biochemical and biophysical analyses combined with single-particle electron microscopy (EM), we examined structural changes in αAc, αBc and native heteromeric lens α-crystallins (αLc) in their apo-states and at varying degree of chaperone saturation leading to co-aggregation, using lysozyme and insulin as model clients. Quantitative single-particle analysis unveiled a continuous spectrum of oligomeric states formed during the co-aggregation process, marked by significant client-triggered expansion and quasi-ordered elongation of the sHSP oligomeric scaffold, whereby the native cage-like sHSP assembly displays a directional growth to accommodate saturating conditions of client sequestration. These structural modifications culminated in an apparent amorphous collapse of chaperone-client complexes, resulting in the creation of co-aggregates capable of scattering visible light. Intriguingly, these co-aggregates maintain internal morphological features of highly elongated sHSP oligomers with striking resemblance to polymeric α-crystallin species isolated from aged lens tissue. This mechanism appears consistent across αAc, αBc and αLc, albeit with varying degrees of susceptibility to client-induced co-aggregation. Importantly, our findings suggest that client-induced co-aggregation follows a distinctive mechanistic and quasi-ordered trajectory, distinct from a purely amorphous process. These insights reshape our understanding of the physiological and pathophysiological co-aggregation processes of α-crystallins, carrying potential implications for a pathway toward cataract formation.

Community-based mental health interventions in low- and middle-income countries: a qualitative study with international experts

BackgroundMental health services are scarce in low- and middle-income countries (LMICs), and designing and implementing effective interventions can be difficult. The aim of this international study was to explore the key lessons for developing, implementing, and evaluating community-based mental health and well-being interventions in LMICs, with an additional focus on older adults.MethodsResearch and clinical experts in developing and implementing psychosocial community-based interventions in LMICs were interviewed remotely between October 2021 and January 2022. Participants were recruited via existing global health networks and via published literature searches. Participants were asked about their experiences of developing and implementing interventions, and about key barriers and facilitators during the process. Interviews lasted up to 45 min, and data were analysed using combined inductive and deductive thematic analysis.ResultsSixteen global mental health experts participated. Five themes with different sub-themes were generated: Mechanisms and contexts; Barriers; Facilitators; Public and stakeholder involvement; Looking through an ageing lens. The development and delivery of mental health interventions in LMICs are facilitated through integration into existing health infrastructures and working with existing job roles as delivery agents. Public and stakeholder involvement are crucial at all stages of development through to implementation to focus on meeting local needs and sustaining participant motivation. Logistical barriers of transport, resources, and location need to be addressed, emphasising local sustainability.ConclusionsThis study provides important insights for how the development, implementation, and evaluation of community-based mental health and well-being interventions in LMICs can be optimised, and can complement general guidance into complex interventions developments.

Senile Cataract Formation Does Not Affect Crystalline Lens Thickness.

Characterizing lens thickness (LT) in patients with cataracts is important for better understanding the lens aging process and for designing new intraocular lens power formulas. This study aimed to analyze the influence of common senile cataract formation on the LT, anterior (ACS) and posterior (PCS) cortex space, and nuclear thickness (NT), controlling for sex, age, and axial length. A cross-sectional study was performed. A consecutive sample of 603 volunteers (403 women, 200 men) aged 59.1 ± 18.8years was recruited. The standardized Lens Opacification Classification System (LOCS)-III was used to classify eyes (randomly selected) into cataractous and non-cataractous groups. Also, they were classified according to the cataract location (presence or absence of cortical, nuclear, or posterior subcapsular cataract). Optical biometry was performed to measure LT, ACS, NT, and PCS. Propensity score was used to match participants one-to-one for sex, age, and axial length. Groups were compared using the Student's ttest or Yuen's test. The four classifications divided unmatched eyes into: 361 cataractous lenses and 242 non-cataractous, 226 cortical and 377 non-cortical cataractous, 313 nuclear and 290 non-nuclear cataractous and 242 subcapsular and 361 non-subcapsular cataractous. Before matching, cataractous eyes showed significantly higher LT (4.52 ± 0.39 vs. 3.94 ± 0.46mm, p < 0.001), ACS (0.75 ± 0.20 vs. 0.58 ± 0.23mm, p < 0.001), NT (3.34 ± 0.23 vs. 3.18 ± 0.25mm, p < 0.001) and PCS (0.42 ± 0.19 vs. 0.37 ± 0.19mm, p = 0.003). Matched lens, cortical, nuclear, and subcapsular cataract samples comprised 146, 258, 182, and 226 eyes, respectively. After matching, no significant differences were observed in LT (4.34 ± 0.37 vs. 4.33 ± 0.36mm, p = 0.94), ACS (0.72 ± 0.20 vs. 0.76 ± 0.19mm, p = 0.08), NT (3.31 ± 0.22 vs. 3.30 ± 0.23mm, p = 0.24) and PCS (0.42 ± 0.19 vs. 0.43 ± 0.16mm, p = 0.79). The presence of senile cortical, nuclear, and posterior subcapsular cataract have no effect on LT, ACS, NT, and PCS. Confounding factors should be controlled for when measuring LT and its main components.

Diving into CDC pregnancy data in the United States: longitudinal study and interactive application.

Preterm birth (PTB) is a major determinant of neonatal mortality, morbidity, and childhood disability. In this article, we present a longitudinal analysis of the risk factors associated with PTB and how they have varied over the years: starting from 1968 when the CDC first started, reporting the natality data, up until 2021. Along with this article, we are also releasing an RShiny web application that will allow for easy consumption of this voluminous dataset by the research community. Further, we hope this tool can aid clinicians in the understanding and prevention of PTB. This study used the CDC Natality data from 1968 to 2021 to analyze trends in PTB outcomes across the lens of various features, including race, maternal age, education, and interval length between pregnancies. Our interactive RShiny web application, CDC NatView, allows users to explore interactions between maternal risk factors and maternal morbidity conditions and the aforementioned features. Our study demonstrates how CDC data can be leveraged to conduct a longitudinal analysis of natality trends in the United States. Our key findings reveal an upward trend in late PTBs, which is concerning. Moreover, a significant disparity exists between African American and White populations in terms of PTB. These disparities persist in other areas, such as education, body-mass index, and access to prenatal care later in pregnancy. Another notable finding is the increase in maternal age over time. Additionally, we confirm that short interpregnancy intervals (IPIs) are a risk factor for PTBs. To facilitate the exploration of pregnancy risk factors, infections, and maternal morbidity, we developed an open-source RShiny tool called CDC NatView. This software offers a user-friendly interface to interact with and visualize the CDC natality data, which constitutes an invaluable resource. In conclusion, our study has shed light on the rise of late PTBs and the persistent disparities in PTB rates between African American and White populations in the US. The increase in maternal age and the confirmation of a short IPI as a risk factor for PTB are noteworthy findings. Our open-source tool, CDC NatView, can be a valuable resource for further exploration of the CDC natality data to enhance our understanding of pregnancy risk factors and the interaction of PTB outcomes and maternal morbidities.

Изображение Хангыля в творчестве современных художников Южной Кореи

This article examines the use of the Hangul image in the works of contemporary South Korean artists as a key element of South Korea’s cultural identity and self-definition. Created in the fifteenth century by King Sejong, Hangul has become an important symbol of the independence of Korean culture from Japanese culture and an element of Korean writing to facilitate literacy. In this way, Hangul played a key role in mass enlightenment by making knowledge accessible, connecting different segments of society, and serving as an important tool in the dissemination of culture and education. In today’s context of globalization and digitalization, artists are increasingly turning to the Korean alphabet, using it in their installations using digital technology and multimedia formats, allowing them not only to preserve cultural heritage but also to reinterpret it through the lens of the digital age. Through such works, Hangul acquires new forms of expression, becoming not just a writing, but also a significant visual and philosophical symbol. Examples of exhibitions and installations, such as those at the National Hangul Museum and the Gangseong Museum, demonstrate not only the significance of Hangul in preserving cultural heritage, but also its role as a bridge between tradition and innovation, confirming its relevance in contemporary society and its significance to Korean national identity. For example, an exhibition at the National Museum of Hangul (Seoul, 2017) focused on Hongminjonim, a treatise explaining the principles of the creation and use of the alphabet. Visual and sound elements created a unique space where the traditional Korean alphabet was perceived through a contemporary lens. Kang Ik Joon’s installation Gwanghwamun Ariran (2020), incorporating elements of digital technology, expresses political and cultural ideas, the pursuit of unity, and the preservation of memory. Kang Ik Joon through his installation “Hangul Wall” (2024) interprets the Korean alphabet into contemporary art without losing its meaning. Through the image of Hangul, the artists lay down a powerful visual image that does not leave their compatriot indifferent. In the context of globalization and technological change, Hangul retains its uniqueness as an important tool for expressing Korean identity and cultural memory. As a stimulus for creative processes, Hangul continues to inspire artists, creating a new space for self-expression.

Clinical value of noninvasive lens advanced glycation end product detection in early screening and severity evaluation of patients with diabetic kidney disease

BackgroundAdvanced glycation end products (AGEs) deposited in the lens are correlated with those in the kidneys, indicating a possible value in evaluating diabetic kidney disease (DKD). This study explored the value of noninvasively measuring lens AGEs to diagnose and evaluate the severity of diabetic nephropathy in patients with type 2 diabetes mellitus (T2DM).MethodologyA total of 134 T2DM patients admitted to the Fifth People's Hospital of Shanghai from March 2020 to May 2021 were selected randomly. Patients were divided into low-, medium-and high-risk groups according to the risk assessment criteria for DKD progression and into DKD and non-DKD (non-DKD) groups according to the Guidelines for the Prevention and Treatment of Diabetic Nephropathy in China. The concentrations of noninvasive AGEs in the lens in all the groups were retrospectively analyzed.ResultsThe concentration of noninvasive lens AGEs in the high-risk patients, according to the 2012 guidelines of the Global Organization for Improving the Prognosis of Kidney Diseases, was significantly higher than that in the remaining groups. Regression analysis suggested the value of lens AGEs in diagnosing DKD and evaluating DKD severity. Cox regression analysis indicated that the noninvasive lens AGE concentration was positive correlated with the course of disease.ConclusionThe receiver operating characteristic (ROC) curve suggested that using noninvasive lens AGE measurements has clinical value in the diagnosis of DKD (area under the curve 62.4%,95% confidence interval (CI) 52.4%–73.9%, p = 0.014) and in assessing the severity of DKD (area under the curve 83.2%, 95% CI 74.1%–92.3%, P < 0.001). Noninvasive lens AGE testing helps screen T2DM patients for DKD and evaluate the severity of DKD.

Penile Trauma Burden and Aetiology in the Paediatric and Adult Population: A Scoping Review and Critical Analysis of the Literature.

Penile trauma is rare. It is associated with the impairment of physiological functions and deterioration in patients' quality of life. Currently, the relevance of age demographics in the occurrence of this debilitating injury has not been well discussed. The objective of this study was to provide a scoping review of penile trauma within the lens of the legal age of maturity. A search of the PubMed, Scopus and Web of Science databases was conducted, and then, the identified publications were used to conduct this scoping review focussing on the study aim. The results identified were categorised into five themes. This included publication information (author, year, country, study duration); demographic information (age of presentation, number of patients, relative burden); penile trauma clinical pattern (type, severity, associated injury), risk factors and clinical consequences. While mobile and active young adults were at risk of outdoor trauma, the report on penile trauma in the paediatric population is rare and usually focussed on sexual trauma. Penetrating trauma has been more extensively studied in comparison to blunt penile trauma despite the significance of the latter in the paediatric population. Injury severity classification is not available for most studies limiting their usefulness in the universal comparison of trauma severity and injury prognostication. There is a diversity in the burden and presentation of penile trauma. Available research studies are limited in the paediatric population, mostly focussed on penile fracture in adults and generally devoid of a standardised penile trauma severity description. Additional studies with a specific focus on penile trauma are required to characterise aetiological risks and injury severity across the legal age of maturity.

Age-related changes in geometry and transparency of human crystalline lens revealed by optical signal discontinuity zones in swept-source OCT images

BackgroundThe shape and microstructure of the human crystalline lens alter with ageing, and this has an effect on the optical properties of the eye. The aim of this study was to characterise the age-related differences in the morphology and transparency of the eye lenses of healthy subjects through the optical signal discontinuity (OSD) zones in optical coherence tomography (OCT) images. We also investigated the association of those changes with the optical quality of the eye and visual function.MethodsOCT images of the anterior segment of 49 eyes of subjects (9–78 years) were acquired, and the OSD zones (nucleus, C1–C4 cortical zones) were identified. Central thickness, curvature and optical density were measured. The eye’s optical quality was evaluated by the objective scatter index (OSI). Contrast sensitivity and visual acuity tests were performed. The correlation between extracted parameters and age was assessed.ResultsThe increase in lens thickness with age was dominated by the thickening of the cortical zone C3 (0.0146 mm/year). The curvature radii of the anterior lens surface and both anterior and posterior nucleo-cortical interfaces decreased with age (− 0.053 mm/year, − 0.013 mm/year and − 0.006 mm/year, respectively), and no change was observed for the posterior lens radius. OCT-based densitometry revealed significant correlations with age for all zones except for C1β, and the highest increase in density was in the C2–C4 zones (R = 0.45, 0.74, 0.56, respectively, P < 0.001). Increase in OSI was associated with the degradation of visual function.ConclusionsOCT enables the identification of OSD zones of the crystalline lens. The most significant age-related changes occur in the C3 zone as it thickens with age at a faster rate and becomes more opaque than other OSD zones. The changes are associated with optical quality deterioration and reduction of visual performance. These findings contribute to a better understanding of the structure–function relationship of the ageing lens and offer insights into both pathological and aging alterations.