Main Cause Of Blindness Research Articles

The Association between Vitamin D3 Deficiency and Cataract Formation in Baghdad Al-Karkh

Background: Visual impairment is a global issue that is particularly problematic for poor nations. It is linked to diminished physical activity, social isolation, reliance on everyday tasks, and even death. The clouding of the lens inside the eye is called a cataract. It is one of the main causes of blindness and visual impairment in the world. Because of its anti-inflammatory and antioxidant properties, vitamin D, a prohormone in the blood, is crucial to the pathophysiology of many ocular illnesses. Given that oxidative stress and inflammation are significant contributors to the development of cataracts, a number of research have evaluated the relationship between vitamin D3 deficiency and cataract formation. Objective: Determine whether a vitamin D3 deficiency and cataracts are related. Patients and Methods: A cross-sectional study that was carried out included a total of 100 cataract patients who are 60 years of age or younger from September 2023 to March 2024 in the Ophthalmology Department of Imamein Kadhimein Medical City, Baghdad, Iraq. Questionnaire form was used which consist of sociodemographic information, socioeconomic status, dietary sources of vitamin D3, sun exposure, anthropometric measures and ophthalmic examination. Vitamin D3 level had been investigated in laboratory of the hospital. Results: Thirty percent of patients had cortical cataracts, 57% had nuclear cataracts, and 13% had posterior subcapsular cataracts. Sixty-nine percent of patients had a vitamin D3 level that is less than 20 ng/ml. Of the patients, 13% had a vitamin D3 level between 20 and 30 ng/ml, while 18% had a level greater than 30 ng/ml. There is a significant association between the level of vitamin D3 and the type of cataract (p-value = 0.013). Sixty-nine percent of patients with deficient vitamin D3 levels had 9% posterior subcapsular cataracts, 36% cortical cataracts, and 55% nuclear cataracts. Patients with insufficient vitamin D3 levels had 8% posterior subcapsular cataracts, 8% cortical cataracts, and 84% nuclear cataracts. While patients with sufficient vitamin D3 levels had 33% posterior subcapsular cataracts, 22% cortical cataracts, and 45% nuclear cataracts. The body mass index and vitamin D3 level were significantly associated (p-value = 0.003). Patients with a vitamin D3 level less than 20 ng/ml comprised 31% overweight patients, 26% class I obese patients, 26% class II obese patients, and 4% class III obese patients. Thirteen percent of these patients had normal weights. Patients with a vitamin D3 level 20-30 ng/ml comprised 46% overweight patients, 23% class II obese patients, and 31% with normal weight. While patients with a vitamin D3 level more than 30 ng/ml comprised 33% normal weight patients and 67% overweight. Conclusion: Vitamin D3 deficiency has a significant association with cataract formation, especially nuclear and cortical types, sun exposure, educational level, socioeconomic status, and obesity.

Peculiarities of the regional hemodynamics in patients with mono- and bilateral herpes simplex virus stromal keratitis

Background. Herpes simplex virus keratitis (HSVK) is the main cause of blindness in the world resulted from corneal pathology. The blood circulation system of the eye plays an important role in the effective implementation of the immune response. The purpose of the study: to determine the influence of the factor of laterality of the stromal HSVK on the ocular hemodynamics and the frequency of complications. Material and methods. Primary stromal HSVK (was registered for the first time and lasted no more than 3 months) was diagnosed in 32 people (35 eyes), 205 patients (226 eyes) had recurrent stromal HSVK. Among these patients, stromal HSVK was detected both in one eye — unilateral, and in two eyes — bilateral. Complications of stromal HSVK includes: the presence of a transparent graft — in 23 eyes and its opacity — in 10 eyes, secondary glaucoma — in 6 eyes, condition after corneal ulcer — in 16 eyes. The average age of the patients (M ± SD) is 42.2 ± 15.0 years. The control group consisted of 16 healthy volunteers (32 eyes) of similar age. The standard technique of rheoophthalmogram on the ReoCom computer rheograph (Kharkiv, Ukraine) was used. The following indicators were analyzed: rheographic quotient (RQ, ‰) (pulse volumetric blood filling); α1/T (%) — the tone of the large vessels of the eye; velocity of blood filling V (Ohm/s). Results. Patients with stromal HSVK had mainly monolateral eye lesion — 89.8 %, and bilateral lesion was present in 10.2 % of cases. There were no significant differences in the frequency of laterality between primary and recurrent stromal HSVK. In case of recurrence of complicated unilateral and bilateral stromal HSVK, the volumetric pulse blood filling was 17.6 and 30.3 % lower, respectively, than in uncomplicated course, which determines the insufficiency of blood supply to the eye. The rate of blood filling in complicated stromal HSVK was lower than in uncomplicated one by 23 %. At the recurrence of bilateral stromal HSVK, the RQ was higher by 26.4 %, and the rate of blood filling was higher by 36.3 % compared to unilateral one. There were no differences in remission. The tone of the large vessels of the eye with bilateral stromal HSVK is 14 % lower than with unilateral course. Conclusions. In case of recurrent stromal HSVK, the volume pulse blood filling of the eye and its velocity are higher, and the vascular tone is lower than in case of unilateral one, both uncomplicated and complicated. It is assumed that such a significant activation of the ocular hemodynamics is compensatory and contributes to a greater local immune response and improvement of trophism.

Vision impairment and blindness in individuals aged 60 years and older in Latin America and the Caribbean.

To determine the prevalence and causes of vision loss and calculate the effective cataract surgery coverage (eCSC) in adults aged 60 years and older in Latin America and the Caribbean in 2020. The International Agency for the Prevention of Blindness Vision Atlas and the Rapid Assessment of Avoidable Blindness databases were used as data source. The collected data were used to estimate the prevalence and causes of vision loss in people aged 60 years and older, and to determine the eCSC. The overall prevalence of moderate to severe vision impairment (MSVI) and blindness in Latin America and the Caribbean were 14.14% and 2.94%, respectively. Tropical Latin America was the subregion with the highest prevalence of blindness (3.89%) while Southern Latin America had the lowest (0.96%). For both MSVI and blindness, cataract was the main cause of vision loss. The eCSC rates showed great variation, ranging from 4.0% in Guatemala to 75.2% in Suriname. The prevalence of vision loss in adults aged 60 years and older in Latin America and the Caribbean was higher than previous estimates on younger groups. Cataract was the main cause of blindness, and the eCSC indicates that the outcomes from cataract surgery should be improved. Specific actions associated with improving access, integrating eye assessment with primary care programs, expanding the use of telemedicine, and improving data quality should be taken by public health authorities aiming to address vision loss in this group.

The role of Atoh7/Notch signaling in the differentiation of retinal stem cells into retinal ganglion cells and its potential application in glaucoma treatment

Background: One of the main causes of blindness in persons over 60 is glaucoma, yet there are presently no viable therapies available. The differentiation to retinal ganglion cell (RGC) is a key step in the stem cell-based ocular regeneration therapy that have become a new hotspot in this field. This study aimed to investigate the differentiation pathway of Retinal stem cells (RSCs) and their potential for future application in glaucoma treatment. Methods: Gas pressurization was employed to simulate intraocular pressure (IOP) conditions in vitro, utilizing polyimide membranes as the culture chamber. RSCs were derived from mice and underwent a series of transfection and detection procedures. The expression levels of mRNA and protein were quantified using quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting, respectively. Cell apoptosis and proportion were assessed through flow cytometry analysis. Immunofluorescence staining was performed to identify cell morphology, growth status, and relative markers. In vivo validation was conducted on glaucoma mouse models, highlighting the regulatory system involving Atoh7/Notch for RSC differentiation. Results: At 40 mmHg, Atoh7 facilitates RGC differentiation through the regulation of Notch expression. Activation of Atoh7/Notch signaling in glaucomatous retina enhances RSC viability and differentiation. Subsequent transplantation of RSCs significantly improves visual acuity in glaucoma animal models, accompanied by increased expression and number of positive cells for RGC markers, as well as activation of Atho7/Notch signaling. Conclusion: The present study elucidates the alterations and impacts of IOP in glaucoma, while also highlighting the potential utility of Atoh7/Notch as a promising avenue for comprehending the underlying mechanisms governing retinal ganglion cell differentiation.

Prevalence, causes and factors associated with vision impairment in Limpopo province

Background: Epidemiological data on the prevalence, causes and risk factors associated with vision impairment (VI) is necessary to evaluate the effectiveness of eye care services.Aim: To determine the prevalence, causes and factors associated with VI among patients presenting to public hospitals of Limpopo province, South Africa.Setting: This study was conducted in public hospitals.Methods: A retrospective chart review of patients seen from April 2019 to March 2022 in 29 public hospitals was conducted. The following information was extracted: demographic information, medical history, visual acuity (VA), refractive and ophthalmoscopy findings.Results: Of the 1140 participants, 56.1% were women. Participants’ ages ranged from 5 to 94 years. The prevalence of VI was 61.5%. Most had moderate-severe VI (57.3%), followed by blindness (22.7%) and mild VI (20.0%). The leading causes of VI were uncorrected refractive error (URE) (28.1%), cataract (26.0%) and glaucoma (25.0%). The main causes of blindness were glaucoma (42.8%) and cataract (32.1%); while URE (7.5%), retinal anomalies (7.5%) and corneal anomalies (6.9%) accounted for almost equal proportions of blindness. Participants aged 50–64 years (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.2–2.6); 65 years and older (OR: 6.6; 95% CI: 4.3–10.2); and those diagnosed with systemic hypertension (OR: 2.5; 95% CI: 1.9–3.2) and diabetes mellitus (OR: 2.9; 95% CI: 1.9–4.4) had increased risk of VI.Conclusion: The prevalence of VI in this population is relatively high. The main causes of VI are correctable, suggesting the need for improved measures to prevent avoidable VI.Contribution: The study addresses the gap in the province’s current prevalence, causes and factors related to VI.

Complement Inhibitors for Geographic Atrophy in Age-Related Macular Degeneration-A Systematic Review.

Age-related macular degeneration (AMD) is one of the main causes of blindness and visual impairment worldwide. Intravitreal complement inhibitors are an emergent approach in the treatment of AMD, which have had encouraging results. This systematic review analyzes the outcomes and safety of complement inhibitor therapies for GA in AMD cases. A comprehensive search on the PubMed and Web of Science databases returned 18 studies involving various complement inhibitor agents, with a total of 4272 patients and a mean follow-up of 68.2 ± 20.4 weeks. Most treated patients were white (96.8%) and female (55.8%), with a mean age of 78.3 ± 7.8 years and a mean GA area of 8.0 ± 3.9 mm2. There were no differences in visual function change between treated and control participants. The mean GA area change was 2.4 ± 0.7 mm2 in treated participants vs. 2.7 ± 0.8 mm2 in control groups (p < 0.001). The ocular and systemic side effects were similar to those of intravitreal anti-VEGF. A less-understood effect was that of the onset of choroidal neovascularization (CNV) in 1.1-13% of patients; this effect was found to be more frequent in patients with neovascular AMD in the fellow eye or nonexudative CNV in the study eye at baseline. Complement inhibitors may represent a useful therapy for GA in AMD, but a personalized approach to patient selection is necessary to optimize the outcomes.

REGULATION OF RETINOGENESIS IN PRENATAL ONTOGENESIS AND ITS DISRUPTION IN AGE-RELATED MACULAR DEGENERATION

One of the main causes of blindness in the elderly in developed countries is age-related macular degeneration (AMD) [1, 2, 3]. Active research is being conducted to identify putative molecular targets for the development of an effective strategy for conservative treatment of both atrophic and neovascular forms of this disease [4, 5, 6], but at the present stage, pharmacotherapy is effective only for some patients, and is insufficient to stop the progression of the disease or eliminate the damage that has already occurred. The most promising and promising potential treatment options are considered to be the introduction of cellular technologies with retinal cell replacement and targeted pharmacotherapy. The aim of this study was to investigate the role of the retinal development inducer, SIRT1 [7, 8, 9], in retinogenesis to justify pharmacological inhibition of this protein as a possible treatment option for neovascular AMD. Using immunohistochemistry and immunocytochemistry, we assessed the expression and subcellular localization of SIRT1 and its innate inhibitor DBC1 in the retina of fetuses, adults, and mice. We also studied SIRT1 in retinal progenitor cells derived from mice and humans, the former having been used in small interfering RNA studies. SIRT1 is widely expressed in the developing and adult retina and is a regulator of key genes in retinal development, namely PAX6, Nestin, and CRX [10, 11, 12]. Moreover, we found that photoreceptor progenitor cells were among the smallest cells in a heterogeneous mouse retinal progenitor cell population [13, 14, 15]. Collectively, these results provide a basis for manipulating SIRT1 expression in small retinal progenitors as a means to increase the yield of photoreceptors for transplantation in retinal degeneration models [16, 17]. Furthermore, SIRT1 was found to be highly expressed in human-derived choroidal neovascular membranes, allowing its activity to be pharmacologically inhibited by the drug nicotinamide as a potent regulator of angiogenic and hypoxic signaling in a human retinal pigment epithelial cell line at both the protein level using angiogenesis arrays and at the RNA level using whole genome microarrays [18, 19]. These results point to the SIRT1 inhibitor, Nicotinamide, as a possible agent for treatment of neovascular AMD. Further studies of Nicotinamide are warranted in animal models of AMD. To the best of our knowledge, this is the first time that a detailed analysis of SIRT1 as a regulator of both retinal development and choroidal neovascularization has been reported.

Role of Artificial Intelligence in Retinal Diseases.

Artificial intelligence (AI) has already found its way into ophthalmology, with the first approved algorithms that can be used in clinical routine. Retinal diseases in particular are proving to be an important area of application for AI, as they are the main cause of blindness and the number of patients suffering from retinal diseases is constantly increasing. At the same time, regular imaging using high-resolution modalities in a standardised and reproducible manner generates immense amounts of data that can hardly be processed by human experts. In addition, ophthalmology is constantly experiencing new developments and breakthroughs that require a re-evaluation of patient management in routine clinical practice. AI is able to analyse these volumes of data efficiently and objectively and also provide new insights into disease progression and therapeutic mechanisms by identifying relevant biomarkers. AI can make a significant contribution to screening, classification and prognosis of various retinal diseases and can ultimately be a clinical decision support system, that significantly reduces the burden on both everyday clinical practice and the healthcare system, by making more efficient use of costly and time-consuming resources.

Ferroptosis contributes to diabetes-induced visual pathway neuronal damage via iron accumulation and GPX4 inactivation

The damage of the diabetic visual pathway is one of the main causes of blindness in diabetic patients. Visual pathways include anatomic parts from the retina to the occipital lobe. This study investigated the involvement of ferroptosis, a planned cell death brought on by the buildup of free iron in cells, in the impairment of visual pathways in diabetes mellitus. Streptozotocin (STZ) was used to construct a diabetic rat model. Pathological and ultrastructural changes of the occipital lobe, retina, and optic nerve were observed by Hematoxylin–Eosin (HE) staining and transmission electron microscopy (TEM). The expressions of Neuronal nuclei (NeuN), Glial fibrillary acidic protein (GFAP), and Glutathione Peroxidase 4 (GPX4) in the occipital lobe and retina were detected by immunofluorescence, and Western Blotting was used to identify the NeuN GFAP and GPX4 expressions in the occipital lobe. Iron content in the occipital lobe and retina was detected by Iron Assay Kit. The success rate of the diabetic rat model was 93.3%. In the diabetic group, the cells of the occipital lobe and retina were arranged disorderly, and the boundaries were unclear. The membrane of the occipital lobe, retina, and optic nerve was broken, some vacuoles were observed, mitochondrial morphology was changed, swelling was observed, and the mitochondrial ridge disappeared. There was a large increase in GFAP expression and iron concentration and a significant decrease in the expression of NeuN, and GPX4 in the retina and occipital lobe. Ferroptosis plays an important role in visual pathway damage in diabetes, and GPX4 regulates this process.

Rapid assessment of avoidable blindness (RAAB): A 15-year follow-up in Gegharkunik province of Armenia

PurposeThis study assessed the changes in the prevalence of visual impairment (VI)/blindness, cataract surgical coverage (CSC), visual outcome after cataract surgery, and main barriers to cataract surgery among the population aged 50 years and older in Gegharkunik province of Armenia from 2003 - 4 to 2019. DesignA cross-sectional study. MethodsA multi-stage cluster sampling technique was used to conduct Rapid Assessment of Cataract Surgical Services (RACSS) and Rapid Assessment of Avoidable Blindness (RAAB) surveys in 2003–4 and 2019, respectively. Overall, 56 clusters (40 people in each cluster) were selected for RACSS, and 24 clusters (50 people in each cluster) for RAAB. Both surveys collected data on participants’ demographics, presenting/pinhole visual acuity (PVA/PinVA), the principal cause of VI, CSC, and barriers to cataract surgery. ResultsOverall, 1,787 people participated in RACSS and 1,099 people in RAAB. Between 2003–4 and 2019, age- and sex-adjusted prevalence of bilateral blindness decreased from 2.0 % to 1.4 % while severe VI decreased from 5.2 % to 2.2 % and moderate VI from 16.0 % to 7.3 %. Untreated cataract contributed to 71.9 % and 40.9 % of all blindness cases in 2003–4 and 2019, respectively. The CSC at the threshold <6/18 improved from 23.7 % in 2003–4 to 64.8 % in 2019. Both surveys mentioned the cost as the most common barrier to cataract surgery. ConclusionDespite substantial improvements, cataract remained the main cause of blindness in the province. Increasing financial coverage of cataract surgeries and improving the quality of surgeries could increase their utilization of services and help improve visual outcomes in the population.

Switching to an Intravitreal Dexamethasone Implant after Intravitreal Anti-VEGF Therapy for Diabetic Macular Edema: A Review.

Among working-age people, diabetic retinopathy and diabetic macular edema are currently considered the main causes of blindness. Nowadays, intravitreal injections are widely acknowledged as a significant milestone in ophthalmology, especially for the treatment of several retinal diseases, including diabetic macular edema. In particular, anti-vascular endothelial growth factor (VEGF) agents are typically the first line of treatment; however, monthly injections are required, at least, during the loading dosage. Notably, an intravitreal 0.7 mg dexamethasone (DEX) implant (Ozurdex®, AbbVie Inc., North Chicago, IL, USA) is considered a legitimate substitute treatment for diabetic eyes that have not responded to anti-VEGF treatment. In fact, clinical trials and real-life studies have demonstrated the effectiveness and safety of an intravitreal DEX implant in treating such conditions over a period of three to six months. For this reason, wisely selecting diabetic patients might be crucial to decreasing the load of injections in clinics and hospitals. The purpose of this review is to analyze the available scientific literature to highlight the benefits, efficacy, and clinical criteria for choosing whether to switch from intravitreal anti-VEGF therapy to an intravitreal DEX implant in diabetic macular edema.

Multi-risk factors joint prediction model for risk prediction of retinopathy of prematurity

PurposeRetinopathy of prematurity (ROP) is a retinal vascular proliferative disease common in low birth weight and premature infants and is one of the main causes of blindness in children.In the context of predictive, preventive and personalized medicine (PPPM/3PM), early screening, identification and treatment of ROP will directly contribute to improve patients’ long-term visual prognosis and reduce the risk of blindness. Thus, our objective is to establish an artificial intelligence (AI) algorithm combined with clinical demographics to create a risk model for ROP including treatment-requiring retinopathy of prematurity (TR-ROP) infants.MethodsA total of 22,569 infants who underwent routine ROP screening in Shenzhen Eye Hospital from March 2003 to September 2023 were collected, including 3335 infants with ROP and 1234 infants with TR-ROP among ROP infants. Two machine learning methods of logistic regression and decision tree and a deep learning method of multi-layer perceptron were trained by using the relevant combination of risk factors such as birth weight (BW), gestational age (GA), gender, whether multiple births (MB) and mode of delivery (MD) to achieve the risk prediction of ROP and TR-ROP. We used five evaluation metrics to evaluate the performance of the risk prediction model. The area under the receiver operating characteristic curve (AUC) and the area under the precision-recall curve (AUCPR) were the main measurement metrics.ResultsIn the risk prediction for ROP, the BW + GA demonstrated the optimal performance (mean ± SD, AUCPR: 0.4849 ± 0.0175, AUC: 0.8124 ± 0.0033). In the risk prediction of TR-ROP, reasonable performance can be achieved by using GA + BW + Gender + MD + MB (AUCPR: 0.2713 ± 0.0214, AUC: 0.8328 ± 0.0088).ConclusionsCombining risk factors with AI in screening programs for ROP could achieve risk prediction of ROP and TR-ROP, detect TR-ROP earlier and reduce the number of ROP examinations and unnecessary physiological stress in low-risk infants. Therefore, combining ROP-related biometric information with AI is a cost-effective strategy for predictive diagnostic, targeted prevention, and personalization of medical services in early screening and treatment of ROP.

Promotion of 14-3-3ζ/Heme Oxygenase-1 Axis on Endotoxin-Induced Uveitis and Microglia Ferroptosis in Mice

ABSTRACT Purpose Uveitis is a common, sight-threatening inflammatory ocular disease and is the main cause of blindness, which is caused by autoimmune response, infection, and injury. The contribution of 14-3-3ζ in uveitis remains obscure. This study aims to investigate the role of 14-3-3ζ in regulating ferroptosis in retinal inflammation and its contribution to uveitis. Methods A lipopolysaccharide (LPS)-induced uveitis mouse model and BV-2 cell line were used to examine the effect of LPS stimulation on the expression of 14-3-3ζ and ferroptosis in microglia. The expression of heme oxygenase-1 (HO-1) was also analyzed to understand its role in promoting microglial ferroptosis. Results We found that LPS stimulation increased the expression of 14-3-3ζ and promoted ferroptosis in microglia. Additionally, 14-3-3ζ was found to promote microglial ferroptosis by stabilizing the expression of HO-1. These findings suggest that the 14-3-3ζ/HO-1 axis plays a crucial role in promoting microglial ferroptosis in retinal inflammation. Conclusion The study provides valuable insights into the mechanisms underlying uveitis and highlights the potential of the 14-3-3ζ/HO-1 axis as a therapeutic target for the disease. Further research in this area could lead to the development of preventive and therapeutic strategies for uveitis.

Results of Quantitative and Qualitative Assessment of Color Vision in Patients with Congenital Partial Atrophy of the Optic Nerve

Background. Congenital partial atrophy of the optic nerve is one of the main causes of blindness and low vision in patients with fundus pathology, and the study of color vision is important in diagnosis and monitoring visual functions in patients with this disease.Purpose: to study the possibilities of using the own developed method of quantitative and qualitative assessment of color vision in patients with partial optic nerve atrophy.Materials and methods. 55 patients aged from 8 to 20 years with congenital partial atrophy of the optic nerve (PAON) with a typical fundus pattern and EFI indicators for this disease were observed. The control group included 116 people of the same age without fundus pathology and with normal visual acuity. To study color vision in both groups, the classic FarnsworthMunsell Dichotomous D15 Test and the own developed method for quantitative and qualitative assessment of color vision were used.Results. The method developed by us made it possible to identify color perception disorders of varying severity in the majority (about 90 %) of patients with PAON. In the control group, no color perception disorders were detected in more than 70 % of the subjects. Quantitative assessment of color vision conducted using the method developed by us demonstrates significantly higher indicators of the total error of perception of color tones in patients with PAON (35.6 ± 3.2 degrees for a better-seeing eye and 39.9 ± 3.3 degrees for a worse-seeing eye) in comparison with the subjects of the control group (6.2 ± 1.1 degrees for a better-seeing eye and 7.5 ± 1.3 degrees for a worse-seeing eye). The severity of color perception disorders in patients with PAON does not depend on age, but has a significant inverse relationship with visual acuity. In the group of patients with PAON, when examining both better-seeing eye and worse-seeing eye, perception disorders of all color tones are detected with a slight predominance of disorders of perception of red, green and blue. The method developed by us has sufficiently higher sensitivity and specificity in comparison with the classic Farnsworth-Mansell D-15 test.Conclusion. The method developed by us makes it possible to effectively carry out a quantitative and qualitative assessment of the state of color perception in patients with PAON.

Gambaran Faktor-Faktor Pemberian Vitamin A Pada Balita Di Puskesmas Kecamatan Muara Satu Kota Lhokseumawe Tahun 2020

Vitamin A has biological activity as retinol that can increase the body's resistance to infectious diseases so that it can reduce morbidity and mortality due to vitamin A deficiency, and has an important role for eye health. Vitamin A deficiency (VAD) is the main cause of blindness in children, Aceh Province ranks the fourth lowest in giving vitamin A, it is estimated 30 million toddlers in Indonesia aged 12-59 months, half of whom suffer from VAD. The role of mothers in giving vitamin A is very important, several factors influence the giving of vitamin A to children, that is the level of mother's education, mother's knowledge, mother's visit to Posyandu, mother's job, and the distance from the mother's house to the Posyandu. The purposes of this research are to know the description of mother's education level, mother's knowledge, mother's visit to Posyandu, mother's job, and distance from mother's house to Posyandu in Muara Satu Subdistrict Health Center, Lhokseumawe City. This research method uses a descriptive approach with cross sectional design and sampling using consecutive sampling technique, for data collection is using primary and secondary data. The results of the research on the description of the factors of giving vitamin A at the Muara Satu Subdistrict Health Center, Lhokseumawe City, find that the mother's education level is low 78.1%, mother's knowledge is less 66.8%, mother's visit to Posyandu is high 53.1%, mother does not have a job 88.4%, and the distance from the mother's house to the Posyandu is near 65.6%. The conclusions of this study are the level of mother's education is low, the mother's knowledge is less, the mother's visit to Posyandu is high, the mother's does not have a job, and the distance between the mother's house to Posyandu is near, these variables are a description of the factors of giving vitamin A at Muara Satu Subdistrict Health Center, Lhokseumawe City.

Perspective of Cataract and Oxidative Stress

One of the main causes of blindness is the multifactorial condition known as cataract. It is believed that oxidative stress plays a significant role in starting the cataractogenesis process. Today, it is a well-established fact that oxidative stress plays a role in both diabetes-induced cataract (diabetic) and age-related cataract (senile). The most likely cause of oxidative damage to the lens is a compromised antioxidant defense system brought on by age and diabetes-related increases in reactive oxygen species (ROS) production. The main factor contributing to cataract formation is systemic oxidative stress, which is produced externally to the lens. An imbalance between pro- and antioxidant-oxidants leads to oxidative stress. It is essential to eliminate hazardous free radicals because they are a byproduct of normal metabolism. Globally, cataracts are the primary cause of blindness. Oxidative stress is the direct cause of the lens’s opacity. Although age is the main cause of cataracts, diabetes is also a common cause, as higher superoxide levels in the mitochondria arise from hyperglycemia. This review will look into ultraviolet (UV) light, diabetes, and diet (fat, alcohol, and vitamins) as risk factors for cataracts.

Proliferative diabetic retinopathy in severe stages: modern approaches to diagnosis and treatment (systematic review)

Diabetic retinopathy (DR) is a leading complication in patients with diabetes mellitus (DM). Because of the increase in the clinical effectiveness of treatment for diabetes, the life expectancy of patients has increased, which accordingly increases the risk of severe forms of DR (proliferative DR), which is one of the main causes of blindness and low vision in the working-age population. In the literature, the overall prevalence of DR and proliferative DR is up to 34.6% and 12.0%, respectively, whereas 25% of cases of vision loss associated with DR are caused by complications of proliferative DR. Colour fundus photography and optical coherence tomography are the most informative clinical diagnostic methods for DR. In severe stages of proliferative DR, the information content of the presented indicators can be significantly reduced because of insufficient visualisation of the patient’s fundus. Thus, the literature proposes qualitative criteria (specific and single indicators) based on an expert assessment of the condition of the fundus by an ophthalmic surgeon. The described approach has a fairly high diagnostic efficiency. Along with this, it appears relevant to study the ‘quality of life’ of a patient with symptoms of proliferative DR caused by the occurrence of characteristic manifestations of psychological distress (psychological and anxiety disorders and depression). In surgical terms, functional results notably improved after vitrectomy for proliferative DR in 49–83% of cases. Moreover, the proposed methods for conducting vitrectomy for patients with advanced stages of proliferative DR do not fully consider ophthalmological and somatic features, which requires the consideration of the surgical treatment of this contingent as a separate area of vitrectomy for improving ophthalmological ‘techniques’, drug support and choice of anaesthesia.

Risk Factors for Retinopathy of Prematurity in Preterm Infants in Kerman, Iran.

Retinopathy of prematurity (ROP) is the main cause of blindness in premature infants. Despite developments in neonatal care and management guidelines, ROP is becoming increasingly prevalent worldwide. Hence, the identification of risk factors for ROP is critical to diminish the burden of the disease. This cross-sectional study included all infants with gestational age 36 weeks referred to the ophthalmology clinic at Shafa hospital, Kerman, Iran from 2014 to 2015. Ophthalmologic examinations were performed followed by demographic and ophthalmic data collection and analysis. A total of 579 preterm neonates were screened including 325 boys and 254 girls. The incidence of ROP was 17.96%. Mean birth weight (BW) and gestational age (GA) were 1668.0 grams and 31.2 weeks, respectively. The results indicated that BW, GA, duration of hospitalization and oxygen therapy were significantly related to the development of ROP, however, after multivariate logistic regression analysis, only BW and duration of hospitalization remained significant. There were no significant associations between gender, type of delivery, or assisted reproductive technologies, and ROP (P = 0.461, 0.461, and 0.826, respectively). BW and duration of hospitalization were significant risk factors for ROP in the current study. BW was also strongly associated with the need for therapy.

Prevalence of visual impairment and its causes in adults aged 50 years and older: Estimates from the National Eye Surveys in Malaysia.

Population surveys are necessary to measure a community's eye care needs. We conducted simultaneous surveys in two regions in Malaysia in 2023 to estimate the prevalence of blindness and/or visual impairment (VI), identify its main causes, and compare the results with the survey in 2014. The surveys were simultaneously done in Eastern and Sarawak administrative regions using the Rapid Assessment of Avoidable Blindness (RAAB) technique. It involved a multistage cluster sampling method, each cluster comprising 50 residents aged 50 years and older. The prevalence of blindness and/or visual impairment (blindness, severe, moderate, and early) and its primary cause were determined through a visual acuity test and eye examination with a hand-held ophthalmoscope. Results were compared with the previous survey in 2014. A total of 10,184 subjects were enumerated, and 9,709 were examined (94.5% and 96.2% responses for Eastern and Sarawak, respectively). The prevalence of blindness and severe VI appeared lower than the previous survey. For blindness: Eastern 1.4%, 95%CI (0.9, 1.9) to 0.8%, 95%CI (0.5, 1.1) and Sarawak: 1.6% 95%CI (1.0, 2.1) to 0.6%, 95%CI (0.3, 0.9). For severe VI: Eastern 1.2%, 95%CI (0.8, 1.7) to 0.9%, 95%CI (0.6, 1.1) and Sarawak 1.1% 95%CI (0.6, 1.6) to 0.9%, 95% CI(0.6, 1.2). The main cause of blindness was untreated cataracts: 77.3% (Eastern) and 75.0% (Sarawak). Diabetic retinopathy was the 2nd main cause of blindness for Eastern at 9.1%, but it only caused early to severe VI in Sarawak. The prevalence of blindness and severe VI were lower than in the previous survey. It could have been attributed to a community cataract program implemented soon after the survey in 2014. However, more efforts are needed to address the high percentage of avoidable blindness within both regions.

The second rapid assessment of avoidable blindness survey in Palestine: A national cross‐sectional study

Aim: To assess prevalence and main causes of blindness, vision impairment and cataract surgical coverage in Palestinians aged 50 years and older.Methods: The survey was part of a larger population‐based survey using the rapid assessment of avoidable blindness (RAAB) methodology to estimate prevalence of vision impairment, blindness and disability in individuals aged 50 years and older in Palestine. It was a nationally representative, cross‐sectional, population‐based survey in Gaza Strip and West Bank. A sample size of 4224 participants aged 50 years and older was determined in 69 clusters in the West Bank and 52 clusters in the Gaza Strip. Within each cluster, 35 people aged 50 years or older were examined in their homes.Results: The total examined was 3848. Adjusted prevalence of blindness was 2.6%. This is a non‐significant decrease from 3.4% in 2008. The prevalence of blindness in Gaza (4.0%) was higher than the prevalence of blindness in the West Bank (1.8%). The prevalence was higher among females than males.Adjusted prevalence of severe vision impairment, moderate vision impairment and mild vision impairment was 1.4%, 10.2% and 11.6%, respectively. Principal cause of blindness, severe and moderate vision impairment was untreated cataract followed by diabetic retinopathy. Refractive error was the principal cause of mild vision impairment. More than 80% of vision impairment was avoidable.Unmet need for cataract surgery varied from 0.9% among blind participants to 6.5% among participants with mild vision impairment. Effective cataract surgical coverage was low in general and varied from 42.4% among blind operated participants to 25.9% among participants with mild vision impairment.Conclusions: Around 80% of vision impairment was avoidable. Untreated cataract and diabetic retinopathy were the main causes of blindness, severe and moderate vision impairment. Refractive error was the principal cause of mild vision impairment. Effective cataract surgical coverage was low.