Blindness Research Articles

Mir-509-3p targets SLC25A13 to regulate ferroptosis and protect retinal endothelial cells in diabetic retinopathy.

Diabetic retinopathy (DR) is a major complication of diabetes that leads to vision impairment. The aim of this study was to investigate the regulatory role of miR-509-3p in DR, focusing on its interaction with SLC25A13 and its impact on retinal endothelial cell function, oxidative stress, apoptosis, and ferroptosis. HRVECs were cultured in high-glucose (HG) conditions to establish an in vitro DR model. miR-509-3p mimics and inhibitors were transfected into HRVECs to assess their effects on SLC25A13 expression, cell viability, apoptosis, reactive oxygen species (ROS) levels, and ferroptosis markers. A luciferase reporter assay and RNA immunoprecipitation were used to confirm the binding of miR-509-3p to SLC25A13 mRNA. For in vivo validation, agomiR-509-3p was injected into the vitreous of DR mice, and retinal thickness, pathological damage, and apoptosis were evaluated. Ferroptosis-related markers (GPX4, TlR4, ASCL4) were analyzed in HRVECs to explore the mechanism of miR-509-3p in regulating ferroptosis. In vitro, miR-509-3p significantly decreased SLC25A13 expression, resulting in enhanced HRVEC viability, reduced apoptosis, and lower ROS levels under HG conditions. Overexpression of SLC25A13 reversed these protective effects, while miR-509-3p knockdown exacerbated oxidative stress and apoptosis. In vivo, agomiR-509-3p increased retinal thickness, reduced pathological damage, and decreased apoptosis in DR mice. Ferroptosis marker analysis revealed that miR-509-3p upregulated GPX4 expression and downregulated TlR4 and ASCL4, whereas SLC25A13 overexpression reversed these effects, further linking miR-509-3p to the regulation of ferroptosis. miR-509-3p exerts a protective effect in DR by targeting SLC25A13, reducing oxidative stress, apoptosis, and ferroptosis in retinal endothelial cells. These findings highlight the potential of miR-509-3p as a therapeutic target for DR management.

Exploring cognitive overload in adults with visual impairment: The association between concentration and fatigue.

This research contributes to the concept of cognitive overload and the association between concentration and fatigue in individuals with visual impairment (VI). Gaining more insight into these and other factors explaining cognitive overload is essential for a better understanding, prevention, and treatment of fatigue severity in individuals with VI. Individuals with VI need to use additional cognitive resources to compensate for their loss of vision. These cognitive demands include increased concentration, which may put an extra burden on energy levels. This study aimed to expand upon previous research on the concept of cognitive overload by exploring the relationship between concentration and fatigue severity in individuals with VI. A cross-sectional study was conducted based on data from the eligibility screening of the E-nergEYEze trial (n = 213). Concentration problems were measured with the Checklist of Individual Strengths subscale Concentration, and fatigue severity was measured with the Checklist of Individual Strengths subscale Fatigue Severity. Linear regression analyses were performed to investigate the association between concentration problems and fatigue severity. Potential effect modifiers (i.e., sociodemographic and vision-related characteristics) were considered, and associations were corrected for confounding. Concentration problems were directly and positively associated with fatigue severity (β = 0.47; R2 = 0.10; 95% confidence interval, 0.28 to 0.66; adjusted model: β = 0.52; R2 = 0.16; 95% confidence interval, 0.32 to 0.72). No relevant effect modifiers were identified. However, other factors that were not included in this study were involved in this association. This study contributes to understanding the cognitive overload as experienced by adults with VI and highlights the importance of the association of concentration problems, as a reflection of the cognitive burden and perceived fatigue. It is recommended to identify and address concentration difficulties through suitable awareness and treatment strategies to prevent and reduce severe fatigue in this population.

Association Analysis of Telomere Length and Vision in a Large Community-Based Survey

ABSTRACT Purpose To investigate whether there is a direct, age-independent association between telomere length and visual acuity decline in a large community-based cohort study. Methods Participants older than 40 with linked leukocyte telomere length (LTL) were enrolled in NHANES. LTL was assayed using qPCR from the participants’ blood samples. Best corrected visual acuity (BCVA) of the better-seeing eye was analyzed, with visual impairment (VI) defined as BCVA ≥ 20/40. LTL was grouped into quartiles, and its association with BCVA and VI was evaluated after adjusting for covariates. Results Among the 4,480 enrolled participants, the weighted means of age, BCVA, and telomere length were 56.1 ± 11.9 years, 0.05 ± 0.08 logMAR, and 5,662 ± 36 base pairs, respectively. The proportion of VI was 2.6%. After adjusting for covariates including sex, ethnicity, education, family poverty income ratio, general health status, hypertension, diabetes, smoking, and body mass index, BCVA was significantly worse in participants with shorter LTL, with a significant trend (p = 0.002). However, after further adjusting for age, the association between LTL and BCVA was no longer significant, without a trend (p = 0.640). No significant association or trend between LTL and VI was found in the stepwise logistic model. Conclusions No age-independent association between LTL and BCVA was found. Our study indicates LTL may not serve as a biomarker for age-related visual acuity decline.

Identifying Multiomic Signatures of X-Linked Retinoschisis-Derived Retinal Organoids and Mice Harboring Patient-Specific Mutation Using Spatiotemporal Single-Cell Transcriptomics.

X-linked retinoschisis (XLRS) is an inherited retinal disorder with severe retinoschisis and visual impairments. Multiomics approaches integrate single-cell RNA-sequencing (scRNA-seq) and spatiotemporal transcriptomics (ST) offering potential for dissecting transcriptional networks and revealing cell-cell interactions involved in biomolecular pathomechanisms. Herein, a multimodal approach is demonstrated combining high-throughput scRNA-seq and ST to elucidate XLRS-specific transcriptomic signatures in two XLRS-like models with retinal splitting phenotypes, including genetically engineered (Rs1emR209C) mice and patient-derived retinal organoids harboring the same patient-specific p.R209C mutation. Through multiomics transcriptomic analysis, the endoplasmic reticulum (ER) stress/eukryotic initiation factor 2 (eIF2) signaling, mTOR pathway, and the regulation of eIF4 and p70S6K pathways are identified as chronically enriched and highly conserved disease pathways between two XLRS-like models. Western blots and proteomics analysis validate the occurrence of unfolded protein responses, chronic eIF2α signaling activation, and chronic ER stress-induced apoptosis. Furthermore, therapeutic targeting of the chronic ER stress/eIF2α pathway activation synergistically enhances the efficacy of AAV-mediated RS1 gene delivery, ultimately improving bipolar cell integrity, postsynaptic transmission, disorganized retinal architecture, and electrophysiological responses. Collectively, the complex transcriptomic signatures obtained from Rs1emR209C mice and patient-derived retinal organoids using the multiomics approach provide opportunities to unravel potential therapeutic targets for incurable retinal diseases, such as XLRS.

Association between glycemia and outcomes of neonates with hypoxic-ischemic encephalopathy: a systematic review and meta-analysis

ObjectivesThe research aimed to provide the most recent and comprehensive analysis and evidence update comparing outcomes in neonatal encephalopathy (NE) based on different glycemia levels.Patients and methodsA comprehensive search of Cochrane, PubMed, Embase, Web of Science, CNKI, and Wanfang databases was conducted until September 2023. The purpose was to identify research that examined the effects of hyperglycemia, hypoglycemia, and normoglycemia on NE outcomes. The hyperglycemic, normoglycemic and hypoglycemic group were compared. Outcomes measured were mortality, abnormal MRI, hearing or visual unfavorable outcomes, neurodevelopmental delay, cerebral palsy, and all unfavorable outcomes.ResultsThirteen literatures comprising 2,427 participants (1,233 with normoglycemia, 835 with hyperglycemia, and 359 with hypoglycemia) were considered. Pooled analysis showed more overall adverse outcomes, higher mortality and worse hearing or visual outcomes in the hyperglycemic and hypoglycemic group compared to the normoglycemic group. There was no notable distinction found in abnormal MRI and cerebral palsy among all groups. The hypoglycemic group exhibited greater neurodevelopmental delay than normoglycemia.ConclusionsMaintaining normal blood glucose levels in neonates with NE can help reduce the risk of adverse consequences such as hearing and visual impairment.

Bioelastic state recovery for haptic sensory substitution.

The rich set of mechanoreceptors found in human skin1,2 offers a versatile engineering interface for transmitting information and eliciting perceptions3,4, potentially serving a broad range of applications in patient care5 and other important industries6,7. Targeted multisensory engagement of these afferent units, however, faces persistent challenges, especially for wearable, programmable systems that need to operate adaptively across the body8-11. Here we present a miniaturized electromechanical structure that, when combined with skin as an elastic, energy-storing element, supports bistable, self-sensing modes of deformation. Targeting specific classes of mechanoreceptors as the basis for distinct, programmed sensory responses, this haptic unit can deliver both dynamic and static stimuli, directed as either normal or shear forces. Systematic experimental and theoretical studies establish foundational principles and practical criteria for low-energy operation across natural anatomical variations in the mechanical properties of human skin. A wireless, skin-conformable haptic interface, integrating an array of these bistable transducers, serves as a high-density channel capable of rendering input from smartphone-based 3D scanning and inertial sensors. Demonstrations of this system include sensory substitution designed to improve the quality of life for patients with visual and proprioceptive impairments.

Rapidly Developing and Elusive Rhino-Orbital-Cerebral Mucormycosis

Purpose: To report a case of rapidly progressing rhino-orbital cerebral mucormycosis that was particularly difficult to diagnose, initially presenting as orbital apex syndrome. Major findings: In this case, a 59-year-old male patient with uncontrolled diabetes presented with a history of facial pain with no ocular involvement. Within 1 day of hospitalization, the patient developed complete ophthalmoplegia and total visual impairment of the right eye. Over the course of 2 hospital stays, several biopsies resulted in no significant histopathological findings, and several cultures resulted in growth of only a single colony of rhizopus mucor from the sinonasal mucosa. Given the high clinical suspicion of an invasive fungal infection, a universal PCR test was performed from a rapidly developing abscess in the frontal lobe and confirmed a diagnosis of mucormycosis. Conclusions: Orbital apex syndrome is a significant diagnosis that can be caused by a variety of factors, including those of fungal, bacterial, neoplastic, or inflammatory origin. Fungal infections, are a particularly concerning cause of orbital apex syndrome, given their ability to penetrate in and through the orbit to the brain, often resulting in an alarmingly high mortality rate. Mucormycosis, specifically rhino-orbital cerebral mucormycosis, is a very severe opportunistic invasive fungal infection, most often afflicting the immunocompromised. A clinician must be very thorough in their workup so as to not miss such a devastating diagnosis. Histopathology and cell cultures are currently the gold standard for diagnosis, with the potential to augment their technical success through the use of molecular techniques, such as universal PCR.

Clinical profile and etiological spectrum of patients presenting with corneal hydrops over a 12-year period.

To describe the demographics, clinical characteristics, and management of corneal hydrops in patients presenting to a multi-tier ophthalmology hospital network in India. Cross-sectional hospital-based study. Of the total of 3,140,941 new patients presenting between October 2010 and March 2022, patients with a clinical diagnosis of corneal hydrops in at least one eye were included in the study. All the data was collected using an electronic medical record system. 1291 eyes of 1110 patients were diagnosed with corneal hydrops and included in the study and 961 patients (83.69%) had a unilateral affliction. Corneal hydrops was noted to be significantly more common in males (62.43%) and adults (62.7%). The most common age group at presentation was during the second decade of life with 472 (42.52%) patients. They were more commonly from the higher socio-economic status (77.3%) and from the urban geography (44.23%). In the 1291 eyes, 567 (43.92%) eyes had a visual impairment of blindness (> 20/400-20/1200) followed by moderate visual impairment (> 20/70-20/200) in 166 (12.86%) eyes. Overall, the most common etiology was keratoconus in 1,082 (83.81%) eyes followed by primary congenital glaucoma (PCG) in 91 (7.05%) eyes. Surgical intervention to hasten the recovery of hydrops was performed in 7.82% of eyes with ectasia and as a definite management in 7.05% eyes with PCG. Visual rehabilitation was with contact lenses in 29.1% eyes and keratoplasty in 13.94% eyes. Corneal hydrops is predominantly unilateral and is more common in males. Keratoconus was the commonest etiological condition; however, the risk of hydrops was highest in keratoglobus, followed by PMD. Most affected age was the second decade of life and visual impairment was severe in majority (60%). A surgical intervention was performed in a third of the cases.

Public Libraries as an Informational Space for Indivi-duals with Blindness and Visual Impairment. Material and Immaterial Artifacts of Access

Public Libraries as an Informational Space for Indivi-duals with Blindness and Visual Impairment. Material and Immaterial Artifacts of Access

InclusiveWeb : A Smart Browser Approach to Enhancing Web Accessibility for Users with Diverse Disabilities

This article presents InclusiveWeb, an innovative accessibility-focused web browser designed to enhance digital inclusion for users with diverse disabilities. The browser addresses the persistent challenge of widespread non-compliance with web accessibility standards by implementing real-time content adaptation mechanisms, disability-specific tools, and a highly customizable user interface. InclusiveWeb's architecture incorporates advanced machine learning algorithms to dynamically modify web content, offering tailored solutions for users with visual impairments, dyslexia, language disorders, cognitive disabilities, and ADHD. The article details the browser's design principles, technical considerations, and user experience features, supported by a comprehensive evaluation methodology involving user studies with various disability groups. Results demonstrate significant improvements in task completion rates, user satisfaction, and overall accessibility compared to standard browsers. While acknowledging limitations and areas for future research, this article highlights InclusiveWeb's potential to revolutionize web accessibility, shifting the paradigm from reliance on content creators' compliance to browser-level adaptations. The implications of this approach for web accessibility standards, digital inclusion, and future technological developments are discussed, emphasizing the browser's role in creating a more equitable digital landscape.

Prevalence and Influence Factors of Cognitive Frailty in the Older Adult Patients Undergoing Maintenance Haemodialysis: A Multi-Centre Cross-Sectional Study.

To examine the prevalence of factors of cognitive frailty in patients undergoing maintenance haemodialysis (MHD). A cross-sectional study. From September 2023 to January 2024, 1023 patients undergoing MHD were recruited from 11 hospitals in Chengdu, China, using convenience sampling. The participants' sociodemographic and lifestyle factors, health information and laboratory indicators were assessed using a general information questionnaire. Cognitive frailty was assessed using the Fried Frailty Phenotype and Montreal Cognitive Assessment Scales. Multivariate logistic regression was used to examine the associations between cognitive frailty and sociodemographic and clinical characteristics. Independent variables for the multivariate logistic regression model encompassing age, sex, educational level, marital status, visual impairment, hearing impairment, falls within a year, depression, weight, height, Malnutrition-inflammation score and serum albumin, sodium, phosphorus, total cholesterol and creatinine levels. Among 1023 participants with a mean age of 69.52 years, 300 (29.3%) had cognitive frailty, with a predominance of older patients. Regression analysis showed that advanced age, low literacy and low serum creatinine, sodium and total cholesterol levels were positively correlated with cognitive frailty. Furthermore, 17.1% of the participants experienced depression, a risk factor for cognitive frailty, and malnutrition was an independent risk factor for cognitive frailty. Older adult patients undergoing (MHD) are at an increased risk of developing cognitive frailty. The aetiology of cognitive frailty in this cohort was multifactorial. Targeted interventions should be designed and implemented based on these factors, prioritising nutritional guidance and mood management to prevent or reverse cognitive frailty. The study adhered to the STROBE checklist. Older adult patients undergoing MHD are at increased risk of developing cognitive frailty. Cognitive frailty screening must be incorporated into the routine assessment of older patients undergoing MHD. No patient or public contribution.

Wernicke's Encephalopathy

Wernicke encephalopathy is a thiamine deficiency condition that has a wide range of somatic causes in addition to alcohol abuse. Most patients do not have the classical clinical triad — oculomotor dysfunction, ataxia and cognitive impairment at the onset of the disease, which makes timely diagnosis difficult. The disease may manifest as dizziness, unsteadiness, double vision, or cognitive impairment. Key clinical manifestations include symmetrical gaze-evoked nystagmus, truncal ataxia, bilateral abducens paresis, internuclear ophthalmoplegia, bilateral vestibular-ocular reflex reduction, and anterograde amnesia. To make a diagnosis, the presence of a condition leading to thiamine deficiency is required. The diagnosis is confirmed by MRI, but even with clinical suspicion of Wernicke encephalopathy, it is necessary to initiate parenteral therapy with thiamine in an adequate dose. With timely treatment, the disease has a good prognosis.

The Effectiveness of Online Courses in Building Nemeth Code Within UEB Contexts Skills and Increasing Knowledge of Strategies to Support Prekindergarten Through Eighth-Grade Students in Their Mathematics Learning

Introduction Professional development can assist individuals in learning a variety of new skills and refining their teaching practice. The purpose of this study was to explore the effectiveness of asynchronous online courses designed to assist individuals in building their Nemeth Code within Unified English Braille (UEB) Contexts skills and strategies for teaching the code to prekindergarten through eighth-grade students. Methods Four teachers of students with visual impairments designed five asynchronous online courses. The courses provided multiple opportunities for participants to actively complete course content as well as learn about strategies and resources for teaching the Nemeth Code within UEB Contexts to children and youths. Each course included an initial survey, pretest, seven self-paced lessons, and posttest. Participants were also invited to complete a follow-up survey. Results Between spring 2020 and spring 2023, 452 participants completed between 1 and 5 of the courses for a total of 620 courses completed. Almost all completers ( n = 598) scored higher on the posttest. Of the 227 individuals who completed the follow-up survey, 223 reported that what they learned in the course had positively impacted how they support or will support students who read braille in their math classes. Discussion Effective professional development goes beyond learning. When individuals actively consume content and reflect upon their learning, their professional practice is transformed. Implications for Practitioners Well-designed asynchronous instructional modules allow professionals to increase their knowledge and skills. Opportunities to practice skills and check one's work, access to instructional videos, and the availability of downloadable slides and resources are helpful to professionals.

Statewide Assessment of Confidence and Training Needs Among Educators Who Support Transition-Aged Students With Visual Impairments

Introduction: Students with visual impairments represent a low-incidence disability group with poor postschool outcomes. Educators who support these students at the transition-age level need access to high-quality training and resources. Method: I surveyed 87 special educators and teachers of students with visual impairments in a southeastern state to ask about their confidence in implementing 33 transition practices and their interest in training and resources on these same topics for youth with visual impairments. Results: Overall, teachers indicated moderate levels of confidence and moderate levels of interest in additional training across the 33 practices. There were some significant differences between teacher groups on ratings of confidence. Discussion: The findings of this study demonstrate the need for regular in-service opportunities for all teachers who support transition-aged youth with visual impairments to increase teacher confidence, as well as a stronger emphasis on transition in preservice programs. Findings of low interest in additional training suggest that more research is necessary to better understand the perceptions of teachers related to their roles in preparing youth in transition. Implications for Practitioners: This study should prompt educators to collaborate around transition for youth with visual impairments to ensure that knowledge that would improve student outcomes is shared, to encourage administrators to survey their staff members to understand which transition topics represent the most pressing need for ongoing training, and to prompt personnel preparation programs to place a stronger emphasis on transition education throughout their courses.

Overcoming the Challenges of Including Learners with Visual Impairments Through Teacher Collaborations

In this article we report on a study undertaken with 255 teachers working with learners with visual impairments. The focus of our discussion is teachers’ implementation of inclusive education policies with learners with visual impairments in full-service schools in South Africa. We foreground the ways in which the teacher participants relied on teacher collaborations to overcome some of the challenges they faced as a result of limited resource provisions in schools in this country. We implemented an instrumental case study design and followed the approach of participatory reflection and action (PRA). The sample included teachers (n = 255) from seven full-service and ten special schools from five provinces in South Africa. In addition, 50 expert stakeholders who work in the field of visual impairment were involved. For data generation and documentation, we utilised PRA-based workshops, the observation-as-context-of-interaction method, audio-visual techniques, field notes, and reflective journals. The findings of our research confirm that full-service schools face distinct challenges regarding limited resources as well as teachers that are inexperienced to accommodate learners with visual impairments. Even though the teachers in our study were initially reluctant to implement inclusive education practices, their collaboration with fellow teachers and other informed stakeholders enabled them to address some of the challenges they experienced and implement inclusive practices. They subsequently formed a team and learnt from one another to facilitate positive changes through the implementation of inclusive practices, thereby following a socio-ecological approach to inclusive practices in full-service schools in South Africa.

AUTOMATED INDOOR ACTIVITY MONITORING FOR ELDERLY AND VISUALLY IMPAIRED PEOPLE USING QUANTUM SALP SWARM ALGORITHM WITH MACHINE LEARNING

Elderly and vision-impaired indoor activity monitoring uses sensor technology to monitor interaction and movement in the living area. This system can identify deviations from regular patterns, provide alerts, and ensure safety in case of emergencies or potential risks. These solutions enhance quality of life by promoting independent living while offering peace of mind to loved ones and caregivers. Visual impairments have become the chief part of these problems over the past few years. Usually, visually impaired people seek help from others to keep doing their daily tasks. An automated human activity recognition (HAR) technique could enhance a vision-impaired person’s transaction activity and safe movement. HAR using deep learning (DL) includes training neural networks to automatically detect and classify various activities carried out by humans based on sensor information. By leveraging DL approaches, the HAR system could accurately identify and classify activities, including sitting, standing, walking, or running, from the information captured by sensors or wearable devices. This system is integral to smart home automation, healthcare, and sports analytics. This study develops an Automated Fractal Quantum Salp Swarm Algorithm with Machine Learning based HAR (QSSA-MLHAR) for assisting elderly and visually impaired people. The QSSA-MLHAR technique uses sensory input data to identify human activities in diverse classes. In the QSSA-MLHAR technique, the min–max scalar is primarily used to scale the input data. Besides, the QSSA-MLHAR technique applies a mixed extreme learning machine (M-ELM) model to classify various human actions. The QSSA-based hyperparameter tuning process is used to improve the detection results of the M-ELM system. A wide range of simulations was performed to ensure the better performance of the QSSA-MLHAR method. The comprehensive outcomes assured that the QSSA-MLHAR technique performs well compared to other models.

An international survey of optometric management of stroke survivors

Objectives A survey was conducted to describe the current status of optometric awareness and involvement regarding post-stroke management as literature suggests that visual impairment often goes undiagnosed and unmanaged in stroke survivors. Materials and methods A questionnaire was developed by the researchers, pilot tested by 5 other optometric researchers and 15 optometrists and modified based on the feedback. Practicing optometrists were invited to complete the anonymous online survey through optometric organizations in Canada, Hong Kong, India, UK, and US. Results Results showed that the majority of optometrists (61%) see 1–5 post-stroke patients per month, although 15% report seeing none. In all cases, optometrists referred stroke patients to other health care professionals more often than receiving incoming referrals from them. About 21% of all respondents were already fully involved in post-stroke vision care and 57% were interested in being more involved. Limiting factors to seeing more post-stroke patients included resources (29.8%), funding (25.8%), awareness (25.1%), and interest (9.8%). There was consensus among respondents in all countries that optometrists should be members of post-stroke care teams. Conclusion Optometrists are well suited to provide post-stroke visual rehabilitation but are often not included in care teams for these patients. As a result, the visual management of post-stroke patients often is unaddressed.

Ocular Surface Disease Index Questionnaire (OSDI-Q), Unidimensionality, and Differential Item Functioning

Objective The OSDI-Q is a 12-item scale used instrument for DED prevalence, assess symptom severity, and impact on vision-related functioning. The research analysis investigates the precision, separation index and reliability of unidimensionality, and DEF, stratified by age and gender. The reliability analysis is to assess the internal consistency of the scale using Cronbach's α coefficient and McDonald's ω coefficient with item-rest correlations. Method 634 respondents took part in the OSDI questionaire. Rasch analysis was conducted using precision, separation index, and reliability for items and person, item and person fit statistics, assessing unidimensionality stratified by age and gender, and the use of SPSS to conduct the reliability analysis of the scale using analytical coefficients. Results The OSDI-Q items displayed robust reliability, with high PSI values of 7.63 and 0.98, respectively. Infit and outfit statistics were within acceptable ranges, explaining 39.90 % of variance. Differential item functioning was observed among the age groups involved. Additionally, the contrast in the principal component analysis of the unexplained variance exhibited an eigenvalue of 2.80 and a proportion of variance of 14%. DIF analysis showed significant differences for age groups of (16-26 years) and (27-40 years). The coefficients of Cronbach's and McDonald's are 0.85 for OSDI-Q demonstrated strong internal consistency. Conclusions OSDI-Q displayed appropriate infit and outfits. DIF analysis results of OSDI-Q of age group (16-26 years) performed better in poor vision while age group (27-40 years) performed better in areas with low humidity. Furthermore, the results of DIF analysis in males group performed better in driving at night, while the female group showed better performance in the questinaire. The OSDI-Q items scale reliability data for Cronbach's scale show high internal consistency and reliability. This research can help the medical communities to begin a better surge for medically integrated research.

High Intraocular Concentration of Fibrinogen Regulates Retinal Function Via the ICAM-1 Pathway.

Diabetic retinopathy (DR) is a significant complication of diabetes mellitus that can lead to progressive visual impairment. This study aimed to elucidate the role of fibrinogen, a protein whose serum and intraocular concentrations are elevated in patients with diabetes and DR, in the pathogenesis of DR. The changes in the protein levels of the neuronal marker tubulin-β3 (TUBB3) and retinal response induced by the intravitreal injections of 1× phosphate-buffered saline, 40mg/mL of fibrinogen, and 40mg/mL of fibrinogen in combination with anti-intracellular adhesion molecule-1 (ICAM-1) antibody in normal mice were observed using immunofluorescence, western blotting, and electroretinography. High concentrations of fibrinogen led to a decrease in the expression of TUBB3 in immunofluorescence and western blotting. The amplitudes of the positive scotopic threshold response and b-wave were notably reduced after the injection of fibrinogen, indicating potential damage to the retinal ganglion cells. The co-administration of anti-ICAM-1 antibody effectively mitigated these fibrinogen-induced changes, indicating that fibrinogen-induced damage is mediated via the ICAM-1 pathway. The present study underscores the significance of elevated intraocular fibrinogen levels as a pathogenic factor in DR. Involvement of the fibrinogen/ICAM-1 pathway presents new avenues for therapeutic intervention, especially in patients with treatment-resistant conditions.

Early detection of age-related macular degeneration using Vision Transformer-based Architectures – A comparative study with offline metrics and data augmenting

Age-related macular degeneration (AMD) is one of the leading causes of vision loss in elderly adults around the world and is among the main visual impairments in Mexico. The difficulty of diagnosing AMD in its early stages motivates the use of advanced deep-learning methods that offer significant potential to improve diagnostic accuracy in retinal image analysis. In recent years, Transformer architectures for computer vision, such as Vision Transformer (ViT), Swin Transformer and BERT Pre-training of Image Transformers (BEiT) have provided a novel perspective for image analysis. This study presents a comparative analysis of these architectures, applied to AMD detection, focusing on each model's capability to classify the early stages of the disease. Although the small size of medical image datasets represented a challenge, our results suggest that ViT-based architectures and their derivatives achieve significant performance in AMD detection. BEiT is particularly notable for its consistently superior performance.