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Almidani L, Miller R, Varadaraj V, Mihailovic A, Swenor BK, Ramulu PY. Vision Impairment and Psychosocial Function in US Adults. JAMA Ophthalmol 2024; 142:283-291. [PMID: 38386343 PMCID: PMC10884944 DOI: 10.1001/jamaophthalmol.2023.6943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/15/2023] [Indexed: 02/23/2024]
Abstract
Importance Vision impairment and psychosocial function, including symptoms of depression and anxiety and social isolation, are a major cause of morbidity in the US. However, there is a lack of nationally representative studies assessing associations between both objective and subjective vision impairment with psychosocial function following the COVID-19 pandemic. Objective To provide updated national estimates on the associations of vision impairment with depressive and anxiety symptoms and social isolation in US adults 65 years and older. Design, Setting, and Participants This was a cross-sectional analysis of the National Health and Aging Trends Study round 9 (2019) and 11 (2021), a nationally representative sample of Medicare beneficiaries aged 65 years and older. Binocular distance visual acuity, near visual acuity, and contrast sensitivity were tested. Objectively measured vision impairment was defined as having vision impairment in either distance visual acuity (worse than 20/40), near visual acuity (worse than 20/40), or contrast sensitivity (worse than 1.55 logCS). Self-reported vision impairment was defined based on participants' report on their vision status. Data were analyzed in May 2023. Main Outcomes and Measures Depressive and anxiety symptoms assessed via the Patient Health Questionnaire. Social isolation was defined based on living arrangement, communication frequency, and activity participation responses. Results Among 2822 community-dwelling adults sampled from a population of 26 182 090, the mean (SD) age was 78.5 (5.6) years; 1605 individuals (54.7%) were female; 1077 (32.3%) had objectively measured vision impairment, and 203 (6.4%) had self-reported vision impairment. In adjusted models, all outcomes were significantly associated with objectively measured vision impairment, including depressive symptoms (odds ratio [OR], 1.81; 95% CI, 1.26-2.58), anxiety symptoms (OR, 1.74; 95% CI, 1.13-2.67), and severe social isolation (OR, 2.01; 95% CI, 1.05-3.87). Similarly, depressive symptoms (OR, 2.37; 95% CI, 1.44-3.88) and anxiety symptoms (OR, 2.10; 95% CI, 1.09-4.05) but not severe social isolation symptoms (OR, 2.07; 95% CI, 0.78-5.49) were significantly associated with self-reported vision impairment. Conclusions and Relevance In this study, vision impairment was associated with several psychosocial outcomes, including symptoms of depression and anxiety and social isolation. These findings provide evidence to support prioritizing research aimed at enhancing the health and inclusion of people with vision impairment.
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Affiliation(s)
- Louay Almidani
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rhonda Miller
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Varshini Varadaraj
- Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing, Baltimore, Maryland
| | - Aleksandra Mihailovic
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bonnielin K. Swenor
- Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing, Baltimore, Maryland
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Pradeep Y. Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Subramanian A, Kodavati KP, Kanchustambam J, Gothwal VK. Social media use and vision impairment in adults between the ages of 18 and 35 years in India. Optom Vis Sci 2024:00006324-990000000-00180. [PMID: 38489231 DOI: 10.1097/opx.0000000000002098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
SIGNIFICANCE Social media is used by >4.48 billion people worldwide. Despite its popularity, vision-impaired individuals struggle to use social media given visual inaccessibility of content and lack of access to Internet/Wireless-Fidelity-enabled devices. Our study explores visually impaired adult's use of social media in comparison to a control group. PURPOSE This study aimed to report the demographic profile and patterns of social media use among adults with vision impairment (VI) aged 18 to 35 years and compare it with an age-matched normally sighted group in India. In addition, we explored barriers to use of social media among adults with VI. METHODS Vision-impaired and normally sighted adults (controls) aged 18 to 35 years at L V Prasad Eye Institute, Hyderabad, India, answered a questionnaire about social media use (e.g., platform used). RESULTS Four hundred twenty-two individuals (201 VI, 221 controls) participated. Normally sighted adults (98%) used social media more than the VI group (81%; p<0.001). Vision-impaired users were predominantly male (85%) and unemployed (57%; p<0.00001 for both). There was no significant difference in educational level between groups (p=0.17). Smartphones were the most popular device used (VI, 161 [99%]; control, 206 [95%]), with tablet PC/iPad being the least popular (VI, 5 [3%]; control, 12 [6%]). Adults with VI and controls commonly used WhatsApp as communication platforms, and Facebook and Twitter as networking platforms. Approximately one-third of individuals across both social media user groups reported barriers to use (VI, 48 [30%]; control, 74 [34%]; p<0.001). Vision-impaired individuals cited accessibility issues of having to rely on audio over vision to navigate social media, whereas controls reported having to share a phone. CONCLUSIONS The proportion of social media usage among VI adults is high (81%) and is substantially higher than the 33% reported in the general Indian population. Vision-impaired adults who used social media were male with moderate VI and were less likely to be employed compared with controls.
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Affiliation(s)
- Ahalya Subramanian
- Centre for Applied Vision Research, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
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Rausch-Koster TP, van der Aa HPA, Verbraak FD, van Rens GHMB, van Nispen RMA. Perspectives of Patients and Professionals on Implementing a Computer Adaptive Vision-Related Quality of Life Outcome (CAT-EyeQ) in Clinical Practice. Transl Vis Sci Technol 2024; 13:6. [PMID: 38470320 PMCID: PMC10941993 DOI: 10.1167/tvst.13.3.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/29/2024] [Indexed: 03/13/2024] Open
Abstract
Purpose The CAT-EyeQ is a computer adaptive test (CAT) which measures vision-related quality of life in patients having exudative retinal diseases. The aim of this study is to investigate the usability of the CAT-EyeQ in clinical practice and identify potential barriers and facilitators for implementation (problem analysis). Methods Patients and health care professionals participated in the study regarding the usability of the CAT-EyeQ, and clinic managers and health care professionals were included in the problem analysis for implementation. In total, we conducted 18 semi-structured interviews. The Consolidated Framework for Implementation Research (CFIR) was used to develop the interview guides and to structure results. Results Six themes were derived from the usability study and problem analysis: (1) quality of the CAT-EyeQ and the applicability to patients' needs and preferences, (2) embedding the CAT-EyeQ in current practice, (3) implementation climate of the eye hospitals, (4) attitude of professionals, (5) engaging and encouraging professionals, and (6) integration of the CAT-EyeQ in health care - needs after piloting. Conclusions Patients and professionals mentioned that the CAT-EyeQ improved insight into the impact of eye diseases on a patient's daily life, it allowed for more attention on the patient perspective and the structured measurement of vision-related quality of life. The main perceived barriers mentioned by professionals for using the CAT-EyeQ were lack of time and the integration of the patient-reported outcome measure (PROM) results within the electronic patient record (EPR). Translational Relevance The CAT-EyeQ, accompanied by an overview of stakeholder perspectives resulting from this implementation study, can now be used in clinical practice.
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Affiliation(s)
- T. P. Rausch-Koster
- Amsterdam UMC location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Aging and Later Life, Amsterdam, The Netherlands
- Bergman Clinics, Department of Ophthalmology, Naarden, The Netherlands
| | - H. P. A. van der Aa
- Amsterdam UMC location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Aging and Later Life, Amsterdam, The Netherlands
- Expertise Innovation Knowledge, Robert Coppes Foundation, Vught, The Netherlands
| | - F. D. Verbraak
- Amsterdam UMC location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Aging and Later Life, Amsterdam, The Netherlands
| | - G. H. M. B. van Rens
- Amsterdam UMC location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Aging and Later Life, Amsterdam, The Netherlands
| | - R. M. A. van Nispen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Aging and Later Life, Amsterdam, The Netherlands
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Gené-Sampedro A, Alonso F, Gene-Morales J, Monteiro PL, Useche SA. Could driving help us to "see better"? A comparative assessment of saccadic efficiency, visual speed, and attention. BMC Ophthalmol 2024; 24:90. [PMID: 38413901 PMCID: PMC10900731 DOI: 10.1186/s12886-024-03349-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 02/15/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND This study aimed at comparing drivers' and non-drivers' results in the Adult Developmental Eye Movement with Distractors test (ADEMd) and the Useful Field of View test (UFOV). METHODS One hundred and twenty Spaniards (mean age 50.90 ± 17.32 years) without eye disease voluntarily participated in this cross-sectional descriptive study. Participants in a single experimental session completed a questionnaire on sociodemographic, health, eyesight, and driving information. They also performed the ADEMd and UFOV tests randomly following standardized protocols. The ADEMd is a visual-verbal test that measures saccadic efficiency and visual attention. Brown-Forsythe (B-F) tests with Games-Howell post-hoc adjustments were conducted to assess differences between groups. Groups were formed according to sex, age (young adults, adults, and older adults), and driver/non-driver for further analysis. Additionally, associations between dependent variables were assessed through Spearman's correlations. RESULTS Drivers obtained significantly better results in the ADEMd compared with non-drivers. Non-significant differences between drivers and non-drivers were encountered in the UFOV. Additionally, significant differences were observed between sexes and age groups. It is worth highlighting that non-driver's age significantly correlated with worse ADEMd performance (rho = .637 to .716). This correlation was non-significant in drivers. Similarly, reading hours significantly correlated with better ADEMd performance in non-drivers (rho = - .291 to - .363), but not in drivers. The only significant correlations between ADEMd and UFOV tests were found in drivers (rho = .307 to .410). CONCLUSION Considering all the discussed results, it could be hypothesized that the driving task promotes abilities, such as oculomotor and cognitive function, which are relevant for the performance in the ADEMd. However, this hypothesis is based on correlational outcomes and further studies should causally assess this possible relation.
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Affiliation(s)
- Andrés Gené-Sampedro
- Research Institute on Traffic and Road Safety (INTRAS), University of Valencia, Valencia, Spain
- Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - Francisco Alonso
- Research Institute on Traffic and Road Safety (INTRAS), University of Valencia, Valencia, Spain
- Faculty of Psychology, University of Valencia, Av. Blasco Ibáñez 21, Valencia, 46010, Spain
| | - Javier Gene-Morales
- Research Institute on Traffic and Road Safety (INTRAS), University of Valencia, Valencia, Spain
- Prevention and Health in Exercise and Sport (PHES) research group, Department of Physical Education of Sports, University of Valencia, Valencia, Spain
| | - Pedro Lourenço Monteiro
- Department of Physics, University of Beira Interior, Covilhã, Portugal
- CICS (Health Sciences Research Centre), University of Beira Interior, Covilhã, Portugal
| | - Sergio A Useche
- Research Institute on Traffic and Road Safety (INTRAS), University of Valencia, Valencia, Spain.
- Faculty of Psychology, University of Valencia, Av. Blasco Ibáñez 21, Valencia, 46010, Spain.
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Nisanova A, Barrios L, Chokshi T, Mannis M, Bloch O, Liu YA. A Feasibility Study on a Portable Vision Device for Patients with Stroke and Brain Tumours. Neuroophthalmology 2024; 48:3-12. [PMID: 38357627 PMCID: PMC10863346 DOI: 10.1080/01658107.2023.2273471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024] Open
Abstract
This prospective, single-centre cohort study aimed to evaluate the impact of a portable vision reading device, OrCam Read, on vision-related quality-of-life and independent functional status in patients with low vision due to stroke or brain tumours. Six patients with poor visual acuity or visual field defects due to a stroke or a brain tumour were enrolled at a U.S. Ophthalmology Department. Participants were trained to use OrCam Read and given a loaner device for the 1 month duration of the study. Various assessments, including daily function tests, the National Eye Institute Visual Function Questionnaire-25, and the 10-item neuro-ophthalmic supplement, were administered at the first and last visits. Patients' experience with the device was evaluated with weekly telephone and end-of-study satisfaction surveys. The main outcome measures were the patient satisfaction with OrCam and the mean assessment scores between enrolment and final visits. The intervention with OrCam significantly improved patients' ability to complete daily tasks and participants reported good satisfaction with the device. The results also show non-significant improvement with distant activities, dependency, and role difficulties. Our findings demonstrate the feasibility of studying vision-related quality-of-life using a portable vision device in this patient population and pave the way for a larger study to validate the results of this study.
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Affiliation(s)
- Arina Nisanova
- School of Medicine, University of California, Davis, California, USA
| | - Laurel Barrios
- School of Medicine, University of California, Davis, California, USA
| | - Tanvi Chokshi
- College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Mark Mannis
- Department of Ophthalmology & Vision Science, University of California, Davis, California, USA
| | - Orin Bloch
- Department of Neurological Surgery, University of California, Davis, California, USA
| | - Yin Allison Liu
- Department of Ophthalmology & Vision Science, University of California, Davis, California, USA
- Department of Neurological Surgery, University of California, Davis, California, USA
- Department of Neurology, University of California, Davis, California, USA
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Yoon JM, Lim DH, Lee YB, Han K, Kim BS, Koo HY, Jung SY, Shin DW, Ham DI. The risk of fracture in age-related macular degeneration according to the presence of visual disability: a nationwide cohort study. Eye (Lond) 2024; 38:364-371. [PMID: 37598260 PMCID: PMC10810787 DOI: 10.1038/s41433-023-02699-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 07/18/2023] [Accepted: 08/02/2023] [Indexed: 08/21/2023] Open
Abstract
PURPOSE To evaluate the association between age-related macular degeneration (AMD) with or without visual disability (VD) and the risk of fracture using the National Health Insurance data in South Korea. METHODS In total, 3,894,702 individuals who had taken part in health-screening programs between January 1, 2009, and December 31, 2009, were included in the cohort and followed until December 31, 2019. The participants with VD, which could be related to the severity of AMD, were defined as those with a loss of vision or visual field defect as certified by the Korean government's Ministry of Health and Welfare. The hazard ratio was calculated for groups (control and AMD with/without VD) using the multivariable-adjusted cox regression analysis. RESULTS In total, 466,890 participants (11.99%) were diagnosed with fractures during the study period. An increased risk of fracture was observed in individuals with AMD compared with the control (adjusted hazard ratio (aHR), 1.09, 95% confidence interval (CI), 1.06-1.11). Furthermore, among the AMD individuals, an increased risk of fracture was prominent in individuals with VD (aHR 1.17, 95% CI 1.08-1.27) than those without VD (aHR 1.08, 95% CI 1.06-1.11) compared with the reference group (control). CONCLUSIONS AMD was associated with an increased risk of fracture even without VD. Prevention for fracture should be considered in AMD patients, especially when accompanied by VD.
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Affiliation(s)
- Je Moon Yoon
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Bong Sung Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Hye Yeon Koo
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Se Young Jung
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Office of eHealth Research and Business and Center for Medical Informatics, Seongnam, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
| | - Don-Il Ham
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
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Du Z, Zhang X, Hu Y, Huang Y, Bulloch G, Shang X, Liang Y, Wu G, Wang Y, Xiao Y, Kong H, Lawali DJAM, Hu Y, Zhu Z, Yang X, Yu H. Association of hyperopia with incident clinically significant depression: epidemiological and genetic evidence in the middle-aged and older population. Br J Ophthalmol 2023; 107:1907-1913. [PMID: 36241375 DOI: 10.1136/bjo-2022-321876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2022]
Abstract
AIMS To investigate the association between hyperopia and clinically significant depression (CSD) in middle-aged and older individuals. The effect of genetic determinants of hyperopia on incident CSD was also explored. METHODS We included participants who had available data on mean spherical equivalent (MSE) and were free of depression at baseline from the UK Biobank. For the phenotypic association, hyperopia was defined as MSE of+2.00 dioptres (D) or greater, and was divided into mild, moderate and high groups. Diagnosis of CSD across follow-up was determined based on electronic hospital inpatients records. For the genetic association analysis, the association between hyperopia Polygenic Risk Score and incident CSD was assessed. Mendelian randomisation was assessed for causality association. RESULTS Over a median follow-up of 11.11 years (IQR: 10.92-11.38), hyperopia was significantly associated with incident CSD independent of genetic risk (HR 1.29, 95% CI 1.05 to 1.59) compared with emmetropia participants, especially in those hyperopic patients without optical correction (HR 1.38, 95% CI 1.07 to 1.76). In addition, participants in the high degree of hyperopia were more likely to have incident CSD than participants in the mild degree of hyperopia (P for trend=0.009). Genetic analyses did not show any significant associations between hyperopia and incident CSD (p≥0.1). CONCLUSIONS Hyperopia was significantly associated with an increased risk of incident CSD. This was independent of genetic predisposition to hyperopia, emphasising the importance of regular vision screening and correction of hyperopia to reduce the risk of CSD regardless of genetic risk.
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Affiliation(s)
- Zijing Du
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Xiayin Zhang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yijun Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yu Huang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Gabriella Bulloch
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Xianwen Shang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yingying Liang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Guanrong Wu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yaxin Wang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yu Xiao
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Huiqian Kong
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Dan Jouma Amadou Maman Lawali
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yunyan Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Zhuoting Zhu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Xiaohong Yang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Honghua Yu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Fernández-Vigo JI, Blanco-Darriba D, Etxabe-Avila H, Montolío-Marzo E, Robles-Amor P, Escobar-Moreno MJ, Burgos-Blasco B. Comparative analysis of the quality of life among different retinal diseases. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:633-639. [PMID: 37748684 DOI: 10.1016/j.oftale.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/26/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE To assess the impact on the quality of life (QoL) among different retinal diseases such as diabetic macular edema (DME), retinal vein occlusion (RVO), pathologic myopia (PM), neovascular age-related macular degeneration (nAMD) and central serous chorioretinopathy (CSC). METHODS A cross-sectional study was carried out in 241 patients, affected by DME (n=44), RVO (n=41), PM (n=34) and nAMD (n=85) receiving intravitreal injections due to the presence of macular edema or choroidal neovascularization. The CSC patients included (n=37) were candidates for laser treatment. The patients included completed the National Eye Visual Functioning Questioning-25 (NEI VFQ-25). Best eye visual acuity (BEVA) was recorded using the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. RESULTS There were significant differences between subgroups for all the domains, except for the general vision in which all scores among diseases ranged from 40.7 to 45.2 out of 100 (P=.436), despite the difference in BEVA (CSC: 86.3±11.9; RVO: 78.5±15.5, DME: 73.3±15.2, nAMD: 72.9±12.6 and PM: 68.5±18.1 letters respectively; P<.001). The lowest VFQ-25 total score was observed in the PM patients (52.1±20.9), followed by nAMD (55.3±20.8), RVO (65.0±22.3), DME (68.6±21.0) and CSC (70.9±16.2). The DME group reported the worst score for general health (38.9±21.4). Mental health and role difficulties were lowest for PM (48.2±28.8 and 48.2±31.9, P<.007). CONCLUSIONS This study reveals the differences in the QoL among DME, RVO, nAMD, PM and CSC, describing the different repercussions that they can suffer, observing a higher impact in PM and nAMD.
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Affiliation(s)
- J I Fernández-Vigo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
| | - D Blanco-Darriba
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - H Etxabe-Avila
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - E Montolío-Marzo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - P Robles-Amor
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - M J Escobar-Moreno
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - B Burgos-Blasco
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
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Hamed MM, Masoud MA. An Exploratory Assessment of Self-Reported Satisfaction with Infrastructure and Out-of-Home Activities for People with Vision Impairments. Vision (Basel) 2023; 7:58. [PMID: 37756132 PMCID: PMC10535916 DOI: 10.3390/vision7030058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
PURPOSE The purpose of this study is to assess the satisfaction levels of people with VI with regard to infrastructure and outdoor activities. Furthermore, this study aims to develop an assessment model for the levels of difficulty in using public transport. METHODS Participants in a standardized survey questionnaire included 74 participants with VI. Three assessment-ordered probit models were estimated based on self-reported responses. RESULTS Estimation results revealed that the use of public transport is extremely difficult for 83.47% of older participants. In addition, 84.2% of people with albinism have extreme difficulty using public transport. Furthermore, 53.98% of people with restricted horizontal and vertical fields face extreme difficulty using public transport. There was dissatisfaction with outdoor activities among 97.40% of people with macular disease. The results show that 51.70% of people with normal or near-normal horizontal visual fields and restricted vertical planes are satisfied with their level of outdoor activity while 72.65% of people with retinal diseases expressed dissatisfaction with the existing infrastructure. CONCLUSION This study revealed that the experiences of people with VI are heterogeneous and depend on their eye condition, access to assistive technology, and socioeconomic characteristics. Results clearly show evidence of heterogeneity among individuals with VI. The combination of horizontal and vertical restrictions yields random parameters, underscoring the heterogeneous experiences of people with VI, influenced by their eye condition and access to assistive devices. Our results have important implications for developing targeted interventions to enhance the mobility of people with VI.
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Affiliation(s)
- Mohammad M. Hamed
- Engineering Faculty, Civil Engineering Department, Isra University, Queen Alia International Airport Road, Amman 11118, Jordan
| | - Maisaa A. Masoud
- Vision Rehabilitation Center, German Jordanian University, Amman 11180, Jordan;
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10
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Erginturk Acar D, Batioglu F, Idil A, Sahli E, Goksuluk D. Rehabilitation Methods for Patients with Geographic Atrophy due to Age-Related Macular Degeneration and Effects of Rehabilitation on Quality of Life. J Ophthalmol 2023; 2023:3389750. [PMID: 37455795 PMCID: PMC10349670 DOI: 10.1155/2023/3389750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/30/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose The purpose of the study is to evaluate the low vision rehabilitation methods and to investigate the effect of visual rehabilitation on quality of life in patients with low vision due to geographic atrophy from age-related macular degeneration (ARMD). Methods The better-seeing eye of 78 patients with geographic atrophy due to ARMD were included in the study. Sociodemographic characteristics, ophthalmological examination findings, and preferred low vision aids for near and distant were recorded. Fifty-seven patients who preferred to use a low vision aid device in daily life were considered as a rehabilitation group, whereas 21 patients who did not use any device were considered as a control group. The National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) was applied to all patients at the initial examination and at least 6 months after the initial examination. Results In the rehabilitation group, statistically significant increases were found in the overall composite score, and general vision, near and distance activities, social functioning, mental health, role difficulties, and dependency subscale scores of the NEI-VFQ-25 quality of life scale after low vision rehabilitation (p=0.009 for general vision, p < 0.001; for others). In the control group, there was no statistically significant change in any of the subscale scores or the overall score of the scale (p > 0.05). All patients (n = 78) were recommended to use at least one low vision aid for near vision. Hyperocular glasses were recommended for 77 patients (98.72%), magnifiers for 15 patients (19.23%), electro-optical devices for 2 patients (2.56%), and telemicroscope for one patient (1.28%). Furthermore, 17 patients (21.8%) were prescribed more than one low vision aids. However, for distance vision, only 29 patients (37.18%) received a recommendation for a low vision aid. Conclusions Low vision patients with ARMD-related geographic atrophy should meet with low vision aids as soon as possible and should be included in low vision rehabilitation programs.
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Affiliation(s)
- Damla Erginturk Acar
- Ankara University Graduate Faculty of Health Sciences, Ankara, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Figen Batioglu
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aysun Idil
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Esra Sahli
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Dincer Goksuluk
- Department of Biostatistics, Erciyes University Faculty of Medicine, Kayseri, Turkey
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11
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Lyu Z, Chen Y, Zhu Z, Luo X, Cui Y, Xie J, Chen Z, Liu J, Wu X, Bulloch G, Meng Q. Associations of concomitant retinopathy and depression with mortality in a nationally representative population. J Affect Disord 2023; 336:15-24. [PMID: 37211053 DOI: 10.1016/j.jad.2023.05.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To evaluate the interaction effects between retinopathy and depression on mortality risks in genral population and subpopulation with diabetes. METHODS Prospective analyses were conducted on data from the National Health and Nutrition Examination Surveys study. Associations of retinopathy, depression and their interaction with all-cause, cardiovascular disease (CVD)-specific, cancer-specific and other-specific mortality risk were estimated using Kaplan-Meier curves and multivariate Cox proportional hazards models. RESULTS Among 5367 participants, the weighted prevalence of retinopathy and depression was 9.6 % and 7.1 %, respectively. After a follow-up period of 12.1 years, 1295 deaths (17.3 %) occurred. Retinopathy was associated with an increased risk of all-cause (hazard ratio [HR]; 95 % confidence interval [CI]) (1.47; 1.27-1.71), CVD-specific (1.87; 1.45-2.41), and other-specific (1.43; 1.14-1.79) mortality. Similar relationship was observed between depression and all-cause mortality (1.24; 1.02-1.52). Retinopathy and depression had a positive multiplicative and additive interaction effect on all-cause (Pinteraction = 0.015; relative excess risk of interaction [RERI] 1.30; 95 % CI 0.15-2.45) and CVD-specific mortality (Pinteraction = 0.042; RERI 2.65; 95 % CI -0.12-5.42). Concomitant retinopathy and depression was more markedly associated with all-cause (2.86; 1.91-4.28), CVD-specific (4.70; 2.57-8.62), and other-specific mortality risks (2.18; 1.14-4.15) compared to those without retinopathy and depression. These associations were more pronounced in the diabetic participants. CONCLUSIONS The co-occurrence of retinopathy and depression increases the risk of all-cause and CVD-specific mortality among middle-aged and older adults in the United States, especially in population with diabetes. Focus on diabetic patients and active evaluation and intervention of retinopathy with depression may improve their quality of life and mortality outcomes.
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Affiliation(s)
- Zheng Lyu
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, China; Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yilin Chen
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, China; Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Zhuoting Zhu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Xiaoyang Luo
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying Cui
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jie Xie
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhifan Chen
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Junbin Liu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiyu Wu
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, China; Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Gabrella Bulloch
- Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Qianli Meng
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, China; Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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12
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Piri N, Kaplan HJ. Role of Complement in the Onset of Age-Related Macular Degeneration. Biomolecules 2023; 13:biom13050832. [PMID: 37238702 DOI: 10.3390/biom13050832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Age-related macular degeneration (AMD) is a progressive degenerative disease of the central retina and the leading cause of severe loss of central vision in people over age 50. Patients gradually lose central visual acuity, compromising their ability to read, write, drive, and recognize faces, all of which greatly impact daily life activities. Quality of life is significantly affected in these patients, and there are worse levels of depression as a result. AMD is a complex, multifactorial disease in which age and genetics, as well as environmental factors, all play a role in its development and progression. The mechanism by which these risk factors interact and converge towards AMD are not fully understood, and therefore, drug discovery is challenging, with no successful therapeutic attempt to prevent the development of this disease. In this review, we describe the pathophysiology of AMD and review the role of complement, which is a major risk factor in the development of AMD.
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Affiliation(s)
- Niloofar Piri
- Department of Ophthalmology, School of Medicine, Saint Louis University, St. Louis, MO 63104, USA
| | - Henry J Kaplan
- Departments of Ophthalmology and Biochemistry & Molecular Biology, School of Medicine, Saint Louis University, St. Louis, MO 63104, USA
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13
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Kassew T, Tilahun SY, Alemayehu BF, Getnet B, Demilew D, Tarekegn GE, Alemu K, Yesuf YM, Oumer M, Mehari EA, Melkam M, Nenko G. Psychotic symptoms and its associated factors relating to psychoactive substance use among the youth population in Northwest Ethiopia. Front Psychiatry 2023; 14:1045111. [PMID: 37215660 PMCID: PMC10196362 DOI: 10.3389/fpsyt.2023.1045111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 04/11/2023] [Indexed: 05/24/2023] Open
Abstract
Background Substance use is associated with high rates of psychiatric symptoms including psychotic symptoms. Despite the severity of the problem, there are intervention gaps in Ethiopia. To combat this, relevant evidence is required to raise the awareness of service providers. This study aimed to assess the prevalence of psychotic symptoms and its associated factors among the youth population who uses psychoactive substances in the Central Gondar Zone, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted among the youth population in the Central Gondar zone, Northwest Ethiopia, from 01 January to 30 March 2021. A multistage sampling technique was used to recruit the study participants. All data were collected using questionnaires assessing socio-demographic; family-related variables; Depression, Anxiety, and Stress Scale; Multidimensional Scale Perceived Social Support (MSPSS), and Self-Reporting Questionnaire (SRQ-24). The data were analyzed using the STATA 14 statistical program. Results A total of 372 young people who used psychoactive substances (79.57%, 53.49%, 34.14%, and 16.13% were consuming alcohol, Khat, tobacco/cigarette products, and other substances such as shisha, inhalants, and drugs, respectively) were included in the study. The prevalence of psychotic symptoms was 24.2% with a 95% CI: 20.1, 28.8. Being married [AOR = 1.87 95% CI: 1.06, 3.48], recent loss of loved ones [AOR = 1.97 95% CI: 1.10, 3.18], low perceived social support [AOR = 1.61 95% CI: 1.11, 3.02], and severe psychological distress [AOR = 3.23 95% CI; 1.64, 6.54] were the factors associated with psychotic symptoms among young people with psychoactive substances use at a p-value of < 0.05. Conclusion Psychotic symptoms related to psychoactive substances among the youth population in Northwest Ethiopia were high. Thus, it is better to give a special attention to the youth population with low social support and existing psychological distress concurrent with psychoactive substance use.
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Affiliation(s)
- Tilahun Kassew
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sewbesew Yitayih Tilahun
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Biruk Fanta Alemayehu
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhanie Getnet
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Demeke Demilew
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebrekidan Ewnetu Tarekegn
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yassin Mohammed Yesuf
- Department of Psychology, College of Social Science and Humanities, University of Gondar, Gondar, Ethiopia
| | - Mohammed Oumer
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eden Abetu Mehari
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health, Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Goshu Nenko
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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14
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Purola P, Kaarniranta K, Ojamo M, Gissler M, Uusitalo H. Visual impairment due to age-related macular degeneration during 40 years in Finland and the impact of novel therapies. Acta Ophthalmol 2023; 101:57-64. [PMID: 35912685 PMCID: PMC10087211 DOI: 10.1111/aos.15224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/19/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE To evaluate the changes in visual impairment (VI) due to age-related macular degeneration (AMD) during the past 40 years and the impact of novel therapies at population level. METHODS In this nationwide register-based study, we assessed the incidence, prevalence, severity, and onset age of VI due to AMD based on the Finnish Register of Visual Impairment data from 1980 to 2019. Our data included 30 016 visually impaired persons with AMD as the main diagnosis for VI. The number of persons treated with intravitreal injections in Finland was obtained from hospital data kept by the Finnish Institute for Health and Welfare. RESULTS Between the 1980s and the 2010s, the incidence of reported VI doubled; however, this increase has stagnated in the 2010s. Since 2012, the prevalence of reported VI has decreased. The number of patients treated with intravitreal injections showed a 40-fold increase during 2005-2019. The severity of reported VI has decreased whereas the mean age at the onset of reported VI has increased during the 40 years. The age-adjusted incidence and prevalence of reported VI were significantly higher in females in comparison to males in all decades. CONCLUSION Increase in the incidence and prevalence of VI due to AMD in the past decades has stagnated and shifted to older age in the 2010s when therapies for exudative class became commonly available. Furthermore, the prognosis of VI has improved during the past 40 years. These positive trends are likely contributable to improved diagnostic tools, earlier diagnoses, and new therapy options.
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Affiliation(s)
- Petri Purola
- SILK, Department of Ophthalmology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Finnish Register of Visual Impairment, Finnish Federation of the Visually Impaired, Helsinki, Finland
| | - Kai Kaarniranta
- Department of Ophthalmology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Matti Ojamo
- Finnish Register of Visual Impairment, Finnish Federation of the Visually Impaired, Helsinki, Finland
| | - Mika Gissler
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland.,Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Hannu Uusitalo
- SILK, Department of Ophthalmology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Finnish Register of Visual Impairment, Finnish Federation of the Visually Impaired, Helsinki, Finland.,Tays Eye Centre, Tampere University Hospital, Tampere, Finland
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15
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Luo Y, Liu J, Feng W, Lin D, Song G, Chen M, Zheng H. Use of β‑blockers and risk of age‑related macular degeneration among hypertensive patients: An insight from The National Health and Nutrition Examination Survey. MEDICINE INTERNATIONAL 2023; 3:10. [PMID: 36793623 PMCID: PMC9922801 DOI: 10.3892/mi.2023.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Although age-related macular degeneration (AMD) is the leading cause of legal blindness, the treatment methods for AMD are limited. The aim of the present study was to examine the association between oral β-blockers (BBs) and the risk of developing AMD among hypertensive patients. For this purpose, a total of 3,311 hypertensive patients from the National Health and Nutrition Examination Survey were included in the study. The use of BBs and treatment duration data were collected using a self-reported questionnaire. AMD was diagnosed by gradable retinal images. Multivariate-adjusted survey-weighted univariate logistic regression was used to confirm the association between the use of BBs and the risk of developing AMD. The results revealed that the use of BBs exerted a beneficial effect (odds ratio (OR), 0.34; 95% confidence interval (95% CI, 0.13-0.92; P=0.04) in late-stage AMD in the multivariate adjusted model. When the BBs were classified into non-selective BBs and selective BBs, the protective effect in late-stage AMD was still observed in the non-selective BBs (OR, 0.20; 95% CI, 0.07-0.61; P<0.001). After accounting for treatment duration, long-term treatment with BBs (>6 years) was also found to reduce the risk of late-stage AMD (OR, 0.13; 95% CI, 0.03-0.63; P=0.01). In late-stage AMD, the long-term use of BBs was beneficial for geographic atrophy (OR, 0.07; 95% CI, 0.02-0.28; P<0.001). On the whole, the present study demonstrates that the use of non-selective BBs exerted a beneficial effect against the risk of late-stage AMD among hypertensive patients. Long-term treatment with BBs was also associated with lower risk of developing AMD. These findings may provide novel strategies for the management and treatment of AMD.
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Affiliation(s)
- Yili Luo
- Department of Ophthalmology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
| | - Jianpeng Liu
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Wangqiang Feng
- Department of Ophthalmology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
| | - Da Lin
- Department of Ophthalmology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
| | - Guangwei Song
- Department of Ophthalmology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
| | - Mengji Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
| | - Haihua Zheng
- Department of Ophthalmology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
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16
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Klauke S, Sondocie C, Fine I. The impact of low vision on social function: The potential importance of lost visual social cues. JOURNAL OF OPTOMETRY 2023; 16:3-11. [PMID: 35568628 PMCID: PMC9811370 DOI: 10.1016/j.optom.2022.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/09/2022] [Accepted: 03/06/2022] [Indexed: 05/06/2023]
Abstract
Visual cues usually play a vital role in social interaction. As well as being the primary cue for identifying other people, visual cues also provide crucial non-verbal social information via both facial expressions and body language. One consequence of vision loss is the need to rely on non-visual cues during social interaction. Although verbal cues can carry a significant amount of information, this information is often not available to an untrained listener. Here, we review the current literature examining potential ways that the loss of social information due to vision loss might impact social functioning. A large number of studies suggest that low vision and blindness is a risk factor for anxiety and depression. This relationship has been attributed to multiple factors, including anxiety about disease progression, and impairments to quality of life that include difficulties reading, and a lack of access to work and social activities. However, our review suggests a potential additional contributing factor to reduced quality of life that has been hitherto overlooked: blindness may make it more difficult to effectively engage in social interactions, due to a loss of visual information. The current literature suggests it might be worth considering training in voice discrimination and/or recognition when carrying out rehabilitative training in late blind individuals.
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Affiliation(s)
| | - Chloe Sondocie
- Department of Psychology, University of Washington, Seattle, USA
| | - Ione Fine
- Department of Psychology, University of Washington, Seattle, USA.
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17
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Cloutier M, DeLucia PR. Topical Review: Impact of Central Vision Loss on Navigation and Obstacle Avoidance while Walking. Optom Vis Sci 2022; 99:890-899. [PMID: 36594757 PMCID: PMC9813875 DOI: 10.1097/opx.0000000000001960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
SIGNIFICANCE Individuals with central vision loss are at higher risk of injury when walking and thus may limit trips outside the home. Understanding the mobility challenges associated with central vision loss (CVL) can lead to more effective interventions.A systematic literature review focusing on mobility in CVL was conducted. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, 2424 articles were identified in 4 databases (PsycINFO, APA PsycArticles, PubMed, and Web of Science). To be included within this review, the study methodology needed to be related to the three components of walking: (1) navigation, defined as the ability to reach a target destination; (2) obstacle avoidance, defined as the ability to avoid collisions with obstacles located at various heights and directions; and (3) street crossing, defined as the ability to both navigate a path and avoid collisions in a traffic environment. The methodology also needed to be empirical. Case studies, unstructured observational studies, studies based on self-report, research proposals, and existing systematic reviews were excluded. Titles, abstracts, and full text of identified articles were screened, yielding 26 articles included in the review. Results showed that, in many tasks, individuals with CVL can accomplish a level of performance comparable with individuals with normal vision. Differences between normal and impaired vision were due to either age or how the groups completed the task. For example, individuals with CVL could cross a street successfully but did so less safely (i.e., smaller safety margins) than individuals with normal vision. To identify new interventions for CVL, future research should focus on the differences in the mechanisms underlying mobility between individuals with normal and impaired vision rather than solely on performance differences.
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Affiliation(s)
- Melissa Cloutier
- Department of Psychological Sciences, Rice University, Houston, Texas
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18
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Rausch-Koster TP, Luijten MAJ, Verbraak FD, van Rens GHMB, van Nispen RMA. Optimizing Computer Adaptive Test Performance: A Hybrid Simulation Study to Customize the Administration Rules of the CAT-EyeQ in Macular Edema Patients. Transl Vis Sci Technol 2022; 11:14. [DOI: 10.1167/tvst.11.11.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- T. Petra Rausch-Koster
- Amsterdam UMC location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Aging and Later Life, Amsterdam, the Netherlands
- Bergman Clinics, Department of Ophthalmology, Naarden, the Netherlands
| | - Michiel A. J. Luijten
- Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, the Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Epidemiology & Data Science, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health & Methodology, Amsterdam the Netherlands
- Amsterdam Reproduction & Development, Child Development, Amsterdam, the Netherlands
| | - Frank D. Verbraak
- Amsterdam UMC location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Aging and Later Life, Amsterdam, the Netherlands
| | - Ger H. M. B. van Rens
- Amsterdam UMC location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Aging and Later Life, Amsterdam, the Netherlands
| | - Ruth M. A. van Nispen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Aging and Later Life, Amsterdam, the Netherlands
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19
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Zhang X, Shang X, Seth I, Huang Y, Wang Y, Liang Y, Du Z, Wu G, Hu Y, Liu S, Hu Y, He M, Zhu Z, Yang X, Yu H. Association of Visual Health With Depressive Symptoms and Brain Imaging Phenotypes Among Middle-Aged and Older Adults. JAMA Netw Open 2022; 5:e2235017. [PMID: 36201210 PMCID: PMC9539722 DOI: 10.1001/jamanetworkopen.2022.35017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Vision loss and depression are common conditions with major health implications. However, mechanisms of the association of visual health (across the full acuity spectrum) with depression remain unclear. OBJECTIVE To characterize the association between visual health and depression and investigate the association between depression and brain microstructure and macrostructure in subgroups divided by visual acuity. DESIGN, SETTING, AND PARTICIPANTS In the UK Biobank Study cohort, 114 583 volunteers were included at baseline from March to June 2006 to July 2010. Habitual distance visual acuity was examined using the logarithm of the minimum angle of resolution (LogMAR) characters. Depression was identified based on Patient Health Questionnaire (PHQ) or through an interview-based psychiatric diagnosis. Subgroup participants completed multimodal magnetic resonance imaging (MRI) of the brain and PHQ evaluation during the imaging visit after 2014. Data were analyzed from May 5 to August 9, 2022. MAIN OUTCOMES AND MEASURES Depression, depressive symptoms, and imaging-derived phenotypes from T1-weighted and diffusion MRI. RESULTS Of the 114 583 participants from the UK Biobank Study, 62 401 (54.5%) were women, and the mean (SD) age was 56.8 (8.1) years (range, 39-72 years). A 1-line worse visual acuity (0.1 LogMAR increase) was associated with 5% higher odds of depression (odds ratio, 1.05 [95% CI, 1.04-1.07]) after adjustment for age, sex, race and ethnicity, Townsend index, educational qualifications, smoking, alcohol consumption, obesity, physical activity, history of hypertension, diabetes, hyperlipidemia, and family history of depression. Of the 7844 participants eligible for MRI analysis, there were linear associations between PHQ score and the left volume of gray matter in supracalcarine cortex (coefficient, 7.61 [95% CI, 3.90-11.31]) and mean isotropic volume fraction (ISOVF) in the right fornix (cres) and/or stria terminalis (coefficient, 0.003 [95% CI, 0.001-0.004]) after correction for multiple comparison. In addition, their association could be moderated by visual acuity, whereby increased PHQ score was associated with higher ISOVF levels only among those with poorer visual acuity (P = .02 for interaction). CONCLUSIONS AND RELEVANCE This study suggests an association between visual health and depression and that the diffusion characteristic of ISOVF in the fornix (cres) and/or stria terminalis is associated with depressive symptoms in participants with poorer visual acuity.
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Affiliation(s)
- Xiayin Zhang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianwen Shang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ishith Seth
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Yu Huang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yaxin Wang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yingying Liang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zijing Du
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guanrong Wu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yunyan Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shunming Liu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yijun Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Mingguang He
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhuoting Zhu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Xiaohong Yang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Honghua Yu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Intérêt du dépistage systématique des affects dépressifs et du syndrome de Charles–Bonnet chez les patients atteints de DMLA. J Fr Ophtalmol 2022; 45:1069-1078. [DOI: 10.1016/j.jfo.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022]
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Xie R, Wang B, Zuo S, Du M, Wang X, Yu Y, Yan H. Protective effects of CRTH2 suppression in dry age-related macular degeneration. Biochem Biophys Res Commun 2022; 624:8-15. [DOI: 10.1016/j.bbrc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/30/2022] [Accepted: 07/02/2022] [Indexed: 11/27/2022]
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22
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Suárez Escudero JC, Oviedo Cáceres MDP, Llano Naranjo Y, Arias Uribe J, Villegas Mesa JD, Zapata Vásquez MC, Ferreira Morales JL, Reyes Cisneros JT, Cano Calle K, Goldfeder de Gracia S, González Franco JF, Astudillo Valverde E. Etiología de baja visión y ceguera en siete centros de referencia en Colombia entre los años 2012 a 2017. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: la baja visión y la ceguera tienen alta prevalencia mundial, siendo categorías de discapacidad frecuentes en Colombia. Se requieren estudios que caractericen la etiología de las deficiencias visuales permanentes. Objetivo: Identificar y caracterizar las diferentes causas de baja visión y ceguera en siete centros de referencia para la población con discapacidad visual en Colombia, atendida entre los años 2012 a 2017 en seis ciudades capitales. Materiales y métodos: estudio retrospectivo, serie de casos, descriptivo y multicéntrico. Resultados: Se contó con una muestra de 879 registros de pacientes con discapacidad visual. El 70% (612/879) con baja visión y 30% (267/879) con ceguera. Para todos los grupos de edad es más prevalente la baja visión. La etiología más frecuente en pacientes con baja visión fue la degeneración macular asociada a la edad (DMAE) (24%, 144/612); en pacientes con ceguera fue el glaucoma (17%, 45/267). Discusión: Posiblemente en Colombia las causas de baja visión y ceguera van más allá de las cataratas, errores de refracción no corregidos y ceguera infecciosa. Conclusiones: las etiologías más frecuentes encontradas son condiciones oculares crónicas y diversas, que requieren intervenciones específicas para disminuir su prevalencia y prevenir casos de baja visión y ceguera.
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Tanner CT, Caserta MS, Clayton MF, Kleinshcmidt JJ, Bernstein PS, Guo JW. Posttraumatic Growth Among Older Adults With Age-Related Macular Degeneration. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2022. [DOI: 10.1177/0145482x221108983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: The term “post-traumatic growth” describes positive outcomes that accrue from the struggle with highly challenging life circumstances. The purpose of this study is to describe post-traumatic growth accruing from experience with vision loss caused by age-related macular degeneration (AMD) and to identify the relationships between depression, cognitive processing, social support, and post-traumatic growth. Methods: Individuals with vision loss caused by AMD completed an interviewer-administered composite questionnaire to identify elements of Tedeschi and Calhoun’s theoretical model of the process of posttraumatic growth, including measures of distress (depression), intrusive and deliberate rumination (cognitive processing), and social support (quality and quantity of social ties). Relationships were examined using path analysis. Results: Eighty-nine participants completed the questionnaire (mean age = 85.3 years, range = 74–98 years). All paths, including from depression to social support (β = –.363, p < .001), from social support to deliberate rumination (β = .233; p ≤ .01), and from intrusive rumination to deliberate rumination (β = .514, p < .01), were significant and consistent with the posttraumatic growth theoretical model. Deliberate rumination had a significant direct path to post-traumatic growth (β = .38, p = .001). Discussion: The findings may illuminate elements of the process of post-traumatic growth among those with AMD. We found that as social support increased, depression decreased. Increased social support seemed to encourage positive deliberate rumination, which led directly to post-traumatic growth. Although intrusive rumination is often associated with negative outcomes, the model demonstrates that it also stimulates engagement in deliberate attempts to process one’s experience. Deliberate cognitive processing is a direct precursor to post-traumatic growth. Implications for Practitioners: A focus on the process of growth and thriving can offer a broader view of the experience of living with vision loss. Interventions that foster post-traumatic growth among those with AMD should focus on enhancing social support and facilitating deliberate cognitive processing.
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Affiliation(s)
| | - Michael S. Caserta
- Gerontology Interdisciplinary Program, College of Nursing, University of Utah, Salt Lake City, UT, USA
| | | | - Julia J. Kleinshcmidt
- Visual and Ophthalmological Sciences, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Paul S. Bernstein
- Visual and Ophthalmological Sciences, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jia-Wen Guo
- Gerontology Interdisciplinary Program, College of Nursing, University of Utah, Salt Lake City, UT, USA
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Bachmann BC, Bachofner M, Mickan S, Stojcic D, Carnier KA, Giamboni A, Neugebauer Z, Lienhard KR, Bachmann LM. Frequency of Eye Diseases in Residents of Nursing Homes - 1-Year Results of a Novel Telemedicine Service in Switzerland. Klin Monbl Augenheilkd 2022; 239:610-614. [PMID: 35472817 DOI: 10.1055/a-1778-4782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE For the elderly in nursery homes, a visit to the ophthalmologist is a burden, which might lead to undertreatment. We have recently started offering a novel ophthalmological service combining onsite examination and telemedical interpretation for patients with limited access to ophthalmological care. This study summarises the frequency of findings of treatable eye diseases after the first year of operation in participants who dropped out from regular ophthalmological control. METHODS Participants' clinical characteristics, frequency of service utilisation, and findings were extracted from the system and analysed. RESULTS Of 1946 residents approached, 540 (27.7%; 1080 eyes) signed up for the service. A complete examination was possible in 412 persons (813 eyes) and partially possible in the remaining 128. The mean age of the examined participants mean age was 83.9 years (SD 9.7), and they were predominantly female (69.8%). The majority had a diagnosis of dementia (54.5%) and 20.2% had diabetes mellitus requiring treatment. The median care level (ranging from 0 - 12) was 7 (interquartile range 6 - 9), corresponding to a care need of 121 - 140 min/d. The mean best-corrected decimal visual acuity was 0.55 (SD 0.24). For 164 eyes (15.2%), the current spectacle correction was insufficient. An untreated cataract was present in 145 eyes (13.4%), 89 eyes (8.2%) were receiving glaucoma treatment, and 7 eyes had a decompensated glaucoma. Dry age-related macular degeneration (AMD) appeared in 276 eyes (25.6%), 12 eyes (1.1%) had wet AMD, and 24 eyes (11.0%) among patients with diabetes showed signs of diabetic retinopathy. Other pathologies were uncommon. CONCLUSION Residents of nursery homes, who are unable to attend regular ophthalmological control, show various treatable ophthalmological conditions, including cataracts, glaucoma, and retinal pathologies. Screening with a novel telemedicine service allows for the identification of treatable conditions and careful planning and referral of patients to appropriate clinics having the necessary infrastructure for this particular population.
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Affiliation(s)
| | | | - Sandra Mickan
- Mobile Messungen, Augenmobil AG, Zürich, Zürich, Switzerland
| | - Danica Stojcic
- Mobile Messungen, Augenmobil AG, Zürich, Zürich, Switzerland
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Rausch-Koster TP, Luijten MAJ, Verbraak FD, van Rens GHMB, van Nispen RMA. Calibration of the Dutch EyeQ to Measure Vision Related Quality of Life in Patients With Exudative Retinal Diseases. Transl Vis Sci Technol 2022; 11:5. [PMID: 35380613 PMCID: PMC8994198 DOI: 10.1167/tvst.11.4.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose This study aims to develop an item-bank to measure vision-related quality of life (Vr-QoL) and subsequently calibrate this set of items. Methods Three Vr-QoL instruments were searched for suitable items to be added in the EyeQ. Patients who received antivascular endothelial growth factor treatment for various retinal diseases involving macular edema were included in the study and completed the 47-item EyeQ. Item response theory (IRT) was used to calibrate the EyeQ items, which was performed multiple times in subsets as a novel approach, containing 80% of the data. Differential item functioning (DIF) was evaluated for various variables. Results Responses of 704 patients were used in analysis. One item violated the local independence IRT-assumption and showed a high percentage of missing values, after which this item was deleted from the item-bank. The data of the five subsets fitted the graded response model adequately, and no DIF was detected for items between subsets, after which mean item parameters were calculated. Item fit statistics were found to be good. DIF was detected for gender, age, and administration mode by the patient (independently vs. with help), this involved three items, which all showed negligible impact on total scores. Conclusions Because of separate calibrations of the EyeQ in multiple subsets, a high robustness of item parameters is expected. Translational Relevance The calibrated EyeQ can now be used for the assessment of Vr-QoL in patients suffering from exudative retinal diseases and is promising for use as a computer adaptive test.
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Affiliation(s)
- T Petra Rausch-Koster
- Amsterdam UMC, Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Bergman Clinics, Department of Ophthalmology, The Netherlands
| | - Michiel A J Luijten
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - F D Verbraak
- Amsterdam UMC, Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ger H M B van Rens
- Amsterdam UMC, Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ruth M A van Nispen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Comparison of Vision-related Quality of Life between Normal Tension Glaucoma and Primary Open Angle Glaucoma. J Glaucoma 2022; 31:322-328. [DOI: 10.1097/ijg.0000000000002007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 01/30/2022] [Indexed: 11/27/2022]
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Exudative versus Nonexudative Age-Related Macular Degeneration: Physiopathology and Treatment Options. Int J Mol Sci 2022; 23:ijms23052592. [PMID: 35269743 PMCID: PMC8910030 DOI: 10.3390/ijms23052592] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 02/01/2023] Open
Abstract
Age-related macular degeneration (AMD) is an eye disease typically associated with the aging and can be classified into two types—namely, the exudative and the nonexudative AMD. Currently available treatments for exudative AMD use intravitreal injections, which are associated with high risk of infection that can lead to endophthalmitis, while no successful treatments yet exist for the nonexudative form of AMD. In addition to the pharmacologic therapies administered by intravitreal injection already approved by the Food and Drug Administration (FDA) in exudative AMD, there are some laser treatments approved that can be used in combination with the pharmacological therapies. In this review, we discuss the latest developments of treatment options for AMD. Relevant literature available from 1993 was used, which included original articles and reviews available in PubMed database and also information collected from Clinical Trials Gov website using “age-related macular degeneration” and “antiangiogenic therapies” as keywords. The clinical trials search was limited to ongoing trials from 2015 to date.
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Association Between Visual Impairment and Health Care Use. Am J Ophthalmol 2022; 234:166-173. [PMID: 34407430 DOI: 10.1016/j.ajo.2021.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 06/04/2021] [Accepted: 07/31/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the association between visual impairment (VI) and medical care use. DESIGN Population-based cohort study. METHODS The study cohort included individuals from 2007 to 2017. The Disability Registry was used to identify all patients aged ≥20 years who newly developed visual disability. All patients were observed until they became visually impaired (case group). They were then matched with 2 control groups: (1) people with nonvisual disability and (2) people without any disability. The main outcome measures were (1) ophthalmic outpatient and inpatient use and (2) nonophthalmic outpatient and inpatient use. RESULTS Compared with people with nonvisual disability, those with visual disability demonstrated a lower nonophthalmic outpatient costs (-NT$42,841, P < .001) and outpatient visits (-2.8 times). However, the opposite was noted for ophthalmic use, where people with visual disability used more medical care compared with people with other types of disability and people without disability. An age-stratified analysis revealed that visual disabilities had an age-related dose-response effect on the reception of nonophthalmic care and a slight nonlinear effect on the receipt of ophthalmic care. CONCLUSIONS Studies investigating the effect of VI on medical use should differentiate aggregate use into different types. Use of ophthalmic and nonophthalmic care for people with VI should be compared with that of people with other types of disability and people without disability.
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White UE, Black AA, Delbaere K, Wood JM. Longitudinal Impact of Vision Impairment on Concern About Falling in People With Age-Related Macular Degeneration. Transl Vis Sci Technol 2022; 11:34. [PMID: 35077531 PMCID: PMC8802008 DOI: 10.1167/tvst.11.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To explore the longitudinal impact of central vision loss on concern about falling (CF), over a 12-month period, in people with age-related macular degeneration (AMD). Methods Participants included 60 community-dwelling older people (age, 79.7 ± 6.4 years) with central vision impairment due to AMD. Binocular high-contrast visual acuity, contrast sensitivity, and visual fields were assessed at baseline and at 12 months. CF was assessed at both time points using the Falls Efficacy Scale–International (FES-I). Sensorimotor function (sit to stand, knee extension, postural sway, and walking speed) and neuropsychological function (reaction time, symptoms of anxiety and depression) were also assessed at both time points using validated instruments. Falls data were collected using monthly diaries during the 12 months. Results CF increased by a small but significant amount over the 12-month follow-up (2.1 units; P = 0.01), with increasing prevalence of high levels of CF (FES-I score ≥ 23), from 48% at baseline to 65% at 12 months. Linear mixed models showed that reduced contrast sensitivity was significantly associated with increased concern about falling (P= 0.004), whereas declines in both visual acuity and contrast sensitivity during the follow-up period were associated with increases in CF over the 12-month follow-up (P = 0.041 and P = 0.054, respectively), independent of age, gender, falls history, or number of comorbidities. Conclusions Higher levels of CF are common in older people with AMD, and levels increase over time; this increase is associated with declines in both visual acuity and contrast sensitivity. These findings highlight the need for regular assessment of both visual acuity and contrast sensitivity to identify those at greatest risk of developing higher CF. Translational Relevance Routine assessment of visual acuity and contrast sensitivity in older people with AMD will assist in identifying those at risk of developing high CF.
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Affiliation(s)
- Ursula E White
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - Alex A Black
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia.,School of Public Health and Community Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Joanne M Wood
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
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Agrawal Y, Van de Berg R, Wuyts F, Walther L, Magnusson M, Oh E, Sharpe M, Strupp M. Presbivestibulopatía: criterios diagnósticos. Documento de consenso del Comité de Clasificación de la Bárány Society. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022. [DOI: 10.1016/j.otorri.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hilal A, Bazarah M, Kapoula Z. Benefits of Implementing Eye-Movement Training in the Rehabilitation of Patients with Age-Related Macular Degeneration: A Review. Brain Sci 2021; 12:36. [PMID: 35053780 PMCID: PMC8774007 DOI: 10.3390/brainsci12010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/18/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Abstract
Age-related macular degeneration (ARMD) is one of the most debilitating eye-related illnesses worldwide. Eye-movement training is evolving to be a non-invasive, rapid, and effective method that is positively impacting vision and QoL (quality of life) in patients suffering from ARMD. This review aims to highlight why a greater adoption of eye-movement training in the clinical and research setting is of importance. A PubMed and ResearchGate search was performed for articles published between 1982 and 2020. Patients with advanced ARMD tend to experience a diminished QoL. Studies regarding eye-movement training for patients with central vision loss revealed overall significant improvements in reading speeds, fixation, and saccade performance. They also experienced less fatigue. In select studies, eye-movement training revealed an improvement in binocular vision, fixation, reading speed, and diminished reading exhaustion. The process of eye-movement training used in some of the studies was rather empirical. The latter requires standardization so that a uniform and applicable methodology can be adopted overall.
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Affiliation(s)
- Anis Hilal
- Department of Ophthalmology, Skåne University Hospital, Kioskgatan 1, 22285 Lund, Sweden
- Laboratoire IRIS, Physiopathologie de la Vision et Motricité Binoculaire, CNRS FR2022 UFR Biomédicale Université de Paris 45, rue des Saints-Pères, 75006 Paris, France
| | - Mazen Bazarah
- Department of Ophthalmology, Skåne University Hospital, Kioskgatan 1, 22285 Lund, Sweden
| | - Zoï Kapoula
- Laboratoire IRIS, Physiopathologie de la Vision et Motricité Binoculaire, CNRS FR2022 UFR Biomédicale Université de Paris 45, rue des Saints-Pères, 75006 Paris, France
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Torres RJDA, Ferreira ALDA. Age-related macular degeneration: an overview. REVISTA BRASILEIRA DE OFTALMOLOGIA 2021. [DOI: 10.37039/1982.8551.20210038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Arruda JSD, Tibúrcio JD, de Campos-Carli SM, Teixeira AL, Vasconcelos-Santos DV. Vision-Related Quality Of Life And Depression In Brazilian Patients With Toxoplasmic Retinochoroiditis. Int J Infect Dis 2021; 112:66-72. [PMID: 34478868 DOI: 10.1016/j.ijid.2021.08.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/19/2021] [Accepted: 08/21/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To investigate visual-related quality of life (VRQL) and prevalence and severity of depressive symptoms in Brazilian individuals with toxoplasmic retinochoroiditis (TRC). DESIGN Comparative observational cross-sectional study. The National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) and Beck Depression Inventory-II (BDI-II) were applied to respectively assess VRQL and depression in individuals consecutively seen at a uveitis referral center. Clinical/demographical data were collected. Descriptive/analytic statistics were employed, with P<0.05. RESULTS Patients and controls were comparable concerning age, sex and socioeconomic level. VRQL scores for all subscales were significantly lower in TRC when compared with controls, particularly associated (P<0.05) with female sex, history of ≥2 prior TRC recurrences, concomitant use of systemic corticosteroids, monocular vision and blindness. Depressive symptoms were more prevalent in TRC (55/188; 29.2%) than in controls (34/182; 18.7%) (P=0.023), also being associated with lower VRQL scores (P<0.001). Seropositive and seronegative controls for toxoplasmosis had similar VRQL scores and comparable rates of depressive symptoms. CONCLUSION TRC affects VRQL in Brazilian individuals, particularly women, using systemic corticosteroids, with visual impairment and presenting recurrences of TRC. One-third of patients with TRC had evidence of depression, which was also associated with lower VRQL scores. Mental health issues in subjects with TRC should not be overlooked.
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Affiliation(s)
- Jacqueline Souza Dutra Arruda
- Department of Ophthalmology, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Programa de Pós-Graduação em Ciências Aplicadas à Cirurgia e à Oftalmologia, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Salvina Maria de Campos-Carli
- Programa Pós-Graduação em Neurociências, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Antônio Lucio Teixeira
- Programa Pós-Graduação em Neurociências, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas, Houston, USA
| | - Daniel Vitor Vasconcelos-Santos
- Department of Ophthalmology, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Programa de Pós-Graduação em Ciências Aplicadas à Cirurgia e à Oftalmologia, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Almony A, Keyloun KR, Shah-Manek B, Multani JK, McGuiness CB, Chen CC, Campbell JH. Clinical and economic burden of neovascular age-related macular degeneration by disease status: a US claims-based analysis. J Manag Care Spec Pharm 2021; 27:1260-1272. [PMID: 34464210 PMCID: PMC10391196 DOI: 10.18553/jmcp.2021.27.9.1260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND: New treatment alternatives have revolutionized the management of nAMD. However, there is limited evidence on the clinical and economic burden of nAMD in commercially insured US patients. OBJECTIVES: To examine the clinical and economic burden in patients with nAMD by disease status in the commercially insured US patient population and to identify drivers of nAMD-related costs. METHODS: Patients with at least 1 International Classification of Diseases, 10th Revision Clinical Modification (ICD-10-CM) diagnosis for nAMD were identified from the IQVIA PharMetrics Plus database between April 2016 and August 2017 (index period). Patients had continuous enrollment for at least 6 months before and at least 12 months after the index date. Eye-level disease status was reported, along with intravitreal anti-VEGF treatment patterns. Health care resource utilization (HRU) (all-cause and nAMD-related) and direct health care costs were estimated over the 12 month follow-up period. Outcomes associated with falls and fractures were also assessed. Multivariate analysis identified drivers of annual nAMD-related outpatient costs among patients with anti-VEGF therapy. Incident patients (defined as those without an nAMD diagnosis 6 months prior to the index date) with at least 18 months of continuous enrollment after the index date were identified for a subset analysis to evaluate documented changes in disease status. RESULTS: A total of 6,076 patients with nAMD were identified for the prevalent cohort; 60.1%, 17.2%, and 5.9% had active CNV, inactive CNV, and inactive scar disease stage at index, respectively. The nAMD-related outpatient visit costs were roughly 4 and roughly 7 times higher, respectively, for the active CNV group ($8,658 [SD = $11,612]) compared with the inactive CNV ($2,406 [SD = $5,510]) and inactive scar ($1,198 [SD = $3,035]) groups (P < 0.0001). About 10% of prevalent patients had a fall/fracture claim over 12 months of follow-up. A total of 3,623 prevalent patients (59.6%) were eligible for the anti-VEGF treatment patterns analysis (mean [SD] duration of therapy = 7.7 [4.5] months; mean [SD] number of injections = 6.0 [3.7]). Qualified incident cases comprised 17.8% (n = 1,081) of the prevalent cohort. Approximately 20% of incident eyes with active CNV at baseline transitioned to inactive CNV. A total of 427 incident patients (39.5%) qualified for anti-VEGF treatment patterns analysis (mean [SD] duration of therapy = 6.2 [4.7] months, mean [SD] number of injections = 5.2 [3.5]). Significant drivers of total nAMD-related costs were the initial anti-VEGF agent and anti-VEGF injection frequency (P < 0.0001) in both prevalent and incident cohorts. CONCLUSIONS: The clinical and economic burden of nAMD treatment is substantial to the US healthcare system, where economic burden is higher among those with active CNV. Appropriate treatment may increase the duration of inactive disease periods and preserve visual acuity while lowering costs. DISCLOSURES: This study was funded by Allergan, an AbbVie Company. Allergan employees were involved in the study design, interpretation of data, writing of the manuscript, and the decision to submit for publication. Keyloun and Campbell are employees of Allergan. Multani, McGuiness, and Chen are employees of IQVIA, which received funding from Allergan for conducting the analysis. Almony and Shah-Manek have nothing to disclose.
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Affiliation(s)
| | - Katelyn R Keyloun
- Global Health Economics and Outcomes Research, Allergen, an AbbVie Company, Irvine, CA
| | - Bijal Shah-Manek
- Global Health Economics and Outcomes Research, Noesis Healthcare Technologies, Inc, Redwood City, CA
| | - Jasjit K Multani
- Health Economics and Outcomes Research, Real-World Evidence, IQVIA Inc, Falls Church, VA
| | - Catherine B McGuiness
- Health Economics and Outcomes Research, Real-World Evidence, IQVIA Inc, Plymouth Meeting, PA
| | - Chi-Chang Chen
- Health Economics and Outcomes Research, Real-World Evidence, IQVIA Inc, Plymouth Meeting, PA
| | - Joanna H Campbell
- Global Health Economics and Outcomes Research, Allergan, an AbbVie Company, Irvine, CA
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Grisafe DJ, Varma R, Burkemper BS, Xu BY, Torres M, Fairbrother-Crisp A, Patino CM, McKean-Cowdin R. Impact of Visual Field Loss on Vision-Specific Quality of Life in African Americans: The African American Eye Disease Study. Am J Ophthalmol 2021; 229:52-62. [PMID: 33571475 DOI: 10.1016/j.ajo.2021.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/29/2021] [Accepted: 02/05/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To elucidate how visual field loss (VFL) impacts self-reported vision-specific quality of life (VSQOL) in African Americans, who experience a disproportionate burden of visual impairment. DESIGN Cross-sectional, population-based cohort. METHODS Eligible participants (n = 7,957) were recruited who self-identified as African American, were aged 40 years or older, and resided in Inglewood, California, USA. A total of 6,347 participants (80.0%) completed clinical eye examinations. Total mean deviation (MD) of VFL was measured bilaterally as decibels (dB) using the Humphrey SITA Standard 24-2 test. VSQOL was measured using the National Eye Institute Visual Function Questionnaire (NEI-VFQ 25) and scored using item response theory (IRT). RESULTS Participants with reliable data (n = 5,121) had a mean age of 60.7 years (standard deviation 11.0); those with worse VFL were older; had more comorbidities, lower income, less education, and worse visual acuity; and were more likely to be unemployed and depressed. Using IRT analysis, a change in VF of 6.2 (95% confidence interval [CI]: 5.3, 7.7) dB and 9.2 (95% CI: 7.5, 11.9) dB was necessary to observe a meaningful (5-point) difference in vision-related task and emotional well-being scores, respectively. VFL had the greatest impact on self-reported driving ability (6.0 dB [95% CI: 5.2, 7.1]), followed by satisfaction with general vision, near vision, vision-related mental health, and peripheral vision. CONCLUSIONS The strongest impact of VFL reported by African Americans was on their ability to complete visual tasks, especially for driving. An effect of VFL on emotional well-being also was observed, but the magnitude of association was about 50% lower for well-being compared to that of task.
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Affiliation(s)
- Dominic J Grisafe
- From the Department of Preventive Medicine and the Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Rohit Varma
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, California, USA.
| | - Bruce S Burkemper
- Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Benjamin Y Xu
- Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Mina Torres
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, California, USA
| | - Alicia Fairbrother-Crisp
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, California, USA
| | - Cecilia M Patino
- From the Department of Preventive Medicine and the Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Roberta McKean-Cowdin
- From the Department of Preventive Medicine and the Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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Fernández-Vigo JI, Burgos-Blasco B, Calvo-González C, Escobar-Moreno MJ, Shi H, Jiménez-Santos M, Valverde-Megías A, Reche-Frutos J, López-Guajardo L, Donate-López J. Assessment of vision-related quality of life and depression and anxiety rates in patients with neovascular age-related macular degeneration. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96:470-475. [PMID: 34479703 DOI: 10.1016/j.oftale.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/12/2020] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the vision-related quality of life and the depression and anxiety rates in patients with neovascular Age-Related Macular Degeneration (nAMD). METHODS A cross-sectional study of patients with nAMD treated with intravitreal injections was performed. The patients completed two validated questionnaires: the Visual Functioning Questionnaire (VFQ-25, score from 0 to 100), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Age, gender and visual acuity (VA) in the Early Treatment Diabetic Retinopathy Study (ETDRS) scale was registered. RESULTS Fifty-five patients with nAMD participated with a mean age of 80.9 ± 6.6 years-old (range 67-93) and a mean VA in the best eye of 73.5 ± 12.7 letters (range 44-95). The global VFQ-25 mean score was 57.4 ± 21.9 being 38.9 ± 13.2 for the general vision and 42.0 ± 19.5 for the general health. VA in the best eye was associated with the global score of the VFQ-25 scale (R = 0.608; P < .001), but no correlation was observed with general health (P = .936). In the HADS scale, 26.9% and 25.5% of patients had symptoms of depression and anxiety respectively. A negative correlation was found between the HADS and VFQ-25 scales for the general vision score (R = -0.438). CONCLUSION This study elucidates the impact of vision impairment and the visual functioning in nAMD, describing an important rate of depression and anxiety symptoms.
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Affiliation(s)
- J I Fernández-Vigo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
| | - B Burgos-Blasco
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - C Calvo-González
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - M J Escobar-Moreno
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - H Shi
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - M Jiménez-Santos
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - A Valverde-Megías
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - J Reche-Frutos
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - L López-Guajardo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - J Donate-López
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
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Fang V, Gomez-Caraballo M, Lad EM. Biomarkers for Nonexudative Age-Related Macular Degeneration and Relevance for Clinical Trials: A Systematic Review. Mol Diagn Ther 2021; 25:691-713. [PMID: 34432254 DOI: 10.1007/s40291-021-00551-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 01/05/2023]
Abstract
TOPIC The purpose of the review was to identify structural, functional, blood-based, and other types of biomarkers for early, intermediate, and late nonexudative stages of age-related macular degeneration (AMD) and summarize the relevant data for proof-of-concept clinical trials. CLINICAL RELEVANCE AMD is a leading cause of blindness in the aging population, yet no treatments exist for its most common nonexudative form. There are limited data on the diagnosis and progression of nonexudative AMD compared to neovascular AMD. Our objective was to provide a comprehensive, systematic review of recently published biomarkers (molecular, structural, and functional) for early AMD, intermediate AMD, and geographic atrophy and to evaluate the relevance of these biomarkers for use in future clinical trials. METHODS A literature search of PubMed, ScienceDirect, EMBASE, and Web of Science from January 1, 1996 to November 30, 2020 and a patent search were conducted. Search terms included "early AMD," "dry AMD," "intermediate AMD," "biomarkers for nonexudative AMD," "fundus autofluorescence patterns," "color fundus photography," "dark adaptation," and "microperimetry." Articles were assessed for bias and quality with the Mixed-Methods Appraisal Tool. A total of 94 articles were included (61,842 individuals). RESULTS Spectral-domain optical coherence tomography was superior at highlighting detailed structural changes in earlier stages of AMD. Fundus autofluorescence patterns were found to be most important in estimating progression of geographic atrophy. Delayed rod intercept time on dark adaptation was the most widely recommended surrogate functional endpoint for early AMD, while retinal sensitivity on microperimetry was most relevant for intermediate AMD. Combinational studies accounting for various patient characteristics and machine/deep-learning approaches were best suited for assessing individualized risk of AMD onset and progression. CONCLUSION This systematic review supports the use of structural and functional biomarkers in early AMD and intermediate AMD, which are more reproducible and less invasive than the other classes of biomarkers described. The use of deep learning and combinational algorithms will gain increasing importance in future clinical trials of nonexudative AMD.
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Affiliation(s)
- Vivienne Fang
- Northwestern University Feinberg School of Medicine, 420 E. Superior St, Chicago, IL, 60611, USA
| | - Maria Gomez-Caraballo
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Rd, DUMC 3802, Durham, NC, 27705, USA
| | - Eleonora M Lad
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Rd, DUMC 3802, Durham, NC, 27705, USA
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Xu HJ, Li QY, Zou T, Yin ZQ. Development-related mitochondrial properties of retinal pigment epithelium cells derived from hEROs. Int J Ophthalmol 2021; 14:1138-1150. [PMID: 34414076 DOI: 10.18240/ijo.2021.08.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/21/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the temporal mitochondrial characteristics of retinal pigment epithelium (RPE) cells obtained from human embryonic stem cells (hESC)-derived retinal organoids (hEROs-RPE), to verify the optimal period for using hEROs-RPE as donor cells from the aspect of mitochondria and to optimize RPE cell-based therapeutic strategies for age-related macular degeneration (AMD). METHODS RPE cells were obtained from hEROs and from spontaneous differentiation (SD-RPE). The mitochondrial characteristics were analyzed every 20d from day 60 to 160. Mitochondrial quantity was measured by MitoTracker Green staining. Transmission electron microscopy (TEM) was adopted to assess the morphological features of the mitochondria, including their distribution, length, and cristae. Mitochondrial membrane potentials (MMPs) were determined by JC-1 staining and evaluated by flow cytometry, reactive oxygen species (ROS) levels were evaluated by flow cytometry, and adenosine triphosphate (ATP) levels were measured by a luminometer. Differences between two groups were analyzed by the independent-samples t-test, and comparisons among multiple groups were made using one-way ANOVA or Kruskal-Wallis H test when equal variance was not assumed. RESULTS hEROs-RPE and SD-RPE cells from day 60 to 160 were successfully differentiated from hESCs and expressed RPE markers (Pax6, MITF, Bestrophin-1, RPE65, Cralbp). RPE features, including a cobblestone-like morphology with tight junctions (ZO-1), pigments and microvilli, were also observed in both hEROs-RPE and SD-RPE cells. The mitochondrial quantities of hEROs-RPE and SD-RPE cells both peaked at day 80. However, the cristae of hEROs-RPE mitochondria were less mature and abundant than those of SD-RPE mitochondria at day 80, with hEROs-RPE mitochondria becoming mature at day 100. Both hEROs-RPE and SD-RPE cells showed low ROS levels from day 100 to 140 and maintained a normal MMP during this period. However, hEROs-RPE mitochondria maintained a longer time to produce high levels of ATP (from day 120 to 140) than SD-RPE cells (only day 120). CONCLUSION hEROs-RPE mitochondria develop more slowly and maintain a longer time to supply high-level energy than SD-RPE mitochondria. From the mitochondrial perspective, hEROs-RPE cells from day 100 to 140 are an optimal cell source for treating AMD.
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Affiliation(s)
- Hao-Jue Xu
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing 400038, China
| | - Qi-You Li
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing 400038, China
| | - Ting Zou
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing 400038, China
| | - Zheng-Qin Yin
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing 400038, China
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Silverstein SM, Sörensen S, Sunkara A, Lai A, Fradkin SI, Ramchandran RS. Association of vision loss and depressive symptomatology in older adults assessed for ocular health in senior living facilities. Ophthalmic Physiol Opt 2021; 41:985-995. [PMID: 34382220 DOI: 10.1111/opo.12869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/05/2021] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE People with vision loss are at increased risk for major depressive disorder (MDD) and subclinical depression. However, screening for depression is rarely done in eye care settings or among groups in the general population known to have vision disorders. METHODS We examined the prevalence of depression, using the Patient Health Questionnaire - 2 (PHQ-2), among a group of older adults (N = 204; mean age = 82.15) at two senior living facilities (SLFs) and determined the relationships between severity of depression and objective visual findings, visual function, beliefs about taking an active role in one's own eye care (i.e., patient activation) and level of social support. RESULTS Approximately 50% of the sample had impaired vision in at least one eye, and close to 30% of the sample obtained a score on the PHQ-2 indicating the likely presence of major depressive disorder. Visual testing findings were related to visual function (e.g., ability to read), but not to depression. Patient activation was also not significantly related to the level of depression. However, impaired visual functioning and less social support were both strong predictors of depression. These two variables and their interaction accounted for 17% of the total PHQ-2 score variance. CONCLUSIONS These data indicate the potential utility of screening for depression as part of vision care in populations likely to have significant vision loss. The findings also suggest that a comprehensive approach to depression prevention and/or reduction in SLF and similar populations may require interventions to address reduced visual functioning and methods to strengthen social networks.
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Affiliation(s)
- Steven M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.,Department of Neuroscience, University of Rochester Medical Center, Rochester, New York, USA.,Department of Ophthalmology, University of Rochester Medical Center, Rochester, New York, USA.,Center for Visual Science, University of Rochester, Rochester, New York, USA
| | - Silvia Sörensen
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.,Department of Ophthalmology, University of Rochester Medical Center, Rochester, New York, USA.,Department of Counseling and Human Development, Margaret Warner Graduate School of Education and Human Development, University of Rochester, Rochester, New York, USA.,Center for Community Health and Prevention, University of Rochester, Rochester, New York, USA
| | - Anoop Sunkara
- Department of Economics, University of Notre Dame, Notre Dame, Indiana, USA
| | - Adriann Lai
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Samantha I Fradkin
- Department of Psychology, University of Rochester, Rochester, New York, USA
| | - Rajeev S Ramchandran
- Department of Ophthalmology, University of Rochester Medical Center, Rochester, New York, USA.,Center for Community Health and Prevention, University of Rochester, Rochester, New York, USA.,Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
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Di Carlo E, Augustin AJ. Prevention of the Onset of Age-Related Macular Degeneration. J Clin Med 2021; 10:jcm10153297. [PMID: 34362080 PMCID: PMC8348883 DOI: 10.3390/jcm10153297] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/12/2022] Open
Abstract
Age-related macular degeneration (AMD) represents the leading cause of irreversible blindness in elderly people, mostly after the age of 65. The progressive deterioration of visual function in patients affected by AMD has a significant impact on quality of life and has also high social costs. The current therapeutic options are only partially able to slow down the natural course of the disease, without being capable of stopping its progression. Therefore, better understanding of the possibilities to prevent the onset of the disease is needed. In this regard, a central role is played by the identification of risk factors, which might participate to the development of the disease. Among these, the most researched are dietary risk factors, lifestyle, and light exposure. Many studies showed that a higher dietary intake of nutrients, such as lutein, zeaxanthin, beta carotene, omega-3 fatty acids and zinc, reduced the risk of early AMD. Regarding lifestyle habits, the association between smoking and AMD is currently accepted. Finally, retinal damage caused by ultraviolet rays and blue light is also worthy of attention. The scope of this review is to summarize the present knowledge focusing on the measures to adopt in order to prevent the onset of AMD.
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Differential Regulation of Lacto-/Neolacto- Glycosphingolipid Biosynthesis Pathway Reveals Transcription Factors as Potential Candidates in Triple-Negative Breast Cancer. Cancers (Basel) 2021; 13:cancers13133330. [PMID: 34283051 PMCID: PMC8268693 DOI: 10.3390/cancers13133330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/26/2021] [Accepted: 06/29/2021] [Indexed: 12/31/2022] Open
Abstract
Triple-negative breast cancer (TNBC) is an aggressive breast cancer with limited treatment options. Glycosylation has been implicated in cancer development, but TNBC-specific glycosylation pathways have not been examined. Here, we applied bioinformatic analyses on public datasets to discover TNBC-specific glycogenes and pathways, as well as their upstream regulatory mechanisms. Unsupervised clustering of 345 glycogene expressions in breast cancer datasets revealed a relative homogenous expression pattern in basal-like TNBC subtype. Differential expression analyses of the 345 glycogenes between basal-like TNBC (hereafter termed TNBC) and other BC subtypes, or normal controls, revealed 84 differential glycogenes in TNBC. Pathway enrichment showed two common TNBC-enriched pathways across all three datasets, cell cycle and lacto-/neolacto- glycosphingolipid (GSL) biosynthesis, while a total of four glycosylation-related pathways were significantly enriched in TNBC. We applied a selection criterion of the top 50% differential anabolic/catabolic glycogenes in the enriched pathways to define 34 TNBC-specific glycogenes. The lacto-/neolacto- GSL biosynthesis pathway was the most highly enriched, with seven glycogenes all up-regulated in TNBC. This data led us to investigate the hypothesis that a common upstream mechanism in TNBC up-regulates the lacto-/neolacto-GSL biosynthesis pathway. Using public multi-omic datasets, we excluded the involvement of copy-number alteration and DNA methylation, but identified three transcription factors (AR, GATA3 and ZNG622) that each target three candidate genes in the lacto-/neolacto- GSL biosynthesis pathway. Interestingly, a subset of TNBC has been reported to express AR and GATA3, and AR antagonists are being trialed for TNBC. Our findings suggest that AR and GATA3 may contribute to TNBC via GSL regulation, and provide a list of candidate glycogenes for further investigation.
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Vu KV, Mitchell P, Dharamdasani Detaram H, Burlutsky G, Liew G, Gopinath B. Prevalence and risk factors for depressive symptoms in patients with neovascular age-related macular degeneration who present for anti-VEGF therapy. Acta Ophthalmol 2021; 99:e547-e554. [PMID: 32981226 DOI: 10.1111/aos.14635] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/27/2020] [Accepted: 09/06/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE To examine the prevalence and risk factors for depressive symptoms in patients with neovascular age-related macular degeneration (nAMD) presenting for anti-vascular endothelial growth factor (anti-VEGF) therapy. METHODS In a clinic-based cohort of 547 patients with nAMD who presented for treatment, the Centre of Epidemiological Studies Depression 10-point scale (CES-D-10) and Mental Health Index (MHI) component of the 36-item Short Form Survey were administered to assess for the presence of depressive symptoms. Logistic regression analyses were used to calculate odds ratios and 95% confidence intervals for factors associated with an increased likelihood of depressive symptoms. RESULTS The prevalence of depressive symptoms was 42.04% and 31.78% as per the CES-D-10 and MHI scales, respectively. Poor self-rated health (SRH) is associated with increased odds of depressive symptoms [multivariable-adjusted OR: 3.00 (95% CI 1.90-4.73) for CES-D-10; OR: 2.67 (95% CI 1.67-4.28) for MHI]. Impaired activities of daily living (ADLs) [multivariable-adjusted OR: 2.62 (95% CI 1.56-4.38) for CES-D-10; OR: 3.59 (95% CI 2.10-6.15) for MHI] and a visual function score within the two lowest quartiles were also associated with increased odds of depressive symptoms using both scales. CONCLUSION A high prevalence of depressive symptoms was observed among nAMD patients presenting for treatment. Poorer SRH, ADL impairment and reduced visual function were associated with increased odds of depressive symptoms.
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Affiliation(s)
- Kim Van Vu
- Centre for Vision Research The Westmead Institute for Medical Research The University of Sydney Sydney Australia
| | - Paul Mitchell
- Centre for Vision Research The Westmead Institute for Medical Research The University of Sydney Sydney Australia
| | - Harshil Dharamdasani Detaram
- Centre for Vision Research The Westmead Institute for Medical Research The University of Sydney Sydney Australia
| | - George Burlutsky
- Centre for Vision Research The Westmead Institute for Medical Research The University of Sydney Sydney Australia
| | - Gerald Liew
- Centre for Vision Research The Westmead Institute for Medical Research The University of Sydney Sydney Australia
| | - Bamini Gopinath
- Centre for Vision Research The Westmead Institute for Medical Research The University of Sydney Sydney Australia
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Liu J, Dong J, Chen Y, Zhang W, Tong S, Guo J. Low vision rehabilitation in improving the quality of life for patients with impaired vision: A systematic review and meta-analysis of 52 randomized clinical trials. Medicine (Baltimore) 2021; 100:e25736. [PMID: 34106601 PMCID: PMC8133190 DOI: 10.1097/md.0000000000025736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AIM Low vision rehabilitation optimizes the use of residual vision after severe vision loss, but also teaches skills to improve visual functioning in daily life. These skills promote independence and active participation in society. This meta-analysis was designed to evaluate the efficacy of low vision rehabilitation in improving the quality of life (QoL) in visually impaired adults. METHODS We searched the Cochrane Library, PubMed, EMBASE, and Web of Science up to January 1, 2020. Randomized controlled trials (RCTs) that compared rehabilitation interventions with active or inactive controls were included. The standardized mean difference (SMD) with a 95% confidence interval (CI) was estimated to compare outcomes. Two reviewers extracted data and assessed trial quality independently. All statistical analyses were performed using the standard statistical procedures of RevMan 5.2. RESULTS A total of 52 RCTs with 6,239 participants were included in this meta-analysis. Compared to inactive comparators including waiting list or no care, low vision rehabilitation improved vision-related QoL, visual functioning (QoL: psychological aspect), and self-efficacy or self-esteem (QoL: psychological aspect), with pooled SMDs of -0.61 (95% CI -0.95 to -0.26; P = .0006), -1.14 (95% CI -1.69 to -0.59; P < .0001), and -0.84 (95% CI -1.47 to -0.22; P < .0001), respectively. Compared to active comparators, low vision rehabilitation improved vision-related QoL (SMD -0.26; 95% CI -0.46 to -0.06; P = .01) and activities of daily living (QoL: physical aspect) (SMD -0.39; 95% CI -0.67 to -0.12 P < .0001). However, no significant difference in health-related QoL and adaptation to vision loss (QoL: psychological aspect) was found between low vision rehabilitation and inactive comparators. CONCLUSIONS This meta-analysis indicated that low vision rehabilitation interventions, particularly psychological therapies and methods of enhancing vision, may improve vision-related QoL and visual functioning in people with sight loss compared to usual care. Further studies should explore longer maintenance effects and the costs of several types of low vision rehabilitation. Studies characterizing the mechanisms of rehabilitation interventions in different settings, including low-income countries, are also required.
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Affiliation(s)
- Jianhua Liu
- Department of Physical Therapy, Beijing Bo'ai Hospital, Chinese Rehabilitation Research Centre
| | - Jige Dong
- Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine
| | - Yaping Chen
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University
| | - Weidong Zhang
- Department of Rehabilitation Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University
| | - Shuai Tong
- Department of Rehabilitation Medicine, Beijing Haidian Hospital, Beijing
| | - Jiangzhou Guo
- Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine
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Versek C, Banijamali SMA, Bex P, Lashkari K, Kamarthi S, Sridhar S. Portable Diagnostic System for Age-Related Macular Degeneration Screening Using Visual Evoked Potentials. Eye Brain 2021; 13:111-127. [PMID: 33953628 PMCID: PMC8092944 DOI: 10.2147/eb.s295745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 03/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Delayed Dark-Adapted vision Recovery (DAR) is a biomarker for Age-related Macular Degeneration (AMD), however its measurement is burdensome for patients and examiners. Methods In this study, we developed a portable, wireless and user-friendly system that employs a headset with a smartphone to deliver controlled photo-bleach and monocular pattern reversal stimuli, while using custom electroencephalography (EEG) electrodes and electronics in order to measure Dark-Adapted Visual Evoked Potentials (DAVEP) objectively and separately at the peripheral and central visual field. This is achieved in one comfortable 20-minute session, without requiring subject reporting. DAVEP responses post photo-bleach for up to 15 minutes were measured concurrently from both eyes in 12 AMD-patients, 1 degenerative myopia patient, and 8 controls who had no diagnosed macular vision loss. Results Robust positive polarity DAVEP responses were observed at 200-500 ms from stimulus onset to scotopic stimuli that have been seldom reported and analyzed previously. The amplitude recovery of the DAVEP response was significantly delayed in AMD patients as compared to controls. We developed DAVEP1 scores, a simple metric for DAR, which classified 90% of subject eyes correctly, indicating the presence of AMD in at least one eye of all pre-confirmed subjects with this diagnosis. Conclusion We developed a user-friendly, portable VEP system and DAVEP1 metric, which show a high potential to identify DAR-deficits in AMD-patients. This novel technology could aid in early diagnosis of AMD.
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Affiliation(s)
| | | | - Peter Bex
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Kameran Lashkari
- Department of Bioengineering, University of Massachusetts Dartmouth, Dartmouth, MA, USA
| | - Sagar Kamarthi
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, USA
| | - Srinivas Sridhar
- NeuroFieldz Inc, Newton, MA, USA.,Departments of Physics, Bioengineering, and Chemical Engineering, Northeastern University, Boston, MA, USA.,Division of Radiation Oncology, Harvard Medical School, Boston, MA, USA
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Guerra MH, Yumnamcha T, Ebrahim AS, Berger EA, Singh LP, Ibrahim AS. Real-Time Monitoring the Effect of Cytopathic Hypoxia on Retinal Pigment Epithelial Barrier Functionality Using Electric Cell-Substrate Impedance Sensing (ECIS) Biosensor Technology. Int J Mol Sci 2021; 22:ijms22094568. [PMID: 33925448 PMCID: PMC8123793 DOI: 10.3390/ijms22094568] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 02/06/2023] Open
Abstract
Disruption of retinal pigment epithelial (RPE barrier integrity is a hallmark feature of various retinal blinding diseases, including diabetic macular edema and age-related macular degeneration, but the underlying causes and pathophysiology are not completely well-defined. One of the most conserved phenomena in biology is the progressive decline in mitochondrial function with aging leading to cytopathic hypoxia, where cells are unable to use oxygen for energy production. Therefore, this study aimed to thoroughly investigate the role of cytopathic hypoxia in compromising the barrier functionality of RPE cells. We used Electric Cell-Substrate Impedance Sensing (ECIS) system to monitor precisely in real time the barrier integrity of RPE cell line (ARPE-19) after treatment with various concentrations of cytopathic hypoxia-inducing agent, Cobalt(II) chloride (CoCl2). We further investigated how the resistance across ARPE-19 cells changes across three separate parameters: Rb (the electrical resistance between ARPE-19 cells), α (the resistance between the ARPE-19 and its substrate), and Cm (the capacitance of the ARPE-19 cell membrane). The viability of the ARPE-19 cells and mitochondrial bioenergetics were quantified with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and seahorse technology, respectively. ECIS measurement showed that CoCl2 reduced the total impedance of ARPE-19 cells in a dose dependent manner across all tested frequencies. Specifically, the ECIS program’s modelling demonstrated that CoCl2 affected Rb as it begins to drastically decrease earlier than α or Cm, although ARPE-19 cells’ viability was not compromised. Using seahorse technology, all three concentrations of CoCl2 significantly impaired basal, maximal, and ATP-linked respirations of ARPE-19 cells but did not affect proton leak and non-mitochondrial bioenergetic. Concordantly, the expression of a major paracellular tight junction protein (ZO-1) was reduced significantly with CoCl2-treatment in a dose-dependent manner. Our data demonstrate that the ARPE-19 cells have distinct dielectric properties in response to cytopathic hypoxia in which disruption of barrier integrity between ARPE-19 cells precedes any changes in cells’ viability, cell-substrate contacts, and cell membrane permeability. Such differences can be used in screening of selective agents that improve the assembly of RPE tight junction without compromising other RPE barrier parameters.
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Affiliation(s)
- Michael H. Guerra
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
| | - Thangal Yumnamcha
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
| | - Abdul-Shukkur Ebrahim
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
| | - Elizabeth A. Berger
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
| | - Lalit Pukhrambam Singh
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
| | - Ahmed S. Ibrahim
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
- Department of Pharmacology, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA
- Department of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
- Correspondence: ; Tel.: +1-313-577-7854 (Office) or +1-313-577-7864 (Lab)
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Naufal F, Gajwani P, Medina R, Dutson M, Mariotti SP, West SK. Knowledge of patient emotional health status: impact on clinical care in glaucoma and retinal services. BMJ Open Ophthalmol 2021; 6:e000640. [PMID: 33981855 PMCID: PMC8061815 DOI: 10.1136/bmjophth-2020-000640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/08/2021] [Accepted: 03/31/2021] [Indexed: 11/04/2022] Open
Abstract
Objective Knowledge of a patient’s emotional health status and using patient-centred communication may be key to providing early intervention and referral to appropriate treatment/support services for ophthalmology patients. This study aims to determine if and how ophthalmologists use anxiety and depression scores to determine clinical care of patients with chronic eye disease. Methods and analysis This cross-sectional study included 10 ophthalmologists and a convenience sample of 100 of their patients (>18 years). The Patient Health Questionnaire (PHQ-9) for depression and the Generalised Anxiety Disorder (GAD-7) tool were administered to patients. Scores from these instruments were provided to ophthalmologists just prior to the clinic visit. After the visit, ophthalmologists were given a questionnaire to assess self-reported change in clinical practice and whether knowledge of scores impacted their communication style, treatment plan and follow-up protocol. Results Of these patients (mean age=63), 27% reported mild-moderate anxiety or depression as their worst score, while 2% reported suicidal thoughts; 20% reported neither anxiety nor depression. Ophthalmologists’ response to patients with mild or worse anxiety or depression was to change clinical approach (28%) and communication style (31%), both metrics increasing with severity of symptoms (Fisher’s exact p<0.05). None reported changing their choice of treatment or modifying follow-up protocols; referral to social work/psychiatry services was 60%, 3.7% and 0% for patients with moderately severe or worse, mild-to-moderate, or minimal scores, respectively. Conclusion Providing ophthalmologists with knowledge of the emotional health of their patients may change the clinical approach and referral pattern.
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Affiliation(s)
- Fahd Naufal
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
| | - Prateek Gajwani
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
| | - Robert Medina
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
| | - Madison Dutson
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
| | | | - Sheila K West
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
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Chang KJ, Dillon LL, Deverell L, Boon MY, Keay L. Orientation and mobility outcome measures. Clin Exp Optom 2021; 103:434-448. [DOI: 10.1111/cxo.13004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/27/2019] [Accepted: 10/09/2019] [Indexed: 11/26/2022] Open
Affiliation(s)
- Kuo‐yi Jade Chang
- School of Public Health, The University of Sydney, Sydney, Australia,
- Injury Division, The George Institute for Global Health, Sydney, Australia,
| | - Lisa Lorraine Dillon
- Injury Division, The George Institute for Global Health, Sydney, Australia,
- Faculty of Medicine, The University of New South Wales, Sydney, Australia,
| | - Lil Deverell
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia,
| | - Mei Ying Boon
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia,
| | - Lisa Keay
- Injury Division, The George Institute for Global Health, Sydney, Australia,
- Faculty of Medicine, The University of New South Wales, Sydney, Australia,
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Geographic atrophy severity and mortality in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2021; 259:2643-2651. [PMID: 33742280 DOI: 10.1007/s00417-021-05145-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/28/2021] [Accepted: 03/02/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To examine the association between geographic atrophy (GA) disease characteristics and mortality risk. METHODS We manually delineated color fundus photographs of 209 Age-Related Eye Disease Study (AREDS) participants with GA secondary to age-related macular degeneration to identify total area of atrophy, GA effective radius growth rate, disease laterality, and the presence of foveal center involvement. Associations between GA characteristics and mortality were assessed with Cox proportional hazards models adjusted for health status indicators. RESULTS During a median follow-up of 6.8 years, 48 (23.0%) participants with GA died. In adjusted models, accounting for age, sex, and health status, participants with total GA area in the highest quartile had a significantly increased risk of all-cause mortality compared to those with total GA area in the lowest quartile (hazard ratio [HR], 3.42; 95% confidence interval [CI], 1.32-8.86; P = 0.011). GA effective radius growth rate, bilateral disease, and the presence of foveal center involvement were not significantly associated with mortality. In a multivariable model, including health status indicators and all GA characteristics, total area of atrophy in the highest quartile remained significantly associated with mortality (HR, 4.65; 95% CI, 1.29-16.70; P = 0.019). CONCLUSIONS More extensive GA, as indicated by a greater total area of atrophy, was associated with an increased risk of all-cause mortality in our cohort. The extent of GA may reflect the extent of underlying disease processes that contribute to greater mortality risk, further suggesting that GA may be part of a systemic rather than purely ocular disease process.
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Roque AB, da Silva Borges GF, Abe RY, de Souza OF, Machado MC, Ferreira T, José NK, de Vasconcellos JPC. The effects of age-related macular degeneration on quality of life in a Brazilian population. Int J Retina Vitreous 2021; 7:20. [PMID: 33726848 PMCID: PMC7962216 DOI: 10.1186/s40942-021-00290-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the impact of age-related macular degeneration (AMD) on the quality of life (QoL) in a Brazilian population using The National Eye Institute-Visual Function Questionnaire-25 (NEI-VFQ-25). METHODS This observational study included 462 participants from the Departments of Ophthalmology of the University of Campinas and Conderg-Divinolândia. The NEI-VFQ-25 questionnaire and Rasch analysis were used to assess the vision-related quality of life (VRQoL). Patients with macular neovascularization were interviewed at enrollment and after three loading doses of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment. RESULTS One hundred thirty-three patients were excluded because they had another ophthalmic disease, for a total of 349 patients included in the study (177 in the AMD group, 172 in the control group; 56.4% were women; mean ± standard deviation age, 70.6 ± 9.5 years). Most NEI-VFQ-25 subscale scores were significantly lower in the AMD group compared with the control group. The Rasch-calibrated NEI-VFQ-25 median score in the visual-functioning component was 56.41 for the AMD group and 61.53 for the control group, a difference of ± 4.00 (P = 0.0001). Separate analyses of the sociodemographic and ocular characteristics showed that the NEI-VFQ-25 scores were affected mostly by family income, educational level, descent, diet (vegetables/fruits), physical activity, and visual acuity (VA). The longitudinal component assessed a different group of 48 patients with exudative disease treated with anti-VEGF drugs. The mean logarithm of the minimum angle of resolution change in VA in treated eyes was a 0.16 decrease (P = 0.01). The mean change in the optical coherence tomography macular thickness was a 36.74-μm decrease (P = 0.012) from baseline to 4 months. The mean NEI-VFQ-25 scores improved significantly from baseline to follow-up at 4 months in almost all subscales. CONCLUSIONS In a Brazilian community, patients with AMD had a worse VRQoL than controls. The AMD severity and bilaterality were associated with decreased NEI-VFQ-25 scores. Higher family income, educational level, descent, and lifestyle significantly improved several subscales of the NEI-VFQ-25 questionnaire. Treated patients with exudative AMD had improvements in the VA, macular thickness, and most NEI-VFQ-25 subscale scores.
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Affiliation(s)
- Alicia Buffoni Roque
- Department of Ophthalmology, Faculty of Medical Science, University of Campinas, Campinas, SP, Brazil.
| | | | - Ricardo Yuji Abe
- Department of Ophthalmology, Faculty of Medical Science, University of Campinas, Campinas, SP, Brazil
| | - Osias Francisco de Souza
- Department of Ophthalmology, Faculty of Medical Science, University of Campinas, Campinas, SP, Brazil
| | | | | | - Newton Kara José
- Department of Ophthalmology, Faculty of Medical Science, University of Campinas, Campinas, SP, Brazil
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Yimer YM, Buli MB, Nenko G, Mirkena Y, Kassew T. The Prevalence and Determinant Factors of Self-Reported Depressive Symptoms Among Elderly People with Visual Impairment Attending an Outpatient Clinic in Ethiopia. CLINICAL OPTOMETRY 2021; 13:63-72. [PMID: 33628068 PMCID: PMC7898220 DOI: 10.2147/opto.s294618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 01/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Depression among older adults with visual impairment is the commonest psychiatric problem and causes a range of effects in on disability and progression of visual health outcomes that may even end in death. In Ethiopia, there are gaps in the detection of the comorbidity of mental health problems especially depressive symptoms among those older people. This study aimed to assess the prevalence of self-reported depressive symptoms and determinant factors among the elderly people with visual impairment attending the ophthalmologic outpatient clinic. METHODS A group of 423 elderly people with visual impairment invited by systematic random sampling technique to took part in the interview for this cross-sectional study at Menelik II referral hospital, Addis Ababa, Ethiopia from January to June 2019. Descriptive statistics like frequency, percentage, mean and standard deviation were used to summarize the distribution of the data. Binary logistic regression analysis was employed to examine the associated factors. An adjusted odds ratio with a 95% confidence interval was used for reporting the result, and a p-value of <0.05 was considered as statistically significant. RESULTS The prevalence of self-reported depressive symptoms among elderly people with visual impairment was 26.7% with a 95% confidence interval (22.6-30.8). Widowhood, single and/divorced [Adjusted Odds Ratio (AOR)= 3.17, 95% CI: 1.71, 5.91]; [AOR=2.70, 95% CI: 1.35, 5.38], respectively, poor social support [AOR=4.34, 95% CI: 1.84, 10.24], severe level [AOR=2.63, 95% CI: 1.73, 6.63] and longer duration (>5 years) of the illness [AOR=3.15, 95% CI: 1.60, 6.19] were the factors significantly associated with higher odds of depressive symptoms. CONCLUSION The Prevalence of self-reported depressive symptoms among elderly people with visual impairment in Ethiopia was high. Public health interventions targeting risky individuals with high depressive symptoms are needed to reduce depressive symptoms and to prevent disability and poor medical illnesses outcomes related to depressive symptoms.
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Affiliation(s)
| | | | - Goshu Nenko
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yohannes Mirkena
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tilahun Kassew
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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