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Jiang Y, Chen X, Cheng M, Li B, Lei Y, Lin IC, Xu G, Mingwei L, Zhou X, Wang X. Immediate versus delayed sequential bilateral ICL implantation: A retrospective comparison of vault height and visual outcomes. Asia Pac J Ophthalmol (Phila) 2024:100075. [PMID: 38795866 DOI: 10.1016/j.apjo.2024.100075] [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: 11/16/2023] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/28/2024] Open
Abstract
PURPOSE To compare the visual outcomes and risks of suboptimal vault-related complications between immediate sequential bilateral ICL surgery (ISBICLS) and delayed sequential bilateral ICL surgery (DSBICLS). DESIGN A retrospective cohort study. METHODS Patients who underwent bilateral ICL implantation between November 2014 and December 2021 at the Eye and ENT Hospital of Fudan University (Shanghai, China) were included and divided into two groups: (1) ISBICLS: both eye surgeries performed on the same day, and (2) DSBICLS: second eye surgery performed < 7 days following the first one. Propensity score matching (PSM) was performed to compare the visual outcomes. Multivariable logistic regression models were used to estimate the odds ratios (ORs) of the suboptimal vaults. RESULTS Finally, 10,985 eyes were included. After PSM, 204 first surgery eyes and 162 s surgery eyes with complete postoperative data were matched. The safety and efficacy indices did not statistically differ between groups (all > 1.00), except that ISBICLS first surgery eyes achieved better efficacy index than DSBICLS group (1.03 ± 0.26 vs. 1.08 ± 0.23, P = 0.034). Excessive vault was observed in eight (4.06 %) ISBICLS first eyes, one (0.50 %) DSBICLS first eye, and none in the second surgery eye in either group. An insufficient vault was observed in one second eye and one DSBICLS second eye. We found no evidence of differences in the rate of excessive vault (OR = 0.831, 95 % CI: 0.426-1.622, P = 0.588) or insufficient vault (OR = 0.609, 95 % CI:0.062-5.850, P = 0.668). CONCLUSION ISBICLS provided safety, efficacy, and refraction predictability comparable to DSBICLS without increasing the risk of suboptimal vault-related complications.
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Affiliation(s)
- Yinjie Jiang
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, National Health Commision, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences
| | - Xun Chen
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, National Health Commision, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences
| | - Mingrui Cheng
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, National Health Commision, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences
| | - Boliang Li
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, National Health Commision, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences
| | - Yadi Lei
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, National Health Commision, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences
| | - I-Chun Lin
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, National Health Commision, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences
| | - Guanghan Xu
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, National Health Commision, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences
| | - Li Mingwei
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, National Health Commision, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences
| | - Xingtao Zhou
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, National Health Commision, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences
| | - Xiaoying Wang
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, National Health Commision, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences.
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Logullo P, van Zuuren EJ, Winchester CC, Tovey D, Gattrell WT, Price A, Harrison N, Goldman K, Chisholm A, Walters K, Blazey P. ACcurate COnsensus Reporting Document (ACCORD) explanation and elaboration: Guidance and examples to support reporting consensus methods. PLoS Med 2024; 21:e1004390. [PMID: 38709851 DOI: 10.1371/journal.pmed.1004390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND When research evidence is limited, inconsistent, or absent, healthcare decisions and policies need to be based on consensus among interested stakeholders. In these processes, the knowledge, experience, and expertise of health professionals, researchers, policymakers, and the public are systematically collected and synthesised to reach agreed clinical recommendations and/or priorities. However, despite the influence of consensus exercises, the methods used to achieve agreement are often poorly reported. The ACCORD (ACcurate COnsensus Reporting Document) guideline was developed to help report any consensus methods used in biomedical research, regardless of the health field, techniques used, or application. This explanatory document facilitates the use of the ACCORD checklist. METHODS AND FINDINGS This paper was built collaboratively based on classic and contemporary literature on consensus methods and publications reporting their use. For each ACCORD checklist item, this explanation and elaboration document unpacks the pieces of information that should be reported and provides a rationale on why it is essential to describe them in detail. Furthermore, this document offers a glossary of terms used in consensus exercises to clarify the meaning of common terms used across consensus methods, to promote uniformity, and to support understanding for consumers who read consensus statements, position statements, or clinical practice guidelines (CPGs). The items are followed by examples of reporting items from the ACCORD guideline, in text, tables, and figures. CONCLUSIONS The ACCORD materials-including the reporting guideline and this explanation and elaboration document-can be used by anyone reporting a consensus exercise used in the context of health research. As a reporting guideline, ACCORD helps researchers to be transparent about the materials, resources (both human and financial), and procedures used in their investigations so readers can judge the trustworthiness and applicability of their results/recommendations.
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Affiliation(s)
- Patricia Logullo
- Centre for Statistics in Medicine, University of Oxford, and EQUATOR Network UK Centre, Oxford, United Kingdom
| | | | - Christopher C Winchester
- Oxford PharmaGenesis, Oxford, United Kingdom
- Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - David Tovey
- Journal of Clinical Epidemiology, London, United Kingdom
| | | | - Amy Price
- Dartmouth Institute for Health Policy & Clinical Practice (TDI), Geisel School of Medicine, Dartmouth College, Hanover, NH, USA, previously at Stanford Anesthesia, Informatics and Media Lab, Stanford University School of Medicine, Stanford, California, United States of America
| | | | - Keith Goldman
- Global Medical Affairs, AbbVie, North Chicago, Illinois, United States of America
| | | | | | - Paul Blazey
- Department of Medicine, University of British Columbia, Vancouver, Canada
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Liu R, Sule AA, Shannon CS, Ravilla T, Taylor H, Rojas-Carabali W, Khanna RC, Mishra C, Sen A, Khatri A, Tan ACS, Sobrin L, Agrawal R. A practical model for effective eye care delivery in Southeast Asian rural communities: A proposal built based on experts' recommendations. Indian J Ophthalmol 2024; 72:S473-S481. [PMID: 38648455 DOI: 10.4103/ijo.ijo_2196_23] [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: 08/14/2023] [Accepted: 01/03/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE To evaluate rural community-based eye care models from the perspective of community ophthalmology experts and suggest sustainable technological solutions for enhancing rural eye care delivery. METHODS A semi-structured descriptive survey, using close-ended and open-ended questions, was administered to the experts in community ophthalmology sourced through purposive sampling. The survey was self-administered and was facilitated through online platforms or in-person meetings. Uniform questions were presented to all participants, irrespective of their roles. RESULTS Surveyed participants (n = 22 with 15 from India and 7 from Nepal) in high-volume tertiary eye hospitals faced challenges with resources and rural outreach. Participants had mixed satisfaction with pre-operative screening and theatre resources. Delayed presentations and inexperienced surgeons contributed to the surgery complications. Barriers to rural eye care included resource scarcity, funding disparities, and limited infrastructure. In rural/peri-urban areas 87% of participants agreed with providing primary eye care services, with more than 60% of the experts not in agreement with the makeshift center model of eye care delivery. Key components for an effective eye care model are sustainability, accessibility, affordability, and quality. These can be bolstered through a healthcare management platform and a human-chain supply distribution system. CONCLUSION Tailored interventions are crucial for rural eye care, emphasizing the need for stronger human resources, optimized funding, and community awareness. Addressing challenges pertinent to delayed presentation and surgical training is vital to minimizing complications, especially with advanced cataracts. Enhancements in rural eye care demand a comprehensive approach prioritizing accessibility, affordability, and consistent quality.
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Affiliation(s)
- Renee Liu
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
| | - Ashita A Sule
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Choo Sheriel Shannon
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | | | - Hugh Taylor
- Indigenous Eye Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - William Rojas-Carabali
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Lee Kong Chian School of Medicine, Singapore
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | | | - Alok Sen
- Sadguru Netra Chikatsalaya, Sri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | | | - Anna C S Tan
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, The Academia, Singapore, Singapore
- Department of Ophthalmology and Visual Sciences, Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Lucia Sobrin
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
| | - Rupesh Agrawal
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Singapore Eye Research Institute, The Academia, Singapore, Singapore
- Department of Ophthalmology and Visual Sciences, Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Singapore
- Moorfields Eye Hospital, NHS Foundation Trust, London, UK
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Bashshur R, DeVries C, Bosman J, Dunn M. A Review of the Published Literature in Global Population-Based Studies of Childhood Blindness and Vision Impairment. Ophthalmic Epidemiol 2024; 31:99-106. [PMID: 37073137 DOI: 10.1080/09286586.2023.2204149] [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: 06/28/2022] [Accepted: 04/12/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Reducing childhood blindness and vision impairment (BVI) remains a global health priority. Our purpose was to summarize the peer-reviewed literature to date on measuring and reporting childhood BVI using population-based surveys and vision examinations. METHODS We conducted a scoping review of published studies that aimed to report BVI prevalence in children or studies that aimed to report BVI prevalence in the general population but which also included children. There were 201 articles identified for abstract review, and 86 studies were included in the final review. RESULTS There were 52 studies (60%) that specifically aimed to investigate prevalence of blindness and/or vision impairment among child populations, while the remaining 34 studies aimed to study BVI in the general population but still reported data for age ranges that included children. The majority of researchers used the WHO criteria for blindness and vision impairment, sometimes with modifications. Age definitions for children varied considerably, with maximum cutoffs ranging from 3 to 20 years. CONCLUSION The available literature on childhood blindness indicates that while there has been substantial progress towards establishing an evidence base, more remains to be accomplished in terms of addressing gaps in understanding of the true prevalence and impacts of childhood blindness and vision loss. All studies in this review cited the need for improved vision care services, either for all ages or for the childhood years in particular.
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Affiliation(s)
| | - Caitlan DeVries
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Joshua Bosman
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthew Dunn
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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McCormick I, Butcher R, Ramke J, Bolster NM, Limburg H, Chroston H, Bastawrous A, Burton MJ, Mactaggart I. The Rapid Assessment of Avoidable Blindness survey: Review of the methodology and protocol for the seventh version (RAAB7). Wellcome Open Res 2024; 9:133. [PMID: 38828387 PMCID: PMC11143406 DOI: 10.12688/wellcomeopenres.20907.1] [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] [Accepted: 02/26/2024] [Indexed: 06/05/2024] Open
Abstract
The Rapid Assessment of Avoidable Blindness (RAAB) is a population-based cross-sectional survey methodology used to collect data on the prevalence of vision impairment and its causes and eye care service indicators among the population 50 years and older. RAAB has been used for over 20 years with modifications to the protocol over time reflected in changing version numbers; this paper describes the latest version of the methodology-RAAB7. RAAB7 is a collaborative project between the International Centre for Eye Health and Peek Vision with guidance from a steering group of global eye health stakeholders. We have fully digitised RAAB, allowing for fast, accurate and secure data collection. A bespoke Android mobile application automatically synchronises data to a secure Amazon Web Services virtual private cloud when devices are online so users can monitor data collection in real-time. Vision is screened using Peek Vision's digital visual acuity test for mobile devices and uncorrected, corrected and pinhole visual acuity are collected. An optional module on Disability is available. We have rebuilt the RAAB data repository as the end point of RAAB7's digital data workflow, including a front-end website to access the past 20 years of RAAB surveys worldwide. This website ( https://www.raab.world) hosts open access RAAB data to support the advocacy and research efforts of the global eye health community. Active research sub-projects are finalising three new components in 2024-2025: 1) Near vision screening to address data gaps on near vision impairment and effective refractive error coverage; 2) an optional Health Economics module to assess the affordability of eye care services and productivity losses associated with vision impairment; 3) an optional Health Systems data collection module to support RAAB's primary aim to inform eye health service planning by supporting users to integrate eye care facility data with population data.
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Affiliation(s)
- Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Robert Butcher
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Nigel M Bolster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- Peek Vision, London, UK
| | - Hans Limburg
- Independent consultant, Grootebroek, The Netherlands
| | - Hannah Chroston
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew Bastawrous
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- Peek Vision, London, UK
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
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Sherief ST, Tesfaye S, Eshetu Z, Ali A, Dimaras H. Child eye health in Ethiopia: a mixed methods analysis of policy and commitment to action. BMJ Open 2023; 13:e075622. [PMID: 37940160 PMCID: PMC10632828 DOI: 10.1136/bmjopen-2023-075622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 09/21/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Child eye health is a serious public health issue in Ethiopia, where children under the age of 15 account for over half of the population. Our aim was to review Ethiopian health policy and practice to reveal approaches and commitment to promotion and delivery of child eye health services. METHODS We conducted a mixed-methods situational analysis employing documentary analysis and key informant interview methods. Government publications touching on any element of child eye health were included. Key informants were eligible if they were leaders, authorities, researchers or clinicians involved in child health. Data was combined and analysed by narrative synthesis, using an adaptation of the Eye Care Situation Analysis Tool as a framework. FINDINGS Eleven documents developed by the Ministries of Health and Education were included and interviews with 14 key informants were conducted. A focus on child eye health was lacking in key health policy documents, demonstrated by limited allocation of funds, a shortage of human resources, and a subpar referral system across all levels of child eye care. CONCLUSION The study identified several gaps and limitations in child eye health in Ethiopia. There is a need for health policies that strengthen ownership, finance and partnerships for improved coordination, and collaboration with line ministries and other stakeholders to improve child eye health services in Ethiopia.
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Affiliation(s)
- Sadik Taju Sherief
- Ophthalmology, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
- Ophthalmology and Visual Science, SickKids Research Institute, Toronto, Ontario, Canada
| | | | - Zelalem Eshetu
- Biruh Vision Speciality Eye Center, Addis Ababa, Ethiopia
| | - Asim Ali
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Helen Dimaras
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- SickKids Research Institute, Toronto, Ontario, Canada
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Bhukya CR, Thakur P, Mudhivarthi BR, Singh G. Cybersecurity in Internet of Medical Vehicles: State-of-the-Art Analysis, Research Challenges and Future Perspectives. SENSORS (BASEL, SWITZERLAND) 2023; 23:8107. [PMID: 37836937 PMCID: PMC10575081 DOI: 10.3390/s23198107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/13/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023]
Abstract
The "Internet-of-Medical-Vehicles (IOMV)" is one of the special applications of the Internet of Things resulting from combining connected healthcare and connected vehicles. As the IOMV communicates with a variety of networks along its travel path, it incurs various security risks due to sophisticated cyber-attacks. This can endanger the onboard patient's life. So, it is critical to understand subjects related to "cybersecurity" in the IOMV to develop robust cybersecurity measures. In this paper, the goal is to evaluate recent trends and state-of-the-art publications, gaps, and future outlooks related to this research area. With this aim, a variety of publications between 2016 and 2023 from "Web-of-Science" and "Scopus" databases were analysed. Our analysis revealed that the IOMV is a niche and unexplored research area with few defined standards and frameworks, and there is a great need to implement robust cybersecurity measures. This paper will help researchers to gain a comprehensive idea of this niche research topic, as it presents an analysis of top journals and highly cited papers, their challenges and limitations, the system model and architecture of the IOMV, related applicable standards, potential cyber-attacks, factors causing cybersecurity risks, various artificial intelligence techniques for developing potential countermeasures, the assessment and parameterisation of cybersecurity risks, constraints and challenges, and future outlooks for implementing cybersecurity measures in the IOMV.
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Affiliation(s)
- Chidambar Rao Bhukya
- Symbiosis Institute of Technology, Symbiosis International Deemed University (SIDU), Pune 412115, India; (C.R.B.); (B.R.M.); (G.S.)
| | - Prabhat Thakur
- Symbiosis Institute of Technology, Symbiosis International Deemed University (SIDU), Pune 412115, India; (C.R.B.); (B.R.M.); (G.S.)
- Department of Electrical and Electronic Engineering Science, University of Johannesburg, Johannesburg 2006, South Africa
| | - Bhavesh Raju Mudhivarthi
- Symbiosis Institute of Technology, Symbiosis International Deemed University (SIDU), Pune 412115, India; (C.R.B.); (B.R.M.); (G.S.)
| | - Ghanshyam Singh
- Symbiosis Institute of Technology, Symbiosis International Deemed University (SIDU), Pune 412115, India; (C.R.B.); (B.R.M.); (G.S.)
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Scarr JP, Jagnoor J. Identifying strategic priorities for advancing global drowning prevention: a Delphi method. BMJ Glob Health 2023; 8:e013303. [PMID: 37709301 PMCID: PMC10503336 DOI: 10.1136/bmjgh-2023-013303] [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: 07/03/2023] [Accepted: 08/20/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION The burden of drowning is gaining prominence on the global agenda. Two United Nations system resolutions in 3 years reflect rising political support, but priorities remain undefined, and the issue lacks a global strategy. We aimed to identify strategic priorities for advancing global drowning prevention using a modified Delphi method. METHODS An advisory group was formed, and participants recruited with diverse expertise and backgrounds. We used document review, and data extracted from global health partnerships to identify strategic domains and draft priorities for global drowning prevention. Participants rated the priorities in two Delphi rounds, guided by relevance, feasibility and impact on equity, and where consensus was ≥70% of participants rating the priority as critical. RESULTS We recruited 134 participants from research (40.2%), policy (26.9%), technical (25.4%) and community (7.5%) backgrounds, with 38.1% representing low- and middle-income countries. We drafted 75 priorities. Following two Delphi rounds, 50 priorities were selected across the seven domains of research and further contextualisation, best practice guidance, capacity building, engagement with other health and sustainable development agendas, high-level political advocacy, multisectoral action and strengthening inclusive global governance. Participants scored priorities based on relevance (43.2%), feasibility (29.4%) and impact on equity (27.4%). CONCLUSION Our study identifies global priorities for drowning prevention and provides evidence for advocacy of drowning prevention in all pertinent policies, and in all relevant agendas. The priorities can be applied by funders to guide investment, by researchers to frame study questions, by policymakers to contrast views of expert groups and by national coalitions to anchor national drowning prevention plans. We identify agendas including disaster risk reduction, sustainable development, child and adolescent health, and climate resilience, where drowning prevention might offer co-benefits. Finally, our findings offer a strategic blueprint as the field looks to accelerate action, and develop a global strategy for drowning prevention.
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Affiliation(s)
- Justin-Paul Scarr
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- Injury Division, The George Institute for Global Health, New Delhi, India
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Tan TF, Thirunavukarasu AJ, Jin L, Lim J, Poh S, Teo ZL, Ang M, Chan RVP, Ong J, Turner A, Karlström J, Wong TY, Stern J, Ting DSW. Artificial intelligence and digital health in global eye health: opportunities and challenges. Lancet Glob Health 2023; 11:e1432-e1443. [PMID: 37591589 DOI: 10.1016/s2214-109x(23)00323-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/26/2023] [Accepted: 07/04/2023] [Indexed: 08/19/2023]
Abstract
Global eye health is defined as the degree to which vision, ocular health, and function are maximised worldwide, thereby optimising overall wellbeing and quality of life. Improving eye health is a global priority as a key to unlocking human potential by reducing the morbidity burden of disease, increasing productivity, and supporting access to education. Although extraordinary progress fuelled by global eye health initiatives has been made over the last decade, there remain substantial challenges impeding further progress. The accelerated development of digital health and artificial intelligence (AI) applications provides an opportunity to transform eye health, from facilitating and increasing access to eye care to supporting clinical decision making with an objective, data-driven approach. Here, we explore the opportunities and challenges presented by digital health and AI in global eye health and describe how these technologies could be leveraged to improve global eye health. AI, telehealth, and emerging technologies have great potential, but require specific work to overcome barriers to implementation. We suggest that a global digital eye health task force could facilitate coordination of funding, infrastructural development, and democratisation of AI and digital health to drive progress forwards in this domain.
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Affiliation(s)
- Ting Fang Tan
- Artificial Intelligence and Digital Innovation Research Group, Singapore Eye Research Institute, Singapore; Singapore National Eye Centre, Singapore General Hospital, Singapore
| | - Arun J Thirunavukarasu
- Artificial Intelligence and Digital Innovation Research Group, Singapore Eye Research Institute, Singapore; Corpus Christi College, University of Cambridge, Cambridge, UK; School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Liyuan Jin
- Artificial Intelligence and Digital Innovation Research Group, Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Joshua Lim
- Artificial Intelligence and Digital Innovation Research Group, Singapore Eye Research Institute, Singapore; Singapore National Eye Centre, Singapore General Hospital, Singapore
| | - Stanley Poh
- Artificial Intelligence and Digital Innovation Research Group, Singapore Eye Research Institute, Singapore; Singapore National Eye Centre, Singapore General Hospital, Singapore
| | - Zhen Ling Teo
- Artificial Intelligence and Digital Innovation Research Group, Singapore Eye Research Institute, Singapore; Singapore National Eye Centre, Singapore General Hospital, Singapore
| | - Marcus Ang
- Singapore National Eye Centre, Singapore General Hospital, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - R V Paul Chan
- Illinois Eye and Ear Infirmary, University of Illinois College of Medicine, Urbana-Champaign, IL, USA
| | - Jasmine Ong
- Pharmacy Department, Singapore General Hospital, Singapore
| | - Angus Turner
- Lions Eye Institute, University of Western Australia, Nedlands, WA, Australia
| | - Jonas Karlström
- Duke-NUS Medical School, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore National Eye Centre, Singapore General Hospital, Singapore; Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Jude Stern
- The International Agency for the Prevention of Blindness, London, UK
| | - Daniel Shu-Wei Ting
- Artificial Intelligence and Digital Innovation Research Group, Singapore Eye Research Institute, Singapore; Singapore National Eye Centre, Singapore General Hospital, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore.
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Ghanbarnia MJ, Hosseini SR, Ghasemi M, Roustaei GA, Mekaniki E, Ghadimi R, Bijani A, Rasoulinejad SA. Association of age-related eye diseases with cognitive frailty in older adults: a population-based study. Aging Clin Exp Res 2023:10.1007/s40520-023-02458-z. [PMID: 37269465 DOI: 10.1007/s40520-023-02458-z] [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: 03/24/2023] [Accepted: 05/26/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Age-related eye diseases and cognitive frailty (CF) are both important predictors of adverse health outcomes in older adults, however, little is known about their association. AIMS To demonstrate the association between age-related eye diseases and cognitive frailty in a population of Iranian older adults. METHODS In this cross-sectional, population-based study, we included 1136 individuals (female n = 514) aged 60 years and older (mean 68.8 ± 6.7 years) who participated in the second cycle of the Amirkola Health and Aging Project (AHAP) between 2016 and 2017. Cognitive function and frailty were evaluated based on Mini-Mental State Examination (MMSE) and the FRAIL scale respectively. Cognitive frailty was defined as coexistence of cognitive impairment (CI) and physical frailty (PF), excluding confirmed cases of dementia such as Alzheimer's disease. Cataract, diabetic retinopathy (DR), age-related macular degeneration (AMD), elevated intraocular pressure (IOP ≥ 21 mmHg) and glaucoma suspects (vertical cup to disc ratio (VCDR) ≥ 0.6) were diagnosed based on standardized grading protocols. Associations between eye diseases and cognitive frailty were evaluated through binary logistic regression analysis. RESULTS Overall, CI, PF and CF were observed in 257 (22.6%), 319 (28.1%) and 114 (10.0%) participants respectively. After adjusting for confounders and ophthalmic conditions, individuals with cataract were more likely to have CF (OR 1.66; p-value 0.043), while DR, AMD, elevated IOP and glaucoma suspects (OR 1.32, 1.62, 1.42, 1.36, respectively) were not significantly associated with CF. Furthermore, cataract was significantly associated with CI (OR 1.50; p-value 0.022), but not with frailty (OR 1.18; p-value 0.313). CONCLUSION Older adults with cataract were more likely to have cognitive frailty and cognitive impairment. This association demonstrates the implications of age-related eye diseases beyond ophthalmology and substantiates the need for further research involving cognitive frailty in the context of eye diseases and visual impairment.
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Affiliation(s)
- Mohammad Javad Ghanbarnia
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Seyed Reza Hosseini
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehrnoosh Ghasemi
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Gholam Abbas Roustaei
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Ebrahim Mekaniki
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Reza Ghadimi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Seyed Ahmad Rasoulinejad
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
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11
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Goodman L, Hamm L, Tousignant B, Black J, Misra S, Woodburn S, Keay L, Harwood M, Gordon I, Evans JR, Ramke J. Primary eye health services for older adults as a component of universal health coverage: a scoping review of evidence from high income countries. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 35:100560. [PMID: 37424679 PMCID: PMC10326716 DOI: 10.1016/j.lanwpc.2022.100560] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
In pursuit of Universal Health Coverage (UHC) for eye health, countries must strengthen services for older adults, who experience the highest prevalence of eye conditions. This scoping review narratively summarised (i) primary eye health services for older adults in eleven high-income countries/territories (from government websites), and (ii) the evidence that eye health services reduced vision impairment and/or provided UHC (access, quality, equity, or financial protection) (from a systematic literature search). We identified 76 services, commonly comprehensive eye examinations ± refractive error correction. Of 102 included publications reporting UHC outcomes, there was no evidence to support vision screening in the absence of follow-up care. Included studies tended to report the UHC dimensions of access (n=70), equity (n=47), and/or quality (n=39), and rarely reported financial protection (n=5). Insufficient access for population subgroups was common; several examples of horizontal and vertical integration of eye health services within the health system were described. Funding This work was funded by Blind Low Vision New Zealand for Eye Health Aotearoa.
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Affiliation(s)
- Lucy Goodman
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Lisa Hamm
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Benoit Tousignant
- School of Optometry, Université de Montréal, 3774 Jean-Brillant, Montreal, Quebec H3T1P1, Canada
- School of Public Health, Université de Montréal, 3774 Jean-Brillant, Montreal, Quebec H3T1P1, Canada
| | - Joanna Black
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Stuti Misra
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, 85 Park Road, Grafton 1023, Auckland, New Zealand
| | - Sophie Woodburn
- Specsavers Queenstown, 12 Hawthorne Drive, Frankton, Queenstown 9300, New Zealand
| | - Lisa Keay
- School of Optometry and Vision Science, UNSW Sydney, Rupert Myers Building (M15), Southern Dr, Kensington, NSW 2052, Australia
- The George Institute for Global Health, UNSW Sydney, Level 5/1 King St, Newtown NSW 2042, Australia
| | - Matire Harwood
- Department of General Practice & Primary Health Care, School of Population Health, University of Auckland, 28 Park Ave, Grafton Auckland 1023, New Zealand
| | - Iris Gordon
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom
| | - Jennifer R. Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom
- Centre for Public Health, Institute of Clinical Science, Block A, Royal Victoria Hospital, Queen's University Belfast BT12 6BA, United Kingdom
| | - Jacqueline Ramke
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom
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12
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Jiang Y, Shen Y, Chen X, Niu L, Li B, Cheng M, Lei Y, Xu Y, Wang C, Zhou X, Wang X. Artificial intelligence-based refractive error prediction and EVO-implantable collamer lens power calculation for myopia correction. EYE AND VISION (LONDON, ENGLAND) 2023; 10:22. [PMID: 37121995 PMCID: PMC10150472 DOI: 10.1186/s40662-023-00338-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/16/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Implantable collamer lens (ICL) has been widely accepted for its excellent visual outcomes for myopia correction. It is a new challenge in phakic IOL power calculation, especially for those with low and moderate myopia. This study aimed to establish a novel stacking machine learning (ML) model for predicting postoperative refraction errors and calculating EVO-ICL lens power. METHODS We enrolled 2767 eyes of 1678 patients (age: 27.5 ± 6.33 years, 18-54 years) who underwent non-toric (NT)-ICL or toric-ICL (TICL) implantation during 2014 to 2021. The postoperative spherical equivalent (SE) and sphere were predicted using stacking ML models [support vector regression (SVR), LASSO, random forest, and XGBoost] and training based on ocular dimensional parameters from NT-ICL and TICL cases, respectively. The accuracy of the stacking ML models was compared with that of the modified vergence formula (MVF) based on the mean absolute error (MAE), median absolute error (MedAE), and percentages of eyes within ± 0.25, ± 0.50, and ± 0.75 diopters (D) and Bland-Altman analyses. In addition, the recommended spheric lens power was calculated with 0.25 D intervals and targeting emmetropia. RESULTS After NT-ICL implantation, the random forest model demonstrated the lowest MAE (0.339 D) for predicting SE. Contrarily, the SVR model showed the lowest MAE (0.386 D) for predicting the sphere. After TICL implantation, the XGBoost model showed the lowest MAE for predicting both SE (0.325 D) and sphere (0.308 D). Compared with MVF, ML models had numerically lower values of standard deviation, MAE, and MedAE and comparable percentages of eyes within ± 0.25 D, ± 0.50 D, and ± 0.75 D prediction errors. The difference between MVF and ML models was larger in eyes with low-to-moderate myopia (preoperative SE > - 6.00 D). Our final optimal stacking ML models showed strong agreement between the predictive values of MVF by Bland-Altman plots. CONCLUSION With various ocular dimensional parameters, ML models demonstrate comparable accuracy than existing MVF models and potential advantages in low-to-moderate myopia, and thus provide a novel nomogram for postoperative refractive error prediction and lens power calculation.
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Affiliation(s)
- Yinjie Jiang
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yang Shen
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xun Chen
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lingling Niu
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Boliang Li
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yadi Lei
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Chongyang Wang
- Research and Development Department, Shanghai MediWorks Precision Instruments Company Limited, Shanghai, China
| | - Xingtao Zhou
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
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13
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Li Y, Yip MYT, Ting DSW, Ang M. Artificial intelligence and digital solutions for myopia. Taiwan J Ophthalmol 2023; 13:142-150. [PMID: 37484621 PMCID: PMC10361438 DOI: 10.4103/tjo.tjo-d-23-00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 07/25/2023] Open
Abstract
Myopia as an uncorrected visual impairment is recognized as a global public health issue with an increasing burden on health-care systems. Moreover, high myopia increases one's risk of developing pathologic myopia, which can lead to irreversible visual impairment. Thus, increased resources are needed for the early identification of complications, timely intervention to prevent myopia progression, and treatment of complications. Emerging artificial intelligence (AI) and digital technologies may have the potential to tackle these unmet needs through automated detection for screening and risk stratification, individualized prediction, and prognostication of myopia progression. AI applications in myopia for children and adults have been developed for the detection, diagnosis, and prediction of progression. Novel AI technologies, including multimodal AI, explainable AI, federated learning, automated machine learning, and blockchain, may further improve prediction performance, safety, accessibility, and also circumvent concerns of explainability. Digital technology advancements include digital therapeutics, self-monitoring devices, virtual reality or augmented reality technology, and wearable devices - which provide possible avenues for monitoring myopia progression and control. However, there are challenges in the implementation of these technologies, which include requirements for specific infrastructure and resources, demonstrating clinically acceptable performance and safety of data management. Nonetheless, this remains an evolving field with the potential to address the growing global burden of myopia.
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Affiliation(s)
- Yong Li
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology and Visual Sciences, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Michelle Y. T. Yip
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Daniel S. W. Ting
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology and Visual Sciences, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology and Visual Sciences, Duke-NUS Medical School, National University of Singapore, Singapore
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14
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Furtado JM, Fernandes AG, Silva JC, Del Pino S, Hommes C. Indigenous Eye Health in the Americas: The Burden of Vision Impairment and Ocular Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3820. [PMID: 36900846 PMCID: PMC10000964 DOI: 10.3390/ijerph20053820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/13/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
Review of the burden of vision impairment and blindness and ocular disease occurrence in Indigenous Peoples of the Americas. We systematically reviewed findings of the frequency of vision impairment and blindness and/or frequency of ocular findings in Indigenous groups. The database search yielded 2829 citations, of which 2747 were excluded. We screened the full texts of 82 records for relevance and excluded 16. The remaining 66 articles were examined thoroughly, and 25 presented sufficient data to be included. Another 7 articles derived from references were included, summing a total of 32 studies selected. When considering adults over 40 years old, the highest frequencies of vision impairment and blindness in Indigenous Peoples varied from 11.1% in high-income North America to 28.5% in tropical Latin America, whose rates are considerably higher than those in the general population. Most of the ocular diseases reported were preventable and/or treatable, so blindness prevention programs should focus on accessibility to eye examinations, cataract surgeries, control of infectious diseases, and spectacles distribution. Finally, we recommend actions in six areas of attention towards improving the eye health in Indigenous Peoples: access and integration of eye services with primary care; telemedicine; customized propaedeutics; education on eye health; and quality of data.
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Affiliation(s)
- João Marcello Furtado
- Pan American Health Organization, Washington, DC 20037, USA
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14015-010, Brazil
| | - Arthur Gustavo Fernandes
- Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, Sao Paulo 04023-062, Brazil
- Department of Anthropology and Archaeology, University of Calgary, Calgary, AB T2N 4N1, Canada
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15
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Huang Y, Mustapha J, Harrison-Williams L, Fashina T, Randleman C, Ifantides C, Shantha JG, Yeh S. Global Ophthalmic Health Initiatives in Ebola and Emerging Infectious Disease Outbreaks: Implications for Vision Health Systems, Program Implementation, and Disease Surveillance. Int Ophthalmol Clin 2023; 63:79-89. [PMID: 36598835 PMCID: PMC9819215 DOI: 10.1097/iio.0000000000000443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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16
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Flessa S. Cataract Surgery in Low-Income Countries: A Good Deal! Healthcare (Basel) 2022; 10:healthcare10122580. [PMID: 36554103 PMCID: PMC9778186 DOI: 10.3390/healthcare10122580] [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: 10/25/2022] [Revised: 12/01/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
Cataract is a major cause of blindness worldwide. In particular, in low-income countries, the burden of disease as well as its direct and indirect economic cost are a major challenge for the population and economy. In many cases, it would be possible to prevent or cure blindness with a comparably simple cataract surgery, but many countries lack the resources to strengthen healthcare systems and implement broad cataract surgery programs reaching, in particular, the rural poor. In this paper, we analyse whether such an intervention could be cost-effective or even cost-saving for the respective health systems. We calculate the net value of the lifelong costs of cataract with and without surgery. This calculation includes direct costs (e.g., treatment, glasses, surgery) as well as indirect cost of the caregiver and the patient. We total all costs from the year of onset of cataract until death and discount the respective values to the year of onset. We define the surgery as cost-saving if the net-value of costs with surgery is lower than without surgery. If the cost per quality adjusted life year is lower than one gross national product per capita, we define the intervention as highly cost-effective. We find that the cost-effectiveness of cataract surgery depends on the age of onset of the disease and the age of surgery. If the surgery is performed with the beginning of severe impairment, even surgery of a 78-year-old patient is still cost-saving. Almost all possible constellations are highly cost-effective, only for the very old it is questionable whether the surgery should be performed. The simulations show that cataract surgery is one of the most cost-effective interventions. However, millions of people in low-income countries still have no chance to prevent or cure blindness due to limited resources. The findings of this paper clearly call for a stronger effort to reach poor and rural populations with this cost-effective service.
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Affiliation(s)
- Steffen Flessa
- Department of Health Care Management, Faculty of Law and Economics, University of Greifswald, 17487 Greifswald, Germany
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17
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Luo Y, Zhang Q, Han L, Shen Z, Chen Y, Wang K, Huang Z, De Fries CM, Cao G, Su H, Xu H, Chen Z, Ren Z, Hu Y, Xu B. Trends in the prevalence of vision impairment among the oldest-old Chinese population from 1998 to 2018. J Glob Health 2022; 12:11006. [PMID: 35862489 DOI: 10.7189/jogh.12.11006] [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] Open
Abstract
Background Vision impairment has become a prominent public health issue worldwide. However, little is known about vision impairment prevalence trends among the oldest-old adults in China. This study aimed to examine 20-year trends in the prevalence of vision impairment among the oldest-old Chinese adults and explore the contributions of sociodemographic variables, health behaviours, and chronic conditions to the trends. Methods This retrospective longitudinal study used data from the Chinese Longitudinal Healthy Longevity Survey during 1998-2018. A total of 45 849 participants aged ≥80 years at study entry were included. Vision impairment was assessed by an adapted Landolt-C chart at each wave. We examined unadjusted and adjusted nonlinear trends using generalized estimating equation models incorporating a natural cubic spline. We conducted linear regression models to estimate absolute annual prevalence changes and determine the contributions of sociodemographic variables, health behaviours, and chronic conditions to the trends. Results The fully adjusted prevalence doubled from 5.5% (95% confidence interval (CI) = 5.1%-6.0%) in 1998 to 10.7% (95% CI = 9.9%-11.5%) in 2011 and slightly increased to 11.1% (95% CI = 10.3%-12.0%) in 2018 among the oldest-old Chinese population. Glaucoma, cataracts, cognitive impairment, hearing impairment, and urban residence were significant contributors to changes in vision impairment prevalence during 1998-2018. Differences in vision impairment prevalence associated with glaucoma and cataracts narrowed since 2005. Disparities in the trends among cognitively impaired and unimpaired older adults remained unchanged over time. Similar results were observed in older people with and without hearing impairment. Conclusions Vision impairment prevalence among the oldest-old Chinese population increased from 1998 to 2011 and remained stable from 2011 to 2018. Future work is needed to improve the prevention and management of chronic diseases associated with vision impairment to reduce its prevalence.
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Affiliation(s)
- Yan Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Qin Zhang
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China.,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
| | - Ling Han
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Zhongchen Shen
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China
| | - Yuming Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Ziting Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Carson M De Fries
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Guiying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Hexuan Su
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Huiwen Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Zishuo Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Zeqin Ren
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China.,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Beibei Xu
- Medical Informatics Center, Peking University, Beijing, China
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18
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Barriers to eye care for older people in the Philippines. THE LANCET. HEALTHY LONGEVITY 2022; 3:e130. [PMID: 36098287 DOI: 10.1016/s2666-7568(22)00025-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/27/2022] [Indexed: 12/24/2022] Open
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19
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Githeko AK, Gichuhi S. Improving cataract services by asking patients for their feedback. COMMUNITY EYE HEALTH 2022; 35:4-5. [PMID: 36704529 PMCID: PMC9872210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
| | - Stephen Gichuhi
- Senior Lecturer, Chairman: Department of Ophthalmology, University of Nairobi. Kenya
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