Time trends and gender disparities of Chinese cataract burden and their predictions

The Association Between Sleep Health and a History of Cataract Surgery in the United States Based on the National Health and Nutrition Examination Survey (NHANES) 2005-2008

Background: The aim of this study was to assess the relationship between sleep-related variables (sleep duration, sleep trouble, and sleep disorder), comprehensive sleep patterns, and the reported history of cataract surgery in the U.S. population aged 20 years and older. Methods: We utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005-2008 database. First, we analyzed the association between covariates and the reported history of cataract surgery using univariable Poisson regression. Subsequently, we constructed three models to evaluate the association between sleep-related variables and the reported history of cataract surgery using multivariable Poisson regression. Subgroup analyses were conducted to determine whether the association between sleep and the reported history of cataract surgery exhibited heterogeneity. Finally, we performed a sensitivity analysis to assess the stability of the results. Results: A total of 8591 participants were included in this study, among whom 774 had a history of cataract surgery. After adjusting for all covariates, participants experiencing sleep trouble had a higher prevalence of reported history of cataract surgery than participants without sleep trouble [PR = 1.40; 95%CI = (1.22, 1.62)]. Regarding combined sleep, participants with poor sleep patterns had a 36% higher prevalence of reported history of cataract surgery than those with healthy sleep patterns [PR = 1.36; 95%CI = (1.13, 1.64)]. The results of the sensitivity analysis indicate that the relationship between sleep patterns and the reported history of cataract surgery is robust. Conclusions: Sleep trouble and poor sleep patterns are positively linked to the high prevalence of a reported history of cataract surgery. Further research is needed to explore the underlying mechanisms.

Potential role of βB1 crystallin in cataract formation:a systematic review

βB1 crystallin is a soluble structural protein of the lens, which plays an important role in maintaining lens transparency and cell homeostasis. βB1 crystallin has conservative dual structural domains, each of which contains two Greek key motifs. Gene mutation or post-translational modification can affect the structure and function of βB1 crystallin, leading to abnormal protein aggregation and the occurrence of cataracts. This article will review the protein structure, post-translational modification, and related gene mutations of βB1 crystallin. Understanding these molecular mechanisms of βB1crystallin mutations not only aids in clarifying the pathogenesis of cataracts but also provides potential targets for pharmacological interventions.

Global regional and national burden of cataract attributable to high body mass index from 1990 to 2019

OBJECTIVES

In order to estimate long-term trends of the years lived with disability (YLDs) for cataract due to high body mass index (BMI).

DESIGN AND PARTICIPANTS

Data were retrieved from the Global Burden of Disease (GBD) 2019. The global cases, age-standardised rates (ASR) of YLDs for cataract attributable to high BMI were described by age, sex, geographical location and sociodemographic index (SDI). The estimated average annual percentage change (AAPC) was analysed to quantify the trends of ASR of YLD from 1990 to 2019.

PRIMARY OUTCOME MEASURES

Years lived with disability.

RESULTS

Globally, there were 370.4 (95% UI: 163.2 to 689.3) YLDs due to cataract attributed to high BMI in 2019, more than triple the number in 1990. Moreover, the ASR of YLD increased during 1990-2019, with AAPC of 1.54 (95% CI: 1.41 to 1.66). In 2019, the burden of cataract due to high BMI was higher in females and the elderly population. North Africa and the Middle East were the high-risk areas of cataract attributable to high BMI in 2019, with Saudi Arabia being the country with the heaviest burden. In terms of SDI, low-middle SDI regions had the greatest number of cataract-related YLDs due to high BMI in 2019.

CONCLUSION

The global YLDs for cataract due to high BMI have shown a notable increase from 1990 to 2019. Addressing BMI control may contribute to cataract prevention, highlighting a potential public health impact, particularly in low-SDI locations and among the elderly.

Global prevalence of cataract surgery

PURPOSE OF REVIEW

The objective of this review article is to ascertain the global distribution of cataract surgery and evaluate the extent of its coverage in recent years.

RECENT FINDINGS

The cataract surgical rate (CSR) has been reported from 36 to 12 800 (per million population) across different countries. The average cataract surgical coverage (CSC) in the majority of countries was around 50% or lower. Additionally, in many countries, the efficient CSC (eCSC) deviates from the CSC, emphasizing the importance of attention to the quality of surgical procedures. Socioeconomic status and access to health services are key determinants in the distribution of cataract surgery. This procedure is more prevalent among older individuals, with a higher incidence among men and private insurances tend to cover a larger portion of cataract surgeries. The pandemic of COVID-19 has had a detrimental effect on cataract surgery rates in numerous countries.

SUMMARY

The rate of cataract surgery and its extent of coverage in certain countries is inadequate. The primary factor influencing the quantity and coverage of cataract surgeries is the economic status of the countries. Additionally, government support through insurance and the provision of appropriate healthcare services can contribute to an increase in cataract surgeries.

Anxiety and depression in Chinese cataract patients: a network analysis

BACKGROUND

Prior research has demonstrated that people with cataracts are more likely to experience anxiety and depression co-occurring when the condition advances to a degree that impairs vision beyond its physiological effects. According to network theory, there is a connection between the interplay of anxiety and depression and the genesis of comorbidity. Using a network viewpoint, our study examined the network properties of anxiety-depression in cataract patients to pinpoint central and bridge symptoms as well as possible intervention targets for more focused and successful therapies.

METHOD

A total of 1,254 cataract patients were enrolled in our study. The Nine-item Patient Health Questionnaire (PHQ-9) and the Seven-item Generalized Anxiety Disorder scale (GAD-7) were used to measure depression and anxiety symptoms, respectively. The R 4.3.3 software was utilized for network model building and descriptive statistics. Furthermore, we displayed a "Thoughts of death" flow network.

RESULT

In the network, A5 "Restlessness"- D7 "Concentration difficulties" showed the strongest edge. A2 "Uncontrollable worry" and D2 "Depressed or sad mood" could be identified as the central symptoms. A7 "Afraid something will happen" and D7 "Concentration difficulties" could be identified as bridge symptoms. The strongest edge in the flow network was D9 "Thoughts of death"-D6 "Feeling of worthlessness".

CONCLUSION

"Uncontrollable worry", "Depressed or sad mood", "Afraid something will happen" and "Concentration difficulties" could be potential targets for the prevention of anxiety and depression in cataract patients. Furthermore, this study emphasizes how important it is to prevent suicide in cataract patients, and the symptom "Feeling of worthlessness" can be used as an effective target.

Based on the relationship between anxiety of existential meaninglessness, hope level, and fear of progression, explored the effect of preoperative nursing with Orem theory in the senile cataract population

Background

Cataracts, characterized by a decrease in vision due to the clouding of the lens, can progress to blindness in advanced stages. The rising incidence of cataract cases has led to a significant number of patients experiencing negative emotions associated with vision loss, thereby diminishing their quality of life. In clinical practice, it is imperative for healthcare professionals to consider the psychological well-being of cataract patients. Currently, there is a scarcity of research focusing on psychological evaluations, such as assessing feelings of meaninglessness among individuals with cataracts.

Objective

This study aims to investigate the factors influencing the anxiety of existential meaninglessness and to explore the relationships among existential anxiety, Herth hope index levels and fear of progression in the elderly cataract-affected population. Additionally, it evaluates the effectiveness of Orem's nursing care strategies.

Methods

Utilizing a sociodemographic questionnaire, the Existential Meaninglessness Anxiety Scale (EM-A), Herth Hope Index Level Scale, and the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), this research employed convenience sampling for a cross-sectional and intervention study. The retrospective study sample comprised 1,029 individuals, while the intervention study included 317. The intervention design assessed psychological changes in existential meaninglessness following Orem's preoperative nursing interventions. Multiple linear regression analysis was employed to ascertain the determinants of EM-A within the population of elderly patients with senile cataracts. Pearson correlation analysis elucidated the relationship between EM-A, levels of hope, and the FoP-Q-SF among this demographic. Subsequent investigations, utilizing a t-test, evaluated the effects by comparing the data before and after the implementation of the interventions.

Results

The correlation between EM-A, hope levels, and FoP-Q-SF was statistically significant (p < 0.05). Factors such as age, education level, alcohol consumption habits, hope levels, and FoP-Q-SF scores significantly affected EM-A scores (p < 0.05). Orem's nursing framework significantly reduced existential anxiety (p < 0.05).

Conclusion

Among elderly patients with cataracts, existential anxiety was generally moderate. Hope levels and fear of progression were closely associated with the EM-A. The novel Orem preoperative care model effectively addresses clinical issues. In clinical practice, it is crucial to address psychological problems and enhance patients' quality of life.

Are there sex-based disparities in cataract surgery?

AIM

To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery.

METHODS

This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of Medicine. Data collected included the patient's health history, ocular comorbidities, operative and post-operative complications, and the post-operative best corrected visual acuity (BCVA). The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the study.

RESULTS

A total of 11 977 eyes from 7253 patients were included in the study. Ocular comorbidities differed by sex, with males having significantly higher percentages of traumatic cataracts (males 0.7% vs females 0.1%), prior ocular surgery (6.7% vs 5.5%), and mature cataracts (2.8% vs 1.9%). Conversely, females had significantly higher rates of pseudoexfoliation (2.0% vs 3.2%). In unadjusted analysis, males had higher rates of posterior capsular rupture (0.8% vs 0.4%) and vitreous loss (1.0% vs 0.6%), but this difference was not significant after adjustment for confounders. Males had a significantly increased risk of post-operative retinal detachment, but in multivariable analysis this was no longer significant. Males were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy for posterior capsule opacification (OR=0.8, 95%CI=0.7-0.9, P=0.0005). The BCVA was slightly worse for males pre-operatively; but post-operatively, both sexes exhibited similar visual acuity of Snellen equivalent 20/25.

CONCLUSION

The study finds that in a cohort of patients presenting for cataract surgery, sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for males. However, observed surgical complication rates exhibit almost no difference by sex after adjusting for pre-operative differences and post-operative BCVA is similar between sexes.