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Wu M, Zhang X, Karunaratne S, Lee JH, Lampugnani ER, Selva KJ, Chung AW, Mueller SN, Chinnery HR, Downie LE. Intravital imaging of the human cornea reveals the differential effects of season on innate and adaptive immune cell morphodynamics. Ophthalmology 2024:S0161-6420(24)00273-2. [PMID: 38703795 DOI: 10.1016/j.ophtha.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
PURPOSE While the external environment has been shown to shape the systemic human immune landscape, defining the in vivo immune status of peripheral tissues has remained a technical challenge. We recently developed functional in vivo confocal microscopy (Fun-IVCM) for dynamic, longitudinal imaging of corneal immune cells in living humans. This study investigated the effect of seasonal-driven environmental factors on the density, morphology and dynamic behavior of human corneal immune cell subsets. DESIGN Longitudinal, observational clinical study. PARTICIPANTS Sixteen healthy participants (18-40 years) attended two visits in distinct seasons in Melbourne, Australia (Visit 1: Spring/Summer: November-December 2021; Visit 2: Autumn/Winter: April-June 2022). METHODS Environmental data were collected over each period. Participants underwent ocular surface examinations and corneal Fun-IVCM (Heidelberg HRT-3, Rostock Corneal Module). Volume scans (80μm) were acquired at 5.5±1.5 minute intervals, for up to five timepoints. Time-lapse videos were created to analyze corneal immune cells, comprising epithelial T cells and dendritic cells (DCs), and stromal macrophages. Tear cytokines were analyzed using multiplex bead-based immunoassay. MAIN OUTCOME MEASURES Difference in the density, morphological and dynamic parameters of corneal immune cell subsets over the study periods. RESULTS Visit 1 was characterized by higher temperature, lower humidity, and higher air particulate and pollen levels than Visit 2. Clinical ocular surface parameters, and the density of immune cell subsets were similar across visits. At Visit 1 (Spring/Summer), corneal epithelial DCs were larger and more elongated, with a lower dendrite probing speed (0.38±0.21 vs 0.68±0.33μm/min, p<0.001) relative to Visit 2; stromal macrophages were more circular and had less dynamic activity (Visit 1: 7.2±1.9 vs Visit 2: 10.3±3.7 'dancing index', p<0.001). T cell morphology and dynamics were unchanged across periods. Basal tear levels of IL-2 and CXCL10 were lower during Spring/Summer. CONCLUSION This novel study shows that the in vivo morphodynamics of innate corneal immune cells (DCs, macrophages) are modified by environmental factors, but such effects are not evident for adaptive immune cells (T cells). The cornea is a potential non-invasive, in vivo 'window' to season-dependent changes to the human immune system, with capacity to yield new insight into environmental influences on immune regulation.
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Affiliation(s)
- Mengliang Wu
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia; Department of Microbiology and Immunology, The University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Xinyuan Zhang
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Senuri Karunaratne
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Ji-Hyun Lee
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Edwin R Lampugnani
- School of BioSciences, The University of Melbourne, Parkville, VIC, Australia; Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Kevin J Selva
- Department of Microbiology and Immunology, The University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Amy W Chung
- Department of Microbiology and Immunology, The University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Scott N Mueller
- Department of Microbiology and Immunology, The University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Holly R Chinnery
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia.
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Surapaneni L, Orlofsky P, Kombo N. Uveitis Onset and Flare-Up: Does the Time of Year Matter? Ocul Immunol Inflamm 2024:1-7. [PMID: 38411923 DOI: 10.1080/09273948.2024.2320701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/14/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE This retrospective chart review tests the hypothesis that initial presentation and flare-up of non-infectious anterior, intermediate, and posterior uveitis varies by month, temperature season, and calendar season among the patient population in Connecticut. METHODS The medical records of all adult patients presenting with a chief concern or diagnosis of "uveitis" at a university-based clinic between March 2013 and February 2019 and a community-based clinic between January 2016 and February 2019 in Connecticut were reviewed. Ongoing, chronic uveitis and infectious/traumatic uveitis were excluded. Patient age, sex, comorbid autoimmune conditions, time of onset, and anatomical location of uveitis was collected. χ 2 testing evaluated variation in uveitis presentation based on month, calendar season, and temperature. RESULTS 353 cases of endogenous uveitis were identified among 272 patients. There was no significant variation by month, calendar season, or temperature across the entire population. There was no significant variation by temperature when assessing anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis cases separately. Though flare-ups did not show any significant seasonal trends, there was significant variation by temperature for new uveitis episodes. Uveitis episodes in patients with autoimmune conditions were shown to have significant variation by temperature. Uveitis episodes in HLA-B27 positive patients were found to have significant variation by both temperature and month. CONCLUSION While variation by month, calendar season, or temperature is not present for all uveitis patients, a subset of patients with comorbid autoimmune conditions, specifically HLA-B27 positive, experience temperature variations with increasing incidence of flare-ups in transitional months in Connecticut.
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Affiliation(s)
- Leena Surapaneni
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut, USA
| | - Paige Orlofsky
- School of Medicine, Quinnipiac University, North Haven, Connecticut, USA
| | - Ninani Kombo
- Department of Ophthalmology and Visual Science, Yale University, New Haven, Connecticut, USA
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Sesmero-Garcia C, Serrador M, Revenga M, Gonzalez-Lopez JJ. An Update on the Epidemiology of Uveitis in an Urban Setting in Northern Madrid, Spain. Ocul Immunol Inflamm 2023; 31:1623-1628. [PMID: 35793514 DOI: 10.1080/09273948.2022.2089900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/08/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To describe the incidence, prevalence and etiologies of uveitis in Madrid, Spain. METHODS A retrospective cross-sectional study was performed in a single hospital. All consecutive cases of uveitis that attended the Hospital during year 2019 were included. Mean incidence and prevalence were calculated. RESULTS Three hundred and one cases were included. Of these, 127 were incident. This represents an incidence of 21.24 new cases per 100,000 persons/year, and a prevalence was 50.43 cases per 100,000 persons. Mean age was 56.89 ± 18.78 years, and 159 were women (52.8%). Sixty-two cases were infectious (20.6%). Age (p = .005), initial visual acuity (p = .001) and cystoid macular oedema (CMO; p = .010) were found to be independent predictors of the final best corrected visual acuity (BCVA) in patients with uveitis. CONCLUSIONS Uveitis affects approximately 1 in 1800 persons in northern Madrid. Younger age, better initial visual acuities and the presence of CMO predicted better final BCVA.
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Affiliation(s)
| | - Mercedes Serrador
- Surgery Department, Universidad de Alcalá School of Medicine, Madrid, Spain
- Ophthalmology Department, Hospital Universitario Ramón Y Cajal, IRYCIS, Madrid, Spain
| | - Marcelino Revenga
- Medicine Department, Universidad de Alcalá School of Medicine, Madrid, Spain
- Rheumatology Department, Hospital Universitario Ramón Y Cajal, IRYCIS, Madrid, Spain
| | - Julio J Gonzalez-Lopez
- Surgery Department, Universidad de Alcalá School of Medicine, Madrid, Spain
- Ophthalmology Department, Hospital Universitario Ramón Y Cajal, IRYCIS, Madrid, Spain
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Cao F, Liu ZR, Ni QY, Zha CK, Zhang SJ, Lu JM, Xu YY, Tao LM, Jiang ZX, Pan HF. Emerging roles of air pollution and meteorological factors in autoimmune eye diseases. Environ Res 2023; 231:116116. [PMID: 37182831 DOI: 10.1016/j.envres.2023.116116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/02/2023] [Accepted: 05/11/2023] [Indexed: 05/16/2023]
Abstract
Autoimmune eye diseases (AEDs), a collection of autoimmune inflammatory ocular conditions resulting from the dysregulation of immune system at the ocular level, can target both intraocular and periorbital structures leading to severe visual deficit and blindness globally. The roles of air pollution and meteorological factors in the initiation and progression of AEDs have been increasingly attractive, among which the systemic and local mechanisms are both involved in. Exposure to excessive air pollution and extreme meteorological conditions including PM2.5/PM0.1, environmental tobacco smoke, insufficient sunshine, and high temperature, etc., can disturb Th17/Treg balance, regulate macrophage polarization, activate neutrophils, induce systemic inflammation and oxidative stress, decrease retinal blood flow, promote tissue fibrosis, activate sympathetic nervous system, adversely affect nutrients synthetization, as well as induce heat stress, therefore may together deteriorate AEDs. The crosstalk among inflammation, oxidative stress and dysregulated immune system appeared to be prominent. In the present review, we will concern and summarize the potential mechanisms underlying linkages of air pollution and meteorological factors to ocular autoimmune and inflammatory responses. Moreover, we concentrate on the specific roles of air pollutants and meteorological factors in several major AEDs including uveitis, Graves' ophthalmopathy (GO), ocular allergic disease (OAD), glaucoma, diabetic retinopathy (DR), etc.
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Affiliation(s)
- Fan Cao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China; Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Zhuo-Ran Liu
- Department of Ophthalmology, Ningbo Hospital, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1155 Binhaier Road, Ningbo, Zhejiang, China
| | - Qin-Yu Ni
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China; Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Chen-Kai Zha
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Shu-Jie Zhang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jia-Min Lu
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Yue-Yang Xu
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Li-Ming Tao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China.
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China.
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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Amaral C, Rodriguez E, Barquet V, Fantauzzi A, De Jesus Rodriguez E, Ulloa-Padilla JP, Pappaterra-Rodriguez M, Requejo GA, Vila MS, Figueroa R, Fernandez CJ, Almodovar JC, Santos C, Oliver AL. Seasonal Patterns of Vogt-Koyanagi-Harada Disease. Ocul Immunol Inflamm 2023; 31:362-366. [PMID: 35133938 DOI: 10.1080/09273948.2022.2029499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To identify the relationship between the incidence of Vogt-Koyanagi-Harada (VKH) disease and seasonality. METHODS A retrospective cohort study was performed, including patients with a confirmed diagnosis of VKH whose month of disease onset was available. Information on patients was entered retrospectively into a database and analyzed according to the month and season. RESULTS Twenty-four patients who met the inclusion criteria were included in the analysis. There was a statistically significant deviation from expected values in the incidences of VKH per season (P = .043). The most common season for the onset of VKH was fall, with 50% of the patients presenting in this season, while spring was the least common season for VKH presentation, with 12.5% of the patients presenting in this season. CONCLUSION Our study suggests that the onset of VKH in Puerto Rico follows a seasonal pattern, with most cases occurring during the fall.
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Affiliation(s)
- Claudia Amaral
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Eduardo Rodriguez
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Viviana Barquet
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA.,Department of Ophthalmology, Cook County Health, Chicago, Illinois, USA
| | - Andres Fantauzzi
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | | | - Jan P Ulloa-Padilla
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | | | - Guillermo A Requejo
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Mariam S Vila
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA.,Bascom Palmer Eye Institute, Bascom Palmer Eye Institute, Miami, Florida, USA
| | - Raul Figueroa
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Carlos J Fernandez
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Juan C Almodovar
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Carmen Santos
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Armando L Oliver
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
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Alryalat SA, Toubasi AA, Patnaik JL, Kahook MY. The impact of air pollution and climate change on eye health: a global review. Rev Environ Health 2022; 0:reveh-2022-0209. [PMID: 36579431 DOI: 10.1515/reveh-2022-0209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Climate change has important implications on human health, affecting almost every system in the body. Multiple studies have raised the possibility of climate change impacting eye health. In this review, we aimed to summarize current literature on the impact of air pollution and climate change on eye health. We performed a search in four different databases, including Medline, Scopus, Cochrane, and Web of Sciences databases. The search strategy combined terms regarding eye health and environmental/climate changes. The outcome of interest included all eye conditions. The search yielded 2,051 unique articles. After applying inclusion and exclusion criteria, 61 articles were included in this systematic review with data covering 2,620,030 participants. Most studies originated from China, India, South Korea, and USA. Climate change adversely affected different eye conditions, with ocular surface diseases (e.g., conjunctivitis and dry eye) being most affected. Moreover, higher particulate matter (PM) was the most widely assessed pollutant and was adversely associated with the majority of eye conditions, increasing the burden on patients and healthcare providers. We found a low frequency of publications related to the delivery of eye care and its impact on climate change in countries with high air pollution and climate change burden.
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Affiliation(s)
| | | | - Jennifer L Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, Sue Anschutz-Rodgers Eye Center, Aurora, CO, USA
| | - Malik Y Kahook
- Department of Ophthalmology, University of Colorado School of Medicine, Sue Anschutz-Rodgers Eye Center, Aurora, CO, USA
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Cao F, He YS, Xiang K, Wan CH, Liu W, Gui YC, Pan HF, Jiang ZX, Tao LM. Association between meteorological factors and hospital admissions for uveitis in Hefei, China: a time-series study. Environ Sci Pollut Res Int 2022; 29:45783-45792. [PMID: 35149948 DOI: 10.1007/s11356-022-19092-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
Meteorological variables are regarded as risk factors for inflammatory diseases, but their associations with uveitis, one of the leading causes accounting for blindness worldwide with an estimated prevalence of 38-714 cases/100,000 person-years, have not been thoroughly investigated. The present study explored the short-term association between meteorological variables and hospital admissions for uveitis in Hefei City, China. Daily data on uveitis hospital admissions and meteorological variables including mean temperature (MT) (°C), diurnal temperature range (DTR) (°C), and relative humidity (RH) (%), from 2014 to 2020, were collected. A time-series study using generalized linear model combined with distributed lag non-linear model was applied. Totally, 1911 admissions for uveitis including 894 first admissions and 1017 readmissions were reported during the study period. The associations of high percentile of MT (75th, 24.5℃) and low percentile of DTR (25th, 5.4℃) with uveitis admissions were observed to be statistically significant from lag9 (RR = 1.041, 95%CI: 1.002-1.081) to lag11 (RR = 1.053, 95%CI: 1.003-1.104) and lag4 (RR = 1.053, 95%CI: 1.019-1.088) to lag5 (RR = 1.052, 95%CI: 1.020-1.085), respectively. Moreover, a significant association between low percentile of RH (1th, 44%) and uveitis admissions appeared at lag0-8 (RR = 1.869, 95%CI: 1.017-3.434) and lasted until lag0-13 (RR = 2.539, 95%CI: 1.102-5.850) in the cumulative lag structure. Subgroup analyses indicated that males and the young seemed to be more sensitive to high MT exposure, while females appeared to be more vulnerable to low DTR exposure. Interestingly, both the young and the elderly are susceptible to low DTR and low RH exposure. Furthermore, high MT and low DTR exposure were associated with increased risk of first admission for uveitis. In summary, exposure to high-value of MT and low-value of DTR and RH may increase the hospital admissions for uveitis, especially for the status of first admission.
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Affiliation(s)
- Fan Cao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, 230032, People's Republic of China
| | - Yi-Sheng He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, People's Republic of China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Kun Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, People's Republic of China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Cheng-Huan Wan
- Department of Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wei Liu
- Department of Pharmacology, School of Pharmacy, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Yan-Chao Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, 230032, People's Republic of China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, People's Republic of China.
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China.
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, 230032, People's Republic of China.
| | - Li-Ming Tao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, 230032, People's Republic of China.
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McCormick I, James C, Welton NJ, Mayaud P, Turner KME, Gottlieb SL, Foster A, Looker KJ. INCIDENCE OF HERPES SIMPLEX VIRUS KERATITIS AND OTHER OCULAR DISEASE: GLOBAL REVIEW AND ESTIMATES. Ophthalmic Epidemiol 2021; 29:353-362. [PMID: 34622738 PMCID: PMC9397127 DOI: 10.1080/09286586.2021.1962919] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose: We aimed to review available data on the incidence of herpes simplex virus (HSV) keratitis and other HSV ocular disease and to estimate the global burden of HSV ocular disease. Methods: We searched Medline and Embase databases to October 2020 for studies reporting on the incidence of HSV ocular disease. Study quality was evaluated using a four-point checklist. Pooled estimates were applied to 2016 population data to estimate global HSV ocular disease burden. Numbers with uniocular vision impairment (any visual acuity <6/12) were estimated by applying published risks to case numbers. Results: Fourteen studies had incidence data; seven met our quality criteria. In 2016, an estimated 1.7 (95% confidence interval, 95% CI 1.0–3.0) million people had HSV keratitis, based on a pooled incidence of 24.0 (95% CI 14.0–41.0; N = 2; I2 = 97.7%) per 100,000 person-years. The majority had epithelial keratitis (pooled incidence 16.1 per 100,000; 95% CI 11.6–22.3; N = 3; I2 = 92.6%). Available studies were few and limited to the USA and Europe. Data were even more limited for HSV uveitis and retinitis, although these conditions may collectively contribute a further >0.1 million cases. Based on global incidence, some 230,000 people may have newly acquired uniocular vision impairment associated with HSV keratitis in 2016. Conclusion: Over 1.8 million people may have herpetic eye disease annually. Preventing HSV infection could therefore have an important impact on eye health. Herpetic eye disease burden is likely to have been underestimated, as many settings outside of the USA and Europe have higher HSV-1 prevalence and poorer access to treatment.
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Affiliation(s)
- Ian McCormick
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Charlotte James
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicky J Welton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Philippe Mayaud
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Sami L Gottlieb
- Department of Sexual and Reproductive Health And Research, World Health Organization, Geneva, Switzerland
| | - Allen Foster
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Katharine J Looker
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Tan H, Pan S, Zhong Z, Shi J, Liao W, Su G, Kijlstra A, Yang P. Association between temperature changes and uveitis onset in mainland China. Br J Ophthalmol 2020; 106:91-96. [PMID: 33055083 DOI: 10.1136/bjophthalmol-2020-317007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/09/2020] [Accepted: 09/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Some uveitis subtypes show seasonal patterns. Whether these patterns are caused by seasonally varying temperatures or by other climatic factors remains unknown. This ecological research aimed to quantify the association between climate variability and uveitis onset. METHODS We combined data from the largest database of uveitis cases with surface climate data to construct panel data. We used choropleth maps to visually assess spatial uveitis variations. RESULTS Among 12 721 reports of uveitis originating from 31 provinces of mainland China from 2006 to 2017, we found that a 1°C increase in monthly temperature was associated with a rise in approximately 2 uveitis reports per 1000 individuals (95% CI 0.00059 to 0.0029). This association was present across all provinces, ranging in effect size from 0.0011 to 0.072 (95% CI 0.00037 to 0.10). A clear 0-3 months of cumulative lagging effect was noted across all types of uveitis, with the strongest effect for non-infectious uveitis (0.0067, 95% CI 0.0041 to 0.013). Stratified by age and sex, we found that men and people aged 20-50 years were more affected by temperature variations. Our model predicts that China might experience an increase in uveitis cases due to future global warming. CONCLUSION Our study is the largest-ever investigation of the association between uveitis and climate and, for the first time, provides evidence that rising temperature can affect large-scale uveitis onset. These results may help promote and implement policies to mitigate future temperature increases and the burden of disease caused by global warming.
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Affiliation(s)
- Handan Tan
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, chongqing, China
| | - Su Pan
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, chongqing, China
| | - Zhenyu Zhong
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, chongqing, China
| | - Jing Shi
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, chongqing, China
| | - Weiting Liao
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, chongqing, China
| | - Guannan Su
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, chongqing, China
| | - Aize Kijlstra
- University Eye Clinic Maastricht, Maastricht, Limburg, the Netherlands, Maastricht, Netherlands
| | - Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, chongqing, China
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