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Loughman J, Kobia-Acquah E, Lingham G, Butler J, Loskutova E, Mackey DA, Lee SSY, Flitcroft DI. Myopia outcome study of atropine in children: Two-year result of daily 0.01% atropine in a European population. Acta Ophthalmol 2024; 102:e245-e256. [PMID: 37694816 DOI: 10.1111/aos.15761] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE The Myopia Outcome Study of Atropine in Children (MOSAIC) is an investigator-led, double-masked, randomized controlled trial investigating the efficacy and safety of 0.01% atropine eye drops for managing myopia progression in a predominantly White, European population. METHODS Children aged 6-16 years with myopia were randomly allocated 2:1 to nightly 0.01% atropine or placebo eye drops in both eyes for 2 years. The primary outcome was cycloplegic spherical equivalent (SE) progression at 24 months. Secondary outcomes included axial length (AL) change, safety and acceptability. Linear mixed models with random intercepts were used for statistical analyses. RESULTS Of 250 participants enrolled, 204 (81.6%) completed the 24-month visit (136 (81.4%) treatment, 68 (81.9%) placebo). Baseline characteristics, drop-out and adverse event rates were similar between treatment and control groups. At 24 months, SE change was not significantly different between 0.01% atropine and placebo groups (effect = 0.10 D, p = 0.07), but AL growth was lower in the 0.01% atropine group, compared to the placebo group (-0.07 mm, p = 0.007). Significant treatment effects on SE (0.14 D, p = 0.049) and AL (-0.11 mm, p = 0.002) were observed in children of White, but not non-White (SE = 0.05 D, p = 0.89; AL = 0.008 mm, p = 0.93), ethnicity at 24 months. A larger treatment effect was observed in subjects least affected by COVID-19 restrictions (SE difference = 0.37 D, p = 0.005; AL difference = -0.17 mm, p = 0.001). CONCLUSIONS Atropine 0.01% was safe, well-tolerated and effective in slowing axial elongation in this European population. Treatment efficacy varied by ethnicity and eye colour, and potentially by degree of COVID-19 public health restriction exposure during trial participation.
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Affiliation(s)
- James Loughman
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Emmanuel Kobia-Acquah
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Gareth Lingham
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia
| | - John Butler
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
- School of Mathematical Sciences, Technological University Dublin, Dublin, Ireland
| | - Ekaterina Loskutova
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Samantha S Y Lee
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia
| | - Daniel I Flitcroft
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
- Department of Ophthalmology, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland
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Loskutova E, Butler JS, Setti A, O'Brien C, Loughman J. Ability to Process Multisensory Information Is Impaired in Open Angle Glaucoma. J Glaucoma 2024; 33:78-86. [PMID: 37974328 DOI: 10.1097/ijg.0000000000002331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
PRCIS Patients with glaucoma demonstrated deficiencies in their ability to process multisensory information when compared with controls, with those deficiencies being related to glaucoma severity. Impaired multisensory integration (MSI) may affect the quality of life in individuals with glaucoma and may contribute to the increased prevalence of falls and driving safety concerns. Therapeutic possibilities to influence cognition in glaucoma should be explored. PURPOSE Glaucoma is a neurodegenerative disease of the optic nerve that has also been linked to cognitive health decline. This study explored MSI as a function of glaucoma status and severity. METHODS MSI was assessed in 37 participants with open angle glaucoma relative to 18 age-matched healthy controls. The sound-induced flash illusion was used to assess MSI efficiency. Participants were presented with various combinations of simultaneous visual and/or auditory stimuli and were required to indicate the number of visual stimuli observed for each of the 96 total presentations. Central retinal sensitivity was assessed as an indicator of glaucoma severity (MAIA; CenterVue). RESULTS Participants with glaucoma performed with equivalent capacity to healthy controls on unisensory trials ( F1,53 =2.222, P =0.142). Both groups performed equivalently on congruent multisensory trials involving equal numbers of auditory and visual stimuli F1,53 =1.032, P =0.314). For incongruent presentations, that is, 2 beeps and 1 flash stimulus, individuals with glaucoma demonstrated a greater influence of the incongruent beeps when judging the number of flashes, indicating less efficient MSI relative to age-matched controls ( F1,53 =11.45, P <0.002). In addition, MSI performance was positively correlated with retinal sensitivity ( F3,49 =4.042, P <0.025), adjusted R ²=0.15). CONCLUSIONS Individuals with open angle glaucoma exhibited MSI deficiencies that relate to disease severity. The type of deficiencies observed were similar to those observed among older individuals with cognitive impairment and balance issues. Impaired MSI may, therefore, be relevant to the increased prevalence of falls observed among individuals with glaucoma, a concept that merits further investigation.
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Affiliation(s)
- Ekaterina Loskutova
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - John S Butler
- Centre for Eye Research Ireland, School of Mathematical Sciences, Technological University Dublin, Dublin, Ireland
| | - Annalisa Setti
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Colm O'Brien
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
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Abstract
BACKGROUND Myopia is becoming increasingly prevalent throughout the world. It is an overlooked but leading cause of blindness, particularly among the working aged population. Myopia is often considered benign because it is easily corrected with glasses, contact lenses or refractive surgery. Traditionally myopia has been classified into physiological and pathological subtypes based on the degree of myopia present. Higher levels of myopia are associated with increased risk of pathological complications but it is important to note that there is no safe level of myopia. Even low levels of myopia increase the risk of retinal detachment and other ocular comorbidities which will be discussed in detail later. The most serious complication, myopic maculopathy, is the only leading cause of blindness without an established treatment and therefore leads to inevitable loss of vision in some myopes, even at a young age. AIM To highlight the current myopia epidemic and the sight threatening complications associated with it. DESIGN This is a commissioned review article. Data were gathered by performing a literature review, searching the PubMed database for recent articles regarding myopia. CONCLUSIONS Myopia is a potentially blinding disease. By identifying at risk individuals and intervening before they become myopic, eye care practitioners can prevent or delay spectacle use, reduce the risk of the myriad of myopic complications, thereby improve the patient's quality of life and positively impact its socio-economic effects.
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Affiliation(s)
- C M Bourke
- From the Ophthalmology Department, The Mater Misericordiae University Hospital, Eccles Street, Inns Quay, Dublin D07R2WY, Ireland
- Ophthalmology Department, Childrens University Hospital Temple Street, Temple Street, Dublin 1 D01YC67, Ireland
| | - J Loughman
- Centre for Eye Research Ireland, Dublin Institute of Technology, City Campus, Dublin D07HK68, Ireland
| | - D I Flitcroft
- Ophthalmology Department, Childrens University Hospital Temple Street, Temple Street, Dublin 1 D01YC67, Ireland
| | - E Loskutova
- Centre for Eye Research Ireland, Dublin Institute of Technology, City Campus, Dublin D07HK68, Ireland
| | - C O'Brien
- From the Ophthalmology Department, The Mater Misericordiae University Hospital, Eccles Street, Inns Quay, Dublin D07R2WY, Ireland
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Udensi J, Loughman J, Loskutova E, Byrne HJ. Raman Spectroscopy of Carotenoid Compounds for Clinical Applications-A Review. Molecules 2022; 27:molecules27249017. [PMID: 36558154 PMCID: PMC9784873 DOI: 10.3390/molecules27249017] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Carotenoid compounds are ubiquitous in nature, providing the characteristic colouring of many algae, bacteria, fruits and vegetables. They are a critical component of the human diet and play a key role in human nutrition, health and disease. Therefore, the clinical importance of qualitative and quantitative carotene content analysis is increasingly recognised. In this review, the structural and optical properties of carotenoid compounds are reviewed, differentiating between those of carotenes and xanthophylls. The strong non-resonant and resonant Raman spectroscopic signatures of carotenoids are described, and advances in the use of Raman spectroscopy to identify carotenoids in biological environments are reviewed. Focus is drawn to applications in nutritional analysis, optometry and serology, based on in vitro and ex vivo measurements in skin, retina and blood, and progress towards establishing the technique in a clinical environment, as well as challenges and future perspectives, are explored.
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Affiliation(s)
- Joy Udensi
- FOCAS Research Institute, Technological University Dublin, City Campus, Camden Row, Dublin 8, D08 CKP1 Dublin, Ireland
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
- Correspondence:
| | - James Loughman
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
| | - Ekaterina Loskutova
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
| | - Hugh J. Byrne
- FOCAS Research Institute, Technological University Dublin, City Campus, Camden Row, Dublin 8, D08 CKP1 Dublin, Ireland
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Udensi J, Loskutova E, Loughman J, Byrne HJ. Quantitative Raman Analysis of Carotenoid Protein Complexes in Aqueous Solution. Molecules 2022; 27:molecules27154724. [PMID: 35897900 PMCID: PMC9329867 DOI: 10.3390/molecules27154724] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/13/2022] [Accepted: 07/18/2022] [Indexed: 02/05/2023] Open
Abstract
Carotenoids are naturally abundant, fat-soluble pigmented compounds with dietary, antioxidant and vision protection advantages. The dietary carotenoids, Beta Carotene, Lutein, and Zeaxanthin, complexed with in bovine serum albumin (BSA) in aqueous solution, were explored using Raman spectroscopy to differentiate and quantify their spectral signatures. UV visible absorption spectroscopy was employed to confirm the linearity of responses over the concentration range employed (0.05–1 mg/mL) and, of the 4 Raman source wavelengths (785 nm, 660 nm, 532 nm, 473 nm), 532 nm was chosen to provide the optimal response. After preprocessing to remove water and BSA contributions, and correct for self-absorption, a partial least squares model with R2 of 0.9995, resulted in an accuracy of the Root Mean Squared Error of Prediction for Beta Carotene of 0.0032 mg/mL and Limit of Detection 0.0106 mg/mL. Principal Components Analysis clearly differentiated solutions of the three carotenoids, based primarily on small shifts of the main peak at ~1520 cm−1. Least squares fitting analysis of the spectra of admixtures of the carotenoid:protein complexes showed reasonable correlation between norminal% and fitted%, yielding 100% contribution when fitted with individual carotenoid complexes and variable contributions with multiple ratios of admixtures. The results indicate the technique can potentially be used to quantify the carotenoid content of human serum and to identify their differential contributions for application in clinical analysis.
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Affiliation(s)
- Joy Udensi
- FOCAS Research Institute, Technological University Dublin, City Campus, Camden Row, Dublin 8, D08 CKP1 Dublin, Ireland;
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland; (E.L.); (J.L.)
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
- Correspondence:
| | - Ekaterina Loskutova
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland; (E.L.); (J.L.)
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
| | - James Loughman
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland; (E.L.); (J.L.)
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
| | - Hugh J. Byrne
- FOCAS Research Institute, Technological University Dublin, City Campus, Camden Row, Dublin 8, D08 CKP1 Dublin, Ireland;
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Ruschil V, Mazurak N, Hofmann M, Loskutova E, Enck P, Freilinger T, Weimer K. Decreased Autonomic Reactivity and Psychiatric Comorbidities in Neurological Patients With Medically Unexplained Sensory Symptoms: A Case-Control Study. Front Neurol 2021; 12:713391. [PMID: 34557148 PMCID: PMC8453010 DOI: 10.3389/fneur.2021.713391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 05/22/2021] [Accepted: 07/30/2021] [Indexed: 12/12/2022] Open
Abstract
Up to 48% of patients with medically unexplained symptoms seen in neurological practice suffer from sensory symptoms, which could be of functional nature or secondary to psychiatric disorders. These patients show high medical care utilization causing elevated healthcare costs. Despite the high prevalence, little is known about clinical characteristics and pathophysiological mechanisms. For functional disorders such as irritable bowel syndrome, a reduction of heart rate variability (HRV) has been shown, suggesting a dysfunction of the autonomic nervous system (ANS). The aim of this study was to investigate psychological data and functional changes of the ANS in patients with medically unexplained sensory symptoms (MUSS). In this exploratory pilot study, 16 patients (11 females, 31.6 ± 11.9 years) with MUSS, who were recruited at a single tertiary neurological center, underwent a structured clinical interview (SCID) to evaluate psychiatric comorbidities. Patients and age- and sex-matched healthy volunteers filled in questionnaires, and individual sensory thresholds (perception, pain) were detected by quantitative sensory testing (QST). HRV was assessed at baseline and under three different experimental conditions (tonic pain stimulus, placebo application, cold-face test). All tests were repeated after 6–8 weeks. SCID interviews revealed clinical or subclinical diagnoses of psychiatric comorbidities for 12 patients. Questionnaires assessing somatization, depression, anxiety, and perceived stress significantly discriminated between patients with MUSS and healthy controls. While there was no difference in QST, reduced ANS reactivity was found in patients during experimental conditions, particularly with regard to vagally mediated HRV. Our pilot study of neurological patients with MUSS reveals a high prevalence of psychiatric comorbidities and provides evidence for altered ANS function. Our data thus give insight in possible underlying mechanisms for these symptoms and may open the door for a better diagnostic and therapeutic approach for these patients in the future.
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Affiliation(s)
- Victoria Ruschil
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Nazar Mazurak
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
| | - Martin Hofmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
| | - Ekaterina Loskutova
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
| | - Tobias Freilinger
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Neurology, Klinikum Passau, Passau, Germany
| | - Katja Weimer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
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Loughman J, Loskutova E, Butler JS, Siah WF, O’Brien C. Macular Pigment Response to Lutein, Zeaxanthin, and Meso-zeaxanthin Supplementation in Open-Angle Glaucoma. Ophthalmology Science 2021; 1:100039. [PMID: 36247822 PMCID: PMC9562333 DOI: 10.1016/j.xops.2021.100039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 01/30/2023]
Abstract
Purpose To evaluate macular pigment response to carotenoid supplementation in glaucomatous eyes. Design Double-masked, randomized, placebo-controlled clinical trial, the European Nutrition in Glaucoma Management Study (ClinicalTrials.gov identifier, NCT04460365). Participants Sixty-two participants (38 men, 24 women) with a diagnosis of open-angle glaucoma were enrolled. Forty-two were randomized to receive the active supplement, 20 participants were allocated to placebo. Methods Macular pigment optical density (MPOD) was measured by autofluorescence using the Heidelberg Spectralis scanning laser ophthalmoscope. Macular pigment optical density volume within the central 6° of retinal eccentricity as well as MPOD at 0.23°, 0.51°, 0.74°, and 1.02° were recorded at baseline and at 6-month intervals over 18 months. Visual function was assessed using visual acuity, mesopic and photopic contrast sensitivity under glare conditions, photo stress recovery time, microperimetry, and Glaucoma Activities Limitation 9 questionnaire. Advanced glaucoma module scans of retinal nerve fiber layer thickness and ganglion cell complex thickness over the central 6° of retinal eccentricity also were completed at each study visit. Main Outcome Measures Change in MPOD after supplementation with 10 mg lutein, 2 mg zeaxanthin, and 10 mg meso-zeaxanthin or placebo over 18 months. Results A mixed-model repeated measures analysis of variance revealed a statistically significant increase in MPOD volume (significant time effect: F(3,111) = 89.31, mean square error (MSE) = 1656.9; P < 0.01). Post hoc t tests revealed a significant difference in MPOD volume at each study visit for the treatment group (P < 0.01 for all), but no change in the placebo group (P > 0.05 for all). A statistically significant increase in mesopic contrast sensitivity under glare conditions was noted at 18 months in the treatment group, but not placebo. No other structural or functional changes were observed. No serious adverse events were noted during the trial. Conclusions Macular pigment can be augmented in glaucomatous eyes by supplementation with a formulation containing the carotenoids lutein, zeaxanthin, and meso-zeaxanthin. The greatest relative benefit was observed in those with the lowest baseline levels, but increases were noted across all participants and each retinal eccentricity. The potential benefits of MP augmentation for macular health in glaucoma merit further long-term evaluation.
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Loskutova E, Butler JS, Hernandez Martinez G, Flitcroft I, Loughman J. Macular Pigment Optical Density Fluctuation as a Function of Pupillary Mydriasis: Methodological Considerations for Dual-Wavelength Autofluorescence. Curr Eye Res 2020; 46:532-538. [PMID: 32842779 DOI: 10.1080/02713683.2020.1815792] [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] [Indexed: 10/23/2022]
Abstract
PURPOSE OF THE STUDY Macular pigment (MP), comprising the dietary carotenoids lutein, zeaxanthin and meso-zeaxanthin, is believed to benefit eye health and vision. Numerous clinical and research devices and techniques are currently available to facilitate MP optical density (MPOD) measurement. One of those techniques, dual-wavelength fundus autofluorescence (AF) is being increasingly used for measurement of MP in the eye. There is substantial methodological variation across the published studies that have employed this technique, including in relation to the use of mydriasis, the possible influence of which does not appear to have been addressed in the literature. This prospective cross-sectional study was designed to investigate the effect of mydriasis on MP measurement quality and MPOD values obtained with dual-wavelength AF using the Heidelberg Spectralis HRA+OCT device. MATERIALS AND METHODS Twenty-one healthy participants were recruited to the study. The mean age of participants was 44.8 years (± 14.63). Pupil size and MPOD were measured in one eye for each participant, initially under natural pupil conditions and subsequently 30 minutes following instillation of one drop of 0.5% tropicamide. RESULTS Despite providing MPOD measurements for the majority of undilated eyes (85.7% of eyes herein), pupillary dilation resulted in statistically significant changes in MPOD (p < .001 for central eccentricities). Our results indicate that the changes in MPOD were not uniform across the spatial profile. Marked improvements were also observed in image quality post-dilation (p < .002 for central eccentricities). CONCLUSIONS This study clearly demonstrates that dual-wavelength AF measurements of MPOD in the same eye vary as a function of pupillary dilation status, with MPOD under-estimated across the entire spatial profile of MP for natural relative to dilated pupillary conditions. Mydriasis should, therefore, be used routinely for MPOD measurements using dual wavelength AF, pupil size should be reported and image quality optimized in order to ensure accurate MPOD quantification.
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Affiliation(s)
- Ekaterina Loskutova
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - John S Butler
- Centre for Eye Research Ireland, School of Mathematical Sciences, Technological University Dublin, Dublin, Ireland
| | - Gabriela Hernandez Martinez
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland.,Department of Ophthalmology, Children's University Hospital, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
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Scanlon G, McCartney D, Butler JS, Loskutova E, Loughman J. Identification of Surrogate Biomarkers for the Prediction of Patients at Risk of Low Macular Pigment in Type 2 Diabetes. Curr Eye Res 2019; 44:1369-1380. [PMID: 31225969 DOI: 10.1080/02713683.2019.1635166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 12/11/2022]
Abstract
Purpose: This cross-sectional study compared macular pigment (MP) levels among persons with Type 2 diabetes relative to healthy controls. Additionally, a range of behavioral, anthropometric, clinical and serum measures were explored as possible predictors of low MP optical density (MPOD) in diabetes.Methods: Two health status groups; Group 1: Type 2 diabetes (n = 188), and Group 2: Healthy controls (n = 2,594) completed a full MP assessment using customized heterochromatic flicker photometry, as part of The Irish Longitudinal Study on Aging (TILDA). Clinical [blood pressure; cataract status; MPOD] and anthropometric [waist (cm); weight (kg); hip (cm)] measurements were taken, and a blood sample drawn for analysis of serum biomarkers [lipoproteins; inflammatory markers (C reactive protein and vitamin-D)].Results: One-way ANOVA revealed lower MPOD in subjects with Type 2 diabetes relative to controls (p = .047). Amongst participants with diabetes, those with low serum vitamin D (≤50 nmol/L) had significantly lower mean MPOD compared to those with sufficient serum vitamin D levels >50 nmol/L (0.173(0.148) vs. 0.226(0.145); p = .006). Concomitantly, MP was significantly lower in diabetes participants with raised serum triglyceride (TG) to high density lipoprotein (HDL) ratio (TG/HDL); values >1.74 mmol/L (0.172 (0.140) vs 0.215 (0.152); p = .039). Body mass index, waist-to-height ratio and waist circumference, were all significantly negatively correlated with MPOD (Pearson's correlation, p < .05 for all). Significant correlates of MPOD in the multivariate regression model included smoking, cataract, and vitamin D, which collectively contributed 18.5% of the overall variability in MPOD status amongst participants with Type 2 diabetes.Conclusions: This study provides additional evidence that low MP may indeed be a feature of Type 2 diabetes, and further identifies smoking, cataract and vitamin D status as plausible predictors of low MPOD amongst persons with Type 2 diabetes.
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Affiliation(s)
- Grainne Scanlon
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Daniel McCartney
- School of Biological and Health Sciences, Technological University Dublin, City Campus, Dublin, Ireland
| | - John S Butler
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland.,School of Mathematical Sciences, Technological University Dublin, City Campus, Dublin, Ireland
| | - Ekaterina Loskutova
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
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Loskutova E, Shah K, Flitcroft ID, Setti A, Butler JS, Nolan Y, Paudel N, Loughman J. Lutein and zeaxanthin: The possible contribution, mechanisms of action and implications of modern dietary intake for cognitive development in children. HRB Open Res 2019. [DOI: 10.12688/hrbopenres.12903.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background:Studies suggest that lutein and zeaxanthin may be important for cognitive development in children, but a comprehensive evidence synthesis is lacking. The purpose of this evidence synthesis was to analyse the available data regarding the role of lutein and zeaxanthin for cognition in children and propose a theoretical basis for future studies.Methods:The PubMed, Scopus, the ISRCTN registry and Cochrane Library databases were searched for studies that evaluated the relationship between lutein and zeaxanthin and cognitive function in children. Reference list and ancestry searches were performed on relevant articles. A total of 543 articles were identified, of which six cross-sectional studies were included.Results:The literature search revealed that the evidence concerning the effect of lutein and zeaxanthin on cognition in children is sparse. However, there is some preliminary evidence indicating a positive association between lutein and zeaxanthin and cognition in childhood.Conclusions:The cross-sectional nature of the few studies available and the lack of RCT data indicates a need for further investigation before any firm conclusions can be drawn.
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Jensen BH, Bram T, Kappelgaard P, Arvidsson H, Loskutova E, Munch IC, Larsen M. Visual function and retinal vessel diameters during hyperthermia in man. Acta Ophthalmol 2017; 95:690-696. [PMID: 28000983 DOI: 10.1111/aos.13361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 07/28/2015] [Accepted: 11/07/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the effect of elevated core body temperature on temporal and spatial contrast sensitivity and retinal vessel diameters. METHODS The study included 13 healthy volunteers aged 20-37 years. Core body temperature elevation (target +1.1°C) was induced by wrapping the participants in cling film, tinfoil and warming blankets. Subsequent cooling was achieved by undressing. Flicker sensitivity (critical flicker fusion frequency) was chosen to assess temporal resolution, while the Freiburg Vision Test was used to determine spatial contrast sensitivity at 1.5 cycles per degree. Scanning laser ophthalmoscopy was used to measure retinal trunk vessel diameters. Assessment was made at baseline, during hyperthermia and after cooling. RESULTS The induction of a mean increase in core body temperature of 1.02°C was associated with a 7.15-mmHg mean reduction in systolic blood pressure (p < 0.01), a 10.6-mmHg mean reduction in diastolic blood pressure (p < 0.01), a mean increase in pulse rate of 36.3 bpm (p < 0.0001), a 2.66% improvement in flicker sensitivity (CI95 1.37-3.94, p < 0.001), a 2.80% increase in retinal artery diameters (CI95 1.09-4.51, p < 0.01) and a 2.95% increase in retinal vein diameters (CI95 0.96-4.94, p < 0.01). There was no detectable effect of temperature on spatial contrast sensitivity. All ocular test parameters returned to baseline levels after cooling. CONCLUSION Increased core body temperature was accompanied by improved temporal visual resolution and retinal trunk vessel dilation. The results suggest that hyperthermia is associated with enhanced retinal function and increased retinal metabolism.
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Affiliation(s)
- Bettina Hagström Jensen
- Faculty of Health and Medical Science; University of Copenhagen; Copenhagen Denmark
- Department of Ophthalmology; Rigshospitalet; Glostrup Denmark
| | - Thue Bram
- Faculty of Health and Medical Science; University of Copenhagen; Copenhagen Denmark
- Department of Ophthalmology; Rigshospitalet; Glostrup Denmark
| | - Per Kappelgaard
- Faculty of Health and Medical Science; University of Copenhagen; Copenhagen Denmark
- Department of Ophthalmology; Rigshospitalet; Glostrup Denmark
| | | | - Ekaterina Loskutova
- Department of Ophthalmology; Rigshospitalet; Glostrup Denmark
- Department of Chemical and Life Sciences; Waterford Institute of Technology; MPRG: Macular Pigment Research Group; Waterford Ireland
| | - Inger Christine Munch
- Faculty of Health and Medical Science; University of Copenhagen; Copenhagen Denmark
- Department of Ophthalmology; Roskilde Hospital; Roskilde Denmark
| | - Michael Larsen
- Faculty of Health and Medical Science; University of Copenhagen; Copenhagen Denmark
- Department of Ophthalmology; Rigshospitalet; Glostrup Denmark
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Norheim AB, Grimholt TK, Loskutova E, Ekeberg O. Attitudes toward suicidal behaviour among professionals at mental health outpatient clinics in Stavropol, Russia and Oslo, Norway. BMC Psychiatry 2016; 16:268. [PMID: 27465292 PMCID: PMC4964267 DOI: 10.1186/s12888-016-0976-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 06/13/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Attitudes toward suicidal behaviour can be essential regarding whether patients seek or are offered help. Patients with suicidal behaviour are increasingly treated by mental health outpatient clinics. Our aim was to study attitudes among professionals at outpatient clinics in Stavropol, Russia and Oslo, Norway. METHODS Three hundred and forty-eight (82 %) professionals anonymously completed a questionnaire about attitudes. Professionals at outpatient clinics in Stavropol (n = 119; 94 %) and Oslo (n = 229; 77 %) were enrolled in the study. The Understanding Suicidal Patients (USP) scale (11 = positive to 55 = negative) and the Attitudes Towards Suicide Scale (ATTS) (1 = totally disagree, 5 = totally agree) were used. Questions about religious background, perceived competence and experiences of and views on suicidal behaviour and treatment (0 = totally disagree, 4 = totally agree) were examined. RESULTS All groups reported positive attitudes, with significant differences between Stavropol and Oslo (USP score, 21.8 vs 18.7; p < 0.001). Professionals from Stavropol vs. Oslo reported significantly less experience with suicidal patients, courses in suicide prevention (15 % vs 79 %) guidelines in suicidal prevention (23 % vs 90 %), interest for suicide prevention (2.0 vs 2.7; p < 0.001), and agreed more with the ATTS factors: avoidance of communication on suicide (3.1 vs 2.3; p < 0.001), suicide is acceptable (2.9 vs 2.6; p = 002), suicide is understandable (2.9 vs 2.7; p = 0.012) and (to a lesser extent) suicide can be prevented (4.2 vs 4.5; p < 0.001). In both cities, psychiatric disorders (3.4) were considered as the most important cause of suicide. Use of alcohol (2.2 vs 2.8; p < 0.001) was considered less important in Stavropol. Psychotherapy was considered significant more important in Stavropol than Oslo (3.6 vs 3.4; p = 0.001). CONCLUSIONS Professionals reported positive attitudes towards helping suicidal patients, with significant differences between cities. A need for further education was reported in both cities, but education was less integrated in mental health care in Stavropol than it was in Oslo. In both cities, psychiatric disorders were considered the major reasons for suicide, and psychotherapy was the most important treatment measure.
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Affiliation(s)
- Astrid Berge Norheim
- Diakonhjemmet hospital, Postboks 23, Vinderen, Oslo, 0319, Norway. .,Regional Centre of Violence Traumatic stress and suicide Prevention Eastern Norway, RVTS-East, Postboks 4623, Nydalen, Oslo, 0405, Norway.
| | - Tine K. Grimholt
- Regional Centre of Violence Traumatic stress and suicide Prevention Eastern Norway, RVTS-East, Postboks 4623, Nydalen, Oslo 0405 Norway ,Department of Acute Medicine, Oslo University Hospital Ullevål, Pb 4965, Nydalen, Oslo 0424 Norway
| | - Ekaterina Loskutova
- Ekaterina Loskutova, ProPsy, Lermontova str. 239/4, ofice 18, Stavropol, 355041 Russia
| | - Oivind Ekeberg
- Division of Mental Health and Addicion, Oslo University Hospital, Box 4956, Nydalen, Oslo 0424 Norway ,Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine University of Oslo, Pb 10/2 Blindern, Oslo, N-0316 Norway
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Nolan JM, Loskutova E, Howard AN, Moran R, Mulcahy R, Stack J, Bolger M, Dennison J, Akuffo KO, Owens N, Thurnham DI, Beatty S. Macular pigment, visual function, and macular disease among subjects with Alzheimer's disease: an exploratory study. J Alzheimers Dis 2015; 42:1191-202. [PMID: 25024317 DOI: 10.3233/jad-140507] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [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: 11/15/2022]
Abstract
BACKGROUND The macula (central retina) contains a yellow pigment, comprising the dietary carotenoids lutein (L), zeaxanthin (Z), and meso-zeaxanthin, known as macular pigment (MP). The concentrations of MP's constituent carotenoids in retina and brain tissue correlate, and there is a biologically-plausible rationale, supported by emerging evidence, that MP's constituent carotenoids are also important for cognitive function. OBJECTIVE To investigate if patients with Alzheimer's disease (AD) are comparable to controls in terms of MP and visual function. METHODS 36 patients with moderate AD and 33 controls with the same age range participated. MP was measured using dual-wavelength autofluorescence (Heidelberg Spectralis®); cognitive function was assessed using a battery of cognition tests (including Cambridge Neuropsychological Test Automated Battery). Visual function was recorded by measuring best corrected visual acuity (BCVA) and contrast sensitivity (CS). Serum L and Z concentrations (by HPLC) and age-related macular degeneration (AMD, by retinal examination) status were also assessed. RESULTS In the AD group, central MP (i.e., at 0.23°) and MP volume were significantly lower than the control group (p < 0.001 for both), as were measures of BCVA, CS, and serum L and Z concentrations (p < 0.05, for all). CONCLUSION AD patients were observed to exhibit significantly less MP, lower serum concentrations of L and Z, poorer vision, and a higher occurrence of AMD when compared to control subjects. A clinical trial in AD patients designed to investigate the impact of macular carotenoid supplementation with respect to MP, visual function, and cognitive function is merited.
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Affiliation(s)
- John M Nolan
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Ekaterina Loskutova
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Alan N Howard
- Howard Foundation, Cambridge, UK Downing College, University of Cambridge, Cambridge, UK
| | - Rachel Moran
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Riona Mulcahy
- Waterford Regional Hospital, Age-Related Care Unit, Waterford, Ireland
| | - Jim Stack
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Maggie Bolger
- Waterford Regional Hospital, Age-Related Care Unit, Waterford, Ireland
| | - Jessica Dennison
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Kwadwo Owusu Akuffo
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Niamh Owens
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - David I Thurnham
- Northern Ireland, Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK
| | - Stephen Beatty
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
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Nolan JM, Loskutova E, Howard A, Mulcahy R, Moran R, Stack J, Bolger M, Coen RF, Dennison J, Akuffo KO, Owens N, Power R, Thurnham D, Beatty S. The Impact of Supplemental Macular Carotenoids in Alzheimer's Disease: A Randomized Clinical Trial. ACTA ACUST UNITED AC 2015; 44:1157-69. [DOI: 10.3233/jad-142265] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- John M. Nolan
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Ekaterina Loskutova
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Alan Howard
- Howard Foundation, Cambridge, UK
- Downing College, University of Cambridge, Cambridge, UK
| | - Riona Mulcahy
- University Hospital Waterford, Age-Related Care Unit, Waterford, Ireland
| | - Rachel Moran
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Jim Stack
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Maggie Bolger
- University Hospital Waterford, Age-Related Care Unit, Waterford, Ireland
| | - Robert F. Coen
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - Jessica Dennison
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Kwadwo Owusu Akuffo
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Niamh Owens
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Rebecca Power
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - David Thurnham
- Northern Ireland, Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK
| | - Stephen Beatty
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
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