Getting a grip on the resilience to blur: The impact of simulated vision loss on a visually guided combat sports interaction

Abstract Background The incidence of Candida bloodstream infections has risen over the last several decades. Complications of candidemia include endogenous fungal endophthalmitis which can result in devastating outcomes including vision loss. In 2015, the IDSA guidelines were updated to recommend echinocandins as initial therapy for candidemia. Given the poor ocular penetration of echinocandins there has been some concern this change may portend an increased incidence of ocular complications in candidemic patients. We sought to examine whether patients who received empiric echinocandin therapy developed higher rates of ophthalmic complications of candidemia. Methods We identified patients in our healthcare system who had blood cultures positive for Candida species and a completed ophthalmology consult between January 1, 2014 and April 30, 2019. Chi-squared analysis was used to compare antifungal prescribing patterns before and after release of the updated IDSA guidelines. We assessed whether the switch to empiric echinocandin therapy as directed by the guidelines was associated with higher rates of abnormal eye exams. Results 47 patients treated before the guideline change were compared to 57 patients treated after the guideline change. There was no significant difference in age, gender, or comorbid diabetes and hypertension between the groups. Before the guideline change, 24/47 (51%) of patients received eye-penetrating antifungals. This decreased to 21/57 after the updated guideline (37%, p=0.21). The percentage of patients with positive eye exams was nearly equal before and after the updated guidelines, 10/47 (21%) before vs 13/57 (22%) after (p=1). After the guideline change, 7/21 (33%) of the patients treated with penetrating antifungals had positive eye exams vs 6/36 (16%) who received echinocandins (p=0.19). Conclusion Echinocandins are known to have poor ocular penetration yet our data demonstrate no change in the incidence of ophthalmic complications of candidemia after the 2016 guideline endorsed echinocandins as empiric therapy. The prevalence of positive eye exams throughout our study period was 22%, suggesting ongoing utility for these exams. Ongoing investigation is necessary to confirm and further study these findings. Disclosures All Authors: No reported disclosures

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Beyond vision loss: the independent impact of diabetic retinopathy on vision-related quality of life in a Chinese Singaporean population

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313082 ◽

2018 ◽

Vol 103 (9) ◽

pp. 1314-1319 ◽

Cited By ~ 1

Author(s):

Eva K Fenwick ◽

Ryan E K Man ◽

Alfred Tau Liang Gan ◽

Neelam Kumari ◽

Charlene Wong ◽

...

Keyword(s):

Quality Of Life ◽

Diabetic Retinopathy ◽

Vision Loss ◽

Well Being ◽

Linear Regression Models ◽

Cross Sectional ◽

Significant Difference ◽

Related Quality ◽

The Impact

Background/aimsTo assess the independent impact of diabetic retinopathy (DR) on three domains of vision-related quality of life (VRQoL) in a Chinese Singapore population.MethodsThe Singapore Chinese Eye Study (n=3353; 2009–2011) was a population-based, prospective, cross-sectional study conducted at the Singapore Eye Research Institute. The study population included 292 adults with diabetes, with and without DR. DR (better eye) was categorised as presence and absence of any DR; severity of DR (no vision-threatening DR (VTDR); severe non-proliferative DR (NPDR); PDR and/or clinically significant macular oedema and VTDR). Our main outcome was VRQoL which was measured using Rasch-calibrated scores from the ‘Reading’, ‘Mobility’ and ‘Emotional’ domains of the Impact of Vision Impairment questionnaire. The relationship between DR and VRQoL was assessed using multiple linear regression models.ResultsOf the 292 individuals (mean age 61.35 ± 9.66 years; 55.8% male), 201 (68.8%), 49 (16.8%), 20 (6.8%), 22 (7.5%) and 27 (9.2%) had no DR, minimal-mild NPDR, moderate-severe NPDR, PDR and VTDR, respectively. Any DR and VTDR were independently associated with 6% and 12% worse Reading scores and 7% and 18% poorer Emotional well-being, respectively, compared with those without DR. These associations persisted after separate adjustment for visual impairment and presenting visual acuity. No significant difference was found in the Mobility domain between persons with and without DR.ConclusionsWe documented that DR, particularly VTDR, was independently associated with restrictions in Reading and Emotional well-being. Understanding factors underlying the detrimental DR-VRQoL relationship may optimise rehabilitation outcomes for individuals with DR.

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The Impact of Lack of Government-Insured Routine Eye Examinations on the Incidence of Self-Reported Glaucoma, Cataracts, and Vision Loss

Investigative Ophthalmology & Visual Science ◽

10.1167/iovs.14-15361 ◽

2014 ◽

Vol 55 (12) ◽

pp. 8544-8549 ◽

Cited By ~ 8

Author(s):

C. H. Chan ◽

G. E. Trope ◽

E. M. Badley ◽

Y. M. Buys ◽

Y.-P. Jin

Keyword(s):

Vision Loss ◽

The Impact

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Poorer Quality of Life and Treatment Satisfaction is Associated with Diabetic Retinopathy in Patients with Type 1 Diabetes without Other Advanced Late Complications

Journal of Clinical Medicine ◽

10.3390/jcm8030377 ◽

2019 ◽

Vol 8 (3) ◽

pp. 377 ◽

Cited By ~ 3

Author(s):

Minerva Granado-Casas ◽

Esmeralda Castelblanco ◽

Anna Ramírez-Morros ◽

Mariona Martín ◽

Nuria Alcubierre ◽

...

Keyword(s):

Quality Of Life ◽

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Treatment Satisfaction ◽

Vision Loss ◽

Multivariable Analysis ◽

Work Life ◽

The Impact

Diabetic retinopathy (DR) may potentially cause vision loss and affect the patient’s quality of life (QoL) and treatment satisfaction (TS). Using specific tools, we aimed to assess the impact of DR and clinical factors on the QoL and TS in patients with type 1 diabetes. This was a cross-sectional, two-centre study. A sample of 102 patients with DR and 140 non-DR patients were compared. The Audit of Diabetes-Dependent Quality of Life (ADDQoL-19) and Diabetes Treatment Satisfaction Questionnaire (DTSQ-s) were administered. Data analysis included bivariate and multivariable analysis. Patients with DR showed a poorer perception of present QoL (p = 0.039), work life (p = 0.037), dependence (p = 0.010), and had a lower average weighted impact (AWI) score (p = 0.045). The multivariable analysis showed that DR was associated with a lower present QoL (p = 0.040), work life (p = 0.036) and dependence (p = 0.016). With regards to TS, DR was associated with a higher perceived frequency of hypoglycaemia (p = 0.019). In patients with type 1 diabetes, the presence of DR is associated with a poorer perception of their QoL. With regard to TS, these subjects also show a higher perceived frequency of hypoglycaemia.

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Andalusian program for early detection of diabetic retinopathy: implementation and 15-year follow-up of a population-based screening program in Andalusia, Southern Spain

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001622 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001622 ◽

Cited By ~ 1

Author(s):

Rafael Rodriguez-Acuña ◽

Eduardo Mayoral ◽

Manuel Aguilar-Diosdado ◽

Reyes Rave ◽

Beatriz Oyarzabal ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Early Detection ◽

Vision Loss ◽

Screening Program ◽

Target Population ◽

Population Based ◽

Annual Incidence ◽

Population Coverage ◽

Visual Disability ◽

The Impact

IntroductionDiabetic retinopathy (DR) is a preventable cause of vision loss and blindness worldwide. We aim at analyzing the impact of a population-based screening program of DR using retinal photography with remote reading in terms of population coverage, diagnosis of asymptomatic DR and impact on visual disability, in the region of Andalusia, Spain, in the period 2005–2019.Research design and methodsDescriptive study. Sociodemographic and clinical features included in the Andalusian program for early detection of diabetic retinopathy (APDR) were analyzed. Population coverage, annual incidence of DR, and DR severity gradation were analyzed. Estimated data on prevalence and incidence of legal blindness due to DR were included.Results407 762 patients with at least one successful DR examination during the study period were included. Most of the performed retinographies (784 584, 84.3%) were ‘non-pathological.’ Asymptomatic DR was detected in 52 748 (5.9%) retinographies, most of them (94.2%) being classified as ‘mild to moderate non-proliferative DR.’ DR was detected in 44 815 patients, while sight-threatening DR (STDR) in 6256 patients; cumulative incidence of DR was 11.0% and STDR was 1.5%, as DR and STDR was detected in 44 815 and 6256 patients, respectively. Annual incidence risk per patient recruitment year progressively decreased from 22.0% by January 2005 to 3.2% by June 2019.ConclusionsImplementation of a long-term population-based screening program for early detection of DR is technically feasible and clinically viable. Thus, after 15 years of existence, the program has enabled the screening of the vast majority of the target population allowing the optimization of healthcare resources and the identification of asymptomatic DR.

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The impact of practice of selected combat sports on signs of aggression in players in comparison with their non-training peers

Journal of Combat Sports and Martial Arts ◽

10.5604/20815735.1127448 ◽

2014 ◽

Vol 5 (1) ◽

pp. 17-22 ◽

Cited By ~ 1

Author(s):

Cezary Kuśnierz ◽

Pavol Bartik

Keyword(s):

Combat Sports ◽

The Impact

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Autophagy: A new insight into pathogenesis and treatment possibilities in age-related macular degeneration

Postępy Higieny i Medycyny Doświadczalnej ◽

10.5604/01.3001.0014.2495 ◽

2020 ◽

Vol 74 ◽

pp. 213-223

Author(s):

Agnieszka Kubicka-Trząska ◽

Izabella Karska-Basta ◽

Katarzyna Żuber-Łaskawiec

Keyword(s):

Macular Degeneration ◽

Vision Loss ◽

Developed Countries ◽

Age Related Macular Degeneration ◽

Therapeutic Modalities ◽

Central Vision Loss ◽

Age Related ◽

Genetic And Environmental Factors ◽

The Impact ◽

Insight Into

Age-related macular degeneration (AMD) is a significant problem in healthcare, because it is a leading cause of central vision loss in individuals over 50 years old in well-developed countries. Pathogenesis of AMD is multifactorial and still not completely understood. Proven risk factors include the following: natural senescence of retina, oxidative stress, complement activation, chronic subretinal inflammatory reaction, genetic and environmental factors. Data on links between autophagy and AMD development are being raised. Autophagy is a cellular process involving the degradation of long-lived proteins and damaged fragments and components of cells; it is responsible for the maintenance of dynamic intracellular homeostasis and it enables cell survival under stress conditions. Disturbances of autophagy mechanisms, i.e. its activation or inhibition, may lead to the development of many various pathologies. Thus, autophagy plays a dual role, as a mechanism responsible for protecting or killing cells. The paper describes autophagy mechanisms and their role in the natural process of retinal cells senescence and presents the autophagy impairment as a crucial cause of AMD development. We also describe the impact of intravitreal anti-VEGF therapy on retinal autophagy mechanisms and potential new therapeutic modalities for AMD based on autophagy modulation.

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Age-Related Macular Degeneration Revisited: From Pathology and Cellular Stress to Potential Therapies

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2020.612812 ◽

2021 ◽

Vol 8 ◽

Author(s):

Majda Hadziahmetovic ◽

Goldis Malek

Keyword(s):

Macular Degeneration ◽

Vision Loss ◽

Clinical Care ◽

Retinal Pigment ◽

Retinal Pigment Epithelial Cells ◽

Age Related Macular Degeneration ◽

Age Related ◽

The Impact

Age-related macular degeneration (AMD) is a neurodegenerative disease of the aging retina, in which patients experience severe vision loss. Therapies available to patients are limited and are only effective in a sub-population of patients. Future comprehensive clinical care depends on identifying new therapeutic targets and adopting a multi-therapeutic approach. With this goal in mind, this review examines the fundamental concepts underlying the development and progression of AMD and re-evaluates the pathogenic pathways associated with the disease, focusing on the impact of injury at the cellular level, with the understanding that critical assessment of the literature may help pave the way to identifying disease-relevant targets. During this process, we elaborate on responses of AMD vulnerable cells, including photoreceptors, retinal pigment epithelial cells, microglia, and choroidal endothelial cells, based on in vitro and in vivo studies, to select stressful agents, and discuss current therapeutic developments in the field, targeting different aspects of AMD pathobiology.

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