Eye disease in older people

2001 ◽  
Vol 11 (1) ◽  
pp. 21-31
Author(s):  
EE Kritzinger
Keyword(s):  
Systemic Disease ◽  
Vascular Occlusion ◽  
The Elderly ◽  
Age Related Macular Degeneration ◽  
Ocular Involvement ◽  
Infectious Agents ◽  
Herpes Zoster Ophthalmicus ◽  
Age Related ◽  
Retinal Vascular Occlusion ◽  
Ocular Disorders

Visual impairment in the aging population may be brought about by localized pathological change or it may be associated with systemic disease. Localized ocular disorders include three of the commonest causes of visual loss in the elderly, namely cataract, glaucoma and age-related macular degeneration. Systemic diseases, with associated ocular involvement which may progress to blindness, include diabetes, hypertension and hyperlipidaemia, which predispose to retinal vascular occlusion. Visual function may also be affected by various autoimmune disorders (e.g. rheumatoid arthritis), cerebrovascular disease, intraocular or intracranial tumours (primary or metastatic), as well as by infectious agents (herpes zoster ophthalmicus) and drugs (steroids).

The aging eye

2006 ◽  
Vol 16 (2) ◽  
pp. 125-139 ◽  
Author(s):  
John J Ah-Chan ◽  
Susan Downes
Keyword(s):  
Older People ◽  
Visual Impairment ◽  
Physical Disability ◽  
Elderly Population ◽  
Systemic Disease ◽  
The Elderly ◽  
Vision Impairment ◽  
Age Related Macular Degeneration ◽  
Visual Rehabilitation ◽  
Age Related

Age has been identified as the single most impor-tant demographic predictor of blindness and visual impairment. Visual impairment is the second most prevalent physical disability in the elderly population. The prevalence of blindness and visual impairment after 60 years of age increases significantly. Furthermore, the number of older people with functional vision impairment is expected to double in the next decade. Visual impairment in the elderly population is commonly due either to localized ocular pathology (cataracts, glaucoma and age-related macular degeneration) or systemic disease with associated ocular or visual pathway involvement (hypertension, diabetes and cerebrovascular disease). Physicians involved in the care of older people play a crucial role in the recognition, prevention and management of morbidity related to visual impairment in this population. Timely screening, referral, intervention and visual rehabilitation is thought to be capable of reducing new blindness and visual impairment by at least one-third.

scholarly journals Intravitreal Steroids for the Treatment of Retinal Diseases

2014 ◽  
Vol 2014 ◽  
pp. 1-14 ◽  
Author(s):  
Valentina Sarao ◽  
Daniele Veritti ◽  
Francesco Boscia ◽  
Paolo Lanzetta
Keyword(s):  
Side Effects ◽  
Macular Edema ◽  
Peak Plasma ◽  
Vascular Occlusion ◽  
Drug Efficacy ◽  
Age Related Macular Degeneration ◽  
Prolonged Treatment ◽  
Retinal Diseases ◽  
Age Related ◽  
Retinal Vascular Occlusion

Diabetic macular edema (DME), pseudophakic cystoid macular edema (CME), age-related macular degeneration (AMD), retinal vascular occlusion (RVO), and uveitis are ocular conditions related to severe visual impairment worldwide. Corticosteroids have been widely used in the treatment of these retinal diseases, due to their well-known antiangiogenic, antiedematous, and anti-inflammatory properties. Intravitreal steroids have emerged as novel and essential tools in the ophthalmologist’s armamentarium, allowing for maximization of drug efficacy and limited risk of systemic side effects. Recent advances in ocular drug delivery methods led to the development of intraocular implants, which help to provide prolonged treatment with controlled drug release. Moreover, they may add some potential advantages over traditional intraocular injections by delivering certain rates of drug directly to the site of action, amplifying the drug’s half-life, contributing in the minimization of peak plasma levels of the drug, and avoiding the side effects associated with repeated intravitreal injections. The purpose of this review is to provide an update on the use of intravitreal steroids as a treatment option for a variety of retinal diseases and to review the current literature considering their properties, safety, and adverse events.

scholarly journals Pharmacotherapy of Retinal Diseases with Ranibizumab

2009 ◽  
Vol 1 ◽  
pp. CMT.S2371
Author(s):  
Daniel F. Kiernan ◽  
Theodore K. Lin ◽  
Veeral Sheth ◽  
Rama D. Jager
Keyword(s):  
United States ◽  
Vascular Occlusion ◽  
Serum Levels ◽  
The United States ◽  
Age Related Macular Degeneration ◽  
Current Therapy ◽  
Ocular Diseases ◽  
Age Related ◽  
Retinal Vascular Occlusion ◽  
Arterial Thromboembolic Events

The development of new, abnormal and leaky blood vessels, termed choroidal neovascularization, causes loss of vision and quality of life as a result of many ocular diseases. A current therapy for a leading cause of irreversible blindness in older people in the United States, age-related macular degeneration, is intravitreal injection of ranibizumab. However, ranibizumab has also been used off-label to successfully treat a number of other ocular diseases causing significant ocular morbidity, including retinal vascular occlusion and diabetic macular edema. Despite its efficacy, the association of detectable serum levels of ranibizumab and arterial thromboembolic events in major follow-up studies since its approval by the United States Food and Drug Administration as well as its high cost relative to the possible existence of cheaper, equally efficacious alternatives has underscored the importance of understanding the mode of action and clinical utility of this novel pharmacotherapy.

scholarly journals Ocular Neurodegenerative Diseases: Interconnection between Retina and Cortical Areas

Cells ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 2394
Author(s):  
Nicoletta Marchesi ◽  
Foroogh Fahmideh ◽  
Federica Boschi ◽  
Alessia Pascale ◽  
Annalisa Barbieri
Keyword(s):  
Neurodegenerative Diseases ◽  
Light Stimulus ◽  
The Elderly ◽  
Cell Types ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Ocular Disorders ◽  
Progressive Neurodegeneration ◽  
Underlying Mechanisms ◽  
The Brain

The possible interconnection between the eye and central nervous system (CNS) has been a topic of discussion for several years just based on fact that the eye is properly considered an extension of the brain. Both organs consist of neurons and derived from a neural tube. The visual process involves photoreceptors that receive light stimulus from the external environment and send it to retinal ganglionic cells (RGC), one of the cell types of which the retina is composed. The retina, the internal visual membrane of the eye, processes the visual stimuli in electric stimuli to transfer it to the brain, through the optic nerve. Retinal chronic progressive neurodegeneration, which may occur among the elderly, can lead to different disorders of the eye such as glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR). Mainly in the elderly population, but also among younger people, such ocular pathologies are the cause of irreversible blindness or impaired, reduced vision. Typical neurodegenerative diseases of the CSN are a group of pathologies with common characteristics and etiology not fully understood; some risk factors have been identified, but they are not enough to justify all the cases observed. Furthermore, several studies have shown that also ocular disorders present characteristics of neurodegenerative diseases and, on the other hand, CNS pathologies, i.e., Alzheimer disease (AD) and Parkinson disease (PD), which are causes of morbidity and mortality worldwide, show peculiar alterations at the ocular level. The knowledge of possible correlations could help to understand the mechanisms of onset. Moreover, the underlying mechanisms of these heterogeneous disorders are still debated. This review discusses the characteristics of the ocular illnesses, focusing on the relationship between the eye and the brain. A better comprehension could help in future new therapies, thus reducing or avoiding loss of vision and improve quality of life.

scholarly journals Impact of neovascular age-related macular degeneration: burden of patients receiving therapies in Japan

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shigeru Honda ◽  
Yasuo Yanagi ◽  
Hideki Koizumi ◽  
Yirong Chen ◽  
Satoru Tanaka ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Productivity Loss ◽  
Work Productivity ◽  
The Elderly ◽  
Developed Countries ◽  
Age Related Macular Degeneration ◽  
Resource Utilisation ◽  
Total Work ◽  
Healthcare Resource Utilisation ◽  
Age Related

AbstractThe chronic eye disorder, neovascular age-related macular degeneration (nAMD), is a common cause of permanent vision impairment and blindness among the elderly in developed countries, including Japan. This study aimed to investigate the disease burden of nAMD patients under treatment, using data from the Japan National Health and Wellness surveys 2009–2014. Out of 147,272 respondents, 100 nAMD patients reported currently receiving treatment. Controls without nAMD were selected by 1:4 propensity score matching. Healthcare Resource Utilisation (HRU), Health-Related Quality of Life (HRQoL), and work productivity loss were compared between the groups. Regarding HRU, nAMD patients had significantly increased number of visits to any healthcare provider (HCP) (13.8 vs. 8.2), ophthalmologist (5.6 vs. 0.8), and other HCP (9.5 vs. 7.1) compared to controls after adjusting for confounding factors. Additionally, nAMD patients had reduced HRQoL and work productivity, i.e., reduced physical component summary (PCS) score (46.3 vs. 47.9), increased absenteeism (18.14% vs. 0.24%), presenteeism (23.89% vs. 12.44%), and total work productivity impairment (33.57% vs. 16.24%). The increased number of ophthalmologist visits were associated with decreased PCS score, increased presenteeism and total work productivity impairment. The current study highlighted substantial burden for nAMD patients, requiring further attention for future healthcare planning and treatment development.

scholarly journals Neovascular Macular Degeneration: A Review of Etiology, Risk Factors, and Recent Advances in Research and Therapy

2021 ◽  
Vol 22 (3) ◽  
pp. 1170
Author(s):  
Arunbalaji Pugazhendhi ◽  
Margaret Hubbell ◽  
Pooja Jairam ◽  
Balamurali Ambati
Keyword(s):  
Risk Factors ◽  
Macular Degeneration ◽  
Kinase Inhibitors ◽  
Rho Kinase ◽  
The Elderly ◽  
Age Related Macular Degeneration ◽  
Gene Therapies ◽  
Rho Kinase Inhibitors ◽  
Age Related ◽  
Endothelial Growth Factor

Neovascular age-related macular degeneration (exudative or wet AMD) is a prevalent, progressive retinal degenerative macular disease that is characterized by neovascularization of the choroid, mainly affecting the elderly population causing gradual vision impairment. Risk factors such as age, race, genetics, iris color, smoking, drinking, BMI, and diet all play a part in nvAMD’s progression, with anti-vascular endothelial growth factor (anti-VEGF) therapy being the mainstay of treatment. Current therapeutic advancements slow the progression of the disease but do not cure or reverse its course. Newer therapies such as gene therapies, Rho-kinase inhibitors, and levodopa offer potential new targets for treatment.

scholarly journals Introduction to the multi-author review on macular degeneration

2020 ◽  
Vol 77 (5) ◽  
pp. 779-780 ◽  
Author(s):  
Anu Kauppinen
Keyword(s):  
Macular Degeneration ◽  
Vision Loss ◽  
The Elderly ◽  
Developed Countries ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Severe Vision Loss ◽  
Author Review ◽  
Dry Amd ◽  
Endothelial Growth Factor

AbstractProlonged life expectancies contribute to the increasing prevalence of age-related macular degeneration (AMD) that is already the leading cause of severe vision loss among the elderly in developed countries. In dry AMD, the disease culminates into vast retinal atrophy, whereas the wet form is characterized by retinal edema and sudden vision loss due to neovascularization originating from the choroid beneath the Bruch’s membrane. There is no treatment for dry AMD and despite intravitreal injections of anti-vascular endothelial growth factor (VEGF) that suppress the neovessel formation, also wet AMD needs new therapies to prevent the disease progression and to serve patients lacking of positive response to current medicines. Knowledge on disease mechanisms is a prerequisite for the drug development, which is hindered by the multifactorial nature of AMD. Numerous distinguished publications have revealed AMD mechanisms at the cellular and molecular level and in this multi-author review, we take a bit broader look at the topic with some novel aspects.

AN AUTOMATED METHOD TO DETECT AGE-RELATED MACULAR DEGENERATION FROM OPTICAL COHERENCE TOMOGRAPHIC IMAGES

2021 ◽  
pp. 2150036
Author(s):  
Anju Thomas ◽  
P. M. Harikrishnan ◽  
Varun P. Gopi ◽  
P. Palanisamy
Keyword(s):  
Early Detection ◽  
Macular Degeneration ◽  
The Elderly ◽  
Age Related Macular Degeneration ◽  
Data Sets ◽  
Sigmoid Function ◽  
Data Set ◽  
Automated Method ◽  
Age Related ◽  
Sd Oct

Age-related macular degeneration (AMD) is an eye disease that affects the elderly. AMD’s prevalence is increasing as society’s population ages; thus, early detection is critical to prevent vision loss in the elderly. Arrangement of a comprehensive examination of the eye for AMD detection is a challenging task. This paper suggests a new poly scale and dual path (PSDP) convolutional neural network (CNN) architecture for early-stage AMD diagnosis automatically. The proposed PSDP architecture has nine convolutional layers to classify the input image as AMD or normal. A PSDP architecture is used to enhance classification efficiency due to the high variation in size and shape of perforation present in OCT images. The poly scale approach employs filters of various sizes to extract features from local regions more effectively. Simultaneously, the dual path architecture incorporates features extracted from different CNN layers to boost features in the global regions. The sigmoid function is used to classify images into binary categories. The Mendeley data set is used to train the proposed network and tested on Mendeley, Duke, SD-OCT Noor, and OCTID data sets. The testing accuracy of the network in Mendeley, Duke, SD-OCT Noor, and OCT-ID is 99.73%,96.66%,94.89%,99.61%, respectively. The comparison with alternative approaches showed that the proposed algorithm is efficient in detecting AMD. Despite having been trained on the Mendeley data set, the proposed model exhibited good detection accuracy when tested on other data sets. This shows that the suggested model can distinguish AMD/Normal images from various data sets. As compared to other methods, the findings show that the proposed algorithm is efficient at detecting AMD. Rapid eye scanning for early detection of AMD could be possible with the proposed architecture. The proposed CNN can be applied in real-time due to its lower complexity and less learnable parameters.

Cell-based therapy for ocular disorders: A promising frontier

2021 ◽  
Vol 16 ◽  
Author(s):  
Milad Ahani-Nahayati ◽  
Vahid Niazi ◽  
Alireza Moradi ◽  
Bahareh Pourjabbar ◽  
Reza Roozafzoon ◽  
...  
Keyword(s):  
Stem Cells ◽  
Wide Spectrum ◽  
Retinal Pigment ◽  
Age Related Macular Degeneration ◽  
Ocular Tissue ◽  
Ocular Diseases ◽  
Cell Based Therapy ◽  
Age Related ◽  
Ocular Disorders

: As the ocular disorders causing long-term blindness or optical abnormalities of the ocular tissue affect the quality of life of patients to a large extent, awareness of their corresponding pathogenesis and the earlier detection and treatment need more consideration. Though current therapeutics result in desirable outcomes, they do not offer an inclusive solution for development of visual impairment to blindness. Accordingly, stem cells, because of their particular competencies, have gained extensive attention for application in regenerative medicine of ocular diseases. In the last decades, a wide spectrum of stem cells surrounding mesenchymal stem/stromal cells (MSC), neural stem cells (NSCs), and embryonic/induced pluripotent stem cells (ESCs/iPSCs) accompanied by Müller glia, ciliary epithelia-derived stem cells, and retinal pigment epithelial (RPE) stem cells have been widely investigated to report their safety and efficacy in preclinical models and also human subjects. In this regard, in the first interventions, RPE cell suspensions were successfully utilized to ameliorate visual defects of the patients suffering from age-related macular degeneration (AMD) after subretinal transplantation. Herein, we will explain the pathogenesis of ocular diseases and highlight the novel discoveries and recent findings in the context of stem cell-based therapies in these disorders, focusing on the in vivo reports published during the last decade.

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