Evaluating the impact of summer vacation on the visual acuity of AMD patients treated with ranibizumab

ABSTRACTBackground:Depression is common among older populations with cataract. However, the impact of cataract surgery on depression in both developed and developing countries remains unclear. The aim of this study is to determine the impact of cataract surgery on depressive symptoms and to examine the association between objective visual measures and change in depressive symptoms after surgery among a Vietnamese population in Ho Chi Minh City.Methods:A cohort of older patients with bilateral cataract were assessed the week before and one to three months after first eye surgery only or first- and second-eye cataract surgeries. Visual measures including visual acuity, contrast sensitivity, and stereopsis were obtained. Depressive symptoms were assessed using the 20-item Center for Epidemiological Studies-Depression Scale (CES-D). Descriptive analyses and a generalized estimating equations (GEE) analysis were undertaken to determine the impact of cataract surgery on depressive symptoms.Results:Four hundred and thirteen participants were recruited into the study before cataract surgery. Two hundred and forty-seven completed the follow-up assessment after surgery. There was a significant decrease (improvement) of one point in the depressive symptoms score (p = 0.04) after cataract surgery, after accounting for potential confounding factors. In addition, females reported a significantly greater decrease (improvement) of two points in depressive symptom scores (p = 0.01), compared to males. However, contrast sensitivity, visual acuity, and stereopsis were not significantly associated with change in depressive symptoms scores. First-eye cataract surgery or both-eye cataract surgery did not modify the change in depressive symptoms score.Conclusion:There was a small but significant improvement in depressive symptoms score after cataract surgery for an older population in Vietnam.

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Evaluation of a calculation model to estimate the impact of the COVID-19 pandemic lockdown on visual acuity in neovascular AMD

European Journal of Ophthalmology ◽

10.1177/11206721211052389 ◽

2021 ◽

pp. 112067212110523

Author(s):

Martin Stattin ◽

Anna-Maria Haas ◽

Daniel Ahmed ◽

Alexandra Graf ◽

Katharina Krepler ◽

...

Keyword(s):

Visual Acuity ◽

Real Life ◽

Treatment Interruption ◽

Term Treatment ◽

Calculation Model ◽

Life Outcomes ◽

Short Term ◽

Short Term Treatment ◽

The Real ◽

The Impact

Purpose A model was calculated during the first Austrian coronavirus disease-2019 (COVID-19) pandemic lockdown to estimate the effect of a short-term treatment interruption due to healthcare restrictions on visual acuity (VA) in neovascular age-related macular degeneration (nAMD). The model was compared to the real-life outcomes before treatment re-started. Methods Retrospective data-collection of 142 eyes in 142 patients receiving repeated intravitreal injections with anti-VEGF at a retina unit in Vienna in a personalized pro-re-nata regimen prior to the COVID-19 associated lockdown, when treatment was deferred between March 16 and May 4, 2020. During the lockdown, the preliminary data was integrated into pre-existing formulae based on the natural course of the disease in untreated eyes in the long term. Patients were re-scheduled and treated after gradually opening operating rooms. The calculation model was compared to the effective VA change. Results The model calculated an overall VA loss of 3.5 ± 0.8 letters early treatment diabetes retinopathy study (ETDRS) ( p < 0.001 [95% CI:3.3;3.6]) on average compared to 2.5 ± 6 letters ETDRS ( p < 0.001 [95% CI:1.5;3.5]) as measured with a mean treatment delay of 61 ± 14 days after previously scheduled appointments. The total difference between the model exercise and the real-life outcomes accounted for 1 ± 5.9 letters ETDRS ( p = 0.051 [95% CI: 0.1;1.9]). Conclusion The herein presented calculation model might not be suitable to estimate the effective VA loss correctly over time, although untreated eyes and eyes under therapy show similarities after short-term treatment interruption. However, this study demonstrated the potentially negative impact of the COVID-19 pandemic lockdown on patients compromised by nAMD.

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Influence of eye diseases on the mortality rate of the population

Ophthalmology journal ◽

10.17816/ov11147-53 ◽

2018 ◽

Vol 11 (1) ◽

pp. 47-53

Author(s):

Andrey V Zolotarev ◽

Elena V Karlova ◽

Elena V Miroshnichenko

Keyword(s):

Quality Of Life ◽

Visual Acuity ◽

Mortality Rate ◽

Life Expectancy ◽

Eye Diseases ◽

Review Of Literature ◽

The Impact

Evaluating of the correlation between quality of life, life expectancy and mortality rate is an important problem of modern ophthalmology. Many researchers note that eye pathology, which leads to a visual acuity decrease and blindness, has a significant impact on the mortality rate of the population. This review of literature is dedicated to studies examining the impact of eye diseases on the mortality rate of the population. (For citation: Zolotarev AV, Karlova EV, Miroshnichenko EV. Influence of eye diseases on the mortality rate of the population. Ophthalmology Journal. 2018;11(1):47-53. doi: 10.17816/OV11147-53).

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Impact of low vision services on the quality of life of low vision patients in Ghana

African Vision and Eye Health ◽

10.4102/aveh.v75i1.19 ◽

2016 ◽

Vol 75 (1) ◽

Author(s):

Godwin O. Ovenseri-Ogbomo ◽

Harriette Osafo-Agyei ◽

Ralph E.U. Akpalaba ◽

James Addy ◽

Elizabeth O. Ovenseri

Keyword(s):

Quality Of Life ◽

Visual Acuity ◽

Positive Impact ◽

Low Vision ◽

Care Quality ◽

Eastern Region ◽

Post Intervention ◽

Low Vision Clinic ◽

The Impact

Patients’ perspectives on the impact of clinical interventions have been recognised as critical elements in patient care. Quality-of-life instruments are designed to measure these perspectives. We used the National Eye Institute’s 25-item Visual Function Questionnaire (NEI VFQ) to measure the impact of optical low vision devices on the quality of life of 22 low vision patients who obtained and were using low vision devices from a secondary low vision clinic in the Eastern Region, Ghana. The study employed a pre- and post-intervention technique. We found statistically significant improvements in measured visual acuity and NEI VFQ scores in 8 of the 10 domains evaluated. We conclude that optical low vision devices have a positive impact on the quality of life of low vision patients in Ghana.Keywords: low vision; quality of life; visual acuity; visual impairment; Ghana

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The Impact of Unilateral or Bilateral Cataract Surgery on Visual Acuity and Life Quality of Elderly Patients

Journal of Ophthalmology ◽

10.1155/2015/509049 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Lei Zuo ◽

Haidong Zou ◽

Xinfeng Fei ◽

Weiqi Xu ◽

Jianhong Zhang

Keyword(s):

Visual Acuity ◽

Elderly Patients ◽

Cataract Surgery ◽

Life Quality ◽

Weighted Average ◽

Bilateral Cataract ◽

Surgical Methods ◽

Group A ◽

Group B ◽

The Impact

In the current study, the CLVQOL was used to assess VRQOL before unilateral or bilateral cataract surgery and at the end of the follow-up period in order to determine the greater beneficial mode of surgery for patients, if one of the two surgical methods is more beneficial over the other. The patients were classified as receiving unilateral (group A) and bilateral cataract surgery (group B). There were no significant differences between groups A and B before the operation in terms of life quality scores, binocular weighted average LogMAR BCVA, age, educational level, gender, systematic and ocular comorbidities, and the complications of the operation. It was shown that visual acuity improved more significantly with bilateral cataract surgery than with unilateral surgery in elderly patients with a high preoperative disease burden in Shanghai city. However, the improvement in life quality was not different in patients receiving either bilateral or unilateral cataract surgery.

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United Kingdom Diabetic Retinopathy Electronic Medical Record (UK DR EMR) Users Group: report 4, real-world data on the impact of deprivation on the presentation of diabetic eye disease at hospital services

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312568 ◽

2018 ◽

Vol 103 (6) ◽

pp. 837-843 ◽

Cited By ~ 8

Author(s):

Alastair K Denniston ◽

Aaron Y Lee ◽

Cecilia S Lee ◽

David P Crabb ◽

Clare Bailey ◽

...

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Medical Record ◽

Electronic Medical Record ◽

Real World ◽

Eye Disease ◽

Inclusion Criteria ◽

Data Set ◽

Diabetic Eye Disease ◽

The Impact

AimTo assess the impact of deprivation on diabetic retinopathy presentation and related treatment interventions, as observed within the UK hospital eye service.MethodsThis is a multicentre, national diabetic retinopathy database study with anonymised data extraction across 22 centres from an electronic medical record system. The following were the inclusion criteria: all patients with diabetes and a recorded, structured diabetic retinopathy grade. The minimum data set included, for baseline, age and Index of Multiple Deprivation, based on residential postcode; and for all time points, visual acuity, ETDRS grading of retinopathy and maculopathy, and interventions (laser, intravitreal therapies and surgery). The main outcome measures were (1) visual acuity and binocular visual state, and (2) presence of sight-threatening complications and need for early treatment.Results79 775 patients met the inclusion criteria. Deprivation was associated with later presentation in patients with diabetic eye disease: the OR of being sight-impaired at entry into the hospital eye service (defined as 6/18 to better than 3/60 in the better seeing eye) was 1.29 (95% CI 1.20 to 1.39) for the most deprived decile vs 0.77 (95% CI 0.70 to 0.86) for the least deprived decile; the OR for being severely sight-impaired (3/60 or worse in the better seeing eye) was 1.17 (95% CI 0.90 to 1.55) for the most deprived decile vs 0.88 (95% CI 0.61 to 1.27) for the least deprived decile (reference=fifth decile in all cases). There is also variation in sight-threatening complications at presentation and treatment undertaken: the least deprived deciles had lower chance of having a tractional retinal detachment (OR=0.48 and 0.58 for deciles 9 and 10, 95% CI 0.24 to 0.90 and 0.29 to 1.09, respectively); in terms of accessing treatment, the rate of having a vitrectomy was lowest in the most deprived cohort (OR=0.34, 95% CI 0.19 to 0.58).ConclusionsThis large real-world study suggests that first presentation at a hospital eye clinic with visual loss or sight-threatening diabetic eye disease is associated with deprivation. These initial hospital visits represent the first opportunities to receive treatment and to formally engage with support services. Such patients are more likely to be sight-impaired or severely sight-impaired at presentation, and may need additional resources to engage with the hospital eye services over complex treatment schedules.

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When Caddy's Went Viral

Muma Case Review ◽

10.28945/4750 ◽

2021 ◽

Vol 6 ◽

pp. 001-025

Author(s):

Samuel Barrington ◽

Randy Esponda ◽

Timothy E Newsome ◽

Say Sengsouvanna ◽

Cynthia L Steel

Keyword(s):

Health And Safety ◽

The Other ◽

The Sun ◽

Executive Order ◽

Summer Vacation ◽

White Sand ◽

The Face ◽

Treasure Island ◽

The Impact ◽

Loyal Customers

With the sun losing its glare and now appearing as a beautiful orange orb just above the distant horizon where the sky meets the sea, Barry O’Connor thought to himself, “This is as close to paradise as you can get.” Yet, the vast empty sea of white sand surrounding him told a very different story. It was July 17, 2020, and this beautiful area should have been overrun with college students and young families as they enjoyed their summer vacation. Instead, the executive order that came as a result of the COVID-19 epidemic four months earlier forced him to immediately close his four bars and six Caddy’s Waterfront Dining restaurants, laying off 600 employees and dashing his dreams of another lucrative season. Barry gazed at the beautiful sunset one more time before turning his thoughts to the monumental problem that faced him. While he agreed that the health and safety of his employees and loyal customers was paramount, he couldn’t help but feel the pang that losing a few million dollars a month brings. Now, as businesses began to reopen their doors in the face of new restrictions brought about by COVID, Barry was left to figure out how to navigate the uncharted landscape of new in-house capacity restrictions, everyone’s fear of contracting the virus, and the unknown of when this pandemic would end. All the while, Barry’s bar business was in shambles due to a second government shutdown of bars, which only added pressure on the Caddy’s brand to drive revenue and keep the other half of the business afloat. A potential solution loomed on the horizon, however. This Caddy’s location in Treasure Island had an extensive beach immediately outside its doors, which could expand its footprint, allowing an additional 450-500 customers to enjoy the Caddy’s experience in the safety of an outdoor arena. However, due to local government zoning restrictions, Caddy’s was not legally allowed to treat this area as a traditional restaurant setting. But Barry had become a self-made man because he understood that the nature of business was never static. He knew that the best way forward was to disregard the inconvenience of circumstances beyond his control, and instead pour his efforts into a search for the opportunities that always accompanied such impacts. But just what opportunities did the pandemic create? How could he best leverage technology to exploit them? How would he manage the impact of the changes on his customers and employees?

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Redistribution of metabolic resources through astrocyte networks mitigates neurodegenerative stress

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2009425117 ◽

2020 ◽

Vol 117 (31) ◽

pp. 18810-18821 ◽

Cited By ~ 5

Author(s):

Melissa L. Cooper ◽

Silvia Pasini ◽

Wendi S. Lambert ◽

Karis B. D’Alessandro ◽

Vincent Yao ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Connexin 43 ◽

Metabolic Networks ◽

Metabolic Stress ◽

Intraocular Pressure Elevation ◽

The Central Nervous System ◽

Stressed Region ◽

The Impact ◽

Neuronal Stress

In the central nervous system, glycogen-derived bioenergetic resources in astrocytes help promote tissue survival in response to focal neuronal stress. However, our understanding of the extent to which these resources are mobilized and utilized during neurodegeneration, especially in nearby regions that are not actively degenerating, remains incomplete. Here we modeled neurodegeneration in glaucoma, the world’s leading cause of irreversible blindness, and measured how metabolites mobilize through astrocyte gap junctions composed of connexin 43 (Cx43). We elevated intraocular pressure in one eye and determined how astrocyte-derived metabolites in the contralateral optic projection responded. Remarkably, astrocyte networks expand and redistribute metabolites along distances even 10 mm in length, donating resources from the unstressed to the stressed projection in response to intraocular pressure elevation. While resource donation improves axon function and visual acuity in the directly stressed region, it renders the donating tissue susceptible to bioenergetic, structural, and physiological degradation. Intriguingly, when both projections are stressed in a WT animal, axon function and visual acuity equilibrate between the two projections even when each projection is stressed for a different length of time. This equilibration does not occur when Cx43 is not present. Thus, Cx43-mediated astrocyte metabolic networks serve as an endogenous mechanism used to mitigate bioenergetic stress and distribute the impact of neurodegenerative disease processes. Redistribution ultimately renders the donating optic nerve vulnerable to further metabolic stress, which could explain why local neurodegeneration does not remain confined, but eventually impacts healthy regions of the brain more broadly.

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The impact of irregular corneal shape parameters on visual acuity and contrast sensitivity

BMC Ophthalmology ◽

10.1186/s12886-020-01737-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sanita Liduma ◽

Artis Luguzis ◽

Gunta Krumina

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Cross Sectional Study ◽

Shape Parameters ◽

Corneal Surface ◽

Cross Sectional ◽

Corneal Shape ◽

Different Diameters ◽

The Impact ◽

Corneal Apex

Abstract Background To understand which irregular corneal parameters determine the visual quality in keratoconus subjects. Methods The cross-sectional study examined the eyes of 44 subjects, graded from the first to third keratoconus stages by Amsler-Krumeich classification. We obtained measurements in two ways: (a) by projecting two perpendicular axes onto a cornea (first, through the central point of the cornea and keratoconus apex; second, as the perpendicular axis) to read the elevation values at points on these axes as parameters characterising the corneal surface; (b) by projecting circles with different diameters around the central part of the cornea (1, 2, and 3 mm) and reading elevation values at points equally displaced on these circles as parameters characterising an anterior surface slope. Irregular corneal shape parameters’ correlations with visual acuity and contrast sensitivity were determined in order to understand which corneal slope parameter has the strongest correlation with visual acuity and contrast sensitivity. Results Parameters characterising the corneal surface’s correlations with contrast sensitivity were from r = 0.25 (p = 0.03) at 3 cpd to r = 0.47 (p < 0.01) at 9 cpd for the highest elevation and from r = 0.33 (p = 0.09) at 5 cpd to r = 0.40 (p < 0.01) at 11 cpd for the lowest elevation in all subjects together, while for visual acuity the parameters were r = 0.30 (p < 0.01) for the highest elevation and r = 0.21 (p = 0.06) for the lowest elevation in all subjects together. The correlation between contrast sensitivity and the highest and lowest corneal point in all measured cornea was stronger for subjects with a peripheral corneal apex than for those with a central apex. In keratoconus subjects, contrast sensitivity displayed a strong correlation with slope in the central part of the cornea (with a radius of 1 mm) ranging from 0.48 (p < 0.01) at 3 cpd to 0.61 (p < 0.01) at 9 cpd. Conclusion Contrast sensitivity has a higher correlation with corneal shape parameters than with visual acuity. Subjects with a peripheral corneal apex had stronger correlations with visual acuity and contrast sensitivity than did subjects with a central apex. In keratoconus subjects, the strongest correlation was for contrast sensitivity and elevation (slope) in the region within a 1 mm radius of the corneal centre in the opposite direction of the keratoconus apex (direction (ax) CB).

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Effect of the variability in implantation depth of intracorneal ring segments using the femtosecond laser technology in corneal ectasia

European Journal of Ophthalmology ◽

10.1177/1120672119852026 ◽

2019 ◽

Vol 30 (4) ◽

pp. 668-675

Author(s):

Cristina Peris-Martínez ◽

Cristina Dualde-Beltrán ◽

Ester Fernández-López ◽

Maria José Roig-Revert ◽

Mikhail Hernández-Díaz ◽

...

Keyword(s):

Visual Acuity ◽

Femtosecond Laser ◽

Clinical Outcomes ◽

Relative Depth ◽

Laser Technology ◽

Corneal Ectasia ◽

Implantation Depth ◽

Prospective Longitudinal ◽

The Impact

Purpose: To analyze the impact of the depth of implantation of intracorneal ring segments on morphological, biomechanical, and clinical outcomes in ectatic corneas. Methods: This prospective longitudinal study enrolled 40 eyes of 29 patients (age 20–51 years) with corneal ectasia that underwent intracorneal ring segments implantation (KeraRing, Mediphacos). Changes in visual acuity, refraction, corneal tomography, and corneal biomechanics (Ocular Response Analyzer, Reichert) were evaluated during a 6 month follow-up. Likewise, changes in ring segment implantation depth measured by optical coherence tomography (Visante OCT, Carl Zeiss Meditec) were also evaluated. Results: Mean relative depth of implantation was 71.6 ± 5.8%, 71.5 ± 6.5%, and 71.9 ± 6.3% at 1, 3, and 6 months after surgery, respectively (p = 0.827). The difference between the real relative depth of implantation and the theoretical attempted value of 70% was not statistically significant (p = 0.072). Differences in spherical equivalent during the follow-up changed significantly depending on the level of relative depth of implantation (p = 0.036), with an increase of 0.114 D per each 1% increase in relative depth of implantation. Likewise, a decrease of –0.194 D in the steepest keratometric reading was found per each decrease of 1% in relative depth of implantation (p = 0.026). Changes in corneal thickness (p = 0.092) and biomechanics (p = 0.080) were not related to relative depth of implantation. Conclusion: The effect on visual acuity and refraction of intracorneal ring segments when implanted in corneal ectasia is less clinically relevant when the implantation is done at a very deep plane. The variability of the depth of intracorneal ring segments implantation when using femtosecond laser technology is minimal and with no clinically significant effect on clinical outcomes.

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