Journal of Clinical Medicine

Background: Interstitial lung diseases (ILDs) profoundly affect daily life, limiting mobility, independence, and emotional stability. While antifibrotic therapies may slow physiological decline, the living experience—characterized by breathlessness, cough, frailty, and psychological distress—remains insufficiently understood; this study therefore aimed to capture real-world patient perspectives on functional capacity, self-management, and mental health to identify treatable traits beyond conventional physiological measures. Materials and Methods: A cross-sectional quantitative online survey was conducted between September 2024 and January 2025 by Lungenfibrose e.V. in collaboration with the Center for Interstitial and Rare Lung Diseases (ZISL), Universities of Giessen and Marburg Lung Center (Giessen site). Patients with physician-confirmed ILD completed standardized instruments assessing dyspnea (MRC), cough intensity (VAS-Cough), frailty (CFS), and health-related quality of life (EQ-5D-5L). Data were analyzed descriptively across physical, functional, and psychosocial domains. Results: The majority of 69 respondents had idiopathic pulmonary fibrosis (64.7%) with a mean diagnostic delay of 1.4 ± 2.2 years; 69% were diagnosed within two years of symptom onset, and 77% were receiving antifibrotic therapy (nintedanib 57%, pirfenidone 19%). Functional limitations were substantial—55% were mobile for fewer than two hours per day, 73% reported mobility impairment, and oxygen use was common (51% during exertion, 26% at rest). Frailty increased over time (mean CFS 3.2 → 3.8), with 46% classified as fit, 36% vulnerable, and 18% frail. Dyspnea and cough remained burdensome (mean VAS-cough 40 ± 26; 58% moderate–severe), and health-related quality of life was reduced (mean EQ-VAS 56.5 ± 23.7), with high rates of anxiety/depression (78%), limitations in daily activities (76%), and pain/discomfort (74%). Despite overall satisfaction with care (mean 7.1 ± 2.5), respondents frequently reported unmet needs for psychological support and clearer communication about treatment and disease management. Conclusions: Despite antifibrotic therapy and structured specialist care, individuals living with ILD continue to face substantial physical and emotional challenges. Treatable traits—including frailty, dyspnea, inactivity, anxiety, and social isolation—emerge as key determinants of well-being. Multidisciplinary strategies integrating rehabilitation, psychosocial support, and patient education alongside pharmacological therapy are essential to preserve autonomy and improve quality of life in pulmonary fibrosis.

Objective: Diabetic retinopathy (DR) is a leading cause of blindness, and understanding its progression from non-proliferative (NPDR) to sight-threatening proliferative diabetic retinopathy (PDR) is crucial. Systemic lactate dehydrogenase (LDH) has been implicated in various disease processes. We investigated the association between systemic LDH levels at the time of NPDR diagnosis and the 1-year risk of progression to PDR and its complications. Methods: We conducted a retrospective, propensity-matched cohort study using the TriNetX US Collaborative Network. Patients with type 2 diabetes and a new diagnosis of NPDR were stratified into three groups based on a single LDH measurement taken within 6 months of the index date: low (<200 U/L), moderate (201–280 U/L), and high (≥281 U/L). Two separate analyses were performed: one comparing the low-LDH group to the moderate-LDH group, and another comparing the low-LDH group to the high-LDH group. The primary outcomes were the 1-year absolute risks and risk ratios (relative risk, RR) for PDR, tractional retinal detachment (TRD), and vitreous hemorrhage (VH). Results: Comparing the low-LDH cohort to the moderate-LDH cohort, the moderate-LDH group had a higher 1-year absolute risk of PDR (3.93% vs. 2.96%), TRD (1.35% vs. 0.99%), and VH (4.38% vs. 3.51%). Comparing the low-LDH group to the high-LDH group, the high-LDH cohort showed an increased risk for PDR (3.66% vs. 3.00%), TRD (1.27% vs. 0.96%), and VH (1.27% vs. 0.96%). Conclusions: Our findings demonstrate a consistent, dose-dependent relationship between higher systemic LDH levels and an increased risk of progression to PDR and its complications.

Background/Objectives: Recurrent corneal erosion syndrome (RCES) is a chronic, recurrent, and painful disorder characterized by repeated episodes of sudden ocular pain due to abnormalities in the corneal epithelium or basement membrane (BM). The aim of this study was to investigate the triggering factors in patients with recurrent corneal erosion syndrome. Methods: Medical charts of patients diagnosed with recurrent corneal erosion syndrome among those who visited the outpatient department of Kangnam Sacred Heart Hospital between 2013 and 2017 were investigated. The trigger factors and the patient’s ocular symptoms were surveyed, and the severity of symptoms was investigated using a questionnaire. Anterior segment photos and anterior segment optical coherence tomography (AS-OCT) scans were performed. Results: The study included a total of 40 patients, with an average age of 46.18 (±13.81) years. Of these, 17 were men and 23 were women. Twelve patients (30%) had a history of trauma. Twelve (30%) drank alcohol the day before the onset of the disease, thirteen (32.5%) had severe fatigue, eight (20%) smoked and two (5%) exercised heavily. The severity of symptoms is related to age and fatigue. AS-OCT was performed in 18 patients; 94.4% had corneal anterior stromal hyperreflectivity, 61.1% had epithelial edema, 50.0% had irregular epithelial break-up, 44.4% had intraepithelial inclusion cysts, 33.3% had intraepithelial BM, and 11.1% had undetectable epithelial BM. Blurred vision and decreased visual acuity are associated with the absence of epithelial BM. Other AS-OCT findings showed no statistically significant difference from the visual symptoms. Conclusions: The most common triggering factors were fatigue and alcohol drinking. The AS-OCT findings may reflect the pathogenesis and progression of RCES.