Search Results (198)

Background/Objectives: Heart rate variability (HRV) is a marker of autonomic nervous system function, based on fluctuations in heartbeat intervals. Although several studies have investigated the association between frequency-domain HRV parameters and glaucoma, evidence based on large sample sizes remains limited. Therefore, the present study aimed to examine the relationship between frequency-domain HRV parameters and glaucoma subtypes, including primary open-angle glaucoma (PG) and exfoliation glaucoma (EG), using a larger sample size. Methods: Participants with primary open-angle glaucoma (PG), exfoliation glaucoma (EG), or no ocular disease other than cataract (controls) were recruited at Shimane University between June 2023 and July 2024. Frequency-domain HRV parameters (total power [TP], very-low-frequency [VLF], low-frequency [LF], high-frequency [HF], and LF/HF) were measured using a sphygmograph (TAS9 Pulse Analyzer Plus View). Group comparisons were conducted using unpaired t-tests, Fisher’s exact tests, and Tukey’s HSD test. Multivariate analyses were performed to identify factors associated with each HRV parameter. Results: A total of 809 participants were analyzed, including 522 with PG, 191 with EG, and 96 controls. The EG group showed significantly lower values across all frequency-domain HRV parameters compared to the PG group, and significantly lower LnLF values than the control group (p = 0.012). Multivariate analyses revealed that no significant associations were found between HRV measures and the presence of glaucoma or pseudoexfoliation material (PEM) deposition. Older age was significantly associated with lower values across all HRV parameters. Conclusions: In elderly glaucoma patients, age-related alterations in frequency-domain HRV parameters have been observed. Full article

Background: Previous proteomic studies provided valuable information about cataracts, but unclarified issues, such as sex and ethnicity-associated differences, remain. This study aimed to provide additional data on cataract-related proteins regarding age, sex, and cataract type. Methods: Twenty-six female and seven male Turkish cataract patients were screened for visual acuity and dysfunctional lens index. A nano-LC-MS/MS system and Progenesis QI software v3.0 were used for protein identification and quantification. The remaining data were evaluated with SPSS Version 29.0 software. Results: Proteins that showed age-associated changes were mainly involved in cytoskeletal organization. A glyoxalase enzyme, caveolin 1, and HS90B were lower, and RAB8B and ATP6V1B1 were higher in lenses in women. Proteins with lower levels in cataractous lenses than in transparent lenses included filensin and phakinin, concurrent with previous publications, and LCTL, GDI, HSPB1, and EIF4A2, not reported before. Corticonuclear cataracts constituted the only group showing depletions in putatively protective proteins, while the cortical type was the least influenced. ANXA1 and DNHD1 positively, and TCPD, SEC14L2, and PRPS1 proteins negatively correlated with visual acuity. Conclusions: This study revealed cataract-related proteins concurrent with earlier studies and new ones hitherto unreported. Despite the low number of patients investigated, the results merit further research, as these new proteins are highly likely to be involved in cataractogenesis. Full article

Advanced glycation end-products (AGEs) and oxidative stress are recognized as central contributors to the pathogenesis of age-related or diabetic cataracts, diabetic retinopathy (DR), and age-related macular degeneration (AMD). These glycation-related diseases are characterized by impaired redox balance and decreased glutathione (GSH) levels. This review aims to examine the mechanistic links between AGEs and GSH depletion across ocular tissues by integrating in vitro, ex vivo, in vivo, and clinical studies relevant to this topic. The multiple levels of evidence highlight GSH homeostasis as both a biomarker and therapeutic target in glycation-related ocular disorders. Therapeutic strategies aimed at restoring GSH homeostasis under glycation stress are categorized into four mechanistic domains: (I) promoting GSH supply and synthesis, (II) enhancing GSH recycling, (III) mitigating glycation stress, and (IV) reducing oxidative and nitrosative stress. Most of these strategies have been explored via different approaches, and experimental findings with various interventions have shown promise in restoring GSH balance and mitigating AGE-induced damage. A pathological link between GSH depletion and vascular endothelial growth factor (VEGF) overexpression is observed in DR and wet AMD. GSH-centered interventions act upstream to modulate redox homeostasis while anti-VEGF therapies target downstream angiogenesis. This study supports the rationale for a dual-targeting strategy that combines redox-based interventions with VEGF inhibition in glycation-related ocular diseases. Full article

Cataract formation remains a significant cause of global visual impairment. Increasing attention has been directed toward antioxidant-based interventions as potential non-surgical strategies to delay or prevent cataractogenesis, particularly in the age-related and diabetic contexts. This review summarizes recent preclinical evidence on nutritional antioxidants for the prevention of age-related and diabetic cataracts. Agents such as trimetazidine, Moringa oleifera stem extract, ginsenoside Rg1, lanosterol nanoparticles, β-casomorphin-7, and cerium oxide-based nanotherapies have been shown to mitigate oxidative damage, modulate redox signaling pathways, and preserve lens clarity. Advances in drug delivery, including topical formulations, nanoparticle carriers, and intravitreal injections, have been proposed to overcome the anatomical and pharmacokinetic barriers associated with the avascular lens. The new data support ongoing translational research to maximize the clinical use of antioxidants and highlight their therapeutic potential in the prevention of age-related and diabetic cataracts. Full article

The process of aging exerts profound effects on various physiological systems, leading to the progression of chronic degenerative disorders and pathologies associated with advancing age. Cellular senescence plays a central role in the aging process and the onset of various eye conditions associated with advancing age, including age-related macular degeneration (AMD), diabetic retinopathy (DR), glaucoma, cataracts, and ocular surface disorders. The accumulation of senescent cells (SnCs) and their secretion of pro-inflammatory and tissue-remodeling factors, collectively known as the senescence-associated secretory phenotype (SASP), exacerbate chronic inflammation, oxidative stress, and tissue dysfunction, contributing to disease progression. This study is the first to systematically integrate the multifaceted mechanisms of cellular senescence in ocular diseases, revealing differential regulatory mechanisms of specific signaling pathways across different ocular pathologies, thereby providing novel insights into the pathogenesis of these disorders. SnC-targeted therapies such as senolytics, senomorphics, SASP modulators, mitochondrial-targeted antioxidants, and epigenetic reprogramming are emerging as regenerative therapies, demonstrating potent anti-inflammatory effects, restoration of normal tissue physiology, and successful regeneration of ocular defects in preclinical models and clinical trials, while slowing senescence-associated disease progression. This review not only summarizes the role of cellular senescence in ocular diseases but also delves into potential therapeutic strategies, particularly highlighting novel perspectives for root-cause-targeted therapies from the unique angle of senescence biology, which may pioneer new directions for the treatment of ocular pathologies. Full article

Background/Objectives: Facial melasma is a common, chronic, and relapsing hyperpigmentation disorder, affecting up to 40% of adult women in Southeast Asia. Although most cases are mild, the condition may have a considerable psychological impact. Ocular photoaging diseases are also common and have been increasingly recognized in aging populations exposed to chronic sunlight. Ultraviolet (UV) radiation is implicated in both melasma and ocular photoaging; however, their relationship remains unclear. Methods: This cross-sectional study investigated the association between facial melasma and UV-induced ocular conditions among 315 participants aged 30–80 years at Walailak University Hospital, Thailand. Facial melasma was diagnosed clinically and dermoscopically, with severity assessed using the modified Melasma Area Severity Index. Ophthalmological examinations evaluated UV-related ocular conditions, including pinguecula, pterygium, climatic droplet keratopathy, cataracts, and age-related macular degeneration. Logistic regression analyses were performed, adjusting for age, sex, and sun exposure. Results: Facial melasma was identified in 66.0% of participants (n = 208), and nuclear cataracts were significantly associated with melasma (adjusted odds ratio, 2.590; 95% confidence interval, 1.410–4.770; p = 0.002). Additionally, melasma severity correlated with nuclear cataract severity (ρ = 0.186, p = 0.001). Other ocular conditions were not significantly associated with melasma. Conclusions: These findings suggest a shared UV-related pathogenesis between facial melasma and nuclear cataracts. Sun protection measures, including regular sunscreen use, UV-blocking eyewear, and wide-brimmed hats, may help mitigate the risk of both conditions. Further multicenter studies are warranted to confirm these findings and explore the underlying mechanisms. Full article

Background: The aim of this study was to assess the relationship between sleep-related variables (sleep duration, sleep trouble, and sleep disorder), comprehensive sleep patterns, and the reported history of cataract surgery in the U.S. population aged 20 years and older. Methods: We utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005–2008 database. First, we analyzed the association between covariates and the reported history of cataract surgery using univariable Poisson regression. Subsequently, we constructed three models to evaluate the association between sleep-related variables and the reported history of cataract surgery using multivariable Poisson regression. Subgroup analyses were conducted to determine whether the association between sleep and the reported history of cataract surgery exhibited heterogeneity. Finally, we performed a sensitivity analysis to assess the stability of the results. Results: A total of 8591 participants were included in this study, among whom 774 had a history of cataract surgery. After adjusting for all covariates, participants experiencing sleep trouble had a higher prevalence of reported history of cataract surgery than participants without sleep trouble [PR = 1.40; 95%CI = (1.22, 1.62)]. Regarding combined sleep, participants with poor sleep patterns had a 36% higher prevalence of reported history of cataract surgery than those with healthy sleep patterns [PR = 1.36; 95%CI = (1.13, 1.64)]. The results of the sensitivity analysis indicate that the relationship between sleep patterns and the reported history of cataract surgery is robust. Conclusions: Sleep trouble and poor sleep patterns are positively linked to the high prevalence of a reported history of cataract surgery. Further research is needed to explore the underlying mechanisms. Full article

Objectives: Intraocular lens dislocation is a well-recognized complication of cataract surgery, necessitating secondary interventions such as retropupillary iris-claw IOL implantation. While effective, this procedure requires larger incisions that may induce significant astigmatism. This study aimed to (1) evaluate anterior chamber changes following retropupillary ICIOL implantation and (2) compare surgically induced astigmatism between corneal and scleral incision techniques. Methods: In this prospective cohort study, patients with IOL dislocation underwent 25-gauge pars plana vitrectomy with ICIOL implantation. Anterior chamber depth, volume, and angle configuration were measured across 12 meridians preoperatively, at 1–1.5 months (short-term), and 5–6 months (long-term). Surgically induced astigmatism was compared between the corneal and scleral incision groups. Statistical analysis included Shapiro–Wilk, Mann–Whitney U, and repeated-measures ANOVA tests. Results: This prospective study included 40 patients (22 females, 18 males) with a mean age of 76.3 ± 5.38 years (range 65–86). Significant reductions in ACD and ACV occurred postoperatively (p < 0.05), with partial recovery at long-term follow up. Surgically induced astigmatism was markedly higher with corneal incisions versus scleral approaches (p < 0.01 short term; p < 0.05 long term). Anterior chamber angle changes varied by meridian but stabilized by 6 months. Conclusions: Retropupillary ICIOL implantation induces predictable anterior segment remodeling, with scleral incisions offering superior refractive stability. Surgical planning should prioritize scleral techniques to minimize surgically induced astigmatism while maintaining anatomical efficacy. Future innovations in IOL design may further reduce incision-related complications. Full article

Background and Objectives: The objective was to assess ocular biometric measurements in relation to age and gender among patients scheduled for cataract surgery, utilizing an optical biometry device. Materials and Methods: The optical biometric parameters evaluated included axial length (AL), central corneal thickness (CCT), anterior chamber depth (AD), lens thickness (LT), horizontal corneal diameter (WTW), and keratometry values in the flat (K1) and steep (K2) meridians. Astigmatism (AST) was also measured as the difference between these keratometry values. Results: A total of 14,183 optical biometric measurements were included in the study. The average age of the participants was determined to be 56 (3–110) years. The average AL was 23.57 ± 1.45 mm, the average AD was 2.76 ± 0.42 mm, the average CCT was 518.13 ± 37.81 μm, the average WTW distance was 11.88 ± 0.59 mm, and the average LT was 4.19 ± 0.51 mm. The keratometry measurements were recorded as K1 = 43.39 ± 1.96 diopters (D), K2 = 44.51 ± 2.31 D, and AST = 1.12 ± 1.15 D. The average values for male eyes in terms of the AL, AD, WTW, and LT measurements were significantly higher than those for female eyes (p = 0.001). The average K1 and K2 values were flatter in males than in females, while the AST value was found to be higher in females (p = 0.001). As age progressed, the mean AL decreased, the CCT decreased, the AD narrowed, the WTW distance decreased, the LT increased, and the keratometric values K1, K2, and AST decreased until the age of 60, after which they increased again. Conclusions: Research indicates that the measurements of the bulbus oculi are generally larger in males than in females. Furthermore, each of the optical biometric measurements is interrelated. Over time, these measurements may change. Full article

Eye illness detection is important, yet it can be difficult and error-prone. In order to effectively and promptly diagnose eye problems, doctors must use cutting-edge technologies. The goal of this research paper is to develop a sophisticated model that will help physicians detect different eye conditions early on. These conditions include age-related macular degeneration (AMD), diabetic retinopathy, cataracts, myopia, and glaucoma. Common eye conditions include cataracts, which cloud the lens and cause blurred vision, and glaucoma, which can cause vision loss due to damage to the optic nerve. The two conditions that could cause blindness if treatment is not received are age-related macular degeneration (AMD) and diabetic retinopathy, a side effect of diabetes that destroys the blood vessels in the retina. Problems include myopic macular degeneration, glaucoma, and retinal detachment—severe types of nearsightedness that are typically defined as having a refractive error of –5 diopters or higher—are also more likely to occur in people with high myopia. We intend to apply a user-friendly approach that will allow for faster and more efficient examinations. Our research attempts to streamline the eye examination procedure, making it simpler and more accessible than traditional hospital approaches. Our goal is to use deep learning and machine learning to develop an extremely accurate model that can assess medical images, such as eye retinal scans. This was accomplished by using a huge dataset to train the machine learning and deep learning model, as well as sophisticated image processing techniques to assist the algorithm in identifying patterns of various eye illnesses. Following training, we discovered that the CNN, VggNet, MobileNet, and hybrid Deep Learning models outperformed the SVM and Random Forest machine learning models in terms of accuracy, achieving above 98%. Therefore, our model could assist physicians in enhancing patient outcomes, raising survival rates, and creating more effective treatment plans for patients with these illnesses. Full article

Purpose: This study aimed to assess the efficacy of for PODEYE TORIC intraocular lenses (IOL). Methods: This study was a retrospective, non-randomized, interventional case series. Inclusion criteria comprised diagnosis of an age-related cataract and a corneal astigmatism equal to or higher than 0.9 D and undergoing implantation of toric IOLs (TIOL). A single toric lens model (PodEye Toric, BVI) was used in all cases. Results: The study includes 51 eyes of 35 patients with TIOL implantation with a mean follow-up time of 45.7 (±36.5) days. Fourteen patients were targeted for mono-vision. Eight eyes had previously undergone refractive surgery (five post Myopic Lasik/PRK, two post RK/AK and one post RK). The mean postoperative adjusted spherical equivalent (SEQ) was −0.57 D ± 0.31 and the residual postoperative refractive astigmatism was −0.49 D ± 0.50. Only 2% of patients had a preoperative subjective astigmatism lower than 1.0 D whereas postoperatively, 94% of the patients had a residual astigmatism of 1.0 D or lower. The average deviation from the planned axis was 2.66 ± 0.26 degrees. None of the IOLs rotated to 10° or higher and 88% remained at 5° or less on the intended IOL axis. Twenty-six (63%) of IOL rotations were counterclockwise. Conclusions: PODEYE TORIC intraocular lenses provide exceptional refractive precision, reliable rotational stability, and consistently strong postoperative vision outcomes. Full article

Background/Objectives: We report a consecutive prospective case series to obtain prospective safety and performance data of a low-energy femtosecond (FS)-laser for cataract surgery in children and to evaluate the applicability of the Bochum formula for capsulotomy diameter calculation. Methods: In pediatric lens surgery with implantation of a bag-in-the-lens intraocular lens (BIL IOL), anterior capsulotomies were performed using the FS-laser. Regression analysis was used to develop an age-dependent correction formula, and the Pearson correlation was used to evaluate the applicability of the Bochum formula. Surgery-related and ocular adverse events (AE) were recorded at 1 day, 1 week, 1 month, and 6 months postoperatively. Results: Thirteen eyes of 10 patients were included in the analysis, among them three cases of subluxated lenses. The mean age was 3.10 ± 2.38 years (range: 4 months to 8 years). The linear bivalent regression yielded the following formula: 1.27 − 0.014 × patient age. Age-related formulas, such as the Bochum formula, are required to calculate the programmed capsulotomy diameter. No complications related to the FS-laser or ocular AEs were observed up to six months; in particular, no excessive shrinkage, retinal detachment, or unusual inflammation were identified. Conclusions: This study indicates that the use of the low-energy femtosecond laser for anterior capsulotomy in pediatric lens surgery is safe and contributes to improved reliability and feasibility. The confirmed age dependence of the enlargement factor of the capsulotomy diameter might be related to the higher capsular elasticity in pediatric eyes. Full article

Cataracts, the leading cause of blindness globally, are caused by oxidative stress and inflammation, which disrupt lens transparency due to increased accumulation of reactive oxygen species (ROS) as well as protein and DNA damage during aging. Using in vitro, ex vivo, and in vivo models, we determined the protective efficacy of N-acetylcysteine amide (NACA) against oxidative stress-induced and aging-induced cataractogenesis. We found that lens epithelial cells exposed to the oxidative stress inducers hydrogen peroxide (H₂O₂) or tert-butyl hydroperoxide showed significant ROS accumulation and reduced cellular viability. These effects were inhibited by NACA via the suppression of ROS and thioredoxin-interacting protein (Txnip) expression, a regulator of oxidative stress-related cellular damage and inflammation. In ex vivo lens experiments, NACA significantly reduced H₂O₂-induced lens opacity and preserved lens integrity. Similarly to NACA-treated lenses ex vivo, the integrity and opacity of aged mouse lenses, when topically instilled with NACA, were preserved and reduced, respectively, and are directly related to reduced Txnip and increased thioredoxin (Trx) expression levels. Overall, our findings demonstrated the protective ability of NACA to abate aberrant redox-active pathways, particularly the ROS/TRX/TXNIP axis, thereby preventing cataractogenesis and preserving eye lens integrity and ultimately impeding aging-related cataracts. Full article

The oxidation of cysteines in crystallins is a major age-related modification associated with cataract formation. The purpose of this research was to determine the susceptibility of γS-crystallin to glutathionylation-induced oxidation and disulfide bond formation. Recombinantly expressed wild-type human γS-crystallin and four cysteine-to-serine mutants were reduced and incubated for up to 2 days with oxidized glutathione. Following incubation and alkylation, the overall degree of glutathionylation and disulfide bond formation were determined by whole-mass measurement. Tryptic digests were also analyzed by LC-MS/MS to identify specific sites of S-glutathionylation and disulfide linkages. We determined that C22, C24, and C26 undergo glutathione-mediated disulfide interchange with each other, with C24 being most susceptible to oxidation and mixed disulfide formation. Our data suggest C24 is S-glutathionylated sequentially with C22 and C26 participating in disulfide exchange reactions, yielding a major species with a single glutathionylation at C24 and a disulfide between C22 and C26. The results imply that as glutathione levels are depleted in aged lenses, γS-crystallin undergoes stepwise oxidation reactions and disulfide shuffling, which may contribute towards its aggregation and cataract formation. Full article

Cornea vascularisation is a significant cause of ocular morbidity. Disease or injury often triggers the development of new blood vessels in the cornea, compromising its clarity and impairing vision. Common causes of corneal neovascularisation include infections, chemical burns, and local and systemic inflammatory disorders. Topical corticosteroid eye drops remain the standard therapy; however, extended use of corticosteroids has been known to cause side-effects including cataracts and raised intraocular pressure. As such, an alternative therapy has been actively sought. Vascular endothelial growth factor (VEGF) is a major angiogenic factor implicated in neovascularisation. The success of anti-VEGF agents in managing leaking blood vessels in neovascular age-related macular degeneration provides an opportunity to explore its use in the treatment of corneal neovascularisation. The therapeutic potential of anti-VEGF agents has been evaluated in experimental models of corneal neovascularisation and clinical trials with variable results. Here, we review the study results and discuss the development of new strategies that may improve treatment outcomes for corneal neovascularisation. Full article