Search Results (20)

Background: This case–control study evaluated the concentrations of zinc (Zn), iron (Fe), and copper (Cu) in the aqueous humor (AH) of patients with primary glaucoma, and their relationships with clinical factors. Methods: This study enrolled 100 patients with primary glaucoma and categorized them into subtypes: acute angle-closure crisis (AACC), primary angle-closure glaucoma (PACG), and primary open-angle glaucoma (POAG). A total of 67 patients with senile cataract were enrolled as controls. Their AH samples and clinical information were obtained. Results: In primary glaucoma, Zn, Fe, and Cu concentrations increased, especially in AACC group; Zn, Fe, and Cu were positively correlated mutually; and decreased Zn/Fe and increased Fe/Cu were observed. The number of quadrants with closed anterior chamber angle on gonioscopy was positively associated with Fe and Cu levels in AACC and with Zn and Cu levels in PACG. In POAG, we found negative associations between Zn and the number of quadrants with retinal nerve fiber layer thinning on optical coherence tomography, Fe and age, and Cu and the cup-to-disc ratio. Trace metals showed high efficiency in discriminating primary glaucoma from controls. Conclusions: Zn, Fe, and Cu concentrations in patients with primary glaucoma increased and were associated with clinical factors, acting as potential biomarkers. Full article

Glycation is known as an important factor inducing human diseases, including diabetic complications. As oxidative stress contributes to procedures of glycation, antioxidants may inhibit glycation and delay the progression of diabetic complications. Our previous investigation of human aqueous humor after the intake of a lutein-containing supplement demonstrated increases in antioxidative activities and decreases in peroxidative products. This study enrolled 25 patients with diabetes (DM group) and 100 age-matched controls. Aqueous humor samples were collected during cataract surgery before and after 6 weeks of oral intake of the lutein-containing antioxidant supplement, Ocuvite + Lutein^®. The carboxymethyl-lysine level (CML) was measured as an indicator of glycation. Levels of superoxide dismutase activities (SOD) and total hydroperoxide (TH) were measured as indicators of oxidation. Changes after intake and the differences between age-matched controls and the DM group were evaluated. CML decreased after intake among the DM group, while there were no changes among the age-matched controls. SOD was significantly lower and TH was significantly higher in the DM group as compared to the age-matched controls, both before and after intake. In line with the decreases in glycation, the intake of lutein-containing antioxidant supplements may inhibit diabetic complications in diabetic patients. Full article

The major function of eye lens is to transmit light onto retina and form an image. This relies on the crystallin proteins, which are tightly packed to achieve a high refractive index and transparency. The proteins are protected and maintained in a reduced state with intrinsic antioxidants, such as glutathione (GSH), and redox-regulating enzyme systems, such as thioltransferase to maintain the SH/-S-S-balance. When the protective systems are impaired or reduced due to aging, oxidative stress can lead to SH/S-S imbalance, protein modification, protein–protein aggregation and loss of transparency (cataract). Oxidative stress is considered the major culprit in senile cataract formation since cataractous lenses are typically low in GSH content and have elevated levels of GS-protein mixed disulfide (PSSG). This review will examine PSSG accumulation with age and cataracts and explore the possible role of oxidants such as H₂O₂. It will also discuss the hypothesis that PSSG formation is not simply a consequence of cataract formation but can trigger the cascade of events leading to loss of lens transparency. The hypothesis is supported by the findings that cataract formation is more rapid with increasing age due to weaker TTase activity and, in animal model systems, when the TTase gene is deleted. Full article

This study aims to characterize the conjunctival flora of patients scheduled for cataract surgery and determine the susceptibility profile of isolated bacteria to several commonly used topical antibiotics. Conjunctival swabs were taken from 44 consecutive patients (25 males, 19 females; mean age of 75.0 ± 12.6 years) who were scheduled for senile cataract surgery at two Italian centers before starting any prophylactic preoperative treatment. Swabs were processed for the detection of the microbial growth and for species identification. Selective culture media were used, and bacteria were identified using the MicroScan Specialty ID Panels (Beckman Coulter^®, Brea, CA, USA). Antimicrobial susceptibility for the following antibiotics (netilmicin, tobramycin, ofloxacin, oxacillin, levofloxacin, moxifloxacin, chloramphenicol, cefuroxime, and azithromycin) were assessed using the Kirby–Bauer disk diffusion method. Susceptibility for oxacillin was useful to identify methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE). Among the swabs analyzed, 61.4% showed only saprophytic flora, 30.7% showed only potential pathogenic flora, and 8.0% showed mixed flora. S. epidermidis (20.5%), S. intermedius (18.2%), and S. aureus (14.8%) were the most frequent isolates; MRSA and MRSE accounted for 8.0% and 6.8% of isolates. Less frequently (9%), Gram-negative bacteria such as Pseudomonas fluorescent, Serratia marcescens, Moraxella lacunata, Morganella morgani, and Stenotrophomonas maltophila were detected. All isolated organisms showed an excellent sensitivity to moxifloxacin and chloramphenicol (range 83–100%, range 67–100%, Gram-positive sensitivity for moxifloxacin and chloramphenicol, respectively; 100% Gram-negative sensitivity for both). A significant percentage of the eyes of candidates for surgery presented potential pathogenic flora alone or in association with saprophytic organisms. Staphylococci were the most frequently isolated bacteria. Tobramycin and Ofloxacin, widely used in the ophthalmic field, are confirmed to have a reduced sensitivity in vitro. Full article

Purpose: To investigate intraretinal changes and central millimeter thickness (CMMT) after successful uncomplicated cataract surgery in patients with asymptomatic epiretinal membrane (ERM). Design: prospective, single-center, interventional case series. Methods: Thirty eyes from 26 patients with cataract and ERM (ERM group) and fifteen consecutive eyes with senile cataract with a healthy macula (control group) were included. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) as well as biomicroscopy were performed at baseline, one week, one month and three months after cataract surgery. OCT raster scans were further analyzed regarding CMMT and structural changes in the retinal morphology. Results: The baseline mean visual acuity improved significantly three months after cataract surgery in both groups (p < 0.05). CMMT in the ERM group was 342 (±53 μm) at baseline and increased significantly to 356 (±57) μm after three months (p < 0.05). One patient in the ERM group developed temporary cystoid macular edema one week after cataract surgery that resolved under topical treatment within three months. CMMT in the control group increased significantly three months after cataract surgery as well but no structural changes in the retinal morphology were observed in this group. Conclusions: This study provides evidence that cataract surgery in eyes with asymptomatic pre-existing ERM can be considered as safe and effective, resulting in good visual acuity outcomes. However, an increase in CMMT and temporary mild changes in retinal morphology may occur. Full article

The pathogenesis of ocular diseases (ODs) remains unclear, although genome-wide association studies (GWAS) have identified numerous associated genetic risk loci. We integrated protein quantitative trait loci (pQTL) datasets and five large-scale GWAS summary statistics of ODs under a cutting-edge systematic analytic framework. Proteome-wide association studies (PWAS) identified plasma and brain proteins associated with ODs, and 11 plasma proteins were identified by Mendelian randomization (MR) and colocalization (COLOC) analyses as being potentially causally associated with ODs. Five of these proteins (protein-coding genes ECI1, LCT, and NPTXR for glaucoma, WARS1 for age-related macular degeneration (AMD), and SIGLEC14 for diabetic retinopathy (DR)) are newly reported. Twenty brain-protein–OD pairs were identified by COLOC analysis. Eight pairs (protein-coding genes TOM1L2, MXRA7, RHPN2, and HINT1 for senile cataract, WARS1 and TDRD7 for AMD, STAT6 for myopia, and TPPP3 for DR) are newly reported in this study. Phenotype-disease mapping analysis revealed 10 genes related to the eye/vision phenotype or ODs. Combined with a drug exploration analysis, we found that the drugs related to C3 and TXN have been used for the treatment of ODs, and another eight genes (GSTM3 for senile cataract, IGFBP7 and CFHR1 for AMD, PTPMT1 for glaucoma, EFEMP1 and ACP1 for myopia, SIRPG and CTSH for DR) are promising targets for pharmacological interventions. Our study highlights the role played by proteins in ODs, in which brain proteins were taken into account due to the deepening of eye–brain connection studies. The potential pathogenic proteins finally identified provide a more reliable reference range for subsequent medical studies. Full article

Cataracts are ocular conditions characterized by the opacification of the natural lens within the eye, which develops gradually over time and can affect one or both eyes. This condition commonly results from age-related changes in the lens, but can also arise from various factors. Cataract surgeries are expensive, particularly in states such as Spain, where they receive full support from the Spanish social welfare system. Despite a significant body of research on cataracts, few studies address the social and environmental factors triggering their development or consider the spatiotemporal evolution of their impacts. We analysed the incidence of cataracts in a southern region of Spain, differentiating between senile cataracts (those over 60 years old) and early cataracts (those between 15 and 59 years old). Twenty-one socio-economic, climate, and air pollution variables were statistically analysed using bivariate correlation, cluster analysis, and Geographic Information Systems. Eleven years of observation show a decadal increase in annually averaged maximum temperature and a decrease in annual precipitation, partially explaining the rising incidence of operable cataracts in the following year (r = 0.77 and −0.84, respectively; p < 0.05). Furthermore, early cataracts responded spatially to % agricultural employment (r = 0.85; p < 0.05) and moderately to maximum temperatures, insolation, and various constituents. Full article

During and after the COVID-19 pandemic, teleophthalmology provided access to eye care for rural populations. This study aimed to assess the efficacy of and satisfaction with an integrated real-time videoconferencing module. This project incorporated ophthalmic instruments and telecommunication devices and provided on-site consultations via videoconferencing. Both patients and healthcare providers completed satisfaction questionnaires. From May 2020 to May 2021, this project provided eye care services to 395 patients (aged 6–90 years). The most frequent eye condition was chronic conjunctivitis (n = 197), followed by senile cataract (n = 163), dry eye (n = 103), and refractive error (n = 95). Among them, 40 (10.1%) patients were referred to secondary or tertiary hospitals for further evaluation or treatment. In total, 181 recruited respondents provided good satisfaction scores in all dimensions, including quality of medical care (4.50 of 5.00), financial aspects of care (4.48), supportive attitude toward the project (4.47), quality of service (4.40), and quality of telecommunication (4.40). Women had a substantially more supportive attitude toward the project, and 25 healthcare providers provided low ratings in areas representing the quality of telecommunication (4.04) and user-friendliness of the instrument (4.00). This teleophthalmology system provided efficient and satisfactory eye care to participants in remote communities. However, better internet access and training in instrument use can reduce obstacles to the future implementation of the project. Full article

Purpose: To investigate the impact of pseudoexfoliation (PEX) syndrome on intraoperative phacoemulsification (PHACO) parameters and assess the economic cost of PHACO surgery for cataracts in patients with and without PEX syndrome. Methods: This was a retrospective quality register study on 5889 patients (6236 eyes) who underwent PHACO cataract surgery in the Eye Clinic, Clinical Hospital Centre Split, Croatia, over a 7-year period (May 2015 to December 2022), in accordance with the Guidelines of the Helsinki Declaration and approval from the Research Ethics Committee of the University Hospital Centre Split, Croatia. Inclusion criteria were patients with either presenile or senile cataract or cataract related to PEX syndrome who undertook PHACO procedure by the same experienced surgeon using the same PHACO device (Infiniti Vision System, Alcon Laboratories, Inc., Fort Worth, TX, USA). Eyes were categorized according to PEX presence- (PEX group) or absence (Group without PEX). The following recorded data about intraoperative PHACO parameters were collected: Cumulative Dissipated Energy (CDE), Ultrasound total time, PHACO time, torsional time, aspiration time, estimated fluid used, and duration of the surgical procedure. In the economic analysis, all PHACO parameters were considered, with a specific focus on the duration of the surgical procedure, costs associated with additional medical materials and devices, complications during surgery, and surgery procedure Diagnosis-Related Group (DRG) codes. Results: A total of 4535 cases were eligible for inclusion in the study, 278 (6.13%) were diagnosed with PEX and 4257 (93.87%) had no PEX. Significantly higher PHACO parameters were observed in the PEX group. Similarly, a statistically significant increase in the values of all PHACO parameters was observed with the increase in nuclear lens density. Intraoperative complications were more frequent in the PEX group. Zonular weakness requiring the use of a capsular tension ring (CTR) and posterior capsular rupture occurred 30 and 13 times more often, respectively, in the PEX group. The expected cost of the PHACO procedure was found to be 1.4 times higher in patients with PEX, compared to those without PEX, for all types of nuclear cataract. Conclusions: All PHACO parameters are significantly higher in patients with PEX. The costs associated with PHACO surgery for cataracts are greater for patients with PEX and are not covered by the present DRG codes, which highlights the need to accordingly adjust the DRGs for PHACO procedures in PEX patients, in order to maintain the quality of healthcare provided for these vulnerable patients. Full article

Purpose: To evaluate residual refractive astigmatism using the Panacea and enVista toric calculators, compared to the gold-standard Barrett toric calculator. Design: A retrospective and comparative study was conducted in one center. Methods: We reviewed the medical records of all patients with a diagnosis of senile cataracts and regular corneal astigmatism, without previous corneal or intraocular surgery, who underwent phacoemulsification with implantation of a toric intraocular lens, who had pre- and postoperative corneal topography, biometry, and refraction measurements. Results: The frequency of preoperative astigmatism according to the axis was 70 (84%) eyes showing with-the-rule (WTR) astigmatism, 9 (14%) eyes with against-the-rule (ATR) astigmatism, and 1 (2%) eye with oblique astigmatism. Regarding astigmatism prediction errors, there were statistically significant differences between the enVista and Panacea calculators (median of 0.39, 0.18, and 0.52 for Barrett, enVista, and Panacea, respectively). The residual astigmatism prediction error centroid was similar for the Barrett and enVista toric calculators, and both were lower compared to the Panacea calculator (x-component p < 0.001). Conclusions: The enVista toric calculator incorporating the Emmetropia Verifying Optical (EVO) toric calculator provides similar results to the gold-standard Barrett calculator. Full article

Pre-senile cataract is the opacity of the crystalline lens of the eye before the age of 50 years. Recently, the incidence of early-onset cataracts has been on the rise. It is closely linked with oxidative stress and antioxidant deficiency. To identify the relationship between serum antioxidant levels (vitamin E and glutathione) and the occurrence of pre-senile cataract, to measure serum vitamin E and glutathione levels in patients with pre-senile cataract and compare them with those of people without a cataract, to determine the effect of dietary habits and socioeconomic status on pre-senile cataract patients and identify the relationship between anthropometric measurements and occurrence of pre-senile cataract, a retrospective case–control study was conducted at an eye hospital in Gaza City. The study consisted of 44 cases of pre-senile cataract patients and 44 cases of region-, sex-, and age-matched controls. Data collection was performed by direct methods that included anthropometric measurement and serum vitamin E and glutathione levels and indirect methods through a structured interview questionnaire. SPSS software version 24 was used to analyze the data. Regarding serum antioxidant status, serum vitamin E and glutathione levels in pre-senile cataract patients were equal to those of healthy controls. The majority of patients were illiterate, married women. An increase in body weight and obesity had a strong association with pre-senile cataract formation. Concerning dietary factors, a high intake of fruits, meat and meat products, starchy food (grains), and healthy snacks was inversely correlated with pre-senile cataract. A direct relationship between vitamin E and glutathione was found. The study concluded that pre-senile cataract is a multifactorial disease and many risk factors (dietary factors, socio-economic factors, medical factors, and anthropometrics factors) play a role in pre-senile cataract formation. Full article

The dipeptide carnosine is a physiologically important molecule in the human body, commonly found in skeletal muscle and brain tissue. Beta-alanine is a limiting precursor of carnosine and is among the most used sports supplements for improving athletic performance. However, carnosine, its metabolite N-acetylcarnosine, and the synthetic derivative zinc-L-carnosine have recently been gaining popularity as supplements in human medicine. These molecules have a wide range of effects—principally with anti-inflammatory, antioxidant, antiglycation, anticarbonylation, calcium-regulatory, immunomodulatory and chelating properties. This review discusses results from recent studies focusing on the impact of this supplementation in several areas of human medicine. We queried PubMed, Web of Science, the National Library of Medicine and the Cochrane Library, employing a search strategy using database-specific keywords. Evidence showed that the supplementation had a beneficial impact in the prevention of sarcopenia, the preservation of cognitive abilities and the improvement of neurodegenerative disorders. Furthermore, the improvement of diabetes mellitus parameters and symptoms of oral mucositis was seen, as well as the regression of esophagitis and taste disorders after chemotherapy, the protection of the gastrointestinal mucosa and the support of Helicobacter pylori eradication treatment. However, in the areas of senile cataracts, cardiovascular disease, schizophrenia and autistic disorders, the results are inconclusive. Full article

The ocular lens has a very high content of the antioxidant glutathione (GSH) and the enzymes that can recycle its oxidized form, glutathione disulfide (GSSG), for further use. It can be synthesized in the lens and, in part, transported from the neighboring anterior aqueous humor and posterior vitreous body. GSH is known to protect the thiols of the structural lens crystallin proteins from oxidation by reactive oxygen species (ROS) so the lens can maintain its transparency for proper visual function. Age-related lens opacity or senile cataract is the major visual impairment in the general population, and its cause is closely associated with aging and a constant exposure to environmental oxidative stress, such as ultraviolet light and the metabolic end product, H₂O₂. The mechanism for senile cataractogenesis has been hypothesized as the results of oxidation-induced protein-thiol mixed disulfide formation, such as protein-S-S-glutathione and protein-S-S-cysteine mixed disulfides, which if not reduced in time, can change the protein conformation to allow cascading modifications of various kinds leading to protein–protein aggregation and insolubilization. The consequence of such changes in lens structural proteins is lens opacity. Besides GSH, the lens has several antioxidation defense enzymes that can repair oxidation damage. One of the specific redox regulating enzymes that has been recently identified is thioltransferase (glutaredoxin 1), which works in concert with GSH, to reduce the oxidative stress as well as to regulate thiol/disulfide redox balance by preventing protein-thiol mixed disulfide accumulation in the lens. This oxidation-resistant and inducible enzyme has multiple physiological functions. In addition to protecting structural proteins and metabolic enzymes, it is able to regulate the redox signaling of the cells during growth factor-stimulated cell proliferation and other cellular functions. This review article focuses on describing the redox regulating functions of GSH and the thioltransferase enzyme in the ocular lens. Full article

Background and Objectives: Subjective visual function is currently becoming an increasing appreciation in assessing the health-related quality of life. This study aimed to assess the vision-related quality of life (VRQOL) among patients with refractive errors, keratoconus, senile cataract, and age-related macular degeneration (AMD) using the Chinese version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25). Materials and Methods: The questionnaire of NEI-VFQ-25 was filled out in a clinical setting or by telephone/mail. Univariate and multivariate analyses were used to determine which factors are associated with the NEI-VFQ-25. Results: From June 2018 to January 2019, 28 patients with refractive error, 20 patients with keratoconus, 61 with senile cataracts, and 17 with AMD completed the questionnaire NEI-VFQ-25. There were significant differences in the NEI-VFQ-25 subscale of general vision (p = 0.0017), ocular pain (p = 0.0156), near activities (p = 0.0002), vision-specific social functioning (p = 0.007), vision-specific mental health (p = 0.0083), vision-specific dependency (p = 0.0049), color vision (p < 0.0001), peripheral vision (p = 0.0065), and total score (p < 0.0001) among four disease groups, respectively. The multiple linear regression revealed that the best-corrected visual acuity (BCVA) and disease group were important factors of the total NEI-VFQ-25. After adjusting for BCVA, patients with AMD had a worse total NEI-VFQ-25 score than patients with refractive error, keratoconus, or senile cataracts. Conclusions: Among the patients with four ocular disorders and a broad vision spectrum from normal, partial sight, low vision to legal blindness, the BCVA of their better eye was the most important factor in the VRQOL. Full article

Cataracts are a serious complication of diabetes. In long-term hyperglycemia, intracellular Ca²⁺ concentration ([Ca²⁺]_i) and reactive oxygen species (ROS) are increased. The apoptosis of lens epithelial cells plays a key role in the development of cataract. We investigated a potential role for transient receptor potential vanilloid 2 (TRPV2) in the development of diabetic cataracts. Immunohistochemical and Western blotting analyses showed that TRPV2 expression levels were significantly increased in the lens epithelial cells of patients with diabetic cataracts as compared with senile cataract, as well as in both a human lens epithelial cell line (HLEpiC) and primary rat lens epithelial cells (RLEpiCs) cultured under high-glucose conditions. The [Ca²⁺]_i increase evoked by a TRPV2 channel agonist was significantly enhanced in both HLEpiCs and RLEpiCs cultured in high-glucose media. This enhancement was blocked by the TRPV2 nonspecific inhibitor ruthenium red and by TRPV2-specific small interfering (si)RNA transfection. Culturing HLEpiCs or RLEpiCs for seven days in high glucose significantly increased apoptosis, which was inhibited by TRPV2-specific siRNA transfection. In addition, ROS inhibitor significantly suppressed the ROS-induced increase of TRPV2-mediated Ca²⁺ signal and apoptosis under high-glucose conditions. These findings suggest a mechanism underlying high-glucose–induced apoptosis of lens epithelial cells, and offer a potential target for developing new therapeutic options for diabetes-related cataracts. Full article