Explore the vast range of titles available.

Myopia is a leading cause of visual impairment and blindness worldwide. However, a safe and accessible approach for myopia control and prevention is currently unavailable. Here, we investigated the therapeutic effect of dietary supplements of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) on myopia progression in animal models and on decreases in choroidal blood perfusion (ChBP) caused by near work, a risk factor for myopia in young adults. We demonstrated that daily gavage of ω-3 PUFAs (300 mg docosahexaenoic acid [DHA] plus 60 mg eicosapentaenoic acid [EPA]) significantly attenuated the development of form deprivation myopia in guinea pigs and mice, as well as of lens-induced myopia in guinea pigs. Peribulbar injections of DHA also inhibited myopia progression in form-deprived guinea pigs. The suppression of myopia in guinea pigs was accompanied by inhibition of the “ChBP reduction–scleral hypoxia cascade.” Additionally, treatment with DHA or EPA antagonized hypoxia-induced myofibroblast transdifferentiation in cultured human scleral fibroblasts. In human subjects, oral administration of ω-3 PUFAs partially alleviated the near-work–induced decreases in ChBP. Therefore, evidence from these animal and human studies suggests ω-3 PUFAs are potential and readily available candidates for myopia control.

Lutein is one of the few xanthophyll carotenoids that is found in high concentration in the macula of human retina. As de novo synthesis of lutein within the human body is impossible, lutein can only be obtained from diet. It is a natural substance abundant in egg yolk and dark green leafy vegetables. Many basic and clinical studies have reported lutein’s anti-oxidative and anti-inflammatory properties in the eye, suggesting its beneficial effects on protection and alleviation of ocular diseases such as age-related macular degeneration, diabetic retinopathy, retinopathy of prematurity, myopia, and cataract. Most importantly, lutein is categorized as Generally Regarded as Safe (GRAS), posing minimal side-effects upon long term consumption. In this review, we will discuss the chemical structure and properties of lutein as well as its application and safety as a nutritional supplement. Finally, the effects of lutein consumption on the aforementioned eye diseases will be reviewed.

Purpose To investigate the association of subjects with refractive error and diabetic retinopathy (DR) in the United States comparing results between different race groups. Methods All data were derived from National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008. The data were divided into four groups (emmetropia, mild myopia, high myopia, hypertropia) according to the spherical equivalent (SE), and those who met the enrollment conditions were selected as the study subjects. Multivariable logistic regression analysis was used to evaluate the relationship between refractive error and diabetic retinopathy risk. Results A total of 1317 participants were included in the study, including 331 participants with diabetic retinopathy, and 986 without diabetic retinopathy. After adjustment for potential confounders, subjects with high myopia were associated with a lower risk of diabetic retinopathy. The odds ratio (OR) was 0.44, 95% confidence interval (CI): (0.20–0.96), P -value = 0.040 in the multivariate regression analysis. Subgroup analyses showed that subjects with high myopia in the non-Hispanic Black group were associated with decreased odds of diabetic retinopathy. (OR was 0.20, and 95% CI: 0.04–0.95, P -value = 0.042). Conclusion The results show that high myopia is associated with diabetic retinopathy in diabetic patients.

ObjectivesTo study changes in tear film inflammatory mediators following continuous wear of silicone-hydrogel lenses and corneal refractive therapy with reverse geometry contact lenses.DesignA prospective, case–control study.MethodsTwenty-eight subjects had worn silicone-hydrogel lenses on a 30-night continuous wear basis. Thirty-two subjects had worn corneal refractive therapy lenses on an overnight basis. Thirty-two matched control subjects were also recruited. Tear samples were obtained 12 months after initial fitting and assayed using ELISA for cytokines (interleukin (IL)-6 and IL-8), matrix metalloproteinase 9 (MMP-9) and epidermal growth factor (EGF).ResultsEGF was significantly increased 12 months after both interventions. IL-6, IL-8 and MMP-9 were significantly increased only after corneal refractive therapy. The inflammatory response for the corneal refractive therapy patients was found to be associated with the degree of myopia corrected and the presence of corneal staining. Moreover, an increased level of MMP-9 and EGF was found to be associated with the presence of corneal-pigmented arc in the corneal refractive therapy group.ConclusionsThis research showed long-term increased tear levels of inflammatory markers in subjects wearing corneal refractive therapy lenses when compared with continuous wear of silicone-hydrogel lenses or no lens wear.

Introduction The dietary carotenoids lutein (L) and zeaxanthin (Z) are transported in the bloodstream by lipoproteins, sequestered by adipose tissue, and eventually captured in the retina where they constitute macular pigment. There are no L&Z dietary intake recommendations nor desired blood/tissue concentrations for the Spanish general population. Our aim was to assess the correlation of L&Z habitual dietary intake (excluding food supplements), resulting serum concentrations and lipid profile with macular pigment optical density (MPOD) as well as the contrast sensitivity (CT), as visual outcome in normolipemic subjects (n = 101) aged 45-65. Methods MPOD was measured by heterochromatic flicker photometry, serum L&Z by HPLC, the dietary intake by a 3-day food records and CT using the CGT-1000-Contrast-Glaretester at six stimulus sizes, with and without glare. Results Lutein and zeaxanthin concentrations (median) in serum: 0.361 and 0.078 [mu]mol/L, in dietary intake: 1.1 mg L+Z/day. MPOD: 0.34du. L+Z intake correlates with their serum concentrations (rho = 0.333, p = 0.001), which in turn correlates with MPOD (rho = 0.229, p = 0.000) and with fruit and vegetable consumption (rho = 0.202, p = 0.001), but not with lutein+zeaxanthin dietary intake. MPOD correlated with CT, with and without glare (rho ranges: -0.135, 0.160 and -0.121, -0.205, respectively). MPOD predictors: serum L+Z, L+Z/HDL-cholesterol ([beta]-coeficient: -0.91±0.2, .sub.95% CI: -1.3,-0.5) and HDL-cholesterol (R.sup.2 = 15.9%). CT predictors: MPOD, mainly at medium and smaller visual angles (corresponding to spatial frequencies for which sensitivity declines with age) and gender ([beta]-coefficients ranges: -0.95,-0.39 and -0.13,-0.39, respectively). Conclusion A higher MPOD is associated with a lower ratio of L+Z/HDL-cholesterol and with a lower CT (higher contrast sensitivity). The HDL-cholesterol would also act indirectly on the CT improving the visual function.

Homocystinuria is an inborn error of metabolism due to the deficiency in cystathionine beta-synthase (CBS) enzyme activity. It leads to the elevation of both homocysteine and methionine levels in the blood and urine. Consequently, this build-up could lead to several complications such as nearsightedness, dislocated eye lenses, a variety of psychiatric and behavioral disorders, as well as vascular system complications. The prevalence of homocystinuria is around 1/200,000 births worldwide. However, its prevalence in the Gulf region, notably Qatar, is exceptionally high and reached 1:1800. To date, more than 191 pathogenic CBS mutations have been documented. The majority of these mutations were identified in Caucasians of European ancestry, whereas only a few mutations from African-Americans or Asians were reported. Approximately 87% of all CBS mutations are missense and do not target the CBS catalytic site, but rather result in unstable misfolded proteins lacking the normal biological function, designating them for degradation. The early detection of homocystinuria along with low protein and methionine-restricted diet is the best treatment approach for all types of homocystinuria patients. Yet, less than 50% of affected individuals show a significant reduction in plasma homocysteine levels after treatment. Patients who fail to lower the elevated homocysteine levels, through high protein-restricted diet or by B6 and folic acid supplements, are at higher risk for cardiovascular diseases, neurodegenerative diseases, neural tube defects, and other severe clinical complications. This review aims to examine the mutations spectrum of the CBS gene, the disease management, as well as the current and potential treatment approaches with a greater emphasis on studies reported in the Middle East and North Africa (MENA) region.

Background: To assess the efficacy and safety of combined intravitreal triamcinolone (IVTA) and photodynamic therapy (PDT) with verteporfin in the treatment of choroidal neovascularisation (CNV) secondary to pathological myopia. Methods: 22 eyes of 22 patients with subfoveal or juxtafoveal CNV due to pathological myopia were prospectively recruited for combined PDT with IVTA. The treatment outcomes at 1 year were compared with those in a control group of 22 eyes that received PDT monotherapy. Results: At 1 year, the logMAR best-corrected visual acuity (BCVA) for the combined PDT with IVTA group changed from 0.62 to 0.61 (p = 0.74), whereas that for the monotherapy group changed from 0.61 to 0.67 (p = 0.33). The mean logMAR BCVA and proportions of patients without losing ⩾3 lines at 1 year were similar between the two groups (p = 0.68 and 0.74, respectively). Subgroup analyses showed that eyes with baseline logMAR BCVA worse than 0.6 (Snellen equivalent 20/80) or CNV with greatest linear dimension ⩾750 μm which received combined therapy had better mean logMAR BCVA at 1 year (p = 0.023 and 0.041, respectively), with a higher proportion of eyes gaining ⩾2 lines of BCVA (p = 0.027 and 0.017, respectively) compared with PDT monotherapy. Conclusions: Combined PDT with IVTA did not seem to result in significantly better visual outcome compared with PDT monotherapy. However, combined therapy might result in better visual outcome in selected patients with worse initial visual acuity or larger myopic CNV. Further studies are warranted to investigate the role of combined PDT with IVTA in the treatment of myopic CNV, especially in patients with worse prognostic factors.

Aims:To examine prospectively the recovery of various parameters after discontinuation of overnight orthokeratology.Methods:Seventeen subjects undergoing orthokeratology for 12 months were examined. Refraction, corneal topography, wavefront aberrometry, a visual acuity test and a contrast sensitivity test were performed at baseline, 12 months after commencement of the procedure, and 1 week and 1 month after discontinuation of the treatment. Asymmetry and higher-order irregularity components were calculated using a Fourier analysis of the corneal topography data. Contrast sensitivity was assessed at four spatial frequencies, and the area under the log contrast sensitivity function (AULCSF) was calculated.Results:Orthokeratology significantly reduced manifest refraction (p<0.0001, Dunnett test) and significantly improved uncorrected visual acuity (UCVA) at 12 months after commencement of the procedure (p<0.0001). Asymmetry and higher-order irregularity components increased significantly (p<0.0001, p = 0.0032, respectively), and third- and fourth-order aberrations also increased significantly (p<0.0001). The treatment resulted in significant decreases in AULCSF (p = 0.0004). After discontinuing lens wear, all parameters, such as refraction, UCVA, asymmetry, higher-order irregularity, third-order aberration, fourth-order aberration and AULCSF, returned to the baseline level at 1 week.Conclusion:This study confirmed that the effect of orthokeratology is completely reversible in light of optical quality of the eye and quality of vision as well as refraction and visual acuity.

Aims:To report the visual outcome in a series of eyes with myopic choroidal neovascularisation treated by photodynamic therapy (PDT) followed during 48 months.Methods:Prospective, consecutive, non-randomised interventional case series. Thirty-nine eyes from 36 highly myopic patients treated by PDT were evaluated. Best corrected visual acuity (BCVA) and fluorescein angiography were performed every 3 months. Multiple regression analysis was used to analyse changes in BCVA in relationship with initial BCVA, spherical equivalent, age, diameter of CNV and chorioretinal atrophy.Results:Mean initial BCVA was 9.0 Early Treatment Diabetic Retinopathy Study lines (SD 4.3). BCVA was 10.4 lines (3.6) at month 12, 9.7 lines (SD 3.9) at month 24, 9.6 lines (SD 3.8) at month 36 and 9.6 lines (SD 4.2) at month 48. BCVA improvement was associated with initial BCVA (p<0.002), lesion diameter (p<0.04) and age (p<0.04) (multiple regression analysis).Conclusions:Our results suggest a better visual outcome for those eyes with better initial BCVA and larger lesions in younger patients treated by PDT. The poorer results for elderly patients with lower initial BCVA might lead us to consider other therapeutic approaches.

We examined the prevalence of and factors associated with lens opacities in a Korean adult population with and without diabetes. Among the 11,163 adults (≥ 19 years old) from the fourth Korea National Health and Nutrition Examination Survey in 2008-2009, the data from laboratory tests, nutritional surveys, and slit-lamp examinations of 10,248 persons (4,397 men, 5,851 women) were examined. Cataract was defined as the presence of any nuclear, cortical, subcapsular, or mixed cataract in at least one eye, using the Lens Opacities Classification System III. The weighted prevalence of cataracts were 23.5% [95% confidence interval (CI), 21.7-25.4] in a Korean adult population (19-39 years old, 1.8% [1.3-2.5], 40-64 years old, 25.2% [22.5-28.1], ≥ 65 years old, 87.8% [85.4-89.9])and 54.7% [50.1-59.2] in a diabetic population(19-39 years old, 11.6% [4.5-26.5], 40-64 years old, 41.1% [35.4-47.0], ≥ 65 years old, 88.3% [83.5-91.8]). In a logistic regression analysis, age, myopia, and the presence of diabetes were independent risk factors. For young (age 19-39 years) and middle aged (age 40-65 years) adults with diabetes, the OR of having a lens opacity is 5.04 [1.41-17.98] and 1.47 [1.11-1.94], respectively, as those without diabetes, whereas for adults aged 65 and older, there was no difference in the prevalence of cataract. According to these national survey data, ∼ 24% of Korean adults and ∼ 55% of people with diabetes have cataracts. The presence of diabetes was independently associated with cataracts in young and middle aged adults.