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PurposeThis study aimed to assess the causal relationships between vitamin D levels and ocular disorders.MethodsIndependent genetic variables were obtained from genome-wide association studies (GWAS) and publicly available databases. The summary statistics for 25-hydroxyvitamin D (25(OH)D) were obtained from two large-scale GWAS studies, with sample sizes of 324,105 and 417,580 European individuals. The genetic variants of myopia, primary open angle glaucoma (POAG), anterior iridocyclitis, senile cataract, diabetic retinopathy (DR), retinal vein occlusion (RVO), wet age-related macular degeneration (WAMD) and optic neuritis were extracted from the latest release of FinnGen consortium, which contains genome data from Finnish participants. Subsequently, Mendelian randomization (MR) analyses were conducted to obtain effect estimates. Additionally, we performed multivariable MR analysis and mediation analysis to validate the results.ResultsIn the discovery dataset, genetically predicted vitamin D concentration was found to be causally associated with an increased risk of WAMD, (odd ratio (OR) = 1.35, 95% confidence interval (CI) = 1.09–1.67, PIVW = 0.005). However, no causal effects of genetically predisposed vitamin D levels on the risk of most types of ocular disorders were observed. Reverse MR revealed no causal relationships between the ocular diseases and vitamin D concentrations. The MR analyses of the validation dataset yielded consistent results. Additionally, the causal effect of vitamin D levels on the risk of WAMD remained significant after adjusting for potential confounders in the multivariable MR analysis (OR = 1.86, 95% CI = 1.26–2.73, PIVW = 0.002).ConclusionOur MR analysis results provide robust evidence of a causal relationship between genetically predicted 25(OH)D levels and an increased risk of WAMD in European population. These findings offer important insights into the management and control of ocular disorders.

Gait disorders are a disabling feature of Parkinson's disease (PD). To avoid falls, people with PD should be able to adequately adapt their gait. This requires correct response inhibition and integration of visual information. In this small pilot study, we investigated PD-related impairments in gait adaptability and the influence of ocular disorders thereon. Compared with controls, persons with PD were less able to adapt their gait in unexpected situations (U = 21.5, p = 0.013), with only a small influence of ocular disorders on precision stepping (U = 6, p = 0.012 in the ML-direction and in the AP-direction, (U = 20, p = 0.456). This shows that people with PD have more difficulty with precision stepping than healthy controls and experience more problems with adapting their gait. We found only a small impact of ocular disorders on successfully execute precision stepping. The ability to adapt gait, particularly in challenging environmental conditions or with impaired vision, may provide a useful assessment and training option for fall prevention in PD. [ABSTRACT FROM AUTHOR]

The intricate functionality of the vertebrate retina relies on the interplay between neurotransmitter activity and calcium (Ca2+) dynamics, offering important insights into developmental processes, physiological functioning, and disease progression. Neurotransmitters orchestrate cellular processes to shape the behavior of the retina under diverse circumstances. Despite research to elucidate the roles of individual neurotransmitters in the visual system, there remains a gap in our understanding of the holistic integration of their interplay with Ca2+ dynamics in the broader context of neuronal development, health, and disease. To address this gap, the present review explores the mechanisms used by the neurotransmitters glutamate, gamma-aminobutyric acid (GABA), glycine, dopamine, and acetylcholine (ACh) and their interplay with Ca2+ dynamics. This conceptual outline is intended to inform and guide future research, underpinning novel therapeutic avenues for retinal-associated disorders. [ABSTRACT FROM AUTHOR]

PURPOSE: This study reports parental attitudes towards preimplantation genetic diagnosis (PGD) and their satisfaction with genetic counseling services offered by a territory eye care hospital in Saudi Arabia. METHODS: This was a cross-sectional study of 30 parents (either father or mother) of children affected by recessive genetic ocular disorders. Their basic knowledge of recessive genetic disorders, attitude toward PGD, and satisfaction with counseling services were assessed using structured telephonic interviews. RESULTS: Eighty percent of the participants understood the concept of recessive inheritance patterns and the effect of consanguineous marriages on raising the likelihood of giving birth to a child with genetic disorders. Forty-seven percent of parents understood the risk of having an affected future offspring. Sixty-seven percent of them mentioned that they would consider using preventive measures when conceiving next time. Seventy-three percent of participants stated that they would share the genetic test results with family members. Ninety percent of the parents were satisfied with the genetic counselor's ability to listen to them and the way the counselor explained the genetic information. There was a statistically significant association between parental willingness to share genetic test results with relatives and being given the opportunity to share information with their genetic counselor (P = 0.01). There was no association between the parental's knowledge and their willingness to consider using preventative measures in the next pregnancy. CONCLUSION: Most parents had a basic understanding of recessive disease. However, they often struggled to comprehend the science and mathematical probabilities determining the recurrence risk in future pregnancies. This complexity makes it difficult for them to recall the information. Attitude toward PGD did not seem to be related with parent knowledge. A significant proportion of the parents expressed willingness to share their genetic test results with relatives, but some were hesitant due to fears of stigma. Most parents were satisfied with genetic counseling services. [ABSTRACT FROM AUTHOR]

Disorders in the development and regulation of blood vessels are involved in various ocular disorders, such as persistent hyperplastic primary vitreous, familial exudative vitreoretinopathy, and choroidal dystrophy. Thus, the appropriate regulation of vascular development is essential for healthy ocular functions. However, regulation of the developing choroidal circulation system has not been well studied compared with vascular regulation in the vitreous and the retina. The choroid is a vascular-rich and uniquely structured tissue supplying oxygen and nutrients to the retina, and hypoplasia and the degeneration of the choroid are involved in many ocular disorders. Therefore, understanding the developing choroidal circulation system expands our knowledge of ocular development and supports our understanding of ocular disorders. In this review, we examine studies on regulating the developing choroidal circulation system at the cellular and molecular levels and discuss the relevance to human diseases. [ABSTRACT FROM AUTHOR]

Aims: To identify and characterize ocular adverse events (oAEs) that are significantly associated with proprotein convertase subtilisin‐like/kexin type 9 (PCSK9) inhibitors using the US Food and Drug Administration Adverse Event Reporting System (FAERS). Methods: We conducted a disproportionality analysis of PCSK9 inhibitors in the FAERS (01/2004–12/2021). The association between PCSK9 inhibitors and oAEs was evaluated using the information component (IC) and the reporting odds ratio (ROR), and the difference in oAEs between evolocumab and alirocumab was compared using the ROR. Different sensitivity analyses were conducted to evaluate the robustness of results. Results: A total of 103 531 reports involving at least 1 PCSK9 inhibitor were found in the FAERS. PCSK9 inhibitors were associated with higher reporting of increased lacrimation (IC 0.27 [95% confidence interval {CI} 0.02–0.45]; ROR 1.21 [95% CI 1.04–1.40]), seasonal allergy (IC 0.39 [95% CI 0.04–0.64]; ROR 1.32 [95% CI 1.07–1.62]) and eye operation (IC 0.66 [95% CI 0.04–1.10]; ROR 1.60 [95% CI 1.11–2.30]) compared with the full database, and there was no difference between evolocumab and alirocumab. Sensitivity analyses showed that the disproportionate signals of increased lacrimation disappeared after excluding cases with other lipid‐lowering agents in the combined drugs. Except for eye operations, most of these adverse events occurred within 30 days of the first dose, and all 3 oAEs were mostly reported in women and individuals >65 years. Conclusion: This pharmacovigilance study identified a possible signal of ocular disorders associated with PCSK9 inhibitors and encourages paying attention to at‐risk populations in PCSK9 inhibitors medication. [ABSTRACT FROM AUTHOR]

Spondyloocular syndrome (SOS, OMIM # 605822) is a rare genetic disorder characterized by osseous and ocular manifestations, including generalized osteoporosis, multiple long bones fractures, platyspondyly, dense cataracts and retinal detachment, and dysmorphic facial features, with or without short stature, cardiopathy, hearing impairment, and intellectual disability. Biallelic mutations in the XYLT2 gene (OMIM * 608125), encoding the xylosyltransferase II, were shown to be responsible for this disease. To date, 22 cases with SOS have been described, with varying clinical presentations and a yet-to-be-established genotypic–phenotypic correlation. Two patients from a consanguineous Lebanese family that presented with SOS were included in this study. Whole exome sequencing revealed a novel homozygous nonsense mutation in XYLT2 (p.Tyr414*) in these patients. We review all previously reported cases with SOS, describe the second nonsense mutation in XYLT2, and contribute to a better delineation of the phenotypic spectrum of the disease. [ABSTRACT FROM AUTHOR]

The rate at which obesity is becoming an epidemic in many countries is alarming. Obese individuals have a high risk of developing elevated intraocular pressure and glaucoma. Additionally, glaucoma is a disease of epidemic proportions. It is characterized by neurodegeneration and neuroinflammation with optic neuropathy and the death of retinal ganglion cells (RGC). On the other hand, there is growing interest in microbiome dysbiosis, particularly in the gut, which has been widely acknowledged to play a prominent role in the etiology of metabolic illnesses such as obesity. Recently, studies have begun to highlight the fact that microbiome dysbiosis could play a critical role in the onset and progression of several neurodegenerative diseases, as well as in the development and progression of several ocular disorders. In obese individuals, gut microbiome dysbiosis can induce endotoxemia and systemic inflammation by causing intestinal barrier malfunction. As a result, bacteria and their metabolites could be delivered via the bloodstream or mesenteric lymphatic vessels to ocular regions at the level of the retina and optic nerve, causing tissue degeneration and neuroinflammation. Nowadays, there is preliminary evidence for the existence of brain and intraocular microbiomes. The altered microbiome of the gut could perturb the resident brain–ocular microbiome ecosystem which, in turn, could exacerbate the local inflammation. All these processes, finally, could lead to the death of RGC and neurodegeneration. The purpose of this literature review is to explore the recent evidence on the role of gut microbiome dysbiosis and related inflammation as common mechanisms underlying obesity and glaucoma. [ABSTRACT FROM AUTHOR]

How to enhance the bioavailability and prolong the residence time of drugs in the eye present the major barriers to traditional eye delivery. Nanotechnology has been widely used in ocular drug delivery systems because of its advantages of minimizing adverse reactions, decreasing the frequency of administration, prolonging the release time, and improving the bioavailability of the drug in the eye. As natural product-based nanostructured systems, bioinspired nanostructured systems have presented as less toxic, easy to prepare, and cost-effective and have potential application value in the field of nanotechnology. A systematic classification of bioinspired nanostructured systems based on their inspiration source and formulation and their brief applications in disease are presented here. A review of recent research progress of the bioinspired nanostructured systems for the treatment of the anterior and posterior segment of ocular disorders is then presented in detail. Finally, current challenges and future directions with regard to manufacturing bioinspired nanomaterials are provided. [ABSTRACT FROM AUTHOR]

Dimethyl fumarate (DMF) is a small molecule currently approved and used in the treatment of psoriasis and multiple sclerosis due to its immuno-modulatory, anti-inflammatory, and antioxidant properties. As an Nrf2 activator through Keap1 protein inhibition, DMF unveils a potential therapeutical use that is much broader than expected so far. In this comprehensive review we discuss the state-of-art and future perspectives regarding the potential repositioning of this molecule in the panorama of eye pathologies, including Age-related Macular Degeneration (AMD). The DMF's mechanism of action, an extensive analysis of the in vitro and in vivo evidence of its beneficial effects, together with a search of the current clinical trials, are here reported. Altogether, this evidence gives an overview of the new potential applications of this molecule in the context of ophthalmological diseases characterized by inflammation and oxidative stress, with a special focus on AMD, for which our gene–disease (KEAP1-AMD) database search, followed by a protein–protein interaction analysis, further supports the rationale of DMF use. The necessity to find a topical route of DMF administration to the eye is also discussed. In conclusion, the challenge of DMF repurposing in eye pathologies is feasible and worth scientific attention and well-focused research efforts. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyze the proteomic composition of plasma rich in growth factors eye drops (PRGF) in comparison to lyophilized PRGF eye drops (PRGF lyo). The differential protein expression of keratocyte (HK) cells after PRGF or PRGF lyo treatment was also determined. Blood from different donors was collected and processed to obtain PRGF and PRGF lyo eye drops. Then, HK cells were treated with both formulations. A proteomic analysis was performed to evaluate the differential proteomic profile between PRGF and PRGF lyo, and the differential protein expression by HK cells after treatment with both blood-derived products. About 280 proteins were detected between both blood-derived formulation, with only 8 of them reaching significant differences. Furthermore, 101 out of 3213 proteins showed statistically significant deregulation in HK cells after treatment with PRGF or PRGF lyo. Gene Ontology analysis showed that these significant deregulated proteins were involved in 30 functional processes. However, the Ingenuity Pathway Analysis showed that no significant differences were found in any of the identified processes. In summary, the present study show that no significant differences were found in the proteomic profile or in the signaling pathways activation in HK cells between PRGF and PRGF lyo. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the causal relationships between vitamin D levels and ocular disorders., Methods: Independent genetic variables were obtained from genome-wide association studies (GWAS) and publicly available databases. The summary statistics for 25-hydroxyvitamin D (25(OH)D) were obtained from two large-scale GWAS studies, with sample sizes of 324,105 and 417,580 European individuals. The genetic variants of myopia, primary open angle glaucoma (POAG), anterior iridocyclitis, senile cataract, diabetic retinopathy (DR), retinal vein occlusion (RVO), wet age-related macular degeneration (WAMD) and optic neuritis were extracted from the latest release of FinnGen consortium, which contains genome data from Finnish participants. Subsequently, Mendelian randomization (MR) analyses were conducted to obtain effect estimates. Additionally, we performed multivariable MR analysis and mediation analysis to validate the results., Results: In the discovery dataset, genetically predicted vitamin D concentration was found to be causally associated with an increased risk of WAMD, (odd ratio (OR) = 1.35, 95% confidence interval (CI) = 1.09-1.67, P = 0.005). However, no causal effects of genetically predisposed vitamin D levels on the risk of most types of ocular disorders were observed. Reverse MR revealed no causal relationships between the ocular diseases and vitamin D concentrations. The MR analyses of the validation dataset yielded consistent results. Additionally, the causal effect of vitamin D levels on the risk of WAMD remained significant after adjusting for potential confounders in the multivariable MR analysis (OR = 1.86, 95% CI = 1.26-2.73, IVW = 0.005). However, no causal effects of genetically predisposed vitamin D levels on the risk of most types of ocular disorders were observed. Reverse MR revealed no causal relationships between the ocular diseases and vitamin D concentrations. The MR analyses of the validation dataset yielded consistent results. Additionally, the causal effect of vitamin D levels on the risk of WAMD remained significant after adjusting for potential confounders in the multivariable MR analysis (OR = 1.86, 95% CI = 1.26-2.73, P IVW = 0.002)., Conclusion: Our MR analysis results provide robust evidence of a causal relationship between genetically predicted 25(OH)D levels and an increased risk of WAMD in European population. These findings offer important insights into the management and control of ocular disorders., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Fan, Shi, Li, Li and Yu.)

This article discusses the potential ocular complications associated with COVID-19 and vaccination. It highlights that COVID-19 can affect the eyes directly or indirectly, leading to various ocular manifestations such as dry eye, conjunctivitis, and retinal vascular occlusions. The article also mentions rare reports of ocular disorders following vaccination, including uveitis and corneal transplant rejection. The authors emphasize the need for a comprehensive understanding of these complications to enhance diagnosis and treatment. They call for further research to unravel the underlying mechanisms and collaborate between the scientific community and clinicians in this rapidly evolving field. [Extracted from the article]

[Display omitted] Ocular delivery is the most challenging aspect in the field of pharmaceutical research. The major hurdle for the controlled delivery of drugs to the eye includes the physiological static barriers such as the complex layers of the cornea, sclera and retina which restrict the drug from permeating into the anterior and posterior segments of the eye. Recent years have witnessed inventions in the field of conventional and nanocarrier drug delivery which have shown considerable enhancement in delivering small to large molecules across the eye. The dynamic challenges associated with conventional systems include limited drug contact time and inadequate ocular bioavailability resulting from solution drainage, tear turnover, and dilution or lacrimation. To this end, various bioactive-based nanosized carriers including liposomes, ethosomes, niosomes, dendrimer, nanogel, nanofibers, contact lenses, nanoprobes, selenium nanobells, nanosponge, polymeric micelles, silver nanoparticles, and gold nanoparticles among others have been developed to circumvent the limitations associated with the conventional dosage forms. These nanocarriers have been shown to achieve enhanced drug permeation or retention and prolong drug release in the ocular tissue due to their better tissue adherence. The surface charge and the size of nanocarriers (10–1000 nm) are the important key factors to overcome ocular barriers. Various nanocarriers have been shown to deliver active therapeutic molecules including timolol maleate, ampicillin, natamycin, voriconazole, cyclosporine A, dexamethasone, moxifloxacin, and fluconazole among others for the treatment of anterior and posterior eye diseases. Taken together, in a nutshell, this extensive review provides a comprehensive perspective on the numerous facets of ocular drug delivery with a special focus on bioactive nanocarrier-based approaches, including the difficulties and constraints involved in the fabrication of nanocarriers. This also provides the detailed invention, applications, biodistribution and safety-toxicity of nanocarriers-based therapeutcis for the ophthalmic delivery. [ABSTRACT FROM AUTHOR]

Disorders in the development and regulation of blood vessels are involved in various ocular disorders, such as persistent hyperplastic primary vitreous, familial exudative vitreoretinopathy, and choroidal dystrophy. Thus, the appropriate regulation of vascular development is essential for healthy ocular functions. However, regulation of the developing choroidal circulation system has not been well studied compared with vascular regulation in the vitreous and the retina. The choroid is a vascular-rich and uniquely structured tissue supplying oxygen and nutrients to the retina, and hypoplasia and the degeneration of the choroid are involved in many ocular disorders. Therefore, understanding the developing choroidal circulation system expands our knowledge of ocular development and supports our understanding of ocular disorders. In this review, we examine studies on regulating the developing choroidal circulation system at the cellular and molecular levels and discuss the relevance to human diseases.

Sex hormones are molecules produced by the gonads and to a small extent by the adrenal gland, which not only determine the primary and secondary sexual characteristics of an individual, differentiating man from woman, but also participate in the functioning of the various systems of the body. The evidence that many eye diseases differ in terms of prevalence between men and women has allowed us, in recent years, to carry out several studies that have investigated the association between sex hormones and the pathophysiology of eye tissues. Specific receptors for sex hormones have been found on the lacrimal and meibomian glands, conjunctiva, cornea, lens, retina, and choroid. This work summarizes the current knowledge on the role that sex hormones play in the pathogenesis of the most common ocular disorders and indicates our clinical experience in these situations. The aim is to stimulate an interdisciplinary approach between endocrinology, neurology, molecular biology, and ophthalmology to improve the management of these diseases and to lay the foundations for new therapeutic strategies. [ABSTRACT FROM AUTHOR]

Abstract Introduction Patients with atopic dermatitis (AD) have a greater risk of conjunctivitis and other ocular surface disorders than the general population. We evaluated the burden of ocular surface disorders and related symptoms prior to treatment initiation in adults with moderate-to-severe AD. Methods Patients were enrolled in a randomized, placebo-controlled, double-blinded, phase 3 trial of dupilumab administered with concomitant topical corticosteroids. At the beginning of the screening period, all enrolled patients completed a survey of ocular disorder diagnoses received in the past year; at baseline, patients completed a survey of frequency and severity of ocular symptoms (discomfort, itching, redness, and tearing) experienced in the past month. Results A total of 712 of 740 patients enrolled in the trial provided responses to the survey. At screening, 286 of 740 patients (38.6%) reported having at least one ocular disorder in the past year. At baseline, 499 of 712 respondents (70.1%) reported having at least one symptom within the past month. Of these patients, 4.4%, 6.0%, 5.5%, and 4.4%, respectively, reported having discomfort, itching, redness, and tearing all of the time. Mild discomfort, itching, redness, and tearing were reported by 26.1%, 33.7%, 30.8%, and 31.6% of patients, respectively, while 7.3%, 7.7%, 6.2%, and 4.2%, reported severe discomfort, itching, redness, and tearing, respectively. Conclusions These data demonstrate a high burden of ocular surface disorders and related symptoms in a population of adults with moderate-to-severe AD. Dermatologists should be aware of increased incidence of these disorders in AD and query their patients for signs and symptoms of eye disease. ClinicalTrials.gov Registration Number NCT02260986.

How to enhance the bioavailability and prolong the residence time of drugs in the eye present the major barriers to traditional eye delivery. Nanotechnology has been widely used in ocular drug delivery systems because of its advantages of minimizing adverse reactions, decreasing the frequency of administration, prolonging the release time, and improving the bioavailability of the drug in the eye. As natural product-based nanostructured systems, bioinspired nanostructured systems have presented as less toxic, easy to prepare, and cost-effective and have potential application value in the field of nanotechnology. A systematic classification of bioinspired nanostructured systems based on their inspiration source and formulation and their brief applications in disease are presented here. A review of recent research progress of the bioinspired nanostructured systems for the treatment of the anterior and posterior segment of ocular disorders is then presented in detail. Finally, current challenges and future directions with regard to manufacturing bioinspired nanomaterials are provided.

The rate at which obesity is becoming an epidemic in many countries is alarming. Obese individuals have a high risk of developing elevated intraocular pressure and glaucoma. Additionally, glaucoma is a disease of epidemic proportions. It is characterized by neurodegeneration and neuroinflammation with optic neuropathy and the death of retinal ganglion cells (RGC). On the other hand, there is growing interest in microbiome dysbiosis, particularly in the gut, which has been widely acknowledged to play a prominent role in the etiology of metabolic illnesses such as obesity. Recently, studies have begun to highlight the fact that microbiome dysbiosis could play a critical role in the onset and progression of several neurodegenerative diseases, as well as in the development and progression of several ocular disorders. In obese individuals, gut microbiome dysbiosis can induce endotoxemia and systemic inflammation by causing intestinal barrier malfunction. As a result, bacteria and their metabolites could be delivered via the bloodstream or mesenteric lymphatic vessels to ocular regions at the level of the retina and optic nerve, causing tissue degeneration and neuroinflammation. Nowadays, there is preliminary evidence for the existence of brain and intraocular microbiomes. The altered microbiome of the gut could perturb the resident brain–ocular microbiome ecosystem which, in turn, could exacerbate the local inflammation. All these processes, finally, could lead to the death of RGC and neurodegeneration. The purpose of this literature review is to explore the recent evidence on the role of gut microbiome dysbiosis and related inflammation as common mechanisms underlying obesity and glaucoma.

Abstract Background Welders are at an increased risk of eye disorders as a result of their occupation, leading to enormous vocational and economic consequences. With limited published studies among welders in low resource settings, we sought to determine the prevalence, pattern and factors associated with ocular disorders among small-scale welders in Katwe, Kampala. Methods In a field-based cross-sectional study, we recruited 343 small-scale welders. Simple random sampling was done to select the study participants. A pretested questionnaire was used to collect information on demographics, ocular, general history, systemic and ocular examination. The proportion of small-scale welders with ocular disorders (defined as any abnormal finding on eye examination) was determined. The bivariate and multivariate analyses were carried out, using logistic regression methods at a level of significance of 0.05. Results The mean age of the participants was 36 years (SD ± 12). The overall prevalence of ocular disorders was found to be 59.9%. The common ocular disorders included conjunctiva disorders (32%) and presbyopia (27%). There was a statistically significant relationship between females (OR = 4.279, P-value = 0.007), age 35 and above (OR = 4.244, P-value

Background: Emerging studies show that certain plant compounds may reduce the severity of most prevalent ocular abnormalities. The aim of this systematic review and meta-analysis was to assess the effect of dietary flavonoids on major eye disorders.Methods: Eligible studies were identified by searching PubMed, Web of Science, Scopus, and Cochrane Library databases for all articles published up to April 2021. The literature search yielded 1,134 articles, and a total of 16 studies were included in the systematic review. A meta-analysis of 11 intervention trials involving a total of 724 participants was performed.Results: Using a random-effects model, the pooled results revealed an overall significant effect of flavonoids on common ophthalmic disorders (standard mean difference = −0.39; 95% CI: −0.56, −0.21, p < 0.01). Of the subclasses of flavonoids, flavan-3-ols (standard mean difference = −0.62; 95% CI: −1.03, −0.22, p < 0.01), and anthocyanins (standard mean difference = −0.42; 95% CI: −0.63, −0.21, p < 0.01) were the only effective intervention for improving the outcomes of ocular conditions. For several of the other flavonoid subclasses, evidence on efficacy was insufficient.Conclusion: Our findings indicate that flavonoids may improve the clinical manifestations associated with ocular disorders. However, further well-constructed clinical trials are required to confirm these results and examine the effect of flavonoids on eye disorders other than those identified in this review.Systematic Review Registration: PROSPERO, identifier CRD42021247332.

Sex hormones are molecules produced by the gonads and to a small extent by the adrenal gland, which not only determine the primary and secondary sexual characteristics of an individual, differentiating man from woman, but also participate in the functioning of the various systems of the body. The evidence that many eye diseases differ in terms of prevalence between men and women has allowed us, in recent years, to carry out several studies that have investigated the association between sex hormones and the pathophysiology of eye tissues. Specific receptors for sex hormones have been found on the lacrimal and meibomian glands, conjunctiva, cornea, lens, retina, and choroid. This work summarizes the current knowledge on the role that sex hormones play in the pathogenesis of the most common ocular disorders and indicates our clinical experience in these situations. The aim is to stimulate an interdisciplinary approach between endocrinology, neurology, molecular biology, and ophthalmology to improve the management of these diseases and to lay the foundations for new therapeutic strategies.

Coursing is a canine sport discipline invented for sighthounds. The dogs chase the mechanically operated lure on an open area at the track that consists of straight lines as well as turns. Thus, the dogs must rely mainly on their sight in order to chase the lure and to compete. Whippets are the most popular sighthound breed in Poland and more and more dogs practice lure coursing on professional level. Several ocular disorders are known or presumed to be inherited in Whippets, so we decided to check how often they occur amongst competing dogs and if they have any impact on the results during competitions. Forty-five regularly competing Whippets underwent complete ophthalmic examination, including evaluation of menace response, pupillary light reflex and dazzle reflex, biomicroscopic examination conducted before and after dilating pupils with topical tropicamide and fundus examination with indirect ophthalmoscopy. Refractive state of each eye was assessed via streak retinoscopy. Ocular abnormalities were identified in 24 dogs (53.3%). The most common finding was vitreous degeneration identified in 9 dogs (20%), five dogs presented multiple lesions. There were no statistically significant differences regarding sex, age, and ranking points between the dogs with and without lesions. However, some of the identified lesions are likely to progress, so we postulate that the ophthalmological examination should receive more attention in sport Whippets, to check if it has any impact on competing dogs at more advanced age., (© 2024 The Authors. This is an open access article under the CC BY-NC-ND 4.0 license.)

Introduction: Patients with atopic dermatitis (AD) have a greater risk of conjunctivitis and other ocular surface disorders than the general population. We evaluated the burden of ocular surface disorders and related symptoms prior to treatment initiation in adults with moderate-to-severe AD. Methods: Patients were enrolled in a randomized, placebo-controlled, double-blinded, phase 3 trial of dupilumab administered with concomitant topical corticosteroids. At the beginning of the screening period, all enrolled patients completed a survey of ocular disorder diagnoses received in the past year; at baseline, patients completed a survey of frequency and severity of ocular symptoms (discomfort, itching, redness, and tearing) experienced in the past month. Results: A total of 712 of 740 patients enrolled in the trial provided responses to the survey. At screening, 286 of 740 patients (38.6%) reported having at least one ocular disorder in the past year. At baseline, 499 of 712 respondents (70.1%) reported having at least one symptom within the past month. Of these patients, 4.4%, 6.0%, 5.5%, and 4.4%, respectively, reported having discomfort, itching, redness, and tearing all of the time. Mild discomfort, itching, redness, and tearing were reported by 26.1%, 33.7%, 30.8%, and 31.6% of patients, respectively, while 7.3%, 7.7%, 6.2%, and 4.2%, reported severe discomfort, itching, redness, and tearing, respectively. Conclusions: These data demonstrate a high burden of ocular surface disorders and related symptoms in a population of adults with moderate-to-severe AD. Dermatologists should be aware of increased incidence of these disorders in AD and query their patients for signs and symptoms of eye disease. ClinicalTrials.gov Registration Number: NCT02260986. [ABSTRACT FROM AUTHOR]

Abstract The fibrocyte, which was first described in 1994, is a type of circulating mesenchymal progenitor cell in the peripheral blood. Fibrocytes play important roles in chronic inflammation, wound healing, tissue remodeling, and fibrosis. Emerging evidence indicates that fibrocytes are involved in a wide variety of ocular disorders associated with inflammation and fibrosis. In this review, we summarize recent advances regarding the general characteristic profile of fibrocytes, molecular mechanisms underlying the fibrocyte recruitment to target tissues, their differentiation into fibroblasts, and the potential role of fibrocytes in ocular disease. Given the critical role of fibrocytes in ocular disorders, fibrocytes may serve as a promising pharmaceutical target in the development of novel therapeutic strategies to treat ocular inflammation and fibrosis.

Aims: This study was carried out to determine ocular disorders and visual impairment among adolescents attending Out Patient Department of Ophthalmology in a tertiary care center Methodology: A retrospective study was carried out among adolescents attending out patient department of Ophthalmology in VMMC and Safdarjung Hospital New Delhi. Data of 191patients between 10-19 years with ocular disorders were analyzed. Findings: 191 adolescent cases and 382 eyes were evaluated for various ocular disorders and visual impairment. The mean age of the cohort was 14.7 years. Uncorrected refractive error and difficulty in seeing objects at distance (far vision) is the commonest among the adolescent group. Blindness was observed in 2.8% with a slight female preponderance. Severe visual impairment is caused by corneal opacity, central nervous system abnormality and phthisis was observed in 13%. Refractive error, corneal opacity, posterior segment diseases and cataract cause moderate impairment in 39.2%. Mild impairment is caused mostly by refractive error. Conclusion: The frequency was higher in females than males across all categories of visual impairment. Uncorrected refractive error is common in adolescent age group and often detected late in the absence of regular screening among adolescent. [ABSTRACT FROM AUTHOR]

Nanomaterials provide enormous opportunities to overcome the limitations of conventional ocular delivery systems, such as low therapeutic efficacy, side effects due to the systemic exposure, or invasive surgery. Apart from the more common ocular disorders, there are some genetic diseases, such as cystic fibrosis, that develop ocular disorders as secondary effects as long as the disease progresses. These patients are more difficult to be pharmacologically treated using conventional drug routes (topically, systemic), since specific pharmacological formulations can be incompatible, display increased toxicity, or their therapeutic efficacy decreases with the administration of different kind of chemical molecules. Magnetic nanoparticles can be used as potent drug carriers and magnetic hyperthermia agents due to their response to an external magnetic field. Drugs can be concentrated in the target point, limiting the damage to other tissues. The other advantage of these magnetic nanoparticles is that they can act as magnetic resonance imaging agents, allowing the detection of the exact location of the disease. However, there are some drawbacks related to their use in drug delivery, such as the limitation to maintain efficacy in the target organ once the magnetic field is removed from outside. Another disadvantage is the difficulty in maintaining the therapeutic action in three dimensions inside the human body. This review summarizes all the application possibilities related to magnetic nanoparticles in ocular diseases.

Traveling to high altitudes can expose the eye to reduced ambient cold and low-pressure environments. These conditions can affect the physiology of the eye and may result in ocular problems and visual disturbances. In this paper, ocular disorders related to high altitudes are briefly reviewed. Then, high-altitude ocular disorders are categorized in three parts: those related to dry and cold environments, those related to low-pressure environments, and those in people with past ocular conditions. In every part, the signs and symptoms of related diseases are discussed. Up-to-date recommendations for the management and prevention of these disorders are presented. The main management for ocular disorders related to dry and cold environments includes the use of eye shields and artificial tear drops. Descending to low-altitude lands is the key to managing eye problems associated with low-pressure environments. Patients with past ocular problems or ocular surgery should consult their doctors before ascending to high altitudes.

Purpose: To review current literature on the renin-angiotensin system (RAS)-mediated pathogenic mechanisms and therapeutic targets in ocular diseases. Methods: A comprehensive literature survey was performed on PubMed, Scopus, and Google Scholar databases published from 1977 to 2016. The search terms were a RAS, angiotensin, angiotensin receptor, prorenin, pro (renin) receptor, angiotensin converting enzyme inhibitor, angiotensin receptor blocker associated with ocular disorders like cataract, glaucoma, diabetic retinopathy (DR), macular degeneration, and uveitis. Articles were reviewed on the basis of the association between ocular disorders and RAS and relevant articles were discussed. Results: The literature revealed that the individual RAS components including renin, angiotensins, angiotensin converting enzymes, and RAS receptors have been expressed in the specific ocular tissues like retina, choroid, and ciliary body. The activation of both circulatory and local RAS potentiate the various inflammatory and angiogenic signaling molecules, including vascular endothelial growth factor (VEGF), extracellular signal-regulated kinase, and advanced glycation end products (AGE) in the ocular tissues and leads to several blinding disorders like DR, glaucoma, and macular degeneration. The classical and newer RAS inhibitors have illustrated protective effects on blinding disorders, including DR, glaucoma, macular degeneration, uveitis, and cataract. Conclusions: The RAS components are present in the extrarenal tissues including ocular tissue and have an imperative role in the ocular pathophysiology. The clinical studies are needed to show the role of therapeutic modalities targeting RAS in the treatment of different ocular disorders.

Purpose: This study aims to determine the prevalence, pattern, and time of presentation for the ocular disorders seen among children attending a pediatric eye clinic in Nigeria. Materials and Methods: A retrospective chart review of all first-time patients at a pediatric eye clinic, within 2005–2007 was carried out. Data on cohort demographics, duration of illness before the presentation, and types of ocular disorders were collected and analyzed. Statistical significance was indicated by P < 0.05. Results: A total of 335 cases were reviewed, comprising 171 males and 164 females. The majority of children were in the 10–14 age group (31.94%). Allergies (40.72%) were the most common ocular disorder followed by refractive errors (22.16%), trauma (7.98%), and inflammation/infections (7.98%). Among others, ocular disorders seen in decreasing frequency were ocular motility imbalance (5.41%), tumors (1.28%), and ptosis (0.77%). Least common was juvenile glaucoma (0.51%). Majority (42.09%) presented more than 1 year after onset of illness while only 16.2% presented within 1 month of their illness. Conclusion: Most common causes of ocular disorder in this study were allergy, refractive error, and trauma. Majority of the children presented late, and most of the disorders can result in visual impairment/blindness if not treated early. This emphasizes the need for appropriate health education to avert most cases of childhood blindness/visual impairment.

Pregnancy is a normal state of physiological stress that induces significant changes in the human body, some of which can potentially affect the visual system. The pregnant state may exacerbate pre-existing ocular disorders (i.e. diabetic retinopathy or central serous retinopathy). Moreover, other systemic conditions related to pregnancy can induce ophthalmic disorders affecting the retina and the choroid, some of which are of acute nature. Increasing awareness and improving collaboration between ophthalmologists, obstetricians and internists can play a pivotal role in the management of complex conditions during pregnancy. Special attention should be given while prescribing medications or deciding about other diagnostic or therapeutic techniques. The purpose of this review is to summarise the physiologic and pathologic effects of pregnancy in the eyes, highlighting the most acute clinical entities that may be threatening for the vision or even the life of the mother and her baby. [ABSTRACT FROM AUTHOR]

Introduction: Approximately 20% of patients with Parkinson's disease (PD) experience diplopia; however, the cause of the diplopia is unclear. We aimed to explore the association of diplopia, and its subtypes, with oculomotor abnormalities, impaired vision, and visual hallucinations, in patients with PD. Methods: This exploratory study included 41 PD patients, recruited from two general hospitals, of whom 25 had diplopia and 16 did not have diplopia, as well as 23 healthy controls (HCs). We defined subtypes of diplopia as selective diplopia, i.e., diplopia of single objects, and complete diplopia, i.e., diplopia of the entire visual field. All participants underwent a full orthoptic and ophthalmologic examination. Results: PD patients with diplopia had a high prevalence of oculomotor abnormalities (84%), impaired vision (44%), and visual hallucinations (44%), compared to PD patients without diplopia (33%, 6%, and none, respectively, p < 0.01), and compared to HCs (23%, 9%, and none, respectively, p < 0.01). Oculomotor abnormalities were equally prevalent in both subtypes of diplopia (selective and complete), whereas impaired vision was predominantly found in patients with selective diplopia. Moreover, only patients with selective diplopia had visual hallucinations. Conclusions: In PD patients, diplopia may be indicative of oculomotor or visual impairments. Hence, it is worthwhile to refer PD patients with diplopia to an orthoptist and an ophthalmologist for evaluation and, possibly, treatment of diplopia. Furthermore, in the case of selective diplopia, the neurologist should consider the presence of visual hallucinations, which may require the adjustment of the patient's medication. [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract Oxidative stress, due to insufficiency of antioxidants or over-production of oxidants, can lead to severe cell and tissue damage. Oxidative stress occurs constantly and has been shown to be involved in innumerable diseases, such as degenerative, cardiovascular, neurological, and metabolic disorders, cancer, and aging, thus highlighting the vital need of antioxidant defense mechanisms. Vascular endothelial growth factor B (VEGF-B) was discovered a long time ago, and is abundantly expressed in most types of cells and tissues. VEGF-B remained functionally mysterious for many years and later on has been shown to be minimally angiogenic. Recently, VEGF-B is reported to be a potent antioxidant by boosting the expression of key antioxidant enzymes. Thus, one major role of VEGF-B lies in safeguarding tissues and cells from oxidative stress-induced damage. VEGF-B may therefore have promising therapeutic utilities in treating oxidative stress-related diseases. In this review, we discuss the current knowledge on the newly discovered antioxidant function of VEGF-B and the related molecular mechanisms, particularly, in relationship to some oxidative stress-related diseases, such as retinitis pigmentosa, age-related macular degeneration, diabetic retinopathy, glaucoma, amyotrophic lateral sclerosis, Alzheimer's disease, and Parkinson's disease. [ABSTRACT FROM AUTHOR]

Multiple myeloma (MM) therapy is evolving, and several new drugs are now available, extending patients' life and exposure to different compounds and toxicities. We conducted a cross-sectional observational study enrolling 93 consecutive patients on active treatment for MM, aiming to assess their ocular complications. All the patients underwent a comprehensive ophthalmic evaluation. In our cohort, prevalence of low visual acuity was in line with similar age healthy population reported in registry studies. Interestingly, we recorded a higher prevalence of lens opacities (46%) and dry eye syndrome (53%). Nevertheless, we did not find any significant association between ocular disorders and anti-myeloma treatments, even steroid therapy. This observation suggests that other factors besides treatments, such as M-protein deposition in eye structures, may have a role in developing ocular toxicities. Since MM patients are elderly patients at higher risk of age-related eye disorders, we recommend periodic ophthalmic assessment in daily practice. [ABSTRACT FROM AUTHOR]

Retinal degeneration is a prominent feature in ocular disorders. In exploring possible treatments, Mesenchymal Stem Cells (MSCs) have been recognized to yield therapeutic role for retinal degenerative diseases. Studies have also displayed that erythropoietin (EPO) administration into degenerative retina models confers significant neuroprotective actions in limiting pathological cell death. In this study, we aimed to use MSCs to deliver EPO and to evaluate the ability of EPO to rescue retinal neurons from dying upon reactive oxidative stress induction. We derived human MSCs from Wharton’s jelly (hWJMSCs) of the umbilical cord and cells were transduced with lentivirus particles encoding EPO and a reporter gene of green fluorescent protein (GFP). The supernatants of both transduced and non-transduced cells were collected and used as a pre-conditioning medium for Y79 retinoblastoma cells (retinal neuron cell line) following exposure to glutamate induction. Retinal cells exposed to glutamate showed reduced mitochondrial depolarization and enhanced improvement in cell viability when incubated with pre-conditioned media of transduced cells. Our results established a proof-of-concept that MSCs could be used as a candidate for the delivery of EPO therapeutic gene in the treatment of retinal degenerations.

Purpose: To compare the prevalence of refractive errors, amblyopia, and strabismus between hearing-impaired and normal children (7–22 years old) in Mashhad. Methods: In this cross-sectional study, cases were selected from hearing-impaired children in Mashhad. The control group consisted of children with no hearing problem. The sampling was done utilizing the cluster sampling method. All of the samples underwent refraction, cover test, and visual examinations. Results: 254 children in the hearing-impaired group (case) and 506 children in the control group were assessed. The mean spherical equivalent was 1.7 ± 1.9 D in the case group, which was significantly different from the control group (0.2 ± 1.5) (P < 0.001). The prevalence of hyperopia was 57.15% and 21.5% in deaf and normal children, respectively, but myopia was mostly seen in the control group (5.5% versus 11.9%, P = 0.007). The mean cylinder was 0.65 ± 1.3 D and 0.43 ± 0.62 D in deaf and normal subjects, respectively (P = 0.002). 12.2% of deaf subjects and 1.2% of normal subjects were amblyopic (P < 0.001), and the prevalence of strabismus was 3.1% in the case group and 2.6% in the control group (P = 0.645). Conclusion: In a comparison of children of the same ages, hearing-impaired children have significantly more eye problems; therefore, a possible relation between deafness and eye problems must exist. Paying attention to eye health assessment in hearing-impaired children may help prevent adding eye problems to hearing difficulties.

Retinal degeneration is a prominent feature in ocular disorders. In exploring possible treatments, Mesenchymal Stem Cells (MSCs) have been recognized to yield therapeutic role for retinal degenerative diseases. Studies have also displayed that erythropoietin (EPO) administration into degenerative retina models confers significant neuroprotective actions in limiting pathological cell death. In this study, we aimed to use MSCs to deliver EPO and to evaluate the ability of EPO to rescue retinal neurons from dying upon reactive oxidative stress induction. We derived human MSCs from Wharton’s jelly (hWJMSCs) of the umbilical cord and cells were transduced with lentivirus particles encoding EPO and a reporter gene of green fluorescent protein (GFP). The supernatants of both transduced and non-transduced cells were collected and used as a pre-conditioning medium for Y79 retinoblastoma cells (retinal neuron cell line) following exposure to glutamate induction. Retinal cells exposed to glutamate showed reduced mitochondrial depolarization and enhanced improvement in cell viability when incubated with pre-conditioned media of transduced cells. Our results established a proof-of-concept that MSCs could be used as a candidate for the delivery of EPO therapeutic gene in the treatment of retinal degenerations. [ABSTRACT FROM AUTHOR]

Multipotent mesenchymal stem cells (MSCs) have been employed in numerous pre-clinical and clinical settings for various diseases. MSCs have been used in treating degenerative disorders pertaining to the eye, for example, age-related macular degeneration, glaucoma, retinitis pigmentosa, diabetic retinopathy, and optic neuritis. Despite the known therapeutic role and mechanisms of MSCs, low cell precision towards the targeted area and cell survivability at tissue needing repair often resulted in a disparity in therapeutic outcomes. In this review, we will discuss the current and feasible strategy options to enhance treatment outcomes with MSC therapy. We will review the application of various types of biomaterials and advances in nanotechnology, which have been employed on MSCs to augment cellular function and differentiation for improving treatment of visual functions. In addition, several modes of gene delivery into MSCs and the types of associated therapeutic genes that are important for modulation of ocular tissue function and repair will be highlighted.

Traveling to high altitudes can expose the eye to reduced ambient cold and low-pressure environments. These conditions can affect the physiology of the eye and may result in ocular problems and visual disturbances. In this paper, ocular disorders related to high altitudes are briefly reviewed. Then, high-altitude ocular disorders are categorized in three parts: those related to dry and cold environments, those related to low-pressure environments, and those in people with past ocular conditions. In every part, the signs and symptoms of related diseases are discussed. Up-to-date recommendations for the management and prevention of these disorders are presented. The main management for ocular disorders related to dry and cold environments includes the use of eye shields and artificial tear drops. Descending to low-altitude lands is the key to managing eye problems associated with low-pressure environments. Patients with past ocular problems or ocular surgery should consult their doctors before ascending to high altitudes. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes Mellitus (DM) is a metabolic disorder which is characterized by elevated blood sugar levels. It is a non-communicable disease and currently, a major disease of concern in terms of public health. Aim: To assess the knowledge, attitude and practice of diabetic retinopathy amongst the diabetic patients of Saudi Arabia. Material and Methods: Patients diagnosed with diabetes mellitus visiting to Ministry of Health hospitals were incorporated in this study. Self administered questionnaires were used to assess knowledge, attitude and practice of diabetic retinopathy amongst the diabetic patients. The data collected was entered in a pre-designed proforma and analysed using SPSS version 20.0 Results: This study incorporated 439 diabetic individuals out of which 251 (57.17%) were male patients and 188 (42.82%) were females. Majority of the diabetic patients (75.62%) were aware that diabetes can cause eye disorders, 73.80% of patients replied that diabetic individuals should go for regular eye check-ups and 65.10% of patients were aware that they should visit an ophthalmologist in the event of eye problem. Out of 439 diabetic 302 patients (68.79%) were aware that timely treatment can prevent or delay damage of eyes in diabetic patients and about 95% of all the participants went for regular ocular examinations. Conclusion: Majority of the diabetes patients were aware that diabetes can cause eye disease and it is necessary for the diabetic individuals to consult the ophthalmologist for the prevention of the same.

Circumscribed choroidal hemangiomas are rare ophthalmic entities that cause diminution in vision due to accumulation of subretinal and/or intraretinal fluid in the macular area. Various treatment options ranging from conventional laser to photodynamic therapy have been employed to destroy the tumor and reduce the exudation; however, either the inability to penetrate through the exudative fluid or the collateral retinal damage induced by these treatment modalities make them unsuitable for lesions within the macula. We evaluated the role of intravitreal bevacizumab, a pan-vascular endothelial growth factor (VEGF) inhibitor, in reducing the sub- and intraretinal fluid in three patients with circumscribed choroidal hemangiomas. All the patients had complete resolution of the serous retinal detachment that was maintained till at least 12 months after the first injection. Intravitreal bevacizumab may be used in combination with thermal laser or photodynamic therapy in treating circumscribed choroidal hemangiomas with subretinal fluid.