Prevalence and risk factors for eye diseases, blindness, and low vision in Lhasa, Tibet

AIM:To determine the prevalence and risk factors for eye diseases, blindness, and low vision in Tibet, and to assist the development of eye disease prevention and treatment schemes.METHODS:We carried out a survey of eye diseases among a population living at high altitude. A total of 1 115 Tibetan permanent residents aged 40 years or older from the towns and villages of Qushui County, Lhasa Prefecture, Tibet Autonomous Region, participated in this study. All participants completed a detailed questionnaire, and underwent presenting and pinhole visual acuity tests, and a comprehensive ophthalmic examination.RESULTS:There were 187 blind eyes (8.43%), 231 eyes with low vision (10.41%). The leading cause of visual impairment was cataract of 55.0% (101/187) blindness and of 50.2% (116/231) low vision, followed by fundus lesions of 22.9% blindness and 23.8% low vision, while only a low prevalence of glaucoma of 9.6% blindness and 1.7% low vision was observed. The analysis of 2 219 eyes showed that the most common external eye disease was pterygium (27.2%) in Tibet.CONCLUSION:The high prevalence of blindness and low vision in the Tibetan population at high altitude is a serious public health issue. There is a need to establish and maintain an appropriate effective eye care program in Tibet.     

三萜类化合物在眼部疾病治疗应用研究的进展

三萜类化合物是一大类地表和海洋植物以及动物体内的代谢产物,具有多种生物活性和广泛的药理特性,如抗氧化、抗炎、抗癌、抗过敏、抗病毒等,近年来已成为各领域的研究热点.而氧化应激、炎性、新生血管形成等又参与了多种眼部疾病的发生发展,三萜类化合物在角膜疾病、葡萄膜炎、青光眼、白内障、视网膜疾病、视神经病变、视网膜母细胞瘤等治疗中的作用已有广泛研究.     

光动力疗法在眼科疾病中的应用

光动力疗法(photodynamic therapy,PDT)是利用光动力效应进行疾病诊断和治疗的一种新技术。其作用基础是光动力效应。这是一种有氧分子参与的伴随生物效应的光敏化动态反应过程。光动力疗法最初是作为肿瘤治疗的一项新技术出现的,但随着第二代光敏剂的发展,PDT已逐渐应用于眼科疾病的治疗,且疗效显著。我们就PDT在眼科疾病中的应用作一综述。     

性别与眼病

随着现代医学的不断发展,对疾病个体化的诊疗已经成为发展趋势.两性差异作为个体化诊治的基础,越来越受到医学界的关注.两性在解剖生理、体内激素变化、免疫状况以及社会心理等方面的巨大差异导致不同眼病在易感性、临床表现以及治疗预后中表现出不同的性别倾向.本次我们结合眼病的流行病学特征,综述两性在眼眶、眼表、角膜、房水、晶状体、视网膜的解剖、生理及其相关疾病的易感性与临床表现上的差异.     

Lack of Awareness of Common Eye Conditions in the Community

ABSTRACT

Purpose: Awareness of eye conditions aids health promotion activities and leads to better outcomes. We examined factors influencing the lack of awareness of common eye conditions in a population.

Methods: The Singapore Malay Eye Study examined 3280 (78.7% response) Malays aged 40–80 years. We included 2112 (64.4%) participants with at least one of five eye conditions: 1504 (71.2%) with cataract, 1013 (47.8%) with myopia, 270 (12.8%) with diabetic retinopathy, 181 (8.6%) with age-related macular degeneration and 150 (7.1%) with glaucoma. Lack of awareness was defined in the questionnaire as not answering “yes” to previously being told by a doctor of having the eye condition.

Results: Among 2112 participants, 83.2% were unaware of at least one of their eye conditions. After controlling for age, sex and socioeconomic factors, participants unaware of their eye condition were older (odds ratio, OR, 1.03, per 1 year, p?<?0.001), had better visual acuity (OR 1.32, p?=?0.04), lower education (OR 1.89, p?<?0.001), poorer literacy (OR 1.44, p?=?0.02), lower income (OR 1.73, p?=?0.009), higher blood glucose (OR 1.08, per 1?mmol/L, p?<?0.001), higher serum cholesterol (OR 1.20, per 1?mmol/L, p?=?0.003), lower annual eye examination attendance (OR 2.08, p?<?0.001) and were less likely to wear glasses (OR 2.90, p?<?0.001) than those who were aware of their condition.

Conclusions: In this community-based population, 80% of those with common eye conditions were unaware of their condition.     

The role of cyclosporin eye drops in ocular inflammatory diseases

Fifty-nine patients were treated with cyclosporin A (CsA) eye drops for various diseases. Most patients with severe vernal keratoconjunctivitis responded well to the treatment. Treatment had little or no effect on anterior uveitis (acute and chronic) or on the fate of high-risk corneal grafts. The response of patients suffering from peripheral corneal melting, ocular pemphigoid or Stevens-Johnson syndrome was variable. Among these, some patients responded well to the treatment with CsA drops while others had no detectable clinical benefit. The large differences in the observed treatment responses may be interpreted to indicate that a different pathological mechanism may take place within a group of patients with similar diagnoses and clinical manifestations.     

Gender inequality in vision loss and eye diseases: Evidence from the Sultanate of Oman

Purpose:

The data from surveys of vision loss and monitoring of services were used to assess changes in gender inequality in Oman.

Study Design:

Retrospective review of data collection instruments.

Materials and Method:

The data sets of 12 years between 1996 and 2007 were abstracted to assess the gender equality for vision loss, eye disease prevalence, and service use. They included two surveys (1996 and 2005), Health Information from eye units (1998 and 2007), and eye screening in schools.

Results:

In 1996, the prevalence of bilateral blindness in ≥ 40 years of age was higher in females [Odd''s Ratio (OR) = 0.36 (95% Confidence Interval (CI) 0.24 – 0.53)]. Gender differences in the prevalence of cataract [OR = 0.82 (95% CI 0.63 – 1.03)] were not significant while trachomatous trichaisis (TT) was less in males [OR = 0.33 (95% CI 0.22-0.48)]. In 2005, gender differences in the prevalence of bilateral blindness [OR = 0.97 (95% CI 0.71 – 1.34)] and TT [OR = 0.66 (95% CI 0.42- 1.04)] were not statistically significant. But males were associated with higher prevalence of cataract [OR = 1.26 (95% CI 1.00 – 1.59)]. Surgery rates for cataract, glaucoma and TT were not different by gender. More male compared to female patients with diabetic retinopathy were treated. Myopia was significantly higher in girls. Compliance of spectacle wear was higher in girls.

Conclusions:

Gender inequality for eye care seems to have reduced in the last 10 years in Oman. However, apart from TT and glaucoma patients the difference in service utilization by gender was not statistically significant.     

Ophthalmic registries for rare eye diseases

The prevalence of rare diseases has been estimated to be around 6%–8%, most of which are genetic in origin. Rare eye diseases constitute a critical public health concern. The major concerns for people suffering from these conditions are diagnosis, treatment, rehabilitation, limited resources, and health infrastructure. Also, as the number of people suffering from these disorders is less, it becomes difficult to study the epidemiological distribution and natural course of the disease. Thus, there is a need to establish registries for such rare disorders. This will help in creating a database of those suffering from rare eye diseases and will prove advantageous for both the patients and the researchers. For patients, it will be helpful as it will provide them will access to families suffering from similar problems, provide rehabilitation services, and provide access to clinical trials working on the development of new treatments for these rare disorders. From the researchers’ point of view, it will be beneficial for them as they will then have access to a pool of data that can be used as a starting point of research on these rare disorders. At present, very few registries exist around the world and none in India. A systematic review of registries for rare eye diseases on Google and PubMed was done for existing registries, their methodology, services provided, applications, and advantages.     

基质金属蛋白酶与眼科疾病的研究进展

基质金属蛋白酶(matrix metalloproteinases,MMPs)属于Zn2+和Ca2+依赖性内肽酶家族,是参与降解细胞外基质(extracellular matrix,ECM)的最重要的蛋白酶。因其参与了多种眼科疾病的病理过程,故对其活化与抑制,以及如何高表达进行研究,可为预防和控制各类眼科疾病的发生发展提供崭新的研究方向,现就其最近的科研进展做一综述。     

系统性疾病对儿童干眼的影响不容忽视

儿童干眼多与先天性、自身免疫性和炎症性疾病等多种系统性疾病有关.由于儿童一般不能配合参与干眼症状的问卷调查,且检查较困难,或因医生缺乏对儿童干眼的认识等,临床常出现对儿童干眼的误诊误治.因此,提高对儿童干眼的认识,了解其常见病因、临床特点,多学科联合对干眼进行诊断与治疗,对儿童干眼防治非常重要.     

纳米材料药物传输载体在治疗眼病中的应用

由于眼表面和眼内结构的解剖、生理屏障作用,常规眼部制剂一般无法到达特定位置发挥作用.纳米材料由于尺寸小、易制备、可降解、靶向性强以及对生物组织刺激性小等特点,不同类型的纳米材料在运载不同化学特性药物方面优势明显.目前,纳米材料作为药物传输载体在眼部给药方面应用越来越多,并被用于各种类型眼部疾病的治疗,显示出良好的应用前景.本文就纳米材料作为药物传输载体在眼科疾病治疗方面的应用作一综述.     

载脂蛋白E基因多态性及其相关眼病

载脂蛋白E(apolipoprotein E,ApoE)是一种多态性蛋白,参与脂蛋白的转化与代谢过程,其基因可以调节许多生物学功能,与许多眼科疾病发病有关,对ApoE及其基因多态性的研究是目前医学研究的热点之一,探讨两者之间的内在联系,对眼病的预防、诊断及治疗具有重要的临床应用价值。     

Awareness of blindness and other smoking-related diseases and its impact on motivation for smoking cessation in eye patients

Purpose

Cigarette smoking is a major cause of morbidity and mortality. The association between smoking and eye diseases is less widely recognised relative to other better-known smoking-related conditions. This study aims to assess the awareness and fear of known smoking-related diseases among current smokers attending an ophthalmology outpatient clinic and to evaluate their relative impact on the likelihood of smoking cessation.

Patients and methods

A cross-sectional survey using a structured interview of randomly selected current smokers attending an eye clinic was conducted. The knowledge of six smoking-related diseases (lung cancer, heart attack, stroke, blindness, other cancers, and other lung diseases) was assessed. The fear of smoking-related conditions and the relative impact of each smoking-related condition on the smoker''s motivation to quit smoking were evaluated.

Results

Out of 200 current smokers aged from 14 to 83 years, only 42.5% (85 patients) were aware that smoking causes blindness. Smokers'' perception of harm caused by smoking was 6.53±3.21 (mean±SD) on a visual analogue scale of 0 to 10. Patients placed blindness as the second most important motivating factor to quit smoking immediately, within 1 year and 5 years, after lung cancer.

Conclusion

The awareness of the risk of blindness from smoking was lowest compared with five other smoking-related diseases among eye patients who smoke. However, blindness remains a key motivational factor in smoking cessation and hence should be emphasised as an important negative health consequence of smoking in public health education and anti-smoking campaigns.     

线粒体融合和裂变在眼科疾病中的研究进展

线粒体是多细胞生命不可缺少的组成部分,通过裂变和融合进行形态上的变化和空间上的重新排列以适应细胞的需求,维持能量平衡。线粒体的这种控制其自身数量、大小、形状和在细胞内的分布特征被称为线粒体动力学。正常情况下,线粒体融合-裂变是平衡的,当细胞早期受到应激时,受损的线粒体首先通过裂变和融合来维持其功能的正常运行。线粒体功能异常可能与细胞的衰老和凋亡密切相关,因此,本文就线粒体动力学包括线粒体裂变和融合在常见眼科疾病中的研究进展进行综述。     

Rare eye diseases in India: A concise review of genes and genetics

Rare eye diseases (REDs) are mostly progressive and are the leading cause of irreversible blindness. The disease onset can vary from early childhood to late adulthood. A high rate of consanguinity contributes to India’s predisposition to RED. Most gene variations causing REDs are monogenic and, in some cases, digenic. All three types of Mendelian inheritance have been reported in REDs. Some of the REDs are related to systemic illness with variable phenotypes in affected family members. Approximately, 50% of the children affected by REDs show associated phenotypes at the early stages of the disease. A precise clinical diagnosis becomes challenging due to high clinical and genetic heterogeneity. Technological advances, such as next-generation sequencing (NGS), have improved genetic and genomic testing for REDs, thereby aiding in determining the underlying causative gene variants. It is noteworthy that genetic testing together with genetic counseling facilitates a more personalized approach in the accurate diagnosis and management of the disease. In this review, we discuss REDs identified in the Indian population and their underlying genetic etiology.     

连接蛋白43:致盲性眼病治疗新靶点

目前常见的主要致盲性眼病如角膜炎、白内障、青光眼、糖尿病视网膜病变等严重威胁人类健康并影响患者的生存质量。连接蛋白43(Cx43)作为脊椎动物体内最常见的缝隙连接蛋白,广泛分布于眼组织中,参与胚胎发育、代谢调节、组织稳态等生理过程及炎症、氧化应激、上皮-间充质样细胞转换、血管渗漏与新生血管形成等病理过程。Cx43在各种致盲性眼病的发生发展中发挥重要作用,本文将就其在上述主要致盲性眼病发病机制中的作用和靶向Cx43治疗进展作一综述。     

尼日利亚阿巴卡利基地区儿童眼病分布特点

目的：研究尼日利亚阿巴卡利基地区儿童眼病的分布特点。 方法：回顾过去15mo就诊于阿巴卡利基联邦医疗中心眼科门诊的15岁及以下儿童的就诊资料，分析阿巴卡利基地区儿童眼病的分布规律。 结果：241位儿童纳入了本次研究。其中男112位为（46．5％），女129位（53．5％）。儿童眼病主要以过敏性结膜炎、屈光不正、感染性结膜炎、眼球挫伤为主。其中过敏性结膜炎患者91人（37．8％），屈光不正37人（15．4名），感染性结膜炎30人（12．4％），眼球挫伤的患者27人（11．2％）。 结论：过敏性结膜炎及屈光不正为阿巴卡利基地区儿童常见的眼病。学前儿童进行眼科检查能有效的早期诊断治疗儿童眼病的发生，并能有效地预防其并发症的发生。     

Sox2基因在眼部疾病中的研究进展

Sox2基因是SRY(sex determination region of Y chromosome)相关基因家族中的一员,是维持胚胎干细胞多能性和自我更新特性的关键转录因子之一。Sox2参与多种生物学过程,如调节细胞增殖和凋亡、参与肿瘤的形成和发展等。但关于Sox2基因在眼部疾病中作用研究的综述较少,为此,本文从Sox2基因的表达水平、相关信号通路及临床应用潜能等方面进行综述,以便于读者对Sox2基因在眼部疾病中的作用有更全面的认识和了解,开展更深入的研究。     

炎性细胞因子与新生血管性眼病

新生血管性眼病是引起人类不可逆视力损害的主要病因.尽管眼内抗血管内皮生长因子药物治疗已成为临床中新生血管性眼病的重要疗法之一,但该疗法本身疗效不稳定且存在诸多的潜在风险和并发症.因此探寻更明确有效的治疗靶点是必要的.研究表明,肿瘤坏死因子-α、白细胞介素-1、白细胞介素-6和白细胞介素-18等炎性细胞因子与新生血管性眼病关系密切,本文就近些年来与新生血管性眼病相关的炎性细胞因子作一综述.