Cataracts

白内障
  • 文章类型: Journal Article
    我们的目的是开发和验证一种新的基于iPad的对比敏感度(CS)测试,用于测量近视力下的对比敏感度功能(Optopad-CSF)。在Optopad-CSF测试(近视)和CSV-1000E测试(远距视力)之间的比较研究中,对100名健康受试者(年龄17-63岁)的总共200只眼进行了评估。用对比敏感度指数(ICS)和曲线下面积(AUC)评估测试之间的一致性。双眼所有空间频率的CS与年龄呈负相关,和校正的距离,和近视眼(r≤-0.512,p≤0.013)。与40岁以下的亚组相比,在40岁以上的亚组中,所有空间频率的Optopad-CSF测试均发现CS显着降低(p≤0.008)。Optopad-CSF测试的平均AUC(5.84)是CSV-1000E测试(2.76)的两倍。Optopad-CSF(-0.019)和CSV-1000E(-0.075)测试的平均ICS显示相似的值,都接近0(p=0.3)。Optopad-CSF和CSV-1000EICS测试之间存在弱但显着的相关性(r=0.246,p<0.02)。计算用Optopad-CSF测试获得的值的正常范围。对于评估的所有空间频率,16例双侧白内障患者的平均CS值超出正常范围(p<0.001)。Optopad-CSF是一种有效的便携式系统,用于在五个空间频率的近视力下测量CS,允许检测与年龄相关的CSF随年龄的变化和白内障的CSF损失,没有天花板效应。
    Our purpose is to develop and validate a new iPad-based contrast sensitivity (CS) test for measuring the contrast sensitivity function at near vision (Optopad-CSF). A total of 200 eyes of 100 healthy subjects (ages 17-63) were evaluated in a comparative study between the Optopad-CSF test (near vision) and the CSV-1000E test (distance vision). The agreement between tests was assessed with the index of contrast sensitivity (ICS) and the area under the curve (AUC). CS for all the spatial frequencies in both eyes showed a negative significant correlation with age, and corrected distance, and near visual acuities (r ≤ -0.512, p ≤ 0.013). A significantly lower CS was found with the Optopad-CSF test in the over-40-year-old subgroup for all the spatial frequencies evaluated compared to the below-40 subgroup (p ≤ 0.008). The mean AUC of the Optopad-CSF test (5.84) was twice that of the CSV-1000E test (2.76). The mean ICS of the Optopad-CSF (-0.019) and CSV-1000E (-0.075) tests showed similar values, both close to 0 (p = 0.3). There was a weak but significant correlation between the Optopad-CSF and CSV-1000E ICS tests (r = 0.246, p < 0.02). A range of normality for the values obtained with the Optopad-CSF test was calculated. The mean CS values in 16 bilateral cataract patients were out of the normal range for all the spatial frequencies evaluated (p < 0.001). Optopad-CSF is a valid portable system for measuring CS at near vision for five spatial frequencies, allowing the detection of age-related changes in CSF with age and CSF loss in cataracts, with no ceiling effect.
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  • 文章类型: Journal Article
    白内障和青光眼占全球视力丧失和失明的比例很高。小细胞外囊泡(sEV)被释放到不同的体液中,包括眼睛的房水。关于其在眼部病理中的蛋白质组含量和表征的信息尚未得到很好的确定。在这项研究中,来自健康个体的房水sEV,白内障,对青光眼患者进行了研究,并对其特定的蛋白质谱进行了表征。此外,对鉴定的蛋白质作为诊断性青光眼生物标志物的潜力进行了评价.通过定量蛋白质组学分析了患有白内障和青光眼的患者房水与健康个体相比的sEV的蛋白质含量。通过蛋白质印迹(WB)和ELISA进行验证。鉴定并定量了总共828种肽和192种蛋白质。用R程序进行数据分析后,白内障中房水sEV中的8种明显失调的蛋白质和青光眼中的16种表达率≥1.5。通过WB和ELISA直接使用房水样品,9种蛋白质的失调大部分被证实。重要的是,GAS6和SPP1对青光眼有较高的诊断能力,结合起来可以将青光眼患者与对照个体区分开来,曲线下面积为76.1%,灵敏度为65.6%,特异性为87.7%。
    Cataracts and glaucoma account for a high percentage of vision loss and blindness worldwide. Small extracellular vesicles (sEVs) are released into different body fluids, including the eye\'s aqueous humor. Information about their proteome content and characterization in ocular pathologies is not yet well established. In this study, aqueous humor sEVs from healthy individuals, cataracts, and glaucoma patients were studied, and their specific protein profiles were characterized. Moreover, the potential of identified proteins as diagnostic glaucoma biomarkers was evaluated. The protein content of sEVs from patients\' aqueous humor with cataracts and glaucoma compared to healthy individuals was analyzed by quantitative proteomics. Validation was performed by western blot (WB) and ELISA. A total of 828 peptides and 192 proteins were identified and quantified. After data analysis with the R program, 8 significantly dysregulated proteins from aqueous humor sEVs in cataracts and 16 in glaucoma showed an expression ratio ≥ 1.5. By WB and ELISA using directly aqueous humor samples, the dysregulation of 9 proteins was mostly confirmed. Importantly, GAS6 and SPP1 showed high diagnostic ability of glaucoma, which in combination allowed for discriminating glaucoma patients from control individuals with an area under the curve of 76.1% and a sensitivity of 65.6% and a specificity of 87.7%.
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  • 文章类型: Journal Article
    眩光是人工晶状体(IOL)植入的已知副作用,主要受人工晶状体材料和光学的影响,尽管据报道,主观上影响随着时间的推移而减少。然而,随着时间的推移,很少有客观的数据被公布,这些与主观报告有什么关系,以及在IOL植入之前是否可以预测那些报告更多眩光症状的人。
    共有32例眼睛健康的患者(年龄72.4±8.0岁)双侧植入亲水性600s(Rayner,更糟糕的是,英国)或疏水Acrysof(Alcon,德州,美国)丙烯酸IOL(每个n=16,随机分配)。每位患者使用经过验证的强迫性选择摄影问卷主观地报告了他们的视力障碍症状,使用AstonHalometer在八个方向上客观地量化了黑暗环境中强光产生的光晕大小。术前以及IOL植入后1、2、3和4周进行双眼评估。
    这项研究是在国家卫生服务眼科部门进行的,伊丽莎白女王医院,伯明翰,英国。
    视力(平均0.37±0.26logMAR)与术前主观眩光(r=0.184,p=0.494)或客观眩光(r=0.294,p=0.270)无关。目标晕圈大小(F=112.781,p<0.001)随着白内障摘除和人工晶状体植入而减小,并在术后一个月内继续减小。主观性失眠主诉(p<0.001)也更多的是手术前,但此后没有变化(p=0.228)。在两种情况下,与IOL材料均不存在差异(p>0.05)。不可能从症状或症状与手术前光环大小的比率来预测手术后视力障碍(p>0.05)。
    白内障摘除后植入IOL可大大减少白内障引起的主观视力障碍和客观光晕,几乎没有可察觉的症状。然而,客观测量能够量化IOL植入后第一个月光散射的进一步减少,这表明在此期间的任何主观影响都是由于愈合过程而不是由于神经适应。
    UNASSIGNED: Glare is a known side effect of intraocular lens (IOL) implantation, affected principally by IOL material and optics, although it is reported subjectively to decrease in impact with time. However, little objective data have been published on changes over time, how these relate to subjective reports, and whether those who will report greater glare symptoms can be predicted prior to IOL implantation.
    UNASSIGNED: A total of 32 patients (aged 72.4 ± 8.0 years) with healthy eyes were implanted bilaterally with hydrophilic 600s (Rayner, Worthing, UK) or hydrophobic Acrysof (Alcon, Texas, USA) acrylic IOLs (n = 16 each, randomly assigned). Each patient reported their dysphotopsia symptoms subjectively using the validated forced choice photographic questionnaire for photic phenomena, and halo size resulting from a bright light in a dark environment was quantified objectively in eight orientations using the Aston Halometer. Assessment was performed binocularly pre-operatively and at 1, 2, 3, and 4 weeks after IOL implantation.
    UNASSIGNED: The study was carried out at the National Health Service Ophthalmology Department, Queen Elizabeth Hospital, Birmingham, UK.
    UNASSIGNED: Visual acuity (average 0.37 ± 0.26 logMAR) did not correlate with subjective glare (r = 0.184, p = 0.494) or objective glare (r = 0.294, p = 0.270) pre-surgery. Objective halo size (F = 112.781, p < 0.001) decreased with cataract removal and IOL implantation and continued to decreased over the month after surgery. Subjective dysphotopsia complaints (p < 0.001) were also greater pre-surgery, but did not change thereafter (p = 0.228). In neither case was there a difference with IOL material (p > 0.05). It was not possible to predict post-surgery dysphotopsia from symptoms or a ratio of symptoms to halo size pre-surgery (p > 0.05).
    UNASSIGNED: Subjective dysphotopsia and objective halos caused by cataracts are greatly reduced by implantation of IOL after cataract removal causing few perceivable symptoms. However, objective measures are able to quantify a further reduction in light scatter over the first month post-IOL implantation, suggesting that any subjective effects over this period are due to the healing process and not due to neuroadaptation.
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  • 文章类型: Journal Article
    蛋白质翻译后修饰(PTM)与衰老和与年龄有关的疾病有关。PTM在长寿命蛋白质中特别有影响力,比如在目镜中发现的,因为它们随着年龄的增长而积累。在老年和白内障晶状体中导致蛋白质-蛋白质交联的两种PTM是脱氢丙氨酸(DHA)和脱氢丁酸(DHB);由半胱氨酸/丝氨酸和苏氨酸残基形成,分别。这项研究的目的是定量人晶状体蛋白中的DHA和DHB与年龄和白内障状态的关系。
    将不同年龄的人类镜片分为五个供体组:透明镜片(18-22岁,48-64岁,和70-93岁)和两个年龄组的白内障人类晶状体(48-64岁的晶状体,和70-93岁的镜片),并进行了蛋白质组学分析。定量相对DHA和DHB肽水平并与其未修饰的肽对应物进行比较。
    对于大多数含有DHA或DHB的晶状体蛋白,在老年和白内障晶状体中检测到较高量的DHA和DHB修饰肽。根据年龄和白内障的丰度变化,将含DHA的肽分为三组:(1)仅在年龄相关性核性白内障(ARNC)中增加,(2)老年和白内障晶状体增加,(3)老年晶状体和ARNC下降。没有迹象表明DHA或DHB水平依赖于晶状体区域。在大多数捐赠团体中,含有DHA和DHB的蛋白质更可能存在于尿素不溶性蛋白质中,而不是水溶性或尿素可溶性蛋白质中.
    DHA和DHB的形成可能会引起结构效应,使蛋白质在水中的溶解度降低,从而导致与年龄相关的蛋白质不溶性以及可能的聚集和光散射。
    UNASSIGNED: Protein post-translational modifications (PTMs) have been associated with aging and age-related diseases. PTMs are particularly impactful in long-lived proteins, such as those found in the ocular lens, because they accumulate with age. Two PTMs that lead to protein-protein crosslinks in aged and cataractous lenses are dehydroalanine (DHA) and dehydrobutyrine (DHB); formed from cysteine/serine and threonine residues, respectively. The purpose of this study was to quantitate DHA and DHB in human lens proteins as a function of age and cataract status.
    UNASSIGNED: Human lenses of various ages were divided into five donor groups: transparent lenses (18-22-year-old, 48-64-year-old, and 70-93-year-old) and cataractous human lenses of two age groups (48-64-year-old lenses, and 70-93-year-old lenses) and were subjected to proteomic analysis. Relative DHA and DHB peptide levels were quantified and compared to their non-modified peptide counterparts.
    UNASSIGNED: For most lens proteins containing DHA or DHB, higher amounts of DHA- and DHB-modified peptides were detected in aged and cataractous lenses. DHA-containing peptides were classified into three groups based on abundance changes with age and cataract: those that (1) increased only in age-related nuclear cataract (ARNC), (2) increased in aged and cataractous lenses, and (3) decreased in aged lenses and ARNC. There was no indication that DHA or DHB levels were dependent on lens region. In most donor groups, proteins with DHA and DHB were more likely to be found among urea-insoluble proteins rather than among water- or urea-soluble proteins.
    UNASSIGNED: DHA and DHB formation may induce structural effects that make proteins less soluble in water that leads to age-related protein insolubility and possibly aggregation and light scattering.
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  • 文章类型: Journal Article
    背景:双等位基因ZBTB11变异体以前与常染色体隐性智力发育障碍(MRT69)的超等位基因亚型有关。
    目的:目的是提供对ZBTB11相关疾病(ZBTB11-RD)的临床和遗传特征的见解,特别强调渐进复杂的运动异常。
    方法:13个新的和16个以前报告的受影响的个体,年龄从2岁到50岁不等,对双等位基因ZBTB11变异体进行了临床和遗传鉴定。
    结果:所有患者均表现出一系列严重程度不同的神经发育表型,包括眼睛和神经特征。11名新患者出现复杂的异常运动,包括共济失调,肌张力障碍,肌阵鸣,刻板印象,和震颤,7名新患者出现白内障。深部脑刺激成功治疗1例广泛性进行性肌张力障碍患者。我们的分析揭示了13个新的变体。
    结论:这项研究为ZBTB11-RD的临床特征和频谱提供了更多的见解,强调神经发育表型背景下运动异常的进行性。©2024作者(S)。由WileyPeriodicalsLLC代表国际帕金森症和运动障碍协会出版的运动障碍。
    BACKGROUND: Biallelic ZBTB11 variants have previously been associated with an ultrarare subtype of autosomal recessive intellectual developmental disorder (MRT69).
    OBJECTIVE: The aim was to provide insights into the clinical and genetic characteristics of ZBTB11-related disorders (ZBTB11-RD), with a particular emphasis on progressive complex movement abnormalities.
    METHODS: Thirteen new and 16 previously reported affected individuals, ranging in age from 2 to 50 years, with biallelic ZBTB11 variants underwent clinical and genetic characterization.
    RESULTS: All patients exhibited a range of neurodevelopmental phenotypes with varying severity, encompassing ocular and neurological features. Eleven new patients presented with complex abnormal movements, including ataxia, dystonia, myoclonus, stereotypies, and tremor, and 7 new patients exhibited cataracts. Deep brain stimulation was successful in treating 1 patient with generalized progressive dystonia. Our analysis revealed 13 novel variants.
    CONCLUSIONS: This study provides additional insights into the clinical features and spectrum of ZBTB11-RD, highlighting the progressive nature of movement abnormalities in the background of neurodevelopmental phenotype. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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  • 文章类型: Journal Article
    背景:抑郁症已被证明与眼部疾病有关,包括干眼症(DED),白内障,青光眼,年龄相关性黄斑变性(AMD),和糖尿病视网膜病变(DR)。这篇叙述性综述探讨了抑郁症和眼病之间潜在的病理生理联系。以及它与眼部参数的潜在相关性。方法:2022年8月在PUBMED进行了文献检索,EMBASE,和PsycINFO。根据各自的眼部疾病和病理生理机制对与该主题相关的已发表文章进行合并和分类。结果:文献综述表明,常见的病理生理状态,如炎症和神经变性可能有助于抑郁症和某些眼部疾病。而躯体症状和生理改变,例如眼病引起的昼夜节律中断,也会影响患者的情绪状态。以共同的胚胎学为基础,解剖学,眼睛和大脑之间的生理特征,抑郁症也与在非侵入性眼科成像模式中观察到的变化相关,如视网膜神经纤维层和视网膜微血管的变化。结论:有大量证据表明抑郁症与眼部疾病密切相关。了解基本概念可以进一步研究治疗方案和基于眼部参数的抑郁症监测。
    Background: Depression has been shown to be associated with eye diseases, including dry eye disease (DED), cataracts, glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR). This narrative review explores potential pathophysiological connections between depression and eye disease, as well as its potential correlations with ocular parameters. Methods: A literature search was conducted in August 2022 in PUBMED, EMBASE, and PsycINFO. Published articles related to the subject were consolidated and classified according to respective eye diseases and pathophysiological mechanisms. Results: The literature reviewed suggests that common pathophysiological states like inflammation and neurodegeneration may contribute to both depression and certain eye diseases, while somatic symptoms and altered physiology, such as disruptions in circadian rhythm due to eye diseases, can also influence patients\' mood states. Grounded in the shared embryological, anatomical, and physiological features between the eye and the brain, depression is also correlated to changes observed in non-invasive ophthalmological imaging modalities, such as changes in the retinal nerve fibre layer and retinal microvasculature. Conclusions: There is substantial evidence of a close association between depression and eye diseases. Understanding the underlying concepts can inform further research on treatment options and monitoring of depression based on ocular parameters.
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  • 文章类型: Journal Article
    剪切波弹性成像(SWE)是一种新颖的成像技术,可对组织硬度进行定量评估。这种非侵入性方法提供了实时,定量测量,并已广泛应用于各种组织,提供有价值的诊断见解。
    本研究旨在探讨使用SWE评估年龄相关性白内障患者晶状体硬度的可行性。
    对92名诊断为年龄相关性白内障的患者和39名健康对照者进行了比较分析。使用SWE测量来量化透镜刚度。根据晶状体不透明度分类系统II(LOCSII)对所有参与者的晶状体核进行分级。还分析了晶状体刚度与年龄之间的相关性。
    研究表明,与年龄相关的白内障患者的晶状体硬度和晶状体核的硬度均明显高于健康对照组(P<0.001)。年龄相关性白内障患者,尽管不同级别白内障严重程度的晶状体核硬度差异无统计学意义,所有等级均显示相对于健康对照的刚度增加.此外,在所有参与者中观察到晶状体硬度与年龄之间的显著正相关(P<0.001).
    SWE似乎是一种有前途的成像技术,用于定量评估年龄相关性白内障患者晶状体的机械特性。
    UNASSIGNED: Shear wave elastography (SWE) is a novel imaging technique that provides quantitative assessments of tissue stiffness. This non-invasive method offers real-time, quantitative measurements and has been widely applied to various tissues, providing valuable diagnostic insights.
    UNASSIGNED: This study aimed to investigate the feasibility of using SWE to evaluate the stiffness of the lens in patients with age-related cataracts.
    UNASSIGNED: A comparative analysis involving 92 patients diagnosed with age-related cataracts and 39 healthy controls was conducted. Lens stiffness was quantified using SWE measurements. The lens nucleus of all participants was graded based on the Lens Opacities Classification System II (LOCS II). Correlations between the stiffness of the lens and age were also analyzed.
    UNASSIGNED: The study indicates that both the stiffness of the lens and the lens nucleus were significantly higher in patients with age-related cataracts compared to healthy controls (P < 0.001). In patients with age-related cataracts, although lens nucleus stiffness variations across different grades of cataract severity were not statistically significant, all grades displayed increased stiffness relative to healthy controls. Additionally, a significant positive correlation between lens stiffness and age was observed in all participants (P < 0.001).
    UNASSIGNED: SWE appears to be a promising imaging technique for quantitatively assessing the mechanical characteristics of the lens in patients with age-related cataracts.
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  • 文章类型: Journal Article
    使用临床全外显子组测序(WES)确定一对夫妇单基因遗传性疾病的遗传原因,并就他们的生殖选择提供建议。
    WES适用于一对寻求生殖建议的夫妇,女性身材矮小,男性患有先天性白内障。
    (1)该女子在chrX:591590-605428(hg19)处表现出13.8Kb的杂合缺失。该区域对应于含有矮小同源异型盒(SHOX)基因(NM000451)的外显子2-6。涉及SHOX基因的相关疾病范围从严重的Leri-Weill软骨发育不良到轻度非特异性身材矮小。同时,使用定量逆转录聚合酶链反应测定的进一步验证证实了先证者中SHOX基因的杂合缺失,以及其他具有相似临床特征的家庭成员(先证者的母亲,阿姨,和表弟)。HGMD数据库中已包含该变体的多种致病报告。根据美国医学遗传学和基因组学学院(ACMG)分类标准,这种缺失被归类为致病性。(2)对于男性患者,在CRYBB3基因中检测到杂合变体:NM004076:c.226G>A(p。Gly76R)。CRYBB3基因的变异可引起白内障22(OMIM:609741)。目前,该变异基因座不包括在数据库中,如gnomAD,而SIFT和PolyPhen2都认为这个地方“有害”。此外,通过Sanger测序的进一步验证证实该变异体遗传自男性患者的母亲,也有白内障。根据ACMG标准和指南,c.226G>A(p。CRYBB3基因中的Gly76Arg)变体被分类为具有“不确定的意义”。
    WES在两个个体中都发现了致病变异,表明健康孩子自然有25%的机会。建议使用第三代辅助生殖技术,以最大程度地减少受影响后代的风险。
    UNASSIGNED: To determine the genetic causes of monogenic inherited diseases in a couple using clinical whole exome sequencing (WES) and advise on their reproductive choices.
    UNASSIGNED: WES was applied to a couple seeking reproductive advice, the female with short stature and the male with congenital cataracts.
    UNASSIGNED: (1) The woman exhibited a 13.8 Kb heterozygous deletion at chrX: 591590-605428 (hg19). This region corresponds to exons 2-6 of the short-stature homeobox-containing (SHOX) gene (NM000451). Associated diseases involving the SHOX gene range from severe Leri-Weill dyschondrosteosis to mild nonspecific short stature. Meanwhile, further validation using a quantitative reverse transcription polymerase chain reaction assay confirmed the heterozygous deletion of the SHOX gene in the proband, as well as other family members with similar clinical characteristics (the proband\'s mother, aunt, and cousin). Multiple pathogenic reports of this variant have been included in the HGMD database. Per the American College of Medical Genetics and Genomics (ACMG) classification criteria, this deletion is classified as pathogenic. (2) For the male patient, a heterozygous variant was detected in the CRYBB3 gene: NM004076: c.226G>A (p.Gly76R). Variants in the CRYBB3 gene can cause Cataract 22 (OMIM: 609741). At present, this variant locus is not included in databases such as the gnomAD, while both SIFT and PolyPhen2 deem this locus \'damaging\'. Moreover, further validation by Sanger sequencing confirmed that the variant was inherited from the male patient\'s mother, who also had cataracts. According to ACMG standards and guidelines, the c.226G>A (p.Gly76Arg) variant in the CRYBB3 gene is classified as having \'uncertain significance\'.
    UNASSIGNED: WES identified pathogenic variants in both individuals, suggesting a 25% chance of a healthy child naturally. Third-generation assisted reproductive techniques are recommended to minimize the risk of affected offspring.
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  • 文章类型: Journal Article
    这项研究评估了近视的患病率,白内障,青光眼,和40岁以上韩国人的黄斑变性,利用来自第七届韩国国家健康和营养检查调查的数据(KNHANESVII,2018)。我们分析了204,973名成年人(44%的男性,56%的女性;平均年龄58.70±10.75岁),通过多因素logistic回归分析探讨近视与这些眼病之间的关系,校正混杂因素,并计算95%置信区间(CI)的校正比值比(OR)。结果显示近视患病率为44.6%,白内障占19.4%,黄斑变性为16.2%,青光眼占2.3%,年龄和性别之间存在显著差异。发现近视与白内障和黄斑变性风险增加之间存在潜在联系,但不是青光眼。此外,饮食中碳水化合物的摄入量较高,多不饱和和n-6脂肪酸,维生素,和矿物质与这些疾病的低风险相关,强调饮食在管理和预防与年龄相关的眼部疾病中的重要性。这些发现强调了公共卫生策略中饮食考虑的必要性,并确认近视是韩国人口老龄化中特定眼病的重要风险因素。
    This study assessed the prevalence of myopia, cataracts, glaucoma, and macular degeneration among Koreans over 40, utilizing data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII, 2018). We analyzed 204,973 adults (44% men, 56% women; mean age 58.70 ± 10.75 years), exploring the association between myopia and these eye diseases through multivariate logistic regression, adjusting for confounders and calculating adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results showed a myopia prevalence of 44.6%, cataracts at 19.4%, macular degeneration at 16.2%, and glaucoma at 2.3%, with significant differences across ages and genders. A potential link was found between myopia and an increased risk of cataracts and macular degeneration, but not with glaucoma. Additionally, a higher dietary intake of carbohydrates, polyunsaturated and n-6 fatty acids, vitamins, and minerals correlated with lower risks of these diseases, underscoring the importance of the diet in managing and preventing age-related eye conditions. These findings highlight the need for dietary considerations in public health strategies and confirm myopia as a significant risk factor for specific eye diseases in the aging Korean population.
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  • 文章类型: Journal Article
    目标:虽然I-131相对安全,对放射性碘(RAI)治疗后可能的眼部相关副作用的关注有限.因此,我们旨在为I-131的不良结局提供证据,仅在甲状腺癌患者中.
    方法:一项基于PRISMA指南的系统评价旨在检查RAI治疗的眼部并发症。包括PubMed在内的数据库,直到2023年10月,Scopus和WebofScience都使用特定的MeSH术语进行了搜索。经过彻底的筛查和审查,提取相关数据。
    结果:数据库搜索产生了3,434篇文章,这导致了最后28项符合条件的研究。这些研究调查了RAI治疗后的眼科症状,将它们分类为阻塞性疾病(例如,鼻泪管阻塞[NLDO;中位发病率:6.8%]),炎症症状(中位发病率:13%),和白内障(中位发病率:2.5%和5%)。RAI治疗和症状发作之间最常见的时间间隔是在前12个月内,然后在前几年下降。在超过100-150mCi(3.7-5.55GBq)的较高I-131剂量与症状发展的风险之间观察到很强的正相关。45岁以上的年龄也显示出与NLDO的显著关联。
    结论:眼科并发症的风险与各种因素有关,包括高剂量的I-131,年龄超过45岁,以及前12个月内的事件时间。考虑到这些情况可能有助于加强患者护理,防止可能限制患者生活质量的不良后果。
    OBJECTIVE: Although I-131 is relatively safe, there is limited focus on probable eye-related side effects after radioactive iodine (RAI) therapy. Thus, we aimed to provide evidence for the adverse outcomes of I-131, exclusively in patients with thyroid cancer.
    METHODS: A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was designed to examine the ocular complications of RAI therapy. Databases including PubMed, Scopus, and Web of Science were searched until October 2023 with specific thyroid neoplasms, ophthalmology and iodine terms. After thorough screening and review, relevant data were extracted.
    RESULTS: The database search yielded 3434 articles, which resulted in the final 28 eligible studies. These studies investigated ophthalmic symptoms following RAI therapy, classifying them as obstructive diseases (for example, nasolacrimal duct obstruction; median incidence rate: 6.8%), inflammatory symptoms (median incidence rate: 13%), and cataracts (median incidence rate: 2.5 and 5%). The most common time interval between RAI therapy and the onset of symptoms was within the first 12 months and then declined in the preceding years. A strong positive correlation was observed between higher I-131 doses of more than 100 to 150 mCi (3.7-5.55 GBq) and the risk of symptom development. Ages older than 45 also showed a significant association with nasolacrimal duct obstruction.
    CONCLUSIONS: The risk of ophthalmic complications is associated with various factors, including the administration of high I-131 doses, age of more than 45 years, and time to event within the first 12 months. Considering these conditions may help enhance patient care and prevent adverse outcomes that may limit patients\' quality of life.
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