Leber Hereditary Optic Neuropathy (LHON) stands as a distinctive maternally inherited mitochondrial disorder marked by painless, subacute central vision loss, primarily affecting young males. This review covers the possible relationship between LHON and multiple sclerosis (MS), covering genetic mutations, clinical presentations, imaging findings, and treatment options. LHON is associated with mutations in mitochondrial DNA (mtDNA), notably m.11778G>A, m.3460G>A, and m.14484T>C, affecting complex I subunits. Beyond ocular manifestations, LHON can go beyond the eye into a multi-systemic disorder, showcasing extraocular abnormalities. Clinical presentations, varying in gender prevalence and outcomes, underscore the nature of mitochondrial optic neuropathies. Hypotheses exploring the connection between LHON and MS encompass mitochondrial DNA mutations triggering neurological diseases, immunologically mediated responses inducing demyelination, and the possibility of coincidental diseases. The research on mtDNA mutations among MS patients sheds light on potential associations with specific clinical subgroups, offering a unique perspective into the broader landscape of MS. Imaging findings, ranging from white matter alterations to cerebrospinal fluid biomarkers, further emphasize shared pathological processes between LHON-MS and classical MS. This comprehensive review contributes to the understanding of the complex relationship between LHON and MS.

Background/Objectives: Geographic atrophy (GA) is an advanced form of age-related macular degeneration (AMD) leading to the progressive and irreversible loss of visual function. Characteristics of GA include atrophic lesions resulting from the loss of photoreceptors, retinal pigment epithelium, and choriocapillaris. During GA progression, atrophic lesions typically advance from the macular periphery to the center, affecting foveal light sensitivity and visual acuity. This study analyzed changes in light sensitivity and visual acuity during the natural course of GA progression using the topographic analysis of structural and functional changes based on Early Treatment Diabetic Retinopathy Study (ETDRS) charts, multimodal imaging, and microperimetry assessment. Methods: Medical chart data of GA patients between 2014 and 2022 from the Internationale Innovative Ophthalmochirurgie GbR (I.I.O.) research center (Düsseldorf, Germany) were retrospectively analyzed. All patient eyes fulfilling the phase 3 OAKS study inclusion criteria were included and followed up for 60 months. The imputation of missing measurements and dropouts was performed by linear mixed models. Results: A total of 20 GA eyes from 13 GA patients were included in the study. At the index, 53.8% of patients had bilateral GA, with 70.0% of the eyes showing multifocal GA and 30.0% subfoveal encroachment (SFE). A total of 35.0% of the eyes had 2-5, and 15.0% over 20, areas of atrophy. Over time, the GA lesion size increased from 6.4 mm2 to 11.8 mm2 (1.08 mm2/year). After an average observation time of 2.9 years, 78.6% of the initially unaffected study eyes developed SFE. The percentage of study eyes without visual impairment decreased from 55.0% to 30.0%, with mean normal-luminance best-corrected visual acuity (NL-BCVA) reducing from 63.7 to 55.7 ETDRS letters. The share of absolute scotoma points in microperimetry assessment increased from 15.7% to 43.5% while overall average macular sensitivity declined from 15.7 dB to 7.4 dB. Conclusions: The substantial deterioration of macular outcomes and visual function was comprehensively detected. The results were a documentation of structural and functional aspects of the natural progression of GA for a 60-month follow-up, providing a typical outline for AMD patients with GA.

BACKGROUND: Giant cell arteritis (GCA) is the most common systemic vasculitis in adults. Presenting features include new-onset headaches, constitutional symptoms, jaw claudication, polymyalgia rheumatica, and visual symptoms. Arterial inflammation with subsequent stenosis and occlusion may cause tissue ischemia, leading to blindness, strokes, and myocardial infarction. Oral antiplatelet therapy has been hypothesized to reduce GCA-related ischemic events. However, previous studies have demonstrated conflicting results regarding the efficacy of antiplatelet agents in GCA. The objective of this systematic review is to assess the safety and efficacy of antiplatelet therapy for the prevention of these events in adults with giant cell arteritis.
METHODS: In this systematic review, we will include randomized controlled trials (RTCs), quasi-randomized trials, non-randomized intervention studies, cohort studies, and case-control studies on patients with new-onset or relapsing GCA. The intervention of interest will be pre-existing use or initiation of an oral antiplatelet medication (aspirin, clopidogrel, prasugrel, or ticagrelor) at GCA onset or relapse. The comparator of interest will be the absence of antiplatelet therapy. Endpoints will be evaluated after 6 and 12 months of follow-up. The primary outcome will be GCA-related ischemic events, including permanent blindness, stroke, myocardial infarction, and ischemic event-related deaths. Adverse events such as major bleeding and death caused by a bleeding event will be assessed.
CONCLUSIONS: GCA-related ischemic events are catastrophic, sudden, often irreversible, and lead to significant morbidity. Antiplatelet agents are affordable, accessible, and could be effective for the prevention of these events. Nevertheless, the potential benefits of platelet aggregation inhibition must be weighed against their associated risk of bleeding. Assessing the efficacy and safety of antiplatelet therapy in GCA is therefore clinically important.
BACKGROUND: Our systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO, registration number CRD42023441574.

BACKGROUND: Vision has a key role in children\'s neuromotor, cognitive and social development. Children with visual impairment attain developmental milestones at later stages and are at higher risk of developing psychological disorders and social withdrawn.
OBJECTIVE: We performed a scoping review to summarize the mostly used instruments assessing the impact of visual impairment on quality of life, functioning and participation of children and adolescents. In addition, the main findings of the included studies are discussed.
METHODS: We searched for papers assessing quality of life, functioning and participation of children and adolescents with visual impairment from 0 to 18 years old conducted between 2000 and 2023.
RESULTS: In total, 69 studies met the inclusion criteria and were included in the review. Child self-report, caregivers-proxy and self-report questionnaires as well as interviews were used. The results showed that quality of life, functioning and participation are significantly reduced in children and adolescents with visual impairment, and that the impact depends on different factors (e.g., severity of the impairment, age).
CONCLUSIONS: Considering the significant impact of visual impairment on quality of life, functioning and participation on this population, it is fundamental to develop integrated and multi-dimensional assessment programs that evaluate the impact of visual impairment on those dimensions considering different contexts of life (e.g., family, school, leisure time). WHAT THIS PAPER ADDS?: The present review aims to give an overview of what is known about the impact of visual impairment on quality of life, functioning and participation of children and adolescents. We assumed a biopsychosocial perspective which, in line with the definition of health by the International Classification of Functioning, Disability and Health (WHO, 2001), considered how body functions and structures, functioning, participation and environmental factors dynamically interact to define the health, or the disease, status of a person at a certain moment of life. We reported the most used instruments for the assessment of quality of life, participation, and functioning, with a specific interest on Patient-Reported Outcome Measures and self-report measures. By reporting the different instruments used, we gave a broad overview about the available tools that can be used in clinical as well as in research field to assess quality of life, functioning and participation in this population. Additionally, the review of the existing literature allowed us to demonstrate that those dimensions are negatively impacted by visual impairment and thus they should be considered in the assessment programs. Specifically, there is the need to provide more integrated assessment programs that investigate the impact of visual impairment on children and adolescents\' social and emotional wellbeing, everyday functioning and social relationship, considering their subjective experience together with the one of caregivers, teachers, health care professionals, and other relevant adults involved in their life. Additionally, it is essential to plan and implement multidimensional assessment programs that consider how all areas of life are differently impacted by visual impairment.

UNASSIGNED: Amidst the global aging population and an increasing prevalence of visual impairment across all age groups, this study aims to investigate the current state of research on sleep health in visually impaired populations.
UNASSIGNED: A scoping review was conducted to synthesize the existing literature on sleep health and visual impairment. We employed conceptual mapping to identify key research topics, analyzing data from four databases: PubMed (n = 290), CINAHL (n = 81), Scopus (n = 117), and PsycInfo (n = 96). A total of 83 peer-reviewed articles, published from 1977 to August 2023, were included in the review.
UNASSIGNED: Our analysis identified 11 distinct eye health conditions including blindness, glaucoma, diabetic retinopathy, low vision, cataract, retinitis pigmentosa, macular degeneration, optic neuropathy, visual field defects, ocular hypertension, and retinal vein occlusion. Additionally, 8 major sleep problems were recognized: abnormal sleep duration, daytime sleepiness, insomnia, Non-24-Hour Sleep Wake Disorder, sleep apnea, sleep disorders, sleep disturbances, and sleep disordered breathing. The dominant research themes were (1) poor sleep quality in individuals with visual impairments and ophthalmic diseases, (2) high prevalence of sleep issues in patients with ophthalmic diseases, (3) sleep apnea in patients with ophthalmic conditions, and (4) circadian rhythm disruptions in blind individuals.
UNASSIGNED: This review highlights research gaps that, when addressed, could greatly enhance our comprehension of the interplay between visual impairment and sleep health. Bridging these gaps promises to lead to more holistic care strategies, potentially improving vision functioning and rehabilitation outcomes for individuals with visual impairments.

UNASSIGNED: This review explores the evolutionary trajectory of navigation assistance tools tailored for the visually impaired, spanning from traditional aids like white canes to contemporary electronic devices. It underlines their pivotal role in fostering safe mobility for visually impaired individuals.
UNASSIGNED: The primary aim is to categorize and assess the plethora of navigation assistance solutions available. Emphasis is placed on technological advancements, particularly in electronic systems employing sensors, AI, and feedback mechanisms. Furthermore, the review underscores the emerging influence of smartphone-based solutions and navigation satellite systems in augmenting independence and quality of life for the visually impaired.
UNASSIGNED: Navigation assistance solutions are segmented into four key categories: Visual Imagery Systems, Non-Visual Data Systems, Map-Based Solutions, and 3D Sound Systems. The integration of diverse sensors like Ultrasonic Sensors and LiDAR for obstacle detection and real-time feedback is scrutinized. Additionally, the fusion of smartphone technology with sensors to deliver location-based assistance is explored. The review also evaluates the functionality, efficacy, and cost-efficiency of navigation satellite systems.
UNASSIGNED: Results indicate a significant evolution in navigation aids, with modern electronic systems proving highly effective in aiding obstacle detection and safe navigation. The convenience and portability of smartphone-based solutions are underscored, along with the potential of navigation satellite systems to enhance navigation assistance.
UNASSIGNED: In conclusion, the review advocates for continued innovation and technological integration in navigation tools to empower visually impaired individuals with increased independence and safe access to their surroundings. It accentuates the imperative of ongoing efforts to enhance the quality of life for those with visual impairments through futuristic technological solutions.

UNASSIGNED: The recent increase in myopia is a major public health concern worldwide, including in the Eastern Mediterranean Region (EMR).
UNASSIGNED: To provide data on the prevalence of myopia among school-age children in the EMR.
UNASSIGNED: This study was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol. We searched the Web of Sciences, Scopus, Index Medicus for the Eastern Mediterranean Region, ProQuest, PubMed, and Medline for studies on the prevalence of myopia in the EMR published from January 2000 to May 2022. The data were analysed using MedCalc version 19.6.1 and myopia was defined as refractive error ≥ 0.50 D. The overall pooled prevalence of myopia was estimated using a random-effects model and its associated 95% confidence intervals.
UNASSIGNED: The meta-analysis included 27 quality-assessed studies from 13 countries among 51 111 school-age children. The overall pooled prevalence of childhood myopia from 2000 to 2022 was 5.23%, which was significantly higher among females than males (4.90% vs 3.94%). The prevalence of myopia was significantly higher among children aged 11-17 years than among those aged 5-10 years (7.50% vs 3.90%). There was a higher prevalence of myopia with cycloplegic refraction than noncycloplegic refraction (5.95% vs 3.73%). There was highly significant heterogeneity between the studies.
UNASSIGNED: Prevalence of myopia among school-age children in the EMR was high, particularly among older children, and it was more common among females. Early intervention to slow myopia progression is essential in the EMR to protect children from irreversible vision loss.
استعراض منهجي وتحليل تلوي لانتشار قصر النظر بين الأطفال في سن المدرسة في إقليم شرق المتوسط.
سيف الرشيد، وليد الغامدي.
UNASSIGNED: تمثِّل الزيادة الأخيرة في الإصابة بقصر النظر شاغلًًا رئيسيًّا من شواغل الصحة العامة في جميع أنحاء العالم، وخاصة إقليم شرق المتوسط.
UNASSIGNED: هدفت هذه الدراسة الى تقديم بيانات عن انتشار قصر النظر بين الأطفال في سن المدرسة في إقليم شرق المتوسط.
UNASSIGNED: أُجريت الدراسة باستخدام بروتوكول بنود التبليغ المفضَّلة للاستعراضات المنهجية والتحليلات التلوية (PRISMA). وبحثنا في \" ويب العلوم\" و\"سكوبوس\" و\"الفهرس الطبي لإقليم شرق المتوسط\" و\"برو-كويست\" و\"بب ميد\"، و\"نظام استرجاع المعلومات البيليوجرافية الطبية والبيولوجية (قاعدة بيانات مدلاين)\" عن الدراسات المتعلقة بانتشار قصر النظر في إقليم شرق المتوسط التي نُشرت في الفترة من يناير / كانون الثاني 2000 إلى مايو / أيار 2022. وحُللت البيانات بالإصدار 19.6.1 من برنامج Med Calc، وعُرِّف قِصََر النظر بأنه خطأ انكساري ≥ 0.50 ديوبتر. وقُدِّر معدل الانتشار الإجمالي المجمَّع لقصر النظر باستخدام نموذج التأثيرات العشوائية، وما يرتبط به من فواصل ثقة قدرها 95٪.
UNASSIGNED: شمل التحليل التلوي 27 دراسة مُقيّمة الجودة من 13 بلدًا شملت 51111 طفلًًا في سن الدراسة. وبلغ معدل الانتشار الإجمالي المجمّع لقِصََر النظر بين الأطفال في الفترة من عام 2000 إلى عام 2022 نسبة 5.23٪ ، وكان أعلى كثيرًا بين الإناث منها بين الذكور (4.90٪ مقابل 3.94٪). وتبين أن معدل انتشار قصر النظر أعلى كثيرًا بين الأطفال الذين تتراوح أعمارهم بين 11 و17 سنة منه بين أولئك الذين تتراوح أعمارهم بين 5 و10 سنوات (7.50٪ مقابل 3.90٪). وتبيََّّن أيضًا أن معدل انتشار قِصََر النظر المصحوب بالانكسار تحت تأثير موسع الحدقة أعلى من معدل الانكسار دون توسيع الحدقة (5.95٪ مقابل 3.73٪). وتبين وجود تباين كبير بين الدراسات.
UNASSIGNED: إن معدل انتشار قصر النظر بين الأطفال في سن المدرسة في إقليم شرق المتوسط مرتفع، لا سيَّما بين الأطفال الأكبر سِنًّا، وهو أكثر شيوعًا بين الإناث. لذا، فإن التدخل المبكر لإبطاء تطور قصر النظر أمرٌ ضروري في الإقليم لحماية الأطفال من فقدان البصر الذي لا رجعة فيه.
Analyse systématique et méta-analyse de la prévalence de la myopie chez les enfants d\'âge scolaire dans la Région de la Méditerranée orientale.
UNASSIGNED: L\'augmentation récente des cas de myopie est un problème majeur de santé publique dans le monde entier, y compris dans la Région de la Méditerranée orientale.
UNASSIGNED: Fournir des données sur la prévalence de la myopie chez les enfants d\'âge scolaire dans la Rég ion de la Méditerranée orientale.
UNASSIGNED: La présente étude a été menée selon le protocole PRISMA (lignes directrices pour la rédaction d\'analyses et de méta-analyses systématiques). Nous avons effectué des recherches dans Web of Sciences, Scopus, Index Medicus pour la Région de la Méditerranée orientale, ProQuest, PubMed et Medline pour les études sur la prévalence de la myopie dans la Région qui ont été publiées entre janvier 2000 et mai 2022. Les données ont été analysées au moyen de la version 19.6.1 de MedCalc et la myopie a été définie comme un défaut de réfraction supérieur ou égal à 0,50 D. La prévalence globale groupée de la myopie a été estimée à l\'aide d\'un modèle à effets aléatoires et des intervalles de confiance à 95 % qui y sont associés.
UNASSIGNED: La méta-analyse a porté sur 27 études, dont la qualité a été évaluée, réalisées dans 13 pays auprès de 51 111 enfants d\'âge scolaire. Entre 2000 et 2022, la prévalence globale groupée de la myopie chez l\'enfant était de 5,23 %, ce qui était significativement plus élevé chez les filles que chez les garçons (4,90 % contre 3,94 %). Cette prévalence était significativement plus élevée chez les enfants âgés de 11 à 17 ans que chez ceux âgés de 5 à 10 ans (7,50 % contre 3,90 %). De plus, elle était plus élevée avec la réfraction cycloplégique qu\'avec la réfraction non cycloplégique (5,95 % contre 3,73 %). L\'hétérogénéité entre les études était hautement significative.
UNASSIGNED: La prévalence de la myopie chez les enfants d\'âge scolaire dans la Région de la Méditerranée orientale était élevée, en particulier chez les enfants plus âgés, et elle était d\'autant plus fréquente chez les filles. Une intervention précoce visant à ralentir la progression de la myopie est essentielle dans la Régio n pour protéger les enfants contre une perte de vision irréversible.

UNASSIGNED: The incidence of visual impairment(VI) in older people is gradually increasing. This review aimed to summarise the evidence on existing health management models and strategies for older adults with VI to improve health-related and vision-related quality of life (QoL) in older people.
UNASSIGNED: Based on the framework of the scoping review methodology of Arksey and O\'Malley (2005), a comprehensive literature search of relevant literature published between January 2010 and June 2022 in PubMed, CINAHL, EMBASE, Web of Science, Cochrane Library, CNKI, VIP, Wanfang database, Sinomed and the grey literature.
UNASSIGNED: Finally, 31 articles were included. The health management model had a multidisciplinary team low vision rehabilitation model, medical consortium two-way management model, low vision community comprehensive rehabilitation model, medical consortium-family contract service model, screening-referral-follow-up model, and three-level low vision care model. The health management strategy covers nine aspects, the combination of multi-element strategies is feasible, and network information technology has also shown positive results.
UNASSIGNED: In the future, under the Internet and hierarchical management model, we should provide demand-based personalized support to rationalize and scientifically achieve hierarchical management and improve resource utilization efficiency and eye health outcomes.

UNASSIGNED: Five-fifths of all incidents of blindness in Saudi Arabia may be attributed to cataracts. Cataracts are the second major cause of blindness, responsible for 35.5% of cases. Therefore, the purpose of the research was to measure the visual acuity improvement after cataract surgery in children.
UNASSIGNED: This systematic review followed PRISMA guidelines for reporting systematic reviews. All procedures followed the recommendations of the Cochrane handbook. Studies of varying study designs, both published and unpublished, are included. Retrospective studies with outcomes of pediatric cataract surgery were identified from various databases.
UNASSIGNED: After an initial screening, 108 out of 167 items were deemed unsuitable for publication. There were 59 full-text papers assessed for inclusion, and only seven matched the criteria. All the articles included were of a very high standard. Both the duration of therapy and the target population varied widely between the studies.
UNASSIGNED: The results indicated that the majority of childhood cataracts are hereditary. Primary posterior capsulectomy and anterior vitrectomy combined with cataract extraction and intra-ocular lens implantation is the treatment of choice for pediatric cataracts. It is recommended that surgery be performed in a properly equipped facility staffed by trained, cooperative personnel and that different procedures be used to enhance post-operative follow-up.

Individuals with multiple disabilities are among the most challenging to serve and AAC teams often lack direction in determining effective interventions. The purpose of this scoping review was to summarize the research evidence on AAC interventions for individuals with complex communication needs and simultaneous motor, and visual impairments as part of their multiple disabilities; to consider implications for practice; and to determine gaps and directions for future research. A total of 27 studies were identified and reviewed, involving 55 unique participants with multiple disabilities. Most studies focused on direct intervention to increase requesting or choice-making, with little focus on social communication. Only two studies focused on training communication partners. Results indicated that AAC interventions can be highly effective to increase communication for individuals with multiple disabilities. However, there is an urgent need for increased rigor and more detailed participant information in future AAC intervention research with this population. Future research should investigate AAC intervention to improve social communication and increase language development, not just expression of needs and wants. Future research should focus on the needs of individuals with multiple disabilities from culturally and linguistically diverse backgrounds and on implementation of AAC within natural environments.