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Li JL, Zhao J, Guo ZF, Xiao C, Liu X. Efficacy of recombinant human epidermal growth factor plus sodium hyaluronate eye drops in diabetic dry eye post-cataract surgery. World J Diabetes 2024; 15:1234-1241. [PMID: 38983819 PMCID: PMC11229957 DOI: 10.4239/wjd.v15.i6.1234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/05/2024] [Accepted: 04/17/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Dry eye syndrome (DES) after diabetic cataract surgery can seriously affect the patient's quality of life. Therefore, effective alleviation of symptoms in patients with this disease has important clinical significance. AIM To explore the clinical effect of recombinant human epidermal growth factor (rhEGF) plus sodium hyaluronate (SH) eye drops on DES after cataract surgery in patients with diabetes. METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital, Affiliated Hospital of Nankai University between April 2021 and April 2023. They were classified into an observation group (42 cases, rhEGF + SH eye drops) and a control group (40 cases, SH eye drops alone), depending on the different treatment schemes. The thera-peutic efficacy, dry eye symptom score, tear film breakup time (TFBUT), basic tear secretion score [assessed using Schirmer I test (SIt)], corneal fluorescein staining (FL) score, tear inflammatory markers, adverse reactions during treatment, and treatment satisfaction were compared between the two groups. RESULTS Therapeutic efficacy was higher in the observation group compared with the control group. Both groups showed improved TFBUT and dry eye, as well as improved SIt and FL scores after treatment, with a more pronounced improvement in the observation group. Although no marked differences in adverse reactions were observed between the two groups, treatment satisfaction was higher in the observation group. CONCLUSION rhEGF + SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy, fewer adverse reactions, and high safety levels. Thus, this treatment should be promoted in clinical practice.
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Affiliation(s)
- Jun-Ling Li
- Department of Ophthalmology, Tianjin Beichen Hospital, The Affiliated Hospital of Nankai University, Tianjin 300400, China
| | - Jin Zhao
- Department of Ophthalmology, Xianyang First People’s Hospital, Xianyang 712000, Shaanxi Province, China
| | - Zhen-Feng Guo
- Department of Ophthalmology, Tianjin Beichen Hospital, The Affiliated Hospital of Nankai University, Tianjin 300400, China
| | - Chang Xiao
- Department of Ophthalmology, Tianjin Beichen Hospital, The Affiliated Hospital of Nankai University, Tianjin 300400, China
| | - Xuan Liu
- Department of Ophthalmology, Xianyang First People’s Hospital, Xianyang 712000, Shaanxi Province, China
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Youngblood H, Schoenlein PV, Pasquale LR, Stamer WD, Liu Y. Estrogen dysregulation, intraocular pressure, and glaucoma risk. Exp Eye Res 2023; 237:109725. [PMID: 37956940 PMCID: PMC10842791 DOI: 10.1016/j.exer.2023.109725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/20/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
Characterized by optic nerve atrophy due to retinal ganglion cell (RGC) death, glaucoma is the leading cause of irreversible blindness worldwide. Of the major risk factors for glaucoma (age, ocular hypertension, and genetics), only elevated intraocular pressure (IOP) is modifiable, which is largely regulated by aqueous humor outflow through the trabecular meshwork. Glucocorticoids such as dexamethasone have long been known to elevate IOP and lead to glaucoma. However, several recent studies have reported that steroid hormone estrogen levels inversely correlate with glaucoma risk, and that variants in estrogen signaling genes have been associated with glaucoma. As a result, estrogen dysregulation may contribute to glaucoma pathogenesis, and estrogen signaling may protect against glaucoma. The mechanism for estrogen-related protection against glaucoma is not completely understood but likely involves both regulation of IOP homeostasis and neuroprotection of RGCs. Based upon its known activities, estrogen signaling may promote IOP homeostasis by affecting extracellular matrix turnover, focal adhesion assembly, actin stress fiber formation, mechanosensation, and nitric oxide production. In addition, estrogen receptors in the RGCs may mediate neuroprotective functions. As a result, the estrogen signaling pathway may offer a therapeutic target for both IOP control and neuroprotection. This review examines the evidence for a relationship between estrogen and IOP and explores the possible mechanisms by which estrogen maintains IOP homeostasis.
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Affiliation(s)
- Hannah Youngblood
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Patricia V Schoenlein
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA; Department of Radiology and Georgia Cancer Center, Augusta University, Augusta, GA, USA; Department of Surgery, Augusta University, Augusta, GA, USA
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - W Daniel Stamer
- Department of Ophthalmology and Biomedical Engineering, Duke University, Durham, NC, USA
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA; James and Jean Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA; Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, USA.
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Cicinelli MV, Buchan JC, Nicholson M, Varadaraj V, Khanna RC. Cataracts. Lancet 2023; 401:377-389. [PMID: 36565712 DOI: 10.1016/s0140-6736(22)01839-6] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/03/2022] [Accepted: 09/15/2022] [Indexed: 12/24/2022]
Abstract
94 million people are blind or visually impaired globally, and cataract is the most common cause of blindness worldwide. However, most cases of blindness are avoidable. Cataract is associated with decreased quality of life and reduced life expectancy. Most cases of cataract occur after birth and share ageing and oxidative stress as primary causes, although several non-modifiable and modifiable risk factors can accelerate cataract formation. In most patients, phacoemulsification with intraocular lens implantation is the preferred treatment and is highly cost-effective. There has been an increase in the use of comprehensive cataract surgical services, including diagnoses, treatment referrals, and rehabilitation. However, global inequity in surgical service quality is still a limitation. Implementation of preoperative risk assessment, risk reduction strategies, and new surgical technologies have made cataract surgery possible at an earlier stage of cataract severity with the expectation of good refractive outcomes. The main challenge is making the service that is currently available to some patients accessible to all by use of universal health coverage.
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Affiliation(s)
- Maria Vittoria Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - John C Buchan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Maneck Nicholson
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | | | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, Hyderabad, India; Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India; School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia; School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
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Hong Y, Sun Y, Ye X, Lu Y, Xu J, Xu J, Ji Y. Prevalence and Risk Factors for Adult Cataract in the Jingan District of Shanghai. J Ophthalmol 2022; 2022:7547043. [PMID: 36091577 PMCID: PMC9453016 DOI: 10.1155/2022/7547043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose We report the prevalence of age-related cataract (ARC) in the Jingan district of Shanghai and analyze the risk factors for ARC to be better prepared for the increasing burden of cataracts as a significant cause of visual impairment worldwide. Methods From March to June 2010, a population-based, cross-sectional study was conducted in a community selected by stratified cluster sampling in the Jingan district of Shanghai. Residents aged 40 and older were recruited and investigated by questionnaires and ophthalmic examination. Univariate and multivariate logistic regression models were used to evaluate the association of these risk factors with any cataract. Results A total of 2894 subjects aged 40 years and above were included in our study. Nine hundred forty-eight people (32.8%) were diagnosed with cataract, including 845 with bilateral cataracts (29.2%) and 292 with moderate and severe visual impairment (low vision, 10.1%). There were significant differences in low vision among different age groups and gender (Χ2 age = 84.420, P age < 0.001, Χ2 gender = 7.696, P gender = 0.021). For any cataract, we found age (OR = 1.107, 95% CI: 1.094-1.120) and refractive error (OR = 1.352, 95% CI: 1.127-1.622) were independent risk factors. Conclusion The prevalence of cataract is estimated to be nearly one-third of the sample, increasing with age. We provided further evidence that age and refractive error are independent cataract risk factors.
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Affiliation(s)
- Yingying Hong
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Yang Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Xiaofang Ye
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai 200030, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Jianjiang Xu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Jianming Xu
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai 200030, China
| | - Yinghong Ji
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
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Affiliation(s)
- Roy Quinlan
- Biomedical Sciences, Department of Biosciences, The University of Durham, Upper Mountjoy Science Site, Durham, DH1 3LE, UK.
| | - Frank Giblin
- Biomedical Sciences Emeritus, Eye Research Institute, Oakland University, Rochester, MI, 48309, USA.
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Machine Learning Based Diabetes Classification and Prediction for Healthcare Applications. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:9930985. [PMID: 34631003 PMCID: PMC8500744 DOI: 10.1155/2021/9930985] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/17/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022]
Abstract
The remarkable advancements in biotechnology and public healthcare infrastructures have led to a momentous production of critical and sensitive healthcare data. By applying intelligent data analysis techniques, many interesting patterns are identified for the early and onset detection and prevention of several fatal diseases. Diabetes mellitus is an extremely life-threatening disease because it contributes to other lethal diseases, i.e., heart, kidney, and nerve damage. In this paper, a machine learning based approach has been proposed for the classification, early-stage identification, and prediction of diabetes. Furthermore, it also presents an IoT-based hypothetical diabetes monitoring system for a healthy and affected person to monitor his blood glucose (BG) level. For diabetes classification, three different classifiers have been employed, i.e., random forest (RF), multilayer perceptron (MLP), and logistic regression (LR). For predictive analysis, we have employed long short-term memory (LSTM), moving averages (MA), and linear regression (LR). For experimental evaluation, a benchmark PIMA Indian Diabetes dataset is used. During the analysis, it is observed that MLP outperforms other classifiers with 86.08% of accuracy and LSTM improves the significant prediction with 87.26% accuracy of diabetes. Moreover, a comparative analysis of the proposed approach is also performed with existing state-of-the-art techniques, demonstrating the adaptability of the proposed approach in many public healthcare applications.
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Clear vision in postmenopausal women: role of hormone therapy and diabetes. Menopause 2020; 27:253-254. [DOI: 10.1097/gme.0000000000001495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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