Table 4 - uploaded by Serge Resnikoff
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This paper presents estimates of the prevalence of visual impairment and its causes in 2002, based on the best available evidence derived from recent studies. Estimates were determined from data on low vision and blindness as defined in the International statistical classification of diseases, injuries and causes of death, 10th revision. The number...
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Citations
... Studies indicate that less than 60% of diabetic patients, for example, undergo routine ophthalmologic examinations at the intervals recommended by current guidelines. 5 The reasons for this include both the countrywide lack of access to specialized healthcare services and the absence of effective strategies for risk factor management and lifestyle changes. Thus, despite its promising nature due to practicality and the lack of need for a specialist, we believe that cost-effectiveness studies need to be conducted. ...
... C orneal blindness remains one of the leading causes of blindness worldwide. 1,2 Corneal opacity is currently ranked as the fifth leading cause of blindness among both global population and Southeast Asia, 3 with the burden of corneal blindness being underestimated in many developing countries, 4 including Indonesia. With a population of 274 million in 2020, an estimated 35 million Indonesian people had vision loss, and 3.7 million were blind; corneal abnormalities are currently ranked fifth at 0.10%. ...
Purpose
To present demographic data on corneal diseases leading to keratoplasty, trends of keratoplasty, corneal procurement, and graft survival in Indonesia.
Methods
A retrospective cohort study of patients who underwent keratoplasty, including deep anterior lamellar keratoplasty (DALK), endothelial keratoplasty (EK), and penetrating keratoplasty (PKP) from January 2018 to November 2024 was conducted. Details on donor and patient demographic data were collected from medical records. The cumulative probability of graft survival rates was analyzed using the Kaplan–Meier curve.
Results
A total of 489 keratoplasty procedures were performed during the study period. EK (261, 53.4%) represented the most common procedures, followed by PKP (215, 44.0%) and DALK (13, 2.6%). Imported (368, 75.3%) corneal donors dominated the corneal procurement. Bullous keratopathy (BK, 234, 47.9%) was the common diagnosis for keratoplasty, followed by corneal scars postinfection (99, 20.2%) and repeat keratoplasty after graft failure (77, 15.7%) in overall cohorts. EK remained the first treatment choice for BK (199, 40.7%), whereas PKP was for corneal scars postinfection (92, 18.8%) and repeat keratoplasty because of graft failure (44, 9.0%). The cumulative graft survival rates of EK (90.9%) were superior to PKP (90.6%) and DALK (88.9%) on third postoperative visit.
Conclusions
BK is the leading cause of indication for keratoplasty, and EK is the most common procedure. Most corneal donors are from imported sources, and local corneal donors only provide one-third. EK shows better graft survival rates than other keratoplasties.
... Infectious keratitis is a leading cause of avoidable blindness in both developing and developed nations [1,2]. Due to the high rate of negative test results, diagnosing infectious keratitis remains a challenge in therapeutic decision-making and represents a major public health concern. ...
Purpose
To evaluate the anterior segment optical coherence tomography (AS-OCT) features of infectious keratitis (IK) and assess their correlation with clinical and microbiological findings.
Methods
This cross-sectional study included 58 patients with culture-positive corneal abscesses, complete medical records, and high-quality AS-OCT imaging. Independent clinical and AS-OCT assessments were conducted to identify pathogen-specific features and evaluate their diagnostic sensitivity.
Results
Distinct AS-OCT patterns were identified for each pathogen. Gram-positive bacterial keratitis was associated with stromal edema (p 0.006; OR = 20.6) and Descemet folds (p 0.01; OR = 4.83), whereas Gram-negative keratitis exhibited diffuse infiltrates (p < 0.001; OR = 14.286) and stromal thinning (p < 0.001; OR = 98.9). Fungal keratitis was characterized by stromal cystic spaces (p < 0.001; OR = 82.1), stromal thinning (p 0.042; OR = 4.71) and endothelial plaques with indistinct corneal boundaries (p < 0.001; OR = 207). Combining AS-OCT with clinical findings enhanced diagnostic sensitivity to 75% for Gram-positive bacterial keratitis, 66.7% for Gram-negative keratitis, and 100% for fungal keratitis.
Conclusions
AS-OCT provides key pathogen-specific features in IK, improving diagnostic accuracy, particularly in cases with inconclusive microbiological results. While AS-OCT should not replace microbiological testing, its integration into clinical protocols can refine diagnostic strategies. Future applications of artificial intelligence could further optimize early pathogen identification and treatment outcomes.
... However, when ROS generation increases, as with aging, as well as in certain diseases viz. diabetes, or with excessive exposure to ultraviolet (UV) radiation, these defenses become overwhelmed, leaving un-scavenged radicals available to react with cell components [7,8]. In addition, the activities of defense enzymes are known to decrease with aging. ...
Oxidative stress is one of the significant factors in the pathogenesis of several retinal diseases, viz. age-related macular degeneration, diabetic retinopathy, etc. Available treatments are not fully effective in attenuating tissue damage and the associated vision loss. Hence development of newer therapeutic compounds is highly desirable. We have previously demonstrated the effectiveness of metabolic and nutritional antioxidants such as pyruvate and caffeine in preventing oxidative damage to the lens. However, so far, studies investigating the protective effect of caffeine on the neural retina exposed to direct oxidative stress are lacking. The primary goal of this study was therefore to examine the efficacy of caffeine in preventing biochemical damage to the neural retina exposed to oxyradicals, in terms of maintaining the concentration of glutathione (GSH), a major endogenous antioxidant reserve. In vitro short-term tissue culture studies were conducted using freshly isolated neural retinas exposed to H 2 O 2 in a medium with/without caffeine supplementation. Bovine neural retinas were incubated in medium 199 for 4 hours. Oxidative stress was induced by incubating the tissue with 9 mM H 2 O 2. Caffeine group was incubated with 9 mM H 2 O 2 + caffeine (5mM). Controls were incubated without H 2 O 2 and caffeine. Tissue damage was assessed by measuring GSH content following incubation. Incubation of neural retina with H 2 O 2 decreased GSH level to ~40% of the controls. Caffeine, however, maintained it at ~95% of the controls, indicating its effectiveness in preventing retinal oxidative stress. This novel effect of caffeine in the neural retina has been shown for the first time. The results are highly encouraging with regard to pursuing further studies investigating its other possible mechanisms of action, and its potential neuroprotective effect.
... Cataract is the total or partial opacification of the lens, usually bilateral, causing varying degrees of visual impairment [1]. It is one of the most common eye diseases worldwide and the leading cause of preventable blindness [2]. ...
In an effort to reduce blindness caused by cataracts and improve the quality of cataract surgery services, an evaluation of the functional outcomes of cataract surgery during a mass campaign was conducted at the Dioila Referral Health Center, Koulikoro region, Republic of Mali. This was a prospective study involving patients who underwent cataract surgery during the mass campaign from August to October 2024. The results were analyzed using the Monitoring Cataract Surgical Outcome (MCSO) software. Among 152 operated eyes, 131 eyes were included in the study. The mean age was 67.5 years, with a median age of 63.6 years (range: 35–85 years). Manual small-incision cataract surgery (MSICS) without sutures, with posterior chamber intraocular lens implantation in 97% of cases, was the primary surgical technique used. Perioperative and postoperative complications included vitreous loss (3%), corneal edema (7.6%), and posterior capsule opacification (6.1%). The functional outcomes showed that 75.6% of patients had good visual acuity (≥3/10) without correction, 16% had borderline visual acuity (1/10–2/10), and 8.4% had poor visual acuity (<1/10). With best correction, the proportion of patients with good outcomes increased to 80.2%, while 13% had borderline visual acuity and 6.8% had poor visual acuity. Poor outcomes were attributed to pre-existing ocular comorbidities (6.9%). These results fall below WHO standards, which recommend an uncorrected visual acuity (UVA) >80% for good outcomes and a best-corrected visual acuity (BCVA) >90%, with poor outcomes below 5%. Identifying the causes of poor outcomes highlights the need for improved patient selection and long-term follow-up.
... Common age-related eye diseases (AREDs), such as cataract, glaucoma, and age-related macular degeneration (AMD), are leading global causes of blindness and visual impairment in adults aged 50 years and older in 2020 (GBD, 2019 Blindness and Vision Impairment Collaborators, 2021; Voleti et al., 2013). According to the reports from the World Health Organization (WHO) in 2004, cataract, glaucoma, and AMD accounted for approximately 47.8 %, 12.3 %, and 8.7 % of global blindness, respectively (Resnikoff et al., 2004). The number of global blindness caused by these eye diseases is also substantially escalating in parallel with the aging global population, imposing a heavy burden on public eye healthcare systems and resulting in significant economic losses (Vision Loss Expert Group of the Global Burden of Disease Study & GBD 2019 Blindness and Vision Impairment Collaborators, 2024a, 2024b, 2024c. ...
... Despite available treatments that can lower the risk by 60% (13, 14), it remains the leading cause of blindness and vision loss among working-age adults worldwide. DR accounts for approximately 2.6% of global blindness (15) and 4.8% of visual impairment (16). In 2020, around 103.12 million people were affected by DR globally, and this number is projected to rise to 160.5 million by 2045, with low-and middle-income countries facing a disproportionately higher burden (17). ...
Background
Diabetic retinopathy (DR) is becoming a more widespread public concern worldwide, leading to visual impairments. It has become the leading cause of blindness among working-age adults globally, despite established treatments that can reduce the risk by 60%.
Objective
This study aimed to determine the incidence of diabetic retinopathy and its predictors among adult patients with diabetes in public hospitals in Central and Southern Ethiopia.
Methods
A hospital-based follow-up study was conducted in selected public hospitals in Central and Southern Ethiopia. A total of 376 participants of newly diagnosed adult diabetes were enrolled from 2015-2023 and the follow-up the date was from date of enrolment to the development of events. The data were collected by reviewing their records and entered in Epi-data version 4.6.0.2 and exported to STATA version 14 for analysis. Descriptive statistics of the variables were obtained. The Weibull model with gamma frailty distribution was fitted. Bivariable and multivariable analyses were done, and variables with a p-value less than 0.05 and a corresponding 95% confidence interval in the final model were used. The model of adequacy was checked.
Results
376 adult diabetic patient records were reviewed with the mean baseline age (± standard deviation) of 34.8±10 years. The univariate frailty was statistically significant (Theta=0.236 (0.131, 0.496)). A total of 376 adult patients with diabetes were followed for 682.894 person-years. Overall, an incidence rate of 14.06/100 person-years. Proteinuria (AHR = 2.21: 95% CI: 1.45, 3.57), cardiovascular disease (AHR = 2.23: 95% CI: 1.34, 4.03), and type II DM (AHR = 2.87: 95% CI: 1.30, 6.13) were identified as significant predictors of diabetic retinopathy.
Conclusion
Overall incidence rate of diabetic retinopathy was high. The most effective way to protect our vision from diabetic retinopathy is to manage diabetes effectively and offer support to high-risk individuals with diabetes. Therefore, healthcare professionals and relevant health authorities should target on addressing these factors in their initiatives to prevent diabetic retinopathy in diabetic patients.
... Cataract is the leading cause of avoidable blindness globally, with surgical techniques evolving to enhance visual outcomes and patient satisfaction [1]. Initially, cataracts were treated by couching, a method dating back to the fifth century BC where a needle displaced the cataractous lens. ...
... 22,23 Rhamnazin (RAM) is a novel flavonoid, which is naturally found in medicinal plants, such as ginkgo, willows, and sea-buckthorn. 24 It is reported to exert antioxidant, anti-inflammatory, anti-angiogenic, anticancerous, anti-bacterial, anti-allergic, anti-viral, and neuroprotective effects. 25,26 In a previous study, RAM was shown to reduce the oxidative stress and inflammatory burden in lipopolysaccharide-induced lung injury in rats. ...
Background/Objective
Cadmium (Cd) is an extremely toxic heavy metal and environmental toxicant, which leads to renal damage by causing oxidative stress. Rhamnazin (RAM) is a novel flavonoid, which possesses multiple pharmacological activities. Therefore, the present study was planned to determine the nephroprotective effects of RAM against Cd-prompted renal toxicity in rats.
Methodology
In this investigation, 24 male albino rats were distributed into four equal groups, i.e., control, CdCl2-intoxicated group (2 mgkg⁻¹), CdCl2 + RAM-treated group (2 mgkg⁻¹ + 20 mgkg⁻¹), and RAM-only treated group (20 mgkg⁻¹). After oral dose administration for 30 days, the alterations in the Nrf2/Keap1 pathway, Cd concentration, antioxidant profile, oxidative stress markers, renal function markers, inflammatory markers, apoptotic markers, and kidney histology were analyzed.
Result
The results of the current study revealed that Cd exposure significantly (P < .05) increased Keap1 expression, while decreasing the expressions of Nrf2 and antioxidant genes and level of total antioxidant status (TAS). Additionally, it decreased the activities of antioxidant enzymes. Whereas, the levels of malondialdehyde (MDA), reactive oxygen species (ROS), and total oxidant status (TOS) were increased. Cd exposure increased Cd concentration in tissues. Additionally, it increased the levels of renal function markers, such as urea, urobilinogen, urinary proteins, creatinine, kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL). On the contrary, Cd exposure reduced albumin and creatinine clearance. Furthermore, it increased the levels of inflammatory markers in the kidneys. Besides, Cd significantly increased the levels of Bax, caspase-3, and caspase-9, whereas lessened Bcl-2 level. Moreover, adverse histoarchitectural changes were observed following the Cd exposure. However, treatment with RAM significantly restored all the damage in the kidneys of the rats.
Conclusion
Our findings highlight the potential of RAM as a valuable therapeutic candidate against heavy metal-induced kidney damage.
... Diabetic Retinopathy (DR) is a common vascular complication of diabetes and a leading cause of blindness globally. Approximately 5% of blindness cases are attributed to DR, affecting nearly all adults with type 1 diabetes and around 75% of adults with type 2 diabetes after about 15 years of disease duration (5,6). Diabetic retinopathy causes retinal vascular abnormalities and severe visual impairment. ...
Background: Diabetic retinopathy is a common vascular complication of diabetes. Vitamin D has been found to play a role in the development and progression of diabetic retinopathy. The aim of this study is to investigate the relationship between vitamin D levels and proliferative and non-proliferative retinopathy in diabetic patients. Methods: The present study is a cross-sectional analytical study. This study was conducted at Hafiz Sabzevar Diabetes Clinic and involved diabetic patients. A total of 80 diabetic patients were categorized into three groups: patients without retinopathy, patients with proliferative diabetic retinopathy, and patients with non-proliferative retinopathy. Patients’ information was collected through a demographic questionnaire and a researcher-made checklist. The data were analyzed using SPSS 28, with descriptive statistical tests, Chi-square, ANOVA, and Bonferroni’s post hoc test. Results: The results of the study showed a significant difference in vitamin D and creatinine levels among the three groups (p<0.001). The post hoc test was used to accurately determine this significant difference. The data revealed that both retinopathy groups had lower levels of vitamin D and higher creatinine compared to the non-retinopathy group, and this difference was statistically significant (p<0.001). However, there was no significant difference between the groups in terms of HDL (p=0.23), LDL (p=0.52), and total cholesterol (p=0.95). Conclusion: Vitamin D deficiency increases the risk of developing diabetic retinopathy, both proliferative and non-proliferative. Therefore, it is recommended to consider taking vitamin D supplements in diabetic patients to maintain normal vitamin D levels, since it has positive effects in preventing the occurrence of diabetic retinopathy
