Acta Ophthalmologica最新文献

{"title":"Effect of panretinal photocoagulation on retinal oxygen metabolism and ocular blood flow in diabetic retinopathy","authors":"Ahmed M. Abu El-Asrar,&nbsp;Waleed K. Alsarhani,&nbsp;Abdulrahman F. AlBloushi,&nbsp;Abdullah Alzubaidi,&nbsp;Priscilla Gikandi,&nbsp;Einar Stefánsson","doi":"10.1111/aos.17442","DOIUrl":"10.1111/aos.17442","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the effects of panretinal photocoagulation (PRP) on retinal oxygen metabolism, calibre of retinal vessels, and blood flow velocity in the optic nerve head (ONH) and choroid in patients with severe nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective study, 37 patients (37 eyes) were studied. Retinal oximetry and laser speckle flowgraphy measurements were performed at baseline and after PRP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After PRP, oxygen saturation of retinal arterioles (<i>p</i> = 0.003) and arteriovenous oxygen saturation difference (<i>p</i> = 0.005) significantly increased. On the other hand, the calibre of retinal arterioles significantly decreased (<i>p</i> = 0.016). In the ONH, mean blur rate (MBR)-vessel (<i>p</i> = 0.002), representing blood flow velocity in the retinal vessels, and MBR-tissue (<i>p</i> = 0.002), representing ONH blood flow velocity, and choroidal MBR (<i>p</i> = 0.012) significantly decreased. At baseline, there were significant negative correlations between ONH MBR-overall (<i>r</i> = −0.382, <i>p</i> = 0.026) and ONH MBR-tissue (<i>r</i> = −0.455, <i>p</i> = 0.007) and arteriovenous oxygen saturation difference. After PRP, choroidal MBR had a significant negative correlation with arteriolar oxygen saturation (<i>r</i> = −0.415, <i>p</i> = 0.016).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The effects of PRP are correlated with increased arteriovenous oxygen saturation difference, reduction in the calibre of retinal arterioles, and reduction of retinal and choroidal blood flow velocities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 4","pages":"380-387"},"PeriodicalIF":3.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-perceived and measured visual function, the impact of eye-disease, wellbeing, social determinants, and personality traits in Swedish 70-year-olds–results from the Gothenburg H70 Study","authors":"Lena Havstam Johansson,&nbsp;Madeleine Zetterberg,&nbsp;Hanna Falk Erhag","doi":"10.1111/aos.17440","DOIUrl":"10.1111/aos.17440","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To explore the potential correlation between subjective and measured visual function, as well as to analyse the influence of eye disease, socioeconomic factors and emotional dimensions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews, physical examinations and functional tests (<i>n</i> = 1203). Demographics covered sex, marital status, education, household economy, smoking and alcohol. Participants (born in 1944) rated their visual function (<i>n</i> = 533); those misjudging (<i>n</i> = 48) were studied. Group A (<i>n</i> = 18) had low presenting visual acuity (PVA) but reported good vision; Group B (<i>n</i> = 30) had normal PVA but reported low vision. Control group (<i>n</i> = 485) matched subjective and measured visual function. Ophthalmic examination tested visual acuity (VA), visual field and contrast sensitivity (CS). Psychometric tests: NEO-FFI, sense of coherence (SOC) and Montgomery–Åsberg Depression Rating Scale (MADRS). Statistical tests: chi-square, t-tests, Mann–Whitney U test and logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the population, 91% made correct assumptions about their vision. The 9% who made incorrect assumptions about their vision ability (combining groups A + B) were more likely to live alone (<i>p</i> = 0.02) and had lower household incomes compared to the control group (<i>p</i> = 0.04). Additionally, the exhibited significantly lower PVA and BCVA, a higher prevalence of visual field defects (<i>p</i> = 0.02) and lower CS, mean 1.63 (<i>p</i> = 0.005). Group A (3.4%) were women (<i>p</i> = 0.002) with the personality of extraversion, mean 40.0 (<i>p</i> = 0.01). Group B (5.6%) had more self-reported eye diseases (<i>p</i> = 0.01), lower CS (<i>p</i> = 0.01), lower educational level (<i>p</i> = 0.03) and border significantly lower SOC (<i>p</i> = 0.06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The perception of visual function is shaped by awareness of an eye disease but is additionally influenced by sex, socioeconomic factors and emotional parameters.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 4","pages":"469-478"},"PeriodicalIF":3.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.17440","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference values for the Teller Acuity Cards II (TAC II) in infants and preverbal children, a meta-analysis","authors":"Catelijne M. Neijzen,&nbsp;Femke M. de Wit,&nbsp;Ymkje M. Hettinga,&nbsp;Joke H. de Boer,&nbsp;Maria M. van Genderen,&nbsp;Gerard C. de Wit","doi":"10.1111/aos.17447","DOIUrl":"10.1111/aos.17447","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The Teller Acuity Card (TAC) procedure is a preferential-looking method to assess visual acuity in infants and preverbal children and provides a quantitative measure of grating acuity. Several studies containing reference values have been published, the majority based on an older version of the TAC card set. In 2003, a new version of the TAC was released, called the TAC II. This study aims to provide clinicians with a unified set of age norms for the TAC II.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a literature search and extracted individual data points per age from either tables or figures. We performed a weighted regression on both the standard deviation and the mean visual acuity as a function of age. Furthermore, based on literature, we corrected data points from studies using the original TAC by subtracting 0.3 octave to align them with the TAC II age norms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 5 studies, published between 1990 and 2006, provided binocular visual acuity data for 837 children and monocular visual acuity data for 1052 children. Age norms were derived from these combined data sets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The TAC charts are the gold standard for assessing visual acuity between the ages of 0 and 36 months. We provide a unified set of age norms for TAC II, the most recent version of the TAC charts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 4","pages":"479-485"},"PeriodicalIF":3.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.17447","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One tube for all: 1-year outcomes after transition to Paul glaucoma implant at a tertiary centre","authors":"Anne Studsgaard,&nbsp;Stine Elkjær Nielsen,&nbsp;Niklas Telinius","doi":"10.1111/aos.17443","DOIUrl":"10.1111/aos.17443","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the intraocular pressure (IOP) lowering effect and success rate of Paul glaucoma implant (PGI) in refractory glaucoma after changing practice pattern from Ahmed and Baerveldt tubes to PGI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective observational study of the first 50 consecutive PGI surgeries at a single Danish tertiary centre from January 2022 to October 2023. Primary endpoints were IOP and success rates after 12 months. Secondary endpoints were the use of IOP-lowering medications and complications. All cases had a risk of failure for traditional glaucoma surgery (neovascular glaucoma, oil-filled eye or uveitis).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preoperative IOP was 29.9 ± 8.6 mmHg and the mean number of topical IOP-lowering medications used was 3.4 ± 0.76 with 14 cases of systemic acetazolamide. Twelve months after surgery IOP was reduced to 11.4 ± 3.1 mmHg and complete success rate with (a) IOP≤21 mmHg was achieved in 43%, (b) IOP≤18 mmHg in 43%, (c) IOP≤15 mmHg in 41% and (d) IOP≤12 mmHg in 33%. Qualified success rate (on topical glaucoma medications) was achieved in (a) 96%, (b) 94%, (c) 86% and (d) 71% of the cases.</p>\u0000 \u0000 <p>The number of topical IOP-lowering medications was 0.9 ± 0.9 after surgery and 47% were medication free. Early (&lt;3 months) and late (&gt;3 months) complications were observed in 22% and 16% of patients respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study indicates that PGI provides a good IOP-lowering effect after 12 months in a population with risk factors for failure for traditional glaucoma surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 4","pages":"461-468"},"PeriodicalIF":3.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.17443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered retinal vasculature in childhood cancer survivors: Data from the German CVSS-study","authors":"Alexander K. Schuster,&nbsp;Anna Maria Voigt,&nbsp;Tamara Jäger,&nbsp;Stefan Nickels,&nbsp;Andreas Schulz,&nbsp;Jörg Faber,&nbsp;Arthur Wingerter,&nbsp;Hiltrud Merzenich,&nbsp;Irene Schmidtmann,&nbsp;Manfred E. Beutel,&nbsp;Thomas Münzel,&nbsp;Karl J. Lackner,&nbsp;Norbert Pfeiffer,&nbsp;Philipp S. Wild","doi":"10.1111/aos.17438","DOIUrl":"10.1111/aos.17438","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Childhood cancer is a risk factor for cardiovascular diseases in later life. Retinal examination allows to non-invasively observe the vasculature of an end-organ. We observe alterations in long-term childhood cancer survivors (CCS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the Cardiac and Vascular Late Sequelae in Long-Term Survivors of Childhood Cancer-Study, 1002 CCS (23–48 years) having neoplasia prior to 15 years of age were prospectively enrolled in a general and ophthalmologic examination including fundus photography. Central retinal vessel equivalents (arterial: CRAE; venous CRVE) were measured and linear regression analysis was computed to compare CCS to controls from the population-based Gutenberg Health Study (GHS) with adjustment for potential cardiovascular and ophthalmological confounders. Differences in cancer types and treatments were explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For 837 CCS (45.3% female), CRAE and CRVE were conducted. Both were smaller in CCS previously having leukaemia, central nervous system tumour, neuroblastoma, renal tumour, malignant bone tumour, soft tissue sarcoma and germ cell tumour than in GHS controls. No difference was found for CCS with prior lymphoma. Previous radiotherapy of head or neck was associated with a smaller CRVE. Higher mean arterial blood pressure and intake of antihypertensive medication were associated with smaller CRAE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Retinal vasculature is altered in CCS leading to smaller retinal arteries and veins. Our finding indicates that childhood cancer and its treatment leads to systemic alterations of the microcirculation on both branches of the vasculature system. While the retinal venous vasculature is altered by radiotherapy, the lower vessel width of the arterial branch is associated with arterial hypertension.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 4","pages":"e231-e239"},"PeriodicalIF":3.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.17438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior segment optical coherence tomography (AS-OCT) assisted analysis of characteristics of graft dehiscence after Descemet membrane endothelial keratoplasty (DMEK) for failed penetrating keratoplasty","authors":"Pratima Vishwakarma,&nbsp;Mert Mestanoglu,&nbsp;Veronika Welge-Lüßen,&nbsp;Simona Schlereth,&nbsp;Claus Cursiefen,&nbsp;Björn Bachmann","doi":"10.1111/aos.17445","DOIUrl":"10.1111/aos.17445","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To analyse anterior segment optical coherence tomography (AS-OCT) parameters of graft dehiscence after Descemet membrane endothelial keratoplasty (DMEK) for graft failure post penetrating keratoplasty (PK).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective evaluation of AS-OCT images of 142 dehiscences post-DMEK in 75 eyes. Dehiscences' size, depth, location, correlation with graft-host interface (GHI) override and step at GHI were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The majority of patients were male (58.7%) and mean age was 67 ± 13.6 years. Multiple dehiscences were observed in 49.3% eyes. Rebubbling was required once in 72% and multiple times in 24% eyes. Among 142 dehiscences, crossing over GHI was noted in 53.5%. The median distance of peripheral edge of dehiscences from GHI was 0.21 mm. Steps at GHI were noted in 41.5% where 22.5% dehiscences with step crossed the GHI. For dehiscences crossing versus not crossing GHI, no significant difference was noted in median depth (<i>p</i> = 0.268) and size (<i>p</i> = 0.206). For dehiscences crossing over GHI with presence versus absence of step, median depth (<i>p</i> = 0.23) and size (<i>p</i> = 0.196) showed no significant difference. No significant difference was noted in dehiscences' median depth (<i>p</i> = 0.16) and size (<i>p</i> = 0.926) among different step sizes. Incidence of dehiscence with or without steps (<i>p</i> = 0.8853) and graded as per size of steps, showed no significant difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Size and depth of dehiscence were not influenced by their crossing over GHI or the presence and size of steps. Dehiscences typically occurred in close vicinity to GHI, suggesting that DMEK graft should be placed 0.25 mm centrally from the prior PK interface, independent of GHI irregularities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 4","pages":"e213-e219"},"PeriodicalIF":3.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.17445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brolucizumab for treating neovascular age-related macular degeneration: An alternative for treatment-refractory patients","authors":"Martin Biilmann Groen,&nbsp;Anders Højslet Vestergaard,&nbsp;Lasse Jørgensen Cehofski","doi":"10.1111/aos.17446","DOIUrl":"10.1111/aos.17446","url":null,"abstract":"","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 4","pages":"e256-e257"},"PeriodicalIF":3.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neovascular age-related macular degeneration on three nationwide survey and register data in Finland during 2000–2017","authors":"Petri Purola,&nbsp;Seppo Koskinen,&nbsp;Kai Kaarniranta,&nbsp;Hannu Uusitalo","doi":"10.1111/aos.17444","DOIUrl":"10.1111/aos.17444","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate time trends in the incidence and prevalence of neovascular age-related macular degeneration (nAMD) and its treatments, associated factors, and effects on vision in Finland during 2000–2017.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used three nationwide health examination surveys representing the Finnish population aged 30 years or older. All three surveys were linked to the national care register covering nAMD diagnoses and intravitreal injections between 2000 and 2017. All three surveys included a health examination in which distance and near visual acuity (VA) were measured, as well as self-reported and register-based information on socio-demographic status and lifestyle, health care use, co-morbidities, and quality of life. The data included two cross-sectional time points in 2011 and 2017 and two 11 year longitudinal follow-ups during 2000–2011 and 2006–2017.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence and prevalence of nAMD were two times higher in women than in men. The annual prevalence of nAMD increased from 0.51% to 0.70% and from 0.22% to 0.46% in treated nAMD between 2011 and 2017. Treated nAMD patients had an average of 4 intravitreal injections per treatment year. nAMD patients showed significantly poorer distance and near VA than persons without any AMD in 2011 and 2017 (<i>p</i> &lt; 0.001). However, near VA was significantly better in 2017 than in 2011 among nAMD patients (<i>p</i> = 0.036). The duration of nAMD showed weak negative correlation with distance and near VA. After adjusting for age and sex, nAMD patients showed significantly higher univariable odds ratios for lower distance VA, low consumption of vegetables, living in central Finland, a higher number of hospitalisations per year, and older age compared with persons without any AMD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Since nAMD is an increasing burden for public health with gender discrepancy and a detrimental impact on vision, we should better find patients who have a high risk of developing nAMD and try to optimise their preventive intervention. Once nAMD is developed, we should understand treatment and follow-up demands at the personalised level. The nationwide register data help us in those challenges.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 4","pages":"449-460"},"PeriodicalIF":3.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Societal costs of decreased visual acuity: A Finnish cohort study with 15 years of registry data follow-up","authors":"Joonas Taipale,&nbsp;Petri K. M. Purola,&nbsp;Saku Väätäinen,&nbsp;Janika E. Nättinen,&nbsp;Seppo V. P. Koskinen,&nbsp;Hannu M. T. Uusitalo","doi":"10.1111/aos.17439","DOIUrl":"10.1111/aos.17439","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To examine what direct and indirect societal costs are associated with decreased visual acuity (VA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nationally representative sample of 8028 Finnish adults aged 30 years or older with survey data and clinical examination including VA assessment was evaluated. These data were linked with multiple national registers to capture health care services utilization during 1999–2013. All direct and indirect costs were calculated using prevalence-based bottom-up approach and adjusted for age, sex, and comorbidities with generalized linear models. The results in 2019 cost level are presented according to VA groups at baseline per person, and with population estimates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total direct health care costs ranged from 1996 €/year/person for those with VA ≥1.0 to 3277 €/year/person for those with weak (0.32–0.5) VA. The increase in direct costs was notable even before the onset of visual impairment. Indirect costs showed monotonously increasing trend with decreasing VA. At the population level, the additional annual direct costs associated with decreased VA were estimated at 1.9 billion €. Only 2% or less of the additional costs are due to increased direct eye-related secondary health care usage. Estimated additional annual national indirect costs were 1.2 billion €.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In addition to those with visual impairment or blindness, health care need, and societal costs are elevated even among those with adequate VA. We conclude, that focusing on prevention of VA decrease would not only help sustain the patients' quality of life but could also reduce the future societal costs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 4","pages":"439-448"},"PeriodicalIF":3.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The debate – when and how should i use idebenone for LHON?","authors":"Marcela Votruba","doi":"10.1111/aos.16902","DOIUrl":"https://doi.org/10.1111/aos.16902","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p>The International Consensus Statement on the Clinical and Therapeutic Management of Leber Hereditary Optic Neuropathy was published in 2017 based on data available in 2016. The intent was to provide expert consensus statements for the clinical and therapeutic management of LHON based on the currently available evidence. It provided the guidelines for clinical and therapeutic management of LHON. It established a number of benchmarks such as clinical staging of LHION into Asymptomatic (mutation carriers), Subacute (&lt;6 months from onset), Dynamic (6–12 months) and Chronic (&gt;12 months) stages. We can all agree on the criteria for the diagnosis of LHON, based on a careful history, evaluation of key structural and functional visual parameters, and on a molecular confirmation of a pathogenic mtDNA mutation. On management it is clearly highly important to include genetic counselling and informing the patient about potentially preventable lifestyle risk factors. The use of idebenone is more debated and much has changed. Further studies and case series have been published and issues around when to start, how long to treat for and whether to treat chronic patients have all emerged. In this debate we shall raise a number of these issues and provide a reflection of the available data, their validity and clinical relevance and debate next steps.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.16902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}