ORCID Profile
0000-0002-9897-1192
Current Organisation
Centre for Eye Research Australia
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Chemical Engineering | Chemical Engineering Design | Process Control And Simulation
Publisher: Springer Science and Business Media LLC
Date: 18-01-2023
DOI: 10.1186/S12916-023-02728-7
Abstract: Retinal structural abnormalities have been found to serve as biomarkers for cardiovascular disease (CVD). However, the association between retinal nerve fiber layer (RNFL) thickness and the incidence of CVD events remains inconclusive, and relevant longitudinal studies are lacking. Therefore, we aimed to examine this link in two prospective cohort studies. A total of 25,563 participants from UK Biobank who were initially free of CVD were included in the current study. Another 635 participants without retinopathy at baseline from the Chinese Guangzhou Diabetes Eye Study (GDES) were adopted as the validation set. Measurements of RNFL thickness in the macular (UK Biobank) and peripapillary (GDES) regions were obtained from optical coherence tomography (OCT). Adjusted hazard ratios (HRs), odd ratios (ORs), and 95% confidence intervals (CI) were calculated to quantify CVD risk. Over a median follow-up period of 7.67 years, 1281 (5.01%) participants in UK Biobank developed CVD events. Each 5-μm decrease in macular RNFL thickness was associated with an 8% increase in incident CVD risk (HR = 1.08, 95% CI: 1.01–1.17, p = 0.033). Compared with participants in the highest tertile of RNFL thickness, the risk of incident CVD was significantly increased in participants in the lowest thickness tertile (HR = 1.18, 95% CI: 1.01–1.38, p = 0.036). In GDES, 29 (4.57%) patients developed CVD events within 3 years. Lower average peripapillary RNFL thickness was also associated with a higher CVD risk (OR = 1.35, 95% CI: 1.11–1.65, p = 0.003). The additive net reclassification improvement (NRI) was 21.8%, and the absolute NRI was 2.0% by addition of RNFL thickness over the Framingham risk score. Of 29 patients with incident CVD, 7 were correctly reclassified to a higher risk category while 1 was reclassified to a lower category, and 21 high risk patients were not reclassified. RNFL thinning was independently associated with increased incident cardiovascular risk and improved reclassification capability, indicating RNFL thickness derived from the non-invasive OCT as a potential retinal fingerprint for CVD event across ethnicities and health conditions. ISRCTN 15853192
Publisher: MDPI AG
Date: 04-01-2023
DOI: 10.3390/NU15020260
Abstract: Background Several studies have investigated the association between dietary iron intake and cognitive impairment, but little is known about the relationship between iron intake and dementia incidence. Objectives This study explored the association between dietary iron intake and incident dementia in males and females. Whether this association was modified by factors such as age and medical diseases was also examined. Methods We included 41,213 males and 48,892 females aged 60 years or over, from the UK-Biobank cohort. Dietary iron intake was measured using a web-based 24-h dietary recall questionnaire from between 2009 and 2012. Incident dementia was ascertained using hospital inpatient records and death registers until April 2021. Cox proportional regression models examined the association between iron intake and incident dementia, and hazard ratio curves were constructed with knots from the analysis indicating insufficient or excessive iron intake. Results During a mean follow-up of 11.8 years, 560 males and 492 females developed dementia. A non-linear relationship between iron intake and incident dementia was observed in both males and females. The lowest incidence rates were observed in the higher iron intake quintile (Q4: ≥15.73, .57 mg/day) for males, and the intermediate iron intake quintile (Q3: ≥12.4, .71 mg/day) for females. Among those aged 60 and above, all-cause dementia in males was associated with deficient iron intake (Q1 versus Q4: Hazard ratio [HR]: 1.37, 95% Confidence interval [95%CI]: 1.01–1.86, p = 0.042) and excessive iron intake (Q5 versus Q4: HR: 1.49, 95%CI: 1.14–1.96, p = 0.003), whilst significant associations between all-cause dementia and deficient iron intake were only observed in females without hypertension. Smoking status was a significant moderator (p-value for trend = 0.017) for dementia in males only. Conclusions Excessive iron intake (≥17.57 mg/day) is associated with a higher incidence of all-cause dementia in males and smoking status modified this association amongst males. Deficient iron intake ( .93 mg/day) was associated with a higher incidence of all-cause dementia in females without a history of hypertension.
Publisher: BMJ
Date: 10-2021
DOI: 10.1136/BMJOPEN-2020-040795
Abstract: To investigate the association between glaucoma and 10-year mortality rate in an adult population in China. Population-based cohort study. The Liwan Eye Study, China. 1405 baseline participants aged 50 years and older were invited to attend a 10-year follow-up examination. The International Society of Geographic and Epidemiologic Ophthalmology criteria was used to define glaucoma. Detailed information of mortality was confirmed using the Chinese Centre for Disease Control and Prevention. Presenting visual impairment (PVI) was defined as a presenting visual acuity of less than 20/40 in the better-seeing eye. The 10-year mortality rates were compared using the log-rank test. Cox proportional hazards regression models were used to investigate the association between glaucoma and mortality. A total of 1372 (97.7%) participants with available gonioscopic data were included in the analysis. Of these, 136 (9.9%), 33 (2.4%) and 21 (1.5%) participants had primary angle closure (PAC) suspect (PACS), PAC and PAC glaucoma (PACG), and 29 (2.1%) had primary open angle glaucoma (POAG). After 10 years, 306 (22.3%) participants were deceased. The 10-year mortality was significantly associated with PACG (HR, 2.15, 95% CI 1.14 to 4.04, p=0.018) but not associated with PAC (HR, 1.27, 95% CI 0.67 to 2.39, p=0.463), PACS (HR, 1.32, 95% CI 0.95 to 1.83, p=0.099) and POAG (HR, 0.74, 95% CI 0.36 to 1.49, p=0.395) when age and gender were adjusted for. This association was no longer statistically significant (HR, 1.60, 95% CI 0.70 to 3.61, p=0.263) when covariables, such as income, education, body mass index, PVI, history of diabetes and hypertension, were adjusted for. Larger vertical cup-to-disc ratio (VCDR .30) was only a significant risk factor in multivariable analysis (HR, 1.60, 95% CI 1.11 to 2.33, p=0.011). PACG was significantly associated with higher long-term mortality, but this association was likely to be confounded by other systemic risk factors. VCDR .3 was the only independent predictor, implying that it may be a marker of ageing and frailty.
Publisher: BMJ
Date: 04-12-2019
DOI: 10.1136/BJOPHTHALMOL-2019-314853
Abstract: To investigate the association between age-related macular degeneration (AMD) and subjective cognitive complaints (SCCs) in the USA. A total of 5604 participants aged 40 years and older from the 2005–2008 National Health and Nutrition Examination Survey were included. Retinal photography was graded into no AMD, early and late AMD based on the modification of the Wisconsin Age-Related Maculopathy Grading System. SCCs were based on the self-reported difficulty in remembering or confusion. S le weights were used to generate nationally representative data. Multivariate regression analyses were used to assess the association between AMD severity and SCCs, controlling for potential confounders. Participants with any AMD had higher prevalence of SCCs relative to participants without AMD (6.8% vs 13.6%, p .001). After adjusting for potential confounding factors, presence of any AMD was significantly associated with 1.62-fold higher odds of having SCCs (95% CI 1.16 to 2.27, p=0.007). Similarly, participants with early (OR 1.58 95% CI 1.14 to 2.17, p=0.007) and late AMD (OR 2.02 95% CI 1.08 to 3.79, p=0.030) were also associated with elevated odds of reporting SCCs after controlling for confounders. We found significant associations between AMD severity and SCCs in this US population. More attention should be paid on the subjective memory function and potential risk of cognitive decline among patients with AMD.
Publisher: Elsevier BV
Date: 05-2023
Publisher: Springer Science and Business Media LLC
Date: 28-09-2023
Publisher: Frontiers Media SA
Date: 14-06-2022
DOI: 10.3389/FNAGI.2022.872967
Abstract: The relationship between sensory impairments and the risk of dementia is inconclusive. We aim to investigate the association of visual impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI) with incident dementia. The UK Biobank study recruited more than 500,000 participants aged 40–69 years across the United Kingdom. Participants with available visual acuity (VA) measurements and speech-reception-threshold (SRT) information and free of dementia at the baseline assessment were included in the analysis. VI was defined as VA worse than 0.3 LogMAR units and HI were defined as an SRT of −5.5 dB or over. DSI was defined as the presence of both VI and HI. Incident dementia was identified through linked data to primary care or hospital admission records and death registries. Multivariable Cox proportional hazard regression models were used to examine the association of VI, HI, and DSI with incident dementia. Among 113,511 participants (mean age: 56.8 ± 8.09 years, female: 54.4%), a total number of 1,135 (1.00%) cases of incident dementia were identified during a median follow up period of 11.1 years [interquartile range (IQR): 10.9–11.4 years]. The incidence of dementia showed significant differences among the non-sensory impairment (NSI) group, VI-only group, HI-only group, and DSI group ( p & 0.001). After adjusting for demographic, lifestyle, health, and genetic factors, isolated VI ( HR = 1.50, 95% CI : 1.06–2.12, p = 0.023), isolated HI ( HR = 1.42, 95% CI :1.20–1.69, p & 0.001), and DSI ( HR = 1.82, 95% CI : 1.10–3.00, p = 0.020) were independently associated with higher risks of incident dementia. Visual, hearing, and dual sensory impairments were associated with an increased risk of developing dementia, suggesting that visual and hearing impairments are modifiable risk factors that can be targeted to prevent dementia.
Publisher: BMJ
Date: 09-2017
DOI: 10.1136/BMJOPEN-2016-014644
Abstract: This study was to aggregate the prevalence and risks of epiretinal membranes (ERMs) and determine the possible causes of the varied estimates. Systematic review and meta-analysis. The search strategy was designed prospectively. We searched PubMed, Embase and Web of Science databases from inception to July 2016. Reference lists of the included literatures were reviewed as well. Surveys published in English language from any population were included if they had a population-based design and reported the prevalence of ERM from retinal photography with or without optical coherence tomography. Eligibility and quality evaluation was conducted independently by two investigators. The literature search generated 2144 records, and 13 population-based studies comprising 49 697 subjects were finally included. The prevalence of ERM and the ORs of potential risk factors (age, sex, myopia, hypertension and so on) were extracted. The pooled age-standardised prevalence estimates of earlier ERM (cellophane macular reflex (CMR)), advanced ERM (preretinal macular fibrosis (PMF)) and any ERM were 6.5% (95% CI 4.2% to 8.9%), 2.6% (95% CI 1.8% to 3.4%) and 9.1% (95% CI 6.0% to 12.2%), respectively. In the subgroup analysis, race and photography modality contributed to the variation in the prevalence estimates of PMF, while the WHO regions and image reading methods were associated with the varied prevalence of CMR and any ERM. Meta-analysis showed that only greater age and female significantly conferred a higher risk of ERMs. Our findings suggest that ERMs are relatively common among aged population. Race, image taking and reading methodology may play important roles in influencing the large variability of ERM prevalence estimates.
Publisher: Wiley
Date: 07-09-2022
DOI: 10.1111/CEO.14149
Abstract: To evaluate the long‐term efficacy and safety of continued repeated low‐level red‐light (RLRL) therapy on myopia control over 2 years, and the potential rebound effect after treatment cessation. The Chinese myopic children who originally completed the one‐year randomised controlled trial were enrolled. Children continued RLRL‐therapy were defined as RLRL‐RLRL group, while those who stopped and switched to single‐vision spectacle (SVS) in the second year were RLRL‐SVS group. Likewise, those who continued to merely wear SVS or received additional RLRL‐therapy were SVS‐SVS and SVS‐RLRL groups, respectively. RLRL‐therapy was provided by an at‐home desktop light device emitting red‐light of 650 nm and was administered for 3 min at a time, twice a day and 5 days per week. Changes in axial length (AL) and cycloplegic spherical equivalence refraction (SER) were measured. Among the 199 children who were eligible, 138 (69.3%) children attended the examination and 114 (57.3%) were analysed (SVS‐SVS: n = 41 SVS‐RLRL: n = 10 RLRL‐SVS: n = 52 RLRL‐RLRL: n = 11). The baseline characteristics were balanced among four groups. In the second year, the mean changes in AL were 0.28 ± 0.14 mm, 0.05 ± 0.24 mm, 0.42 ± 0.20 mm and 0.12 ± 0.16 mm in SVS‐SVS, SVS‐RLRL, RLRL‐SVS and RLRL‐RLRL group, respectively ( p 0.001). The respective mean SER changes were −0.54 ± 0.39D, −0.09 ± 0.55D, −0.91 ± 0.48D, and −0.20 ± 0.56D ( p 0.001). Over the 2‐year period, axial elongation and SER progression were smallest in RLRL‐RLRL group (AL: 0.16 ± 0.37 mm SER: −0.31 ± 0.79D), followed by SVS‐RLRL (AL: 0.44 ± 0.37 mm SER: −0.96 ± 0.70D), RLRL‐SVS (AL: 0.50 ± 0.28 mm SER: −1.07 ± 0.69D) and SVS‐SVS group (AL: 0.64 ± 0.29 mm SER: −1.24 ± 0.63D). No self‐reported adverse events, functional or structural damages were noted. Continued RLRL therapy sustained promising efficacy and safety in slowing myopia progression over 2 years. A modest rebound effect was noted after treatment cessation.
Publisher: Elsevier BV
Date: 08-2021
Publisher: BMJ
Date: 18-01-2022
DOI: 10.1136/BJOPHTHALMOL-2021-319807
Abstract: To develop a deep learning (DL) model that predicts age from fundus images (retinal age) and to investigate the association between retinal age gap (retinal age predicted by DL model minus chronological age) and mortality risk. A total of 80 169 fundus images taken from 46 969 participants in the UK Biobank with reasonable quality were included in this study. Of these, 19 200 fundus images from 11 052 participants without prior medical history at the baseline examination were used to train and validate the DL model for age prediction using fivefold cross-validation. A total of 35 913 of the remaining 35 917 participants had available mortality data and were used to investigate the association between retinal age gap and mortality. The DL model achieved a strong correlation of 0.81 (p ·001) between retinal age and chronological age, and an overall mean absolute error of 3.55 years. Cox regression models showed that each 1 year increase in the retinal age gap was associated with a 2% increase in risk of all-cause mortality (hazard ratio (HR)=1.02, 95% CI 1.00 to 1.03, p=0.020) and a 3% increase in risk of cause-specific mortality attributable to non-cardiovascular and non-cancer disease (HR=1.03, 95% CI 1.00 to 1.05, p=0.041) after multivariable adjustments. No significant association was identified between retinal age gap and cardiovascular- or cancer-related mortality. Our findings indicate that retinal age gap might be a potential biomarker of ageing that is closely related to risk of mortality, implying the potential of retinal image as a screening tool for risk stratification and delivery of tailored interventions.
Publisher: Frontiers Media SA
Date: 16-05-2022
Abstract: To investigate the association between myopia and risk of metabolic syndrome (MetS) in a prospective cohort from the UK Biobank Study. Volunteers (aged 40 years and above) free of baseline MetS and cataract included from the UK Biobank Study, a prospective follow-up cohort. Myopia was defined using uncycloplegic autorefraction, self-report-myopia, and medical records for refractive error at baseline. MetS as well as components of MetS were diagnosed based on health records, blood biochemistry, and questionnaires. Questionnaires determined the status of smoking, drinking, physical activity and dietary supplements, as well as ethnicity and education. A total of 91,591 participants were available in the analysis, with a mean age of 55.37 ± 8.07 years at baseline and a median follow-up years of 11.16 years. The proportion of myopia was 49.7%, and a total of 937 (1.0%) participants were identified as having incident MetS (0.09/100 person years). Subjects with myopia were more likely to have MetS compared with non-myopic subjects (0.82 vs. 0.21%, Log-rank test P & 0.001). Mopes had greater risk of incident MetS (Hazard ratio [HR] = 4.19, 95% confidence interval [CI] 3.57–4.93, P & 0.001) adjusting for baseline age, gender, education and ethnicity. After further controlling for lifestyle factors (smoking, drinking, physical activity, and fish oil supplement) or baseline metabolic disorders, the risk of incident MetS were 3.88- and 4.06-fold greater in myopic subjects than those without myopia, respectively ( P & 0.001 for both models). The severity of myopia was not significantly correlated to incident MetS in multivariate-adjusted models. An increased risk of incident MetS among the elderly is associated with myopia, but not the degree of myopia. These findings highlighted the need of prevention of MetS among older adults with myopia.
Publisher: Elsevier BV
Date: 12-2021
Publisher: Elsevier BV
Date: 03-2023
Publisher: Cold Spring Harbor Laboratory
Date: 11-01-2021
DOI: 10.1101/2021.01.09.21249189
Abstract: To investigate the association of visual impairment (VI) with brain structures in the UK Biobank Study. The UK Biobank Study is a large prospective study that recruited more than 500,000 participants aged 40-69 from 2006 to 2010 across the UK. Visual acuity (VA) of worse than 0.3 LogMAR units (Snellen 20/40) was defined as VI. Structural magnetic resonance imaging (MRI) data were obtained using a 3.0-T MRI imager. Volumetric measures of five global brain volumes (total brain volume, total grey matter, total white matter, cerebrospinal fluid (CSF), brain stem) and the volumes of seven specific brain region (thalamus, caudate nucleus, basal ganglia, pallidum, hippoc us, amygdala and nucleus accumbens) were included in the present analysis. Multivariable linear regression was used to investigate the association of VI with global and specific brain volumes. A total of 8976 participants free of neurological disorders at baseline assessment were included for the present analysis. The prevalence of VI was 0.02% (n=181). After adjusting for a range of cofounding factors, VI was significantly associated with decreased volumes of the total brain (β = -0.12, 95% confidence interval (CI) -0.23 to 0.00, P = 0.049), thalamus (β = -0.16, 95% CI -0.18 to -0.04, P = 0.010), caudatenucleus (β = -0.14, 95% CI -0.27 to 0.00, P = 0.046), pallidum (β = -0.15, 95% CI-0.27 to -0.02, P = 0.028) and amygdala (β = -0.18, 95% CI -0.31 to -0.04, P = 0.012). We found that VI is associated with a decrease in total brain volumes and the volumes of specific brain regions implicated in neurodegenerative diseases.
Publisher: Springer Nature Singapore
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 31-10-2022
DOI: 10.1186/S13148-022-01354-Z
Abstract: Aberrant epigenetic modifications such as DNA methylation may contribute to the pathogenesis of DR. We aimed at elucidating the role of novel DNA methylation modifications in diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) using an extreme phenotypic design. Two consecutive studies were conducted. A cross-sectional study using an extreme phenotypic design was conducted to identify rare methylation modifications that might contribute to DR pathogenesis. A 2-year longitudinal nested case–control study was conducted to validate the results and assess whether these novel methylation modifications could be used as biomarkers for predicting DR onset. A large number of differentially methylated CpG sites were identified in the cross-sectional study, and two (cg12869254 and cg04026387) corresponding to known genes were replicated in the longitudinal study. Higher methylation of cg12869254 significantly correlated with macular RNFL thinning in the superior and nasal subregions, and that of cg04026387 correlated with reduced deep capillary plexus VD in the superior and inferior subregions after adjusting for covariates. Cg12869254 and cg04026387 hypermethylation may complement the known risk factors that contribute to the pathogenesis of DR and as novel biomarkers for disease prediction.
Publisher: Cold Spring Harbor Laboratory
Date: 11-01-2021
DOI: 10.1101/2021.01.09.21249187
Abstract: Although visual dysfunction is one of the most common non-motor symptoms among patients with Parkinson’s disease (PD), it is not known whether such dysfunction predates the onset of clinical PD. To examine the association of visual impairment (VI) with the future development of PD in the UK Biobank Study. The UK Biobank Study is one of the largest prospective cohort studies of health, enrolling over 500,000 participants aged 40-69 years between 2006 and 2010 across the UK. VI was defined as a habitual distance visual acuity (VA) worse than 0.3 LogMAR in the better-seeing eye. Incident cases of PD were determined by self report data, hospital admission records or death records, whichever came first. Multivariable Cox proportional hazard regression models were used to investigate the association between VI and the risk of incident PD. A total of 117,050 participants were free of PD at the baseline assessment. During the median observation period of 5.96 (interquantile range [IQR]: 5.77-6.23) years, PD occurred in 222 (0.19%) participants. Visually impaired participants were at a higher risk of developing PD than non-VI participants (p .001). Compared with the non-VI group, the adjusted hazard ratio was 2.28 (95% CI 1.29-4.04, p=0.005) in the VI group. These results were consistent in the sensitivity analysis, where incident PD cases diagnosed within one year after the baseline assessment were excluded. This prospective cohort study found that VI was associated with an increased risk of incident PD, suggesting that VI may represent a prodromal feature of PD.
Publisher: Wiley
Date: 03-2023
Abstract: Metabolic syndrome (MetS) is a clustering of cardiometabolic components, posing tremendous burdens in the aging society. Retinal age gap has been proposed as a robust biomarker associated with mortality and Parkinson's disease. Although MetS and chronic inflammation could accelerate the aging process and increase the risk of mortality, the association of the retinal age gap with MetS and inflammation has not been examined yet. Retinal age gap (retina‐predicted age minus chronological age) was calculated using a deep learning model. MetS was defined as the presence of three or more of the following: central obesity, hypertension, dyslipidemia, hypertriglyceridemia, and hyperglycemia. Inflammation index was defined as a high‐sensitivity C‐reactive protein level above 3.0 mg/L. Logistic regression models were used to examine the associations of retinal age gaps with MetS and inflammation. We found that retinal age gap was significantly associated with MetS and inflammation. Specifically, compared to participants with retinal age gaps in the lowest quartile, the risk of MetS was significantly increased by 10% and 14% for participants with retinal age gaps in the third and fourth quartile (odds ratio [OR]:1.10 95% confidence interval [CI], 1.01,1.21 , p = .030 OR: 1.14, 95% CI, 1.03,1.26 p = .012, respectively). Similar trends were identified for the risk of inflammation and combined MetS and inflammation. We found that retinal age gaps were significantly associated with MetS as well as inflammation. Given the noninvasive and cost‐effective nature and the efficacy of the retinal age gap, it has great potential to be used as a screening tool for MetS in large populations.
Publisher: BMJ
Date: 19-12-2022
Abstract: To test whether vision impairment and major ophthalmic conditions are predictive of frailty. The analysis included 5321 participants aged 60–95 years at baseline from the China Health and Retirement Longitudinal Study. Participants were enrolled in 2011 and followed up in 2013, and 2015 through a face-to-face interview. Distance/near vision impairment was defined by reporting poor eyesight and reporting excellent, very good, good or fair eyesight was used as the reference. A history of cataract surgery and glaucoma were also self-reported. Frailty was defined as the presence of ≥3 of the five components of the Fried phenotype: weakness, slowness, exhaustion, inactivity and shrinking. In the cross-sectional analysis, both near (odds ratio [OR] (95% confidence interval [CI]): 1.62 (1.30 to 2.00)) and distance (1.59 (1.30 to 1.96)) vision impairment was associated with a higher prevalence of frailty independent of confounders. In the longitudinal analysis, the multivariable-adjusted OR (95% CI) for incident frailty associated with glaucoma, distance vision impairment, near vision impairment and vision problem was 3.41 (1.46 to 7.99), 1.59 (1.17 to 2.17), 1.62 (1.17 to 2.23) and 2.11 (1.41 to 3.15), respectively. Vision problem was associated with decreased handgrip strength (β (95% CI): −1.47 (−2.20 to –0.75) kg) during follow-up. In iduals with glaucoma (−0.11 (−0.16 to –0.05) m/s), distance vision impairment (−0.02 (−0.03 to 0.00) m/s) or vision problem (−0.02 (−0.05 to 0.00) m/s) had decreased gait speed compared with the control group. Vision problem, vision impairment and glaucoma are important predictors of frailty in older adults.
Publisher: Wiley
Date: 06-2023
DOI: 10.1002/MEF2.50
Abstract: Given the unprecedented phenomenon of population ageing, studies have increasing captured the heterogeneity within the ageing process. In this context, the concept of “biological age” has been introduced as an integrated measure reflecting the in idualized ageing pace. Identifying reliable and robust biomarkers of age is critical for the accurate risk stratification of in iduals and exploration into antiageing interventions. Numerous potential biomarkers of ageing have been proposed, spanning from molecular changes and imaging characteristics to clinical phenotypes. In this review, we will start off with a discussion of the development of ageing biomarkers, then we will provide a comprehensive summary of currently identified ageing biomarkers in humans, discuss the rationale behind each biomarker and highlight their accuracy and clinical value with a contemporary perspective. Additionally, we will discuss the challenges, potential applications, and future opportunities in this field. While research on ageing biomarkers has led to significant progress and applications, further investigations are still necessary. We anticipate that future breakthroughs in this field will involve exploring potential mechanisms, developing biomarkers by combining various data sources or employing new technologies, and validating the clinical value of existing and emerging biomarkers through comprehensive collaboration and longitudinal studies.
Publisher: Informa UK Limited
Date: 18-05-2020
Publisher: Cold Spring Harbor Laboratory
Date: 14-01-2022
DOI: 10.1101/2022.01.13.22269272
Abstract: Retinal parameters could reflect systemic vascular changes. With the advances of deep learning technology, we have recently developed an algorithm to predict retinal age based on fundus images, which could be a novel biomarker for ageing and mortality. To investigate associations of retinal age gap with arterial stiffness index (ASI) and incident cardiovascular disease (CVD). A deep learning (DL) model was trained based on 19,200 fundus images of 11,052 participants without any past medical history at baseline to predict the retinal age. Retinal age gap (retinal age predicted minus chronological age) was generated for the remaining 35,917 participants. Regression models were used to assess the association between retinal age gap and ASI. Cox proportional hazards regression models and restricted cubic splines were used to explore the association between retinal age gap and incident CVD. We found each one-year increase in retinal age gap was associated with increased ASI (β=0.002, 95% confidence interval [CI]: 0.001-0.003, P .001). After a median follow-up of 5.83 years (interquartile range [IQR]: 5.73-5.97), 675 (2.00%) developed CVD. In the fully adjusted model, each one-year increase in retinal age gap was associated with a 3% increase in the risk of incident CVD (hazard ratio [HR]=1.03, 95% CI: 1.01-1.06, P=0.012). In the restricted cubic splines analysis, the risk of incident CVD increased significantly when retinal age gap reached 1.21 (HR=1.05 95% CI, 1.00-1.10 P-overall .0001 P-nonlinear=0.0681). We found that retinal age gap was significantly associated with ASI and incident CVD events, supporting the potential of this novel biomarker in identifying in iduals at high risk of future CVD events.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 28-06-2022
DOI: 10.1167/IOVS.63.6.29
Publisher: Frontiers Media SA
Date: 09-2022
DOI: 10.3389/FNAGI.2022.880576
Abstract: Considered as the representatives of neurodegenerative diseases, Alzheimer’s disease (AD) and glaucoma are complex progressive neuropathies affected by both genetic and environmental risk factors and cause irreversible damages. Current research indicates that there are common features between AD and glaucoma in terms of epidemiology and pathophysiology. However, the understandings and explanations of their comorbidity and potential genetic overlaps are still limited and insufficient. Genetic pleiotropy analysis was performed using large genome-wide association studies summary statistics of AD and glaucoma, with an independent cohort of glaucoma for replication. Conditional and conjunctional false discovery rate methods were applied to identify the shared loci. Biological function and network analysis, as well as the expression level analysis were performed to investigate the significance of the shared genes. A significant positive genetic correlation between AD and glaucoma was identified, indicating that there were significant polygenetic overlaps. Forty-nine shared loci were identified and mapped to 11 shared protein-coding genes. Functional genomic analyses of the shared genes indicate their modulation of critical physiological processes in human cells, including those occurring in the mitochondria, nucleus, and cellular membranes. Most of the shared genes indicated a potential modulation of metabolic processes in human cells and tissues. Furthermore, human protein–protein interaction network analyses revealed that some of the shared genes, especially MTCH2 , NDUFS3 , and PTPMT1 , as well as SPI1 and MYBPC3 , may function concordantly. The modulation of their expressions may be related to metabolic dysfunction and pathogenic processes. Our study identified a shared genetic architecture between AD and glaucoma, which may explain their shared features in epidemiology and pathophysiology. The potential involvement of these shared genes in molecular and cellular processes reflects the “inter-organ crosstalk” between AD and glaucoma. These results may serve as a genetic basis for the development of innovative and effective therapeutics for AD, glaucoma, and other neurodegenerative diseases.
Publisher: BMJ
Date: 14-10-2022
Abstract: To investigate the association between hyperopia and clinically significant depression (CSD) in middle-aged and older in iduals. The effect of genetic determinants of hyperopia on incident CSD was also explored. We included participants who had available data on mean spherical equivalent (MSE) and were free of depression at baseline from the UK Biobank. For the phenotypic association, hyperopia was defined as MSE of+2.00 dioptres (D) or greater, and was ided into mild, moderate and high groups. Diagnosis of CSD across follow-up was determined based on electronic hospital inpatients records. For the genetic association analysis, the association between hyperopia Polygenic Risk Score and incident CSD was assessed. Mendelian randomisation was assessed for causality association. Over a median follow-up of 11.11 years (IQR: 10.92–11.38), hyperopia was significantly associated with incident CSD independent of genetic risk (HR 1.29, 95% CI 1.05 to 1.59) compared with emmetropia participants, especially in those hyperopic patients without optical correction (HR 1.38, 95% CI 1.07 to 1.76). In addition, participants in the high degree of hyperopia were more likely to have incident CSD than participants in the mild degree of hyperopia (P for trend=0.009). Genetic analyses did not show any significant associations between hyperopia and incident CSD (p≥0.1). Hyperopia was significantly associated with an increased risk of incident CSD. This was independent of genetic predisposition to hyperopia, emphasising the importance of regular vision screening and correction of hyperopia to reduce the risk of CSD regardless of genetic risk.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2023
Publisher: BMJ
Date: 09-2020
DOI: 10.1136/BMJOPEN-2019-032745
Abstract: To determine the association between cataract surgery and age-related macular degeneration (AMD) in a representative US s le. Population-based, cross-sectional study. The US National Health and Nutrition Examination Survey 2005–2008. A total of 5401 participants aged ≥40 years had information in cataract surgery status and gradable retinal photographs for right eyes. Cataract surgery status was obtained from questionnaire. Non-mydriatic fundus photographs were collected and AMD status was assessed. The associations between AMD and cataract surgery were evaluated in right eyes using logistic regression models. Of 338 right eyes with any AMD, 107 right eyes (28.9%) had cataract surgery. After adjusting for multiple variables, there were significant associations between cataract surgery and any AMD (OR 1.36 95% CI 1.03 to 1.81) or late AMD (OR 2.48 95% CI 1.01 to 6.09). No significant association was found between cataract surgery and early AMD after adjusting for multiple covariates (OR 1.20 95% CI 0.91 to 1.59). Our results suggest that cataract surgery is associated with the presence of AMD, particularly for late AMD. Longitudinal studies investigating the risk and progression of AMD after cataract surgery are needed in the era of phacoemulsification.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 22-03-2023
DOI: 10.1167/TVST.12.3.22
Publisher: JMIR Publications Inc.
Date: 25-09-2020
Abstract: he COVID-19 pandemic has led to worldwide school closures, with millions of children confined to online learning at home. As a result, children may be susceptible to anxiety and digital eye strain, highlighting a need for population interventions. he objective of our study was to investigate whether a digital behavior change intervention aimed at promoting physical activity could reduce children’s anxiety and digital eye strain while undergoing prolonged homeschooling during the COVID-19 pandemic. n this cluster randomized controlled trial, homeschooled grade 7 students at 12 middle schools in southern China were recruited through local schools and randomly assigned by the school to receive (1:1 allocation): (1) health education information promoting exercise and ocular relaxation, and access to a digital behavior change intervention, with live streaming and peer sharing of promoted activities (intervention), or (2) health education information only (control). The primary outcome was change in self-reported anxiety score. Secondary outcomes included change in self-reported eye strain and sleep quality. n March 16, 2020, 1009 children were evaluated, and 954 (94.5%) eligible children of consenting families were included in the intention-to-treat analysis. Children in the intervention (n=485, 6 schools) and control (n=469, 6 schools) groups were aged 13.5 (SD 0.5) years, and 52.3% (n=499) were male. The assigned interventions were completed by 896 children (intervention: n=467, 96.3% control: n=429, 91.5%). The 2-week change in square-root–transformed self-reported anxiety scores was greater in the intervention (–0.23, 95% CI –0.27 to –0.20) vs control group (0.12, 95% CI 0.09-0.16 unadjusted difference –0.36, 95% CI –0.63 to –0.08 i P /i =.02). There was a significant reduction in square-root–transformed eye strain in the intervention group (–0.08, 95% CI –0.10 to 0.06) compared to controls (0.07, 95% CI 0.05-0.09 difference –0.15, 95% CI –0.26 to –0.03 i P /i =.02). Change in sleep quality was similar between the two groups. his digital behavior change intervention reduced children’s anxiety and eye strain during COVID-19–associated online schooling. linicalTrials.gov NCT04309097 t2/show/NCT04309097
Publisher: Cold Spring Harbor Laboratory
Date: 26-09-2022
DOI: 10.1101/2022.09.26.22280334
Abstract: The retina is considered a unique window to systemic health, but their biological link remains unknown. A total of 93,838 UK Biobank participants with metabolomics data were included in the study. Plasma metabolites associated with GCIPLT were identified in 7,824 participants who also underwent retinal optical coherence tomography prospective associations of GCIPLT-associated metabolites with 12-year risk of mortality and major age-related diseases were assessed in 86,014 participants. The primary outcomes included all- and specific-cause mortality. The secondary outcomes included incident type 2 diabetes mellitus (T2DM), obstructive sleep apnea/hypopnea syndrome (OSAHS), myocardial infarction (MI), heart failure, ischemic stroke, and dementia. C-statistics and net reclassification indexes (NRIs) were calculated to evaluate the added predictive value of GCIPLT metabolites. Calibration was assessed using calibration plots. Sixteen metabolomic signatures were associated with GCIPLT (P 0.009 [Bonferroni-corrected threshold]), and most were associated with the future risk of mortality and age-related diseases. The constructed meta-GCIPLT scores distinguished well between patients with high and low risks of mortality and morbidity, showing predictive values higher than or comparable to those of traditional risk factors (C-statistics: 0.780[0.771-0.788], T2DM 0.725[0.707-0.743], OSAHS 0.711[0.695-0.726], MI 0.685[0.662-0.707], cardiovascular mortality 0.657[0.640-0.674], heart failure 0.638[0.636-0.660], other mortality 0.630[0.618-0.642], all-cause mortality 0.620[0.598-0.643], dementia 0.614[0.593-0.634], stroke and 0.601[0.585-0.617], cancer mortality). The NRIs confirmed the inclusion of GCIPLT metabolomic signatures to the models based on traditional risk factors resulted in significant improvements in model performance (5.18%, T2DM [P=3.86E-11] 4.43%, dementia [P=0.003] 4.20%, cardiovascular mortality [P=6.04E-04] 3.73%, MI [P=1.72E-07] 2.93%, OSAHS [P=3.13E-05] 2.39%, all-cause mortality [P=3.89E-05] 2.33%, stroke [P=0.049] 2.09%, cancer mortality [P=0.039] and 1.59%, heart failure [P=2.72E-083.07E-04]). Calibration plots showed excellent calibration between predicted risk and actual incidence in the new models. GCIPLT-associated plasma metabolites captured the residual risk for mortality and major systemic diseases not quantified by traditional risk factors in the general population. Incorporating GCIPLT metabolomic signatures into prediction models may assist in screening for future risks of these health outcomes. National Natural Science Foundation (China). Recent studies have recognized that retinal measurements can indicate an accelerated risk of aging and multiple systemic diseases preceding clinical symptoms and signs. Despite these insights, it remains unknown how retinal alterations are biologically linked to systemic health. Using the UK Biobank, we identified ganglion cell–inner plexiform layer thickness (GCIPLT) metabolomic signatures, and revealed their association with the risk of all- and specific-cause mortality and six age related diseases: type 2 diabetes, dementia, stroke, myocardial infarction, heart failure, and obstructive sleep apnea/hypopnea syndrome. The meta-GCIPLT score significantly improved the discriminative power of the predictive models for theses health outcomes based on conventional risk factors. GCIPLT-associated plasma metabolites have the potential to capture the residual risk of systemic diseases and mortality not quantified by traditional risk factors. Incorporating GCIPLT metabolomic signatures into prediction models may assist in screening for future risks of these health outcomes. Since metabolism is a modifiable risk factor that can be treated medically, the future holds promise for the development of new strategies that reverse or interrupt the onset of these diseases by modifying metabolic factors.
Publisher: Cold Spring Harbor Laboratory
Date: 11-01-2021
DOI: 10.1101/2021.01.08.21249188
Abstract: The association between visual impairment (VI) and the risk of dementia has been poorly understood. We sought to investigate the VI-dementia relationship in the UK Biobank Study. A total of 117,187 volunteers (aged 40-69 years) deemed free of dementia at baseline were included. Habitual distance visual acuity worse than 0.3 logMAR units in the better-seeing eye was used to define VI. The incident dementia was based on electronically linked hospital inpatient and death records. During a median follow up of 5.96 years, the presence of VI was significantly associated with incident dementia (HR=1.78, 95% CI: 1.18-2.68, P=0.006). There was a clear trend between the severity of VI and the risk of dementia (P for trend=0.002). Visually impaired in iduals were more likely to develop incident dementia, with a progressively greater risk among those with worse visual acuity. Our findings highlight the value of regular vision screening and elimination of VI. The association between VI and dementia has been poorly understood VI is associated with incident dementia in non-demented adults There is a clear trend between the severity of VI and the risk of dementia VI may be a marker of increased dementia risk. We searched and reviewed the literature using traditional sources (e.g., PubMed and GoogleScholar). While the association between VI and cognitive function/decline are increasingly studies, investigation of the association between VI and the risk of dementia has been largely overlooked. We found that visually impaired in iduals were more likely to develop incident dementia, with a progressively greater risk among those with worse visual acuity. Our findings imply that VI may be an important marker of dementia. These findings call for more studies to investigate (a) the role of visual acuity changes on the risk of dementia (b) the relationship between other components of visual function and incident dementia (c) the relationship between eye diseases and incident dementia and (d) the potential benefits of vision rehabilitation on dementia prevention.
Publisher: American Medical Association (AMA)
Date: 03-2019
Publisher: Wiley
Date: 27-09-2019
DOI: 10.1111/AOS.14258
Abstract: To explore the association between age-related cataract and 10-year mortality in an adult population in urban China. A total of 1405 participants aged 50 years or older were examined at baseline in the Guangzhou Liwan Eye Study. All participants were invited to attend a 10-year follow-up visit. Cataract cases were defined as either having visible lens opacity confirmed with direct ophthalmoscope under pupil dilation or previous history of cataract surgery. Visual impairment (VI) was defined as a visual acuity of 20/40 or worse in the better-seeing eye with habitual correction if worn. Body mass index (BMI) was based on anthropometric data. A brief questionnaire regarding family income, educational attainment and medical history of systemic disease was administered. Mortality rates were compared using the log-rank test and Cox proportional hazards regression models. Among 1405 participants examined at baseline, 957 participants (68.1%) had visible lens opacity or history of cataract surgery. After 10 years, 320 (22.8%) participants died. The 10-year mortality rate was significantly higher in participants with cataract than in those without (30.1% versus 7.14%, log-rank p < 0.05). After adjusting for age, gender, family income, educational attainment, BMI, history of diabetes and hypertension and presence of VI, presence of cataract predicted a nearly threefold increase in the risk of mortality (HR, 2.99 95% CI, 1.89-4.71). Our findings that age-related cataract is a predictor for poorer survival compared to those without may imply that cataract is a biomarker of ageing and frailty.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.IJCARD.2019.11.131
Abstract: To evaluate impacts of cognitive impairment and systemic vascular comorbidities on hazards of all-cause and cardiovascular mortality in a representative United States population. Subjects aged ≥60 years from two waves of National Health and Nutrition Examination Survey were analyzed. Cognitive function was evaluated by Digit Symbol Substitution Test. Systemic vascular comorbidities included diabetes mellitus (DM), chronic kidney disease (CKD), high blood pressure (HBP) and hypotension. Hazards of all-cause and cardiovascular mortality were estimated with Cox proportional hazard regression models. After a median follow-up of 9.83 years, 937 (35.6%) and 247 (8.6%) deaths caused by all causes and cardiovascular diseases, respectively. After adjusting for confounders, cognitive impairment predicted a higher risk of all-cause mortality (Hazard Ratios (HR), 2.00 95% confidence interval (CI), 1.62-2.46) and cardiovascular mortality (HR, 1.79 95% CI, 1.27-2.53). Risk of all-cause mortality was further increased among those with cognitive impairment concomitant with DM (HR, 2.24 95% CI, 1.61-3.13), CKD (HR, 2.56 95% CI, 1.77-3.67), HBP (HR, 2.57 95% CI, 1.73-3.84) or hypotension (HR, 2.38 95% CI, 1.78-3.18). Co-presence of cognitive impairment with DM (HR, 2.30 95% CI, 1.25-4.26), CKD (HR, 2.56 95% CI, 1.35-4.88), HBP (HR, 4.65 95% CI, 2.28-9.46) or hypotension (HR, 2.69 95% CI, 1.67-4.31) also posed a significant higher risk of cardiovascular mortality than participants with neither condition. Cognitive impairment concomitant with other systemic vascular comorbidities predicted further increased risks of mortality. More extensive assessments and management of cognitive function and systemic vascular comorbidities are warranted.
Publisher: Wiley
Date: 02-08-2019
DOI: 10.1111/CEO.13595
Abstract: Recent US national population-based data on the prevalence of retinopathy in non-diabetic participants is limited. To assess the prevalence and risk factors of retinopathy in a representative US population without diabetes. Population-based, cross-sectional study. A total of 4354 non-diabetic participants 40 years and older with valid fundus photographs in the 2005 to 2008 National Health and Nutrition Examination Survey. Diabetes mellitus was defined as glycosylated haemoglobin (HbA1c) ≥6.5%, physician diagnosis of diabetes mellitus or use of diabetic medication. Retinopathy level was based on the Modified Airlie House adaptation from the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Risk profile was assessed from standardized interviews, clinical examinations and laboratory measurements. Prevalence and risk profile of retinopathy in non-diabetic participants. The overall weighted prevalence of retinopathy was 6.7% (n = 341). Among them, 98.2% (n = 331) had signs of minimal-to-mild non-proliferative retinopathy (ETDRS level 14-31) while only 1.8% (n = 10) had moderate-to-severe non-proliferative retinopathy (ETDRS level 41-51). After adjusting for multiple covariates, retinopathy signs in non-diabetic participants were associated with male gender (odds ratio [OR] 1.54 95% confidence interval [CI] 1.22-1.93), systolic blood pressure (OR per 10 mmHg increase 1.11 95% CI 1.03-1.19), HbA1c (OR per % increase 1.43 95% CI 1.01-2.05) and history of stroke (OR 2.39 95% CI 1.14-5.04). Consistent with previous studies, signs of retinopathy are common in US persons without diabetes. Risk factors for retinopathy signs include gender, blood pressure, HbA1c and history of stroke.
Publisher: BMJ
Date: 12-2020
DOI: 10.1136/BMJOPEN-2019-035805
Abstract: To explore the association between age-related macular degeneration (AMD) and arthritis in a representative s le of the US population. Population-based, cross-sectional study. The National Health and Nutrition Examination Survey (NHANES) 2005–2008. A total of 4813 participants aged 40 years and older with available information on AMD and arthritis in the 2005–2008 NHANES. The status and types of arthritis were obtained from questionnaires. Non-mydriatic fundus photographs were collected. The types of AMD were assessed using the modified Wisconsin Age-Related Maculopathy Grading Classification Scheme. The association between arthritis and AMD was evaluated using logistic regression models. After adjusting for covariates, participants with any or early AMD had significantly lower odds of having any type of arthritis (any AMD: OR=0.56, 95% CI: 0.36–0.86 early AMD: OR=0.55, 95% CI: 0.34–0.88) or osteoarthritis (OA) (any AMD: OR=0.43, 95% CI: 0.26–0.71 early AMD: OR=0.44, 95% CI: 0.25–0.76) compared with those without AMD. When considering AMD as the outcome, significant negative associations were also found between any arthritis or OA and any (any arthritis: OR=0.64, 95% CI: 0.43–0.94 OA: OR=0.52, 95% CI: 0.33–0.82) or early AMD (any arthritis: OR=0.61, 95% CI: 0.40–0.93 OA: OR=0.51, 95% CI: 0.31–0.86) in the multivariable logistic models. There was no significant association between different types of arthritis and late AMD. People with arthritis, especially those with OA, were less likely to have AMD compared with those without arthritis and vice versa. Further studies are needed to confirm this potential protective effect of arthritis and/or arthritis treatment on AMD and to explore the underlying mechanisms.
Publisher: BMJ
Date: 29-11-2021
DOI: 10.1136/BJOPHTHALMOL-2021-319306
Abstract: In 2018, a consortium of government bodies in China led by the Ministry of Education released the
Publisher: Elsevier BV
Date: 2023
DOI: 10.1016/J.AJO.2022.07.008
Abstract: To determine the predictive value of the microcirculation of the optic nerve head by swept-source optical coherence tomography angiography for identifying in iduals with high risk of diabetic retinopathy (DR) progression and diabetic macular edema (DME) development. Prospective observational cohort study. A total of 946 patients (1879 eyes) with type 2 diabetes mellitus were recruited who had no DR or mild nonproliferative DR at baseline, and no DME. All subjects underwent 3 × 3 mm swept-source optical coherence tomography angiography centered on the optic nerve head to generate angiograms in 4 layers: radial peripapillary plexus, superficial retinal capillary plexus (SCP), deep retinal capillary plexus, and choriocapillaris (CC). The CC flow deficit percentage (CC FD%), vessel density (VD), and perfusion density (PD) were quantified. During the 3 consecutive years of follow-up, 312 eyes (16.60%) experienced DR progression and 115 eyes (6.12%) developed DME. The DR progression was related to a lower VD of the SCP (relative risk per standard deviation decrease, 95% confidence interval): 1.30, 1.14-1.48 P < .001), a lower PD of the SCP (1.41, 1.24-1.60 P < .001), a lower VD of the radial peripapillary plexus (1.23, 1.08-1.40 P = .002), and an elevated CC FD% (1.62, 1.40-1.88 P < .001). The DME occurrence was associated with a lower VD of SCP (1.35, 1.09-1.66 P = .005), a lower PD of SCP (1.29, 1.05-1.59 P = .016), and a higher CC FD% (1.29, 1.03-1.61 P < .001). The CC FD% significantly improved the predictive power, with the increase of the C-statistic for DR progression and DME occurrence by 3.83% (P = .002) and 5.24% (P < .001), respectively. This study provides the first longitudinal evidence suggesting that peripapillary CC FD% can improve the prediction of DR progression and DME development beyond traditional risk factors.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 17-12-2019
DOI: 10.1167/19.14.17
Abstract: Visual span, which is the number of recognizable letters seen without moving the eyes, has been proven to impose a sensory limitation for alphabetic reading speed (Chung, 2011 Chung, Legge, & Cheung, 2004 Lee, Kwon, Legge, & Gefroh, 2010 Legge, Ahn, Klitz, & Luebker, 1997 Legge, Hooven, Klitz, Stephen Mansfield, & Tjan, 2002 D. Yu, Cheung, Legge, & Chung, 2010). However, little is known about the effects of visual span on Chinese reading performance. Of note, Chinese text differs greatly from that of the alphabetic writing system. There are no spaces between words, and readers are forced to utilize their lexical knowledge to segment Chinese characters into meaningful words, thus increasing the relative importance of cognitive/linguistic factors in reading performance. Therefore, the aim of the present study is to explore whether visual span and cognitive/linguistic factors have independent effects on Chinese reading speed. Visual span profiles, cognitive/linguistic factors indicated by word frequency, and Chinese sentence-reading performance were collected from 28 native Chinese-speaking subjects. We found that the visual-span size and cognitive/linguistic factors independently contributed to Chinese sentence-reading speed (all ps < 0.05). We concluded that both the visual-span size and cognitive/linguistic factors represented bottlenecks for Chinese sentence-reading speed.
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.AJO.2021.08.010
Abstract: To investigate the relationship between visual impairment (VI) and dementia in the UK Biobank Study. Prospective cohort study. A total of 117,187 volunteers (aged 40-69 years) deemed free of dementia at baseline were included. Habitual distance visual acuity worse than 0.3 logMAR units in the better-seeing eye was used to define VI. The incident dementia was based on electronically linked hospital inpatient and death records. During a median follow-up of 5.96 years, the presence of VI was significantly associated with incident dementia (hazard ratio: 1.78 95% confidence interval: 1.18-2.68 P = .006). There was a clear trend between the severity of VI and risk of dementia (P for trend = .002). We found VI was associated with increased risk of dementia, with a progressively greater risk among those with worse visual acuity. Our findings suggested that VI might be a modifiable risk factor for dementia and highlighted the potential value of VI elimination to delay the manifestation of dementia.
Publisher: Frontiers Media SA
Date: 18-11-2021
DOI: 10.3389/FENDO.2021.750017
Abstract: To assess the impact of retinopathy and systemic vascular comorbidities on the all-cause mortality in a representative U.S. s le. A total of 5703 participants (≥40 years old) from the 2005-2008 National Health and Nutrition Examination Survey. The Early Treatment Diabetic Retinopathy Study grading scale was used to evaluate the retinopathy status. Systemic vascular comorbidities included diabetes mellitus (DM), high blood pressure (HBP), chronic kidney disease (CKD) and cardiovascular disease (CVD). Time to death was calculated as the time from baseline to either the date of death or censoring (December 31 st , 2015), whichever came first. Risks of mortality were estimated using Cox proportional hazards models after adjusting for confounders and vascular comorbidities. After a median follow-up of 8.33 years (IQR: 7.50-9.67 years), there were 949 (11.8%) deaths from all causes. After adjusting for confounders, the presence of retinopathy predicted higher all-cause mortality (hazard ratio (HR), 1.41 95% confidence interval (CI), 1.08-1.83). The all-cause mortality among participants with both retinopathy and systemic vascular comorbidities including DM (HR, 1.72 95% CI, 1.21-2.43), HBP (HR, 1.47 95% CI, 1.03-2.10), CKD (HR, 1.73 95% CI, 1.26-2.39) and CVD (HR, 1.92 95% CI, 1.21-3.04) was significantly higher than that among those without either condition. When stratified by diabetic or hypertension status, the co-occurrence of retinopathy and CKD or CVD further increased the all-cause mortality compared to those without either condition. The co-occurrence of retinopathy and systemic vascular conditions predicted a further increase in the risk of mortality. More extensive vascular risk factor assessment and management are needed to detect the burden of vascular pathologies and improve long-term survival in in iduals with retinopathy.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Elsevier BV
Date: 02-2023
Publisher: BMJ
Date: 16-11-2022
Abstract: To investigate longitudinal choroid and ganglion cell–inner plexiform layer (GCIPL) changes in type 2 diabetes mellitus (T2DM) patients and healthy populations across 2 years. This prospective cohort study included T2DM patients and healthy controls. T2DM patients were ided into mild non-proliferative diabetic retinopathy (NPDR) or non-DR (NDR) groups. Macular choroidal and GCIPL thickness was measured using swept-source optical coherence tomography at baseline and follow-up after 2 years. A linear-mixed effect model compared rates of change in choroidal and GCIPL thicknesses between the three groups. 895 T2DM patients (770 in the NDR group and 125 in the NPDR group) and 847 healthy controls were included. Following 2 years, choroidal thinning occurred at a rate of −7.7±9.2 µm/year, −8.1±8.7 µm/year and −5.2±8.1 µm/year in NDR, NPDR and control groups, respectively (p .001). GCIPL loss occurred quickest in NPDR patients (−0.97±0.97 µm/year), followed by NDR (−0.91±0.89 µm/year) and the control group (−0.04±0.55 µm/year) (p .001). Following multivariate adjustment, choroidal thinning was −2.04 µm/year (95% CI: −4.05 to –0.03 p=0.047) and −1.95 µm/year (95% CI: −3.14 to –0.75 p=0.001) faster in NPDR and NDR groups than in the control group, respectively, and GCIPL thinning was −1.02 µm/year (95% CI: −1.19 to –0.84 p .001) and −0.88 µm/year (95% CI: −0.98 to –0.78 p .001) faster in the NPDR and NDR groups than in the control group, respectively. Progressive choroidal and GCIPL thinning occurs in healthy in iduals and T2DM patients however, T2DM undergoes accelerated choroidal and GCIPL loss in NPDR patients.
Publisher: BMJ
Date: 02-10-2018
DOI: 10.1136/BJOPHTHALMOL-2018-312262
Abstract: To assess the potential of ready-made (spherical) spectacles (RMS) in meeting the need for refractive correction in visually impaired children in China. Eligible children aged 5–17 years were identified from the three study sites in China. Distance visual acuity was measured with a retroilluminated logarithm of the minimum angle of resolution chart with tumbling E optotypes. Cycloplegic autorefraction was performed on all children using a handheld autorefractor. If uncorrected visual acuity (UCVA) was ≤20/40 in either eye, best corrected visual acuity was measured with subjective refractive error. A total of 13 702 children were enumerated from the three studies, with 12 334 (90.0%) having both reliable visual acuity measurements and successful cycloplegia. Among the 12 334 study children, the prevalence of UCVA ≤20/40 in the better seeing eye was 16.4% (95% CI 15.0% to 17.8%), with 91.1% (1843) of these improving by ≥3 lines of visual acuity with refractive correction. Prevalence was 12.7% (95% CI 11.5% to 13.9%) for UCVA 20/50 with 97.4% (1521) improving by ≥3 lines, and 9.38% (95% CI 8.39% to 19.4%) for UCVA ≤20/63 with 98.4% (1138) improving by ≥3 lines. Depending on the severity of visual impairment, 62.8%–64.0% of children could be accommodated with RMS if not correcting for astigmatism of ≤0.75 dioptres and anisometropia of ≤0.50 spherical equivalent dioptres. Approximately 87% of children could be accommodated with RMS if astigmatism and anisometropia limits were increased to ≤1.25 and ≤1.50 dioptres, respectively. RMS could substantially alleviate visual morbidity in two-thirds or more of visually impaired schoolchildren in China. This cost-effective approach to refractive correction might also be useful in low/middle-income countries with poor access to optometric services.
Publisher: Springer Science and Business Media LLC
Date: 30-11-2022
DOI: 10.1007/S00417-022-05901-5
Abstract: Due to pubertal development and crystalline lens compensation, axial length (AL) continues to increase among non-progressive myopic children (absolute annual spherical equivalent (SE) progression less than 0.25 diopter), but the amount is unknown. This study was to investigate the cutoff of AL change to accurately differentiate between progressive and non-progressive myopes. A total of 8,546 myopic and treatment-naive children aged 6–10 years were enrolled from two cohort studies. AL with optical biometer and cycloplegic SE with auto refraction were evaluated at baseline and annually. Annual AL change was calculated, and the percentiles of annual axial elongation among progressive and non-progressive myopes were estimated by quantile regression with restricted cubic spline. Area under receiver-operating characteristic (ROC) curve (AUROC), positive predictive value (PPV), and negative predictive value (NPV) were applied to evaluate the accuracy of predicting progressive and non-progressive myopes. Among 8,546 myopic children, 603 (7.06%) were non-progressive myopes. Annual AL changes among non-progressive myopes remained stable with the median annual change being 0.25 mm, while the median for progressive myopes decreased with age from 0.58 to 0.42 mm. AUROC for distinguishing between non-progressive and progressive myopes was 0.88 and was 0.85 for each age group. Annual AL change, the cutoff of 0.20 mm/year, had significantly high PPV and NPV in predicting progressive myopes with high proportion of progressive myopes and non-progressive myopes with low proportions of progressive myopes. Myopic children with non-progressive status had markedly less axial elongation than progressive ones. AL changes with cutoff of 0.20 mm/year could differentiate between non-progressive and progressive status and may be an alternative for evaluating progressive status.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 28-05-2019
Abstract: Evidence has indicated that the size of the visual span (the number of identifiable letters without movement of the eyes) and reading speed can be boosted through perceptual learning in alphabetic scripts. In this study, we investigated whether benefits of perceptual learning could be extended to visual-span size and sentence reading (all characters are presented at the same time) for Chinese characters and explored changes in sensory factors contributing to changes in visual-span size following training. We randomly assigned 26 normally sighted subjects to either a control group (n = 13) or a training group (n = 13). Pre- and posttests were administered to evaluate visual-span profiles (VSPs) and reading speed. Training consisted of trigram (sequences of three characters) character-recognition trials over 4 consecutive days. VSPs are plots of recognition accuracy as a function of character position. Visual-span size was quantified as the area under VSPs in bits of information transmitted. A decomposition analysis of VSPs was used to quantify the effects of sensory factors (crowding and mislocation). We compared the size and sensory factors of visual span and reading speed following training. Following training, the visual-span size significantly increased by 11.7 bits, and reading speed increased by 50.8%. The decomposition analysis showed a significant reduction for crowding (-13.1 bits) but a minor increase in the magnitude of mislocation errors (1.46 bits) following training. These results suggest that perceptual learning expands the visual-span size and further improves Chinese text sentence-reading speed, indicating that visual span may be a common sensory limitation on reading that can be overcome with practice.
Publisher: MDPI AG
Date: 27-02-2015
DOI: 10.3390/NU15051196
Abstract: Coffee and tea drinking are thought to be protective for the development and progression of neurodegenerative disorders. This study aims to investigate associations between coffee and tea consumption with macular retinal nerve fiber layer (mRNFL) thickness, a marker of neurodegeneration. After quality control and eligibility screening, 35,557 out of 67,321 United Kingdom (UK) Biobank participants from six assessment centers were included in this cross-sectional study. In the touchscreen questionnaire, participants were asked how many cups of coffee and tea were consumed daily on average over the last year. Self-reported coffee and tea consumption were ided into four categories including 0 cup/day, 0.5–1 cups/day, 2–3 cups/day, and ≥4 cups/day, respectively. The mRNFL thickness was measured by the optical coherence tomography (Topcon 3D OCT-1000 Mark II) and automatically analyzed by segmentation algorithms. After adjusting for covariates, coffee consumption was significantly associated with an increased mRNFL thickness (β = 0.13, 95% CI = 0.01~0.25), which was more prominent in those who drank 2~3 cups coffee per day (β = 0.16, 95% CI = 0.03~0.30). The mRNFL thickness was also significantly increased in tea drinkers (β = 0.13, 95% CI = 0.01~0.26), especially for those who drank more than 4 cups of tea per day (β = 0.15, 95% CI = 0.01~0.29). The positive associations with mRNFL thickness, indicating that both coffee and tea consumptions had likely neuroprotective potentials. Causal links and underlying mechanisms for these associations should be explored further.
Publisher: Springer Science and Business Media LLC
Date: 27-05-2022
DOI: 10.1186/S12916-022-02384-3
Abstract: Little is known regarding life-course trajectories of important diseases. We aimed to identify diseases that were strongly associated with mortality and test temporal trajectories of these diseases before mortality. Our analysis was based on UK Biobank. Diseases were identified using questionnaires, nurses’ interviews, or inpatient data. Mortality register data were used to identify mortality up to January 2021. The association between 60 in idual diseases at baseline and in the life course and incident mortality was examined using Cox proportional regression models. Those diseases with great contribution to mortality were identified and disease trajectories in life course were then derived. During a median follow-up of 11.8 years, 31,373 in iduals (median age at death (interquartile range): 70.7 (65.3–74.8) years, 59.4% male) died of all-cause mortality (with complete data on diagnosis date of disease), with 16,237 dying with cancer and 6702 with cardiovascular disease (CVD). We identified 37 diseases including cancers and heart diseases that were associated with an increased risk of mortality independent of other diseases (hazard ratio ranged from 1.09 to 7.77). Among those who died during follow-up, 2.2% did not have a diagnosis of any disease of interest and 90.1% were diagnosed with two or more diseases in their life course. In iduals who were diagnosed with more diseases in their life course were more likely to have longer longevity. Cancer was more likely to be diagnosed following hypertension, hypercholesterolemia, CVD, or digestive disorders and more likely to be diagnosed ahead of CVD, chronic kidney disease (CKD), or digestive disorders. CVD was more likely to be diagnosed following hypertension, hypercholesterolemia, or digestive disorders and more likely to be diagnosed ahead of cancer or CKD. Hypertension was more likely to precede other diseases, and CKD was more likely to be diagnosed as the last disease before more mortality. There are significant interplays between cancer and CVD for mortality. Cancer and CVD were frequently clustered with hypertension, CKD, and digestive disorders with CKD highly being diagnosed as the last disease in the life course. Our findings underline the importance of health checks among middle-aged adults for the prevention of premature mortality.
Publisher: Elsevier BV
Date: 02-2023
DOI: 10.1016/J.AJO.2022.07.011
Abstract: To evaluate the longitudinal changes of retinal neurodegeneration and choroidal thickness in diabetic patients with and without diabetic retinopathy (DR). Prospective observational cohort study. This prospective observational cohort study recruited type 2 diabetic patients from a community registry in Guangzhou. All participants underwent annual ocular examinations via swept-source optical coherence tomography that obtained choroid thickness (CT), retinal thickness (RT), and ganglion cell-inner plexiform layer (GC-IPL) thickness. The changes in GC-IPL, CT, and RT between patients who developed incident DR (IDR) or remained non-DR (NDR) were compared during a 3-year follow-up. Among 924 patients, 159 (17.2%) patients developed IDR within the 3-year follow-up. A reduction in GC-IPL, RT, and CT was observed in NDR and IDR however, CT thinning in patients with IDR was significantly accelerated, with an average CT reduction of -6.98 (95% CI: -8.26, -5.71) μm/y in patients with IDR and -3.98 (95% CI: -4.60, -3.36) μm/y in NDR patients (P < .001). Reductions in average GC-IPL thickness over 3 years were -0.97 (95% CI: -1.24, -0.70) μm/y in patients with IDR and -0.76 (95% CI: -0.82, -0.70) μm/y in NDR patients (P = .025). After adjusting for confounding factors, the average CT and GC-IPL thinning were significantly faster in patients with IDR compared with those who remained NDR by 2.09 μm/y (95% CI: 1.01, 3.16 P = .004) and -0.29 μm/y (95% CI: -0.49, -0.09 P = .004), respectively. The RT in the IDR group increased, whereas the RT in the NDR group decreased over time, with the adjusted difference of 2.09 μm/y (95% CI: 1.01, 3.16 P < .001) for central field RT. The rate of retinal neurodegeneration and CT thinning were significantly different between the eyes that developed IDR and remained NDR during the 3-year follow-up, but both groups observed thickness reduction. This indicates that GC-IPL and CTs may decrease before the clinical manifestations of DR.
Publisher: Elsevier BV
Date: 04-2023
DOI: 10.1016/J.AJO.2022.11.018
Abstract: To investigate the relationship between choriocapillaris flow deficit percentage (CC FD%) by swept-source optical coherence tomography angiography (SS-OCTA) and 3-year risk of diabetic retinopathy (DR) progression and diabetic macular edema (DME) development. Prospective, observational cohort study. A total of 903 participants with type 2 diabetes mellitus (T2DM) without DR or with mild non-proliferative DR (NPDR) free of DME at baseline were followed up annually for 3 years. All participants underwent standard 7-field fundus photography and spectral-domain OCT. SS-OCTA was used for retinal and choriocapillaris imaging and 3 × 3 mm Over 3 years, 295 of 1805 eyes (16.34%) developed DR progression, and 118 eyes (6.54%) developed DME. A higher average CC FD% was correlated with DR progression (odds ratio [OR], 3.41 per SD increase, 95% confidence interval [CI]: 2.65-4.39, P<0.001) and DME development (OR, 1.37 per SD increase, 95% CI: 1.06-1.77, P=0.016) after adjusting for confounders. In the ETDRS regions, increased CC FD% in all fields was associated with DR progression however, increased CC FD% in the inferior field was associated with DME development. Compared with the models based on established risk factors, the addition of average CC FD% significantly improved the C-statistics for DR progression (0.712 to 0.777, P 0) indicated that the addition of CC FD% led to a significant improvement in the discriminative performance for endpoints. CC FD% is independently associated with DR progression and DME development in the Chinese T2DM population and provides incremental predictive value beyond traditional risk factors and retinal microvascular parameters. Further inclusion of CC FD% in DR prediction models helps guide population-based screening and personalized management.
Publisher: Springer Science and Business Media LLC
Date: 25-07-2023
DOI: 10.1038/S41366-023-01345-X
Abstract: Conflicting evidence exists on the association between ageing and obesity. Retinal age derived from fundus images has been validated as a novel biomarker of ageing. In this study, we aim to investigate the association between different anthropometric phenotypes based on body mass index (BMI) and waist circumference (WC) and the retinal age gap (retinal age minus chronological age). A total of 35,550 participants with BMI, WC and qualified retinal imaging data available were included to investigate the association between anthropometric groups and retinal ageing. Participants were stratified into 7 different body composition groups based on BMI and WC (Normal-weight/Normal WC, Overweight/Normal WC, Mild obesity/Normal WC, Normal-weight/High WC, Overweight/High WC, Mild obesity/High WC, and Severe obesity/High WC). Linear regression and logistic regression models were fitted to investigate the association between the seven anthropometric groups and retinal age gap as continuous and categorical outcomes, respectively. A total of 35,550 participants (55.6% females) with a mean age 56.8 ± 8.04 years were included in the study. In iduals in the Overweight/High WC, Mild obesity/High WC and Severe obesity/High WC groups were associated with an increase in the retinal age gap, compared with those in the Normal Weight/Normal WC group (β = 0.264, 95% CI: 0.105–0.424, P =0.001 β = 0.226, 95% CI: 0.082–0.371, P = 0.002 β = 0.273, 95% CI: 0.081–0.465, P = 0.005 respectively) in fully adjusted models. Similar findings were noted in the association between the anthropometric groups and retinal ageing process as a categorical outcome. A significant positive association exists between central obesity and accelerated ageing indexed by retinal age gaps, highlighting the significance of maintaining a healthy body shape.
Publisher: Wiley
Date: 05-09-2022
DOI: 10.1111/OPO.13043
Abstract: To conduct a systemic review and meta‐analysis on the normative range of ocular biometry in healthy children under seven years of age. A literature search was performed using the PubMed (MEDLINE) database. The main outcomes were normative values of axial length (AL), central corneal thickness (CCT), cornea curvature (CC), anterior chamber depth (ACD), lens thickness (LT) and vitreous chamber depth (VCD). Pooled estimates were obtained with a random‐effects meta‐analysis. Multivariate meta‐regressions ascertained the moderator‐related trends. We included 47 studies for a total of 33,559 subjects. The pooled ALs for 0.0–1.9 years, 2.0–3.9 years and 4.0–6.9 years were 18.33 mm (95% confidence interval [CI] 17.57–19.09), 21.71 mm (21.49–21.93) and 22.37 mm (22.29–22.45), respectively. Children aged 0.0–1.9 years had a greater CCT (576.70 μm, 567.20–586.21), steeper cornea (7.41 mm, 7.16–7.65) and shallower ACD (2.46 mm, 2.23–2.69). LT ranged from 3.65 to 3.74 mm for 0–6 years, and VCD increased from 11.94 mm at birth to 15.36 mm at 4.0–6.9 years. Differences in AL between East Asian and non‐East Asian children were found below two years of age (17.30 mm vs. 18.40 mm, p = 0.008) and for CC at 4.0–6.9 years of age (7.82 mm vs. 7.79 mm, p = 0.004). In a multivariate meta‐regression, AL, CC, ACD and VCD increased with age ( p 0.05 for all), while CCT decreased with age ( p = 0.0007). This study reports normative data for ocular biometry in children. Few differences were found with ethnicity in the ocular biometry of infants and pre‐schoolers.
Publisher: BMJ
Date: 25-10-2021
DOI: 10.1136/BJOPHTHALMOL-2021-319678
Abstract: To investigate the association of self-reported cataract surgery with all-cause and cause-specific mortality using a large-scale population-based s le. Data from the 1999–2008 cycles of the National Health and Nutrition Examination Survey were used. A self-reported history of cataract surgery was considered a surrogate for the presence of clinically significant cataract surgery. Mortality data were ascertained from National Death Index records. Hazard ratios (HRs) and 95% confidence intervals (CIs) for survival were estimated using Cox proportional hazards regression models. A total of 14 918 participants were included in the analysis. During a median follow-up of 10.8 (Interquartile range, IQR, 8.25–13.7) years, 3966 (19.1%) participants died. Participants with self-reported cataract surgery were more likely to die from all causes and specific causes (vascular disease, cancer, accident, Alzheimer’s disease, respiratory disease, renal disease and others) compared with those without (all Ps .05). The association between self-reported cataract surgery and all-cause mortality remained significant after multiple adjustments (HR=1.13 95% CI 1.01 to 1.26). For cause-specific mortality, multivariable Cox models showed that self-reported cataract surgery predicted a 36% higher risk of vascular-related mortality (HR=1.36 95% CI 1.01 to 1.82). The association with other specific causes of mortality did not reach statistical significance after multiple adjustments. This study found significant associations of self-reported cataract surgery with all-cause and vascular mortalities. Our findings provide potential insights into the pathogenic pathways underlying cataract.
Publisher: Wiley
Date: 16-05-2019
DOI: 10.1111/CEO.13524
Abstract: The rate and determinants of persistence to topical glaucoma medications are important for identifying patients at high risk of discontinuing medications and designing targeted approaches to improve persistence. To evaluate the rate and determinants of persistence to topical glaucoma medications among middle-aged and older Australian adults. Population-based cohort study. Participants in need of persistent topical glaucoma medications in the 45 and Up Study. The 45 and Up Study is a large-scale population-based cohort study. Participants were classified as needing persistent topical glaucoma medications if at least three claims with related prescriptions were recorded. Persistence was defined as topical glaucoma medications were filled within 90 days. The rates and determinants of medication persistence at 2-year follow-up. A total of 12 899 patients requiring persistent topical glaucoma medications were identified. Among them, 9019 (69.9%) had persisted with their glaucoma medications for at least 2 years. Multiple logistic regression analysis documented significant effects of patient-related factors (gender, socioeconomic status, language spoken at home, lifestyle and comorbidities) and drug-related factors (total number and drug class) on the persistence rate. Those most at risk groups of non-persistence were those patients living in remote areas (odds ratio, OR: 0.59, 95% confidence interval, CI: 0.37-0.92), having family income over 70 000 AUD/year (OR: 0.53, 95% CI: 0.45-0.62), speaking other languages at home (OR: 0.61, 95% CI: 0.53-0.68), and using cholinergic classes of medications (OR: 0.55, 95% CI: 0.38-0.79). Our data has shown a medium level of persistence to topical glaucoma medication among middle-aged and older Australian adults. However, efforts are still needed to improve the rate of persistence.
Publisher: Elsevier BV
Date: 05-2020
DOI: 10.1016/J.AJO.2020.01.002
Abstract: To investigate the prevalence and associations of visual impairment (VI) and major eye diseases with chronic kidney disease (CKD) in the United States. Cross-sectional study. We investigated the prevalence and associations of VI and major eye diseases with CKD among 5,518 participants aged 40 years or older in the 2005-2008 National Health and Nutrition Examination Survey. An estimated glomerular filtration rate of lower than 60 mL/min/1.73 m The prevalence of VI and major eye diseases were approximately 2- to 7-fold higher in participants with CKD than in those without (all P < .05). After controlling for multiple confounders, the presence of CKD was associated with VI (odds ratio [OR]: 2.01, 95% confidence interval [CI]: 1.14-3.54), any ocular disease (OR: 1.65, 95% CI: 1.22-2.22), any objectively determined ocular disease (OR: 1.52, 95% CI: 1.06-2.19), any retinopathy (OR: 1.70, 95% CI: 1.18-2.45), and DR (OR: 2.34, 95% CI: 1.23-4.42). There was no association of CKD with cataract surgery, AMD, or glaucoma. A significant association between CKD and any ocular disease was observed among nondiabetic participants. The presence of CKD was closely related to VI and any retinopathy among diabetic participants. This nationally representative s le of the US population demonstrated high prevalence and strong associations of VI and major eye diseases with CKD, highlighting the importance of ocular screening among CKD patients and potential common pathogenesis underlying these conditions.
Publisher: International Society of Global Health
Date: 24-03-2023
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 13-02-2017
Abstract: To evaluate the features of extrafoveal retinoschisis (EFRS) in highly myopic eyes detected by swept-source optical coherence tomography (SS-OCT). In this retrospective case series, 89 eyes of 65 patients with high myopia and coexisting EFRS were included. The participants underwent a comprehensive ophthalmologic examination, including visual acuity, ocular biometry, refraction, and perimetry. Three-dimensional wide-field scans were obtained with SS-OCT, and en face images were reconstructed with custom software. En face OCT features of EFRS were determined by two ophthalmologists masked to clinical characteristics. The associations of EFRS subtypes with ocular biometry and other OCT changes were evaluated as well. In wide-field SS-OCT scans, EFRS was classified into three different types, the inner limiting membrane (ILM) detachment and inner and outer EFRS, according to the specific layer of the splitting. All these three types were most frequently distributed in the inferotemporal quadrant (71.2% for ILM detachment, 59.5% for inner EFRS, and 75.0% for outer EFRS). Inner limiting membrane detachment and inner EFRS were often adjacent to peripapillary atrophy. Outer EFRS tends to coexist with inner EFRS, as we did not observe any case with standalone outer EFRS or with coexisting with ILM detachment. Eyes with all three types combined had the longest axial length (29.1 ± 1.26 mm, P = 0.003) and the greatest refractive error (-13.0 ± 2.86 diopters [D], P = 0.014). The incidence of retinal microfolds and breaks among subgroups was significantly different (P = 0.012 and 0.003, respectively). Staphyloma was associated with outer EFRS (30.6% with versus 7.6% without outer EFRS). Wide-field SS-OCT reveals the spatial distribution of retinoschisis outside the fovea, and associations with retinal vessels and other retinal landmark structures. Further observations on the longitudinal changes and functional damage would help lead to a better understanding of its mechanism and prognosis.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2022
DOI: 10.1161/STROKEAHA.122.038809
Abstract: Retinal parameters could reflect systemic vascular changes. With the advances of deep learning technology, we have recently developed an algorithm to predict retinal age based on fundus images, which could be a novel biomarker for aging and mortality. Therefore, we aim to investigate associations of retinal age gap with arterial stiffness index and incident cardiovascular disease (CVD). A deep learning model was trained based on 19 200 fundus images of 11 052 participants without any medical history at baseline to predict the retinal age. Retinal age gap (retinal age predicted minus chronological age) was generated for the remaining 35 917 participants. Regression models were used to assess the association between retinal age gap and arterial stiffness index. Cox proportional hazards regression models and restricted cubic splines were used to explore the association between retinal age gap and incident CVD. We found each 1-year increase in retinal age gap was associated with increased arterial stiffness index (β=0.002 [95% CI, 0.001–0.003] P .001). After a median follow-up of 5.83 years (interquartile range: 5.73–5.97), 675 (2.00%) developed CVD. In the fully adjusted model, each 1-year increase in retinal age gap was associated with a 3% increase in the risk of incident CVD (hazard ratio=1.03 [95% CI, 1.01–1.06] P =0.014). In the restricted cubic splines analysis, the risk of incident CVD increased significantly when retinal age gap reached 1.21 (hazard ratio=1.05 [95% CI, 1.00–1.10] P -overall .0001 P -nonlinear=0.0681). We found that retinal age gap was significantly associated with arterial stiffness index and incident CVD events, supporting the potential of this novel biomarker in identifying in iduals at high risk of future CVD events.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2021
DOI: 10.1161/HYPERTENSIONAHA.121.17608
Abstract: Little is known about whether the association of hypertension with brain volume and dementia is modified by an in idual’s age at their diagnosis of hypertension. Our analysis was based on the UK Biobank with baseline data collected between 2006 and 2010. Brain magnetic resonance imaging was used to measure brain volumes between 2014 and 2019. Dementia was ascertained using hospital inpatient, mortality, and self-reported data until 2021. We randomly selected a control participant for each hypertensive participant stratified by hypertension diagnosis age using propensity score. The cohort comprised 11 399 in iduals with hypertension and 11 399 controls for the brain volume analysis and 124 053 in iduals with hypertension and 124 053 controls for the dementia analysis. In iduals with hypertension diagnosed at ages (β (95% CI, −10.83 [−19.27 to −2.39] mL), 35 to 44 (−6.82 [−12.18 to −1.46] mL), and 45 to 54 years (−3.77 [−6.91 to −0.64] mL) had smaller total brain volume compared with the corresponding controls in the multivariable analysis. Similarly, hypertension diagnosed in early- and mid-life was independently associated with smaller volumes of gray matter, peripheral cortical gray matter, and white matter. Over a median follow-up of 11.9 years, 4626 cases of incident all-cause dementia were documented. In iduals with hypertension diagnosed at 35 to 44 years of age only (hazard ratio [95% CI]: 1.61 [1.31–1.99]) had a higher risk of all-cause dementia compared with the corresponding controls after adjustment for covariates. Hypertension diagnosed in young adulthood or mid-life, but not late life is associated with smaller brain volumes and an increased risk of dementia.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.OPHTHA.2022.06.024
Abstract: To evaluate the efficacy of time outdoors per school day over 2 years on myopia onset and shift. A prospective, cluster-randomized, examiner-masked, 3-arm trial. A total of 6295 students aged 6 to 9 years from 24 primary schools in Shanghai, China, stratified and randomized by school in a 1:1:1 ratio to control (n = 2037), test I (n = 2329), or test II (n = 1929) group. An additional 40 or 80 minutes of outdoor time was allocated to each school day for test I and II groups. Children in the control group continued their habitual outdoor time. Objective monitoring of outdoor and indoor time and light intensity each day was measured with a wrist-worn wearable during the second-year follow-up. The 2-year cumulative incidence of myopia (defined as cycloplegic spherical equivalent [SE] of ≤-0.5 diopters [D] in the right eye) among the students without myopia at baseline and changes in SE and axial length (AL) after 2 years. The unadjusted 2-year cumulative incidence of myopia was 24.9%, 20.6%, and 23.8% for control, test I, and II groups, respectively. The adjusted incidence decreased by 16% (incidence risk ratio [IRR], 0.84 95% confidence interval [CI], 0.72-0.99 P = 0.035) in test I and 11% (IRR = 0.89 95% CI, 0.79-0.99 P = 0.041) in test II when compared with the control group. The test groups showed less myopic shift and axial elongation compared with the control group (test I: -0.84 D and 0.55 mm, test II: -0.91 D and 0.57 mm, control: -1.04 D and 0.65 mm). There was no significant difference in the adjusted incidence of myopia and myopic shift between the 2 test groups. The test groups had similar outdoor time and light intensity (test I: 127 ± 30 minutes/day and 3557 ± 970 lux/minute test II: 127 ± 26 minutes/day and 3662 ± 803 lux/minute) but significantly more outdoor time and higher light intensity compared with the control group (106 ± 27 minutes/day and 2984 ± 806 lux/minute). Daily outdoor time of 120 to 150 minutes at 5000 lux/minutes or cumulative outdoor light intensity of 600 000 to 750 000 lux significantly reduced the IRR by 15%~ 24%. Increasing outdoor time reduced the risk of myopia onset and myopic shifts, especially in nonmyopic children. The protective effect of outdoor time was related to the duration of exposure and light intensity. The dose-response effect between test I and test II was not observed probably because of insufficient outdoor time achieved in the test groups, which suggests that proper monitoring on the compliance on outdoor intervention is critical if one wants to see the protective effect.
Publisher: American Medical Association (AMA)
Date: 06-10-2022
DOI: 10.1001/JAMANETWORKOPEN.2022.35017
Abstract: Vision loss and depression are common conditions with major health implications. However, mechanisms of the association of visual health (across the full acuity spectrum) with depression remain unclear. To characterize the association between visual health and depression and investigate the association between depression and brain microstructure and macrostructure in subgroups ided by visual acuity. In the UK Biobank Study cohort, 114 583 volunteers were included at baseline from March to June 2006 to July 2010. Habitual distance visual acuity was examined using the logarithm of the minimum angle of resolution (LogMAR) characters. Depression was identified based on Patient Health Questionnaire (PHQ) or through an interview-based psychiatric diagnosis. Subgroup participants completed multimodal magnetic resonance imaging (MRI) of the brain and PHQ evaluation during the imaging visit after 2014. Data were analyzed from May 5 to August 9, 2022. Depression, depressive symptoms, and imaging-derived phenotypes from T1-weighted and diffusion MRI. Of the 114 583 participants from the UK Biobank Study, 62 401 (54.5%) were women, and the mean (SD) age was 56.8 (8.1) years (range, 39-72 years). A 1-line worse visual acuity (0.1 LogMAR increase) was associated with 5% higher odds of depression (odds ratio, 1.05 [95% CI, 1.04-1.07]) after adjustment for age, sex, race and ethnicity, Townsend index, educational qualifications, smoking, alcohol consumption, obesity, physical activity, history of hypertension, diabetes, hyperlipidemia, and family history of depression. Of the 7844 participants eligible for MRI analysis, there were linear associations between PHQ score and the left volume of gray matter in supracalcarine cortex (coefficient, 7.61 [95% CI, 3.90-11.31]) and mean isotropic volume fraction (ISOVF) in the right fornix (cres) and/or stria terminalis (coefficient, 0.003 [95% CI, 0.001-0.004]) after correction for multiple comparison. In addition, their association could be moderated by visual acuity, whereby increased PHQ score was associated with higher ISOVF levels only among those with poorer visual acuity ( P = .02 for interaction). This study suggests an association between visual health and depression and that the diffusion characteristic of ISOVF in the fornix (cres) and/or stria terminalis is associated with depressive symptoms in participants with poorer visual acuity.
Publisher: Springer Science and Business Media LLC
Date: 29-08-2018
Publisher: Springer Science and Business Media LLC
Date: 09-01-2023
DOI: 10.1186/S13195-022-01140-2
Abstract: Little is known regarding whether sex assigned at birth modifies the association between several predictive factors for dementia and the risk of dementia itself. Our retrospective cohort study included 214,670 men and 214,670 women matched by age at baseline from the UK Biobank. Baseline data were collected between 2006 and 2010, and incident dementia was ascertained using hospital inpatient or death records until January 2021. Mediation analysis was tested for 133 in idual factors. Over 5,117,381 person-years of follow-up, 5928 cases of incident all-cause dementia (452 cases of young-onset dementia, 5476 cases of late-onset dementia) were documented. Hazard ratios (95% CI) for all-cause, young-onset, and late-onset dementias associated with the male sex (female as reference) were 1.23 (1.17–1.29), 1.42 (1.18–1.71), and 1.21 (1.15–1.28), respectively. Out of 133 in idual factors, the strongest mediators for the association between sex and incident dementia were multimorbidity risk score (percentage explained (95% CI): 62.1% (45.2–76.6%)), apolipoprotein A in the blood (25.5% (15.2–39.4%)), creatinine in urine (24.9% (16.1–36.5%)), low-density lipoprotein cholesterol in the blood (23.2% (16.2–32.1%)), and blood lymphocyte percentage (21.1% (14.5–29.5%)). Health-related conditions (percentage (95% CI) explained: 74.4% (51.3–88.9%)) and biomarkers (83.0% (37.5–97.5%)), but not lifestyle factors combined (30.1% (20.7–41.6%)), fully mediated sex differences in incident dementia. Health-related conditions combined were a stronger mediator for late-onset (75.4% (48.6–90.8%)) than for young-onset dementia (52.3% (25.8–77.6%)), whilst lifestyle factors combined were a stronger mediator for young-onset (42.3% (19.4–69.0%)) than for late-onset dementia (26.7% (17.1–39.2%)). Our analysis matched by age has demonstrated that men had a higher risk of all-cause, young-onset, and late-onset dementias than women. This association was fully mediated by health-related conditions or blood/urinary biomarkers and largely mediated by lifestyle factors. Our findings are important for understanding potential mechanisms of sex in dementia risk.
Publisher: Elsevier BV
Date: 05-2022
Publisher: Elsevier BV
Date: 05-2023
Publisher: Wiley
Date: 31-05-2022
DOI: 10.1111/CEO.14107
Abstract: Abnormal blood pressure is a potential risk factor for glaucoma. However, the role of antihypertensive medications on glaucoma pathogenesis is controversial. This study aims to investigate the association between the use of antihypertensive medications and glaucoma onset. This nested case–control study, based on a large‐scale longitudinal cohort in Australia, retrieved participants' claims records on drugs and Medicare services from national health databases. Participants with three or more claim records of anti‐glaucoma medications from 2009 to 2016 were classified as glaucoma patients those with none were classified as controls. Claim records of antihypertensive medications were identified within the 5 years before glaucoma onset and contemporary periods in matched controls without glaucoma. The association between the use of antihypertensive medications and glaucoma onset was assessed by multivariable logistic regression models. A total of 6748 cases and 13 496 controls were analysed. Compared with controls, the proportion of users of antihypertensive medications was slightly higher in glaucoma patients (46.9% vs. 46.0%, p 0.05). After adjustments for demographics, health‐related factors and medical history, the association between the use of antihypertensive medications and glaucoma onset was nonsignificant (OR 0.95, 95% CI = 0.89–1.02). As for specific subtypes, only beta‐blocking agents (BBA) (OR 0.82, 95% CI = 0.75–0.90) and diuretics (OR 0.85, 95% CI = 0.77–0.95) were significantly associated with reduced risks of glaucoma onset. This study indicated that the use of antihypertensive medications was not associated with glaucoma onset. Decreased risks of glaucoma onset in users of BBA and diuretics require further validation.
Publisher: Wiley
Date: 31-10-2023
DOI: 10.1111/DME.14966
Abstract: To investigate the association of type 1 diabetes (T1D) and age at diagnosis of type 2 diabetes (T2D) with brain structure and incident dementia. Our analysis was based on the UK Biobank. We included 1376 participants with diabetes and 2752 randomly selected controls for brain volume analysis, and 25,141 participants with diabetes and 50,282 randomly selected controls for dementia analysis. Brain volume was measured using magnetic resonance imaging. Dementia was identified using hospital inpatient records and mortality register data until January 2021. T2D diagnosed at a younger age was associated with larger reductions in brain volume. After adjustment for glycated haemoglobin (HbA1c) and other covariates, only T2D diagnosed years was associated with smaller total brain volume (β (95% CI): −14.56 (−24.67, −4.44) ml), and grey (−6.47[−12.75, −0.20] ml) and white matter volumes (−8.08[−14.66, −1.51] ml). Corresponding numbers for total brain, grey matter and white matter volumes associated with T1D were −62.86 (−93.71,‐32.01), −34.27 (−53.72, −14.83), and −28.59 (−47.65, −9.52) ml, respectively. During a median follow‐up of 11.9 years, 2035 new dementia cases were identified. Younger age at diagnosis of T2D was associated with larger excessive risk of dementia, whereas T2D diagnosed years was associated with the largest hazard ratio (HR) (95% CI: 2.03[1.53–2.69]) in the multivariable analysis. The HR (95% CI) for dementia associated with T1D was 2.08 (1.40–3.09). In iduals with T1D or T2D diagnosed at younger age are at larger excessive risk of brain volume reduction and dementia.
Publisher: Cold Spring Harbor Laboratory
Date: 30-12-2020
DOI: 10.1101/2020.12.24.20248817
Abstract: Ageing varies substantially, thus an accurate quantification of ageing is important. We developed a deep learning (DL) model that predicted age from fundus images (retinal age). We investigated the association between retinal age gap (retinal age-chronological age) and mortality risk in a population-based s le of middle-aged and elderly adults. The DL model was trained, validated and tested on 46,834, 15,612 and 8,212 fundus images respectively from participants of the UK Biobank study alive on 28 th February 2018. Retinal age gap was calculated for participants in the test (n=8,212) and death (n=1,117) datasets. Cox regression models were used to assess association between retinal age gap and mortality risk. A restricted cubic spline analyses was conducted to investigate possible non-linear association between retinal age gap and mortality risk. The DL model achieved a strong correlation of 0·83 (P ·001) between retinal age and chronological age, and an overall mean absolute error of 3·50 years. Cox regression models showed that each one-year increase in the retinal age gap was associated with a 2% increase in mortality risk (hazard ratio=1·02, 95% confidence interval:1·00-1·04, P=0·021). Restricted cubic spline analyses showed a non-linear relationship between retinal age gap and mortality (P non-linear =0·001). Higher retinal age gaps were associated with substantially increased risks of mortality, but only if the gap exceeded 3·71 years. Our findings indicate that retinal age gap is a robust biomarker of ageing that is closely related to risk of mortality. National Health and Medical Research Council Investigator Grant, Science and Technology Program of Guangzhou. Ageing at an in idual level is heterogeneous. An accurate quantification of the biological ageing process is significant for risk stratification and delivery of tailored interventions. To date, cell-, molecular-, and imaging-based biomarkers have been developed, such as epigenetic clock, brain age and facial age. While the invasiveness of cellular and molecular ageing biomarkers, high cost and time-consuming nature of neuroimaging and facial ages, as well as ethical and privacy concerns of facial imaging, have limited their utilities. The retina is considered a window to the whole body, implying that the retina could provide clues for ageing. We developed a deep learning (DL) model that can detect footprints of aging in fundus images and predict age with high accuracy for the UK population between 40 and 69 years old. Further, we have been the first to demonstrate that each one-year increase in retinal age gap (retinal age-chronological age) was significantly associated with a 2% increase in mortality risk. Evidence of a non-linear association between retinal age gap and mortality risk was observed. Higher retinal age gaps were associated with substantially increased risks of mortality, but only if the retinal age gap exceeded 3·71 years. This is the first study to link the retinal age gap and mortality risk, implying that retinal age is a clinically significant biomarker of ageing. Our findings show the potential of retinal images as a screening tool for risk stratification and delivery of tailored interventions. Further, the capability to use fundus imaging in predicting ageing may improve the potential health benefits of eye disease screening, beyond the detection of sight-threatening eye diseases.
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.AJO.2022.01.005
Abstract: To investigate the associations between circulating micronutrients (vitamins A, C, D, E, and carotenoids) and risk of diabetic retinopathy (DR). Cross-sectional study and meta-analysis. The cross-sectional study included 517 diabetic participants aged ≥40 years in the 2005-2006 National Health and Nutrition Examination Survey. Serum vitamin D was converted to liquid chromatography-tandem mass spectrometry-equivalent results, while other micronutrients were measured using high-performance liquid chromatography. Presence of DR was determined based on non-mydriatic fundus photographs. A meta-analysis was subsequently performed, which included relevant studies published from January 01, 1990 to December 31, 2020. Of the 517 included participants, DR was identified in 159 participants (25.17%). After adjusting for multiple confounders, only serum vitamin C was associated with a lower risk of DR (odds ratio [OR]: 0.60 95% confidence interval [CI]: 0.38-0.95). A total of 35 studies were included in the subsequent meta-analysis. Comparing 1056 participants with DR to 920 controls, the pooled weighted mean difference (WMD) of vitamin C was -11.01 (95% CI: -19.35 to -2.67). Regarding vitamins D and E, the pooled WMD was -3.06 (95% CI: -5.15 to -0.96) and -3.03 (95% CI: -4.24 to -1.82), respectively. No associations were identified between DR and circulating vitamin A or carotenoids. Lower levels of circulating vitamins C, D, and E were found in DR patients than those without. More high-quality studies are required to assess the real effects of micronutrients on DR.
Publisher: American Psychological Association (APA)
Date: 27-02-2023
DOI: 10.1037/AMP0001143
Publisher: American Medical Association (AMA)
Date: 11-2022
DOI: 10.1001/JAMAOPHTHALMOL.2022.3779
Abstract: Mild thyroid-associated ophthalmopathy (TAO) negatively impacts quality of life, yet no clinical guidelines for its treatment are available. Existing evidence supports the use of doxycycline in treating mild TAO. To evaluate the short-term (12 weeks) efficacy of doxycycline in treating mild TAO. In this placebo-controlled multicenter randomized double-masked trial, 148 patients were assessed for eligibility. After exclusions (patients who were pregnant or lactating, had an allergy to tetracyclines, or had uncontrolled systematic diseases), 100 patients with mild TAO (orbital soft tissue affected mildly) at 5 centers in China were enrolled from July 2013 to December 2019 and monitored for 12 weeks. Participants were randomly assigned 1:1 to receive doxycycline (50 mg) or placebo once daily for 12 weeks. The primary outcome was the rate of improvement at 12 weeks compared with baseline assessed by a composite indicator of eyelid aperture (reduction ≥2 mm), proptosis (reduction ≥2 mm), ocular motility (increase ≥8°), and Graves ophthalmopathy-specific quality-of-life (GO-QOL) scale score (increase ≥6 points). Adverse events were recorded. A total of 50 participants were assigned to doxycycline and 50 to placebo. The mean (SD) age was 36.7 (9.1) years 75 participants (75.0%) were female and 100 (100.0%) were Asian. Medication compliance was checked during participant interviews and by counting excess tablets. At week 12, the improvement rate was 38.0% (19 of 50) in the doxycycline group and 16.0% (8 of 50) in the placebo group (difference, 22.0% 95% CI, 5.0-39.0 P = .01) in the intention-to-treat population. The per-protocol sensitivity analysis showed similar results (39.6% [19 of 48] vs 16.0% [8 of 50] difference, 23.6% 95% CI, 6.4-40.8 P = .009). No adverse events other than 1 case of mild gastric acid regurgitation was recorded in either group. The results of this study indicate that oral doxycycline, 50 mg daily, resulted in greater improvement of TAO-related symptoms at 12 weeks compared with placebo in patients with mild TAO. These findings support the consideration of doxycycline for mild TAO but should be tempered by recognizing the relatively short follow-up and the size of the cohort. ClinicalTrials.gov Identifier: NCT02203682
Publisher: Elsevier BV
Date: 06-2023
Publisher: Elsevier BV
Date: 02-2023
Publisher: Springer Science and Business Media LLC
Date: 15-08-2022
DOI: 10.1186/S12916-022-02449-3
Abstract: Plasma metabolomic profile is disturbed in dementia patients, but previous studies have discordant conclusions. Circulating metabolomic data of 110,655 people in the UK Biobank study were measured with nuclear magnetic resonance technique, and incident dementia records were obtained from national health registers. The associations between plasma metabolites and dementia were estimated using Cox proportional hazard models. The 10-fold cross-validation elastic net regression models selected metabolites that predicted incident dementia, and a 10-year prediction model for dementia was constructed by multivariable logistic regression. The predictive values of the conventional risk model, the metabolites model, and the combined model were discriminated by comparison of area under the receiver operating characteristic curves (AUCs). Net reclassification improvement (NRI) was used to estimate the change of reclassification ability when adding metabolites into the conventional prediction model. Amongst 110,655 participants, the mean (standard deviation) age was 56.5 (8.1) years, and 51 186 (46.3%) were male. A total of 1439 (13.0%) developed dementia during a median follow-up of 12.2 years (interquartile range: 11.5–12.9 years). A total of 38 metabolites, including lipids and lipoproteins, ketone bodies, glycolysis-related metabolites, and amino acids, were found to be significantly associated with incident dementia. Adding selected metabolites ( n =24) to the conventional dementia risk prediction model significantly improved the prediction for incident dementia (AUC: 0.824 versus 0.817, p =0.042) and reclassification ability (NRI = 4.97%, P = 0.009) for identifying high risk groups. Our analysis identified various metabolomic biomarkers which were significantly associated with incident dementia. Metabolomic profiles also provided opportunities for dementia risk reclassification. These findings may help explain the biological mechanisms underlying dementia and improve dementia prediction.
Publisher: Cold Spring Harbor Laboratory
Date: 20-01-2021
DOI: 10.1101/2021.01.19.21249177
Abstract: To investigate the joint effects of retinopathy and systemic vascular comorbidities on mortality. This study included 5703 participants (≥40 years old) from the 2005-2008 National Health and Nutrition Examination Survey. The Early Treatment Diabetic Retinopathy Study grading scale was used to evaluate the retinopathy status. Systemic vascular comorbidities included diabetes mellitus (DM), high blood pressure (HBP), chronic kidney disease (CKD) and cardiovascular disease (CVD). Time to death was calculated as the time from baseline to either the date of death or censoring (December 31 st , 2015), whichever came first. Risks of mortality were estimated using Cox proportional hazards models. After adjusting for confounders, the presence of retinopathy predicted higher all-cause mortality (hazard ratio [HR], 1.40 95% confidence interval [CI], 1.09-1.81). The all-cause mortality among participants with both retinopathy and systemic vascular comorbidities including DM (HR, 1.63 95% CI, 1.06-2.50), HBP (HR, 1.46 95% CI, 1.03-2.08), CKD (HR, 1.71 95% CI, 1.24-2.35) and CVD (HR, 1.88 95% CI, 1.19-2.96) was significantly higher than that among those without either condition. In this prospective study, in iduals with retinopathy had increased all-cause mortality. The joint effects of retinopathy and major systemic vascular comorbidities increased the all-cause mortality further, suggesting that more extensive vascular risk factor assessment and management are needed to detect the burden of vascular pathologies and improve long-term survival in in iduals with retinopathy. Retinopathy has been recognized as an independent risk factor for mortality. What are the joint effects of retinopathy and systemic vascular comorbidities (including diabetes mellitus, hypertension and chronic kidney disease and cardiovascular disease) on mortality? Consistent evidence on the increased risk of mortality among in iduals with retinopathy was noted in a large s le of middle-aged and older adults. The co-occurrence of retinopathy and systemic vascular conditions (diabetes mellitus, hypertension and chronic kidney disease and cardiovascular disease) further increased all-cause mortality independent of other covariates. In iduals with retinopathy may benefit from a comprehensive vascular assessment. Intensive vascular risk reduction is needed in the management of patients with retinopathy and and micro- or macrovascular disorders. Highlighted the importance of retinopathy screening using retinal imaging for identifying in iduals at high risk of mortality, particularly among in iduals with systemic vascular comorbidities.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 29-04-2016
Abstract: To assess 10-year mortality in people who had undergone cataract surgery with no residual visual impairment (VI) and those who had persistent VI due to cataract using a population-based cohort. The Liwan Eye Study is a 10-year longitudinal study commenced in 2003. According to the World Health Organization, presenting VI was defined as visual acuity less than 20/63 in the better-seeing eye. History of cataract surgery was defined as cataract surgery performed on either eye. Information on the date of surgery was recorded. Dates of death occurring between baseline and April 30, 2014 were obtained from the National Death Index data. Information on socioeconomic factors was obtained from questionnaire interviews. Cox proportional hazards regression models were used to assess the hazard ratios (HRs) and 95% confidence intervals (CIs). Fifty-nine participants had undergone cataract surgery without residual VI and 67 participants had persistent cataract-related VI. The 10-year mortality rate for participants who had undergone cataract surgery without residual VI was statistically significant lower than that in participants who had VI due to cataract based on log-rank test (32.2% vs. 64.2% P = 0.002). This finding remained significant in the unadjusted Cox proportional hazards model (HR, 0.43 95% CI, 0.25-0.74 P = 0.002). After adjusting for age, sex, history of diabetes, and hypertension, body mass index (BMI), education level, and personal income, participants with cataract surgery and no residual VI did not have a higher chance of survival than participants with persistent VI due to cataract (HR, 0.56 95% CI, 0.26-1.20 P = 0.136). Cataract-related VI corrected by cataract surgery was not associated with better survival after adjusting for a number of possible confounders. Given our s le size is relatively small and limited power, further studies with larger s le are needed.
Publisher: Hindawi Limited
Date: 16-09-2022
DOI: 10.1155/2022/9618912
Abstract: Using a geographical information system (GIS), we investigated the spatiotemporal evolution of a cataract surgery service and its association with socioeconomic factors and private insurance, based on 10-year real-world medical claim data in an Australian population. The data collected cover a decade (2007–2016) from the “45 and Up Study”. A total of 234,201 participants within the cataract surgery service were grouped into 88 Statistical Area Level 3 (SA3s) according to their residential postcodes in New South Wales Australia. We analyzed the spatiotemporal variations and geographical distribution inequality in cataract surgery incidence and its respect to socioeconomic status (SES) and private health insurance coverage by Spearman correlation analysis and Moran’s I test. Then these variations were intuitive displayed by six-quartile maps and a local indicator of spatial association (LISA) maps based on GIS. The average cumulative age-gender-standardized of the incidence of cataract surgery (ICS) was 8.85% (95% CI, 5.33–15.6). Spatial variation was significant (univariate Moran’s I = 0.45, P = 0.001) with incidence gradually decreasing from the coastal regions to the north-western inland regions, suggesting inequality in the cataract surgery service across the state of New South Wales. Notably, clustering of the low incidence areas had gradually disappeared over the decade, suggesting that the cataract surgery service has improved over time. Low scores on the “index of socioeconomic disadvantages” (IRSD) and high private health insurance coverage were significantly associated with a higher incidence of cataract surgery (bivariate Moran’s I = −0.13 and 0.23, P 0.01 Spearman correlation r = 0.25 and −0.25, P = 0.02), which is displayed on the map visually and obviously. Spatiotemporal variations in the incidence of cataract surgery are significant, but the low incidence area had gradually disappeared over time. High socioeconomic status and private insurance contribute to a higher incidence of cataract surgery in Australia.
Publisher: Springer Science and Business Media LLC
Date: 19-10-2021
Publisher: Springer Science and Business Media LLC
Date: 04-08-2021
DOI: 10.1038/S41598-021-94178-5
Abstract: This study investigated the diagnostic performance, feasibility, and end-user experiences of an artificial intelligence (AI)-assisted diabetic retinopathy (DR) screening model in real-world Australian healthcare settings. The study consisted of two components: (1) DR screening of patients using an AI-assisted system and (2) in-depth interviews with health professionals involved in implementing screening. Participants with type 1 or type 2 diabetes mellitus attending two endocrinology outpatient and three Aboriginal Medical Services clinics between March 2018 and May 2019 were invited to a prospective observational study. A single 45-degree (macula centred), non-stereoscopic, colour retinal image was taken of each eye from participants and were instantly screened for referable DR using a custom offline automated AI system. A total of 236 participants, including 174 from endocrinology and 62 from Aboriginal Medical Services clinics, provided informed consent and 203 (86.0%) were included in the analysis. A total of 33 consenting participants (14%) were excluded from the primary analysis due to ungradable or missing images from small pupils (n = 21, 63.6%), cataract (n = 7, 21.2%), poor fixation (n = 2, 6.1%), technical issues (n = 2, 6.1%), and corneal scarring (n = 1, 3%). The area under the curve, sensitivity, and specificity of the AI system for referable DR were 0.92, 96.9% and 87.7%, respectively. There were 51 disagreements between the reference standard and index test diagnoses, including 29 which were manually graded as ungradable, 21 false positives, and one false negative. A total of 28 participants (11.9%) were referred for follow-up based on new ocular findings, among whom, 15 (53.6%) were able to be contacted and 9 (60%) adhered to referral. Of 207 participants who completed a satisfaction questionnaire, 93.7% specified they were either satisfied or extremely satisfied, and 93.2% specified they would be likely or extremely likely to use this service again. Clinical staff involved in screening most frequently noted that the AI system was easy to use, and the real-time diagnostic report was useful. Our study indicates that AI-assisted DR screening model is accurate and well-accepted by patients and clinicians in endocrinology and indigenous healthcare settings. Future deployments of AI-assisted screening models would require consideration of downstream referral pathways.
Publisher: Cold Spring Harbor Laboratory
Date: 11-10-2022
DOI: 10.1101/2022.10.09.511456
Abstract: Glaucoma is an optic neuropathy, and the leading cause of irreversible blindness worldwide. However, the early detection of glaucoma remains challenging as chronic forms of glaucoma remain largely asymptomatic until considerable irreversible visual field deficits have ensued. Thus, biomarkers that facilitate early diagnosis and treatment for patients with a high risk of progression are critical. Network medicine approaches can be useful in identifying key relationships and important biomolecules for complex diseases. In this paper, we identified several hub biomarkers/drug targets for the diagnosis, treatment and prognosis for glaucoma and explored their associations for glaucoma based on human disease-biomarker and disease-target-drug networks. These results were verified by text-mining and genomic/epidemiology data. We also predicted the new application of BMP1 and MMP9 to diagnose glaucoma and confirm the theory of hub biomarkers with multiple clinical applications. Further, relevant pivotal pathways (regulation of the multicellular organismal process, regulation of localisation, and cytoplasmic vesicle for biomarkers signal transduction and developmental process for targets) for these hub biomolecules were discovered, which may be foundations for future biomarker and drug target prediction for glaucoma. In conclusion, based on complex networks, hub biomolecules, essential pathways, and close diseases were identified for glaucoma in diagnosis, treatment and prognosis.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.OPHTHA.2021.11.023
Abstract: To assess the efficacy and safety of repeated low-level red-light (RLRL) therapy in myopia control in children. Multicenter, randomized, parallel-group, single-blind clinical trial. Two hundred sixty-four eligible children 8 to 13 years of age with myopia of cycloplegic spherical equivalent refraction (SER) of -1.00 to -5.00 diopters (D), astigmatism of 2.50 D or less, anisometropia of 1.50 D or less, and best-corrected visual acuity (BCVA) of 0.0 logarithm of the minimum angle of resolution or more were enrolled in July and August 2019. Follow-up was completed in September 2020. Children were assigned randomly to the intervention group (RLRL treatment plus single-vision spectacle [SVS]) and the control group (SVS). The RLRL treatment was provided by a desktop light therapy device that emits red light of 650-nm wavelength at an illuminance level of approximately 1600 lux and a power of 0.29 mW for a 4-mm pupil (class I classification) and was administered at home under supervision of parents for 3 minutes per session, twice daily with a minimum interval of 4 hours, 5 days per week. The primary outcome and a key secondary outcome were changes in axial length and SER measured at baseline and the 1-, 3-, 6-, and 12-month follow-up visits. Participants who had at least 1 postrandomization follow-up visit were analyzed for treatment efficacy based on a longitudinal mixed model. Among 264 randomized participants, 246 children (93.2%) were included in the analysis (117 in the RLRL group and 129 in the SVS group). Adjusted 12-month axial elongation and SER progression were 0.13 mm (95% confidence interval [CI], 0.09-0.17mm) and -0.20 D (95% CI, -0.29 to -0.11D) for RLRL treatment and 0.38 mm (95% CI, 0.34-0.42 mm) and -0.79 D (95% CI, -0.88 to -0.69 D) for SVS treatment. The differences in axial elongation and SER progression were 0.26 mm (95% CI, 0.20-0.31 mm) and -0.59D (95% CI, -0.72 to -0.46 D) between the RLRL and SVS groups. No severe adverse events (sudden vision loss ≥2 lines or scotoma), functional visual loss indicated by BCVA, or structural damage seen on OCT scans were observed. Repeated low-level red-light therapy is a promising alternative treatment for myopia control in children with good user acceptability and no documented functional or structural damage.
Publisher: Cold Spring Harbor Laboratory
Date: 21-01-2022
DOI: 10.1101/2022.01.18.22269511
Abstract: To investigate the association between age-related macular degeneration (AMD) and 10-year all-cause and cause-specific mortality using a large-scale population-based s le. Data from the 2005-2008 cycles of the National Health and Nutrition Examination Survey were used to assess the risk of mortality in relation to AMD in a propensity score-matched cohort. AMD status was assessed by retinal images with the standardized grading scheme. Mortality data until 31st December 2015 were derived from mortality archives. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for survival. A total of 4691 participants were included. After a median follow-up of 8.42 (IQR: 7.58-9.67) years, 698 participants died. Participants with any AMD had an increased risk of all-cause mortality (HR, 2.02 95% CI, 1.37-2.98). Similar results were observed for early (HR, 1.93 95% CI, 1.31-2.85) and late AMD (HR, 4.29 95% CI, 2.10-8.79). For cause-specific mortality, any (HR, 2.17 95% CI, 1.39-3.39), early (HR, 2.18 95% CI, 1.36-3.51), and late AMD (HR, 3.95 95% CI, 1.65-9.46) were associated with significantly higher mortality due to causes other than cardiovascular disease (CVD) or cancer. Late AMD independently predicted a higher risk of CVD mortality (HR, 2.48 95% CI, 1.32-4.65). The current study showed that any, early, and late AMD were associated with increased risks of all-cause mortality and mortality due to causes other than CVD or cancer. In addition, we found that late AMD was associated with increased risks of CVD mortality. Late macular degeneration independently predicted higher cardiovascular disease mortality. Any, early and late age-related macular degeneration were associated with higher all-cause mortality and mortality due to causes other than cardiovascular disease or cancer.
Publisher: JMIR Publications Inc.
Date: 30-04-2021
DOI: 10.2196/24316
Abstract: The COVID-19 pandemic has led to worldwide school closures, with millions of children confined to online learning at home. As a result, children may be susceptible to anxiety and digital eye strain, highlighting a need for population interventions. The objective of our study was to investigate whether a digital behavior change intervention aimed at promoting physical activity could reduce children’s anxiety and digital eye strain while undergoing prolonged homeschooling during the COVID-19 pandemic. In this cluster randomized controlled trial, homeschooled grade 7 students at 12 middle schools in southern China were recruited through local schools and randomly assigned by the school to receive (1:1 allocation): (1) health education information promoting exercise and ocular relaxation, and access to a digital behavior change intervention, with live streaming and peer sharing of promoted activities (intervention), or (2) health education information only (control). The primary outcome was change in self-reported anxiety score. Secondary outcomes included change in self-reported eye strain and sleep quality. On March 16, 2020, 1009 children were evaluated, and 954 (94.5%) eligible children of consenting families were included in the intention-to-treat analysis. Children in the intervention (n=485, 6 schools) and control (n=469, 6 schools) groups were aged 13.5 (SD 0.5) years, and 52.3% (n=499) were male. The assigned interventions were completed by 896 children (intervention: n=467, 96.3% control: n=429, 91.5%). The 2-week change in square-root–transformed self-reported anxiety scores was greater in the intervention (–0.23, 95% CI –0.27 to –0.20) vs control group (0.12, 95% CI 0.09-0.16 unadjusted difference –0.36, 95% CI –0.63 to –0.08 P=.02). There was a significant reduction in square-root–transformed eye strain in the intervention group (–0.08, 95% CI –0.10 to 0.06) compared to controls (0.07, 95% CI 0.05-0.09 difference –0.15, 95% CI –0.26 to –0.03 P=.02). Change in sleep quality was similar between the two groups. This digital behavior change intervention reduced children’s anxiety and eye strain during COVID-19–associated online schooling. ClinicalTrials.gov NCT04309097 t2/show/NCT04309097
Publisher: Wiley
Date: 23-03-2023
DOI: 10.1111/AOS.15662
Abstract: To determine how orthokeratology (ortho‐k) affects corneal biomechanical properties in myopia control and whether corneal biomechanical parameters can predict clinical efficacy of ortho‐k. A total of 125 children 7–15 years of age using ortho‐k lenses were followed in this clinical practice and data of their right eyes were analysed. Corneal biomechanical parameters and most ocular biometry were measured at baseline, 1 week, and at 1, 3, 6, 12, 18 and 24 months. Axial length (AL) was collected every 6 months after baseline measurements. During the 2‐year follow up, nine corneal biomechanical parameters, including deformation litude maximum (DA), varied between baseline and 1 week ( p 0.05) and stabilized during the rest of wearing period ( p 0.05). The mean AL increased from 25.02 ± 0.84 mm to 25.38 ± 0.81 mm and baseline DA strongly correlated with AL progression (Pearson r = 0.37). In the multiple regression models, baseline age, AL and DA were the independent factors for AL progression ( R 2 : 0.7849, 0.2180 in low and moderate myopes). The area under the receiver operating characteristic curves using the three variables for predicting excessive AL progression ( .35 mm during 2 years) in low and moderate myopes was 0.902 and 0.698. Corneal biomechanics firstly fluctuated before becoming stable with long‐term ortho‐k use. Corneal biomechanics was associated with AL progression in children wearing ortho‐k lenses. DA combined with age and AL at baseline could predict AL progression in low myopes using ortho‐k.
Publisher: Springer Science and Business Media LLC
Date: 09-08-2021
Publisher: Cold Spring Harbor Laboratory
Date: 29-09-2022
DOI: 10.1101/2022.09.27.22280405
Abstract: Retinal neurodegeneration, an easily accessible biomarker of dementia risk, is exacerbated by age and hypertension however, the relative roles of systolic and diastolic blood pressure (SBP and DPB) remain unclear. This study aimed to determine the cross-sectional and longitudinal associations between BP and atherosclerosis levels along with the different retinal neurodegeneration parameters. This study used cross-sectional data from the United Kingdom (UK) BioBank (UKB) and longitudinal data from the Chinese Ocular Imaging Project (COIP). The macular ganglion cell-inner plexiform layer thickness (mGCIPLT) and macular retinal nerve fiber layer thickness (mRNFLT) were measured using spectral domain optical coherence tomography imaging. Swept-source optical coherence tomography was performed at each follow-up visit to obtain the longitudinal trajectory of the mGCIPLT and peripapillary RNFLT (pRNFLT) in the COIP cohort. Multivariable linear models were used to analyze the cross-sectional and longitudinal associations between BP metrics and retinal measurements. In a cross-sectional analysis of 22,801 participants from the UKB, thinner mGCIPLT was related to older age (per 10 years, β = −0.274, 95% confidence interval (CI): −0.358 to −0.189, p 0.001), female sex (female vs male, β = −0.897, 95% CI: −1.031 to −0.763, p = 0.000), higher SBP (per 10 mmHg increase, β = −0.085, 95% CI: −0.125 to −0.045, p = 0.000), and higher DBP (per 10 mmHg increase, β = −0.105, 95% CI: −0.174 to −0.036, p = 0.003), and was significantly associated with higher mean arterial pressure (MAP per 10 mmHg increase, β = −0.116, 95% CI: −0.176, −0.056, p = 0.000) and higher mean pulse pressure (MPP per 10 mmHg increase, β = −0.099, 95% CI: −0.155, −0.043, p = 0.001). In a longitudinal analysis of 2,012 eligible COIP participants, higher levels of baseline SBP, DBP, MAP, and MPP were associated with faster thinning in mGCIPLT and pRNFLT (all p 0.001). The strongest association was with MAP, which produced an effect on mGCIPLT (β = −0.118, 95% CI: −0.175 to −0.061, p 0.001) per 10 mmHg increase, comparable to a 5-year increase in age (β = −0.210, 95% CI: −0.282 to −0.138, p 0.001). The results of the analysis of mRNFL and pRNFL were consistent with those of mGCIPLT. BP levels were independently and consistently associated with various retinal neurodegenerative exacerbations, both cross-sectionally and longitudinally, regardless of the race and disease status. BP plays a key role in neurodegeneration, and long-term prevention in the population requires the control of BP levels.
Publisher: BMJ
Date: 13-09-2021
DOI: 10.1136/BJOPHTHALMOL-2021-319508
Abstract: To examine independent and interactive associations of ophthalmic and systemic conditions with incident dementia. Our analysis included 12 364 adults aged 55–73 years from the UK Biobank cohort. Participants were assessed between 2006 and 2010 at baseline and were followed up until the early of 2021. Incident dementia was ascertained using hospital inpatient, death records and self-reported data. Over 1 263 513 person-years of follow-up, 2304 cases of incident dementia were documented. The multivariable-adjusted HRs (95% CI) for dementia associated with age-related macular degeneration (AMD), cataract, diabetes-related eye disease (DRED) and glaucoma at baseline were 1.26 (1.05 to 1.52), 1.11 (1.00 to 1.24), 1.61 (1.30 to 2.00) and (1.07 (0.92 to 1.25), respectively. Diabetes, heart disease, stroke and depression at baseline were all associated with an increased risk of dementia. Of the combination of AMD and a systemic condition, AMD-diabetes was associated with the highest risk for incident dementia (HR (95% CI): 2.73 (1.79 to 4.17)). In iduals with cataract and a systemic condition were 1.19–2.29 times more likely to develop dementia compared with those without cataract and systemic conditions. The corresponding number for DRED and a systemic condition was 1.50–3.24. Diabetes, hypertension, heart disease, depression and stroke newly identified during follow-up mediated the association between cataract and incident dementia as well as the association between DRED and incident dementia. AMD, cataract and DRED but not glaucoma are associated with an increased risk of dementia. In iduals with both ophthalmic and systemic conditions are at higher risk of dementia compared with those with an ophthalmic or systemic condition only.
Publisher: Springer Science and Business Media LLC
Date: 23-10-2019
DOI: 10.1007/S40520-019-01376-3
Abstract: Frailty and short telomere length, which address different aspects of biological aging, are separately associated with mortality in older adults. To evaluate whether the combination of these two biomarkers would be a better predictor of mortality than either alone. This present study included participants 60 years of age or older from the National Health and Nutrition Examination Survey in the 1999-2002 phase. The frailty phenotype was identified based on the Fried definition. Telomere length relative to standard reference DNA (T/S ratio) was assessed using quantitative polymerase chain reaction (PCR). Cox proportional hazards regression models were used to estimate the in idual and combined effects of frailty phenotype and telomere length on all-cause and cardiovascular mortality. Compared with participants with neither impairment, the mortality risks increased slightly among participants with short telomere length only (hazard ratio [HR] 1.19, 95% confidence interval [CI]: 1.00-1.42) or pre-frailty only (HR 2.16, 95% CI 1.80-2.60) and gradually elevated approximately 3 folds with both short telomere length and pre-frailty (HR 2.23, 95% CI 1.81-2.74) or frailty (HR 3.57, 95% CI 2.56-4.98). Moreover, participants with both short telomere length and frailty had the highest increased all-cause mortality (HR 5.16, 95% CI 3.38-7.85) and cardiovascular mortality (HR 4.67, 95% CI 2.02-10.82). The combined predictor had more capability of predicting mortality, which suggested that integrating both molecular biomarkers and physiological functional parameters would be a more informative measure of biological aging.
Publisher: Springer Science and Business Media LLC
Date: 15-06-2023
Publisher: Springer Science and Business Media LLC
Date: 26-08-2022
Publisher: Frontiers Media SA
Date: 22-03-2019
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 19-11-2021
Publisher: Springer Science and Business Media LLC
Date: 30-11-2022
DOI: 10.1186/S12916-022-02620-W
Abstract: The aim of this study is to investigate the association of retinal age gap with the risk of incident stroke and its predictive value for incident stroke. A total of 80,169 fundus images from 46,969 participants in the UK Biobank cohort met the image quality standard. A deep learning model was constructed based on 19,200 fundus images of 11,052 disease-free participants at baseline for age prediction. Retinal age gap (retinal age predicted based on the fundus image minus chronological age) was generated for the remaining 35,917 participants. Stroke events were determined by data linkage to hospital records on admissions and diagnoses, and national death registers, whichever occurred earliest. Cox proportional hazards regression models were used to estimate the effect of retinal age gap on risk of stroke. Logistic regression models were used to estimate the predictive value of retinal age and well-established risk factors in 10-year stroke risk. A total of 35,304 participants without history of stroke at baseline were included. During a median follow-up of 5.83 years, 282 (0.80%) participants had stroke events. In the fully adjusted model, each one-year increase in the retinal age gap was associated with a 4% increase in the risk of stroke (hazard ratio [HR] = 1.04, 95% confidence interval [CI]: 1.00–1.08, P = 0.029). Compared to participants with retinal age gap in the first quintile, participants with retinal age gap in the fifth quintile had significantly higher risks of stroke events (HR = 2.37, 95% CI: 1.37–4.10, P = 0.002). The predictive capability of retinal age alone was comparable to the well-established risk factor-based model (AUC=0.676 vs AUC=0.661, p =0.511). We found that retinal age gap was significantly associated with incident stroke, implying the potential of retinal age gap as a predictive biomarker of stroke risk.
Publisher: Springer Science and Business Media LLC
Date: 08-2022
DOI: 10.1186/S12877-022-03322-X
Abstract: Dual sensory impairment is affecting over 10% of older adults worldwide. However, the long-term effect of dual sensory impairment (DSI) on the risk of mortality remains controversial. We aim to investigate the impact of single or/and dual sensory impairment on the risk of mortality in a large population-based s le of the adult in the UK with 14-years of follow-up. This population-based prospective cohort study included participants aged 40 and over with complete records of visual and hearing functions from the UK Biobank study. Measurements of visual and hearing functions were performed at baseline examinations between 2006 and 2010, and data on mortality was obtained by 2021. Dual sensory impairment was defined as concurrent visual and hearing impairments. Cox proportional hazards regression models were employed to evaluate the impact of sensory impairment (dual sensory impairment, single visual or hearing impairment) on the hazard of mortality. Of the 113,563 participants included in this study, the mean age (standard deviation) was 56.8 (8.09) years, and 61,849 (54.5%) were female. At baseline measurements, there were 733 (0.65%) participants with dual sensory impairment, 2,973 (2.62%) participants with single visual impairment, and 13,560 (11.94%) with single hearing impairment. After a follow-up period of 14 years (mean duration of 11 years), 5,992 (5.28%) participants died from all causes. Compared with no sensory impairment, dual sensory impairment was significantly associated with an estimated 44% higher hazard of mortality (hazard ratio: 1.44 [95% confidence interval, 1.11–1.88], p = 0.007) after multiple adjustments. In iduals with dual sensory impairment were found to have an independently 44% higher hazard of mortality than those with neither sensory impairment. Timely intervention of sensory impairment and early prevention of its underlying causes should help to reduce the associated risk of mortality.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 28-10-2022
DOI: 10.1097/APO.0000000000000578
Abstract: The purpose of this study is to compare daily patterns of accelerometer-measured movement behaviors between glaucoma patients and those without glaucoma. From 2013 to 2015, 106,053 UK Biobank participants took part in a 7-day accelerometer test. Based on established algorithms, continuous accelerometer data were classified into 4 movement behaviors: moderate to vigorous physical activity (MVPA), light physical activity, sedentary behaviors, and sleep. Glaucoma and other covariates were defined according to baseline assessments and inpatient diagnosis records. Negative binomial regression models were used to compare daily patterns of movement behaviors between glaucoma patients and those without glaucoma. Accelerometer data from 1262 glaucoma patients and 81,551 participants without glaucoma were included. Compared with participants without glaucoma, glaucoma patients spent 4.7% less time on MVPA in multivariable models [mean=28.3 vs 31.4 min/d incidence-rate ratio (IRR) 0.953, 95% confidence interval (CI): 0.910–0.998 P =0.044], which was mainly attributed to the decreased MVPA time during 18:00–23:59 (IRR=0.863, Bonferroni-corrected 95% CI: 0.768–0.970 P =0.002). Subgroup analyses indicated that compared with those with normal body mass index, the decreased MVPA time was more pronounced in participants with overweight and obesity (IRR=0.912, Bonferroni-corrected 95% CI: 0.851–0.978 P for interaction=0.007). No significant association was found between glaucoma and time spent on other movement behaviors including light physical activity, sedentary behaviors, and sleep. Daily patterns of movement behaviors were significantly changed in glaucoma patients. Compared with those without glaucoma, glaucoma patients spent less time on MVPA, especially in the evening.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2023
DOI: 10.1161/HYPERTENSIONAHA.122.20364
Abstract: Hypertension might be a modifiable risk factor for neurodegeneration diseases. However, the associations between blood pressure (BP), arterial stiffness index and retinal neurodegeneration remain unclear. This study used cross-sectional data from the United Kingdom BioBank (UKB) and longitudinal data from the Chinese Ocular Imaging Project (COIP). The macular ganglion cell-inner plexiform layer thickness (mGCIPLT) and macular retinal nerve fiber layer thickness were measured using spectral domain optical coherence tomography imaging. Swept-source optical coherence tomography was performed to obtain the longitudinal trajectory of the mGCIPLT and peripapillary retinal nerve fiber layer thickness in the COIP cohort. Multivariable linear models were used to analyze the associations between BP and retinal measurements. In a cross-sectional analysis of 22 801 participants from UKB, thinner mGCIPLT was related to higher systolic BP (β: −0.103 [−0.146 to −0.061] P .001), and higher diastolic BP (β: −0.191 [−0.265 to −0.117] P .001), and was significantly associated with higher mean arterial pressure (β: −0.174 [−0.238 to −0.109] P .001) and higher mean pulse pressure (β: −0.080 [−0.139 to −0.020] P =009). In a longitudinal analysis of 2012 eligible COIP participants, higher levels of baseline systolic BP, diastolic BP, mean arterial pressure, and mean pulse pressure were associated with faster thinning in mGCIPLT and peripapillary retinal nerve fiber layer thickness (all P .001). The strongest association was the effect of mean arterial pressure on mGCIPLT (β: −0.118 [−0.175 to −0.061] P .001). The results of the analysis of macular retinal nerve fiber layer thickness and peripapillary retinal nerve fiber layer thickness were consistent with those of mGCIPLT. BP levels were independently and consistently associated with various retinal neurodegenerative exacerbations.
Publisher: Elsevier BV
Date: 09-2020
Publisher: BMJ
Date: 04-08-2021
DOI: 10.1136/BJOPHTHALMOL-2021-318789
Abstract: In a cohort of middle-aged and elderly Australians, we found that long-term statin use was associated with a higher risk of glaucoma onset. As to subtypes of statins, the increased risk was only found in rosuvastatin users. To investigate the relationship between statin use and glaucoma onset in a 10-year longitudinal study. This nested case–control study was based on data from a large-scale cohort of Australians aged over 45 years old. Medication exposure was identified by claims records from the Pharmaceutical Benefits Scheme during the follow-up period (2009–2016). The onset of glaucoma was defined as the people with at least three claims of antiglaucoma medications. Controls matched by age, gender and cardiovascular diseases were selected from participants without prescription of antiglaucoma medications. A conditional logistic regression model was used to assess the association between statin use and glaucoma onset. The proportion of statin users was higher in the case group (40.5%) than that in the control group (38.4%). After adjusting for baseline characteristics and longitudinal claims records, statin use was not associated with glaucoma onset (OR 1.04, 95% CI 0.97 to 1.11). However, an increased risk of glaucoma onset was observed in participants with a longer duration of statin use ( years vs year: OR 1.12, 95% CI 1.04 to 1.21). With respect to specific types of statins, participants taking rosuvastatin were more likely to suffer from glaucoma (OR 1.11, 95%CI 1.01 to 1.22). The use of other statins was not significantly associated with glaucoma onset. Long-term statin use was found to be associated with a higher risk of glaucoma onset in this study. Regarding specific types of statins, the increased risk of glaucoma onset was only observed in users of rosuvastatin.
Publisher: Springer Science and Business Media LLC
Date: 27-03-2023
DOI: 10.1038/S41433-023-02498-9
Abstract: A prospective cohort study to investigate the association between fruit and vegetable (F& V) intake and the risk of cataract. We included 72,160 participants who were free of cataract at baseline from the UK Biobank. Frequency and type of F& V intake were assessed using a web-based 24 h dietary questionnaire from 2009 to 2012. Development of cataract during the follow-up was defined by self-report or hospital inpatient records up to 2021. Cox proportional regression models were used to estimate the association between F& V intake and incident cataract. During a mean follow-up of 9.1 years, 5753 participants developed cataract with a corresponding incidence of 8.0%. After adjusting for multiple demographic, medical and lifestyle covariates, higher intake of F& V were associated with a lower risk of cataract (≥6.5 vs. servings/week: hazards ratio [HR]: 0.82, 95% CI: 0.76 to 0.89 P 0.0001). Regarding specific types, significant reduced risk of cataract was found for higher intake of legumes ( P = 0.0016), tomatoes (≥5.2 vs. .8 servings/week: HR: 0.94, 95% CI: 0.88 to 1.00), and apple and pear ( vs. .5 servings/week: 0.89, 95% CI: 0.83 to 0.94 P 0.0001), but not for cruciferous vegetables, green leafy vegetables, berry, citrus fruit or melon. Smokers were found to benefit more from F& V intake than former and never smokers. Men also could benefit more from higher vegetable intake than women. More F& V intake, especially legumes, tomatoes, apple, and pear, was associated with a lower risk of cataract in this UK Biobank cohort.
Publisher: Frontiers Media SA
Date: 22-06-2018
Publisher: Springer Science and Business Media LLC
Date: 17-03-2023
DOI: 10.1007/S11357-023-00743-3
Abstract: The study aims to investigate associations between cardiovascular health (CVH) metrics and retinal ageing indexed by retinal age gap. A total of 26,354 participants from the UK Biobank study with available CVH metrics and qualified retinal imaging were included in the present analysis. CVH included 7 metrics (smoking, physical activity, diet, body mass index [BMI], total cholesterol, blood pressure [BP], blood glucose). These were summarized to classify the overall CVH as poor (0–7), intermediate (8–10) or ideal (11–14). Retinal age gap was defined as the difference between biological age predicted by fundus images and chronological age. Accelerated and non-accelerated retinal ageing was defined if retinal age gap was in the upper or lower 50% quantiles of the study population, respectively. Linear and logistic regression models estimated the association of overall CVH and each metric of CVH with retinal age gap respectively. Our results showed that in the fully adjusted model, each one-unit score increase in overall CVH was negatively associated with retinal age gap (odds ratio [OR] = 0.89, 95% confidence interval [CI]: 0.87-0.92, P 0.001). Compared with poor overall CVH, people with intermediate and ideal overall CVH had significantly lower retinal age gap (OR = 0.76, 95%CI: 0.67–0.85, P 0.001 OR = 0.58, 95%CI: 0.50–0.67, P 0.001). Similar associations were found between overall CVH and accelerated retinal ageing. CVH metrics including smoking, BMI, BP, and blood glucose were also significantly associated with higher retinal age gap. Taken together, we found a significant and inverse dose-response association between CVH metrics and retinal age gap, indicating that maintaining healthy metrics especially smoking, BMI, BP, and blood glucose may be crucial to slow down biological ageing.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2022
DOI: 10.1097/IAE.0000000000003613
Abstract: To investigate longitudinal changes in peripapillary choroidal thickness (pCT) and retinal nerve fiber thickness (pRNFLT) in patients with Type 2 diabetes mellitus. This was a prospective observational cohort study. Patients with Type 2 diabetes mellitus without diabetic retinopathy (DR) at baseline were recruited, followed up for three years, and further ided into an incident DR group and a non-DR group according to the outcome. The pCT and pRNFLT were measured through swept-source optical coherence tomography at 1-year interval, and the mean rates of pCT and pRNFLT thinning were compared between the DR groups. A total of 682 patients (682 eyes) were included in the final analysis. After 3-years follow-up, 122 (17.89%) developed DR. Both pCT and pRNFLT progressively thinned (−2.37 [−2.80 to −1.95] µ m/year −0.40 [−0.55 to −0.25] µ m/year, respectively, P 0.05) and accelerated thinning was observed in the incident DR group. The rates of pCT thinning (−3.92 [−4.96 to −2.88] µ m/year, −2.03 [−2.49 to −1.57] µ m/year, respectively) and pRNFLT loss (−1.03 [−1.31 to −0.76] µ m/year, −0.26 [−0.43 to −0.09] µ m/year, respectively) in the incident DR group were 1.93 and 3.96 times faster than those in the non-DR group, respectively. In addition, pCT and pRNFLT thinning were negatively related in Type 2 diabetes mellitus population, and faster pCT thinning indicated slower pRNFLT loss. Patients with Type 2 diabetes mellitus were at a higher risk of developing DR when accelerated pCT and pRNFLT thinning were present, indicating that heavier choroidal damage and retinal neurodegeneration precede clinical DR. The pCT and pRNFLT have the potential to serve as novel sensitive biomarkers of preclinical and early DR.
Publisher: Elsevier BV
Date: 03-2022
Start Date: 2004
End Date: 12-2006
Amount: $27,000.00
Funder: Australian Research Council
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