Prevalance of ocular disorders from three communities in Oregon

Objective: The goal of this study was to understand and categorize the patients seen by interns at several Pacific University College of Optometry clinics. Methods: We performed a retrospective study of the files contained within 3 of the 5 Pacific University affiliated clinics that have ongoing patient care. 300 patient records were reviewed at the largest clinic, Forest Grove, 205 from the downtown Portland clinic, and 100 from the Virginia Garcia clinic. Information was collected on patient demographics, chief complaint, symptoms and disorders, the 21-point exam and clinical diagnoses. Results: Demographically all three clinics show patient bases of equal numbers of females and males. The Virginia Garcia clinic was 95 % Hispanic whereas the other two clinics showed smaller ethnic/minority population proportions. The most common reasons patients came to our clinics was for a regular eye checkup, blurred vision near, far or both. The third most common reason overall, and the most common for Virginia Garcia patients, was for diseases-like symptoms. The most common complaints checked on the intake form were blurred vision, headaches and irritated eyes. Both Portland and Forest Grove patient files reported myopia as the most prevalent type of ametropia whereas in Virginia Garcia; emmetropia was the most prevalent. The study also found that although Pacific University teaches the 21-point eye exam, interns do not seem to gather enough information on what is termed complete eye exams to make conclusive diagnoses of binocular disorders. Furthermore, although one of the goals of this study was to describe the demographics of the clinic\u27s patient populations, the amount of information collected from the patient records was limited. Conclusion: The study shows that Virginia Garcia has a large Hispanic component and that their chief complaints are more often disease oriented than for blurry vision. Also our study indicates that Vision Therapy should be offered in English and in Spanish at either the Virginia Garcia and Forest Grove clinic at least once a week since there is greater amount of amblyopia found in these clinics. Lastly, training at Pacific University and each of the affiliated clinics should stress more the importance of collecting complete information during patient interviews and eye exams

Acanthamoeba keratitis: perspectives for patients

Purpose: To unveil the long-term prognosis of Acanthamoeba keratitis based on clinical presentation and timing of diagnosis to better inform patients since the first visit regarding their length of treatment, quality of life, and visual function.Methods: Retrospective observational study enrolling patients with Acanthamoeba keratitis from 1994 to 2019. Patients with a complete eye examination and medical records were analyzed. The severity of the disease, the time from onset of symptoms to the appropriate therapeutic regimen, the time until clinical resolution, visual function, and long term follow-up was evaluated. Quality of life was assessed at the last follow-up visit by means of the VFQ-25 questionnaire.Results: Thirty-five patients (40 eyes) were assessed. The overall healing time of patients with Acanthamoeba keratitis was 12.5 ± 3.5 months, while patients with a severe corneal ulcer (stage III) had a significant longer healing time (16.2 ± 3.7 months) compared to patients with stage II (7.04 ± 0.7 months) or I (7.7 ± 1.5 months; p < .05). Patients who received a prompt therapy (<30 days form symptoms onset) had a reduced healing time compared to patients with a delayed diagnosis (p < .01). Quality of life was assessed after a mean of 11.7 ± 4.7 years and it was mildly reduced (86.6 ± 17). Patients that were diagnosed early (<30 days from onset) showed a lower reduction in quality of life than in patients that were diagnosed >30 days from onset. After resolution, 59% of the patients considered unnecessary any further proposed surgical intervention.Conclusions: Delayed diagnosis of Acanthamoeba keratitis and disease severity significantly increases healing time and duration of treatment. The time to diagnosis and disease stage at diagnosis predicts the duration of treatment, the final outcome, quality of life, and the requirement of surgery. These data would allow us to promptly inform patients about long-term disease timeline, future outcomes, improving disease acceptance, and quality of life

Sands of Sahara after LASIK in Avellino Corneal Dystrophy

We report the case of a patient diagnosed with Avellino corneal dystrophy (ACD) who developed diffuse interstitial keratitis following excimer laser insitu keratomileusis (LASIK). ACD is an autosomal dominant corneal dystrophy characterized by multiple asymmetric stromal opacities that impair vision. Accepted treatments for this condition include corneal transplantation and phototherapeutic keratectomy (PTK). Our patient underwent LASIK at another institution to correct myopia. LASIK and photorefractive keratectomy (PRK) are usually contraindicated in ACD for the high risk of disease recurrence and postoperative complications. The patient came to our attention lamenting blurry vision, decreased visual acuity, and photophobia. Ophthalmologic examination revealed bilateral interstitial keratitis, also known as “sands of Sahara”, a seldom-seen complication of LASIK characterized by fine and diffuse granular infiltrates at the surgical flap interface.The risk of developing interstitial keratitis, as in the case presented here, represents another valid reason for avoiding LASIK in patients with ACD

Critical function of PRDM2 in the neoplastic growth of testicular germ cell tumors

Testicular germ cell tumors (TGCTs) derive from primordial germ cells. Their maturation is blocked at different stages, reflecting histological tumor subtypes. A common genetic alteration in TGCT is a deletion of the chromosome 1 short arm, where the PRDM2 gene, belonging to the Positive Regulatory domain gene (PRDM) family, is located. Expression of PRDM2 gene is shifted in different human tumors, where the expression of the two principal protein forms coded by PRDM2 gene, RIZ1 and RIZ2, is frequently unbalanced. Therefore, PRDM2 is actually considered a candidate tumor suppressor gene in different types of cancer. Although recent studies have demonstrated that PRDM gene family members have a pivotal role during the early stages of testicular development, no information are actually available on the involvement of these genes in TGCTs. In this article we show by qRT-PCR analysis that PRDM2 expression level is modulated by proliferation and differentiation agents such as estradiol, whose exposure during fetal life is probably an important risk factor for TGCTs development in adulthood. Furthermore in normal and cancer germ cell lines, PRDM2 binds estradiol receptor α (ERα) and influences proliferation, survival and apoptosis, as previously reported using MCF-7 breast cancer cell line, suggesting a potential tumor-suppressor role in TGCT formation

NGF modulates trkANGFR/p75NTR in αsMA-expressing conjunctival fibroblasts from human ocular cicatricial pemphigoid (OCP)

OBJECTIVE: In a previous study, we reported the upregulation of Nerve Growth Factor (NGF) and trkANGFR expression in Ocular Cicatricial Pemphigoid (OCP), an inflammatory and remodeling eye disease. Herein, we hypothesize a potential NGF-driven mechanism on fibroblasts (FBs) during OCP remodeling events. To verify, human derived OCP-FBs were isolated and characterized either at baseline or after NGF exposure. MATERIALS AND METHODS: Conjunctival biopsies were obtained from 7 patients having OCP and 6 control subjects (cataract surgery). Both conjunctivas and primary FB cultures were characterised for αSMA, NGF and trkANGFR/p75NTR expression. Subcultures were exposed to NGF and evaluated for αSMA, NGF, trkANGFR/p75NTR expression as well as TGFβ1/IL4 release. For analysis, early and advanced subgroups were defined according to clinical parameters. RESULTS: OCP-conjunctivas showed αSMA-expressing FBs and high NGF levels. Advanced OCP-FBs showed higher αSMA expression associated with higher p75NTR and lower trkANGFR expression, as compared to early counterparts. αSMA expression was in keeping with disease severity and correlated to p75NTR. NGF exposure did not affect trkANGFR levels in early OCP-FBs while decreased both αSMA/p75NTR expression and TGFβ1/IL4 release. These effects were not observed in advanced OCP-FBs. CONCLUSIONS: Taken together, these data are suggestive for a NGF/p75NTR task in the potential modulation of OCP fibrosis and encourages further studies to fully understand the underlying mechanism occurring in fibrosis. NGF/p75NTR might be viewed as a potential therapeutic target

Sensor-embedded face masks for detection of volatiles in breath: a proof of concept study

The correlation between breath volatilome and health is prompting a growing interest in the development of sensors optimized for breath analysis. On the other hand, the outbreak of COVID-19 evidenced that breath is a vehicle of infection; thus, the introduction of low-cost and disposable devices is becoming urgent for a clinical implementation of breath analysis. In this paper, a proof of concept about the functionalization of face masks is provided. Porphyrin-based sensors are among the most performant devices for breath analysis, but since porphyrins are scarcely conductive, they make use of costly and bulky mass or optical transducers. To overcome this drawback, we introduce here a hybrid material made of conducting polymer and porphyrins. The resulting material can be easily deposited on the internal surface of standard FFP face masks producing resistive sensors that retain the chemical sensitivity of porphyrins implementing their combinatorial selectivity for the identification of volatile compounds and the classification of complex samples. The sensitivity of sensors has been tested with respect to a set of seven volatile compounds representative of diverse chemical families. Sensors react to all compounds but with a different sensitivity pattern. Functionalized face masks have been tested in a proof-of-concept test aimed at identifying changes of breath due to the ingestion of beverages (coffee and wine) and solid food (banana- and mint-flavored candies). Results indicate that sensors can detect volatile compounds against the background of normal breath VOCs, suggesting the possibility to embed sensors in face masks for extensive breath analysis

Lamellar macular holes: monitoring and management strategies

Lamellar macular holes are a vitreoretinal condition characterized by abnormalities in foveal contour with splitting of the neuroepithelium and often an intact photoreceptor layer. Recent developments in high-resolution imaging have increased our ability to study the details of the vitreoretinal interface and to distinguish between different forms of lamellar holes. A new classification is needed to help clinicians in the management of lamellar macular holes. Some clinicians prefer to observe these clinical entities, especially when visual acuity is maintained or alterations of the photoreceptor layer are present. Nevertheless, lamellar holes may sometimes progress, and visual acuity can deteriorate. On the other hand, surgical treatment may lead to positive anatomical and functional outcomes, but not without risks. This review provides a critical overview of the available data on lamellar macular holes, focusing on diagnosis and managing options

ROS in cancer therapy: the bright side of the moon.

Reactive oxygen species (ROS) constitute a group of highly reactive molecules that have evolved as regulators of important signaling pathways. It is now well accepted that moderate levels of ROS are required for several cellular functions, including gene expression. The production of ROS is elevated in tumor cells as a consequence of increased metabolic rate, gene mutation and relative hypoxia, and excess ROS are quenched by increased antioxidant enzymatic and nonenzymatic pathways in the same cells. Moderate increases of ROS contribute to several pathologic conditions, among which are tumor promotion and progression, as they are involved in different signaling pathways and induce DNA mutation. However, ROS are also able to trigger programmed cell death (PCD). Our review will emphasize the molecular mechanisms useful for the development of therapeutic strategies that are based on modulating ROS levels to treat cancer. Specifically, we will report on the growing data that highlight the role of ROS generated by different metabolic pathways as Trojan horses to eliminate cancer cells

Challenges in acanthamoeba keratitis: a review

To review challenges in the diagnosis and management of Acanthamoeba keratitis (AK), along with prognostic factors, in order to help ophthalmologists avoid misdiagnosis, protracted treatment periods, and long-term negative sequelae, with an overarching goal of improving patient outcomes and quality of life, we examined AK studies published between January 1998 and December 2019. All manuscripts describing clinical manifestations, diagnosis, treatment, prognosis, and challenges in short- and long-term management were included. The diagnosis of AK is often challenging. An increased time between symptom onset and the initiation of appropriate therapy is associated with poorer visual outcomes. The timely initiation of standardized antiamoebic therapies improves visual outcomes, decreases the duration of treatment, and reduces the chances of needing surgical intervention. In clinical practice, AK diagnosis is often missed or delayed, leading to poorer final visual outcomes and a negative impact on patient morbidity and quality of life

Inflammaging at ocular surface: clinical and biomolecular analyses in healthy volunteers

PURPOSE. To assess the ocular surface in volunteers who consider themselves as healthy, in order to evaluate how para-inflammatory mechanisms fail with age, and thus investigate the phenomenon of "InflammAging.''METHODS. In this observational prospective cohort study, volunteers were categorized into three groups according to age: young (19-40 years), middle-aged (41-60 years), and older adults (61-93 years). Clinical assessments included tear breakup time (T-BUT) and Schirmer test type I. Dry eye symptoms were evaluated by the Ocular Surface Disease Index (OSDI) questionnaire. Conjunctival mRNA and protein expression of intercellular adhesion molecule-1 (ICAM-1), MUC5AC, and IL-8 were measured by real-time PCR and immunofluorescence.RESULTS. A total of 82 volunteers (38 males and 44 females) were enrolled. T-BUT decreased significantly with increasing age (young: 11.13 +/- 0.18 seconds; middle-aged: 10.83 +/- 0.56 seconds; older: 9.00 +/- 1.00 seconds, P < 0.05). Schirmer test values decreased significantly with age (young: 20.6 +/- 1.0 mm; middle-aged: 19.2 +/- 1.2 mm; older: 16.0 +/- 1.1 mm, P < 0.05). OSDI scores increased with age in both groups, but they were substantially higher in women. Conjunctival expression of inflammatory markers ICAM-1, IL-8, and MUC5AC increased with age.CONCLUSIONS. Clinical signs, symptoms, and biomarkers of chronic inflammation increased with age in a cohort of volunteers who considered themselves healthy, indicating an age-related progressive impairment of ocular surface system function