Prevalence of comorbidities with the potential to increase the risk of nonadherence to topical ocular hypotensive medication in patients with open-angle glaucoma

To evaluate the prevalence of comorbidities that may limit or prevent adherence to topical ocular hypotensive therapy in patients with open-angle glaucoma (OAG). The UK Clinical Practice Research Datalink (CPRD) database of primary and secondary care and prescription records was analyzed to identify patients with a first (index) diagnosis of OAG during 2016–2020. The primary care records of these patients were screened for diagnostic terms linked to prespecified (qualifying) comorbidities considered to have the potential to impact patients’ ability to instill eye drops. The prevalence of each of 10 categories of qualifying comorbidity recorded within the period from 5 years before to 2 years after the index OAG diagnosis was analyzed. A total of 100,968 patients with OAG were included in the analysis. Among the patients in the OAG cohort, 13,962 (13.8%) were aged 40–54 years, 32,145 (31.8%) were aged 55–69 years, 42,042 (41.6%) were aged 70–84 years, and 12,819 (12.7%) were aged 85+ years. Within the OAG population, 82.7%, 14.6%, and 2.7% of patients had no category, one category, and two or more categories of qualifying comorbidity, respectively. Qualifying comorbidities were most common in older patients. The most prevalent qualifying comorbidities were categorized as degenerative, traumatic, or pathological central nervous system disorder disrupting cognitive function (5.2%), movement disorder (4.4%), and low vision (4.1%). The prevalence of arthropathies and injuries affecting upper limbs (including arthritis in the hands) was 2.4%. The presence of comorbidities should be considered when determining whether eye drops are suitable treatment for glaucoma. Neurodegenerative disease affecting cognition and memory, motor disease, and low vision are common comorbidities that may impact adherence to eye drops, and affected patients may benefit from non-drop treatment modalities.</p

Systemic Effects of Repeated Intraocular Dexamethasone Intravitreal Implant in Diabetic Patients: A Retrospective Study

<p><strong>Article full text</strong></p> <p><br> The full text of this article can be found <a href="https://link.springer.com/article/10.1007/s13300-017-0307-y"><b>here</b>.</a><br> <br> <strong>Provide enhanced content for this article</strong><br> If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <u>[email protected]</u>.<br> <br> The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.<br> <br> Other enhanced features include, but are not limited to:<br> • Slide decks<br> • Videos and animations<br> • Audio abstracts<br> • Audio slides</p> <p> </p> <p> </p> <p> </p> <p> </p

Vision-related Quality of Life in Patients with Non-infectious Uveitis: A Cross-sectional Study

<p><i>Purpose</i>: To analyze the influence of socio-demographic, comorbidity, and clinical-related variables in the vision-related quality of life (VR-QoL) of non-infectious uveitis patients.</p> <p><i>Methods</i>: Cross-sectional study includes 156 consecutive non-infectious uveitis patients from a tertiary uveitis clinic from Madrid (Spain). The main outcome was the log-transformed composite score of the Visual Functioning Questionnaire 25. Bivariate and multivariate ordinary least-squares regression models were performed and results expressed using effect sizes with 95% confidence intervals (95% CI).</p> <p><i>Results</i>: In the multivariate analysis, one unit increase in the logarithm of the minimum angle of resolution scale [i.e., worse best corrected visual acuity (BCVA)] was associated with a seven times worse VR-QoL (a 0.14-fold change [95% CI: 0.07–0.27]). Patients with ocular comorbidities had a 64% worse VR-QoL (a 0.61-fold change [95% CI: 0.49–0.77]).</p> <p><i>Conclusions</i>: Lower BCVA and the presence of ocular comorbidities had a significant, independent, and deleterious effect in the VR-QoL of non-infectious uveitis patients.</p

Case 3.

<p><b>Trabeculectomy sample from the left eye.</b> Transmission electron microscopy. A: Uveal trabecular meshwork. B: High magnification of inset in A. The endothelial cells of the trabecular beams have disappeared and the remains are necrotic (N). In some areas, the trabecular beams have an empty appearance (white arrow) while others are completely filled (arrowhead) with type VI non-fibrillary collagen (nf) intermingled with the collagen of the basal membrane (bm), as observed in B. The degraded type VI collagen detaches from the periphery of the trabecular beam (black arrow). [e: elastic-like tissue; G: ground substance].</p

Case 4.

<p><b>Trabeculectomy sample from the left eye.</b> Transmission electron microscopy. A and B: Schlemm’s canal (SC), juxtacanalicular tissue (JCT) (double arrows), and corneoscleral trabecular meshwork (CTM) (double arrows). Some endothelial cells lining the inner wall of SC are necrotic (inset in A) and others have some vacuoles (inset in B). The JCT has two differentiated areas: a band (double white arrow) formed mainly by coalescent fibrillary collagen (C) with scarce “optically empty spaces” (o). Next to this band the second area is composed of fibrillary collagen (C), abundant elastic-like fibers (e), stellate cells (some of them necrotic) (S), and “optically empty spaces” (o). Most endothelial trabecular cells are necrotic (N). C: High magnification of the corneoscleral trabecular meshwork beams. The trabecular core is filled with coalescent fibrillary collagen (C), elastic-like fibers (e) and few “optically empty spaces” (o). The trabecular beams are lined by necrotic endothelial cells (N) lying on a basal membrane (bm) which is thickened in some areas. [a: intertrabecular spaces in CTM].</p

Case 1.

<p><b>Trabeculectomy sample from the right eye.</b> A: Light micrograph. B-D: Transmission electron microscopy. A: Schlemm’s canal is absent. The region corresponding to the trabecular meshwork (TM) consists of a compact tissue. The ciliary muscle (CM) is located in front of the undifferentiated TM. B: Compacted trabecular beams (TB) (double arrows). Large endothelial cells (E) lining some of the trabeculae. Melanin granules (arrow). C: The image shows two trabecular beams fused (double arrows), the endothelial coating has disappeared at the point of fusion (asterisk). D: The trabecular core is filled by collagen (C) and elastic-like tissue (e). An enlarged endothelial cell (E) between two trabecular beams (TB) is shown. [double arrow: trabecular beam].</p

Case 3.

<p><b>Trabeculectomy sample from the left eye.</b> A: Light micrograph. B-G: Transmission electron microscopy. A: Schlemm’s canal (SC) has an open lumen. The corneoscleral trabecular meshwork (CTM) is constituted by quite compact trabecular beams. In the uveal trabecular meshwork (UTM) the intertrabecular spaces (b) are evident. B: The image shows a part of Schlemm’s canal (SC) and the juxtacanalicular tissue. In the SC, only debris of necrotic endothelial cells (N) is visible on a thick basal membrane (bm). In the juxtacanalicular tissue, alternate layers of elastic tissue (e), necrotic cells (N), fibrillary collagen (C) and abundant ground substance (G) are seen. C: The corneoscleral trabecular meshwork is constituted by a quite disintegrated tissue. The trabecular beams (TB) (double arrows) have an “empty” appearance and are separated by intertrabecular spaces filled with debris of necrotic endothelial cells (N) and detached collagen (C) from the trabecular beams. D: The image shows fused trabecular beams (TB) (double arrows) and in some zones between them, debris from necrotic cells (white arrowhead) appears. The trabecular beams is constituted by a basal membrane (bm), many elastic-like fibers (e), fibrillary collagen (C), and abundant ground substance (G). E: The image shows two endothelial cells, one shows necrosis (N) and the other one has autophagic activity (arrow). F and G: Detail of the autophagic activity of an endothelial trabecular cell. F: Mitophagy (mp). G: Autophagosome (ap) with a double-membrane containing cytoplasmic material and organelles: mitochondria (M), rough endoplasmic reticulum (RER) and ribosomes (R).</p

Case 4.

<p><b>Trabeculectomy sample from the left eye.</b> Light micrographs. A: Schlemm’s canal (SC), juxtacanalicular tissue (JCT) (double arrows), corneoscleral trabecular meshwork (CTM) (double arrows) and uveoscleral trabecular meshwork (UTM) (double arrows) are shown. Intertrabecular spaces are evident in both the CTM (a) and UTM (b). The ciliary muscle (CM) is inserted overlapping the SC. Numerous red blood cells can be observed in all aqueous outflow pathways (arrowhead). B: High magnification of the image shown in A. The SC shows a large lumen. A well-defined light-blue band (arrow) is visible in the JCT (double arrows) next to the endothelial cells lining the inner wall of the SC. The CTM has evident intertrabecular spaces in some areas (a) while in others, the trabecular beams are fused (white double arrow).</p

Reclamation of the Lake Most and Impact on Tourism of the Town

Tato bakalářská práce je zaměřena na rekultivované jezero Most a jeho ekonomický dopad na město Most. Předmětem práce je především analýza vnějšího okolí a jeho celkové začlenění do zdejšího území. Dotazníkové šetření z kterého vyplývá odhad budoucí návštěvnosti. Zájem obyvatel o projekt a zhodnocení zda-li zvolený návrh dle veřejného mínění je dobrou volbou. Poslední část je věnována SWOT analýze, která hodnotí silné a slabé stránky projektu a budoucí příležitosti a hrozby.This Bachelor's thesis focuses on the reclaimed Most lake and its economic impact on the city of Most. The primary subject of this document is the analysis of the external environment and its total integration into the local area. A questionnaire is used to determine an estimation of future visitor traffic, the interest of residents in the project and, according to public opinion, an evaluation of whether the selected design was a good choice. The final section is dedicated to a SWOT analysis that assesses the strengths and weaknesses of the project as well as future opportunities and threats.545 - Institut ekonomiky a systémů řízenívýborn

Anterior-chamber angle of normal eyes.

<p>A: Light micrograph. B and C: Transmission electron microscopy. B: Juxtacanalicular tissue (JCT) and corneoscleral trabecular meshwork (CTM). C: Uveal trabecular meshwork (UTM). A: The ciliary muscle (CM) is inserted backwards to the scleral spur (SP). Schlemm’s canal (SC) and the collector channel (CC) have an open lumen. The trabecular meshwork is constituted by well-developed trabecular beams (TB) and intertrabecular spaces (*). Two regions can be distinguished in the TM: the CTM, formed by 6 to 8 layers of trabecular beams and the UTM composed of 2 to 3 layers of trabecular beams. B and C: The JCT (in B) is composed by stellate cells (S) and a loose extracellular matrix in which collagen (C), elastic fibers (e), and numerous “optically empty spaces” (o) are visible. The trabecular beams both in CTM and UTM (in B and C) are constituted by a central core made up mainly by collagen (C), elastic-like fibers (e) and amorphous ground substance (G). This central core is coated by phagocytic endothelial cells (E) that can bridge the intertrabecular spaces (arrow). The main difference between CTM (in B) and UTM (in C) is the size of the intertrabecular spaces, being larger in UTM (b) than in CTM (a). [arrowhead: pigmented granules phagocyted].</p