Human lens proteins: aspects of aging

Contains fulltext : mmubn000001_026873729.pdf (publisher's version ) (Open Access)Promotores : H. Hoenders en H. Bloemendal[8], 91 p

[Revised guideline 'Diabetic retinopathy: screening, diagnosis and treatment']

Item does not contain fulltextThe revised evidence-based guideline 'Diabetic retinopathy: screening, diagnosis and treatment' contains important recommendations concerning screening, diagnosis and treatment of diabetic retinopathy. Regular screening and the treatment of risk factors, such as hyperglycemia, hypertension, adipositas and dyslipidemia, can prevent retinopathy and slow down its development. Fundus photography is recommended as a screening method. If necessary, diagnosis by biomicroscopy and a treatment consisting of photocoagulation and/or vitrectomy should be performed by the ophthalmologist. The reassessment of responsibilities is a vital component of the implementation of the guideline bearing in mind that the screening in particular, can be performed by personnel other than ophthalmologists

Measuring the refractive properties of the diabetic eye during blurred vision and hyperglycaemia using aberrometry and Scheimpflug imaging

PURPOSE: This study aimed to measure the refraction and geometry in the diabetic eye during the presence and absence of hyperglycaemia and blurred vision, using aberrometry and Scheimpflug imaging. METHODS: Aberrometry and Scheimpflug imaging were used to examine ocular refraction and higher-order aberrations, as well as the shape of the cornea and the lens, in 25 patients with diabetes mellitus. From these parameters, the equivalent refractive index of the lens was calculated. Using paired t-tests, comparisons were made between a first series of measurements (Visit 1) taken in the presence of blurred vision and hyperglycaemia (> 10.0 micromol/l), and a second series of measurements (Visit 2) taken under normal conditions. RESULTS: The mean difference in blood glucose between Visits 1 and 2 was 5.9 mmol/l (standard deviation [SD] 3.1) (p <0.0001). Both small hyperopic and myopic shifts of equivalent refractive error (ERE) were found in nine patients (mean absolute difference ERE: 0.38 D [SD 0.12]; p = 0.02). Furthermore, higher-order aberrations (root mean square [RMS] error) were slightly increased in four patients (mean difference RMS error: 0.07 microm [SD 0.02]; p = 0.04) at Visit 1, compared to Visit 2. No significant changes were observed in the shape of the cornea or lens in any of the patients. No significant correlations were found between changes in blood glucose levels and the measured parameters in diabetic eyes. CONCLUSIONS: The present study suggests that subjective symptoms of blurred vision during hyperglycaemia are not necessarily caused by changes in the refractive properties of the diabetic ey

Randomized Controlled Trial on the Effects of CCTV Training on Quality of Life, Depression, and Adaptation to Vision Loss

PURPOSE. In addition to performance-based measures, visionrelated quality of life (QOL) and other subjective measures of psychosocial functioning are considered important outcomes of training in the visually impaired. In a multicenter, masked, randomized controlled trial, subjective effects of training in the use of closed-circuit televisions (CCTV) were investigated. METHODS. Patients (n 1/4 122) were randomized either to a treatment group that received usual delivery instructions from the supplier combined with concise outpatient training, or to a control group that received delivery instructions only. Subjective outcomes were the Low Vision Quality-of-Life Questionnaire (LVQOL), EuroQOL 5 Dimensions, Adaptation to Age- Related Vision Loss (AVL), and the Center of Epidemiologic Studies Depression scales. Linear mixed models were used to investigate treatment effects. Differential effects of patient characteristics were studied by implementing higher order interactions into the models. RESULTS. From baseline to follow-up, all patients perceived significantly less problems on the reading and fine work dimension (-28.8 points; P < 0.001) and the adaptation dimension (-4.67 points; P 1/4 0.04) of the LVQOL. However, no treatment effect was found based on the intention-to-treat analysis. CONCLUSIONS. This study demonstrated the effect of receiving and using a CCTV on two vision-related QOL dimensions; however, outpatient training in the use of CCTVs had no additional value. © 2012 The Association for Research in Vision and Ophthalmology, Inc