Real-world management of treatment-naïve diabetic macular oedema : 2-year visual outcome focusing on the starting year of intervention from STREAT-DMO study

Background/aims To investigate the yearly change of real-world outcomes for best corrected visual acuity (BCVA) after 2-year clinical intervention for treatment-naïve diabetic macular oedema (DMO). Methods Retrospective analysis of aggregated, longitudinal medical records obtained from 27 retina specialised institutions in Japan from Survey of Treatment for DMO database. A total of 2049 treatment-naïve centre involving DMO eyes of which the initial intervention started between 2010 and 2015, and had been followed for 2 years, were eligible. As interventions, antivascular endothelial growth factor (VEGF) agents, local corticosteroids, macular photocoagulation and vitrectomy were defined. In each eye, baseline and final BCVA, the number of each intervention for 2 years was extracted. Each eye was classified by starting year of interventional treatment. Results Although baseline BCVA did not change by year, 2-year improvement of BCVA had been increased, and reached to +6.5 letters in the latest term. There is little difference among starting year about proportions of eyes which BCVA gained >15 letters, in contrast to those which lost >15 letters were decreased by year. The proportion of eyes receiving anti-VEGF therapy was dramatically increased, while those receiving the other therapies were gradually decreased. The proportion of eyes which maintained socially good vision of BCVA>20/40 has been increased and reached to 59.0% in the latest term. Conclusion For recent years, treatment patterns for DMO have been gradually but certainly changed; as a result, better visual gain, suppression of worsened eyes and better final BCVA have been obtained. Anti-VEGF therapy has become the first-line therapy and its injection frequency has been increasing

Diabetic macular edema and aging

Aims/Introduction: In older patients, the management of diabetic macular edema (DME) can be complicated by comorbidities, geriatric syndrome, and socioeconomic status. This study aims to evaluate the effects of aging on the management of DME. Materials and Methods: This is a real-world clinical study including 1,552 patients with treatment-naïve center-involved DME. The patients were categorized into 4 categories by age at baseline (C1, <55; C2, 55–64; C3, 65–74; and C4, ≥75 years). The outcomes were the change in logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA) and central retinal thickness (CRT), and the number of treatments from baseline to 2 years. Results: From baseline to 2 years, the mean changes in logMAR BCVA from baseline to 2 years were −0.01 in C1, −0.06 in C2, −0.07 in C3, and 0.01 in C4 (P = 0.016), and the mean changes in CRT were −136.2 μm in C1, −108.8 μm in C2, −100.6 μm in C3, and −89.5 μm in C4 (P = 0.008). Treatments applied in the 2 year period exhibited decreasing trends with increasing age category on the number of intravitreal injections of anti-VEGF agents (P = 0.06), selecting local corticosteroid injection (P = 0.031), vitrectomy (P < 0.001), and laser photocoagulation outside the great vascular arcade (P < 0.001). Conclusions: Compared with younger patients with DME, patients with DME aged ≥75 years showed less frequent treatment, a lower BCVA gain, and a smaller CRT decrease. The management and visual outcome in older patients with DME would be unsatisfactory in real-world clinical practice

Real-world management of treatment-naïve diabetic macular oedema in Japan : two-year visual outcomes with and without anti-VEGF therapy in the STREAT-DME study

Background/Aims To investigate real-world outcomes for best-corrected visual acuity (BCVA) after 2-year clinical intervention for treatment-naïve, centr-involving diabetic macular oedema (DME). Methods Retrospective analysis of longitudinal medical records obtained from 27 institutions specialising in retinal diseases in Japan. A total of 2049 eyes with treatment-naïve DME commencing intervention between 2010 and 2015 who were followed for 2 years were eligible. Interventions for DME included anti-vascular endothelial growth factor (VEGF) therapy, local corticosteroid therapy, macular photocoagulation and vitrectomy. Baseline and final BCVA (logMAR) were assessed. Eyes were classified by the treatment pattern, depending on whether anti-VEGF therapy was used, into an anti-VEGF monotherapy group (group A), a combination therapy group (group B) and a group without anti-VEGF therapy (group C). Results The mean 2-year improvement of BCVA was −0.04±0.40 and final BCVA of >20/40 was obtained in 46.3% of eyes. Based on the treatment pattern, there were 427 eyes (20.9%) in group A, 807 eyes (39.4%) in group B and 815 eyes (39.8%) in group C. Mean improvement of BCVA was −0.09±0.39, –0.02±0.40 and −0.05±0.39, and the percentage of eyes with final BCVA of >20/40 was 49.4%, 38.9%, and 52.0%, respectively. Conclusion Following 2-year real-world management of treatment-naïve DME in Japan, BCVA improved by 2 letters. Eyes treated by anti-VEGF monotherapy showed a better visual prognosis than eyes receiving combination therapy. Despite treatment for DME being selected by specialists in consideration of medical and social factors, a satisfactory visual prognosis was not obtained, but final BCVA remained >20/40 in half of all eyes

Evaluation of angiotensin-converting enzyme-inhibitory activity in abalone viscera fermented by Lactobacillus casei 001

Abalone viscera are typically discarded in the food industry. This study evaluated the potential use of abalone viscera as a functional food. After fermentation by lactic acid bacteria, namely Lactobacillus casei 001, abalone viscera exhibited the ability to inhibit angiotensin-converting enzyme (ACE) and suppressed blood pressure increases in healthy mice and spontaneously hypertensive rats. Purification and characterization of extracts derived from fermented abalone viscera showed that the active component was homarine, which exhibited strong, noncompetitive ACE-inhibitory capacity. Altogether, these findings suggest that abalone viscera fermented by lactic acid bacteria hold potential as functional food materials to manage blood pressure

Antihypertensive effects of abalone viscera fermented with Lactiplantibacillus pentosus SN001 via angiotensin-converting enzyme inhibition

Abalone viscera, which accounts for more than 20% of body weight, is typically discarded. With increases in abalone aquaculture production, novel uses for abalone viscera are needed. Here, we evaluated the effects of abalone viscera fermented with Lactiplantibacillus pentosus SN001 on angiotensin-converting enzyme (ACE) activity and blood pressure elevation in spontaneously hypertensive rats.The fermented product significantly reduced systolic blood pressure compared with the control. There were no significant differences in blood glucose, triglyceride, total cholesterol, or high-density lipoprotein cholesterol levels; alanine aminotransferase activity; and aspartate aminotransferase activity between the fermented product and control groups. Uracil was isolated and identified from the fermented product.Uracil may be the active component. Overall, L. pentosus SN001-fermented abalone viscera showed sustained inhibitory effects on blood pressure elevation but did not alter blood components after long-term intake.These results provide insights into the safety of L. pentosus SN001-fermented abalone viscera as a food product

Antihypertensive effects of abalone viscera fermented with Lactiplantibacillus pentosus SN001 via angiotensin-converting enzyme inhibition

Abalone viscera, which accounts for more than 20% of body weight, is typically discarded. With increases in abalone aquaculture production, novel uses for abalone viscera are needed. Here, we evaluated the effects of abalone viscera fermented with Lactiplantibacillus pentosus SN001 on angiotensin-converting enzyme (ACE) activity and blood pressure elevation in spontaneously hypertensive rats. The fermented product significantly reduced systolic blood pressure compared with the control. There were no significant differences in blood glucose, triglyceride, total cholesterol, or high-density lipoprotein cholesterol levels; alanine aminotransferase activity; and aspartate aminotransferase activity between the fermented product and control groups. Uracil was isolated and identified from the fermented product. Uracil may be the active component. Overall, L. pentosus SN001-fermented abalone viscera showed sustained inhibitory effects on blood pressure elevation but did not alter blood components after long-term intake. These results provide insights into the safety of L. pentosus SN001-fermented abalone viscera as a food product

A Longitudinal Study of Subjective Daytime Sleepiness Changes in Elementary School Children Following a Temporary School Closure Due to COVID-19

Excessive daytime sleepiness is increasingly being recognized as a major global health concern. However, there have been few studies related to sleepiness and its associated factors in elementary school children. In Japan, all schools were closed from February to May 2020 to prevent coronavirus disease 2019 (COVID-19) outbreaks. The aim of this study was to identify changes in the subjective sleepiness of pupils during the 1.5-year period and to elucidate factors associated with changes in sleepiness. Questionnaire surveys about pupils’ sleep habits and the Japanese version of the Pediatric Daytime Sleepiness Scale (PDSS-J) were conducted longitudinally at one elementary school in June 2019, January 2020, and June 2020. The average ∆PDSS score was 0.94 ± 5.51 (mean ± standard deviation) from June 2019 to January 2020 and −1.65 ± 5.71 (t[498] = 6.13, p p = 0.02) during the school closure. A less restrictive school schedule secondary to a COVID-19-related school closure decreased sleepiness in children and was associated with decreasing social jetlag