For individuals with type 2 diabetes (T2D), semaglutide is associated with a modestly increased risk for nonarteritic anterior ischemic optic neuropathy (NAION), according to a study published online Feb. 20 in JAMA Ophthalmology.

Cindy X. Cai, M.D., from the Johns Hopkins School of Medicine in Baltimore, and colleagues conducted a retrospective study across 14 databases to examine the potential association between semaglutide and NAION. Adults with T2D taking semaglutide, other glucagon-like peptide 1 receptor agonists (GLP-1 RAs; dulaglutide and exenatide), or non-GLP-1 RA medications (empagliflozin, sitagliptin, and glipizide) from Dec. 1, 2017, to Dec. 31, 2023, were included. Of 37.1 million individuals with T2D, there were 810,390 new semaglutide users.

The researchers found that among semaglutide users, the incidence rate of NAION was 14.5 per 100,000 person-years. Using the sensitive NAION definition, the hazard ratio for NAION among new users of semaglutide was not different compared with that of the non-GLP-1 RA medications empagliflozin, sitagliptin, and glipizide. Using the specific definition, the risk was higher for semaglutide users compared with patients taking empagliflozin (hazard ratio, 2.27). The risk for NAION was increased in a self-controlled case series analysis of semaglutide exposure (meta-analysis incidence rate ratio, 1.32).

"In the absence of a known mechanism for this association, we urge clinicians to weigh the concern for an increased risk of a rare but potentially blinding eye condition with the many therapeutic benefits of semaglutide," the authors write.

Several authors disclosed ties to industry.

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There was a notable decrease in common ophthalmic procedures among Medicare beneficiaries during the first year of the COVID-19 pandemic, according to a study published online Feb. 6 in JAMA Ophthalmology.

Raziyeh Mahmoudzadeh, M.D., from the Virginia Commonwealth University in Richmond, and colleagues estimated changes in the rates of the 10 most prevalent ophthalmic procedures among Medicare beneficiaries during the COVID-19 pandemic in a retrospective U.S. cross-sectional study. The analyses included 3,879,533 procedure entries in 2019 and 3,181,439 entries in 2020.

The researchers found that from 2019 to 2020, there was a −17.9 percent overall decrease in the rates of the 10 ophthalmic procedures. The largest reduction was seen for laser peripheral iridotomy, while the smallest decrease was seen for eye drug injections (−43.6 and −1.5 percent, respectively). There was a reduction of −23.0 percent in cataract surgery. Regionally, the greatest reductions in cataract surgery occurred in the Northeast (−27.9 percent).

"Our results demonstrated an overall decrease of 17.9 percent in the rates of the 10 most prevalent ophthalmic procedures during the pandemic," the authors write. "This reduction appears less substantial compared with other fields of medicine, like ear nose and throat, where up to 98 percent reduction in volume of surgical procedures was reported."

One author disclosed financial ties to Regeneron, Astellas, Apellis, and Allergan.

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Elevated high-density lipoprotein cholesterol (HDL-C) is associated with an increased risk for glaucoma, while elevated low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG) are associated with a reduced risk, according to a study published online Feb. 4 in the British Journal of Ophthalmology.

Yiyuan Ma, from Sun Yat-sen University in Guangzhou, China, and colleagues conducted a prospective cohort study involving 400,229 participants from the U.K. Biobank to examine the associations of HDL-C, LDL-C, TC, and TG with glaucoma.

The researchers found that 1.72 percent of the participants developed glaucoma during a mean follow-up of 14.44 years. Higher levels of HDL-C were associated with increased glaucoma risk (hazard ratio, 1.05 [95 percent confidence interval, 1.02 to 1.08; P = 0.001] for one standard deviation increase in HDL-C) in multivariate Cox regression, while reduced risk was seen in association with elevated levels of LDL-C, TC, and TG (hazard ratios [95 percent confidence intervals], 0.96 [0.94 to 0.99; P = 0.005], 0.97 [0.94 to 1.00; P = 0.037], and 0.96 [0.94 to 0.99; P = 0.008], respectively). An analysis of associations between the polygenic risk score of serum lipids and glaucoma showed an increased hazard ratio in association with a one-standard deviation increment of HDL-C genetic risk (hazard ratio, 1.05; 95 percent confidence interval, 1.00 to 1.11; P = 0.031). There were no significant associations seen for the polygenic risk scores of LDL-C, TC, and TG with glaucoma.

"HDL cholesterol has been regarded as the 'good cholesterol' for seven decades," the authors write. "However, this study demonstrates that high levels of HDL cholesterol are not consistently associated with a favorable prognostic outcome."

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No evidence is seen for loss of treatment effect after discontinuing soft multifocal contact lenses in older teenagers with myopia, according to a study published online Jan. 16 in JAMA Ophthalmology.

David A. Berntsen, O.D., Ph.D., from the University of Houston College of Optometry, and colleagues examined whether there is a loss of treatment effect (rebound) after discontinuing soft multifocal contact lenses in the Bifocal Lenses in Nearsighted Kids 2 (BLINK2) cohort study involving 248 children (aged 11 to 17 years at baseline) with myopia who completed the BLINK randomized clinical trial. All children in the BLINK2 study wore high-add (+2.50 diopter [D]) multifocal soft contact lenses for two years and single-vision soft contact lenses during the third year to ascertain whether rebound occurred.

The researchers found that the mean axial length and spherical equivalent refractive error were 25.2 mm and −3.40 D, respectively, at baseline. Regardless of the original BLINK treatment assignment, axial elongation increased by 0.03 mm/year after participants switched from multifocal to single-vision contact lenses, and myopia progression increased by −0.17 D per year after switching to single-vision contact lenses. Throughout BLINK2, there continued to be a difference in axial length and refractive error based on the BLINK Study treatment assignment; shorter eyes and less myopia were seen in the original high-add group than in the original medium-add (+1.50 D) and single-vision groups.

These results "support fitting children with multifocal contact lenses for myopia control at a younger age and, when possible, continuing treatment until the late teenage years when myopia progression has naturally slowed," the authors write.

Several authors disclosed ties to the ophthalmic industry.

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Rural areas are increasingly facing ophthalmic subspecialty surgeon shortages, according to a study published online Jan. 2 in JAMA Ophthalmology.

Aishah Ahmed, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues assessed the geographic distribution of the ophthalmic subspecialist surgeon workforce and evaluated factors associated with practicing in rural areas. The analysis included Medicare Fee-for-Service claims for 1.6 million patients (aged 65 years and older) who underwent subspecialized ophthalmic procedures (2012 through 2022) and 13,526 surgeons performing at least one subspecialty procedure from the following subspecialties: cornea, glaucoma, oculoplastic, retina, or strabismus.

The researchers found that 72.6 percent of the surgeons were male and 33.2 percent practiced in the South. Subspecialty classification included 18.5 percent cornea subspecialists, 26.8 percent glaucoma subspecialists, 14.2 percent oculoplastic subspecialists, 30.0 percent retina subspecialists, and 9.0 percent strabismus subspecialists. A higher proportion of patients (17.4 percent) resided in rural areas relative to surgeons (5.6 percent), with differences ranging from 6.2 to 14.8 percent across subspecialties. Practicing in rural areas was less likely among female surgeons (adjusted odds ratio [aOR], 0.63), surgeons in the Northeast (aOR, 0.62), surgeons in the West (aOR, 0.63), and recent graduates compared with those who graduated 11 to 20 years ago (aOR, 1.66), 21 to 30 years ago (aOR, 1.83), or ≥31 years ago (aOR, 1.43).

"These results suggest that the rural U.S. faces increasing ophthalmic subspecialty surgeon shortages," the authors write.

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Empagliflozin initiation is not associated with incident nonproliferative diabetic retinopathy (NPDR) compared with initiation of a dipeptidyl peptidase 4 inhibitor (DPP4i), according to a study published online Dec. 5 in JAMA Ophthalmology.

Helen Tesfaye, Pharm.D., from Brigham and Women’s Hospital in Boston, and colleagues compared the risk for incident NPDR and DR progression in patients with type 2 diabetes (T2D) initiating empagliflozin versus a DPP4i. The analysis included 34,239 pairs of propensity score-matched adults in the incident NPDR cohort and 7,831 pairs in the DR progression cohort.

The researchers found that during a mean follow-up period of eight months receiving treatment, the risk for incident NPDR did not differ across groups (hazard ratio [HR], 1.04; 95 percent confidence interval [CI], 0.94 to 1.15; rate difference [RD], 1.30; 95 percent CI, −1.83 to 4.44). The risk for DR progression was lower among individuals who initiated empagliflozin versus those who began DPP4i therapy (HR, 0.78; 95 percent CI, 0.63 to 0.96; RD, −9.44; 95 percent CI, −16.90 to −1.98). Across multiple subgroups and sensitivity analyses, results were similar.

"Although residual confounding cannot be entirely ruled out due to the observational nature of our study, these findings may be helpful when weighing the risks and benefits of various glucose-lowering agents in adults with T2D," the authors write.

Several authors disclosed ties to pharmaceutical companies, including Boehringer Ingelheim and Eli Lilly, which manufacture empagliflozin; Boehringer Ingelheim funded the study.

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The genetic testing rate is lower for Black than non-Hispanic White patients with inherited retinal diseases (IRDs), according to a study published online Nov. 7 in JAMA Ophthalmology.

Rebhi O. Abuzaitoun, M.D., from the University of Michigan Medical School in Ann Arbor, and colleagues examined the genetic detection rates of wide-panel testing in Black and non-Hispanic White patients with IRDs using retrospective patient data collected at the University of Michigan (UM) and Blueprint Genetics (BG).

A total of 572 patients were included in UM (9.4 percent Black; 90.6 percent White), while the BG database included 320 Black patients and 2,931 White patients. The researchers found that at UM, there were independent associations for Black race (odds ratio, 0.25) and age (odds ratio per 10 years, 0.84) with reduced odds of a positive test. In the BG database, 44.4 and 57.7 percent of Black and White patients, respectively, had a positive/likely positive result.

"Given that patients with no known genetic diagnosis have fewer options for receiving novel treatments, the equity of genetic testing directly impacts the equity of IRD clinical trials," the authors write. "As future treatments become available, we must critically examine the genetic detection rates across majority and minority subgroups alike."

Authors disclosed ties to Blueprint Genetics and ExamOne (owned by Quest Diagnostics).

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The annual meeting of the American Academy of Ophthalmology was held from Oct. 18 to 21 in Chicago and attracted participants from around the world, including ophthalmologists, optometrists, opticians, and other eye health care professionals. The conference featured presentations focusing on the latest advances in comprehensive eye care, including medical, surgical, and optical care.

In one study, Aidin Spina, of the University of California Irvine School of Medicine, and colleagues found that highly customizable three-dimensional (3D) printed glasses provide a simple yet innovative solution that improves access to specialized eye wear for any pediatric patient, even those with intracranial abnormalities.

From 61 individuals who underwent comprehensive eye exams, four children, aged 2 to 14 years, were selected to receive a pair of customizable 3D-printed glasses based on their unresolved refractive error and diagnosis of amblyopia or strabismus. The researchers say that these low-cost, highly customizable 3D printed glasses are a breakthrough in vision correction for all patients, including children with craniofacial abnormalities. The glasses are lightweight in design, affordable, customizable, and allow for ease of distribution. They do not require onsite 3D printing, which makes them ideal for use in medically underserved areas.

"These glasses expand the options available to all patients with craniofacial abnormalities, providing a significant improvement in visual acuity for those who typically have few choices for effective eye wear," Spina said.

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Among a population-based analysis of 163,663 adults with retinal disease, Winnie Yu, M.D., of the University of Toronto Temerty Faculty of Medicine, and colleagues assessed the risk for cataract surgery complications among patients who previously received intravitreal injections (IVIs).

The authors evaluated differences in the risk for cataract surgery-related complications in patients with retinal disease who previously received IVIs compared to those with no IVI history. Compared with no history of IVI treatment, the researchers found that prior IVI treatment increased the risk for nonclearing vitreous hemorrhage, retained lens fragments, retinal detachment, retinal tear, intraocular lens (IOL) dislocation, anterior vitrectomy, and glaucoma surgery following cataract surgery. However, there was no greater risk seen for corneal transplant, IOL exchange, or IOL repositioning.

"Findings of this study highlight the importance of preoperative and intraoperative surgical planning in the prevention and management of these possible complication events in patients receiving cataract surgery," Yu said. "As well, patients with prior IVI history should be counseled of the potential risks of cataract surgery to ensure appropriate informed surgical decision-making."

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As part of the phase 2 ARCHER study, Rahul Khurana, M.D., of the Northern California Retina-Vitreous Associates in Mountain View, and colleagues found that ANX007, a C1q inhibitor, provides consistent, significant, dose- and time-dependent protection from vision loss among patients with geographic atrophy.

Patients with geographic atrophy were randomly assigned to intravitreal administration of ANX007 5 mg monthly, ANX007 5 mg every other month, or sham treatment for 12 months, with a six-month follow-up. The researchers found that ANX007 protected patients against vision loss from geographic atrophy and helped preserve retinal anatomy. Specifically, the novel agent protected structures in the central fovea, areas most closely correlated with vision. In addition, the researchers identified a more robust effect in patients with less-advanced disease.

"As a physician, I know my patients want to preserve vision so that they can maintain their quality of life," Khurana said. "The therapies we have today for geographic atrophy protect [patients] from retinal pigment epithelium loss/lesion growth, but do not protect against vision loss."

The ARCHER study was funded by Annexon, which is developing ANX007.

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AAO: Prior Intravitreal Injections Increase Risk for Cataract Surgery Complications

WEDNESDAY, Oct. 23, 2024 (HealthDay News) -- A history of multiple past intravitreal injections poses a risk for certain future cataract surgery complications, according to a study presented at the annual meeting of the American Academy of Ophthalmology, held from Oct. 18 to 21 in Chicago.

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AAO: One Year of Valacyclovir Beneficial for Herpes Zoster Ophthalmicus

WEDNESDAY, Oct. 23, 2024 (HealthDay News) -- One year of valacyclovir is beneficial for patients with herpes zoster ophthalmicus, according to a study presented at the annual meeting of the American Academy of Ophthalmology, held from Oct. 18 to 21 in Chicago.

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AAO: Corneal Toxicity Reported With Mirvetuximab Soravtansine

TUESDAY, Oct. 22, 2024 (HealthDay News) -- For patients receiving mirvetuximab soravtansine treatment for primary gynecologic malignancies, corneal toxicity is not uncommon, but usually resolves, according to a study presented at the annual meeting of the American Academy of Ophthalmology, held from Oct. 18 to 21 in Chicago.

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AAO: Wastage Seen With Artificial Expiration of Eye Drops in Ophthalmic Clinics

TUESDAY, Oct. 22, 2024 (HealthDay News) -- Artificial expiration dates on eye drops in ophthalmology clinics result in significant waste in terms of medication, plastic, and cost, according to a study presented at the annual meeting of the American Academy of Ophthalmology, held from Oct. 18 to 21 in Chicago.

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A history of multiple past intravitreal injections (IVIs) poses a risk for certain future cataract surgery complications, according to a study presented at the annual meeting of the American Academy of Ophthalmology, held from Oct. 18 to 21 in Chicago.

Winnie Yu, from the University of Toronto, and colleagues used physician billing and diagnostic data from the Ontario Health Insurance Plan to identify 163,663 adults (aged 20 years and older) with retinal conditions who had undergone cataract surgery between 2009 and 2018, of whom 3,243 received anti-vascular endothelial growth factor (VEGF) eye injections prior to surgery. Occurrence of 10 visually significant complication events due to cataract surgery were compared among patients who had a history of IVIs and those who did not.

In patients with prior IVIs, the researchers observed an increased risk for nonclearing vitreous hemorrhage (adjusted hazard ratio [aHR], 3.37), retained lens fragments (aHR, 2.00), retinal tear (aHR, 3.24), retinal detachment (aHR, 3.63), intraocular lens (IOL) dislocation (aHR, 1.97), anterior vitrectomy (aHR, 1.67), and glaucoma surgery (aHR, 4.03). There was no increased risk for corneal transplants, IOL exchange, or IOL repositioning in patients who had a history of treatment with anti-VEGF medications.

"Findings of this study highlight the importance of preoperative and intraoperative surgical planning in the prevention and management of these possible complications in patients receiving cataract surgery," Yu said in a statement. "Patients with prior intravitreal injection history should be counselled on the potential risks of cataract surgery to ensure appropriate informed surgical decision-making."

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One year of valacyclovir is beneficial for patients with herpes zoster ophthalmicus (HZO), according to a study presented at the annual meeting of the American Academy of Ophthalmology, held from Oct. 18 to 21 in Chicago.

Elisabeth Cohen, M.D., from the NYU Grossman School of Medicine and NYU Langone Health in New York City, and colleagues conducted a multicenter, randomized controlled trial involving immunocompetent adults with HZO. A total of 527 participants were randomly assigned to suppressive valacyclovir 1,000 mg daily or placebo (266 and 261 individuals, respectively) for one year of treatment and were assessed at 18-month follow-up.

The researchers observed no significant treatment benefit in terms of reducing new/worsening stromal keratitis, iritis, dendriform epithelial keratitis, or endothelial keratitis at the primary end point of 12 months of treatment, but significant benefit was seen for the secondary end point of new or worsening eye disease at 18 months (hazard ratio, 0.74). Participants receiving valacyclovir versus placebo had a significantly lower risk for experiencing subsequent end points (i.e., multiple disease flare-ups; hazard ratios, 0.70 and 0.72 at 12 and 18 months, respectively). Participants on valacyclovir also had a significant reduction in the dose of neuropathic medications at 12 and 18 months.

"Our results support changes in clinical practice, with suppressive valacyclovir recommended to reduce new, worsening, and repeated episodes of eye disease, as well as need for neuropathic pain medication in HZO patients and in those with shingles-related pain," Cohen said in a statement.

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The U.S. Food and Drug Administration announced Tuesday that it has appointed Dr. Michelle Tarver to head its division that oversees medical devices.

The appointment of a new director for the Center for Devices and Radiological Health comes at a time of great innovation and change in the medical device field, with AI playing an increasing role in medical technologies.

Tarver replaces outgoing director Dr. Jeffrey Shuren, who faced criticism over ethical lapses during his 15 years of running an agency with close ties to the medical device industry. Shuren announced his retirement in July.

“Dr. Tarver demonstrates a true passion about data, science, medicine and the evidence, all of which are critical to supporting and driving the FDA’s decisions,” FDA Commissioner Dr. Robert Califf said in an announcement to agency staff, the New York Times reported. “She works to build collaboration and transparency in achieving the strategic priorities for the center and the agency.”

Tarver said in a statement that she was honored to lead the division and planned to “remain committed in our service to public health and ensuring all patients in the U.S. have access to high-quality, safe and effective medical devices.”

According to the Times, the FDA's medical device division has a budget of $790 million and a staff of over 2,500 people. It oversees the development of thousands of devices used in medical diagnosis and treatment.

These devices include items that have been around for decades, such as hip replacements and coronary stents, as well as cutting-edge devices that are utilizing technologies such as AI.

Her FDA bio describers Tarver as "a visionary public health executive, board-certified in ophthalmology with a doctorate in epidemiology....She has spent more than 15 years as a medical device regulator, driving strategic initiatives, conducting clinical research and changing organizational culture."

"Dr. Tarver received a B.S. in Biochemistry from Spelman College in Atlanta and completed the M.D./Ph.D. program at the Johns Hopkins University School of Medicine and Bloomberg School of Public Health," the bio goes on to say. "As a dedicated clinician, she continues to care for people living with inflammatory eye conditions."

Reaction to Tarver's appointment was generally positive.

Scott Whitaker, president of AdvaMed, the largest device industry trade association, said in a statement that Tarver will lead the division "with a collaborative approach and an appreciation for the need to get safe, proven technologies into the hands of the patients and providers who need them.”

Diane Zuckerman is president of the National Center for Health Research, a nonprofit that monitors FDA device policy. Speaking to the Times, she said Tarver is focused on patient safety and “in making sure that patients understand the risks and benefits” of medical devices.

SOURCES: U.S. Food and Drug Administration, website; AdvaMed, news release, Oct. 22, 2024; New York Times

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Artificial expiration dates on eye drops in ophthalmology clinics result in significant waste in terms of medication, plastic, and cost, according to a study presented at the annual meeting of the American Academy of Ophthalmology, held from Oct. 18 to 21 in Chicago.

Noting that eye drops in ophthalmology clinics have artificial expiration dates of 14 and 28 days, John M. Tan, from the New York Eye and Ear Infirmary of Mount Sinai in New York City, and colleagues collected multiuse ophthalmic drops planned to be discarded at three ophthalmology clinics over three 14-day study periods. The volume of residual medication, and waste in terms of plastic and cost were measured and extrapolated to one year.

The researchers found that 297 bottles were discarded over six weeks of collection. On average, 71.9 percent of medication remained and bottles were discarded 494 days before expiration listed by the manufacturer. Ninety-one percent of bottles would have been completely used by the manufacturer's expiration date based on medication usage frequency. Due to artificial expiration dates, each exam lane wasted an extra $1,328 in costs, 207 g of plastic (30 medication bottles), and 11,881 drops per year.

"We were really surprised by just how much medication was being wasted," Tan said in a statement. "We hope that clinics and providers use the FDA-regulated expiration date printed on each bottle. Considering the frequent medication shortages we have to contend with, this is one simple way to reduce the strain on our supply of ophthalmic medications."

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For patients receiving mirvetuximab soravtansine (MIRV) treatment for primary gynecologic malignancies, corneal toxicity is not uncommon, but usually resolves, according to a study presented at the annual meeting of the American Academy of Ophthalmology, held from Oct. 18 to 21 in Chicago.

Filippos Vingopoulos, M.D., Ph.D., from Stanford University in Palo Alto, California, and colleagues examined longitudinal changes in 36 eyes of 18 patients on MIRV treatment for primary gynecologic malignancies. Corneal toxicity, visual acuity (VA), ocular therapeutic regimen, and ensuing changes in MIRV dose and spacing were recorded.

The researchers found that 47, 22, and 31 percent of the 36 eyes had moderate or severe, mild, and no corneal toxicity, respectively, at 5.5-month follow-up. Mainly after the second cycle (19 of 25), paracentral ring-like subepithelial deposits, corneal haze, and filamentous keratitis occurred (24 of 36, three of 36, and one of 36, respectively), resulting in reduced VA in 20 eyes (55.5 percent). Complete resolution was achieved in 20 of 25 eyes (80 percent) following dose reduction, spacing, and high-potency topical steroid taper (12 of 25, eight of 25, and 25 of 25, respectively), with VA returning to baseline in 13 of 20 eyes (65 percent).

"As novel promising treatments are incorporated in our anticancer treatment algorithms, postmarket surveillance with real-world studies and close collaboration between ophthalmology and multiple other disciplines of medicine will allow for optimal care for our patients," Vingopoulos said in a statement.

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An estimated 2.56 percent of U.S. adults ages 40 years and older have glaucoma, according to a study published online Oct. 17 in JAMA Ophthalmology.

Joshua R. Ehrlich, M.D., from University of Michigan, Ann Arbor, and colleagues used the Centers for Disease Control and Prevention Vision and Eye Health Surveillance System to estimate glaucoma prevalence among U.S. states and counties in 2022.

The researchers found that an estimated 4.22 million people were living with glaucoma in the United States in 2022. The prevalence was 1.62 percent for adults overall and 2.56 percent for those ages 40 years and older. Vision-affecting glaucoma impacted an estimated 1.49 million people (0.57 percent of adults overall and 0.91 percent among people ages 40 years and older). Geographic prevalence varied from 1.11 percent of adults in Utah to 1.95 percent in Mississippi. Prevalence was higher among Black adults versus White (3.15 and 1.42 percent, respectively). For Hispanic adults, the prevalence was 1.56 percent.

“These estimates may help provide information for the development and prioritization of public health strategies and interventions, the monitoring of epidemiologic trends, and evaluation of programs tailored for communities and populations at highest risk of glaucoma,” the authors write.

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The global prevalence of child myopia is increasing and is projected to reach 39.80 percent in 2050, according to a systematic review and meta-analysis published online Sept. 24 in the British Journal of Ophthalmology.

Jinghong Liang, from Sun Yat-Sen University in Guangzhou, China, and colleagues conducted a literature review to examine the global and regional prevalence of myopia and its occurrence within specific demographic groups. The analysis included 276 studies, with 5,410,945 children or adolescents from 50 countries in six continents.

The researchers observed a gradual increase in the pooled prevalence of myopia, varying from 24.32 to 35.81 percent from 1990 to 2023; prevalence is projected to reach 36.59 and 39.80 percent in 2040 and 2050, respectively. A higher proportion of myopia prevalence is exhibited in individuals residing in East Asia (35.22 percent) or in urban areas (28.55 percent) and in females, adolescents, and high school students (33.57, 47.00, and 45.71 percent, respectively).

"It is crucial to recognize that myopia may become a global health burden in the future," the authors write. "To address this growing epidemic, further research with a more region-specific approach is required to develop effective strategies at the local level."

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Certain social determinants of health (SDOH) affect monitoring for diabetic retinopathy (DR), according to a study published online Sept. 12 in JAMA Ophthalmology.

Azraa S. Chaudhury, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the association between multiple SDOH and monitoring for DR in accordance with clinical practice guidelines (CPGs) in a cohort study conducted in 11 U.S. medical centers including 37,397 adults with diabetes.

The researchers found that the odds of having eye-care visits were lower for Black and White patients with diabetes living in rural communities compared with those of the same race in urban communities (adjusted odds ratios [aORs], 0.12 and 0.75, respectively). Higher odds of having an eye-care visit were seen for sicker Black and White patients, defined by the Charlson Comorbidity Index (aORs, 1.04 and 1.05, respectively). Black patients with preexisting DR had lower odds of visits, while White patients with preexisting DR had higher odds of visits compared with those without preexisting DR. Lower odds of eye-care visits were reported by White patients with Medicare and Medicaid compared with those with commercial health insurance. Lower odds of eye-care visits were also reported by Hispanic White patients versus non-Hispanic White patients (aOR, 0.85).

"This study found that approximately half of patients with diabetes were undergoing DR monitoring that conformed to CPGs," the authors write. "These findings support exploring targeted interventions to improve care quality for these groups."

Several authors disclosed ties to the biopharmaceutical industry.

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The population-attributable fraction of dementia from vision impairments ranges from 4.9 to 19.0 percent, according to a study published online Sept. 5 in JAMA Ophthalmology.

Jason R. Smith, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues estimated the contribution of vision impairments to dementia using data from the National Health and Aging Trends Study (2,767 community-dwelling Medicare beneficiaries aged 65 years and older). 

The researchers found that the population-attributable fraction of prevalent dementia from at least one vision impairment was 19.0 percent. The strongest attributable fraction among all impairments was seen for contrast sensitivity impairment (15.0 percent), followed by near acuity (9.7 percent) and distance acuity (4.9 percent). Population-level dementia-attributable fractions from at least one visual impairment were highest among subpopulations of participants aged 71 to 79 years (24.3 percent), female individuals (26.8 percent), and non-Hispanic White individuals (22.3 percent), with estimates consistent across educational strata.

"While not proving a cause-and-effect relationship, these findings support inclusion of multiple objective measures of vision impairments, including contrast sensitivity and visual acuity, to capture the total potential impact of addressing vision impairment on dementia," the authors write.

Several authors disclosed ties to relevant organizations.

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A novel free eye disease screening program is engaging adults at high risk for eye disease who are underusing eye care services, according to a study published online Aug. 22 in JAMA Ophthalmology.

Eric Sherman, M.D., from the University of Michigan in Ann Arbor, and colleagues examined the reasons for underuse of eye care and whether a novel, free eye disease screening program is engaging adults at high risk for eye disease, who were underusing eye care services. A total of 1,171 Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine participants who were recruited from primary care clinics serving two low-income communities were included in the study.

The researchers found that the characteristics of participants reporting not having had an eye examination in two years or longer included age 65 years and older, self-reported diabetes, family history of glaucoma, self-reported glaucoma, and Black or African-American individual aged 50 years and older (23, 33, 25, 3, and 33 percent, respectively). In those who reported not having had an eye examination in two or more years, 21, 20, 6, and 1 percent screened positive for glaucoma, cataract, diabetic retinopathy, and age-related macular degeneration, respectively. No insurance, no reason to go (no problem), and cost of eye examination were reported reasons for why participants had not had an eye examination (28, 22, and 16 percent, respectively).

"Increasing access and use of eye care will likely require large-scale efforts to increase access to and public awareness of affordable eye care," John S. Wittenborn, and David B. Rein, Ph.D., from NORC at the University of Chicago, write in an accompanying editorial.

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