Dr Ray O’Connor takes a have a look at latest scientific articles on opthalmology, together with the affiliation between long-term publicity to ambient air air pollution and the danger of major open-angle glaucoma, and the expansion of neuro‑ophthalmology
Glaucoma is the main reason behind irreversible blindness worldwide and, within the US, disproportionately impacts folks from racial and ethnic minority teams. Glaucoma prevalence has not been estimated for the US in additional than a decade.
The target of this meta-analysis1 was to estimate glaucoma and vision-affecting glaucoma prevalence by demographic components and US state and county for the Centres for Illness Management and Prevention’s Imaginative and prescient and Eye Well being Surveillance System. PubMed was looked for population-based research of glaucoma prevalence revealed between 1991 and 2016.
The outcomes have been that for 2022, an estimated 4.22 million folks within the US have been dwelling with glaucoma, with a prevalence of 1.62 per cent amongst folks 18 years or older and a pair of.56 per cent amongst folks 40 years or older. An estimated 1.49 million folks have been dwelling with vision-affecting glaucoma, with a prevalence of 0.57 per cent amongst folks 18 years or older and 0.91 per cent amongst folks 40 years or older.
Dr Ray O’Connor
It was discovered additionally that African-American people have been disproportionately affected.
The goal of this retrospective, nationwide, population-based cohort research2 was to research the affiliation between long-term publicity to ambient air air pollution and the danger of major open-angle glaucoma (POAG). The research included 590,338 people aged 20 years and older who had no prior analysis of glaucoma and not less than 10 years of air air pollution publicity knowledge.
Seven air pollution have been examined: sulphur dioxide, carbon monoxide, particles lower than 10 micrometers in diameter, particles lower than 2.5 micrometers in diameter, nitrogen oxides, nitrogen monoxide, and nitrogen dioxide. The authors utilized knowledge from the Nationwide Well being Insurance coverage Analysis Database (NHIRD) in Taiwan.
Members have been adopted from January 1, 2000, to December 31, 2013. Air air pollution knowledge have been linked to sufferers’ residential postal codes recorded in insurance coverage registration information. The cumulative each day common degree of every pollutant was calculated for every participant over the 10-year publicity interval.
Throughout the follow-up interval, 3,158 sufferers with POAG have been recognized (0.53 per cent incidence). A 1-standard-deviation enhance within the 10-year common pollutant degree was related to a major enhance in POAG threat, starting from 40 per cent to 108 per cent.
This affiliation was constantly noticed throughout pollution, with the very best threat linked to carbon monoxide publicity. The authors’ conclusion is that long-term publicity to air air pollution is considerably related to an elevated threat of POAG. The authors name for additional analysis and public well being interventions to mitigate this threat, notably in areas with excessive air pollution ranges.
This evaluation3 highlights therapy choices, each below investigation and presently accessible, for the therapy of dry age-related macular degeneration (AMD). Superior dry AMD, characterised by geographic atrophy (GA), is a number one reason behind blindness within the developed world, although previous to 2023 there was no permitted therapy.
There are actually two permitted remedies in the US for GA. These medicine goal the complement cascade and cease it from attacking the retina and have not too long ago been permitted by the FDA. They’re Pegcetacoplan and avacincaptad pegol. Like presently accessible remedies for moist AMD, these medicine are injected immediately into the affected person’s eye. Whereas they’ve been proven to sluggish the event of geographic atrophy by as much as 20 per cent, they don’t enhance imaginative and prescient. These medicine can even trigger unwanted side effects or problems starting from delicate to extreme.
Lastly, the authors additionally describe how there are a number of research and trials to research therapeutic potential and results of therapies for earlier intervention in dry AMD. Approaches to remedy embody inhibiting the complement system, using gene remedy, stem cell remedy, laser remedy, and surgical implants.
Neuro‑ophthalmology is a medical specialty that mixes ophthalmology and neurology to diagnose and deal with imaginative and prescient issues associated to the nervous system. It has advanced significantly as a specialty within the latest previous as a result of availability of newer diagnostic and therapeutic modalities. This evaluation article4 discusses among the latest advances of scientific relevance.
The authors describe how, among the many most vital developments is the rise of optical coherence tomography (OCT), now acknowledged as an indispensable instrument in neuro-ophthalmological analysis, offering unparalleled insights into optic nerve and central nervous system pathologies.
Gene remedy, marks a brand new frontier in personalised drugs, providing hope for beforehand untreatable circumstances. The article additionally examines the transformative position of telemedicine and synthetic intelligence (AI) in scientific apply, that are revolutionizing affected person care and enhancing diagnostic precision.
Moreover, it highlights the impression of novel serological biomarkers on the understanding and administration of immune-mediated optic neuritis and discusses the introduction of latest therapeutic brokers like Tocilizumab and Teprotumumab, that are redefining therapy paradigms.
The time period ‘basis mannequin’ was coined in 2021 by researchers on the Stanford College Institute for Human-Centred AI. It describes a big AI mannequin skilled on huge portions of numerous knowledge, which might then be tailored to a variety of downstream duties. The authors of this evaluation paper5 talk about how ophthalmology as a specialty has the potential to behave as an exemplar for different medical specialties, providing a blueprint for integrating basis fashions broadly into scientific apply. The evaluation serves as a roadmap for eyecare professionals searching for to higher perceive basis fashions.
The authors define the important thing ideas and technological advances which have enabled the event of those fashions, offering an outline of novel coaching approaches and trendy AI architectures. In addition they summarise present literature on the subject of basis fashions in ophthalmology and talk about main challenges regarding privateness, bias and scientific validation.
References:
- Ehrlich J et al. Prevalence of Glaucoma Amongst US Adults in 2022. JAMA Ophthalmol 2024 Nov 1;142(11):1046-1053. DOI: 10.1001/jamaophthalmol.2024.3884.
- Chuang S et al. Affiliation Between Lengthy-Time period Ambient Air Air pollution and Main Open-Angle Glaucoma: A Nationwide Cohort Examine in Taiwan. Am J Ophthalmol 2025 Sep:277:441-450. DOI: 10.1016/j.ajo.2025.05.031. Epub 2025 Might 31.
- Wheeler S et al. Remedy for dry age-related macular degeneration: the place we stand in 2024. Curr Opin Ophthalmol 2024 Sep 1;35(5):359-364. DOI:10.1097/ICU.0000000000001064. Epub 2024 Jun 13.
- Bassi S et al. Assessment Article. Latest advances in neuro‑ ndian J Ophthalmol 2024;72:1544-59.
- Chia MA et al. Basis fashions in ophthalmology. Chia MA, et al. Br J Ophthalmol 2024;0:1–8. DOI:10.1136/bjo-2024-325459.
