Cataract Blindness in the Developing World

Isaacs, Robert T.; Ram, Jagat; Apple, David J.

doi:10.1300/j096v03n04_02

Cited by 15 publications

(11 citation statements)

References 19 publications

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“…Alterations in lens cell structure/function, as well as the physical properties of its constituent proteins can lead to the opacity of the lens known as cataract (Graw, 1997). While cataract treatment has become ubiquitous in the developed world, cataract is still the leading cause of blindness worldwide (Isaacs et al, 2004). Congenital cataract is particularly problematic since it must be treated in infancy to prevent permanent amblyopia due to early visual deprivation (Bremond-Gignac et al, 2011; Levi and Li, 2009; Rahi and Cable, 2003).…”

Section: Introductionmentioning

confidence: 99%

The unfolded protein response is activated in connexin 50 mutant mouse lenses

Alapure

Stull

Firtina

et al. 2012

Experimental Eye Research

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The unfolded protein response is a set of cell signaling pathways recently recognized to be activated in the lens during both normal development and endoplasmic reticulum stress induced by either unfolded proteins or oxidative damage. While mutations in the gene for connexin 50 are known to cause autosomal dominant cataracts, it has not been previously reported whether mutant connexins can activate the unfolded protein response in the lens. Mice homozygous for the S50P or G22R mutation of connexin 50 have reduced amounts of connexin 50 protein at the cell membrane, with some intracellular staining consistent with retention in the endoplasmic reticulum. Connexin 50 mutants have elevated levels of BiP expression in both lens epithelial and fiber cells from E15.5 with the most robust elevation detected in newborns. While this elevation decreases in magnitude postnatally, BiP expression is still abnormally high in adults, particularly in the perinuclear endoplasmic reticulum of cell nuclei that are inappropriately retained in adult homozygous mutant lenses. Xbp1 splicing was elevated in lenses from both connexin mutants studied, while Atf4 and Atf6 levels were not majorly affected. Overall, these data suggest that UPR may be a contributing factor to the phenotype of connexin 50 mutant lenses even though the relatively modest extent of the response suggests that it is unlikely to be a major driver of the pathology.

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Section: Introductionmentioning

confidence: 99%

The unfolded protein response is activated in connexin 50 mutant mouse lenses

Alapure

Stull

Firtina

et al. 2012

Experimental Eye Research

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“…Cataracts are the major cause of blindness in developing countries and their treatment, while being one of the most cost‐effective interventions, still faces many challenges, especially within the ageing population. The majority of the world’s 20 million cataract blind live in the developing world, including more than 6 million Africans who are blind as a consequence of unoperated cataracts (Isaacs et al. 2004).…”

mentioning

confidence: 99%

Cataract surgery in West Africa: is couching still a choice?

Signes-Soler¹,

Javaloy²,

Montés‐Micó³

et al. 2012

Acta Ophthalmologica

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epidemiology of PCV among Scandinavians has yet been available. Our study is the first to discover that PCV is not rare in a lightly pigmented homogeneous Scandinavian population. We found out that 8% of the patients presenting with presumed neovascular AMD actually had PCV. This may seem somewhat surprising as most reports on PCV emanate from clinics dealing with mixed or pigmented populations. Omission of ICG angiography from the investigational strategy irrefutably leads to underestimation of PCV and, consequently, suboptimal treatment.

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“…Fifty to 90 percent of all blindness in the majority world is caused by cataracts (4). While these may be congenital in nature, there are established risk factors for acquired cataracts, with age being the most important non-modifiable risk factor.…”

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confidence: 99%

“…Other proposed risk factors include diarrheal illnesses (6), homelessness (7), poor diet, or medical insurance status (8) in affluent nations. While prevention of some risk factors is possible for cataract-induced visual impairment, treatment remains curative (4).…”

mentioning

confidence: 99%

“…In the context of disability caused by cataracts, the WHO provided a cost-effective analysis demonstrating that cataract surgery to restore vision is one of the most cost-effective surgeries available (9). A significant limitation in poor countries or for-profit settings includes the availability of surgeons willing to perform cataract surgery, especially in rural and inaccessible areas (4). One measure of effectiveness of cataract surgery provision is the Cataract Surgery Rate (CSR), a metric for the number of cataract surgeries performed each year per 1 million population (1).…”

mentioning

confidence: 99%

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The Politics of Avoidable Blindness in Latin America—Surgery, Solidarity, and Solutions: The Case of Misión Milagro

Zakrison

Armada²,

Rai³

et al. 2012

Int J Health Serv

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Avoidable blindness, especially when caused by cataracts, is a disease primarily of the economically disadvantaged sectors of the population. With a focus on Latin America and the Caribbean, this paper focuses on the program Misión Milagro within its historical, political, and economic contexts. This initiative, led by the governments of Cuba and Venezuela, covers close to 35 countries across Latin America, the Caribbean, Asia, and Africa. It is well-known throughout Latin America as close to 2 million patients have undergone free screening, corrective surgery, and rehabilitation since its inception in 2004. Misión Milagro shows that implementation of a massive initiative to curb avoidable blindness caused by cataracts in a relatively short time is feasible. The program is also built upon a unique model of international cooperation, which stresses social objectives and solidarity rather than hegemonic international initiatives built on commercial relationships. It also provides elements that could be applied to other public health issues of global or national relevance, not only to other low-middle-income countries, but also to high-income countries such as Canada.

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Cataract Blindness in the Developing World

Cited by 15 publications

References 19 publications

The unfolded protein response is activated in connexin 50 mutant mouse lenses

The unfolded protein response is activated in connexin 50 mutant mouse lenses

Cataract surgery in West Africa: is couching still a choice?

The Politics of Avoidable Blindness in Latin America—Surgery, Solidarity, and Solutions: The Case of Misión Milagro

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