Screening for Impaired Visual Acuity in Older Adults

Chou, Roger; Dana, Tracy; Bougatsos, Christina; Grusing, Sara; Blazina, Ian

doi:10.1001/jama.2016.0783

Cited by 82 publications

(53 citation statements)

References 60 publications

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“…More interestingly, these abnormalities were not recorded in their medical history. As retinal abnormalities can result in a reduced visual acuity 49 , which is related to a decreased quality of life and physical functioning, and increased risk of falling 50 , an ophthalmological screening might be valuable in patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

Structural analysis of retinal blood vessels in patients with COPD during a pulmonary rehabilitation program

Vaes

Spruit

Keer

et al. 2020

Sci Rep

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cardiovascular diseases are frequently present in chronic obstructive pulmonary disease (copD). population-based studies found associations between retinal vessel diameters and cardiovascular health, but it is unknown whether this also applies to COPD patients. Therefore, we measured retinal vessel diameters in copD patients and aimed to determine the association with cardiovascular risk factors, lung function, and functional outcomes. In addition, we investigated whether an exercisebased pulmonary rehabilitation (PR) program would change retinal vessel diameters, as a proxy for improved microvascular health. Demographics and clinical characteristics, including pulmonary function, exercise capacity, blood pressure, blood measurements and level of systemic inflammation were obtained from 246 patients during routine assessment before and after PR. Retinal vessel diameters were measured from digital retinal images. older age and higher systolic blood pressure were associated with narrower retinal arterioles (β: −0.224; p = 0.042 and β: −0.136; p < 0.001, respectively). Older age, higher systolic blood pressure and lower level of systemic inflammation were associated with narrower retinal venules (β: −0.654; −0.229; and −13.767, respectively; p < 0.05). No associations were found between retinal vessel diameters and lung function parameters or functional outcomes. After PR, no significant changes in retinal venular or arteriolar diameter were found. To conclude, retinal vessel diameters of COPD patients were significantly associated with systolic blood pressure and systemic inflammation, whilst there was no evidence for an association with lung function parameters, functional outcomes or other cardiovascular risk factors. Furthermore, an exercise-based PR program did not affect retinal vessel diameter. Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases 1. Although the diagnosis of COPD is based on spirometry, it is well recognized that COPD is associated with a range of systemic extrapulmonary effects 1. Indeed, comorbidities are frequently present and contribute to the severity of disease 2-4. Cardiovascular disease (including hypertension, coronary artery disease, congestive heart failure, stroke and peripheral arterial disease) is a common comorbidity in COPD 2,5. Smoking is the most important risk factor for the development of COPD, but it is also a major risk factor for the development of cardiovascular disease 6,7. Indeed, cigarette smoke not only affects the airway epithelium, but also causes vascular endothelial damage and loss of microvascular integrity in several organs, including the heart, brain, and kidney 8,9. In addition, systemic inflammatory processes, oxidative stress, and hypoxia may contribute

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Section: Discussionmentioning

confidence: 99%

Structural analysis of retinal blood vessels in patients with COPD during a pulmonary rehabilitation program

Vaes

Spruit

Keer

et al. 2020

Sci Rep

View full text Add to dashboard Cite

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“…(3, 8, 13) VI affects the ability to participate in activities of daily living (ADL), social integration, health and wellbeing. (2, 5) The reduction in ADL were similar regardless of whether near or distance vision was impaired, and ADL reduction was greatest when both were impaired.…”

Section: Health Outcomes Impacted By Correction Of Urementioning

confidence: 99%

“…(2, 6) Key investigators across the nation including the National Academy of Medicine have recommended the inclusion of ophthalmic measures in health surveys to reach the vision-related objectives of Healthy People 2020. (5, 7, 8) Our review explores the scope of URE both in the United States (US) and globally, to identify health and lifestyle consequences associated with URE, to identify the underlying reasons for URE, and to explore interventions for this preventable cause of VI.…”

Section: Introductionmentioning

confidence: 99%

Refractive error in underserved adults

Jeganathan

Robin

Woodward

2017

Current Opinion in Ophthalmology

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Purpose of Review To evaluate the epidemiology of uncorrected refractive errors (URE) in adults both in the US and globally, health outcomes impacted by URE, common barriers to treatment, and propose potential interventions. Recent Findings URE is the main cause of visual impairment (VI) and the second leading cause of blindness globally. Rates of URE are rising, and cause disability that reduces productivity, economic earnings, and the quality of life of affected individuals. Economic barriers, health care access, and socio-cultural constraints are among the most fundamental barriers to correcting URE. However, innovative approaches are poised to lower rates of URE. Summary URE is a leading cause of preventable VI with serious health consequences. Numerous social and financial barriers are associated with the high prevalence of URE in low-income adults. Novel delivery programs for eyeglasses and programs to provide refractive surgery to correct refractive error could decrease rates of URE.

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“…A variety of factors promote retinal tissue degeneration and AMD progression, including genetic and environmental factors, aging, and oxidative stress [ 4 ]. AMD involves reduced photoreceptor cells and retinal pigment epithelium dysfunction in the macula and can be classified as “dry AMD” or “wet/exudative/neovascular AMD.” Compared to neovascular AMD, dry AMD has a higher incidence, but involves less vision degradation and is thus less frequently a cause of “blindness” [ 5 , 6 ]. Neovascular AMD is characterized by excessive choroidal neovascularization (CNV) under the retina, leading to retinal edema and even detachment, thereby causing vision loss.…”

Section: Introductionmentioning

confidence: 99%

Luteolin Attenuates IL-1β-Induced THP-1 Adhesion to ARPE-19 Cells via Suppression of NF-κB and MAPK Pathways

Huang

Liou

Shen

et al. 2020

Mediators of Inflammation

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Cytokine-induced endothelial dysfunction leads to inflammation and vascular adhesion molecule production in retinal pigment epithelium (RPE) cells. Inflammation is a critical mediator in retinal degeneration (RD) diseases, including age-related macular degeneration (AMD), and RD progression may be prevented through anti-inflammatory activity in RPE cells. The flavonoid polyphenol luteolin (LU) has anti-inflammatory and antidiabetes activities, but its effects regarding retinal protection remain unknown. Here, we examined the ability of luteolin to alleviate markers of inflammation related to RD in cytokine-primed APPE-19 cells. We found that luteolin decreased the levels of interleukin- (IL-) 6, IL-8, soluble intercellular adhesion molecule-1 (sICAM-1), and monocyte chemoattractant protein-1 (MCP-1) and attenuated adherence of the human monocytic leukemia cell line THP-1 to IL-1β-stimulated ARPE-19 cells. Luteolin also increased anti-inflammatory protein heme oxygenase-1 (HO-1) levels. Interestingly, luteolin induced protein kinase B (AKT) phosphorylation, thus inhibiting nuclear factor- (NF-) κB transfer from cytoplasm into the nucleus and suppressing mitogen-activated protein kinase (MAPK) inflammatory pathways. Furthermore, cotreatment with MAPK inhibitors and luteolin decreased inflammatory cytokine and chemokine levels, and further suppressed THP-1 adhesion. Overall, these results provide evidence that luteolin protects ARPE-19 cells from IL-1β-stimulated increases of IL-6, IL-8, sICAM-1, and MCP-1 production by blocking the activation of MAPK and NF-κB signaling pathways, thus ameliorating the inflammatory response.

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Screening for Impaired Visual Acuity in Older Adults

Cited by 82 publications

References 60 publications

Structural analysis of retinal blood vessels in patients with COPD during a pulmonary rehabilitation program

Structural analysis of retinal blood vessels in patients with COPD during a pulmonary rehabilitation program

Refractive error in underserved adults

Luteolin Attenuates IL-1β-Induced THP-1 Adhesion to ARPE-19 Cells via Suppression of NF-κB and MAPK Pathways

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