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From exciting findings out of Sweden about a new corneal transplantation strategy to concerns about glaucoma in specific populations and links between visual problems and psychosis, recent news related to the eyes resulted in this week's top trending clinical topic. Scientists at Linköping University in Sweden recently bioengineered a tissue implant that restored sight in severely visually impaired and blind people (see Infographic).
The approach with the pig-derived material was as successful as with a donated human cornea. "This was beyond our expectations," study authors Mehrdad Rafat, PhD, and Neil Lagali, PhD, told Medscape Medical News. "What surprised us was how well the implant worked to restore the thickness and shape of the diseased cornea and how this translated into excellent vision for the patients, in some cases resulting in perfect 20/20 vision." An estimated 12.7 million people worldwide are awaiting a cornea transplant, with only one human-donor cornea available for every 70 that are needed. Low- and middle-income countries are most affected, with limited or no access to corneal transplants.
In concerning eye-related news, a recent study found that Black people are six times more likely than non-Hispanic White people to lose significant eyesight due to glaucoma, even when access to healthcare is similar. Black participants had double the risk for the early visual field loss archetypes compared with non-Hispanic White participants (hazard ratio [HR], 1.98; 95% CI, 1.48-2.66). They also had six times the risk for advanced loss archetypes (HR, 6.17; 95% CI, 3.69-10.32). Even after adjusting statistical models for eye exam frequency, the difference between Black and non-Hispanic White participants persisted. Researchers also adjusted for many other potential risk factors, including socioeconomic status, glaucoma family history, body mass index, blood pressure, diabetes, and physical activity.
Another eye-related concern receiving recent attention is computer vision syndrome (CVS). A recent study found that CVS is significantly associated with both migraine and insomnia, with stress as a central mediating factor. Investigators administered an online questionnaire to more than 700 adults. Results showed that 70.5% of participants had CVS. Headache was reported as "the most disturbing ocular symptom" (34%), followed by eye burning (10.8%). The most disturbing extraocular symptoms were neck pain and backache (43.3% and 33.4%, respectively). A multivariable analysis using a linear regression model also showed that presence of CVS (β = 3.26) was significantly associated with a higher rate of insomnia. Analysis showed that stress mediated the association between CVS and migraine by 52.8% and between CVS and insomnia by 80%.
A separate study recently found that subtle subjective visual dysfunctions (VisDys) are associated with poorer outcomes among patients with schizophrenia and recent-onset psychosis or who are at clinical high risk (CHR) for psychosis. A multinational group of investigators analyzed 721 participants, including 147 participants with recent-onset psychosis, 143 with CHR, 151 with recent-onset depression, and 280 in the healthy-controls group. Results showed that VisDys were reported more frequently in both recent-onset psychosis and CHR groups compared with the recent-onset depression and healthy-controls groups (50.34% and 55.94% vs 16.56% and 4.28%, respectively). Among those with recent-onset psychosis, a higher VisDys sum score was correlated with lower scores for functional remission (P = .036) and social functioning (P = .014). In CHR, higher VisDys sum scores were associated with lower scores for health-related functional remission (P = .024), lower physical and psychological quality of life (P = .004 and P = .015, respectively), more severe depression on the Beck Depression Inventory (P = .021), and more impaired visuospatial constructability (P = .027).
Promising news about pig skin–derived corneal transplants, concerning findings about glaucoma incidence among Black populations, migraines and insomnia in CVS, and insights into VisDys and psychosis drew focus on the eyes this week, leading to the top trending clinical topic.
Learn more about ophthalmologic conditions.
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Cite this: Ryan Syrek. Trending Clinical Topic: Eyes - Medscape - Sep 23, 2022.