Objective:Near vision loss(NVL)is one of the leading causes of visual impairment worldwide,exerting a profound impact on individual quality of life and socio-economic development.This study aims to analyze the burden ...Objective:Near vision loss(NVL)is one of the leading causes of visual impairment worldwide,exerting a profound impact on individual quality of life and socio-economic development.This study aims to analyze the burden of NVL in China by sex and age groups from 1990 to 2021 and to project trends over the next 15 years.Methods:Using data from the Global Burden of Disease(GBD)2021 database,we conducted descriptive analyses of NVL prevalence in China,calculated age-standardized prevalence rates(ASPR)and age-standardized disability-adjusted life years rates(ASDR)to compare burden differences between sexes and age groups,and applied an autoregressive integrated moving average(ARIMA)model to predict NVL trends for the next 15 years.The model selection was based on best-fit criteria to ensure reliable projections.Results:From 1990 to 2021,China’s ASPR of NVL rose from 10096.24/100000 to 15624.54/100000,and ASDR increased from 101.75/100000 to 158.75/100000.In 2021,ASPR(16551.70/100000)and ASDR(167.69/100000)were higher among females than males(14686.21/100000 and 149.76/100000,respectively).China ranked highest globally in both NVL cases and disability-adjusted life years(DALYs),with female burden significantly exceeding male burden.Projections indicated this trend and sex gap will persist until 2036.Compared with 1990,the prevalence cases and DALYs increased by 239.20%and 238.82%,respectively in 2021,with the highest burden among females and the 55−59 age group.The ARIMA model predicted continued increases in prevalence and DALYs by 2036,with females maintaining a higher burden than males.Conclusion:This study reveals a marked increase in the NVL burden in China and predicts continued growth in the coming years.Public health policies should prioritize NVL prevention and control,with special attention to women and middle-aged populations to mitigate long-term societal and health impacts.展开更多
BACKGROUND To our knowledge,no study has obtained specific estimates of depression for young and middle-aged adults with visual impairment(VI).As estimates of depression varies across age groups in the general populat...BACKGROUND To our knowledge,no study has obtained specific estimates of depression for young and middle-aged adults with visual impairment(VI).As estimates of depression varies across age groups in the general population,it is of interest to examine whether the same applies to adults with low vision or blindness.AIM To estimate depression prevalence and its association with VI-related characteristics and life satisfaction in adults with VI.METHODS A telephone-based cross-sectional survey was conducted between January and May 2017 in an age-stratified sample of adults who were members of the Norwegian Association of the Blind and Partially Sighted.Participants were asked questions about their sociodemographic characteristics,VI characteristics,and life satisfaction.Depression was measured with the Patient Health Questionnaire.The diagnostic scoring algorithm was used to calculate the point prevalence of depression(i.e.,major depression and other depressive disorders)across categories of gender and age(years:18-35,36-50,51-65,≥66).The associations were estimated using regression models.RESULTS Overall,736 adults participated in the study(response rate:61%).The prevalence estimates of depression varied across different age groups,ranging from 11.1%-22.8%in women and 9.4%-16.5%in men,with the highest rates for the two youngest age groups.Results from the multivariable models including sociodemographic and VI-related variables showed that losing vision late in life[Prevalence ratio(PR),1.76,95%CI:1.11,2.79]and having other impairments(PR:1.88,95%CI:1.32,2.67)were associated with higher rates of depression,whereas older age was associated with lower rates(PR:0.83,95%CI:0.74,0.93).Additionally,participants who were depressed had lower life satisfaction than those who were not depressed(adjustedβ:-2.36,95%CI:-2.75,-1.98).CONCLUSION Our findings suggest that depression in adults with VI,and especially among young and middle-aged adults,warrants greater attention by user organisations,clinicians,and healthcare authorities.展开更多
Older individuals with macular diseases,such as age-related macular degeneration,experience central vision loss(CVL)due to degeneration of their photoreceptors and retinal cells.Patients with CVL may experience variou...Older individuals with macular diseases,such as age-related macular degeneration,experience central vision loss(CVL)due to degeneration of their photoreceptors and retinal cells.Patients with CVL may experience various vision impairments,including of visual acuity,fixation stability,contrast sensitivity,and stereoacuity.After CVL,most patients develop a preferred retinal locus outside the affected macular region,which serves as a new visual reference.In this review,we provide an overview of the visual function and impairment in individuals with CVL.In addition,the important role of biofeedback training on the visual function and activity of individuals with CVL is also reviewed.Accordingly,the location and development of the preferred retinal loci are discussed.Finally,this review discusses how to conduct biofeedback training to treat individuals with CVL.展开更多
Background:As the prevalence of age-related vision loss continues to increase,vision rehabilitation practitioners will encounter a growing number of older adults who experience reading-related difficulties.Braille may...Background:As the prevalence of age-related vision loss continues to increase,vision rehabilitation practitioners will encounter a growing number of older adults who experience reading-related difficulties.Braille may be considered as an alternative to sight enhancement options for clients with progressive or significant visual pathologies.However,little is known about the impact of aging on braille reading performance.The goal of this research was to explore the experiences of older adults with acquired vision loss who have learned braille later in life,and to better understand the facilitators and barriers encountered throughout this process.Methods:Qualitative interviews were conducted by telephone with 14 participants from across Canada(age 40-72,Mdn=55.5,7 female).All participants learned braille in adulthood(starting age 33-60,Mdn=46.5).Recorded interviews were transcribed verbatim and later analyzed by two independent researchers based on the phenomenological method of analysis.Results:Personal,social and environmental factors were shown to influence the braille-learning process.In particular,prior learning experiences(both positive and negative)were shown to impact both the decision to learn braille and participant training experiences.Participants highlighted the importance of perceived support from family and friends,and reactions towards braille from the general public posed a barrier to those still adjusting to vision loss.Participants also highlighted the value of knowing others who learned braille later in life.Conversely,a reoccurring environmental barrier that emerged was the perceived response from rehabilitation practitioners who believed that clients should not or could not learn braille due to their age,as well as the lack of available resources to facilitate training.Conclusions:Results highlight the need to explore the influence of stereotypes associated with aging,blindness and braille,and the degree to which this may impact opportunities for clients who may benefit from braille training.Though previous learning experiences appear to influence successful rehabilitation outcomes,these factors are not routinely considered during the braille assessment process.Our findings will therefore contribute to future research and the development of assessments to better meet the needs of older adults who pursue braille training.展开更多
Blindness affected 45 million people globally in 2021,and moderate to severe vision loss a further 295 million.[1]The most common causes,cataract and uncorrected refractive error,are generally the easiest to treat,and...Blindness affected 45 million people globally in 2021,and moderate to severe vision loss a further 295 million.[1]The most common causes,cataract and uncorrected refractive error,are generally the easiest to treat,and are among the most cost-effective procedures in all of medicine and international development.[1-2]Thus,vision impairment is both extremely common and,in principle,readily manageable.展开更多
Neurodegenerative diseases account for a large and increasing health and economic burden worldwide.With an increasingly aged population,this burden is set to increase.Optic neuropathies make up a large proportion of n...Neurodegenerative diseases account for a large and increasing health and economic burden worldwide.With an increasingly aged population,this burden is set to increase.Optic neuropathies make up a large proportion of neurodegenerative diseases with glaucoma being highly prevalent.Glaucoma is characterized by the progressive dysfunction and loss of retinal ganglion cells and their axons which make up the optic nerve.It is the leading cause of irreversible vision loss and affects an estimated 80 million people.The mammalian central nervous system is non-regenerative and,once lost or injured,retinal ganglion cells cannot regenerate an axon into the optic nerve under basal conditions.Thus,strategies that provide neuroprotection to stressed,dysfunctional,or dying retinal ganglion cells are likely to be of high therapeutic and translational value.Advancing age,genetics,and elevated intraocular pressure are all major risk factors for glaucoma,however,all clinically available glaucoma treatments focus on intraocular pressure management and do not directly address the neurodegenerative component of glaucoma.展开更多
Background:Taking part in productive and enjoyable recreational activities has been shown improve quality of life for people of all ages and capabilities.However,vision loss can have a significant impact on participat...Background:Taking part in productive and enjoyable recreational activities has been shown improve quality of life for people of all ages and capabilities.However,vision loss can have a significant impact on participation in important leisure activities.This is especially the case for the elderly,whose lowered mobility is further impacted by vision loss.Technology can offer solutions to bridging some barriers caused by these deficits by bringing leisure activities to the user in the form of mobile applications.As such,the purpose of the present study was to evaluate the accessibility and usability of the ArtOnTheBrain application,a visual art based mobile health solution to promote brain health and well-being,by older adults with low vision due to age-related macular degeneration(AMD).Methods:There were a total of 16 participants(age range,65-93 years,M=79,10 males).All had a diagnosis of AMD with visual acuities in the better eye between 20/60 and 20/200.Additionally,all participants had accessed rehabilitation services and most had experience using a computer at home.Using an Apple iPad Air(2013),they were asked to interact with the ArtOnTheBrain website’s Learn(e.g.,Listen to artwork description)and Play(e.g.,complete a word-search game)features with either the Safari or Google Chrome Internet apps.Using the Concurrent Think Aloud method,participants were asked to continuously comment on their activities and experiences with the app and verbalize their internal monologue while being audio and video recorded.These recordings were later transcribed verbatim and analysed using qualitative description and thematic analysis.Results:Participants’behaviours and verbal feedback were divided based on whether they presented as barriers or facilitators.Beginning with barriers,these were mostly related to the accessibility of the visual aspects of the applications interface(i.e.,contrast and font size),whereby participants requested additional control over the magnification options,both for text as well as images of the artwork.The main facilitator was the audio option built into the Learn tab,which allowed participants to listen to the artwork descriptions.Facilitators also included the aesthetics of the app,the perceived boost in confidence in interacting with technology,and the educational and leisure benefits.Conclusions:Older adults with low vision are faced with a decreased ability to engage in leisure activities.The development of technologies aimed at increasing the accessibility of leisure activities for these individuals is an important step in increasing their quality of life.As such,despite some of the accessibility challenges,the majority of participants viewed ArtontheBrain positively.Identifying the barriers and facilitators to its use is an important step in the development of this application in order to optimize its accessibility for older adults with low vision.Future work to be done with this application will be to evaluate the cognitive impact of ArtontheBrain on low vision users.展开更多
Here we report a case of a 67-year-old female patient who presented with headache,limb tremors,and acute complete vision loss.Physical examination revealed bilateral miosis,and diffusion-weighted imaging sequences sho...Here we report a case of a 67-year-old female patient who presented with headache,limb tremors,and acute complete vision loss.Physical examination revealed bilateral miosis,and diffusion-weighted imaging sequences showed mild diffusion restriction in the subcortical regions of both occipital lobes.Genetic results revealed 85 GGC repeats in the 50-untranslated region of the NOTCH2NLC gene.The therapeutic effect of dexamethasone and acyclovir was minimal.NIID must be considered in patients with acute onset and various clinical manifestations and imagingfindings similar to encephalitis.We hope that our case presentation will enhance clinicians’awareness of NIID.展开更多
Central retinal artery occlusion(CRAO)is an acute ophthalmic emergency,characterized by sudden vision loss due to retinal ischemia in areas corresponding to arterial occlusion sites.Diagnosis primarily relies on fundu...Central retinal artery occlusion(CRAO)is an acute ophthalmic emergency,characterized by sudden vision loss due to retinal ischemia in areas corresponding to arterial occlusion sites.Diagnosis primarily relies on fundus fluorescein angiography(FFA)and optical coherence tomography(OCT),which show delayed retinal artery filling time hours to days after occlusion and increased hyperreflectivity of the inner retina.展开更多
基金supported by the Natural Science Foundation of Hunan Province(2023JJ30817)Hunan Provincial Natural Science Foundation-Hengyang City Joint Fund Project(2025JJ70129)+1 种基金Changsha Natural Science Foundation(kq2403057)China。
文摘Objective:Near vision loss(NVL)is one of the leading causes of visual impairment worldwide,exerting a profound impact on individual quality of life and socio-economic development.This study aims to analyze the burden of NVL in China by sex and age groups from 1990 to 2021 and to project trends over the next 15 years.Methods:Using data from the Global Burden of Disease(GBD)2021 database,we conducted descriptive analyses of NVL prevalence in China,calculated age-standardized prevalence rates(ASPR)and age-standardized disability-adjusted life years rates(ASDR)to compare burden differences between sexes and age groups,and applied an autoregressive integrated moving average(ARIMA)model to predict NVL trends for the next 15 years.The model selection was based on best-fit criteria to ensure reliable projections.Results:From 1990 to 2021,China’s ASPR of NVL rose from 10096.24/100000 to 15624.54/100000,and ASDR increased from 101.75/100000 to 158.75/100000.In 2021,ASPR(16551.70/100000)and ASDR(167.69/100000)were higher among females than males(14686.21/100000 and 149.76/100000,respectively).China ranked highest globally in both NVL cases and disability-adjusted life years(DALYs),with female burden significantly exceeding male burden.Projections indicated this trend and sex gap will persist until 2036.Compared with 1990,the prevalence cases and DALYs increased by 239.20%and 238.82%,respectively in 2021,with the highest burden among females and the 55−59 age group.The ARIMA model predicted continued increases in prevalence and DALYs by 2036,with females maintaining a higher burden than males.Conclusion:This study reveals a marked increase in the NVL burden in China and predicts continued growth in the coming years.Public health policies should prioritize NVL prevention and control,with special attention to women and middle-aged populations to mitigate long-term societal and health impacts.
基金European Commission,Directorate-General for European Civil Protection and Humanitarian Aid Operations,No.ECHO/SUB/2015/718665/PREP17the Norwegian Association of the Blind and Partially Sighted,No.S23/2017,No.S20/2018 and No.S12/2019.
文摘BACKGROUND To our knowledge,no study has obtained specific estimates of depression for young and middle-aged adults with visual impairment(VI).As estimates of depression varies across age groups in the general population,it is of interest to examine whether the same applies to adults with low vision or blindness.AIM To estimate depression prevalence and its association with VI-related characteristics and life satisfaction in adults with VI.METHODS A telephone-based cross-sectional survey was conducted between January and May 2017 in an age-stratified sample of adults who were members of the Norwegian Association of the Blind and Partially Sighted.Participants were asked questions about their sociodemographic characteristics,VI characteristics,and life satisfaction.Depression was measured with the Patient Health Questionnaire.The diagnostic scoring algorithm was used to calculate the point prevalence of depression(i.e.,major depression and other depressive disorders)across categories of gender and age(years:18-35,36-50,51-65,≥66).The associations were estimated using regression models.RESULTS Overall,736 adults participated in the study(response rate:61%).The prevalence estimates of depression varied across different age groups,ranging from 11.1%-22.8%in women and 9.4%-16.5%in men,with the highest rates for the two youngest age groups.Results from the multivariable models including sociodemographic and VI-related variables showed that losing vision late in life[Prevalence ratio(PR),1.76,95%CI:1.11,2.79]and having other impairments(PR:1.88,95%CI:1.32,2.67)were associated with higher rates of depression,whereas older age was associated with lower rates(PR:0.83,95%CI:0.74,0.93).Additionally,participants who were depressed had lower life satisfaction than those who were not depressed(adjustedβ:-2.36,95%CI:-2.75,-1.98).CONCLUSION Our findings suggest that depression in adults with VI,and especially among young and middle-aged adults,warrants greater attention by user organisations,clinicians,and healthcare authorities.
基金Supported by the National Natural Science Foundation of China(No.81874494)Natural Science Foundation of Beijing Municipality(No.7182187)+1 种基金Capital Foundation of Medical Development(No.2020-2-4182No.2020-3-4184)。
文摘Older individuals with macular diseases,such as age-related macular degeneration,experience central vision loss(CVL)due to degeneration of their photoreceptors and retinal cells.Patients with CVL may experience various vision impairments,including of visual acuity,fixation stability,contrast sensitivity,and stereoacuity.After CVL,most patients develop a preferred retinal locus outside the affected macular region,which serves as a new visual reference.In this review,we provide an overview of the visual function and impairment in individuals with CVL.In addition,the important role of biofeedback training on the visual function and activity of individuals with CVL is also reviewed.Accordingly,the location and development of the preferred retinal loci are discussed.Finally,this review discusses how to conduct biofeedback training to treat individuals with CVL.
文摘Background:As the prevalence of age-related vision loss continues to increase,vision rehabilitation practitioners will encounter a growing number of older adults who experience reading-related difficulties.Braille may be considered as an alternative to sight enhancement options for clients with progressive or significant visual pathologies.However,little is known about the impact of aging on braille reading performance.The goal of this research was to explore the experiences of older adults with acquired vision loss who have learned braille later in life,and to better understand the facilitators and barriers encountered throughout this process.Methods:Qualitative interviews were conducted by telephone with 14 participants from across Canada(age 40-72,Mdn=55.5,7 female).All participants learned braille in adulthood(starting age 33-60,Mdn=46.5).Recorded interviews were transcribed verbatim and later analyzed by two independent researchers based on the phenomenological method of analysis.Results:Personal,social and environmental factors were shown to influence the braille-learning process.In particular,prior learning experiences(both positive and negative)were shown to impact both the decision to learn braille and participant training experiences.Participants highlighted the importance of perceived support from family and friends,and reactions towards braille from the general public posed a barrier to those still adjusting to vision loss.Participants also highlighted the value of knowing others who learned braille later in life.Conversely,a reoccurring environmental barrier that emerged was the perceived response from rehabilitation practitioners who believed that clients should not or could not learn braille due to their age,as well as the lack of available resources to facilitate training.Conclusions:Results highlight the need to explore the influence of stereotypes associated with aging,blindness and braille,and the degree to which this may impact opportunities for clients who may benefit from braille training.Though previous learning experiences appear to influence successful rehabilitation outcomes,these factors are not routinely considered during the braille assessment process.Our findings will therefore contribute to future research and the development of assessments to better meet the needs of older adults who pursue braille training.
文摘Blindness affected 45 million people globally in 2021,and moderate to severe vision loss a further 295 million.[1]The most common causes,cataract and uncorrected refractive error,are generally the easiest to treat,and are among the most cost-effective procedures in all of medicine and international development.[1-2]Thus,vision impairment is both extremely common and,in principle,readily manageable.
基金supported by St.Erik Eye Hospital philanthropic donations,Vetenskapsrådet 2022-00799(to PAW).
文摘Neurodegenerative diseases account for a large and increasing health and economic burden worldwide.With an increasingly aged population,this burden is set to increase.Optic neuropathies make up a large proportion of neurodegenerative diseases with glaucoma being highly prevalent.Glaucoma is characterized by the progressive dysfunction and loss of retinal ganglion cells and their axons which make up the optic nerve.It is the leading cause of irreversible vision loss and affects an estimated 80 million people.The mammalian central nervous system is non-regenerative and,once lost or injured,retinal ganglion cells cannot regenerate an axon into the optic nerve under basal conditions.Thus,strategies that provide neuroprotection to stressed,dysfunctional,or dying retinal ganglion cells are likely to be of high therapeutic and translational value.Advancing age,genetics,and elevated intraocular pressure are all major risk factors for glaucoma,however,all clinically available glaucoma treatments focus on intraocular pressure management and do not directly address the neurodegenerative component of glaucoma.
文摘Background:Taking part in productive and enjoyable recreational activities has been shown improve quality of life for people of all ages and capabilities.However,vision loss can have a significant impact on participation in important leisure activities.This is especially the case for the elderly,whose lowered mobility is further impacted by vision loss.Technology can offer solutions to bridging some barriers caused by these deficits by bringing leisure activities to the user in the form of mobile applications.As such,the purpose of the present study was to evaluate the accessibility and usability of the ArtOnTheBrain application,a visual art based mobile health solution to promote brain health and well-being,by older adults with low vision due to age-related macular degeneration(AMD).Methods:There were a total of 16 participants(age range,65-93 years,M=79,10 males).All had a diagnosis of AMD with visual acuities in the better eye between 20/60 and 20/200.Additionally,all participants had accessed rehabilitation services and most had experience using a computer at home.Using an Apple iPad Air(2013),they were asked to interact with the ArtOnTheBrain website’s Learn(e.g.,Listen to artwork description)and Play(e.g.,complete a word-search game)features with either the Safari or Google Chrome Internet apps.Using the Concurrent Think Aloud method,participants were asked to continuously comment on their activities and experiences with the app and verbalize their internal monologue while being audio and video recorded.These recordings were later transcribed verbatim and analysed using qualitative description and thematic analysis.Results:Participants’behaviours and verbal feedback were divided based on whether they presented as barriers or facilitators.Beginning with barriers,these were mostly related to the accessibility of the visual aspects of the applications interface(i.e.,contrast and font size),whereby participants requested additional control over the magnification options,both for text as well as images of the artwork.The main facilitator was the audio option built into the Learn tab,which allowed participants to listen to the artwork descriptions.Facilitators also included the aesthetics of the app,the perceived boost in confidence in interacting with technology,and the educational and leisure benefits.Conclusions:Older adults with low vision are faced with a decreased ability to engage in leisure activities.The development of technologies aimed at increasing the accessibility of leisure activities for these individuals is an important step in increasing their quality of life.As such,despite some of the accessibility challenges,the majority of participants viewed ArtontheBrain positively.Identifying the barriers and facilitators to its use is an important step in the development of this application in order to optimize its accessibility for older adults with low vision.Future work to be done with this application will be to evaluate the cognitive impact of ArtontheBrain on low vision users.
文摘Here we report a case of a 67-year-old female patient who presented with headache,limb tremors,and acute complete vision loss.Physical examination revealed bilateral miosis,and diffusion-weighted imaging sequences showed mild diffusion restriction in the subcortical regions of both occipital lobes.Genetic results revealed 85 GGC repeats in the 50-untranslated region of the NOTCH2NLC gene.The therapeutic effect of dexamethasone and acyclovir was minimal.NIID must be considered in patients with acute onset and various clinical manifestations and imagingfindings similar to encephalitis.We hope that our case presentation will enhance clinicians’awareness of NIID.
基金Supported by National Natural Science Foundation of China(No.82070991).
文摘Central retinal artery occlusion(CRAO)is an acute ophthalmic emergency,characterized by sudden vision loss due to retinal ischemia in areas corresponding to arterial occlusion sites.Diagnosis primarily relies on fundus fluorescein angiography(FFA)and optical coherence tomography(OCT),which show delayed retinal artery filling time hours to days after occlusion and increased hyperreflectivity of the inner retina.
