Research Article
Racial and Socioeconomic Differences Correlate with Healthcare Disparities in Patients with Diabetic Retinopathy
Issue:
Volume 9, Issue 3, September 2024
Pages:
30-39
Received:
30 May 2024
Accepted:
20 June 2024
Published:
2 July 2024
Abstract: Diabetic retinopathy (DR), an ocular complication of diabetes mellitus, is the leading cause of permanent blindness in the United States for young adults. Due to biological and environmental factors, diabetes mellitus is well known to disproportionally affect people of color and those of lower socioeconomic status; however, the racial and socioeconomic disparities of DR are less researched. The purpose of this research is to elucidate any differences in DR presentation that arise across racial and socioeconomic lines and to determine if diabetic control can be a predicting factor for DR severity. For this study, a retrospective patient chart analysis was performed on 511 consecutive newly referred patients with diabetes at New England Retina Associates, a vitreo-retinal ophthalmology practice with four locations throughout Connecticut. Our analysis shows that, when compared to their White and Asian counterparts, Black/African American and Hispanic patients present with DR at younger ages, had the higher HbA1c, were uninsured at higher rates, and presented with severe forms of DR in higher rates when compared to their counterparts. Many of these patterns are mirrored in patients that are uninsured or on Medicaid, indicators of lower socioeconomic status. Additionally, regardless of race or socioeconomic status, patients with higher HbA1c tended to present with more severe forms of DR. These findings indicate that DR disproportionately affects racial minority populations and those in socioeconomically disadvantageous positions, but effective glycemic control and routine eye exam screening can improve the outcomes of these patients. It is important for medical providers to recognize the disparities in these vulnerable populations in order to facilitate the timely referrals and the proper care for their long-term ocular health.
Abstract: Diabetic retinopathy (DR), an ocular complication of diabetes mellitus, is the leading cause of permanent blindness in the United States for young adults. Due to biological and environmental factors, diabetes mellitus is well known to disproportionally affect people of color and those of lower socioeconomic status; however, the racial and socioecon...
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Review Article
A Closer Look: Environmental Stressors and Their Effects on the Ocular Surface
Issue:
Volume 9, Issue 3, September 2024
Pages:
40-45
Received:
3 July 2024
Accepted:
22 July 2024
Published:
31 July 2024
Abstract: Environmental variables have a considerable impact on the ocular surface, both structurally and functionally. The cornea, conjunctiva, and tear film form the ocular surface, which is essential for preserving visual clarity and comfort. UV radiation, air pollutants, allergens, and climatic changes can all upset the delicate balance of the ocular surface ecosystem, resulting in disorders such as dry eye disease (DED), allergic conjunctivitis, and photokeratitis. UV radiation is a well-documented environmental threat that can induce eye surface damage, both acute and chronic. Fine and ultrafine particles can get into the tear film and conjunctiva, producing oxidative stress and inflammation. Allergens such as pollen, dust mites, and pet dander cause allergic conjunctivitis, which is the most prevalent allergic eye illness. Climate variables such as temperature, humidity, and wind all have a substantial influence on ocular surface health. Understanding these environmental consequences necessitates a multidisciplinary strategy that combines ophthalmology, environmental science, and public health. Clinicians can measure the effect of environmental exposures on ocular health using diagnostic procedures such as tear film analysis, ocular surface imaging, and biomarker studies. Management options include preventative measures and therapies that are customized to individual illnesses. Preventive measures include wearing protective eyewear to shield against UV radiation and pollutants, using air purifiers to reduce indoor allergens, and avoiding outdoor activities during peak pollution hours. Emerging research focuses on elucidating molecular mechanisms underlying environmental-induced ocular surface disorders and developing novel therapies to mitigate their effects. By advancing knowledge in this field, we aim to enhance preventive strategies and therapeutic interventions, ultimately improving the quality of life for individuals affected by environmental-related ocular surface conditions.
Abstract: Environmental variables have a considerable impact on the ocular surface, both structurally and functionally. The cornea, conjunctiva, and tear film form the ocular surface, which is essential for preserving visual clarity and comfort. UV radiation, air pollutants, allergens, and climatic changes can all upset the delicate balance of the ocular sur...
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Research Article
Use of Tear Substitutes to enhance the Image Quality of the Optic Nerve and Retina by Optical Coherence Tomography
Issue:
Volume 9, Issue 3, September 2024
Pages:
46-55
Received:
14 April 2024
Accepted:
26 August 2024
Published:
26 September 2024
Abstract: Background & Objectives: Dry eye disease (DED) has become very prevalent, with the increased usage of internet and video terminals. The present study was carried out to compare the efficacy of tear substitutes in enhancing the signal strength of measurements of optic nerve head, retinal nerve fiber layer and macula by Optical coherence tomography (OCT), and resultant change in image quality. Thus proving the role of artificial tear substitutes in increasing the diagnostic accuracy of Optical coherence tomography (OCT) measurements. Methods: A double blinded randomized control trial was performed on one hundred and fifty patients needing optical coherence tomography. They were randomly allocated into three groups to receive any one of the three tear substitutes Group 1 –Sodium hyaluronate (Molecular Weight M Wt 799.6g/mol) Group 2 – Poly ethylene glycol (Molecular Weight M Wt 400g/mol), Group -3 Hydroxy Propyl Methyl cellulose (Molecular Weight M Wt 1261.4 g/mol); Measurement of signal strength for optic nerve head, retinal nerve fiber thickness RNFL and sub foveal thickness SFT was done before and after instillation of tear substitutes. Data was analyzed using the Statistical Package for Social Sciences SPSS 22 version software. P value <0.05 was considered statistically significant. Results: The groups were comparable with respect to mean age and gender distribution. The mean signal strength (SS) of Optic Nerve Head (ONH) evaluation improved in all the groups in both eyes. The increase was the highest in Group II in both eyes. The increase in retinal nerve fiber layer thickness [RNFL] was seen in both eyes in all the groups. Improvement in macular evaluation sub foveal thickness (SFT) was seen in Group II of both eyes and group III in the Left eye. Interpretation and Conclusion: All tear substitutes improved the quality of the image but the improvement varied with regard to the parameters measured, thus proving artificial tear application is an essential for Optical coherence tomography OCT measurements in persons prone to dry eye This reduces the scope for error due to bad images and thereby the possibility of misdiagnosis of ophthalmic disease.
Abstract: Background & Objectives: Dry eye disease (DED) has become very prevalent, with the increased usage of internet and video terminals. The present study was carried out to compare the efficacy of tear substitutes in enhancing the signal strength of measurements of optic nerve head, retinal nerve fiber layer and macula by Optical coherence tomography (...
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,
Sara Channamsetty
