Browsing by Author "Grzybowski, Andrzej"
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- Accommodative–vergence disorders in a paediatric ophthalmology clinical setting in ArgentinaPublication . Iurescia, Alejandra; Iribarren, Rafael; Lança, Carla; Grzybowski, AndrzejPurpose: To determine the frequency of potential non-strabismic accommodative-vergence anomalies (NSAVA) and investigate associations between NSAVA, refractive errors, and age among children attending a paediatric ophthalmology clinic. Methods: This study included children and adolescents aged 5-19 years attending an ophthalmology clinic with at least two follow-up visits. At their first visit, children had a comprehensive ophthalmic examination, including refractive error measurement by cycloplegic autorefraction, and spectacles were prescribed if necessary. At the second visit, children had an examination of best-corrected visual acuity, convergence, and accommodation to identify potential NSAVA. The relationship between age, sex, heterophoria refractive error, and potential NSAVA was assessed by a multivariable logistic regression model. Results: A total of 384 children and adolescents were evaluated. Their mean age was 10.97 ± 3.07 years and 58.9% were females. Forty-two percent of children failed the NSAVA tests and 34.1% had myopia (≤-0.50 D). Children who failed NSAVA tests self-reported a higher proportion of reading problems (73.7%) compared to those who passed the tests (26.3%; p < 0.001). Children with self-reported reading problems were more likely to have accommodative infacility (57.9%) compared with children without (42.1%; p < 0.001). Refractive error and age were not associated with failure in NSAVA tests (p > 0.05). Conclusions: NSAVA was a frequent cause of vision problems found in a sample of children from an ophthalmology paediatric clinic. Thus, further research is necessary to understand the potential of public health policies to prevent, refer, diagnose, and treat those conditions.
- Anti-myopia spectacles: the standard of care in the future?Publication . Lança, Carla; Pan, Chen-Wei; Grzybowski, AndrzejReports of myopia increases across the world show an expanding growing public health problem. Myopia prevalence is exceptionally high in some continents, especially in Asia and particularly east Asian countries, but was also reported to have increased in other continents, such as North America and Europe, although there is considerable variation between geographic areas and racial groups in the myopia burden. The presence of myopia, especially high myopia, increases the risk of development of pathologic myopia and visual impairment. The peak incidence of myopia occurs in childhood, but the associated blinding ocular complications develop later during adulthood. Children with an increased risk of visual impairment due to pathologic myopia often have a longer duration of the disease, longer axial length (AL), and thinner choroid. Thus, myopia control therapies should be implemented early to avoid the development of high myopia, as the early age of myopia onset plays a fundamental role in myopia progression, with about 50% of children with myopia onset at 7 or 8 years of age developing high myopia in adulthood, if left untreated. Increased prevalence of high myopia related to AL elongation is likely to result in higher rates of myopic macular degeneration (MMD). At present, we do not know if treating myopic progression will avoid the development of MMD. However, it seems logical to slow AL elongation to prevent severe disease and complications associated with pathologic myopia. Consequently, controlling myopia progression has become one of the highest priorities for eye care professionals all over the world.
- Association between ambient air pollution and dry eye symptoms among Chinese individuals during the COVID-19 pandemic: a national-based studyPublication . Kai, Jia-Yan; Wu, Yi-Bo; Dong, Xing-Xuan; Miao, Yi-Fan; Li, Dan-Lin; Hu, Dan-Ning; Lança, Carla; Grzybowski, Andrzej; Pan, Chen-WeiPurpose: To examine the association between ambient air pollution and dry eye symptoms (DES) during the COVID-19 pandemic and explore whether air pollution had increased the risk of DES to a greater extent than other risk factors. Methods: A nationwide cross-sectional survey was conducted from June 20, 2022 to August 31, 2022. The Ocular Surface Disease Index-6 (OSDI-6) questionnaire was used to assess the presence of DES. Logistic regression models were employed to analyze the associations between DES and air pollution variables, including air quality index (AQI), fine particulate matter (PM2.5), PM10, sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3) and residing near industrial zones. We explored the interactions of air pollutants and other risk factors in the additive models by calculating the synergy index (SI). Standardized regression coefficients were calculated to compare the relative importance of risk factors for DES. Results: A total of 21,909 participants were included in the analysis. Residing near industrial zones was significantly correlated with a higher risk of DES (Odds ratio (OR): 1.57, 95 % confidence interval (CI): 1.38–1.79). No significant associations were found between DES and air pollutants except SO2 (OR: 1.05, 95 % CI: 1.02–1.09, per standard deviation increment in SO2 concentration). The restricted cubic spline analyses revealed a linear concentration-response relationship between SO2 and DES. The interaction analyses suggested synergetic interactions of SO2 with depression and problematic internet use. Among the risk factors, depression, anxiety, and problematic Internet use contributed more to the increased risk of DES. Conclusion: The association between ambient air pollutants and DES may have been mitigated during the pandemic due to increased time spent indoors. Despite this, our findings support the deleterious health impact of air pollutants. Future urban planning should plan industrial zones further away from residential areas.
- Association between pets and dry eye symptoms: a Chinese national-based studyPublication . Kai, Jia-Yan; Wu, Yi-Bo; Chen, Hui-Min; Hu, Dan-Ning; Lança, Carla; Grzybowski, Andrzej; Zhang, Lijun; Zhang, Xiao-Feng; Pan, Chen-WeiBackground: Pet-derived allergens are another source of indoor air pollution that could affect human health. However, the association between pet ownership and the risk of dry eye symptoms (DES) remains to be elucidated. Methods: We conducted a nationwide cross-sectional survey among Chinese residents aged over 12 years from June 20, 2022, to August 31, 2022. The Ocular Surface Disease Index-6 (OSDI-6) questionnaire was utilized to evaluate the presence of DES. Multivariable logistic regression models were used to analyze the associations between pet ownership and DES. Subgroup analyses were conducted based on sex, age, residence and affective disorders, and sensitivity analysis by excluding participants with major ocular diseases. The interactions between pet ownership and other risk factors on DES were explored in the additive scale by calculating the synergy index (SI). Results: A total of 21,916 subjects replied to the questionnaire. The prevalence of DES was 43.6 % (95 % confidence interval (CI), 43.0 %-44.3 %). Pet ownership was significantly associated with increased risk of DES (Odds ratio (OR): 1.13, 95%CI: 1.05-1.21), especially among the elderly (OR: 1.28, 95%CI: 1.09-1.51) and urban residents (OR: 1.13, 95%CI: 1.04-1.24). The individual effect of allergic rhinitis on DES was 2.59 (95%CI: 1.27-5.53), while the joint effect of pets and allergic rhinitis was 5.26 (95%CI: 1.20-36.74), suggesting a synergistic interaction with a SI of 2.48 (95%CI: 0.25-24.39). Furthermore, the interaction analysis also indicated a synergistic interaction between pet ownership and low health literacy with a SI of 1.12 (95%CI: 0.66-1.87). Conclusion: Pet ownership was identified as a risk factor for DES. The synergistic interaction of pet ownership and allergic rhinitis suggests shared mechanisms between DES and allergic conditions.
- Association of sleep traits with myopia in children and adolescents: a meta-analysis and Mendelian randomization studyPublication . Dong, Xing-Xuan; Xie, Jia-Yu; Li, Dan-Lin; Dong, Yi; Zhang, Xiao-Feng; Lança, Carla; Grzybowski, Andrzej; Pan, Chen-WeiPurpose: The association between sleep and myopia in children and adolescents has been reported, yet it remains controversial and inconclusive. This study aimed to investigate the influence of different sleep traits on the risk of myopia using meta-analytical and Mendelian randomization (MR) techniques. Methods: The literature search was performed on August 31, 2023, based on PubMed, Embase, Web of Science, and Cochrane Library. A meta-analysis of observational studies reporting the relationship between sleep and myopia was conducted. MR analyses were carried out to assess the causal impact of genetic pre-disposition for sleep traits on myopia. Results: The results of the meta-analysis indicated a significant association between the risk of myopia and both short sleep duration [odds ratio (OR) = 1.23, 95% confidence interval (CI) = 1.08-1.42, P = 0.003] and long sleep duration (OR = 0.75, 95% CI = 0.66-0.86, P < 0.001). MR analyses revealed no significant causal associations of genetically determined sleep traits with myopia, including chronotype, sleep duration, short sleep duration, and long sleep duration (all P > 0.05). Conclusions: No evidence was found to support a causal relationship between sleep traits and myopia. While sleep may not independently predict the risk of myopia, the potential impact of sleep on the occurrence and development of myopia cannot be disregarded.
- Biomarkers: promising tools towards the diagnosis, prognosis, and treatment of myopiaPublication . Ruamviboonsuk, Varis; Lança, Carla; Grzybowski, AndrzejThe prevalence of myopia, especially high myopia, continues to increase in several parts of the world. Thus, using biomarkers for early myopia detection would be highly valuable for clinical practice aiding in the prevention and myopia control management. Identifying biomarkers that can predict the risk of myopia development, severity of myopia, and treatment response are of paramount significance. In this review, we present the current state of research on biomarkers and myopia, highlighting the challenges and opportunities in biomarkers research for myopia. Although myopia biomarkers may have a role as early indicators of myopia or treatment response, the adoption of biomarkers into myopia clinical practice may only be done when tests have high accuracy, are easily measurable, minimally invasive, and acceptable to parents, children, and eye care professionals. Large consortia studies are necessary to validate biomarkers and translate evidence into clinical practice.
- Comment on: Development and validation of a novel nomogram for predicting the occurrence of myopia in schoolchildren: a prospective cohort studyPublication . Lança, Carla; Parssinen, Olavi; Mehravaran, Shiva; Nordhausen, Klaus; Emamian, Mohammad Hassan; Grzybowski, AndrzejIn the recent article published by Guo et al., the authors used data from 2nd and 3rd graders to develop a nomogram to predict myopia onset in schoolchildren. Given that myopia can progress to high myopia, which is in turn a risk factor for pathologic myopia, prediction tools are timely and relevant. We would like to provide insights into other limitations and offer suggestions that can inform future works.
- Controversies in myopia control treatment: what does it mean for future research?Publication . Lança, Carla; Repka, Michael X.; Grzybowski, AndrzejPurpose: Treatment of myopia has been informed by more than 3 decades of clinical trials and other observations. However, controversies regarding myopia control remain, such as when to stop treatment and what is the long-term efficacy of treatment. This perspective aims to describe clinically relevant and current controversies regarding myopia treatment. Design: Perspective. Methods: We reviewed clinical trial data and other studies regarding myopia control therapies. Results: Controversies in myopia treatment are related to the efficacy of low-dose atropine eyedrops and new lens design spectacles to reduce the progression of myopia substantially. In addition to efficacy, the safety of therapies including soft contact lenses, orthokeratology, and low-level red light remains a concern. The therapeutic role of outdoor time in reducing myopia progression also requires further investigation. More research is necessary to confirm treatment effectiveness, required treatment duration, tapering schedules, and when to begin and stop treatment. Conclusions: Myopia management is evolving and maintaining competency in the multiple approaches poses a challenge. Key challenges include identifying high-risk children who would benefit most from treatment, limited evidence supporting the effectiveness of myopia progression control treatments in certain populations, and concerns regarding the availability and cost of treatment, which may create socioeconomic barriers to access. The limitations of current methods to slow or stop myopia progression highlight the need for continuing rigorous investigation of new and improved strategies to reduce the burden of myopia.
- Corrigendum: Effectiveness of myopia control interventions: a systematic review of 12 randomized control trials published between 2019 and 2021Publication . Lança, Carla; Pang, Chi Pui; Grzybowski, Andrzej[Erratum for: Front Public Health. 2023;11:1125000. DOI: 10.3389/fpubh.2023.1125000.]
- Effectiveness of myopia control interventions: a systematic review of 12 randomized control trials published between 2019 and 2021Publication . Lança, Carla; Pang, Chi Pui; Grzybowski, AndrzejPurpose: This study aims to investigate the effectiveness of interventions to control myopia progression. In this systematic review, the primary outcomes were mean differences (MD) between treatment and control groups in myopia progression (D) and axial length (AL) elongation (mm). Results: The following interventions were found to be effective (p < 0.001): highly aspherical lenslets (HAL, 0.80 D, 95% CI, 0.77-0.83; -0.35 mm, 95% CI -0.36 to -0.34), MiSight contact lenses (0.66 D, 95% CI, 0.63-0.69; -0.28 mm, 95% CI -0.29 to -0.27), low dose atropine 0.05% (0.54 D, 95% CI, 0.38-0.70; -0.21 mm, 95% CI-0.28 to -0.14), Biofinity +2.50 D (0.45 D, 95% CI, 0.29, 0.61; -0.24 mm, 95% CI -0.33 to -0.15), defocus incorporated multiple segments [DIMS] (0.44 D, 95% CI, 0.42-0.46; -0.34 mm, 95% CI -0.35 to -0.33) and ortho-k lenses (-0.24 mm, 95% CI -0.33 to -01.5). Conclusion: Low-dose atropine 0.01% was not effective in reducing AL progression in two studies. Treatment efficacy with low-dose atropine of 0.05% showed good efficacy. Spectacles (HAL and DIMS) and contact lenses (MiSight and Biofinity) may confer a comparable treatment benefit compared to atropine, to slow myopia progression.
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