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Potential guidelines for cataract surgery and rehabilitation in visually impaired patients: Literature analysis.

Aging Med (Milton)

December 2024

Department of Sense Organs, Faculty of Medicine and Odontology, Rare Retinal Diseases and Ocular Electrophysiology Centre, Umberto I Policlinic Sapienza University of Rome Rome Italy.

Cataracts can reduce the quality of vision in visually impaired patients who already have a visual impairment. The most common causes of low vision include age-related macular degeneration (AMD), high myopia (HM), diabetic retinopathy (DR), glaucoma (GL), and inherited degenerative ocular diseases. The surgery aims to improve their independence, quality of life, and ability to engage in daily, social, and work activities.

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Optical coherence tomography (OCT) and confocal microscopy are pivotal in retinal imaging, offering distinct advantages and limitations. OCT offers rapid, noninvasive imaging but can suffer from clarity issues and motion artifacts, while confocal microscopy, providing high-resolution, cellular-detailed color images, is invasive and raises ethical concerns. To bridge the benefits of both modalities, we propose a novel framework based on unsupervised 3D CycleGAN for translating unpaired OCT to confocal microscopy images.

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Diabetic retinopathy (DR) is a public health issue affecting millions in the United States and Europe. However, despite strong recommendations for screening at regular intervals by many professional societies, including the American Diabetes Association and the American Academy of Ophthalmology, screening rates remain suboptimal, with only 50-70% of patients with diabetes adhering to recommended annual eye exams. Barriers to screening include lack of awareness, socioeconomic factors, health care system fragmentation, and workforce shortages, among others.

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Ceroid lipofuscinosis type 2 (CLN2) is caused by biallelic pathogenic variants in the TPP1 gene, encoding lysosomal tripeptidyl peptidase 1 (TPP1). The classical late-infantile phenotype has an age of onset between 2 and 4 years and is characterized by psychomotor regression, myoclonus, ataxia, blindness, and shortened life expectancy. Vision loss occurs due to retinal degeneration, usually when severe neurological symptoms are already evident.

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Purpose Of Review: Cardiovascular disease (CVD) is a leading cause of preventable morbidity and mortality globally, and retinal imaging modalities (old and new) are being explored as noninvasive tools to predict latent atherosclerosis and cardiovascular disease. This review focuses on the emerging promise of fundoscopy, optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) in CVD prognostication.

Recent Findings: High-quality studies have established the utility of vessel-based parameters and discrete conditions diagnosable via fundoscopy in subclinical atherosclerosis detection or CVD prediction.

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