Browsing by Subject "Vision loss"

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    Risk Of Diabetes Among Adults Aging With Vision Impairment: The Role Of The Neighborhood Environment
    (Oxford University Press, 2022) Clarke, Philippa; Khan, Anam; Mintus, Kenzie; Ehrlich, Joshua; Sociology, School of Liberal Arts
    Experiencing vision loss as a result of the aging process may be different from aging with vision impairment (VI) acquired earlier in life. Adults aging with VI may be at risk for Type-2 Diabetes (T2DM) due to community barriers in accessing health care, healthy food, and recreational resources. We examined the relationship between neighborhood characteristics and incident diabetes in 22,719 adults aging with VI (without prevalent T2DM) in a private medical claims database (2008-2019). The primary outcome was time to incident T2DM diagnosis over 3+ years of enrollment. Cox models estimated hazard ratios (HRs) for incident diabetes (adjusted for age, sex, and comorbidities). Residence in neighborhoods with greater intersection density (HR=1.26) and traffic (HR=1.22) increased risk of T2DM, while broadband internet access (HR=0.67), optical stores (HR=0.62), supermarkets (HR=0.78), and gyms/fitness centers (HR=0.63) were associated with reduced risk. Results emphasize the importance of neighborhood context for aging well with VI.
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    VP6: Sustained Topical Release of Tacrolimus Promotes Corneal Reinnervation in Rats
    (Wolters Kluwer, 2022) Daeschler, Simeon C.; Feinberg, Konstantin; Mirmoeini, Kaveh; Chan, Katelyn; Zhang, Jennifer; Gordon, Tessa; Borschel, Gregory H.; Surgery, School of Medicine
    INTRODUCTION: Corneal nerve fibers provide sensibility and maintain ocular surface health. Impaired corneal innervation results in progressive corneal breakdown and vision loss termed neurotrophic keratopathy. Non-surgical therapies that promote corneal reinnervation and thereby prevent vision loss are presently unavailable. MATERIALS AND METHODS: In a compartmentalized neuronal cell culture system only the axonal compartments were exposed to either Tacrolimus (50 ng/ml, n=15) or a vehicle (n=9). After 48h, the axonal surface area and axon length were measured. A biodegradable drug-delivery-system (DDS) was fabricated via electrospinning of a Tacrolimus loaded polycarbonte-urethane-polymer (100 µg Tacrolimus per DDS) which achieved sustained Tacrolimus release for >31 days. Effectiveness was tested in a rat model of neurotrophic keratopathy. Adult rats (n=16) underwent trigeminal nerve ablation and received either a Tacrolimus DDS topically before tarsorrhaphy or tarsorrhaphy only. After 28 days, the normalized corneal nerve fiber density was determined and Tacrolimus biodistribution was assessed via mass spectrometry. RESULTS: Sensory neurons whose axons were exposed to Tacrolimus regenerated significantly more axons (surface area: 2.46±0.7mm2 vs. 0.45±0.2mm2; p<0.001) that were significantly longer on average (2.49±0.5mm vs. 0.84±0.39 mm; p < 0.001) compared to vehicle treated cultures. In agreement with the in vitro results, rats that had received Tacrolimus topically showed significantly higher corneal nerve fiber density (1.48±0.68) compared to the non-treated control (0.19±0.18; p < 0.001) and 7-days post denervation (0.07±0.04; p < 0.001). Tacrolimus was detectable in the ipsilateral vitreal body (3.2±1.9 ng/g), the plasma (1.3±0.7 ng/ml) and the ipsilateral trigeminal ganglion (0.6±0.1 ng/g) but not in their contralateral counterparts or vital organs (liver, kidey, heart) 28-days post denervation. CONCLUSION: Local delivery of low-dose Tacrolimus accelerates sensory axon regeneration in vitro and corneal reinnervation in vivo with minimal systemic drug exposure. Therefore, topically applied Tacrolimus may provide a readily translatable approach to promote corneal reinnervation in patients suffering from corneal nerve fiber loss.