The OD’s Role in Halloween Eye Safety Awareness Month

Metabolic Vulnerability Index May Be Associated with Age-Related Eye Diseases

A patient’s metabolic vulnerability index (MVX) may be linked to a risk for many age-related eye diseases, according to a study in Frontiers in Nutrition. The MVX is created from biomarkers of inflammation and malnutrition, which are measured by nuclear magnetic resonance spectroscopy. Specifically, out of a prospective population-based cohort of 206,311 subjects analyzed for MVX, 4,144 developed AMD, 13,574 cataract, 1,483 diabetic retinopathy (DR), and 5,525 glaucoma. After multivariable adjustment for demographic, socioeconomic, clinical, and lifestyle factors, each one standard deviation increase in MVX was linked with higher risks of incident AMD, cataract, and DR. Additionally, subjects who had both high genetic risk and elevated MVX showed the greatest risks of AMD, cataract, and DR.

Implementation in Practice. While the study’s researchers say additional studies are required to determine whether MVX provides worthwhile predictive value or clinical utility exceeding conventional risk factors, it may still be important to discuss with patients the potential influence of inflammation and malnutrition on ocular health.

Statin Use May Be Linked with Dry Eye Disease

The use of statins may be linked with a small, though statistically significant, increase in dry eye disease (DED), according to a recent observational-based meta-analysis in the American Journal of Ophthalmology.

Implementation in Practice. The study’s authors say these findings suggest doctors should educate statin users about this link and monitor them for symptoms of DED.

Risk of Astigmatism Increases in Overweight and Obese Children

Being overweight or obese is associated with an increased risk of astigmatism, according to a recent study in the Canadian Journal of Ophthalmology. Specifically, in a multivariable analysis of 22,130 children 6 to 10 years of age who underwent refractive assessment between 2012 and 2022 and who had at least 2 years of follow-up, those overweight and obese had higher odds of having low-to-moderate astigmatism and high astigmatism. What’s more, body mass index (BMI) was linked with against-the-rule astigmatism, with the strongest association observed in obesity.

Implementation in Practice. The researchers note that “early vision screening in children with high BMI may support timely correction and reduce visual impairment.”

Cataract Surgery Increases Risk of Diabetic Retinopathy in Patients Diagnosed With Diabetes

Patients who have diabetes and undergo cataract surgery are at an increased risk of incident diabetic retinopathy (DR) and progressive disease, especially within the surgery's first year, according to a Taiwan population-based retrospective study in BMJ Open Ophthalmology. Specifically, in those patients who underwent cataract surgery, 3.1% had incident DR and progressive disease at 1 year postop versus 1% in the nonsurgical group. Additionally, increased risk was linked with more aggressive diabetes treatment.

Implementation in Practice. The study’s authors say that these results support considering cataract surgery as a “clinically relevant risk window” for elevated monitoring of retinal health. They add that “incorporating surgical history into DR risk stratification and screening strategies may improve early detection and inform postoperative care pathways.”

Corneal Disease Associated With Attention Deficit Hyperactivity Disorder

The prevalence of keratoconus (KC) was significantly higher among adults with attention deficit hyperactivity disorder (ADHD) compared with controls, according to a recent large, cross-sectional retrospective study in the Canadian Journal of Ophthalmology. Additionally, tear film disorders, which may potentially represent a cause for eye rubbing, emerged as an independent predictor.

Implementation in Practice. In adult patients who disclose a diagnosis of ADHD, it may make sense to inquire about habitual eye rubbing. “Given the substantial quality-of-life burden associated with KC, it is crucial to investigate this potential association in populations who have ADHD, who may be at particular risk,” the study’s authors say.

Possible Phenotype in AMD Linked With Increased Risk of Stroke

Increased reticular pseudodrusen (RPD), recognized more and more as a distinct phenotype in AMD, is linked with an increased risk of stroke, according to a recent retrospective analysis in BMJ Open Ophthalmology. What’s more, this risk was independent of traditional cardiovascular risk factors. Specifically, univariable analysis revealed that for every 20 RPD lesions, the odds ratio for stroke increased by 1.02. It’s worth mentioning that the mean number of RPD per patient in this cohort was 199, indicating an increased stroke risk of 20%.

Implementation in Practice. As this study suggests RPD may represent a distinct disease entity, assessing cardiovascular risk in those who have many RPD may make sense, the study’s authors say. They add, “further prospective studies are needed to validate these findings and explore the underlying mechanisms.”