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PurposeTo obtain age-specific data on changes in the prevalence and management of optically correctable visual impairments (OCVIs) in Ponza, Italy.MethodsOphthalmologic examinations were carried out to 1000 Ponzans aged 40–87 years in 1988 and to 836 persons in 2000. Visual acuity (VA) was evaluated under uncorrected (VAUC), presenting (VAPR), and best-corrected (VABC) conditions. We calculated the prevalence of total OCVIs (subjects with VAUC>0.5 logMAR and VABC0.5 logMAR in the better eye), uncorrected OCVIs (VAPR>0.5 logMAR), and corrected OCVIs (VAPR0.5 logMAR) as well as the OCVI correction rate ((corrected OCVI/total OCVI) × 100). Subjects with uncorrected OCVIs were compared to those with corrected OCVIs to evaluate possible associations with some risk factors.ResultsAmong 52- to 63-year olds there were increases in the prevalence of total OCVI (from 15.7 to 22.7%, P=0.051), corrected OCVI (from 10.9 to 19.9%, P=0.005), and OCVI correction rate (from 69.2 to 87.8%, P=0.045). Among 64- to 75-year olds decreases were observed in the prevalence of total OCVI (from 28.5 to 20.0%, P=0.029) and uncorrected OCVI (from 12.6 to 4.8%, P=0.003) while the OCVI correction rate increased from 55.9 to 76.1% (P=0.033). The overall prevalence of uncorrected OCVIs dropped from 7.5 to 4.1%. In 2000, uncorrected OCVI was associated with limited education, very advanced age, retirement, and refractive error associated with eye diseases.ConclusionsRefractive error management has improved in Ponza since 1988, and these changes may be, in part, due to higher education levels, increased frequency of cataract surgery, and slower progression of cataract-related disability.Eye (2009) 23, 522–529; doi:10.1038/eye.2008.104; published online 18 April 2008 [ABSTRACT FROM AUTHOR]

AimThe scientific literature contains recent data on the prevalence of blindness and low vision for a few European countries, but most of these studies have been focused exclusively on the elderly sector of the populations. The purpose of the present study was to provide age-specific estimates of the prevalence and causes of visual loss in an Italian population aged 40 years and over.MethodsIn total, 847 of the 1200 citizens >40 years of age (70.6%) in the island community of Ponza underwent complete standardized ophthalmological examinations. Visual acuity (VA) was measured using a standard logarithmic chart. World health organization (WHO) definitions of blindness and low vision were adopted (respectively, VA>1.3 logMAR or a visual field <10° around central fixation, and VA >0.5 to 1.3 logMAR or a visual field <20° around central fixation). Prevalence rates based on presenting VAs were also calculated.ResultsThe overall best-corrected prevalence rates were 0.6% (presenting, 0.8%) for better eye blindness, 2.1% (presenting, 6.7%) for better eye low vision, 1.8% (presenting, 2.6%) for monocular blindness, 5.0% (presenting, 11.2%) for monocular low vision. Cataract, glaucoma, degenerative myopia, and AMD were the main causes of better eye visual loss.ConclusionAge-specific prevalence rates in Ponza are fairly consistent with those for other European countries with similar socio-economic conditions and public healthcare systems. A substantial percentage of visual losses remains uncorrected despite the availability of potentially curative therapy. Greater emphasis needs to be placed on educating the public regarding the importance of good vision.Eye (2006) 20, 661–667. doi:10.1038/sj.eye.6701934; published online 27 May 2005 [ABSTRACT FROM AUTHOR]

Purpose: To describe a new proxy of the Eye Bank (EB) activity named "Eye Bank Efficiency Index" (EBEI), calculated as the ratio between the number of corneal tissues distributed by an EB within a certain time period, and the difference between the number of procured and discarded tissues., Methods: To demonstrate the effectiveness of the new metric as compared to traditional statistics, an analysis was conducted using data from the largest Italian Eye Bank (Fondazione Banca degli Occhi del Veneto Venice, Italy). Collected data included: the number of corneas retrieved, the number of discarded grafts, and the number of distributed tissues. The analysis focused on three defined timeframes: January to December, March to May (the "Italian Lockdown period"), and June to December (the "Italian post-lockdown period")., Results: In 2020, the annual variation of the EBEI showed a significant increase of up to 3.4% compared to the previous year (0.986 in 2019; 1.020 in 2020), but then gradually decreased to 0.993 in 2022. However, during the months of lockdown in 2020, there was a significant decline of -13.8% in the EBEI compared to the same period in the previous year. The variation in the EBEI during the post-lockdown months was minimal in 2020 and 2021, with the lowest EBEI value of 0.976 being reached in 2022 (-7.8% compared to 2019)., Conclusion: The EBEI is a simple and reliable new measure of the EB activity. Its widespread adoption could ensure a more accurate and reliable analysis of EB data for academic, political, and economic purposes., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

To investigate the impact of Coronavirus Disease-2019 lockdown on the Italian Eye Bank organization. In this national retrospective, multicentric, cohort study, data from the Italian Eye Bank during both the lockdown and the first month after the lockdown period were retrieved. We compared the Italian Eye Bank metrics with the same timeframe of 2019 and 2018. Data from 13 out of 13 (100%) Italian Eye Banks were included in the analysis. A statistically significant reduction in the number of donor corneas retrieved in 2020 was found as compared to the same period in 2019 and in 2018, respectively (2020 = 1284; 2019 = 3088; 2018 = 3221; ANOVA: p < 0.0001). Only 534 corneas have been distributed by Eye Banks during the COVID-19-lockdown period (2020 = 534; 2019 = 1220; 2018 = 1237. ANOVA: p < 0.0001). Similarly, the number of wasted corneas due to postponed or cancelled surgeries was 421, resulting in a considerable increase as compared to the previous 2 years (2020 = 421; 2019 = 67; 2018 = 84; ANOVA: p = 0.0035). Overall, 45 donor corneas were rejected in accordance with the guidance of the Italian National Health Institute Italian National Transplant Centre (CNT). SARS-CoV-2 pandemic has profoundly affected every social and medical field, including the Eye Bank procurement and distribution programs. The current data collected from all the Italian Eye Banks highlights the present and the forthcoming difficulties that the Eye Bank community is going to experience, as for the ongoing pandemic., (© 2021. The Author(s).)

Purpose: To assess the 12-year incidence of glaucoma and glaucoma-related visual field loss in a population-based cohort study., Patients: In 2000, we reexamined 411 of the 581 survivors from the original Ponza eye study conducted in 1988., Methods: Primary open-angle (POAG), primary angle-closure (PACG), and secondary [pseudoexfoliative (PEX)] glaucoma were diagnosed according to the 3-tiered system of evidence developed by the International Society of Geographical and Epidemiological Ophthalmology. Severity of glaucoma was classified according to the Bascom-Palmer system. Visual loss was defined according to World Health Organization guidelines. Relative risk ratios were calculated for several variables., Results: The 12-year incidence of definite POAG was 3.8% (95% confidence intervals (CI), 2.3-6.2), that is, an average annual rate of 0.32%. Corresponding rates for PACG and PEX glaucoma were 0.5% (95% CI, 0.1-1.8) and 0.8% (95% CI, 0.3-2.2), respectively. Half the incident glaucoma cases (45%) had not been diagnosed earlier. Fifty-five percent of the incident POAG eyes had Bascom-Palmer stage 1 or 2 disease and 40% of the incident PACG or PEX glaucoma eyes had stage 3 or 4 disease. Seven of 20 incident glaucoma cases presented with monocular or binocular visual loss because of advanced visual field loss. Significant risk factors for POAG included high myopia (>6.0 D), intraocular pressure ≥22 mm Hg, and glaucoma family history., Conclusion: The average annual incidence of definite POAG in Ponzas lower than that reported in persons of African ancestry and higher than that observed in certain other white populations.

Background: Inflammation triggers secondary neurodegeneration in multiple sclerosis (MS)., Objectives: It is unclear whether classical anti-inflammatory cytokines have the potential to interfere with synaptic transmission and neuronal survival in MS., Methods: Correlation analyses between cerebrospinal fluid (CSF) contents of anti-inflammatory cytokines and molecular, imaging, clinical, and neurophysiological measures of neuronal alterations were performed., Results: Our data suggest that interleukin-13 (IL-13) plays a neuroprotective role in MS brains. We found, in fact, that the levels of IL-13 in the CSF of MS patients were correlated with the contents of amyloid-β(1-42). Correlations were also found between IL-13 and imaging indexes of axonal and neuronal integrity, such as the retinal nerve fibre layer thickness and the macular volume evaluated by optical coherence tomography. Furthermore, the levels of IL-13 were related to better performance in the low-contrast acuity test and Multiple Sclerosis Functional Composite scoring. Finally, by means of transcranial magnetic stimulation, we have shown that GABAA-mediated cortical inhibition was more pronounced in patients with high IL-13 levels in the CSF, as expected for a neuroprotective, anti-excitotoxic effect., Conclusions: The present correlation study provides some evidence for the involvement of IL-13 in the modulation of neuronal integrity and synaptic function in patients with MS.

Purpose: To investigate changes in the prevalence of visual impairment in an Italian population from 1988 to 2000., Methods: Standardized ophthalmologic examinations were administered to citizens of Ponza, Italy aged 40-87 years in 1988 and 2000. Visual Acuity (VA) was measured using a standard logarithmic chart. Visual fields (VF) were tested in all subjects with diagnosed or suspected glaucoma or hereditary degenerative retinopathy. Visual impairment was classified as blindness (VA > 1.3 LogMAR or VF < 10 degrees around central fixation) or low vision (VA > 0.5 to 1.3 LogMAR or VF < 20 degrees to 10 degrees) according to WHO criteria., Results: The prevalence of binocular total visual impairments decreased significantly among 64-75 year-olds (from 6.7% to 2.6%, p = 0.045), and almost significantly among 40-51 year-olds (from 2.4%, 95% CI 1.1-5.3, to 0.0%, 95% CI 0.0-1.3). By 2000, visual impairment was no longer significantly associated with female gender, and age 64-75 years; the mean age of subjects with vision-impairing cataract, diabetic retinopathy, or age-related macular degeneration had risen significantly., Conclusions: A decline in the prevalence of visual impairment, particularly in cataract-associated visual impairment was found in the middle-aged groups. The progression of age-related eye diseases seems to have slowed in this population possibly due to improvements in the life expectancy and socio-economic conditions.

Aim: To study the incidence of visual loss over a 12-year period in the survivors of an original cohort aged 40 years or older at baseline., Methods: Visual acuity (VA) was measured by means of a standardized logMAR chart. World Health Organization definition of blindness and low vision was adopted (respectively, best-corrected VA >1.3 logMAR or a visual field <10 degrees around central fixation, and best-corrected VA >0.5-1.3 logMAR or a visual field <20 degrees around central fixation). Moreover, binocular visual loss incidence (VA>0.5 logMAR) was calculated in a 'healthy' group who had uncorrected VA of 0.0 logMAR or better in both eyes at baseline and absence of eye diseases., Results: Of the 584 eligible survivors, 411 (70.7%) had a 12-year follow-up visit. The overall incidence figures were as follows: best-corrected binocular blindness (0.7%), binocular low vision (3.9%), monocular blindness (2.7%), and monocular low vision (5.0%), respectively. The results for presenting VAs were 1.2, 9.5, 4.2, and 15.3%. Figures for uncorrected, best-corrected, and presenting binocular visual loss incidence in the 'healthy' group were respectively 12.7, 0.9, and 3.7%., Conclusion: The discrepancy between the ideal and real situations that emerges from this study has important implications for health-care planning. Over a period of 12 years, a substantial percentage of 'healthy' subjects will have to seek medical care. Incident visual loss was caused mainly by untreated cataract, glaucoma, myopia, and age-related macular degeneration.

Background: Lens opacities are associated with a higher risk of death, although there are some discrepancies regarding the specific types of cataract representing risk. The purpose of the present study was to further investigate the relationships between different types of lens opacity and patient survival., Methods: In 1987, 860 residents of Priverno, Italy, aged 45-69 years underwent an ophthalmologic examination. Based on patient histories and the findings of the slit-lamp examination, each of the 860 patients was classified according to the type of opacity (pure cortical, pure nuclear, pure posterior subcapsular, mixed, and surgical aphakia). The survivors of the original cohort were re-examined in 1994. Death and survival rates were computed by the Kaplan-Meier method. Associations between mortality and significant factors were included in a stepwise Cox proportional-hazards regression model., Results: Forty-four members of the original cohort had died during the 7-year follow-up. Age-adjusted survival curves based on Kaplan-Meier estimates showed significantly lower survival in those whose baseline examinations had revealed pure nuclear opacity (log rank test: P=0.020) and aphakia (log rank test: P<0.001). When adjusted for other mortality risk factors (age, sex, diabetes, cardiovascular diseases), the hazard ratio was 4.32 for pure nuclear opacity (95% CI 1.13-16.4) and 18.3 for aphakia (95% CI 3.21-104.0)., Conclusions: The analysis of the Priverno data seems to confirm an association between lower survival and cataracts, particularly those confined to the lens nucleus and those that had already prompted surgery.

Purpose: To study the incidence of blindness and low vision over a 7-year period., Design: Population-based cohort study., Participants: The survivors of the original cohort of 860 persons from Priverno, Italy, aged 45 to 69 years, were reexamined. Of the 760 eligible survivors, 619 (81.4%) had a 7-year follow-up visit., Methods: Baseline and follow-up examinations included the collection of anamnestic and ophthalmologic data by the same observers using the same methods and classification criteria to minimize sources of variability., Main Outcome Measures: Best-corrected visual acuity (VA) measured at 4 m by standardized logarithmic chart was expressed as the logarithm of the minimum angle of resolution (logMAR). World Health Organization definitions of blindness and low vision were adopted (respectively, VA > 1.3 logMar and VA > 0.6 to 1.3 logMar in the better eye or in either eye). Participants at risk for visual impairment were those without blindness or low vision in one or both eyes at baseline; participants at risk for one-eye visual impairment were those without blindness or low vision in both eyes at baseline., Results: A total of 33 participants were defined as incident cases of visual impairment. The overall incidence figures for blindness, low vision, one-eye blindness, and one-eye low vision were respectively 0.2% (95% confidence interval [CI], 0.0-0.9), 1.3% (95% CI, 0.7-2.6), 1.2% (95% CI, 0.6-2.4), and 2.9% (95% CI, 1.8-4.6)., Conclusions: This study provides population-based estimates of the incidence of visual impairment in an adult, free-living European population. With respect to the younger participants, older subjects at baseline were at higher risk for incident visual impairment, the main causes of which were cataract, myopia, and diabetic retinopathy. The incidence of visual impairment in the subgroup aged 55 to 64 years at baseline was significantly higher than that found in Beaver Dam 5-year study and similar to that found in Beaver Dam 10-year Study, when the same definitions were adopted. This difference may be partially explained by social and cultural habits of the female samples, but many other factors may play a role.

Background: The protozoan disease giardiasis can cause ocular complications, including "salt and pepper" retinal changes., Methods: Ophthalmic examinations were performed in 141 children (mean age 4.7 (SD 2.0) years) with active or past giardiasis diagnosed on the basis of microscopic examination of stool specimens or duodenal secretions--53 were newly diagnosed and untreated (group A), 50 had active infections in spite of metronidazole therapy (group B), and 38 had been successfully treated, with negative stool specimens for 1-3 years (group C). 300 children with no evidence of giardiasis were used as controls., Results: Salt and pepper retinal changes (with normal electroretinographic findings) were diagnosed in 28 (19.9%) of the patients with giardiasis (11 from group A, 10 from group B, and seven from group C), including five pairs of siblings. In all subgroups, the children with retinal changes were consistently younger than those with normal retinas. In eight cases, the lesions could be visualised only with direct ophthalmoscopy., Conclusion: Our findings indicate that asymptomatic, non-progressive retinal lesions are particularly common in younger children with giardiasis. This risk does not seem to be related to the severity of the infection, its duration, or the use of metronidazole but may reflect a genetic predisposition.