Prevalence, Risk Factors, and Interventions of Postpartum Depression in Refugees and Asylum-Seeking Women: A Systematic Review and Meta-Analysis.

INTRODUCTION: Refugee women are at an increased risk of developing postpartum depression (PPD) due to a combination of various psychosocial stressors. This systematic review aimed to outline the prevalence of PPD among refugee women and explore related risk factors and interventions currently in practice. METHODS: A search was conducted using MEDLINE, Embase, PsycINFO, CINAHL, and Core Collection (Web of Science) for articles published until August 2022, yielding 1,678 records. RESULTS: The prevalence of refugee and asylum-seeking women was 22.5% (n = 657/2,922), while the prevalence of non-refugee/asylum-seeking women with PPD was 17.5% (n = 400/2,285). Refugee/asylum-seeking women face a unique set of issues such as domestic abuse, separation and lack of support, stress, pre-migrational experiences, prior history of mental illness, low income, and discrimination. Refugee/asylum-seeking women may benefit from support groups, individual support, self-coping mechanisms, and familial support. CONCLUSION: This review identifies that a higher prevalence of PPD in refugee and asylum-seeking women compared to other groups can potentially be attributed to the unique risk factors they face. This warrants the need for further research as studies on interventions for this condition are limited among this population.

Quality of Life after Pars Plana Vitrectomy, Scleral Buckle, or Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment: A Meta-Analysis.

PURPOSE: Comparisons of the surgical and anatomic results of rhegmatogenous retinal detachment surgery have been investigated previously. A systematic evaluation of the available evidence comparing quality of life outcomes of either pars plana vitrectomy, scleral buckling, or pneumatic retinopexy has not been evaluated to date. This article analyzes whether pars plana vitrectomy, scleral buckling, or pneumatic retinopexy for the treatment of rhegmatogenous retinal detachment results in differing quality of life outcomes. METHODS: In February of 2022, a comprehensive search of MEDLINE, EMBASE, CINHAL, and Cochrane Library was conducted for studies on patients treated surgically for rhegmatogenous retinal detachment and included follow-up measurements of quality of life outcomes. Meta-analysis was completed using STATA v. 14.0. The main outcomes of interest were the mean vision-related quality of life score (VRQOL) and SD of VRQOL of each type of surgical procedure. RESULTS: In this systematic review of 13 distinct trials including follow-up of patient quality of life after rhegmatogenous retinal detachment surgery (n = 1063), a better correlation was found between higher quality of life outcomes with scleral buckling than with pars plana vitrectomy (SMD = 0.62, CI: [0.31, 0.93]). There was also no signficant difference in quality of life outcomes between pneumatic retinopexy and pars plana vitrectomy (SMD = 0.08, CI: [-0.07, 0.22]). CONCLUSIONS: Scleral buckling results in better quality of life outcomes for patients when compared to pars plana vitrectomy. Pneumatic retinopexy did not show a difference in quality of life outcomes compared to pars plana vitrectomy.

Patterns of anti-vascular endothelial growth factor discontinuation in neovascular age-related macular degeneration.

OBJECTIVE: To report on anti-vascular endothelial growth factor (anti-VEGF) discontinuation in neovascular age-related macular degeneration (nAMD). DESIGN: Retrospective cohort study. PARTICIPANTS: Treatment-naive nAMD patients initiating anti-VEGF injections between 2015 and 2021. METHODS: Demographics, treatment start and end dates, number of injections, treatment length, reason for discontinuation, and baseline and final data (i.e., age, best-corrected visual acuity, and central subfield thickness) were recorded. Statistical analyses using STATA 17.0 assessed differences between baseline and final values and between treatment-discontinuation subgroups. RESULTS: A total of 619 eyes of 502 treatment-naive patients (9015 injections) were included (age, 81.6 ± 8.4 years; 64.0% female). Discontinuation rate was 58.3% (361 of 619), with 310 patients discontinuing because of the lack of visual benefit (n = 152), severe comorbidity or death (n = 82), transferred (n = 33), stable off active treatment (n = 19), lack of benefit plus stable off treatment (n = 14), patient decision (n = 6), and ocular comorbidity (n = 4). Among the 309 remaining patients, 51 (16.5%) were lost to follow-up. Discontinuation occurred within the first year in 49.3% (n = 178). Visual acuity was at least maintained in all groups and improved in the following groups: severe comorbidity or death (p < 0.0001), lost to follow-up (p = 0.0003), transferred (p = 0.0004), and stable off treatment (p = 0.0053). The lack of visual benefit group had no improvement in vision regardless of treatment length. Compared with other subgroups, those stable off treatment group was younger (p = 0.0055), had better baseline vision (p = 0.0018), received more injections (p = 0.0437) over a longer time (p = 0.0034), and achieved better final vision (p < 0.0001). CONCLUSION: While there was a high discontinuation rate over 7.5 years, most were attributable to disease or treatment factors and nonmodifiable patient factors. Discontinuation frequently occurred within the first year.

Treatment discontinuation patterns of anti VEGF in retinal vein occlusion.

OBJECTIVE: The purpose of this research is to report on real-world anti-vascular endothelial growth factor (anti-VEGF) treatment patterns in retinal vein occlusions (RVO). DESIGN: Retrospective cohort study. PARTICIPANTS: Treatment-naive RVO patients initiating anti-VEGF injections between 2015 and 2021. METHODS: Medical records available until June 2022 were reviewed. Demographics, diagnosis, number of injections, treatment length, reason for discontinuation, and baseline and final data (e.g., date, age, best-corrected visual acuity [BCVA], and central subfield thickness) were recorded. Statistical analyses performed with STATA 17.0 assessed differences between baseline and final values, branch (BRVO) and central retinal vein occlusion (CRVO), and treatment-discontinuation subgroups. RESULTS: A total of 219 treatment-naive eyes were included (70.3 ± 13.2 years of age, 52.5% female), with 99 BRVOs and 120 CRVOs (2482 injections). The discontinuation rate was 76.7% (168 of 219), with 72.7% of patients (77 of 99) with BRVOs and 75.8% of patients (91 of 120) with CRVOs discontinuing injections. Reasons for discontinuation included stable off active therapy (98 eyes), severe comorbidity or death (17 eyes), switched to intraocular steroid (implant or injection) (12 eyes), lack of visual benefit (10 eyes), ocular comorbidity (5 eyes), patient decision (5 eyes), and patient transfer (5 eyes). Among the remaining 67 eyes, 16 (24%) were lost to follow-up. Reasons for discontinuation differed between BRVO and CRVO patients (p = 0.002). Eyes with CRVO presented with worse BCVA (p < 0.0001) and achieved worse final BCVA (p < 0.0001), but both groups experienced improvements (p < 0.0001). Younger age, better baseline BCVA, and a diagnosis of BRVO were independent predictors of better final visual acuity. CONCLUSION: Over 7.5 years, treatment was discontinued for three-quarters of RVOs. Stable disease was the most common reason for discontinuation, with nearly half (45%) of all RVOs in the cohort stable off active therapy. Better visual outcomes were achieved in BRVO than in CRVO, although both groups benefited from treatment.

Ocular manifestations of COVID-19: systematic review and meta-analysis.

OBJECTIVE: Our study aims to build on our understanding of COVID-19 by detailing a comprehensive look at the prevalence of different ocular manifestations related to COVID-19 infection. DESIGN: Systematic review and meta-analysis. METHODS: Eligible studies published between June 20, 2021, and May 11, 2023, were retrieved from the MEDLINE, EMBASE, and CINAHL databases as well as grey literature. Covidence was used to conduct the systematic review. Duplicate records were removed, and 2 independent reviewers screened records for relevance. After screening, a risk-of-bias assessment was carried out. Data were extracted, and a meta-analysis was performed using STATA 14.0. Fixed-effects and random-effects models were computed based on heterogeneity. RESULTS: Our meta-analysis included 43 articles with a total of 10,572 subjects. The results showed that COVID-19 patients had a significantly higher prevalence of conjunctivitis (effect size [ES] = 0.11; 95% CI, 0.07-0.15), ptosis (ES = 0.22; 95% CI, 0.15-0.30), and ophthalmoplegia (ES = 0.40; 95% CI, 0.06-0.74). Our results also indicate that COVID-19 patients have higher prevalence of cotton wool spots (ES = 0.06; 95% CI, 0.03-0.09), retinal hemorrhages (ES = 0.12; 95% CI, 0.06-0.18), and retinal vein tortuosity (ES = 0.19; 95% CI, 0.09-0.35). CONCLUSION: COVID-19 can exhibit extrapulmonary manifestations, affecting both the anterior and posterior segments of the eye. Common anterior-segment findings include conjunctivitis, whereas posterior-segment findings may include cotton wool spots, retinal hemorrhages, and retinal vein tortuosity. Improving our understanding of the ocular manifestations of COVID-19 has the potential to facilitate quicker diagnosis and subsequent treatment.

The effects of age-related macular degeneration on work productivity: A meta-analysis.

Age-related macular degeneration (AMD) is one of the leading causes of vision loss and blindness in older adults. Given the aging population in developed countries and the increased participation of older adults in the labour market, this paper aims to understand the impact of AMD on workplace productivity. Economic studies, comparative studies, observational studies, cohort studies, case series, randomized control trials, clinical trials, multicenter studies from MEDLINE, EMBASE, and CINHAL, as well as grey literature, were systematically searched to obtain all relevant literature. Duplicate records were removed, and two independent reviewers screened records for relevance. After screening, a risk of bias assessment was carried out. Data were extracted and a meta-analysis was performed using STATA 15.0. Fixed-effect and random-effect models were computed based on heterogeneity. Seven studies consisting of 3,060,864 subjects from 5 different countries were included in this systematic review. Mean wages lost due to impaired work productivity ranged from $1,395 to $55,180. The mean unemployment rate attributed to AMD ranged from 5.50% to 77.00%. Meta-analysis results indicated a significant unemployment rate (SMD = 0.44, CI: [0.27, 0.62]). Patients with AMD experience impaired work productivity as demonstrated by the wages lost and significantly higher rates of unemployment.

Effect of various relaxation techniques on the intraocular pressure of patients with glaucoma: systematic review and meta-analysis.

OBJECTIVE: To conduct a systematic review focusing on the impact of various relaxation techniques on the intraocular pressure of patients with glaucoma. METHODS: A systematic literature search was performed through CINAHL, MEDLINE, EMBASE, ClinicalTrials.gov, ProQuest Dissertations and Theses Global, and conferences until July 2022. Covidence software (Veritas Health Innovation, Melbourne, Australia) was used to conduct the systematic review. The screening was done by 2 independent reviewers, and a risk-of-bias assessment was completed after data extraction. Stata Statistical Software, version 14 (StataCorp LLC, College Station, Texas) was used to conduct a meta-analysis. RESULTS: Twelve articles (596 subjects) were included for qualitative analysis and 5 articles (332 subjects) for quantitative analysis. One hour of daily mindfulness meditation for 3 weeks resulted in the most significant reduction in intraocular pressure (IOP) at 31.8%. Meditation consistently caused long-term reductions in IOP (standardized mean difference = -2.02; range, -3.16 to -0.89). Autogenic relaxation exercises showed a trend toward reducing IOP acutely but a significant reduction in the long term. Ocular relaxation exercises combined with visual imagery of aqueous humour drainage showed both acute and long-term reductions in IOP. The effects of yoga on IOP could depend on the positions being practiced. CONCLUSION: Various relaxation techniques, such as meditation, visual imagery, autogenic relaxation exercises, and ocular relaxation exercises, seem to cause significant reductions in IOP. Future randomized, controlled trials should be carried out to further explore the utility of these techniques for patients with glaucoma.

Antiviral and Anti-Inflammatory Therapeutic Interventions for Treating Herpes Stromal Keratitis: A Systematic Review.

PURPOSE: Herpes stromal keratitis (HSK) is an immune-mediated corneal inflammation that occurs after a herpes simplex virus infection. This paper aims to systematically identify and compare interventions for treating HSK and their patient outcomes. METHODS: This systematic review followed the PRISMA methodology. Online databases were searched to obtain all relevant papers. Two independent reviewers screened through 168 records. Seven papers were included and used for data extraction. A qualitative analysis was conducted. RESULTS: HSK patients receiving prednisolone phosphate and acyclovir showed a higher treatment success rate and significantly longer time to failure compared to patients receiving only acyclovir (P < .001). No difference in resolution time was found between oral and topical acyclovir. Between groups receiving dexamethasone and flurbiprofen, resolution occurred in 93% and 67% of patients, and BCVA (LogMAR) improved from 1.0 to 0.30 and 0.48, respectively. BCVA improved in both cyclosporine-A (P < .001) and its control (prednisolone) groups (P = .002). A tacrolimus treatment group showed greater improvement in BCVA compared to its control (prednisolone) group (P < .001). CONCLUSION: Corticosteroids and antivirals managed HSK most effectively only when used concurrently. Oral acyclovir showed similar effectiveness to its ointment counterpart, a preferable alternative for easier administration. Corticosteroid use could induce greater therapeutic benefits when tapered in concentration and frequency and administrated for at least 10 weeks. Anti-inflammatory drugs including flurbiprofen, cyclosporine-A, and tacrolimus could be safe and effective for treating HSK. Future long-term follow-up and RCTs could provide insights on the therapeutic benefits of these potential alternatives.

Evaluating Measurement Properties of Patient-Reported Outcome Measures in Glaucoma: A Systematic Review.

TOPIC: The purpose of the current study was to systematically identify and evaluate existing patient-reported outcome measures (PROMs) for clinical glaucoma practice. CLINICAL RELEVANCE: Understanding and incorporating patient preferences into decision-making is now recognized as critical for optimal resource allocation, especially in technologically advancing areas, such as minimally invasive surgeries. Patient-reported outcome measures are instruments designed to evaluate the health outcomes that are most important to patients. Despite their recognized importance, especially in the era of patient-centered care, their routine use in clinical settings remains low. METHODS: A systematic literature search was conducted in 6 databases (EMBASE, MEDLINE, PsycINFO, Scopus, BIOSIS, and Web of Science) from the date of inception. Studies were included in the qualitative review if they reported measurement properties of PROMs in adult patients with glaucoma. COnsensus-based Standards for the selection of health Measurement INstruments guidelines were used to assess the included PROMs. The study protocol is registered with PROSPERO (registration number: CRD42020176064). RESULTS: The literature search yielded 2661 records. After deduplication, 1259 studies entered level 1 screening, and based on title and abstract review, 164 records proceeded to full-text screening. In 48 included studies, 70 instrument reports discuss 43 distinct instruments in 3 major categories: glaucoma-specific, vision-specific, and general health-related quality of life. Most used measures were glaucoma-specific (Glaucoma Quality of Life [GQL] and Glaucoma Symptom Scale [GSS]) and vision-specific (National Eye Institute Visual Function Questionnaire [NEI VFQ-25]). All 3 have sufficient validity (especially construct), with GQL and GSS having sufficient internal consistency, cross-cultural validity, and reliability, with reports suggesting high methodological quality. CONCLUSION: The GQL, GSS, and NEI VFQ-25 are the 3 most used questionnaires in a research setting, having considerable validation in a patient population with glaucoma. Limited reports on interpretability, responsiveness, and feasibility in all 43 identified instruments make identifying a single optimal questionnaire for clinical use challenging and highlight the need for further studies. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Access to Pediatric Eye Care During a Pandemic: Systematic Review and Meta-Analysis.

Visual impairment affects many children and can lead to blindness if untreated. The coronavirus disease 2019 (COVID-19) pandemic has led to various restrictions and other challenges accessing in-person medical care, including essential pediatric eye care. The aim of this article was to determine and quantify the effect that pandemics have on access to pediatric eye care. A systematic literature search was conducted using various databases, which yielded 257 articles; nine were included in the final review. All included studies reported a decrease in the number of children accessing eye care during COVID-19. Most studies described virtual triage systems, which restricted in-person care to emergent cases. The average decrease in daily pediatric visits was 67.32% and reached statistical significance in the meta-analysis (P < .01). However, out of all patients with ocular complaints, the proportion of pediatric visits was unchanged, suggesting that the decrease in access to eye care was not specific to pediatric patients. [Pediatr Ann. 2023;52(2):e68-e75.].

Exploring the Impact of Family Separation on Refugee Mental Health: A Systematic Review and Meta-narrative Analysis.

The refugee crisis is spreading rapidly, with the number of global refugees this decade doubling in comparison to the last, leading to further concern regarding asylum policies and their psychological impacts. The aim of this systematic review is to further emphasize the correlation between familial separation and the risk of mental health disorders in refugees. This particular review uses quantitative and qualitative data sourced from a variety of countries to comparatively view the mental health status of approximately 8,737 refugees ages 15 and older. This was done to determine if familial separation could potentially impact their overall quality of life. As a result, separation from one's family was found to be correlated with symptoms of posttraumatic stress disorder, depression, anxiety, adult separation anxiety disorder, intermittent explosive disorder, and more. Studies reported a high variance in the prevalence of mental health disorders when models were adjusted for family separation. Methods to improve asylum procedure and mental health services for refugees is taken into consideration.

Anxiety, depression, and sleep-related outcomes of glaucoma patients: systematic review and meta-analysis.

OBJECTIVE: This study aims to synthesize data quantifying the prevalence and severity of common psychological conditions in patients with glaucoma. DESIGN: Systematic review and meta-analysis. METHODS: Databases including Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane Library, Web of Science, Open Grey, and ProQuest Theses and dissertations were searched. Two reviewers independently assessed and screened all studies, followed by quality assessment of included studies using the modified Downs and Black checklist. Data were pooled using fixed-effect and random-effects models. RESULTS: Of 2067 studies identified by the search strategy, 57 passed full-text screening, and 45 studies (4 995 538 subjects) were eligible for analysis. Overall, the prevalence of depression (effect size [ES] = 0.19, 95% CI 0.16-0.23; n = 31), anxiety (ES = 0.25, 95% CI 0.21-0.30; n = 18), and sleep disorders (ES = 0.47, 95% CI 0.26-0.68; n = 7) were high in patients with glaucoma. Similarly, symptomatic measurements of depression (standardized mean difference [SMD] = 0.46, 95% CI 0.19-0.73), anxiety (SMD = 0.44, 95% CI 0.08-0.81), and sleep quality (SMD = 0.72, 95% CI 0.22-1.21) were significant in glaucoma patients. CONCLUSIONS: A higher prevalence and severity of depression, anxiety, and sleep disorders was experienced in patients with glaucoma compared with patients without glaucoma. Caregivers as well as health care providers may need to be aware of unique psychological and social stressors placed on glaucoma patients.

Impact on caregivers of patients with eye diseases: systematic review and meta-analysis.

OBJECTIVE: The burden on caregivers of patients with eye disease is exacerbated by competing priorities and their own advancing age. The objective of this paper is to identify and characterize the burden of caregiving for patients with eye diseases. DESIGN: Systematic review and meta-analysis. METHODS: A comprehensive review of the literature was conducted accessing the main databases up to March 25, 2021: Medline (Ovid), Embase, CINAHL, Cochrane Library, PsycINFO, and PubMed. Studies included referred to the burden experienced by caregivers of adults with any eye disease. Review studies, editorials, commentaries, opinion studies, and single case reports were excluded as well as studies that described only the quality of life and (or) burdens of the care recipient. Two independent reviewers carried 2-level screening. Risk of bias assessment was determined according to the Modified Downs and Black Checklist. Demographic data and measures of burden were extracted and tabulated. RESULTS: In total, 2421 articles were identified after duplicate removal; 17 progressed to data extraction after full-text screening, and 7 were included in the meta-analysis. Overall, caregiving was associated with significant burden (65%; 95% CI, 12%-17%). Meta-analysis indicated significant severe burden (24%; 95% CI, 3%-45%), moderate burden (18%; 95% CI, 9%-28%), and mild burden (34%; 95% CI, 7%-61%) on caregivers of visually impaired patients. CONCLUSIONS: Awareness of the psychosocial impact and risk of severe burden experienced by caregivers of eye disease patients is required to aid health care providers to develop proactive interventions for both providers and recipients of care.

Linkage between a plant-based diet and age-related eye diseases: a systematic review and meta-analysis.

CONTEXT: An increased risk of age-related eye disease has been observed in individuals lacking a balanced diet. Following a plant-based diet may result in nutritional insufficiencies and negatively affect health if an effort is not made to ensure the consumption of fortified foods or specific supplements. OBJECTIVE: The purpose of this article is to characterize the relationship between plant-based diets and age-related ocular outcomes among adults. DATA SOURCES: A comprehensive literature review was performed using the MEDLINE, Embase, Cochrane, and PubMed databases up until December 19, 2021. STUDY SELECTION: Studies that focused on observed visual changes due to a reduced intake of animal products and that included a minimum of 50 eyes were eligible for inclusion. DATA EXTRACTION: Two levels of screening, quality assessment, and data extraction were conducted by 2 reviewers independently. The 21 studies identified from 814 unique studies progressed to data extraction and 15 were included in the quantitative analysis using STATA 15.0 fixed-effect and random-effect models computed on the basis of heterogeneity. RESULTS: The 15 (n = 51 695 participants) assessed the impact of fish consumption, 8 studies (n = 28 753 participants) analyzed the effect of red meat intake, and 3 studies (n = 7723 participants) assessed the impact of omission of skim milk, poultry, and non-meat animal products and the presence of disease incidence as indicated by age-related macular degeneration or cataract development. Meta-analysis indicated regular consumption of fish (odds ratio [OR], 0.70; 95%CI, 0.62-0.79) and skim milk, poultry, and non-meat animal products (OR, 0.70; 95%CI, 0.61-0.79) reduced the risk of age-related eye disease development among adults. Consumption of red meat (OR, 1.41; 95%CI, 1.07-1.86) may increase the risk of age-related eye disease development. CONCLUSION: A pescatarian diet is associated with the most favorable visual outcomes among adults, whereas consumption of red meat negatively affects ocular health. Results suggest a need for more initiatives promoting a healthy and balanced diet. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021269925.

Psychological Impact of Caregiving for Children With Eye Diseases: A Systematic Review and Meta-analysis.

PURPOSE: To identify and characterize the psychological impact of caregiving for children with eye disease. Awareness of the caregiving experience and insight into the factors related to caregiver burden is necessary to support high-quality ophthalmic care and develop supportive interventions. METHODS: The databases MEDLINE (Ovid), CINAHL, EMBASE, Cochrane Library, PsychINFO, PubMed, and Google Scholar were queried up to June 25, 2021. Studies included assessed the psychological impact of providing care to children with eye diseases. A risk of bias assessment was performed according to the Modified Downs and Black Checklist. Demographic data and measures of burden were extracted and tabulated. RESULTS: A total of 2,823 articles were screened, 28 underwent data extraction, and 7 were included in the meta-analysis. The meta-analysis indicated significant levels of burden (40% mild, 95% CI: [0.28 to 0.53]; 59% moderate, 95% CI: [0.36 to 0.82]; 7% severe, 95% CI: [0.02 to 0.11]) and depression (26% mild, 95% CI: [0.17 to 0.35]; 8% moderate, 95% CI: [0.03 to 0.14]); 11% severe, 95% CI:[0.03 to 0.10]). Interventions such as educational programs, life skills training programs, and other home-based early intervention programs were shown to improve psychological well-being of families. CONCLUSIONS: Caregivers experience significant levels of burden and depression, which may, in turn, affect the level of ophthalmic care they can provide for their children. Further studies investigating educational or psychological interventions for parents are needed, because the small number of studies that investigated these types of interventions have reported reduced parental stress and improved well-being. [J Pediatr Ophthalmol Strabismus. 2023;60(4):238-247.].

Quality of life and caregiver burden in pediatric glaucoma: A systematic review.

Pediatric conditions can lead to significant caregiver burden and poor quality of life (QoL). This systematic review describes research relating to caregiver burden and QoL of caregivers of pediatric glaucoma patients. A systematic database search of Embase, Medline, PsycINFO, CINAHL, Web of Science, and the three journals within the Association for Research in Vision and Ophthalmology (ARVO) was conducted in October 2021. Publications underwent abstract and full-text screening and were included if they reported pediatric caregivers' QoL using quantitative or qualitative methods. Review articles, publications not in English, and articles focusing on adult glaucoma patients were excluded. Studies then underwent risk of bias assessment and data extraction. Of the 105 publications identified, 8 publications with 667 participants were included in the review. Studies indicated significantly higher burden and poor QoL in caregivers. Female sex, lower education level, lower income, and working status of caregivers were associated with poorer QoL and greater burden. Additionally, more severe and longer duration of the child's disease negatively impacted these measures of caregiver wellbeing. Additionally, studies found significant improvement in caregiver QoL after patients underwent surgery with combined trabeculotomy-trabeculectomy. In conclusion, few studies have investigated the impact of pediatric glaucoma on caregivers. This review of the existing studies found poor QoL and high levels of caregiver burden within this population. Given the lifelong nature of pediatric glaucoma, there is a need for further longitudinal research focusing on the caregivers of these pediatric patients. Long-term follow-up would allow for a greater understanding of how caregiver QoL changes over the course of the disease.

Barriers adult refugees face to community health and patient engagement: a systematic review.

Meeting the health needs of refugee populations and increasing access to healthcare remains a challenge for healthcare systems globally. As such, community health and patient engagement are increasingly recommended strategies to address health-related issues among refugees. This systematic review aims to identify the reported barriers that adult refugees encounter with community health and patient engagement. Data sources included MEDLINE, Embase, APA PsycINFO, CINAHL, and Core Collection (Web of Science), yielding 1156 records. After removing duplicates and two levels of screening, 18 studies were selected for qualitative analysis. The barriers were conceptualised as cultural norms, pre-departure history, education, language proficiency, stigma, racism, social support, and multi-factorial barriers. These barriers can be addressed to improve rapport with refugees and the quality of community health and patient engagement initiatives.

Ocular adverse effects of bladder medication: a systematic review.

BACKGROUND: With the ageing population, lower urinary tract symptoms are becoming more prevalent with an estimate that by 2025, 52 million adults in the USA will be affected. After lifestyle modifications fail to resolve symptoms, second-line therapy with medications is often recommended by both the European Association of Urology and the American Urological Association. Considering the vulnerability of older patients to co-morbidities, physicians must be more aware of adverse side effects. This study aims to identify a linkage between common overactive bladder and interstitial cystitis medication and adverse ocular symptoms. METHODS: A comprehensive literature search was conducted in MEDLINE, EMBASE, CINAHL, PsycInfo, and HealthSTAR alongside a grey literature search in clinicaltrials.gov to include all articles relating to bladder medication and vision-threatening loss. Covidence review software was utilised to conduct the systematic review. RESULTS: In total, 222 articles were screened, and 23 articles met the inclusion criteria. Comprehensive coverage of 10 available medications was analysed. All medications reported adverse vision effects stratified over 15 categories. The most common adverse effect was reported to be blurred vision (n = 12 studies). Mirabegron had the most number of adverse types of ocular symptoms that covered 6 categories. Cizolirthine Citrate and Elocatitol had the least amount of ocular side effects reported. From the total of 8459 patients that were treated for either overactive bladder syndrome or interstitial cystitis with oral medications, 422 reported adverse vision effects. CONCLUSIONS: This review suggests that ocular safety should be assessed in patients requiring systematic drug therapy in order to guide future research, focussing on long-term tolerability.

Risk of Parkinson's disease in glaucoma patients: a systematic review and meta-analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis to evaluate the relationship between glaucoma and the risk of Parkinson's disease. METHODS: A systematic search of databases including MEDLINE, EMBASE, and CINAHL were conducted. Grey literature search, including Dissertations and Theses databases and conference abstracts, was performed. Duplicates were removed, and two independent reviewers conducted the screening. We included any primary observational studies that examined the relationship between glaucoma and Parkinson's disease. Study characteristics along with relevant outcome measurements such as hazard ratio (HR), odds ratio (OR), and prevalence were extracted. Meta-analysis using STATA 15.0 was performed, and the presence of heterogeneity was determined using I2 statistics, Z-test, and p-value. RESULTS: A total of 746 citations were found through the databases and grey literature searches. After screening, five studies met the inclusion criteria, and three studies were included in the meta-analysis. There was a non-significant hazard of developing Parkinson's disease (Hazard Ratio = 1.13, 95% CI: [0.99, 1.29]) in patients with glaucoma compared to controls. DISCUSSION: The hazard of developing Parkinson's disease was non-significantly different for those with glaucoma compared to controls; however, there were not enough studies available to draw definitive conclusions.

Comparing the diagnostic accuracy of telemedicine utilization versus in-person clinical examination for retinopathy of prematurity in premature infants: a systematic review.

PURPOSE: To synthesize the literature assessing the diagnostic accuracy of telemedicine evaluation compared with clinical examination for retinopathy of prematurity (ROP) in premature infants. METHODS: Covidence software was used to conduct a systematic literature search from September 14, 2020, through September 27, 2020, on MEDLINE (Ovid), EMBASE (Ovid), CINAHL, and the gray literature to identify studies relevant to telemedicine utilization for ROP detection. After duplicate removal and two-levels of screening, studies comparing telemedicine evaluation with binocular indirect ophthalmoscopic examination were included. Risk of bias assessment was conducted for the included studies following data extraction. A qualitative review was performed to summarize estimates of accuracy of ROP evaluation by telemedicine. RESULTS: A total of 507 studies were reviewed, of which 323 were found in EMBASE, 115 in MEDLINE, and 79 in CINAHL. Three possibly relevant conference abstracts were found. Following duplicate removal, 410 studies were reviewed based on titles and abstracts. Subsequently, 19 articles were thoroughly examined, and 14 studies (2,655 participants) were included. Most studies found that telemedicine performance for detecting ROP was comparable to ophthalmic examination, especially with regard to identifying treatment-requiring ROP. CONCLUSIONS: Telemedicine evaluation can reliably detect ROP. Incorporation of telemedicine into conventional neonatal care has the potential to improve access to ROP care.