1.
Ocular manifestations in IgA nephropathy.
Oo, HH, Choy, MYD, Arora, A, Yeo, SC, Ramachandran, R, Gupta, V, McCluskey, P, Agrawal, R
Survey of ophthalmology. 2023;(2):290-307
Abstract
Immunoglobulin A nephropathy (IgAN) is a rare but important systemic disease with or without ocular manifestations. We describe 4 cases of IgAN presenting with scleritis and review the various ocular manifestations in patients with IgAN. We found 55 cases with ocular manifestations in patients with prior or newly-diagnosed IgAN described in 38 publications. The most common ocular manifestations of IgAN were episcleritis (23.6%), scleritis (16.4%), hypertensive retinopathy or retinal vasculopathy (20.0%), and uveitis (14.5%). The median age at presentation was 36.5 years, with 54.5% female patients. 61.8% had history of IgAN prior to ocular involvement, while 29.1% had ocular presentations as the first manifestation of IgAN. The majority received systemic corticosteroids and/or immunosuppressants. Additionally, we report 4 women with anterior scleritis and previous diagnosis of IgAN. All 4 were treated with topical and systemic corticosteroids. Three out of 4 patients had no recurrence for at least 1 year since the first presentation. IgAN is a rare but important systemic association to be considered in ocular inflammatory conditions. Timely recognition and comanagement of the disease with nephrologist could reduce disease morbidity.
2.
Investigating the Relationship between Vitamin D and Persistent Symptoms Following SARS-CoV-2 Infection.
Townsend, L, Dyer, AH, McCluskey, P, O'Brien, K, Dowds, J, Laird, E, Bannan, C, Bourke, NM, Ní Cheallaigh, C, Byrne, DG, et al
Nutrients. 2021;13(7)
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Plain language summary
Persistence of symptoms following COVID-19 infection is known as long COVID and occurs in up to a third of sufferers and can last for as long as 6 months post infection. Tiredness and reduced capacity to exercise are characteristic of long COVID, however why these symptoms persist in a handful of patients is unknown. Vitamin D deficiency is gaining attention for its potential to improve symptoms of tiredness, however there are few studies examining its relationship with long COVID. This observational study of 149 patients who had been diagnosed with COVID-19 aimed to determine the relationship between symptoms of long COVID, inflammation in the body and vitamin D levels. The results showed that fatigue was common, but there was no association between vitamin D levels and fatigue, inflammation, or capacity to exercise. Interestingly women were more likely to experience fatigue in this study. It was concluded that fatigue and reduced exercise capacity are independent of vitamin D in those who have had COVID-19. This study could be used by healthcare professionals to understand symptoms of long COVID, and that vitamin D may not be effective for those symptoms.
Abstract
The emergence of persistent symptoms following SARS-CoV-2 infection, known as long COVID, is providing a new challenge to healthcare systems. The cardinal features are fatigue and reduced exercise tolerance. Vitamin D is known to have pleotropic effects far beyond bone health and is associated with immune modulation and autoimmunity. We hypothesize that vitamin D levels are associated with persistent symptoms following COVID-19. Herein, we investigate the relationship between vitamin D and fatigue and reduced exercise tolerance, assessed by the Chalder Fatigue Score, six-minute walk test and modified Borg scale. Multivariable linear and logistic regression models were used to evaluate the relationships. A total of 149 patients were recruited at a median of 79 days after COVID-19 illness. The median vitamin D level was 62 nmol/L, with n = 36 (24%) having levels 30-49 nmol/L and n = 14 (9%) with levels <30 nmol/L. Fatigue was common, with n = 86 (58%) meeting the case definition. The median Borg score was 3, while the median distance covered for the walk test was 450 m. No relationship between vitamin D and the measures of ongoing ill-health assessed in the study was found following multivariable regression analysis. These results suggest that persistent fatigue and reduced exercise tolerance following COVID-19 are independent of vitamin D.
3.
Saffron therapy for the treatment of mild/moderate age-related macular degeneration: a randomised clinical trial.
Broadhead, GK, Grigg, JR, McCluskey, P, Hong, T, Schlub, TE, Chang, AA
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. 2019;(1):31-40
Abstract
PURPOSE To assess the efficacy and safety of oral saffron, a natural antioxidant, in treating mild/moderate age-related macular degeneration (AMD). METHODS Randomised, double-blinded, placebo-controlled crossover trial of 100 adults (> 50 years) with mild/moderate AMD and vision > 20/70 Snellen equivalent in at least one eye. Exclusion criteria included confounding visual lesions, or significant gastrointestinal disease impairing absorption. Participants were given oral saffron supplementation (20 mg/day) for 3 months or placebo for 3 months, followed by crossover for 3 months. Participants already consuming Age-Related Eye Diseases Study (AREDS) supplements or equivalent maintained these. Primary outcomes included changes in best-corrected visual acuity (BCVA) and changes in multifocal electroretinogram (mfERG) response density and latency. Secondary outcomes included safety outcomes and changes in mfERG and BCVA amongst participants on AREDS supplements. RESULTS Mean BCVA improved 0.69 letters (p = 0.001) and mean-pooled mfERG latency reduced 0.17 ms (p = 0.04) on saffron compared to placebo. Amongst participants on AREDS supplements, mean BCVA improved 0.73 letters p = 0.006) and mean-pooled mfERG response density improved 2.8% (p = 0.038). There was no significant difference in adverse event occurrence (p > 0.10). CONCLUSION Saffron supplementation modestly improved visual function in participants with AMD, including those using AREDS supplements. Given the chronic nature of AMD, longer-term supplementation may produce greater benefits.