Toll like receptors play a role in general immunity, eye infection and inflammation : TLRs for nanodelivery

Dendritic cells [DCs] are potent antigen presenting cells [APC], which plays a vital role in immune system by detecting and capturing pathogens in the body. DCs perform a pivotal role in induction of T cell response. Regulation of immune response can be achieved by specific antigen [Ag] delivery to DCs. A delivery system that can efficiently target and present Ags to DCs for the purpose of anti-tumour activity is currently a topic of significant research interest. DCs are receiving attention due to their key role in anti cancer host response and due to their adjuvanic property in tumour vaccines. Role of toll like receptors [TLR] in innate immune system and their part in eventual stimulation of adaptive immunity is exploited to develop vaccines. TLR agonists in conjugation with vaccines are shown to increase therapeutic efficacy in some cases. TLRs also play a vital role in protecting the cornea from invading pathogens. Due to adverse effects in the treatment of ocular inflammations, cancer and in viral infections, an alternate approach such as the use of TLRs will solve the inquisitive question regarding side effects. The intended delivery is attained by the use of nanoparticles which in turn leads to prolonged half-life in the body. Co-delivery of Ags, TLRs and immunomodulators using nanoparticles has been demonstrated to elicit potent cellular immune responses and are currently under development of clinically applicable immunisations and vaccines.

Human saccadic eye movements and tracking by active foveation in log polar space

One of the possible models of the human visual system (HVS) in the computer vision literature has a high resolution fovea and exponentially decreasing resolution periphery. The high resolution fovea is used to extract necessary information in order to solve a vision task and the periphery may be used to detect motion. To obtain the desired information, the fovea is guided by the contents of the scene and other knowledge to position the fovea over areas of interest. These eye movements are called saccades and corrective saccades. A two stage process has been implemented as a mechanism for changing foveation in log polar space. Initially, the open loop stage roughly foveates on the best interest feature and then the closed loop stage is invoked to accurately iteratively converge onto the foveation point. The open loop stage developed for the foveation algorithm is applied to saccadic eye movements and a tracking system. Log polar space is preferred over Cartesian space as: (1) it simultaneously provides high resolution and a wide viewing angle; and (2) feature invariance occurs in the fovea which simplifies the foveation process.

The Australian burden of disease study : measuring the loss of health from diseases, injuries and risk factors

This is an overview of the first burden of disease and injury studies carried out in Australia. Methods developed for the World Bank and World Health Organization Global Burden of Disease Study were adapted and applied to Australian population health data. Depression was found to be the top- ranking cause of non-fatal disease burden in Australia, causing 8% of the total years lost due to disability in 1996. Mental disorders overall were responsible for nearly 30% of the non-fatal disease burden. The leading causes of total disease burden (disability-adjusted life years [DALYs]) were ischaemic heart disease and stroke, together causing nearly 18% of the total disease burden. Depression was the fourth leading cause of disease burden, accounting for 3.7% of the total burden. Of the 10 major risk factors to which the disease burden can be attributed, tobacco smoking causes an estimated 10% of the total disease burden in Australia, followed by physical inactivity (7%).

Shared care for chronic eye diseases : perspectives of ophthalmologists, optometrists and patients

Objective: To report the perspectives of optometrists, ophthalmologists and patients on a model of shared care for patients with chronic eye diseases.

Design, setting and participants: Qualitative study of a model of shared care between optometrists and ophthalmologists for patients with stable age-related macular degeneration, diabetic retinopathy and glaucoma, trialled by the Royal Victorian Eye and Ear Hospital in Melbourne during 2007–2009. Semi-structured interviews were conducted with optometrists, ophthalmologists and patients at completion of the project to obtain their perspectives on this model.

Results: Seventeen optometrists submitted expressions of interest to participate, and 12 completed web-based training modules and clinical observerships and adhered to specified examination and reporting protocols. All five participating ophthalmologists and 11 of the optometrists were interviewed. Ninety-eight patients participated and 37 were interviewed. Optometrists not only met ophthalmologists’ expectations but exceeded them, appropriately detecting and referring patients with additional, previously undetected conditions. Patients reported savings in travel time and were satisfied with the quality of care they received. Optometrists, ophthalmologists and patients indicated a general acceptance of shared care arrangements, although there were some issues relating to interprofessional trust.

Conclusions: Shared care between local optometrists and hospital-based ophthalmologists can help to reduce patient waiting time for review and offers an opportunity for these two groups of eye care professionals to collaborate in providing localised care for the benefit of patients. However, trust and relationship building need to be further developed.

Visual impairment and eye care among Alaska native people

Purpose: To estimate the prevalence of visual impairment, eye disease and eye care in the Alaska Native (AN) population, by demographic and socioeconomic factors.

Methods: Population-based cross-sectional study of 3,793 AN adults aged 18–94 years enrolled in the Education and Research Towards Health (EARTH) Study from March 2004–March 2006. Data on self-reported visual impairment, cataract, glaucoma, diabetic eye disease and previous dilated eye examinations were collected using audio computer-assisted self-administered questionnaires.

Results: The unadjusted prevalence of self-reported visual impairment was 8.7% (95% confidence interval (CI): 7.9–9.7), cataract 5.9% (95% CI: 5.2–6.7), glaucoma 2.5% (95% CI: 2.0–3.0) and diabetic eye disease 1.3% (95% CI: 0.9–1.7). In all cases, age-sex adjusted prevalence estimates for the AN population were greater than available estimates for the general U.S. population. Prevalence of visual impairment and each eye disease increased with age (P < 0.01). Additional factors associated with visual impairment were education and annual household income. Overall, 70.0% (95% CI: 68.5–71.6) of participants reported a dilated eye examination within the previous two years. Dilated eye examination within the previous two years was associated with increasing age (P < 0.001). However, men and participants with lower formal education were less likely to report recent dilated eye examination. Among those with diabetes, only 67.7% (95% CI: 60.8–74.1) reported a dilated eye examination within the recommended previous one year.

Conclusions: Self-reported visual impairment, cataract, glaucoma and diabetic eye disease are prevalent in the AN population. These data may be useful in healthcare planning and education programs.

The eye

An oil painting in 2 panels on Cherrywood