Individual's recollections of their experiences in eye clinics and understanding of their eye condition:results from a survey of visually impaired people in Britain

Background/aims: Network 1000 is a UK-based panel survey of a representative sample of adults with registered visual impairment, with the aim of gathering information about people’s opinions and circumstances. Method: Participants were interviewed (Survey 1, n = 1007: 2005; Survey 2, n = 922: 2006/07) on a range of topics including the nature of their eye condition, details of other health issues, use of low vision aids (LVAs) and their experiences in eye clinics. Results: Eleven percent of individuals did not know the name of their eye condition. Seventy percent of participants reported having long-term health problems or disabilities in addition to visual impairment and 43% reported having hearing difficulties. Seventy one percent reported using LVAs for reading tasks. Participants who had become registered as visually impaired in the previous 8 years (n = 395) were asked questions about non-medical information received in the eye clinic around that time. Reported information received included advice about ‘registration’ (48%), low vision aids (45%) and social care routes (43%); 17% reported receiving no information. While 70% of people were satisfied with the information received, this was lower for those of working age (56%) compared with retirement age (72%). Those who recalled receiving additional non-medical information and advice at the time of registration also recalled their experiences more positively. Conclusions: Whilst caution should be applied to the accuracy of recall of past events, the data provide a valuable insight into the types of information and support that visually impaired people feel they would benefit from in the eye clinic.

Fibronectin-tissue transglutaminase matrix rescues RGD-impaired celladhesion through syndecan-4 and β integrin co-signaling

Heterotropic association of tissue transglutaminase (TG2) with extracellular matrix-associated fibronectin (FN) can restore the adhesion of fibroblasts when the integrin-mediated direct binding to FN is impaired using RGD-containing peptide. We demonstrate that the compensatory effect of the TG-FN complex in the presence of RGD-containing peptides is mediated by TG2 binding to the heparan sulfate chains of the syndecan-4 cell surface receptor. This binding mediates activation of protein kinase Ca (PKCa) and its subsequent interaction with ß1 integrin since disruption of PKCa binding to ß1 integrins with a cell-permeant competitive peptide inhibits cell adhesion and the associated actin stress fiber formation. Cell signaling by this process leads to the activation of focal adhesion kinase and ERK1/2 mitogen-activated protein kinases. Fibroblasts deficient in Raf-1 do not respond fully to the TG-FN complex unless either the full-length kinase competent Raf-1 or the kinase-inactive domain of Raf-1 is reintroduced, indicating the involvement of the Raf-1 protein in the signaling mechanism. We propose a model for a novel RGD-independent cell adhesion process that could be important during tissue injury and/or remodeling whereby TG-FN binding to syndecan-4 activates PKCa leading to its association with ß1 integrin, reinforcement of actin-stress fiber organization, and MAPK pathway activation.