Week in review: Elderly patients with ocular trauma, keratoconus in young men with ADHD, iron and toxoplasmosis

A weekly roundup of ophthalmic news from around the web.

Elderly patients who experience ocular trauma may be more likely to develop neurologic or cardiovascular conditions later. That was the finding of a cohort study using data from the US-based I2B2 Carolina Data Warehouse for Health that were specifically related to geriatric patients who came to the hospital with ocular trauma. A total of 699 patients were identified, with an age- and sex-matched control group of 1099 cataract surgery patients. During the 5-year follow-up period, the ocular trauma group was significantly more likely to be diagnosed with Alzheimer’s disease, dementia, vascular disease, and heart failure than the control group. Additional studies may be needed to determine if these conditions are true risk factors for ocular injury and injury-related mortality in the elderly. Clinical Ophthalmology

Male teenagers and adults with ADHD could be at greater risk for keratoconus. Israeli investigators conducted a retrospective cross-sectional study of medical files and fitness-for-service evaluations of more than 940,000 soldiers in the Israeli Defense Forces to evaluate a potential link between certain psychiatric conditions and keratoconus. Nearly 60% of included individuals were male, and the overall keratoconus rate was 0.16%. Those with keratoconus were more likely to have attention-deficit/hyperactivity disorder (ADHD) than the general population (odds ratio 1.58). Individuals with ADHD who were male and/or were aged 16–45 had even higher keratoconus prevalence rates. However, the authors note that “While the study design provides hypotheses of associations for future investigations, cause and effect could not be ascribed directly.” JAMA Ophthalmology

Early study data indicate iron as a potential biomarker for ocular toxoplasmosis. To investigate the role of iron levels in ocular toxoplasmosis (OT), Japanese researchers reviewed the vitreous humor of patients with OT and other ocular diseases and then created a mouse model of OT based on Toxoplasma gondii infection. While the vitreous humor of patients with OT had lower iron levels than that of patients with other retinal diseases, iron was detected in the neurosensory retinas of the OT group and not in the other groups. This iron uptake in the retina was also seen in the mouse eyes following T. gondii infection, and the researchers posited that the subsequent oxidative stress may point to the involvement of ferroptosis (iron-related regulated necrosis). Giving the mice deferiprone, an iron chelator, prevented development of toxoplasmic retinochoroiditis. The authors conclude that “Understanding the pathological role of ferroptosis in OT may potentially advance future diagnostic methods and treatment strategies.” Redox Biology