Current Eye Research最新文献

Purpose: To observe the Long-term results of pterygium extended removal combined conjunctival autograft and amniotic membrane transplantation.

Methods: This is a prospective study of 666 eyes (606 patients, 332 right eyes and 336 left eyes). All patients underwent pterygium extended removal combined conjunctival autograft and amniotic membrane transplantation in a same hospital. The primary outcome measures included the cosmetic appearances and recurrence rate; the secondary outcome measures were some serious complications, like Keratitis, conjunctival cyst and conjunctival granuloma.

Results: 606 patients (82.34% of surviving) were able to be followed up. The mean follow-up period was 29.96 ± 13.34 months. Recurrence was noted in 7 eyes (1.05%), and there were no serious complications. 89.04% of eyes were graded as having excellent cosmetic appearance.

Conclusions: The long-term recurrence rate of pterygium extended removal combined conjunctival autograft and amniotic membrane Graft is very low, and the long-term cosmetic appearance is excellent. And also, there were no other serious complications.

Purpose: Increasing epidemiologic evidence has indicated that PM2.5 exposure is strongly correlated with the prevalence of allergic conjunctivitis (AC), but there is no experimental model for elucidating the underlying mechanism involved. We established a stable PM2.5-induced mouse model of AC to explore the adverse effects of PM2.5 on the ocular surfaces and the underlying mechanisms involved.

Methods: BALB/c mice were sensitized by intraplanar injection of 200 μg PM2.5 on day 0 and challenged for 10 consecutive days, beginning on day 9, with eye drops containing 12.5 mg/mL PM2.5. Assessments of the ocular surfaces, eye blink counts, and tear secretion were performed to evaluate clinical symptoms. The whole eyes were harvested for histopathological and immunofluorescence analyses, the conjunctiva was isolated for Western blotting, and the sera were subjected to IgE ELISA to evaluate the immune characteristics and TSLP-related pathway expression. Furthermore, mouse bone marrow-derived macrophages (BMDMs) were incubated with 25 μg/mL PM2.5 for 24 h. Cellular protein and RNA were extracted for Western blotting and RNA sequencing.

Results: PM2.5 exposure induced clinical manifestations and pathological changes similar to those in human AC. The sensitization and challenge evoked Th2 responses and serum IgE production. PM2.5 exposure mediated TSLP production in macrophages and aggravated allergic inflammation through the TSLP-TSLPR and TSLP-OX40L signaling pathways in vivo. Macrophages produced TSLP and polarized to the M1 phenotype after PM2.5 administration in vitro.

Conclusions: These results demonstrate a reproducible method for establishing a PM2.5-induced AC model. In addition, PM2.5 exposure stimulated macrophages to secrete TSLP and enhance allergic inflammation.

Purpose: To analyze the causes of failure in primary external dacryocystorhinostomy versus endoscopic dacryocystorhinostomy and surgical outcomes of powered revision endoscopic dacryocystorhinostomy and the role of pre-operative lacrimal imaging in surgical planning.

Methods: Retrospective, interventional study on patients with an earlier failed dacryocystorhinostomy who underwent revision endoscopic dacryocystorhinostomy surgery from January 2016 to June 2024. Data collected included the demographic profile, clinical presentation, details of prior intervention, pre- and intra-operative endoscopic findings, adjunctive procedures, and the computed tomography dacryocystography characteristics. Successful outcomes were anatomic success (patent irrigation) and functional success (resolution of epiphora).

Results: Two hundred and ten lacrimal drainage systems of 205 patients who underwent revision endoscopic dacryocystorhinostomy were analyzed. The mean age at the presentation was 45 years. Of the 210 lacrimal surgeries, 17 (8%) had multiple surgeries, 129 (61%) underwent prior endoscopic dacryocystorhinostomy, and 81 (39%) had external dacryocystorhinostomy. One hundred and eight (51%) primary surgeries were performed by an ophthalmologist, 94 (45%) by an ear nose throat surgeon, and eight (3.8%) were unknown. The most common cause of failure was complete cicatricial closure (73%) followed by interfering osteo-septal synechiae (20%). The most common location of previous osteotomy was inferior (37%). Preoperative three-dimensional computed tomography-dacryocystography showed inadequate superior osteotomy in 62.5%, and sac displacement in 57%. Three-dimensional computed tomography-dacryocystography correlated with intra-operative findings in 96% cases. Adjunct procedures were performed in 42% of revision endoscopic dacryocystorhinostomy's. Successful outcome was achieved in 199 (94.7%), regardless of nature of primary surgery (p = .63), at 3-months follow-up.

Conclusion: With proper planning, comparable success to external approach can be achieved with a revision endoscopic dacryocystorhinostomy. Computed tomography dacryocystography in select cases can guide surgical planning and anticipate intra-operative challenges.

Purpose: To design, produce and implant one-piece flexible acrylic keratoprostheses for the treatment of corneal blindness.

Methods: A protocol was developed to produce flexible acrylic sheets of differing properties, and their mechanical characteristics were evaluated. To assess in vitro toxicity, an MTT assay was performed. 3D-printed injection molding technique of this material was designed to fabricate flexible keratoprostheses with complex shapes. A pilot study involving a 3-month implantation in a rabbit was conducted, including histological analysis.

Results: Flexible acrylic copolymer sheets of high clarity were produced by free radical polymerization. Their mechanical properties and refractive indices could be altered with different material formulations. They demonstrated no in vitro toxicity in human corneal cells via MTT assay. 3D printed silver molds allowed for the production of keratoprostheses of complex shapes made from these materials. Surgical implantation resulted in clear implant at 3 months.

Conclusions: Molding of flexible acrylic allows for production of one-piece keratoprostheses of a complex shape and opens new possibilities for the treatment of corneal blindness.

Purpose: Primary angle-closure glaucoma (PACG) is a significant cause of blindness globally, particularly in Asian populations, where it accounts for 25% of glaucoma cases. Selective laser trabeculoplasty (SLT) has emerged as a promising treatment for PACG, but its efficacy varies across studies. This meta-analysis aims to evaluate the effectiveness of SLT in reducing intraocular pressure (IOP) and compare outcomes between PACG and primary open-angle glaucoma (POAG).

Methods: A systematic search was conducted in PubMed, Scopus, Medline, and EMBASE up to July 2024 using predefined criteria. Studies assessing SLT in patients with PACG were included. Data extraction included study characteristics, SLT parameters, and primary outcomes, such as mean post-intervention IOP reduction and SLT failure rates. Statistical analysis was performed using pooled estimates with 95% confidence intervals (CI) through Comprehensive Meta-Analysis software.

Results: Of the 754 potentially relevant articles assessed, 7 met the inclusion criteria. The mean IOP post-SLT among PACG patients significantly decreased to 17.30 mmHg (95% CI: 16.99-17.61; p = 0.0001). The SLT failure rate in PACG was 7.95% (95% CI: 6.15-10.28%; p = 0.00001). Studies reported varying trends in medication use and the need for further interventions post-SLT in PACG patients.

Conclusions: This study comprehensively examined the effectiveness of SLT in treating PACG across multiple studies. Despite variations in sample sizes, demographics, and study locations, SLT effectively reduced IOP in PACG patients. The meta-analysis demonstrated a statistically significant decrease in mean post-SLT IOP, highlighting its therapeutic benefit despite notable heterogeneity among the included studies.

Purpose: Tear film instability is one of the principal pathomechanisms of dry eye disease (DED), arising from disrupted tear homeostasis, reduced tear volume, or lipid layer alterations. The lipid layer, secreted by the meibomian glands, can be imaged qualitatively and quantitatively. This review summarizes different lipid layer thickness (LLT) measurement techniques, normative values, and alterations in ocular surface disorders.

Method: Full-texts of 88 of 236 searched articles from PubMed, ScienceDirect, and Google Scholar using the terms 'Tear film lipid layer thickness,' 'Lipid layer thickness', 'Tear film lipids,' 'Dry eye disease,' 'Meibomian gland dysfunction,' 'Meibography,' and 'Interferometry' were reviewed.

Result: Advanced imaging techniques, such as LipiView, Oculus Keratograph 5M, and Tearscope, utilize interference principles, but are not interchangeable for measuring LLT. LLT ranges from 13 to 170 nm in healthy individuals, depending on the instrument and grading scale used. The reported central LLT values in DED vary from 33 to 84 nm, varying with disease severity. There are conflicting reports on the association between age, gender, and LLT values. LLT positively correlates with expressible meibomian glands, and negatively with gland loss. LLT has been associated with tear film breakup time, MGD severity, and blink pattern irregularities.

Conclusion: The significant overlap in LLT values between the normal individuals and DED patients precludes its role in the diagnosis of DED. Future studies exploring LLT variations under different environmental conditions and across larger cohorts with varying DED severity are essential to enhance clinical applicability.

Purpose: The potential risks and benefits of cataract surgery, in context of congenital aniridia (CA), are not widely understood, yet. Our purpose was to investigate the effect of lens properties on visual acuity (VA), aniridia-associated keratopathy (AAK) stage and presence of glaucoma at the Homburg Aniridia Center.

Methods: CA subjects, examined at the Department of Ophthalmology of Saarland University between June 2003 and January 2022, were included. VA, slit-lamp examination, AAK grade, and glaucoma evaluation data were extracted from the medical records, from the first visit to the center. Eyes were categorized as clear lens, cataract, pseudophakic, aphakic, or subluxated lens. Patients were grouped by age (0-10, 10-20, 20-40, 40+ years).

Results: In 553 eyes of 286 CA subjects (age 19.9 ± 19.9 (0-83) years, 46.1% males), analysis revealed significant differences in VA and mean IOP (ANOVA p < 0.0001; p = 0.001, respectively) with lens status. Lens status was strongly associated with AAK Grade and glaucoma presence (p < 0.0001 for both). In age subgroups, AAK Stage was strongly associated with lens status in the 0-10 years (p < 0.001), 10-20 years (p < 0.001), and 40+ years (p = 0.02) groups and lens status was strongly associated with glaucoma presence in the 0-10 years (p = 0.003) and 20-40 years (p = 0.002) groups. AAK Stage was the most advanced in pseudophakic and aphakic eyes and presence of glaucoma was more pronounced in pseudophakic, aphakic and subluxated lens eyes.

Conclusions: In a large population of CA, previous cataract surgery was associated with higher AAK Grade and presence of secondary glaucoma both in postoperatively pseudophakic and aphakic eyes. Our data indicate that caution is warranted with cataract surgery in congenital aniridia.

Purpose: Oxidative stress, ultraviolet radiation, and calcium imbalance are key components in the onset and advancement of cataract, which continue to be the leading cause of blindness globally. An important newly discovered aging maker, Senescence marker protein 30 (SMP30) regulates calcium and participates in mitigating oxidative stress damage. Here, we examined the beneficial role of SMP30 in protecting against ultraviolet radiation type B (UVR-B)-induced cataract in rats.

Methods: Wistar rats (2 months) were arbitrarily assigned into 4 groups of 10 rats. These groups included the Control group, UVR-B group, adeno-associated virus 2 vectors negative control (AAV2-NC) group, and adeno-associated virus 2-mediated overexpression of SMP30 (AAV2-SMP30) group. The control group received Phosphate-buffered saline (PBS) via injection, while the AAV2-NC group and AAV-SMP30 group were separately injected with AAV2-NC and AAV2-SMP30 vectors. In addition to the control group, the remaining three experimental groups were subjected to ultraviolet light exposure 4 weeks post-injection. The lens opacity was examined by stereoscopic microscope, and the lenses were separated to measure oxidative damage parameters particularly superoxide dismutase (SOD), glutathione peroxidase (GPX), and Ca²⁺-ATPase activity. The localization and expression of SMP30 and Ca²⁺-ATPase in the lenses were determined using immunohistochemistry and RT-qPCR.

Results: After UVR-B irradiation, the AAV2-SMP30 group exhibited a substantial decrease in lens opacity compared to the UVR-B group. The results revealed a notable downregulation of SMP30 expression and the activities of SOD, GPX, and Ca²⁺-ATPase of rat lens following exposure to UVR-B radiation. However, SMP30 overexpression partially reversed these effects. In vivo experiments demonstrated SMP30 overexpression attenuated the UVR-B-induced decline in SOD, GPX, and Ca²⁺-ATPase activities.

Conclusion: This study demonstrates that SMP30 has the potential to reduce lens opacity caused by UVR-B by increasing antioxidant stress and regulating Ca²⁺-ATPase activity. SMP30 might be a cutting-edge target for the treatment of cataracts.

Purpose: To evaluate the visual performance of a blue-light filter (BLF). The following visual parameters were assessed: glare disability (GD); chromatic contrast (CC); two-point light thresholds; and dysphotopsia symptoms (snowball and spoke diameter).

Methods: Twenty-five pseudophakic patients previously implanted with a "UV-only" intraocular lens (IOL) were tested using a single-masked randomized cross-over design. In the control condition, a UV-only filter (matched to the implant) was used. In the test condition, a BLF was used (matching the absorbance profile of a common BLF IOL; Acrysof Natural and Clareon; Alcon Research Ltd). The intensity (expressed as log relative energy, LRE) of broad-band xenon light and a sky-blue background needed to veil a central grating target was used to measure GD and CC, respectively. The diameter of spokes/snowballs was determined by measuring their lateral extent induced by a bright white point source. Two-point light thresholds were measured as the separation between two small relatively intense point sources of light (Rayleigh criterion).

Results: The BLF test lens resulted in improved CC (LRE 2.04 vs 1.83) and GD (LRE = 2.46 vs 2.27, p < 0.001). Snowballs (49 vs 69 mm, p < 0.01) and spoke (139 vs 171, p < 0.001) diameters were also reduced in the BLF condition.

Conclusion: About 6% and 10% more light energy was needed to occlude the grating stimulus for GD and CC. Light spread measured using the two-point technique was about 26% less for the BLF. The BLF reduced snowballs and spokes by about 24% and 19%. The BLF significantly improved function across a variety of visual indices.

Purpose: Chronic inflammation plays an important role in the pathogenesis of choroidal neovascularization (CNV). This study aimed to investigate the effect of the CHF5074, a γ-secretase inhibitor, on angiogenesis in a laser-induced CNV model and elucidate its possible molecular mechanism.

Methods: Male C57/BL6J mice aged between 6 to 8 weeks were employed to set up a laser-induced model of CNV. Then, CHF5074 was injected intraperitoneally on the day after laser modeling, as well as on the second, third, and fourth days. Immunofluorescence staining was used to evaluate the retinal and choroidal complex. The markers used were CD31 for neovascularization and IBA1 for microglia staining in ocular tissue slices. Fundus fluorescein angiography on days 3d, 7d, and 14d analyzed neovascularization and leakage areas. Inflammatory indicators were examined by Western blot (WB) and enzyme-linked immunosorbent assay (ELISA). High-throughput whole-tissue sequencing of retinal choroids identified relevant cell pathways. Key regulatory factors modulated by CHF5074 were identified via WB. Co-culture of BV2 cells and human umbilical vein endothelial cells (HUVEC) were used to explore the function of CHF5074 on the inhibition of tube formation.

Results: CHF5074 significantly decreased CD31 expression in the choroid on 3d, 7d, and 14d post-laser modeling (p < 0.05) and decreased both neovascularization and leakage areas (p < 0.05). Additionally, CHF5074 significantly lowered TNF-α, IL-10, and IL-1β expression levels in the choroid (p < 0.05), as demonstrated by WB analysis and ELISA. High-throughput whole-tissue sequencing identified P38-MAPK, JNK, and Wnt signaling pathways associated with neovascularization. CHF5074 decreased P38 protein phosphorylation (p < 0.05) as confirmed by WB analysis. CHF5074 inhibited the tube formation of HUVECs co-cultured with LPS and ATP-treated BV2 cells.

Conclusion: CHF5074 significantly suppresses angiogenesis in laser-induced choroidal neovascularization models, suggesting its potential as a novel agent for preventing and treating CNV.