Current Eye Research最新文献

Purpose: DNA damage and repair defects in lens epithelial cells (LECs) contribute to the formation and progression of age-related cataracts (ARC). Ku antigen 80 kDa (Ku80) plays an important role in the non-homologous end-joining (NHEJ) pathway for repairing DNA double-strand breaks, while the Cockayne Syndrome Complementary B (CSB) protein plays a critical role in the nucleotide excision repair pathway. This study evaluates the protective effect of AAV-mediated overexpression of Ku80 in rat LECs and explores its contribution to delaying selenium-induced cataract formation.

Methods: SD rats (11 days) were randomly divided into three groups: control group (n = 7), AAV-NC group (n = 14), and AAV-Ku80 group (n = 14). The AAV-Ku80 group received adenovirus-mediated overexpression of Ku80, the AAV-NC group received adenoviral vector negative control, and the control group was injected with physiological saline. All injections were performed in the anterior chamber. Except for the control group, the other two groups were subcutaneously injected with sodium selenite solution into the nape of the neck 30 min after the injection. The degree of lens opacity was examined using a slit-lamp, and lenses were harvested to assess antioxidant parameters, including superoxide dismutase (SOD) activity, reduced glutathione (GSH) content, and the oxidative damage marker malondialdehyde (MDA) content. Western blot analysis was performed to examine the upregulation of CSB protein and its association with delayed cataract formation.

Results: Overexpression of Ku80 significantly enhanced the expression of CSB protein, improved DNA repair capacity, and mitigated the influences of oxidative stress on rat LECs. This resulted in a significant increase in SOD and GSH levels, a significant decrease in MDA levels, and postponed the onset of selenium-induced cataracts, hence preserving lens clarity. Moreover, Ku80 overexpression partially alleviated damage to the corneal endothelium and retina.

Conclusion: Ku80 overexpression alleviates damage to LECs and postpones the development of selenium-induced cataracts by increasing CSB protein levels and controlling DNA repair processes. This research underscores the significant therapeutic potential of Ku80 in postponing cataract formation and may offer new avenues for gene therapy in the prevention and treatment of cataracts.

Purpose: To evaluate the refractive changes induced by ophthalmic viscosurgical devices (OVDs) in the anterior chamber after intraocular lens (IOL) implantation using intraoperative aberrometry (IA).

Methods: A nonrandomized prospective interventional case series of ten consecutive patients undergoing routine cataract surgery was conducted. Exclusion criteria included previous ocular surgery, corneal opacities, vitreous or macular lesions, and extreme axial lengths. Intraoperative refractive measurements were taken using IA after IOL implantation with cohesive (Provisc, Alcon), intermediate (Vistagel, Johnson & Johnson), and dispersive (Viscoat, Alcon) OVDs. Balanced Salt Solution (BSS) was used as a control. Statistical analysis compared refractive deviations across OVDs.

Results: Provisc, a cohesive OVD, demonstrated the least refractive deviation (median SE -1.0 D) and minimal impact on refractive outcomes. Viscoat, a highly dispersive OVD, induced the greatest refractive deviation (median SE -1.7 D) compared to the control with BSS (median SE -0.1 D). Statistically significant differences in refractive deviations were observed among the tested OVDs compared to BSS (p < 0.05).

Conclusion: This study demonstrates that OVD choice significantly influences refractive outcomes in cataract surgery. Provisc (cohesive) produced the smallest refractive deviation (median SE -1.0 D), whereas Viscoat (dispersive) caused the greatest deviation (median SE -1.7 D) compared with BSS (-0.1 D). These findings underscore the importance of careful OVD selection to optimize refractive precision and highlight the need for further research in diverse surgical settings.

Purpose: Use of illicit substances such as cocaine is associated with alteration in catecholamine-mediated neurotransmission throughout the CNS, including the eye. One of the most accessible physiologic parameters associated with neuromodulatory features of substance abuse is the pupillary light reflex (PLR). In this study, we examined a domain of the PLR characterized by melanopsin-driven intrinsically photosensitive retinal ganglion cells (ipRGCs) to assess the impact of substance abuse on ipRGC function.

Methods: An exploratory PLR examination on ten subjects with a documented history of substance use (HSU) without preexisting ocular disease was conducted with a comparator control cohort. Cases included assessment of cognitive function, depression, insomnia, and retinal nerve fiber thickness. IpRGC functionality was demonstrated by the PLR using a pedagogical-based methodology centered on response parameters with the introduction of a complementary analysis employing pseudo-one-phase modeling. Discriminant analysis employing the area under the receiver operating characteristic curve (AUC of ROC) categorized normal vs. abnormal ipRGC response.

Results: There was no statistical association between ipRGC function and insomnia; however, insomnia was more prevalent among those with ipRGC abnormality. Indication of clinical depression was seen in 70% of study participants and was unrelated to ipRGC function. Pseudo-one-phase modeling demonstrated a significantly higher plateau in the HSU group as well as a slower initial rate of pupil recovery consistent with abnormal PIPR dynamics and complementary to AUC metrics. Discriminant analysis identified that 60% of HSU demonstrated ipRGC abnormality.

Conclusion: Abnormal ipRGC functionality was demonstrated among those with HSU in this small exploratory study utilizing both AUC-ROC analysis as well as assessment of PLR waveform characteristics using features of a pseudo-first-order model.

Purpose: Growing evidence implicates gut microbiota dysbiosis in the pathogenesis of diabetic retinopathy (DR). This study aimed to investigate the associations between dietary index for gut microbiota (DI-GM), a novel metric reflecting gut microbiota composition and diversity, and DR risk, as well as to examine the mediating role of inflammatory and oxidative stress biomarkers.

Methods: This cross-sectional study analyzed 4,003 diabetic individuals (mean age 59 years, 51.21% men) from 1999-2018 National Health and Nutrition Examination Survey. DI-GM was derived from self-reported 24-hour dietary recalls. Mediation analysis was used to investigate the role of inflammation (neutrophils, lymphocytes, and alkaline phosphatase) and oxidative stress (gamma-glutamyl transferase, uric acid, and total bilirubin) biomarkers in the effects of DI-GM on DR prevalence. Binary logistic regression analysis was adopted to explore the association of DI-GM and DR prevalence.

Results: The prevalence of DR was 19.64%. Multivariate-adjusted odds ratio (95% confidence intervals) for the association between DI-GM and DR prevalence was 0.73 (0.68-0.79). Restricted cubic spline curves showed a non-linear inverse relationship between DI-GM and DR prevalence. Subgroup analysis indicated that the association between DI-GM and DR prevalence was more pronounced in participants with a body mass index > 25 kg/m². Alkaline phosphatase and total bilirubin mediated 10.27% and 9.45% of the effects of DI-GM scores on DR prevalence.

Conclusions: Adherence to microbiota-friendly diet was associated with a lower DR prevalence, especially among individuals with overweight or obesity. Alkaline phosphatase and total bilirubin may be associated with the gut microbiota-retina interactions in DR.

Purpose: Neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy is among the most frequently performed postoperative procedures in pseudophakic patients. Despite its widespread use and generally favorable safety profile, its potential to release solid-phase polymer debris from intraocular lenses (IOLs) has not been fully characterized. In this study, we investigated whether clinically relevant laser settings can cause the liberation of detachable fragments from both hydrophobic and hydrophilic acrylic IOLs.

Methods: Six commercially available one-piece IOLs were exposed to 2.6 mJ single-pulse Nd:YAG laser shots under standardized in vitro conditions. Microscopic evaluation before and after ultrasonic cleaning was performed. Raman spectroscopy was used to identify the chemical composition of any released fragments.

Results: Fragments adjacent to YAG-induced pits were observed in all lens types. Raman spectroscopy confirmed that the fragments matched the chemical signature of the respective IOL material. After sonication and filtration, identical Raman spectra were obtained from fragments retained on gold-coated filters, confirming their origin from the lens surface. Fragment sizes ranged from 10-20 µm.

Conclusions: This study demonstrates that solid IOL-derived fragments can be released by standard laser energy levels used in posterior capsulotomy. Although conducted in vitro, the findings raise concerns about the potential clinical relevance of laser-induced material release. Free-floating debris may contribute to straylight, glare, increased intraocular pressure, or inflammatory responses. Further clinical studies are warranted to systematically assess whether such microfragments lead to postoperative complications. Optimized laser parameters and precise focusing are recommended to minimize structural damage and fragment release.

Purpose: Diabetic retinopathy is an ophthalmic disease that impairs the retinal blood vessels. Diabetic retinopathy can lead to blindness when it is not examined in earlier phases. Adversely, the accurate diabetic retinopathy recognition phase is prominently complicated and needs experienced human analysis of fundus images. Blockchain technology helps share data by allowing users to select what information to share and control who can access it, which is important for managing electronic health records in healthcare sector. Nevertheless, the privacy of user data is compromised due to the training data, which is revealed to unauthorized users.

Methods: In this work, a superior module for diabetic retinopathy classification based on Blockchain using principal convolutional analysis neural network is designed. Here, the simulation of Blockchain is carried out. Here, the input image is pre-processed using the Gaussian filter. LadderNet is deployed for lesion segmentation, and the segmentation of blood vessel is done using the Sine-Net model. Moreover, feature extraction is performed with the input image, lesion-segmented image, and blood vessel-segmented image. Finally, diabetic retinopathy classification is executed utilizing the proposed principal convolutional analysis neural network, which is classified into normal, mild non-proliferative diabetic retinopathy, moderate non-proliferative diabetic retinopathy, severe non-proliferative diabetic retinopathy, and proliferative.

Results: The Blockchain enabled principal convolutional analysis neural network obtains superior values of 90.9%, 91.9%, 92.5%, 89.4%, 88.4%, and 75.5% in terms of metrics like accuracy, true positive rate, true negative rate, positive predictive value, negative predictive value, and Mathews correlation coefficient.

Conclusion: The integration of principal convolutional analysis neural network with Blockchain enhances data integrity and patient privacy, making it a promising solution for early diagnosis and treatment. Also, this approach ensures accurate and efficient detection of diabetic retinopathy.

Purpose: Several risk stratification systems against intraoperative complications of phacoemulsification cataract surgery have been empirically validated as to their usefulness in clinical settings, yet it remains unclear whether their application is making a notable difference in the training of resident surgeons in clinical practice. The purpose of this study is to compare practice-as-usual in assignment of training cases to residents versus the application of a statistically validated risk classification system.

Methods: This cross-sectional observational study included patients who underwent phacoemulsification surgery by residents in training, divided into two groups of 440 and 452 patients. The first group of patients had been assigned to residents following practice-as-usual while the second group followed the assessment with a validated risk stratification system.

Results: Although residents were assigned patients who were considered less prone to complications even before the introduction of a consistent risk stratification system, the difference in the assignment of riskier cases was statistically significant (p = 0.002). The reduction in the assignment of riskier cases was associated with fewer complications (64 complications/440 eyes versus 33/452, p = 0.004).

Conclusion: The introduction of a risk stratification system correlated with fewer interoperative complications and less challenging cases assigned to residents.

Purpose: To explore the efficacy of vitrectomy combined with intravitreal injection of Triamcinolone acetonide (TA) in the treatment of proliferative diabetic retinopathy (PDR).

Methods: This was a retrospective cohort study of patients who received intraocular surgery at Wuhan Tongji Hospital between January and December 2024. One hundred and thirty-three cases (138 eyes) with PDR were randomly divided into two groups: 72 cases (75 eyes) in the combined TA group and 61 cases (63 eyes) in the simple vitrectomy group (control group). Both groups underwent vitrectomy. Before closing the incision, the combination group was intravitreal injected with 4 mg TA. The patients were followed up for 3 months. The recovery of visual function and the control of PDR were analyzed.

Results: The postoperative outcomes revealed that in the combined treatment group, 86.67% of patients experienced improved visual acuity, with 13.33% showing no change and no cases of decreased vision, leading to a significant improvement compared to the control group where visual acuity increased in 71.43% of patients, remained unchanged in 12.70%, and decreased in 15.87% (p < 0.05). Additionally, the combined group had a lower incidence of postoperative bleeding at 12.00 versus 23.81% in the control group (p < 0.05). Notably, the incidence of tractional retinal detachment was similar in both groups (p > 0.05), but macular epiretinal membrane was observed in 24.00% of the combined group's eyes compared to 41.27% in the control group, which was a significant difference (p < 0.05).

Conclusions: Vitrectomy combined with intravitreal injection of TA in the treatment of PDR can better improve the postoperative visual outcome and may help reduce the occurrence of postoperative proliferation, postoperative bleeding and other complications.

Purpose: Metabolic syndrome (MetS) is a known risk factor for retinal vein occlusion (RVO); however, the molecular mechanisms linking their comorbidity and their relationship with previously established clinical predictors of RVO are not fully elucidated. This study aimed to identify a shared TF-miRNA-mRNA regulatory network in RVO and MetS, and to examine its correlation with key clinical predictors.

Methods: Common genes for RVO and MetS were identified from CTD, GeneCards, DisGeNET, and the GEO dataset GSE98895. Functional enrichment, protein‑protein interaction (PPI), and TF-miRNA-mRNA network analyses were conducted. Key molecules were validated by qRT‑PCR in peripheral blood mononuclear cells from 21 subjects (7 with MetS-RVO, 7 with RVO only, and 7 controls). Spearman and Kendall correlation analyses were used to assess relationships between network components and clinical predictors (hypertension, BMI, HDL‑C, PDW, etc.).

Results: Six overlapping genes (CHD7, IFNG, ABCA1, THBS1, PDGFRB, JUN) were enriched in pathways related to vascular remodeling, lipid metabolism, and inflammation. The regulatory network comprised 20 nodes and 28 edges. qRT‑PCR confirmed up‑regulation of hsa‑miR‑192‑5p and down‑regulation of ABCA1 in the MetS-RVO group. Correlation analysis revealed 27 significant associations (FDR < 0.05), with notable correlations between RELA and PDW (r = 0.759) and between RELA and HDL‑C (r = -0.688). HDL‑C was inversely correlated with several inflammatory markers (RELA, IFNG, STAT3).

Conclusion: This study proposes a TF-miRNA-mRNA network associated with RVO-MetS comorbidity and offers molecular support for previously reported clinical predictors. ABCA1 and hsa‑miR‑192‑5p may serve as potential biomarkers. The limited sample size warrants cautious interpretation, and these findings provide a hypothesis‑generating foundation for future targeted investigations.

Purpose: To evaluate the visit time in a neuro-ophthalmology clinic by comparing virtual reality visual field (VRVF) testing versus the standard Humphrey visual field (HVF) and the influence of the technician's learning curve.

Materials and methods: Data from 66 patients were included in the initial phase of the study (baseline), and data from a new cohort (n = 66) were collected six months later. Participants were divided into two age- and diagnosis-matched groups: those who underwent an ophthalmic technician workup using VRVF testing (n = 33) and those whose workup included HVF testing (n = 33). Total clinic visit duration and technician workup time were recorded independently for new patient and follow-up visits. Statistical comparisons were conducted between the two groups at both time points: baseline and six months.

Results: The mean age was 47.6 ± 21.7 years (65.2% female) at baseline and 47.9 ± 21.1 years (66.7% female) at 6 months. Technician workup time for follow-up visits was significantly shorter when using VRVF at both the baseline (p < 0.0001) and 6-month time points (p < 0.0001), compared to HVF. For new patient visits, workup time at baseline was comparable between methods (VRVF: 70.3 ± 19.8 min; HVF: 73.5 ± 9.1 min; p > 0.05), but time was significantly reduced at 6 months when using the VRVF (59.9 ± 17.1 min vs. 96.6 ± 16.0 min; p < 0.0001), likely due to the technician learning effect.

Conclusions: The use of VRVF in neuro-ophthalmology clinics improved workflow by reducing technician workup time for new and follow-up patient visits. Consistent results across two time points underscore the role of VRVF testing in streamlining clinic visits and alleviating high patient volume pressures.