Current Eye Research最新文献

Purpose: To assess the usability of a smartphone-based augmented reality tool for capsulorhexis training.

Methods: This is a single-center, prospective, clinical study conducted at the Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany. Surgery-naïve residents were included and divided into three subgroups: (1) augmented reality supported by the Custom Surgical MicroREC system during their capsulorhexis procedures; (2) Expert support supported by an experienced cataract surgeon; (3) No support without support. Capsulorhexis quality was graded by circularity, centration, and radius.

Results: Twenty-one (n_total = 21) participants were enrolled. The augmented reality group was statistically significantly better in terms of circularity than the Expert support (Mann-Whitney's U-test: p = .00175) and the No support group (Mann-Whitney's U-test: p = .00268). The procedure duration decreased statistically significantly for all three groups when try 1 and 10 were compared (augmented reality: p < .0001; Expert support: p = .0099; No support: p < .0001). The other parameters did not differ statistically significantly. The questionnaires handed to the augmented reality and No support group before and after the wet lab revealed a high importance of wet lab trainings to all polled participants. The provided wet lab setup was considered adequate by both groups.

Conclusion: Augmented reality can assist in cataract training. The Custom Surgical MicroREC system can have a positive influence on capsulorhexis quality in a training environment. Automated quality metrics measured by the augmented reality software provide an objective quality score of the performed surgical procedure. As the tested augmented reality system can be used in training as well as in a real-world setting, this will be a useful tool for trainees and expert surgeons alike.

Purpose: To investigate the oxidative stress (OS) and inflammatory cytokine (IC) levels in vitreous and subsilicone fluid (SSF) in cases with rhegmatogenous retinal detachment (RRD).

Methods: This prospective study included 21 cases of uncomplicated RRD. Total antioxidant status (TAS) and total oxidant status (TOS) in the samples were determined by automatic measurement method and IC levels were determined by ELISA method. In addition to routine ophthalmological examinations, flare, optic coherence tomography (OCT) and enhanced depth imaging-OCT measurements were performed during follow-up.

Results: There was a significant difference in the TOS and oxidative stress index (OSI) in SSF compared to vitreous (p < 0.05). IL-1β level was detected significantly higher in vitreous fluid (p = 0.004). When the correlation between TAS, TOS, OSI and cytokine levels in SSF and the difference in central macular thickness (CMT), choroidal thickness and flare changes measured in the 1st and 3rd month follow up of the cases after vitrectomy were evaluated, only negative correlation was observed between TOS, OSI, and CMT.

Conclusion: OS, which has not been previously investigated in SSF, was significantly higher in this study, and our findings suggest that OS may have an initiating role in retinal damage thought to be caused by silicone oil.

Purpose: To determine histological effects of myopia progression control (MPC) lens-induced refractive changes on scleral remodeling in chicks.

Methods: 24 Ross-Ross chicks were raised for 14 days. 6 chicks wore conventional -10D lenses for 7 days, followed by no lenses for 7 days. 6 chicks wore conventional -10D lenses for the full 14 days. 6 chicks wore conventional -10D lenses for 7 days, followed by +10D lenses for 7 days. 6 chicks wore conventional -10D lenses for 7 days, followed by MPC lenses for 7 days. MPC lenses had a central power of -10D and a gradient power rise at pupil edge (+2.75D). Chicks were euthanized after 14 days and eyes were processed for histopathological evaluation. Whole mount H&E-stained tissue sections were analyzed using bright field microscopy.

Results: Total scleral thickness was significantly reduced in the group wearing conventional -10D lenses (p < 0.05) but remained comparable to the control group for MPC lenses treated chicks. Appositional growth of the cartilaginous sclera (CS) was observed in all MPC lenses treated eyes and only in those eyes. There was a significant increase in CS thickness in MPC lenses treated chicks compared to the other two groups (p < 0.03) but not between conventional -10D lens treated and control chicks (p > 0.05).

Conclusion: It is possible to induce appositional growth in hyaline cartilage in the chick sclera. In our study, this has only been achieved by using MPC lenses to reverse previously induced experimental myopia with conventional minus lenses. Our findings suggest that a gradient decrease in peripheral lens power and the resulting differential defocus could trigger of scleral reinforcement through of cartilage growth stimulation in the chick sclera.

Purpose: This study aims to elucidate the causal relationships and shared genetic architecture between metabolic-associated diseases and risk factors-including hypertension, type 1 diabetes (T1D), type 2 diabetes (T2D), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and body mass index (BMI)-and primary vision-threatening eye disorders, involving glaucoma, cataracts, refractive disorders, and age-related macular degeneration (AMD).

Methods: We analyzed genome-wide association study (GWAS) summary statistics from > 500 000 individuals of European ancestry in the FinnGen, UK Biobank, and MRC-IEU databases to ensure adequate sample size. Linkage disequilibrium score regression (LDSC) was applied to estimate genetic correlations, while two-sample Mendelian randomization (MR) was performed to assess causal effects. Furthermore, a bidirectional Mendelian Randomization was further conducted to examine the directionality of associations between hypertension and cataracts.

Results: This study was the first to reveal genetic correlations and causal effects of hypertension on cataracts, particularly senile cataracts. MR analysis provided evidence that hypertension is causally associated with an increased risk of cataracts, particularly senile cataract, whereas the reverse association was not supported. Additionally, LDL cholesterol was suggested as a protective factor for AMD, while HDL cholesterol was associated with an increased risk. The LDSC analysis also indicated a suggestive genetic correlation between T2D and both cataracts and glaucoma, but not for T1D.

Conclusion: This study provides comprehensive evidence of genetic correlations and potential causal relationships between metabolic-associated conditions and major eye diseases contributing to vision loss.

Purpose: The decision when to operate cataract can be difficult when there are subjective visual complaints but visual acuity is intact. Straylight measurements can help to improve surgical decision making in this group of patients. It is however unclear if pupil size can affect straylight when cataract is present. In this study we investigate the effects of pupil size on intra-ocular straylight in patients with multiple types of cataract.

Methods: A total of 85 eyes from 51 participants were measured, with an average age of 66 years. Straylight was measured before and after pharmacologic mydriasis with the Oculus C-Quant device. Cataract was graded using the LOCS III classification system. Exploratory analysis using retro-illumination slit-lamp photography was performed to divide between central and peripheral lens opacities.

Results: Mean straylight both before and after dilation was 1.57 log(s). Reliable individual effects from dilation ranged between -0.42 and +0.48 log(s). No significant differences were found between cataract subtype groups using mixed model analysis. In nuclear cataract mean straylight levels were 1.71 log(s) undilated and 1.66 log(s) dilated. Mean straylight in cortical cataract was 1.38 log(s) undilated and 1.51 log(s) dilated. Centrally and peripherally located cataracts showed a mean change after mydriasis of -0.08 and +0.07 log(s), respectively.

Conclusions: Straylight after pupil dilation showed varying degrees of change, with a tendency to increase in cortical cataract and decrease in nuclear cataract. However, in all forms of cataract both large increases and decreases can be found. These changes were found to be repeatable and reliably measured. Centrality determination from retro-illumination photography can only partly predict these changes.

Purpose: This review provides an outcome-oriented, comprehensive summary of published works on the topic of repurposing the anterior lens capsule (ALC) in various subfields of ophthalmic surgery. Covering a broad spectrum of studies ranging from pre-clinical experiments on animal models to blinded prospective clinical trials involving patients.

Materials and methods: National Institute of Health (NIH) and COCHRANE libraries were comprehensively searched for published works covering the topic of ALC utilization in corneal, retinal, and glaucoma surgical procedures. Studies covering the topic of ALC use unrelated to ophthalmic surgical trials were excluded. A total of 15 studies were included based on the search criteria. Patient follow-up was limited to 18 months. Primary and secondary post-surgical outcomes were evaluated to assess the surgical effectiveness and complication risk of ALC use compared to alternative surgical techniques.

Results: ALC is a viable ophthalmic tissue for prospective use in ophthalmic surgery. Despite the limited number of studies conducted on the topic, the results presented have shown promise. Three studies demonstrated superior post-surgical outcomes in ALC-utilizing procedures compared to other ophthalmologic interventions. Remaining studies included in this review have demonstrated potential equivalence of outcomes after ALC-utilizing surgeries to established surgical methods without presenting new limitations and complications.

Conclusions: ALC is an abundant, routinely discarded tissue during cataract surgery. It possesses unique properties of acellularity, optical transparency, and immunologic nativity to the human eye, which enables it to be an excellent donor tissue for ophthalmic surgeries ranging from corneal defect management to prolonging the longevity of anti-glaucoma filtering blebs. The use of ALC autografts in ophthalmic surgery allows for augmentation of standard procedures in phakic patients, delivering satisfactory outcomes and potentially reducing costs. Further research into ALC collection, processing, and long-term storage is needed to enable ALC allograft use in pseudophakic and aphakic patients.

Purpose: This study aims to investigate the longitudinal changes in ocular biometry in mice treated with exogenous all-trans retinoic acid (atRA) and make comparisons with the lens-induced myopia (LIM) model.

Materials and methods: Male C57BL/6J mice were administered 10 µl of atRA (1 milligram [mg]/milliliter [mL]) every other two days via peribulbar injection. The LIM group received monocular -30D lenses. Ocular biometrics were measured on Days 0, 3, 6, 10, and 15 using swept-source optical coherence tomography. Scleral thickness (ST) and retinal arc length (RAL) were measured on histological sections.

Results: Both exogenous atRA and negative lenses induced longer axial length (AL) from Day 3 and thinner retinal thickness (RT) from Day 6 (all p < 0.05). An increase in vitreous chamber depth (VCD) was noted from Day 3 in atRA-Treated (p = 0.001) eyes and from Day 6 in LIM-Treated eyes (p < 0.001). The interocular difference in lens thickness (LT) varied significantly over time (p = 0.004) in the atRA group. The LT to AL ratios (LT/AL) for atRA-Treated eyes were notably higher than those for the LIM eyes on Days 10 and 15 (all p < 0.05). The VCD to AL ratios (VCD/AL) were comparable between the two groups, with notable declines observed in the late stage (all p < 0.01). Additionally, both treatment groups showed similarly reduced ST and larger RAL than untreated eyes.

Conclusions: Mice treated with exogenous atRA demonstrated comparable longitudinal ocular biometric alterations to the LIM model, except for the relatively thicker lenses.

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: To investigate the variations in retinal thickness and choroidal thickness at different distances from the optic disk in the guinea pigs.

Methods: Twenty 3-week-old pigmented guinea pigs were randomly divided into a normal control group and a lens-induced myopia group. The normal control group received no intervention, while the lens-induced myopia group wore a -10D lens on the right eye to induce myopia and a 0D lens on the left eye as control. Refraction, axial length, corneal curvature radius, vitreous chamber depth, retinal thickness, and choroidal thickness were measured at baseline, 2 and 4 weeks. Centered on the optic disk, concentric circles with radii of 1000, 1500, 2000, and 2500 μm were drawn using Image J software (Bethesda, MD) to partition the retina and choroid.

Results: After 4 weeks, lens-induced myopia-eyes showed lower refraction (lens-induced myopia vs. normal control, -1.38 ± 0.91D vs. 2.64 ± 0.76D, p < 0.0001), retinal thickness (lens-induced myopia vs. normal control, 149.14 ± 4.64 μm vs. 159.63 ± 4.64 μm, p < 0.0001) and choroidal thickness (39.07 ± 3.30 μm vs. 45.80 ± 5.32 μm, p < 0.01), and increased axial length (lens-induced myopia vs. normal control, 8.34 ± 0.20 mm vs. 8.01 ± 0.16 mm, p < 0.0001) and vitreous chamber depth (lens-induced myopia vs. normal control, 3.87 ± 0.11 mm vs. 3.50 ± 0.11 mm, p < 0.0001) compared with the normal control group and Fellow-eye. At week 4, retinal thickness at all positions of the lens-induced myopia-eye differed from normal control and Fellow-eye, while choroidal thickness differed only at 1500 μm and 2000 µm. Thinning of retinal thickness and choroidal thickness are both at distances of 1500 μm and 2000 μm. Mean retinal thickness and choroidal thickness correlated positively with refraction, but the changes in retinal thickness and choroidal thickness at each position are not correlated with the changes in RE.

Conclusion: The structural changes in the retina and choroid during myopia progression are region-specific rather than uniform across the posterior pole.