Current Eye Research最新文献

Purpose: With age, the mammalian lens forms successive layers of crystallin protein fibers which infoliate with lens growth and development. As heavy metals generally bind to tissue protein, heavy metals are posited to sequester within the lens with age. Therefore, this study aims to compare heavy metals in human crystalline lens of older adults to known physiologic blood and urine levels and assess the association between concentrations in the lens and metabolic biomarkers.

Methods: Consecutive lens specimens obtained during cataract surgery by phacoemulsification were subjected to atomic spectrometry for heavy metal content. A one-sample t-test compared heavy metals in lens to known physiologic blood and urine concentrations. Linear regression models assessed the association between heavy metals and biomarkers of metabolic function. Linear discriminant analysis assessed the classification of gender and smoking status based on multiple and individual heavy metals.

Results: All heavy metal levels were elevated in lens specimens compared to blood and urine with the exception of iron (p < 0.0001). Lens titanium and copper were positively associated with blood-urea nitrogen (Titanium: $\hat{\beta }$ = 1.14, p = 0.04, Copper: $\hat{\beta }$ = 1.12, p = 0.03. Lens copper was positively associated with creatinine ($\hat{\beta }$ = 1.10; p = 0.02), but negatively associated with glomerular filtration rate ($\hat{\beta }$ = 0.89; p = 0.02). Lens chromium and lead were positively associated with albumin (Chromium: $\hat{\beta }$ = 1.03, p = 0.03; Lead: $\hat{\beta }$ = 1.02, p = 0.04). Lens nickel was positively associated with bilirubin ($\hat{\beta }$ = 1.14; p = 0.03). Classification based on multiple or individual heavy metals for gender and smoking status was not statistically significant.

Conclusions: Our results suggest the human crystalline lens accumulates heavy metals with age and demonstrate the correlation between abnormality of metabolic function and heavy metal deposition in older adult lens.

Purpose: To compare the visual outcomes, rate of cystoid macular edema (CME), and additional associated complications in eyes that exhibited zonular dialysis (ZD) during phacoemulsification to a reference group of uneventful phacoemulsification eyes.

Methods: A retrospective multicenter comparative database study. We pooled data from 8 United Kingdom sites between 2003 and 2015. The main outcome measures were the mean postoperative visual acuity (VA) at 12-24 weeks and the rates of CME and additional associated complications.

Results: We included 1074 eyes in the ZD group and 112,479 in the reference group. Logistic regression analysis showed that pseudoexfoliation was the strongest associated factor of ZD (OR: 6.1), followed by previous glaucoma surgery (OR: 4.4). Mean logMAR preoperative VA was 0.8 ± 0.6 in the ZD group vs. 0.6 ± 0.5 in the reference group (p < 0.001). Mean postoperative VA was worse in the ZD group (p < 0.001); 0.4 ± 0.6 vs. 0.2 ± 0.3 and 0.5 ± 0.6 vs. 0.2 ± 0.3 at 4-12 weeks and 12-24 weeks, respectively. At 12-24 weeks, the proportions of eyes that gained ≥0.3 logMAR units were 50% in the ZD group vs. 62% in the reference group (p < 0.001). In the ZD group, the most common intraoperative complication was vitreous loss (34.3%), followed by posterior capsular rupture (PCR) (11.1%). Postoperative CME occurred in 2.3% vs. 1.4% (p = 0.01), and 9.3% of eyes required surgery for correction of aphakia, intraocular lens decentration, or dropped lens figments removal.

Conclusions: The occurrence of ZD was associated with worse postoperative vision, an increased rate of vitreous loss and PCR, and a higher risk of CME.

Purpose: To analyze the efficacy and safety of microsecond pulsing laser therapy (MLT) in the management of central serous chorioretinopathy (CSCR) complicated by choroidal neovascularization (CNV).

Methods: Patients with CSCR complicated by CNV defined as the presence of characteristic OCT angiography features were randomly assigned to either study or control group. All patients of the study group underwent MLT targeting CNV area using navigated laser system followed by at least 6-month follow-up. Sham treatment was performed in the control group. No other treatment or anti-VEGF therapy was used during the follow-up. Main outcome measure was complete resolution of subretinal fluid at the end of follow-up.

Results: Twenty-three eyes (13 males and 10 females, mean age 58.2 ± 8.0 years) with a mean CNV area 0.62 ± 0.77 mm² were included in the study group. Fourteen (60.9%) patients achieved complete resolution of SRF, five (21.7%) patients demonstrated some reduction of SRF, and four (17.4%) patients demonstrated no improvement after MLT in the study group. Twelve eyes (8 males and 4 females, mean age 59.8 ± 4.6 years) were included in the control group where none of them demonstrated resolution of SRF at the end of the follow-up (p = 0.0018 compared to the study group). No adverse effects, such as changes of CNV size, deterioration of exudation, or decline in visual acuity were observed in the study group.

Conclusion: Microsecond pulsing laser is an effective and safe option for the treatment of CSCR complicated by relatively small CNV and achieves complete resolution of SRF in 61% of cases.

Purpose: We analysed the refractive state and the factors that influence the best-corrected visual acuity (BCVA) in congenital macular coloboma (CMC) to provide new ideas for improving and predicting the vision of patients with CMC.

Methods: We reported three patients and reviewed 26 cases of CMC reported in the China National Knowledge Infrastructure (CNKI) database. We measured the BCVA, spherical equivalent refraction (SER), the macular coloboma's diameter and area, and the distance from the macular coloboma's nasal edge to the optic disc's temporal edge (DISTANCE). We analyzed the refractive status of CMC and the factors affecting BCVA.

Result: The three patients with CMC we reported all had myopia. The study also included 26 patients with CMC reported in the CNKI database (9 unilateral, 17 bilateral) and we analyzed the findings of 26 patients with 43 eyes. The mean age at diagnosis was 22.96 ± 2.32 years. All patients underwent a comprehensive eye examination; 39 eyes (91%) had myopia (44% mild myopia; 28% moderate myopia; 28% high myopia); 23 eyes (53%) had a BCVA ≤6/60 and other 20 eyes (47%)>6/60. No correlation was found between SER or BCVA and the macular coloboma's diameter or area. BCVA correlated positively with DISTANCE (r = 0.603, p < 0.001). No correlation was found between SER and DISTANCE. The study found a significant difference in SER or BCVA between the affected and fellow eyes in patients with unilateral CMC (n = 9, T=-3.259, p = 0.012; Z=-2.521, p = 0.012, respectively).

Conclusion: CMC seriously affects visual acuity. The refractive state is mostly myopia. We hypothesize that the DISTANCE is related to the integrity of the papillomacular bundle and affects BCVA.

Purpose: Comparison of dynamic pupillary parameters (DPPs) between healthy volunteers and multi- or monofocal intraocular lens (IOL) implanted eyes, and examination of the correlation between postoperative visual acuity (VA), contrast sensitivity (CS), visual dysphotopsias (VD), and these parameters in IOL-implanted eyes.

Methods: This cross-sectional study classified and analyzed DPPs from healthy volunteers (308 eyes) according to age. In the multifocal IOL group (119 eyes), 51 eyes were implanted with Lentis Comfort^® (L group), 32 with PanOptix^® (P group), and 36 with Synergy^® (S group). The monofocal IOL group included 33 eyes implanted with Vivinex Impress^® (V group). DPPs by the pupillometer (PLR-3000), distance, intermediate and near VA, and CS and VD were examined one month postoperatively in 152 eyes.

Results: Significant decreases in maximum or minimum pupillary diameter (INIT, END), percentage of pupillary constriction (DELTA), latency between light stimulation and constriction (LAT), and average and maximum constriction velocity (ACV, MCV), average dilation velocity (ADV), were observed with aging in the healthy eyes group. The preoperative group showed a significant age-related decrease in DELTA and increase in LAT. The postoperative group showed a significant age-related decrease in INIT, END, and ADV. The L group exhibited a significant positive correlation between ADV and uncorrected intermediate VA (UIVA), while the P group exhibited a significant positive correlation between ACV and UIVA, and the S group exhibited a significant negative correlation between ACV and uncorrected near VA. For CS, the S group exhibited a significant positive correlation with ADV at 1.0 and 0.7 degrees, and the P group exhibited a significant negative correlation between ACV and glare.

Conclusion: DPPs are greatly affected by age. DPPs for multi- or monofocal IOL eyes correlate with uncorrected VA, CS, and VD.

Purpose: The goal of this study was to assess the changes in choriocapillaris perfusion density (CCD) after 24 weeks of structured high-speed circuit resistance training (HSCT) in healthy older adults.

Methods: A total of 30 healthy, cognitively normal adults, 60 years old and above, were recruited for the study. The participants were randomized to either the HSCT group (n = 15) or the control group (CON, n = 15). The HSCT group trained 3 times a week on non-consecutive days for 24 weeks, while the CON group did not perform formal training. Optical coherence tomography angiography (OCTA) was used to image both eyes of each study participant at baseline and 24-week follow-up. The follow-up session was completed within 3 days of the last exercise session for the HSCT group. The CCD was measured within a 2.5-mm in diameter centered on the fovea.

Results: There were no significant differences in CCD between baseline and 24-week follow-up in either the HSCT group or the CON group. In the HSCT group, the CCD was 62.6 ± 6.1% (mean ± SD) at baseline and 63.7 ± 6.1% at the 24-week follow-up (p = 0.21). In the CON group, the CCD was 62.8 ± 5.6% at baseline and 63.8 ± 4.9% at 24 weeks (p = 0.18).

Conclusion: CCD was unchanged after a 24-week high-speed circuit resistance training in healthy older individuals, suggesting possible regulatory maintenance of choroidal blood flow. Further research with multiple age cohorts may be necessary to corroborate these findings.

Purpose: Rhegmatogenous retinal detachment associated with choroidal detachment (RRDCD) is known for its rapid progression and poor prognosis, making it a subject of significant clinical interest due to its complex pathogenesis. This study aims to utilize mass spectrometry for proteomic analysis of vitreous humor to identify proteins and biomarkers critical to the pathophysiology of RRDCD.

Methods: Data-independent acquisition (DIA) mass spectrometry was employed to analyze vitreous humor samples from RRDCD and Rhegmatogenous retinal detachment (RRD) patients. The analysis focused on identifying differentially expressed proteins (DEPs) and determining their functional roles. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to explore the biological processes and pathways associated with these DEPs. DEPs were validated using ELISA to confirm the reliability of the mass spectrometry results.

Results: A total of 237 DEPs were identified, including 63 upregulated and 174 downregulated proteins. GO functional analysis showed enrichment in terms related to molecular function regulators, biological adhesion, and the extracellular region. KEGG pathway analysis revealed significant associations with the Extracellular environment (ECM)-receptor interaction, complement and coagulation cascades, and lysosome pathways. Receiver operating characteristic (ROC) analysis further confirmed that Serum amyloid A-4 protein (SAA4), Inter-alpha-trypsin inhibitor heavy chain H1 (ITIH1), and Vitronectin (VTN) exhibit excellent performance in the diagnosis of RRDCD. Both VTN and SAA4 showed positive correlations with BCVA at 6 months post-surgery.

Conclusion: RRDCD activates a variety of cellular pathways, not only complement and inflammation, but also the remodeling of the extracellular matrix and the activation of lysosome-related pathways disrupt normal retinal cell function. SAA4, ITIH1, and VTN in vitreous fluid can serve as effective biomarkers for diagnosing patients with RRDCD. Additionally, both VTN and SAA4 are correlated with post-operative visual outcomes.

Purpose: This study aimed to investigate the regulatory role of the AMP-activated protein kinase (AMPK)/mechanistic target of rapamycin (mTOR) signaling pathway in mediating transforming growth factor-beta 1 (TGF-β1)-induced cellular proliferation and transdifferentiation processes in human pterygium fibroblasts (HPFs).

Methods: HPFs were stimulated with TGF-β1 in vitro. Cell viability was assessed using the CCK-8 assay at 12/24/48-h post-stimulation, while migratory capacity was evaluated through standardized wound healing assays. Quantitative real-time PCR (qPCR) and western blotting analyses were employed to evaluate the expression of proliferation marker proliferating cell nuclear antigen (PCNA) and myofibroblast transdifferentiation biomarker α-smooth muscle actin (α-SMA). Western blotting further characterized the activation status of AMPK/mTOR signaling by quantifying phosphorylated AMPK (p-AMPK) and phosphorylated mTOR (p-mTOR), with total AMPK and mTOR levels serving as loading controls. To establish mechanistic causality, TGF-β1-primed HPFs were modulated using the AMPK inhibitor Compound C and activator AICAR for 24 h. Functional consequences were analyzed through CCK-8 viability assays and wound healing assays, while molecular correlates were assessed via qPCR and western blotting for PCNA, α-SMA, and pathway components. This comprehensive approach delineated the AMPK/mTOR axis as a critical regulator of TGF-β1-driven fibrotic phenotype acquisition in HPFs.

Results: Following TGF-β1 pretreatment-induced activation of human HPFs, both cell viability and migratory capacity were markedly enhanced, with concomitant upregulation of PCNA and α-SMA. Compound C-mediated AMPK inhibition potentiated the TGF-β1-induced enhancements in HPFs viability and migration rate, concomitant with reduced p-AMPK/AMPK ratio and elevated expression of PCNA, α-SMA, and p-mTOR/mTOR ratio. Conversely, AICAR-driven AMPK activation attenuated TGF-β1-stimulated effects, demonstrating diminished viability, suppressed migratory capacity, increased p-AMPK/AMPK ratio, and decreased expression of PCNA, α-SMA, and p-mTOR/mTOR ratio.

Conclusions: This study demonstrates the critical regulatory role of the AMPK/mTOR signaling pathway in controlling TGF-β1-induced proliferation and transdifferentiation in HPFs, thereby providing a potential mechanistic framework for developing novel therapeutic interventions targeting fibrotic ocular surface disorders.

Purpose: To investigate the keratoconus characteristics and progression rate in a patient group of adolescents aged 19-24 years and to compare the results with young adults aged 25-30 years.

Methods: A total of 158 keratoconic eyes (82 and 76 eyes in the adolescent and young adult groups) of the Homburg Keratoconus Center, which were examined by Scheimpflug tomography at least two times, were included in this retrospective study. The visual characteristics, corneal tomography, and biomechanical measurements were noted at the initial visit, 6 months, 12 months, and 24 months after the initial visit. Progression rates and the amounts of change were calculated and compared between groups.

Results: Baseline visual, tomographical, and biomechanical characteristics along with keratoconus staging were similar between groups at the initial visit (p > .05 for all values). Progression rate was 76.8% vs 14.9% with respect to Kmax change, 72.3% vs 12.0% with respect to ABC parameters, and 26.4% vs 16.4% with respect to E staging in the adolescent vs young adult groups, respectively (p < .001, p < .001, and p = .25).

Conclusions: Keratoconus may worsen more rapidly in adolescent patients aged 19-24 years compared to young adult patients aged 25-30 years. This study emphasizes the high progression rate in adolescent patients and the consideration of early cross-linking and/or at least closer follow-ups in this age group.

Infection with Plasmodium falciparum carries a significant risk of cerebral malaria (CM). Children are particularly susceptible to human CM (HCM) which manifests as an acute neurovascular encephalopathy leading to high levels of mortality. Occurring in parallel with CM, malarial retinopathy (MR) is readily detected on ophthalmoscopy as one or more of: white-centered retinal hemorrhage, retinal whitening, and vessel discoloration. It leads to several distinct types of blood retinal barrier (BRB) breakdown. The precise molecular mechanisms underpinning CM and MR remain ill-defined, but parasitemia is known to drive progressive neurovascular obstruction and inflammation leading to cerebral and retinal edema and ischemia. Extensive clinical studies in patients with CM have shown that retinal examination is a useful approach for understanding pathology and an indicator for risk of mortality and morbidity. Fully understanding the cellular and molecular mechanisms that underpin CM and MR is important for developing new therapeutic approaches and in this regard the murine model of experimental CM (ECM) has proved to offer considerable value. Much is known about brain pathology in this model although much less is understood about the retina. In this review, we seek to evaluate MR in clinical scenarios and make comparisons with the retina from mice with ECM. Through detailed in vivo and post-mortem studies in the mouse and human retina, this review highlights the links between CM and MR and how this will aid our understanding of the disease progression and pathogenesis.