Current Eye Research最新文献

Purpose: This study aims to determine if using pilocarpine postoperatively affects clinical outcomes after goniotomy.

Methods: Retrospective series comparing 532 Kahook Dual Blade goniotomy (KDB-G) procedures with (P+) or without (P-) pilocarpine use in the postoperative period. This study includes patients with both primary and secondary glaucoma ranging from mild to end-stage, undergoing KDB-G with or without phacoemulsification (phaco). The primary outcome measure was surgical success defined as intraocular pressure (IOP) < 21 mmHg in addition to either a reduction of >20% and/or the reduction of ≥1 topical glaucoma medications. Secondary outcomes were mean IOP, number of medications, and rate of hyphema and IOP spike at one week postoperatively.

Results: The success rate was significantly greater in Group P + at postoperative month 1 (p = .02), 3 (p = .01), 12 (p = .048), and 16 (p = .02). The differences in mean IOP (p = .084) and number of medications (p = .15) were not significantly different at one year. However, Group P + required significantly less medications than Group P - at nearly all time points (months 1, 3, 6, 20, and 24). There were no differences in rates of hyphema (p = .30) or postoperative week 1 IOP spikes (p = .66) between groups.

Conclusion: The use of pilocarpine postoperatively may improve surgical success and may reduce the number of glaucoma medications needed after goniotomy.

Purpose: To evaluate the effect of cyclosporine-A (CsA) 0.05% eye drops for management of acquired punctal stenosis, either alone or in combination with punctoplasty.

Methods: In this prospective study patients referred to the oculoplastics clinic with acquired punctal stenosis (APS) were divided into three groups. Group A consisted of patients treated with CsA, Group B consisted of patients who underwent punctoplasty, and Group C included patients treated with both CsA and punctoplasty. Munk score, fluorescein dye disappearence test (FDDT), punctal opening grading were evaluated at baseline, and at the 1st and 6th month follow-ups.

Results: One hundred-eleven eyes of 80 patients were included in the study. While the punctum grade was significantly higher, the FDDT grade and Munk scores were significantly lower in group C compared to groups A and B at the 1st and 6th month follow-ups. The functional success rate was 69%, 79%, and 88% (p = .01), and the anatomical success rate was 77%, 77%, and 90% (p = .03) in Group A, B, and C, respectively, at the 6th month follow-up.

Conclusions: In the treatment of APS, the use of CsA alone and the punctoplasty procedure demonstrated comparable anatomical and functional success rates at the 6th month follow-up. However, combining CsA with punctoplasty enhances both anatomical and functional success rates.

Purpose: The cornea is a transparent avascular tissue that serves as the first line of defense against opportunistic pathogens and provides a smooth refractive surface for vision. Due to its external location, the cornea is vulnerable to stress from the outer environment. This can lead to corneal epithelial breakdown and subsequent corneal disease. Extracellular vesicles (EVs) are nano-sized vesicles enclosed within a lipid bilayer that are secreted by all cells in the body and play a key role in cell-to-cell communication. Within the cornea field, EVs and exosomes, the latter of which represents a subpopulation of small EVs, have emerged as potential therapies for treating corneal diseases and have increased our understanding of the mechanisms by which EVs, and more specifically, exosomes released by stressed or unhealthy cells, leads to corneal dysfunction and disease.

Methods: We conducted a literature search using PubMed and Google Scholar using keywords relevant to exosomes, extracellular vesicles, and cornea. We reviewed the literature focusing on EV studies on corneal wound healing and therapy.

Results: This review provides a comprehensive overview of the current state of exosome biology as it relates to corneal disease and wound healing. Studies to date provide compelling data indicating that EVs and exosomes may play an integral role in the maintenance of corneal homeostasis. EVs and exosomes also have exciting potential as therapeutics in corneal wound healing and disease; and their presence in tear fluid may serve as potential diagnostic biomarkers for ocular and systemic diseases.

Conclusion: While corneal exosome biology is still in its infancy state, continued progress in this area will improve our understanding of the functional capacity of these small vesicles in the human cornea and may lead to the development of novel regenerative therapies.

Purpose: Epithelial-mesenchymal transition (EMT) of retinal pigment epithelial (RPE) cells contributes to the epiretinal membrane development in proliferative vitreoretinopathy (PVR). This study aimed at investigating changes in mitochondrial function during EMT in PVR.

Methods: Transmission electron microscopy (TEM) was utilized to examine the mitochondrial morphology in human PVR epiretinal membranes and retinal pigment epithelium of human donor eyes. Utilizing TGF-β1 induced EMT in ARPE-19 cells as an in vitro model, we assessed mitochondrial morphology using transmission electron microscopy (TEM), evaluated mitochondrial function through various assays including detection and analysis of mitochondrial membrane potential (MMP), mitochondrial deoxyribonucleic acid (mtDNA), reactive oxygen species (ROS), ATP, oxygen consumption rate (OCR), and extracellular acidification rate (ECAR). RNA sequencing was performed to identify differentially expressed genes (DEGs) related to mitochondrial function and PVR pathogenesis.

Results: Mitochondrial morphological damage was observed in human PVR epiretinal membranes. TGF-β1 treatment led to morphological changes in mitochondria, increased oxidative stress, mitochondrial membrane depolarization, and reduction in mtDNA, mitochondrial respiration, and ATP production, indicating mitochondrial dysfunction in EMT ARPE-19 cells. Furthermore, RNA sequencing data highlighted the dysfunction, showing downregulation of mitochondria-related pathways and mitochondrial transcription factor A (TFAM), crucial for mtDNA maintenance.

Conclusion: Our findings indicated that TGF-β1 treatment induced mitochondrial dysfunction in RPE cells during EMT, providing insights into the molecular mechanisms of PVR development.

Purpose: To investigate the effect of an AI-assisted portable slit lamp (iSpector) and basic ophthalmology training on cataract detection, referral, and surgery rate in rural areas.

Methods: This randomized control trial randomly assigned 63 village doctors to either the AI-assisted group (providing iSpector and training) or the control group (providing training). Doctors were followed for 1 year before intervention as a baseline and 1 year after to make the comparison. Multivariable Poisson regression was applied to compare the difference in cataract detection, referral, and surgery rate between the two groups, adjusted for primary doctors' baseline characteristics. We further conducted subgroup analysis to estimate the change after the intervention.

Results: Compared to the control group, the detection, referral, and surgery rate of cataracts among the AI-assisted group was comparable, 1.7 times higher, and 4.9 times higher, respectively. Providing iSpector and training increased the detection, referral, and surgery rate of cataracts. However, only based on training to elevate the detection rate of cataracts did not change the referral and surgery rate.

Conclusions: iSpector helps village doctors detect and refer cataract patients appropriately, thus increasing the probability that patients receive cataract surgery.

A growing body of research on extracellular vesicles (EVs) in cancer has revealed their novel and crucial activities in the progression of tumors while also paving the way for potential therapeutic interventions. It is now known that EVs are natural delivery vehicles for particular payloads of source cells, enabling them to influence diverse functions of cells both in healthy and malignant cells. In this review, we comprehensively summarize mechanistic insights into sEV roles in RB, the most frequent intraocular malignancy that affects the retina of young children. We also explore the therapeutic potential of sEVs as an emerging area as biomarkers and vehicles for targeted therapy. Additionally, we address the potential challenges and limitations of translating sEVs-based technologies into clinical practice.

Purpose: Glaucoma is one of the leading causes of irreversible blindness, characterized by progressive visual field loss. Several risk factors are associated with developing the disease. However, the exact mechanisms or pathological pathways involved are still unknown. There is an urgent need to find the mechanisms and biomarkers for early detection and therapy to halt progression or cure the disease. Extracellular vesicles (EVs), specifically exosomes, have emerged as a crucial player in all aspects of glaucoma, including pathogenesis to therapeutic application with their cell-cell communication properties.

Methods: We performed a literature search on PubMed, Google Scholar, and Web of Science using different keywords. Next, we reviewed the literature with studies focusing on the role of EVs as a causative factor in disease progression, biomarker discovery based on their contents, and protection from glaucoma.

Results: Studies summarized here provide reports of differential EV miRNA and protein expression alterations when communicating with aqueous humor drainage tissues. We described how EV contents are involved in various pathways, including extracellular matrix remodeling and miRNA-mediated oxidative stress transmission between outflow tissues, thereby contributing to glaucoma. Extracellular vesicles, mainly derived from mesenchymal stem cells protecting the optic nerve from degeneration, have also been discussed as potential therapies for glaucoma.

Conclusions: Overall, this review provides a comprehensive discussion of the role of extracellular vesicles in glaucoma. We identified the challenges in finding major signaling molecules of glaucoma etiology. Lastly, we highlighted future directions to improve the treatment of glaucoma by extracellular vesicles.

Purpose: To compare clinical outcomes of eyes undergoing Descemet stripping automated endothelial keratoplasty (DSAEK) with 51-99 μm and <50 μm lenticules.

Methods: Retrospective, multi-center case series of 480 eyes undergoing DSAEK with precut tissue from a single eye bank between 2019 and 2022 performed by five surgeons at five centers. Eyes were divided into 51-99 μm or <50 μm groups according to post-cut graft thickness. The main outcome measure was inter-group comparison according to best-corrected distance visual acuity (BCDVA); additional outcome measures were primary graft failure (PGF), rebubbling, and cystoid macular edema (CME) rates in context of specific preoperative risk factors, intraoperative characteristics, and vision-limiting vs. non-vision-limiting morbidities.

Results: BCDVA at one year postoperatively was 0.5 ± 0.5 and 0.4 ± 0.4 logMAR for the 51-99 μm and <50 μm groups, respectively (p = 0.692). Regraft rate was 3.21% for 51-99 μm and 1.89% for <50 μm grafts (p = 0.4854). Rebubbling rate was 8.56% for the 51-99 μm group and 13.21% for the <50 μm group (p = 0.151). Analysis of rebubbled eyes showed no difference in rate of sulfur hexafluoride tamponade (p = 0.201), lenticule insertion method (p = 0.293), and glaucoma surgery history (p = 0.996). Higher rebubbling rates occurred in eyes with previous scleral-fixated intraocular lenses (p < 0.001). The effect of potential preoperative and intraoperative risk factors (e.g. insertion method (p = 0.979) and concurrent cataract surgery (p = 0.701)) on rebubbling was not significantly different between the two groups. CME rate was 4.01% for 51-99 μm and 7.54% for <50 μm groups (p = 0.131).

Conclusions: 51-99 μm and <50 μm DSAEK grafts offer similar visual outcomes. Both lenticule thicknesses have similar regrafting, rebubbling, and CME rates.

Purpose: Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly, but the therapies are not satisfactory. This study aimed to find AMD specific features through the analysis of high-throughput sequencing.

Methods: In this study, we integrated six projects containing single-cell RNA sequencing (scRNA-seq) data to perform a comprehensive analysis for AMD samples in the tissues of retina and retinal pigment epithelium/choroid, and in the positions of macula and periphery. Differentially expressed genes (DEGs) were analyzed and crucial signaling pathways were identified across cell types and between the macula and periphery. The intercellular signaling transduction among cell types were inferred by "CellChat" to build cell-cell communication network under normal and AMD conditions, and verified at the transcriptional level. The CD31+ endothelial cells were obtained to evaluate the enrichment of KEGG pathways in atrophic and neovascular AMD, and GSVA was adopted to discover differential metabolic signals in each AMD type.

Results: Thirteen major cell types were identified in the integrated scRNA-seq data. Although no disease-specific cell type or differential cell proportion was found, DEGs and enriched pathways were shown in cell-type- and position-dependent manners. Severe impairment of endothelial cell-mediated cell interactions was found in the signaling transduction network of the macula, and compromised cell interactions were observed in the periphery. Furthermore, distinct signaling pathways and metabolic states were uncovered in atrophic and neovascular AMD. Striking reduction in energy metabolism, lipid metabolism, and oxidative stress was indicated in the atrophic AMD.

Conclusion: Conclusively, we discover aberrant signals and metabolic pathways in AMD samples, providing insight into mechanisms and potential therapeutic targets for the AMD treatment.

Purpose: Bufalin (BU) is a bioactive ingredient extracted from the skin and parotid venom glands of Bufo raddei, which can effectively inhibit angiogenesis. The aim of this study was to investigate whether BU could affect corneal neovascularization (CoNV).

Methods: A rat CoNV model (right eye) was constructed by administration of NaOH, and the left eye served as a control. Corneal damage scores of rats were detected. Hematoxylin & eosin, TUNEL, and Masson staining examined pathological changes, apoptosis, and fibrosis of corneal tissues. Immunohistochemistry and western blotting assessed the expression of proteins.

Results: BU intervention resulted in a significant reduction in corneal inflammatory cells, repair of corneal epithelial hyperplasia, significant reduction in stromal edema, and reduction in vascular proliferation. BU can inhibit corneal neovascularization.

Conclusion: This study demonstrated that BU inhibits CoNV, fibrosis, and inflammation by modulating the STAT3 signaling pathway, elucidating the intrinsic mechanism of its protective effect. BU has great potential in the treatment of CoNV caused by corneal alkali burns.