Current Eye Research最新文献

Purpose: To comparatively evaluate the influence of different riboflavin formulations and soaking durations on the anterior segment optical coherence tomography (AS-OCT) findings following accelerated corneal crosslinking (ACXL) at 9 mW/cm² for in progressive keratoconus.

Methods: In this prospective study, consecutive patients with progressive keratoconus were randomized into 4 groups. Group 1: hydroxypropyl methylcellulose (HPMC)-based riboflavin for 10 min; Group 2: HPMC-based riboflavin for 20 min; Group 3: dextran-based riboflavin (0.1%) for 30 min. Riboflavin soaking was followed by ultraviolet-A irradiation at 9 mW/cm² for 10 min in all three groups. Group 4 underwent conventional CXL (CCXL) using Dresden protocol. The AS-OCT features of the crosslinked cornea were evaluated at postoperative month 1 and correlated to the clinical outcomes at postoperative month 12.

Results: The study enrolled 26 eyes of 26 patients in each group. In groups 1 and 2, the AS-OCT findings were similar (p > .05) and the demarcation lines depth (DLD) were deep as obtained following CCXL. The DLD was significantly shallower in group 3 compared to the other groups (p < .01). There were no between-group differences in regards to the visual, refractive, keratometric, and tomographic outcomes at postoperative month 12. No significant endothelial cell loss or any other clinically significant adverse event was encountered in any patient's eye at 12 months follow-up.

Conclusion: Although structural variations were noted in the crosslinked cornea, DLDs observed following ACXL (9 mW/cm²) using HPMC-based solution for 10 or 20 min were similar to those observed following CCXL. Whereas, ACXL (9 mW/cm²) using dextran-based solution for 30 min resulted in the shallowest DLD. Despite these remodeling differences, the visual, refractive and tomographic outcomes of all groups were comparable at postoperative 1-year follow-up. Studies with a greater number of patients and longer follow-ups are required to establish any relation between AS-OCT characteristics of crosslinked cornea and ACXL efficacy.

Purpose: Artificial intelligence (AI)-tools hold great potential to compensate for missing resources in health-care systems but often fail to be implemented in clinical routine. Intriguingly, no-code and low-code technologies allow clinicians to develop Artificial intelligence (AI)-tools without requiring in-depth programming knowledge. Clinician-driven projects allow to adequately identify and address real clinical needs and, therefore, hold superior potential for clinical implementation. In this light, this study aimed for the clinician-driven development of a tool capable of measuring corneal lesions relative to total corneal surface area and eliminating inaccuracies in two-dimensional measurements by three-dimensional fitting of the corneal surface.

Methods: Standard slit-lamp photographs using a blue-light filter after fluorescein instillation taken during clinical routine were used to train a fully convolutional network to automatically detect the corneal white-to-white distance, the total fluorescent area and the total erosive area. Based on these values, the algorithm calculates the affected area relative to total corneal surface area and fits the area on a three-dimensional representation of the corneal surface.

Results: The developed algorithm reached dice scores >0.9 for an automated measurement of the relative lesion size. Furthermore, only 25% of conventional manual measurements were within a ± 10% range of the ground truth.

Conclusions: The developed algorithm is capable of reliably providing exact values for corneal lesion sizes. Additionally, three-dimensional modeling of the corneal surface is essential for an accurate measurement of lesion sizes. Besides telemedicine applications, this approach harbors great potential for clinical trials where exact quantitative and observer-independent measurements are essential.

Purpose: A cataract is a cloudy area in the crystalline lens. Cataracts are the leading cause of blindness and the second cause of severe vision impairment worldwide. During cataract surgery, the clouded lens is extracted and replaced with an artificial intraocular lens, which restores the optical power. The fabrication of intraocular lenses using existing molding and lathing techniques is a complex and time-consuming process that limits the development of novel materials and designs. To overcome these limitations, we have developed a stereolithography-based process for producing models of clear lens designs without refractive function, serving as a proof of concept. This process has the potential to contribute toward new lens development, allowing for unlimited design iterations and an expanded range of materials for scientists to explore.

Methods: Lens-like 3D objects without refractive function were fabricated by using stereolithography. A photopolymerizable resin containing 2-phenoxyethyl acrylate, poly (ethylene glycol) dimethacrylate, and a suitable photoinitiator was developed for the production of lens-like 3D object prototypes. The morphology of the printed devices was characterized by scanning electron microscopy. The transparency and thermal properties were analyzed using spectrophotometry and differential scanning calorimetry, respectively. The biocompatibility of the devices was investigated in a cultured human lens cell line (FHL-124), using a standard lactate dehydrogenase assay, and the lenses were folded and implanted in the human capsular bag model.

Results: One-piece lens-like 3D objects without refractive function and with loop-haptic design were successfully fabricated using Stereolithography (SLA) technique. The resulting 3D objects were transparent, as determined by UV spectroscopy. The lactate dehydrogenase test demonstrated the tolerance of lens cells to the prototyping material, and apparent foldability and shape recovery was observed during direct injection into a human capsular bag model in vitro.

Conclusions: This proof-of-principle study demonstrated the potential and significance of the rapid prototyping process for research and development of lens-like 3D object prototypes, such as intraocular lenses.

Purpose: This study assesses the effectiveness and safety of using Ologen implants (Aeon Astron Europe BV, Leiden, The Netherlands) as an adjunctive therapy in childhood glaucoma surgeries.

Methods: We systematically reviewed the existing literature across various electronic databases to examine the effectiveness and safety of Ologen implants in childhood glaucoma surgeries.

Results: Our analysis encompassed 14 studies on the use of Ologen implants in childhood glaucoma. Among these, seven were prospective, five were retrospective, and two did not specify their study design. Success rates varied depending on the type of surgery and the included childhood glaucoma subtype. The success rates for Ologen implants-augmented surgeries were as follows: 33.3-70% for trabeculectomy, 50-81% for combined trabeculotomy-trabeculectomy procedure, 33%-87% for glaucoma drainage device, and 60% in deep sclerectomy.

Conclusion: Ologen implant has a potential role in mitigating postoperative fibrosis and enhancing success rates in various childhood glaucoma surgeries. However, the existing literature is limited. Future comparative prospective studies with larger cohorts are needed.

Purpose: It is well-known that patients' perceptions of their disease can impact management strategies and disease outcomes. Limited knowledge exists on such perceptions in dry eye disease (DED) and the role of language in these perceptions. Herein, we compared the perceptions about DED between Spanish- and English-speaking patients.

Methods: This cross-sectional study included 146 patients with DED who underwent ophthalmic evaluation and completed questionnaires assessing their perceptions of DED on a 10-point scale during their routine appointments. Perceptions included opinions on the level of satisfaction with understanding of DED, ease of following doctor's advice, effectiveness of treatment, satisfaction with DED care, and outlook on DED. Perceptions were categorized as low (scores 0-2), moderate (scores 3-7), and high (scores 8-10). The percentage of patients with high perception scores were then compared between Spanish- and English-speaking patients.

Results: There were 48 Spanish speakers and 98 English speakers. Overall, high scores of DED perceptions were identified in 47.9% for satisfaction with the level of understanding of DED, 72.6% for ease of following doctor's advice, 52.1% for helpfulness of DED treatment, 64.4% for satisfaction with DED care, and 52.1% for optimistic outlook on DED. High scores for satisfaction with the level of understanding of DED were significantly lower in Spanish speakers (27.1%) than English speakers (58.2%, p < .001). No significant differences were observed in other perceptions between Spanish- and English-speaking participants.

Conclusions: Spanish-speaking subjects reported lower satisfaction with their understanding of DED than English speakers. Clinicians should provide health services and educational materials in the patient's preferred language to minimize barriers to understanding their disease.

Purpose: This study aimed to assess the effectiveness of monocular and bilateral injections of Dexamethasone-21-acetate (Dex-21-Ac) into the murine fornix twice a week as a glucocorticoid-induced ocular hypertension model and investigated potential systemic side effects.

Methods: Dex-21-Ac was administered twice weekly in three groups: bilateral injections, monocular injections, and a control group receiving the vehicle solution bilateral. After 21 days, enucleated eyes were examined using immunocytochemistry (ICC), and organ histology was performed.

Results: All groups receiving Dex-21-Ac injections had a significant increase in intraocular pressure (IOP). Monocular injections also resulted in a significant increase in IOP in the fellow eye. The Dex-21-Ac-treated groups showed a bilateral increase in IOP of approximately 8 mmHg, accompanied by elevated expression of alpha smooth muscle actin and fibronectin in the anterior chamber angle. There were no significant changes in weight progression. Hepatic steatosis was observed in all Dex-21-Ac-treated animals, and some suffered from residual neuromuscular blockade under fentanyl anesthesia.

Conclusion: Bilateral injections of Dex-21-Ac twice a week lead to a significant increase in daytime IOP and fibrotic changes in the trabecular meshwork. Unilateral application has a significant impact on the fellow eye. Local dexamethasone leads to notable systemic effects independent of changes in animal weight. Considering liver damage and associated influence on metabolization, hepatically eliminated injection anesthetics may lead to overdosing and are not recommended. They should be replaced by inhalation anesthesia.

Purpose: This study assesses the diluted Schirmer method's effectiveness in collecting tears from dry eye syndrome patients, aiming to identify the most suitable tear collection technique for them.

Methods: A prospective study. Tear samples were collected from patients with dry eye syndrome and healthy individuals using two methods: (1) Direct Schirmer Method: Schirmer strips were directly inserted into the eye to collect tears. (2) Diluted Schirmer Method: After instilling physiological saline into the eye and waiting for 30 s to ensure thorough mixing with tears, Schirmer strips were used for collection. Tear samples from both groups were analyzed and compared for total protein and cytokine levels (IL-1β, IL-6, IL-8, TNF-α).

Results: (1) The study included 32 participants: 16 with dry eye syndrome (4 males, 12 females, average age 34.92 ± 10.13 years) and 16 healthy controls (5 males, 11 females, average age 32.25 ± 9.87 years). (2) The diluted Schirmer method produced a significantly larger tear volume compared to the direct method (p < 0.05), with lower Visual Analogue Scale (VAS) scores indicating less discomfort (p < 0.05). (3) The average total protein content of the two groups was 51.70 ± 3.166 ng measured by Direct Schirmer method, and the average total protein content of the Diluted Schirmer method was 50.05 ± 3.263 ng. There was no statistical difference between the two groups. (t = 1.051, p = 0.3098) (4) The concentrations of total tear protein and various cytokines measured by both methods were higher in the dry eye group compared to the normal group, with statistically significant differences (p < 0.05). Both methods reflected consistent changes in tear protein profiles.

Conclusion: The diluted Schirmer method can comfortably collect an adequate volume of tear samples in a short time and consistently reflect changes in tear proteins, making it an effective method for tear collection in patients with dry eye syndrome.

Purpose: This study aimed to investigate the protective or therapeutic effect of thymoquinone (TQ) in a retinal degeneration rat model and its relationships with the retina ultrastructure, heme oxygenase 1 (HO-1), caspase-3, and RPE65 expressions and to determine whether TQ has a therapeutic effect at the biochemical level.

Methods: A total of 25 adult Wistar albino rats were divided into the following treatment groups: saline (control: CONT), CO (corn oil), sodium iodate (SI), TQ + SI, and SI + TQ injection groups. Retina morphology, RPE65, HO-1, and caspase-3 expression levels were evaluated using immunohistochemistry, and optical density was determined using ImageJ. Ultrastructural evaluations were performed with electron microscopy. Thiol-disulfide homeostatic parameters were examined in serum samples.

Results: Outer nuclear layer (ONL) thickness was significantly higher in the SI + TQ group compared to the SI group. The RPE65 expression significantly decreased in the SI group compared with the CONT and CO groups. A significant increase in RPE65 expression level and a significant decrease in caspase-3 expression level were found in the SI + TQ group compared with the SI group. The increase in HO-1 expression level was significantly higher in the TQ treatment groups, particularly in the SI + TQ group. In the SI and TQ + SI groups, the ONL thickness significantly decreased with a significant increase in caspase-3 expression compared to the CONT and CO groups. In the treatment groups, decreased organelle damage was observed on electron microscopy. In the SI + TQ group, the disulfide/native thiol and disulfide/total thiol ratios were significantly lower than all other groups, while the native/total thiol ratio was significantly higher than the other experimental groups.

Conclusions: The present study provides evidence that continuous TQ treatment can increase HO-1 and RPE65 expression and decrease apoptosis (caspase-3 levels), thereby preserving the retina at the ultrastructural level. Moreover, TQ administration can maintain thiol/disulfide homeostasis in SI-induced retinal degeneration-modelled rats.

Purpose: To evaluate the protective role of Laurus Nobilis eye drops on selenite-induced cataracts in suckling rabbits.

Methods: Fifteen male albino suckling rabbits with no signs of ocular inflammation were randomly assigned to three groups: controls (Group A), sodium-selenite group (Group B) and sodium-selenite plus Laurus Nobilis group (Group C). By selenite treatment, cataract formation was experimentally induced and then graded. The grade of oxidative stress was defined in the lens, measuring the concentration of malondialdehyde, alpha-tocopherol, oxidized glutathione, ascorbic acid and hydrogen peroxide, and in blood samples as levels of alpha-tocopherol and malondialdehyde.

Results: Mean lens concentrations of GSSG, H2O2, and MDA levels in group B were significantly higher than in both group C and control. Ascorbic acid and alpha-tocopherol concentrations were lower in group B than in both group C and A. As plasma oxidative status markers, the level of MDA was higher in group B respected group C and A. The mean alpha-tocopherol levels in group B were significantly lower than in both group A and group C.

Conclusions: In animals treated with Laurus Nobilis-based eye drops, inflammation was inhibited, and lipid peroxidation was significantly reduced. Laurus nobilis leaves extract represents a good source of antioxidant components that may contrast sodium selenite-induced cataractogenesis in suckling rabbits.

Purpose: Effect of topical administration of a Rho kinase inhibitor, ripasudil, on epithelial wound healing in a mouse cornea was investigated. Effects of treatment of cultured human corneal epithelial cell (HCEC) line and organ-cultured corneal epithelium with ripasudil on expression of p-ERK was also examined.

Methods: Epithelial defects with a diameter of 2.0 mm were prepared in the central corneas of C57BL/6 mice with or without 1-week travoprost pre-treatment, to which ripasudil or PBS as a control was instilled every 6 h immediately after preparation. The mice eyes were cultured with or without travoprost for 24-hrs. The expression levels of p-ERK in epithelium of mice eyes were compared by immunostaining after further 24-hrs culture with or without ripasudil for 24-hrs. HCEC were cultured with or without ripasudil and processed for examination for proliferation activity and protein expression of p-ERK by either immunostaining or Western blotting. The cells were also treated with or without travoprost for 24-hrs, and were further cultured with or without ripasudil. Expression levels of p-ERK were examined by Western blotting.

Results: Ripasudil treatment suppressed post-debridement epithelial healing in association with reduced proliferation activity in peripheral (limbal) epithelium in cornea with or without pre-treatment with travoprost. Ripasudil treatment accelerated p-ERK expression. Ripasudil supplementation upregulated proliferation with increased p-ERK in HCEC.

Conclusion: Ripasudil treatment promotes wound healing of the mouse corneal epithelium by enhancing cell proliferation on peripheral (limbal) epithelium.