Current Eye Research最新文献

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 assess the efficacy of image-guided limbal relaxing incisions (LRIs) in enhancing outcomes of cataract surgery with trifocal intraocular lenses (IOLs) implantation.

Methods: This prospective cohort study included consecutive cataract patients with predicted postoperative corneal astigmatism of 0.5-1.0 D and intended for cataract surgery with trifocal IOL implantation. The enrolled subjects were randomized into the non-LRI group, manual-marked LRI group and image-guided LRI group. Correction effect of corneal astigmatism, as well as visual outcomes at 3 months after surgery were compared among the three groups.

Results: Finally, 30 eyes of 30 patients in every group were included. The image-guided LRI group showed more corneal astigmatism correction (0.81 ± 0.32 D vs. 0.17 ± 0.22 D vs. 0.48 ± 0.37 D, p < .001) and less refractive postoperative cylinder (0.33 ± 0.29 D vs. 0.90 ± 0.25 D vs. 0.65 ± 0.31 D, p < .001) than the non-LRI group and manual-marked LRI group. The uncorrected near visual acuity and uncorrected intermediate visual acuity were significantly better in the image-guided LRI group and manual-marked LRI group than the non-LRI group (all p < .05). The image-guided LRI group also displayed significantly better ocular modulation transfer functions than the other two groups (all p < .05).

Conclusion: LRIs, especially image-guided LRIs, can effectively reduce corneal astigmatism and improve both near and intermediate vision, as well as visual quality of patients undergoing trifocal IOLs implantation.

Purpose: To compare analyte concentrations in paired tear fluid and blood samples, and to evaluate their correlations.

Methods: Studies published between January 1974 and May 2024 and between May 2024 and March 2025, reporting analyte concentrations in tear fluid and blood (including whole blood, serum, or plasma), were identified from a recent scoping review and through searches of MEDLINE and EMBASE, respectively. Two reviewers independently screened studies and extracted relevant data. Concentration data were then pooled using a random-effects model. Comparisons between pooled tear fluid and blood concentrations were performed using Bayesian posterior simulation methods, in which the differences in concentrations were evaluated based on estimated posterior probabilities. Blood-to-tear and tear-to-blood ratios were calculated. A total of 72 significant correlation coefficients from 65 studies were analyzed.

Results: A total of 367 paired tear fluid and blood concentrations for 138 analytes were collected. Based on their functional characteristics, these analytes were divided into nine categories. Most cytokines and neuromodulators exhibited higher concentrations in tear fluid than in blood, while antibodies, drugs, and other proteins or enzymes were generally found at higher concentrations in blood. The highest tear-to-blood ratio was for lactoferrin at 1281-fold, while the highest blood-to-tear ratio was observed for MMP-2 (400-fold). Most analytes (n = 64, 89%) showed positive correlations (r > 0), with the majority (n = 23, 32%) exhibiting strong positive correlations (r > 0.8).

Conclusion: This comprehensive analysis demonstrates that analyte concentrations in paired tear fluid and blood vary according to their functional categories, with cytokines and neuromodulators generally enriched in tear fluid, and antibodies and drugs more abundant in blood. Strong positive correlations between tear fluid and blood concentrations for most analytes support the potential of tear fluid analysis for monitoring systemic physiological and pathological conditions.

Purpose: Retinal vascular occlusion, ischemic optic neuropathy, and normotensive glaucoma have been found to be associated with migraine in several studies. By examining the optic nerve, macula, and choroid of newly diagnosed migraine (NDM) patients, this study aims to investigate possible early changes in these structures, thus guiding both the diagnosis and treatment of migraine.

Methods: Forty-one (82 eyes) NDM patients and 41 (82 eyes) healthy controls (HC) were enrolled in this prospective cohort study. Participants were divided into two groups, the NDM group and the HC group, and optic nerve, macula, and choroid structures were prospectively examined and compared with both intra-group and inter-group comparison methods.

Results: In the inter-group comparison performed by using Generalized Estimating Equations analysis, all Retinal Nerve Fiber Layer Thickness (RNFL) parameters were statistically significantly lower in the NDM group compared to the HC group (p < 0.05). Regarding the ganglion cell complex (GCC) and choroidal parameters, statistically significant differences were found between the two groups in all parameters except for choroidal thickness (CT). In the NDM intra-group comparison, temporal RNFL, temporal-upper RNFL, and temporal-lower RNFL values of the right eye (RE) were significantly lower than the left eye (LE); nasal RNFL, nasal upper RNFL, and nasal lower RNFL values of the LE were significantly lower than the RE (p < 0.05).

Conclusions: Statistically significant values in RNFL, GCC, and choroid in the NDM group indicate the possible early changes in optic nerve, macula, and choroid in NDM patients. In intra-NDM group comparison, lower values of the temporal RNFL sectors in the RE and nasal RNFL sectors in the LE may suggest the involvement of the lateral geniculate nucleus in migraine.

Purpose: Determination of the amplitude of accommodation (AoA) is a clinical technique used in ophthalmology and optometry to assess the eye's ability to focus on near objects. This study compares the reliability of a novel motorized push-up variant with conventional manual push-up and push-down methods for the determination of AoA in 26 emmetropes.

Methods: The motorized push-up method reduces limitations of the manual methods, such as differences due to varying examiner abilities, ruler placement (forehead, zygomatic bone, spectacle plane), and inconsistent target movement speeds. This is achieved by providing a participant-controlled, constant target movement of 2 cm/s, with the medial zone of the zygomatic bone as the reference point for ruler placement. Additionally, digital image-based and traditional ruler-based AoA measurements were compared. The participants' impressions of the three methods were assessed based on ease of use, confidence in measurement reliability, and comfort of experience, using a questionnaire.

Results: The comparison of the AoA across the methods revealed no statistically significant differences. However, the concordance correlation coefficient was highest between the motorized and manual push-up method (ρ_c = 0.72). All methods showed good test-retest reliability with the highest ICC found for the motorized push-up method (0.83), which also had the narrowest limits of agreement interval for accommodative demand (3.22 cm). Beyond digital and ruler-based measurements showed underestimation by both rulers, with a mean bias of 0.3 cm for the motorized ruler compared to about 2.0 cm for the conventional ruler. The questionnaire responses suggest that the motorized version outperforms the manual versions being 5 times more likely to score higher for ease of use and 6 times more likely for confidence in measurement reliability.

Conclusion: These findings demonstrate that the motorized push-up method effectively measures the AoA, reduces interfering factors, and provides higher reliability without compromising precision, making it a valuable alternative to conventional methods.

Purpose: Repeated low-level red-light (RLRL) therapy is an emerging technique for managing myopia progression. Clinical trials have demonstrated its efficacy, but uncertainties remain on its effect on immediate vision perception. This study evaluated the impact of RLRL on short-term color vision perception and choroidal thickness. Attitudes towards RLRL were also explored.

Methods: Twenty participants underwent color vision assessment using the Colour Assessment Diagnosis (CAD) test and macular optical coherence tomography (OCT) to determine their eligibility and establish baseline measures for color vision perception threshold and choroidal thickness, with color vision perception measured using chromatic displacement (CD). Participants then underwent three sessions of RLRL, at the required time intervals as per manufacturer guidance. After each session, the CAD test was performed immediately, and repeated after a 5-minute interval. At the final visit, the OCT scan was retaken, and participants were asked about their experience of using RLRL. CD was measured and compared before and after RLRL exposure, to identify if there was any differences following usage.

Results: A significant reduction in color perception sensitivity was observed immediately after exposure to RLRL at each visit (p < 0.001 for all), which returned to baseline levels after 5 min. Three sessions of RLRL caused no change compared to baseline color perception (p = 0.054). There was no significant difference in the mean choroidal thickness in the left eye; the right eye showed a small reduction in macular choroidal thickness 5.1 µm (± 8.551 µm SD, p = 0.015). Participant feedback demonstrated a generally positive response, indicating people would consider using RLRL for myopia management if recommended.

Conclusions: There appears to be only a temporary impact of RLRL on color vision perception, which returns to baseline after 5 min. Furthermore, feedback suggests that UK populations may be receptive to RLRL if prescribed to them by an eye care practitioner.

Purpose: Experimental studies of Dry Eye Disease (DED) using animal models are hampered by the lack of reliable, easy-to-use assays that can adequately diagnose disease or monitor effects of novel treatments. The Oculus Keratograph 5 M, an advanced keratography unit (AKU), has shown promise, enjoying recent clinical use. We assessed whether this AKU could be used in DED studies in the rabbit, perhaps the ideal experimental animal for this disease.

Methods: All measures were made in strictly controlled temperature and humidity spaces. A panel of AKU parameters was measured in 15 New Zealand White rabbits at baseline, after Concanavalin A induced DED, and following recovery. Eyelid aperture and corneal irregularity were also measured. A subset of these parameters was measured in patients and compared with those from rabbits.

Results: AKU parameters in both humans and rabbits showed similar patterns and coefficients of variation (CV). Measurements of tear and eyelid architecture were more reproducible than tear film function in both species. The CV for most parameters were less than the observed changes in the respective parameters after DED induction. In rabbits, all parameters improved returning close to baseline following DED recovery. In the rabbit, additional measures (eyelid aperture and corneal irregularity) not traditionally associated with DED, also demonstrated changes that evolved over the development and recovery of DED.

Conclusions: AKU technology can effectively detect changes in multiple parameters during the evolution and resolution of DED in rabbits. DED parameters showed similar patterns for most variables in both humans and rabbits demonstrating great potential of this device in translational research. The AKU can also follow additional parameters evaluating the responses of the lacrimal functional unit. Our findings document the applicability of this technology for translational studies of DED and underscores its potential to further refine understanding of the disease pathophysiology.

Purpose: Long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs) in the retina play crucial roles in myopia; however, their regulatory mechanisms remain unclear. This study aimed to investigate significant genes and related signaling pathways associated with myopia by constructing and analyzing competitive endogenous RNA (ceRNA) networks within the retina.

Materials and methods: We investigated the expression patterns of lncRNAs, circRNAs, microRNAs (miRNAs), and messenger RNAs (mRNAs) within the retina using a form-deprivation myopia mouse model to elucidate their regulatory mechanisms in myopia. Transcriptomic sequencing was performed on retinal cells obtained from a mouse myopia model, followed by differential expression and functional enrichment analyses. Relevant ceRNA networks (lncRNA-miRNA-mRNA and circRNA-miRNA-mRNA) were constructed. Key pathways in these networks were validated via quantitative real-time polymerase chain reaction and western blotting, while Immunohistochemistry and single-cell sequencing analyses were conducted to analyze significant gene distribution.

Results: The model exhibited approximately -6D diopters after 14 days of form deprivation. Transcriptomic analysis identified 187 differentially expressed lncRNAs (DE lncRNAs), 22 DE circRNAs, 24 DE miRNAs, and 368 DE mRNAs. Enrichment analysis linked these differentially expressed genes to various retinal functions and pathways. Validation revealed that the TCONS_00102163-mmu-miR-540-3p-Kcnq2, TCONS_00127926-novel_234-Tepp, and novel_circ_0001750-mmu-miR-212-5p-Sstr3 pathways in the retina were involved in regulating myopia. All experiments were conducted in three independent biological replicates.

Conclusions: This study systematically elucidated the synergistic regulatory mechanisms of non-coding RNAs in the development of myopia by constructing a ceRNA regulatory network in the retina, and further validated key regulatory axes. This provides an important theoretical foundation for understanding the molecular mechanisms of myopia and developing novel intervention strategies.

Purpose: Presbyopia is an age-related condition characterized by diminished near-vision, primarily due to changes in the lens' adaptive capacity. Shear Wave Ultrasound Elastography (SWE) offers a novel/noninvasive method to measure lens stiffness and could potentially enhance our understanding of presbyopia's development. We aimed to use SWE to assess the elasticity of the human lens and explore the correlation between lens flexibility, age, presbyopia, and accommodation capacity.

Methods: A cross-sectional analysis was conducted with 84 participants (mean age = 39.61 ± 9.60) from a government hospital in Serdang, Selangor, Malaysia. Eligibility was confirmed through refractive error and visual acuity tests. Selected participants underwent SWE scanning, and measurements of accommodation and presbyopia were taken. Statistical analysis included descriptive summaries and Pearson correlation coefficients to examine relationships between lens elasticity age, presbyopia, and amplitude of accommodation.

Results: The analysis demonstrated a weak correlation between lens elasticity and age in nonpresbyopic group (r = 0.289) while positive strong correlation in presbyopic group (r = 0.674). A strong positive correlation was observed between lens elasticity and presbyopia in presbyopic group (r = 0.612). Moreover, there was a negative correlation with accommodation in both groups, (r = -0.358) for nonpresbyopic and (r = -0.493) presbyopic group.

Conclusions: While lens elasticity diminishes with age, changes in ocular biomechanical properties impact lens function, particularly affecting near vision. Importantly, SWE is found to be an effective tool for assessing age-related changes in lens elasticity and presbyopia across various age groups, highlighting its potential for broader clinical application in diagnosing and understanding presbyopia.

Purpose: To characterize retinal mitochondrial function and its relationship with intraretinal thicknesses in healthy adults.

Methods: Retinal flavoprotein fluorescence (FPF), a marker of mitochondrial function, was measured using the OcuMet Beacon (OcuSciences, Inc., Ann Arbor, MI), and a stress index (SI) was computed using Enhanced Retinal Metabolic Analysis software 2.0 (RMA). After lens compensation, mean FPF in the macula and optic nerve head (ONH) was obtained. The macular SI summarizes FPF heterogeneity, while the ONH SI reflects the extent to which ONH FPF exceeds a normative threshold. Intraretinal layer thicknesses and total retinal thickness (TRT) were measured via spectral-domain OCT (AngioVue, Optovue, Inc., ver. 2018.1.0.43) using 6 x 6 mm macular scans. A total of 75 healthy adults (mean age ± SD: 56.1 ± 21.7 years; range: 23-89) were imaged.

Results: Macular and ONH FPF were inversely correlated with TRT (p < 0.01), retinal nerve fiber layer (RNFL) thickness (p < 0.05), and ganglion cell-inner plexiform layer (GCIPL) thickness (p < 0.01). ONH FPF also showed a negative correlation with the thickness of the OPL-EZ region-defined as the area between the posterior boundary of the outer plexiform layer (OPL) and the anterior boundary of the ellipsoid zone (EZ) (r = -0.24, p = 0.044)-and the photoreceptor layer (PR) (r = -0.34, p = 0.003). Age was significantly associated with FPF and with several intraretinal layer thicknesses, including TRT, RNFL, GCIPL, OPL-EZ region, and PR (all p < 0.05). However, after adjusting for age, associations between FPF and intraretinal thicknesses were no longer significant (all p > 0.05).

Conclusion: This study is the first to examine the relationship between retinal mitochondrial function and intraretinal layer thicknesses in healthy adults. Findings suggest that age mediates the observed associations.