Current Eye Research最新文献

Purpose: Myopia is a significant public health concern with increased risk of ocular complications. Intense Foveal Red Light (IFRL) therapy has been explored in myopia control, but its efficacy at the pre-myopic stage remains underexplored. The use of this therapy in a population without a myopia diagnosis may offer a new window for the prophylactic application of IFRL therapy. The purpose of this meta-analysis is to determine the effectiveness of IFRL therapy in children with pre-myopia.

Methods: PubMed, Embase, and the Cochrane Library were systematically searched for studies investigating the effects of IFRL therapy on myopia incidence, changes in axial length (AL), choroidal thickness (CT), and cycloplegic spherical equivalent refraction (SER). Two independent reviewers screened studies, extracted data, and assessed the risk of bias. Meta-analyses were conducted using random-effects models to estimate the pooled effect sizes.

Results: Of 365 studies identified, 4 met the criteria, totaling 619 participants (mean age 8.48 years, 51.8% female). At 6 months, IFRL significantly reduced myopia incidence (Risk Difference [RD] - 0.1; 95% CI -0.15 to -0.05; p < 0.01), with benefits persisting at 12 months (RD -0.17; 95% CI -0.26 to 0.09; p < 0.01). IFRL also reduced AL at 6 months (Mean Difference [MD] - 0.12 mm; 95% CI -0.16 to -0.09; p < 0.01) and 12 months (MD -0.18 mm; 95% CI -0.23 to -0.14; p < 0.01), increased CT (MD 22.34 µm; 95% CI 5.45-39.24; p < 0.01), and improved SER at 6 (MD 0.27 D; 95% CI 0.23 to 0.32; p < 0.01) and 12 months (MD 0.36 D; 95% CI 0.27-0.46; p < 0.01).

Conclusion: IFRL effectively reduced myopia incidence, AL, and improved SER and CT. These findings support further research on its long-term efficacy and safety, particularly regarding potential adverse effects and durability of outcomes. Overall, IFRL may offer a preventive strategy for pre-myopic children.

Purpose: Financial incentives have proven successful in addressing health behaviors associated with several chronic diseases and may represent a potential method to improve adherence to follow-up eye examinations from vision screening programs. The study was conducted to determine the effect of financial incentives on follow-up adherence in the Alabama Screening and Intervention for Glaucoma and eye Health through Telemedicine.

Methods: This study enrolled eligible patients receiving care at three Federally Qualified Health Centers to undergo screening for refractive error and ocular diseases. Follow-up appointments for continued care were made for patients suspected to have uncorrected refractive error or ocular disease. A subset of patients (n = 187) received a financial incentive while a control group did not (n = 234). Follow-up attendance within 6 months was compared with Poisson's models between incentivized and non-incentivized groups for all referrals and across specific disease states.

Results: Among 187 patients with and 234 without incentive, there was a significantly higher rates of follow-up in the incentivized group (83.4% incentivized vs. 74.4% non-incentivized, p = .05) overall. There was a significantly higher rate of attendance for patients referred for diabetic retinopathy (p = .02) and refractive error (p = .02), but not glaucoma (p = .46), glaucoma suspect (p = .70), ocular hypertension (p = .22), and cataract (p = .29). After matching across groups, these differences were less pronounced and only remained significant for diabetic retinopathy (p = .04).

Conclusion: Patients receiving financial incentive had a higher follow-up rate within 6 months. These differences where primarily driven by patients referred for refractive error and diabetic retinopathy. However, once matched for baseline covariates, this improvement was not seen in the overall group. This suggests that incentives may not be an effective method to improve adherence to vision screening in this setting especially for glaucoma screening.

Purpose: This study aimed to compare subjective (questionnaire-based) and objective (dosimeter-based) measurements of children's outdoor activity, to improve assessment methods for future research on the potential impact of outdoor activity on myopia development.

Methods: The study was conducted among children aged 5 to 11 years in Lisbon, Portugal. Subjective data on after-school outdoor activities during weekdays were collected using the "Myopia Risk Assessment Worksheet," completed by parents to report their child's typical after-school outdoor time. Objective measurements for the same period were obtained using UV dosimeters worn by participants, recording their exposure to solar radiation between 4:00 PM and 9:00 PM on weekdays. The analysis compared these two data sources to evaluate their agreement and to assess the accuracy of self-reported after-school outdoor activity.

Results: The results indicated a moderate correlation (rs = 0.417; p < 0.001) between questionnaire responses and dosimetric data, with self-reported data typically underestimating outdoor exposure compared to dosimetric measurements. The median difference was -0.25 h/day (95% CI: -0.52 to 0.15 h/day), indicating no significant systematic bias in the overall sample. However, variability in differences increased with longer outdoor times, as shown by a positive slope of 0.540 (p < 0.001) in the regression of absolute residuals on average outdoor time.

Conclusions: This study demonstrates that lifestyle questionnaires and dosimetric measurements yield moderately correlated estimates of weekly UV exposure, with minimal differences between them. Combining subjective and objective methods enhances the accuracy of assessing children's outdoor exposure, an essential factor in developing effective myopia prevention strategies.

Purpose: Use of illicit substances such as cocaine is associated with alteration in catecholamine-mediated neurotransmission throughout the CNS, including the eye. One of the most accessible physiologic parameters associated with neuromodulatory features of substance abuse is the pupillary light reflex (PLR). In this study, we examined a domain of the PLR characterized by melanopsin-driven intrinsically photosensitive retinal ganglion cells (ipRGCs) to assess the impact of substance abuse on ipRGC function.

Methods: An exploratory PLR examination on ten subjects with a documented history of substance use (HSU) without preexisting ocular disease was conducted with a comparator control cohort. Cases included assessment of cognitive function, depression, insomnia, and retinal nerve fiber thickness. IpRGC functionality was demonstrated by the PLR using a pedagogical-based methodology centered on response parameters with the introduction of a complementary analysis employing pseudo-one-phase modeling. Discriminant analysis employing the area under the receiver operating characteristic curve (AUC of ROC) categorized normal vs. abnormal ipRGC response.

Results: There was no statistical association between ipRGC function and insomnia; however, insomnia was more prevalent among those with ipRGC abnormality. Indication of clinical depression was seen in 70% of study participants and was unrelated to ipRGC function. Pseudo-one-phase modeling demonstrated a significantly higher plateau in the HSU group as well as a slower initial rate of pupil recovery consistent with abnormal PIPR dynamics and complementary to AUC metrics. Discriminant analysis identified that 60% of HSU demonstrated ipRGC abnormality.

Conclusion: Abnormal ipRGC functionality was demonstrated among those with HSU in this small exploratory study utilizing both AUC-ROC analysis as well as assessment of PLR waveform characteristics using features of a pseudo-first-order model.

Purpose: To evaluate the refractive changes induced by ophthalmic viscosurgical devices (OVDs) in the anterior chamber after intraocular lens (IOL) implantation using intraoperative aberrometry (IA).

Methods: A nonrandomized prospective interventional case series of ten consecutive patients undergoing routine cataract surgery was conducted. Exclusion criteria included previous ocular surgery, corneal opacities, vitreous or macular lesions, and extreme axial lengths. Intraoperative refractive measurements were taken using IA after IOL implantation with cohesive (Provisc, Alcon), intermediate (Vistagel, Johnson & Johnson), and dispersive (Viscoat, Alcon) OVDs. Balanced Salt Solution (BSS) was used as a control. Statistical analysis compared refractive deviations across OVDs.

Results: Provisc, a cohesive OVD, demonstrated the least refractive deviation (median SE -1.0 D) and minimal impact on refractive outcomes. Viscoat, a highly dispersive OVD, induced the greatest refractive deviation (median SE -1.7 D) compared to the control with BSS (median SE -0.1 D). Statistically significant differences in refractive deviations were observed among the tested OVDs compared to BSS (p < 0.05).

Conclusion: This study demonstrates that OVD choice significantly influences refractive outcomes in cataract surgery. Provisc (cohesive) produced the smallest refractive deviation (median SE -1.0 D), whereas Viscoat (dispersive) caused the greatest deviation (median SE -1.7 D) compared with BSS (-0.1 D). These findings underscore the importance of careful OVD selection to optimize refractive precision and highlight the need for further research in diverse surgical settings.

Purpose: Chemotherapy protocols for lung, breast, and prostate cancer include Docetaxel (DTX). Several case series have reported ophthalmic side effects of DTX, such as epiphora and blurred vision, which significantly affect quality of life. This experimental study aims to investigate the potential histopathological impacts of DTX on ocular structures.

Methods: A DTX-treated group consisting of male Wistar rats aged 6 to 8 months (n = 7) received intraperitoneal administration of 10 mg/kg DTX three times on days 0, 8, and 15. A control group (n = 6) received weekly intraperitoneal injections of physiological saline. On the 22nd day, ocular tissues were evaluated using hematoxylin and eosin (H&E) staining, along with immunohistochemical analysis of iNOS, eNOS, IL-6, TGF-β, VEGF, and TUNEL markers.

Results: The main outcomes observed through H&E evaluation revealed corneal neovascularization, inflammatory cells with cystic dilatations in the lacrimal gland, and degeneration of the retinal nerve fiber layer. DTX treatment significantly increased the levels of iNOS, eNOS, IL-6, TGF-β, VEGF, and apoptosis markers compared to the control group.

Conclusions: This experimental study demonstrated that DTX induces inflammation and ischemia in ocular tissues, as shown in histopathological sections. Given the rising incidence of cancer and the related use of chemotherapeutics, it is crucial for ophthalmologists to recognize the ocular side effects of drugs like DTX in order to enhance the quality of life for cancer patients undergoing chemotherapy.

Purpose: DNA damage and repair defects in lens epithelial cells (LECs) contribute to the formation and progression of age-related cataracts (ARC). Ku antigen 80 kDa (Ku80) plays an important role in the non-homologous end-joining (NHEJ) pathway for repairing DNA double-strand breaks, while the Cockayne Syndrome Complementary B (CSB) protein plays a critical role in the nucleotide excision repair pathway. This study evaluates the protective effect of AAV-mediated overexpression of Ku80 in rat LECs and explores its contribution to delaying selenium-induced cataract formation.

Methods: SD rats (11 days) were randomly divided into three groups: control group (n = 7), AAV-NC group (n = 14), and AAV-Ku80 group (n = 14). The AAV-Ku80 group received adenovirus-mediated overexpression of Ku80, the AAV-NC group received adenoviral vector negative control, and the control group was injected with physiological saline. All injections were performed in the anterior chamber. Except for the control group, the other two groups were subcutaneously injected with sodium selenite solution into the nape of the neck 30 min after the injection. The degree of lens opacity was examined using a slit-lamp, and lenses were harvested to assess antioxidant parameters, including superoxide dismutase (SOD) activity, reduced glutathione (GSH) content, and the oxidative damage marker malondialdehyde (MDA) content. Western blot analysis was performed to examine the upregulation of CSB protein and its association with delayed cataract formation.

Results: Overexpression of Ku80 significantly enhanced the expression of CSB protein, improved DNA repair capacity, and mitigated the influences of oxidative stress on rat LECs. This resulted in a significant increase in SOD and GSH levels, a significant decrease in MDA levels, and postponed the onset of selenium-induced cataracts, hence preserving lens clarity. Moreover, Ku80 overexpression partially alleviated damage to the corneal endothelium and retina.

Conclusion: Ku80 overexpression alleviates damage to LECs and postpones the development of selenium-induced cataracts by increasing CSB protein levels and controlling DNA repair processes. This research underscores the significant therapeutic potential of Ku80 in postponing cataract formation and may offer new avenues for gene therapy in the prevention and treatment of cataracts.

Purpose: To investigate the possible contribution of nitrosative stress, mitochondrial peptide levels (humanin and mitochondrial open-reading frame of the 12S rRNA-c), and ferroptosis parameters in corneal epithelial cells obtained from patients with keratoconus.

Methods: This prospective study was conducted on corneal epithelial cell samples taken from 75 adult patients with keratoconus and 25 age-matched postmortem controls. The Amsler-Krumeich classification was used for staging the keratoconus. All parameters, except nitric oxide, were measured by ELISA, and nitric oxide levels were determined by the chemiluminescence method.

Results: Humanin levels in keratoconus corneal epithelial cells were increased in stage 3 (p < .05), while mitochondrial open-reading frame of the 12S rRNA-c (p < .01) levels were diminished in all stages. Significant increases in nitric oxide (p < .001) and 3-nitrotyrosine (p < .05) levels were detected in the keratoconus group, indicating the involvement of nitrosative stress. In stage 3, glutathione peroxidase 4 levels were shown to be decreased (p < .01), while long-chain fatty acid CoA ligase 4 (p < .05) and malondialdehyde (p < .05) levels were increased.

Conclusion: This is the first study to show that humanin and mitochondrial open-reading frame of the 12S rRNA-c can participate in the pathophysiology of keratoconus. In addition to the mitochondrial peptides, our data suggest that increased nitrosative stress and ferroptosis may contribute to the pathophysiology of keratoconus.

Purpose: Keratoconus is a progressive corneal disorder characterized by thinning of the stromal layer. Corneal cross-linking (CXL), a widely used treatment, focuses on improving corneal strength by enhancing collagen cross-links. Alternative methods are being explored to increase the efficacy of CXL. This study aims to evaluate whether ozone, as a strong oxygen donor, can be utilized as an adjuvant or standalone cross-linking agent in an in vivo model.

Methods: The study involved 12 New Zealand albino rabbits, which were divided into three treatment groups, each receiving a different therapy: (1) CXL, (2) ozone, and (3) CXL combined with ozone (CXL+ozone). Corneal Visualization Scheimpflug Technology (Corvis ST), Anterior Segment Optical Coherence Tomography (AS-OCT), and Corneal Confocal Microscopy (CCM) measurements were performed post-procedure.

Results: Ozone therapy did not result in statistically significant differences compared to CXL in biomechanical parameters. Corvis ST measurements were not significantly different between groups. AS-OCT revealed full-thickness stromal brightness in the CXL+ozone group. CCM imaging showed hyperreflectivity limited to the anterior stroma in the CXL and ozone groups but distributed throughout the stroma in the CXL+ozone group. No adverse effects were observed.

Conclusion: Ozone therapy may enhance CXL efficacy and serves as a potential alternative. Its affordability, shorter duration, and comparable clinical outcomes make it particularly promising for resource-limited settings.

Purpose: Neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy is among the most frequently performed postoperative procedures in pseudophakic patients. Despite its widespread use and generally favorable safety profile, its potential to release solid-phase polymer debris from intraocular lenses (IOLs) has not been fully characterized. In this study, we investigated whether clinically relevant laser settings can cause the liberation of detachable fragments from both hydrophobic and hydrophilic acrylic IOLs.

Methods: Six commercially available one-piece IOLs were exposed to 2.6 mJ single-pulse Nd:YAG laser shots under standardized in vitro conditions. Microscopic evaluation before and after ultrasonic cleaning was performed. Raman spectroscopy was used to identify the chemical composition of any released fragments.

Results: Fragments adjacent to YAG-induced pits were observed in all lens types. Raman spectroscopy confirmed that the fragments matched the chemical signature of the respective IOL material. After sonication and filtration, identical Raman spectra were obtained from fragments retained on gold-coated filters, confirming their origin from the lens surface. Fragment sizes ranged from 10-20 µm.

Conclusions: This study demonstrates that solid IOL-derived fragments can be released by standard laser energy levels used in posterior capsulotomy. Although conducted in vitro, the findings raise concerns about the potential clinical relevance of laser-induced material release. Free-floating debris may contribute to straylight, glare, increased intraocular pressure, or inflammatory responses. Further clinical studies are warranted to systematically assess whether such microfragments lead to postoperative complications. Optimized laser parameters and precise focusing are recommended to minimize structural damage and fragment release.