Eye and Vision最新文献

Purpose: This study investigated how aspheric lens design changes the corneal power distribution and how such changes are associated with the axial elongation in myopic children who underwent orthokeratology.

Methods: This retrospective study of 116 eyes from children aged 8-13 years were enrolled and fitted with three types of lenses: fully spherical lenses (Alpha, n = 45), those with an aspheric alignment curve (AC) and a spherical base curve (BC) (Dreamlite, n = 37), and lenses with a partly aspheric BC and an aspheric AC (Myok, n = 34). Axial lengths were measured at baseline, 6 and 12 months. Corneal topography maps obtained at baseline and after 1 month of lens wear were analyzed with Fourier decomposition: the F0 (spherical), F1 (asymmetry), F2 (regular astigmatism), and F3 (higher-order irregularity) components were extracted and quantified across ten concentric rings with 0.5 mm width.

Results: The 1-year axial elongation was 0.26 ± 0.21 mm, 0.16 ± 0.19 mm, and 0.10 ± 0.19 mm for the Alpha, Dreamlite, and Myok groups, respectively (P < 0.001). In the 1-month maps, F0 and F1 peaked at the mid-periphery, and declined peripherally. Dreamlite exhibited F0 values greater than those of Alpha (mean difference: 0.02-0.46 D) within the central 2 mm (P < 0.01) and lower than Myok's values (mean difference: 0.66-1.05 D) in the peripheral 3 to 4.5 mm (P < 0.01). Dreamlite also displayed greater F1 compared to Alpha (mean difference: 0.68-0.78 D) within the 1 to 2 mm rings (P < 0.01) but showed no significant difference from Myok. F2 and F3 remained flat and small. Three components, F0, F1, and F3, were negatively associated with axial elongation in these children (P < 0.001).

Conclusion: Lenses featuring an aspheric AC resulted in reduced axial elongation and increased spherical power and asymmetry in the central cornea, while lenses with a partly aspherical BC improved spherical power in the mid-periphery. A smaller axial elongation was associated with greater post treatment central cornea asymmetry.

Purpose: Keratoconus is a progressive corneal ectatic disorder characterized by thinning and irregularity of the cornea, significantly impairing visual acuity. Recent studies have explored how non-ectatic conditions, such as dry eye and tear film instability and alteration of the ocular surface microenvironment, contribute to the development and progression of keratoconus. This comprehensive review aims to investigate the complex relationship between keratoconus and ocular surface diseases by examining the microenvironmental changes that occur on the ocular surface throughout the course of keratoconus, as well as the related clinical implications.

Methods: In this PROSPERO-registered study (ID: CRD42025643808), PubMed, Scopus, Cochrane, Embase, Web of Science, and Google Scholar were thoroughly searched to retrieve all pertinent papers published up to January 2025. The retrieved publications were then reviewed, and the eligible ones were included.

Results: Keratoconus, with a similar inflammatory profile to that of ocular surface disease, has elevated Interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and matrix metalloproteinase (MMP)-9, contributing to extracellular matrix degradation and stromal thinning. Tear film instability, altered lipid secretion, and oxidative stress exacerbate disease progression. These findings suggest that keratoconus is not only a biomechanical disorder but also an inflammation-driven one.

Conclusion: This study comprehensively reviews the intricate relationship between the ocular surface microenvironment and keratoconus. Managing this microenvironment in keratoconus patients, as well as inflammation, oxidative stress, and tear film dysfunction, can potentially improve patient outcomes.

Background: Diabetic retinopathy (DR) is often diagnosed many years after diabetes onset, highlighting the need for early diagnosis. The current study aimed to assess whether texture analysis of computed optical coherence tomography (OCT) retinal images can identify (very) early retinal changes. We previously reported retinal texture changes in a type 1 diabetes animal model. This study extends this approach to a type 2 diabetes model exhibiting subtler, more gradually developing retinal alterations to further explore its potential for detecting texture changes when DR-related retinal alterations are minor, strengthening its promising value.

Methods: OCT scans and electroretinograms were acquired at baseline and 4, 8, and 12 weeks after initiating the diabetes induction protocol. Automated OCT segmentation, retinal thickness computation, and texture analysis were performed. Blood-retinal barrier permeability, glial reactivity, neuroinflammation, and nitrosative stress were assessed.

Results: Retinal texture was affected in the inner plexiform layer and inner/outer photoreceptor segments. At weeks 8 and 12, autocorrelation, cluster prominence, correlation, homogeneity, information measure of correlation II, inverse difference moment normalised, inverse difference normalised, and sum average texture metrics significantly increased/decreased. Importantly, seven of these metrics were also altered in our previous study with type 1 diabetic animals. Type 2 diabetic retinas presented subtle thinning and impaired function, along with a slight reduction in tight junction proteins immunoreactivity, without affecting the blood-retinal barrier.

Conclusions: The findings from this study indicate that texture analysis can identify subtle retinal changes during early, clinically silent stages of disease, when biological alterations remain minimal. This highlights its potential utility for the early diagnosis of diabetic retinopathy, though further clinical validation is needed.

Purpose: To describe the prevalence and clinical characteristics of focal choroidal excavation (FCE) in a large cohort of Chinese patients with choroidal osteoma (CO).

Methods: One hundred and thirty-two eyes of 110 Chinese patients diagnosed with CO were enrolled. The prevalence and clinical characteristics of FCE were studied. Univariate and multivariate linear regression analyses were used to identify the factors associated with the occurrence of FCE. Furthermore, FCEs were divided into two types based on their location: Type 1 (at the edge of the tumor) and Type 2 (inside the tumor), and their clinical features were analyzed.

Results: The prevalence of FCE was 46.2% in 132 eyes with CO. Eyes with FCEs demonstrated a longer disease duration (P < 0.01), worse BCVA (P = 0.01), longer greatest tumor linear dimension (P < 0.01), larger total tumor area (P < 0.01) and decalcification area (P < 0.01), and a higher incidence of outer retinal tubulation (ORT) (P = 0.01). Only disease duration (P = 0.025) was significantly correlated with the occurrence of FCE. Patients with Type 2 FCEs had a larger greatest linear dimension of FCEs and a higher likelihood of ORT, choroidal neovascularization, disruption of the external limiting membrane, and inner retina compared with those with Type 1 FCEs (all P < 0.05).

Conclusions: The duration is associated with the development of FCE in CO. The different types of FCE may indicate varying stages of CO, suggesting the occurrence and enlargement of FCE in CO are associated with the lateral expansive growth of the tumor. Comprehensive optical coherence tomography evaluation of tumor margins and extramacular regions during initial assessment and regular follow-up is recommended to enable early FCE detection (particularly Type 2), allowing timely identification of CNV and other complications for prompt vision-preserving intervention.

Background: The visual pathway, consisting of the eye, optic nerve, and brain, serves as a valuable model for studying neural regeneration. The exceptional regenerative capacity of the zebrafish visual system enables detailed investigation of neural repair mechanisms in vivo. Although the transparency of zebrafish larvae permits real-time imaging of axonal regeneration following transection, previous methodological limitations such as pigment interference and suboptimal imaging protocols have hindered high-resolution analyses of structural recovery and cellular interaction throughout the entire visual pathway after optic nerve injury. This study aimed to overcome these barriers and enable comprehensive assessment of visual pathway regeneration.

Methods: In this study, we dissect the regenerative processes underlying structural recovery and cellular interplay across the entire visual pathway in larval zebrafish with an optic nerve transection model, using two-photon imaging and optokinetic response assays. Data were analyzed via multi-factorial ANOVA, unpaired t-tests, or Welch's t-test.

Results: We developed a longitudinal imaging platform by integrating two-photon microscopy (930 nm excitation), pigment suppression with phenylthiourea (PTU), and multi-axis positioning to observe visual pathway regeneration in vivo in zebrafish larvae at cellular resolution. This system enabled high-resolution imaging of the entire visual pathway, capturing the dynamics of green fluorescent protein (GFP)-labeled retinal ganglion cell (RGC) axons, optic nerve projections, and tectal reinnervation following optic nerve transection. Notably, enucleation of the contralateral eye resulted in aberrant optic nerve regrowth and impaired visual recovery after transection, indicating that guidance cues from the contralateral eye were essential for successful functional optic nerve regeneration. Additionally, the optimized two-photon imaging protocol allowed direct in vivo visualization of cellular interactions, revealing the rapid recruitment of DsRed-labeled neutrophils to the injured retina, optic nerve, and tectum during the repair process in double-transgenic Tg(lyz:DsRed); Tg(isl2b.2:Gal4-VP16; myl7:EGFP); Tg(4XnrUAS:GFP) larvae.

Conclusions: Our optimized imaging platform visualizes the entire visual pathway and cell interactions during regeneration, revealing contralateral eye is essential for functional recovery following optic nerve transection. Combined with multi-omics and calcium imaging, this approach potentially provides a powerful platform to decipher the cellular and molecular mechanisms of zebrafish eye-brain pathway reconstruction and offers insights into therapeutic targets for human optic neuropathies.

Background: Diabetic keratopathy (DK) is a common ocular complication of diabetes, with its progression closely linked to autophagy regulation. This study aims to explore the role of long non-coding RNAs (lncRNAs) in modulating autophagy during diabetic pathogenesis, focusing on lncRNA general transcription factor IIIC subunit 1 (GTF3C1) and its potential as a therapeutic target for diabetic corneal neuropathy (DCN).

Methods: High-throughput sequencing identified dysregulated lncRNAs in the trigeminal ganglia of diabetic mice. Functional validation included mechanistic studies on lncRNA GTF3C1, miR-542-3p, and autophagy-related targets. Autophagy activity, corneal nerve density, and epithelial healing were quantified using quantitative real-time polymerase chain reaction (qRT-PCR), immunofluorescence, and histology in diabetic models.

Results: lncRNA GTF3C1 was significantly downregulated in diabetic trigeminal ganglion (TG). It functioned as a molecular sponge for miR-542-3p, alleviating its repression on GABA type A receptor-associated protein (GABARAP) and phosphatase and tensin homolog (PTEN), thereby enhancing autophagy activity. This process promoted corneal nerve fiber regeneration and epithelial wound healing in diabetic mice.

Conclusions: Our findings highlight lncRNA GTF3C1 as a critical regulator of autophagy in diabetic corneal nerves, offering a potential diagnostic and therapeutic target for DCN. This study provides molecular insights into the pathogenesis of DCN and lays the groundwork for future clinical strategies.

Background: This retrospective study aimed to identify risk factors for subretinal fibrosis (SF) and evaluate the response to anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with myopic choroidal neovascularization (mCNV), with a specific focus on the role of dilated choroidal vessels (DCVs) in disease progression.

Methods: In this retrospective study, patients with high myopia (spherical equivalent < -6.0 D, pathological myopia, Asian ethnicity) and active mCNV lesions, diagnosed between 2021 to 2023, were evaluated. The location of DCVs and mCNV was assessed, and macular thickness, submacular choroid thickness, best-corrected visual acuity, CNV area, and flow density were measured at baseline and during follow-up. The presence of posterior staphyloma was evaluated at baseline. SF around the mCNV was evaluated lesions during follow-up. The time to SF detection was recorded using survival analysis. Risk factors for SF were analyzed using Kaplan-Meier and multivariable Cox regression analyses.

Results: A total of 46 eyes from 46 patients were included, with a mean age of 54.17 ± 14.37 years, and a baseline spherical equivalent of 12.36 ± 3.21 D. The logarithm of the minimum angle of resolution for the mean visual acuity was 0.70 (0.40-1.30), and the mean macular thickness was 313.11 ± 63.57 μm at baseline. DCV was detected in 29 of the 46 eyes (63.0%), and the median time to detect SF was 43.41 [95% confidence interval (CI): 37.27-49.55] months. Multivariable Cox regression analysis identified submacular DCV [hazard ratio (HR): 14.93, 95% CI: 5.72-38.91, P < 0.001) and absence of posterior staphyloma (HR: 43.48, 95% CI: 12.15-156.32, P = 0.002) as independent predictors of SF. The presence of DCV under the fovea compared to the peripheral zone achieved a poorer therapeutic response and was prone to progress to SF after anti-VEGF therapy (P = 0.041).

Conclusions: Submacular DCV is associated with poor therapeutic response to anti-VEGF therapy and an increased risk of SF in patients with mCNV.

Purpose: To assess the ability of corneal epithelial aberrations to discriminate forme fruste keratoconus (FFKC) and keratoconus (KC) from normal eyes.

Methods: This prospective, case-control study enrolled 91 right eyes from 91 normal participants, 87 eyes with FFKC and 148 eyes with KC. Epithelial aberrations for the 6-mm pupil were measured using an anterior segment optical coherence tomography (MS-39, CSO). The epithelial root mean square of higher and lower-order aberrations (total RMS), root mean square of higher-order aberrations (HOAs RMS, from the 3rd to the 7th Zernike polynomials), coma, trefoil, spherical aberration, and secondary astigmatism were recorded. Stepwise logistic regression was utilized to develop the epithelial aberrations index (EAI) for obtaining the optimal discriminant function to diagnose FFKC (EAI-FFKC) and KC (EAI-KC). Area under the receiver operating characteristic curve (AUC) analysis was used to determine the diagnostic accuracy of the indices.

Results: FFKC and KC eyes had significantly higher epithelial aberrations than normal eyes. Comparing FFKC with the normal group, epithelial HOAs RMS and coma attained AUC values of 0.714 and 0.788, respectively. The EAI-FFKC showed the highest discrimination ability to differentiate FFKC from normal eyes indicated by an AUC value of 0.822 with 77.0% sensitivity and 75.8% specificity. Comparing KC with the normal group, epithelial HOAs RMS attained AUC values of 0.976-0.998 with 95.2%-100% sensitivity and 92.3%-96.7% specificity, epithelial coma attained AUC values of 0.974-0.997 with 92.9%-100% sensitivity and 96.7%-98.9% specificity. The EAI-KC showed the highest discriminative ability to differentiate KC from normal eyes indicated by AUC of 0.996 with 98.6% sensitivity and 98.9% specificity.

Conclusion: Epithelial wavefront analysis can identify abnormal epithelial changes across all stages of KC, from very early to severe. Epithelial aberrations can be used as a diagnostic tool for KC and FFKC.

Macular hole surgery, primarily pars plana vitrectomy with internal limiting membrane peeling (ILM) and gas tamponade, has become the standard of care for full-thickness macular hole (FTMH). Despite the 85% to 95% anatomical closure rate, several aspects of the procedure are well accepted whereas some may remain controversial among vitreoretinal surgeons. An international panel of experts (IPE) comprising 27 experts from 10 countries/territories was established to evaluate a total of 38 consensus statements on ILM peeling extent, vital dye selection, face-down positioning requirements, tamponade options, timing of surgery and re-surgery, management of difficult and refractory cases, and adjuvant therapies. The objective is to synthesize evidence-based real-world practice recommendations from leading global experts to guide the management of FTMH. Of the 38 statements, the IPE reached consensus (75% voted as "Strong Agreement" or "Agreement") on 29 (76.3%). The IPE emphasized the importance of individualized patient factors-such as hole size, chronicity, lens status, and preoperative visual acuity-in surgical planning and tempering patient's postoperative expectations. There was strong agreement on the need of adequate peeling of the ILM, adjunctive measures including the inverted ILM flap, and face-down positioning for large and refractory FTMH. Controversial statements, such as the use of air tamponade or observation of small FTMH, not reaching consensus are identified. We hope the consensus statements agreed and disagreed by the IPE would help serve as good reference and guidelines in managing FTMH.

Bone morphogenetic proteins (BMPs), belonging to the transforming growth factor β (TGF-β) family, are multifunctional growth factors predominantly distributed in human bone tissue. Some studies also have revealed that BMPs are widely expressed in ocular tissues. Over the past two decades, research on the therapeutic application of BMPs has yielded significant advancements not only in the treatment of skeletal, cardiac, renal and neurological diseases but also in ocular conditions. Both in vivo and in vitro experiments have demonstrated the significant therapeutic efficacy of BMPs in various ocular disorders, including myopia, corneal opacity, cataract, uveal melanoma, retinal detachment and other eye diseases. Studies have further identified that BMPs exert their actions through mechanisms closely associated with the canonical Smad pathway. Compared to traditional therapeutic drugs, BMPs exhibit some advantages, including low toxicity, minimal side effects, amongst others. However, numerous unresolved issues persist during in vivo and in vitro experiments. The objective of this review is to explore the advancements in the application of BMPs for the treatment of ocular diseases in animal models or in vitro experiments, and to provide some insights into the challenges that need to be addressed for the translation of BMP-based therapies into clinical practice.