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Potential applications of artificial intelligence in image analysis in cornea diseases: a review. 人工智能在角膜疾病图像分析中的潜在应用:综述。
IF 4.2 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-03-07 DOI: 10.1186/s40662-024-00376-3
Kai Yuan Tey, Ezekiel Ze Ken Cheong, Marcus Ang

Artificial intelligence (AI) is an emerging field which could make an intelligent healthcare model a reality and has been garnering traction in the field of medicine, with promising results. There have been recent developments in machine learning and/or deep learning algorithms for applications in ophthalmology-primarily for diabetic retinopathy, and age-related macular degeneration. However, AI research in the field of cornea diseases is relatively new. Algorithms have been described to assist clinicians in diagnosis or detection of cornea conditions such as keratoconus, infectious keratitis and dry eye disease. AI may also be used for segmentation and analysis of cornea imaging or tomography as an adjunctive tool. Despite the potential advantages that these new technologies offer, there are challenges that need to be addressed before they can be integrated into clinical practice. In this review, we aim to summarize current literature and provide an update regarding recent advances in AI technologies pertaining to corneal diseases, and its potential future application, in particular pertaining to image analysis.

人工智能(AI)是一个新兴领域,它可以使智能医疗模式成为现实,并在医学领域获得了广泛的关注,取得了可喜的成果。最近,机器学习和/或深度学习算法在眼科领域的应用有了新的发展--主要用于糖尿病视网膜病变和老年性黄斑变性。然而,角膜疾病领域的人工智能研究相对较新。已有算法用于协助临床医生诊断或检测角膜疾病,如角膜炎、感染性角膜炎和干眼症。作为一种辅助工具,人工智能还可用于角膜成像或断层扫描的分割和分析。尽管这些新技术具有潜在的优势,但在将其融入临床实践之前,还需要应对一些挑战。在这篇综述中,我们旨在总结当前的文献,并提供有关角膜疾病的人工智能技术最新进展及其未来的潜在应用,特别是在图像分析方面。
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引用次数: 0
Evaluation of a new dynamic real-time visualization 25 kHz swept-source optical coherence tomography based biometer. 基于光学相干断层扫描的新型动态实时可视化 25 kHz 扫源生物测量仪的评估。
IF 4.2 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-03-04 DOI: 10.1186/s40662-024-00377-2
Jinjin Yu, Xuanqiao Lin, Xiaomin Huang, Zhenyu Xu, Rui Ning, Kexin Li, Giacomo Savini, Domenico Schiano-Lomoriello, Xingtao Zhou, Jinhai Huang

Background: To evaluate the intraobserver repeatability and interobserver reproducibility of a newly developed dynamic real-time visualization 25 kHz swept-source optical coherence tomography (SS-OCT) based biometer (ZW-30, TowardPi Medical Technology Ltd, China) and compare its agreement with another SS-OCT based biometer (IOLMaster 700, Carl Zeiss Meditec AG, Jena, Germany).

Methods: Eighty-two healthy right eyes were enrolled in this prospective observational study. Measurements were repeated for three times using the ZW-30 and IOLMaster 700 in a random order. Obtained parameters included axial length (AL), central corneal thickness (CCT), aqueous depth (AQD), anterior chamber depth (ACD), lens thickness (LT), mean keratometry (Km), astigmatism magnitude (AST), vector J0, vector J45, and corneal diameter (CD). The within-subject standard deviation (Sw), test-retest (TRT) variability, coefficient of variation (CoV), and intraclass correlation coefficient (ICC) were adopted to assess the intraobserver repeatability and interobserver reproducibility. The double-angle plot was also used to display the distribution of AST. To estimate agreement, Bland-Altman plots were used.

Results: For the intraobserver repeatability and interobserver reproducibility, the Sw, TRT and CoV for all parameters were low. Meanwhile, the ICC values were all close to 1.000, except for the J45 (ICC = 0.887 for the intraobserver repeatability). The double-angle plot showed that the distribution of AST measured by these two devices was similar. For agreement, the Bland-Altman plots showed narrow 95% limits of agreements (LoAs) for AL, CCT, AQD, ACD, LT, Km AST, J0, J45, and CD (- 0.02 mm to 0.02 mm, - 7.49 μm to 8.08 μm, - 0.07 mm to 0.04 mm, - 0.07 mm to 0.04 mm, - 0.07 mm to 0.08 mm, - 0.16 D to 0.30 D, - 0.30 D to 0.29 D, - 0.16 D to 0.16 D, - 0.23 D to 0.13 D, and - 0.39 mm to 0.10 mm, respectively).

Conclusions: The newly dynamic real-time visualization biometer exhibited excellent intraobserver repeatability and interobserver reproducibility. The two devices both based on the SS-OCT principle had similar ocular parameters measurement values and can be interchanged in clinical practice.

背景:目的:评估一种新开发的基于动态实时可视化25 kHz扫源光学相干断层扫描(SS-OCT)的生物测量仪(ZW-30,TowardPi Medical Technology Ltd,中国)的观察者内重复性和观察者间重复性,并将其与另一种基于SS-OCT的生物测量仪(IOLMaster 700,Carl Zeiss Meditec AG,Jena,德国)进行比较:方法:82 只健康右眼被纳入这项前瞻性观察研究。使用 ZW-30 和 IOLMaster 700 按随机顺序重复测量三次。获得的参数包括轴长(AL)、中央角膜厚度(CCT)、水深(AQD)、前房深度(ACD)、晶状体厚度(LT)、平均角膜度数(Km)、散光幅度(AST)、矢量 J0、矢量 J45 和角膜直径(CD)。采用受试者内标准偏差(Sw)、重复测试(TRT)变异性、变异系数(CoV)和类内相关系数(ICC)来评估观察者内重复性和观察者间重复性。双角图也用于显示 AST 的分布。为了估计一致性,采用了布兰-阿尔特曼图:结果:在观察者内重复性和观察者间重复性方面,所有参数的 Sw、TRT 和 CoV 均较低。同时,除 J45(观察者内重复性 ICC = 0.887)外,其他参数的 ICC 值均接近 1.000。双角图显示,这两种仪器测量的 AST 分布相似。在一致性方面,Bland-Altman 图显示 AL、CCT、AQD、ACD、LT、Km AST、J0、J45 和 CD 的 95% 一致性限 (LoAs) 很窄(- 0.02 mm 至 0.02 mm、- 7.49 μm 至 8.08 μm、- 0.07 mm 至 0.04 mm,- 0.07 mm 至 0.04 mm,- 0.07 mm 至 0.08 mm,- 0.16 D 至 0.30 D,- 0.30 D 至 0.29 D,- 0.16 D 至 0.16 D,- 0.23 D 至 0.13 D,以及- 0.39 mm 至 0.10 mm).结论:结论:新的动态实时可视生物测量仪具有极佳的观察者内重复性和观察者间重复性。两种基于 SS-OCT 原理的设备具有相似的眼部参数测量值,可在临床实践中互换使用。
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引用次数: 0
An in vitro investigation into the impact of corneal rinsing on riboflavin/UVA corneal cross-linking. 角膜冲洗对核黄素/UVA 角膜交联影响的体外研究。
IF 4.2 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-02-28 DOI: 10.1186/s40662-024-00375-4
Siân R Morgan, David P S O'Brart, Jinhai Huang, Keith M Meek, Sally Hayes

Background: Corneal cross-linking (CXL) using riboflavin and ultraviolet-A light (UVA) is a treatment used to prevent progression of keratoconus. This ex vivo study assesses the impact on CXL effectiveness, as measured by tissue enzymatic resistance and confocal microscopy, of including a pre-UVA corneal surface rinse with balanced salt solution (BSS) as part of the epithelium-off treatment protocol.

Methods: Sixty-eight porcine eyes, after epithelial debridement, were assigned to six groups in three experimental runs. Group 1 remained untreated. Groups 2-6 received a 16-min application of 0.1% riboflavin/Hydroxypropyl methylcellulose (HPMC) drops, after which Group 3 was exposed to 9 mW/cm2 UVA for 10 min, and Groups 4-6 underwent corneal surface rinsing with 0.25 mL, 1 mL or 10 mL BSS followed by 9 mW/cm2 UVA exposure for 10 min. Central corneal thickness (CCT) was recorded at each stage. Central 8.0 mm corneal buttons from all eyes were subjected to 0.3% collagenase digestion at 37 °C and the time required for complete digestion determined. A further 15 eyes underwent fluorescence confocal microscopy to assess the impact of rinsing on stromal riboflavin concentration.

Results: Application of riboflavin/HPMC solution led to an increase in CCT of 73 ± 14 µm (P < 0.01) after 16 min. All CXL-treated corneas displayed a 2-4 fold greater resistance to collagenase digestion than non-irradiated corneas. There was no difference in resistance between corneas that received no BSS rinse and those that received a 0.25 mL or 1 mL pre-UVA rinse, but each showed a greater level of resistance than those that received a 10 mL pre-UVA rinse (P < 0.05). Confocal microscopy demonstrated reduced stromal riboflavin fluorescence after rinsing.

Conclusions: All protocols, with and without rinsing, were effective at enhancing the resistance to collagenase digestion, although resistance was significantly decreased, and stromal riboflavin fluorescence reduced with a 10 mL rinse. This suggests that a 10 mL surface rinse can reduce the efficacy of CXL through the dilution of the stromal riboflavin concentration.

背景:使用核黄素和紫外线-A 光(UVA)进行角膜交联(CXL)是一种用于防止角膜炎恶化的治疗方法。这项体外研究通过组织酶抗性和共聚焦显微镜测量,评估了作为上皮细胞脱落治疗方案的一部分,用平衡盐溶液(BSS)进行 UVA 前角膜表面冲洗对 CXL 效果的影响:在三次实验中,68 只猪眼睛在上皮剥离后被分配到六个组。第 1 组未经处理。第 2-6 组滴入 0.1% 核黄素/羟丙基甲基纤维素(HPMC)滴眼液 16 分钟,然后第 3 组接受 9 mW/cm2 UVA 照射 10 分钟,第 4-6 组分别用 0.25 mL、1 mL 或 10 mL BSS 冲洗角膜表面,然后接受 9 mW/cm2 UVA 照射 10 分钟。在每个阶段记录中心角膜厚度(CCT)。在 37 °C下对所有眼球中央 8.0 mm 的角膜扣进行 0.3% 胶原酶消化,并确定完全消化所需的时间。另外 15 只眼睛接受荧光共聚焦显微镜检查,以评估冲洗对基质核黄素浓度的影响:结果:使用核黄素/HPMC溶液可使CCT增加73 ± 14 µm(P 结论:核黄素/HPMC溶液可使CCT增加73 ± 14 µm(P):所有方案,无论是否冲洗,都能有效增强胶原酶消化的抵抗力,但抵抗力显著下降,基质核黄素荧光在冲洗 10 mL 后减少。这表明,10 毫升的表面冲洗会稀释基质核黄素浓度,从而降低 CXL 的疗效。
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引用次数: 0
Comparison of deep learning-assisted blinking analysis system and Lipiview interferometer in dry eye patients: a cross-sectional study. 干眼症患者深度学习辅助眨眼分析系统与 Lipiview 干涉仪的比较:一项横断面研究。
IF 4.2 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-02-19 DOI: 10.1186/s40662-024-00373-6
Yueping Ren, Han Wen, Furong Bai, Binge Huang, Zhenzhen Wang, Shuwen Zhang, Yaojia Pu, Zhenmin Le, Xianhui Gong, Lei Wang, Wei Chen, Qinxiang Zheng

Background: Abnormal blinking pattern is associated with ocular surface diseases. However, blink is difficult to analyze due to the rapid movement of eyelids. Deep learning machine (DLM) has been proposed as an optional tool for blinking analysis, but its clinical practicability still needs to be proven. Therefore, the study aims to compare the DLM-assisted Keratograph 5M (K5M) as a novel method with the currently available Lipiview in the clinic and assess whether blinking parameters can be applied in the diagnosis of dry eye disease (DED).

Methods: Thirty-five DED participants and 35 normal subjects were recruited in this cross-sectional study. DED questionnaire and ocular surface signs were evaluated. Blinking parameters including number of blinks, number of incomplete blinking (IB), and IB rate were collected from the blinking videos recorded by the K5M and Lipiview. Blinking parameters were individually collected from the DLM analyzed K5M videos and Lipiview generated results. The agreement and consistency of blinking parameters were compared between the two devices. The association of blinking parameters to DED symptoms and signs were evaluated via heatmap.

Results: In total, 140 eyes of 70 participants were included in this study. Lipiview presented a higher number of IB and IB rate than those from DLM-assisted K5M (P ≤ 0.006). DLM-assisted K5M captured significant differences in number of blinks, number of IB and IB rate between DED and normal subjects (P ≤ 0.035). In all three parameters, DLM-assisted K5M also showed a better consistency in repeated measurements than Lipiview with higher intraclass correlation coefficients (number of blinks: 0.841 versus 0.665; number of IB: 0.750 versus 0.564; IB rate: 0.633 versus 0.589). More correlations between blinking parameters and DED symptoms and signs were found by DLM-assisted K5M. Moreover, the receiver operating characteristic analysis showed the number of IB from K5M exhibiting the highest area under curve of 0.773.

Conclusions: DLM-assisted K5M is a useful tool to analyze blinking videos and detect abnormal blinking patterns, especially in distinguishing DED patients from normal subjects. Large sample investigations are therefore warranted to assess its clinical utility before implementation.

背景:异常眨眼模式与眼表疾病有关。然而,由于眼睑的快速运动,眨眼很难分析。深度学习机器(DLM)已被提出作为眨眼分析的可选工具,但其临床实用性仍有待验证。因此,本研究旨在将 DLM 辅助的 Keratograph 5M (K5M) 作为一种新方法与目前临床上可用的 Lipiview 进行比较,并评估眨眼参数是否可用于干眼症(DED)的诊断:这项横断面研究招募了 35 名干眼症患者和 35 名正常人。对 DED 问卷和眼表体征进行了评估。从 K5M 和 Lipiview 记录的眨眼视频中收集眨眼参数,包括眨眼次数、不完全眨眼(IB)次数和 IB 率。眨眼参数分别从 DLM 分析的 K5M 视频和 Lipiview 生成的结果中收集。比较了两种设备之间眨眼参数的一致性。通过热图评估眨眼参数与 DED 症状和体征的关联:本研究共纳入了 70 名参与者的 140 只眼睛。Lipiview 的 IB 数和 IB 率均高于 DLM 辅助的 K5M(P ≤ 0.006)。DLM 辅助 K5M 在眨眼次数、IB 次数和 IB 率方面捕捉到了 DED 与正常受试者之间的显著差异(P ≤ 0.035)。在所有三个参数中,DLM 辅助 K5M 在重复测量中也比 Lipiview 表现出更好的一致性,具有更高的类内相关系数(眨眼次数:0.841 对 0.035):眨眼次数:0.841 对 0.665;IB 次数:0.750 对 0.564;IB 率:0.633 对 0.564:0.633 对 0.589)。DLM 辅助 K5M 发现眨眼参数与 DED 症状和体征之间存在更多相关性。此外,接收器操作特征分析显示,K5M 的 IB 数量曲线下面积最高,为 0.773:DLM 辅助 K5M 是分析眨眼视频和检测异常眨眼模式的有用工具,特别是在区分 DED 患者和正常人方面。因此,在实施之前,有必要进行大样本调查,以评估其临床实用性。
{"title":"Comparison of deep learning-assisted blinking analysis system and Lipiview interferometer in dry eye patients: a cross-sectional study.","authors":"Yueping Ren, Han Wen, Furong Bai, Binge Huang, Zhenzhen Wang, Shuwen Zhang, Yaojia Pu, Zhenmin Le, Xianhui Gong, Lei Wang, Wei Chen, Qinxiang Zheng","doi":"10.1186/s40662-024-00373-6","DOIUrl":"10.1186/s40662-024-00373-6","url":null,"abstract":"<p><strong>Background: </strong>Abnormal blinking pattern is associated with ocular surface diseases. However, blink is difficult to analyze due to the rapid movement of eyelids. Deep learning machine (DLM) has been proposed as an optional tool for blinking analysis, but its clinical practicability still needs to be proven. Therefore, the study aims to compare the DLM-assisted Keratograph 5M (K5M) as a novel method with the currently available Lipiview in the clinic and assess whether blinking parameters can be applied in the diagnosis of dry eye disease (DED).</p><p><strong>Methods: </strong>Thirty-five DED participants and 35 normal subjects were recruited in this cross-sectional study. DED questionnaire and ocular surface signs were evaluated. Blinking parameters including number of blinks, number of incomplete blinking (IB), and IB rate were collected from the blinking videos recorded by the K5M and Lipiview. Blinking parameters were individually collected from the DLM analyzed K5M videos and Lipiview generated results. The agreement and consistency of blinking parameters were compared between the two devices. The association of blinking parameters to DED symptoms and signs were evaluated via heatmap.</p><p><strong>Results: </strong>In total, 140 eyes of 70 participants were included in this study. Lipiview presented a higher number of IB and IB rate than those from DLM-assisted K5M (P ≤ 0.006). DLM-assisted K5M captured significant differences in number of blinks, number of IB and IB rate between DED and normal subjects (P ≤ 0.035). In all three parameters, DLM-assisted K5M also showed a better consistency in repeated measurements than Lipiview with higher intraclass correlation coefficients (number of blinks: 0.841 versus 0.665; number of IB: 0.750 versus 0.564; IB rate: 0.633 versus 0.589). More correlations between blinking parameters and DED symptoms and signs were found by DLM-assisted K5M. Moreover, the receiver operating characteristic analysis showed the number of IB from K5M exhibiting the highest area under curve of 0.773.</p><p><strong>Conclusions: </strong>DLM-assisted K5M is a useful tool to analyze blinking videos and detect abnormal blinking patterns, especially in distinguishing DED patients from normal subjects. Large sample investigations are therefore warranted to assess its clinical utility before implementation.</p>","PeriodicalId":12194,"journal":{"name":"Eye and Vision","volume":"11 1","pages":"7"},"PeriodicalIF":4.2,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10875838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Myopic choroidal neovascularization with neovascular signal around perforating scleral vessel prone to recur after anti-VEGF therapy. 近视眼脉络膜新生血管,在抗血管内皮生长因子治疗后,穿孔巩膜血管周围的新生血管信号容易复发。
IF 4.2 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-02-07 DOI: 10.1186/s40662-024-00374-5
Xiangjun She, Wangjing Yao, Gongyu Huang, Zhi Liang, Jin Xie, Jiwei Tao, Sulan Wu, Jianbo Mao, Yiqi Chen, Yun Zhang, Lijun Shen

Background: To compare the recurrence of myopic choroidal neovascularization (mCNV) based on the neovascular signal of mCNV around the perforating scleral vessel (PSV).

Methods: A consecutive series of naïve patients with mCNV accepted anti-VEGF therapy with a minimum 12-month follow-up period. The neovascular signal relationship between PSV and mCNV were classified into the presence of neovascular signal of CNV around PSV or not. The recurrence of mCNV, best-corrected visual acuity (BCVA), hyperreflective foci height, CNV area and CNV flow area were analyzed between two groups.

Results: Neovascular signal of CNV around PSV was detected in 20 eyes (39.2%). The one-year recurrence rate in the group with neovascular signal of CNV around PSV was significantly higher than that in the group without neovascular signal of CNV around PSV (P = 0.045). The recurrence time in the group with neovascular signal around PSV was shorter than that in the group without neovascular signal around PSV (P = 0.030). Cox proportional hazard model showed that the presence of neovascular signal of CNV around PSV [hazard ratio (HR): 2.904] and subfoveal choroidal thickness ≤ 50 μm (HR: 0.368) were risk factors for recurrence of mCNV. In the group with neovascular signal around PSV, the BCVA was worse (P = 0.024) and the CNV flow area was more unstable (P = 0.027) after therapy.

Conclusions: PSV was commonly detected in patients with mCNV. The presence of neovascular signal of CNV around PSV was prone to recur with a shorter time in mCNV patients.

背景:根据巩膜穿孔血管(PSV)周围近视脉络膜新生血管(mCNV)的新生血管信号,比较其复发情况:方法:对接受抗血管内皮生长因子(anti-VEGF)治疗的一系列新发近视患者进行连续随访,随访期至少12个月。将 PSV 和 mCNV 之间的新生血管信号关系分为 PSV 周围是否存在 CNV 新生血管信号。对两组间的 mCNV 复发率、最佳矫正视力(BCVA)、高反射灶高度、CNV 面积和 CNV 血流面积进行分析:结果:20 只眼睛(39.2%)在 PSV 周围检测到了 CNV 的新生血管信号。PSV周围CNV新生血管信号组的一年复发率明显高于PSV周围无CNV新生血管信号组(P = 0.045)。PSV周围有新生血管信号组的复发时间短于PSV周围无新生血管信号组(P = 0.030)。Cox比例危险模型显示,PSV周围CNV新生血管信号[危险比(HR):2.904]和叶脉下脉络膜厚度≤50 μm(HR:0.368)是mCNV复发的危险因素。在 PSV 周围有新生血管信号的组别中,治疗后 BCVA 更差(P = 0.024),CNV 血流面积更不稳定(P = 0.027):结论:在mCNV患者中,PSV很常见。结论:PSV 常见于 mCNV 患者,PSV 周围的 CNV 新生血管信号容易在 mCNV 患者中复发,且复发时间较短。
{"title":"Myopic choroidal neovascularization with neovascular signal around perforating scleral vessel prone to recur after anti-VEGF therapy.","authors":"Xiangjun She, Wangjing Yao, Gongyu Huang, Zhi Liang, Jin Xie, Jiwei Tao, Sulan Wu, Jianbo Mao, Yiqi Chen, Yun Zhang, Lijun Shen","doi":"10.1186/s40662-024-00374-5","DOIUrl":"10.1186/s40662-024-00374-5","url":null,"abstract":"<p><strong>Background: </strong>To compare the recurrence of myopic choroidal neovascularization (mCNV) based on the neovascular signal of mCNV around the perforating scleral vessel (PSV).</p><p><strong>Methods: </strong>A consecutive series of naïve patients with mCNV accepted anti-VEGF therapy with a minimum 12-month follow-up period. The neovascular signal relationship between PSV and mCNV were classified into the presence of neovascular signal of CNV around PSV or not. The recurrence of mCNV, best-corrected visual acuity (BCVA), hyperreflective foci height, CNV area and CNV flow area were analyzed between two groups.</p><p><strong>Results: </strong>Neovascular signal of CNV around PSV was detected in 20 eyes (39.2%). The one-year recurrence rate in the group with neovascular signal of CNV around PSV was significantly higher than that in the group without neovascular signal of CNV around PSV (P = 0.045). The recurrence time in the group with neovascular signal around PSV was shorter than that in the group without neovascular signal around PSV (P = 0.030). Cox proportional hazard model showed that the presence of neovascular signal of CNV around PSV [hazard ratio (HR): 2.904] and subfoveal choroidal thickness ≤ 50 μm (HR: 0.368) were risk factors for recurrence of mCNV. In the group with neovascular signal around PSV, the BCVA was worse (P = 0.024) and the CNV flow area was more unstable (P = 0.027) after therapy.</p><p><strong>Conclusions: </strong>PSV was commonly detected in patients with mCNV. The presence of neovascular signal of CNV around PSV was prone to recur with a shorter time in mCNV patients.</p>","PeriodicalId":12194,"journal":{"name":"Eye and Vision","volume":"11 1","pages":"6"},"PeriodicalIF":4.2,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10848438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Features of optical coherence tomography angiography in age-related macular degeneration with residual fluid after three loading doses of aflibercept. 老年性黄斑变性伴有残余液体的光学相干断层血管造影的特点,经过三次阿弗利贝赛(aflibercept)负荷剂量。
IF 4.2 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-02-01 DOI: 10.1186/s40662-023-00372-z
Yong-Yeon Song, Hyun-Je Seong, Jung-Tae Kim, Sung-Chul Lee, Min-Woo Lee

Background: To identify the macular neovascularization (MNV) features in exudative age-related macular degeneration (AMD) patients who exhibited residual fluid after receiving three loading doses of aflibercept.

Methods: Patients were classified into two groups: Group 1, which did not exhibit intraretinal fluid (IRF) and subretinal fluid (SRF), and Group 2, which did exhibit IRF and/or SRF. Optical coherence tomography angiography (OCTA) features were assessed and compared between the groups.

Results: A total of 101 eyes were enrolled; 65 for Group 1 and 36 for Group 2. No significant differences were found in baseline MNV size (2.94 ± 2.51 µm2 vs. 2.22 ± 2.26 µm2, P = 0.178) or vessel density (47.1 ± 15.4 % vs. 41.3 ± 10.5%, P = 0.052) between Groups 1 and 2. There were significant differences in the presence of loops (52.3% vs. 75%, P = 0.026) and peripheral arcades (29.2% vs. 55.6%, P < 0.001) at baseline between the two groups. In Group 1, there was a significant reduction in the presence of branching (P < 0.001) and loops (P = 0.016) after treatment. In Group 2, only the presence of branching decreased significantly (P < 0.001) after treatment. Multivariable analysis revealed that the presence of a peripheral arcade (B = 4.77, P = 0.001) was significantly associated with residual fluid.

Conclusions: Although responding to treatment, the presence of loops and peripheral arcades in exudative AMD patients may contribute to residual fluid following the three loading doses of aflibercept. The peripheral arcade, in particular, may play a more significant role in the presence of residual fluid.

背景:旨在确定渗出性年龄相关性黄斑变性(AMD)患者在接受三个负荷剂量的阿夫利百普治疗后出现残留液体的黄斑新生血管(MNV)特征:目的:确定渗出性年龄相关性黄斑变性(AMD)患者的黄斑新生血管(MNV)特征:将患者分为两组:第1组未出现视网膜内积液(IRF)和视网膜下积液(SRF),第2组出现IRF和/或SRF。对两组的光学相干断层血管造影(OCTA)特征进行评估和比较:第一组和第二组的基线 MNV 大小(2.94 ± 2.51 µm2 vs. 2.22 ± 2.26 µm2,P = 0.178)或血管密度(47.1 ± 15.4 % vs. 41.3 ± 10.5%,P = 0.052)无显著差异。在出现襻(52.3% 对 75%,P = 0.026)和外周弧(29.2% 对 55.6%,P 结论)方面存在明显差异:虽然渗出性AMD患者对治疗有反应,但在使用三种负荷剂量的阿弗利百普后,襻和外周弧的存在可能会导致残留液体。尤其是外周弧可能在残留液体中起着更重要的作用。
{"title":"Features of optical coherence tomography angiography in age-related macular degeneration with residual fluid after three loading doses of aflibercept.","authors":"Yong-Yeon Song, Hyun-Je Seong, Jung-Tae Kim, Sung-Chul Lee, Min-Woo Lee","doi":"10.1186/s40662-023-00372-z","DOIUrl":"10.1186/s40662-023-00372-z","url":null,"abstract":"<p><strong>Background: </strong>To identify the macular neovascularization (MNV) features in exudative age-related macular degeneration (AMD) patients who exhibited residual fluid after receiving three loading doses of aflibercept.</p><p><strong>Methods: </strong>Patients were classified into two groups: Group 1, which did not exhibit intraretinal fluid (IRF) and subretinal fluid (SRF), and Group 2, which did exhibit IRF and/or SRF. Optical coherence tomography angiography (OCTA) features were assessed and compared between the groups.</p><p><strong>Results: </strong>A total of 101 eyes were enrolled; 65 for Group 1 and 36 for Group 2. No significant differences were found in baseline MNV size (2.94 ± 2.51 µm<sup>2</sup> vs. 2.22 ± 2.26 µm<sup>2</sup>, P = 0.178) or vessel density (47.1 ± 15.4 % vs. 41.3 ± 10.5%, P = 0.052) between Groups 1 and 2. There were significant differences in the presence of loops (52.3% vs. 75%, P = 0.026) and peripheral arcades (29.2% vs. 55.6%, P < 0.001) at baseline between the two groups. In Group 1, there was a significant reduction in the presence of branching (P < 0.001) and loops (P = 0.016) after treatment. In Group 2, only the presence of branching decreased significantly (P < 0.001) after treatment. Multivariable analysis revealed that the presence of a peripheral arcade (B = 4.77, P = 0.001) was significantly associated with residual fluid.</p><p><strong>Conclusions: </strong>Although responding to treatment, the presence of loops and peripheral arcades in exudative AMD patients may contribute to residual fluid following the three loading doses of aflibercept. The peripheral arcade, in particular, may play a more significant role in the presence of residual fluid.</p>","PeriodicalId":12194,"journal":{"name":"Eye and Vision","volume":"11 1","pages":"4"},"PeriodicalIF":4.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Homocysteine and mitochondrial quality control in diabetic retinopathy 糖尿病视网膜病变中的同型半胱氨酸和线粒体质量控制
IF 4.2 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-01-16 DOI: 10.1186/s40662-023-00362-1
Pooja Malaviya, Renu A. Kowluru
Diabetic retinopathy is a progressive disease, and one of the key metabolic abnormalities in the pathogenesis of diabetic retinopathy, mitochondrial damage, is also influenced by the duration of hyperglycemia. Mitochondrial quality control involves a coordination of mitochondrial dynamics, biogenesis and removal of the damaged mitochondria. In diabetes, these processes are impaired, and the damaged mitochondria continue to produce free radicals. Diabetic patients also have high homocysteine and reduced levels of hydrogen sulfide, and hyperhomocysteinemia is shown to exacerbate diabetes-induced mitochondrial damage and worsen their dynamics. This study aims to investigate the temporal relationship between hyperhomocysteinemia and retinal mitochondrial quality control in diabetic retinopathy. Human retinal endothelial cells incubated in 20 mM d-glucose for 24 to 96 h, in the absence or presence of 100 µM homocysteine, with/without a hydrogen sulfide donor GYY4137, were analyzed for mitochondrial ROS (MitoSox fluorescence), DNA damage (transcripts of mtDNA-encoded ND6 and CytB), copy numbers, oxygen consumption rate (Seahorse XF analyzer) and mitophagy (mitophagosomes immunofluorescence labeling and flow cytometry). Results were confirmed in the retina from mice genetically manipulated for hyperhomocysteinemia (cystathionine β-synthase deficient mice, Cbs+/−), streptozotocin-induced diabetic for 8 to 24 weeks. At 24 weeks of diabetes, vascular health was evaluated by counting acellular capillaries in the trypsin digested retinal vasculature and by fluorescein angiography. Homocysteine, in high glucose medium, exacerbated mitochondrial ROS production, mtDNA damage and impaired mitochondrial respiration within 24 h, and slowed down/worsened mitochondrial biogenesis and mitophagy, as compared to 48 to 96 h in high glucose alone. GYY4137 supplementation ameliorated homocysteine + high glucose-induced mitochondrial damage and impairment in biogenesis and mitophagy. Similar results were obtained from Cbs+/− mice-mitochondrial ROS, mtDNA damage and decline in biogenesis and mitophagy were observed within eight weeks of diabetes vs. 16 to 24 weeks of diabetes in Cbs+/+ mice, and at 24 weeks of diabetes, Cbs+/− mice had significantly higher acellular capillaries and vascular leakage. Hyperhomocysteinemia, in a hyperglycemic environment, overwhelms the mitochondria, accelerating and exacerbating their dysfunction, and also delays/worsens their removal, augmenting the development of diabetic retinopathy. Thus, our results strengthen the importance of maintaining homocysteine-hydrogen sulfide balance during the early stages of diabetes for a patient to prevent/retard vision loss.
糖尿病视网膜病变是一种进行性疾病,而糖尿病视网膜病变发病机制中的关键代谢异常之一--线粒体损伤,也受高血糖持续时间的影响。线粒体质量控制涉及线粒体动力学、生物生成和清除受损线粒体之间的协调。糖尿病患者的这些过程都会受损,受损的线粒体会继续产生自由基。糖尿病患者的同型半胱氨酸含量也很高,硫化氢水平降低,而高同型半胱氨酸血症会加剧糖尿病引起的线粒体损伤并恶化其动态变化。本研究旨在探讨糖尿病视网膜病变中高同型半胱氨酸血症与视网膜线粒体质量控制之间的时间关系。将人视网膜内皮细胞置于 20 mM d-葡萄糖中培养 24 至 96 小时,在无或有 100 µM 高同型半胱氨酸、有/无硫化氢供体 GYY4137 的情况下,分析线粒体 ROS(MitoSox 荧光)、DNA损伤(mtDNA编码的ND6和CytB的转录本)、拷贝数、耗氧量(Seahorse XF分析仪)和有丝分裂(有丝分裂小体免疫荧光标记和流式细胞术)。研究结果在高同型半胱氨酸血症遗传小鼠(胱硫醚 β 合成酶缺乏小鼠,Cbs+/-)、链脲佐菌素诱导的 8 至 24 周糖尿病小鼠视网膜上得到了证实。糖尿病 24 周时,通过计数胰蛋白酶消化视网膜血管中的无细胞毛细血管和荧光素血管造影来评估血管健康状况。在高葡萄糖培养基中,同型半胱氨酸会在 24 小时内加剧线粒体 ROS 生成、mtDNA 损伤和线粒体呼吸受损,并减缓/恶化线粒体生物生成和有丝分裂,而在单独的高葡萄糖培养基中则会持续 48 到 96 小时。补充 GYY4137 可改善同型半胱氨酸+高糖诱导的线粒体损伤以及线粒体生物生成和有丝分裂的损害。Cbs+/- 小鼠在糖尿病八周内观察到线粒体 ROS、mtDNA 损伤以及生物生成和有丝分裂的下降,而 Cbs+/+ 小鼠在糖尿病 16-24 周时观察到线粒体 ROS、mtDNA 损伤以及生物生成和有丝分裂的下降。在高血糖环境中,高同型半胱氨酸血症会使线粒体不堪重负,加速和加剧线粒体的功能障碍,也会延迟/加剧线粒体的清除,从而加剧糖尿病视网膜病变的发展。因此,我们的研究结果加强了糖尿病患者在早期阶段保持同型半胱氨酸-硫化氢平衡对预防/延缓视力丧失的重要性。
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引用次数: 0
Inhibition of miR-542-3p augments autophagy to promote diabetic corneal wound healing 抑制 miR-542-3p 可增强自噬作用,促进糖尿病角膜伤口愈合
IF 4.2 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-01-03 DOI: 10.1186/s40662-023-00370-1
Danling Liao, Shijia Wei, Jianzhang Hu
Autophagy has recently been shown to be critical for protecting peripheral nerve regeneration. This study explored the impact of miR-542-3p on diabetic corneal nerve regeneration and epithelial healing through the regulation of autophagy. A type 1 diabetes model was established in male mice through streptozotocin administration. Immunofluorescence staining of β-Tubulin III and sodium fluorescein staining were performed to observe corneal nerve fiber density and corneal epithelial healing, respectively. Western blotting, immunofluorescence and transmission electron microscopy were used to determine autophagy levels. Subconjunctival injection of RAPA and 3-MA altered autophagy levels; with them, we evaluated the role of autophagy in diabetic keratopathy. miRNA sequencing and bioinformatics analysis were performed to identify miRNA-mRNA networks with potential autophagy-regulating roles, and miR-542-3p was measured by quantitative real-time polymerase chain reaction (qRT-PCR). miR-542-3p antagomir was injected subconjunctivally to assess the role in diabetic corneal neuropathy. Our data suggest that autophagy is suppressed in the diabetic corneal nerve and that activation of autophagy promotes diabetic corneal wound healing. We identified a potential autophagy-regulating miRNA-mRNA network in the diabetic trigeminal ganglion, in which miR-542-3p expression was significantly upregulated. Inhibition of miR-542-3p significantly enhanced the level of autophagy in trigeminal ganglion by upregulating ATG4D expression, thereby accelerating diabetic corneal nerve regeneration and epithelial healing. Dysregulated autophagy is an important contributor to delayed diabetic corneal injury healing. Inhibiting miR-542-3p promotes diabetic corneal nerve regeneration and epithelial healing through autophagy activation by ATG4D.
自噬最近被证明是保护周围神经再生的关键。本研究探讨了 miR-542-3p 通过调节自噬对糖尿病角膜神经再生和上皮愈合的影响。研究人员通过给雄性小鼠注射链脲佐菌素建立了 1 型糖尿病模型。免疫荧光染色法和荧光素钠染色法分别观察角膜神经纤维密度和角膜上皮愈合情况。用 Western 印迹、免疫荧光和透射电子显微镜测定自噬水平。结膜下注射RAPA和3-MA可改变自噬水平;通过它们,我们评估了自噬在糖尿病角膜病变中的作用。我们进行了 miRNA 测序和生物信息学分析,以确定具有潜在自噬调节作用的 miRNA-mRNA 网络,并通过定量实时聚合酶链式反应(qRT-PCR)测定了 miR-542-3p。我们的数据表明,自噬在糖尿病角膜神经中受到抑制,而激活自噬可促进糖尿病角膜伤口愈合。我们在糖尿病三叉神经节中发现了一个潜在的自噬调节 miRNA-mRNA 网络,其中 miR-542-3p 的表达显著上调。抑制miR-542-3p可通过上调ATG4D的表达,显著提高三叉神经节的自噬水平,从而加速糖尿病角膜神经再生和上皮愈合。自噬失调是导致糖尿病角膜损伤延迟愈合的重要原因。抑制 miR-542-3p 可通过 ATG4D 激活自噬促进糖尿病角膜神经再生和上皮愈合。
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引用次数: 0
Keratoconus cone location influences ocular biomechanical parameters measured by the Ocular Response Analyzer 角膜圆锥体位置对眼球反应分析仪测量的眼球生物力学参数的影响
IF 4.2 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-01-03 DOI: 10.1186/s40662-023-00371-0
Phillip T. Yuhas, Maddison M. Fortman, Ashraf M. Mahmoud, Cynthia J. Roberts
Keratoconus is characterized by asymmetry in the biomechanical properties of the cornea, with focal weakness in the area of cone formation. We tested the hypothesis that centrally-measured biomechanical parameters differ between corneas with peripheral cones and corneas with central cones. Fifty participants with keratoconus were prospectively recruited. The mean ± standard deviation age was 38 ± 13 years. Axial and tangential corneal topography were analyzed in both eyes, if eligible. Cones in the central 3 mm of the cornea were considered central, and cones outside the central 3 mm were considered peripheral. Each eye was then measured with the Ocular Response Analyzer (ORA) tonometer. T-tests compared differences in ORA-generated waveform parameters between cohorts. Seventy-eight eyes were analyzed. According to the axial topography maps, 37 eyes had central cones and 41 eyes had peripheral cones. According to the tangential topography maps, 53 eyes had central cones, and 25 eyes had peripheral cones. For the axial-topography algorithm, wave score (WS) was significantly higher in peripheral cones than central cones (inter-cohort difference = 1.27 ± 1.87). Peripheral cones had a significantly higher area of first peak, p1area (1047 ± 1346), area of second peak, p2area (1130 ± 1478), height of first peak, h1 (102 ± 147), and height of second peak, h2 (102 ± 127), than central cones. Corneal hysteresis (CH), width of the first peak, w1, and width of the second peak, w2, did not significantly differ between cohorts. There were similar results for the tangential-topography algorithm, with a significant difference between the cohorts for p1area (855 ± 1389), p2area (860 ± 1531), h1 (81.7 ± 151), and h2 (92.1 ± 131). Cone location affects the biomechanical response parameters measured under central loading of the cornea. The ORA delivers its air puff to the central cornea, so the fact that h1 and h2 and that p1area and p2area were smaller in the central cone cohort than in the peripheral cone cohort suggests that corneas with central cones are softer or more compliant centrally than corneas with peripheral cones, which is consistent with the location of the pathology. This result is evidence that corneal weakening in keratoconus is focal in nature and is consistent with localized disruption of lamellar orientation.
角膜病的特点是角膜的生物力学特性不对称,圆锥体形成区域的病灶薄弱。我们测试了一个假设,即中心测量的生物力学参数在周边圆锥角膜和中心圆锥角膜之间存在差异。我们前瞻性地招募了 50 名角膜炎患者。平均年龄为 38±13 岁。在符合条件的情况下,对双眼的轴向和切线角膜地形图进行分析。角膜中央 3 毫米内的圆锥体被视为中心圆锥体,中央 3 毫米以外的圆锥体被视为周边圆锥体。然后用眼球反应分析仪(ORA)眼压计测量每只眼睛。通过 T 检验比较不同组群之间 ORA 生成的波形参数的差异。共分析了 78 只眼睛。根据轴向地形图,37 只眼睛有中心圆锥,41 只眼睛有周边圆锥。根据切向地形图,53 只眼睛有中心锥体,25 只眼睛有周边锥体。在轴向地形图算法中,周边圆锥体的波得分(WS)明显高于中心圆锥体(组间差异 = 1.27 ± 1.87)。周边圆锥体的第一峰面积 p1area(1047 ± 1346)、第二峰面积 p2area(1130 ± 1478)、第一峰高度 h1(102 ± 147)和第二峰高度 h2(102 ± 127)均明显高于中心圆锥体。角膜滞后(CH)、第一峰宽度 w1 和第二峰宽度 w2 在不同组群之间没有显著差异。切线形图算法的结果与此类似,不同组群之间的 p1 面积(855 ± 1389)、p2 面积(860 ± 1531)、h1(81.7 ± 151)和 h2(92.1 ± 131)差异显著。角膜塑形镜的位置会影响角膜中心负荷下测得的生物力学响应参数。角膜塑形镜向角膜中央输送气泡,因此中央圆锥体的 h1 和 h2 以及 p1area 和 p2area 小于周边圆锥体的事实表明,中央圆锥体的角膜比周边圆锥体的角膜更软或中央顺应性更强,这与病变的位置一致。这一结果证明角膜塑形镜的角膜弱化是局灶性的,与角膜板层定向的局部破坏相一致。
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引用次数: 0
Assessing progression limits in different grades of keratoconus from a novel perspective: precision of measurements of the corneal epithelium. 从新的角度评估不同等级角膜病的进展极限:角膜上皮测量的精确性。
IF 4.2 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-01-02 DOI: 10.1186/s40662-023-00368-9
Rui Ning, Yiran Wang, Zhenyu Xu, Ingemar Gustafsson, Jiawei Li, Giacomo Savini, Domenico Schiano-Lomoriello, Yichen Xiao, Aodong Chen, Xiaoying Wang, Xingtao Zhou, Jinhai Huang

Background: To assess repeatability and reproducibility of corneal epithelium thickness (ET) measured by a spectral-domain optical coherence tomographer (SD-OCT)/Placido topographer (MS-39, CSO, Florence, Italy) in keratoconus (KC) population at different stages, as well as to determine the progression limits for evaluating KC progression.

Methods: A total of 149 eyes were enrolled in this study, with 29 eyes in the forme fruste keratoconus (FFKC) group, 34 eyes in the mild KC group, 40 eyes in the moderate KC group, and 46 eyes in the severe KC group. Employing the within-subject standard deviation (Sw), test-retest variability (TRT), coefficient of variation (CoV), and intraclass correlation coefficient (ICC) to evaluate intraoperator repeatability and interoperator reproducibility.

Results: The repeatability and reproducibility of MS-39 in patients with KC were acceptable, according to ICC values ranging from 0.732 to 0.954. However, patients with more severe KC and progressive peripheralization of the measurement points had higher TRTs but a thinning trend. The current study tended to set the cut-off values of mild KC, moderate KC, and severe KC to 4.9 µm, 5.2 µm, and 7.4 µm for thinnest epithelium thickness (TET). When differences between follow-ups are higher than those values, progression of the disease is possible. As for center epithelium thickness (CET), cut-off values for mild KC, moderate KC, and severe KC should be 2.8 µm, 4.4 µm, and 5.3 µm. This might be useful in the follow-up and diagnosis of keratoconus.

Conclusions: This study demonstrated that the precision of MS-39 was reduced in measuring more severe KC patients and more peripheral corneal points. In determining disease progression, values should be differentiated between disease-related real changes and measurement inaccuracies. Due to the large difference in ET measured by MS-39 between various stages of disease progression, it is necessary to accurately grade KC patients to avoid errors in KC clinical decision-making.

背景:目的:评估光谱域光学相干断层扫描仪(SD-OCT)/Placido角膜地形图仪(MS-39,CSO,意大利佛罗伦萨)在不同阶段的角膜上皮厚度(ET)测量的重复性和再现性,并确定评估角膜上皮厚度的进展极限:本研究共招募了 149 只眼睛,其中 29 只属于 FFKC 组,34 只属于轻度 KC 组,40 只属于中度 KC 组,46 只属于重度 KC 组。采用受试者内标准偏差(Sw)、重复测试变异性(TRT)、变异系数(CoV)和类内相关系数(ICC)来评估操作者内的重复性和操作者间的再现性:根据 0.732 至 0.954 的 ICC 值,MS-39 对 KC 患者的重复性和再现性均可接受。然而,KC 更严重和测量点逐渐周边化的患者的 TRT 值更高,但有变薄的趋势。目前的研究倾向于将轻度 KC、中度 KC 和重度 KC 的最薄上皮厚度 (TET) 的临界值分别设定为 4.9 µm、5.2 µm 和 7.4 µm。当两次随访之间的差异高于这些值时,疾病就有可能恶化。至于中心上皮厚度(CET),轻度 KC、中度 KC 和重度 KC 的临界值应分别为 2.8 微米、4.4 微米和 5.3 微米。这可能有助于角膜炎的随访和诊断:这项研究表明,在测量更严重的 KC 患者和更多的周边角膜点时,MS-39 的精确度会降低。在确定疾病进展时,应区分与疾病相关的实际变化和测量误差。由于 MS-39 测得的 ET 值在疾病进展的不同阶段差异很大,因此有必要对 KC 患者进行准确分级,以避免 KC 临床决策失误。
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Eye and Vision
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