International journal of ophthalmology最新文献

Aim: To investigate the postnatal development of parvalbumin (PV)-positive gamma-aminobutyric acid (GABA) interneurons and the co-expression of perineuronal nets (PNNs) and PV in the visual cortex of rats, as well as the regulatory effects of fluoxetine (FLX) treatment and binocular form deprivation (BFD) on these indices.

Methods: Wistar rats were assigned to three experimental cohorts: 1) Age-related groups: postnatal week (PW) 1, PW3, PW5, PW7, and PW9; 2) FLX treatment duration groups: FLX 0W, FLX 2W, FLX 4W, FLX 6W, and FLX 8W; 3) Intervention groups: control (Cont), FLX, BFD, and BFD+FLX. The levels of PNNs, PV, and PNNs/PV co-expression in the visual cortex were detected and analyzed.

Results: The density of PV-positive cells and the co-expression of PNNs and PV increased gradually with the maturation of the visual cortex (b=0.960, P<0.01). The ratio of PV-positive cells surrounded by PNNs to total PV-positive cells (PNNs⁺/PV⁺/total PV⁺) was significantly decreased in the FLX 4W group (χ²=9.03, P=0.003). There was no significant difference in the PNNs⁺/PV⁺/total PV⁺ ratio between the FLX and BFD groups (χ²=1.08, P=0.161), but a significant difference was observed between the BFD+FLX group and the BFD group (χ²=5.82, P<0.01).

Conclusion: The number of PV-positive neurons and PNNs-surrounded PV neurons in the rat visual cortex increases postnatally and reaches adult levels by postnatal week 7. Chronic FLX treatment downregulates these expressions. Combined 4-week FLX treatment and BFD exerts a more significant inhibitory effect on the PNNs⁺/PV⁺/total PV⁺ ratio than either intervention alone.

Aim: To evaluate whether fluid-air exchange is an effective treatment for unclosed macular hole (MH) after primary vitrectomy.

Methods: This retrospective study included patients with an unclosed MH within 1-2wk after vitrectomy. Patients were divided into the vitrectomy, fluid-air exchange, and observation groups according to the secondary treatment. The anatomical outcomes and postoperative visual acuity were recorded.

Results: The analysis included 25 eyes in 25 patients (16 females) aged 37-74y (vitrectomy group, n=10; fluid-air exchange group, n=9; observation group, n=6). Closure rate after secondary treatment was 100% in the vitrectomy group, 88.9% in the fluid-air exchange group and 33.3% in the observation group. Optical coherence tomography images obtained at the last follow-up revealed that continuity of the external limiting membrane (ELM) was significantly more common (P=0.004) in the fluid-air group (8/9 eyes, 88.9%) than in the vitrectomy group (2/10 eyes, 20.0%) and that macular morphology was better in the fluid-air group than in the vitrectomy group. No serious complications were observed after secondary treatment.

Conclusion: Fluid-air exchange is an alternative option to repeat vitrectomy for patients with an unclosed MH after initial vitrectomy with elevated macular edge.

Aim: To evaluate the effects of polarized and non-polarized sunglasses on visual functions, including distance and near visual acuity, phoria, stereopsis and contrast sensitivity across five spatial frequencies (1.5, 3, 6, 12, 18 cycles/degree).

Methods: A before-after study was conducted on 45 emmetropic students from Shahid Beheshti University of Medical Sciences. Visual acuity, contrast sensitivity, stereopsis and phoria were measured under three conditions: without sunglasses, with non-polarized sunglasses and with polarized sunglasses. Tests were conducted under controlled glare conditions to simulate outdoor environments.

Results: A total of 45 participants were evaluated, comprising 17 males (37.8%) and 28 females (62.2%). The mean age was 21.67±2.31y (range 18-27y). The mean of distance and near visual acuity in all three conditions were equal to 0.00 logMAR. Contrast sensitivity generally decreased slightly with the use of non-polarized sunglasses compared to the no-sunglasses condition. The mean stereopsis with polarized sunglasses was 101.33±56.139 arc sec, which was worse than the no-sunglasses condition (94.33±46.632 arc sec) and better than the non-polarized sunglasses condition (105.67±58.965 arc sec), although these changes were not significant. In the phoria parameter, distance phoria appeared more affected than near phoria.

Conclusion: Polarized and non-polarized sunglasses do not significantly affect visual acuity, stereopsis, or phoria under controlled glare conditions. Slight changes in contrast sensitivity are noted, but they are not statistically significant.

Retinoblastoma (RB) is the most common intraocular malignancy in children. In recent years, advancements in chemotherapy-based comprehensive treatment approaches and diagnostic technologies have significantly improved long-term survival rates, shifting treatment goals from saving lives toward preserving vision and enhancing quality of life. In major RB treatment centers in China, survival rates have reached levels comparable to those in developed countries. However, in some underdeveloped regions, RB continues to pose a serious threat to affected children. To further improve survival rates and quality of life for RB patients and their families in China, a series of essential measures should be implemented. These include strengthening public education to raise awareness of RB, enhancing diagnostic efficiency, promoting standardized treatment protocols, providing genetic counseling and prenatal assessment for high-risk populations, and fostering the training of specialized healthcare professionals.

Aim: To investigate the association between active corneal epithelial dendritic cells (CEDCs) and ocular pain in patients with dry eye disease (DED).

Methods: This cross-sectional study enrolled 67 DED patients, who were divided into two groups based on numerical rating scale (NRS) scores: the mild pain group (n=44) and the moderate-to-severe pain group (n=23). In vivo confocal microscopy (IVCM) was used to image the subbasal layer of the central cornea. Corneal nerve characteristics were analyzed using ACCMetrics software, while CEDCs were quantified manually with Image J software. Regression and correlation analyses were performed to assess the impact of active CEDCs on ocular pain. Additionally, the Luminex method was employed to compare the concentrations of inflammation-related cytokines in tears between patients with ≥2 CEDCs and those with <2 CEDCs. Differences in cytokine levels between the two groups were analyzed using Student's t-test.

Results: The study included 44 eyes of 44 patients with mild ocular pain (12 males and 32 females) and 23 eyes of 23 patients with moderate-to-severe ocular pain (3 males and 20 females). The mean age was 36.2±13.5y in the mild pain group and 39.7±12.4y in the moderate to severe pain group. There were no significant differences in age or sex between the two groups (P=0.30; P=0.19). Multivariable regression analysis showed that older age [odds ratio (OR) =1.05, 95% confidence interval (CI) 1.00-1.11] and a higher number of CEDCs (OR=1.80, 95%CI 1.17-2.76) were associated with ocular pain. Patients with ≥2 CEDCs had significantly higher tear concentrations of interleukin (IL)-6 (P<0.05), IL-8 (P<0.05), and tumor necrosis factor (TNF)-α (P<0.05) compared to those with <2 active CEDCs.

Conclusion: The findings suggest that infiltrating CEDCs in the corneal subbasal layer are a potential risk factor for ocular pain in DED.

Aim: To analyze the general profile, clinical symptoms, pathological features, and prognostic characteristics of extranodal Rosai-Dorfman disease (RDD) with ocular involvement.

Methods: This was a retrospective series of case study. Clinical data from 35 cases who had extranodal RDD with ocular involvement were collected for analysis, including 5 cases diagnosed at our hospital and 30 reported in the literature which searched via PubMed, the Chinese National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP), and WanFang Data database from database creation to April 2023. Lesion location, clinical presentation, pathological presentation, treatment modality, follow-up time, and prognosis were recorded.

Results: Lesions of five cases were located in the orbit, eyelid, lacrimal gland, or conjunctiva. The main presenting features were proptosis, eyelid swelling, and conjunctival hyperemia with decreased vision. Four patients underwent surgical resection, one received surgery and adjunctive immunosuppression, and none experienced recurrence during follow-up. A total of 30 cases were retrieved from the literature. The mean age was 41.4y, and 66.7% were male. The lacrimal gland and conjunctiva/subconjunctiva were the most commonly affected sites (each 20.0%). Most patients received surgical management (50.0%) or immunosuppressive therapy (20.0%). Only one recurrence (3.3%) was reported during follow-up.

Conclusion: When symptoms like ocular protrusion and visual acuity loss occur, RDD should be considered in the differential diagnosis. The diagnosis of RDD primarily depends on pathological histology, which serves as the key basis for confirmation. Although RDD generally has a favorable prognosis, long-term follow-up of patients is still essential to closely monitor for potential recurrence.

Aim: To evaluate the surgical outcomes of the perfluorocarbon liquid (PFCL)-assisted inverted multilayer internal limiting membrane (ILM) flaps covering technique in macular hole retinal detachment (MHRD) in high myopia with axial length (AL) ≥30 mm.

Methods: In this retrospective, interventional, consecutive comparative study, 44 MHRD eyes were divided into two groups: the PFCL-assisted inverted multilayer ILM flaps covering technique group (Group 1, 21 eyes) and the ILM peeling group (Group 2, 23 eyes). The follow-up period was >12mo. Postoperative outcomes, including retinal reattachment, macular hole (MH) closure, and best-corrected visual acuity (BCVA), were assessed. Statistical analysis using the Mann-Whitney U test and Fisher's exact test was conducted to compare differences between groups.

Results: There were no statistically significant differences in baseline preoperative clinical characteristics, including age, sex, AL, diopters, duration of symptom, lens status, posterior staphyloma presence and extent of RD. Retinal reattachment rates were higher in Group 1 (90.5%) than in Group 2 (82.6%), without statistical significance (P=0.667). MH closure rates were significantly higher in Group 1 (85.7%) than in Group 2 (17.4%; P<0.001). The Group-1 BCVA (logMAR) improved significantly from 2.13±0.91 preoperatively to 1.21±0.66 postoperatively (P=0.026). The Group 2 BCVA improved significantly from 1.91±0.53 preoperatively to 1.19±0.41 postoperatively (P=0.032). However, there were no significant differences in visual-acuity improvement between groups (P=0.460).

Conclusion: This technique offers a more effective approach for improving MH closure rates and postoperative visual function in MHRD with AL≥30 mm in high myopia.

Aim: To investigate the impact of preoperative anterior corneal topographic parameters on the morphology of the postoperative effective optical zone (EOZ) in patients undergoing keratorefractive lenticule extraction (KLEx) and wavefront-guided LASIK (WG-LASIK).

Methods: This retrospective study included 310 eyes from patients who underwent either KLEx (via small incision lenticule extraction, 171 eyes) or WG-LASIK (139 eyes). Patients were stratified into subgroups based on the median values of spherical equivalent (SE) and anterior corneal topographic parameters. Postoperative EOZ parameters were measured 1mo after surgery and compared across subgroups. Correlation analysis and multivariable linear regression analysis were performed to explore the associations between preoperative anterior corneal topographic parameters and EOZ parameters.

Results: A total of 310 eyes were included (KLEx: 171 eyes from 88 patients; WG-LASIK: 139 eyes from 82 patients). The mean age was 30.65±5.67y in the KLEx cohort and 29.06±5.94y in the WG-LASIK cohort. In the KLEx cohort, SE, preoperative mean keratometry (Km), steep keratometry (K2), and anterior corneal astigmatism (K2-K1) were positively correlated with the postoperative optical zone reduction ratio (RR=EOZ/planned optical zone ×100%; all P<0.01). Multivariable regression identified SE [β=0.027, 95% confidence interval (CI): 0.022-0.032, P<0.001], Km (β=0.009, 95%CI: 0.002-0.016, P=0.014), and anterior corneal astigmatism (β=0.031, 95%CI: 0.013-0.049, P<0.001) as significant predictors of RR (R²=0.456, P<0.001). In the WG-LASIK cohort, SE was positively correlated with RR (P<0.01); K2 and anterior corneal astigmatism were positively correlated with both RR (P<0.05) and EOZ eccentricity (P<0.01). Multivariable regression showed SE (β=0.015, 95%CI: 0.007-0.023, P<0.001) and anterior corneal astigmatism (β=0.029, 95%CI: 0.012-0.047, P=0.001) were significant predictors of RR (R²=0.121, P<0.001).

Conclusion: Preoperative anterior corneal topographic parameters, particularly anterior corneal astigmatism, significantly affect postoperative EOZ morphology in both KLEx and WG-LASIK. Additionally, Km is a predictor of EOZ reduction specifically in KLEx.

Aim: To explore the methylation status of MSH6 in retinoblastoma (RB) and its impact on clinicopathological features and diagnosis.

Methods: Differentially expressed genes were identified through bioinformatics screening of the GSE24673 and GSE125903 datasets, combined with GeneCards database analysis. A total of 102 RB patients and 62 trauma-enucleated controls between January 2018 and December 2023 were enrolled, with their clinicopathological data and retinal tissues collected. The mRNA and methylation levels of MSH6 in retinal tissues were detected using real-time quantitative polymerase chain reaction (PCR) and methylation-specific PCR. Western blot analysis was conducted in one pair of RB and control tissues for preliminary protein-level validation of MSH6 expression. Based on the methylation status of MSH6, RB patients were categorized into two groups: low-methylation and high-methylation. Both univariate and multivariate analyses were conducted to identify independent factors influencing the methylation levels using clinicopathological data. Receiver operating characteristic (ROC) curves were applied to evaluate the diagnostic potential of MSH6 methylation in RB.

Results: Bioinformatics analysis of public datasets revealed that MSH6 expression was downregulated across multiple cancers, RB. Consistently, in clinical RB tissues, MSH6 mRNA expression was significantly lower than that in control retinal tissues, whereas the promoter methylation level of MSH6 was markedly higher (both P<0.001), indicating that promoter hypermethylation may contribute to transcriptional silencing of MSH6 in RB. Patients with higher MSH6 methylation levels showed more advanced pathological classification and a higher frequency of metastasis. Multivariate logistic regression confirmed that metastatic status (P=0.008, OR=3.51) and pathological classification (P=0.005, OR=3.7) were independent factors associated with MSH6 methylation. Receiver operating characteristic (ROC) analysis demonstrated that MSH6 methylation could effectively distinguish RB tissues from non-tumorous controls (AUC=0.847, sensitivity=78.43%, specificity=80.65%), suggesting that MSH6 hypermethylation may serve as a potential diagnostic biomarker for RB.

Conclusion: The methylation level of the MSH6 gene may be a key factor in RB pathogenesis. The methylation status of the MSH6 gene is closely associated with clinicopathological features and shows diagnostic potential.