International journal of ophthalmology最新文献

Aim: To study functional brain abnormalities in patients with eye trauma (ET) and to discuss the pathophysiological mechanisms of ET.

Methods: Totally 31 ET patients and 31 healthy controls (HCs) were recruited. The age, gender, and educational background characteristics of the two groups were similar. After functional magnetic resonance imaging (fMRI) scanning, the subjects' spontaneous brain activity was evaluated with the functional connectivity (FC) method. Receiver operating characteristic (ROC) curve analysis was used to classify the data. Pearson's correlation analysis was used to explore the relationship between FC values in specific brain regions and clinical behaviors in patients with ET.

Results: Significantly increased FC between several regions was identified including the medial prefrontal cortex (MPFC) and left hippocampus formations (HF), the MPFC and left inferior parietal lobule (IPL), the left IPL and left medial temporal lobe (MTL), the left IPL and right MTL, and the right IPL and left MTL. No decreased region-to-region connectivity was detected in default mode network (DMN) sub-regions in patients with ET. Compared with HCs, ET patients exhibited significantly increased FC between several paired DMN regions, as follows: posterior cingulate cortex (PCC) and right HF (HF.R, t=2.196, P=0.032), right inferior parietal cortices (IPC.R) and left MTL (MTL.L, t=2.243, P=0.029), and right MTL (MTL.R) and HF.R (t=2.236, P=0.029).

Conclusion: FC values in multiple brain regions of ET patients are abnormal, suggesting that these brain regions in ET patients may be dysfunctional, which may help to reveal the pathophysiological mechanisms of ET.

Aim: To establish a meaningful standard for diagnosing ocular metastasis (OM) in menopausal breast cancer (BC) women, and explore the relationship between CA-153, CA-125, apolipoprotein A, and OM.

Methods: A total of 1362 menopausal female BC patients with OM volunteered to take part in this study between July 2012 and July 2022. Women with BC who are menopausal were found to have an OM incidence of 1.6%. Furthermore, CA-153, CA-125, and apolipoprotein A (Apo A) all contributed to OM in women with BC who are postmenopausal according to binary logistic regression. Receiver operating curve (ROC) analysis was used to assess the diagnostic value of OM in patients with BC.

Results: Both CA-153 and CA-153+CA-125 showed a higher sensitivity of 95.45%, whereas CA-153+Apo A illustrated the highest specificity of 99.02%. Moreover, CA-153 and CA-153+CA-125 had higher areas under the curve (AUC) of 0.973.

Conclusion: The data indicate that the serum concentrations of CA-153 exhibited the most significant predictors of the diagnosis of OM in menopausal women with BC. The current study researches the utility of risk factors in predicting of OM in menopausal BC women and put forward the latest suggestions on their clinical application.

Aim: To quantify the severity and frequency of ocular pain in Tibetan plateau patients with dry eye, and to evaluate the related factors affecting ocular pain.

Methods: A retrospective study included 160 cases of dry eye disease (DED) patients who were treated from July 2022 to June 2023. Age, gender, occupation, illness course, anxiety, plateau duration, plateau protection, ocular surface disease index scale (OSDI), break-up time (BUT), Schirmer I test (SIT), conjunctivitis, history of ophthalmic medication, autoimmune disease, the workload of daily near vision range, smoking and overnight stay were obtained via comprehensive ophthalmic assessment, and their duration was followed up. Logistic regression analysis was used to determine the related factors affecting ocular pain.

Results: Totally 77.5% (124/160) of DED patients had ocular pain, of which the severity of ocular pain was mild, moderate, and severe in 30.0%, 36.3%, and 11.3% of patients, respectively. Frequency of ocular pain was reported occasional, half the time, frequent, and persistent pain in 19.4%, 36.9%, 16.9%, and 4.4%. OSDI score was 19.67±5.70 (13 to 36), and the level of pain was lowly correlated with OSDI (r_s =0.316, P<0.001). Logistic regression showed that in plateau DED patients, increased anxiety led to increased severity and frequency of ocular pain [odds ratio (OR)=3.662, 5.613, 2.387, and 4.870; all P<0.05], professional eye protection and improvement of daily sleep quantity decreased pain (OR=0.307, 0.572, 0.418, and 0.789; all P<0.05), while smoking and general protection of plateau did not affect the severity and frequency of ocular pain (all P>0.05).

Conclusion: Ocular pain is a common complaint in high-altitude DED patients during the pandemic. Anxiety, eye protection, and adequate sleep during the epidemic period are significantly associated with the severity and frequency of ocular pain in patients with plateau DED, while symptoms of DED have relatively little influence on them.

Aim: To investigate the biocompatibility and bacterial adhesion properties of light responsive materials (LRM) and analyze the feasibility and biosafety of employing LRM in the preparation of accommodative intraocular lenses (AIOLs).

Methods: Employing fundamental experimental research techniques, LRM with human lens epithelial cells (hLECs) and human retinal pigment epithelium cells (ARPE-19 cells) were co-cultured. Commercially available intraocular lenses (IOLs) were used as controls to perform cell counting kit-8 (CCK-8), cell staining under varying light intensities, cell adhesion and bacterial adhesion experiments.

Results: LRM exhibited a stronger inhibitory effect on the proliferation of ARPE19 cells than commercially available IOLs when co-cultured with the undiluted extract for 96h (P<0.05). Under other culturing conditions, the effects on the proliferation of hLECs and ARPE-19 cells were not significantly different between the two materials. Under the influence of light irradiation at intensities of 200 and 300 mW/cm², LRM demonstrated a markedly higher inhibitory effect on the survival of hLECs compared to commercially available IOLs (P<0.0001). They also showed a stronger suppressive effect on the survival rate of ARPE-19 cells, with significant differences observed at 200 mW/cm² (P<0.001) and extremely significant differences at 300 mW/cm² (P<0.0001). Additionally, compared to commercially available IOLs, LRM had a higher number of cells adhering to their surface (P<0.05), as well as a significantly greater number of adherent bacterium (P<0.0001).

Conclusion: LRM, characterized by their excellent non-contact tunable deformability and low cytotoxicity to ocular tissues, show considerable potential for use in the fabrication of AIOLs. These materials demonstrate strong cell adhesion; however, during photothermal conversion processes involving shape deformation under various light intensities, the resultant temperature rise may harm surrounding cells. These factors suggest that while the material plays a positive role in reducing the incidence of posterior capsule opacification (PCO), it also poses potential risks for retinal damage. Additionally, the strong bacterial adhesion of these materials indicates an increased risk of endophthalmitis.

This paper analyzes the current status, technological developments, academic exchange platforms, and future challenges and solutions in the field of intelligent ophthalmology (IO) in China. In terms of technology, significant progress has been made in various areas, including diabetic retinopathy, fundus image analysis, quality assessment of medical artificial intelligence products, clinical research methods, technical evaluation, and industry standards. Researchers continually enhance the safety and standardization of IO technology by formulating a series of clinical application guidelines and standards. The establishment of domestic and international academic exchange platforms provides extensive collaboration opportunities for professionals in various fields, and various academic journals serve as publication platforms for IO research. However, challenges such as technological innovation, data privacy and security, lagging regulations, and talent shortages still pose obstacles to future development. To address these issues, future efforts should focus on strengthening technological research and development, regulatory framework construction, talent cultivation, and increasing patient awareness and acceptance of new technologies. By comprehensively addressing these challenges, IO in China is poised to further lead the industry's development on a global scale, bringing more innovation and convenience to the field of ophthalmic healthcare.

Aim: To investigate the effect of astigmatism and spherical equivalent (SE) correction on contrast sensitivity (CS).

Methods: In this cross-sectional study, 103 visually normal subjects aged 18 to 36y with bilateral regular astigmatism in range of 1.00 diopter cylinder (DC) to 4.00 DC and normal best-corrected visual acuity (20/20) were recruited. Binocular CS was assessed by linear sine-wave gratings at 1.5, 3, 6, 12, and 18 cycles per degree (cpd), before correction of astigmatism, after full correction of astigmatism by cylindrical spectacle lenses, and after SE of refractive error. The repeated measures ANOVA and Bonferroni test were used to compare the effects of astigmatism correction on logCS.

Results: Totally 39 patients were male and 64 patients were female with the mean age of 28.25±5.38y. The average degree of astigmatism in right and left eye was 2.03±0.83 and 2.10±0.78, respectively. Increases in uncorrected astigmatic power correlated with decreases in the logCS, especially at high spatial frequencies. A statistically significant difference in logCS was found between these three cases: before correction of astigmatism, after SE of refractive error, and after full correction of astigmatism by cylindrical spectacle lenses at all frequencies (P<0.001), except at 18 cpd. At 18 cpd, there was no statistically significant difference between logCS before and after SE of refractive error (P=1.0). Also, there was no statistically significant difference in mean CS between with-the-rule (WTR) and against-the-rule (ATR) astigmatism, before correction of astigmatism, after correction of astigmatism with cylindrical lenses, and after SE of refractive error.

Conclusion: Binocular astigmatism defocus decreases CS depending on the degree of astigmatism power; correction of this will improve patent's quality of vision. Although high astigmatism refractive error (more than 2.00 DC) that is fully corrected by cylindrical spectacle lenses doesn't increase the CS to the maximum value, especially at higher spatial frequencies (12 and 18). Also SE refractive error effects on improving CS in low astigmatism power (less than 2.00 DC), especially at lower spatial frequencies.

Aim: To compare the short-term effectiveness of intelligent navigated laser photocoagulation and 577-nm subthreshold micropulse laser (SML) treatment in patients with chronic central serous chorioretinopathy (cCSC).

Methods: This observational retrospective cohort study included 60 consecutive patients who underwent intelligent navigated laser photocoagulation (n=30) or 577-nm SML treatment (n=30) for cCSC between Jan. 2021 and Oct. 2022. During 3mo follow-up, all patients underwent assessments of best correct visual acuity (BCVA) and optical coherence tomography (OCT).

Results: The operation of laser treatment was successful in all cases. At 1mo, BCVA improved significantly more in the intelligent navigated laser photocoagulation group compared to the SML group (P<0.05). The change was not significantly different at 3mo (P>0.05). Central macular thickness (CMT) in the intelligent navigated laser photocoagulation group was lower than in the SML group at 1mo (P<0.05). The subfoveal choroidal thickness (SFCT) in two groups were all significantly improved at 3mo (all P<0.05). The change between two groups was not significantly different at 1mo or at 3mo (P>0.05).

Conclusion: Intelligent navigated laser photocoagulation is superior to SML for treating cCSC, leading to better improvements in vision and CMT for short term.

Aim: To investigate the proliferation regulatory effect of cone-rod homeobox (CRX) in retinal pigment epithelium (RPE) and retinoblastoma (RB) cells to explore the potential application and side effect (oncogenic potential) of CRX-based gene therapy in RPE-based retinopathies.

Methods: Adult human retinal pigment epithelial (ARPE)-19 and human retinal pigment epithelial (RPE)-1 cells and Y79 RB cell were used in the study. Genetic manipulation was performed by lentivirus-based technology. The cell proliferation was determined by a CellTiter-Glo Reagent. The mRNA and protein levels were determined by quantitative real-time polymerase chain reaction (qPCR) and Western blot assay. The transcriptional activity of the promoter was determined by luciferase reporter gene assay. The bindings between CRX and transcription factor 7 (TCF7) promoter as well as TCF7 and the promoters of TCF7 target genes were examined by chromatin immunoprecipitation (ChIP) assay. The transcription of the TCF7 was determined by a modified nuclear run-on assay.

Results: CRX overexpression and knockdown significantly increased (n=3, P<0.05 in all the cells) and decreased (n=3, P<0.01 in all the cells) the proliferation of RPE and RB cells. CRX overexpression and knockdown significantly increased and deceased the mRNA levels of Wnt signaling target genes [including MYC proto-oncogene (MYC), JUN, FOS like 1 (FOSL1), CCND1, cyclin D2 (CCND2), cyclin D3 (CCND3), cellular communication network factor 4 (CCN4), peroxisome proliferator activated receptor delta (PPARD), and matrix metallopeptidase 7 (MMP7)] and the luciferase activity driven by the Wnt signaling transcription factor (TCF7). TCF7 overexpression and knockdown significantly increased and decreased the proliferation of RPE and RB cells and depletion of TCF7 significantly abolished the stimulatory effect of CRX on the proliferation of RPE and RB cells. CRX overexpression and knockdown significantly increased and decreased the mRNA level of TCF7 and the promoter of TCF7 was significantly immunoprecipitated by CRX antibody.

Conclusion: CRX transcriptionally activates TCF7 to promote the proliferation of RPE and RB cells in vitro. CRX is a potential target for RPE-based regenerative medicine. The potential risk of this strategy, tumorigenic potential, should be considered.

Aim: To observe the changes in corneal subepithelial nerve fibers (CNFs) and Langerhans cells (LCs) in patients with type 2 diabetes using corneal laser confocal microscopy (CLCM).

Methods: A total of 60 patients (64 eyes), including 40 patients with type 2 diabetes (DM group) and 20 subjects without diabetes (control group) were included with CLCM. Neuron J plugin of Image J software were used for quantitative analysis of CNF length (CNFL), CNF density (CNFD), corneal nerve branch fiber density (CNBD), main branch length density, branch length density, corneal nerve fiber tortuosity (NT) score, and LCs density. An independent samples t-test to analyze the variability between the two groups was performed, and Pearson correlation analysis was used to analyze the relationships between CNF and multiple biochemical indicators in the DM group. The predictive power of CNF for type 2 diabetes was assessed using the receiver operating characteristic (ROC) curve.

Results: There were significant differences in the CNFL, CNFD, and main branch length density between two groups. The results of Pearson correlation analysis showed a significant negative correlation between CNFD and the duration of diabetes as well as triglyceride levels and total cholesterol, and a significant positive correlation between CNFD and serum albumin. In addition, the NT score showed a positive correlation and urea nitrogen, similar to the positive correlation observed between LC density and glycosylated hemoglobin (HbA1c) levels. CNFD showed the highest area under the curve (AUC of ROC) value, followed by main branch length density and CNFL. The AUC of the ROC curve under the logistic regression model also demonstrated good predictive values. The cut-off values of CNFD, CNFL, and main branch length density for diabetes showed 31.25, 18.85, and 12.56, respectively.

Conclusion: In patients with type 2 diabetes, there is a notable reduction in both CNFL and CNFD. These measurements can be influenced by various blood biochemical factors. However, the compromised nerve fibers can serve as valuable indicators for predicting the onset of type 2 diabetes and also as biomarkers for detecting diabetic neuropathy and its related complications.

Aim: To investigate the patterns of short-term intraocular pressure (IOP) fluctuations and identify the contributing factors following intravitreal injection in patients with retinal vascular diseases.

Methods: Totally 81 patients were enrolled in this case control study. Eyes were categorized into 7 groups, including age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV), idiopathic choroidal neovascularization (CNV), proliferative diabetic retinopathy (PDR), diabetic macular edema (DME), macular edema secondary to branch (BVOME) and central (CVOME) retinal vein occlusion. IOP was measured in all patients using rebound tonometer at 7 preset time points perioperatively. Additionally, based on the administered medication, the eyes were classified into three treatment groups, including dexamethasone intravitreal implant (IVO), intravitreal conbercept (IVC), and intravitreal ranibizumab (IVR). To compare IOP values at various time points across groups, we employed one-way ANOVA, independent sample t-test or χ ² test and multivariate logistic regression analysis.

Results: Peak IOP values across all groups were observed at 40s, and 5min after intravitreal injection. Statistical differences in IOP were detected at the 5min among the 7 indication groups (F=2.50, P=0.029). When examing the impact of medications, the IVO group exhibited lower average IOP values at both 40s and 5min compared to the IVC and IVR groups (P<0.001; P=0.007). The IOP values at 40s and 5min were significantly higher in BVOME and CVOME group compared to non-retinal vein occlusion-secondary macular edema (RVOME) group (P<0.001). Multivariate logistic regression analysis further confirmed that IOP measurement at 40s was significantly higher in CVOME group than in non-RVOME group (OR=1.64, 95%CI: 1.09-2.47; P=0.018).

Conclusion: Needle size plays a crucial role in the transient changes of IOP following intravitreal injection. Before administering intravitreal injection to patients with central retinal vein occlusion, it is essential to exclude any underlysing causes of increased IOP.