International Ophthalmology最新文献

Purpose: The aim of the present study is to examine the demographic data and clinical features of ocular surface injuries due to thermal burns and to evaluate LSCD in the light of global consensus.

Methods: Thirty-three eyes of 20 cases with ocular surface injury due to thermal burn who attended to the clinic between 2012 and 2023 were included in the study. LSCD severity was staged according to the global consensus which was published in 2019.

Results: The mean age of 20 cases was 45.8 ± 13.362 (19-78) and female/male ratio was 4/16. The causes of thermal burns were exposure to fire in 10 (50%), molten metal in 5 (25%), pressure cooker explosion in 3 (15%), and hot water in 2 (10%) cases. The number of cases who recovered without sequelae was 15. The observed sequelaes were LSCD (21.2%), symblepharon (6.06%), and corneal opacity (9.09%). Considering the distribution of LSCD, 28.57% of the eyes were Stage Ia, 14.28% were Stage Ib, 28.57% were Stage IIb, 28.57% were Stage III. The symblepharon was Stage IIa in 2 patients. Surgery was performed in 4 patients with sequelae (penetrating keratoplasty in 1, corneal debridement in 1, limbal autograft in 1, amniotic membrane transplantation + symblepharon excision + limbal autograft in 1 eyes).

Conclusion: Most of the thermal injuries heal without sequelae. If a sequela takes place, the most common one is severe LSCD-half of which are severe.

Purpose: This study evaluates the effectiveness of the inverted internal limiting membrane (ILM) flap technique during vitrectomy for treating macular hole-induced retinal detachment (MHRD) in high myopia patients, a challenging complication for vitreoretinal surgeons due to its treatment complexity.

Methods: We conducted a prospective study analyzing 92 eyes diagnosed with MHRD, all undergoing vitrectomy using the inverted ILM flap technique between February 2022 and September 2024. Successful surgery was defined as achieving retinal reattachment, macular hole closure, and improvement in visual acuity by the 12-month postoperative follow-up. Microstructural recovery was assessed using spectral domain optical coherence tomography. Logistic regression analysis was performed to identify prognostic factors of surgical outcome.

Results: Of the 92 eyes, 94.6% achieved retinal reattachment, and 92.4% experienced macular hole closure. Visual acuity significantly improved in 91.3% of cases, with a mean improvement of 0.95 logarithm of the minimum angle of resolution. Recovery rates for the external limiting membrane, the ellipsoid zone, and the cone outer segment tip were 76.1%, 66.3%, and 66.3%, respectively. Larger retinal detachments and macular holes were important predictors of lower surgical success (p < 0.001; p = 0.015, respectively). There was a significant correlation between vision improvement and the recovery of structural integrity and foveal microstructures.

Conclusions: The ILM coverage technique represents a breakthrough in the treatment of MHRD, promoting both anatomical and functional recovery. This approach enhances the management of this complex condition, ultimately improving the quality of life for affected individuals.

Purpose: To examine the detailed vascular and morphological characteristics of the choroidal tissue in subjects with myopia.

Methods: A total of 111 subjects with myopia were included in the study. The study was conducted in three groups according to spherical equivalent(SE). Group 1 comprised subjects with low myopia (SE between 0.00 diopter (D) and - 3.00 D), Group 2 included those with moderate myopia (SE between - 3.25 D and - 6.00 D), and Group 3 consisted of subjects with high myopia (SE of - 6.25 D or worse). The following parameters were measured: axial length(AL), SE, central macular thickness (CMT), choroidal thickness(CT), total choroidal area(TCA), luminal area(LA), stromal area(SA), LA/SA ratio, and choroidal vascularity index(CVI). The binarization method was employed to calculate the TCA, LA, SA, LA/SA ratio, and CVI values. A comparison was conducted between the groups with respect to all parameters.

Results: In patients with high myopia, CT values (subfoveal, nasal, and temporal) were significantly thinner than moderate and low myopic patients (< 0.001). The low myopic group exhibited significantly elevated LA, SA, and TCA values in comparison to the moderate and high myopic groups. Conversely, the LA/SA ratio and CVI values were observed to be higher in patients with high myopia than in those with low or moderate myopia. A statistically significant negative correlation was identified between CVI and LA/SA values and SE(r = - 0.270, P = 0.004; r = - 0.291, P = 0.002, respectively). A statistically significant positive correlation was identified between CVI and LA/SA values and AL (r = 0.269, P = 0.004; r = 0.281, P = 0.003, respectively).

Conclusion: In young adults, high myopia has been linked to significant choroidal thinning in the macular region. This reduction in choroidal thickness is largely attributed to a decrease in the stromal component of the choroid, rather than the luminal (vascular) component.

Trial registration date and number: 08/06/2022, 2022-49.

Purpose: To characterize the anterior segment (AS) morphology of patients with long-term silicone oil (SiO) in situ (> 12 months) following pars plana vitrectomy (PPV).

Methods: This prospective, comparative characterization study was conducted between January 2022 and July 2023. Patients were included and sorted based on if they had undergone PPV without long-term SiO or had SiO in situ for at least 12 months at the time of review and image collection. The Zeiss Cirrus HD-OCT (Carl Zeiss, Dublin, California, USA) was employed to image the ASs of study patients. Software within the OCT was used to collect the central corneal thickness (CCT), anterior chamber diameter (ACd), anterior chamber depth (ACD), chamber area, temporal irideocorneal angle and nasal irideocorneal angle.

Results: A total of 78 eyes from 42 total patients were included, their mean age was 63.74 ± 19.13 years and 64.29% (27/42) of participants were males. Patients who underwent PPV with and without long-term SiO were found to have no significant difference in CCT, ACd, ACD, chamber area and irideocorneal angles compared to their fellow unoperated eyes. The multivariate analysis of variance of the pooled data noted a statistically significant difference in the ACd of PPV with long-term SiO eyes compared to PPV without long-term SiO and unoperated eyes (p = < 0.001).

Conclusion: These findings suggest PPV with long-term SiO may alter the AS morphology of patients, its influence on the development of OAG remains unclear and warrants further investigation.

Background: Retinopathy of prematurity (ROP) is a major cause of childhood blindness worldwide, highlighted by retinal neovascularization. Ubiquitin is present throughout the retina. The deubiquitinating enzyme ubiquitin-specific protease 39 (USP39) has been reported to be involved in angiogenesis. Here, this study aimed to investigate the effects of USP39 on ROP and its associated mechanism.

Methods: Hypoxia-induced human retinal microvascular endothelial cells (hRMECs) were adopted for functional analyses. Detection of mRNA and protein was conducted using quantitative real-time PCR and western blotting. Cell migration, invasion and angiogenesis were evaluated using transwell and tube formation assays. Protein interaction was determined by immunoprecipitation assay. Oxygen-induced retinopathy (OIR) mouse models were used for in vivo analysis.

Results: USP39 level was higher in hypoxia-induced hRMECs, functionally, USP39 silencing reversed hypoxia-induced migration, invasion and angiogenesis in hRMECs. In further mechanism analysis, we found that USP39 stabilized SIRT2 protein expression in hRMECs by inducing SIRT2 deubiquitination. Moreover, SIRT2 up-regulation abated hypoxia-evoked migration, invasion and angiogenesis in hRMECs. Besides that, the inhibitory effects of USP39 silencing on hypoxia-induced metastatic and angiogenic behaviors were abolished after SIRT2 overexpression. In addition, USP39 silencing blocked the activation of phosphoinositide 3-kinase (PI3K)/protein kinase B pathway (AKT) by regulating SIRT2. In vivo assay showed that levels of USP39, SIRT2, matrix metalloproteinase (MMP)-2 (MMP-2), MMP-9 and Vascular endothelial growth factor A (VEGFA) were increased in the retinas of OIR mice, while intravitreal injection of USP39 short hairpin RNA (shRNA) could reduce their expression.

Conclusion: USP39 stabilized SIRT2 expression by deubiquitination and promoted hypoxia-induced metastatic and angiogenic behaviors of RMECs in vitro, as well as retinal angiogenesis in vivo.

Purpose: To evaluate the efficacy of sulfasalazine (SSZ) for recurrent acute anterior uveitis (AAU).

Methods: Retrospective chart review of patients diagnosed with recurrent AAU treated with SSZ from January 2008 to September 2023. The grading of uveitis activity was defined as per SUN working group. The primary outcome was the reduction in the number of uveitis flare-ups over a one-year, two-year and three year-period, compared to pre-treatment year. The response criteria to SSZ were defined as normal ophthalmologic examination. Paired samples Wilcoxon test and Kaplan-Meier survival curve were calculated using R-Commander statistical software (p < 0.05).

Results: Fifty-three patients were included. Mean time of follow up was 38.51 ± 38.45 months. Nine patients developed adverse effects to SSZ (16.98%) most of them mild. Ankylosing spondylitis was the most frequent association (n = 28, 52.83%), while HLA-B27 was positive in 69.23% of the patients (n = 36). The most frequent indication for SSZ was based on ocular activity in 52.83% (n = 28). The number of flare-ups dropped from 2.25 (± 1.34) in the pre-treatment year to, 0.81 (± 0.99) at year 1 (p < 0.001), 0.61 (± 0.78) at year 2 (p < 0.001) and 0.65 (± 0.83) at year 3 (p = 0.005). The median time to flare-up of AAU after SSZ was 15.13 months (CI 95, 7.97-27.40).

Conclusion: Our data point to sulfasalazine as an effective treatment to reduce flare-ups in patients with recurrent non-infectious AAU. Its low cost and good safety profile make it an interesting therapeutic alternative, especially in women of childbearing age.

Purpose: We aimed to evaluate the effects of autologous serum plus artificial tears on corneal sensation and tear film stability in patients with mild to moderate xerophthalmia after cataract surgery.

Methods: A total of 150 patients with mild to moderate xerophthalmia after one-time cataract surgery from March 2022 to September 2023 were selected and randomly divided into a control group (n = 75) and a study group (n = 75). The control group was treated with artificial tears (polyvinyl alcohol eye drops), while the study group was given autologous serum plus artificial tears. The treatment lasted for four weeks in both groups. The clinical efficacy was observed and adverse reactions were recorded.

Results: The clinical effective rate of the study group was higher than that of the control group (96.00% versus 86.67%) (χ² = 4.127, P < 0.05). After four weeks of treatment, the corneal sensation was superior to that before treatment in both groups, and it was better in the study group than that in the control group (Z = 2.053, P < 0.05). In comparison with the pre-treatment period, the tear film break-up time (BUT) increased, while the corneal fluorescein staining (FL) score and levels of inflammatory factors tumor necrosis factor-α, interleukin-6 (IL-6) and IL-1β dropped in both groups after treatment, and the study group had longer BUT and a lower FL score than those of the control group (t = 6.492, 7.033, 7.140, 4.709 and 3.059, P < 0.05). The incidence rates of adverse reactions were similar between the two groups (χ² = 0.132, P > 0.05).

Conclusions: Autologous serum plus artificial tears can improve the corneal sensation and tear film stability and alleviate inflammatory responses without increasing adverse reactions in patients with mild to moderate xerophthalmia after cataract surgery.

Purpose: To evaluate the severity distribution of chemical burn-induced Limbal stem cell deficiency (LSCD) according to the novel global consensus classification and to compare the treatment approach, before and after the global consensus.

Methods: Medical records of 127 eyes of 109 patients with LSCD were included. LSCD stages were categorized according to the global consensus classification published by "International LSCD Working Group".

Results: The mean age was 37.5 ± 16.5(6-75). The distribution of LSCD stage according to the global consensus scale was as follows: Stage 1A in 5 eyes(3.9%);Stage 1B in 16 eyes(12.6%);Stage 1C in 4 eyes(3.2%);Stage 2A in 15 eyes(11.8%);Stage 2B in 36 eyes(28.3%);Stage 3 in 51 eyes(40.2%). A total of 88(69.3%) eyes underwent surgery for LSCD. Of these, 80 had surgery prior to the publication of the global consensus (before October 2020), 58(72.5%) had preoperative severe (≥ Stage 2B) LSCD and 22(27.5%) had preoperative early stage (≤ Stage 2A) LSCD. As of October 2020, all 8 eyes that underwent surgery had preoperative severe (≥ Stage 2B) LSCD, as recommended by global consensus.

Conclusion: Recently, a global consensus has been established on both the classification and the management of LSCD. This study is one of the first to present small-scale epidemiological data on the severity distribution of LSCD in the light of the global consensus. It was observed that surgery was performed on 27.5% of the eyes that were not recommended for surgery according to this new consensus. With the increasing awareness of this consensus, it might be possible to avoid unnecessary surgical intervention.

Purpose: To compare the accuracy of intraocular lens (IOL) power calculation formulas in cataract patients with keratoconus (KC).

Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis statementand and was registered on PROSPERO (CRD42024568997). Pubmed, Web of Science, Cochrane Library, and EMBASE were searched for retrospective and prospective clinical studies published until October 2024. The outcome measurement was the percentage of eyes with a predicted error (PE) within ± 0.50 or ± 1.00 diopter (D).

Results: The study have nine retrospective clinical trials, involving a total of 637 eyes and 18 calculation formulas. According to the ranking based on the surface under the cumulative ranking curve by Bayesian method, the top three formulas were Barrett True-K formula for keratoconus predicted posterior corneal astigmatism (Barrett KC P-PCA), EVO2.0, and Barrett True-K formula for keratoconus measured posterior corneal astigmatism (Barrett KC M-PCA) on the percentage of PE within ± 0.50 D, and the comparison between the three formulas and Barrett Universal II formula has statistical significance. In the range of ± 1.00D, the top three formulas were Barrett KC P-PCA, Barrett KC M-PCA and Kane for keratoconus formula, and the difference was significant. Thereforewe recommend using the Barrett KC P-PCA formula and the Barrett KC M-PCA formula for calculating IOL power in cataract patients with KC.

Conclusion: This study revealed that the KC-specific IOL formulas, notably the Barrett KC P-PCA and Barrett KC M-PCA formulas, demonstrated superior accuracy. In clinical practice, when managing patients with different degrees of KC, surgeons should take into account the individual characteristics of each patient and adopt multiple formulas to improve the accuracy of refractive prediction.