International Ophthalmology最新文献

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease with a strong genetic component, frequently accompanied by extra-articular manifestations such as acute anterior uveitis (AAU). This study aimed to evaluate the association of the rs11362 and rs1800972 (DEFB1), and rs3806268 and rs10754558 (NLRP3) gene variants in AS patients with and without AAU.

Methods: A case control-study was conducted on 58 patients with AS and 70 healthy controls. Genotyping was performed using the TaqMan® SNP Genotyping Assay. Genotype frequencies were compared between studied groups and subgroups, and associations were estimated by logistic regression models. Interactions between these variants were also evaluated.

Results: In the case-control analysis after adjusment, the TT (rs11362) and CC (rs1800972) genotypes of the DEFB1 gene were significantly associated with an increased risk of AS (OR = 6.89, 95% CI = 1.66-28.4, p = 0.008 and OR = 3.43, 95% CI = 1.02-11.5, p = 0.046, respectively). Then, in the subanalysis, the GC (rs1800972) genotype was associated with an increased risk of AAU (OR = 9.93, 95% CI = 1.76-55.7, p = 0.009). No significant associations were observed for NLRP3 polymorphisms individually. However, a strong interaction between rs1800972 and rs3806268 polymorphisms was observed (entropy = 22.95%).

Conclusions: These results suggest that DEFB1 gene variants (rs11362 and rs1800972) are associated with an increased risk of developing AS. Specifically, rs1800972 is associated with increased susceptibility to AAU. While NLRP3 variants did not show significant associations independently, their interaction with DEFB1 variants suggests a possible synergistic effect on AAU development.

Purpose: This study evaluates the impact of medical versus combined medical and surgical glaucoma treatments on patients' quality of life (QoL). While both approaches reduce intraocular pressure, research shows mixed effects on QoL. Given updated clinical guidelines and the gap in QoL-focused glaucoma management, this study applies validated QoL measures to assess treatment effects and inform patient-centered care.

Methods: From June to October 2023, 180 patients at Augusta University Eye Care Center completed the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and Glaucoma Profile Instrument (GPI) surveys. Chart reviews provided demographic and clinical data, including glaucoma status and treatment. QoL scores were calculated using validated algorithms. Associations between clinical variables and QoL outcomes were analyzed using ANOVA and t-tests in R 4.4.1.

Results: Among 180 patients, 103 had glaucoma or were suspects. 64% of glaucoma patients received medical treatment only, and 34% received combined medical and surgical treatment. VFQ-25 scores differed significantly by race (p = 0.0489), severity (p = 0.0001), and age (p = 0.0459), but not by gender, glaucoma status, or treatment. Severe glaucoma patients had the lowest QoL. Severity strongly impacted GPI scores (p = 0.0092) and multiple VFQ-25 domains. Differences by treatment modality were observed only in the driving subscale (p = 0.0378). No significant differences were observed in overall QoL scores between treatment groups.

Conclusion: No significant vision-related QoL differences were found between treatment groups. Most patients were medically managed, possibly reflecting limited QoL benefit from surgery. QoL correlated more with disease severity than treatment modality or demographics. These findings highlight a disconnect between current treatment strategies and patient-perceived outcomes, underscoring the need for innovative strategies to improve QoL in glaucoma care.

Purpose: This study aims to systematically evaluate the consistency of total keratometry (TK) and posterior keratometry (PK) measurements obtained by the IOL Master 700 and Pentacam in cataract patients with varying axial lengths (AL).

Methods: A total of 240 cataract patients (240 eyes) were recruited from Beijing Tongren Hospital between February and April 2025. Participants were categorized into six groups based on AL: < 22 mm, 22-24 mm, 24-26 mm, 26-28 mm, 28-30 mm, and ≥ 30 mm. All patients underwent preoperative examinations using the IOL Master 700 and Pentacam systems to obtain measurements of TK and PK. The paired t-test or Wilcoxon signed-rank test was employed to evaluate intergroup differences. The Bland-Altman analysis was conducted to assess the 95% limits of agreement (LoA), with calculation of the mean difference.

Results: Except for the subgroup with AL < 22 mm, the TK measured by the IOL Master 700 was significantly higher than that obtained using the Pentacam across all AL subgroups. The mean difference ranged from 0.005D to 0.406 D, with the width of the 95% LoA varying between 1.071D and 2.382D. For PK, measurements obtained by the IOLMaster 700 were significantly flatter compared to those from the Pentacam across all subgroups. The mean differences ranged from 0.442 to 0.478 D, with the width of the 95% LoA ranging from 0.244 to 0.319 D.

Conclusion: Regardless of AL, the measurement discrepancies in TK and PK between the two devices exceed the clinically acceptable limits, suggesting that these devices are not interchangeable across patients with varying AL.

Purpose: To evaluate the long-term efficacy of corneal crosslinking using the standard protocol (S-CXL) and the accelerated protocol (A-CXL) over a period of 8 years.

Methods: This retrospective cohort study included 61 eyes from 61 patients with progressive keratoconus (KC). They were treated with either the S-CXL (3*30, N = 16) or the A-CXL (9*10, N = 45). Visual acuity and corneal parameters, including higher-order aberrations (HOAs), corneal tomography, and corneal densitometry, were recorded prior to the intervention and at four follow-up visits using Scheimpflug tomography. A linear mixed model with Bonferroni correction was used to analyze the longitudinal data.

Results: Anterior corneal curvature parameters were significantly reduced in both groups at 3 and 8 years (all p ≤ 0.019). Central and thinnest corneal thickness decreased significantly after 12 and 36 months (p < 0.001). Surface variance and vertical asymmetry indices remained unchanged postoperatively, despite the significant reduction at 8 years in the A-CXL group (p < 0.001). The greatest increase in corneal optical density was observed in both groups at 6 months in the anterior layer up to a diameter of 10 mm, which roughly normalized at 12 months. HOA coma was reduced in both groups at 36 and 96 months (all p ≤ 0.012). In contrast, only the S-CXL group showed a borderline significant improvement in visual acuity after 96 months (p = 0.049) which should be interpreted cautiously due to differences in sample size and baseline characteristics. The rate of postoperative complications was comparable in both protocols.

Conclusion: In an 8-year long-term follow-up, both S-CXL and A-CXL successfully halted KC progression. Non-inferiority of the accelerated protocol was demonstrated.

This study discusses four cases of fungal keratitis (FK) caused by uncommon fungal pathogens. It's important to note that FK caused by these species is either rare or has not been reported before. Rare fungal pathogens including Subramaniula lateralis, Inocutis levis, Neoscytalidium dimidiatum, and Bipolaris panini-miliacei were identified in corneal scraping specimens. Patients were treated with systemic and topical antifungal agents, and surgical intervention was performed when necessary. This report emphasizes the importance of considering rare fungal species in cases of keratitis, highlighting the necessity of recognizing and awareness of these less common fungal species.

Purpose: The extraocular muscles (EOM) within the orbit provide ocular motility. Knowing the morphometric properties of these muscles is of clinical importance because various pathologies can affect the orbit and its structures. This study aims to compare normative EOM thickness values across gender and age groups and to investigate the potential relationship between refractive errors caused by the eye's axial length (AL).

Methods: A retrospective study was conducted on 120 males and 125 females over 20 years of age who underwent orbital magnetic resonance imaging (MRI) in the Department of Radiology. Interzygomatic line length (IZL) in 245 individuals, axial length in 490 eyes, and long-short diameters of the EOM in coronal sections were measured, and variations were investigated.

Results: Three of the 11 EOM measurements were significantly larger on the left and one was significantly larger on the right (p  <  0.05). AL was not significantly different between the sides (p˃0.05). AL, IZL, and 8 of the 11 EOM lengths were significantly larger in men (p < 0.05). Among the individuals divided into 20-year age groups, the EOM short diameters were smaller in individuals aged 20-39 compared to those in older age groups (p < 0.05).

Conclusion: While normative EOM lengths may vary depending on gender, side of eyelid, and age, they have been shown to be unchanged in axial myopia or hyperopia. The information obtained may contribute to the diagnosis and treatment of orbital pathologies.

Purpose: To investigate the neuroprotective effects of N-acetylcysteine (NAC) in comparison with brimonidine in an experimental glaucoma model.

Methods: Thirty-two adult female Wistar albino rats were randomly assigned to five groups: Control, Sham, NAC, Brimonidine, and Combination (NAC + Brimonidine). Glaucoma was induced in the right eye by optic nerve crush in all groups except Control. Treatments were administered intraperitoneally every 72 h for 30 days. Neuroprotection was assessed histopathologically by measuring ganglion cell layer (GCL) thickness and total retinal thickness. Apoptotic activity and glial activation were evaluated by quantifying B-cell lymphoma/leukemia-2 (BCL-2), BCL-2-associated X protein (BAX) and glial fibrillary acidic protein (GFAP) expression. Oxidative stress and antioxidant capacity were assessed using malondialdehyde (MDA), total oxidant status (TOS), glutathione (GSH) and total antioxidant capacity (TAC) levels.

Results: NAC significantly preserved GCL and total retinal thickness compared with the Sham group (P < 0.001), with neuroprotective efficacy comparable to brimonidine (P > 0.05). The combination therapy group demonstrated the most pronounced neuroprotective effects. NAC treatment increased antiapoptotic BCL-2 and GSH levels while reducing BAX, GFAP, MDA, and TOS levels (P < 0.001).

Conclusions: NAC exhibited substantial neuroprotective effects in an intraocular pressure-independent glaucoma model, likely mediated through its antioxidant properties and modulation of apoptotic pathways. These findings suggest that NAC may serve as a promising adjunctive therapy for glaucomatous optic neuropathy and other retinal neurodegenerative disorders characterized by oxidative stress and apoptosis.

Purpose: This study aimed to compare the effects of trifocal (TF) and monofocal intraocular lenses (Mono-IOL) on microperimetry outcomes in patients who underwent uncomplicated cataract surgery.

Methods: A total of 44 Mono-IOL and 38 TF-IOL recipients were evaluated six months postoperatively. Corrected distance visual acuity (CDVA) was assessed using a standard logMAR chart. Microperimetry assessments were performed using the MP-1 microperimeter to measure retinal sensitivity (RS) at 2°, 6°, and 10°, fixation points (FP) within 2° and 4°; and fixation stability. Fixation stability was quantified using the Bivariate Contour Ellipse Area (BCEA). Contrast sensitivity was assessed separately using the Pelli-Robson chart.

Results: The Mono-IOL group exhibited significantly higher CS (1.80 ± 0.10 vs. 1.70 ± 0.11, p < 0.01) and better CDVA (p = 0.044). Retinal sensitivity was also greater at RS-2° (p = 0.036), RS-6° (p = 0.014), and RS-10° (p = 0.01). Fixation stability was better in the Mono-IOL group, with significantly smaller BCEA values at 1SD (1292 ± 1128 vs. 2027 ± 1637 min arc², p = 0.013), 2SD (3551 ± 3164 vs. 5416 ± 4454 min arc², p = 0.032), and 3SD (6361 ± 5685 vs. 9654 ± 7929 min arc², p = 0.029). FP-2° was also higher in the Mono-IOL group (p = 0.012), while FP-4° and fixation location showed no significant differences.

Conclusion: Mono-IOLs provided superior contrast sensitivity, retinal sensitivity, and fixation stability compared to TF-IOLs, indicating better postoperative visual function.

Purpose: To evaluate the effects of upper eyelid blepharoplasty on corneal topography and higher-order optical aberrations (HOAs).

Methods: Seventy-seven patients (154 eyes) who underwent upper eyelid blepharoplasty for dermatochalasis and had complete preoperative and 3-month postoperative corneal topography and aberrometry data were included. All measurements were obtained using the Sirius topography system. Aberrometric parameters-including total RMS, HOA RMS, coma, trefoil, and spherical aberration-as well as advanced topographic indices such as EIf, EIb, TSI, and TImax were analyzed. As this was a retrospective observational study, trial registration was not applicable.

Results: No statistically significant change was observed in total RMS values. At a 6 mm pupil diameter, HOA RMS decreased from 0.53 ± 0.25 to 0.49 ± 0.17 (p = 0.014), and coma decreased from 0.31 ± 0.20 to 0.27 ± 0.14 (p = 0.002). Spherical aberration also showed a postoperative reduction (0.23 ± 0.10 to 0.21 ± 0.10; p = 0.008). Significant improvements were detected in trefoil (p < 0.001), TImax (p < 0.001), EIf (p < 0.001), EIb (p = 0.008), and TSI (p = 0.005). No significant postoperative differences were observed in keratometric values or secondary astigmatism (p > 0.05).

Conclusion: Upper eyelid blepharoplasty appears to produce beneficial changes in corneal surface morphology and optical aberrations. Given its potential to enhance visual quality and patient satisfaction, the functional implications of blepharoplasty should be considered alongside its aesthetic goals during surgical planning.

Purpose: Age-related macular degeneration (AMD) is the leading cause of blindness among middle-aged and older adults, bringing a heavy health burden. Understanding the patterns of AMD disease burden and the risk factors associated with early AMD development is crucial for formulating targeted public health policies.

Methods: We estimated the prevalence of AMD and disability-adjusted life year (DALY) using data from the 2021 Global Burden of Disease (GBD). Our analysis examined trends in prevalence and DALY by age, sex, and sociodemographic index (SDI) at global, regional, and national levels from 1990 to 2021. We performed data analysis using two Mendelian randomization (MR) samples to explore the causal relationship between lipid metabolism, nutrients, and early AMD risk. The primary analysis was conducted using the inverse variance weighting method, along with a range of sensitivity analyses.

Results: In 2021, AMD's DALY was 570,000, the age-standardized prevalence rate (ASPR) was 94.00/100,000 (95% UI, 78.32-114.42), and the age-standardized disability rate (ASDR) was 6.78/100,000 (95% UI, 4.70-9.32). The burden of AMD showed a downward trend during the study period. The disease burden is closely related to socioeconomic development and is unevenly distributed, with a heavier burden in low sociodemographic index (SDI) regions, especially in southern and central sub-Saharan Africa. Age-specific DALYs showed a gradual increasing trend, with female DALYs higher than male DALYs in all age groups. Decomposition analysis showed that population growth led to an increase in AMD DALYs. Projections from the Bayesian Age-Period Cohort (BAPC) model indicate that global AMD DALYs may continue to rise by 2045. Additionally, multivariate Mendelian randomization (MVMR) evaluation results showed that triglycerides (TG) (OR, 0.82; 95% CI, 0.73-0.92; p = 0.001) and high-density lipoprotein (HDL) (OR, 1.15; 95% CI, 1.04-1.28; p = 0.009) were significantly associated with early AMD. For every one standard deviation increase in TG levels, the risk of AMD decreases by an average of 18%. Higher TG levels are a protective factor for early AMD. However, the effect of HDL on AMD is the opposite of that of TG. For every one standard deviation increase in HDL levels, the risk of AMD increases by an average of 15%. Higher HDL levels are a risk factor for AMD.

Conclusions: AMD remains a major health problem worldwide, especially in low SDI regions. Population growth and aging have the most significant impact on AMD DALYs. HDL was identified as a risk factor, while TG was identified as a protective factor. These findings highlight the need for targeted interventions in low SDI regions, including dietary control, early screening, and addressing socioeconomic factors through balanced dietary plans.