Contact Lens & Anterior Eye最新文献

Purpose: To analyze the efficacy of different disinfecting methods for contact lenses (CL) against Acanthamoeba castellanii (AC) using quantitative PCR (qPCR) based on RNA detection.

Methods: Three CL materials: rigid gas permeable (RGP), hydrogel (Hy), and silicone hydrogel (SiHy), were contaminated with 1x10⁵ amoebae/ml and incubated for 24 h at 30 °C. After contamination, pre-cleaning steps were performed before using four maintenance solutions based on hydrogen peroxide (HP), sodium hypochlorite (SH), povidone-iodine (PI), and a multipurpose solution (MS). The pre-cleaning steps involved using a cleaner (20 % isopropyl alcohol) and rinsing the CL. Disinfection systems 1 and 2 involved no cleaner and rinsed the CL with tap water or saline solution, respectively. Systems 3 and 4 included a cleaner and rinsed with tap water or saline, respectively. After cleaning, A. castellanii was extracted and stored for qPCR analysis, using Hsp70 and TPBF genes to detect RNA A. castellanii. Results were presented as the percentage of positives or negatives (presence or absence of amoebae), with a p-value < 0.05 considered statistically significant.

Results: Disinfection system 1 with MS resulted in 56 % positives for RGP lenses and 100 % positives for both hydrogel materials. When MS was combined with a cleaner, 12.5 % positives were found for SiHy and 100 % negatives for Hy and RGP lenses (p < 0.05). PI solution alone yielded 38 % and 12 % positives for hydrogel and silicone hydrogel lenses, respectively, but was 100 % effective when combined with a cleaner. HP and SH, whether combined with a cleaner or not, were effective against AC for all CL materials, except HP without a cleaner for Hy lenses.

Conclusion: All disinfection methods showed some efficacy against Acanthamoeba on any CL material. The most effective solutions were those based on hydrogen peroxide and sodium hypochlorite. Using a cleaner enhanced the final disinfecting efficacy, especially with the multipurpose solution.

Background: To compare the efficiency of three artificial intelligence (AI) frameworks (Standard Machine Learning (ML), Multi-Layer Perceptron (MLP) and Convolution Neural Networks (CNN)) with a reference method (Mean radius of curvature (K)) to predict the posterior radius of curvature of the best-fitted rigid contact lens (RCBFL) in keratoconus eyes.

Methods: This retrospective study included 197 keratoconus eyes of 135 patients fitted with Rose K2® (Menicon®, Nagoya, Japan) rigid contact lenses with one or more topographies available (MS39®, CSO®, Ferrara, Italy) between January 2020 and September 2022. Two types of topographic data (indices and reconstructed maps from raw data) were used for AI analysis. Three distinct approaches were utilized for leveraging AI: Standard ML methods and MLPs based on topographic indices and CNNs based on topographic maps (i.e., corneal thickness, sagittal, and tangential maps). Seventeen AI framework's accuracies were compared with the r² determination coefficient of linear regression between predicted and best-fitted radii. Framework accuracies were compared with the Fisher z-transformation of Pearson correlation coefficients.

Results: In multiple linear regression, only three topographic indices (i.e., 3- & 5-mm mean K and Kmax) were significantly associated with RCBFL (p ≤ 0.0001). Compared with the reference method (mean-K; r² = 0.36), a significantly better RCBFL prediction was achieved with Random Forest using the three topographic indices, MLP using all indices, ResNet18 CNN using anterior topographic maps and CNNs using combined parameters (0.69 ≤ r² ≤ 0.80; p < 0.05). The best accuracy was obtained with the EfficientNetB0 CNN trained with three maps (r² = 0.80).

Conclusions: Artificial intelligence methods, particularly CNNs, with corneal topography data of MS39® topographer, have demonstrated superiority over conventional approaches in predicting the posterior curvature radius of Rose K2® rigid contact lenses in patients with keratoconus.

Purpose: To assess the repeatability of measures for dry eye disease (DED) symptoms and signs in the DREAM study.

Methods: At screening and baseline visits approximately 2 weeks apart, participants were assessed for symptoms by Ocular Surface Disease Index (OSDI) and Brief Ocular Discomfort Index (BODI), and signs by the same physician in the same order: tear break-up time (TBUT), corneal staining, conjunctival staining, Meibomian gland evaluation, and the Schirmer test. The repeatability of DED symptoms and signs was assessed by interclass correlation coefficient (ICC), 95 % limits of agreement, and the percent of eyes with inter-visit difference above the clinically significant threshold.

Results: Among 1046 eyes (523 participants), ICC for signs ranged from 0.53 (TBUT) to 0.73 (corneal staining). A substantial percentage of eyes showed clinically significant inter-visit differences: ≥2 points in 17.8 % of eyes for conjunctival staining; ≥3 points in 18.8 % for corneal staining; >2 s in 14.1 % for TBUT; ≥5 mm/5 min in 29.9 % for the Schirmer test, and ≥ 2 points in 27.5 % for Meibomian gland plugging and lid secretion. The OSDI and BODI had ICC of 0.64 and 0.63 respectively, and nearly 40 % of participants had inter-visit score differences ≥ 10 points.

Conclusion: In DREAM participants with moderate-to-severe DED, DED signs and symptoms had moderate repeatability, with ocular surface staining scores being the most repeatable and TBUT the least repeatable. A notable percentage of participants had inter-visit differences above the clinically meaningful threshold. These test-retest variabilities in DED signs and symptoms should be considered for designing clinical trials and monitoring disease progression.

Purpose: To investigate changes in the choroid and axial length (AL) during one month of combined therapy and monotherapy with 0.05% atropine and dual-focus soft contact lens (DFCL), and the impact after discontinuation.

Methods: Myopic adults randomly received three interventions: 0.05 % atropine, DFCL, and 0.05 % atropine combined with DFCL. Choroidal thickness (ChT), choroidal vascularity index (CVI) and AL were measured at baseline, 3, 7, 14, and 30 days after intervention, and 1, 2, 7, 14, and 30 days after discontinuation.

Results: The ChT thickened and AL decreased after one month of combination therapy (24.19 ± 4.13 μm, P = 0.001; -40.35 ± 9.55 μm, P = 0.024) or 0.05 % atropine (20.52 ± 4.35 μm, P = 0.008; -8.07 ± 7.22 μm, P = 0.002) but not DFCL (8.95 ± 4.25 μm, P > 0.999; -14.89 ± 7.28 μm, P > 0.999). The increase in ChT and decrease in AL persisted for 2 days after 0.05 % atropine was discontinued, persisted for 7 days and 14 days after combination therapy was discontinued. There was no significant change in the CVI after one month use or withdrawal of any intervention (P > 0.999). After one month of combination therapy, significant correlations were observed between the baseline CVI and changes in ChT (r = 0.485, P = 0.035) or AL (r = -0.589, P = 0.008).

Conclusion: Monotherapy involving 0.05% atropine or the combination of 0.05% atropine with DFCL significantly affected ChT thickening and AL shortening. These changes were maintained for a longer duration post combination intervention. The baseline CVI was associated with changes in ChT and AL during combination treatment.

Purpose: To assess the tear levels of a set of apoptotic, matrix-degrading and antioxidant biomarkers, including Metalloproteinase 9 (MMP9), High Mobility Group Box 1 (HMGB1) and Superoxide Dismutase 3-Extracellular (SOD3).

Methods: Sandwich-ELISA commercial kits were used to test the expression of the three tear biomarkers in the lacrimal fluid of eligible participants. Linear logistic regression analysis was performed todetermine whether the set of tear biomarkers could be associated with clinically manifest keratoconus. ROC curve analysis using 10-fold cross-validation was performedto evaluate the prediction accuracy of the model.

Results: Eighty-one participants aged 30-48 years old were enrolled in this study; 48 were patients with keratoconus and 33 were age-matched healthy subjects. The linear combination of the three tear biomarkers levels (AUC = 0.811; CI 95 %: 0.712-0.911) accurately indicated the existence of keratoconus; higher levels of MMP9 (Odd Ratio: 1.069; CI 95 %: 1.029-1.130) and HMGB1 (OR: 1.011; CI 95 %: 1.003-1.022) and lower levels of SOD3 (OR: 0.994; CI 95 %: 0.989-0.997) were significantly associated with a higher probability of keratoconus.

Conclusion: Multivariable analysis of the set of tear levels of MMP9, HMGB1 and SOD3 biomarkers confirmed a chronic state of inflammation in the ocular surface of patients with keratoconus.

Purpose: To investigate the efficacy and safety of 0.01% atropine (AT) in combination with different optical treatments for controlling myopia in Chinese children.

Methods: This retrospective study analyzed 341 Chinese children aged 6-11 years with myopia between -0.50 D and -3.0 D between January 2022 and May 2023. The fast-progressing, myopic children received three optical treatments combined with 0.01 % atropine: 75 children with single-vision spectacles and atropine (SV + AT), 162 children with defocus-incorporated multi-segment spectacles and atropine (DIMS + AT), or 104 children with orthokeratology and atropine (OK + AT). The changes in spherical equivalent refraction (SER), axial length (AL), intraocular pressure (IOP), and amplitude of accommodation (AMP) were observed at 6-month and 1-year intervals.

Results: After controlling for baseline variables, at 6 months, the increase in adjusted AL was significantly greater in the SV + AT group than in the DIMS + AT group (difference = 0.13 mm, 95 % CI: 0.07-0.20, P < 0.05) and in the OK + AT group (difference = 0.09 mm, 95 % CI: 0.09-0.17, P < 0.05). A more significant progression in adjusted SER was also observed in the SV + AT group than in the DIMS group (difference = -0.20D, 95 % CI: -0.29 to -0.11, P < 0.05). At 12 months, the greatest increase in adjusted AL was observed in the SV + AT group, with a statistically significant difference of 0.24 mm (95 % CI: 0.19-0.29, P < 0.05) compared with the DIMS group and a difference of 0.19 mm (95 % CI: 0.13-0.25, P < 0.05) compared with the OK + ST group. Similarly, a more significant progression in adjusted SER was observed in the SV + AT group than in the DIMS group (difference = -0.36 D, 95 % CI: -0.48 to -0.24, P < 0.05).

Conclusions: This study suggested that 0.01% atropine combined with DIMS or orthokeratology may be viable for controlling low myopia in fast-progressing, myopic children.

Purpose: To explore the complex interface between the tear film, a unique mucosal fluid which is fundamental to ocular homeostasis and optimal vision, and an in-situ contact lens. This study exploits the use of a unique tear envelope (TE) extraction technique, which harvests the material-influenced layer of tear film that is in intimate contact with the lens during wear, to specifically investigate the influence of contact lens wear on tear film protein dynamics.

Methods: TEs were collected from freshly removed worn lens using a novel microcentrifuge 'piggyback' technique. Two distinct ex vivo studies were performed to investigate the key influencing factors involved. Non lens-wearing tear samples were also collected from all wearers. A compositional protein profile for each TE and tear film (TF) sample was obtained using an Agilent 2100 Bioanalyzer lab-on-a-chip microfluidic assay which detected proteins in a 14-230 kDa range.

Results: The data demonstrated that the TE protein compositional profile was quite distinct from either that of tear components deposited on the lens or those held in the tear menisci. For example, for one of the participant subgroups the tear protein average values in tears (n = 39) were determined at 35.2 ± 2.5 % lysozyme, 17.2 ± 0.6 % lipocalin, 7.3 ± 1.6 % IgA, 20.3 ± 1.3 % lactoferrin and 0.4 ± 0.4 % albumin as a function of total protein detected. In contrast, the average TE values were measured at 49.2 ± 3.7 %, 21.3 ± 3.9 %, 7.8 ± 1.6 % and 10.2 ± 1.7 % and 1.3 ± 2.8 % respectively with omafilcon A wear. In addition, 63 % of all TE samples (n = 180) (wearing lotrafilcon B and omafilcon A lenses) were albumin positive compared with only 19 % of all pre-lens insertion tear film samples (n = 237).

Conclusions: The TE approach not only allows material differentiation, but it can determine changes in the ocular host response that may otherwise be missed by sole non lens-wearing tear film sample analysis.

Purpose: Myopia has emerged as a significant public health concern. Recent studies have demonstrated that Orthokeratology (Ortho-K) can effectively decelerate axial length (AL) growth, with eyes possessing smaller back optical zone diameters (BOZD) exhibiting greater effectiveness compared to those with larger BOZD. This study aims to analyze the impact of Ortho-K with varying BOZD.

Method: This systematic review involved the retrieval of articles from eight databases: PubMed, Embase, Web of Science, Cochrane, CNKI, Wanfang, Sinomed, and VIP, covering the period from each database's inception to January 2024. It compared axial length (AL) changes between smaller and larger back optic zone diameters (BOZD). Review Manager 5.4 was used to statistical analysis and the results presented as weighted mean differences and 95% confidence intervals (CI). This review adheres to the PRISMA guidelines.

Result: This systematic review included two randomized controlled trials (RCTs) and five cohort studies (CS), analyzing a total of 702 eyes (352 eyes are treated with Ortho-K and BOZD ≤ 5.5 mm, 350 eyes are treated with Ortho-K and BOZD ≥ 6.0 mm). The findings indicate that the Ortho-K with smaller BOZD significantly reduces AL growth [WMD = -0.13, 95 %CI (-0.16 to -0.10), P < 0.001].

Conclusion: The Ortho-K with smaller BOZD prove more effective in controlling myopic AL growth compared with larger BOZD. However, in clinical practice, it is necessary to comprehensively evaluating factors such as patient age, myopia diopter, pupil diameter, higher-order aberration, treatment zone area, and corneal eccentricity to achieve optimized outcomes in improving naked-eye vision and myopia controlling.