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Novel Insight of Posterior Capsule Opacification: The Role of Lens Epithelial Cell Senescence 后囊膜混浊的新认识:晶状体上皮细胞衰老的作用。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-14 DOI: 10.1111/ceo.14582
Yu Ma, Zewen Ren, Yang Chen, Lu Qin, Rong Ju, Yingyan Qin, Mingxing Wu

Background

Posterior capsule opacification (PCO), the most common complication following cataract surgery, results from the proliferation, migration and epithelial–mesenchymal transition (EMT) of residual lens epithelial cells (LECs), typically driven by postoperative inflammatory and growth factor changes. However, delayed-onset PCO, occurring years after surgery without obvious inflammation, suggests the involvement of additional mechanisms, with senescent cells identified as contributors to EMT. This study investigates the role of LEC senescence in PCO development.

Methods

Transcriptomic data from the Gene Expression Omnibus (GEO) were analysed to identify senescence-associated pathways in PCO. Rabbit PCO models and oxidative stress-induced senescent SRA01/04 LECs were treated with dasatinib and quercetin (DQ) to target senescent cells and inhibit the senescence-associated secretory phenotype (SASP). Senescence, SASP and EMT biomarkers were assessed by qPCR, immunofluorescence and Western blotting. Cell migration, proliferation and apoptosis were analysed through wound healing, Transwell and flow cytometry assays.

Results

RNA sequencing from GEO revealed a significant correlation between senescence and PCO. In vitro, oxidative stress-induced senescent LECs exhibited increased EMT biomarkers, including vimentin and α-SMA. In a rabbit PCO model, senescence- and SASP-related genes (p53, MMP3 and IL-6) and proteins were upregulated. DQ treatment reduced senescence and EMT by inhibiting multiple EMT-related signalling pathways, especially the PI3K-Akt pathway (p-PI3K, p-Akt), leading to a significant reduction in PCO volume.

Conclusions

LEC senescence plays a key role in PCO development. DQ effectively targets multiple EMT signalling pathways, particularly PI3K-Akt, and shows promise as a strategy for the prevention and management of PCO.

背景:后囊膜混浊(PCO)是白内障手术后最常见的并发症,主要由术后炎症和生长因子变化引起的残留晶状体上皮细胞(LECs)的增殖、迁移和上皮间质转化(EMT)引起。然而,迟发性PCO,发生在手术后数年,无明显炎症,表明涉及其他机制,衰老细胞被认为是EMT的促成因素。本研究探讨LEC衰老在PCO发展中的作用。方法:分析基因表达图谱(Gene Expression Omnibus, GEO)的转录组学数据,以确定PCO中与衰老相关的途径。用达沙替尼和槲皮素(DQ)处理兔PCO模型和氧化应激诱导的衰老SRA01/04 LECs,以衰老细胞为靶点,抑制衰老相关分泌表型(SASP)。采用qPCR、免疫荧光和Western blotting检测衰老、SASP和EMT生物标志物。通过创面愈合、Transwell和流式细胞术分析细胞迁移、增殖和凋亡情况。结果:GEO的RNA测序显示衰老与PCO有显著相关性。在体外,氧化应激诱导的衰老LECs表现出增加的EMT生物标志物,包括vimentin和α-SMA。在兔PCO模型中,衰老和sasp相关基因(p53、MMP3和IL-6)和蛋白上调。DQ处理通过抑制EMT相关的多种信号通路,特别是PI3K-Akt通路(p-PI3K, p-Akt),导致PCO体积显著减少,从而减少衰老和EMT。结论:LEC衰老在PCO的发展中起关键作用。DQ有效地靶向多种EMT信号通路,特别是PI3K-Akt,并有望作为预防和管理PCO的策略。
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引用次数: 0
Retinal Prostheses for Profound Vision Loss—Have We Lost Our Way? 视网膜假体治疗重度视力丧失——我们迷失了方向吗?
IF 4.9 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-07 DOI: 10.1111/ceo.14564
Lyndon da Cruz
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引用次数: 0
Hyaluronic Acid Hydrogel as a Retinal Patch in the Treatment of Rhegmatogenous Retinal Detachment: A Multicenter Randomised Parallel-Controlled Trial 透明质酸水凝胶作为视网膜贴片治疗孔源性视网膜脱离:一项多中心随机平行对照试验。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-07 DOI: 10.1111/ceo.14570
Boshi Liu, Manqiao Wang, Liangzhang Tan, Emmanuel Eric Pazo, Lili Yuan, Qingli Shang, Jingxue Ma, Jianmin Wang, Xiang Ma, Cong Ma, Qinghuai Liu, Jiangdong Ji, Yao Lu, Yong Tao, Li Chen, Peiquan Zhao, Jiao Lyn, Qiang Lu, Yan Shao, Xinjun Ren, Xiaorong Li

Background

To evaluate the efficacy and safety of a linearly cross-linked sodium hyaluronic acid (HA) hydrogel used as a retinal patch in the treatment of rhegmatogenous retinal detachment (RRD).

Methods

This multicenter, randomised, parallel-controlled trial included 313 participants diagnosed with RRD classified as PVR grade A or B, excluding those with giant retinal tears (defined as tears spanning more than one quadrant). Participants were randomly assigned to either an experimental group or a control group. Following laser photocoagulation to retinal breaks, the experimental group received intraocular tamponade with a combination of linearly cross-linked sodium HA hydrogel and sterile air, whereas the control group received intraocular tamponade with perfluoropropane gas (C3F8). According to the intention-to-treat (ITT) principle, the final analysis included 155 subjects in the experimental group and 158 in the control group. The primary outcome measure was the retinal reattachment rate within 24 weeks postoperatively.

Results

At 24 weeks, retinal reattachment rates were 91.8% in the experimental group and 91.4% in the control group (p = 0.903), with no statistically significant differences at any follow-up time point. Additionally, there were no significant differences between the two groups regarding best-corrected visual acuity (BCVA), intraocular pressure (IOP), or postoperative complications.

Conclusions

The application of linearly cross-linked sodium HA hydrogel as a retinal patch demonstrated effectiveness comparable to traditional gas tamponade in the treatment of RRD. Furthermore, this method exhibited a favourable safety profile. The technique obviates the need for postoperative prone positioning, significantly improving the patient's postoperative comfort and quality of life.

Trial Registration

Chinese Clinical Trial Registry: ChiCTR2000037030

背景:评价线性交联透明质酸钠(HA)水凝胶作为视网膜贴片治疗孔源性视网膜脱离(RRD)的疗效和安全性。方法:这项多中心、随机、平行对照试验包括313名被诊断为RRD的参与者,分为PVR A级或B级,不包括巨大视网膜撕裂(定义为撕裂跨越一个象限以上)。参与者被随机分为实验组和对照组。激光光凝治疗视网膜破裂后,实验组采用线性交联HA水凝胶与无菌空气联合进行眼内填塞,对照组采用全氟丙烷气体(C3F8)进行眼内填塞。根据意向治疗(intention-to-treat, ITT)原则,最终分析实验组155例,对照组158例。主要观察指标为术后24周内视网膜再附着率。结果:24周时,实验组视网膜再附着率为91.8%,对照组为91.4% (p = 0.903),各随访时间点差异均无统计学意义。此外,两组在最佳矫正视力(BCVA)、眼压(IOP)或术后并发症方面无显著差异。结论:应用线性交联的透明质酸钠水凝胶作为视网膜贴片,在治疗RRD方面的效果与传统的气体填塞相当。此外,该方法还具有良好的安全性。该技术避免了术后俯卧位的需要,显著提高了患者术后的舒适度和生活质量。试验注册:中国临床试验注册中心:ChiCTR2000037030。
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引用次数: 0
Continuing Professional Development 持续专业发展
IF 4.9 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-07 DOI: 10.1111/ceo.14565
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引用次数: 0
Expanding Access to Monoclonal Antibody Treatment by the Adoption of Biosimilar Agents 通过采用生物仿制药扩大单克隆抗体治疗的可及性
IF 4.9 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-07 DOI: 10.1111/ceo.14553
Michael Goggin
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引用次数: 0
Proposal of a Simpler Eye-Level Risk Model Incorporating Reticular Pseudodrusen for the Clinical Prediction of Late Age-Related Macular Degeneration 提出一种结合网状假性黄斑变性的简单眼位风险模型用于临床预测晚期黄斑变性。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-03 DOI: 10.1111/ceo.14576
Matt Trinh, Annita Duong, Rene Cheung, Simon Chen, David Ng, Jeff Friedrich, Chris Hodge, Lisa Nivison-Smith, Angelica Ly

Background

The updated simplified AREDS risk model predicts progression to late age-related macular degeneration (AMD) by person, describing up to nine observations across both eyes and 10 annual risk scores (0–4, with/without reticular pseudodrusen [RPD]). This study proposes an abridged model to enable inter-eye comparisons and potentially enhance clinical efficiency.

Methods

This retrospective cohort study included 269 participants with early/intermediate AMD over 7 years. The full, person-level updated simplified AREDS risk model was compared to eye-level candidate risk models, derived by removing the least predictive biomarkers. The main outcomes were prognostic performance (AUC) and risk score separability (χ 2).

Results

At 1–3 years, the full model showed prognostic performance (AUC ± SE) up to 84.52% ± 5.93%, with overlap between most risk scores (χ 2 ≤ 2.08). Removing large drusen and pigmentary abnormalities in the fellow eye, intermediate drusen in both eyes, and redefining RPD presence as eye-specific maintained prognostic performance (up to 84.71% ± 4.72%). Assigning one point per retained biomarker, based on similar adjusted risks, improved risk score separability (χ 2 ≥ 3.85, p < 0.05) while reducing the number of annual scores from 10 to five.

Conclusions

The updated simplified AREDS risk model can be essentially halved without compromising prognostic performance by deriving eye-specific biomarkers and assigning one point per biomarker (large drusen, pigmentary abnormalities, and RPD in the primary eye, and late AMD in the fellow eye). This eye-level risk stratification may improve clinical efficiency and inter-eye study designs when one eye is of particular interest. An example of 3-year risks (scores 0–4) was ≈4%, 8%, 16%, 32%, and 64%.

背景:最新的简化AREDS风险模型预测人进展为晚期年龄相关性黄斑变性(AMD),描述了双眼多达9个观察结果和10个年度风险评分(0-4,有/没有网状假性黄斑[RPD])。本研究提出了一个简化的模型,使眼间比较和潜在地提高临床效率。方法:这项回顾性队列研究包括269名早期/中期AMD患者,时间超过7年。将完整的、个人水平更新的简化AREDS风险模型与眼水平候选风险模型进行比较,候选风险模型是通过去除最不具预测性的生物标志物而得到的。主要预后指标为预后表现(AUC)和风险评分可分性(χ2)。结果:在1-3年时,全模型的预后表现(AUC±SE)高达84.52%±5.93%,大部分风险评分之间存在重叠(χ2≤2.08)。切除同侧眼的大结节和色素异常,双眼的中度结节,并将RPD的存在重新定义为眼部特异性,可维持预后(高达84.71%±4.72%)。结论:更新后的简化AREDS风险模型可以在不影响预后的情况下减半,方法是获得眼部特异性生物标志物,并为每个生物标志物(原眼大结节、色素异常、RPD和伴眼晚期AMD)分配1分。这种眼水平风险分层可以提高临床效率和眼间研究设计,当一只眼睛是特别感兴趣的。例如,3年风险(评分0-4)分别≈4%、8%、16%、32%和64%。
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引用次数: 0
Current Pharmaceutical Therapies for Meibomian Gland Dysfunction: From Basic Research to Clinical Practice 睑板腺功能障碍的药物治疗现状:从基础研究到临床实践。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-03 DOI: 10.1111/ceo.14577
Sai Luo, Yuli Guo, Zuguo Liu

Meibomian gland dysfunction (MGD) is a group of chronic abnormalities of meibomian glands (MGs), which is recognised as the leading cause of evaporative dry eye. MGD is characterised by obstruction of the terminal ducts and/or alterations in the glandular secretion, which culminates in alterations in tear film stability, inflammation and ocular irritation. Lately, several physical therapies have been developed clinically, including warming compress and massage, eyelid hygiene, as well as advanced approaches such as intraductal probing, thermal pulsation and intense pulsed light therapy. Recently, there is increasing awareness regarding the pharmaceutical therapies for MGD, which have shown potential. Here, we summarise current pharmaceutical therapies for MGD from four aspects including ameliorating microenvironment, inhibiting keratinisation, regulating secretory function and therapies targeting stem cells based on basic and clinical research, discuss their applications and limitations, and provide perspectives for future studies in the field.

睑板腺功能障碍(MGD)是一组睑板腺(mg)的慢性异常,被认为是蒸发性干眼的主要原因。MGD的特征是末梢导管阻塞和/或腺体分泌改变,最终导致泪膜稳定性改变、炎症和眼部刺激。最近,临床上发展了几种物理疗法,包括热敷和按摩,眼睑卫生,以及先进的方法,如导管内探查,热脉冲和强脉冲光疗法。最近,人们越来越关注MGD的药物治疗,这已经显示出潜力。本文基于基础研究和临床研究,从改善微环境、抑制角化、调节分泌功能和靶向干细胞治疗四个方面对目前MGD的药物治疗进行了综述,并对其应用和局限性进行了讨论,并对未来的研究进行了展望。
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引用次数: 0
Comparison of Clinical and Angiographic Outcomes of Ranibizumab and Aflibercept in Type 1 and Aggressive Retinopathy of Prematurity 雷尼单抗和阿非利塞普治疗1型和侵袭性早产儿视网膜病变的临床和血管造影结果比较。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-02 DOI: 10.1111/ceo.14575
Wenting Zhang, Haonan Ma, Jianhui Wang, Zhijun Chen, Xuerui Zhang, Haodong Xiao, Huanyu Liu, Yuan Yang, Jiawei Yin, Mingyang Wang, Jie Peng, Yu Xu, Peiquan Zhao

Background

To compare the clinical and angiographic outcomes of aggressive retinopathy of prematurity (A-ROP) and type 1 retinopathy of prematurity (ROP) treated with intravitreal injection of ranibizumab (IVR) or aflibercept (IVA).

Methods

This retrospective, non-randomised study included a consecutive series of patients with type 1 ROP or A-ROP who initially treated with ranibizumab (0.25 mg/0.025 mL) or aflibercept (1.0 mg/0.025 mL) between October 2017 and November 2020. Clinical data and long-term vascular characteristics were analysed.

Results

A total of 297 eyes of 151 infants were included. Compared to IVA, IVR was a significant risk factor for reactivation in multivariate regression analysis. The risk time of reactivation in A-ROP and Type 1 Zone I ROP was shorter in the IVR group (p < 0.001). Fewer injections were required in the IVA group for patients with A-ROP and Type 1 Zone I ROP (p = 0.012). More vascular abnormalities were observed in the IVA group during reactivation, with increased arteriovenous shunting (p = 0.028) in Type 1 Zone II ROP and more tortuosity (p = 0.047), dilation (p = 0.047) and plus disease (p = 0.020) in Type 1 Zone I ROP and A-ROP. In fundus fluorescein angiography, staining of the vessel wall and telangiectasia were more frequent in the IVA group.

Conclusions

Ranibizumab treatment was associated with a higher rate of reactivation and a shorter risk period for reactivation compared to aflibercept, potentially requiring more frequent injections, though some differences did not reach statistical significance. However, there were more signs of vascular abnormalities after receiving aflibercept treatment.

背景:比较玻璃体内注射雷尼单抗(IVR)或阿非利西普(IVA)治疗侵袭性早产儿视网膜病变(A-ROP)和1型早产儿视网膜病变(ROP)的临床和血管造影结果。方法:这项回顾性、非随机研究纳入了一系列连续的1型ROP或a型ROP患者,这些患者最初接受雷尼单抗(0.25 mg/0.025 mL)或阿非利西普(1.0 mg/0.025 mL)治疗,时间为2017年10月至2020年11月。分析临床资料及长期血管特征。结果:共纳入151例患儿297只眼。与IVA相比,在多变量回归分析中,IVR是再激活的重要危险因素。结论:与阿非利西普相比,雷尼珠单抗治疗与更高的再激活率和更短的再激活风险期相关,可能需要更频繁的注射,但一些差异没有达到统计学意义。然而,接受阿布西普治疗后,血管异常的迹象更多。
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引用次数: 0
Randomised Controlled Trial: Influence of Subconjunctival Anaesthesia Duration on Pain Perception During Intravitreal Injections 随机对照试验:结膜下麻醉时间对玻璃体内注射疼痛感觉的影响。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-01 DOI: 10.1111/ceo.14579
Jiyeon Kim, Louis S. Han, Logan Robinson, Tafadzwa Young-Zvandasara

Background

The intravitreal injection (IVI) is one of the most performed vitreoretinal procedures in ophthalmology. Subconjunctival anaesthesia (SCA) with 2% lidocaine is a commonly used modality to reduce procedural pain and patient distress. Currently, there is no unifying recommended wait time between SCA and IVI. The purpose of this study is to determine the optimal wait time between the two, whilst maintaining clinical efficiency.

Methods

Single-blinded randomised clinical trial. Two hundred and forty patients were randomly assigned to one of four groups: wait time of 2, 3, 4 or 5 min. The primary outcome was pain level graded by the patient on a 10-point visual analogue scale. The secondary outcome was the willingness to receive further IVI with the current pain level. Data points were collected on patient demographics and characteristics.

Results

The mean pain scores showed a decreasing trend with increasing wait times, 2.27 (2 min), 1.03 (3 min), 0.67 (4 min) and 0.58 (5 min). More patients were willing to receive further IVI with increasing wait times, 92% (2 min), 97% (3 and 4 min), and 100% (5 min). These differences were statistically significant at each time interval.

Conclusion

Longer wait times post-SCA were associated with better anaesthetic effect and higher patient acceptance to continue receiving IVI. The most marked difference was observed between 2- and 3-min groups. Based on our findings, a minimum wait time of 3 min should be recommended as the group had reported acceptably low pain scores (1.03) while maintaining high patient satisfaction (97%).

背景:玻璃体内注射(IVI)是眼科应用最多的玻璃体视网膜手术之一。结膜下麻醉(SCA)与2%利多卡因是一种常用的方式,以减少手术疼痛和病人的痛苦。目前,SCA和IVI之间没有统一的推荐等待时间。本研究的目的是确定两者之间的最佳等待时间,同时保持临床效率。方法:单盲随机临床试验。240名患者被随机分为四组:等待时间为2分钟、3分钟、4分钟或5分钟。主要结果是患者在10分视觉模拟量表上对疼痛水平进行分级。次要结果是在当前疼痛水平下接受进一步静脉注射的意愿。收集患者人口统计学和特征的数据点。结果:平均疼痛评分随等待时间的增加呈下降趋势,分别为2.27 (2 min)、1.03 (3 min)、0.67 (4 min)和0.58 (5 min)。随着等待时间的增加,更多的患者愿意接受进一步的IVI, 92%(2分钟),97%(3和4分钟)和100%(5分钟)。这些差异在每个时间间隔内都具有统计学意义。结论:sca后等待时间越长,麻醉效果越好,患者对继续静脉注射的接受程度越高。2分钟组和3分钟组的差异最为显著。根据我们的研究结果,建议最小等待时间为3分钟,因为该组报告了可接受的低疼痛评分(1.03),同时保持了较高的患者满意度(97%)。
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引用次数: 0
Aqueous Humour Concentration of Topically Applied 2.0% Ganciclovir Eye Drops in Eyes With Cytomegalovirus Anterior Uveitis and Endotheliitis: Comment 2.0%更昔洛韦滴眼液在巨细胞病毒前葡萄膜炎和内皮炎中的应用
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-06-29 DOI: 10.1111/ceo.14580
Haixing Cao, Yujie Zhang, Xiang Ma
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引用次数: 0
期刊
Clinical and Experimental Ophthalmology
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