Clinical and Experimental Ophthalmology最新文献

Background: To explore the role of gut microbiota in preterm infants at high risk of developing retinopathy of prematurity (ROP).

Methods: Preterm infants with gestational age (GA) < 32 weeks and/or birth weight (BW) < 1500 g born between 2020 and 2021 were prospectively enrolled. Their faecal samples were collected and analysed at different postnatal ages of life using 16S rRNA gene sequencing on the Miseq platform. The main outcome measures were the microbial diversity, taxonomy, relative abundance, bacterial predicted functional analysis, and their associations with different ROP groups. Subgroup analyses were performed by matching their GA and BW across different ROP groups.

Results: A total of 268 stool samples were collected from 110 preterm infants, including 13 with type 1 ROP, 44 with type 2 or mild ROP, and 53 without ROP. Type 1 ROP showed no significant difference in microbial diversity up to 8 postnatal weeks (p = 0.057), while type 2 and no ROP groups displayed increased diversity (p = 0.0015 and p = 0.049, respectively). Bifidobacterium genera was notably less abundant in type 1 ROP group at first postnatal week (p = 0.022) and remained low in subsequent weeks. Predicted functional analysis revealed enriched pathways in membrane transport, carbohydrate metabolism, amino acid metabolism, and replication and repair.

Conclusions: Reduced gut microbial diversity may be associated with ROP development in high-risk preterm infants. Further research is needed to comprehend how early-life Bifidobacterium reduction affects metabolism and how targeting microbiome may help for ROP prevention and management.

Background: This systematic review and meta-analysis investigated different treatment modalities' effect on the risk of central nervous system lymphoma progression, ocular disease relapse, systemic lymphoma development and overall survival in primary vitreoretinal lymphoma patients.

Methods: PubMed, EMBASE, Scopus and the Cochrane Library of clinical trials were searched from inception to April 21, 2024. Cohort, cross-sectional and case series studies were included. Methodological quality was assessed using the NIH quality assessment tools. Heterogeneity between studies was assessed using Chi square test and I² statistic. Outcomes were pooled as odds ratios (OR) using fixed-effects models. Risk of publication bias was assessed using a funnel plot.

Results: Included were 28 studies with 476 participants. Ocular treatments included intravitreal methotrexate and/or rituximab injections and ocular radiotherapy. Systemic treatments included intravenous and/or intrathecal chemotherapy, whole-brain radiotherapy and autologous stem cell transplantation. Ocular treatment alone, as compared to systemic or combined treatment, resulted in significantly lower risk of central nervous system lymphoma development (OR = 0.54, p = 0.02) and in no significant difference in the risk for progression to systemic disease (OR = 0.38, p = 0.30) or in overall survival. Significantly lower risk of ocular relapse was found in patients receiving ocular or combined therapy as compared to systemic therapy alone (OR = 0.26, p = 0.001). A subgroup analysis, comparing ocular treatment alone and combined treatment, found no significant difference regarding the risk of central nervous system or systemic lymphoma progression, ocular disease relapse and overall survival.

Conclusions: No benefit was observed for the addition of systemic therapy to ocular treatment in patients with primary vitreoretinal lymphoma.

Background: Effective clinical implementation of polygenic risk testing for glaucoma relies on healthcare professionals' attitudes and knowledge of the test. Given the emerging applications of the test, it will likely impact a range of healthcare professionals and will require competency in polygenic risk scores concepts for all those involved in patient care. To our knowledge, this is the first study to assess healthcare professionals' views towards polygenic testing for glaucoma.

Methods: An online cross-sectional questionnaire was distributed to healthcare professionals via relevant professional organisations in Australia. The questionnaire assessed experience and confidence with genetic testing, glaucoma and genetic knowledge, recommendations for the tests, and factors affecting the decision.

Results: A total of 94 participants completed the questionnaire. The sample was composed of ophthalmologists (36%), optometrists (21%), orthoptists (17%), general practitioners (16%) and clinical geneticists/genetic counsellors (10%). Although familiarity with polygenic risk scores for glaucoma was low overall (11%), the majority reported a positive attitude towards recommending testing based on known risk factors such as family history (91%) and older age (57%). Over 95% indicated that ophthalmologists would be the most appropriate group to order polygenic risk testing and communicate results. The majority felt they would benefit from more training on polygenic risk scores (93%).

Conclusions: Our findings indicated that multiple groups of healthcare professionals were neither familiar nor confident with the concept of glaucoma polygenic risk testing, and identified training and education needs to support the implementation of testing into clinical practice.

Background: To compare pain perception, pupil behaviours, and cytokine levels during first-eye and second-eye femtosecond laser-assisted cataract surgery (FLACS) and determine which is better regarding a short or long interval for bilateral FLACS.

Methods: Notably, 96 eyes of 48 patients with bilateral cataracts underwent the first surgeries in the left or right eye, according to a random sequence. They were further randomised into 2- and 6-week subgroups based on surgery intervals. Pupil size was measured from captured images, and pain perception was assessed using a visual analog scale (VAS). Aqueous humour prostaglandin E2 (PGE2), monocyte chemoattractant protein-1 (MCP-1), interleukin (IL)-6, and IL-8 levels were also quantitatively analysed. All patients were followed for 1 week to evaluate changes in endothelial cell density (ECD), central corneal thickness (CCT), and macular central subfield thickness (CST).

Results: Ocular pain was significantly higher in patients who underwent second-eye FLACS. First tear break-up time was negatively correlated with VAS score. MCP-1 levels were significantly higher in patients who underwent second-eye FLACS, and VAS scores were positively correlated with MCP-1 levels across all patients. There were no differences between sequential FLACS in miosis, PGE2, IL-6, IL-8 levels and changes in postoperative ECD, CCT, and CST. Patients who underwent second-eye FLACS after 6 weeks showed more CCT, CST, and MCP-1 changes than baseline.

Conclusion: Second-eye FLACS causes more pain and upregulated MCP-1. There was no difference between sequential FLACS in PGE2 levels, miosis, and postoperative inflammation. Furthermore, first-eye FLACS triggered a sympathetic irritation, particularly after a 6-week interval.

Background: To establish a novel vault prediction formula after implantable collamer lens (ICL) implantation that considers both anterior and posterior chamber characteristics with multi-modal parameters.

Methods: A total of 103 and 65 eyes were included in the development and validation groups, respectively. Exploratory factor analysis was performed using data from optical coherence tomography and ultrasound biomicroscopy in the development group to synthesise summative factors with different clinical significance. Dominant original metrics with heavy loadings on significant factors (absolute value of the loading coefficient >0.5) were screened for multivariate linear regression models using a stepwise method. The newly derived formula was evaluated and compared to the NK and KS formulas in the validation group.

Results: Six factors (anterior chamber angle, horizontal width, lens, iris, iridociliary complex and ciliary body) were generated after dimension reduction via factor analysis. Factors 2 (horizontal width), 3 (lens), and 5 (iridociliary complex) had a significant influence on the vault. When dominant metrics on these factors were screened for further model building, ICL size, anterior chamber width, crystalline lens rise, iris curvature, and iris-ciliary process distance were retained in the final formula, with an adjusted R² of 0.698, a median absolute error of 81.97 mm, and a root-mean-square error of 103.35 mm.

Conclusions: Multiple intraocular components, including the lens, iris, and ciliary body, play important roles in vault determination. The new formula exhibits good accuracy for vault predictions and ICL size recommendations.

Background: To investigate the prevalence and correction of anisometropia among primary school children in northwestern China.

Methods: A cross-sectional school-based study was conducted in Shaanxi Province. Visual acuity (VA) and autorefraction without cycloplegia were assessed in all participants, and some received axial length (AL) measurements. Anisometropia was categorised based on spherical equivalent (SE), cylindrical (CYL), and AL. The prevalence of anisometropia and refractive correction across different ages and sexes, and correlations between ocular parameters, were analysed.

Results: The study included 29 153 children aged 6-12 (mean age 9.52 ± 1.73 years) for VA and autorefraction measurements, and 1176 children for AL measurements. The prevalence of myopia (SE ≤ -0.50 D), hyperopia (SE ≥ +0.50 D), and anisometropia (interocular SE difference ≥1.00 D) was 65.26%, 15.09%, and 16.50%, respectively. Anisometropia severity, based on SE (χ² = 443.758, p < 0.001), CYL (χ² = 41.669, p < 0.001), and AL (χ² = 95.505, p < 0.001), increased with age, with no significant differences between sexes. Interocular SE difference correlated with interocular spherical power (r = 0.806, p < 0.001), CYL (r = 0.21, p < 0.001), and AL (r = 0.365, p < 0.001). Additionally, interocular CYL difference was positively correlated with interocular AL difference (r = 0.16, p < 0.001). Despite the high prevalence of anisometropia, less than 30% of affected children received refractive correction.

Conclusions: Anisometropia of SE, CYL, and AL increased progressively with age. Despite the elevated prevalence of anisometropia, the utilisation of refractive correction remained strikingly low.