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Continuing Professional Development 持续专业发展
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-08-06 DOI: 10.1111/ceo.14581
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引用次数: 0
In the Race Against Time to Treat Vogt–Koyanagi–Harada Disease 与时间赛跑治疗Vogt-Koyanagi-Harada病
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-08-06 DOI: 10.1111/ceo.14584
Judy L. Chen, Edmund Tsui
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引用次数: 0
Natural History and Biomarker Challenges in Dominant Optic Atrophy: Implications for Therapeutic Studies 显性视神经萎缩的自然历史和生物标志物挑战:对治疗研究的启示
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-08-06 DOI: 10.1111/ceo.14583
Joshua Paul Harvey, Eun Hee Hong, Patrick Yu-Wai-Man
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引用次数: 0
Investigating Microinvasive Intra-Ocular Biopsy 微创眼内活检的研究。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-08-04 DOI: 10.1111/ceo.14591
Jared Ching, Shohei Kitahata, Hinako Ichikawa, Kazuaki Kadonosono

Background

Current minimally invasive methods of intraocular biopsy are confined to small gauge (G) needles and subretinal cannulae that can be prone to wound leakage at the biopsy site. We investigate the role of microneedles with internal diameters as small as 49G for intraocular biopsy in the posterior and anterior segments.

Methods

Human uveal melanoma (UM 92–1) and retinoblastoma (Y79) cancer cell lines were aspirated using microneedles of different sizes with a vitrectomy set up, and cell viability was analysed. Suspensions of cancer cells with fluorescent microbeads were injected into the subretinal space of fresh ex vivo porcine eyes before simulating biopsy with microneedle retinal puncture, followed by imaging with optical coherence tomography (OCT) and histology. Anterior chamber puncture was performed with microneedles and imaged with anterior segment OCT and examined for aqueous leakage.

Results

We find that microneedles can aspirate ocular cancer cells, both retinoblastoma and uveal melanoma, in vitro and retain a high level of cell viability, 72.83% (49G) compared to 97.00% (25G vitrector) in UM 92–1. Using an ex vivo porcine model, we find that a 49G microneedle creates a self-sealing retinal wound that does not reflux microbeads of 200 nm in diameter. Further, we find that anterior chamber puncture with a microneedle via a corneal paracentesis results in no evidence of an aqueous leak (0%) compared to a leakage rate of 100% and 66% when using a 30G and 34G needle, respectively.

Conclusion

A microinvasive approach to biopsy intraocular specimens is feasible, warranting further in vivo studies.

背景:目前的微创眼内活检方法仅限于小直径(G)针和视网膜下套管,这可能容易导致活检部位的伤口渗漏。我们研究了内径小至49G的微针在眼后和眼前段的眼内活检中的作用。方法:采用玻璃体切割装置,用不同大小的微针抽吸人葡萄膜黑色素瘤(um92 -1)和视网膜母细胞瘤(Y79)癌细胞系,分析细胞活力。将带有荧光微珠的癌细胞悬浮液注入新鲜离体猪眼视网膜下间隙,然后用微针视网膜穿刺模拟活检,然后进行光学相干断层扫描(OCT)成像和组织学检查。用微针穿刺前房,用前段OCT成像,检查房水渗漏。结果:我们发现微针可以在体外吸出眼癌细胞,包括视网膜母细胞瘤和葡萄膜黑色素瘤,并保持高水平的细胞活力,在UM 92-1中,72.83% (49G)的细胞活力高于97.00% (25G)的细胞活力。在离体猪模型中,我们发现49G微针可以产生一个自密封的视网膜伤口,该伤口不会回流直径为200nm的微珠。此外,我们发现,与使用30G和34G针的渗漏率分别为100%和66%相比,使用微针通过角膜穿刺术的前房穿刺没有水泄漏的证据(0%)。结论:微创方法对眼内标本进行活检是可行的,需要进一步的体内研究。
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引用次数: 0
Progression of Loss of Vision From Centre-Involving Macular Atrophy in Eyes Treated for nAMD 在nAMD治疗的眼睛中从中心到黄斑萎缩的视力丧失的进展。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-08-03 DOI: 10.1111/ceo.14587
Kelvin Y. C. Teo, Theodorus Leonardus Ponsioen, Sioe Lan, Louise OToole, Carolina Arruabarrena Sanchez, Richard Barry, Helena Brosa Morros, Charmaine Chung, Alessandro Invernizzi, Gemmy Chui Ming Cheung, Daniel Barthelmes, Mark C. Gillies

Background

This study aimed to characterise visual acuity (VA) changes in eyes without baseline macular atrophy (MA) that subsequently developed MA during treatment for neovascular age-related macular degeneration (nAMD).

Methods

A case–control analysis was performed using data from a multicentre real-world AMD registry. We compared VA outcomes in 1998 treatment-naïve eyes without MA at baseline and ≥ 5 years of follow-up. Two matched groups (999 eyes each) were analysed: eyes that developed incident MA and those that never did.

Results

Comparisons were made between two matched groups of 999 eyes each with incident MA and those that never developed it with at least 5 years of follow-up. Final VA was best in eyes that never developed MA, followed by eyes that developed extrafoveal and sub-foveal MA (68.9 ± 16.7, 67.0 ± 16.9 and 52.1 ± 23.6 letters, p < 0.01). Eyes with incident MA had more inactive disease visits compared to those that never developed MA. Features associated with poor final VA included the presence of sub-foveal MA (odds ratio [OR] [95% confidence interval (CI)] −16.63 [−18.7 to 14.56], p < 0.01) and a higher proportion of active visits (per 10%) (OR [95% CI] −0.73 [−1.12 to 0.34], p < 0.01). The mean time to lose five letters of vision from first grading of sub-foveal MA was 17.3 ± 4.6 months.

Conclusion

It is important to achieve disease inactivity in nAMD despite its association with incident MA, as neovascular complications play a significant role in VA loss. The long duration between the incidence of MA and clinically significant loss of vision offers an opportunity for potential interventions against atrophy.

背景:本研究旨在描述无基线黄斑萎缩(MA)的眼睛的视力(VA)变化,这些眼睛随后在治疗新生血管性年龄相关性黄斑变性(nAMD)期间发展为MA。方法:使用来自多中心真实世界AMD注册表的数据进行病例对照分析。我们比较了1998年treatment-naïve无MA的眼睛在基线和≥5年随访时的VA结果。研究人员对两组相匹配的眼睛(每组999只眼睛)进行了分析:一组发生偶发性MA的眼睛和一组从未发生过MA的眼睛。结果:在至少5年的随访中,对两组相匹配的999只眼睛进行了比较,每组眼睛有偶发MA和从未发生MA。未发生MA的眼睛的最终VA最好,其次是发生中央凹外和中央凹下MA的眼睛(68.9±16.7,67.0±16.9和52.1±23.6个字母)。结论:尽管与MA事件相关,但在nAMD中实现疾病不活动是重要的,因为新生血管并发症在VA损失中起重要作用。从MA发病到临床上明显的视力丧失之间的长时间间隔为潜在的干预萎缩提供了机会。
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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: Response 2.0%更昔洛韦滴眼液对巨细胞病毒前葡萄膜炎和内皮炎的治疗效果
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-25 DOI: 10.1111/ceo.14590
Samanthila Waduthantri, Soon Phaik Chee
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引用次数: 0
Optimising Paul Glaucoma Implant Stent Management: Prophylactic Aqueous Suppression, Telemetric IOP Monitoring, and Microfluidic Insights 优化保罗青光眼植入支架管理:预防性水抑制、遥测IOP监测和微流体洞察。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-23 DOI: 10.1111/ceo.14586
Yuwan Gao
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引用次数: 0
Comparison of the Peripapillary Structure–Vessel Density Relationship Before and After Axial Length Magnification Correction Using Different Methods 不同方法轴长矫正前后乳头周围结构-血管密度关系的比较。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-22 DOI: 10.1111/ceo.14585
Zhuoyan Yang, Yidan Wu, Jiaxin Gao, Shiyuan Hu, Jianming Wang, Ruihua Jing

Background

To evaluate changes in OCTA-derived structural and vascular parameters before and after axial length (AL) magnification correction using two different formulas, and to explore their correlations with vessel density (VD).

Methods

This study included 45 high myopic eyes and 45 age- and gender-matched controls. Both 6 × 6 mm2 optic nerve head imaging and biological measurement were performed using OCTA. Magnification correction was performed using both the Bennett formula and the device's built-in algorithm. Parameters analysed included retinal nerve fibre layer (RNFL) thickness, superficial vascular complex (SVC) VD, deep vascular complex (DVC) VD, and choroidal VD.

Results

In long AL eyes, uncorrected values underestimated RNFL thickness and SVC VD but overestimated DVC VD and choroidal VD; discrepancies increased with AL. The opposite pattern was observed in shorter eyes. After correction, all vascular parameters except DVC VD showed significant changes in the high myopia group, while non-high myopic eyes showed no significant differences. The two correction methods showed strong agreement across all layers. RNFL thickness correlated strongly with SVC VD, and choroidal thickness (CT) with choroidal VD, both before and after correction. Post-correction, AL was no longer associated with RNFL thickness or SVC VD, while its correlation with CT and choroidal VD persisted. Mediation analysis showed AL fully mediated the CT–choroidal VD relationship, with a stronger effect post-correction.

Conclusions

Magnification correction is crucial in high myopic eyes. Both formulas showed high consistency. Correction eliminated AL's confounding effects on RNFL and SVC VD, while emphasising its mediating role between CT and choroidal VD.

研究背景:利用两种不同的计算公式评估轴向长度(AL)放大校正前后octa衍生的结构和血管参数的变化,并探讨其与血管密度(VD)的相关性。方法:本研究纳入45只高度近视眼和45只年龄和性别匹配的对照组。采用OCTA进行6 × 6 mm2视神经头成像和生物测量。使用Bennett公式和设备的内置算法进行放大率校正。分析参数包括视网膜神经纤维层(RNFL)厚度、浅血管复合体(SVC) VD、深血管复合体(DVC) VD和脉络膜VD。结果:在长AL眼中,未校正值低估了RNFL厚度和SVC VD,高估了DVC VD和脉络膜VD;这种差异随着AL的增加而增加。在较短的眼睛中观察到相反的模式。矫正后,高度近视组除DVC VD外,其他血管参数均有显著变化,非高度近视组无显著差异。两种校正方法在各层均表现出较强的一致性。在校正前后,RNFL厚度与SVC VD密切相关,脉络膜厚度(CT)与脉络膜VD密切相关。校正后,AL不再与RNFL厚度或SVC VD相关,但其与CT和脉络膜VD的相关性仍然存在。中介分析显示AL完全介导ct -脉络膜VD关系,校正后效果更强。结论:放大矫正是高度近视的关键。两种公式均具有较高的一致性。校正消除了AL对RNFL和SVC VD的混杂影响,同时强调了其在CT和脉络膜VD之间的中介作用。
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引用次数: 0
Inhibitory Effects of 3′,4′-Dihydroxyflavonol in a Rabbit Model of Minimally Invasive Bleb Surgery With PreserFlo MicroShunt 3',4'-二羟基黄酮醇在PreserFlo微分流兔微创水泡手术模型中的抑制作用。
IF 5.6 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-07-16 DOI: 10.1111/ceo.14578
Zoe Pasvanis, Roy C. K. Kong, Elsa C. Chan, Jennifer C. Fan Gaskin

Background

The success of minimally invasive bleb surgery (MIBS) such as the PreserFlo MicroShunt (PFMS) is limited by post-operative bleb fibrosis. Current clinical practice prescribes the use of off-label cytotoxic antimetabolites such as Mitomycin C (MMC) as antifibrotic therapy. This study investigates the anti-scarring properties of a novel compound, 3′,4′-Dihydroxyflavonol (DiOHF) in a rabbit model of PFMS filtration surgery.

Methods

Fifteen New Zealand white rabbits underwent unilateral MIBS with PFMS. Treatment was randomised to the following groups: (1) vehicle (n = 5), (2) DiOHF (n = 5), both applied three times daily for 2 weeks or (3) a single dose of MMC administered intraoperatively (n = 5). Blebs were photographed post-operatively on Days 0, 7 and 14 for clinical examination. Eyes were harvested on Day 14 and processed for immunohistochemical tissue staining to assess collagen deposition, expression of αSMA, oxidative stress, fibroblast activity, angiogenesis and inflammation in the conjunctiva/Tenon's layer.

Results

At 2-weeks post-surgery, MMC blebs were larger and more ischaemic than other treatments (Bleb size: MMC vs. DiOHF, p = 0.0098; MMC vs. vehicle, p = 0.0001. Ischaemia: p = 0.0004 for both). Compared to vehicle control, DiOHF blebs expressed decreased vimentin (p = 0.0099), αSMA (p = 0.0231) and 3-nitrotyrosine (p = 0.0410) after 2 weeks. DiOHF blebs expressed less CD45 than other treatments (DiOHF vs. Vehicle, p = 0.0013; DiOHF vs. MMC, p = 0.0232) and less collagen accumulation (DiOHF vs. vehicle, p = 0.0512). There was no difference in CD31 expression between treatment groups.

Conclusions

DiOHF inhibited scarring following implantation of PFMS in rabbit eyes by reducing local oxidative stress, inflammation and fibroblastic activity. DiOHF may be a safer and more effective wound modulating agent than the conventional use of MMC.

背景:微创泡手术(MIBS)如PreserFlo MicroShunt (PFMS)的成功受到术后泡纤维化的限制。目前的临床实践规定使用说明书外的细胞毒性抗代谢物,如丝裂霉素C (MMC)作为抗纤维化治疗。本研究探讨了一种新型化合物3',4'-二羟基黄酮醇(DiOHF)在PFMS滤过手术兔模型中的抗疤痕特性。方法:15只新西兰大白兔单侧MIBS伴PFMS。治疗随机分为以下组:(1)对照剂(n = 5), (2) DiOHF (n = 5),均每日应用3次,持续2周,或(3)术中给予单剂量MMC (n = 5)。术后第0、7、14天对水泡进行拍照,用于临床检查。第14天取眼,进行免疫组织化学染色,评估结膜/Tenon层胶原沉积、αSMA表达、氧化应激、成纤维细胞活性、血管生成和炎症。结果:术后2周,MMC比其他治疗组水泡更大、更缺血(水泡大小:MMC vs. DiOHF, p = 0.0098;MMC vs. vehicle, p = 0.0001。缺血:两者p = 0.0004)。与对照相比,2周后,DiOHF泡表达的波形蛋白(p = 0.0099)、αSMA (p = 0.0231)和3-硝基酪氨酸(p = 0.0410)降低。与其他处理相比,DiOHF泡表达CD45较少(DiOHF vs. Vehicle, p = 0.0013;DiOHF vs. MMC, p = 0.0232),胶原积累较少(DiOHF vs.载体,p = 0.0512)。治疗组间CD31表达无差异。结论:DiOHF通过降低局部氧化应激、炎症和成纤维细胞活性抑制PFMS植入后兔眼瘢痕形成。与传统的MMC相比,DiOHF可能是一种更安全、更有效的伤口调节剂。
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引用次数: 0
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
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Clinical and Experimental Ophthalmology
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