Advances in ophthalmology practice and research最新文献_第5页

A deep learning model for generating fundus autofluorescence images from color fundus photography 彩色眼底摄影生成眼底自体荧光图像的深度学习模型

Advances in ophthalmology practice and research

Pub Date : 2023-11-01 DOI: 10.1016/j.aopr.2023.11.001

Fan Song , Weiyi Zhang , Yingfeng Zheng , Danli Shi , Mingguang He

Background

Fundus Autofluorescence (FAF) is a valuable imaging technique used to assess metabolic alterations in the retinal pigment epithelium (RPE) associated with various age-related and disease-related changes. The practical uses of FAF are ever-growing. This study aimed to evaluate the effectiveness of a generative deep learning (DL) model in translating color fundus (CF) images into synthetic FAF images and explore its potential for enhancing screening of age-related macular degeneration (AMD).

Methods

A generative adversarial network (GAN) model was trained on pairs of CF and FAF images to generate synthetic FAF images. The quality of synthesized FAF images was assessed objectively by common generation metrics. Additionally, the clinical effectiveness of the generated FAF images in AMD classification was evaluated by measuring the area under the curve (AUC), using the LabelMe dataset.

Results

A total of 8410 FAF images from 2586 patients were analyzed. The synthesized FAF images exhibited an impressive objectively assessed quality, achieving a multi-scale structural similarity index (MS-SSIM) of 0.67. When evaluated on the LabelMe dataset, the combination of generated FAF images and CF images resulted in a noteworthy improvement in AMD classification accuracy, with the AUC increasing from 0.931 to 0.968.

Conclusions

This study presents the first attempt to use a generative deep learning model to create authentic and high-quality FAF images from CF images. The incorporation of the translated FAF images on top of CF images improved the accuracy of AMD classification. Overall, this study presents a promising approach to enhance large-scale AMD screening.

眼底自体荧光(FAF)是一种有价值的成像技术，用于评估视网膜色素上皮(RPE)与各种年龄相关和疾病相关变化相关的代谢改变。FAF的实际应用正在不断增长。本研究旨在评估生成式深度学习(DL)模型在将彩色眼底(CF)图像转化为合成FAF图像方面的有效性，并探讨其在增强年龄相关性黄斑变性(AMD)筛查方面的潜力。在CF和FAF图像对上训练生成对抗网络(GAN)模型，生成合成FAF图像。采用常用的生成指标客观评价合成FAF图像的质量。此外，使用LabelMe数据集，通过测量曲线下面积(AUC)来评估生成的FAF图像在AMD分类中的临床有效性。共分析2586例患者的8410张FAF图像。合成的FAF图像表现出令人印象深刻的客观评价质量，实现了0.67的多尺度结构相似指数(MS-SSIM)。当在LabelMe数据集上进行评估时，生成的FAF图像和CF图像组合在AMD分类精度上有了显著的提高，AUC从0.931提高到0.968。本研究首次尝试使用生成式深度学习模型从CF图像中创建真实且高质量的FAF图像。将翻译后的FAF图像合并到CF图像上，提高了AMD分类的准确性。总的来说，这项研究提出了一种有希望的方法来加强大规模AMD筛查。

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引用次数: 0

Oxidative stress, epigenetic regulation and pathological processes of lens epithelial cells underlying diabetic cataract 糖尿病性白内障晶状体上皮细胞的氧化应激、表观遗传调控及病理过程

Advances in ophthalmology practice and research

Pub Date : 2023-10-05 DOI: 10.1016/j.aopr.2023.10.001

Zaoxia Guo , Xiaopan Ma , Rui Xue Zhang , Hong Yan

Background

Cataract is a blinding disease worldwide. It is an age-related disease that mainly occurs in people over 65 years old. Cataract is also prevalent in patients with diabetes mellites (DM). The pathological mechanisms underlying diabetic cataract (DC) are more complex than that of age-related cataract. Studies have identified that polyol pathway, advanced glycation end products (AGEs) and oxidative stress are the primary pathogenesis of DC. In recent years, molecular-level regulations and pathological processes of lens epithelial cells (LECs) have been confirmed to play roles in the initiation and progression of DC. A comprehensive understanding and elucidation of how chronic hyperglycemia drives molecular-level regulations and cytopathological processes in the lens will shed lights on the prevention, delay and treatment of DC.

Main text

Excessive glucose in the lens enhances polyol pathway and AGEs formation. Polyol pathway causes imbalance in the ratio of NADPH/NADP⁺ and NADH/NAD⁺. Decrease in NADPH/NADP⁺ ratio compromises antioxidant enzymes, while increase in NADH/NAD⁺ ratio promotes reactive oxygen species (ROS) overproduction in mitochondria, resulting in oxidative stress. Oxidative stress in the lens causes oxidation of DNA, proteins and lipids, leading to abnormalities in their structure and functions. Glycation of proteins by AGEs decreases solubility of proteins. High glucose triggered epigenetic regulations directly or indirectly affect expressions of genes and proteins in LECs. Changes in autophagic activity, increases in fibrosis and apoptosis of LECs destroy the morphological structure and physiological functions of the lens epithelium, disrupting lens homeostasis.

Conclusions

In both diabetic animal models and diabetics, oxidative stress plays crucial roles in the formation of cataract. Epigenetic regulations, include lncRNA, circRNA, microRNA, methylation of RNA and DNA, histone acetylation and pathological processes, include autophagy, fibrosis and apoptosis of LECs also involved in DC.

背景白内障是一种全球性的致盲性疾病。它是一种与年龄相关的疾病，主要发生在65岁以上的人群中。白内障在患有糖尿病的患者中也很普遍。糖尿病性白内障（DC）的病理机制比年龄相关性白内障更为复杂。研究表明，多元醇途径、晚期糖基化终产物（AGEs）和氧化应激是DC的主要发病机制。近年来，晶状体上皮细胞（LECs）的分子水平调控和病理过程已被证实在DC的发生和发展中发挥作用。全面了解和阐明慢性高血糖如何驱动晶状体中的分子水平调节和细胞病理过程，将有助于DC的预防、延迟和治疗。正文晶状体中过量的葡萄糖会增强多元醇途径和AGEs的形成。多元醇途径导致NADPH/NADP+和NADH/NAD+的比例失衡。NADPH/NADP+比率的降低会损害抗氧化酶，而NADH/NAD+比率的增加会促进线粒体中活性氧（ROS）的过量产生，从而导致氧化应激。晶状体中的氧化应激会导致DNA、蛋白质和脂质的氧化，导致其结构和功能异常。AGEs对蛋白质的糖化作用降低了蛋白质的溶解度。高糖触发的表观遗传调控直接或间接影响LECs中基因和蛋白质的表达。LECs自噬活性的变化、纤维化的增加和细胞凋亡破坏了晶状体上皮的形态结构和生理功能，破坏了晶状体的稳态。结论在糖尿病动物模型和糖尿病模型中，氧化应激在白内障的形成中起着至关重要的作用。表观遗传学调控，包括lncRNA、circRNA、microRNA、RNA和DNA的甲基化、组蛋白乙酰化和病理过程，包括自噬、纤维化和也参与DC的LECs的凋亡。

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引用次数: 0

Development and material characteristics of glaucoma surgical implants 青光眼手术植入物的研制及材料特性

Advances in ophthalmology practice and research

Pub Date : 2023-09-23 DOI: 10.1016/j.aopr.2023.09.001

Qiyu Qin , Chengshou Zhang , Naiji Yu , Fan Jia , Xin Liu , Qi Zhang , Min Chen , Kaijun Wang

Background

Glaucoma is the leading cause of irreversible blindness worldwide. The reduction of intraocular pressure has proved to be the only factor which can be modified in the treatment, and surgical management is one of the important methods for the treatment of glaucoma patients.

Main text

In order to increase aqueous humor outflow and further reduce intraocular pressure, various drainage implants have been designed and applied in clinical practice. From initial Molteno, Baerveldt and Ahmed glaucoma implants to the Ahmed ClearPath device, Paul glaucoma implant, EX-PRESS and the eyeWatch implant, to iStent, Hydrus, XEN, PreserFlo, Cypass, SOLX Gold Shunt, etc., glaucoma surgical implants are currently undergoing a massive transformation on their structures and performances. Multitudinous materials have been used to produce these implants, from original silicone and porous polyethylene, to gelatin, stainless steel, SIBS, titanium, nitinol and even 24-carat gold. Moreover, the material geometry, size, rigidity, biocompatibility and mechanism (valved versus nonvalved) among these implants are markedly different. In this review, we discussed the development and material characteristics of both conventional glaucoma drainage devices and more recent implants, such as the eyeWatch and the new minimally invasive glaucoma surgery (MIGS) devices.

Conclusions

Although different in design and materials, these delicate glaucoma surgical implants have widely expanded the glaucoma surgical methods, and improved the success rate and safety of glaucoma surgery significantly. However, all of these glaucoma surgical implants have various limitations and should be used for different glaucoma patients at different conditions.

背景青光眼是世界范围内不可逆失明的主要原因。眼压降低已被证明是治疗中唯一可以改变的因素，手术治疗是治疗青光眼患者的重要方法之一。为了增加房水流出量，进一步降低眼压，人们设计了各种引流植入物并在临床实践中应用。从最初的Molteno、Baerveldt和Ahmed青光眼植入物到Ahmed ClearPath设备、Paul青光眼植入物、EX-PRESS和eyeWatch植入物，再到iStent、Hydrus、XEN、PreserFlo、Cypass、SOLX Gold Shunt等，青光眼手术植入物目前正在经历结构和性能的巨大转变。多种材料已被用于生产这些植入物，从原始的硅树脂和多孔聚乙烯，到明胶、不锈钢、SIBS、钛、镍钛诺，甚至24克拉黄金。此外，这些植入物的材料几何形状、尺寸、刚度、生物相容性和机制（有阀和无阀）明显不同。在这篇综述中，我们讨论了传统青光眼引流装置和最近的植入物的发展和材料特性，如eyeWatch和新型微创青光眼手术（MIGS）装置。结论尽管在设计和材料上有所不同，但这些精致的青光眼手术植入物广泛扩展了青光眼手术方法，显著提高了青光眼手术的成功率和安全性。然而，所有这些青光眼手术植入物都有各种局限性，应该用于不同条件下的不同青光眼患者。

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引用次数: 0

Research trends of worldwide ophthalmologic randomized controlled trials in the 21st century: A bibliometric study 21世纪世界眼科随机对照试验的研究趋势：文献计量学研究

Advances in ophthalmology practice and research

Pub Date : 2023-08-05 DOI: 10.1016/j.aopr.2023.07.003

Hao Wang , Qiang Ye , Weihe Xu , Jing Wang , Jianhan Liu , Xintong Xu , Wenfang Zhang

Background

Randomized controlled trials (RCTs) are often considered the gold standard and the cornerstone for clinical practice. However, bibliometric studies on worldwide RCTs of ophthalmology published in the 21st century have not been reported in detail yet. This study aims to perform a bibliometric study and visualization analysis of worldwide ophthalmologic RCTs in the 21st century.

Methods

Global ophthalmologic RCTs from 2000 to 2022 were searched in the Web of Science Core Collection. The number of publications, country/region, institution, author, journal, and research hotspots of RCTs were analyzed using HistCite, VOSviewer, CiteSpace, and Excel software.

Results

2366 institutions and 90 journals from 83 countries/regions participated in the publication of 1769 global ophthalmologic RCTs, with the United States leading in the number of volumes and research field, and the Moorfields Eye Hospital contributing to the most publications. Ophthalmology received the greatest number of publications and co-citations. Jeffrey S. Heier owned the most publications and Jost B. Jonas owned the most co-citations. The knowledge foundations of global ophthalmologic RCTs were mainly retinopathy, glaucoma, dry eye disease (DED), and cataracts, and anti-vascular endothelial growth factor (VEGF) therapy (ranibizumab), topical ocular hypotensive medication, laser trabeculoplasty. Anti-VEGF therapy for age-related macular degeneration (AMD), DME (diabetic macular edema), and DED, the use of new diagnostic tools, and myopia were the hottest research highlights. Anti-VEGF therapy, prompt laser, triamcinolone, and verteporfin photodynamic therapy for AMD, DME, and CNV (choroidal neovascularization), DED, myopia, and open-angle glaucoma were the research hotspots with the longest duration. The future research hotspots might be DED and the prevention and control of myopia.

Conclusions

Overall, the number of global ophthalmologic RCTs in the 21st century was keeping growing, there was an imbalance between the regions and institutions, and more efforts are required to raise the quantity, quality, and global impact of high-quality clinical evidence in developing countries/regions.

背景随机对照试验通常被认为是临床实践的金标准和基石。然而，21世纪世界范围内发表的眼科随机对照试验的文献计量学研究尚未得到详细报道。本研究旨在对21世纪全球眼科随机对照试验进行文献计量学研究和可视化分析。方法检索2000年至2022年的全球眼科随机对照试验（RCTs）。使用HistCite、VOSviewer、CiteSpace和Excel软件分析随机对照试验的出版物数量、国家/地区、机构、作者、期刊和研究热点。结果来自83个国家/地区的2366家机构和90种期刊参与了1769份全球眼科随机对照试验的出版，其中美国在数量和研究领域领先，Moorfields眼科医院贡献了最多的出版物。《眼科学》获得了最多的出版物和共同引用。Jeffrey S.Heier拥有最多的出版物，Jost B.Jonas拥有最多的共同引用。全球眼科随机对照试验的知识基础主要是视网膜病变、青光眼、干眼病（DED）和白内障，以及抗血管内皮生长因子（VEGF）治疗（雷尼珠单抗）、局部眼部降压药物、激光小梁成形术。抗VEGF治疗年龄相关性黄斑变性（AMD）、DME（糖尿病黄斑水肿）和DED、新诊断工具的使用以及近视是最热门的研究热点。抗VEGF治疗、即时激光、曲安奈德和维替泊芬光动力治疗AMD、DME和CNV（脉络膜新生血管）、DED、近视和开角型青光眼是持续时间最长的研究热点。未来的研究热点可能是DED和近视的预防和控制。结论总体而言，21世纪全球眼科随机对照试验的数量持续增长，地区和机构之间存在不平衡，需要更多的努力来提高发展中国家/地区高质量临床证据的数量、质量和全球影响力。

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引用次数: 1

Genetic and epigenetic regulators of retinal Müller glial cell reprogramming 视网膜Müller神经胶质细胞重编程的遗传和表观遗传学调节因子。

Advances in ophthalmology practice and research

Pub Date : 2023-08-01 DOI: 10.1016/j.aopr.2023.05.004

Xueqi Xiao , Zhiyong Liao , Jian Zou

Background

Retinal diseases characterized with irreversible loss of retinal nerve cells, such as optic atrophy and retinal degeneration, are the main causes of blindness. Current treatments for these diseases are very limited. An emerging treatment strategy is to induce the reprogramming of Müller glial cells to generate new retinal nerve cells, which could potentially restore vision.

Main text

Müller glial cells are the predominant glial cells in retinae and play multiple roles to maintain retinal homeostasis. In lower vertebrates, such as in zebrafish, Müller glial cells can undergo cell reprogramming to regenerate new retinal neurons in response to various damage factors, while in mammals, this ability is limited. Interestingly, with proper treatments, Müller glial cells can display the potential for regeneration of retinal neurons in mammalian retinae. Recent studies have revealed that dozens of genetic and epigenetic regulators play a vital role in inducing the reprogramming of Müller glial cells in vivo. This review summarizes these critical regulators for Müller glial cell reprogramming and highlights their differences between zebrafish and mammals.

Conclusions

A number of factors have been identified as the important regulators in Müller glial cell reprogramming. The early response of Müller glial cells upon acute retinal injury, such as the regulation in the exit from quiescent state, the initiation of reactive gliosis, and the re-entry of cell cycle of Müller glial cells, displays significant difference between mouse and zebrafish, which may be mediated by the diverse regulation of Notch and TGFβ (transforming growth factor-β) isoforms and different chromatin accessibility.

背景：以视网膜神经细胞不可逆损失为特征的视网膜疾病，如视神经萎缩和视网膜变性，是导致失明的主要原因。目前对这些疾病的治疗非常有限。一种新兴的治疗策略是诱导穆勒神经胶质细胞重新编程，产生新的视网膜神经细胞，这可能会恢复视力。正文：Müller神经胶质细胞是视网膜中占主导地位的神经胶质细胞，在维持视网膜稳态方面发挥着多种作用。在低等脊椎动物中，如斑马鱼，Müller神经胶质细胞可以进行细胞重编程，以再生新的视网膜神经元，以应对各种损伤因素，而在哺乳动物中，这种能力是有限的。有趣的是，通过适当的治疗，Müller神经胶质细胞可以显示出哺乳动物视网膜中视网膜神经元再生的潜力。最近的研究表明，数十种遗传和表观遗传学调控因子在体内诱导穆勒神经胶质细胞的重编程中发挥着至关重要的作用。这篇综述总结了穆勒神经胶质细胞重编程的这些关键调节因子，并强调了它们在斑马鱼和哺乳动物之间的差异。结论：许多因素已被确定为Müller神经胶质细胞重编程的重要调节因子。Müller神经胶质细胞对急性视网膜损伤的早期反应，如从静止状态退出的调节、反应性胶质细胞增生的启动和Müler神经胶质细胞细胞周期的重新进入，在小鼠和斑马鱼之间显示出显著差异，这可能是由Notch和TGFβ（转化生长因子-β）异构体的不同调节以及不同的染色质可及性介导的。

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引用次数: 1

Genomic instability and eye diseases 基因组不稳定和眼病。

Advances in ophthalmology practice and research

Pub Date : 2023-08-01 DOI: 10.1016/j.aopr.2023.03.002

Hongyan Liu , Jun Cheng , Xiaoyun Zhuang , Benxiang Qi , Fenfen Li , Bining Zhang

Background

Genetic information is stored in the bases of double-stranded DNA. However, the integrity of DNA molecules is constantly threatened by various mutagenic agents, including pollutants, ultraviolet light (UV), and medications. To counteract these environmental damages, cells have established multiple mechanisms, such as producing molecules to identify and eliminate damaged DNA, as well as reconstruct the original DNA structures. Failure or insufficiency of these mechanisms can cause genetic instability. However, the role of genome stability in eye diseases is still under-researched, despite extensive study in cancer biology.

Main text

As the eye is directly exposed to the external environment, the genetic materials of ocular cells are constantly under threat. Some of the proteins essential for DNA damage repair, such as pRb, p53, and RAD21, are also key during the ocular disease development. In this review, we discuss five ocular diseases that are associated with genomic instability. Retinoblastoma and pterygium are linked to abnormal cell cycles. Fuchs’ corneal endothelial dystrophy and age-related macular degeneration are related to the accumulation of DNA damage caused by oxidative damage and UV. The mutation of the subunit of the cohesin complex during eye development is linked to sclerocornea.

Conclusions

Failure of DNA damage detection or repair leads to increased genomic instability. Deciphering the role of genomic instability in ocular diseases can lead to the development of new treatments and strategies, such as protecting vulnerable cells from risk factors or intensifying damage to unwanted cells.

背景：遗传信息存储在双链DNA的碱基中。然而，DNA分子的完整性不断受到各种致突变剂的威胁，包括污染物、紫外线和药物。为了抵消这些环境损害，细胞已经建立了多种机制，例如产生识别和消除受损DNA的分子，以及重建原始DNA结构。这些机制的失败或不足会导致遗传不稳定。然而，尽管在癌症生物学方面进行了广泛的研究，但基因组稳定性在眼科疾病中的作用仍然缺乏研究。正文：由于眼睛直接暴露在外部环境中，眼睛细胞的遗传物质不断受到威胁。一些对DNA损伤修复至关重要的蛋白质，如pRb、p53和RAD21，也是眼病发展过程中的关键。在这篇综述中，我们讨论了五种与基因组不稳定相关的眼病。视网膜母细胞瘤和翼状胬肉与异常细胞周期有关。Fuchs角膜内皮营养不良和年龄相关性黄斑变性与氧化损伤和紫外线引起的DNA损伤的积累有关。眼睛发育过程中粘着蛋白复合体亚基的突变与角膜硬化有关。结论：DNA损伤检测或修复失败会导致基因组不稳定性增加。破译基因组不稳定性在眼部疾病中的作用可以开发新的治疗方法和策略，例如保护脆弱细胞免受风险因素的影响或加剧对不需要的细胞的损伤。

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引用次数: 0

TOC TOC

Advances in ophthalmology practice and research

Pub Date : 2023-08-01 DOI: 10.1016/S2667-3762(23)00025-2

引用次数: 0

Quantification of vascular morphology in optical coherence tomography angiography in primary open angle glaucoma 原发性开角型青光眼光学相干断层扫描血管造影术中血管形态的量化。

Advances in ophthalmology practice and research

Pub Date : 2023-08-01 DOI: 10.1016/j.aopr.2023.05.002

Praneeth Kalva , Rubeel Akram , Priya Mekala , Monica Patel , Sruthi Suresh , Karanjit S. Kooner

Purpose

To quantitatively measure and compare the vascular morphology in healthy eyes and eyes with primary open-angle glaucoma (POAG) using optical coherence tomography angiography (OCTA) scans.

Methods

This is a retrospective and cross-sectional study which include healthy individuals and individuals with POAG that underwent OCTA imaging at an academic center's glaucoma clinic. We analyzed OCTA scans of the macula and optic nerve head (ONH) of one eye from each subject to quantitatively measure vessel density (VD), vessel length density (VLD), and branchpoint density (BPD). We compared these 3 parameters between the healthy and POAG groups and used logistic regression classification models to determine their diagnostic value in differentiating healthy and glaucomatous eyes.

Results

We included 49 healthy subjects and 49 subjects with POAG. After age-adjusted analysis, the parameters of VD, VLD, and BPD were significantly reduced in eyes with POAG (P < 0.001) in all scan layers and most significantly around the ONH. The parameter with the best performances were radial peripapillary capillary (RPC) VD [AUC (areas under the curve): 0.939 (0.891, 0.987)] which had statistically higher performances (P < 0.05) than parameters in the superficial or deep layers. All 3 parameters in the RPC layer had statistically similar performances.

Conclusions

We found that VD, VLD, and BPD were reduced in glaucomatous eyes. The morphologic parameters of VLD and BPD had similar performances to the traditional parameter of VD in RPC layers. Our results suggest that vascular morphology parameters may provide additional value in the diagnosis and evaluation of glaucoma.

目的：应用光学相干断层扫描血管造影术（OCTA）对健康眼和原发性开角型青光眼（POAG）眼的血管形态进行定量测量和比较。方法：这是一项回顾性和横断面研究，包括健康个体和在学术中心青光眼诊所接受OCTA成像的POAG患者。我们分析了每个受试者一只眼睛的黄斑和视神经头（ONH）的OCTA扫描，以定量测量血管密度（VD）、血管长度密度（VLD）和分支点密度（BPD）。我们比较了健康组和POAG组的这3个参数，并使用逻辑回归分类模型来确定它们在区分健康眼和青光眼方面的诊断价值。结果：我们纳入了49名健康受试者和49名POAG受试者。经年龄校正分析，POAG患者VD、VLD和BPD参数均显著降低（PP结论：我们发现青光眼患者VD、VLD和BPD降低。在RPC层中，VLD和BPD的形态学参数与VD的传统参数具有相似的性能。我们的研究结果表明，血管形态学参数可能在青光眼的诊断和评估中提供额外的价值。

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引用次数: 0

Stereopsis after bilateral implantation of Toric intraocular lenses in high myopic cataract patients with astigmatism 高度近视散光白内障患者双侧托里人工晶状体植入术后的立体视觉。

Advances in ophthalmology practice and research

Pub Date : 2023-08-01 DOI: 10.1016/j.aopr.2023.07.001

Wei Fan , Guangbin Zhang

Purpose

To evaluate near, intermediate, distance visual acuity and stereopsis after bilateral implantation of Toric intraocular lenses (IOLs) in high myopic patients with astigmatism.

Methods

Bilateral Toric or non-Toric IOL implantation (n = 40 eyes each) was performed on high myopic cataract eyes with astigmatism. Best-corrected distance visual acuity (BCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), residual refractive astigmatism (RRA), and near, intermediate, and distance stereoacuity were measured postoperatively at 7 days, 1 month, and 3 months.

Results

The three-month postoperative BCDVA, UCIVA, and UCNVA of the Toric group were 0.08 ± 0.07, 0.30 ± 0.11, and 0.23 ± 0.14 LogMAR. All improved over the preoperative assessments (P < 0.05). The RRA, UCIVA, and UCNVA were significantly better in the Toric group than the non-Toric group at all follow-up examinations (all P < 0.05). At 3 months, the median near and intermediate stereoacuity of the Toric group were 100 (range 40 – 400) and 120 (range 50 – 400) arcsec, which were better than the non-Toric group (both P < 0.05). Fine near stereopsis ≥100 arcsec was present in 65% of the Toric patients, and 50% had good intermediate stereopsis of ≥100 arcsec. However among non-Toric patients, only 15% and 5% achieved fine near and intermediate stereopsis. The postoperative BCDVA and best-corrected distance stereoacuity were similar in the two groups (P > 0.05).

Conclusions

In bilateral high myopic cataract patients with astigmatism, Toric IOLs not only improved UCIVA, UCNVA, and RRA, but also enhanced near and intermediate stereopsis acuity.

目的：评价高度近视散光患者双侧托里人工晶状体植入术后的近、中、远视力和立体视觉。方法：双侧托里或非托里人工晶状体植入术（n=每只40眼）对具有散光的高度近视性白内障眼进行。术后第7天、第1个月和第3个月分别测量最佳矫正远距视力（BCDVA）、未矫正中距视力（UCIVA）、未矫治近距视力（UCNVA）、残余屈光性散光（RRA）以及近、中、远距立体视力。结果：Toric组术后3个月BCDVA、UCIVA和UCNVA分别为0.08±0.070.30±0.11和0.23±0.14 LogMAR。与术前评估相比均有改善（PPPP>结论：在伴有散光的双侧高度近视白内障患者中，Toric IOL不仅改善了UCIVA、UCNVA和RRA，而且提高了近中立体视觉的视力。

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引用次数: 0

Late postoperative opacification of a new type hydrophilic acrylic intraocular lens 新型亲水性丙烯酸人工晶状体术后晚期混浊。

Advances in ophthalmology practice and research

Pub Date : 2023-08-01 DOI: 10.1016/j.aopr.2023.06.001

Jin Xie , Xinyi Zang , Shilan Mao , Jie Sun , Ting Liu , Yunhai Dai

Background

To report the clinical consequences and laboratory characteristics of late postoperative opacification of a hydrophilic acrylic intraocular lens (US-860UV IOL) as well as the prognosis of IOL replacement.

Methods

Forty medical records (42 eyes) of patients with US-860UV IOL opacification reporting decreased or lost vision who underwent IOL explantation between 2017 and 2019 were reviewed. Explanted IOLs were analyzed by slit-lamp examination, confocal microscopy, scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) at the Shandong Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, and Qingdao University of Science and Technology, Qingdao, China.

Results

The mean age of the 40 patients was 74.83 ± 7.57 (63–92) years. The mean interval between cataract surgery and diagnosis of opacification was 32.38 ± 8.76 (17–48) months. Systemic diseases were found without statistical correlations, the most frequent being arterial hypertension, coronary heart disease, and diabetes mellitus. Visual acuity improved from 1.42 ± 1.03 to 0.31 ± 0.16 (logMAR) after IOL replacement. SEM, EDS and alizarin red staining showed uniformly distributed, diffuse, milk-white opacification, with calcium and phosphorus deposits on the optic and haptic surfaces that could be dissolved in 1% HCl.

Conclusions

Calcium and phosphorus deposition was the main cause of hydrophilic acrylic US-860UV IOL opacification. IOL replacement can safely and effectively improve the visual acuity of patients.

背景：报道亲水性丙烯酸人工晶状体（US-860UV IOL）术后晚期混浊的临床后果、实验室特征以及人工晶状体置换术的预后。方法：回顾2017年至2019年间接受人工晶状体植入术的40例US-860UV人工晶状体混浊患者（42眼）的病历，这些患者报告视力下降或丧失。在中国青岛的山东眼科重点实验室、山东眼科研究所、山东第一医科大学和青岛科技大学，通过裂隙灯检查、共聚焦显微镜、扫描电子显微镜（SEM）和能谱仪（EDS）对植入的人工晶状体进行了分析±7.57（63-92）年。白内障手术与混浊诊断之间的平均间隔时间为32.38±8.76（17-48）个月。系统性疾病没有统计学相关性，最常见的是动脉高压、冠心病和糖尿病。视力从1.42提高±1.03至0.31±0.16（logMAR）。扫描电镜、能谱仪和茜素红染色显示乳白色混浊，钙和磷沉积在视觉和触觉表面，可溶解在1%盐酸中。结论：钙和磷的沉积是亲水性丙烯酸US-860UV IOL混浊的主要原因。人工晶状体置换术可以安全有效地提高患者的视力。

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