BMC Ophthalmology最新文献

Background: Epiphora and secondary ocular surface damage are increasingly impairing the quality of life of people, particularly elderly women. We aimed to investigate the changes in tear cytokine and lactoferrin levels in postmenopausal women with primary acquired nasolacrimal duct obstruction (PANDO) complicated with obstructed meibomian gland dysfunction (OMGD) and preliminary explore the pathological mechanisms of OMGD in patients with PANDO.

Methods: The prospective study involved 43 and 41 postmenopausal women with and without PANDO, respectively. Based on the presence or absence of OMGD, the participants were subdivided. Tear fluid was collected from affected eyes of all participants using Schirmer I test and tested for cytokine concentrations (interleukin (IL)-6, IL-8, IL-1β, interferon-gamma, tumour necrotic factor (TNF)-α, IL-10, epidermal growth factor (EGF)) using the Multiplex Luminex Assay. Tear lactoferrin levels was determined using ELISA.

Results: In the PANDO with OMGD group, the IL-8, IL-1α, IL-1β, and macrophage inflammatory protein-1α levels were significantly higher than those in the other groups. The IL-6 and TNF-α levels were significantly higher than those in the controls. The lactoferrin level in the PANDO with OMGD group was lower than that in the Non-PANDO with OMGD group. The IL-10 and EGF levels were not significantly different among the groups.

Conclusion: The level of pro-inflammatory factors in the tears of patients with PANDO complicated with OMGD was significantly increased, which is likely to cause further damage to ocular surface. Anti-inflammatory therapy may help protect ocular surface in postmenopausal women with PANDO.

Background: Human anterior lens capsules (ALCs) have great potential in the treatment of multiple eye diseases, including corneal ulcers, glaucoma, age-related macular degeneration and macular holes. ALCs are also regarded as promising scaffolds for various ocular cells. Here, we investigated different decellularization methods for removing lens epithelial cells (LECs) that adhered to ALCs.

Methods: Human ALCs were treated with various solutions, including 2% lidocaine, 10% sodium chloride, 50% glucose and sterile water. Trypan blue and alizarin red (TB-AR) staining, H&E staining and hydroxyproline assays were used to assess the degree of decellularization. The impacts of acellular ALCs on cell viability and cell-tissue interaction were investigated in vitro.

Results: These findings revealed that 2% lidocaine, 10% sodium chloride, 50% glucose, and sterile water had the capacity to decellularize ALCs at 37 °C. The structure of ALCs in all decellularization groups was similar to that of intact ALCs. The effects of 10% sodium chloride and sterile water on decellularization were significantly better than those of 2% lidocaine and 50% glucose. The H&E staining revealed that the different decellularization methods maintained the integrity of the lens capsular structure. Compared with sterile water, 10% sodium chloride preserved a better level of hydroxyproline. The ALCs in the 10% sodium chloride-treated group and the sterile water-treated group were shown to be suitable for cell adhesion in vitro.

Conclusion: This study identified two optimal decellularization methods for acellular ALCs: using 10% sodium chloride and using sterile water. The obtained acellular ALCs could be promising scaffolds for ocular cells. In addition, acellular ALCs do not need resterilization and may be directly used for autologous lens capsule transplantation in clinical applications.

Objectives: To evaluate the effects of short-acting cycloplegic agents, tropicamide and compound tropicamide, on ocular biological parameters and choroid thickness.

Methods: In this study, seventy pediatric subjects aged 6 to 13 years were randomly assigned to two groups: the tropicamide group and compound tropicamide group. Ocular biological parameters and choroidal thickness (CT) and subfoveal choroid thickness (SFCT) were measured in both groups and were retested 40 min after drug administration. The tropicamide eye drops were administered into the conjunctival sac every 5 min with 1 drop, for a total of 4 doses. Compound tropicamide was administered in the same way as tropicamide. Ocular biological parameters included refraction (spherical equivalent, SE), intraocular pressure (IOP), axial length (AL), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), and white to white (WTW). The CT is the regional inferior choroidal thickness of nine sectors centered on the macular fovea and automatically generated using an ETDRS grid. And the SFCT is the choroidal thickness at the subfoveal point of the macular region.

Results: After application of tropicamide and compound tropicamide to induce the ciliary muscle paralysis, SE, AL, and LT decreased, while ACD, CCT, and WTW increased compared to baseline(all P values < 0.05). There was no significant change in IOP before and after cycloplegia (p > 0.05). The CT in the nasal quadrant before and after ciliary paralysis was significantly thinner than other areas, the CT in the temporal quadrant was significantly thicker than others, and the CT in the inner quadrant was higher than the CT in the outer quadrant. In the tropicamide group: CT was significantly increased in the remaining quadrants except the inner inferior(I) and outer superior(S) quadrants (p < 0.05), and SFCT was also significantly increased (p = 0.005). In the compound tropicamide group: there is a significant increase in CT outer superior(S) quadrant CT (p = 0.043). Increase in the mean values of CT and SFCT in the remaining quadrants was also observed, but the difference was not statistically significant (p > 0.05). Additionally, AL and SFCT were negatively correlated.

Conclusions: Some ocular biological parameters were altered after application of short-acting cycloplegic agent tropicamide and compound tropicamide to paralyze the ciliary muscle. Compared with compound tropicamide, tropicamide eye drops can reduce axial length while increasing choroid thickness.

Background: The psychometric properties of the Convergence Insufficiency Symptom Survey (CISS) have been previously determined across the younger adult population. This study investigated the psychometric properties of the CISS in presbyopic adults via classical and Rasch analysis.

Methods: A total of 100 presbyopic individuals (40-60 years) were selected with far and near acuity of 20/20 with their habitual spectacles; 50 had convergence insufficiency and 50 had normal binocular vision. Refraction, cover test, near point of convergence, and positive fusional ranges were examined. The Persian translated CISS was administered twice, once in the first session and 7 to 14 days later. Classical and Rasch analyses were conducted.

Results: The mean ages and gender ratios in the CI group and normal group were 49.70 ± 5.96 and 49.82 ± 5.64 years with a 50% female distribution among individuals. The mean CISS scores for presbyopes with CI and normal groups were 19.24 ± 5.33 and 13.26 ± 3.53 respectively (p < 0.001). Effective discrimination was achieved with a score greater than 15, yielding a sensitivity of 72%, a specificity of 69%, and an Area Under the Curve (AUC) of 0.813. For internal consistency, Cronbach's α coefficient was 0.82. For test-retest reliability in CISS scores, ICC was 0.91 (confidence interval 0.88-0.93) with the 95% limits of agreement in CI group being - 3.91 to 2.59. The Rasch analysis demonstrated a satisfactory model fit, as all items had infit and outfit mean square values ranging between 0.6 and 1.4. The measurement precision was good, with a person separation value of 2.30. Additionally, the first contrast eigenvalue of 2.34 and a raw variance of less than 50% indicated multidimensionality. The CI group reported headaches (item 3) more frequently than the normal binocular vision group did. However, eye discomfort scores (item 10) were similar for both groups.

Conclusions: The CISS is a valid and reliable tool for assessing the symptoms in presbyopic adults. However, due to this survey's multidimensionality, we recommend additional objective examinations in presbyopic adults with CI.

Background: This study evaluates retinal oxygen saturation and vessel density within the macula and correlates these measures in controls and subjects with type 2 diabetes (DM) with (DMR) and without (DMnR) retinopathy. Changes in retinal oxygen saturation have not been evaluated regionally in diabetic patients.

Methods: Data from seventy subjects (28 controls, 26 DMnR, and 16 DMR were analyzed. For those with DMR,8 were mild/moderate diabetic retinopathy (NPDR) and 8 severe NPDR/proliferative (PDR). Subjects were categorized with glycosylated hemoglobin A1c and fundus photography. Retinal oximetry measurements were performed within a 300-400 μm region at four diagonal locations 3.1 degrees from the center of the fovea in the superior nasal, superior temporal, inferior nasal, and inferior temporal locations adjacent to the foveal avascular zone (FAZ). Optical coherence tomography angiography (OCTA) was performed and corrected for refractive error. Photoshop and ImageJ were utilized to calculate the superficial capillary plexus vascular density (SCP). Oximetry and OCTA vessel density were analyzed overall and by region.

Results: Average retinal oxygen saturation was highest in DMR (p = 0.008). Average OCTA density was less in DMR compared to controls (p = 0.01), but not compared to DMnR subjects (p = 0.07). A significant inverse correlation was observed between averaged oxygen saturation and SCP vascular density for all subjects (p = 0.02). Duration of DM was positively associated with oxygen saturation (p = 0.01) and negatively with OCTA SCP vascular density (p = 0.009). There were no differential effects of retinal location.

Conclusion: To our knowledge, this study is the first to evaluate the relationship between macular oxygen saturation and SCP vascular density at different levels of retinopathy. This may be useful to track patients with DM as they move through stages of retinopathy.

Purpose: To evaluate the macular development in preterm infants with spontaneously regressed retinopathy of prematurity (ROP) utilizing handheld spectral domain optical coherence tomography (SD-OCT) during the early postnatal period.

Design: A cross-sectional observational study.

Methods: Using handheld SD-OCT, OCT images were acquired in non-sedated infants ages about 37 weeks(w) post-menstrual-age (PMA = gestational age in weeks + chronological age). Central foveal thickness (CFT), mean parafoveal thickness (PT, mean of the temporal and nasal-lateral retinal thickness 1000 μm from the foveal center), the thickness of inner retina layers (IRL) and outer retina layers (ORL) of the foveal center and parafoveal, the depth of the macular fovea (FD), and the angle of the macular fovea (FA) were measured and analyzed.

Results: In contrast to the infants without ROP (group 1), OCT images of the infants with spontaneously regressed ROP (group 2) were more immature. The FD of Group 2 was shallower than Group 1 (P < 0.05); CFT and the foveal center IRL (FIRL) of Group 2 were thicker than Group 1 (P < 0.05); conversely, PT and the mean parafoveal IRL (PIRL) of Group 2 were thinner than Group 1 (P < 0.05); FA of Group 2 was bigger than Group 1 (P < 0.05); however, there was no significant difference in the foveal center ORL (FORL) and the mean parafoveal ORL (PORL) between Groups 1 and 2 (P > 0.05). Furthermore, in preterm infants, ROP was moderately correlated with FD, CFT, PT, FIRL, and PIRL (P < 0.05).

Conclusions: The spontaneously regressed ROP resulted in immature macular development in the early postnatal period. The inner retinal layers mainly contribute to this but not the outer retinal layers, indicating that the macular fovea's inner and outer retina layers developed asynchronously. ROP is an influential factor in macular development and maturation. This may be associated with the higher probability of visual impairment in children with a history of spontaneous regression of ROP at a prior time.

Background: While vaccination remains crucial in mitigating the impact of the COVID-19 pandemic, several ocular adverse events has been reported, including Acute Zonal Occult Outer Retinopathy (AZOOR) complex.

Case presentation: A 31-year-old female presented declined best corrected visual acuity (BCVA) and flashes in both eyes three days following second recombinant mRNA COVID-19 vaccine (Moderna). Fundus autofluorescence (FAF) illustrated speckled hyper-AF lesions surrounding right eye torpedo maculopathy site and hyper-AF lesions in the left macula. The spectral-domain optical coherence tomography delineated inner and outer segment (IS/OS) line disruption; hyperreflective deposits in the outer nuclear layer (ONL); and undetectable interdigitation zone (IDZ). Her BCVA further declined after 3-month observation, thus she received 8-month oral prednisolone and mycophenolate mofetil treatment. Her BCVA recovered; the hype-AF lesions resolved; and the IS/OS line and ONL resumed.

Conclusions: We present a rare case of AZOOR complex following COVID-19 vaccination inciting from torpedo retinopathy where outer-retinal barrier breaks down.

Background/ aims: To analyze the longitudinal change in Bruch's membrane opening minimal rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (pRNFL) thickness using optical coherence tomography (OCT) after implantation of a PRESERFLO® microshunt for surgical glaucoma management in adult glaucoma patients.

Methods: Retrospective data analysis of 59 eyes of 59 participants undergoing implantation of a PRESERFLO microshunt between 2019 and 2022 at a tertiary center for glaucoma management. Surgical management included primary temporary occlusion of the glaucoma shunt to prevent early hypotony. Pre- and post-operative OCT examinations of the optic nerve head (ONH) and intraocular pressure (IOP) were assessed. Longitudinal change in morphometric spectral domain OCT parameters of the ONH was correlated to change in IOP.

Results: BMO-MRW increased significantly between baseline (BL) and follow-up (FU) within the first three months after surgery (BL = 171.15 ± 66.80 μm; FU = 180.78 ± 70.394 μm; p = 0.034). For the same postoperative period, the mean preoperative IOP of 24.97 ± 7.22mmHg was lowered after surgery to 13.70 ± 5.09 mmHg. Eighteen months after surgery, there was no significant change in BMO-MRW compared to baseline (BL = 169.83 ± 52.69 μm; FU = 164.98 ± 55.85 μm; p = 0.271), while mean IOP was 13.08 ± 4.48 mmHg. A decrease in IOP correlated significantly with a change in BMO-MRW (r = 0.453, p < 0.05) three months after surgery. Peripapillary RNFL thickness was unchanged in follow-up after three months (p > 0.16) and significantly decreased in later follow-up (p = 0.009).

Conclusion: PRESERFLO® microshunt implantation with primary temporary occlusion leads to a significant transient increase in BMO-MRW. This phenomenon is also known as structural reversal of disc cupping (SRDC). The effect seems to be less pronounced and of shorter duration when compared to previous data after trabeculectomy with comparable pre- and postoperative IOP levels.

Background: This study investigates the effect of botulinum toxin A on lipid layer thickness (LLT) and blink dynamics in patients with benign essential blepharospasm (BEB) compared to dry eye disease (DED) patients.

Methods: We reviewed the medical records of patients with dry eye disease (DED) and BEB treated with botulinum toxin A (BoT A) injections. Data on demographics, lipid layer thickness (LLT), meiboscore, and blink dynamics measured using a LipiView II interferometer before and 2 months after BoT A were collected.

Results: Each 28 eyes from 28 patients with BEB and age- and sex-matched patients with DED were included. When comparing blink dynamics, complete blink rate was significantly higher in the pre-injection BEB group compared to the DED group (5.25 ± 4.32 times/20 s vs. 2.43 ± 2.82 times/20 s, p = 0.0055). In tear film lipid profiles analyzed in BEB patients at pre-injection and 2-month follow-up after injection, average LLT significantly increased after injection (72.4 ± 22.7 nm to 83.0 ± 22.2 nm, p = 0.0215). Diabetes and young age were associated factors influencing the LLT increase. Significant increase in LLT was observed post-injection, with specific demographic factors, including diabetes and age, associated with this improvement. Additionally, blink dynamics showed a decrease in complete blink rate post-injection.

Conclusions: These findings suggest that BoT-A may alleviate BEB symptoms, but ophthalmologists should carefully interpret LLT and blink patterns in BEB patients due to potential overestimations of blink efficacy by the interferometer.

Herpes zoster Ophthalmicus (HZO) affecting the ophthalmic division (V1) of the trigeminal nerve. HZO may cause extraocular muscle palsies, with the third nerve being the most commonly affected and the fourth nerve the least. The combined involvement of the optic nerve and isolated paralysis of the eye muscle is very rare, with only limited case reports documenting this complication of ocular herpes zoster. This case report also describes a case of optic nerve involvement with 6th nerve palsy, which was treated with corticosteroid and valacyclovir.