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Established in April, 2008
ISSN 2222-3959 print
ISSN 2227-4898 online
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2023, 23(1):1-3. DOI: 10.3980/j.issn.1672-5123.2023.1.01
Abstract:Peripapillary pachychoroid syndrome(PPS)is a novel entity of pachychoroid disease spectrum(PDS)reported online in 2017. PPS eyes displayed thicker nasal versus temporal macular choroids, unlike PDS eyes with thicker temporal macular choroids. Peripapillary intraretinal and/or subretinal fluid was often overlying dilated Haller layer vessels(pachyvessels). Most PPS eyes exhibited other PDS findings including retinal pigment epithelial changes, serous pigment epithelial detachment and outer retinal atrophy. Their optic disc is usually crowded, and some eyes have disc edema and mild late fluorescence leakage. Most of the patients are elderly, and short axial length and hyperopia are common. While some patients experienced visual decline, the overall visual outcome was relatively favourable. Although anti-VEGF or photodynamic therapy were applied, the optimal management remains to be determined. Recognition of PPS is important to distinguish it from disorders with overlapping features such as posterior uveitis and neuro-ophthalmologic conditions. It has been suggested that PDS is consequences of chronic vortex vein stasis. And the hypothesis of choroidal venous overload provides with a unifying concept for pathophysiology of the diseases.
Xuan-Wei Liang , Yu-Xian Zou , Shu Liu , Zi-Wei Meng , Xin-Yue Yu , Ye-Hong Zhuo , Rong-Xin Chen
2023, 23(1):4-9. DOI: 10.3980/j.issn.1672-5123.2023.1.02
Abstract:AIM: To evaluate the necessity of slit-lamp biomicroscopy(referred to here as “slit-lamp”)training from the student's perspective and reach a consensus on slit-lamp training in medical students during ophthalmology clerkship.
METHODS: A controlled before-after clerkship study was performed on 117 students of the class of 2017 enrolled in clinical medicine at Sun Yat-sen University. All medical students underwent slit-lamp training during ophthalmology clerkship. We evaluated the students' cognition, perceived need and recommendations for slit-lamp teaching, using a self-completed questionnaire survey and compared the students' scores in these aspects before and after their ophthalmology clerkships. Additionally, the efficiency of slit-lamp training was evaluated by subjective student assessment after the ophthalmology clerkship. Each item was scored on a five-point Likert Scale. Statistical analysis was performed by IBM SPSS(Version 20.0; SPSS Inc., Chicago, IL, USA).
RESULTS: A total of 116(99.1%)medical students completed the survey. The average score before clerkship was 19.99±3.03, which indicated a high level of cognition regarding slit-lamp utility; However, this score significantly increased to 22.97±2.37 after clerkship(P<0.001). The average score regarding perceived need was also higher for post-clerkship students than for pre-clerkship students(24.62±3.15 vs. 23.60±2.36, P=0.009). Moreover, 86.2% of post-clerkship students reported that hands-on slit-lamp practice could help promote clerkship quality. More than three-quarters of the surveyed students tended to agree that slit-lamp practice time should be increased(76.7% and 77.6% before and after clerkship, respectively).
CONCLUSION: A hands-on approach to slit-lamp training is more favored by medical students in ophthalmology clerkships, and this training should be recommended in ophthalmology clerkships given its potential usefulness for improving clerkship quality.
Wen-Jun Gou , Heng Li , Hui You , Yi-Fan Tao , Bo Li , Hui Zhang
2023, 23(1):10-16. DOI: 10.3980/j.issn.1672-5123.2023.1.03
Abstract:AIM: To investigate the effect of Conbercept on serum lncRNA MALAT1 levels, central macular thickness(CMT)and best corrected visual acuity(BCVA)in patients with diabetic macular edema(DME), and to observe its efficacy and safety.
METHODS: A total of 300 patients(300 eyes)with DME were included in this study, all of whom had monocular lesions. They were divided into non-injection group with 100 patients(100 eyes), control group with 100 patients(100 eyes)treated with Ranibizumab injections and study group with 100 patients(100 eyes)treated with Conbercept injections according to a random numbers table.
RESULTS: The BCVA, serum lncRNA MALAT1 level and CMT were measured before and 1, 2 and 3mo after treatment. In addition, the clinical efficacy was assessed and the patients were followed up to record the adverse reactions. There were no significant changes in BCVA(LogMAR), serum lncRNA MALAT1 level and CMT in the non- injection group(P>0.05). The BCVA(LogMAR)in the control group and study group at 1, 2 and 3mo after treatment was significantly higher than that before treatment(all P<0.05). The BCVA(LogMAR)of patients in the study group at 1, 2 and 3mo after treatment was significantly higher than that before treatment(all P<0.05), but there was no significant difference between the study group and control group. The level of serum lncRNA MALAT1 in the control group decreased at 1, 2 and 3mo after treatment, and it decreased more significantly in the study group at 1, 2 and 3mo after treatment. The level of serum lncRNA MALAT1 in the study group was significantly lower than that in the control group(all P<0.05).The CMT of patients in the control group decreased at 1, 2 and 3mo after treatment; however, the CMT of patients in the study group decreased more significantly at 1, 2 and 3mo after treatment. The CMT of the study group was significantly lower than that of the control group(all P<0.05).The incidence of adverse reactions in the study group(2.0%)was significantly lower than that in the control group(11.0%).
CONCLUSION: Conbercept can significantly reduce the level of serum lncRNA MALAT1, CMT and macular edema and improve BCVA in patients with DME. Its therapeutic efficacy and safety are significantly better than Ranibizumab.
Ling-Chun Kong , Hong Zou , Jing-Jing Li , Yun Ling , Hui-Xin Tang
2023, 23(1):17-22. DOI: 10.3980/j.issn.1672-5123.2023.1.04
Abstract:AIM: To investigate the protective effect of Modified Taohong Siwu Decoction(MTSD)on hypoxia injury to retinal Müller cells rMC-1.
METHODS: Retinal Müller cells rMC-1 were interfered with the MTSD drug-containing serum under hypoxia condition, and were randomly divided into control group(21%O2), hypoxia model group(1%O2), MTSD drug-containing serum low-dose(1%O2+5% medicated serum), medium-dose(1%O2+10% medicated serum)and high-dose(1%O2+15%medicated serum)groups. Cell viability was detected by CCK-8 method, and secretion of vascular endothelial growth factor(VEGF)and pigment epithelium derived factor(PEDF)was detected by ELISA. The protein expressions of p-STAT3, STAT3 and hypoxia-inducible factor-1α(HIF-1α)were detected by Western blot, and the gene expressions of VEGF, PEDF, STAT3 and HIF-1α were detected by real-time polymerase chain reaction(PCR).
RESULTS: The viability of rMC-1 cells was significantly inhibited when cultured at 1%O2 for 48h compared with that of control group(P<0.05), while it was improved in both low and medium dose of MTSD groups(P<0.05). The viability of rMC-1 cells in high dose group was not improved in hypoxia condition(P>0.05). The low and medium doses of MTSD could reduce the protein expressions of VEGF in supernatant of rMC-1 cells under hypoxia condition(P<0.05), while the protein expressions of PEDF could not be increased(P>0.05). The above two dose groups down-regulated the protein levels of both p-STAT3 and HIF-1α(P<0.05), and the inhibition effect of low dose group was better than that of medium dose group(P<0.05). The medium dose of MTSD could up-regulate STAT3 protein level after hypoxia culture in rMC-1 cells(P<0.05). The low and medium doses of MTSD significantly down-regulated VEGF gene level(P<0.05)and up-regulated PEDF gene level after hypoxia culture in rMC-1 cells(P<0.05), and the function in the low dose group was superior to that in the medium dose group(P<0.05). The low dose of MTSD could down-regulate STAT3 and HIF-1α gene levels after hypoxia culture in rMC-1 cells(P<0.05).
CONCLUSION: Probably by inhibiting the STAT3/HIF-1α pathway, the drug-containing serum of MDST down-regulated the expression of VEGF protein and gene in hypoxia-induced retinal Müller cells, rMC-1, up-regulated the gene expression of PEDF, and alleviated the hypoxia injury to the cells.
Hui-Ling Bai , Xiao-Yan Zhu , Qin Liu , Yan-Ying Zhang , Wan-Rong Kang , Shu Zhang
2023, 23(1):23-31. DOI: 10.3980/j.issn.1672-5123.2023.1.05
Abstract:AIM: To prepare the model of diabetic retinopathy(DR)on the basis of the model of type 2 diabetes mellitus(T2DM)in rats, observe the preventive and protective effect of metformin on DR in T2DM rats and the effect on serum Cystatin C(Cys C), and discuss its mechanism.
METHODS: A total of 120 male SD rats were selected and 30 rats were randomly divided into blank control group A(10 rats), T2DM group(10 rats)and metformin intervention group A(10 rats). The remaining 90 rats were randomly divided into three groups: blank control group B(30 rats), DR group(30 rats)and metformin intervention group B(30 rats). Except for blank control groups A and B, T2DM models were constructed in all other groups. After modeling, rats in metformin intervention group A were given metformin by gavage, and rats in blank control group A and T2DM group were given normal saline by gavage. After 3mo of intervention, fasting blood glucose(FBG)and fasting serum insulin(FINS)indexes of the three groups were measured respectively, and the homeostasis model assessment of insulin resistance(HOMA-IR)was calculated and analyzed; The serum Cys C, tumor necrosis factor-α(TNF-α), the levels of Interleukin-8(IL-8), vascular endothelial growth factor(VEGF)and reactive oxygen species(ROS)were measured, and we observed the retinal tissue and vascular morphology of rats by FFA, HE staining and transmission electron microscopy; rats in metformin intervention group B began to give metformin by gavage 3mo after the course of T2DM, and other rats were given normal saline. According to the length of intervention, 10 rats were taken from each group and observed at 4, 5 and 6mo respectively. Serum levels of Cys C, TNF-α, IL-8, VEGF and ROS were measured in each group. We observed the retinal tissue and vascular morphology of rats by FFA, HE staining and transmission electron microscopy.
RESULTS: The expressions of serum FBG, FINS, HOMA-IR, Cys C, TNF-α, IL-8, VEGF and ROS were statistically significant among the blank control group A, T2DM group and metformin intervention group A(P<0.05), which were the highest in T2DM group, and the metformin intervention group A were lower than T2DM group; The expression of Cys C, TNF-α, IL-8, VEGF and ROS of rat serum were statistically significant among the blank control group B, DR group and metformin intervention group B within the same age groups at 4, 5 and 6mo respectively(P<0.05), and were all the highest in DR group. The expressions of metformin intervention group B were lower than those of the DR group. With the prolongation of DR course, the expression of Cys C, TNF-α, IL-8, VEGF and ROS also increased further; FFA results showed that compared with the corresponding blank control group, the retinal blood vessels of each model group were tortuous, and microaneurysms and fluorescence leakage were visible with the prolongation of the disease course; HE staining results showed that compared with the corresponding blank control group, the retinal cells of each model group were arranged disorderly, and abnormal dilated blood vessels were visible with the prolongation of the disease course; Transmission electron microscopy results showed that compared with the corresponding blank control group, the retinal capillaries in each model group were seriously damaged; However, compared with the corresponding model group, the results of FFA, HE and transmission electron microscopy of rats in each metformin intervention group had different degrees of improvement.
CONCLUSIONS: Metformin can improve retinal tissue lesions by down-regulating serum Cys C-mediated levels of inflammation and oxidative stress, thus playing a preventive and therapeutic role in the retinopathy in T2DM rats.
Xiao-Hong Chen , Wan-Jiao Liang , Shi-Shu Huang , Yan Sun , Xin Luo , Lu Lai , Zhao-Sheng Chi , Mei-Zhu Chen , Yun-Peng Wang , Wei-Ming Yan
2023, 23(1):32-38. DOI: 10.3980/j.issn.1672-5123.2023.1.06
Abstract:AIM: To explore the optimal concentration of endoplasmic reticulum stress immunohistochemical(IHC)staining antibody in mouse retinitis pigmentosa(RP)model, which provides the corresponding index detection method for studying the pathogenesis and intervention measures of RP.
METHODS: Clean male C57BL/6J mice were intraperitoneally injected with N-methyl-N-nitrosourea(MNU, 60mg/kg)to prepare RP mouse model. Electroretinogram(ERG)and hematoxylin-eosin(HE)staining were performed on 7d after modeling to verify the successful modeling. The expression of endoplasmic reticulum stress-related proteins(IRE1, ATF6, PERK, GRP78, Caspase-12)was detected by IHC staining.
RESULTS: The following proteins, including IRE1, ATF6, PERK, GRP78 and Caspase-12, were positively expressed in retina of RP mouse. The optimal concentrations of the above proteins were as follows: IRE1 antibody concentration was 1:1000, ATF6 antibody concentration was 1:500 and 1:1000(with no difference in positive expression, P>0.05), PERK antibody concentration was 1:1500, GRP78 antibody concentration was 1:200 and Caspase-12 antibody concentration was 1:100, the proteins were well expressed at the above concentrations, and the positive expressions of corresponding proteins were different from those of other antibody concentrations(P<0.05).
CONCLUSION: The optimal concentrations for IHC staining in different proteins of mouse RP models were as follows: the concentrations of endoplasmic reticulum stress-related protein antibodies were 1:1000 in IRE1, 1:500 and 1:1000 in ATF6, 1:1500 in PERK, 1:200 in GRP78, and 1:100 in Caspase-12.
Jing Zhu , Ming Lu , Ze-Feng Xiao
2023, 23(1):39-42. DOI: 10.3980/j.issn.1672-5123.2023.1.07
Abstract:AIM: To compare the visual effect of patients with presbyopia corrected by bifocal(AtLisa tri 809MP)intraocular lens(IOL)and trifocal(AtLisa tri 839MP)IOL implantation.
METHOD:A total of 40 patients(51 eyes)who underwent cataract phacomulsification surgery in our hospital were collected, and they were retrospectively analyzed and divided into group A and group B. The group A with 20 patients(25 eyes)implanted the bifocal 809MP IOL, while the group B with 20 patients(26 eyes)implanted the trifocal 839MP IOL. The uncorrected distance visual acuity(UDVA), uncorrected intermediate distance visual acuity(UIVA), uncorrected near distance visual acuity(UNVA), and the defocus curve of the patients in two groups were measured at 3mo after surgery. Additionally, statistical analysis was carried out through satisfaction questionnaire.
RESULT:There were no significant differences in the UDVA and best corrected visual acuity(BCVA)between the two groups at 3mo after surgery(P>0.05). In group B, the UIVA(80cm)was significantly better than that in group A(P<0.01); there was no statistically significant differences in the UNVA of group A and B(P>0.05). The defocus curve analysis at 3mo after surgery revealed that the group A had double peaks at 0D and -3D; while the group B had double peaks at 0D and -2.5D. Patients in the two groups showed different degrees of halo, glare and other optical manifestation, but the overall satisfactions and the near vision satisfactions were higher.
CONCLUSION: Two types of IOL can provide patients with full range of vision that including both near and far distance visual acuity. Both of the AtLisa tri 839MP IOL and 809MP IOL can provide good near vision, while the trifocal IOL is more suitable for intermediate distance vision.
Fang Li , Jun Yang , Ting-Fei Wu , Deng-Hong Long
2023, 23(1):43-47. DOI: 10.3980/j.issn.1672-5123.2023.1.08
Abstract:AIM: To evaluate macular light sensitivity and fixation stability in anisometropic amblyopia by microperimetry.
METHODS: In this cross-sectional study, 39 children(39 eyes with amblyopia and 39 fellow eyes)who were initially diagnosed with monocular anisometropic amblyopia between July 2020 and January 2022 and 42 patients with normal best corrected visual acuity(BCVA)but suffered from improper refraction were selected, and the right eyes were selected as control group. Microperimetry(MP-3)was used to measure the average threshold(AT)of macular light sensitivity at 10°and fixation stability \〖including the percentage of fixation points within 2° and 4°(P1, P2), bivariate contour ellipse area(BCEA)for 68.2%, 95.4% and 99.6% of points\〗 in amblyopic eyes, fellow eyes and normal control group. The AT and fixation stability of amblyopic eyes, fellow eyes and normal control group were compared.
RESULTS: Children with amblyopia had significantly lower AT than fellow eyes and right eyes of normal control group(all P<0.017), and there were no differences in the macular light sensitivity of both fellow eyes and normal control group(P=0.555). The P1 was significantly lower in amblyopic eyes than in fellow eyes and normal control eyes(all P<0.017), and there were no differences in P1 between fellow eyes and normal control group(P=0.887).There were no differences in P2, 68.2%BCEA, 95.4%BCEA and 99.6%BCEA in patients among the three groups(all P>0.05). Moreover, there was no correlation between BCVA and AT, P1, P2, 68.2%BCEA, 95.4%BCEA and 99.6%BCEA in amblyopic eyes, fellow eyes and normal control eyes(all P>0.05).
CONCLUSION: The macular light sensitivity and fixation stability within 2° may be decreased in eyes with anisometropic amblyopia.
Feng Wang , Jiang-Feng Lai , Ling-Ying Cao , Yi Shao
2023, 23(1):48-52. DOI: 10.3980/j.issn.1672-5123.2023.1.09
Abstract:Transient potential receptor vanilloid 4(TRPV4)is a cluster of non-selective cation channels presented on cell membranes. They are important mediators of sensory signals that regulate cell function and signaling pathways. TRPV4 is widely expressed in various ocular tissues and can participate in a variety of physiological functions, including osmotic pressure regulation, Ca2+ homeostasis, apoptosis and autophagy. It plays an important role in normal physiological functions and different pathology. Recent studies have revealed that TRPV4 is closely correlated to corneal epithelial injury, glaucoma, age-related cataract, diabetic retinopathy, retinopathy of prematurity, retinal detachment and other diseases. Besides, studies also showed that TRPV4 regulates the occurrence and development of its related ophthalmic diseases. This paper briefly reviewed the research progress on TRPV4 pathway in ophthalmic diseases, so as to provide ideas for the clinical treatment of ophthalmopathy.
2023, 23(1):53-57. DOI: 10.3980/j.issn.1672-5123.2023.1.10
Abstract:Childhood glaucoma is a kind of refractory glaucoma. Minimally invasive glaucoma surgery(MIGS)provides a safe and effective treatment option for childhood glaucoma. Most of the published studies tend to be with circumferential ab interno trabeculotomy, showing that its safety and effectiveness in the treatment of childhood glaucoma are comparable to non-MIGS circumferential ab externo trabeculotomy. Studies on KDB, trabectome and Xen-gel stent are relatively limited, but they may have advantages in some specific cases. While considering the advantages of each MIGs operation, it is also necessary to weigh the long-term effect of each operation method. In addition, more prospective and comparative researches, larger sample size and longer follow-up time are needed to verify the safety and effectiveness of MIGs in the treatment of childhood glaucoma.
Mei Sun , Xiao-Feng Hao , Li-Ke Xie , Qi Jin
2023, 23(1):58-61. DOI: 10.3980/j.issn.1672-5123.2023.1.11
Abstract:Retinal vein occlusion(RVO)is the second most common cause of visual loss classified under retinal vascular disorders after diabetic retinopathy, and its complication, macular edema(ME), is the leading cause of vision loss. Currently, the first-line treatment for RVO-ME is the intravitreal injection of anti-vascular endothelial growth factor drugs, which can improve retinal morphology and patients' vision. Optical coherence tomography(OCT)can clearly image retinal structures, and some specific imaging features found by OCT have become biomarkers for evaluating the prognosis of RVO patients. The recent findings of biomarkers are reviewed, such as central retinal thickness, choroidal thickness, disorganization of retinal inner layers, hyperreflective foci, integrity of external limiting membrane and ellipsoid zone, central macular volume, prominent middle limiting membrane, paracentral acute middle maculopathy, highly reflective line, to provide references for selecting the best treatment for RVO.
Zi-Wei Zhao , Jie Peng , Pei-Quan Zhao
2023, 23(1):62-66. DOI: 10.3980/j.issn.1672-5123.2023.1.12
Abstract:Familial exudative vitreoretinopathy(FEVR)is a hereditary disorder of retinal angiogenesis, of which the most typical clinical feature is the peripheral avascular area. The progression of the disease can lead to retinal detachment(RD), followed by secondary complications such as cataracts, glaucoma, corneal opacification, and even bulbi phthisis. As one of the main reasons for the RD in Asian children and juvenile, FEVR-associated retinal detachment(FEVR-RD)is mainly treated by surgery, including pars plana vitrectomy, scleral bucking, and combined with retinal photocoagulation or anti-vascular endothelial grouth factor(VEGF)sometimes. The surgery of FEVR-RD requires careful pre/intra-operative evaluation to determine the best surgical procedure and its outcome, including the nature of the affected eye, the stage, the fibrosis of fiber proliferation and the anterior complications, and the anatomy and prognosis of eyes in different stages vary greatly. Adult patients with rhegmatogenous RD have a higher rate of post-operative retina reattachment compared to young patients with tractional RD. In young or advanced patients, surgery is difficult and the prognosis is less optimistic, thus the surgery strategy is controversial. This article reviews the surgical outcomes and progress of FEVR-associated RD.
Wen-Jing Luo , Jin-Wei Hu , Shu-Qiong Hu
2023, 23(1):67-70. DOI: 10.3980/j.issn.1672-5123.2023.1.13
Abstract:Glaucoma is the world's No.1 irreversible disease causing blindness. It is one of the neuroophthalmic diseases characterized by an optic nerve injury and visual field defect. Numerous studies have shown that the damage caused by glaucoma is not only limited to the apoptosis of local visual ganglion cells in the eye, but also involves the entire visual pathway of the cerebral visual cortex, which is a neurodegenerative disease of the entire brain. Recently, with the rapid development of functional magnetic resonance imaging(fMRI), anatomy and function of nervous system are combined, so that the damage of local brain tissue corresponds to the lack of brain function, which helped in achieving the observation of anatomical structure and functional changes of the central nervous system under non-invasive conditions, thus providing the effective evidence for the pathological mechanism in glaucoma's research. Being a popular research technology in neuroimaging, resting-state functional magnetic resonance imaging(rs-fMRI)provides important evidences for exploring the anatomical structure, metabolism and functional changes of vision-related brain regions in patients with glaucoma. This review mainly discusses the principle of rs-fMRI and some common analysis methods such as amplitude of low-frequency fluctuation(ALFF), regional homogeneity(ReHo), degree centrality(DC)and functional connectivity(FC)in the application and research progress in glaucoma.
2023, 23(1):71-74. DOI: 10.3980/j.issn.1672-5123.2023.1.14
Abstract:With complicated pathogenesis and limited treatment options, optic neuropathy is one of the major blinding diseases characterized by damaged retinal ganglion cells(RGC)and axons. Sigma-1 receptor(S1R)is a chaperone protein mainly located in the endoplasmic reticulum membrane, which is abundant in retina and highly expressed in the ganglion cell layer. S1R has been noted increasingly as a novel target for the treatment of neuro-degenerations. More studies have shown that S1R is a pluripotent modulator including Ca2+ homeostasis, endoplasmic reticulum stress response, oxidative stress response, neurotrophic factor secretion and glial cell activation, indicating that S1R can generate significant impacts on neuroprotection in neurodegenerative diseases. Additionally, S1R also has neuroprotective effects against RGC loss and dysfunction both in vivo and in vitro, reversing loss partially and maintaining structural integrity, while the absence of S1R exacerbates the disease or increases vulnerability to degenerative diseases. This article intends to review the progress and mechanisms in neuroprotection of S1R in RGC, aiming to provide a new target for the treatment of optic neuropathy.
2023, 23(1):75-78. DOI: 10.3980/j.issn.1672-5123.2023.1.15
Abstract:Ferroptosis is a newly identified programmed cell death characterized by lipid peroxidation and iron accumulation. In recent years, with the proposal of the concept of ferroptosis as well as the deepening of its mechanism research, great breakthroughs have been made in the exploration of the pathogenesis of ocular diseases related to the function decline of retinal pigment epithelium cells(RPECs), such as age-related macular degeneration(AMD), retinitis pigmentosa(RP)and diabetic retinopathy(DR). This article reviews the basic concept of ferroptosis, the main mechanism of ferroptosis in RPECs and the role of ferroptosis regulation in the development of RPECs-related ocular diseases, hoping to provide references for the study of the pathogenesis of RPECs-related ocular diseases.
Shi-Yu Jia , Qin Liu , Na-Na Zhang , Mei-Ling Qian , Jun Yang
2023, 23(1):79-83. DOI: 10.3980/j.issn.1672-5123.2023.1.16
Abstract:Myopia is currently one of the eye diseases that seriously threaten patients' vision worldwide, and its occurrence and development is a complex mechanism. It has been found that retinal pigment epithelium(RPE)cells play a key role in the progression of myopia. RPE cells mainly regulate cell function by regulating the expression of intracellular growth factor and matrix metalloproteinase-2(MMP-2)through the signal pathway of mammalian target of rapamycin(mTOR). At the same time, RPE cells can also be regulated by dopamine receptor agonists, so that cell function changes. When dopamine receptor activation weakened, RPE cell function will be impaired, thus promoting the development of myopia. Studies have shown that the expression of acetylcholine and all-trans retinoic acid in RPE cells can regulate the secretion of growth factors by RPE cells, and the growth factors act on scleral fibroblasts, thus indirectly regulating the course of myopia. Additionally, some studies have shown that RPE cells can coordinate the regulation of γ-aminobutyric acid on scleral cells and indirectly regulate the course of myopia. Besides, the expression of microRNA(microRNA)in RPE cells, such as microRNA-328 and microRNA-29a, was found through previous studies that they can affect the content and composition of extracellular matrix by regulating the expression of MMP-2 in RPE cells, thus leading to the occurrence and development of myopia. Therefore, the expression of multiple signaling pathways and miRNA in RPE cells are closely related to the occurrence and development of myopia. This article reviews the research progress of the molecular mechanism of RPE in the development of myopia, with a view to provide some theoretical basis for the specific molecular mechanism in the development of myopia.
Yan Cheng , Yan-Yan Liu , Miao Wei , Hua-Xiang Gu , Min Ji
2023, 23(1):84-89. DOI: 10.3980/j.issn.1672-5123.2023.1.17
Abstract:Dry eye is a multifactorial disease characterized by loss of ocular surface homeostasis and increased tear film instability, accompanied by ocular symptoms such as ocular dryness, foreign body sensation, burning sensation, eye redness, pain, photophobia, tearing, eye fatigue, decreased visual acuity, increased secretion, and sensitivity to external stimuli. Its pathophysiological mechanisms are mainly tear film instability, elevated tear osmolarity(Tosm), ocular surface inflammation and injury, and neurosensory abnormalities. Tosm is an important factor in maintaining tear film stability and ocular surface comfort. Elevated Tosm can cause ocular discomfort, corneal epithelial damage, loss of goblet cells and ocular inflammatory response in dry eye patients, and the inflammatory response can further reduce tear film stability and increase Tosm, which puts dry eye in a vicious cycle. In order to have a more comprehensive understanding of the relationship between tear hyperosmolarity(THO)and dry eye, this article will focus on the role of THO in the pathogenesis, diagnosis, severity classification and targeted treatment of dry eyes from the aspect of pathophysiology.
Jia-Lu You , Yan-Nian Hui , Le Zhang
2023, 23(1):90-95. DOI: 10.3980/j.issn.1672-5123.2023.1.18
Abstract:Eye movements refer to a series of spontaneous, controlled and purposeful movements of the eye. Based on a large number of observations on eye movement in scientific research and clinical work, eye movements are not only essential for maintaining clear vision in humans, but also an objective embodiment of brain activity, which is of great significance for the diagnosis and localization of multidisciplinary diseases. Eye tracking technology is a measurement technique that obtains information about eye movements. The use of eye tracking technology can obtain accurate and objective eye movement data, and explore the mechanism of eye movement, the development process and clinical significance of different eye movement types. In addition, eye tracking technology also has positive significance in the objective visual examination, diagnostic and treatment of ophthalmology. In this paper, we review the research progress of eye movements and eye tracking technology in the clinical application of ophthalmology, such as in the application of objective vision examination in infants, strabismus diagnosis and treatment, corneal refractive surgery and glaucoma diagnosis.
Song-Yu Li , Ying-Xin Yang , Chao Yang , Zi-Yi Yang , Yu-Xin Xue , Jing-Hua Feng
2023, 23(1):96-102. DOI: 10.3980/j.issn.1672-5123.2023.1.19
Abstract:AIM: To evaluate the published researches on the efficacy of atropine eye drops with different concentrations in delaying the progression of myopia in children and adolescents.
METHODS: Randomized controlled trials(RCT)in PubMed, the Cochrane Library, Embase, CNKI, VIP and WanFang Data databases were retrieved from the creation to May 2022. The quality of the included literature was evaluated by using the bias risk evaluation tool in Cochrane Intervention System Evaluation Manual. Meta-analysis was carried out via Review Manager 5.4.
RESULTS: A total of 14 RCT studies, involving 3 946 children and adolescents. Meta-analysis showed that compared with the control group, atropine eye drops with different concentrations could delay the progression of myopia in children and adolescents. The growth of axial length of the groups with 1%, 0.5%, 0.05%, 0.02% and 0.01% atropine eye drops respectively was lower than that of the control group, the difference was statistically significant(MD=-0.34, 95%CI:-0.39~-0.29, P<0.00001; MD=-0.51, 95%CI:-0.79~-0.24, P=0.0003; MD=-0.17, 95%CI:-0.30~-0.04, P=0.01; MD=-0.21, 95%CI:-0.30~-0.11, P<0.0001; MD=-0.09, 95%CI:-0.13~-0.05, P<0.0001), while the growth of axial length of group with 0.1% atropine eye drops was lower than that of control group, the difference was not statistically significant(MD=-0.50, 95%CI:-1.28~0.28, P=0.21).
CONCLUSION: Atropine eye drops with different concentrations can effectively delay the progression of myopia in children and adolescents, while 0.01% can delay the progression of myopia with the lowest incidence of adverse reactions.
Wen-Hui Liu , Feng Wang , Wen-Jun Zou , Shui Lu , Tian-Tian Chen
2023, 23(1):103-108. DOI: 10.3980/j.issn.1672-5123.2023.1.20
Abstract:AIM: To analyze the diagnostic value of macular ganglion cell complex(mGCC)and thickness and visual field of peripapillary retinal nerve fiber layer(pRNFL)on neovascular glaucoma(NVG).
METHODS: Retrospective study. A total of 92 patients(100 eyes)with NVG who were admitted to our hospital from January 2018 to October 2021 were selected. They were divided into 31 cases(32 eyes)with early NVG, 31 cases(36 eyes)with open angle glaucoma and 30 cases(32 eyes)with angle-closure glaucoma according to their pathology and term. Additionally, 50 cases(100 eyes)receiving health examination in our hospital at the same period were selected as the control group. Pearson correlation was used to analyze the correlation among mGCC, pRNFL thickness and mean deviation(MD), and the diagnostic efficiency of each index was studied by the receiver operating characteristic(ROC)curve.
RESULTS: The levels of mGCC-average(a), mGCC-superior(s)and mGCC-inferior(i)in the patients with early NVG, open-angle glaucoma and angle-closure glaucoma were lower than those in the control group(all P<0.001). The levels of mGCC-a, mGCC-s and mGCC-i in the patients with early NVG and the open-angle glaucoma group were higher than those in the angle-closure glaucoma group(all P<0.001). The levels of mGCC-a, mGCC-s and mGCC-i in the patients with early NVG were higher than patients with open-angle glaucoma group(all P<0.001). The thickness of pRNFL-a, pRNFL-temporal(t), pRNFL-s, pRNFL-nasal(n), and pRNFL-i in the patients with early NVG, open-angle glaucoma and angle-closure glaucoma was lower than that in the control group, while the MD was higher than that in the control group(all P<0.001). The thickness of pRNFL-a, pRNFL-t, pRNFL-s, pRNFL-n and pRNFL-i in the patients with early NVG and the open-angle glaucoma was higher than that of patients with angle-closure glaucoma group, while the MD level was higher than that in the patients with angle-closure glaucoma(all P<0.001). The thickness of pRNFL-a, pRNFL-t, pRNFL-s, pRNFL-n and pRNFL-i in the patients with early NVG was higher than that in the patients with open-angle glaucoma, while the MD level was higher than that those with open-angle glaucoma(all P<0.001). The mGCC-a, mGCC-s, mGCC-i, and the thickness of pRNFL-a, pRNFL-t, pRNFL-s, pRNFL-n, and pRNFL-i had a negative correlation with MD(all P<0.001). The combined diagnosis of mGCC, pRNFL thickness and MD had the highest efficiency in NVG(sensitivity: 79.00%, specificity: 87.00, AUC=0.973, 95%CI=0.956-0.990, P<0.05).
CONCLUSION: The mGCC and thickness of pRNFL in patients with NVG had a negative correlation with MD. mGCC, pRNFL thickness and MD have a certain diagnostic value on NVG, and the efficiency of combined diagnosis is the highest.
Ya-Ru Hu , Yue Chen , Xue Han , Ya-Ru Chen , Zhu-Yu Ma , Jian-Feng Wang
2023, 23(1):109-112. DOI: 10.3980/j.issn.1672-5123.2023.1.21
Abstract:AIM: To observe the expression levels of pigment epithelium-derived factor(PEDF)and vascular endothelial growth factor(VEGF)in lens epithelial cells(LECs)of diabetic patients with age-related cataract, and explore the pathogenesis of diabetic with age-related cataract.
METHODS: Retrospectively study. A total of 30 patients with age-related cataract(ARC group)and 30 patients with type 2 diabetes mellitus combined with age-related cataract(DC group)who treated at the Department of Ophthalmology of the First Affiliated Hospital of Bengbu Medical College from August 2020 to April 2021 were collected. Anterior capsule specimens with a diameter of 5.5-6.0mm in the central region of the intraoperative eye were collected during phacoemulsification. The protein expression levels of PEDF and VEGF in LECs were detected by Western-blot. Quantitative real-time PCR(qRT-PCR)was used to detect the relative mRNA expression levels of PEDF and VEGF.
RESULTS:PEDF and VEGF were expressed in LECs of both groups, and the relative expression of VEGF mRNA in DC group was 1.364±0.062, which was higher than that of ARC group(1.000±0.0; P<0.01). The relative mRNA expression level of PEDF was 0.398±0.053, which was significantly lower than 1.000±0.0 in the ARC group(P<0.001). The expression of VEGF protein in LECs was 2.053±0.026 in DC group and 1.680±0.064 in ARC group, respectively. Meanwhile, the expression of PEDF protein was 0.579±0.045 in DC group and 1.058±0.007 in ARC group(all P<0.01).
CONCLUSION:The changes of PEDF and VEGF expression levels in LECs may be related to the occurrence and development of cataract in diabetic patients.
Ke-Qing Meng , Yan-Hui Xu , Wei Dong , Jian-Feng Xu
2023, 23(1):113-116. DOI: 10.3980/j.issn.1672-5123.2023.1.22
Abstract:AIM: To explore the application effect of capsular tension ring(CTR)in phacoemulsification(Phaco)combined with intraocular lens(IOL)implantation for patients with high myopia, cataract and suspensory ligament relaxation.
METHODS: Prospective study. A total of 80 patients(80 eyes)with high myopia, cataract and suspensory ligament relaxation who underwent Phaco combined with IOL implantation in the hospital between April 2020 and August 2021 were enrolled. According to random number table method, they were divided into CTR group(Phaco combined with CTR and IOL implantation)and control group(Phaco combined with IOL implantation), with 40 cases(40 eyes)in each group. The best corrected distance visual acuity(BCDVA), anterior capsule area, total IOL inclination and subjective visual quality before and after surgery were compared between the two groups.
RESULTS: At 1, 3 and 6mo after surgery, BCDVA was improved(P<0.05), and intraocular pressure was decreased in both groups(P<0.05). The anterior capsule area in CTR group was larger than that in control group, and total IOL inclination was lower than that in control group(P<0.001). After surgery, scores of subjective visual quality in both groups were increased(P<0.05), which were higher in CTR group than control group(P<0.001). Within 6mo of follow-up, total incidence of postoperative complications in CTR group was lower than that in control group(7.5% vs. 25.0%, P<0.05).
CONCLUSION: With fewer complications, the application of CTR in Phaco combined with IOL implantation is beneficial to maintain capsular morphology, reduce capsular contraction, stabilize IOL position and improve postoperative visual quality in patients with high myopia, cataract and suspensory ligament relaxation.
Gang Ma , Lin-Wei Hong , Pei-Qi Guo , Yu-Yan Cui
2023, 23(1):117-120. DOI: 10.3980/j.issn.1672-5123.2023.1.23
Abstract:AIM: To analyze the characteristics of conventional ultrasound and contrast-enhanced ultrasound(CEUS)in choroidal metastatic carcinoma and choroidal hemangioma, and to explore the clinical application value of conventional ultrasound combined with CEUS in the differential diagnosis of choroidal metastatic carcinoma and choroidal hemangioma.
METHODS: The conventional ultrasound and CEUS data of 17 cases(17 eyes)with choroidal metastatic carcinoma and 35 cases(35 eyes)with choroidal hemangioma treated in the Fourth People's Hospital of Shenyang from May 2010 to January 2016 was retrospectively analyzed. The two-dimensional color ultrasound and the color Doppler characteristics of the tumors were observed by conventional ultrasound. CEUS was used to observe the contrast agent perfusion intensity and changes of tumors, and CEUS dynamic data was analyzed to obtain TI curves and CEUS parameters.
RESULTS: Conventional ultrasound examination showed that choroidal metastatic carcinoma had lower echo, less uniform, more uniform uplift, and wavy surface compared with choroidal hemangioma. The accuracy of diagnosis of choroidal metastatic carcinoma and choroidal hemangioma were 59%(10/17)and 68%(24/35)respectively. CEUS examination showed that the TI curve types of choroidal metastatic carcinoma were mostly in fast-in and fast-out mode(14/17), while the TI curve types of choroidal hemangioma were mostly in fast-in and slow-out mode(31/35). Both maximum intensity(IMAX)and rise time(RT)of choroid metastatic carcinoma were lower than those of choroid hemangioma(P<0.05). The accuracy of conventional ultrasound combined with CEUS in the diagnosis of choroidal metastatic carcinoma and choroidal hemangioma was 82%(14/17)and 88%(31/35)respectively.
CONCLUSION: Conventional ultrasound combined with CEUS can provide a relatively reliable imaging basis for the differential diagnosis of choroidal metastatic carcinoma and choroidal hemangioma, which is helpful for the early qualitative diagnosis of the two tumors.
Ying-Hui Ma , Lu-Yao Jia , Lin-Li Ma , Xiu-Cheng Cui , Jie Yang , Wei-Li Dong
2023, 23(1):121-125. DOI: 10.3980/j.issn.1672-5123.2023.1.24
Abstract:AIM: To investigate the effect of Nd:YAG laser peripheral iridotomy(LPI)on macular retinal thickness in patients with primary angle-closure glaucoma(PACG).
METHODS: Prospective study. A total of 30 patients(30 eyes)with PACG in our hospital from October 2019 to October 2021 were selected as the PACG group, and 20 healthy people(20 eyes)were selected as the control group(randomly selected one eye)during the same period. The PACG group received LPI treatment and was followed up for 1mo after surgery. Best corrected visual acuity(BCVA), intraocular pressure, corneal endothelial cells, anterior chamber depth(ACD)and axial length(AL)measured by IOL Master 500 optical measuring instrument and macular retinal thickness measured by spectral-domain optical coherence tomography(SD-OCT)in both groups were collected. The ACD, intraocular pressure, AL and macular retinal thickness were compared between the two groups and the PACG group before and after LPI, and the correlation was analyzed.
RESULTS: The ACD in the PACG group at 1wk and 1mo after surgery was deeper than that before surgery(all P<0.05). There was no significant difference in intraocular pressure and AL in the PACG group before and after surgery(all P>0.05). The retinal thickness at central fovea of macula, the superior side, temporal side, inferior side, and nasal side of the inner and outer central macular rings were 243.50±13.24, 324.50±13.46, 308.83±15.94, 310.00±14.24, 314.50±16.29, 300.67±19.95, 290.17±12.58, 302.40±16.37 and 307.33±14.84μm in the PACG group, respectively, and were 266.14±16.16, 342.67±15.86, 327.95±16.41, 337.85±13.03, 341.24±15.58, 313.76±17.59, 290.24±16.29, 303.81±13.91, 323.01±14.80μm in the control group, respectively. The differences at central fovea of macula, the superior side, temporal side, inferior side, and nasal side of the inner central macular rings were statistically significant between the two groups(all P<0.05). In the PACG group, the retinal thickness at 9 areas of macular in 1wk after operation were higher than those before operation, and they were close to the preoperative level at 1mo after operation, but the differences of each area in the overall comparison were not statistically significant(all P>0.05).
CONCLUSIONS: The macular retinal thickness of patients with PACG is thinner than that of normal people, and it can become thicker in the early stage after LPI.
Pei-Yan Zhu , Shao-Qin Lin , Wan-Ying Lin , Mu-Ling Li , Hong-Ying Fan , Qiong-Xi Lin , Yu-Han Feng , Jing Xu , Juan Yang , Qiong Liu
2023, 23(1):126-131. DOI: 10.3980/j.issn.1672-5123.2023.1.25
Abstract:AIM: To investigate the correlation between the ocular demodex infection and the composition of meibum lipid flora.
METHODS: A non-interventional and observational study was performed on recruited 39 patients in our hospital between July 2020 and February 2021. They were divided into control group(n=14), meibomian gland dysfunction(MGD)group(n=14), and demodex group(FM, n=11)according to the presence or absence of demodex infection or MGD. High-throughput sequencing of V3-V4 fragment of 16S rRNA gene was performed on the meibomian ester samples of the three groups of subjects, and bioinformatics analysis was performed on the sequencing data to study the composition and difference of meibum lipid flora in the subjects of ocular demodex.
RESULTS: Pseudomonas and Comamonas in FM group were significantly higher than those in control group and MGD group(P<0.05), while Ralstonia in Demodex infection group was significantly lower than that in control group and MGD group(P<0.05). The microbial richness and community diversity of meibum lipid flora of the MGD group and the FM group were significantly higher than those of the control group(P<0.05).
CONCLUSION: Ocular demodex infection changed the composition of meibum lipid flora and increased the microbial richness and community diversity of meibum lipid flora.
Pan Li , Xue-Hui Zhang , Yan-Hong Li , Xin Ai , Tong Li , Ruo-Xin Wang , Jin Wang
2023, 23(1):132-137. DOI: 10.3980/j.issn.1672-5123.2023.1.26
Abstract:AIM: To compare the changes of corneal refractive power before and after wearing defocus rigid gas permeable contact lens(RGPCL)in children with high myopia, and to analyze its influence on corneal refractive power and astigmatism after wearing glasses.
METHODS: Self-controlled before-after study. A total of 30 cases(60 eyes)of children aged 8-12, with high myopia who were treated and fitted with defocus RGPCL in the Optometry Center of Xi'an First Hospital from June 2019 to June 2020 were collected. Using TMS-4N corneal topography instrument to measure the corneal tangential refractive power at baseline and wearing lens for 0.5 and 1a, and analyze the nasal side(N), temporal side(T), superior(S)and inferior(I)of the maximum corneal refractive power values at the 4 axial directions and the changes of the corneal refractive power at the center were collected at the same time at 1 mm intervals. The changes of corneal refractive power at each point before and after wearing glasses were analyzed. The axial length, diopter and corneal topography were required to be measured after 0.5 and 1a, and the changes in axial length, spherical equivalent, astigmatism and corneal refraction compared with baseline were analyzed.
RESULTS: The maximum corneal refractive power of nasal(N), temporal(T), superior(S)and inferior(I)side was significantly increased at 0.5 and 1a when wearing defocus RGPCL compared with that before wearing glasses, which all showed positive relative refractive power compared with the corneal refractive power at center and was significantly different from the negative relative refractive power before wearing lenses. The relative peripheral refractive power of the cornea changed in the direction of positive refractive power when the lenses were worn for 0.5 and 1a. Except for the increase in the peripheral negative refractive power at the T1 point, the peripheral refractive power at all points in the other axes increased significantly. After wearing for 0.5a, the corneal steep K value became flat by 0.11±0.10D, the simK value decreased by 0.20±0.18D, the corneal steep K value became flat by 0.10±0.12D after 1a, the average K value became flat by 0.02±0.05D, and the simK value decreased by 0.16±0.13D. There was no significant difference in corneal level K from the baseline after wearing glasses for 0.5 and 1a.
CONCLUSIONS: The maximum refractive power of the cornea in the state of wearing defocus RGPCL is positive relative refractive power compared with the vertex of cornea, and the relative peripheral negative refractive power of the cornea at each point on the 4 axes changes from negative value to positive value. Within 1a of wearing glasses, the axial length and spherical equivalent increased compared with the baseline, while the amount of astigmatism decreased, and the corneal refractive power showed a trend of steep K and flattening.
Ting Meng , Hong-Yan Sun , Bin Luo , Jing Wang , Li-Yu Wang , Ya-Li Gao , Li Jiang , Jun Wang , Ting-Ming Deng , Ai-Neng Zeng , Xiao-Ling Luo , Ming-Ming Yang
2023, 23(1):138-141. DOI: 10.3980/j.issn.1672-5123.2023.1.27
Abstract:AIM: To evaluate the efficacy and safety of different Conbercept treatment on diabetic macular edema(DME)with 3+PRN and 5+PRN.
METHODS: Retrospective case-control study. A total of 51 patients(92 eyes)with DME who were treated in our hospital during December 2019 and June 2020 were included, and they were divided into 3+PRN group with 26 cases(48 eyes)and 5+PRN group with 25 cases(44 eyes). All patients received monthly follow-up for 12mo and the changes of best-corrected visual acuity(BCVA)and central macular thickness(CMT), the number of intravitreal injections and the occurrence of complications were compared and observed in the two groups.
RESULTS:After follow-up for 12mo, there was no difference in the average injection times between the 3+PRN group and the 5+PRN group(7.24±0.91 times vs. 7.56±1.04 times, P=0.117). The BCVA and CMT of the two groups improved at 3, 6, 9, and 12mo after treatment compared with those before treatment(all P<0.05), and the BCVA and CMT of the 5+PRN group were better than those of the 3+PRN group at 6, 9, and 12mo after treatment(all P<0.05). During the follow-up period, no serious adverse events occurred in the two groups of patients, and the total incidence of ocular adverse events in the two groups was 27%. All adverse events were improved after symptomatic treatment.
CONCLUSION: Both the 3+PRN and 5+PRN treatment strategy of Conbercept can treat DME safely and effectively, the total times of injection were comparable. However, the BCVA and CMT improved more in the 5+PRN group than that in 3+PRN group.
Fang-Yuan Han , Ru-Yi Zhao , Xin Jin , Yue-Ling Cui , Wei Tan , Ying Zhang
2023, 23(1):142-146. DOI: 10.3980/j.issn.1672-5123.2023.1.28
Abstract:AIM: To investigate the effect of repeated intravitreal injection of anti-vascular endothelial growth factor(VEGF)on the vitreomacular interface(VMI)and its related risk factors in patients with diabetic macular edema(DME).
METHODS: The clinical data of 31 patients(55 eyes)with DME who received intravitreal injections of Conbercept(3+PRN)in the ophthalmology department of the First People's Hospital of Zunyi from January 2018 to December 2021 were analyzed retrospectively. There were 9 cases(13 eyes)in the group that has changes in VMI and 22 cases(42 eyes)in the other group that has no changes in VMI. The best corrected visual acuity(BCVA), central retinal thickness(CRT), and central choroidal thickness(CCT)of the two groups were compared, and the risk factors of VMI change were analyzed.
RESULTS: The patients were followed up for an average of 9.58±8.32mo, received an average of 4.07±2.17 times of anti-VEGF therapy, and the number of intravitreal injections in VMI changed group was more than that in VMI unchanged group(5.77±2.09 times vs. 3.55±1.93 times, P=0.001). At the last follow-up, compared with before treatment, the BCVA of both patients improved significantly after treatment(both P<0.05), while CCT had no significant change(both P>0.05). CRT of patients in the VMI unchanged group decreased significantly(P=0.039), but there was no significant change in patients of VMI changed group(P=0.627). Logistic regression analysis showed that BCVA was a risk factor for VMI change before treatment(P=0.049, OR=6.210, 95%CI 1.006~38.346).
CONCLUSIONS: The VMI of DME patients may change during repeated intravitreal injections of anti-VEGF drugs. The worse the BCVA before treatment, the higher the risk of change in VMI, and the patients with VMI change have a poor response to anti-VEGF treatment.
Jia-Wei Luo , Min Ji , Miao-Miao Qin , Peng-Fei Li , Huai-Jin Guan
2023, 23(1):147-152. DOI: 10.3980/j.issn.1672-5123.2023.1.29
Abstract:AIM: To analyze the correlations among parameters from iTrace visual function analyzer, Pentacam 3D anterior segment analysis system and lens opacities classification system(LOCS)Ⅲ in the assessment of lens opacity of age-related cataract(ARC)patients.
METHODS: A prospective cross-sectional study. A total of 104 ARC patients(104 eyes)in the department of ophthalmology of our hospital from May to August, 2021 were included. The cataracts of patients were graded based on LOCSⅢ using a slit-lamp. Opacity map grade(OMG)and dysfunctional lens index(DLI)were obtained by iTrace. Pentacam nucleus staging(PNS)and Scheimpflug images of lenses were acquired by Pentacam. The regional integrated density(IntDen)of Scheimpflug images was obtained by ImageJ. The normality and correlations of parameters were analyzed by SPSS 26.0.
RESULTS: All the parameters were normally distributed except 3mm IntDen and IntDen of 6mm posterior subcapsular region. PNS positively correlated with nuclear color(NC)and nuclear opalescence(NO)(r=0.521, 0.440, all P<0.01). The 3mm IntDen positively correlated with NC and NO(rs=0.459, 0.450, all P<0.01). IntDen of 3mm nucleus region positively correlated with NC and NO(r=0.539, 0.543, all P<0.01). IntDen of 3mm posterior subcapsular region was negatively correlated with NC and NO(r=-0.315, -0.321, all P<0.01). 6mm IntDen positively correlated with NC and NO(r=0.321, 0.288, all P<0.01). 3mm DLI negatively correlated with NC, NO, and posterior subcapsular cataract(PSC)(r=-0.257, -0.234, -0.282, all P<0.01). 6mm DLI negatively correlated with NC, NO, PSC(r=-0.247, -0.304, -0.227, all P<0.05). 3mm OMG positively correlated with CC and PSC(r=0.268, 0.333, all P<0.01), and 6mm OMG positively correlated with CC and PSC(r=0.275, 0.245, all P<0.05). 3mm DLI negatively correlated with PNS and IntDen of 3mm nucleus region(r=-0.217, -0.197, all P<0.05).
CONCLUSION:Each lens opacity assessment system had its own advantages. Taking all parameters into comprehensive consideration is conducive to objectively eraluate the opacity degree of each area of the lens and provide references for clinical work.
Shu-Wei Bai , Feng-Zhi Li , Chun-Chao Bi , Juan Shao , Rong Zeng
2023, 23(1):153-157. DOI: 10.3980/j.issn.1672-5123.2023.1.30
Abstract:AIM: To explore the correlation between the integrity of the macular microstructures and the visual outcomes before and after idiopathic macular epiretinal membrane(IMEM)surgery.
METHODS: A total of 43 patients(43 eyes)with IMEM who were treated in our hospital between January 2017 and December 2019 were selected. The best corrected visual acuity(BCVA)of each patient was examined preoperatively and at 3, 6, 9mo after surgery. Moreover, metamorphopsia(M-chart)examination was given, and spectral domain-optical coherence tomography(SD-OCT)was used to measure central foveal thickness(CFT), subfoveal choroidal thickness(SFCT), the thickness of ganglion cells-inner plexiform layer(GC-IPL)and the length of interdigitation zone(IZ)defect.
RESULTS: The BCVA and the metamorphopsia were gradually improved at postoperative 3, 6 and 9 mo(all P<0.05). Moreover, the BCVA was positively correlated with CFT and the length of the IZ defect(P<0.05), while it was not correlated with SFCT and the thickness of GC-IPL(P>0.05). The metamorphopsia assessment was positively correlated with the CFT at postoperative 3, 6, and 9mo(P<0.05), while it was not correlated with SFCT, the thickness of GC-IPL and the length of IZ defect(P>0.05).
CONCLUSIONS: The CFT and the length of IZ defect were significantly correlated with the BCVA after IMEM surgery, which can be used as indicators to predict the recovery of visual function after IMEM surgery.
Shao-Jin Zhu , Chi Xie , Zi-Yu Tao , Yun Wang , Yan Fang
2023, 23(1):158-162. DOI: 10.3980/j.issn.1672-5123.2023.1.31
Abstract:AIM: To quantitatively analyze the changes of the peripapillary capillary vessel density(ppVD)and the peripapillary retina nerve fiber layer(pRNFL)thickness in patients with monocular retinal vein occlusion(RVO)by optical coherence tomography angiography(OCTA), and further analyze the correlation between the ppVD and the pRNFL thickness.
METHODS: Prospective observational research. A total of 43 patients diagnosed with monocular RVO were enrolled in the Department of Ophthalmology of the First Affiliated Hospital of Anhui University of Science and Technology from January to December 2021, among which 43 RVO eyes were regarded as the affected group and 43 fellow eyes were regarded as the contralateral group. At the same time, 21 healthy volunteers(42 eyes)matching the age and gender with RVO patients were regarded as the control group. The vessel density(VD)of inside optic disc, the whole VD of around disc and the ppVD and pRNFL thickness around the optic disc were measured by OCTA, including peripapillary superior(pS), peripapillary inferior(pI), temporal superior(TS), superior temporal(ST), superior nasal(SN), nasal superior(NS), nasal inferior(NI), inferior nasal(IN), inferior temporal(IT), and temporal inferior(TI). The characteristic changes of ppVD and pRNFL thickness and theirs correlation in the three groups were analyzed.
RESULTS: The VD of inside optic disc, the whole VD of around disc and the ppVD in the pS, pI, TI, ST and SN side of the affected group were all significantly decreased compared with the control group(all P<0.05). But only VD of the inside disc in contralateral group was decreased(all P<0.05). Compared with the control group, the pRNFL thickness in the TS side of the affected group was increased, and the ST and IT side pRNFL thickness of the contralateral group were decreased(all P<0.01). The canonical correlation analysis revealed that ppVD and pRNFL thickness were provided with a strong correlation between the two comprehensive variables. There were 2 pairs of canonical correlation variables in affected group and contralateral group, and 3 pairs of canonical correlation variables in control group.
CONCLUSION: The VD in the optic disc area of the affected group was decreased in patients with monocular RVO, and the pRNFL thickness in ST and IT side of the contralateral group was thinner. There was a strong positive correlation between ppVD and pRNFL thickness as a whole. The changes of ppVD and pRNFL thickness in the optic disc area were mostly manifested in the superior quadrant of the affected group and the inferior quadrant of the contralateral group.
2023, 23(1):163-166. DOI: 10.3980/j.issn.1672-5123.2023.1.32
Abstract:AIM: To investigate the difference of corneal higher-order aberrations and corneal diopter before and after chalazion resection.
METHODS: A total of 49 patients(49 eyes)with unilateral upper eyelid chalazion who underwent surgical treatment in our hospital from January 2021 to January 2022 were selected for prospective study. They were divided into two groups according to the size of the cyst, with 24 patients(24 eyes)in 3-5mm group and 25 patients(25 eyes)in >5mm group. The total higher-order aberrations, coma, trefoil, spherical aberrations, corneal SimK values, and horizontal axis astigmatism(Minimum SimK)and steep axis astigmatism(Maximum SimK)of the cornea before and at 2mo after the resection of the chalazion with a diameter of 6mm were measured by Sirius anterior segment analysis system.
RESULTS: The total higher-order aberrations, trefoil and coma aberrations of the patients in the >5mm group at 2mo after operation were statistically significant compared with those before operation(P<0.05), while the spherical aberrations were not statistically significant(P>0.05). There was no statistically significant difference in the 3-5mm group in the comparison between the Maximum SimK value and the Minimum SimK value before and after the operation(P>0.05), while the difference was statistically significant in the >5mm group(P<0.05).
CONCLUSION: The corneal higher-order aberrations, especially trefoil and coma aberration, and astigmatism of large chalazion after surgical treatment are significantly reduced. Therefore, it is recommended that patients with chalazion, especially those with lesions larger than 5mm, should resect the chalazion before detailed refractive examination.
Peng-Fei Tian , Kun He , Shou-Hui Zhu , Min Zhang , Guo-Ning Ye , Bing-Xin Pan
2023, 23(1):167-171. DOI: 10.3980/j.issn.1672-5123.2023.1.33
Abstract:AIM: To investigate the clinical effect and stability of biological amnion membrane coverage combined with corneal bandage lens for patients with chemical burns of ocular surface.
METHODS: Retrospective study. The clinical data of 49 cases(49 eyes)of patients with chemical burns of ocular surface treated in our hospital between December 2018 and August 2021 were collected. They were divided into the biological amnion membrane coverage group and the biological amnion membrane coverage combined with corneal bandage lens group according to the surgical method. The loss time of biological amniotic membrane, postoperative pain score, repair rate and time of ocular surface, visual acuity and complications were compared between the two groups.
RESULTS: The ocular pain scores of the two groups were 2.208±0.758(the biological amnion membrane coverage group)and 2.063±0.800(the biological amnion membrane coverage combined with corneal bandage lens group)at 1d after surgery, respectively(P>0.05). But at the 3d and 7d after surgery, pain scores were 1.844±0.762 and 1.150±0.582, 1.684±0.820 and 0.750±0.514, respectively(all P<0.05). The loss time of biological amniotic membrane in the biological amnion membrane coverage combined with corneal bandage lens group was 10.75±2.63d, which was longer than that in the biological amnion membrane coverage group(7.60±2.22d; P<0.05). Moreover, it has better ocular surface repair effect than the biological amnion membrane coverage group. At 6mo after operation, visual acuity in the two groups was 0.30(0.10, 0.55)and 0.30(0.20, 0.58), respectively(P>0.05). Additionally, there was no differences in the complications of both groups(P>0.05).
CONCLUSION:Biological amnion membrane coverage has effective treatment effects on patients with chemical burns of ocular surface, and it can delay the loss time of biological amniotic membrane, increase repair rate of ocular surface and alleviate postoperative discomfort if combined with corneal bandage lens.
Xiao-Lan Xie , Bi-Dan Zhu , Shao-Jun Li
2023, 23(1):172-174. DOI: 10.3980/j.issn.1672-5123.2023.1.34
Abstract:AIM: To investigate the current visual acuity of the preschool children in Tongzhou district of Beijing and analyze their refractive status.
METHODS: A cross-sectional study. A total of 1 513 children(3 026 eyes)aged 3-6 years old from 9 kindergartens in Tongzhou District of Beijing were selected by cluster random sampling method from December 2021 to January 2022. Visual acuity and diopters were examined in all of them, and the distribution of visual acuity and diopters of children in different age groups were analyzed.
RESULTS: The visual acuity abnormality rate of the included children was 15.47%, and the refractive abnormality rate was 14.24%, and the detection rate of abnormal refractive error decreased with the increase of age, while the type of abnormal refractive error was mainly simple myopic astigmatism(11.46%). With the increase of age, the rate of simple hyperopia gradually decreased, and the rate of simple myopia gradually increased. The diopters test results showed that the spherical diopters of the included children were 0.50(0.25, 1.00)D, the cylindrical diopters were -0.25(-0.50, -0.25)D, and the equivalent spherical diopters were 0.375(0, 0.625)D. There was no difference in equivalent spherical diopters among children of different ages(P>0.05), but there was difference in cylindrical diopters(P<0.001).
CONCLUSION: The abnormal visual acuity rate of the children aged 3-5 years decreased gradually with the increase of age, and then increased after 6 years old. At 3-6 years, simple myopic astigmatism was the main refractive abnormality. Attention should be paid to the development of visual acuity in preschool children, and regular visual acuity and refractive status examinations should be carried out.
Juan-Juan Xie , Ying Chen , Guo-Wei Zhang , Hai-Yue Cui , Meng-Yao Hao , Shao-Wen Wang , Zhen Jia , Chun-Long Xu , Hong Lu
2023, 23(1):175-180. DOI: 10.3980/j.issn.1672-5123.2023.1.35
Abstract:AIM: To identify the pathogenic gene in a family with primary open angle glaucoma(POAG)from Nantong, Jiang Province, and to analyze its clinical phenotype and pathogenic mechanism.
METHOD: A POAG pedigree was reviewed and recruited from January 2020 to December 2020, which spans 5 generations, with 33 people in total. A total of 13 family members were enrolled in our study, of whom 4 members were diagnosed with POAG, 1 with ocular hypertension(OHT), and the other 8 members were unaffected. Detailed medical history was collected and a comprehensive ophthalmic examination was performed. High throughput sequencing was used to screen for possible pathogenic gene, and Sanger sequencing was used to verify candidate pathogenic gene.
RESULT: All patients in this family were found to have elevated intraocular pressure(IOP)and diagnosed with glaucoma at a young age, requiring surgical treatments to control the IOP. The highest IOP of proband was up to 55mmHg. A heterozygous mutation(c.1197C>A, p.Phe399Leu)of LTBP2 gene was found in the proband genome by whole exon sequencing(WES). Sanger sequencing verified that the mutation was not isolated from the family disease.
CONCLUSION: LTBP2 (c.1197C>A)mutation was not the pathogenic gene of POAG in this family. However, the pathogenic potential of LTBP2 gene in POAG cases is worth studying.
Editors-in-Chief: Yan-Nian Hui and Peter Wiedemann
Established in April, 2008
ISSN 2222-3959 print
ISSN 2227-4898 online