Volume 10,Issue 2,2017 Table of Contents

1 The anti-inflammatory effects of asiatic acid in lipopolysaccharide-stimulated human corneal epithelial cells

Hao Chen , Xiao-Min Hua , Bai-Chen Ze , Bin Wang , Li Wei

2017, 10(2):179-185. DOI: 10.18240/ijo.2017.02.01

[Abstract](1826) [HTML](257) [PDF 3.09 M](764)

Abstract:
AIM: To investigate the anti-inflammatory effects of asiatic acid (AA) on lipopolysaccharide (LPS)-induced inflammatory response in human corneal epithelial cells (HCECs). METHODS: Cell viability was measured using a cell counting kit-8 (CCK-8) assay. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to determine the mRNA expression of interleukin-8 (IL-8), interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α), and transforming growth factor-β (TGF-β) in HCECs. Intracellular reactive oxygen species (ROS) was measured using the ROS assay kit. Glutathione (GSH) concentration was measured using the total GSH assay kit. Akt1 and Akt phosphorylation (p-Akt1) levels were measured by Western blotting and immunofluorescence. RESULTS: AA induced toxicity at high concentrations and significantly stimulated the proliferation of HCECs at concentrations of 20 μmol/L for 1h. LPS at concentrations of 300 ng/mL for 1h significantly stimulated the mRNA expression of IL-8, IL-6, IL-1β, TNF-α, and TGF-β in HCECs, while the stimulation effects were significantly inhibited by AA (20 μmol/L). In addition, AA was found to decrease the content of ROS, increase GSH generation, and also inhibit LPS-induced p-Akt in HCECs. CONCLUSION: AA decreases the generation of inflammatory factors IL-8, IL-6, IL-1β, TNF-α, and TGF-β in LPS-stimulated HCECs. AA significantly inhibites the intracellular concentrations of ROS and increases GSH generation. AA also inhibites LPS-induced p-Akt in HCECs. These findings reveal that AA has anti-inflammation effects in LPS-stimulated HCECs.

2 Intraocular pressure with rebound tonometry and effects of topical intraocular pressure reducing medications in guinea pigs

Yue Di , Xiu-Mei Luo , Tong Qiao , Na Lu

2017, 10(2):186-190. DOI: 10.18240/ijo.2017.02.02

[Abstract](1790) [HTML](250) [PDF 898.68 K](662)

Abstract:
AIM: To investigate the intraocular pressure (IOP) of adult guinea pig eyes with rebound tonometry (RBT), and assess the effects of four distinctive topical IOP reducing medications including Carteolol, Brimonidine, Brinzolamide and Latanoprost. METHODS: The IOPs of twenty-four 12-week-old guinea pigs (48 eyes) were measured every two hours in one day with RBT as baselines. All the animals were then divided into four groups (Carteolol, Brimonidine, Brinzolamide and Latanaprost groups, n=6). The IOPs were measured and compared to the baseline 1, 2, 3, 5, 7, 9, 15 and 24h after treatment. RESULTS: The mean baseline IOP of 24 guinea pigs (48 eyes) was 10.3±0.36 mm Hg (6-13 mm Hg) and no binocular significant differences of IOPs were observed (t=1.76, P>0.05). No significant difference of IOP in Carteolol group at each time point was observed before and after treatment (t=1.48, P>0.05). In Brimonidine group, IOP was 2.2±1.9 mm Hg lower than the baseline after one hour (t=3.856, P=0.003) and lasted for one hour. In Brinzolamide group, IOP was 1.4±1.1 mm Hg lower than the baseline after one hour (t=4.53, P=0.001) and lasted for 7h and the IOP declined most at 3h. In Latanaprost group, IOP was 2.1±1.3 mm Hg lower than the baseline after one hour (t=6.11, P=0.001) and lasted for one hour. CONCLUSION: The IOP of guinea pig eyes is relatively stable compared to human eyes. In four reducing IOP medications, no significant effect of Carteolol is observed. Brinzolamide has the longest duration, while the Brimonidine has the shortest duration and the maximum level of treatment.

3 Light-emitting-diode induced retinal damage and its wavelength dependency in vivo

Yu-Man Shang , Gen-Shuh Wang , David H. Sliney , Chang-Hao Yang , Li-Ling Lee

2017, 10(2):191-202. DOI: 10.18240/ijo.2017.02.03

[Abstract](4488) [HTML](279) [PDF 3.48 M](746)

Abstract:
AIM: To examine light-emitting-diode (LED)-induced retinal neuronal cell damage and its wavelength-driven pathogenic mechanisms. METHODS: Sprague-Dawley rats were exposed to blue LEDs (460 nm), green LEDs (530 nm), and red LEDs (620 nm). Electroretinography (ERG), Hematoxylin and eosin (H&E) staining, transmission electron microscopy (TEM), terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), and immunohistochemical (IHC) staining, Western blotting (WB) and the detection of superoxide anion (O2-·), hydrogen peroxide (H2O2), total iron, and ferric (Fe3+) levels were applied. RESULTS: ERG results showed the blue LED group induced more functional damage than that of green or red LED groups. H&E staining, TUNEL, IHC, and TEM revealed apoptosis and necrosis of photoreceptors and RPE, which indicated blue LED also induced more photochemical injury. Free radical production and iron-related molecular marker expressions demonstrated that oxidative stress and iron-overload were associated with retinal injury. WB assays correspondingly showed that defense gene expression was up-regulated after the LED light exposure with a wavelength dependency. CONCLUSION: The study results indicate that LED blue-light exposure poses a great risk of retinal injury in awake, task-oriented rod-dominant animals. The wavelength-dependent effect should be considered carefully when switching to LED lighting applications.

4 The effects of anti-vascular endothelial growth factor agents on human retinal pigment epithelial cells under high glucose conditions

Jong Rok Oh , Jung Woo Han , Yoon Kyung Kim , Young-Hoon Ohn , Tae Kwann Park

2017, 10(2):203-210. DOI: 10.18240/ijo.2017.02.04

[Abstract](1696) [HTML](252) [PDF 4.87 M](621)

Abstract:
AIM: To investigate the effects of high glucose levels and anti-vascular endothelial growth factor (VEGF) agents (bevacizumab, ranibizumab and aflibercept) on retinal pigment epithelium (RPE) cells. METHODS: ARPE-19 cells were cultured at different glucose levels (5.5 mmol/L, 25 mmol/L, and 75 mmol/L). Cell viability was evaluated by MTT assay at 3d after treatment with D-glucose. Cell migration ability was measured by wound healing assay at 3d. A cell death detection kit was used to assess apoptosis at 3 and 14d. Cell proliferation was assessed by EdU assay at 3d. The culture medium was treated with anti-VEGF agents at clinically relevant concentrations. The experiment was then repeated at a different glucose level. RESULTS: The viability and migration of ARPE-19 cells were significantly decreased in the presence of 75 mmol/L as compared to 5.5 mmol/L glucose. The percentage of TUNEL-positive cells was significantly increased and the proliferative potential was decreased with 75 mmol/L compared to 5.5 mmol/L glucose. There were no significant differences in the results between 25 mmol/L and 5.5 mmol/L glucose. In the presence of 75 mmol/L glucose, the groups treated with anti-VEGF showed decreased cell viability and proliferation and increased apoptosis. However, there were no significant differences between the anti-VEGF groups. CONCLUSION: High glucose level decreases the viability, wound healing ability, and proliferation of RPE cells, while increasing apoptosis. Furthermore, anti-VEGF agents interfered with the physiological functions of RPE cells under high-glucose conditions, accompanied by decreases in cell viability and proliferation.

5 Vasoactive intestinal peptide, a promising agent for myopia?

Ayse Idil Cakmak , Hikmet Basmak , Huseyin Gursoy , Mete Ozkurt , Nilgun Yildirim , Nilufer Erkasap , Mustafa Deger Bilgec , Nese Tuncel , Ertugrul Colak

2017, 10(2):211-216. DOI: 10.18240/ijo.2017.02.05

[Abstract](1722) [HTML](253) [PDF 335.37 K](616)

Abstract:
AIM: To investigate the role of vasoactive intestinal peptide (VIP) in form-deprivation myopia (FDM).METHODS: FDM was created in three groups of eight chicks by placing a translucent diffuser on their right eyes. Intravitreal injections of saline and VIP were applied once a day into the occluded eyes of groups 2 and 3, respectively. Retinoscopy and axial length (AL) measurements were performed on the first and 8th days of diffuser wear. The retina mRNA levels of the VIP receptors and the ZENK protein in right eyes of the three groups and left eyes of the first group on day 8 were determined using real time polymerase chain reaction (PCR). RESULTS: The median final refraction (D) in right eyes were -13.75 (-16.00, -12.00), -11.50 (-12.50, -7.50), and -1.50 (-4.75, -0.75) in groups 1, 2, and 3, respectively (P<0.001). The median AL (mm) in right eyes were 10.65 (10.00, 11.10), 9.90 (9.70, 10.00), and 9.20 (9.15, 9.25) in groups 1, 2, and 3, respectively (P<0.001). The median delta-delta cycle threshold (CT) values for the VIP2 receptors were 1.07 (0.82, 1.43), 1.22 (0.98, 1.65), 0.29 (0.22, 0.45) in right eyes of groups 1, 2, and 3, and 1.18 (0.90, 1.37) in left eyes of group 1, respectively (P=0.001). The median delta-delta CT values for the ZENK protein were 1.07 (0.63, 5.03), 3.55 (2.20, 5.55), undetectable in right eyes of groups 1, 2, and 3 and 1.89 (0.21, 4.73) in left eyes of group 1, respectively (P=0.001). CONCLUSION: VIP has potential inhibitory effects in the development of FDM.

6 Corneal biomechanical data and biometric parameters measured with Scheimpflug-based devices on normal corneas

Gabor Nemeth , Eszter Szalai , Ziad Hassan , Agnes Lipecz , Zsuzsa Flasko , Laszlo Modis

2017, 10(2):217-222. DOI: 10.18240/ijo.2017.02.06

[Abstract](1612) [HTML](253) [PDF 527.95 K](628)

Abstract:
AIM: To analyze the correlations between ocular biomechanical and biometric data of the eye, measured by Scheimpflug-based devices on healthy subjects. METHODS: Three consecutive measurements were carried out using the corneal visualization Scheimpflug technology (CorVis ST) device on healthy eyes and the 10 device-specific parameters were recorded. Pentacam HR-derived parameters (corneal curvature radii on the anterior and posterior surfaces; apical pachymetry; corneal volume; corneal aberration data; depth, volume and angle of the anterior chamber) and axial length (AL) from IOLMaster were correlated with the 10 specific CorVis ST parameters. RESULTS: Measurements were conducted in 43 eyes of 43 volunteers (age 61.24±15.72y). The 10 specific CorVis ST data showed significant relationships with corneal curvature radii both on the anterior and posterior surface, pachymetric data, root mean square (RMS) data of lower-order aberrations, and posterior RMS of higher-order aberrations and spherical aberration of the posterior cornea. Anterior chamber depth showed a significant relationship, but there were no significant correlations between corneal volume, anterior chamber volume, mean chamber angle or AL and the 10 specific CorVis ST parameters.

7 Clinical results of non-Descemet stripping endothelial keratoplasty

Tao Zhang , Shao-Wei Li , Tie-Hong Chen , Jing-Liang He , Yan-Wei Kang , Fang-Qi Lyu , Jian-Hua Ning , Chang Liu

2017, 10(2):223-227. DOI: 10.18240/ijo.2017.02.07

[Abstract](1378) [HTML](251) [PDF 606.23 K](628)

Abstract:
AIM: To investigate the impact of non-Descemet stripping endothelial keratoplasty (non-DSEK) on graft rejection rate, and its overall procedural effectiveness in patients. METHODS: Non-DSEK was performed on 65 eyes of 64 patients, and the procedural outcomes, including rejection episodes, failure and dislocation of the grafts, best corrected visual acuity (BCVA), endothelial cell density (ECD), and other complications, were analyzed retrospectively. RESULTS: Of the 65 eyes, 63 recovered from bullous keratopathy with a clear cornea. The mean follow-up time was 26.4mo (range, 6-84mo). The mean BCVA improved from 1.70 logMAR preoperatively to 0.54 logMAR at 3mo, 0.46 logMAR at 6mo, and 0.37 logMAR at 1y after surgery. The postoperative donor ECD of the 25 patients who successfully underwent specular microscopic examination was 1918±534 cells/mm2 (range, 637 to 3056 cells/mm2), and the mean endothelial cell loss was 41.9% at 24mo postoperatively. One eye developed secondary glaucoma and required regrafting via penetrating keratoplasty (PKP). Another eye had postoperative graft failure due to rejection at 26mo. Postoperative graft dislocation occurred in eight eyes. All of the eight dislocated grafts were reattached using air reinjection. CONCLUSION: Immunological graft rejection of the donor graft rarely occurs in non-DSEK. Therefore, non-DSEK is a safe, concise, and effective alternative to restore corneal decompensation when the Descemet membrane is disease-free.

8 Effects of contact lens wearing on keratoconus: a confocal microscopy observation

Somnath Ghosh , Haliza A Mutalib , Sharanjeet Kaur , Rituparna Ghoshal , Shamala Retnasabapathy

2017, 10(2):228-234. DOI: 10.18240/ijo.2017.02.08

[Abstract](1617) [HTML](244) [PDF 754.53 K](681)

Abstract:
AIM: To evaluate the corneal cell morphology of new keratoconus patients wearing two different types of rigid gas-permeable (RGP) contact lenses for 1y. METHODS: Thirty nine eyes of 39 new keratoconus patients were selected and randomly fitted with two types of RGP contact lenses. Group 1 had 21 eyes with regular rigid gas-permeable (RRGP) contact lens and rest 18 eyes were in group 2 with specially designed rigid gas-permeable (SRGP) contact lens. Corneal cell morphology was evaluated using a slit scanning confocal microscope at no-lens wear and after 1y of contact lens wearing. RESULTS: After 1y of contact lens wearing in group 1, the mean anterior and posterior stromal keratocyte density were significantly less (P=0.006 and P=0.001, respectively) compared to no-lens wear. The mean cell area of anterior and posterior stromal keratocyte were also significantly different (P=0.005 and P=0.001) from no-lens wear. The anterior and posterior stromal haze increased by 18.74% and 23.81%, respectively after 1y of contact lens wearing. Whereas in group 2, statistically significant changes were observed only in cell density & area of anterior stroma (P=0.001 and P=0.001, respectively) after 1y. While, level of anterior and posterior stromal haze increased by 16.67% and 11.11% after 1y of contact lens wearing. Polymegathism and pleomorphism also increased after 1y of contact lens wearing in both the contact lens groups. CONCLUSION: Confocal microscopy observation shows the significant alterations in corneal cell morphology of keratoconic corneas wearing contact lenses especially in group 1. The type of contact lens must be carefully selected to minimize changes in corneal cell morphology.

9 Visual performance with accommodating and multifocal intraocular lenses

Jie Lan , Yu-Sen Huang , Yun-Hai Dai , Xiao-Ming Wu , Jia-Jun Sun , Li-Xin Xie

2017, 10(2):235-240. DOI: 10.18240/ijo.2017.02.09

[Abstract](1391) [HTML](262) [PDF 412.58 K](679)

Abstract:
AIM: To compare the visual functional outcomes with accommodating and multifocal intraocular lenses (IOLs). METHODS: Our retrospective comparative study included 51 patients (60 eyes) received implantation of an accommodating IOL (Tetraflex; 16 patients, 20 eyes), a refractive multifocal IOL (ReZoom; 18 patients, 20 eyes), or a diffractive multifocal IOL (ZMA00; 17 patients, 20 eyes). Subjective refraction, visual acuity, contrast sensitivity (CS), intraocular aberration, and subjective photic phenomena were detected at 3mo after surgery. RESULTS: The spherical equivalent in the three groups was -0.38±0.54 D, 0.14±0.56 D, and 0.35±0.41 D, respectively. No statistically significant differences were found in uncorrected and corrected distance visual acuity and uncorrected intermediate visual acuity among the groups (P=0.39). The ReZoom group had significantly better distance-corrected intermediate visual acuity than the ZMA00 group (P=0.003). The ZMA00 group had significantly better near visual acuity than the other groups (P＜0.05). Better contrast sensitivity values were observed in the Tetraflex group under most of the spatial frequencies conditions (P=0.025). The total aberration was lowest in the ZMA00 group (P=0.000), and the spherical aberration was highest in the Tetraflex group (P=0.000). The three groups had similar frequency of ghosting and glare, and the Tetraflex group had a low rate of halos (P=0.01). CONCLUSION: Both accommodating and multifocal IOLs can successfully restore distance and uncorrected intermediate visual acuities. Tetraflex accommodating IOLs perform better in CS and with less halos of photic phenomena. ReZoom refractive multifocal IOLs have better performance in distance-corrected intermediate visual acuity than ZMA00 diffractive multifocal IOLs, and the latter achieved better near visual acuity and efficiently decreased the optical aberration.

10 Predictive factors for photic phenomena after refractive, rotationally asymmetric, multifocal intraocular lens implantation

Hungwon Tchah , Kiyeun Nam , Aeri Yoo

2017, 10(2):241-245. DOI: 10.18240/ijo.2017.02.10

[Abstract](2181) [HTML](249) [PDF 635.14 K](801)

Abstract:
AIM: To investigate the independent factors associated with photic phenomena in patients implanted with refractive, rotationally asymmetric, multifocal intraocular lenses (MIOLs). METHODS: Thirty-four eyes of 34 patients who underwent unilateral cataract surgery, followed by implantation of rotationally asymmetric MIOLs were included. Distance and near visual acuity outcomes, intraocular aberrations, preferred reading distances, preoperative and postoperative refractive errors, mesopic and photopic pupil diameters, and the mesopic and photopic kappa angles were assessed. Patients were also administered a satisfaction survey. Photic phenomena were graded by questionnaire. Independent-related factors were identified by correlation and bivariate logistic regression analyses. RESULTS: The distance from the photopic to the mesopic pupil center (pupil center shift) was significantly associated with glare/halo symptoms [odds ratio (OR)=2.065, 95% confidence interval (CI)=0.916-4.679, P=0.006] and night vision problems (OR=1.832, 95% CI=0.721-2.158, P=0.007). The preoperative photopic angle kappa was significantly associated with glare/halo symptoms (OR=2.155, 95% CI=1.065-4.362, P=0.041). The photopic angle kappa was also significantly associated with glare/halo symptoms (OR=2.155, 95% CI=1.065-4.362, P=0.041) and with night vision problems (OR=1.832, 95% CI=0.721-2.158, P=0.007) in patients implanted with rotationally asymmetric MIOLs. CONCLUSION: A large pupil center shift and misalignment between the visual and pupillary axis (angle kappa) may play a role in the occurrence of photic phenomena after implantation of rotationally asymmetric MIOLs.

11 The vitreomacular interface in different types of age-related macular degeneration

Mohamed Abd ElMonaem El-Hifnawy , Hisham Ali Ibrahim , Amir Ramadan Gomaa , Mohamed A Elmasry

2017, 10(2):246-253. DOI: 10.18240/ijo.2017.02.11

[Abstract](1388) [HTML](245) [PDF 481.24 K](669)

Abstract:
AIM: To evaluate the vitreomacular interface in cases with wet age-related macular degeneration (AMD) and to compare them to eyes with dry AMD and normal eyes. METHODS: This was a cross-sectional comparative study that included 87 eyes with wet AMD, 42 eyes with dry AMD and 40 eyes without AMD as a control group. Optical coherence tomography (OCT) examination was performed for all patients to assess the vitreomacular interface. RESULTS: In the wet AMD group, 34.5% of cases had vitreomacular adhesion (VMA). Only 14.3% of dry AMD cases and 10% of control cases had VMA. There was a significant difference between the control group and the wet AMD group (P=0.004) as well as the dry and wet AMD group (P=0.017). There was also a significant difference between the incidence of VMA in patients with subretinal choroidal neovascularization (CNV, type 1) and intraretinal CNV (type 2 or type 3) (P=0.020). CONCLUSION: There is an association between posterior vitreous attachment and AMD. There is also an increased incidence of VMA with intra-retinal CNV.

12 Short-duration transient visual evoked potentials and color reflectivity discretization analysis in glaucoma patients and suspects

Michael Waisbourd , Rebekah H. Gensure , Ardalan Aminlari , Sonya B. Shah , Nitasha Khanna , Neil Sood , Jeanne Molineaux , Alberto Gonzalez , JonathanS.Myers , L. Jay Katz

2017, 10(2):254-261. DOI: 10.18240/ijo.2017.02.12

[Abstract](1287) [HTML](249) [PDF 1.07 M](669)

Abstract:
AIM: To evaluate the use of short-duration transient visual evoked potentials (VEP) and color reflectivity discretization analysis (CORDA) in glaucomatous eyes, eyes suspected of having glaucoma, and healthy eyes. METHODS: The study included 136 eyes from 136 subjects: 49 eyes with glaucoma, 45 glaucoma suspect eyes, and 42 healthy eyes. Subjects underwent Humphrey visual field (VF) testing, VEP testing, as well as peripapillary retinal nerve fiber layer optical coherence tomography imaging studies with post-acquisition CORDA applied. Statistical analysis was performed using means and ranges, ANOVA, post-hoc comparisons using Turkey’s adjustment, Fisher’s Exact test, area under the curve, and Spearman correlation coefficients. RESULTS: Parameters from VEP and CORDA correlated significantly with VF mean deviation (MD) (P<0.05). In distinguishing glaucomatous eyes from controls, VEP demonstrated area under the curve (AUC) values of 0.64-0.75 for amplitude and 0.67-0.81 for latency. The CORDA HR1 parameter was highly discriminative for glaucomatous eyes vs controls (AUC=0.94). CONCLUSION: Significant correlations are found between MD and parameters of short-duration transient VEP and CORDA, diagnostic modalities which warrant further consideration in identifying glaucoma characteristics.

13 Novel biomarkers for patients with idiopathic acute anterior uveitis: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio

Cem Ozgonul , Erdim Sertoglu , Onder Ayyildiz , Tarkan Mumcuoglu , Murat Kucukevcilioglu , Gokcen Gokce , Ali Hakan Durukan

2017, 10(2):262-266. DOI: 10.18240/ijo.2017.02.13

[Abstract](1644) [HTML](245) [PDF 421.81 K](686)

Abstract:
AIM: To assess the levels of the neutrophil to lymphocyte ratio (N/L) and the platelet to lymphocyte ratio (P/L) in patients with idiopathic acute anterior uveitis (AAU) and to compare with healthy controls. METHODS: Thirty-six male patients with idiopathic AAU and 36 male healthy subjects were enrolled in this retrospective study. Complete ophthalmological examination and complete blood count measurements results of all subjects were evaluated. RESULTS: There was a significant difference in N/L and P/L between idiopathic AAU and control groups (P=0.006, P=0.022). Also, correlation analysis revealed a significant correlation between C-reactive protein (CRP) and N/L (P=0.002; r=0.461). CONCLUSION: Our study for the first time provides evidence of N/L and P/L may be useful biomarkers in patients with idiopathic AAU. N/L is correlated with CRP, so it can be a useful biomarker to predict the prognosis in idiopathic AAU.

14 Retinal vessel oxygen saturation in healthy subjects and early branch retinal vein occlusion

Jing-Yan Yang , Bing You , Qian Wang , Szy Yann Chan , Jost B. Jonas , Wen-Bin Wei

2017, 10(2):267-270. DOI: 10.18240/ijo.2017.02.14

[Abstract](1457) [HTML](244) [PDF 579.67 K](643)

Abstract:
AIM: To measure the retinal oxygen saturation in healthy subjects and early branch retinal vein occlusion (BRVO) in Chinese population. METHODS: The retinal vessel oxygen saturation of the healthy subjects and BRVO patients were measured by a noninvasive retinal oximeter (Oxymap ehf., Reykjavik, Iceland). RESULTS: The study included 22 patients with unilateral BRVO (mean age: 55.1±8.8y) in the study group and 91 healthy participants (mean age: 37.5±14.0y) in the control group. In the healthy individuals, mean arterial and venous oxygen saturation were significantly (P<0.001) higher in the superior nasal quadrant (98.5%±10.1% and 57.3%±8.7%, respectively) than in the inferior nasal quadrant (94.2%±9.0% and 54.1%±9.6%, respectively), followed by the superior temporal quadrant (89.1%±10.1% and 51.9%±8.9%, respectively) and the inferior temporal quadrant (86.4%±9.4% and 46.6%±9.6%, respectively). In patients with ischemic BRVO, arterial oxymetric values were significantly higher and venous measurements significantly lower for the affected vessel (107.5%±9.7% and 46.4%±14.2%, respectively) than the unaffected vessel in the same eye (99.2%±12.2% and 55.5%±7.9%, respectively) and as compared to the vessel in the unaffected fellow eye (93.1%±6.9% and 55.7%±6.8%) (P=0.005 and P=0.02, respectively). In the patients with non-ischemic BRVO, mean venous oxygen saturation was lower in the affected vein (39.8%±12.2%) than in the unaffected vessels of the same eye (50.8%±10.5%) and in the fellow eye (58.21%±5.7%) (P=0.03). Mean arterial oxygen saturation did not differ significantly (P=0.42) between all three groups. CONCLUSION: In patients with BRVO, the venous oxygen saturation in the affected vessels is decreased potentially due to decreased blood velocity and flow. Interestingly, the arterial oxygen saturation in eyes with ischemic BRVO is increased in the affected arteries.

15 Characteristics of retinal vein occlusion with final vision better than 78 letters after sequential therapy with ranibizumab and triamcinolone acetate

Yao-Wu Qin , Jia Yu , Quan Zhang

2017, 10(2):271-276. DOI: 10.18240/ijo.2017.02.15

[Abstract](1348) [HTML](245) [PDF 954.70 K](627)

Abstract:
AIM: To analyze the reasons that may lead to the different vision result by combining the ranibizumab and triamcinolone acetate (TA) in sequence to treat macular edema in retinal vein occlusion (RVO). METHODS: Ranibizumab and TA were combined in sequence to treat 43 patients with macular edema secondary to RVO. Six months after the treatment, patients with central fovea thickness (CFT) less than 300 μm in optical coherence tomography (OCT) were collected into GroupsⅠand Ⅱ, based on vision acuity (VA) better than 78 letters or less than 60 letters. The age, baseline VA, duration from onset to treatment, CFT at the baseline, sub-retinal fluid (SRF), sub-foveal exudates and injection times of TA and ranibizumab were taken into comparison. RESULTS: The mean age of the subjects was 46.4y in Group Ⅰbut 57.5y in Group Ⅱ. The difference of age was significant between groups (P<0.01). The mean baseline VA was 51.4 letters in Group Ⅰand 43.9 letters in Group Ⅱ (P<0.05). The baseline CFT were 670.9 μm in Group Ⅰwith SRF in 54.3% patients and 678.1 μm in Group Ⅱ with SRF in 52.9% (P>0.05). The mean number of injections of TA was 0.9 and the mean number of injections of ranibizumab was 2.3 in Group Ⅰbut 1.7 and 2.9 respectively in Group Ⅱ. The treatment times of ranibizumab had no difference between the 2 groups (P>0.05) but the difference of TA injection times was significant, P<0.05. Subfoveal exudates at final stage happened in no subjects in Group Ⅰ but in 45.83% subjects in Group Ⅱ. CONCLUSION: This combined treatment is safer than TA injection and cheaper than ranibizumab injection alone. Younger patients and earlier treatment will help to get better vision outcome. Subfoveal exudates at the final stage have significant relationship with vision outcome. No relationship existed between the baseline CFT, SRF and the vision outcome.

16 Long-term follow-up of vitrectomy in patients with pathologic myopic foveoschisis

Ting Zhang , Ying Zhu , Chun-Hui Jiang , Ge-Zhi Xu

2017, 10(2):277-284. DOI: 10.18240/ijo.2017.02.16

[Abstract](1863) [HTML](247) [PDF 2.47 M](647)

Abstract:
AIM: To report the long-term surgical outcomes of pathologic myopic foveoschisis (MF) following vitrectomy. METHODS: We performed a retrospective case series analysis of 50 consecutive patients diagnosed with MF who experienced vision loss due to progression of foveoschisis. The 50 patients (67 eyes) were treated in our hospital with vitrectomy with internal limiting membrane (ILM) peeling from December 2004 to September 2010. Best corrected visual acuity (BCVA), refractive error, optical coherence tomography (OCT), and routine examination results were analysed. The changes of BCVA, foveal anatomical features on OCT scan, and complications were the main outcome measures. RESULTS: The mean follow-up duration was 42±17mo (range 24 to 93mo). BCVA improved significantly postoperatively (0.76±0.65 logMAR) compared with preoperative baselines (1.31±0.78 logMAR, P<0.0001), and in 53 eyes (79%) including 3 lines gain in 44 eyes (66%) at the last follow-up visit. OCT scans showed that central retinal thickness decreased from 580.0±270.0 μm preoperatively (n=67) to 179.7±84.7 μm postoperatively (n=58, P<0.0001). Total resolution of foveoschisis occurred in 41 eyes (61%). Preoperative BCVA correlated well with postoperative BCVA, whereas other factors such as age, axial length, and refractive error were not correlated. The most common complications were cataract and full-thickness macular hole formation in 14 and 9 cases, respectively. CONCLUSION: Patients with progressive vision loss due to MF who were treated with vitrectomy with ILM peeling show favourable outcomes. In most eyes, visual acuity and foveal structure remain stable during long-term observation.

17 Comparative analysis of the efficacy of astigmatic correction after wavefront-guided and wavefront-optimized LASIK in low and moderate myopic eyes

Mounir A. Khalifa , Mahmoud F. Alsahn , Mohamed Shafik Shaheen , David P. Pinero

2017, 10(2):285-292. DOI: 10.18240/ijo.2017.02.17

[Abstract](1419) [HTML](244) [PDF 1.17 M](621)

Abstract:
AIM: To evaluate and compare the efficacy of the astigmatic correction achieved with laser in situ keratomileusis (LASIK) in eyes with myopic astigmatism using wavefront-guided (WFG) and wavefront-optimized (WFO) ablation profiles. METHODS: Prospective study included 221 eyes undergoing LASIK: 99 and 122 eyes with low and moderate myopic astigmatism (low and moderate myopia groups). Two subgroups were differentiated in each group according to the ablation profile: WFG subgroup, 109 eyes (45/64, low/moderate myopia groups) treated using the Advanced CustomVue platform (Abbott Medical Optics Inc.), and WFO subgroup, 112 eyes (54/58, low/moderate myopia groups) treated using the EX-500 platform (Alcon). Clinical outcomes were evaluated during a 6-month follow-up, including a vector analysis of astigmatic changes. RESULTS: Significantly better postoperative uncorrected visual acuity and efficacy index was found in the WFG subgroups of each group (P≤0.041). Postoperative spherical equivalent and cylinder were significantly higher in WFO subgroups (P≤0.003). In moderate myopia group, a higher percentage of eyes with a postoperative cylinder ≤0.25 D was found in the WFG subgroup (90.6% vs 65.5%, P=0.002). In low and moderate myopia groups, the difference vector was significantly higher in the WFO subgroup compared to WFG (P<0.001). In moderate myopia group, the magnitude (P=0.008) and angle of error (P<0.001) were also significantly higher in the WFO subgroup. Significantly less induction of high order aberrations were found with WFG treatments in both low and moderate myopia groups (P≤0.006). CONCLUSION: A more efficacious correction of myopic astigmatism providing a better visual outcome is achieved with WFG LASIK compared to WFO LASIK.

18 A cross-sectional study on compliance with topical glaucoma medication and its associated socioeconomic burden for a Chinese population

Man-Hin Lui , Jason Chun Ho Lam , Yi Lee Kwong , Tak Siu Wong , Pak Long Cheung , Sherri Shun Yan Lai , Pak Lun Yuen , Wai Yiu Lam , Ho Yan Chan , Yiu Fai Wong , Jimmy Shiu Ming Lai , Kendrick Co Shih

2017, 10(2):293-299. DOI: 10.18240/ijo.2017.02.18

[Abstract](1876) [HTML](245) [PDF 643.26 K](613)

Abstract:
AIM: To estimate the overall drug compliance for local Chinese glaucoma patients on long-term topical treatment. METHODS: This was a retrospective cross-sectional study. Fifty-seven primary glaucoma patients from the subspecialty clinic of a publicly-funded tertiary care hospital in Hong Kong completed a questionnaire on compliance with topical glaucoma medication, attitude towards glaucoma and therapy and vision related quality of life. Noncompliance was defined as reporting missing more than or equal to 10% of the prescribed topical glaucoma medication during the 2wk immediately prior to the consultation. Relationships between noncompliance and demographics, attitude, disease and treatment status was studied. Cost was estimated with quality of life and direct medical cost involved with noncompliance. Multivariable logistic regression on noncompliance was performed on selected factors. RESULTS: Compliance was calculated as 75% (95% CI: 64%-87%) among 57 subjects (mean age 69y, female 51%). No statistical significant relationship was established between noncompliance and any single factors or outcomes. Age (P=0.048) and forgetfulness (P=0.064) were found to be marginally significant predictive factors on noncompliance in multivariable logistic regression. Noncompliance might be related (P=0.130) to poorer self-rated vision-associated quality of life. The societal cost of noncompliance was estimated to be over 2510 life-years and US$ 3.7 million territory-wide. CONCLUSION: The compliance of Chinese glaucoma patients in Hong Kong is comparable to other parts in the world, and carries detrimental impacts on individual and societal levels. Age and forgetfulness are two possible independent predictors for noncompliance.

19 The omega-3 and retinopathy of prematurity relationship

Angelakis Malamas , Angeliki Chranioti , Christos Tsakalidis , Stavros A Dimitrakos , Asimina Mataftsi

2017, 10(2):300-305. DOI: 10.18240/ijo.2017.02.19

[Abstract](1704) [HTML](250) [PDF 283.89 K](658)

Abstract:
The aim of this article is to examine the effect of omega-3 (ω-3) long-chain polyunsaturated fatty acids (LCPUFAs) intake on retinopathy of prematurity (ROP) by reviewing the experimental and clinical trials conducted on animal models and infants. LCPUFAs demonstrate cytoprotective and cytotherapeutic actions contributing to a number of anti-angiogenic and neuroprotective mechanisms within the retina. Their intake appears to have a beneficial effect on ischemia, oxidative stress, inflammation and cellular signaling mechanisms, influencing retinal cell gene expression and cellular differentiation. ω-3 LCPUFAs may modulate metabolic processes that activate molecules implicated in the pathogenesis of vasoproliferative and neurodegenerative retinal diseases such as ROP.

20 Enhanced depth OCT imaging of the lamina cribrosa for 24 hours

Pedro Naranjo Bonilla , Rafael Giménez Gómez , David Ríos Jiménez , María Luísa Varas Fabra , María del Carmen Muñoz Villanueva , Rocío García Catalán , Pilar Font Ugalde , María Soledad Poblador Fernández , José Luís Lancho Alonso , José María Gallardo Galera

2017, 10(2):306-309. DOI: 10.18240/ijo.2017.02.20

[Abstract](1370) [HTML](250) [PDF 503.97 K](635)

Abstract:
The lamina cribrosa thickness (LCT) could be affected by dynamic changes in its structure. Using Spectral-domain-optical coherence tomography (SD-OCT), we have studied the behaviour of the laminar region in 14 young subjects over 24h. Significant changes in LCT were observed, depending on the time at which the measurement was taken, with the maximum thickness being observed at 7.30 p.m., and the minimum at 7.30 a.m. This finding could suggests a circadian pattern in the LCT thickness in healthy subjects, which could have implications for the classification, diagnosis and prognosis of both normal and glaucomatous subjects.

21 Development of a new choroidal metastasis in resistance to crizotinib therapy in anaplastic lymphoma kinase-rearranged non-small cell lung cancer

Zhi-Hua Cui , Yan Zhang , Ling-Ling Liang , Zhao-Hui Li , Inna Abramova , Qian Hao

2017, 10(2):310-314. DOI: 10.18240/ijo.2017.02.21

[Abstract](1251) [HTML](233) [PDF 1.35 M](635)

Abstract:

22 Post photorefractive keratectomy corneal ectasia

Anna M Roszkowska , Margherita S Sommario , Mario Urso , Pasquale Aragona

2017, 10(2):315-317. DOI: 10.18240/ijo.2017.02.22

[Abstract](1295) [HTML](250) [PDF 1.93 M](731)

Abstract:

23 A case of 9p deletion syndrome with congenital infantile glaucoma, effective method of diagnosis, and treatment

Xu Jia , Xu-Yang Liu , Xuan-Chu Duan

2017, 10(2):318-320. DOI: 10.18240/ijo.2017.02.23

[Abstract](1456) [HTML](234) [PDF 1.05 M](734)

Abstract:

24 Demonstration of reversible retinal ganglion cell dysfunction in inflammatory optic neuropathies utilizing pattern electroretinography

Austin Bach , Matthew D Kay

2017, 10(2):321-324. DOI: 10.18240/ijo.2017.02.24

[Abstract](1245) [HTML](240) [PDF 1.26 M](683)

Abstract:

25 Digenic heterozygous mutations in EYS/LRP5 in a Chinese family with retinitis pigmentosa

Feng-Juan Gao , Sheng-Hai Zhang , Jun-Yi Chen , Ge-Zhi Xu , Ji-Hong Wu

2017, 10(2):325-328. DOI: 10.18240/ijo.2017.02.25

[Abstract](1571) [HTML](253) [PDF 2.30 M](649)

Abstract:

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Volume 10,Issue 2,2017 Table of Contents