International Journal of Ophthalmology-IJO is a global ophthalmological scientific publication and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online). This journal is sponsored by Chinese Medical Association Xi’an Branch and published by the IJO Press. It has been indexed in SCIE, PubMed, PMC, CA, IC, Scopus, EMBASE and DOAJ, and was selected for China's Science and Technology Journal International Influence Enhancement Plan (D-class projects). IJO’s JCR IF in 2024 is 1.8 (Q3), Five-year Impact Factor is 1.8, CiteScore in 2024 is 2.8. IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication and accept contributions from all over the world, both basic and clinical research.
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Jin-Shuo Liu, Nai-Qin Yan, Ying-Yan Mao, Chen Xin, Da-Peng Mou, Xin-Xiao Gao, Jia Guo, Ning-Li Wang, Si-Quan Zhu
2025,18(8):1409-1425 ,DOI: 10.18240/ijo.2025.08.01
Abstract:
AIM: To analyze visual dysfunction in rats under simulated weightlessness (SW) by examining trans-laminar cribrosa pressure difference (TLCPD) and neuroimmune responses. METHODS: The 72 male Sprague-Dawley rats were randomly assigned into two groups (ground control and hindlimb unloading-simulated microgravity) using stratified randomization, with each group further subdivided into three exposure durations: SW 2-week (SW-2W), 4-week (SW-4W), and 8-week (SW-8W), n=12 per subgroup. At the designated time points for each group, intraocular pressure (IOP) and intracranial pressure (ICP) were measured, and the trans-laminar cribrosa pressure difference (TLCPD) was calculated. Additionally, optomotor response (OMR), electroretinography (ERG), and optical coherence tomography (OCT) were performed. The number of retinal ganglion cells (RGCs) was quantified via immunofluorescence, the activation of astrocytes and microglial cells was determined, and Sholl analysis was conducted to assess the function and morphology of microglial cells. Data were analyzed with SPSS and GraphPad Prism (P<0.05). RESULTS: Under prolonged simulated microgravity, rats exhibited a progressive increase in both IOP and ICP, with the most pronounced rise observed at 8wk. Concurrently, the TLCPD shifted from a negative value in controls to a positive value. These pressure alterations were associated with retinal dysfunction, as evidenced by significant reductions in ERG b-wave and photopic negative response (PhNR) amplitudes. OCT and histological analyses revealed subtle photoreceptor layer damage: while the inner nuclear layer (INL) thickness remained relatively unchanged, the outer nuclear layer (ONL) thinned significantly, and the nerve fiber layer-ganglion cell layer complex thickness (NFL-GCL) complex initially thickened before later thinning. Immunofluorescence further demonstrated marked neuroimmune activation, with astrocytes transitioning from having large cell bodies with small, elongated, sparse processes to a phenotype characterized by compact, enlarged nuclei and aggregated processes, alongside notable RGC loss. CONCLUSION: Based on the results from the simulated microgravity rat model, microgravity-induced changes in dual-chamber pressure, and neuroimmune responses in the retina may play a key role in visual dysfunction. Specifically, the activation of retinal neuroimmune cells (astrocytes and microglial cells) induced by mechanical stress appears to be central to retinal and optic nerve damage.
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Dan Zhu, Xiao-Yang Wu, Liang-Chang Li
2025,18(8):1426-1432 ,DOI: 10.18240/ijo.2025.08.02
Abstract:
AIM: To investigate the functions and potential mechanisms of obtusifolin in dry eye disease (DED) in a rat model. METHODS: A rat DED model was established via topical administration of benzalkonium chloride (BAC), followed by administration of obtusifolin. Conjunctival irritation score and tear production were measured to evaluate DED symptoms. Enzyme-linked immunosorbent assay (ELISA) was employed for determining inflammatory cytokine levels in rat conjunctiva. Periodic acid-Schiff staining and corneal fluorescein staining were implemented for assessing goblet cell numbers and corneal epithelial defects, respectively. Western blotting showed zonula occludens-1 (ZO-1), matrix metalloproteinase-9 (MMP-9), and mitogen-activated protein kinase (MAPK)/nuclear factor kappa B (NF-κB) signaling-related protein levels in the conjunctiva. RESULTS: Topical application of obtusifolin alleviated conjunctival irritation and enhanced tear production in BAC-induced DED rats. Obtusifolin attenuated conjunctival inflammatory response and goblet cell loss as well as corneal epithelial barrier disruption in DED rats. Obtusifolin suppressed extracellular signal-regulated kinase (ERK), p38, and NF-κB phosphorylation in the conjunctiva of DED rats. CONCLUSION: Obtusifolin ameliorates DED in rats possibly by alleviating inflammation via the inactivation of MAPK/NF-κB signaling.
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Yu-Han Yan, Hong-Yu Li, Li-Xiong Gao, Wen Li, Ling-Ping Zhao, Quan Zeng, Yu Luo, Tian-Tian Cui, Ru-Ge Zang, Zi Ye, Jia-Fei Xi, Wen Yue, Zhao-Hui Li
2025,18(8):1433-1449 ,DOI: 10.18240/ijo.2025.08.03
Abstract:
AIM: To explore the changes in early retinal development after the occurrence of ischemia. METHODS: Human retinal organoids (hROs) of day 18 or day 30 were treated with oxygen-glucose deprivation and reperfusion (OGD/R) to simulate the retinal ischemia. All hROs were maintained normally until day 60 to evaluate changes in ischemic injuries during retinal development. Paraffin section staining was used for detecting changes in organoid structure and cell number. Real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot (WB) analyses were used to observe the change in the expression of retinal cell markers. RESULTS: In hROs, OGD/R induced the decrease of proliferating cells, inhibited the expression of proliferated marker Ki67 and promoted early apoptosis of retinal cells (P<0.05). Under OGD/R condition, the progenitor cell layer and ganglion cell layer of hROs lost normal structure, and the number of neural stem cells (SOX2+), retinal progenitor cells (CHX10+) and retinal ganglion cells (TUJ1+/BRN3+/ATOH7+) decreased (P<0.05). The expression of corresponding retinal cell markers also decreased (P<0.05). Organoids treated with OGD/R on day 30 had similar injuries in retinal structure and retinal cell markers to those on day 18. Long-term observations revealed that day 18-treated organoids remained disorganized progenitor and ganglion cell layers by day 60, with no recovery in proliferating cell nuclear antigen (PCNA) protein expression. RT-qPCR showed persistently low Ki67 transcription levels (P<0.001), while other retinal cell markers recovered or exceeded normal levels, indicating a limited self-repair happened in the development of hROs. In contrast, day 30-treated organoids exhibited normal structure and marker expression by day 60, with transcription levels of retinal cell markers returning to normal (P>0.05), demonstrating complete recovery from OGD/R damage. CONCLUSION: Retinal ischemia damage the retinal development in the short-term. After the restoration of retinal blood supply, the retinal ischemic damage can be recovered during subsequent development. However, retinal ischemic injuries at different developmental stages exhibit varying degrees of reversibility. The earlier ischemic injury occurs, the more difficult it is to repair retinal cell and structure damage.
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Yomna Amr Alahmadawy, Radwa Taher Elzanaty, Shaimaa Abdelsalam Arfeen
2025,18(8):1450-1455 ,DOI: 10.18240/ijo.2025.08.04
Abstract:
AIM: To evaluate the outcome and the degree of patient satisfaction with the reconstruction of full-thickness medial and central lower lid defects using a pendular flap of the remaining lateral part of the lower lid. METHODS: Totally 20 patients with full thickness medial or central lower lid defects that could not be repaired by direct closure with or without cantholysis. A sliding full-thickness composite flap was created from the lateral part of the remaining lid to cover the defect. The posterior lamella of the induced lateral defect was repaired by either a periosteal flap alone or in combination with a free tarsal graft. Postoperative cosmetic and functional outcomes were evaluated. RESULTS: The mean age of the patients was 46.3±18.1y (20-70y). The defects ranged from 30%-80% of the lid width and resulted from the excision of lid tumors in 11 patients (55%) and from trauma in 9 (45%) patients. Postoperative complications included one case of lateral graft ectropion, 2 cases of lid retraction and 3 cases of marginal graft necrosis. Most of the patients had an acceptable final cosmetic outcome. CONCLUSION: Reconstruction of moderate-sized defects in the medial/central lower lid via a sliding flap yielded acceptable cosmetic and functional outcomes with high patient satisfaction. Large defects ≥50% of the horizontal length are at greater risk of complications. Reconstruction of medial defects by this technique was associated with a greater incidence of complications.
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Jiao Wang, Guang-Hong Chu, Zi-Huan Wang, Xiao-Yu Cai, Si-Yuan Shi, Qi-Ping Qing, Qi Zhang
2025,18(8):1456-1463 ,DOI: 10.18240/ijo.2025.08.05
Abstract:
AIM: To investigate the expression of interferon regulatory factors (IRFs) in peripheral blood mononuclear cells (PBMCs) of patients with Sjögren’s syndrome-related dry eye (SSDE) and to explore their correlation with clinical features, dendritic cell activation, and serological indicators. METHODS: A total of 53 SSDE patients and 62 non-Sjögren’s syndrome dry eye (NSSDE) patients were enrolled. Demographic and clinical data were collected, and comprehensive ophthalmic examinations were performed, including the ocular surface disease index (OSDI) questionnaires, Schirmer I test (SIT), tear break-up time (TBUT), corneal fluorescein staining score (CFS), and in vivo confocal microscopy (IVCM). PBMCs were isolated, and IRFs expression levels were analyzed using Western blotting (WB) and quantitative real-time polymerase chain reaction (qRT-PCR). Serological indicators, including antinuclear antibodies (ANA) and anti-Ro60, anti-Ro52, and anti-La autoantibodies, were detected. Statistical analyses evaluated correlations between IRFs expression and clinical parameters. RESULTS: Compared to NSSDE, the relative mRNA and protein expression of the IRF-8 was significantly upregulated in patients with SSDE (P<0.001), whereas no significant differences were observed in IRF-1, IRF-3, IRF-5, and IRF-7 (P=0.12, P=0.10, P=0.66, P=0.96). Correlation analysis revealed that IRF-8 expression was positively associated with CFS and OSDI scores (r=0.57, r=0.38, both P<0.05). Moreover, IRF-8 expression correlated with corneal dendritic cell (DC) density and size, and the number of dendrites (r=0.43, r=0.40, r=0.65, all P<0.05). IRF-8 expression was significantly elevated in patients positive for anti-Ro60, anti-Ro52 and anti-La autoantibodies (P<0.05). CONCLUSION: In SSDE, IRF-8 is upregulated and associated with clinical features, DC activation, and serological indicators. These findings suggest that IRF-8 plays a critical role in SSDE pathogenesis and may serve as a potential therapeutic target for diagnosis and treatment.
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Zakieh Vahedian, Ali Azimi, Seyed Mehdi Tabatabaei, Ghasem Fakhraie
2025,18(8):1464-1469 ,DOI: 10.18240/ijo.2025.08.06
Abstract:
AIM: To evaluate the mid-term effects of topical latanoprost 0.005% on vessel density (VD) of the bulbar conjunctiva using anterior segment optical coherence tomography angiography (OCTA). METHODS: Thirty-four eyes of 21 patients and 18 eyes of 9 healthy subjects were recruited as the treatment and control groups, respectively. The treatment group was instructed to apply generic latanoprost 0.005% once daily at night, while the control group received no medication. Anterior segment OCTA was performed on all eyes at baseline, 3wk, and 12wk after initiation of latanoprost. The superficial bulbar conjunctival VD was measured in the superior, inferior, temporal, and nasal quadrants. A linear mixed model was used to compare the change in the VD between groups. RESULTS: The change in the VD was not different between groups in temporal, and nasal quadrants at 3-week and 12-week time points. The VD in the superior bulbar conjunctiva was significantly increased after 12wk (P=0.029) while the change from baseline after 3wk was not different between groups (P=0.218). After adjustment for age and gender superior hemi (P=0.006) and center (P=0.016) of the inferior quadrant of bulbar conjunctiva showed increased VD after 12wk. CONCLUSION: The trend of changes in the superior and inferior conjunctival VD is increased following topical latanoprost administration and these changes can be quantified using anterior segment OCTA.
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Da-Dong Jia, Qing-Ao Xiao, Shi-Yi Song, Meng Pan, Hao Hu, Kai-Li Wu, Jia-Bing Ran, Liang Liang
2025,18(8):1470-1477 ,DOI: 10.18240/ijo.2025.08.07
Abstract:
AIM: To explore whether plasma proteins serve as potential therapeutic targets for primary open angle glaucoma (POAG) based on a Mendelian randomization (MR) study. METHODS: Large-scale protein quantitative trait loci (pQTLs) data from the Icelandic deCODE database and two large POAG Genome-Wide Association Study (GWAS) summary datasets were used in this study. Causal associations between plasma proteins and POAG were identified using summary-data-based MR (SMR) analysis and the heterogeneity in dependent instruments (HEIDI) test. Colocalization analysis was then conducted to assess the genetic associations between these two factors. Phenotype-wide MR analysis was performed to validate protein targets as potential drug targets and to evaluate potential side effects. Finally, protein-protein interactions (PPI) were studied, and the Drug-Gene Interaction Database (DGIDb) was used to identify associations between drugs and the identified proteins. RESULTS: Four proteins (SVEP1, TMEM190, ROBO1, and ENPP5) were identified as potential drug targets in this study. Phenome-wide MR analysis showed that SVEP1, ROBO1, and ENPP5 were not associated with adverse effects, while TMEM190 was linked to nerve root and plexus disorders, as well as subarachnoid hemorrhage. Ticagrelor was suggested as a potential new drug for the treatment of glaucoma by regulating SVEP1. CONCLUSION: Four plasma proteins—SVEP1, TMEM190, ROBO1, and ENPP5—are identified as potential therapeutic targets for POAG through an MR approach. Phenome-wide MR analysis reveals that SVEP1, ROBO1, and ENPP5 are not associated with adverse effects, while TMEM190 is linked to nerve root and plexus disorders, as well as subarachnoid hemorrhage. Ticagrelor is proposed as a potential therapeutic drug for glaucoma by regulating SVEP1. These findings highlight the potential of plasma proteins as drug targets for POAG and provide valuable insights for further research.
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Si-Yi Wang, Mi-Mi Liu, Xi-Le Li, Chao-Xiang Ge, Wei Chen, Zhen-Quan Zhao
2025,18(8):1478-1483 ,DOI: 10.18240/ijo.2025.08.08
Abstract:
AIM: To preliminary explore the safety and effectiveness of artificial iris implantation. METHODS: Fourteen patients with iris defects who underwent artificial iris implantation at Hainan Boao Super Hospital from June 2020 to September 2021 were retrospectively analyzed for safety and effectiveness of the surgery by comparing the preoperative and postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), corneal endothelial cell density (ECD), ocular axial length (AL), anterior chamber depth (ACD), patient satisfaction of photophobia and appearance improvement, and postoperative complications. RESULTS: The mean age was 37.21±14.85 (7-60)y, including 13 males and 1 female. The mean follow-up period was 4.64±2.32 (1-10)mo. The mean AL was 24.00±1.06 (21.68-25.58) mm. The postoperative mean anterior chamber depth measured was 4.07±0.75 (2.61-5.07) mm. The mean BCVA was 0.69±0.65 logMAR preoperatively and 0.46±0.60 logMAR at the last follow-up time (P=0.36). There was no significant differences in the IOP preoperative and postoperative (14.14±3.10 and 13.65±3.08 mm Hg, respectively, P=0.69). The preoperative ECD was 1674.09±566.11 per 1 mm2, and the postoperative ECD was 1439.45±425.15 per 1 mm2 (P=0.21). No obvious corneal opacity or corneal decompensation was observed in all patients. The preoperative and postoperative photophobia scores were 8.50±1.55 and 4.50±1.94, respectively (P<0.05), and the preoperative and postoperative appearance defect scores were 6.58±2.98 and 2.75±1.69, respectively (P<0.05). Among the 14 patients, one had artificial iris displacement, two had a transient IOP rise after treatment of antiglaucomatous eyedrops. No complications were observed during surgery. CONCLUSION: The novel artificial iris material is safe, which can significantly improve the appearance defects and photophobia, improve the postoperative visual acuity to a certain extent. This surgery had a high patient satisfaction rate with few and controllable postoperative complications. At the same time, the artificial iris, with its diverse configurations, variable colors, arbitrary cutting, and various surgical procedures, fully realizes personalized treatment, which solves the clinical problem of iris defect.
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Rui-Hua Jing, Deng-Ke Zhou, Zhuo-Yan Yang, Zhao-Dan Ding, Jia-Hui Deng, Yao Xing, Xiao-Feng Chen
2025,18(8):1484-1489 ,DOI: 10.18240/ijo.2025.08.09
Abstract:
AIM: To use two-sample Mendelian randomization (MR) method to study uveitis causal association with wet age-related macular degeneration (wAMD) risk from the genetic level. METHODS: Two-sample MR analysis was used to assess the causal role of uveitis on wAMD risk, using the 8 genetic variants associated strongly with uveitis as instrumental variables. Besides, eight MR methods [inverse variance weighted (IVW), weighted median, MR-Egger regression, weighted mode, simple mode, robust adjusted profile score (RAPS), contamination inverse-variance weighted method, and debiased inverse-variance weighted method] were used to get the whole causal estimate for multiple instrumental single nucleotide polymorphism (SNPs). The MR analysis was based on Europeans. RESULTS: Uveitis was related to a higher risk of wAMD [odds ratio (OR): 1.08, 95% confidence interval (CI) 1.03–1.12; P=1.03×10-3] with the IVW method. No heterogeneity and directional pleiotropy were detected. On the contrary, no significant results were detected in reverse MR analysis. CONCLUSION: Uveitis is related to an increased risk of wAMD. Due to the high blindness rate of wAMD, understanding and controlling the risk factors of AMD is of great significance for reducing its incidence and early diagnosis and treatment.
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Yan-Mei Shi, Xiao Xie, Wen-Qi Wang, Xiao-Meng Yuan, Zhi-Ping Zhang, Hong-Yan Wang, Jie Meng, Ze-Hao Kong, Xia Jing, Ting-Ting Liu
2025,18(8):1490-1497 ,DOI: 10.18240/ijo.2025.08.10
Abstract:
AIM: To quantitatively assess central macular thickness (CMT), macular neovascularization (MNV) area, vascular tortuosity (VT), and vascular dispersion (VDisp) in neovascular age-related macular degeneration (nAMD), type 1 and type 2 MNV, by means of optical coherence tomography (OCT) and OCT angiography (OCTA) techniques. METHODS: In this retrospective and observational case series, patients were classified into type 1 or type 2 MNV groups. A comprehensive panel of OCT and OCTA metrics was evaluated, including CMT, MNV area, VT, and VDisp. All subjects underwent a standardized intravitreal conbercept (IVC) regimen [3+pro re nata (PRN)] with a 12-month follow-up. MNV area was obtained by manual measurements with OCTA software, and VT and VDisp were calculated by automated analysis with Image J software. RESULTS: A total of 101 participants were included, with 51 patients in the type 1 MNV group (mean age 67.32±9.12y) and 50 patients in the type 2 MNV group (mean age 64.74±5.21y). The mean number of IVC injections was 3.98±1.53 for type 1 MNV and 3.73±0.81 for type 2 MNV. Both subtypes exhibited significant improvements in visual acuity, accompanied by marked reductions in CMT and MNV area (P<0.05) at 12mo after treatment. In type 2 MNV, VT significantly decreased (P<0.05), whereas no significant change was observed in VT for type 1 MNV. VDisp did not significantly changed in either sybtypes. Moreover, in type 1 MNV, final best-corrected visual acuity (BCVA) using logMAR correlated positively with both pre- and post-treatment CMT, while in type 2 MNV, a significant positive correlation was found between the number of injections and final CMT. CONCLUSION: This study shows that conbercept treatment significantly improves visual acuity and macular structure in both type 1 and type 2 MNV with reductions in CMT and MNV area. The significant reduction in VT in type 2 MNV suggests its potential as a biomarker for disease activity. The findings imply the quantitative assessment useful for the stratification, prognostication, and personalized management of MNV in nAMD.
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Ramya Gnanaraj, Alan G. Palestine, Brandie D. Wagner, Jennifer L. Patnaik, Talisa E. de Carlo Forest, Marc T. Mathias, Niranjan Manoharan, Vivian Rajeswaren, Naresh Mandava, Anne M. Lynch
2025,18(8):1498-1505 ,DOI: 10.18240/ijo.2025.08.11
Abstract:
AIM: To determine the differences in levels of systemic C-reactive protein (CRP) in patients with geographic atrophy (GA) and sex-based differences in CRP levels. METHODS: Blood samples from patients with GA and controls were collected in a prospective age-related macular degeneration (AMD) registry from August 2014 to June 2021. AMD was confirmed using multimodal imaging and the Beckman and Consensus of Atrophy Meeting criteria for GA. High-sensitivity serum CRP levels were measured using an automated nephelometer. A non-parametric (rank-based) linear regression model was fit with an interaction between sex and GA. RESULTS: There were 97 GA patients and 139 controls, with females comprising 55% and 66% of each cohort, respectively. There is no difference in CRP between cases and controls, with a median (interquartile range) of 1.2 (0.6-2.6) mg/L in GA patients versus 1.3 (0.8–2.9) mg/L in controls (P=0.52). Although females had higher CRP levels compared to males in both the GA and control groups, this difference did not reach statistical significance after adjustment for multiple comparisons. CONCLUSION: There is no significant difference in systemic CRP levels between GA cases and controls.
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Zhi-Mei Wei, Yu Zhao, Ran-Ran Ding, Yu-Song Zeng, Zheng Zeng, Zi-Tong He, Jing Hao, Jing-Jing Hu, Jin-Guo Yu, Cai-Yun You
2025,18(8):1506-1514 ,DOI: 10.18240/ijo.2025.08.12
Abstract:
AIM: To assess and compare the utility of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), and red blood cell distribution width (RDW) as potential biomarkers to predict the severity of diabetic retinopathy (DR) in the United States population. METHODS: The observational study enlisted patients diagnosed with DR from the National Health and Nutrition Examination Survey (NHANES) database, spanning the period from 2005 to 2008. The severity of DR was defined according to Early Treatment for Diabetic Retinopathy Study (ETDRs). The effect of NLR, PLR, SII, and RDW on proliferative diabetic retinopathy (PDR) were explored using multivariable logistic regression analysis model. Subgroup analysis and restricted cubic splines (RCS) were conducted to assess the robustness of the correlations across subgroups and to explore nonlinear relationships between four indices and PDR. The receiver operating characteristic (ROC) analysis was employed for the purpose of assessing and evaluating the predictive efficacy of NLR, PLR, SII, and RDW in determining the severity of DR. RESULTS: After adjusting for other confounders (age, gender, race, body mass index, diabetes duration, and HbA1c) in multivariable analysis, a unit increase of PLR×0.1, SII×0.01, and RDW would raise the risk for PDR by 15.6%, 22.2%, and 33%, respectively. Particularly, there was a 2.208-fold greater risk of PDR in individuals with an elevated NLR (OR=2.208, 95%CI, 1.348-3.617, P<0.001). RCS analyses showed positive relationships of four indices and PDR after segmented regression based on their own turning points. The results of ROC analysis revealed that PLR+RDW [area under the curve (AUC)=0.772, 95%CI: 0.669-0.874] had the best predictive value for PDR, compared with NLR+PLR+SII (AUC=0.697, 95%CI: 0.570-0.825) or RDW alone (AUC=0.736, 95%CI: 0.646-0.826). CONCLUSION: The combination of RDW and NLR demonstrates a promising ability to predict the severity of DR across the United States population, and it could be promisingly used in clinics for monitoring the progress of DR.
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Sebnem Kaya Ergen, Anil Ergen, Busra Gunduz, Ecem Cemre Ceylan, Sevgi Subasi, Melih Caklili, Burak Cabuk, Ihsan Anik, Savas Ceylan
2025,18(8):1515-1521 ,DOI: 10.18240/ijo.2025.08.13
Abstract:
AIM: To evaluate retinal microcirculation changes at the 3rd and 12th months following endoscopic endonasal surgery in patients with sellar region tumors using optical coherence tomography angiography (OCT-A). METHODS: This prospective longitudinal observational study included 78 eyes of 39 patients with sellar tumors and 78 eyes of 39 age- and gender-matched healthy controls. Standard automated perimetry and OCT-A were performed preoperatively and at 3- and 12-month follow-ups. Visual field (VF) recovery was assessed using mean deviation (MD) values, and correlations between preoperative structural parameters and postoperative visual outcomes were analyzed. RESULTS: Baseline OCT-A values revealed significantly reduced papillary and foveal vessel densities in almost all quadrants in sellar tumor patients compared to controls (P<0.05, respectively). While VF MD values improved significantly postoperatively (P<0.001), no significant improvement was observed in microvascular vessel density or retinal nerve fiber layer (RNFL) thickness (P>0.05, respectively); instead, a tendency toward reduction was noted over 12mo. Correlation analysis between postoperative MD values and preoperative parameters showed a strong positive correlation with the superior quadrant of papillary vessel density (r=0.703, P<0.001) and RNFL thickness (r=0.518, P<0.001). CONCLUSION: Although decompressive surgery improves visual function, retinal microvascular alterations appear to deteriorate over time. These findings suggest that irreversible neurovascular damage occurs despite surgical intervention, emphasizing the importance of early diagnosis and treatment in patients with chiasmal compression. OCT-A may serve as a valuable prognostic tool for assessing structural and functional recovery in these patients.
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Jing Zhai, Hao Chen, Xin-Jie Ye, Wei-Jun Cai, Li-Jie Hou, Mei-Xiao Shen, Fan Lyu
2025,18(8):1522-1528 ,DOI: 10.18240/ijo.2025.08.14
Abstract:
AIM: To investigate the ocular biological characteristics of children with myopia and rapid axial length (AL) changes prescribed spectacles with highly aspherical lenslets (HAL). METHODS: Data were collected from 156 children (252 eyes) with myopia and HAL treatment who were aged 7-13 and had rapid AL changes. The participants were divided into groups with AL reduction and elongation according to the changes in AL within 6mo. Paired t-tests were used to compare the ocular biological parameters at baseline and after rapid changes post-HAL treatment. Pearson’s correlation analysis was used to determine the association between the ocular parameters and AL changes. RESULTS: The ocular biological parameters significantly changed in the children with myopia and rapid AL changes after HAL treatment. In the group with AL reduction, the anterior chamber depth (ACD) and vitreous chamber depth (VCD) decreased. The crystalline lens thickness (CLT) increased, corneal flat keratometry (FK) decreased, and steep keratometry (SK) increased (all P<0.001). The eyes in the group with AL elongation had increased ACD and VCD and steepened SK, but the CLT or FK findings were not different. AL change was negatively associated with baseline astigmatism (r=-0.171; P=0.007). CONCLUSION: In the eyes with HAL treatment, decreased ACD and VCD, thickened CLT, flattened FK, and steepened SK are observed during AL reduction. Lower baseline astigmatism is associated with AL reduction. The AL reduction may suggest the potential efficacy of HAL intervention in myopia control, while providing evidence for optimizing personalized myopia management strategies. Further longitudinal studies are warranted to validate whether rapid AL changes predict sustained treatment efficacy.
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Muteb K. Alanazi, Mohammed Alshehri, Mohammed Althomali, Mohammed Alhazmi, Mansour Alghamdi, Nawaf M. Almutairi, Basal Altoaimi, Ahmed Alharbi, Ali Almustanyir, Maria Liu
2025,18(8):1529-1536 ,DOI: 10.18240/ijo.2025.08.15
Abstract:
AIM: To investigate short-term changes in choroidal thickness in response to peripheral myopic defocus induced by two designs of multifocal corneal gas permeable contact lenses (MFGPCL) in young adults. METHODS: Seventeen participants, with a mean age of 24.5±4y, underwent choroidal thickness and vascularity index measurements using enhanced depth imaging optical coherence tomography (EDI OCT) at baseline, one day, and one week following MFGPCL wear. Two center-distance MFGPCL designs with similar center zone diameters of 3.0 mm but different peripheral add powers (low add: +1.5 D and high add: +3.0 D) were tested. Each participant was randomly assigned to wear one of the two MFGPCL designs. Measurements of total, luminal, and stromal choroid thickness were obtained in five eccentric regions (6 mm towards the periphery) in all quadrants. RESULTS: Significant thickening in total choroidal thickness were observed after one week of wearing both high add (+10±6 µm) and low add (+7±5 µm) MFGPCLs, with no statistically significant difference between the two groups (P=0.42). Choroidal thickening was consistent across eccentric regions and quadrants, with no significant differences based on eccentricity or quadrant (all P>0.05). Both lens designs induced choroidal thickening, with no significant difference between them in total choroidal thickness (P=0.18 for quadrants, P=0.51 for eccentric regions). CONCLUSION: Peripheral myopic defocus induced by MFGPCLs lead to significant choroidal thickening, including total, luminal, and stromal components. This study highlights the need for future research to explore the dose-response relationship between peripheral myopic defocus and choroidal thickening, utilizing choroidal response as a potential biomarker.
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Hassan Hashemi, Mojgan Pakbin, Alireza Hashemi, Mohammadreza Aghamirsalim, Mehdi Khabazkhoob
2025,18(8):1537-1543 ,DOI: 10.18240/ijo.2025.08.16
Abstract:
AIM: To compare the visual and optical outcomes following femtosecond laser in situ keratomileusis (FS-LASIK) using an aberration neutral profile with asymmetric offset (AO) and pupil center (PC) treatments. METHODS: In this randomized double-blind clinical trial study, 48 (24 cases) and 38 eyes (19 cases) underwent myopic astigmatism and hyperopic astigmatism LASIK. One eye of each individual was randomly assigned to AO centration and the fellow eye underwent the PC-centered method. The clinical outcomes including uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), safety and efficacy indexes, subjective spherical equivalent (SE) and corneal high-order aberrations (HOAs) were measured at baseline and 6mo postoperatively. RESULTS: In the myopic group, the mean preoperative SE and astigmatism were -4.12±0.87 (-2.88 to -6.00) diopter (D) and -0.88±0.79 (0 to -2.75) D, respectively. In the hyperopic group, the mean preoperative SE and astigmatism were 0.93±0.59 (-0.25 to 2.25) D and -0.73±1.00 (0 to -4.25) D, respectively. At 6mo postoperatively, the safety and efficacy indexes were similar for centration in myopic and hyperopic LASIK groups. In the myopic group, significant changes were found in horizontal trefoil (P=0.041) and oblique trefoil (P=0.031) in favor of AO centration treatment. CONCLUSION: Femtosecond-LASIK is a safe and efficacious procedure for treatment of myopic and hyperopic astigmatism. AO-centered and PC-centered approaches provide similar visual and refractive outcomes. Myopic astigmatism LASIK with AO centration leads to slightly better corneal aberration outcomes.
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Xin-Lei Hao, Man Yuan, Ming Wang, Ai-Si Fu, Jia-Shuang Gu, Bing-Qian Yang, Wei Jin, An-Huai Yang
2025,18(8):1544-1552 ,DOI: 10.18240/ijo.2025.08.17
Abstract:
AIM: To estimate if nanopore targeted sequencing (NTS) could identify pathogens causing postoperative endophthalmitis and further determine the feasibility of clinical application of NTS. METHODS: A total of 55 patients (55 eyes) with postoperative endophthalmitis were retrospectively included in this study with their medical records. Intraocular fluid samples were examined by NTS and microbial culture. All included patients had undergone examinations including measurement of best corrected visual acuity (BCVA) and intraocular pressure (IOP), slit-lamp biomicroscopy, and indirect ophthalmoscopy; additionally, they underwent B-ultrasound, anterior segment photography, and fundus photography if necessary. RESULTS: Among 55 patients with postoperative endophthalmitis, the age was 65.25±15.04y and there were 30 female (54.54%) patients. Forty-one (74.54%) vitreous humor samples and fourteen (25.45%) aqueous humor samples were sent for both NTS and microbial culture. NTS had a notable higher detection rate than microbial culture in detecting pathogens (90.91% vs 38.18%, χ2=33.409, P<0.001). NTS exhibited high sensitivity of pathogen detection in both microbial culture positive and negative samples (100% and 85.29%, respectively). In 16 of 21 (76.19%) patients who showed culture-positivity, their results corresponded with those of NTS. Moreover, in two patients (9.52%), NTS showed a better species resolution than microbial culture; in three patients (14.28%), NTS identified additional pathogens. As for fungus, the positive detection rate of NTS was significantly higher than that of microbial culture (20% vs 3.64%, χ2=7.066, P=0.008). Also, NTS could detect multi-infection by bacteria and fungi than microbial culture (32.73% vs 0, χ2=21.522, P<0.001). NTS could detect bacteria as well as fungi simultaneously within 48h in all patients. Meanwhile, NTS had a shorter detection time than microbial culture (1.13±0.34 vs 2.67±0.55d, Z= -9.218, P<0.001). After the NTS results were obtained, 15 patients received additional intravitreal/intracameral anti-infection treatment. At follow-up, there was a statistically significant improvement in the visual acuity relative to the baseline (Z=−5.222, P<0.001). CONCLUSION: NTS can provide rapid identification and highly sensitive detection of pathogens among patients with postoperative endophthalmitis, which can guide anti-infection treatment and improve visual prognosis.
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Gyu Chul Chung, Dong Sun Kim, Ji Eun Lee, Iksoo Byon, Sung Who Park, Han Jo Kwon, EunAh Kim
2025,18(8):1553-1560 ,DOI: 10.18240/ijo.2025.08.18
Abstract:
AIM: To report the demographic and systemic characteristics of patients, clinical progression of endophthalmitis, and the efficacy of various treatment strategies, with a focus on identifying key factors for preserving vision in eyes with endogenous endophthalmitis due to Klebsiella pneumoniae (K. pneumoniae) liver abscess. METHODS: In this single-center, retrospective case series of 18 patients with endogenous endophthalmitis due to K. pneumoniae liver abscess were analyzed. Ophthalmologic features of endophthalmitis at early, intermediate and advanced stages were obtained from eyes with endophthalmitis of different severities. Prompt vitrectomy was considered primarily for all eyes except for very early endophthalmitis. Intravitreal injections of antibiotics were performed in eyes with endophthalmitis in the very early stages and in eyes where vitrectomy was not available, and additional control of infection was needed after vitrectomy. Evisceration was performed in eyes with corneoscleral perforation, advanced endophthalmitis, perforation with preseptal or orbital cellulitis, uncontrolled infection, or severe pain with no vision. RESULTS: Mean (±standard deviation) age of the 18 patients with endophthalmitis was 64.5±12.2 (range: 32-84)y, and 14 patients (77.8%) were males. Endophthalmitis tended to involve the retinal parenchyma first and then progressed into the vitreous cavity and anterior segments. However, it presented a tendency to cause massive subretinal abscesses even after vitrectomy with silicone oil tamponade. Very high intraocular pressure with new vessels on the iris (41.7%) were also commonly observed. Although all but three patients had systemic disease such as diabetes or hypertension, visual prognosis after treatment did not appear to depend significantly on underlying comorbidities. A final best-corrected visual acuity better than 20/60 was achieved only when lesions were detected very early, with relatively good initial visual acuity, likely reflecting lower bacterial inoculation in the eye. CONCLUSION: Detection of early endophthalmitis lesions appears to be the only way to preserve good vision in patients with K. pneumoniae liver abscesses. Therefore, proper guidelines for ophthalmologic screening remain to be established for subjects at a high risk of endophthalmitis.
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Kun Huang, Zhi-Dan Wu, Ze-Hao Chen, Jin Chen, Zhuo-Ming Tang, Rong Lin
2025,18(8):1561-1569 ,DOI: 10.18240/ijo.2025.08.19
Abstract:
AIM: To investigate the prevalence and characteristics of myopia in school-aged students and effects of environmental and genetic factors on the progression of myopia. METHODS: A total of 2422 students aged between 5 and 18y from nine schools in Baiyun District of Guangzhou, China were sampled using a stratified sampling method in 2020. Among them, 1066 students participated in the follow-up survey the following year. Data were obtained based on ocular examinations and a questionnaire survey conducted during two visits. Factors potentially influencing the progression of myopia were analyzed. RESULTS: During the year assessed in this study, the percentage of students with myopia increased from 58.4% to 64.8% (P=0.002). Spherical equivalent (SE) progressed from -1.44±1.91 diopters (D) at baseline to -1.66±1.10 D (P=0.005). A generalized estimating equation (GEE) model revealed that age [adjusted odds ratio (aOR)=1.298, P<0.001], residential students (aOR=2.428, P=0.018), parental myopia (one myopic parent: aOR=1.553, both parents myopic: aOR=2.609, P<0.001), frequent reading of books or viewing of screens in direct sunlight (aOR=3.502, P=0.023), using only overhead lighting for reading and writing at night (aOR=1.633, P=0.011), parental restrictions on exercise time (aOR=2.286, P=0.012), and having less than 2h of outdoor exercise per day during the past week (aOR=1.584, P=0.019) were all identified as independent risk factors for progression of myopia. CONCLUSION: Our findings in this study indicate that age, residential students, parental myopia, indoor lighting environment, and physical activity have significant effects on the progression of myopia, providing evidence for further in-depth mechanistic interpretation and efficient intervention strategies for school-age children in this area.
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2025,18(8):1570-1578 ,DOI: 10.18240/ijo.2025.08.20
Abstract:
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Wei-Dao Zhang, Xin Li, Jun Feng, Jie Chen
2025,18(8):1579-1586 ,DOI: 10.18240/ijo.2025.08.21
Abstract:
Glaucoma filtration surgery (GFS) stands as the most effective intervention for reducing intraocular pressure, a critical component in glaucoma management. Despite its pivotal role, the scarring of the filtration bleb remains the primary impediment to successful GFS outcomes. Perioperative utilization of antimitotics, while frontline in combating fibrosis and modulating the wound healing process, carries the risk of vision-threatening complications. Given the complexity of the wound healing cascade and the potential insufficiency of targeting a single molecule, there is an imperative to expand therapeutic modalities through combination therapies. This review offers a comprehensive elucidation of the fibrogenesis post-GFS, a synthesis unprecedented in the available literature, and aims to inform the broadening of therapeutic strategies for GFS.
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Jing-Ting Luo, Zhao-Xun Feng, Cong Wang
2025,18(8):1587-1593 ,DOI: 10.18240/ijo.2025.08.22
Abstract:
The uveitis-glaucoma-hyphema (UGH) syndrome, initially described in 1978, presents as an iatrogenic complication associated with contact between intraocular implant and ocular tissue. This syndrome encompasses a spectrum of clinical manifestations, including intraocular inflammation, elevated intraocular pressure, and recurrent hemorrhage. Advances in cataract surgery techniques reduced the incidence of early intraocular lens (IOL) dislocation while inversely increased rates of delayed dislocation. The primary etiology of UGH syndrome is IOL subluxation. Weakness of the ciliary zonules or unstable IOL fixation techniques may predispose the eye to iris-lens contact. Other contributing factors include Soemmering’s ring formation, abnormal iris and ciliary body anatomy, positional changes, and improper positioning of glaucoma implants. Clinical examination and imaging modalities such as ultrasound biomicroscopy and anterior segment optical coherence tomography supports diagnosis of UGH. Treatment options range from observation and medical therapies to invasive procedures such as laser therapy, IOL repositioning, or replacement. Endoscopy provides direct visualization for identifying causes intraoperatively, aiding in tailored surgical approaches towards minimal intervention. In conclusion, UGH syndrome poses a complex clinical challenge, emphasizing the importance of understanding its etiology, accurate diagnosis, and personalized management strategies to mitigate its impact on visual function and ensure favorable outcomes.
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Elizabeth Ndunge Mutua, Bernard Shibwabo Kasamani, Christoph Reich
2025,18(8):1594-1602 ,DOI: 10.18240/ijo.2025.08.23
Abstract:
To review the existing deep learning applications for diagnosing diabetic retinopathy and retinopathy of prematurity diseases, the available public retinal databases for the diseases and apply the International Journal of Medical Informatics (IJMEDI) checklist were assessed the quality of included studies; an in-depth literature search in Scopus, Web of Science, IEEE and ACM databases targeting articles from inception up to 31st January 2023 was done by two independent reviewers. In the review, 26 out of 1476 articles with a total of 36 models were included. Data size and model validation were found to be challenges for most studies. Deep learning models are gaining focus in the development of medical diagnosis tools and applications. However, there seems to be a critical issue with most of the studies being published, with some not including information about data sources and data sizes which is important for their performance verification.
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Ze-Yu Zhang, Zhi-Qiao Liang, Yong-Zhen Bao
2025,18(8):1606-1609 ,DOI: 10.18240/ijo.2025.08.25
Abstract:
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Zhi-Hui Dong, Jia-Yu Zhang, Chao-Yang Zhang, Zhen-Guo Chen, Jing-Fa Zhang
2025,18(8):1610-1612 ,DOI: 10.18240/ijo.2025.08.26
Abstract:
Volume 18,2025 Issue 8
Basic Research
Clinical Research
Investigation
Review Article
Letter to the Editor
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Algorithm of automatic identification of diabetic retinopathy foci based on ultra-widefield scanning laser ophthalmoscopy
Jie Wang, Su-Zhen Wang, Xiao-Lin Qin, Meng Chen, Heng-Ming Zhang, Xin Liu, Meng-Jun Xiang, Jian-Bin Hu, Hai-Yu Huang, Chang-Jun Lan
Abstract:
● AIM: To propose an algorithm for automatic detection of diabetic retinopathy (DR) lesions based on ultra-widefield scanning laser ophthalmoscopy (SLO). ● METHODS: The algorithm utilized the FasterRCNN (Faster Regions with CNN features)+ResNet50 (Residua Network 50)+FPN (Feature Pyramid Networks) method for detecting hemorrhagic spots, cotton wool spots, exudates, and microaneurysms in DR ultra-widefield SLO. Subimage segmentation combined with a deeper residual network FasterRCNN+ResNet50 was employed for feature extraction to enhance intelligent learning rate. Feature fusion was carried out by the feature pyramid network FPN, which significantly improved lesion detection rates in SLO fundus images. ● RESULTS: By analyzing 1076 ultra-widefield SLO images provided by our hospital, with a resolution of 2600×2048 dpi, the accuracy rates for hemorrhagic spots, cotton wool spots, exudates, and microaneurysms were found to be 87.23%, 83.57%, 86.75%, and 54.94%, respectively. ● CONCLUSION: The proposed algorithm demonstrates intelligent detection of DR lesions in ultra-widefield SLO, providing significant advantages over traditional fundus color imaging intelligent diagnosis algorithms.
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Abstract:
AIM: To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume (MPV), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and the presence and severity of diabetic retinopathy (DR). METHODS: We searched for eligible studies from PubMed, EMBASE, Web of Science and CNKI up to December 13, 2017. Standardized mean difference (SMD) calculated with confidence interval (CI) of 95% was used to estimate the values of those indices. RESULTS: A total of 31 studies were included in the present Meta-analysis. As compared with type 2 diabetes mellitus (T2DM) patients without DR, the values of MPV, PDW, NLR, and PLR were higher in patients with DR (SMD=0.67; 95%CI: 0.36 to 0.98; SMD=0.51; 95%CI: 0.27 to 0.75; SMD=0.77; 95%CI: 0.49 to 1.05 and SMD=1.18; 95%CI: 0.07 to 2.28). Additionally, it was also observed that MPV was closely correlated with the severity of DR. CONCLUSION: MPV, PDW, NLR, and PLR could be recommended as diagnostic biomarkers for DR, and MPV could be applied to assess the severity of DR.
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Arshad Ali Lodhi, Sameen Afzal Junejo, Mahtab Alam Khanzada, Imran Akram Sahaf, Zahid Kamal Siddique
Abstract:
AIM: To evaluate the surgical outcome of congenital upper eyelid coloboma repair. · METHODS: All patients underwent complete ophthalmic and general examination before going to surgery, and then examination under anesthesia was performed to assess the site and size of eyelid defect, conjunctival involvement. The status of cornea and ocular motility with forced duction test was also being noted. The surgical procedure was performed according to the size of defect. · RESULTS: Out of 21 cases of congenital upper eyelid coloboma, 18 occurred in isolation with upper eyelid medial defect, 13 were bilateral and 5 were unilateral. Others were associated with Goldenhar syndrome and CHARGE syndrome with bilateral upper lid medial defects. All patients were presented for surgical corrections during age of 2.5-4.0 years except one that presented at 25 years of age. Cosmetically surgical results were acceptable, except one that was already presented with opaque corneal. · CONCLUSION: In this study, overall surgical results were satisfactory except one that was presented late with compromised cornea.
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Veronica E. Giordano, Sergio E. Hernandez-Da Mota, Tania N. Adabache-Guel, Armando Castillejos-Chevez, Sonia Corredor-Casas, Samantha M. Salinas-Longoria, Rafael Romero-Vera, Juan M. Jimenez-Sierra, Jose L. Guerrero-Naranjo, Virgilio Morales-Canton
Abstract:
AIM: To determine whether different intravitreal doses of quinupristin/dalfopristin lead to electroretinographic or histological changes in the rabbit retina over one month period after injection. METHODS: Eighteen New Zealand white rabbits were divided into three treatment groups (groups 1 to 3) and different intravitreal doses of quinupristin/dalfopristin were tested in each group. The right eye was injected with the drug and the left eye received intravitreal injection of 5% dextrose water and served as control eye. The doses delivered to each group were 0.1 mg/0.1 mL, 1 mg/0.1 mL and 10 mg/0.1 mL. Simultaneous, bilateral, dark-adapted electroretinography and clinical images of both eyes were obtained in all groups before injection (baseline) and after 7, 14, 21 and 28d, followed by enucleation for histological examination. RESULTS: Subjects in the group 1 showed no signs of toxicity in the electroretinogram when compared with groups 2 and 3 (Kruskall-Wallis test, P=0.000). By day 7, no electrical response to light stimuli was recorded in the treated eyes in groups 2 and 3, consistent with severe damage due to retinal toxicity. Light microscopy revealed no significant histopathological changes in the group 1, while rabbits in groups 2 and 3 had signs of granulomatous inflammation in most cases. CONCLUSION: Intravitreal 0.1 mg/0.1 mL doses of quinupristin/dalfopristin do not lead to electroretinographic or histological signs of retinal toxicity compared with 1 mg/0.1 mL and 10 mg/0.1 mL in this rabbit model.
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Anteneh Amsalu, Kindie Desta, Demiss Nigussie, Demoze Delelegne
Abstract:
AIM: To assess the pattern of ocular manifestation and associated factors among human immunodeficiency virus (HIV) /acquired immunodeficiency syndrome (AIDS) patients on highly active antiretroviral therapy (HAART) at Hawassa University Referral Hospital, Southern Ethiopia. METHODS: A cross sectional study was conducted from January 2014 to April 2015. After obtaining informed written consent, 240 adult HIV/AIDS patients on HAART were randomly selected regardless of their ophthalmic symptoms, WHO status or CD4 count. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 20.0 software. RESULTS: The mean duration of HAART was 62.5mo. The prevalence of HIV related ocular manifestation was 14.2%. Seborrheic blepharitis (5%) was the most common ocular manifestation, followed by squamoid conjunctival growth (3.8%). The rate of ocular manifestation was significantly higher among study participants who had CD4+ count <200 cells/μL (AOR=3.83; 95%CI: 1.315-11.153), low duration of HAART (AOR=3.0; 95%CI: 1.305-6.891) and who had primary school education [odds ratio (OR) =2.8; 95%CI: 1.105-7.099]. Prevalence of visual impairment and blindness was 10.9% and 5.8%, respectively. CONCLUSION: HAART may be the reason for the decline in the prevalence of ocular manifestation in HIV/AIDS patients in the study area. Ophthalmologic screening of HIV/AIDS patients, especially those with CD4 counts of <200/μL cells and in the first five years of HAART follow-up is recommended to reduce visual impairment and/or blindness.
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Zhi-Chun Zhao, Ying Zhou, Gang Tan, Juan Li
Abstract:
In recent years, people have become increasingly attentive to light pollution influences on their eyes. In the visible spectrum, short-wave blue light with wavelength between 415 nm and 455 nm is closely related to eye light damage. This high energy blue light passes through the cornea and lens to the retina causing diseases such as dry eye, cataract, age-related macular degeneration, even stimulating the brain, inhibiting melatonin secretion, and enhancing adrenocortical hormone production, which will destroy the hormonal balance and directly affect sleep quality. Therefore, the effect of Blu-rays on ocular is becoming an important concern for the future. We describe blue light’s effects on eye tissues, summarize the research on eye injury and its physical prevention and medical treatment.
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Ji Jin, Lei Chen, Gao-Qin Liu, Pei-Rong Lu
Abstract:
AIM: To analyze the retinal proteomes with and without conbercept treatments in mice with oxygen-induced retinopathy (OIR) and identify proteins involved in the molecular mechanisms mediated by conbercept. METHODS: OIR was induced in fifty-six C57BL/6J mouse pups and randomly divided into four groups. Group 1: Normal17 (n=7), mice without OIR and treated with normal air. Group 2: OIR12/EXP1 (n=14), mice received 75% oxygen from postnatal day (P) 7 to 12. Group 3: OIR17/Control (n=14), mice received 75% oxygen from P7 to P12 and then normal air to P17. Group 4: Lang17/EXP2 (n=21), mice received 75% oxygen from P7 to P12 with intravitreal injection of 1 μL conbercept at the concentration of 10 mg/mL at P12, and then normal air from P12 to P17. Liquid Chromatography-Mass Spectrometry (LC-MS)/MS data were reviewed to find proteins that were up-regulated after the conbercept treatment. Gene ontology (GO) analysis was performed of conbercept-mediated changes in proteins involved in single-organism processes, biological regulation, cellular processes, immune responses, metabolic processes, locomotion and multiple-organism processes. RESULTS: Conbercept induced a reversal of hypoxia-inducible factor 1 signaling pathway as revealed by the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and also induced down-regulation of proteins involved in blood coagulation and fibrin clot formation as demonstrated by the Database for Annotation, Visualization and Integrated Discovery (DAVID) and the stimulation of interferon genes studies. These appear to be risk factors of retinal fibrosis. Additional conbercept-specific fibrosis risk factors were also identified and may serve as therapeutic targets for fibrosis. CONCLUSION: Our studies reveal that many novel proteins are differentially regulated by conbercept. The new insights may warrant a valuable resource for conbercept treatment.
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Xi-Teng Chen, Hui Huang, Yan-Hua Chen, Li-Jie Dong, Xiao-Rong Li, Xiao-Min Zhang
Abstract:
AIM:To identify the genetic defects in a Chinese family with achromatopsia.METHODS:A 2.5-year-old boy, who displayed nystagmus, photophobia, and hyperopia since early infancy, was clinically evaluated. To further confirm and localize the causative mutations in this family, targeted region capture and next-generation sequencing of candidate genes, such as CNGA3, CNGB3, GNAT2, PDE6C, and PDE6H were performed using a custom-made capture array.RESULTS:Slit-lamp examination showed no specific findings in the anterior segments. The optic discs and maculae were normal on fundoscopy. The unaffected family members reported no ocular complaints. Clinical signs and symptoms were consistent with a clinical impression of autosomal recessive achromatopsia. The results of sequence analysis revealed two novel missense mutations in CNGA3, c.633T>A (p.D211E) and c.1006G>T (p.V336F), with an autosomal recessive mode of inheritance.CONCLUSION: Genetic analysis of a Chinese family confirmed the clinical diagnosis of achromatopsia. Two novel mutations were identified in CNGA3, which extended the mutation spectrum of this disorder.
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Abstract:
Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today’s world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician’s responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of optical coherence tomography, frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.
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Ping-Ting Zhao, Ling-Jun Zhang, Hui Shao, Ling-Ling Bai, Bo Yu, Chang Su, Li-Jie Dong, Xun Liu, Xiao-Rong Li, Xiao-Min Zhang
Abstract:
AIM: To test the therapeutic effects of delayed treatment of mesenchymal stem cells (MSCs) in recurrent experimental autoimmune uveitis (rEAU). METHODS: The efficacy of different regimens of MSC administration in rEAU were tested by evaluation of clinical and pathological intraocular inflammation, as well as retinal structural and functional integrity using optical coherence tomography (OCT) and electroretinogram (ERG). The retinal sections were also immunostained with antibodies to glial fibrillary acidic protein (GFAP) and rhodopsin (RHO). RESULTS: Delayed treatment of MSCs effectively alleviated the severity of intraocular inflammation with relative intact of outer retinal structure and function. Moreover, double therapies with longer interval led to an even better clinical evaluation, as well as a trend of decrease in relapse and amelioration of retinal function. MSC therapies also effectively reduced GFAP expression and increased RHO expression in the retina. CONCLUSION: MSC administration can effectively treat developed diseases of rEAU, and multiple therapies can provide additional therapeutic benefits.
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Li-Fei Yuan, Guang-Da Li, Xin-Jun Ren, Hong Nian, Xiao-Rong Li, Xiao-Min Zhang
Abstract:
AIM:To determine the effects of rapamycin on experimental autoimmune uveoretinitis (EAU) and investigate of role of rapamycin on T cell subsets in the disease. METHODS:EAU was induced in rats using peptides 1169 to 1191 of the interphotoreceptor binding protein (IRBP). Rapamycin (0.2 mg/kg/d) was administrated by intraperitoneal injection for a consecutive 7d after immunization. Th1/Th2/Th17 cytokines, TGF-β1, and IL-6 produced by lymphocyteswere measured by ELISA, while Th17 cells and CD4+CD25+ regulatory T cells (Tregs) from rat spleen were detected by flow cytometry. RESULTS: Intraperitoneal treatment immediately after immunization dramatically ameliorated the clinical course of EAU. Clinical responses were associated with reduced retinal inflammatory cell infiltration and tissue destruction. Rapamycin induced suppression of Th1/Th2/Th17 cytokines, including IFN-γ, IL-2, IL-17, IL-4, and IL-10 release from T lymphocytes of EAU rats, in vitro. Rapamycin also significantly increased TGF-β1 production but had no effect on IL-6 productionof T lymphocytes from EAU rats in vitro. Furthermore, rapamycin decreased the ratio of Th17 cells/CD4+T cells and upregulated Tregs in EAU, as detected by flow cytometry. CONCLUSION: Rapamycin effectively interferes with T cell mediated autoimmune uveitis by inhibiting antigen-specific T cell functions and enhancing Tregs in EAU. Rapamycin is a promising new alternative as an adjunct corticosteroid-sparing agent for treating uveitis.
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Abstract:
AIM: To report various ocular lesions caused by accidental instillation of superglue.METHODS: Three cases of ocular injuries are described in children aged 6 years, 3 years and 8 months, following accidental instillation of superglue in the eye.RESULTS: In the first case there was sticking of eyelashes in the medial 1/3 of eyelids in both eyes. In the second case sticking of eye lashes was present in the lateral 1/3 of eyelids in the left eye. In the third case, superglue was present on the right cheek, above the right ear and sticking of eyelids in medial 1/3 in right eye. The eyelids were separated by pulling the lid margins with fingers in the first case and later on superglue was removed by trimming the eyelashes; and by direct trimming the eyelashes in second and third cases. There was no injury to other structures of anterior segment in the first two cases. However, removal of the superglue on the cornea resulted in corneal abrasion in the third case which healed with medical treatment and patching of the right eye.CONCLUSION: Accidental instillation of superglue is possible because of the appearance of the tube like eye ointment tube. Immediate medical aid will prevent ocular morbidity.
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Yang-Qing Huang, He Huang, Rong-Zhi Huang
Abstract:
AIM:To introduce a new near-vision chart for children aged 3-5 years old and its clinical applications.METHODS:The new near-vision chart which combined the Bailey-Lovie layout with a newly devised set of symmetry symbols was designed based on Weber-Fechner law. It consists of 15 rows of symmetry symbols, corresponding to a visual acuity range from 1.3 to 0.1 logMAR. The optotypes were red against a white background and were specially shaped four basic geometric symbols:circle, square, triangle，and cross, which matched the preschool children''s cognitive level. A regular geometric progression of the optotype sizes and distribution was employed to arrange in 15 lines. The progression rate of the optotype size between two lines was 1.2589 and two smaller groups of optotypes ranging from 0.7 to -0.1 logMAR were included for repetitive testing. A near visual acuity was recorded in logMAR or decimal, and the testing distance was 25 cm.RESULTS:This new near-vision chart with pediatric acuity test optotypes which consists of 4 different symbols (triangle, square, cross, and circle) met the national and international eye chart design guidelines. When performing the near visual acuity assessment in preschoolers (3-5 years old). It overcame an inability to recognize the letters of the alphabet and difficulties in designating the direction of black abstract symbols such as the tumbling ''E'' or Landolt ''C'', which the subjects were prone to lose interest in. Near vision may be recorded in different notations:decimal acuity and logMAR. These two notations can be easily converted each other in the new near-vision chart. The measurements of this new chart not only showed a significant correlation and a good consistency with the Chinese national standard logarithmic near-vision chart (r=0.932, P<0.01), but also indicated good test-retest reliability (89% of retest scores were within 0.1 logMAR units of the initial test score) and a high response rate.CONCLUSION:The results of this study support the validity and reliability of near visual acuity measurements using the new near-vision chart in children aged 3-5y over a wide range of visual acuities, and the new eye chart was especially suitable for the detection of amblyopia risk factors and low vision examination in children (3-5y of age). It can be applied in routine clinical practice.
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Ali Ihsan Incesu, Güng?r Sobac?
Abstract:
Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today's world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician's responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of OCT (optical coherence tomography), frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.
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Blake F. Webb, Jadon R. Webb, Mary C. Schroeder, Carol S. North
Abstract:
AIM: To estimate the prevalence and risk factors for vitreous floaters in the general population.METHODS: An electronic survey was administered through a smartphone app asking various demographic and health questions, including whether users experience floaters in their field of vision. Multivariate logistic regression analysis was used to determine risk factors.RESULTS:A total of 603 individuals completed the survey, with 76% reporting that they see floaters, and 33% reporting that floaters caused noticeable impairment in vision. Myopes were 3.5 times more likely (P=0.0004), and hyperopes 4.4 times more likely (P=0.0069) to report moderate to severe floaters compared to those with normal vision. Floater prevalence was not significantly affected by respondent age, race, gender, and eye color.CONCLUSION:Vitreous floaters were found to be a very common phenomenon in this non-clinical general population sample, and more likely to be impairing in myopes and hyperopes.
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Bora Yüksel, Sultan Kaya ünsal, Sevgi Onat
Abstract:
AIM: To compare the efficiency and safety of fibrin glue to suture technique in pterygium surgery performed with limbal autograft. METHODS: A prospective randomised clinical trial was carried out in 58 eyes of 58 patients operated for primary nasal pterygium. Autologous conjunctival graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision. In 29 eyes, the transplant was attached to the sclera with a fibrin tissue adhesive (Beriplast P) and in 29 eyes with 8-0 Virgin silk sutures. The Mann-Whitney U test was used for statistical analysis. Postoperative patient discomfort (pain, stinging, watering) and biomicroscopic findings (hyperemia, edema) were graded. Patients were followed up at least for six months. RESULTS: Subconjunctival hemorrhage occured under the graft in one patient in group 1. In seven cases of group 2, sutures were removed at the 15th day because of granulomatous tissue reaction. Patient symptoms were significantly less and biomicroscopic findings were better in group 1. Pterygium recurrence was seen in one case of group 1, and 2 cases of group 2. Average surgery cost was higher (P<0.05) and surgery time was shorter (P<0.05) in fibrin group. CONCLUSION: Using fibrin glue for graft fixation in pterygium surgery causes significantly less postoperative pain and shortens surgery time significantly.
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Abstract:
Photobiomodulation (PBM), also known as low level laser therapy, has recently risen to the attention of the ophthalmology community as a promising new approach to treat a variety of retinal conditions including age-related macular degeneration, retinopathy of prematurity, diabetic retinopathy, Leber’s hereditary optic neuropathy, amblyopia, methanol-induced retinal damage, and possibly others. This review evaluates the existing research pertaining to PBM applications in the retina, with a focus on the mechanisms of action and clinical outcomes. All available literature until April 2015 was reviewed using PubMed and the following keywords: “photobiomodulation AND retina”, “low level light therapy AND retina”, “low level laser therapy AND retina”, and “FR/NIR therapy AND retina”. In addition, the relevant references listed within the papers identified through PubMed were incorporated. The literature supports the conclusion that the low-cost and non-invasive nature of PBM, coupled with the first promising clinical reports and the numerous preclinical-studies in animal models, make PBM well-poised to become an important player in the treatment of a wide range of retinal disorders. Nevertheless, large-scale clinical trials will be necessary to establish the PBM therapeutic ranges for the various retinal diseases, as well as to gain a deeper understanding of its mechanisms of action.
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Wen-Bin Huang, Qian Fan, Xiu-Lan Zhang
Abstract:
Glaucoma is one of the leading causes of visual impairment and blindness. Improved knowledge of the pathogenesis of this disease has allowed the exploration of new therapeutic methods. In general, elevated intraocular pressure (IOP), oxidative stress, and vascular insufficiency are accepted as the major risk factors for the progression of glaucoma. Many natural compounds have been found beneficial for glaucoma. Nutritional therapies are now emerging as potentially effective in glaucomatous therapy. One nutritional supplement with potential therapeutic value is cod liver oil, a dietary supplement that contains vitamin A and omega-3 polyunsaturated fatty acids (PUFAs). Vitamin A is important for preserving normal vision and it is a well-known antioxidant that prevents the oxidative damage that contributes to the etiology and progression of glaucoma. Vitamin A is also a crucial factor for maintaining the integrity of conjunctival and corneal ocular surfaces, and preventing the impairment of ocular epithelium caused by topical antiglaucomatous drugs. Omega-3 fatty acids are beneficial for glaucoma patients as they decrease IOP, increase ocular blood flow, and improve optic neuroprotective function. In this article, we propose that cod liver oil, as a combination of vitamin A and omega-3 fatty acids, should be beneficial for the treatment of glaucoma. However, further studies are needed to explore the relationship between cod liver oil and glaucoma.
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Jun Yi, Jun Yun, Zhi-Kui Li, Chang-Tai Xu, Bo-Rong Pan
Abstract:
· Congenital cataract is a crystallin severe blinding disease and genetic factors in disease development are important. Crystallin growth is under a combination of genes and their products in time and space to complete the coordination role of the guidance. Congenital cataract-related genes, included crystallin protein gene (CRYAA, CRYAB, CRYBA1/A3, CRYBA4, CRYBB1, CRYBB2, CRYBB3, CRYGC, CRYGD, CRYGS), gap junction channel protein gene (GJA1, GJA3, GJA8), membrane protein gene (GJA3, GJA8, MIP, LIM2), cytoskeletal protein gene (BF-SP2), transcription factor genes (HSF4, MAF, PITX3, PAX6), ferritin light chain gene (FTL), fibroblast growth factor (FGF) and so on. Currently, there are about 39 genetic loci isolated to which primary cataracts have been mapped, although the number is constantly increasing and depends to some extent on definition. We summarized the recent advances on epidemiology and genetic locations of congenital cataract in this review.
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Juan-Juan Li, Yun-Peng Li, Zhu-Lin Hu
Abstract:
We describe the successful treatment in a patient with bilateral congenital aniridia and cataract by insertion of capsular tension rings and IOL.
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Abstract:
AIM: To compare the efficacy for preventing exposure keratopathy of three forms of eye care (artificial tear, moist chamber and polyethylene covers) for intensive care patients. METHODS: Eighty-four patients in Intensive Care Unit (ICU) were randomized to three treatment groups, including artificial tears group, moist chambers group and polyethylene film group. Patients of artificial tear group received two drops of carboxymethylcellulose drops to each eye every 2 hours. The moist chambers and the polyethylene were changed every 12 hours or as needed if they became unclean or torn. The corneal fluorescein stains were performed daily. RESULTS: No of 28 patients (0%) in the polyethylene group and one of the 27 patients (3.70%) in the moist chamber group had exposure keratopathy, compared to 8 of the 29 patients (27.59%) in the artificial tear group. There were statistical significance between the artificial tear group and the moist chamber group (P=0.02), and the artificial tear group and the polyethylene group (P =0.003). The time on eye care every day of the artificial tear group, the moist chamber group and the polyethylene group was 26.69±2.39 minutes, 35.33±2.63 minutes and 7.48±0.87 minutes, respectively. The eye care of the polyethylene group were statistically more time-save than that of the artificial tear group (P<0.001) and the moist chamber group (P<0.001). CONCLUSION: Polyethylene covers are more effective and more time-saving in reducing the incidence of corneal damage in intensive care patients
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