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. IJO’s JCR IF in 2023 is 1.9, Five-year Impact Factor is 1.8, CiteScore in 2023 is 2.5. IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication and accept contribations from all over the world, both basic and Chinical research.
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Yue-Qi Yuan, Xing-Yuan Yan, Fang Zheng, Ming Yan
2025(2):199-208, DOI: 10.18240/ijo.2025.02.01
Abstract:
AIM: To explore the effect of co-host non-coding RNA (ncRNA) MIR503HG/miR-503-5p on the angiogenesis of pterygium. METHODS: MIR503HG/miR-503-5p/fibroblast growth factor 2 (FGF2) expression levels in pterygium tissues, control conjunctival tissues, and human pterygium fibroblasts (HPF) were examined by reverse transcription-polymerase chain reaction (qRT-PCR) and immunohistochemical methods. Effects of MIR503HG/miR-503-5p on low molecular weight FGF2 (LWM FGF2), migration and angiogenesis of human retinal microvascular endothelial cells (HRMEC) were determined in an HPF and HRMEC co-culture model using Western blots, wound healing assay, Matrigel-based tube formation assay, and Transwell assay. RESULTS: MIR503HG/miR-503-5p/FGF2 pathway was actively increased in pterygium tissue and there was a negative correlation between the expression of the two ncRNAs. FGF2 expression level was positively correlated with MIR503HG and negatively correlated with miR-503-5p. Overexpressed MIR503HG/miR-503-5p did not affect the migration and angiogenesis of HRMECs cultured separately, but significantly affected migration and angiogenesis of HRMEC in HPF and HRMEC co-culture models. Western blotting revealed that MIR503HG/miR-503-5p overexpression significantly increased LMW FGF2 expression in HPF. CONCLUSION: MIR503HG/miR-503-5p inhibits HRMEC migration and angiogenic function by interfering with the interaction between HPF and endothelial cells via reducing LMW FGF2 in HPF.
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Meng-Xi Li, Zhen Zhang, Yue Zhang, Fan-Ru Zhao, Yu-Fan Li, Yu-Fei Dang, Yang-Yang Yue, Li Li
2025(2):209-215, DOI: 10.18240/ijo.2025.02.02
Abstract:
AIM: To investigate the effect of skullcapflavone II (SCF-II) on the epithelial-mesenchymal transition (EMT) induced by transforming growth factor beta (TGF-β) in human corneal epithelial cells (HCECs), as well as to identify the signaling pathways that may be involved. METHODS: HCECs were cultured in vitro. At a SCF-II (5, 10 µmol/L) dose, cell viability was analysed with a cell counting kit-8 (CCK-8) assay, and cell migration was monitored with wound healing and Transwell migration assays. There were 4 groups: SCF-II, TGF-β, SCF-II+TGF-β and Control. Western blotting and immunofluorescence were performed to show the expression of EMT markers and the translocation of nuclear factor kappa-B (NF-κB) into the nucleus in the 4 groups. RESULTS: Treatment with SCF-II decreased HCEC viability in a dose-dependent manner. A concentration below 10 µmol/L did not present obvious cell toxicity, and survival rates were more than 70% at 48h. Treatment with SCF-II (5 and 10 µmol/L) significantly impeded migration in wound healing and Transwell migration assays (P<0.05), and EMT markers and NF-κB translocation into the nucleus were inhibited. After both TGF-β and SCF-II treatment, the migration of TGF-β-treated HCECs were suppressed by SCF-II (P<0.05). The expression levels of the mesenchymal markers N-cadherin (P<0.05), α-smooth muscle actin (α-SMA; P<0.05) and NF-κB (P<0.05) in both TGF-β- and SCF-II-treated HCECs were lower than those in the HCECs treated with TGF-β alone and higher than those in HCECs treated with SCF-II alone. Immunofluorescence showed that the entry of NF-κB into the nucleus in both TGF-β- and SCF-II-treated HCECs was less than that in the TGF-β-treated HCECs. CONCLUSION: SCF-II inhibit TGF-β-induced EMT in HCECs by potentially regulating the NF-κB signalling pathway. Thus, SCF-II represents a candidate putative therapeutic agent in corneal fibrotic diseases.
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Bin Wu, Xue Wang, Wei Zhang, Xin Wang, Qi-Miao Wang, Ya-Ju Pang, Yi-Chun Kong
2025(2):216-221, DOI: 10.18240/ijo.2025.02.03
Abstract:
AIM: To explore the effect and mechanism of Lycium barbarum polysaccharide (LBP) inhibiting retinal neovascularization. METHODS: In vitro tests were performed on human retinal microvascular endothelial cells (HRECs) from three groups, including control group (normal oxygen), hypoxic group (hypoxia at 37℃, 1% O2, 5% CO2, and 94% N2), and LBP group (hypoxic group with LBP 100 μg/mL). In vivo experiments, C57 mice were divided into three groups: control group (normal rearing group), the oxygen-induced ischemic retinopathy (OIR) group, and the OIR with 50 mg/kg LBP group. Retinal neovascularization was observed by fluorescein angiography and quantified. Retinal thickness was evaluated by Hematoxylin and eosin (HE) stain. The expression of epidermal growth factor receptor (EGFR), phosphatidylinositol 3-kinase (PI3K), mammalian target of rapamycin (mTOR), phosphorylated mammalian target of rapamycin (p-mTOR), protein kinase B (AKT), phosphorylated protein kinase B (p-AKT), interleukin-1β (IL-1β), inducible nitric oxide synthase (iNOS), and tumor necrosis factor-α (TNF-α) in each group were analyzed by Western blot. IL-1β level in retina was analyzed using immunohistochemical staining. RESULTS: The increased area of neovascular clusters in OIR mice was significantly decreased by LBP. Retinal thickness of OIR mice was significantly thinner compared with normal oxygenated mice and was increased in LBP group. Compared with those in the hypoxic groups, Western blotting of HRECs and retinal tissues revealed that the expression of EGFR, PI3K, p-mTOR, p-AKT, IL-1β, iNOS, and TNF-α decreased in the LBP group but was still greater than that in control group. Moreover, IL-1β was reduced in retinal sections treated with LBP. In the scratch test, the cell migration of the hypoxic group was significantly greater than that of the control group, while LBP treatment attenuated this increase in migration. CONCLUSION: LBP reduces retinal neovascularization and inflammation in vivo and inhibits the migration of HRECs in vitro by regulating the EGFR/PI3K/Akt/mTOR signaling pathway.
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Ahmet Mehmet Somuncu, Busra Parlak Somuncu, Ahmet Duhan Ozbay, Ibrahim Cicek, Bahadir Suleyman, Renad Mammadov, Seval Bulut, Tugba Bal Tastan, Taha Abdulkadir Coban, Halis Suleyman, Aliyev Aydin
2025(2):222-228, DOI: 10.18240/ijo.2025.02.04
Abstract:
AIM: To investigate the effects of adenosine triphosphate (ATP) and melatonin, which have antioxidant and anti-inflammatory activities, on potential 5-fluorouracil (5-FU)-induced optic nerve damage in rats. METHODS: Twenty-four rats were categorized into four groups of six rats: healthy (HG), 5-FU (FUG), ATP+5-FU (AFU), and melatonin+5-FU (MFU). ATP (4 mg/kg) and melatonin (10 mg/kg) were administered intraperitoneally and orally, respectively. One hour after ATP and melatonin administration, rats in the AFU, MFU, and FUG were intraperitoneally injected with 5-FU (100 mg/kg). ATP and melatonin were administered once daily for 10d. 5-FU was administered at a single dose on days 1, 3, and 5 of the experiment. After 10d, the rats were euthanized and optic nerve tissues were extracted. Optic nerve tissues were biochemically and histopathologically examined. RESULTS: ATP and melatonin treatments inhibited the increase in malondialdehyde (MDA) and interleukin-6 (IL-6) levels, which were elevated in the FUG. The treatments also prevented the decrease in total glutathione (tGSH) levels and the superoxide dismutase (SOD) and catalase (CAT) activities (P<0.001). This inhibition was higher in the ATP group than in the melatonin group (P<0.001). ATP prevented histopathological damage better than melatonin (P<0.05). CONCLUSION: ATP and melatonin have the potential to be used in alleviating 5-FU-induced optic nerve damage. In addition, ATP treatment shows better protective effects than melatonin.
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Xu Li, Ping Hou, Xiao-Lin Qi, Su-Xia Li, Wei-Yun Shi, Hua Gao, Ting Zhang
2025(2):229-236, DOI: 10.18240/ijo.2025.02.05
Abstract:
AIM: To investigate the clinical signs of blepharokeratoconjunctivitis (BKC) and evaluate the efficacy of penetrating keratoplasty (PKP) for the disease. METHODS: Sixteen patients (16 eyes) with BKC complicated by corneal perforation hospitalised at Shandong Eye Hospital were retrospectively analyzed. All patients received PKP. Participants were assessed for symptoms, clinical manifestations, the activity and damage grading of BKC. A paired t-test was used to compare the uncorrected visual acuity (UCVA) before and after surgery for the perforated eye. RESULTS: The mean age of the patients was 16.3y. Blurred vision is the most common discomfort, followed by redness, and then photophobia. The duration of ocular discomfort lasted for 3.2y, on average. Three (18.8%) participants were associated with rosacea, while 11 (68.8%) patients had recurrent chalazion or hordeolum. Demodex in eyelash follicles was positive in 11 (68.8%) cases. All corneal perforations were ≤3.0 mm in diameter. The perforation was located mainly in the inferior cornea (68.8%). The mean area of corneal vascularisation was 3.0 quadrants. All patients manifested bilateral BKC, with the perforated eyes ranked as severely damaged and presenting with severe inflammation. Most contralateral eyes manifested mild damage with no active inflammation. Majority (68.8%) of the perforated eyes were treated with PKP using a minimal graft. The UCVA increased significantly at the final follow-up (mean, 21mo; P<0.001), with the manifestation of BKC alleviated greatly. None of the patients developed immune rejection or other serious complications. CONCLUSION: BKC combined with corneal perforation occurs mainly among young people with a long history of ocular discomfort. PKP, especially using a minimal graft, is an effective and safe option for treating the disease.
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Tian-Yao Zhao, Yu-Chen Wang, Ying-Juan Sun, Jun-Yue Wang, Xiao-Dan Jiang, Xue-Min Li, Ai-Hua Deng
2025(2):237-243, DOI: 10.18240/ijo.2025.02.06
Abstract:
AIM: To isolate and identify the conjunctival microbiota of cataract patients and analyze the associated influencing factors. METHODS: This study recruited 216 participants (216 eyes) from April 2022 to July 2022. Under the condition of no antibiotic use prior to cataract surgery, sterile swabs were used to collect samples from the lower conjunctival sac. Bacterial cultures were then conducted, followed by species identification through 16S rDNA gene sequencing. Clinical factors associated with positive or negative bacterial isolation rates were analyzed, including age, gender, meibomian gland dysfunction (MGD), history of hypertension, history of diabetes, history of cancer, history of infectious diseases and the habit of wearing masks. RESULTS: Among the 216 eyes, 78 eyes yielded isolates, with an isolation rate of 36.11%, detecting a total of 122 strains. Gram-positive rods accounted for 49.18% (60 strains), gram-positive cocci accounted for 45.08% (55 strains), gram-negative bacteria accounted for 4.92% (6 strains), and fungi accounted for 0.82% (1 strain). This study found that the most abundant genera in the conjunctival sac were Corynebacterium (42.62%), Staphylococcus (31.15%), Micrococcus (9.84%), Acinetobacter (4.10%), and Bacillus (3.28%). Furthermore, age (P=0.006), gender (P=0.039), diabetes (P=0.003), history of infectious diseases (P=0.02), and duration of mask replacement (P<0.001) were important factors influencing the positive bacterial culture of the conjunctival microbiota. Although hypertensive patients exhibited a higher isolation rate of conjunctival bacteria, it did not reach statistical significance, and the history of cancer did not affect the isolation rate of the conjunctival microbial community in cataract patients before surgery. CONCLUSION: Potential changes are observed in the conjunctival microbiota among a sample of middle-aged and elderly individuals from Beijing, China. Notably, an increased isolation rate of Corynebacterium and Micrococcus is detected, suggesting a possible change in the microbial balance that requires further investigation and attention from the ophthalmological community. Advanced age, female gender, MGD, diabetes, a recent history of infectious diseases, and inadequate mask-wearing habits are potentially significant factors associated with the conjunctival microbiota. These factors should be considered in the development of strategies to prevent perioperative infections in cataract surgery patients.
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Ying-Jie Ma, Guang-Ming Zhou, Zhi-Rong Liu, Jin-Fei Wei, Xin-Yu Li, Bin Dong, Lin-Juan Wu, Wen-Can Wu, Bo Yu
2025(2):244-250, DOI: 10.18240/ijo.2025.02.07
Abstract:
AIM: To investigate the clinical profile of patients with acquired lacrimal sac mucocele (ALSM) and evaluate the efficacy of endoscopic dacryocystorhinostomy (En-DCR) for this condition. METHODS: En-DCRs were performed on 141 patients with ALSM patients from January 2016 to March 2022. The clinical baseline information and magnetic resonance imaging (MRI) images were recorded and summarized. To assess the effectiveness of En-DCR therapy, both anatomical and functional success rate was assessed during a 12mo follow-up. RESULTS: A total of 141 patients, with a mean age of 57.70±14.11y, were enrolled in this study. Majority of the patients were female (n=91; 64.54%) and all had unilateral disease. All patients had a previous history of epiphora and purulent secretion, and the duration from lacrimal duct obstruction to mucocele formation ranged from 6 to 120mo. MRI findings consistently revealed an enlarged sac diameter, fluid accumulation separated by a thin rim from adjacent tissues, which is indicative of lacrimal sac mucocele. En-DCR was performed with an anatomical success rate of 93.62% and a functional success rate of 81.56%. CONCLUSION: ALSM is more commonly seen in females and unilaterally. It is essentially a complication of lacrimal duct obstruction. MRI characteristics can be used for precise clinical diagnosis, while En-DCR emerges as an optimal therapy for this condition. Our results provide a comprehensive reference for the diagnosis and treatment of ALSM.
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Xin-Han Cui, Yan-Wen Fang, Li-Min Zhang, Ji-Ni Qiu, Chao-Ran Zhang, Yan Wang
2025(2):251-257, DOI: 10.18240/ijo.2025.02.08
Abstract:
AIM: To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy (EN-DCR). METHODS: This retrospective comparative study involved 118 sides with complete nasolacrimal duct obstruction and 83 unaffected sides from 126 patients. Computed tomographic-dacryocystography (CT-DCG) scans were performed before lacrimal surgery, and image reconstruction was used to obtain continuous 0.75-mm axial, coronal, and segmental sections for review. The morphology of the lacrimal sac and its relationship with adjacent bony structures were determined for measurement, as well as the obstructed location. RESULTS: The height of the lacrimal sac was 12.99±2.10 mm in this study. The operculum of the middle turbinate (OMT) was located vertically in the lower third of the lacrimal sac. Horizontally, the junction between the maxillary bone and the lacrimal bone (MB-LB) was close to, mostly (60.2%) posterior to, the lacrimal sac. The uncinate process was more frequently attached to the lacrimal bones (75.1%). The obstructions were generally located around the entrance of the nasolacrimal duct (NLD). However, some were placed higher, with 7.63% blocked not lower than the OMT. There was a negative correlation between the diameter of the lacrimal sac and the level of obstruction (r= -0.35, P<0.01). CONCLUSION: In this study, the OMT and MB-LB can be served as the landmarks in EN-DCR. Partial uncinectomy should be performed in most cases. The obstructions were generally located around the entrance of the NLD, but some extreme individual variations strongly implies the importance of CT-DCG scanning before surgery.
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Li-Jun Ji, Jin-Yu Hu, Yan-Mei Zeng, Qian Ling, Jie Zou, Cheng Chen, Liang-Qi He, Xiao-Yu Wang, Hong Wei, Xu Chen, Yi-Xin Wang, Yi Shao, Yao Yu
2025(2):258-267, DOI: 10.18240/ijo.2025.02.09
Abstract:
AIM: To elucidate the neuropathological mechanisms underlying diabetic vitreous hemorrhage (DVH) and its correlation with clinical characteristics. METHODS: Twenty-one individuals with DVH (male/female 12/9; mean age 52.29±11.66y) were selected, alongside 21 appropriately matched controls with diabetes mellitus (DM). Voxel-based morphometry (VBM) techniques were employed to identify aberrant functional regions in the brain. Receiver operating characteristic (ROC) curves were utilized for classification based on the average VBM values of the two groups, and Pearson correlation analysis was conducted to assess the relationship between average VBM values in distinct brain regions and clinical manifestations. RESULTS: Relative to the DM controls, DVH patients exhibited reduced VBM values in the right superior temporal pole, the right superior temporal gyrus, the right medial orbital frontal gyrus, and the left superior frontal gyrus. Furthermore, ROC curve analysis of these four brain regions in DVH patients demonstrated a high degree of accuracy, as indicated by the area under the curve. The average VBM value in each of these regions exhibited a negative correlation with both the duration of DVH and the score on the Hospital Anxiety and Depression Scale (HADS). CONCLUSION: Pathological alterations in four distinct brain regions are observed in patients with DVH, potentially reflecting neuropathological changes associated with this condition.
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Lin Fu, Jiang-Tao Lou, Yue Guo, Pei-Juan Wang, Rong-Rong Le, Shu-Xia Xu, Guo-Xing Li, Yuan-Bo Liang
2025(2):268-274, DOI: 10.18240/ijo.2025.02.10
Abstract:
AIM: To report the one-year surgical outcome Kahook Dual Blade goniotomy combined with phacoemulsification (KDB-Phaco) in Chinese patients with primary open angle glaucoma (POAG). METHODS: This is a retrospective study included 43 eyes of 28 Chinese POAG patients with cataract who accepted KDB-Phaco and followed-up for 12mo. Intraocular pressure (IOP), glaucoma medications and surgical complications were recorded. Success 1 and success 2 was defined as 5-21 mm Hg and 5-18 mm Hg, and success plus was determined if additional criteria of IOP reduction ≥20% from baseline was reached. A corrected IOP by adding 3 mm Hg for each medication was used to do correlation test. Cox’s proportional hazards regression model was used to test the hazard ratio for factors associated with surgical success. RESULTS: After a 12-month follow up, the IOP decreased from 28.1±6.3 to 13.8±3.0 mm Hg (47.92% reduction, P<0.001), and the medications used decreased from 2.0 (1.0) to 0.0 (0.0) (95% reduction, P<0.001). The mean IOP of all postoperative visits were lower than preoperative IOP (all P<0.001), so as the number of glaucoma medications (all P<0.001). Complete success 1 and qualified success 1 were 87.80% and 100.00% respectively. The complete success 1 plus and qualified success 1 plus were 85.37% and 97.56%, respectively. Totally 82.93% and 90.24% of patients got complete success 2 and qualified success 2 while 80.49% and 87.80% of patients satisfied complete success 2 plus and qualified success 2 plus. Age (r=-0.511, P=0.001) and visual acuity (VA; r=-0.321, P=0.041) were negatively correlated with postoperative corrected IOP at 12mo, while anterior chamber depth (r=0.432, P=0.005), mean deviation (r=0.617, P<0.001) and visual field index (r=0.524, P<0.001) were positively correlated with it. Preoperative VA (OR=33.092, P=0.004) and MD (OR=1.481, P=0.018) were hazard factors associated with failure based on qualified success as 18 mm Hg. The main complications of KDB were hyphema (9.30%), IOP spike (11.63%) and peripheral anterior synechia (6.98%). CONCLUSION: KDB goniotomy is a safe and effective in the treatment for Chinese POAG patients. Preoperative VA and mean deviation may predict the surgical success.
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Yue Xu, Yue-Cong Yin, Ze-Yu Song, Xiao-Yu Zhou, Jia-Ju Zhang, Juan Liang
2025(2):275-282, DOI: 10.18240/ijo.2025.02.11
Abstract:
AIM: To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab (IVR) in treating macular edema (ME) secondary to retinal vein occlusion (RVO). METHODS: This retrospective study involved 65 RVO patients (65 eyes) who received IVR and were followed-up for more than 3mo. ME was categorized into cystoid macular edema (CME), diffuse retinal thickening (DRT), and serous retinal detachment (SRD) according to optical coherence tomography (OCT) images. The comparison of best corrected visual acuity (BCVA; logMAR) and central macular thickness (CMT) among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test. The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis. RESULTS: BCVA tended to improve in all groups, with marked improvement in CME and DRT groups. CMT showed the greatest reduction after 1wk, and remained stable over the following 3mo. DRT patients had the worst BCVA and the highest CMT at baseline, but the differences became smaller after IVR treatment. CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR. Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up. DRT patients were most likely to transform into the other morphological groups, while SRD patients showed minimal transitions. BCVA at baseline was identified as the most important prognostic indicator in all 3 groups. Additionally, DRT patients with a longer clinical course, higher CMT and central retinal vein occlusion (CRVO) tend to exhibit worse BCVA after treatment. In addition, CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion (BRVO) patients in CME group. SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment. CONCLUSION: The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups. Baseline parameters including clinical course, CMT, and RVO position are also useful in predicting the BCVA at different time points after treatment.
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Kazim Kiratli, Hazan Gul Kahraman, Yusuf Ziya Guven, Fahrettin Akay, Murat Aysin
2025(2):283-289, DOI: 10.18240/ijo.2025.02.12
Abstract:
AIM: To examine the subclinical alterations in the retina and choroid between patients with 2019 coronavirus disease (COVID-19)-related lung involvement and the healthy control group. METHODS: In this prospective case-control study, 85 cases with lung involvement due to COVID-19 and 50 healthy cases were included. Best-corrected visual acuity, intraocular pressure measurement, and anterior and posterior segment examination were performed on both eyes for each individual. Choroidal and retinal changes were examined and recorded by optical coherence tomography angiography. RESULTS: All choroidal thickness measurements of the COVID-19 group showed no statistically significant difference when compared to healthy individuals. When vascular density and perfusion density values were compared, there was a decrease in the average of these values in the COVID-19 group, although it was not statistically significant (P=0.088, P=0.065 respectively). When the fovea avascular zone (FAZ) area values were compared, the average was 0.57±0.38 in the COVID-19 group, while it was 0.54±0.24 in the control group. CONCLUSION: Although our data are not statistically significant, the decrease in vascularity and perfusion and the accompanying FAZ expansion are detected in the acute period (1st month). These changes may anatomically alter the retina in the long term and affect functional vision. Future ischemia-related alterations in the retina caused by a prior COVID-19 infection may arise in situations without comorbidities and may require concern in the patient’s systemic assessment.
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Parinee Kemchoknatee, Duanghathai Tangon, Thansit Srisombut
2025(2):290-296, DOI: 10.18240/ijo.2025.02.13
Abstract:
AIM: To determine the risk factors and time to non-arteric ischemic optic neuropathy (NAION) occurrence among Thai type 2 diabetes mellitus (T2DM) patients. METHODS: A retrospective review of 266 newly diagnosed T2DM cases at Rajavithi Hospital between 2007 and 2016 was conducted to determine time to occurrence of NAION and evaluate associated risk factors. RESULTS: Hypertension and dyslipidemia were the most common pre-existing vascular diseases and there was a significant male predominance in the NAION group. The mean age of the NAION group was significantly higher than that of the group without NAION. A higher proportion of subjects in the NAION group had hypertension, dyslipidemia, high diastolic blood pressure, smokers, and had a small cup-to-disc ratio (CDR). Higher levels of triglycerides and low-density lipoprotein-cholesterol in the group with NAION. Fifty-five patients among 266 participants (20.68%) developed NAION during a mean follow-up time of 81.26±25.04mo. In a multivariable logistic regression analysis, dyslipidemia (OR=8.36, 95%CI, 3.447–20.273, P<0.001), high low density lipoprotein levels (OR=1.017, 95%CI, 1.004–1.029, P=0.009), and small CDR (OR=11.92, 95%CI, 4.477–31.741, P<0.001) were significant risk factors for NAION development. Smoking was the strongest predictive risk (OR=12.843, 95%CI, 3.959–41.659, P<0.001). Vascular complications of T2DM and aspirin were not associated with NAION. CONCLUSION: T2DM patients with dyslipidemia or a small CDR should be carefully followed up as they are at increased risk of developing NAION.
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Xue-Lin Wang, Yu Chen, Jin-Yu Hu, Hong Wei, Qian Ling, Liang-Qi He, Cheng Chen, Yi-Xin Wang, Yan-Mei Zeng, Xiao-Yu Wang, Qian-Min Ge, Xu Chen, Yi Shao
2025(2):297-307, DOI: 10.18240/ijo.2025.02.14
Abstract:
AIM: To analyze whether alterations of voxel mirror homology connectivity (VMHC) values, as determined by resting-state functional magnetic resonance imaging (rs-fMRI), occur in cerebral regions of patients with hypertensive retinopathy (HR) and to determine the relationship between VMHC values and clinical characteristics in patients with HR. METHODS: Twenty-one patients with HR and 21 age-matched healthy controls (HCs) were assessed by rs-fMRI scanning. The functional connectivity between the hemispheres of the cerebrum was assessed by measuring VMHC, with the ability of VMHC to distinguish between the HR and HC groups assessed using receiver operating characteristic (ROC) curve analysis. Differences in the demographic and clinical characteristics of the HR and HC groups were analyzed by independent sample t-tests. The relationship between average VMHC in several brain areas of HR patients and clinical features was determined using Pearson correlation analysis. RESULTS: Mean VMHC values of the bilateral cuneus gyrus (BA19), bilateral middle orbitofrontal gyrus (BA47), bilateral middle temporal gyrus (BA39) and bilateral superior medial frontal gyrus (BA9) were lower in the HR than in the HC group. CONCLUSION: VMHC values can predict the development of early HR, prevent the transformation of hypertensive microangiopathy, and provide useful information explaining the changes in neural mechanism associated with HR.
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Jian-Bing Li, Wan-Ting Kong, Tao Shen, Yong-Guang Yuan, Chong-Lin Chen, Dan-Min Peng, Min-Tong Liang, Xuan He, Dan Luo, Jia-Yi Su, Wei Wang, Rui-Xin Wang, Xin-Ping Yu
2025(2):308-314, DOI: 10.18240/ijo.2025.02.15
Abstract:
AIM: To investigate the underlying factors by establishing a new paradigm for assessing control ability under stereopsis testing conditions. METHODS: This was a prospective observational study. We evaluated the control ability of intermittent exotropia (IXT) patients in three conditions: natural 2D optotype viewing, 2D optotype viewing with polarized glasses, and 3D optotype viewing with polarized glasses. Recording with a smartphone, we captured videos to analyze the accurate time of spontaneous exodeviation and subsequent realignment before and after breaking fusion. Additionally, the correlation of stereopsis were also analyzed. RESULTS: A total of 48 patients (age range: 4-33y; 54.17% male) participated in the study. When viewing 3D optotypes with polarized glasses, their median control scores were 1 (interquartile range, 0-4) at distance and 0 (0-1) at near. These scores were significantly better than those observed under natural viewing conditions, which were 2.5 (1-5) at a distance and 1 (0-3) at near (Friedman test, P=0.049). Furthermore, those subjects who exhibited exophoria (realignment within 2 seconds) while viewing 3D optotypes with polarized glasses were more likely to have measurable stereo vision (Kendall’s τb=-0.344, P=0.018). CONCLUSION: IXT patients exhibit enhanced control ability when using polarized glasses to view 3D optotypes, notably improving realignment capabilities. This expands our understanding of current tests and offers a potentially sensitive method for assessing IXT severity.
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Dong-Qing Yuan, Wei-Wei Zhang, Liu-Wei Gu, Qing-Huai Liu
2025(2):315-322, DOI: 10.18240/ijo.2025.02.16
Abstract:
AIM: To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment. METHODS: Twenty-one children with functional amblyopia, aged 5.7±2.1y (range: 4-10y), underwent comprehensive ophthalmic and refractive evaluations. Spectral domain-optical coherence tomography (SD-OCT) and multifocal electroretinography (mfERG) were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye (AE) compared to the fellow good eye (GE). RESULTS: Initially, visual acuity in the AE ranged from 20/800 to 20/40, while the GE exhibited a range of 20/25 to 20/20 (P<0.01). After 6mo of treatment, 17 patients demonstrated improved visual acuity in the AE to 20/50 or better, while 4 children showed no improvement. SD-OCT revealed comparable macular and optic disc structures between the AE and GE. Prior to treatment, the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE (P<0.05). The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment. However, a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment. CONCLUSION: In the management of functional amblyopia, a thorough assessment of amblyopic eye examinations is crucial. Approximately 20% of amblyopic eyes may not achieve significant improvement in visual acuity, despite the absence of detectable organic retinal abnormalities. mfERG may reveal underlying abnormalities. Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.
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Bin-Bin Zhu, Shi-Yu Tang, Xiang-Jun Wang, Li-Cheng Fu, Jian-Hua Yan
2025(2):323-329, DOI: 10.18240/ijo.2025.02.17
Abstract:
AIM: To investigate the potential mechanisms of A-V pattern and evaluate the surgical outcomes used in the treatment of sensory exotropia. METHODS: The medical records of patients with sensory A-V pattern exotropia who underwent strabismus surgery between May 2014 to June 2019 was retrospectively reviewed. The control group included sensory exotropia patients without A-V pattern and concomitant A-V pattern exotropia patients with normal vision who undergone strabismus surgery over this same time period. Ocular alignment, best corrected visual acuity, oblique muscle function, and stereopsis records were collected. RESULTS: Among the 843 eligible patients, 91 (10.79%; 39 males and 52 females) had A-pattern (54, 6.4%) or V-pattern (37, 4.4%). Age at onset of vision impairment was 4±5y and at the time of surgery was 25±9y. Statistically significant negative correlations were present between impaired visual acuity and the pre-operative exodeviation (r=-0.198, P=0.016) and patterns (r=-0.207, P=0.015). Age at surgery and exodeviation in patients with concomitant A-V pattern exotropia was significantly earlier as compared with that of sensory A-V pattern exotropia and sensory exotropia (both P<0.0001). There were no significant differences in these clinical variables between sensory exotropia with or without A-V pattern. Deviation and pattern were significantly reduced in patients receiving horizontal rectus surgery with or without oblique muscle surgery (both P<0.0001). CONCLUSION: The prevalence of sensory A-V pattern exotropia in our study is 10.79%. Visual acuity represents an important factor contributing to the occurrence and development of A-V pattern. Isolated horizontal rectus surgery can provide a good option for the correction of sensory A-V pattern exotropia.
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Narisa Rattanalert, Supaporn Tengtrisorn, Supawan Surukrattanaskul, Phanthipha Wongwai, Nutsuchar Wangtiraumnuay, Wadakarn Wuthisiri, Suntaree Thitiwichienlert, Warassabhorn Ployprasith, Rattiya Pornchaisuree, Piangporn Saksiriwutto, Penny Singha, Warakorn Thiamthat, Parnchat Pukrushpan, Sirinya Suwannaraj, Yutthaphong Imsuwan, Arpha Pornseth, Atchareeya Wiwatwongwana, Oracha Teerakapong, Juthathip Hiriotappa, Apatsa Lekskul, Variya Nganthavee, Poonyawee Nunthanid, Worawalun Honglertnapakul, Worapot Srimanan, Prangkhwan Jiaranaisilawong, Prapatsorn Patikulsila, Phantaraporn Tangtammaruk, Dussadee Tatritorn, Thunyaluck Jiwanarom, Jipada Pruksacholavit, Puncharut Preechaharn, La-ongsri Atchaneeyasakul, Phawasutthi Keokajee, Thammanoon Surachatkumtonekul, Pittaya Phamonvaechavan, Sorot Wutthiphan, Orapan Aryasit, Parichat Damthongsuk, Alan Frederick Geater
2025(2):330-339, DOI: 10.18240/ijo.2025.02.18
Abstract:
AIM: To evaluate the characteristics of exotropia (XT) and motor-sensory outcomes after surgical correction and to determine the factors associated with sensory outcomes of XT surgery. METHODS: The medical records of all patients that were diagnosed with XT and underwent strabismus surgery in 13 major government hospitals in Thailand; from January 2012 to December 2019, were retrospectively reviewed. Univariable and multivariable logistic regression were performed to identify factors related to binocular vision. RESULTS: Data of five hundred and thirty-seven patients were analyzed. Two hundred and twenty-six patients were men (42.1%). The median age of onset was 3 years old [Interquartile range (IQR): 1, 8]. The median age at diagnosis was 9.21 years old (IQR; 4.64, 21.06). intermittent exotropia [X(T)] was the most common type (52.1%); 19.5% of the patients had amblyopia. For refractive error, spherical equivalent refraction on right eye (RE) and left eye (LE) were -0.53±2.45 diopters (D) (range -14.88 to +10 D) and -0.48±2.37 D (range -19.50 to +7.75 D), respectively. The mean angle of deviation at distance and near before surgery were 42.06±14.91 prism diopters (PD) and 40.81±16.09 PD, respectively. Follow-up time after first operation was 2.48±2.27y. Four hundred sixty-two patients (86%) needed only one operation and 299 (55.6%) patients had bilateral lateral rectus recession. At final visit, the mean angles of deviation at distance and near decreased to 5.76±8.96 PD and 5.01±8.73 PD, respectively. After surgery, two hundred seventy-three patients (50.8%) were evaluated for binocular function, but the others did not have result. From multivariable logistic regression in 273 patients, the factors related to better binocular function were type of XT which was X(T) [adjusted odds ratio (aOR) 10.35; 95%CI: 4.73, 22.66] compared to constant XT, without amblyopia (aOR 3.97; 95%CI: 1.84, 8.53), underwent only single operation compared with more than 1 operation (aOR 3.80, 95%CI: 1.58, 9.16), the angle of deviation at near in last visit less than 10 PD better than 10–30 PD with aOR 0.42 (95%CI: 0.18, 0.96) and type of refraction revealed isometropia better than anisometropia with aOR 4.13 (95%CI: 1.19, 14.32). CONCLUSION: The surgical outcomes of XT within one operation in Thailand is 86%. The factors related to achieve binocular function includes type of XT as X(T), without amblyopia, angle of deviation at final visit less than 10 PD, isometropia type of refraction and underwent only one surgical correction.
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Fei-Fei Zong, Da-Dong Jia, Guang-Kun Huang, Meng Pan, Hao Hu, Shi-Yi Song, Liang Xiao, Ru-Weng Wang, Liang Liang
2025(2):340-350, DOI: 10.18240/ijo.2025.02.19
Abstract:
The methylation of DNA is a prevalent epigenetic modification that plays a crucial role in the pathological progression of ocular diseases. DNA methylation can regulate gene expression, thereby affecting cell function and signal transduction. Ophthalmic diseases are a kind of complex diseases, and their pathogenesis involves many factors such as genetic, environmental and individual differences. In addition, inflammation, oxidative stress and lipid metabolism, which abnormal DNA methylation is closely related to, are also considered to be major factors in eye diseases. The current understanding of DNA methylation in eye diseases is becoming more complex and comprehensive. In addition to the simple suppression of gene expression by hypermethylation, factors such as hypomethylation or demethylation, DNA methylation in non-promoter regions, interactions with other epigenetic modifications, and dynamic changes in DNA methylation must also be considered. Interestingly, although some genes are at abnormal methylation levels, their expression is not significantly changed, which indirectly reflects the complexity of gene regulation. This review aims to summarize and compare some relevant studies, and provide with new ideas and methods for the prevention and treatment of different eye diseases, such as glaucoma, retinoblastoma, and diabetic retinopathy.
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Hasan Chichan, Iftkhar Hamzah Aldujaly, Konstantinos Michalakis, Levent Kanal
2025(2):351-357, DOI: 10.18240/ijo.2025.02.20
Abstract:
Photobiomodulation has been known to have potential medicinal effects for ages. It involves the use of specific wavelengths to target specific regions in the cell. Different health conditions have been reported to be treated with exposure to light such as cardiovascular conditions, inflammatory diseases, infectious diseases, and most importantly ocular diseases. This review specifically targets the treatment of retinal diseases including age-related macular degeneration, diabetic macular edema, myopia and acute retinal light injury with photobiomodulation. Red light is used in this therapy since this wavelength has lower frequency and hence minimal chance of causing any damage. Red light has the potential to penetrate cellular structures such as mitochondria and facilitate cellular processes. For ocular diseases, the target wavelength ranges between 630 to 800 nm. In most of the cases the primary target for red light is the cytochrome C oxidase enzyme in mitochondria, which alters the gene expression and promotes cellular energy production. Clinical evidence shows improvement of visual activity and reduction in thickness of retina post treatment. Future prospects of photobiomodulation involve target-specific treatment, combinational therapy to treat complex retinal diseases including gene therapy, and longitudinal studies to predict long-term efficacy and the chance of any recurrence in the patients. Hence the future of photobiomodulation holds significant potential in medicine especially in ocular diseases characterized by progress in research, technology, and clinical trials.
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Zhen-Bo Zhao, Kai-Li Tang, Yu-Xi Ding, Ji-Kun Yang, Huan-Ping Wang, Li-Wei Ma
2025(2):358-361, DOI: 10.18240/ijo.2025.02.21
Abstract:
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2025(2):362-365, DOI: 10.18240/ijo.2025.02.22
Abstract:
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Chao Xiong, Zhang-Jun Ren, Xue-Mei Li, Jin-Hai Yu, Yue Li, Yun-Xiu Chen, Qi Jin, Ze-Xi Sang, Si-Yi Wang, An-An Wang, Pu-Ying Gan, Qi-Hua Xu, Yao-Hua Wang, Hong-Fei Liao
2025(2):366-369, DOI: 10.18240/ijo.2025.02.23
Abstract:
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Qiu-Mei Gu, Xue-Fei He, Wen-Zhe Xiao, Chao Qu
2025(2):370-374, DOI: 10.18240/ijo.2025.02.24
Abstract:
Volume ,2025 Issue 2
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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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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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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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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