International Journal of Ophthalmology-IJO (English edition) 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 obtains guidance and support from WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed, PMC, CA, IC, Scopus, EMBASE and DOAJ.  IJO’s JCR IF in 2022 is 1.4, Five year Impact Factor is 1.8, CiteScore of IJO in 2022 is 2.7. IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication.

 

  • Current Issue
  • Advance Publication
  • Latest Accepted
  • Article Ranking
  • Archive
    Select All
    Display Method:: |
    Volume 17,2024 Issue 4
      Editorial
    • Peter Wiedemann

      2024,17(4):607-609, DOI: 10.18240/ijo.2024.04.01

      Abstract:

    • Intelligent Ophthalmology
    • 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

      2024,17(4):610-615, DOI: 10.18240/ijo.2024.04.02

      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.

    • Basic Research
    • Wen-Hao Shi, Li-Mei Wang, Hai-Jing Yan, Shi-Long Liu, Xian Yang, Xue-Jiao Yang, Cheng-Ye Che

      2024,17(4):616-624, DOI: 10.18240/ijo.2024.04.03

      Abstract:

      AIM: To explore whether CD3ε is involved in the adaptive immunity of Aspergillus fumigatus (A. fumigatus) keratitis in mice and the role of innate and adaptive immunity in it. METHODS: Mice models of A. fumigatus keratitis were established by intra-stromal injection and corneal epithelial scratching. Subconjunctival injections of natamycin, wedelolactone, LOX-1 inhibitor (poly I) or Dectin-1 inhibitor (laminarin) were used to treat mice with A. fumigatus keratitis. Mice were pretreated by intraperitoneal injection of anti-mouse CD3ε. We observed the corneal infection of mice under the slit lamp microscope and made a clinical score. The protein expression of CD3ε and interleukin-10 (IL-10) was determined by Western blotting. RESULTS: With the disease progresses, the degree of corneal opacity and edema augmented. In the intra-stromal injection models, CD3ε protein expression began to increase significantly on the 2nd day. However, in the scraping epithelial method models, CD3ε only began to increase on the 3rd day. After natamycin treatment, the degree of corneal inflammation in mice was significantly attenuated on the 3rd day. After wedelolactone treatment, the severity of keratitis worsened. And the amount of CD3ε protein was also reduced, compared with the control group. By inhibiting LOX-1 and Dectin-1, there was no significant difference in CD3ε production compared with the control group. After inhibiting CD3ε, corneal ulcer area and clinical score increased, and IL-10 expression was downregulated. CONCLUSION: As a pan T cell marker, CD3ε participate in the adaptive immunity of A. fumigatus keratitis in mice. In our mice models, the corneas will enter the adaptive immune stage faster. By regulating IL-10, CD3ε exerts anti-inflammatory and repairs effects in the adaptive immune stage.

    • Hui-Jie Hao, Ya-Hong Li, Bo Yu, Xun Liu, Yan Zhang, Xiao-Li Xing

      2024,17(4):625-637, DOI: 10.18240/ijo.2024.04.04

      Abstract:

      AIM: To explore the therapeutic effect and main molecular mechanisms of acteoside in a glaucoma model in DBA/2J mice. METHODS: Proteomics was used to compare the differentially expressed proteins of C57 and DBA/2J mice. After acteoside administration in DBA/2J mice, anterior segment observation, intraocular pressure (IOP) monitoring, electrophysiology examination, and hematoxylin and eosin staining were used to analyze any potential effects. Immunohistochemistry (IHC) assays were used to verify the proteomics results. Furthermore, retinal ganglion cell 5 (RGC5) cell proliferation was assessed with cell counting kit-8 (CCK-8) assays. Serta domain-containing protein 4 (Sertad4) mRNA and protein expression levels were measured by qRT-PCR and Western blot analysis, respectively. RESULTS: Proteomics analysis suggested that Sertad4 was the most significantly differentially expressed protein. Compared with the saline group, the acteoside treatment group showed decreased IOP, improved N1-P1 wave amplitudes, thicker retina, and larger numbers of cells in the ganglion cell layer (GCL). The IHC results showed that Sertad4 expression levels in DBA/2J mice treated with acteoside were significantly lower than in the saline group. Acteoside treatment could improve RGC5 cell survival and reduce the Sertad4 mRNA and protein expression levels after glutamate injury. CONCLUSION: Sertad4 is differentially expressed in DBA/2J mice. Acteoside can protect RGCs from damage, possibly through the downregulation of Sertad4, and has a potential use in glaucoma treatment.

    • Zhen-Kai Wu, Huan-Yu Li, You-Lin Zhu, Meng-Qin Xiong, Jing-Xiang Zhong

      2024,17(4):638-645, DOI: 10.18240/ijo.2024.04.05

      Abstract:

      AIM: To investigate the protective effects, antioxidant potential, and anti-inflammatory mechanisms of eicosane on glutamate-induced cell damage and on N-methyl-D-aspartate (NMDA)-induced retinal ganglion cell (RGC) injury in a mouse model of glaucoma. METHODS: The protective effects of eicosane on the rat R28 retinal precursor cell line were assessed using cell counting kit-8 assays and Hoechst-propidium iodide staining. Intracellular reactive oxygen species (ROS) production was measured using the fluorescent probe 2'-7'-dichlorofluorescin diacetate and flow cytometry. The protective role of eicosane on NMDA-induced RGC injury in a mouse glaucoma model was determined by immunostaining of frozen sections of retina. The effects of eicosane on the metabolome of the retina in mice with NMDA-induced RGC damage were evaluated by liquid chromatography-mass spectroscopy (LC-MS) and untargeted metabolomics analyses. RESULTS: Eicosane treatment significantly attenuated glutamate-induced damage to R28 cells in vitro. Eicosane also protected RGCs against NMDA-induced injury in a mouse glaucoma model. Untargeted metabolomics analyses showed that eicosane increased multiple metabolites, including L-arginine and L-carnitine, in the retina. CONCLUSION: Eicosane has protective effects, antioxidant potential, and anti-inflammatory properties in an in vitro model of glutamate-induced cell damage and in an in vivo model of NMDA-induced RGC injury in mouse glaucoma through modulation of L-arginine and/or L-carnitine metabolism.

    • Xuan Liu, Ming Liu, Meng Ji, Bo Ma, Yu-Cen Hou, Xin-Yue Yao, Qiao-Chu Cheng, Li Chen

      2024,17(4):646-652, DOI: 10.18240/ijo.2024.04.06

      Abstract:

      AIM: To evaluate the effect of bone morphogenetic protein-6 (BMP-6) on transforming growth factor (TGF)-β2-induced epithelial-mesenchymal transition (EMT) in retinal pigment epithelium (RPE). METHODS: Adult retinal pigment epithelial cell line (ARPE-19) were randomly divided into control, TGF-β2 (5 µg/L), and BMP-6 small interfering RNA (siRNA) group. The cell morphology was observed by microscopy, and the cell migration ability were detected by Transwell chamber. The EMT-related indexes and BMP-6 protein levels were detected by Western blotting. Furthermore, a BMP-6 overexpression plasmid was constructed and RPE cells were divided into the control group, TGF-β2+empty plasmid group, BMP-6 overexpression group, and TGF-β2+BMP-6 overexpression group. The EMT-related indexes and extracellular regulated protein kinases (ERK) protein levels were detected. RESULTS: Compared with the control group, the migration of RPE cells in the TGF-β2 group was significantly enhanced. TGF-β2 increased the protein expression levels of α-smooth muscle actin (α-SMA), fibronectin and vimentin but significantly decreased the protein levels of E-cadherin and BMP-6 (P<0.05) in RPE. Similarly, the migration of RPE cells in the BMP-6 siRNA group was also significantly enhanced. BMP-6 siRNA increased the protein expression levels of α-SMA, fibronectin and vimentin but significantly decreased the protein expression levels of E-cadherin (P<0.05). Overexpression of BMP-6 inhibited the migration of RPE cells induced by TGF-β2 and prevented TGF-β2 from affecting EMT-related biomarkers (P<0.05). CONCLUSION: BMP-6 prevents the EMT in RPE cells induced by TGF-β2, which may provide a theoretical basis for the prevention and treatment of proliferative vitreoretinopathy.

    • Clinical Research
    • Tran Tat Thang, Pham Hong Phuong, Nguyen Sa Huynh, Nguyen Trung Kien, Nguyen Duy Toan, Nguyen Thi Thu Ha, Le Ha Khoa, Nguyen Huu Dung, Thai Doan Thang, Le Viet Thang

      2024,17(4):653-658, DOI: 10.18240/ijo.2024.04.07

      Abstract:

      AIM: To determine the dry eye (DE) rate and its relationship with disease stage in patients with primary hypertension. METHODS: A cross-sectional study included 432 patients with primary hypertension (with an equal number of patients in each group: 144 in stage I, II, and III hypertension) and 144 healthy subjects as a control group. The Ocular Surface Disease Index (OSDI) and Schirmer I test without anesthetics were conducted on all 576 subjects. Subjects with OSDI scores <13 and Schirmer I values equal to or under 10 mm were diagnosed with DE. RESULTS: The ratio of DE in hypertension patients was higher than in the control group (41.7% versus 18.8%; P<0.001). The proportion of patients with DE increased gradually according to the hypertension stage: 27.1% in stage I, 40.3% in stage II, and 57.6% in stage III, P<0.001. Age, duration of hypertension, plasma urea, creatinine, and high-sensitivity C-reactive protein (CRP-hs) levels in hypertension patients with DE were higher than those without DE, P<0.001. Advanced age, a long duration of hypertension, diabetes mellitus, elevated plasma creatinine, and CRP-hs levels were independent factors associated with DE in primary hypertension patients, P<0.001. CONCLUSION: DE is a common disorder associated with advanced age, a long duration of hypertension, diabetes mellitus, elevated plasma CRP-hs, and creatinine levels in patients with primary hypertension.

    • Amal Aldarwesh, Ali Almustanyir, Raied Fagehi, Khalaf Alruways, Abdulaziz Bin Turki, Mansour Alghamdi, Muteb Khalaf Alanazi, Balsam Alabdulkader, Wafa Alotaibi, Mosaad Alhassan

      2024,17(4):659-664, DOI: 10.18240/ijo.2024.04.08

      Abstract:

      AIM: To investigate the short-term effects of commercially available eyelid-cleaning wipes on film parameters. METHODS: This study enrolled 48 healthy participants aged 20-35y (both males and females). Clinical assessment included the Ocular Surface Disease Index (OSDI) questionnaire, non-invasive tear break-up time (NITBUT), tear meniscus height (TMH), and lipid layer pattern (LLP). Based on these initial results, participants were categorized as either non-dry eye or dry eye. Participants in each group were randomly allocated to either Blephaclean® or Systane® treatments. Changes in NITBUT, TMH, and LLP levels before and after lid wipe treatment were assessed. RESULTS: The dry eye group exhibited significantly higher OSDI scores and lower NITBUT and TMH levels than in the non-dry eye group (P<0.001). Following the application of eyelid wipes (Systane® wipes), dry eye subjects experienced a significant improvement in NITBUT levels (P=0.0014) compared to the non-dry eye individuals. Although the remaining participants showed a marginal increase in TMH and NITBUT levels, these changes did not achieve statistical significance (P>0.05). Similarly, the LLP levels were significantly improved with Systane® (P<0.001) post-treatment compared to individuals in the non-dry eye group. However, the dry eye subjects showed higher post-treatment LLP levels than the untreated group (P<0.02). CONCLUSION: The short-term effects of Systane® eyelid wipes on tear film parameters suggest their effectiveness in dry eye disease. Nonetheless, further exploration of their long-term impact is essential to justify their cost effectiveness and efficacy in treating both aqueous deficiency and evaporative dryness.

    • Wei-Yu Huang, Yung-Jen Chen

      2024,17(4):665-669, DOI: 10.18240/ijo.2024.04.09

      Abstract:

      AIM: To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses (IOLs). METHODS: This study retrospectively enrolled a consecutive series of patients who underwent a surgery of sutured existing subluxated or dislocated IOLs from October 2018 to June 2020. All patients underwent comprehensive preoperative and postoperative ophthalmologic examination, and data were collected including age, sex, surgical indications, best-corrected visual acuity, refractive error, intraocular pressure. Presence of intraoperative and postoperative surgical complications was documented. RESULTS: A total of 20 consecutive cases were enrolled for analysis with mean final follow-up period 9.8±5.3mo. Visual acuity improved from a mean of 0.35 (0.46±0.32 logMAR) preoperatively to 0.61 (0.21±0.18 logMAR) at the 3-month follow-up (P=0.002). The mean amount of preoperative keratometric astigmatism and total postoperative refractive astigmatism was -1.24±0.80 diopters (D) and -1.42±0.97 D, respectively. There was no statistically significant difference between preoperative and postoperative astigmatism (P=0.156). The mean IOL-induced astigmatism was -0.23±0.53 D. The mean spherical equivalent at the 3-month follow-up was -0.1±0.94 D. No major complications were noted during the follow-up period. CONCLUSION: Surgical techniques using sutured scleral fixation of existing subluxated or dislocated acrylic one-piece IOLs result in favorable visual and refractive outcomes without major complications.

    • De-Shuang Li, Hong-Xia Liao, Chuan-He Zhang, Jian-Guo Huang, Wei Chen, Jing-Lin Zhang, Bo Qin

      2024,17(4):670-675, DOI: 10.18240/ijo.2024.04.10

      Abstract:

      AIM: To analyze the relationship between optical coherence tomography (OCT) and OCT angiography (OCTA) imaging in patients with diabetic macular edema (DME) who are treated with a combination of aflibercept and triamcinolone acetonide (TA). METHODS: A total of 76 eyes newly diagnosed DME were included in this study. They were randomly assigned to receive either aflibercept or a combination of aflibercept and TA. Injections once a month for a total of three injections. Central macular thickness (CMT), number of hyperreflective foci (HRF), height of subretinal fluid (SRF), and area of foveal avascular zone (FAZ) were evaluated using OCT and OCTA at baseline and after each monthly treatment. RESULTS: Both groups showed improvement in best corrected visual acuity (BCVA) and reduction in macular edema after treatment, and the difference in BCVA between the two groups was statistically significant after each treatment (P<0.05). The difference in CMT between the two groups was statistically significant after the first two injections (P<0.01), but not after the third injection (P=0.875). The number of HRF (1mo: 7.41±8.25 vs 10.86±7.22, P=0.027; 2mo: 5.33±6.13 vs 9.12±8.61, P=0.034; 3mo: 3.58±3.00 vs 6.37±5.97, P=0.007) and height of SRF (1mo: 82.39±39.12 vs 105.77±42.26 μm, P=0.011; 2mo: 36.84±10.02 vs 83.59±37.78 μm, P<0.01; 3mo: 11.57±3.29 vs 45.43±12.60 μm, P<0.01) in combined group were statistically significant less than aflibercept group after each injection, while the area of FAZ showed no significant change before and after treatment in both groups. CONCLUSION: The combination therapy of aflibercept and TA shows more significant effects on DME eyes with decreased HRF and SRF. However, both aflibercept and combination therapy show no significant change in the area of FAZ.

    • Ting-Ting Feng, Xiang Gao, An-Ran Liang, Bo-Wen Zhao, Guang-Hui He, Song Chen

      2024,17(4):676-685, DOI: 10.18240/ijo.2024.04.11

      Abstract:

      AIM: To identify different metabolites, proteins and related pathways to elucidate the causes of proliferative diabetic retinopathy (PDR) and resistance to anti-vascular endothelial growth factor (VEGF) drugs, and to provide biomarkers for the diagnosis and treatment of PDR. METHODS: Vitreous specimens from patients with diabetic retinopathy were collected and analyzed by Liquid Chromatography-Mass Spectrometry (LC-MS/MS) analyses based on 4D label-free technology. Statistically differentially expressed proteins (DEPs), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway representation and protein interactions were analyzed. RESULTS: A total of 12 samples were analyzed. The proteomics results showed that a total of 58 proteins were identified as DEPs, of which 47 proteins were up-regulated and 11 proteins were down-regulated. We found that C1q and tumor necrosis factor related protein 5 (C1QTNF5), Clusterin (CLU), tissue inhibitor of metal protease 1 (TIMP1) and signal regulatory protein alpha (SIRPα) can all be specifically regulated after aflibercept treatment. GO functional analysis showed that some DEPs are related to changes in inflammatory regulatory pathways caused by PDR. In addition, protein-protein interaction (PPI) network evaluation revealed that TIMP1 plays a central role in neural regulation. In addition, CD47/SIRPα may become a key target to resolve anti-VEGF drug resistance in PDR. CONCLUSION: Proteomic analysis is an approach of choice to explore the molecular mechanisms of PDR. Our data show that multiple proteins are differentially changed in PDR patients after intravitreal injection of aflibercept, among which C1QTNF5, CLU, TIMP1 and SIRPα may become targets for future treatment of PDR and resolution of anti-VEGF resistance.

    • Yeji Moon, Sung-Min Kim, Jae Ho Jung

      2024,17(4):686-692, DOI: 10.18240/ijo.2024.04.12

      Abstract:

      AIM: To compare the macular structure including foveal thickness among patients with optic neuritis (ON) according to the etiology and to investigate the possible correlation between structural and visual outcomes METHODS: In this retrospective cross-sectional study, the clinical data of patients with aquaporin-4 immunoglobulin G-related ON (AQP4 group, 40 eyes), myelin oligodendrocyte glycoprotein IgG-related ON (MOG group, 31 eyes), and multiple sclerosis-related ON (MS group, 24 eyes) were obtained. The retinal thickness of the foveal, parafoveal and perifoveal regions were measured. Visual acuity (VA), visual field index and mean deviation were measured as visual outcomes. RESULTS: The AQP4 group showed a significantly thinner fovea (226.4±13.4 μm) relative to the MOG (236.8±14.0 μm, P=0.015) and MS (238.9±14.3 μm, P=0.007) groups. The thickness in the parafoveal area also was thinner in the AQP4 group, though the difference in perifoveal retinal thickness was not significant. Foveal thickness was correlated with VA in the AQP4 group (coefficient ρ=-0.418, P=0.014), but not in the MOG and MS groups (P=0.218 and P=0.138, respectively). There was no significant correlation between foveal thickness and visual field test in all three groups. CONCLUSION: The significant thinning in the fovea and parafoveal areas in the AQP4 group compared to the MOG and MS groups are found. Additionally, macular changes in AQP4-ON show a significant correlation with VA. The results provide the possibility that retinal structural damage could reflect functional damage in AQP4-ON, distinct from MOG-ON and MS-ON.

    • Xuan Zhang, Qi-Han Guo, Rui Liu, Jing Li, Ying-Chao Li, Jian-Min Ma

      2024,17(4):693-699, DOI: 10.18240/ijo.2024.04.13

      Abstract:

      AIM: To explore the role of positron emission tomography-computed tomography (PET-CT) examination in the diagnosis and treatment of ocular adnexal mucosa associated lymphoid tissue lymphoma (OAML). METHODS: The general clinical data, postoperative PET-CT results, treatment regimens, and the prognosis of 21 histopathologically confirmed OAML patients between October 2017 and September 2021 were collected. Among the 21 patients, five patients underwent surgical treatment alone, 13 patients underwent surgical treatment combined with radiotherapy, and three patients underwent surgical treatment combined with chemotherapy. RESULTS: The follow-up period ranged from 8 to 79mo, with four cases of recurrence and no deaths. Through PET-CT examination, two patients exhibited both local ocular metabolic elevation and systemic metastasis, and one of these patients had cervical lymph node metastasis, while the other had submandibular and parotid gland metastasis. Nine patients showed only local ocular metabolic elevation, while 10 patients had no abnormal metabolic activity locally. CONCLUSION: PET-CT examination plays a crucial role in detecting residual lesions and recurrence following tumor resection, aiding in precise disease staging, and facilitating the development of personalized treatment plans, ultimately improving patient prognosis.

    • Li Zhang, Hai-Zhang You, Guo-Hui Wang, Wei Xu, Jian-Shan Li, Qing-Liang Zhao, Shu Du

      2024,17(4):700-706, DOI: 10.18240/ijo.2024.04.14

      Abstract:

      AIM: To investigate the types of bacteria in patients with eye infections in Suzhou and their drug resistance to commonly used antibacterial drugs. METHODS: The clinical data of 155 patients were retrospectively collected in this study, and the pathogenic bacteria species and drug resistance of each pathogenic bacteria were analyzed. RESULTS: Among the 155 patients (age from 12 to 87 years old, with an average age of 57, 99 males and 56 females) with eye infections (160 eyes: 74 in the left eye, 76 in the right eye and 5 in both eyes, all of which were exogenous), 71 (45.81%) strains were gram-positive bacteria, 23 (14.84%) strains were gram-negative bacteria and 61 (39.35%) strains were fungi. Gram-positive bacteria were highly resistant to penicillin and erythromycin (78.87% and 46.48% respectively), but least resistant to vancomycin at 0. Gram-negative bacteria were highly resistant to cefoxitin and compound sulfamethoxazole (100% and 95.65% respectively), but least resistant to meropenem at 0. Comparison of the resistance of gram-positive and gram-negative bacteria to some drugs revealed statistically significant differences (P<0.05) in the resistance of both to cefoxitin, cotrimoxazole, levofloxacin, cefuroxime, ceftriaxone and ceftazidime, and both had higher rates of resistance to gram-negative bacteria than to gram-positive bacteria. The distribution of bacterial infection strains showed that Staphylococcus epidermidis was the most common strain in the conjunctiva, cornea, aqueous humor or vitreous body and other eye parts. Besides, Fusarium and Pseudomonas aeruginosa were also among the most common strains of conjunctival and corneal infections. CONCLUSION: Gram-positive bacteria are the dominant bacteria in eye infections, followed by gram-negative bacteria and fungi. Considering the resistance of gram-negative bacteria to multiple drugs, monitoring of bacteria should be strengthened in eye bacterial infections for effective prevention and control to reduce complications caused by eye infections.

    • Qing-Jian Li, Sheng-Mei Zhou, Ling-Yu Zhang, An-Ni Lin, Yang Zhang, Jing Jiang, Xin Che, Yi-Wen Qian, Yan Liu, Zhi-Liang Wang

      2024,17(4):707-712, DOI: 10.18240/ijo.2024.04.15

      Abstract:

      AIM: To evaluate the relationship of overweight and obesity with retinal and choroidal thickness in adults without ocular symptoms by swept-source optical coherence tomography (SS-OCT). METHODS: According to the body mass index (BMI) results, the adults enrolled in the cross-sectional study were divided into the normal group (18.50≤BMI<25.00 kg/m2), the overweight group (25.00≤BMI<30.00 kg/m2), and the obesity group (BMI≥30.00 kg/m2). The one-way ANOVA and the Chi-square test were used for comparisons. Pearson’s correlation analysis was used to evaluate the relationships between the measured variables. RESULTS: This research covered the left eyes of 3 groups of 434 age- and sex-matched subjects each: normal, overweight, and obesity. The mean BMI was 22.20±1.67, 26.82±1.38, and 32.21±2.35 kg/m2 in normal, overweight and obesity groups, respectively. The choroid was significantly thinner in both the overweight and obesity groups compared to the normal group (P<0.05 for all), while the retinal thickness of the three groups did not differ significantly. Pearson’s correlation analysis showed that BMI was significantly negatively correlated with choroidal thickness, but no significant correlation was observed between BMI and retinal thickness. CONCLUSION: Choroidal thickness is decreased in people with overweight or obesity. Research on changes in choroidal thickness contributes to the understanding of the mechanisms of certain ocular disorders in overweight and obese adults.

    • Investigation
    • Si-Yuan He, Ting He, Meng-Yue Xu, Ying-Jie Ni, Chao-Yang Hong, Ting Shen

      2024,17(4):713-720, DOI: 10.18240/ijo.2024.04.16

      Abstract:

      AIM: To analyze the distribution of refractive status in school-age children with different corneal curvatures (CC) and the correlation between CC and refractive status. METHODS: A total of 2214 school-aged children of grade 4 in Hangzhou who were screened for school myopia were included. Uncorrected distance visual acuity (UCDVA), non-cycloplegic refraction, axial length (AL), horizontal and vertical corneal curvature (K1, K2) were measured and spherical equivalent (SE), corneal curvature radius (CCR) and axial length/corneal radius of curvature ratio (AL/CR) were calculated. UCDVA<5.0 and SE≤-0.50 D were classified as school-screening myopia. According to the different CCRs, the patients were divided into the lower corneal curvature (LCC) group (CCR≥7.92) and the higher corneal curvature (HCC) group (CCR<7.92). Each group was further divided into the normal AL subgroup and the long AL subgroup. The refractive parameters were compared to identify any differences between the two groups. RESULTS: Both SE and AL were greater in the LCC group (P=0.013, P<0.001). The prevalence of myopia was 38% in the LCC group and 44% in the HCC group (P<0.001). The proportion of children without screening myopia was higher in the LCC group (62%) than in the HCC group (56%). Among these children without screening myopia, the proportion of long AL in the LCC group (24%) was significantly higher than that in the HCC group (0.012%; P<0.001). The change of SE in the LCC group was less affected by the increase of AL than that in the HCC group. CONCLUSION: School-aged children in the LCC group have a lower incidence of screening myopia and longer AL. Low CC can mask SE reduction and AL growth to some extent, and the change of AL growth change more in children with low CC than high CC. Before the onset of myopia, its growth rate is even faster than that after the onset of myopia.

    • Abolghasem Mortazavi, Alireza Hashemi, Alirerza Jamali, Hassan Hashemi, Mohammadreza Aghamirsalim, Mehdi Khabazkhoob

      2024,17(4):721-728, DOI: 10.18240/ijo.2024.04.17

      Abstract:

      AIM: To determine the prevalence of some retinal pathologies in people over 60y and their association with demographic and ocular factors. METHODS: A cross-sectional study was conducted in Tehran using multistage cluster sampling. After selecting subjects aged 60 and over, optometric, and ophthalmic examinations were done. For retinal examination, a 90 D lens was used and indirect ophthalmoscopy was performed after instilling tropicamide drops. Biometry was done using the IOL Master for all participants. RESULTS: Of 3791 people that were invited through cluster sampling, 3310 participated in the study (response rate=82%). The prevalence of retinal pigmented epithelium (RPE) change, drusen, geographic atrophy (GA), hypertensive retinopathy (HTR), nonproliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), choroidal neovascularization (CNV), central retinal artery occlusion (CRAO), myopic retinopathy (MR), branch retinal vein occlusion (BRVO), and central retinal vein occlusion (CRVO) was 27.42%, 11.08%, 4.52%, 3.03%, 4.05%, 0.54%, 0.82%, 0.39%, 0.20%, 0.49%, and 0.19%, respectively. After removing the effect of age, the odds of NPDR were 1.68 times higher in women compared to men (P=0.014). After removing the effect of sex, the odds of drusen, RPE change, GA, CNV, BRVO, and CRVO increased with age. CONCLUSION: There is a higher prevalence of RPE change, drusen, GA, CNV and a lower prevalence of MR and CRAO in the elderly population of Tehran aged over 60y compared to global average values. Considering the correlation of most of the diseases with age and their effects on vision, attention should be paid to these diseases and the related screening programs to prevent vision impairment.

    • Meta-Analysis
    • Yi-Heng Wang, Qian Xu, Jie Luan

      2024,17(4):729-735, DOI: 10.18240/ijo.2024.04.18

      Abstract:

      AIM: To evaluate the effectiveness and safety of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) in vitrectomized versus non-vitrectomized eyes. METHODS: The PubMed, EMBASE, Web of Science, Cochrane, EBSCO were comprehensively searched for studies comparing vitrectomized and non-vitrectomized eyes with DME. Clinical outcomes of best-corrected visual acuity (BCVA), central macular thickness (CMT), the mean number of intravitreal injection and adverse events were extracted and analyzed. RESULTS: Six studies involving 641 eyes were included. Final visual gain significantly improved and CMT significantly reduced in vitrectomized eyes at 6mo and 12mo visits (P<0.05). Although the mean reduction in CMT among non-vitrectomized eyes was significantly greater than in vitrectomized eyes at the 6mo [mean difference (MD)=53.57, 95% confidence interval (CI): 28.03 to 78.72, P<0.0001] and 12mo (MD=49.65, 95%CI: 19.58 to 79.72, P=0.01), no significant difference was detected in improvement in BCVA at either 6mo (MD=0.05, 95%CI: -0.02 to 0.13, P=0.14) or 12mo (MD=0.03, 95%CI: -0.04 to 0.09, P=0.43). Injection number of ranibizumab in non-vitrectomized eyes was significantly less than that in vitrectomized eyes during 6-month period (MD=0.60, 95%CI: 0.16 to 1.04, P=0.008), while there was no statistically significant difference between the two groups during 12mo of follow-up. CONCLUSION: Evidence from current study suggests that IVR was useful for both vitrectomized group and non-vitrectomized group with DME. Although less reduction in macular thickness is found in vitrectomized group, visual improvement between two groups is similar.

    • Bibliometric Research
    • Liang-Pin Li, Li-Yun Yuan, De-Shen Mao, Xia Hua, Xiao-Yong Yuan

      2024,17(4):736-747, DOI: 10.18240/ijo.2024.04.19

      Abstract:

      AIM: To analysis of research hotspots and trends on the application of premium intraocular lens (PIOLs) in the past 2 decades. METHODS: The literature search was performed on the Web of Science and included PIOLs studies published between January 2000 and December 2022. The retrieved literature was collated and analyzed by R-tool’s Bibliometrix package, CitNetExplorer, CiteSpace and other software. RESULTS: A total of 1801 articles about PIOLs were obtained, most of which were published in Spain and the United States. The organization that published the most articles was the University of Valencia in Spain. Alió JL, and Montés-Micó R, from Spain were the most influential authors in this field. The Journal of Cataract and Refractive Surgery and Journal of Refractive Surgery were the core journals for this field; the top 10 cited articles mainly focus on postoperative satisfaction with multifocal intraocular lens (IOLs) and postoperative results of toric IOLs. Through the keyword analysis, we found that trifocal IOLs, astigmatism and extended depth of focus (EDoF) IOLs are the most discussed topics at present, and the importance of astigmatism and the clinical application of the new generation of PIOLs are the emerging research trends. CONCLUSION: Bibliometric analysis can effectively help to identify multilevel concerns in PIOLs research and the prevailing research trends in the realm of PIOLs encompass the adoption of EDoF IOLs, trifocal IOLs, and their respective Toric models.

    • Review Article
    • Bai-Yu Hu, Mei Xin, Ming Chen, Ping Yu, Liu-Zhi Zeng

      2024,17(4):748-760, DOI: 10.18240/ijo.2024.04.20

      Abstract:

      Glaucoma is a common and complex neurodegenerative disease characterized by progressive loss of retinal ganglion cells (RGCs) and axons. Currently, there is no effective method to address the cause of RGCs degeneration. However, studies on neuroprotective strategies for optic neuropathy have increased in recent years. Cell replacement and neuroprotection are major strategies for treating glaucoma and optic neuropathy. Regenerative medicine research into the repair of optic nerve damage using stem cells has received considerable attention. Stem cells possess the potential for multidirectional differentiation abilities and are capable of producing RGC-friendly microenvironments through paracrine effects. This article reviews a thorough researches of recent advances and approaches in stem cell repair of optic nerve injury, raising the controversies and unresolved issues surrounding the future of stem cells.

    • Brief Report
    • Su-Lan Wu, Yi-Qi Chen, Li-Jun Shen, Jian-Bo Mao, Li Lin, Ji-Wei Tao, Huan Chen, Shi-An Zhang, Jia-Feng Yu, Chen-Xi Wang

      2024,17(4):761-766, DOI: 10.18240/ijo.2024.04.21

      Abstract:

      AIM: To evaluate scleral buckling (SB) surgery using a non-contact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil (SO)-filled eyes. METHODS: Totally 9 patients (9 eyes) with retinal detachment in SO-filled eyes were retrospectively analyzed. All patients underwent non-contact wide-field viewing system-assisted buckling surgery with 23-gauge intraocular illumination. SO was removed at an appropriate time based on recovery. The patients were followed up for at least 3mo after SO removal. Retinal reattachment, complications, visual acuity and intraocular pressure (IOP) before and after surgery were observed. RESULTS: Patients were followed up for a mean of 8.22mo (3-22mo) after SO removal. All patients had retinal reattachment. At the final follow-up, visual acuity showed improvement for 8 patients, and no change for 1 patient. The IOP was high in 3 patients before surgery, but it stabilized after treatment; it was not affected in the other patients. None of the patients had infections, hemorrhage, anterior ischemia, or any other complication. CONCLUSION: This new non-contact wide-field viewing system-assisted SB surgery with 23-gauge intraocular illumination is effective and safe for retinal detachment in SO-filled eyes.

    • Letter to the Editor
    • Comment and Response
    Select All
    Display Method::
    • 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.

      • 1
    Select All
    Display Method:
    • 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.

      • 1
    Select All
    Display Method: |
    • Wen-Juan Luo, Wen-Fang Zhang

      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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • Ali Ihsan Incesu

      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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • Sagili Chandrasekhara Reddy

      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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • 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.

      • 1
    • Ivayla I. Geneva

      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.

      • 1
    • 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.

      • 1
    • Hua Shan, Du Min

      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

      • 1

UserLogin

Press search
Search term
From To

Editors-in-Chief: Yan-Nian Hui and Peter Wiedemann

Established in April, 2008

ISSN 2222-3959 print

ISSN 2227-4898 online

Sweep code subscribe

  • Most Read
  • Most Cited
  • Article Ranking