International Journal of Ophthalmology-IJO is a global ophthalmological scientific publication and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online). This journal is sponsored by Chinese Medical Association Xi’an Branch and published by the IJO Press. It has been indexed in SCIE, PubMed, PMC, CA, IC, Scopus, EMBASE and DOAJ, and was selected for China's Science and Technology Journal International Influence Enhancement Plan (D-class projects). IJO’s JCR IF in 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 contributions from all over the world, both basic and clinical research.
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Hao Yuan, Zhen-Yu Wang, Jia-Rui Yang, Chen Huang, Liang Zhu, Xue-Min Li
2025,18(6):969-977 ,DOI: 10.18240/ijo.2025.06.01
Abstract:
AIM: To explore the role of a previously-found MYH9 tail domain mutation (p.E1384Q) in the pathogenesis of congenital cataract. METHODS: The cell experiments were conducted in vitro. Wild-type (WT) MYH9 and p.E1384Q mutant fragments were constructed, which was then transiently transfected into Hek293T cell lines. Western blotting and quantitative real time polymerase chain reaction (qRT-PCR) were used to analyze the protein and mRNA level of non-muscle myosin IIA (NM IIA) and F-actin in transfected cells, and fluorescence microscopy was applied to explore the subcellular localization of NM IIA and F-actin. Cell counting kit-8 (CCK8), wound-healing and double staining flow cytometry assays were performed to evaluate the proliferation, migration and apoptosis function of transfected cells, respectively. Transmission electron microscope was conducted to observe the alteration of organelle structure. RESULTS: The transiently-transfected WT and p.E1384Q mutant Hek293T cell lines was constructed. Western blot demonstrated that, comparing with MYH9WT group, the relative protein amount of NM IIA and F-actin significantly decreased in MYH9E1384Q cells (P<0.001). qRT-PCR analysis revealed that the relative mRNA amount of NM IIA and F-actin also significantly reduced in MYH9E1384Q cells when compared with MYH9WT. The immunofluorescence microscopy showed that the fluorescence signal of NM IIA and F-actin significantly decreased in E1384Q cells. The diffuse cytoplasmic distribution of NM IIA in MYH9WT was changed to be clumped distribution, presenting a “speckled” pattern characterized by aggregates of small size in MYH9E1384Q. Functional study revealed that the E1384Q mutation significantly inhibited cell proliferation (P=0.003) and migration (P<0.001), and promoted apoptosis (P<0.001). Electron microscope showed that the mutation remarkably decreased the number of mitochondria (P<0.001) and changed the phenotype of mitochondria. CONCLUSION: The missense gene mutation in MYH9 (p.E1384Q) causing congenital cataract results in decreased amount and altered subcellular distribution of NM IIA and F-actin, accompanied by decreased cell proliferation and migration, promotes apoptosis and mitochondrial alteration.
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Fen-Fen Wang, Rong Li, Dan Liao, Chao-Qun Liu, Xiao-Li Yang
2025,18(6):978-985 ,DOI: 10.18240/ijo.2025.06.02
Abstract:
AIM: To investigate the protective role of ghrelin against diabetic retinopathy (DR), focusing on its anti-ferroptotic mechanism in high glucose-induced retinal endothelial injury. METHODS: First, small interfering RNA (siRNA)-mediated interference was conducted to knockdown nuclear factor erythroid 2-related factor 2 (Nrf2). Using reverse transcription-polymerase chain reaction (RT-PCR), the expression level of Nrf2 was determined from human retinal microvascular endothelial cells (HRMECs) transfected with either si-NC or si-Nrf2. After that, cells were treated with 10 nmol/L ghrelin and then cultured in a high glucose (30 mmol/L) environment. EdU assay was utilized to assess cell proliferation, while transmission electron microscopy was employed to observe mitochondrial morphology. Flow cytometry was used to measure the level of intracellular reactive oxygen species (ROS), and biochemical assays were conducted to detect malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), and ferrous iron (Fe2+). Western blotting was used to identify the presence of ferroptosis-related proteins such as glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), Nrf2, and haem oxygenase-1 (HO-1). RESULTS: Under a high glucose environment, ghrelin could significantly promote the proliferation of HRMECs and mitochondrial status, remarkably decrease the levels of intracellular ROS and MDA, and up-regulate the level of GSH and SOD. Besides, ghrelin greatly reduced Fe2+ level in the cells while increased protein levels of GPX4 and SLC7A11. Subsequently, we found that high glucose induced inactivation of Nrf2/HO-1 axis and the protein expression profile were significantly promoted by ghrelin. Moreover, silencing of Nrf2 by siRNA delivery markedly diminished the changes induced by ghrelin in high glucose-induced HRMECs, shown as reduced cell proliferation and increased mitochondrial malformation, up-regulated ROS, MDA, Fe2+, GPX4 and SLC7A11, as well as down-regulated GSH, SOD, Nrf2 and HO-1. CONCLUSION: Ghrelin attenuates high glucose-induced injury of retinal endothelial cells via inhibiting ferroptosis, and activation of Nrf2/HO-1 pathway may be one of the mechanisms involved in this effect of ghrelin.
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Xue Wang, Jing-Jing Ding, Chao-Feng Yu, Deng-Cheng Xiao, Li-Ming Tao, Zheng-Xuan Jiang
2025,18(6):986-995 ,DOI: 10.18240/ijo.2025.06.03
Abstract:
AIM: To examined the effects of a high-fat diet (HFD) on retinal pathological changes and dysfunction using peroxisome proliferator-activated receptor-alpha (PPARα) knockout mice. METHODS: For four months, C57BL/6J and PPARα knockout mice received either HFD or a standard diet (SD). A fluorometric method was used to determine the retinal triglycerides. The retinal malondialdehyde (MDA) content was measured. Hematoxylin-eosin was used to evaluate retinal pathological changes. Protein expression was analyzed by Western blot and immunofluorescence, while mRNA expression was evaluated by quantitative reverse transcription-polymerase chain reaction. Electroretinogram was used to assess retinal function. RESULTS: HFD resulted in increased fatty acid β-oxidation in the inner retina, particularly retinal ganglion cells (RGCs), as well as increased weight and accumulation of retinal triglyceride. Retinal fatty acid β-oxidation and triglyceride accumulation were affected by PPARα−/− abnormalities. PPARα knockdown increased the infiltration and activation of inflammatory cells, as well as it upregulated the nuclear factor kappa B (NF-κB) signaling pathway and corresponding proinflammatory cytokine levels in the most retina subjected to the HFD. In the HFD mice, oxidative stress levels were elevated in the inner retina, particularly in the HFD PPARα−/− mice. HFD-induced RGCs apoptosis initiation was exacerbated by PPARα deficiency. Lastly, HFD feeding resulted in the lower amplitudes of scotopic a-wave, b-wave and photopic negative response (PhNR) wave, particularly in HFD PPARα−/− mice. CONCLUSION: In HFD-fed mice retina, particularly in the inner retina, PPARα knockout increases lipid metabolic abnormalities, inflammatory responses, oxidative stress, apoptosis initiation and dysfunction.
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Jin-Jin Wang, Ao-Miao Yu, Chang Liu, Yue Huang, Rui-Bo Yang, Chen Zhang, Hui Liu, Shao-Zhen Zhao
2025,18(6):996-1002 ,DOI: 10.18240/ijo.2025.06.04
Abstract:
AIM: To compare the efficacy of 3% diquafosol sodium (DQS) eye drops at different frequencies in dry eye (DE) after femtosecond laser-assisted in situ keratomileusis (FS-LASIK). METHODS: In this prospective study, DE patients after FS-LASIK were randomly divided into two groups. All patients were administered routine anti-inflammatory and anti-infective drugs after FS-LASIK. Additionally, both groups were treated with DQS, at frequencies of 4 (DQS4 group) and 6 (DQS6 group) times daily. Corneal fluorescein staining (CFS) score, non-invasive tear breakup time (NIBUT), tear meniscus height (TMH), lipid layer thickness (LLT), and incomplete blink rate (IBR) were assessed in patients preoperatively and at 1wk, 1, and 3mo postoperatively. The Ocular Surface Disease Index (OSDI) questionnaire was also administered. RESULTS: Totally 119 patients (238 eyes) were randomly divided into the DQS4 group (60 individuals with 120 eyes) and DQS6 group (59 individuals with 118 eyes). From 1wk to 1mo after FS-LASIK, the CFS score in the DQS6 group decreased with statistical significance (P=0.014), while the DQS4 group showed an upward trend. Comparing with preoperative values, the NIBUT of both groups was significantly prolonged at various time points after FS-LASIK (P<0.05). Within 1mo post FS-LASIK, both groups had significantly higher OSDI scores compared with preoperative values (P<0.05). At postoperative 3mo, the DQS4 group recovered to a level similar to that before surgery (P>0.05), while the DQS6 group remained a little higher than preoperative values (P>0.05). The TMH levels in the DQS4 group increased significantly at 1wk postoperatively (P<0.05), while there was no statistically significant change in the TMH levels in the DQS6 group (P>0.05). There was no significant difference in IBR and LLT between the two groups within 1mo postoperatively. At postoperative 3mo, the LLT in the DQS4 group was significantly higher than that in the DQS6 group (P<0.05). CONCLUSION: Within 1mo post-FS-LASIK, applying DQS six times daily is superior to four daily applications in improving CFS score, and in increasing NIBUT meanwhile. After 1mo, applying DQS four times daily also effectively alleviate DE symptoms and improve DE signs. Therefore, we recommend DE patients using DQS eye drops 6 times daily within 1mo after FS-LASIK, and maintaining it 4 times daily until 3mo postoperatively.
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Xi-Yu Sun, Di Shen, Hao-Xi Chen, Wen-Jia Cao, Kun Zhou, Ya-Ni Wang, Rui Wang, Wei Wei
2025,18(6):1003-1010 ,DOI: 10.18240/ijo.2025.06.05
Abstract:
AIM: To investigate the response of the anterior and posterior corneal surface in femtosecond laser-assisted convex stromal lenticule addition keratoplasty (SLAK) combined with cross-linking (CXL) for treating keratoconus at the first 3mo of follow-up. METHODS: In this prospective observational study, 20 eyes of 20 keratoconus patients who underwent SLAK combined with CXL were included. The morphological indices in keratometry and elevation data were recorded from the Sirius at baseline and 1 and 3mo postoperatively. The mean values of maximum keratometry (Kmax), flat keratometry (K1), and steep keratometry (K2) at the central, 3-mm, 5-mm, and 7-mm areas were measured from the curvature map. The changes in anterior and posterior corneal elevation under the best-fit sphere (BFS) radius at seven points horizontally of the center, 3-mm, 5-mm, and 7-mm area from the center at both nasal (N) and temporal (T) side were measured from elevation map. RESULTS: For the front corneal curvature, K1, and K2 at 3-mm, 5-mm, and 7-mm of the anterior corneal surface increased significantly 1mo postoperatively (all P<0.05) and remained unchanged until 3mo (P>0.05). For the back corneal curvature, K1 and K2 along the 3-mm back meridian significantly decreased after month 1 (P=0.002, 0.077, respectively). Posterior K2-readings along the 5-mm and 7-mm did not change after surgery (P>0.05). Anterior BFS decreased 1mo (P<0.001) postoperatively but remained unchanged until 3mo after SLAK (P>0.05). There was no change in posterior BFS before and after the surgery (P>0.05). Anterior elevation at N5, N3, central, and T5 points and posterior elevation at central and T7 points shifted backward 1mo postoperatively (all P<0.05) and remained stable until 3mo (P>0.05). CONCLUSION: The myopic SLAK combined with CXL is an economical alternative for stabilizing the corneal surface in severe keraoconus. “Pseudoprogression” occurs in the early phase postoperatively, but it is not an indicator of keratoconus progression.
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Yu-Yao Qu, Le Dong, Ya-Guang Hu, Ning Gao, Jing-Ming Li, Qiao-Chu Cheng, Shan Gao, Ting Wei, Jian-Min Ma, Wan-Hu Zhang
2025,18(6):1011-1015 ,DOI: 10.18240/ijo.2025.06.06
Abstract:
AIM: To analyze the clinical and pathological features of 89 patients presenting as lacrimal gland prolapse (LGP). METHODS: This retrospective study included 89 patients presenting as LGP. Magnetic resonance imaging (MRI) scan was performed for all patients. Pathology and immunohistochemical staining of prolapsed tissue were performed during the surgery. The histopathological subtype was obtained, and the related clinical manifestations of different subtype were marked. RESULTS: Among the 89 patients involved, the histopathological subtype includes dacryoadenitis (43%; n=38), focal lymphocytes infiltration (20%; n=18), immunoglobulin G4 (IgG4)-related lacrimal gland inflammatory disease (15%; n=13), lacrimal gland (13%; n=12), and extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (9%; n=8). As for manifestations of different subtypes, eyelid swelling was found the most frequent of lymphocytes infiltration (44%, n=8), and palpable lacrimal gland mass of dacryoadenitis (55%, n=21). All the IgG4-related lacrimal gland inflammatory disease (100%, n=13) and most dacryoadenitis (97%, n=37) presented as bilateral. CONCLUSION: LGP has the histopathological subtype most commonly as inflammation, followed by structural and lymphoproliferative changes. Most of patients present as eyelid swelling. Clinical manifestations can be significant to differentiate the diagnosis.
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Jia-Song Wang, Dan Zhao, Tian-Yu Yao, Xiao-Ying Jiang, Hua-Tao Xie, Ming-Chang Zhang
2025,18(6):1016-1022 ,DOI: 10.18240/ijo.2025.06.07
Abstract:
AIM: To investigate the demographics, risk factors, clinical presentation, treatments and outcomes of Acanthamoeba keratitis (AK) in a tertiary referral hospital in central China. METHODS: In this noncomparative, retrospective study, a total of 21 AK patients were enrolled between April 2020 and March 2023. All patients underwent anterior segment photography, in vivo confocal microscopy (IVCM), best-corrected visual acuity (BCVA) and anterior segment optical coherence tomography (AS-OCT). RESULTS: The most common potential predisposing factors were contact lens wearing (71.4%), mostly were students, and organic trauma (23.8%), mainly by outdoor workers. And 80.9% of patients were initially misdiagnosed with herpes keratitis. The clinical features were radial keratoneuritis 42.8% (n=9), crude salt-like granular dense infiltration 28.6% (n=6), and corneal ring infiltration 28.6% (n=6). Fifteen patients were completely cured by medical therapy, and six patients with corneal ring infiltration feature were performed conjunctival flap covering surgery (CFCS), three of them later underwent secondary deep anterior lamellar keratoplasty (DALK). All patients completed their follow-up at the Union Hospital, with a total of 20 patients (95.2%) had improved visual acuity after treatment, 1 had no change. Corneal scarring and vascularization were the two most common complications of AK in this study, with incidence rates of 85.7% and 28.6%, respectively. CONCLUSION: In central China, AK occurs predominantly in contact lens wearers, mainly in students with myopia prevention and control. The radial keratoneuritis with crude salt-like granular dense infiltration can generally be effectively managed with medications. In contrast, corneal ring infiltration necessitates immediate surgical intervention. The CFCS combined with secondary DALK is effective for patients with high-risk AK in this condition.
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Xiao-Na Chen, Ying-Yue Xiong, Jia Wei, Bin Luo, Ya-Li Gao
2025,18(6):1023-1031 ,DOI: 10.18240/ijo.2025.06.08
Abstract:
AIM: To explore the effect of Alpha angle and Kappa angle before multifocal intraocular lenses (MIOLs) implantation on postoperative visual quality of patients. METHODS: Before and 3mo after cataract surgery, Alpha angle and Kappa angle were collected using IOL Master 700, iTrace, and Pentacam for clinical observation. Postoperative visual quality indicators, including high-order aberrations (HOA), modulation transfer function (MTF) and point spread function (PSF), were collected using iTrace. multiple linear regression analysis was used to analyze the correlation of the Kappa angle and the Alpha angle with age, axial length (AL), anterior chamber depth (ACD), keratometry (K), lens thickness (LT) and corneal white to white distance (WTW). Pearson correlation coefficient was used to analyze the correlation between Alpha angle and Kappa angle; Bland Altman analysis was used to evaluate the consistency of pairwise detection results of three instruments. RESULTS: The Alpha angle was modeled as Alpha=2.230+0.003×age-0.036×AL-0.025×K-0.058×WTW and the Kappa angle was modeled as Kappa=0.685+ 0.003×age-0.013×K-0.061×WTW. The correlation between the total Alpha angle and Kappa angle of the three instruments was weakly positive (r=0.291, P=0.000). Comparing the measurement of Alpha angle and Kappa angle using three instruments, only IOL Master 700 and iTrace showed good consistency in measuring Kappa angle (P=0.4254). After 3mo of surgery, the Alpha angle and Kappa angle significantly decreased (P=0.011, 0.018; P=0.008, 0.036). △Kappa=1.136-0.021×AL-0.013×K. Kappa angle could positively predict HOA (β=0.18, P=0.000), MTF (β=0.171, P=0.000), PSF (β=0.088, P=0.000), Alpha angle cannot (P>0.05). CONCLUSION: The patients with older age, flatter K and shorter WTW should be alert to the possibility of larger Alpha angle and Kappa angle. Alpha angle should also consider the factor of AL. When selecting patients with MIOLs implantation, there is no need to consider the Alpha angle. Careful consideration should be given to the Kappa angle, and the preoperative standard of <0.5 mm can refer to △Kappa=1.136-0.021×AL-0.013×K and be appropriately relaxed.
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Medhat A Bakr, Ussama Alnaqib, Saleh S. Algamdi, Hatim Najmi, Askar K. Alshaibani, Moataza M. Abdel Wahab, Mohammed Barnawi, Abdulaziz I. AlSomali, Khalid B. Alburayk
2025,18(6):1032-1041 ,DOI: 10.18240/ijo.2025.06.09
Abstract:
AIM: To compare trabeculectomy with mitomycin C (MMC) alone to trabeculectomy with a combination of MMC and Ologen implant in glaucoma patients. METHODS: A retrospective cohort study including 94 eyes recruited in two groups [50 in the mitomycin C (MMC) group and 44 in the combined Ologen+MMC (OLO) group]. The medical charts of the patients were collected and analyzed at different time points: 1d, 10-30d, 3-5mo, 6-9mo, 1, 2, and 3y postoperatively. We assessed the intraocular pressure (IOP) reduction, cup-disc (CD) ratio, visual acuity (VA), bleb morphology, and complications. RESULTS: Both groups showed a significant reduction of the mean IOP from 28.8 to 10 mm Hg in 1 and 2y. However, no significant difference was noticed between both groups. We observed a stable visual acuity in 40% and 11.8%, improved in 20% and 41.2%, and worsened in 40% and 47.1% in the MMC and OLO groups, respectively. Complications were statistically significantly lower in the OLO group than in the MMC group. Bleb morphology showed statistically significant differences between the groups, with grade C blebs being more prevalent in the OLO group (43.2% in 1y) compared to the MMC group (16% in 1y) and flat blebs being more prevalent in the OLO group (43.2% in 2y) compare to MMC group (20% in 2y). Both MMC and OLO groups were effective in reducing IOP. CONCLUSION: The combined use of the Ologen implant and MMC may provide better outcomes in terms of preserving the optic nerve structure, reducing complications, and maintaining stable bleb morphology postoperatively.
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Alper Can Yilmaz, Hayati Yilmaz
2025,18(6):1042-1052 ,DOI: 10.18240/ijo.2025.06.10
Abstract:
AIM: To evaluate complete blood count and biochemical parameters in patients with pseudoexfoliation syndrome (PEXS) and pseudoexfoliation glaucoma (PEXG) and compare the results with healthy controls. METHODS: Forty-four patients with PEXS, 61 patients with PEXG, and 55 healthy subjects were enrolled in this retrospective study. All systemic and especially pseudoexfoliation-related ophthalmic examination findings of the participants were evaluated. Complete blood count, glucose, creatinine, and serum lipid values were obtained. In line with these data, monocyte-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, monocyte-to-high density lipoprotein (HDL) ratio (MHR), and mean platelet volume-to-platelet count ratio were obtained and comparison were made among groups. RESULTS: Diabetes mellitus and hypertension were significantly more common in the PEXS and PEXG groups than in the control group (P=0.021, P=0.016, respectively). In the analysis of complete blood count parameters, NLR and MHR values were statistically significantly higher in PEXS and PEXG compared to the control group (P=0.037, P=0.025, respectively). In addition, glucose, low-density lipoprotein, and triglyceride values were significantly higher in the PEXS and PEXG groups compared to the control group (P<0.001, P=0.035, P<0.001, respectively), and HDL value was significantly lower (P=0.031). CONCLUSION: The hematological inflammation biomarkers we evaluated in our study provide evidence that systemic inflammation and oxidative stress processes play an important role in the pathogenesis of PEXS and PEXG.
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Emine Gökçen Bayuk, Sibel Doğuizi, Abdulsamet Erden, Özlem Karakaş, Pınar Çakar Özdal
2025,18(6):1053-1063 ,DOI: 10.18240/ijo.2025.06.11
Abstract:
AIM: To evaluate the choroidopathy in patients with systemic lupus erythematosus (SLE) using enhanced depth imaging spectral domain optical coherence tomography (EDI SD-OCT) and optical coherence tomography angiography (OCTA). METHODS: A total of 74 patients with SLE and 40 healthy volunteers were included in this cross-sectional study. SLE patients were further divided into three subgroups based on clinical and blood biochemistry findings. Ocular parameters obtained on ophthalmologic examination and optical imaging (EDI SD-OCT and OCTA) included the best corrected distance visual acuity (logMAR CDVA), subfoveal choroidal thickness (SCT), choroidal vascularity index (CVI) and vessel density (VD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP). RESULTS: SLE patients had significantly lower values for CVI and VD of DCP (DVD) than control subjects. Amongst SLE patients, gender and chloroquine dose were found to be independent determinants of CVI while age predicted SCT. Steroid dose was a significant predictor for foveal VD of SCP (SVD), chloroquine dose for parafoveal SVD, gender for total DVD, and gender and steroid dose for perifoveal DVD. No correlation of logMAR CDVA and SCT was noted between SLE patients and control subjects. No correlation of SCT was noted with disease duration, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score, hydroxychloroquine (HCQ) dose or steroid dose. No correlation of CVI was noted with patient age, disease duration, SLEDAI score, HCQ dose or steroid dose. No significant difference was noted between SLE subgroups in terms of any of the ocular parameters studied. CONCLUSION: The findings reveal the presence of ocular findings suggestive of early onset choroidopathy on EDI SD-OCT and OCTA in SLE patients, in the absence of ocular manifestations or active disease.
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Wael Ahmed Ewais, Lamia Samy Ali, Fayrouz Aboalazayem
2025,18(6):1064-1070 ,DOI: 10.18240/ijo.2025.06.12
Abstract:
AIM: To describe the influence of adding topical nepafenac to both; oral eplerenone and intravitreal aflibercept on serous foveal detachment in eyes with central serous chorioretinopathy (CSCR). METHODS: This retrospective cohort study included 31 eyes with non-resolving and recurrent CSCR that have been treated between 2015 and 2022 at Kasr Alainy Hospital. They were subdivided into Group A, which had been treated with a combination of systemic eplerenone, intravitreal aflibercept and topical nepafenac, and Group B, which had been treated with a combination of systemic eplerenone and intravitreal aflibercept (without topical nepafenac). Our outcome measures included changes in the best corrected visual acuity (BCVA), central subfield macular thickness (CMT) and serous detachment height (SDH) at baseline and at 2mo after treatment. RESULTS: Group A included 16 eyes. BCVA improved significantly from a logMAR of 0.62±0.44 to 0.42±0.47 (P=0.03), CMT decreased significantly from 401±61 to 301±100 µm, and SDH decreased significantly from 188±81 to 71±100 µm. Group B included 15 eyes. BCVA improved significantly from a logMAR of 0.68±0.39 to 0.55±0.62 (P=0.03), CMT decreased significantly from 411±39 µm to 334±92 µm, and SDH decreased significantly from 191±88 to 121±74 µm. There was a significant difference between changes in BCVA, CMT, and SDH between the two groups. CONCLUSION: Using topical nepafenac in combination with both systemic eplerenone, and intravitreal aflibercept may provide better results in the treatment of CSCR.
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Kai Gao, Zi-Ye Chen, Zhuang-Ling Lin, Ya-Ping Liu, Bao-Yi Liu, Yuan Ma, Zi-Tong Chen, Rebiya●Tuxun, Lan Jiang, Zhuo-Jun Xu, Chin-Ling Tsai, Kun-Bei Lai, Tao Li
2025,18(6):1071-1076 ,DOI: 10.18240/ijo.2025.06.13
Abstract:
AIM: To compare the proportion of rhegmatogenous retinal detachment (RRD) associated with choroidal detachment (RRDCD) in the emergency surgery group with the routine inpatient surgery group and determine risk factors for RRDCD. METHODS: A total of 694 patients (694 eyes) diagnosed with RRD in the emergency surgery (the median duration of RRD was 5d) group were included from the Department of Ophthalmic Emergency, and 692 patients (eyes) in the routine inpatient surgery group (the median duration was 15d) were selected randomly from the Ocular Fundus Department. Demographics, refractive status, macular status, lens status, extent of retinal detachment, number of retinal breaks, duration of symptoms before surgery, and the incidence of RRDCD were compared. A logistic regression analysis was used to determine potential risk factors for RRDCD. RESULTS: Compared to the routine inpatient surgery group, the emergency surgery group had a significant less median time to surgery (P<0.001) and a decreased proportion of RRDCD (2.88% vs 10.84%, P<0.001). Logistic regression analysis revealed that a prolonged duration of RRD [OR 3.51, 95% confidence interval (CI) 1.98-6.23], pseudophakia/aphakia status [OR 2.74, 95%CI (1.50-4.98)], multiple retinal breaks [OR 1.67, 95%CI (1.03-2.70)], and a substantial extent of RRD [OR 11.58, 95%CI (7.12-18.84)] were independent risk factors for RRDCD. CONCLUSION: Emergency surgical pattern of RRD demonstrates a lower incidence of RRDCD. The adoption of an expedited surgical approach has the potential to reduce the duration of RRD, possibly correlating with a decreased risk of RRDCD development.
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Si Chen, Jie Ye, Qin-Tuo Pan, Fang Huang, Lin-Yan Zheng, Hui-Fang Ye, Yan-Feng Su, Yan Li, Shuang-Qian Zhu
2025,18(6):1077-1084 ,DOI: 10.18240/ijo.2025.06.14
Abstract:
AIM: To evaluate the efficacy and safety of combining posterior scleral contraction (PSC) with intravitreal perfluoropropane (C3F8) injection in high myopia with macular hole retinal detachment (MHRD). METHODS: A total of 22 participants (22 eyes) with high myopia [axial length (AL)≥26.5 mm] and MHRD who underwent PSC combined with intravitreal C3F8 injection, with at least 6mo of follow-up were retrospectively recruited. Outcome measures included best-corrected visual acuity (BCVA), AL, optical coherence tomography (OCT) findings, and adverse events. Retinal recovery was categorized as type I (macular hole bridging with retinal reattachment) or type II (reattachment without hole bridging). RESULTS: The mean age of participants was 62.1±8.8y and mean follow-up duration was 9.18±4.21mo. Complete retinal reattachment was observed in 11 eyes (50%) at postoperative day 1, 19 eyes (86.3%) at week 1, and all 22 eyes at month 1. Ten eyes (45.5%) achieved type I recovery and 12 eyes (54.5%) achieved type II. Mean BCVA improved from 1.68±0.84 logMAR before surgery to 1.21±0.65 logMAR after surgery (P<0.001), and AL was significantly reduced compared to baseline (29.07±2.05 vs 30.8±2.2 mm; P<0.001). No serious complications were reported. CONCLUSION: PSC combined with intravitreal C3F8 injection is a safe and effective treatment for MHRD in highly myopic eyes, especially for retinal detachment limited within the vascular arcade.
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Hitomi Fujihara, Shinji Kakihara, Takao Hirano, Toshinori Murata
2025,18(6):1085-1089 ,DOI: 10.18240/ijo.2025.06.15
Abstract:
AIM: To determine the utility of the RS-1 spectral domain optical coherence tomography (SD-OCT), which incorporates an “OCT Analysis Correction Parameter” for approximating axial length, in comparison with measurements obtained from the OA-2000. METHODS: Twenty-five right eyes of healthy individuals were included. Two horizontal line scans were conducted using the RS-1, and OCT Analysis Correction Parameters were recorded. Axial length was measured twice per eye using the OA-2000. Correlation between devices was assessed using Pearson correlation coefficient, coefficient of repeatability (CR%), and Bland-Altman analysis. RESULTS: High correlation was found between axial length measurements from RS-1 and OA-2000 (r=0.986, P<0.0001). The coefficient of repeatability was 1.56% for RS-1 and 0.115% for OA-2000. Mean axial length was 25.12±1.38 mm for RS-1 and 24.90±1.54 mm for OA-2000, with RS-1 showing a statistically significant larger value (paired t-test, P=0.0009). CONCLUSION: The axial length measurements of RS-1 demonstrate a strong positive correlation with those from the OA-2000. This indicates that it could potentially be used to forecast scan ranges and choose suitable databases according to axial length categories.
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Shi-Yu Tang, Xiang-Jun Wang, Meng-Ya Han, Jian-Hua Yan
2025,18(6):1090-1096 ,DOI: 10.18240/ijo.2025.06.16
Abstract:
AIM: To describe the clinical manifestations, imaging features and surgical treatments in 5 cases of extraocular muscle (EOM) dysplasia presenting as orbital space-occupying lesions (SOL). METHODS: Records from the 5 cases with EOM dysplasia between 2004 and 2016 were retrospectively reviewed and clinical data were recorded including family history, age at onset, age at surgery, visual acuity, cycloplegic refraction, ocular alignment and motility, stereoacuity, exophthalmos, anterior segment and fundus, orbital computed tomography (CT) or magnetic resonance imaging (MRI) scan, surgical methods and final outcomes. RESULTS: All 5 cases (1 male, 4 females) were unilateral (3 right, 2 left eyes). The average age was 5.4y (range 4-6y) with no family history. Patients had unilateral strabismus (horizontal and vertical), restricted eye movement, and eyelid changes (abnormal fissures, lagophthalmos, and/or entropion) in the affected eye. None had proptosis; 1 had 2-mm enophthalmos. Orbital CT/MRI showed irregular, ill-defined masses in EOM. Two anterior orbitotomies and 3 strabismus surgeries were performed, and pathology confirmed EOM dysplasia. After surgery, horizontal deviations, which ranged from exotropia (XT) 10 prism diopter (PD) to esotropia (ET) 10 PD (average 6 PD), decreased by an average of 18 PD, while vertical deviations, which ranged from 4 PD to 20 PD (mean 9.8 PD), decreased by an average of 23.2 PD. CONCLUSION: SOL from EOM dysplasia is non-familial and typically presenting unilaterally characterized by an irregular, diffusely infiltrating mass within the EOM. EOM involvement causes strabismus, restricted eye movement, eyelid changes, and enophthalmos likely due to cicatricial processes.
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Fei-Fei Dai, Jian-Dong Pan, Xiao-Jie He
2025,18(6):1097-1104 ,DOI: 10.18240/ijo.2025.06.17
Abstract:
AIM: To investigate whether blood urea nitrogen to serum albumin ratio (BAR) influences the onset and progression of diabetic retinopathy (DR) in diabetic patients. METHODS: The diabetic individuals were extracted from the National Health and Nutrition Examination Survey (NHANES) database spanning 1999 to 2018. The BAR was calculated as the ratio of blood urea nitrogen to serum albumin. To evaluate the association between BAR levels and DR, a generalized additive model and multivariate logistic regression analysis were performed. Additionally, subgroup analyses were conducted to determine whether other factors modified this association. RESULTS: The number of eligible individuals in the current research endeavor equaled 5798. The resulting data were indicative of the existence of a nearly linearly positive relationship between BAR levels and DR. Following confounding variable adjustment (age, gender, marital status, red blood cell, hemoglobin, lactate dehydrogenase, uric acid, creatinine, gender, red cell distribution width, high-density lipoprotein, glucose, sodium, glycated hemoglobin, hypertension, and total cholesterol), the multivariate investigation implied that an elevated DR risk correlated with elevated levels of BAR (OR: 1.46, 95%CI: 1.20-1.79). This relationship was noted to be reliable and stable across diverse analyses, following the conduction of sensitivity analysis (P for trend: 0.0002). Subgroup analysis showed no statistically significant interactions between BAR and most other risk factors for DR. CONCLUSION: The study provides evidence of a positive association between elevated BAR levels and an increased risk of DR in diabetic individuals.
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Xin-Rong Li, Wen-Bo Cheng, Lu-Mei Hu, Hai-Nan Zhang, Xing-Xing Peng, Xiang-Long Yi
2025,18(6):1105-1112 ,DOI: 10.18240/ijo.2025.06.18
Abstract:
AIM: To describe ocular biometric parameters among Han and Uyghur myopic adults in Xinjiang, China. METHODS: A cross-sectional study was conducted. The different ocular biometric parameters collected using Pentacam were analyzed, including corneal curvature, corneal astigmatism (CA), horizontal corneal diameter (white-to-white, WTW), corneal volume (CV), pupil diameter (PD), anterior chamber angle (ACA), anterior chamber depth (ACD), anterior chamber volume (ACV) and axial length (AL). RESULTS: In total, 2932 participants were included in the final analysis, comprising 2310 Han and 622 Uyghur adults. Adults in the high myopia (HM) group had steeper K2, larger CA, smaller WTW and longer AL in both the Uyghur and Han adults (all P<0.05). The moderate myopia (MM) and HM group had deeper ACV, ACD and wider ACA than the low myopia (all P<0.05) in Han adults, however there were no differences in anterior chamber indices with Uyghur adults. In the Uyghur adults, we noticed that CV, WTW, and ACD were smaller, ACA was narrower, PD was larger, and AL was shorter (all P<0.05). We also noticed sex differences: males had flatter corneas, deeper ACD and ACV, and larger WTW than females (all P<0.05). In the correlation analysis, WTW was positively correlated with ACD and ACV but negatively correlated with K1, K2 and CV (all P<0.05). Narrower ACA was associated with larger PD (rU=-0.25, rH=-0.16, all P<0.01). CONCLUSION: The Han population have different biometric parameters in eyes with HM compared to the Uyghur population, and the Uyghur population may anatomically more susceptible to primary angle closure glaucoma than the Han population.
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Maryam Firdous, Muhammad Farooq Umer, Suriyakala Perumal Chandran
2025,18(6):1113-1122 ,DOI: 10.18240/ijo.2025.06.19
Abstract:
AIM: To describe the optical coherence tomography (OCT) findings of the retinal nerve fiber layer thickness (RNFLT) and choroidal thickness (CT) in beta-thalassemia major. METHODS: A systematic search was conducted on PubMed, Cochrane, and Embase using a combination of specific key words. The records found were screened in two phases (title/abstract, and full-text screening). All the original observational cross-sectional studies conducted on beta-thalassemia major cases and controls reporting the RNFLT and CT were included. The Meta-analysis was run for comparing the OCT measurements between beta-thalassemia cases and controls including pooled effect size, confidence intervals (CI), quality assessment, and publication bias. The measurements included were RNFLT (average, and in various quadrants), and CT. RESULTS: A total of 10 studies were included in this Meta-analysis including a total of 684 individuals, 362 cases and 322 controls. The RNFLT and CT showed a significant reduction in the values of beta-thalassemia cases as compared to controls. The heterogeneity among the included studies was found to be 92.65% for the average RNFLT and 30.13% for the CT making it obvious to use random effects model for analyzing the RNFLT values while fixed effects model for the CT. The Egger’s test showed significant publication bias among all the parameters except for nasal RNFLT (P=0.507), and CT (P=0.281). The estimated average effect size for the average RNFLT was 1.04 (95%CI: 0.35 to 1.72, Z=2.961, P=0.003) and for CT was 0.74 (95%CI: 0.51 to 0.96, Z=6.523, P<0.001). CONCLUSION: This Meta-analysis concludes that the RNFLT and CT are significantly thinner in beta-thalassemia cases in comparison to healthy individuals. Therefore, the RNFLT and CT must be evaluated in routine clinical practice in order to avoid irreversible vision loss particularly in beta-thalassemia individuals.
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Qi Yan, Shi-Si Chen, Xi-Ting Lu, Hao Chen, Chao-Ying Han, Hui-Qun Wu, Li-Li Shi
2025,18(6):1123-1130 ,DOI: 10.18240/ijo.2025.06.20
Abstract:
AIM: To systematically evaluate the association between nailfold capillaroscopic findings and diabetic retinopathy (DR) and compare findings in diabetic patients with and without DR. METHODS: PubMed, Web of Science, and Embase databases were searched from inception to February 2024. The quality of the included studies was evaluated using a National Institutes of Health (NIH) Quality Assessment tool for Observational Cohort and Cross Sectional Studies. Meta-analysis was conducted to compare the findings of nailfold capillaroscopy between diabetic patients with or without DR. Subgroup analysis was employed to investigate the source of heterogeneity. RESULTS: Totally 12 studies with 1349 diabetic patients were included, of which 628 had DR. The overall quality of included studies was acceptable. Patients with DR had increased arteriolar diameters [mean difference (MD): 2.68, 95% confidence interval (CI): 0.64-4.72] and a higher risk of developing nailfold capillaroscopic abnormalities, including bushy capillaries [odds ratio (OR): 2.82, 95%CI: 1.65-4.80], neoformation (OR: 4.61, 95%CI: 3.15-6.76), megacapillaries (OR: 8.37, 95%CI: 5.07-13.80), tortuosity (OR: 7.29, 95%CI: 2.76-19.22), microhemorrhages (OR: 6.16, 95%CI: 2.48-15.26), meandering capillaries (OR: 4.68, 95%CI: 1.05-20.80) and avascular areas (OR: 7.92, 95%CI: 2.68-23.38). The presence of tortuous capillary was more common in DR in India than in Turkey, while avascular area in the nailfolds was linked to DR only in India (OR: 11.28, 95%CI: 3.91-32.60). Among the nailfold capillaroscopic abnormalities, tortuosity, microhemorrhage, and meandering capillary showed no significant correlation with the severity of DR, except for avascular area (P=0.04). CONCLUSION: There are significant associations between nailfold capillaroscopic findings and the presence of DR, supporting its potential as a non-invasive technique for monitoring microvascular changes in diabetic patients. However, further research is needed to validate its utility as an early screening tool for microvascular complications in diabetes.
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Puneet Agarwal, Renu Agarwal, Igor Iezhitsa
2025,18(6):1131-1145 ,DOI: 10.18240/ijo.2025.06.21
Abstract:
Glaucoma, a degenerative optic neuropathy, causes retinal ganglion cell (RGC) apoptosis and irreversible vision loss. Current therapies often fail to stop disease progression despite lowering intraocular pressure, the main risk factor. Thus, neuroprotective strategies have gained interest. We performed a bibliometric analysis to determine global publishing trends and relationships among prolific authors, publications, institutions, funding agencies, and journals. We also analyzed author keywords to identify research hotspots in glaucoma neuroprotection. Further, based on keyword analysis, we reviewed most recent literature to understand mechanistic pathways underlying glaucoma-related pathophysiological responses leading to RGC loss. Bibliographic data were sourced from Scopus. Basic bibliographic features were characterized using Scopus’s functions. VOSviewer was used for mapping and visualizing bibliometric networks. The analysis included trends in publications since 2000, the most prolific countries, institutions, authors, and the strength of their linkages. A significant increase in publication output over the past two decades was noted. The United States leads in funding support, research output, and citation links, followed by China and the UK. Among the top 10 most cited authors, three are from Japanese institutions. Keyword analysis shows a focus on molecular targets related to ischemia, excitotoxicity, inflammation, and oxidative stress, with fewer emerging drug candidates and limited clinical trials. Based on the most recent literature, emerging molecular targets underlying these key pathophysiological mechanisms are summarized. In conclusion, while pathophysiology and molecular mechanisms are the current focus, there is not much progress in developing new drug candidates and conducting clinical trials.
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Ying-Chao Xue, Xiao-Long Liu, Bo-Yu Liu, Sheng-Xiang Zhang, Qi-Hua Xu, Ling-Dan Wu
2025,18(6):1146-1151 ,DOI: 10.18240/ijo.2025.06.22
Abstract:
Artesunate is a derivative of artemisinin, and due to its high solubility, and it has a broader application in clinical settings. Extensive research has confirmed that artemisinin-based drugs show significant activities in anti-inflammatory, anti-tumor, anti-viral, and anti-angiogenesis aspects, suggesting that artesunate might have potential in treating retinal diseases. Currently, the etiology of most retinal diseases is not fully understood, and there is a lack of effective treatment methods. This paper summarized the research progress of artesunate in the treatment of retinal diseases, including retinoblastoma, choroidal melanoma, diabetic retinopathy, central retinal vein occlusion, proliferative retinopathy, and ocular neovascularization. In addition, the potential applications and future research directions of artesunate in the treatment of retinal diseases were also discussed.
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Yu-Xuan Yuan, Hong-Yun Wu, Wen-Jin Yuan, Yi-Lin Zhong, Zhe Xu
2025,18(6):1152-1162 ,DOI: 10.18240/ijo.2025.06.23
Abstract:
Macular pigment (MP) is a crucial pigment in the macular region. It plays an important role in filtering blue light, and exhibits anti-inflammatory and antioxidant properties. Macular pigment optical density (MPOD) is a key indicator for assessing the density of MP in the macular area and is closely associated with eye diseases, including age-related macular degeneration, diabetic retinopathy, and glaucoma. This review aims to explore the clinical significance of MPOD and its research value in ophthalmology and other medical fields. It summarizes the current MPOD measurement techniques, categorizing them into two main types (in vivo and in vitro), and discusses their respective advantages and limitations. Additionally, given the advancements in artificial intelligence (AI) and deep-learning technologies that offer new opportunities for improving MPOD assessment, this review analyzes the significant potential and future prospects of AI-based fundus image analysis in MPOD measurement. The goal of AI-based analysis is to provide faster and more accurate detection methods, thereby promoting further research and new clinical applications of MPOD in the field of ophthalmology.
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Wen-Ting Ding, Yi-Le Xu, Di Li, Xiao-Xiao Qian, Jian Li, Hong-Wei Ge, Xiao-Hua Zhang, Ren-Jian Hu, Yong-Ping Hu
2025,18(6):1163-1168 ,DOI: 10.18240/ijo.2025.06.24
Abstract:
AIM: To describe an innovative surgical technique for pathologic myopia and macular holes accompanied by retinal detachment using allogeneic corneal stromal lenticule transplantation combined with pars plana vitrectomy. METHODS: The allogeneic corneal stromal lenticule was harvested through small incision lenticule extraction (SMILE) and stored at -30°C in advance. After pars plana vitrectomy, an allogeneic corneal stromal lenticule was thawed, trimmed into approximately 60 μm thick and 100 μm larger than the macular hole and transferred to cover the macular hole through the trocar. Autologous whole blood was dripped to seal the corneal stromal lenticule. The vitreous cavity was then filled with perfluoropropane (C3F8) or sterile air. RESULTS: The technique was performed on three eyes of three patients. The mean postoperative follow-up period was 77.3±50.0d. Postoperatively, the macular hole of all eyes was restored. All patients’ visual acuities also improved. No complications occurred during the follow-up period. CONCLUSION: The innovative corneal stromal lenticule transplantation technique provides convenient operations, less surgical invasion, effective results, and reliable safety for macular hole repair during follow-up time.
Volume 18,2025 Issue 6
Basic Research
Clinical Research
Investigation
Meta-Analysis
Bibliometric Research
Review Article
Brief Report
Letter to the Editor
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Abstract:
AIM: To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume (MPV), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and the presence and severity of diabetic retinopathy (DR). METHODS: We searched for eligible studies from PubMed, EMBASE, Web of Science and CNKI up to December 13, 2017. Standardized mean difference (SMD) calculated with confidence interval (CI) of 95% was used to estimate the values of those indices. RESULTS: A total of 31 studies were included in the present Meta-analysis. As compared with type 2 diabetes mellitus (T2DM) patients without DR, the values of MPV, PDW, NLR, and PLR were higher in patients with DR (SMD=0.67; 95%CI: 0.36 to 0.98; SMD=0.51; 95%CI: 0.27 to 0.75; SMD=0.77; 95%CI: 0.49 to 1.05 and SMD=1.18; 95%CI: 0.07 to 2.28). Additionally, it was also observed that MPV was closely correlated with the severity of DR. CONCLUSION: MPV, PDW, NLR, and PLR could be recommended as diagnostic biomarkers for DR, and MPV could be applied to assess the severity of DR.
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Arshad Ali Lodhi, Sameen Afzal Junejo, Mahtab Alam Khanzada, Imran Akram Sahaf, Zahid Kamal Siddique
Abstract:
AIM: To evaluate the surgical outcome of congenital upper eyelid coloboma repair. · METHODS: All patients underwent complete ophthalmic and general examination before going to surgery, and then examination under anesthesia was performed to assess the site and size of eyelid defect, conjunctival involvement. The status of cornea and ocular motility with forced duction test was also being noted. The surgical procedure was performed according to the size of defect. · RESULTS: Out of 21 cases of congenital upper eyelid coloboma, 18 occurred in isolation with upper eyelid medial defect, 13 were bilateral and 5 were unilateral. Others were associated with Goldenhar syndrome and CHARGE syndrome with bilateral upper lid medial defects. All patients were presented for surgical corrections during age of 2.5-4.0 years except one that presented at 25 years of age. Cosmetically surgical results were acceptable, except one that was already presented with opaque corneal. · CONCLUSION: In this study, overall surgical results were satisfactory except one that was presented late with compromised cornea.
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Veronica E. Giordano, Sergio E. Hernandez-Da Mota, Tania N. Adabache-Guel, Armando Castillejos-Chevez, Sonia Corredor-Casas, Samantha M. Salinas-Longoria, Rafael Romero-Vera, Juan M. Jimenez-Sierra, Jose L. Guerrero-Naranjo, Virgilio Morales-Canton
Abstract:
AIM: To determine whether different intravitreal doses of quinupristin/dalfopristin lead to electroretinographic or histological changes in the rabbit retina over one month period after injection. METHODS: Eighteen New Zealand white rabbits were divided into three treatment groups (groups 1 to 3) and different intravitreal doses of quinupristin/dalfopristin were tested in each group. The right eye was injected with the drug and the left eye received intravitreal injection of 5% dextrose water and served as control eye. The doses delivered to each group were 0.1 mg/0.1 mL, 1 mg/0.1 mL and 10 mg/0.1 mL. Simultaneous, bilateral, dark-adapted electroretinography and clinical images of both eyes were obtained in all groups before injection (baseline) and after 7, 14, 21 and 28d, followed by enucleation for histological examination. RESULTS: Subjects in the group 1 showed no signs of toxicity in the electroretinogram when compared with groups 2 and 3 (Kruskall-Wallis test, P=0.000). By day 7, no electrical response to light stimuli was recorded in the treated eyes in groups 2 and 3, consistent with severe damage due to retinal toxicity. Light microscopy revealed no significant histopathological changes in the group 1, while rabbits in groups 2 and 3 had signs of granulomatous inflammation in most cases. CONCLUSION: Intravitreal 0.1 mg/0.1 mL doses of quinupristin/dalfopristin do not lead to electroretinographic or histological signs of retinal toxicity compared with 1 mg/0.1 mL and 10 mg/0.1 mL in this rabbit model.
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Anteneh Amsalu, Kindie Desta, Demiss Nigussie, Demoze Delelegne
Abstract:
AIM: To assess the pattern of ocular manifestation and associated factors among human immunodeficiency virus (HIV) /acquired immunodeficiency syndrome (AIDS) patients on highly active antiretroviral therapy (HAART) at Hawassa University Referral Hospital, Southern Ethiopia. METHODS: A cross sectional study was conducted from January 2014 to April 2015. After obtaining informed written consent, 240 adult HIV/AIDS patients on HAART were randomly selected regardless of their ophthalmic symptoms, WHO status or CD4 count. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 20.0 software. RESULTS: The mean duration of HAART was 62.5mo. The prevalence of HIV related ocular manifestation was 14.2%. Seborrheic blepharitis (5%) was the most common ocular manifestation, followed by squamoid conjunctival growth (3.8%). The rate of ocular manifestation was significantly higher among study participants who had CD4+ count <200 cells/μL (AOR=3.83; 95%CI: 1.315-11.153), low duration of HAART (AOR=3.0; 95%CI: 1.305-6.891) and who had primary school education [odds ratio (OR) =2.8; 95%CI: 1.105-7.099]. Prevalence of visual impairment and blindness was 10.9% and 5.8%, respectively. CONCLUSION: HAART may be the reason for the decline in the prevalence of ocular manifestation in HIV/AIDS patients in the study area. Ophthalmologic screening of HIV/AIDS patients, especially those with CD4 counts of <200/μL cells and in the first five years of HAART follow-up is recommended to reduce visual impairment and/or blindness.
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Zhi-Chun Zhao, Ying Zhou, Gang Tan, Juan Li
Abstract:
In recent years, people have become increasingly attentive to light pollution influences on their eyes. In the visible spectrum, short-wave blue light with wavelength between 415 nm and 455 nm is closely related to eye light damage. This high energy blue light passes through the cornea and lens to the retina causing diseases such as dry eye, cataract, age-related macular degeneration, even stimulating the brain, inhibiting melatonin secretion, and enhancing adrenocortical hormone production, which will destroy the hormonal balance and directly affect sleep quality. Therefore, the effect of Blu-rays on ocular is becoming an important concern for the future. We describe blue light’s effects on eye tissues, summarize the research on eye injury and its physical prevention and medical treatment.
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Ji Jin, Lei Chen, Gao-Qin Liu, Pei-Rong Lu
Abstract:
AIM: To analyze the retinal proteomes with and without conbercept treatments in mice with oxygen-induced retinopathy (OIR) and identify proteins involved in the molecular mechanisms mediated by conbercept. METHODS: OIR was induced in fifty-six C57BL/6J mouse pups and randomly divided into four groups. Group 1: Normal17 (n=7), mice without OIR and treated with normal air. Group 2: OIR12/EXP1 (n=14), mice received 75% oxygen from postnatal day (P) 7 to 12. Group 3: OIR17/Control (n=14), mice received 75% oxygen from P7 to P12 and then normal air to P17. Group 4: Lang17/EXP2 (n=21), mice received 75% oxygen from P7 to P12 with intravitreal injection of 1 μL conbercept at the concentration of 10 mg/mL at P12, and then normal air from P12 to P17. Liquid Chromatography-Mass Spectrometry (LC-MS)/MS data were reviewed to find proteins that were up-regulated after the conbercept treatment. Gene ontology (GO) analysis was performed of conbercept-mediated changes in proteins involved in single-organism processes, biological regulation, cellular processes, immune responses, metabolic processes, locomotion and multiple-organism processes. RESULTS: Conbercept induced a reversal of hypoxia-inducible factor 1 signaling pathway as revealed by the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and also induced down-regulation of proteins involved in blood coagulation and fibrin clot formation as demonstrated by the Database for Annotation, Visualization and Integrated Discovery (DAVID) and the stimulation of interferon genes studies. These appear to be risk factors of retinal fibrosis. Additional conbercept-specific fibrosis risk factors were also identified and may serve as therapeutic targets for fibrosis. CONCLUSION: Our studies reveal that many novel proteins are differentially regulated by conbercept. The new insights may warrant a valuable resource for conbercept treatment.
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Xi-Teng Chen, Hui Huang, Yan-Hua Chen, Li-Jie Dong, Xiao-Rong Li, Xiao-Min Zhang
Abstract:
AIM:To identify the genetic defects in a Chinese family with achromatopsia.METHODS:A 2.5-year-old boy, who displayed nystagmus, photophobia, and hyperopia since early infancy, was clinically evaluated. To further confirm and localize the causative mutations in this family, targeted region capture and next-generation sequencing of candidate genes, such as CNGA3, CNGB3, GNAT2, PDE6C, and PDE6H were performed using a custom-made capture array.RESULTS:Slit-lamp examination showed no specific findings in the anterior segments. The optic discs and maculae were normal on fundoscopy. The unaffected family members reported no ocular complaints. Clinical signs and symptoms were consistent with a clinical impression of autosomal recessive achromatopsia. The results of sequence analysis revealed two novel missense mutations in CNGA3, c.633T>A (p.D211E) and c.1006G>T (p.V336F), with an autosomal recessive mode of inheritance.CONCLUSION: Genetic analysis of a Chinese family confirmed the clinical diagnosis of achromatopsia. Two novel mutations were identified in CNGA3, which extended the mutation spectrum of this disorder.
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Abstract:
Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today’s world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician’s responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of optical coherence tomography, frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.
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Ping-Ting Zhao, Ling-Jun Zhang, Hui Shao, Ling-Ling Bai, Bo Yu, Chang Su, Li-Jie Dong, Xun Liu, Xiao-Rong Li, Xiao-Min Zhang
Abstract:
AIM: To test the therapeutic effects of delayed treatment of mesenchymal stem cells (MSCs) in recurrent experimental autoimmune uveitis (rEAU). METHODS: The efficacy of different regimens of MSC administration in rEAU were tested by evaluation of clinical and pathological intraocular inflammation, as well as retinal structural and functional integrity using optical coherence tomography (OCT) and electroretinogram (ERG). The retinal sections were also immunostained with antibodies to glial fibrillary acidic protein (GFAP) and rhodopsin (RHO). RESULTS: Delayed treatment of MSCs effectively alleviated the severity of intraocular inflammation with relative intact of outer retinal structure and function. Moreover, double therapies with longer interval led to an even better clinical evaluation, as well as a trend of decrease in relapse and amelioration of retinal function. MSC therapies also effectively reduced GFAP expression and increased RHO expression in the retina. CONCLUSION: MSC administration can effectively treat developed diseases of rEAU, and multiple therapies can provide additional therapeutic benefits.
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Li-Fei Yuan, Guang-Da Li, Xin-Jun Ren, Hong Nian, Xiao-Rong Li, Xiao-Min Zhang
Abstract:
AIM:To determine the effects of rapamycin on experimental autoimmune uveoretinitis (EAU) and investigate of role of rapamycin on T cell subsets in the disease. METHODS:EAU was induced in rats using peptides 1169 to 1191 of the interphotoreceptor binding protein (IRBP). Rapamycin (0.2 mg/kg/d) was administrated by intraperitoneal injection for a consecutive 7d after immunization. Th1/Th2/Th17 cytokines, TGF-β1, and IL-6 produced by lymphocyteswere measured by ELISA, while Th17 cells and CD4+CD25+ regulatory T cells (Tregs) from rat spleen were detected by flow cytometry. RESULTS: Intraperitoneal treatment immediately after immunization dramatically ameliorated the clinical course of EAU. Clinical responses were associated with reduced retinal inflammatory cell infiltration and tissue destruction. Rapamycin induced suppression of Th1/Th2/Th17 cytokines, including IFN-γ, IL-2, IL-17, IL-4, and IL-10 release from T lymphocytes of EAU rats, in vitro. Rapamycin also significantly increased TGF-β1 production but had no effect on IL-6 productionof T lymphocytes from EAU rats in vitro. Furthermore, rapamycin decreased the ratio of Th17 cells/CD4+T cells and upregulated Tregs in EAU, as detected by flow cytometry. CONCLUSION: Rapamycin effectively interferes with T cell mediated autoimmune uveitis by inhibiting antigen-specific T cell functions and enhancing Tregs in EAU. Rapamycin is a promising new alternative as an adjunct corticosteroid-sparing agent for treating uveitis.
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Abstract:
AIM: To report various ocular lesions caused by accidental instillation of superglue.METHODS: Three cases of ocular injuries are described in children aged 6 years, 3 years and 8 months, following accidental instillation of superglue in the eye.RESULTS: In the first case there was sticking of eyelashes in the medial 1/3 of eyelids in both eyes. In the second case sticking of eye lashes was present in the lateral 1/3 of eyelids in the left eye. In the third case, superglue was present on the right cheek, above the right ear and sticking of eyelids in medial 1/3 in right eye. The eyelids were separated by pulling the lid margins with fingers in the first case and later on superglue was removed by trimming the eyelashes; and by direct trimming the eyelashes in second and third cases. There was no injury to other structures of anterior segment in the first two cases. However, removal of the superglue on the cornea resulted in corneal abrasion in the third case which healed with medical treatment and patching of the right eye.CONCLUSION: Accidental instillation of superglue is possible because of the appearance of the tube like eye ointment tube. Immediate medical aid will prevent ocular morbidity.
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Yang-Qing Huang, He Huang, Rong-Zhi Huang
Abstract:
AIM:To introduce a new near-vision chart for children aged 3-5 years old and its clinical applications.METHODS:The new near-vision chart which combined the Bailey-Lovie layout with a newly devised set of symmetry symbols was designed based on Weber-Fechner law. It consists of 15 rows of symmetry symbols, corresponding to a visual acuity range from 1.3 to 0.1 logMAR. The optotypes were red against a white background and were specially shaped four basic geometric symbols:circle, square, triangle，and cross, which matched the preschool children''s cognitive level. A regular geometric progression of the optotype sizes and distribution was employed to arrange in 15 lines. The progression rate of the optotype size between two lines was 1.2589 and two smaller groups of optotypes ranging from 0.7 to -0.1 logMAR were included for repetitive testing. A near visual acuity was recorded in logMAR or decimal, and the testing distance was 25 cm.RESULTS:This new near-vision chart with pediatric acuity test optotypes which consists of 4 different symbols (triangle, square, cross, and circle) met the national and international eye chart design guidelines. When performing the near visual acuity assessment in preschoolers (3-5 years old). It overcame an inability to recognize the letters of the alphabet and difficulties in designating the direction of black abstract symbols such as the tumbling ''E'' or Landolt ''C'', which the subjects were prone to lose interest in. Near vision may be recorded in different notations:decimal acuity and logMAR. These two notations can be easily converted each other in the new near-vision chart. The measurements of this new chart not only showed a significant correlation and a good consistency with the Chinese national standard logarithmic near-vision chart (r=0.932, P<0.01), but also indicated good test-retest reliability (89% of retest scores were within 0.1 logMAR units of the initial test score) and a high response rate.CONCLUSION:The results of this study support the validity and reliability of near visual acuity measurements using the new near-vision chart in children aged 3-5y over a wide range of visual acuities, and the new eye chart was especially suitable for the detection of amblyopia risk factors and low vision examination in children (3-5y of age). It can be applied in routine clinical practice.
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Ali Ihsan Incesu, Güng?r Sobac?
Abstract:
Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today's world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician's responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of OCT (optical coherence tomography), frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.
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Blake F. Webb, Jadon R. Webb, Mary C. Schroeder, Carol S. North
Abstract:
AIM: To estimate the prevalence and risk factors for vitreous floaters in the general population.METHODS: An electronic survey was administered through a smartphone app asking various demographic and health questions, including whether users experience floaters in their field of vision. Multivariate logistic regression analysis was used to determine risk factors.RESULTS:A total of 603 individuals completed the survey, with 76% reporting that they see floaters, and 33% reporting that floaters caused noticeable impairment in vision. Myopes were 3.5 times more likely (P=0.0004), and hyperopes 4.4 times more likely (P=0.0069) to report moderate to severe floaters compared to those with normal vision. Floater prevalence was not significantly affected by respondent age, race, gender, and eye color.CONCLUSION:Vitreous floaters were found to be a very common phenomenon in this non-clinical general population sample, and more likely to be impairing in myopes and hyperopes.
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Bora Yüksel, Sultan Kaya ünsal, Sevgi Onat
Abstract:
AIM: To compare the efficiency and safety of fibrin glue to suture technique in pterygium surgery performed with limbal autograft. METHODS: A prospective randomised clinical trial was carried out in 58 eyes of 58 patients operated for primary nasal pterygium. Autologous conjunctival graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision. In 29 eyes, the transplant was attached to the sclera with a fibrin tissue adhesive (Beriplast P) and in 29 eyes with 8-0 Virgin silk sutures. The Mann-Whitney U test was used for statistical analysis. Postoperative patient discomfort (pain, stinging, watering) and biomicroscopic findings (hyperemia, edema) were graded. Patients were followed up at least for six months. RESULTS: Subconjunctival hemorrhage occured under the graft in one patient in group 1. In seven cases of group 2, sutures were removed at the 15th day because of granulomatous tissue reaction. Patient symptoms were significantly less and biomicroscopic findings were better in group 1. Pterygium recurrence was seen in one case of group 1, and 2 cases of group 2. Average surgery cost was higher (P<0.05) and surgery time was shorter (P<0.05) in fibrin group. CONCLUSION: Using fibrin glue for graft fixation in pterygium surgery causes significantly less postoperative pain and shortens surgery time significantly.
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Abstract:
Photobiomodulation (PBM), also known as low level laser therapy, has recently risen to the attention of the ophthalmology community as a promising new approach to treat a variety of retinal conditions including age-related macular degeneration, retinopathy of prematurity, diabetic retinopathy, Leber’s hereditary optic neuropathy, amblyopia, methanol-induced retinal damage, and possibly others. This review evaluates the existing research pertaining to PBM applications in the retina, with a focus on the mechanisms of action and clinical outcomes. All available literature until April 2015 was reviewed using PubMed and the following keywords: “photobiomodulation AND retina”, “low level light therapy AND retina”, “low level laser therapy AND retina”, and “FR/NIR therapy AND retina”. In addition, the relevant references listed within the papers identified through PubMed were incorporated. The literature supports the conclusion that the low-cost and non-invasive nature of PBM, coupled with the first promising clinical reports and the numerous preclinical-studies in animal models, make PBM well-poised to become an important player in the treatment of a wide range of retinal disorders. Nevertheless, large-scale clinical trials will be necessary to establish the PBM therapeutic ranges for the various retinal diseases, as well as to gain a deeper understanding of its mechanisms of action.
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Wen-Bin Huang, Qian Fan, Xiu-Lan Zhang
Abstract:
Glaucoma is one of the leading causes of visual impairment and blindness. Improved knowledge of the pathogenesis of this disease has allowed the exploration of new therapeutic methods. In general, elevated intraocular pressure (IOP), oxidative stress, and vascular insufficiency are accepted as the major risk factors for the progression of glaucoma. Many natural compounds have been found beneficial for glaucoma. Nutritional therapies are now emerging as potentially effective in glaucomatous therapy. One nutritional supplement with potential therapeutic value is cod liver oil, a dietary supplement that contains vitamin A and omega-3 polyunsaturated fatty acids (PUFAs). Vitamin A is important for preserving normal vision and it is a well-known antioxidant that prevents the oxidative damage that contributes to the etiology and progression of glaucoma. Vitamin A is also a crucial factor for maintaining the integrity of conjunctival and corneal ocular surfaces, and preventing the impairment of ocular epithelium caused by topical antiglaucomatous drugs. Omega-3 fatty acids are beneficial for glaucoma patients as they decrease IOP, increase ocular blood flow, and improve optic neuroprotective function. In this article, we propose that cod liver oil, as a combination of vitamin A and omega-3 fatty acids, should be beneficial for the treatment of glaucoma. However, further studies are needed to explore the relationship between cod liver oil and glaucoma.
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Jun Yi, Jun Yun, Zhi-Kui Li, Chang-Tai Xu, Bo-Rong Pan
Abstract:
· Congenital cataract is a crystallin severe blinding disease and genetic factors in disease development are important. Crystallin growth is under a combination of genes and their products in time and space to complete the coordination role of the guidance. Congenital cataract-related genes, included crystallin protein gene (CRYAA, CRYAB, CRYBA1/A3, CRYBA4, CRYBB1, CRYBB2, CRYBB3, CRYGC, CRYGD, CRYGS), gap junction channel protein gene (GJA1, GJA3, GJA8), membrane protein gene (GJA3, GJA8, MIP, LIM2), cytoskeletal protein gene (BF-SP2), transcription factor genes (HSF4, MAF, PITX3, PAX6), ferritin light chain gene (FTL), fibroblast growth factor (FGF) and so on. Currently, there are about 39 genetic loci isolated to which primary cataracts have been mapped, although the number is constantly increasing and depends to some extent on definition. We summarized the recent advances on epidemiology and genetic locations of congenital cataract in this review.
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Juan-Juan Li, Yun-Peng Li, Zhu-Lin Hu
Abstract:
We describe the successful treatment in a patient with bilateral congenital aniridia and cataract by insertion of capsular tension rings and IOL.
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Abstract:
AIM: To compare the efficacy for preventing exposure keratopathy of three forms of eye care (artificial tear, moist chamber and polyethylene covers) for intensive care patients. METHODS: Eighty-four patients in Intensive Care Unit (ICU) were randomized to three treatment groups, including artificial tears group, moist chambers group and polyethylene film group. Patients of artificial tear group received two drops of carboxymethylcellulose drops to each eye every 2 hours. The moist chambers and the polyethylene were changed every 12 hours or as needed if they became unclean or torn. The corneal fluorescein stains were performed daily. RESULTS: No of 28 patients (0%) in the polyethylene group and one of the 27 patients (3.70%) in the moist chamber group had exposure keratopathy, compared to 8 of the 29 patients (27.59%) in the artificial tear group. There were statistical significance between the artificial tear group and the moist chamber group (P=0.02), and the artificial tear group and the polyethylene group (P =0.003). The time on eye care every day of the artificial tear group, the moist chamber group and the polyethylene group was 26.69±2.39 minutes, 35.33±2.63 minutes and 7.48±0.87 minutes, respectively. The eye care of the polyethylene group were statistically more time-save than that of the artificial tear group (P<0.001) and the moist chamber group (P<0.001). CONCLUSION: Polyethylene covers are more effective and more time-saving in reducing the incidence of corneal damage in intensive care patients
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