In recent years,the number of cataract patients with a history of corneal refractive surgery has gradually in-creased,posing many challenges for cataract surgery,such as the decreased corneal endothelial cell density,the destructed corneal integrity,the changed corneal curvature,and the reduced accuracy of the calculation of intraocular lens power,which increase the difficulty of cataract surgery and affect postoperative satisfaction.It is one of the important challenges in refractive cataract surgery.This article elaborates on the difficulties of cataract surgery after corneal refractive surgery,fac-tors affecting visual acuity and visual quality,as well as preoperative preparation,intraoperative precautions,and postoper-ative management for cataract patients after refractive surgery,providing a reference for clinical physicians to understand the research progress on cataract surgery after corneal refractive surgery.
一例74岁男性因左眼眶内肿物渐进性增大3个月就诊。诊断为套细胞淋巴瘤(经典型、Ⅳ期)。在局麻下行左眼眶内肿物切除及眶膈加固术,术后予以环磷酰胺、长春瑞滨、泼尼松片(COP方案)治疗,病情稳定后规律口服奥布替尼治疗。提示应提高以眼眶肿物为首发表现的套细胞淋巴瘤的认识,以免误诊、漏诊。(眼科,2024,33:381-382)
Objective To analyze the peripheral defocus of the retina in myopic children wearing orthokeratology lenses(OK lenses)using multispectral refraction topography(MRT).Methods A retrospective study was conducted.A total of 128 eyes of 128 myopic children(right eye)who got OK lenses in Ineye Hospital of Chengdu University of TCM from January to April 2021 were included.The steep keratometry(Ks),flat keratometry(Kf),eccentricity at the meridian of Ks and eccentricity at the meridian of Kf were measured by corneal topography before wearing OK lenses.The central corneal thickness before wearing OK lenses,baseline axial length(AL1)and axial length(AL2)after wearing OK lenses for 1 year were measured by optical biometer,and retinal defocus value(RDV)after wearing OK lenses for 1 year was meas-ured by MRT.According to the change in axial length(CAL)after wearing OK lenses for 1 year,subjects were divided into the SAL group(CAL≤0.3 mm)and LAL group(CAL＞0.3 mm).The peripheral RDV in the range of 0°-10°,＞10°-20°,＞20°-30°,＞30°-40°,and＞40°-53°(RDV0°-10°,RDV10°-20°,RDV20°-30°,RDV30°-40°,RDV40°-53°),av-erage RDV in the range of 0°-53°,and average RDVs in the superior,inferior,temporal and nasal quadrants(RDV-S,RDV-I,RDV-T and RDV-N)of both groups were compared after wearing OK lenses for 1 year.In addition,the effect of RDV in different peripheral retinal regions on AL growth was analyzed.Results After wearing OK lenses for 1 year,the peripheral RDV20°-30°,RDV30°-40°,RDV40°-53°,TRDV,RDV-I and RDV-T were higher in the LAL group than those in the SAL group(all P＜0.05).Correlation analysis showed that AL1 was negatively correlated with CAL(P＜0.05),whereas age,peripheral RDV0°-10°,RDV-S,RDV-N and other ocular biological parameters were not correlated with CAL(all P＞0.05).The peripheral RDV10°-20°,RDV20°-30°,RDV30°-40°,RDV40°-53°,TRDV,RDV-I and RDV-T were positively correlated with CAL(all P＜0.05).Conclusion Peripheral retinal defocus in the range of 10°-53° in myopic children is closely related to AL growth.The lower the RDV,the slower the AL growth.
Diabetic retinopathy(DR)is a severe blinding eye disease caused by diabetes.A number of studies have shown that there is a phenomenon of"metabolic memory"in diabetic patients,but its mechanism is still unclear.In the oc-currence and progression of DR,oxidative stress in a high-glucose environment causes abnormal mutations of mitochondrial DNA(mtDNA)copy number in retinal cells,and its repair system is destroyed at the same time and forms a vicious circle,resulting in excessive production of reactive oxygen,destruction of redox homeostasis and apoptosis.The mtDNA can be independently replicated and passed on to the next generation,and epigenetic modification can also affect the regulation of genes related to the pathogenesis of DR.In the occurrence and development of DR,it is of great significance to clarify the mechanism of mitochondrial damage and"metabolic memory"for the prevention and treatment of DR.The emergence of mitochondrial transfer technology is expected to break the"metabolic memory"phenomenon and open up new avenues for treating such diseases.This article gives a review of the related research and development.
Objective To detect the expression levels of cytokines[Interleukin-6(IL-6),Interleukin-8(IL-8),In-terleukin-10(IL-10),vascular endothelial growth factor(VEGF),cell adhesion molecule(CAM)and basic fibroblast growth factor(BFGF)],cytomegalovirus(CMV)nucleic acid,rubella virus(RV)nucleic acid and antibodies in patients with Fuchs syndrome and cataract,evaluating the inflammation and viral expression in aqueous humor of patients.Meth-ods A retrospective study was conducted.A total of 18 patients(18 eyes)clinically diagnosed with Fuchs syndrome com-plicated with cataract from October 2020 to July 2022 in the Ophthalmology Department of the Zhengzhou Second Hospital were included and their preoperative data were recorded.These patients underwent phacoemulsification and intraocular lens implantation,with 0.1 mL aqueous humor extracted during the operation.The expression levels of cytokines(IL-6,IL-8,IL-10,VEGF,CAM and BFGF),CMV nucleic acid,RV nucleic acid and viral antibodies were quantitatively analyzed.Results In these 18 patients,the IL-6 level was normal in 13 patients and mildly elevated in 5 patients.The levels of IL-8,IL-10,VEGF,CAM and BFGF were detected in 8 patients,IL-10 was normal in all these patients,IL-8 was elevated in 2 patients,VEGF was mildly elevated in 1 patient,and CAM and BFGF levels were increased in 7 patients.The CMV and RV nucleic acids were tested in 12 patients,with all negative results.In the 18 patients involved,the RV-IgG increased in 12 patients and was normal in other 6 patients with certain titer values.In 16 patients tested for CMV-IgG and herpes simplex virus-IgG,only one patient was slightly elevated in CMV-IgG,and the rest were normal.Varicella-zoster virus-IgG was test-ed in 8 patients,and all of them were negative.Conclusion The eye inflammation of patients with Fuchs syndrome and cataract is not obvious,thus clinical RV nucleic acid is not easily detected,and the RV-IgG has a reference value in clinical diagnosis of Fuchs syndrome.
Objective To investigate the influence of Nei endonuclease Ⅷ-like protein 1(NEIL1)on H2O2-induced apoptosis and autophagy in lens epithelial cells(LECs).Methods Reverse transcription polymerase chain reaction(RT-PCR)was used to detect the expression of NEIL1 messenger ribonucleic acid(mRNA)in the anterior lens capsule and LEC line SRA01/04 cells from age-related cataract(ARC)patients and macular epiretinal membrane patients who underwent the clear lens extraction.SRA01/04 cells were then divided into the control group,OE-Vector group and OE-NEIL1 group.RT-PCR and Western blot(WB)were used to detect the overexpression efficiency.Subsequently,the cells were divided into the control group,H2O2 group,OE-Vector H2O2 group and OE-NEIL1 H2O2 group;cell viability was detected by Cell Count-ing Kit-8,WB was used to evaluate the expression of autophagy-related proteins(ATG7,P62,Beclinl,LC3-Ⅰ and LC3-Ⅱ)and apoptosis-related proteins(Bax and Bcl-2),and fluorescent staining was adopted to measure cell apoptosis and mito-chondrial membrane potential.Results The expression of NEIL1 mRNA in the anterior lens capsule samples from ARC patients was significantly lower than that of macular epiretinal membrane patients,and the expression of NEIL1 mRNA in the SRA01/04 cells in the H2O2 group was also lower than that in the control group(both P＜0.05).The results of RT-PCR and WB revealed that the expressions of NEIL1 mRNA and protein in the SRA01/04 cells of the OE-NEIL1 group were signif-icantly higher than those in the OE-Vector group(both P=0.000).Compared with the control group,the viability of SRA01/04 cells in the H2O2 group decreased,the expression of the Bax protein was up-regulated,the Bcl-2 protein was down-regulated,viable cells labeled with Mito-Tracker decreased,and apoptotic cells labeled with Annexin V-FITC in-creased,with statistical significances(all P＜0.05).Compared with the OE-Vector H2O2 group,in the OE-NEIL1 H2O2 group,the viability of SRA01/04 cells significantly improved,the autophagy-related proteins(ATG7,P62,Beclin1,LC3-Ⅰand LC3-Ⅱ)and Bcl-2 protein were significantly up-regulated,the Bax protein was down-regulated,viable cells marked with Mito-Tracker increased,and apoptotic cells labeled with Annexin V-FITC decreased(all P＜0.05).Conclusion Under the oxidative stress induced by H2O2,NEIL1 can promote autophagy of LECs,maintain homeostasis of LECs,and then increase cell viability and reduce apoptosis of LECs,participating in the occurrence and development of ARC.
In the early stage of diabetes retinopathy(DR),the change in the molecular level is often earlier than chan-ges in retinal microvessels.Under the chronic high-glucose environment,oxidative stress,epigenetic changes and other mechanisms cause retinal mitochondrial DNA(mtDNA)damage,affect the transcription process of mtDNA coding genes,and damage the electronic transport chain,leading to a vicious cycle of free radicals,which accelerates the apoptosis of retinal capillary pericytes and endothelial cells,leads to retinal microcirculation dysfunction,and cause DR.This paper will review the epigenetic changes,oxidative stress,damage to replication and repair system,gene mutation and other aspects,in order to elaborate on the research progress of retinal mtDNA damage in the pathogenesis of DR.
The rapid development of artificial intelligence technology has promoted the intelligentization of healthcare systems.Neuro-ophthalmology is an emerging branch of ophthalmology,which includes research in common diseases such as optic disc disorders and eye movement disorders.Due to the continuous improvement of machine learning and deep learning technologies,artificial intelligence is increasingly applied in the diagnosis and treatment of neuro-ophthalmic disea-ses.This paper aims to form a guideline on the application of artificial intelligence technology in the diagnosis of neuro-oph-thalmic diseases,laying the foundation for further research and application of artificial intelligence in this field.
Microglia is involved in the occurrence and development of retinal degenerative diseases,thus its activation is a marker for retinal degenerative diseases.Microglia can be activated by different external stimulating factors and polar-ized into two phenotypes with different functional states and surface markers.The classical activation pathway produces M1 phenotype microglia,which mainly exerts pro-inflammatory and neurotoxic effects;the selective activation pathway pro-duces M2 phenotype microglia,which mainly exerts anti-inflammatory and neuroprotective effects.Precise modulation of microglia polarization is a promising approach for treating retinal degenerative diseases.This paper reviews the role of mi-croglia polarization in the pathogenesis of retinal degenerative diseases,aiming to pioneer new avenues and research ideas for treating retinal degenerative diseases.
Objective To investigate the action mechanism of cyclic RNA0001287(circ_0001287)and miR-21 in the pathogenesis of diabetic retinopathy(DR).Methods Primary human retinal pigment epithelium(phRPE)cells were iso-lated for circRNA microarray analysis.Arising retinal pigment epithelium(ARPE)-19 cells were cultured in vitro and divid-ed into the blank group,high-glucose group,negative group,si-circ group,circ_0001287 group,circ_0001287+negative group,and circ_0001287+miR-21 group.Small interfering RNA(siRNA)oligonucleotides against circ_0001287,mimics containing miR-21 sequences and miR-21 mimic plasmids were constructed.In the negative group,si-circ group,circ_0001287 group,circ_0001287+negative group and circ_0001287+miR-21 group,the empty plasmid,circ_0001287 siRNA,circ_0001287 mimics,circ_0001287 mimics+miRNA disordered sequence,and circ_0001287 mimics+miR-21 mimic plasmid were transfected into ARPE-19 cells using Lipofectamine 2000 Transfection Reagent.After transfection for 6 h,the Opti-MEM medium was replaced with a fresh normal medium.Cells in the blank group and the high-glucose group were not transfected.Cells in the blank group were cultured with culture solution containing 5.5 mmol·L-1 glucose,and cells in the high-glucose group were cultured with culture solution containing 15.5 mmol·L-1,25.5 mmol·L-1 and 35.5 mmol·L-1 glucose,respectively.Cells in other groups were treated with 35.5 mmol·L-1 glucose for 48 h.The expressions of circ_0001287 and miR-21 were detected by reverse transcription polymerase chain reaction(RT-PCR),cell proliferation activity was detected by Cell Counting Kit-8,and the targeting relationship between circ_0001287 and miR-21 was detected by Dual Luciferase Reporter Assay.RNA immunoprecipitation(RIP)assay and biotin-coupled probe pull-down assay were used to verify the targeting relationship between circ_0001287 and miR-21.Western blot was used to detect protein expression.Re-sults After screening by circRNA,the expression of hsa_circ_0001287 in phRPE cells was significantly reduced.RT-PCR detection showed that compared with the blank group,circ_0001287 expression in ARPE-19 cells in the high-glucose group decreased(P＜0.05)in a dose-dependent manner,and miR-21 expression in ARPE-19 cells gradually increased with the in-crease of glucose concentration(P＜0.05).After co-transfection of siRNA with circ_0001287 mimics,siRNA also reduced circ_0001287 expression,and the relative expression of circ_0001287 in the circ_0001287+negative group(0.70±0.03)was significantly lower than that in the negative group(0.98±0.04,P＜0.05).For cells transfected with the circ_0001287-WT plasmid,compared with the control simulation group(0.98±0.03),the relative luciferase activity of the miR-21 simulation group(0.59±0.02)decreased(P＜0.05).However,for cells transfected with circ_0001287-MUT plasmid,the relative ac-tivity of luciferase was almost the same in the control simulation group(0.96±0.05)and the miR-21 simulation group(1.00±0.04,P＞0.05).In the anti-Ago RIP experiment,miR-21 was significantly enriched in the circ_0001287 group com-pared with the control group,indicating that miR-21 could be significantly pulled down by the biotinylated circ_0001287 probe.Pull-down analysis demonstrated that compared with the control IgG,circ_0001287 specific probe pull-down sam-ples showed significant enrichment of circ_0001287 and miR-21.In this experiment,the cell proliferation rate of the circ_0001287+miR-21 group(78.25％±3.01％)was lower than that of the circ_0001287+negative group(90.88％±3.51％,P＜0.05).Compared with the blank group,the expression of PTEN protein in ARPE-19 cells in the high-glucose group treated with 35.5 mmol·L-1 glucose was significantly down-regulated(P＜0.05),the expression of PTEN protein in ARPE-19 cells in the circ_0001287 group was higher than that in the negative group(P＜0.05),and the expression of PTEN protein in ARPE-19 cells in the circ_0001287+miR-21 group was higher than that in the circ_0001287 group(P＜0.05).Conclusion The expression of circ_0001287 is down-regulated in phRPE cells and high-glucose induced ARPE-19 cells,and up-regulated circ_0001287 can inhibit the injuiy of diabetic RPE cells by adsorption of miR-21 and activation of PTEN expression.
Objective To investigate the clinical effect of pars plana vitrectomy combined with segmental scleral buckling(PPV-SSB)in the treatment of inferior rhegmatogenous retinal detachment(RRD).Methods Totally 87 eyes of 87 patients with inferior RRD who attended the Ophthalmology Department Ⅱ,the First Affiliated Hospital of Zhengzhou University from October 2020 to April 2022 were retrospectively included.Among them,45 patients(45 eyes)were treated with PPV-SSB(PPV-SSB group),and 42 patients(42 eyes)were treated with PPV(PPV group).The retinal reattachment rate,best corrected visual acuity(BCVA)and complications of patients who underwent single surgery in the two groups were compared.Results After a single surgery,the retinal reattachment rate was 95.56％(43/45)in the PPV-SSB group and 80.95％(34/42)in the PPV group,with a statistically significant difference(P=0.033).At 3 months and 6 months af-ter surgery,there were significant differences in BCVA between the PPV-SSB group and the PPV group(P=0.010,0.004).The incidence of postoperative phacoscotasmus in the PPV-SSB group and the PPV group was 28.89(13/45)and 54.76％(23/42),respectively,with a significant difference(P=0.018),while there were no significant differences in the inci-dence of the remaining few complications(all P＞0.05).Conclusion PPV-SSB has a higher retinal reattachment rate,better visual effect and fewer complications in the treatment of inferior RRD.
Objective To investigate the possible action mechanism of the micro ribonucleic acid-1-3p(miR-1-3p)/Annexin A2(AnxA2)molecular axis in high glucose(HG)-induced neovascularization of human retinal microvascular en-dothelial cells(HRMECs).Methods A cell injury model was established by culturing HRMECs in vitro and treating them with HG.The HRMECs were divided into the Con group(DMEM medium containing fetal bovine serum in volume fraction of 10％),HG group(cultured in 25 mmol·L-1 D-glucose),HG+miR-NC group(transfected with miR-NC),HG+miR-1-3p group(transfected with miR-1-3p mimics),HG+sh-NC group(transfected with sh-NC),HG+sh-AnxA2 group(transfect-ed with sh-AnxA2),HG+miR-1-3p+pcDNA group(transfected with miR-1-3p mimics+pcDNA),and HG+miR-1-3p+pcDNA-AnxA2 group(transfected with miR-1-3p mimics+pcDNA-AnxA2).After 48 h of transfection,cells were collected and cultured in 25 mmol·L-1 D-glucose medium for 24 h.Cell viability and number of migrating cells were detected using MTT and Transwell chamber experiments,respectively.The number of lumen formations was detected by the lumen forma-tion experiment.The dual luciferase reporter assay was adopted to detect the targeting relationship between miR-1-3p and AnxA2.Western blot was used to detect the protein levels of vascular endothelial growth factor(VEGF)and matrix metal-loproteinase-2(MMP-2).Results Compared with the Con group,the expression level of miR-1-3p in the HG group de-creased,while the levels of AnxA2 messenger ribonucleic acid(mRNA)and protein increased,with statistically significant differences(all P＜0.05).Compared with the Con group,the HG group showed an increase in cell viability,number of mi-grating cells,lumen formation and protein levels of VEGF and MMP-2,with statistically significant differences(all P＜0.05).Compared with the HG+miR-NC group,the HG+miR-1-3p group showed a decrease in cell viability,number of migrating cells,lumen formation and protein levels of VEGF and MMP-2,with statistically significant differences(all P＜0.05).Compared with the HG+sh-NC group,the HG+sh-AnxA2 group showed a decrease in cell viability,number of mi-grating cells,lumen formation and protein levels of VEGF and MMP-2,with statistically significant differences(all P＜0.05).Compared with the HG+miR-1-3p+pcDNA group,the HG+miR-1-3p+pcDNA-AnxA2 group showed an increase in cell viability,number of migrating cells,lumen formation and protein levels of VEGF and MMP-2,with statistically signifi-cant differences(all P＜0.05).Conclusion Overexpression of miR-1-3p can inhibit proliferation,migration and neovas-cularization of HRMECs by targetedly regulating AnxA2 expression.
Objective To investigate the expression of hypoxia-inducible factor-1α(HIF-1α),matrix metalloprotein-ase(MMP)-1 and MMP-2 in the serum of patients with diabetic retinopathy(DR),and to analyze their relationship with the stage of DR and angiogenesis.Methods A total of 280 patients with type 2 diabetes mellitus(T2DM)and no DR who were hospitalized in our hospital from December 2020 to December 2021 were selected as the T2DM group;276 DR patients who were hospitalized in the ophthalmology department of our hospital during the same period were selected as the DR group;another 282 healthy subjects who underwent physical examination in our hospital were selected as the normal group.There were no significant differences in gender and age distribution among the normal group,T2DM group and DR group(both P＞0.05).According to the results of fundus examination and fluorescein angiography,the patients in the DR group were divided into non-proliferative diabetic retinopathy(NPDR)group(129 patients)and proliferative diabetic reti-nopathy(PDR)group(147 patients).The fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c)and serum HIF-1 α,MMP-1,MMP-2 levels of subjects in the normal group,T2DM group and DR group,as well as NPDR group and PDR group were compared.The serum basic fibroblast growth factor(bFGF),angiopoietin-1(Ang-1)and vascular endo-thelial growth factor(VEGF)levels of subjects in the normal group,T2DM group and DR group,as well as NPDR group and PDR group were compared.Pearson correlation analysis was used to analyze the correlation between serum HIF-1α,MMP-1,MMP-2 and bFGF,Ang-1,VEGF levels in DR patients.Results The FPG,HbA1c and serum HIF-1α,MMP-1,MMP-2 levels of the T2DM group and DR group were higher than those of the normal group,and the differences were statis-tically significant(all P＜0.05).The serum HIF-1α,MMP-1 and MMP-2 levels of the DR group were significantly higher than those of the T2DM group(all P＜0.05);there were no significant differences in FPG and HbA1 c between the two groups(both P＞0.05).The serum HIF-1α,MMP-1 and MMP-2 levels of the PDR group were significantly higher than those of the NPDR group(all P＜0.05);there were no significant differences in FPG and HbA1c between the two groups(both P＞0.05).The serum bFGF,Ang-1 and VEGF levels of the T2DM group and DR group were higher than those of the normal group,and the differences were statistically significant(all P＜0.05).The serum bFGF,Ang-1 and VEGF levels of the DR group were significantly higher than those of the T2DM group(all P＜0.05).The serum bFGF,Ang-1 and VEGF levels of the PDR group were significantly higher than those of the NPDR group(all P＜0.05).Pearson correlation analysis showed that HIF-1α,MMP-1 and MMP-2 were positively correlated with bFGF,Ang-1 and VEGF levels in DR patients(all P＜0.05).Conclusion The serum HIF-1α,MMP-1 and MMP-2 levels of DR patients are abnormally elevated,and are closely related to the progression of DR and angiogenesis.These parameters can be used to predict the disease development trend and guide clinical intervention.
Objective To observe the thickness changes in the peripapillary retinal nerve fiber layer(RNFL)and the ganglion cell-inner plexiform layer(GC-IPL)in the macular region,so as to analyze the pathological rules of retinal nerve injury in diabetes retinopathy(DR)patients and explore the related risk factors.Methods A total of 164 patients(164 eyes)with type 2 diabetes who visited the Department of Ophthalmology and Department of Endocrinology of Shaanxi Pro-vincial People's Hospital from January 1,2017 to January 1,2018 were selected as the subjects.According to the condition of concomitant DR,these subjects were divided into three groups:non-DR(NDR)group(56 eyes of 56 patients),mild non-proliferative DR(NPDR)group(53 eyes of 53 patients)and moderate NPDR group(55 eyes of 55 patients).Healthy individuals who underwent physical examinations in the same period were selected as the control group(50 eyes of 50 pa-tients).Optical coherence tomography and optical coherence tomography angiography were used to measure the peripapil-lary RNFL,macular GC-IPL,and macular vessel density(VD)of all subjects.Comparison among groups and correlation analysis were conducted on the above retinal nerve injury indicators.Results Compared with the control group and NDR group,the average,upper and lower peripapillary RNFL in the mild NPDR group and moderate NPDR group were signifi-cantly thinner,and the differences were statistically significant(all P＜0.05).The differences in macular GC-IPL thickness at the average,upper,upper temporal,lower temporal,lower,lower nasal,and upper nasal regions in all groups were sta-tistically significant(all P＜0.05);pairwise comparisons showed that compared with the control group,the GC-IPL thick-ness in each quadrant of the macular area of patients in the NDR group,mild NPDR group and moderate NPDR group de-creased significantly(all P＜0.05),with the upper GC-IPL thinning being the most significant;compared with the NDR group,the GC-IPL thickness in the upper,average,and upper temporal macular area of patients with mild NPDR decreased significantly(all P＜0.05);compared with the mild NPDR group,the GC-IPL thickness in the upper macular area was thin-ner in the moderate NPDR group,and the difference was statistically significant(P＜0.05).There were statistically signifi-cant differences in the average and inner ring VDs in the macular area among the groups(both P＜0.05).The correlation analysis results showed that there was a significantly positive correlation between the peripapillary RNFL thickness and the average VD in the macular area(r=0.517,P＜0.01),while the average GC-IPL thickness in the macular area was weakly positively correlated with the average VD in the macular area(r=0.279,P＜0.01).Conclusion The peripapillary RNFL thickness objectively reflects the degree of retinal neuron injury,and is a key index to evaluate the degree of retinal nerve injury in diabetes patients.
Peripapillary intrachoroidal cavitation(PICC)is a common fundus lesion in high myopia.The typical mani-festation of PICC in fundus color photography is orange lesions with clear boundaries,which often occur below the myopic arc,and a weak reflection cavity in the choroid in optical coherence tomography(OCT).With the development and wide-spread application of OCT technology,researchers have gained a clearer understanding of the imaging features,pathogene-sis and clinical significance of PICC.This article introduces the definition,imaging features,pathogenesis,and relationship with glaucoma of PICC to provide new ideas for further elucidating the pathogenesis and clinical significance of PICC.
Objective To characterize the distribution of conjunctival sac flora and antibiotic susceptibility in healthy people of different ages.Methods Totally 1 839 conjunctival sac secretion samples from 1 131 people without infectious eye diseases attending Qingdao Eye Hospital of Shandong First Medical University from 2018 to 2021 were retrospectively analyzed.These people were divided into four groups according to age:children(≤18 years old),young(19-45 years old),middle-aged(46-65 years old),and elderly(＞65 years old).Differences in the distribution of conjunctival sac flo-ra and antibiotic susceptibility among these groups were compared using the chi-square test or Fisher's exact test.The Bonferroni method was used for pairwise comparisons.Results The total bacterial detection rate of the conjunctival sac in the study population aged 1 month to 91 years old(median:11.00 years old;quartiles:5.00 years old,40.00 years old)was 64.93％;the bacterial detection rate in the children group(76.79％)was significantly higher than that in the young,middle-aged and elderly groups(all P＜0.001).Staphylococcus epidermidis(55.97％),Staphylococcus aureus(8.60％)and Streptococcus mitis(7.52％)were the most common bacteria in the conjunctival sacs.Gram-positive bacteria were re-sistant to most penicillins(16.79％-53.47％)and macrolides(17.21％-20.87％)antibiotics,and highly susceptive to van-comycin(99.56％)and gatifloxacin(98.57％).Gram-negative bacteria had low susceptibility rates to cephalosporin(41.38％-80.00％)antibiotics and were susceptive to amikacin(90.48％)and fluoroquinolone(90.91％-97.73％)antibi-otics.Of the common antibiotics used in ophthalmology,the susceptibility rate of fusidic acid was the worst in the children group(54.55％),which was significantly lower than the other three groups(all P＜0.001).Gatifloxacin had a susceptibili-ty rate of more than 90％in different Gram-stained bacteria in all groups,with an overall sensitivity rate of 98.44％.Con-clusion Staphylococcus epidermidis is the most common bacteria in the conjunctival sac in healthy people of all ages.Gatifloxacin is generally susceptive in different Gram-stained bacteria in people at different ages,and may be considered as the first choice for perioperative empiric antibiotics in ophthalmology.
Objective To investigate the relationship between corneal hysteresis(CH)and retinal nerve fiber layer(RNFL)thickness in patients with glaucoma.Methods In this study,186 eyes of 133 patients with open-angle glaucoma who attended the ophthalmology department of our hospital were included,with a follow-up of(3.8±0.8)years and an average of 9 visits.The CH measurements were acquired using the Ocular Response Analyzer,and RNFL thickness was measured at each follow-up using spectral domain optical coherence tomography.All statistical analyses were performed with Stata software.Univariate and multivariable linear regression models were used to investigate the relationship between age,baseline CH,intraocular pressure(IOP),central corneal thickness(CCT)and RNFL thickness.Results The aver-age baseline CH was(9.2±1.8)mmHg(1 kPa=7.5 mmHg),average baseline RNFL thickness was(76.4±18.1)μm,the average baseline IOP was(13.8±3.7)mmHg,and the average baseline CCT was(533±42)μm.Univariate model analysis showed that the baseline CH had a positive correlation with RNFL thickness(P＜0.05).The lower the CH,the thinner the RNFL.For every 1 mmHg reduction in CH,the thickness of RNFL was reduced by 0.13 μm,indicating that CH may be involved in the occurrence and development of glaucoma.The univariate model analysis also showed that there was a negative correlation between IOP and RNFL thickness(P＜0.05).The higher the IOP,the thinner the RNFL.However,there was no significant correlation between age,CCT and RNFL thickness(both P＞0.05).The multivariate model analy-sis showed that there was a positive correlation between baseline CH and RNFL thickness during the follow-up,excluding the influence of age,IOP and CCT(P＜0.05).For every l mmHg reduction in CH,the thickness of RNFL was reduced by 0.13 μm.Conclusion There is a positive correlation between baseline CH and RNFL thickness in glaucoma.The lower the CH,the thinner the RNFL.Low CH may be a risk factor for the progression of glaucoma.
Objective To investigate the mechanism of electroacupuncture in relieving the apoptosis of retinal cells in experimental myopia based on mitochondrial dynamics.Methods In the study,140 two-week-old tricolor guinea pigs were divided into the normal control(NC)group,lens-induced myopia(LIM)group,LIM+sham acupoint(LIM+SHAM)group,and LIM+electroacupuncture intervention(LIM+EA)group,with 35 guinea pigs in each group.Guinea pigs in the NC group were fed normally,and those in the LIM group,LIM+SHAM group and LIM+EA group wore a-6.0D lens on the right eye to induce myopia.Guinea pigs in the LIM+EA group were treated at Hegu and Taiyang acupoints,while those in the LIM+SHAM group were treated at sham acupoints.After 2-and 4-week myopia induction,the diopter and axial length of the guinea pigs were measured,and the messenger ribonucleic acid(mRNA)and protein levels of dynam in-related pro-tein 1(DRP1),optic atrophy 1(OPA1),Bcl-2 associated X protein(BAX)and B cell lymphoma-2(BCL-2)in the retinas of the guinea pigs in each group were detected by quantitative PCR and Western blot,respectively.Meanwhile,HE staining was taken to observe the morphological changes in the retina of the guinea pigs in each group,and TUNEL staining was used to detect apoptosis.Results After 2-and 4-week myopic induction,compared with the NC group,the differences in diopter and axial length between the right and left eyes of guinea pigs in the LIM and the LIM+SHAM groups significantly increased(all P＜0.001).Compared with the LIM group,the differences in diopter and axial length between both eyes of guinea pigs in the LIM+EA group significantly decreased(all P＜0.01).At 4 weeks after myopic induction,HE staining re-sults showed that the retinas of the guinea pigs in the NC group were evenly arranged,and the morphology of inner and out-er nuclear layer cells was normal.Compared with the NC group,the retinas of the guinea pigs in the LIM and the LIM+SHAM groups were significantly thinner and disorderly arranged.Compared with the LIM group,the retinal thickness of guinea pigs in the LIM+EA group slightly increased,and the arrangement was relatively regular.The TUNEL staining re-sults showed that compared with the NC group,the green fluorescence of the guinea pig retina in the LIM group and LIM+SHAM group was significantly enhanced;compared with the LIM group,the green fluorescence of the guinea pig retina in the LIM+EA group was significantly weaken.After 2-and 4-week myopic induction,the mRNA and protein expression lev-els of DRP1 and BAX in the LIM and the LIM+SHAM groups were significantly higher than those in the NC group(all P＜0.05),while the mRNA and protein expression levels of OPA1 and BCL-2 were significantly lower(all P＜0.05).The mR-NA and protein expression levels of DRP1 and BAX in the LIM+EA group were significantly lower than those in the LIM group(all P＜0.05),while the mRNA and protein expression levels of OPA1 and BCL-2 were significantly higher(all P＜0.05).Conclusion Experimental myopia can enhance retinal mitochondrial fission.Electroacupuncture intervention can alleviate retinal cell apoptosis and improve the morphological structure of the retina by inhibiting retinal mitochondrial fis-sion and increasing mitochondrial fusion,thereby delaying myopia development.
目的 探讨角膜塑形镜联合0.1 g·L-1 阿托品(AOK)控制儿童近视进展效果,并分析影响控制近视进展疗效的因素.方法 回顾性研究.选取2020 年10 月至2022 年11 月在西安市第一医院激光近视治疗中心就诊的近视儿童60 例(112 眼)作为研究对象,根据治疗方法不同分为仅接受OK 镜治疗的OK 镜组31 例(55 眼)和同时接受OK 镜和0.1 g·L-1 阿托品治疗的AOK 组29 例(57 眼).根据基线年龄[年龄较小组(8～＜10岁)和年龄较大组(10～14 岁)]和基线眼轴长度(AL)[AL 较短组(22.00～24.50 mm)与AL 较长组(＞24.50～27.00 mm)]对患儿进行分层比较.分析治疗后3 个月、6 个月、12 个月两组患儿AL 变化,采用混合线性模型分析两组患儿治疗前后数据,采用多因素线性回归分析比较影响控制近视进展疗效的因素.结果 AOK 组患儿在治疗后12 个月累积AL 增长(0.14±0.20)mm,显著小于OK 镜组的(0.20±0.20)mm(P=0.01),AOK 组比OK 镜组患儿AL 增长减少约30％.根据基线年龄和基线AL 分层比较结果显示,AOK 组患儿在年龄较小组、AL 较长组等亚分组时AL 变化显著小于OK 镜组(均为P＜0.05).多因素线性回归分析结果表明,AOK 组患儿的年龄、初始AL 缩短、放松时长与AL 变化均呈负相关(β=-0.20,P=0.04;β=-0.59,P＜0.01;β=-0.22,P=0.02).结论 AOK 控制儿童近视疗效优于单纯使用OK 镜,联合治疗在控制基线年龄较小、基线AL 较长儿童的AL 增长方面更有效,治疗效果受到患儿年龄、初始AL 长度、放松功能等因素的影响.
目的 探讨飞秒激光小切口角膜基质透镜取出术(SMILE)术后角膜生物力学特性变化相关的影响因素.方法 回顾性病例对照研究.选取2020 年7 月至2022 年8 月于西南医科大学附属医院眼科进行SMILE 手术的患者108 例203 眼,应用Corvis ST 测量所有研究对象硬度参数A1(SPA1)、综合半径(IR)、水平方向Ambrósio 相关厚度(ARTh)、1 mm 范围内形变幅度比(DAR/1 mm)、2 mm 范围内形变幅度比(DAR/2 mm)和最大形变幅度(DA),并应用统计学方法分析角膜生物力学参数术后3 个月与术前的改变量与年龄、球镜度、柱镜度、等效球镜度(SE)、眼轴长度(AL)、眼压(IOP)、中央角膜厚度(CCT)、残余基质厚度(RST)、RST/CCT、角膜帽厚度(CAP)/CCT、切削厚度和组织改变百分比(PTA)之间的相关性.结果 经相关性分析,PTA 与ΔDAR/1 mm(r=0.302,P＜0.001)(Δ 指术后3 个月与术前的改变量)、ΔDAR/2 mm(r=0.355,P＜0.001)、ΔARTh(r=0.470,P＜0.001)、ΔIR(r=0.501,P＜0.001)、ΔSPA1(r=0.318,P=0.016)均呈显著正相关;RST 与 ΔDAR/1 mm(r=-0.202,P=0.004)、ΔDAR/2 mm(r=-0.365,P＜0.001)、ΔARTh(r=-0.244,P＜0.001)、ΔIR(r=-0.402,P＜0.001)、ΔSPA1(r=-0.169,P=0.016)均呈显著负相关;CAP/CCT 与ΔARTh(r=-0.339,P＜0.001)、ΔIR(r=-0.141,P=0.044)、ΔSPA1(r=-0.243,P＜0.001)均呈显著负相关;AL 与ΔARTh(r=0.434,P＜0.001)、ΔIR(r=0.245,P=0.001)、ΔSPA1(r=0.336,P＜0.001)均呈显著正相关.PTA与ΔIR 的6 阶拟合曲线提示,当PTA＞26％时曲线斜率明显增大.结论 PTA 越小、RST越大、CAP/CCT 越大,SMILE 术后安全性越高,且当PTA＞26％时,较小的切削厚度占比增加即可造成SMILE 术后较大的角膜生物力学改变.
