Purpose: The purpose of this study was to design a new parameter “integral” to quantitatively evaluate the spatial cumulative reflectivity of the outer retinal layers in optical coherence tomography (OCT), and to investigate its role in the detection of outer retinal diseases. Methods: This was a cross-sectional study. Fovea-centered line OCT scans were performed on 60 eyes of 60 healthy volunteers and 44 eyes of 44 patients diagnosed with outer retinal diseases. The integrals of the ellipsoid zone (EZ) and interdigitation zone (IZ) were measured by respectively accumulating the grayscale values of all the pixels within the EZ and IZ at specified locations on the scanning lines, and were then adjusted by calculating their percentages on the outer retina. The integrals of the EZ and IZ were compared between the two groups. Results: The integrals of the EZ and IZ were stably and normally distributed in the healthy eyes, and were significantly lower in eyes with outer retinal lesions than in healthy ones (P < 0.05). Moreover, the integrals of the EZ and IZ were correlated with best corrected visual acuity (BCVA; adjusted R2 = 0.620) and the presence of outer retinal lesions (Nagelkerke R2 = 0.767). The area under the receiver operating characteristic (ROC) curve was 0.954 (95% confidence interval [CI] = 0.918–0.990) when the integral was selected as a diagnostic variable. Conclusions: Obtained from this novel quantification method, the new parameter integral was comparable between different individuals and had the potential to detect outer retinal abnormalities in reflectivity through OCT. Translational Relevance: Our work verified the feasibility of the new image analysis technique in the detection of the diseases affecting the outer retina.

Circular RNAs (circRNAs) are a novel class of non-coding RNAs generated from back splicing. Accumulating evidence has demonstrated their vital regulation in several biological processes and ocular diseases. However, the role of circRNAs in age-related cataract (ARC), the leading cause of visual impairment worldwide, is still unknown. CircRNA sequencing reveals that 101 circRNAs are differentially expressed between the capsules of transparent and ARC lenses, including 75 down-regulated circRNAs and 26 up-regulated circRNAs transcripts. Eight of 10 differentially expressed circRNAs are further verified by quantitative RT-PCRs. One highly conserved circRNA, circHIPK3, is significantly down-regulated in all cortical, nuclear and posterior subcapsular subtypes of ARC. The silencing of circHIPK3, but not HIPK3 mRNA, significantly accelerates apoptosis development upon oxidative stress and decreases cell viability and proliferation in primary cultured human lens epithelial cells (HLECs). The expression of α-SMA and vimentin was downregulated, while the expression of E-cadherin and ZO-1was upregulated, suggesting the repression of epithelial-mesenchymal transition after circHIPK3 knockdown. CircHIPK3 silencing increases miR-193a expression. miR-193a regulates CRYAA expression by targeting the binding site within the 3'UTR. Moreover, miR-193a decreases the viability and proliferation, and increases the apoptosis of HLECs upon oxidative stress. This study suggests that circRNAs are the potential regulators in cataractogenesis. CircHIPK3 regulates HLECs function through miR-193a-mediated CRYAA expression. This finding would provide a novel insight into the pathogenesis of ARC.

Objective: To evaluate the postoperative complications and additional surgeries of limbal and pars plana approaches using microincision vitrectomy (25G/23G) for removal of congenital cataracts. Methods: In this retrospective cohort study, patients with a congenital cataract were referred to the Eye & ENT Hospital of Fudan University from March 2009 to December 2013. There, they underwent cataract surgeries through either the limbal approach or the pars plana approach. All of the surgeries were performed by one surgeon. For patients older than 1 year, primary intraocular lens implantation was performed. For patients younger than 1 year, secondary intraocular lens implantation was performed during follow-up after the initial cataract surgery. Complications and additional surgeries were recorded. Logistic regression was used to test the influence of potential risk factors on the incidence of postoperative complications. Fisher exact test was used to compare the incidence of postoperative complication between the different surgical approaches. Results: Of the 67 patients, 99 eyes with congenital cataract were included. The mean follow-up time was 4.4 years (range 0.9-8.3 years). Postoperative complications that required additional surgeries occurred 15 times in 11 eyes. These included 5 times of visual axis opacification in 5 eyes, 4 times of intraocular lens (IOL) pupillary capture in 3 eyes, 1 time of dislocation of IOL in vitreous in 1 eye, 2 times of retained cortex in 2 eyes, 2 times of pupillary membrane in 2 eyes, and 1 time of retinal detachment in 1 eye. Surgery at less than 1 year of age and surgery through the limbal approach were risk factors of complication requiring additional surgery (OR=17.9, P=0.009; OR=7.9, P=0.041; respectively). There was no statistical significance in the type of postoperative complications between the limbal approach and the pars plana approach (P>0.05). Conclusions: Age at surgery of less than 1 year and surgery through the limbal approach are the risk factors for postoperative complications requiring additional surgeries in patients with congenital cataract. The distribution of postoperative complications is not correlated with either of the two surgical approaches.

Postoperative glaucoma is one of the most common complications after congenital cataract surgery and an important cause of unsatisfactory long-term visual acuity rehabilitation. Recently, the diagnostic criteria of glaucoma after congenital cataract surgery have been gradually complemented; the measurement of intraocular pressure is improved and the follow-up is standardized. The risk factors of glaucoma after congenital cataract surgery include age at surgery, ocular abnormalities and central corneal thickness, some of which still remain controversial. The main treatment of postoperative glaucoma is surgery, while some patients need adjuvant medications in addition to surgery. (Chin J Ophthalmol, 2017, 53: 863-867).

BACKGROUND:Plasmin is a serine protease that plays a critical role in fibrinolysis, which is a process that prevents blood clots from growing and becoming problematic. Recombinant human microplasminogen (rhμPlg) is a derivative of plasmin that solely consists of the catalytic domain of human plasmin and lacks the five kringle domains found in the native protein. Developing an industrial production method that provides high yields of this protein with high purity, quality, and potency is critical for preclinical research.RESULTS:The human microplasminogen gene was cloned into the pPIC9K vector, and the recombinant plasmid was transformed into Pichia pastoris strain GS115. The concentration of plasmin reached 510.1 mg/L of culture medium. Under fermentation conditions, the yield of rhμPlg was 1.0 g/L. We purified rhμPlg to 96% purity by gel-filtration and cation-exchange chromatography. The specific activity of rhμPlg reached 23.6 U/mg. The K m of substrate hydrolysis by recombinant human microplasmin was comparable to that of human plasmin, while rhμPlm had higher k cat /Km values than plasmin. The high purity and activity of the rhμPlg obtained here will likely prove to be a valuable tool for studies of its application in thrombotic diseases and vitreoretinopathies.CONCLUSIONS:Reliable rhμPlg production (for use in therapeutic applications) is feasible using genetically modified P. pastoris as a host strain. The successful expression of rhμPlg in P. pastoris lays a solid foundation for its downstream application.