Efficacy of anti-VEGF intravitreal injection in traumatic submacular hemorrhage: a retrospective study.

OBJECTIVE: In this study we investigated the efficacy of short-term intravitreal injections of anti-vascular endothelial growth factors (anti-VEGF) in treating traumatic submacular hemorrhage. METHODS: A total of 115 patients were diagnosed with submacular hemorrhage between 2018 and 2022 at Shenzhen Eye Hospital. In a retrospective analysis, we examined 13 of these patients who presented with submacular hemorrhage and choroidal rupture due to ocular trauma. Eight patients were treated with intravitreal anti-VEGF injection and 5 with oral drugs. We systematically analyzed changes in their ocular conditions pre and post-treatment. The evaluations encompassed best-corrected visual acuity (BCVA), optical coherence tomography, fundus fluorescein angiography, and retinal imaging. RESULTS: The 13 patients diagnosed with submacular hemorrhage comprised of 10 males and 3 female, with their age ranging between 27 and 64 years, with an average age of 38.1 years (standard deviation [SD]: 11.27). A statistically significant reduction in central foveal thickness (CFT) was observed following intravitreal injections of anti-VEGF drugs (P = 0.03). In control group, the CFT was reduced without statistical significance (P = 0.10). The BCVA of the patients in treatment group improved significantly from 1.15 (SD: 0.62. Range: 0.4-2) to 0.63 (SD: 0.59. Range: 0.1-1.6), indicating an average increase of 4.13 lines (SD: 3.36. Range: 0-9) as measured by the visual acuity test using an eye chart (P = 0.01). The difference between baseline visual acuity and final visual acuity was not statistically significant in control group (P = 0.51). CONCLUSION: Short-term administration of anti-VEGF drugs exhibited significant efficacy in reducing submacular hemorrhage following ocular trauma and enhancing visual acuity.

Fast Ionic Conducting Hydroxyapatite Solid Electrolyte Interphase Enables Ultra-Stable Zinc Metal Anodes.

Zn metal has been extensively utilized as an anode in aqueous zinc-ion batteries attributed to its affordable cost and superior theoretical capacity. Nevertheless, the presence of dendrites and undesirable side reactions poses challenges to its widespread commercialization. To address these issues, herein, a surface coating composed of hydroxyapatite (HAP) was developed on the Zn anode to create an artificial solid electrolyte interphase. After the application of a hydroxyapatite layer, dendrites and corrosion of the Zn anode are sufficiently inhibited. Furthermore, the hydroxyapatite interphase with a low ionic diffusion barrier enables fast anodic redox kinetics. Consequently, the Zn@HAP symmetric cell possesses a durable lifespan over 2000 h at 1 mA cm-2, while maintaining minimal polarization. Moreover, the practical feasibilities of the Zn@HAP anode are also manifested in full batteries combined with MnO2 cathodes, exhibiting exceptional cycling performance up to 500 cycles at 1 A g-1 and excellent rate capability with a retention of 109 mAh g-1 at 5 A g-1.

Effect of pupil dilation on biometry measurements and intraocular lens power in eyes with high myopia.

Purpose: The present study sought to evaluate the effects of pupil dilation on ocular parameter measurements and intraocular lens (IOL) power calculation using IOLMaster in highly myopic cataract patients. Materials and methods: A total of 233 eyes were included in this prospective study and assigned to four groups based on range of axial length (AL) as follows: group A:26-28 mm, group B:28-30 mm, group C:30-32 mm, and group D:32-36 mm. Flattest and steepest keratometry (K1 and K2), AL, anterior chamber depth (ACD), lens thickness (LT), and white-to-white (WtW) were determined using IOLMaster before and after administration of topical tropicamide. The corresponding IOL powers were calculated using Sanders-Retzlaff-Kraff/theoretical (SRK/T), Haigis, and Barrett Universal II formulas. Results: Variations in AL, K1 and K2 following dilation were not significant (P > 0.05 in all groups). The results showed that ACD increased significantly after dilation (P = 0.000 in all groups), whereas LT decreased significantly after dilation (P = 0.000, 0.000, 0.001, and 0.003). Post-dilation WtW increased significantly in Group A, B, and C (P = 0.001, 0.001, and 0.025) but not in Group D. When IOL power was calculated as a discrete variable, significant differences were observed between pre- and post-dilation IOL power. Conclusion: Pupil dilation in cataract eyes with high myopia does not cause significant changes in AL and K. However, it significantly increases ACD as well as WtW values and significantly decreases the LT value. Surgeons should evaluate the effect of pupil dilation on IOL power prediction as the present findings show extreme cases. Notably, Barrett Universal II formula had the best concordance between different pupil conditions in long eyes.

Reattachment After Foldable Capsular Vitreous Body Implantation in Severe Retinal Detachment Eyes.

Purpose: To evaluate the clinical effectiveness and safety of foldable capsular vitreous body (FCVB) implantation for severe retinal detachment. Methods: A retrospective analysis was performed on 26 patients with severe ocular trauma and one with recurrent retinal detachment. Clinical data-including surgery success, complications, retinal reattachment, vision, and intraocular pressure (IOP)-were analyzed for patients who underwent 23G pars plana vitrectomy and FCVB implantation combined with silicone oil tamponade. Results: The mean follow-up period was 10.44 ± 2.68 months. All surgeries were smooth; the FCVBs were properly positioned and supported the retina well, and the retinal reattachment rate reached 92.59%. At the six-month follow-up, preoperative (1.30 ± 1.20) and postoperative (0.63 ± 0.79) vision was significantly different (t = 3.03, P = 0.005), and the postoperative IOP (7.93 ± 3.57 mm Hg) was lower than the preoperative IOP (13.98 ± 10.72 mm Hg) (t = 2.74, P = 0.01). Among 20 patients followed up for >12 months, preoperative (1.20 ± 0.95) and postoperative (0.75 ± 0.91) visions were significantly different (t = 1.831, P = 0.005), and the postoperative IOP (9.85 ± 6.48 mm Hg) was lower than the preoperative IOP (14.85 ± 12.17 mm Hg) (t = 1.82, P = 0.01). No endophthalmitis, sympathetic ophthalmia, and rejection of FCVB occurred during follow-up. Conclusions: FCVB combined with silicone oil tamponade showed good efficacy and safety in severe retinal detachment treatment during the follow-up period. Translational Relevance: Vitreous substitution is deemed a highly challenging and interesting research topic in ophthalmology. Traditional method such as silicone oil tamponade often causes various complications such as silicone oil emulsification, silicone oil migration, and corneal degeneration. The foldable capsular vitreous body as a novel vitreous substitute combined silicone oil injection into it can stay in the eyeball for a long time without obvious complications.

Implantation of Foldable Capsular Vitreous Body for the Treatment of Acute Retinal Necrosis Syndrome: A Case Report.

The authors present the case of a 35-year-old male who was diagnosed with acute retinal necrosis syndrome that evolved into retinal detachment (RD), even after immediate treatment with systemic antiviral medications, as well as intravitreal injection and laser photocoagulation. Pars plana vitrectomy plus silicone oil tamponade was performed, but silicone oil emulsified 22 months later. Due to the widespread necrosis lesions and defects of the peripheral retina, RD was highly likely to reoccur after silicone oil removal; thus, foldable capsular vitreous body was implanted to support the retina. No recurrent RD was observed afterward. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:653-657.].

Ghrelin protects retinal ganglion cells against rotenone via inhibiting apoptosis, restoring mitochondrial function, and activating AKT-mTOR signaling.

Ghrelin, a 28-amino acid peptide hormone, has protective effects on neuronal cells. The present study aimed to examine the neuroprotective effects of ghrelin on the rat retinal ganglion cells in the rotenone-induced in vitro model of Parkinson's disease (PD). Cell viability and cell apoptosis were determined by MTT assay and flow cytometry, respectively. Mitochondrial functions were detected by mitochondrial complex I activity assay and mitochondrial membrane potential (MMP) assay. The mRNA and protein expression levels were determined by qRT-PCR and western blot, respectively. Rotenone significantly suppressed cell viability and increased cell apoptosis, also decreased the mitochondrial complex I activity as well as MMP in rat retinal ganglion cell line (RGC-5). Growth hormone secretagogue receptor (Ghsr) siRNA transfection significantly suppressed the expression of Ghsr in RGC-5 cells. Ghrelin treatment attenuated the effects of rotenone-induced changes in cell viability, cell apoptosis and mitochondrial functions in RGC-5 cells. Post-transcriptional suppression by Ghsr siRNA transfection and treatment with GHS-R antagonist, YIL781, both significantly attenuated the effects of ghrelin in RGC-5 cells. Rotenone decreased the protein levels of Bcl-2 and increased the protein levels of Bax, cleaved caspase-3 and cleaved caspase-9, and this effect was reversed by ghrelin treatment. Ghrelin also prevented the inhibitory effects of rotenone on the AKT-mTOR signaling. The effects of ghrelin on the rotenone-induced changes in apoptosis-related protein levels and AKT-mTOR signaling were attenuated by Ghsr siRNA transfection and treatment with YIL781 in the RGC-5 cells. In addition, both rapamycin and AKT inhibitor IV pre-treatment significantly attenuated the effects of ghrelin on rotenone-induced changes in cell viability and cell apoptosis. In conclusion, ghrelin by acting on the GSH-R to protect rat retinal ganglion cells against rotenone via inhibiting apoptosis and restore mitochondrial functions in RGC-5 cells, and this effect was partially associated with the AKT-mTOR signaling pathway in RGC-5 cells.

MiR-20b targets AKT3 and modulates vascular endothelial growth factor-mediated changes in diabetic retinopathy.

Diabetic retinopathy (DR) is the leading cause of new-onset blindness. The roles of microRNAs in diabetic retinopathy are largely unknown. The aim of this study is to investigate the role of miR-20b in DR. Transfection of miR-20b mimic in high glucose (HG)-treated human retinal endothelial cells (HRECs) increased miR-20b expression and decreased the expression level of VEGF mRNA, while transfection of miR-20b inhibitor in control HRECs reduced the miR-20b expression with a corresponding increase of VEGF mRNA. In vitro functional assay showed that transfection of miR-20b mimic prevented HG-induced increase in transendothelial permeability and tube formation in HRECs. Transfection of miR-20b inhibitor or treatment of VEGF increased transendothelial permeability and tube formation in control HRECs. Luciferase reported assay showed that AKT3 is a target of miR-20b. Transfection of miR-20b mimic prevented the up-regulation of AKT3 induced by HG without changing the protein levels of other isoforms of AKT, and silencing of AKT3 caused decrease of VEGF mRNA and protein levels as well as prevented HG-induced increase in transendothelial permeability and tube formation. Finally, we showed that miR-20b was down-regulated in the retina and retinal endothelial cells in diabetic rats, with a correlated up-regulation of VEGF and AKT3. Intravitreal injection of miR-20b mimic in the diabetic rat significantly increased the miR-20b expression and decreased the expression levels of AKT3 and VEGF in the retina tissues, and intravitreal delivery of AKT3 siRNA in the diabetic rat significantly decreased the expressions of AKT3 and VEGF. Collectively, miR-20b is important for the regulation of VEGF-mediated changes in HRECs and rat retinal tissues under hyperglycemic conditions possibly via targeting AKT3.