Comparison of Diatrizoate and Iohexol for Patient Acceptance and Fecal-Tagging Performance in Noncathartic CT Colonography.

OBJECTIVE: The aim of this study was to compare diatrizoate and iohexol regarding patient acceptance and fecal-tagging performance in noncathartic computed tomography colonography. METHODS: This study enrolled 284 volunteers with fecal tagging by either diatrizoate or iohexol at an iodine concentration of 13.33 mg/mL and an iodine load of 24 g. Patient acceptance was rated on a 4-point scale of gastrointestinal discomfort. Two gastrointestinal radiologists jointly analyzed image quality, fecal-tagging density and homogeneity, and residual contrast agent in the small intestine. The results were compared by the generalized estimating equation method. RESULTS: Patient acceptance was comparable between the 2 groups (3.95 ± 0.22 vs 3.96 ± 0.20, P = 0.777). The diatrizoate group had less residual fluid and stool than the iohexol group ( P = 0.019, P = 0.004, respectively). There was no significant difference in colorectal distention, residual fluid, and stool tagging quality between the 2 groups (all P 's > 0.05). The mean 2-dimensional image quality score was 4.59 ± 0.68 with diatrizoate and 3.60 ± 1.14 with iohexol ( P < 0.001). The attenuation of tagged feces was 581 ± 66 HU with diatrizoate and 1038 ± 117 HU with iohexol ( P < 0.001). Residual contrast agent in the small intestine was assessed at 55.3% and 62.3% for the diatrizoate group and iohexol group, respectively ( P = 0.003). CONCLUSIONS: Compared with iohexol, diatrizoate had better image quality, proper fecal-tagging density, and more homogeneous tagging along with comparable excellent patient acceptance, and might be more suitable for fecal tagging in noncathartic computed tomography colonography.

An abbreviated Chinese dyslexia screening behavior checklist for primary school students using a machine learning approach.

To increase early identification and intervention of dyslexia, a prescreening instrument is critical to identifying children at risk. The present work sought to shorten and validate the 30-item Mandarin Dyslexia Screening Behavior Checklist for Primary School Students (the full checklist; Fan et al., , 19, 521-527, 2021). Our participants were 15,522 Mandarin-Chinese-speaking students and their parents, sampled from classrooms in grades 2-6 across regions in mainland China. A machine learning approach (lasso regression) was applied to shorten the full checklist (Fan et al., , 19, 521-527, 2021), constructing grade-specific brief checklists first, followed by a compilation of the common brief checklist based on the similarity across grade-specific checklists. All checklists (the full, grade-specific brief, and common brief versions) were validated and compared with data in our sample and an external sample (N = 114; Fan et al., , 19, 521-527, 2021). The results indicated that the six-item common brief checklist showed consistently high reliability (αs > .82) and reasonable classification performance (about 60% prediction accuracy and 70% sensitivity), comparable to that of the full checklist and all grade-specific brief checklists across our current sample and the external sample from Fan et al., , 19, 521-527, (2021). Our analysis showed that 2.42 (out of 5) was the cutoff score that helped classify children's reading status (children who scored higher than 2.42 might be considered at risk for dyslexia). Our final product is a valid, accessible, common brief checklist for prescreening primary school children at risk for Chinese dyslexia, which can be used across grades and regions in mainland China.

Cytological and functional effect of complement 3a on Human Scleral Fibroblasts.

PURPOSE: The complement system is considered to play an important role in the progression of myopia, whereas the influence of complement activation on the human scleral fibroblasts (HSFs) remains unknown. Hence, the effect of complement 3a (C3a) on HSFs was investigated in this study. METHODS: HSFs were cultured with exogenous C3a at 0.1 µM for various periods following different measurement protocols, and cells without C3a treatment served as negative control (NC). Cell viability was investigated using the MTS assay after 3 days of C3a treatment. Cell proliferation was evaluated by the 5-Ethynyl-20-Deoxyuridine (EdU) assay following C3a stimulation for 24 hours. Apoptosis was assessed by Annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) double staining following C3a stimulation for 48 hours and the stained cells were analysed using flow cytometry. The levels of type I collagen and matrix metalloproteinase-2 (MMP-2) were analysed using ELISA following C3a stimulation for 36 and 60 hours. The level of CD59 were analysed using western blot following C3a stimulation for 60 hours. RESULTS: The MTS assay revealed that cell viability was attenuated by 13% and 8% after C3a for 2 and 3 days, respectively (P < 0.05). The EdU assay demonstrated a 9% decrease in proliferation rate for the C3a-treated cells after 24 hours (P < 0.05). The apoptosis analysis revealed an increased percentage of cells in early apoptosis (P = 0.02) and total apoptosis (P = 0.02) in the C3a-treated group. Compared with NC group, the level of MMP-2 was increased by 17.6% (P = 0.002), whereas the levels of type I collagen and CD59 were respectively decreased by 12.5% (P = 0.024) and 21.6% (P = 0.044) with C3a treatment for 60 hours. CONCLUSIONS: These results indicated that C3a-induced complement activation is potentially involved in inducing myopic-associated scleral extracellular matrix remodelling via mediating the proliferation and function of HSFs.

Blastocyst euploidy rates in low-prognosis patients according to the POSEIDON criteria: a retrospective analysis of 3016 embryos.

RESEARCH QUESTION: Do embryo euploidy rates differ in the four groups of women with low prognosis as stratified by the POSEIDON criteria? DESIGN: This was a retrospective cohort study of low-prognosis patients who met the POSEIDON criteria and underwent preimplantation genetic testing for aneuploidies (PGT-A) from January 2013 to June 2020 at the Center for Reproductive Medicine, Shandong University, China. A total of 3016 blastocysts from 1269 PGT-A cycles were included in the study. The primary outcome was the euploidy rate of the blastocysts. For each group, regression analyses were performed to quantitatively describe the relationship between maternal age and embryo euploidy rate. RESULTS: The euploidy rate of embryos in women with poor ovarian response (POR) was 39.1% in total. There were 727, 1052, 275 and 962 blastocysts in groups 1, 2, 3 and 4, respectively, with corresponding embryo euploidy rates of 57.2%, 34.9%, 52.4% and 26.2% (P < 0.001). Within each group, the euploidy rate decreased with age, especially in women aged 35 years or older (i.e. groups 2 and 4). CONCLUSIONS: Euploidy rates were more favourable in groups 1 and 3, of a young age, re-emphasizing that oocyte quality is the primary factor determining embryo euploidy rate. The study's findings demonstrated the reasonability of categorizing women with POR by the POSEIDON criteria depending on female age and ovarian reserve biomarkers. These results also provide information for women with POR in different subgroups so they can receive proper counselling on the possible prognosis.

A label-free and modification-free ratiometric electrochemical strategy for enhanced natural enzyme detection using a bare electrode and nanozymes system.

Ratiometric electrochemical assays have been demonstrated to be more sensitive and selective in various sensing events, mainly due to their affordable built-in correction and good self-reference capability. But it is known that complicated modification and labeling operations usually are necessary for the construction of ratiometric electrochemical assays, therefore is a hot and important issue needing consideration carefully. We herein report a new yet simple bare electrode-based ratiometric electrochemical bioassay to achieve sensitive and selective analysis of alkaline phosphatase (ALP), using a liquid phase system that contains CoOOH nanozymes and commercially available indicator substrate. This proposed bioassay works based on the ratiometric change of dual electrochemical signals, arising from an exclusive target ALP-triggered hydrolysis of electrochemical substrate p-nitrophenyl phosphate (PNPP). In this design, the two hydrolyzed products of electrochemically active p-nitrophenol (PNP) and electrochemically inactive phosphate anion (PO43-) are responsible together for the ratiometric electrochemical analysis of ALP. PNP exhibits a straightforward current response toward ALP content; however, PO43- cannot show a direct electrochemical signal thus is rationally designed to offer an alternative response by linking it with the specific CoOOH nanozyme-catalyzed reaction of 3,3',5,5'-tetramethylbenzidine (TMB) and H2O2, in which the nanozyme-catalyzed product oxTMB shows a direct reduction current at the GCE, and significantly decreases with increasing PO43- species due to the good inhibition of PO43- toward CoOOH nanozyme activity. As a result, a ratiometric electrochemical strategy for ALP analysis with a low limit of detection of 0.366 U/L (S/N = 3) was successfully achieved by integrating the above direct and indirect dual electrochemical responses. This developed bioassay can allow the quantitative diagnosis of ALP activity especially with a label-free and modification-free merit, therefore paving the way for simple, convenient, and portable electroanalytical tools in biosensing design and application.

Application of a 3D-printed eye model for teaching direct ophthalmoscopy to undergraduates.

PURPOSE: This study aims to design an eye model that can simulate the fundus for teaching direct ophthalmoscopy and to evaluate its effectiveness. METHODS: We first used 3D printing materials to make an eye model and then randomly assigned 92 undergraduates into group A (model-assisted training group) and group B (traditional training group) to test our model. After the same training time, real patients were used to test the students, with 120 s as the examination time limit. We recorded the students' ability to clearly see the optic disk, the time to determine the cup-to-disk ratio, and whether they were correct. RESULTS: Forty-three students in group A (93.48%) successfully saw the fundus, while 21 in group B (45.65%) succeeded. The difference between the two groups was 47.83% (95% confidence interval, 29.59-66.07%, P < 0.0001). The median time to see the fundus was 29s (95% confidence interval 23-45 s) in group A, while an estimated minimum time in group B was 80 s, indicating that group A was significantly faster than group B (P < 0.0001). CONCLUSIONS: This 3D-printed eye model significantly improved the students' study interest, study efficiency, and study results and is worthy of being promoted.

A Fenton-like reaction system with analyte-activated catfish effect as an enhanced colorimetric and photothermal dopamine bioassay.

Fenton-like reaction systems have been proven to be efficient as powerful promoters in advanced oxidation processes (AOPs) due to their generated reactive oxygen species (ROS), such as ˙OH and ˙O2-, which can further oxidize a specific chromogenic substrate like 3,3',5,5'-tetramethylbenzidine (TMB) to generate sensitive color readout and thereby demonstrate more potential in the colorimetric analysis field. However, the inherent drawback of the low rate-limiting step of Fe3+/Fe2+ conversion in the Fenton-like reaction and its resultant inefficiency for H2O2 decomposition hinder its practical applications. We herein communicate an analyte-activated catfish effect based catalysis strategy to promote the Fenton-like reaction, in which dopamine, like a catfish, was added to activate the Fenton-like reaction. By definition, the conversion rate of Fe3+ to Fe2+ in the proposed Fenton-like reaction can be significantly accelerated through a specific DA-mediated electron transfer process which further promotes the reaction activity in the Fenton-like reaction to generate more ˙OH and ˙O2- radicals. As a result, the produced ˙OH and ˙O2- radicals in such a reaction system can significantly oxidize TMB indicator into its oxidation product (TMBox) and therefore indicate the corresponding target-dependent color and photothermal signal readout, enabling the successful fabrication of a more sensitive and stable colorimetric and photothermometric DA sensor. More significantly, this strategy can greatly advance the practical application of Fenton-like reactions in the fields of colorimetric and photothermometric bioassays.

Photothermometric analysis of bismuth ions using aggregation-induced nanozyme system with a target-triggered surface cleaning effect.

The development of nanozyme-based photothermometric sensing for point-of-care testing (POCT) heavy metal ions is of great significance for disease diagnosis and health management. Considering the low catalytic activity of most nanozymes at physiological pH, we found bismuth ions (Bi3+) could effectively enhance the peroxidase (POX)-like activity of cetyltrimethylammonium bromide and citrate-capped octahedral gold nanoparticle (CTAB/Cit-AuNP) nanozymes. It is mainly based on Bi3+ ions being able to trigger the surface cleaning effect of CTAB/Cit-AuNPs. Because the more active Bi3+ ions could effectively bind with citrate on the gold surface and competitively destroy the electrostatic interaction between citrate and CTAB, resulting in the removal of CTAB ligands from the gold surface. Without the ligand protection, CTAB/Cit-AuNPs aggregated immediately, and further resulted in a significant activation of the POX-like activity of AuNP nanozymes. Based on this principle, we introduced the enzyme substrate 3,3',5,5'-tetramethylbenzidine (TMB) into this aggregation-induced nanozyme system, and rationally designed a photothermometric platform to quickly and sensitively detect Bi3+ ions by using the good photothermal effect of the oxidation product of TMB (oxTMB). The developed photothermometric method only using a common thermometer has a limit of detection (LOD) as low as 45.7 nM for POCT analysis of Bi3+ ions. This study not only provides a more accurate understanding of the aggregation-induced nanozymes based on the surface cleaning principle, but also shows the potential applications of aggregation-induced nanozymes in the POCT field.

A sensitive photothermometric biosensor based on redox reaction-controlled nanoprobe conversion from Prussian blue to Prussian white.

As a new low-cost photothermal nanoprobe, Prussian blue nanoparticles (PB NPs) have been demonstrated to have more potential in photothermometric-based point-of-care testing (POCT) application. However, most of the existing PB NP-based photothermometric sensors were constructed mainly relying on in situ generation of PB NPs or their combination with antigens and antibodies, therefore usually suffering from the inherent defects like complicated preparation and cumbersome surface process as well as high-cost modification. To break this limitation of PB NP-based photothermometric POCT, we proposed an ingenious redox reaction-controlled nanoprobe conversion strategy and successfully applied to photothermometric detection of ascorbate oxidase (AAO). In this design, the heat of PB NP photothermal system under 808-nm laser irradiation dramatically decreased with the addition of AA, due to a unique AA-induced Prussian blue to Prussian white (PB-to-PW) conversion. Upon AAO addition, the heat of reaction system increased because of the enzymatic catalytic reaction between AAO and AA, which led to a significant reduction of AA and resultantly inhibited PB-to-PW conversion. Such target-mediated nanoprobe conversion resulted in an obvious temperature change that could be easily detected by a common thermometer and exhibited good linear ranges from 0.25 to 14 mU/mL with a detection limit as low as 0.21 mU/mL for POCT analysis of AAO. This facile, convenient, and portable photothermometric sensing platform provides an innovative route for the design of PB NP nanoprobe-based photothermometric detection methods. A sensitive photothermometric AAO sensor based on a redox reaction-controlled nanoprobe conversion strategy from Prussian blue to Prussian white.

THE INCIDENCE, CHARACTERISTICS, MANAGEMENT, PROGNOSIS, AND CLASSIFICATION OF BREAKTHROUGH VITREOUS HEMORRHAGE SECONDARY TO POLYPOIDAL CHOROIDAL VASCULOPATHY.

PURPOSE: To describe breakthrough vitreous hemorrhage secondary to polypoidal choroidal vasculopathy (PCV). METHODS: Patients with the diagnosis of PCV from January 2005 to March 2020 at Peking Union Medical College Hospital were retrospectively reviewed, cases with breakthrough vitreous hemorrhage were analyzed. Subgroup analysis was conducted regarding pachychoroid PCV and nonpachychoroid PCV. RESULTS: Among 722 PCV patients (834 eyes), 103 eyes with breakthrough vitreous hemorrhage (12.4%) were included. Pars plana vitrectomy and proper further interventions could significantly improve the best-corrected visual acuity from logMAR 2.15 ± 0.48 (Snellen 20/2825) to 1.65 ± 0.67 (20/893). Hemorrhagic retinal detachment, baseline central macular thickness, and best-corrected visual acuity were factors associated with final best-corrected visual acuity (P < 0.05). In the pachychoroid PCV group, patients were younger, all had hemorrhagic pigment epithelial detachment, with a higher prevalence of choroidal vascular hyperpermeability and hemorrhagic retinal detachment, thicker subfoveal choroidal thickness, and thinner central macular thickness; besides, the initial pars plana vitrectomy were more complicated, more additional surgeries had to be performed. More eyes in the nonpachychoroid PCV group had received anti-vascular endothelial growth factor or photodynamic therapy, mostly fibrovascular pigment epithelial detachment, the best-corrected visual acuity and the status of the fellow eye were significantly worse. For the final ocular status, more eyes in nonpachychoroid PCV group were taking anti-vascular endothelial growth factor monotherapy, whereas more eyes in pachychoroid PCV group were stable. The choroidal parameters of these two groups were all significantly different. CONCLUSION: Breakthrough vitreous hemorrhage is a troublesome complication of PCV. Pars plana vitrectomy and additional interventions are required for better prognosis. Vitreous hemorrhage secondary to pachychoroid PCV or nonpachychoroid PCV have different characteristics and prognosis.

Enhanced Thermometric Sensor for Arsenate Analysis Based on Dual Temperature Readout Signaling Strategy.

New methods for portable detection of arsenate are still in urgent need. Herein, we explored a simple but sensitive thermometric strategy for arsenate determination without complex instruments and skilled technicians. Cobalt oxyhydroxide (CoOOH) nanoflakes, can ingeniously decompose hydrogen peroxide into oxygen in a sealed reaction vessel, accompanied by marked pressure and significant temperature increase due to the exothermic reaction effect (ΔH = -98.2 kJ/mol). The increased pressure then compelled a certain amount of H2O overflowing from the drainage device into another vessel, leading to a significant temperature decrease due to the preloaded ammonium nitrate (NH4NO3) and its good dissolution endothermic effect (ΔH = 25.4 kJ/mol). In the presence of arsenate, the catalytic activity of CoOOH nanoflakes for H2O2 decomposition was inhibited dramatically, resulting in an obvious decrease of the pressure, weighting water and temperature response. The two temperature responses with increasing and decreasing feature were easily measured through a common thermometer, and exhibited an effective signaling amplification via coupling both "signal-on" and "signal-off" temperature readout elements. The obtained dual superimposing temperature readout exhibits a good linear with the concentration of arsenate with a lower detection limit (51 nM, 3.8 ppb). Compared to the inductively coupled plasma mass spectrometry, this enhanced thermometric strategy provides a simple, rapid, convenient, low cost, and portable platform for sensing arsenate in real environmental water.

White matter networks dissociate semantic control from semantic knowledge representations: Evidence from voxel-based lesion-symptom mapping.

Although semantic system is composed of two distinctive processes (i.e., semantic knowledge and semantic control), it remains unknown in which way these two processes dissociate from each other. Investigating the white matter neuroanatomy underlying these processes helps improve understanding of this question. To address this issue, we recruited brain-damaged patients with semantic dementia (SD) and semantic aphasia (SA), who had selective predominant deficits in semantic knowledge and semantic control, respectively. We built regression models to identify the white matter network associated with the semantic performance of each patient group. Semantic knowledge deficits in the SD patients were associated with damage to the left medial temporal network, while semantic control deficits in the SA patients were associated with damage to the other two networks (left frontal-temporal/occipital and frontal-subcortical networks). The further voxel-based analysis revealed additional semantic-relevant white matter tracts. These findings specify different processing principles of the components in semantic system.

Molecule-gated surface chemistry of Pt nanoparticles for constructing activity-controllable nanozymes and a three-in-one sensor.

Herein, a simple strategy for constructing activity-controllable nanozymes is proposed based on the glutathione (GSH)-gated surface chemistry of citrate-capped Pt nanoparticles (PtNPs). PtNPs have been shown to have oxidase-like activity that can effectively catalyze the oxidation of 3,3',5,5'-tertamethylbenzidine (TMB) by O2, resulting in a typical color reaction from colorless to blue. We found that GSH can inhibit the oxidase-like activity of PtNPs as a molecule-gated surface chemistry element, resulting in a dramatic decrease of the oxidation of TMB. The addition of copper ions (Cu2+) could oxidize GSH into glutathione disulfide (GSSG), resulting in the distinct suppression of GSH-modulated PtNP surface chemistry and oxidase-like activity inhibition, which further results in a significant acceleration of TMB oxidation and the obvious recovery of intense blue color. Furthermore, the color-based detection signal associated with the redox of TMB indicator here was found to show good fluorescence and a photothermal effect and exhibit sensitive and selective response toward the proposed molecule-gated surface chemistry and Cu2+ target. On the basis of this phenomenon, we successfully constructed a three-in-one sensor for Cu2+ with a triple signal readout, colorimetric, photothermal (temperature), and fluorescence, depending on the proposed in situ modulation method for PtNP catalysis. The applicability of the three-in-one sensor was also demonstrated by measuring Cu2+ in human serum with a standard addition method, and the results are of satisfactory accuracy as confirmed by ICP-MS measurements.

Advances in Understanding Mobilization Processes of Trace Metals in Marine Sediments.

Different mobilization mechanisms control the metal distribution in surface sediments of the Belgium coastal zone (BCZ) and the anoxic Gotland basin (GB). This mobilization was studied using DGT (diffusive gradients in thin films): vertical one-dimensional (1D) profiles of Cd, Co, Cu, Fe, Mn, Ni, Pb, and Zn were measured at 5 mm intervals, while two-dimensional (2D) high-resolution (100 µm) images of smaller zones of the sediment profile were obtained on separate DGT probes. Removal of dissolved Cd, Cu, and Pb in BCZ sediments caused steep vertical gradients at the sediment-water interface that were well replicated in 1D profiles and 2D images. While 1D profiles showed apparent coincident maxima of Co, Mn, and Fe, 2D images revealed mutually exclusive Co and Fe mobilization. Correlation analysis supported this observation and showed a consistent linkage between Co and Mn. Sharp maxima of some metals in the vertical 1D profiles of GB sediment were attributed to localized mobilization in microniches. Examination of an ∼1 mm diameter Cu and Ni maximum in 2D, defined by ∼300 data points, showed that the metals were supplied from localized decomposition of reactive organic material, rather than from reductively dissolving Fe or Mn oxides, and that they were removed as their sulfides.

The association of polypoidal choroidal vasculopathy clinical phenotypes with previously reported genetic markers.

PURPOSE: Genetic studies have identified the association of some single-nucleotide polymorphisms (SNPs) with polypoidal choroidal vasculopathy (PCV), but little is known about whether these SNPs are related to PCV clinical features as well. We performed this study to examine the association of 12 SNPs with PCV clinical phenotypes. METHODS: Sixty-nine PCV eyes of 69 patients were included. Genomic DNA was extracted from peripheral blood. Agilent SureSelect Human ALL Exon V6 was used to sequence the 12 SNPs previously reported to associate with PCV. Baseline best-corrected visual acuity (BCVA), sub-foveal choroidal thickness (SFCT), choroid maximum vascular diameter (MVD), choroidal vascular hyperpermeability (CVH), and greatest linear dimension (GLD) of entire lesion were measured and compared between patients of different genotypes. Fisher's exact test and Mann-Whitney U test were mainly used to compare categorical variables and continuous variables respectively. RESULTS: HTRA1 rs2293870 was a protective factor of PCV or AMD in the fellow eye (P = 0.040) and was related with greater SFCT in PCV eye after multiple linear regression (P = 0.043). C3 rs17030 was associated with smaller GLD (P = 0.033). CFH rs2274700 was related to lower MVD (P = 0.043) and was a protective factor for CVH (P = 0.034). CONCLUSION: Multiple PCV-associated SNPs are associated with PCV clinical phenotypes. The involvement of several synonymous SNPs calls for further research on the role of transcriptional alterations and trans-regulation of distant signaling pathways in PCV pathogenesis.

THE OCCURRENCE, CHARACTERISTICS, MANAGEMENT, AND PROGNOSIS OF RETINAL PIGMENT EPITHELIUM TEARS IN PATIENTS WITH POLYPOIDAL CHOROIDAL VASCULOPATHY: A Retrospective Study of 397 Patients.

PURPOSE: To investigate retinal pigment epithelium (RPE) tears in patients with polypoidal choroidal vasculopathy. METHOD: A retrospective review of polypoidal choroidal vasculopathy cases with confirmed RPE tears was conducted. Patients' comprehensive clinical data were collected and analyzed. The treatment strategy was a loading dose of one intravitreal antivascular endothelial growth factor injection, combined with additional injections if exudative activities or visual deterioration were detected. RESULTS: Among 397 polypoidal choroidal vasculopathy patients, 33 patients with RPE tears (8.3%) were included. 42.4% of them happened spontaneously. Pigment epithelial detachment (PED) occurred more frequently in RPE tear patients and most of them had serous vascularized or hemorrhagic PED. The height and greatest linear diameter of PED, and the subfoveal choroidal thickness of these cases were significantly larger, whereas the central foveal thickness was significantly smaller. Most of the RPE tears occurred at the edge of the PED. After our treatment strategy, patients' best-corrected visual acuity improved significantly from 2.13 ± 1.24 (median 20/52) to 1.32 ± 1.31 (median 20/166). Large subretinal hemorrhage may increase the risk of the formation of subretinal fibrosis (P < 0.05). CONCLUSION: Retinal pigment epithelium tears in polypoidal choroidal vasculopathy are associated with high subRPE hydrostatic pressure, produced by a large PED or hemorrhage. After our intervention strategy, this condition may not necessarily result in poor prognosis.

Diagnosis of bilateral diffuse uveal melanocytic proliferation unveils primary gastric adenocarcinoma: a case report.

BACKGROUND: Bilateral diffuse uveal melanocytic proliferation (BDUMP) is an extremely rare paraneoplastic syndrome, with most cases reported as secondary to female urogenital and male lung malignancies. We reported this case of BDUMP patient whose primary malignancy was gastric adenocarcinoma verified with gastroscopy and subsequent pathological test. CASE PRESENTATION: A patient complaining blurred vision was suspected of bilateral diffuse uveal melanocytic proliferation (BDUMP), due to bilateral round oval patches at the posterior pole and cardinal signs in retinal angiography. Malignancy screening was suggested, and pathological report from gastroscopy confirmed the primary lesion as gastric adenocarcinoma. The patient chose palliative care due to late stage and unresectable nature of the malignancy. CONCLUSIONS: Identifying BDUMP warrants further investigation of a primary malignancy. Our case provided evidence for the link between gastric adenocarcinoma and BDUMP.

Peripheral retinal neovascularization secondary to highly myopic superficial Retinoschisis: a case report.

BACKGROUND: Peripheral Retinal neovascularization is well-described as a complication of X-linked retinoschisis, but less often observed in myopic and primary retinoschisis. We present a case of a myopic female who developed retinal microvascular abnormalities due to retinoschisis and subsequent vitreous hemorrhage which would cause severe visual damage without timely and proper treatment. CASE PRESENTATION: A 38-year-old highly myopic Chinese female complained of blurred vision in her right eye. Her best corrected visual acuitiy was 20/20 OU, and her refraction was - 9.00S OU. Dilated fundus examination revealed mild vitreous hemorrhage and abnormal vascular network nasal to the optic disc in her right eye. Optical Coherence Tomography (OCT)- angiography (OCTA) B-Scan showed superficial retinoschisis and well-depicted abnormal retinal microvascular network in inner retinal layer. Sectoral scatter laser photocoagulation was administered. Regression of most abnormal vessels was achieved in 1 month, but the patient experienced an unexpected episode of vitreous hemorrhage 3 months after the initial treatment, which was absorbed spontaneously in 2 weeks. Supplemental laser photocoagulation was applied and regular follow-up visit was suggested. CONCLUSION: Superficial retinoschisis in pathological myopia can be a driver of retinal microvascular abnormalities, possibly neovascularization, an extremely rare but severe complication which can be vision-threatening without timely and proper intervention.

Comparison of choriocapillary flow density between fellow eyes of polypoidal choroidal vasculopathy and neovascular age-related macular degeneration.

BACKGROUND: To compare the choriocapillary flow density (CFD) among the fellow eyes of polypoidal choroidal vasculopathy (PCV), neovascular age-related macular degeneration (nAMD), and healthy controls using spectral-domain optical coherence angiography tomography (SD-OCTA). METHODS: This is a cross-sectional study that includes the fellow eyes of 38 patients with unilateral PCV, 36 patients with unilateral nAMD, and 36 eyes from 36 healthy volunteers. The PCV group was further classified into polypoidal CNV (P-CNV) and typical PCV (T-PCV) for subgroup analysis. The age, subfoveal choroidal thickness (SFCT), Age-Related Eye Disease Study (AREDS) classification, and fellow eye diagnosis were acquired. All subjects underwent SD-OCTA with a 6.0-mm scan pattern. Circles with radius of 1.00, 1.50, and 3.00 mm were manually selected in the choriocapillaris (CC) slab, and the CFD was calculated as the percentage of the flow area to the whole selected area as CFD-1.00, 1.50, and 3.00, respectively. Univariate and multivariate analysis were performed to study the correlation between the aforementioned factors with CFD. RESULTS: The mean CFD-1.00, 1.50, and 3.00 of the nAMD group were 61.51, 63.18, and 66.20, respectively; these were significantly lower than those of the PCV group (65.90, 66.89, and 67.94; P < 0.001, P < 0.001, and P = 0.010; respectively) and control group (66.28, 66.96, and 68.42; P < 0.001, P < 0.001, and P = 0.001, respectively), and no difference was detected between the PCV and control group or between PCV subtypes. The AREDS classification and fellow eye diagnosis were correlated with CFD in univariate analysis; however, only the fellow eye diagnosis showed a significant correlation after multiple linear regression. CONCLUSIONS: The CFD of nAMD fellow eyes was significantly lower than that of PCV and control eyes, and no difference was detected between PCV and control group, indicating that CC loss plays a different role in the early pathogenesis of nAMD and PCV.

Central retinal vein occlusion in patients with metastatic solid tumors on tyrosine kinase inhibitors: a report of case series and literature review.

Background: Central retinal vein occlusion (CRVO) is a rare adverse effect related to the use of tyrosine kinase inhibitors (TKIs) in patients with metastatic malignancies, which has only been reported in several case reports. Case presentation: We reported the case series of three CRVO patients on regular regimens of TKIs as part of targeted therapies for metastatic malignancies, all of whom were otherwise healthy with no or well-controlled systemic conditions. All these patients received injections of intravitreal dexamethasone implant (IDI) and achieved a fluid-free macula at the end of the visit. In addition, we reviewed the existing literature on this subject and present here an updated analysis of the related TKIs, ocular presentation, treatment, and prognosis. Conclusion: All patients diagnosed with CRVO on TKIs received dexamethasone implant treatment and obtained a fluid-free macula. We would like to raise awareness among our colleague oncologists about the possibility of CRVO related to TKI use and the necessity for patients to be screened regularly by a retinal specialist.