A multifactorial screening model based on the Graves ophthalmopathy quality of life scores in dysthyroid optic neuropathy.

PURPOSE: To validate the Graves ophthalmopathy quality of life (GO-QOL) questionnaire in screening DON and to construct an effective model. METHODS: A total of 194 GO patients were recruited and divided into DON and non-DON (mild and moderate-to-severe) groups. Eye examinations were performed, and quality of life was assessed by the GO-QOL questionnaire. The random forest, decision tree model, receiver operator characteristic (ROC) curve, accuracy and Brier score were determined by R software. RESULTS: In GO-QOL, age, best corrected visual acuity (BCVA), exophthalmos, CAS, severity, and Gorman score were found to be factors related to visual function scores. On the appearance scale, gender, duration of GO, BCVA, exophthalmos, CAS and severity of GO were relevant. Both the visual function scores and appearance scores were significantly lower in DON groups than in non-DON groups (33.18 ± 24.54 versus 81.26 ± 17.39, 60.08 ± 24.82 versus 76.14 ± 27.56). The sensitivity, specificity, and AUC of the visual function scores were 91.1%, 81.7% and 0.939, respectively Visual function scores were used to construct a decision tree model. The sensitivity, specificity, and AUC of the model were 92.9%, 88.0% and 0.941, respectively, with an accuracy of 89.7% and a Brier score of 0.024. CONCLUSIONS: Visual function scores were qualified as a screening method for DON, with a cutoff point of 58. A multifactorial screening model based on visual function scores was constructed.

Evolving indications and surgical techniques for corneal transplantation at a tertiary eye care center in southern China.

BACKGROUND: This retrospective study aimed to analyze the evolution of primary indications and surgical techniques for corneal transplantation in Southern China from 2012 to 2021. METHODS: The medical charts of all patients who underwent keratoplasty between January 2012 and December 2021 at Zhongshan Ophthalmic Centre, Sun Yat-Sen University, Guangzhou, Southern China were reviewed. We collected and analyzed the primary indications for corneal transplantation and the surgical methods used in each keratoplasty. RESULTS: The total number of corneal transplantations was 7,286 during this decade, increasing from 210 cases in 2012 to 1054 cases in 2021. The primary indications for keratoplasty included acquired nontraumatic corneal diseases (56.2%), congenital corneal abnormalities (16.4%), acquired traumatic corneal diseases (14.0%), and regraft (13.4%). Infectious keratitis was the leading indication among all keratoplasties (18.5%), followed by regraft (13.4%). Over the decade, the proportion of infectious keratitis gradually decreased (P = 0.013), while the proportion of regraft increased (P = 0.019). The predominant surgical technique was penetrating keratoplasty (PKP), accounting for 56.7%. However, the number of deep anterior lamellar keratoplasty (DALK) and endothelial keratoplasty (EK) significantly increased from 2012 to 2021 (P = 0.007 and P = 0.002). CONCLUSIONS: The annual number of corneal transplants significantly increased from 2012 to 2021. In the past decade, infectious keratitis and regraft have become the leading primary indications for corneal transplantation. Although the use of customized lamellar techniques has dramatically increased, PKP remains the predominant surgical technique for keratoplasty.

Therapeutic effects of a novel venom abstract (ZK002) solution in an alkali-burned corneal wound-healing model.

Purpose: Corneal alkali burns can progress to corneal epithelial defects, inflammation, scarring, and angiogenesis, potentially leading to blindness. Therefore, we examined the therapeutic effects of a novel ophthalmic solution (ZK002) on wound healing in alkali-burned rat corneas. Methods: In this study, we attempted to treat alkali-exposed rat corneas using topical application of either an ophthalmic solution with ZK002 or an anti-vascular endothelial growth factor agent for 14 days. We evaluated corneal edema, corneal neovascularization area, and histological changes. We also assessed the inflammatory (MMP-9, MMP-2, and interleukin-1ß) and angiogenic (vascular endothelial growth factor receptor 2, VEGFR2) markers. Levels of inflammatory (matrix metalloproteinase (MMP)-9, MMP-2, and interleukin-1ß), profibrotic (α-smooth muscle actin, α-SMA; transforming growth factor-ß2,TGF-ß2), and angiogenic (vascular endothelial growth factor-receptor 2, VEGFR2) factors, as well as peroxisome proliferator-activated receptor γ (PPARγ) mRNA expression, were measured. Results: The analyses showed that alkali exposure caused an increase in corneal edema and fibrosis with corneal neovascularization. The accumulation of α-smooth muscle actin-positive myofibroblasts and the deposition of transforming growth factor-ß2 on the alkali-exposed corneas were noted on day 14. The mRNA expression levels of interleukin-1ß, MMP-9, MMP-2, VEGFR2, and profibrotic factors were decreased in the ZK002 group compared with the control group during the early period of corneal alkali burns on day 14. However, the expression level of PPARγ mRNA was increased in the ZK002 group. Conclusions: ZK002 decreased the fibrotic reaction and prevented neovascularization in the cornea after an alkali burn. Therefore, the novel ophthalmic solution ZK002 could be a potentially promising therapeutic clinical treatment for corneal wound healing.

Charge doping and electric field tunable ferromagnetism and Curie temperature of the MnS2 monolayer.

Two-dimensional ferromagnets with a long-range ferromagnetic ordering at finite temperature present a bright prospect for their potential applications in nanoscale spintronic devices. The tuning of their intrinsic ferromagnetism and Curie temperature is essential for the development of next-generation data storage and spintronic devices. In this work, the electronic structures, ferromagnetism and Curie temperature of two-dimensional MnS2 monolayer are controlled by charge doping and electric field using first principles calculations. The results show that the dynamic and thermal stability of monolayer MnS2 for all of the cases can be still maintained. Moreover, there is no existence of phase transition and all MnS2 monolayers at any charge doping concentrations and electric field intensities favor ferromagnetic coupling. For the manipulation of electron doping, the calculated total magnetic moment Mtot of the MnS2 monolayer exhibits an increase from 3.112 to 3.491µB per unit cell. Further analysis indicates that a transition from half-metal to metal occurs by introducing the charge doping and vertical electric field, and the Mn 3d electronic states are the major determinants of ferromagnetism. Additionally, the charge doping enables the magnetic anisotropy energy to transform from an in-plane easy axis to the magnetization direction out of the plane. The Curie temperature Tc of the MnS2 monolayer can be moderately enhanced above room temperature by hole doping and application of a vertical electric field. Remarkably, Tc reaches its peak at 767 K at a hole doping concentration of -0.8e. This work enriches the microscopic understanding of the tuning mechanism of ferromagnetism and supplies a sound theoretical basis for subsequent experimental studies.

Discovery of Ingenane Diterpenoids from Euphorbia hylonoma as Antiadipogenic Agents.

Thirteen new Euphorbia diterpenoids, euphylonanes A-M (1-13), and eight known ones were isolated from the whole plants of Euphorbia hylonoma. Compounds 1 and 2 are two rearranged ingenanes bearing a rare 6/6/7/3-fused ring system. Compound 3 represents the first example of a 9,10-epoxy tigliane, while 4-21 are typical ingenanes varying with substituents. Structures were elucidated using a combination of spectroscopic, computational, and chemical methods. Most ingenanes exerted a significant antiadipogenic effect in 3T3-L1 adipocytes, among which 4 was the most active with an EC50 value of 0.60 ± 0.27 µM. Mechanistic study revealed that 4 inhibited the adipogenesis and lipogenesis in adipocytes via activation of the AMPK signaling pathway.

Acrolein Induces Retinal Abnormalities of Alzheimer's Disease in Mice.

It is reported that retinal abnormities are related to Alzheimer's disease (AD) in patients and animal models. However, it is unclear whether the retinal abnormities appear in the mouse model of sporadic Alzheimer's disease (sAD) induced by acrolein. We investigated the alterations of retinal function and structure, the levels of ß-amyloid (Aß) and phosphorylated Tau (p-Tau) in the retina, and the changes in the retinal vascular system in this mouse model. We demonstrated that the levels of Aß and p-Tau were increased in the retinas of mice from the acrolein groups. Subsequently, a decreased amplitudes of b-waves in the scotopic and photopic electroretinogram (ERG), decreased thicknesses of the retinal nerve fiber layer (RNFL) in the retina, and slight retinal venous beading were found in the mice induced by acrolein. We propose that sAD mice induced by acrolein showed abnormalities in the retina, which may provide a valuable reference for the study of the retina in sAD.

Effects of PPAR-γ and RXR-α on mouse meibomian gland epithelial cells during inflammation induced by latanoprost.

The purpose of this study is to investigate the effects of latanoprost on the secretion of cytokines and chemokines from meibomian gland epithelial cells, and to evaluate the modulation of peroxisome proliferator-activated receptor γ (PPAR-γ) and retinoid X receptor α (RXR-α) during latanoprost-induced inflammation. Mouse meibomian gland epithelial cells were cultured in proliferation and differentiation medium, respectively. Cells were exposed to latanoprost, rosiglitazone (PPAR-γ agonist), or LG100268 (RXR-α agonist), respectively. The expression of IL-6, IL-1ß, TNF-α, MMP-9, MCP-1, and CCL-5 were detected by real-time PCR and ELISA. The effect of latanoprost, rosiglitazone, LG100268, and inflammatory cytokines on the differentiation of meibocyte were evaluated by related gene expression and lipid staining. The expression of Keratin-1, 6, 17 protein was detected by western immunoblotting. The results showed that the above cytokines could be induced by latanoprost in meibomian gland epithelial cells. LG100268 and rosiglitazone could inhibit the production of IL-6 and TNF-α induced by latanoprost, respectively. Latanoprost suppressed the expression of differentiation-related mRNA through a positive feedback loop by enhancement of COX-2 expression via FP receptor-activated ERK signaling. The expression of Keratin-17 was upregulated by rosiglitazone and suppressed by LG100268. The application of IL-6 and TNF-α showed negative effects on lipid accumulation in meibomian gland epithelial cells. These results demonstrated that latanoprost could induce inflammation and suppress differentiation of mouse meibomian gland epithelial cells. The activation of PPAR-γ and RXR-α showed an anti-inflammatory effect, showing a potential role to antagonize the effect of latanoprost eyedrops on meibomian gland epithelial cells.

Conjunctival Fluid Secretion Impairment via CaCC-CFTR Dysfunction Is the Key Mechanism in Environmental Dry Eye.

Dry eye disease (DED) is a multifactorial disease with an incidence of approximately 50% worldwide. DED seriously affects quality of life and work. The prevalence of environmental DED (eDED) ranges from 35 to 48%. Conjunctival fluid secretion dysfunction may be one of the major causes of DED. Notably, the Cl- flux corresponds to the conjunctival fluid secretion and could be affected by ATP. Both the cystic fibrosis transmembrane conductance regulator (CFTR) and the Ca2+-activated Cl- channel (CaCC) are Cl- channels involved in epithelial fluid secretion. Conjunctival fluid secretion could be increased by activating P2Y2R (an ATP receptor) in DED. However, the role of the CaCC and CFTR channels regulated by P2Y2R in eDED remains unclear. In this study, we established a rabbit eDED model using a controlled drying system. A Ussing chamber was used to perform a conjunctival short-circuit current induced by ATP to evaluate the reactivity of the ion channels to the ATP. Our results revealed that eDED accompanied by conjunctival fluid secretion impairment was caused by a P2Y2R dysfunction, which is related to CaCC-CFTR signaling in the conjunctiva epithelium. Notably, the coupling effect of the ATP-induced CaCC-CFTR activation and intracellular Ca2+ may represent a promising therapeutic target for treating eDED.

Comparing the efficacy and safety of femtosecond laser-assisted vs conventional penetrating keratoplasty: a meta-analysis of comparative studies.

PURPOSE: To investigate the safety and efficacy of femtosecond laser-assisted penetrating keratoplasty (FLAK) versus conventional penetrating keratoplasty (CPK). METHODS: A literature search of PubMed, Cochrane, Embase, Web of Science, and Clinicaltrials.gov was conducted for comparative studies published from January 2007 to October 2019. Studies that involved both FLAK and CPK groups and reported on the relevant efficacy and/or safety parameters were included. The Newcastle-Ottawa quality assessment scale was used to analyse the methodological quality of these studies. Further, weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated. RESULTS: From the screened articles, a total of 1991 eyes from nine comparative studies were included. FLAK was not statistically superior for twelve-month postoperative best corrected visual acuity (WMD = - 0.06; 95% CI [- 0.16, 0.04]; P = 0.22), corneal astigmatism (WMD = - 0.81; 95% CI [- 1.63, 0.01]; P = 0.05) or six-month postoperative uncorrected visual acuity (WMD = - 0.11; 95% CI [- 0.27, 0.06]; P = 0.21). There were no significant differences in corneal graft rejection rate and the graft failure between FLAK and CPK at twelve months postoperative. However, best-corrected visual acuity (BCVA) and corneal astigmatism corrected with FLAK were better than those with CPK six months postoperative after elimination of data heterogeneity. CONCLUSION: Visual outcomes improvement in FLAK was better than that in CPK at six months postoperative, but not twelve months postoperative. This review recommends selecting a technique based on patients' work demands and economic burdens.

Limbal conjunctival versus amniotic membrane in the intraoperative application of mitomycin C for recurrent pterygium: a randomized controlled trial.

PURPOSE: This study compared the outcomes of a limbal conjunctival autograft (LCAG) with those of an amniotic membrane graft (AMG) followed by intraoperative 0.02 % mitomycin C (MMC) to treat recurrent pterygium. METHODS: In this randomized controlled trial, ninety-six eyes with recurrent pterygium were enrolled and randomly allocated into two groups using a computer-generated random number table. Pterygium removal was followed by intraoperative 0.02 % MMC for 3 min and then either LCAG or AMG transplantation. The major outcomes were recurrence rate, conjunctival inflammation grade, healing time of the corneal epithelial defect, eye-movement amplitude (EMA), uncorrected distance visual acuity (UDVA), and complications. RESULTS: A follow-up of 12 months was conducted for 93 eyes of 82 patients. Grade D (recurrence) presented in one eye of the LCAG group and five eyes of the AMG group, with no between-group difference (p = 0.196). However, Grades A, B, and C presented in 46, zero and zero eyes of the LCAG group respectively, and in 37, two and two eyes of the AMG group respectively, with the surgical bed generally showing a better appearance in the LCAG group than in the AMG group (p = 0.008). Compared with baseline values, the postoperative EMA improved significantly in both groups (p < 0.001 for the LCAG group; p = 0.001 for the AMG group), as did UDVA (p = 0.005 for the LCAG group; p = 0.012 for the AMG group). No between-group differences were found in terms of the healing time for epithelial defect, conjunctival inflammation grade, or the frequency of complications such as punctate epithelial keratitis, episcleral melting, corneal pannus, and delayed corneal epithelium healing. CONCLUSIONS: LCAG transplantation with intraoperative 0.02 % MMC is as efficacious in treating recurrent pterygium as AMG transplantation with MMC. The former procedure results in an attractive cosmetic appearance but might result in limbal damage in some eyes. The surgeon's familiarity with these procedures should determine the method of treatment.

Case report of ocular Kaposi's sarcoma.

BACKGROUND: Kaposi's sarcoma (KS) is generally considered a neoplastic disorder of vascular origin and occurs in patients with acquired immunodeficiency syndrome (AIDS) or who have received immunosuppressive treatments after an organ transplant (Soulier et al., Blood 86(4):1276-80, 1995; Viejo-Borbolla and Schulz, AIDS Rev 5(4):222-9, 2003; Schulz, J Antimicrob Chemother 45(Suppl T3):15-27, 2000; Aversa et al. Crit Rev Oncol Hematol 53(3):253-65, 2005; Mbulaiteye and Engels, Int J Cancer 119(11):2685-91, 2006; Tessari et al., Eur J Dermatol 16(5):553-7, 2006). Several Kaposi's sarcoma case reports involving eyelids and conjunctiva have been published (Bavishi et al., Int J STD AIDS 23(3):221-2, 2012; Baumann et al., Ger J Ophthalmol 4(4):239-45, 1995). CASE PRESENTATION: we report a 13 years old asian male patient rare case of ocular KS that was initiated from the sclera and progressed into the cornea and conjunctiva without an human Immunodeificiency Virus (HIV) or HHV-8 infection after a peripheral blood stem cells transplantation. In this case, anti- vascular endothelial growth factor (VEGF) therapy was attempted to stop the advance of ocular lesions and failed. Eventually, the KS was cured by a limbo-corneal lamellar graft, an amniotic membrane and scleral allograft transplantation plus intraoperative mitomycin C(MMC) after the complete excision of the tumors. CONCLUSION: A compete surgical excision combined with the intraoperative application of MMC, as well as grafts to repair the scleral, conjunctival, and corneal surfaces, could prevent a recurrence of KS.

Associated factors, diagnosis and management of Acanthamoeba keratitis in a referral Center in Southern China.

BACKGROUND: To analyse the associated factors, diagnosis, clinical manifestations and therapeutic effects of Acanthamoeba keratitis at a tertiary ophthalmic centre in Southern China. METHODS: A retrospective clinical study was performed in fifteen patients who were admitted to Zhongshan Ophthalmic Centre (ZOC) from January 2004 to December 2014. The patients' pathogenesis-associated factors were analysed, and preoperative diagnoses were determined using corneal scraping cultures and/or confocal microscopy followed. All diagnoses were confirmed by postoperative pathological examinations. At follow-up, best-corrected visual acuity (BCVA), the recurrence rate and graft transparency were evaluated to assess therapeutic effects. RESULTS: The main pathogenic factors observed in the fifteen patients were a history of injury or a foreign body entering the eyes (12 cases). In all, Acanthamoeba keratitis was preoperatively diagnosed in 5 cases using corneal scraping cultures or confocal microscopy. Ocular symptoms included redness, photophobia, tearing, and blurred vision. Penetrating keratoplasty was performed in thirteen patients, and postoperative pathological examinations were performed to confirm these diagnoses. The logarithm of the minimum angle of resolution (logMAR) of visual acuity was significantly improved after keratoplasty (p < 0.01). No recurrence was observed, and approximately 90% of the corneal grafts were found to be transparent during the follow-up period. CONCLUSIONS: Corneal trauma may be the main pathogenic factor that causes Acanthamoeba keratitis in southern China. Corneal scraping combined with confocal microscopy was helpful for achieving a correct diagnosis. Early keratoplasty combined with amoebicidal therapy is an effective treatment strategy in Acanthamoeba keratitis.

Recurrent corneal melting in the paraneoplastic pemphigus associated with Castleman's disease.

BACKGROUND: The ocular presentation of Castleman's disease (CD)-associated paraneoplastic pemphigus (PNP) has rarely been reported. In this report, we describe a young patient with CD-associated PNP who had recurrent corneal ulceration in addition to cicatrizing conjunctivitis. CASE PRESENTATION: We describe a case of 23-year-old male with mucocutaneous erosion and conjunctival injection and erosion who was found to have PNP. Pelvic hyaline-vascular CD was detected and completely excised. The mucocutaneous lesions improved postoperatively. Two years after pelvic surgery, the patient gradually developed conjunctival symblepharon in both eyes and pterygium in the right eye. The patient then underwent a successful exclusion of the symblepharon, an excision of the pterygium and an amniotic membrane transplantation in the right eye. However, after 6 months, he experienced an aseptic corneal ulcer and recurrent pterygiumin the right eye. After treatment with systemic and local immunosuppressive medications, the corneal ulcer gradually healed and remained stable. CONCLUSION: Corneal ulceration and melting, in addition to conjunctivitis, as a complication of CD-associated PNP, can be successfully managed with systemic and local immunosuppressants.

[Preliminary results of femtosecond laser-assisted Descemet stripping endothelial keratoplasty for bullous keratopathy].

OBJECTIVE: To evaluate the preliminary results of femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK) for the treatment of bullous keratopathy. METHODS: In the nonrandomized, prospective, consecutive case series, 7 eyes with bullous keratopathy induced by cataract surgery received FS-DSEK surgery between September and December 2013. Standard Descemet stripping endothelial keratoplasty procedure was performed. The Descemet membrane and abnormal endothelial layer were stripped from the central recipient posterior surface in a diameter of 7.75 mm. The graft was fixed to the edge of recipient cornea with one single stitch. The donor lenticule was produced by Intralase 150 femtosecond laser with a diameter of 7.75 mm. The adherence of donor lenticule to the recipient posterior stroma and postoperative donor lenticule dislocation were monitored in the early stage after surgery. Best spectacle-corrected visual acuity, refraction, endothelial cell density and thickness of grafts were measured preoperatively, and at 1 week, 1, 3, 6 and 12 months after FS-DSEK. RESULTS: Two eyes had graft dislocation, with a gap between the graft and recipent posterior stroma at 2 days after surgery. The grafts were repositioned after bubbles were added into the anterior chamber. All grafts were well adherent to the recipent posterior stromal surface at 1 week postoperatively. One graft failed at 3 months postoperatively, and penetrating keratoplasty was performed. At 12 months, the best spectacle-corrected visual acuity was 0.04 to 0.7, the mean endothelial cell density was (1 698.0±251.8) cells/mm(2), and the mean thickness of grafts was (124.2 ± 11.4) µm. CONCLUSION: Femtosecond laser-assisted Descemet stripping endothelial keratoplasty was effective in treating bullous keratopathy. Stitching the graft to the recipent cornea can prevent postoperative graft dislocation effectively.

Fasudil hydrochloride, a potent ROCK inhibitor, inhibits corneal neovascularization after alkali burns in mice.

PURPOSE: To investigate the effects and mechanisms of fasudil hydrochloride (fasudil) on and in alkali burn-induced corneal neovascularization (CNV) in mice. METHODS: To observe the effect of fasudil, mice with alkali-burned corneas were treated with either fasudil eye drops or phosphate-buffered saline (PBS) four times per day for 14 consecutive days. After injury, CNV and corneal epithelial defects were measured. The production of reactive oxygen species (ROS) and heme oxygenase-1(HO-1) was measured. The infiltration of polymorphonuclear neutrophils (PMNs) and the mRNA expressions of CNV-related genes were analyzed on day 14. RESULTS: The incidence of CNV was significantly lower after treatment with 100 µM and 300 µM fasudil than with PBS, especially with 100 µM fasudil. Meanwhile, the incidences of corneal epithelial defects was lower (n=15, all p<0.01). After treatment with 100 µM fasudil, the intensity of DHE fluorescence was reduced in the corneal epithelium and stroma than with PBS treatment (n=5, all p<0.01), and the number of filtrated PMNs decreased. There were significant differences between the expressions of VEGF, TNF-a, MMP-8, and MMP-9 in the 100 µM fasudil group and the PBS group (n=8, all p<0.05). The production of HO-1 protein in the 100 µM fasudil group was 1.52±0.34 times more than in the PBS group (n=5 sample, p<0.05). CONCLUSIONS: 100 µM fasudil eye drops administered four times daily can significantly inhibit alkali burn-induced CNV and promote the healing of corneal epithelial defects in mice. These effects are attributed to a decrease in inflammatory cell infiltration, reduction of ROS, and upregulation of HO-1 protein after fasudil treatment.

Staging of development in Terrien's degeneration based on corneal curvatures detected by optical coherence tomography.

PURPOSE: We aimed to explore a new classification system based on the change of focal corneal curvatures and corneal thickness in Terrien's corneal degeneration with optical coherence tomography. METHODS: This was a cross-sectional study. Ninety eyes of 59 patients with Terrien's degeneration were examined with slit lamp biomicroscopy, Orbscan II corneal tomography and the Visante OCT system, and were staged according to Süveges's classification. RESULTS: The ratio of female to male patients was 1.57:1. The ratio of bilateral to unilateral lesions was 1.27:1. The occurrence of bilateral lesion was higher in males than in females (x(2) = 7.791, p = 0.005). There was no difference in the mean age between female and male patients (t = 1.859, p = 0.068), or between patients with bilateral and unilateral lesions (t = 1.797, p = 0.078).The minimum corneal thickness at the thinnest point (MinCT) and anterior curvature of the peripheral cornea were almost normal in the initial stages of disease. The anterior curvature was flattened when MinCT became less than 0.56 mm, returned to normal when MinCT was no more than 0.24 mm, and bowed forward when MinCT was no more than 0.13 mm. The posterior corneal curvatures were bowed forward from their normal curvatures in 42 of 90 eyes when MinCT was no more than 0.41 mm. These eyes' MinCT ranged from 0 to 0.41 mm. There was a strong correlation between change of corneal curvatures and MinCT (r = -0.943, p < 0.01). A new classification of six stages based on corneal curvatures is proposed for evaluating the development of Terrien's degeneration. Statistically, there was a moderate correlation between either the Süveges staging or the new staging and the width and circumference of corneal lesions, visual acuity, and simulated keratometric value (all r < 0.6). The correlation of MinCT with the new classification based on corneal curvatures was higher than that with Süveges's classification (r 1 vs. r 2 , -0.943 vs. -0.801). CONCLUSION: The proposed new classification based on focal corneal curvatures is closely associated with corneal thinning, is valuable for evaluating the development of Terrien's degeneration and may enhance surgical planning.

Comparison of photodynamic therapy with two different parameters combined with subconjunctival injection of bevacizumab for corneal neovascularization.

BACKGROUND: To the best of our knowledge, no studies have been performed to determine the optimal parameters of photodynamic therapy (PDT) combined with subconjunctival injection of bevacizumab for corneal neovascularization. This study aimed to compare the effect of photodynamic therapy with two different sets of parameters combined with subconjunctival injection of bevacizumab for corneal neovascularization. METHODS: Patients with stable corneal neovascularization (CNV) unresponsive to conventional treatment (topical steroid) were included in this study. Patients were divided into two groups, receiving PDT with two different sets of parameters (group 1 receiving fluence of 50 J/cm2 at 15 min after intravenous injection of verteporfin with, group 2 receiving fluence of 150 J/cm2 at 60 min after intravenous injection of verteporfin with). Subconjunctival injection of bevacizumab was performed immediately after PDT. All patients were followed for 6 months. Best-corrected visual acuity and intraocular pressure were evaluated, and slit-lamp biomicroscopy as well as digital photography were performed. Average diameter and cumulative length of corneal neovascular were measured to evaluate the corneal neovascularization. RESULTS: Seventeen patients (20 eyes) were included in this study. At the last visit, the vision was improved in 12 eyes (60 %), steady in 4 eyes (20 %) and worsen in 4 eyes (20 %). The intraocular pressure (IOP) of all patients remained in normal range. A significant decrease in corneal neovascularization was showed in all the eyes after treatment. At 6 months after the combined treatment, the average diameter and cumulative length of vessels significantly decreased to 0.041 ± 0.023 mm (P < 0.05) and 18.78 ± 17.73 mm (P < 0.05), respectively, compared with the pretreatment data (0.062 ± 0.015 mm, 31.48 ± 18.21 mm). The reduction was more remarkable in group 2 compared to group 1.In group 1, the average diameter was 0.062 ± 0.013mm before and 0.056 ± 0.017mm after, the cumulative length of vessels was 38.66 ± 22.55mm before and 31.21 ± 17.30 after. In group 2, the date were 0.061 ± 0.016mm before and 0.029 ± 0.020mm after, 25.60 ± 8.95 mm before and 8.61 ± 8.26 mm. The reported complications included epithelial defect in four eyes, small white filaments in two eyes and corneal epithelial erosion in two eyes. CONCLUSION: The PDT combined with subconjunctival injection of bevacizumab was effective for the chronic corneal neovascularization. A more promising treatment outcome was observed when PDT was performed at 60 min after intravenous injection of verteporfin with fluence of 150 J/cm2. No serious complications or systemic events were observed throughout the follow-up period.

A Rabbit Dry Eye Model Induced by Subcutaneous Scopolamine.

PURPOSE: To establish and characterize a dry eye model in New Zealand rabbits by subcutaneous injections of scopolamine hydrobromide (SCOP). METHODS: Twenty New Zealand male rabbits were injected subcutaneously SCOP for 14 consecutive days; subcutaneous saline was used as a negative control. The correlated clinical parameters of ocular surface dryness were detected in vivo using tear secretion and corneal fluorescein staining. The expression of IL-1ß and TNF-α on the ocular surface and in lacrimal glands were analyzed by real-time PCR and western blot on the 14th day. The expression of Mucin-5 subtype AC (MUC5AC) was detected by Immunofluorescence staining in conjunctival tissue. RESULTS: The SCOP-treated rabbits exhibited significantly decreased aqueous tear secretion and increased corneal fluorescein staining scores over time. Both the mRNA expression levels and the protein expression levels of IL-1ß and TNF-α were significantly increased after SCOP treatment compared with those after saline treatment. The loss of conjunctival MUC5AC was found in the SCOP-injected rabbits. Some infiltrated inflammatory cells and atrophic acinar cells were observed in the lacrimal gland after SCOP treatment. The disordered structures of the ocular surface and lacrimal glands were also observed. CONCLUSIONS: This study showed that repeated subcutaneous SCOP injections successfully elicited some of the typical dry eye symptoms commonly seen in humans.

Corrigendum: Involvement of endoplasmic reticulum stress in trigeminal ganglion corneal neuron injury in dry eye disease.

[This corrects the article DOI: 10.3389/fnmol.2023.1083850.].