Characteristics of tear film lipid layer in young dry eye patients.

BACKGROUND/PURPOSE: To investigate the characteristics of subjective symptoms and objective parameters among young patients with dry eye disease (DED) and compare them with those of older patients. METHODS: We retrospectively enrolled 675 patients with DED who were divided into three age groups (20-41 years [younger], 41-60 years [middle], and >60 years [older]) (n = 143, 304, and 228, respectively). Subjective symptoms were evaluated using Standardized Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index (OSDI) questionnaires. Aqueous tear secretion was evaluated with the Schirmer test II. The number of expressible meibomian glands was evaluated with a slit-lamp-aided standardized evaluator. Lipid layer thickness (LLT), blink/incomplete blink rates and meibography were measured with the LipiView® II interferometer. The extent of the meibomian gland dropout was graded using a meiboscale. RESULTS: The younger age group had higher subjective symptom severity, as reflected by higher SPEED (p < 0.001) and OSDI scores (p = 0.051). The SPEED scores negatively correlated with LLT in all patients (r = -0.136, p < 0.001). Younger patients also had thinner average LLT (p < 0.001), lower meiboscale (p < 0.001) and a higher number of expressible meibomian glands (p < 0.001). Additionally, they had significantly more total blinks (p < 0.001), incomplete blinks (p < 0.001), and incomplete blink rate (p = 0.006). CONCLUSION: Manifestations of DED vary with age. In our cohort, younger age patients had more symptoms and blinks, which may have resulted from thinner LLT as the structure and function of the meibomian glands were affected less than in middle and older age patients.

Cataract surgery reduces intraocular pressure but not posture-induced intraocular pressure changes in patients with angle-closure glaucoma.

Cataract surgery leads to a sustained decrease in sitting intraocular pressure (IOP) in patients with angle-closure glaucoma (ACG). The purpose of this study is to evaluate whether cataract surgery can also reduce postural IOP changes. We prospectively examined 106 eyes from 53 patients with narrow angles scheduled for phacoemulsification. IOP was measured in the sitting, supine, and lateral decubitus positions using an ICare rebound tonometer before and 1 week, 1 month, and 3 months postoperatively. The mean baseline IOP in the sitting and lateral decubitus positions was 17.9 ± 4.8 mmHg and 21.43 ± 6.44 mmHg, which significantly reduced to 13.52 ± 3.8 and 17.46 ± 3.62, respectively, 3 month postoperatively (p < 0.001). However, postural IOP change (lateral decubitus minus sitting) at 3 months postoperatively was not significantly different from that at the baseline (3.17 ± 2.63 vs. 3.53 ± 3.38 mmHg, p = 0.85). Postural IOP change was not associated with preoperative sitting IOP, anterior chamber depth, axial length, fixed pupil, or presence of glaucomatous optic neuropathy. Patients with higher preoperative IOP exhibited greater IOP reduction after cataract surgery in every posture (p < 0.0001). In conclusion, cataract surgery reduces IOP in all postures among patients with ACG; however, it does not reduce the magnitude of postural IOP change.

One-year outcome of combination therapy with intravitreal aflibercept and photodynamic therapy for polypoidal choroidal vasculopathy.

BACKGROUND: To investigate the one-year visual and anatomical outcomes of combination therapy with intravitreal aflibercept (IVA) and photodynamic therapy (PDT) for treating polypoidal choroidal vasculopathy (PCV). METHODS: This was a retrospective case-series study, including 30 eyes from 30 patients with treatment-naïve PCV treated by combination therapy with IVA and PDT. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), complete polyp regression rate, and dry macula rate were recorded every 3 months during 12-month follow-up. Clinical factors associated with final visual outcome and retreatment were investigated. RESULTS: The mean LogMAR BCVA was significantly improved from 0.73 ± 0.65 at baseline to 0.51 ± 0.60 (p = 0.01), and the mean CRT was also significantly improved from 339 ± 96 µm at baseline to 244 ± 43 µm at 12-month follow-up (p <  0.001). Complete regression of polypoidal lesions was 76.7%, and dry macula rate was 100% at 12 months. Better final BCVA was associated with younger age and better baseline BCVA (p = 0.02 and p <  0 001). The patients without complete polyp regression at 3-month follow-up were associated with retreatment (p = 0.03). CONCLUSION: In this study, combination therapy with IVA and PDT had significant visual and anatomical improvements to PCV patients during one-year follow-up. Better baseline BCVA and younger age were found to be associated with better visual outcome.

Conformational dynamics and excitation wavelength dependent photoluminescence of decameric organic nanoparticles.

We report a new type of fluorescent organic nanoparticles (16-EDFONP) which are composed of ten bis(3,4,5-tris(16-alkyloxy) monobenzoylglyceride) bisphenol A molecules. The nanoparticles are only found in high concentration solution and exhibit the excitation-dependent fluorescence (EDF). The 16-EDFONP shows clear spectral relaxation on the nanosecond time scale. We have observed similar spectral shifts in cyclohexane, and thus attribute the time-dependent Stokes shift to the emission from multiple conformations of 16-EDFONP. With the employment of steady state and time-resolved fluorescence anisotropy measurements, the hydrodynamic radius of 16-EDFONP is estimated to be 3.13 nm, which is consistent with the size measured using the dynamic light scattering and high-resolution transmission electron microscopy techniques. The time-resolved anisotropy reveals the change in fundamental anisotropy upon different excitation wavelengths, arising from the structural heterogeneity of hydrogen-bonded monoacylglycerol clusters of the 16-EDFONP. Our findings indicate that incomplete spectral relaxation and the size distribution of nanoparticles are not the source of the observed EDF. The EDF comes from the selective excitation of the 16-EDFONP with different monoacylglycerol hydrogen-bond conformations.