Human Pluripotent Stem Cells Derived Endothelial Cells Repair Choroidal Ischemia.

Choroidal atrophy is a common fundus pathological change closely related to the development of age-related macular degeneration (AMD), retinitis pigmentosa, and pathological myopia. Studies suggest that choroidal endothelial cells (CECs) that form the choriocapillaris vessels are the first cells lost in choroidal atrophy. It is found that endothelial cells derived from human pluripotent stem cells (hPSC-ECs) through the MESP1+ mesodermal progenitor stage express CECs-specific markers and can integrate into choriocapillaris. Single-cell RNA-seq (scRNA-seq) studies show that hPSC-ECs upregulate angiogenesis and immune-modulatory and neural protective genes after interacting with ex vivo ischemic choroid. In a rat model of choroidal ischemia (CI), transplantation of hPSC-ECs into the suprachoroidal space increases choroid thickness and vasculature density. Close-up examination shows that engrafted hPSC-ECs integrate with all layers of rat choroidal vessels and last 90 days. Remarkably, EC transplantation improves the visual function of CI rats. The work demonstrates that hPSC-ECs can be used to repair choroidal ischemia in the animal model, which may lead to a new therapy to alleviate choroidal atrophy implicated in dry AMD, pathological myopia, and other ocular diseases.

Poor response to first intravitreal injection for predicting unfavorable outcomes of retinal vein occlusion related macular edema.

PURPOSES: To screen key indicators leading to unfavorable outcomes of retinal vein occlusion related macular edema (RVO-ME) within long-term follow-up duration and to evaluate their predictive values. METHODS: A study involving patients with RVO-ME was conducted between April 2021 and September 2022. All eligible patients were divided into two groups (favorable and unfavorable group) according to their final best corrected visual acuity (BCVA) and whether neovascular glaucoma (NVG) occurred. The unfavorable group was further divided into subgroups 1 (with BCVA of ≥ 20/400 and < 20/60 and without NVG) and 2 (blindness group, with BCVA of < 20/400 or with NVG). Demographic, past medical history, ocular characteristics and blood parameters were compared between the groups. RESULTS: A total of 73 eyes from 73 Chinese Han patients (34 males vs. 39 females) with RVO-ME were enrolled. In multivariable regression analysis of continuous variables for unfavorable results, 1-month BCVA after the first intravitreal injection (IVI) was an independent risk factor (odds ratios (ORs) = 2.313, 95% confidence interval (CI) 1.387-3.858, P = 0.001). The area under the curve (AUC) of 1-month BCVA after the first IVI for predicting low vision and blindness was 0.948 (95% CI 0.859-1.000, P < .001) and 0.892 (95% CI 0.744-1.000, P < .001), with a cut-off value of 0.65 logarithm of the minimum angle of resolution (log MAR) (Snellen 20/90) and 1.15 log MAR (Snellen 20/300), respectively. CONCLUSION: The most valuable indicator for predicting low vision and blindness was poor 1-month BCVA after first IVI compared with favorable group.

A novel predictive model for phthisis bulbi following facial hyaluronic acid cosmetic injection.

PURPOSE: To observe long-term prognosis of anterior segment ischemia (ASI) following hyaluronic acid (HA) injection, propose a severity grading system for ASI and a predictive model for phthisis bulbi (PB) based on long-term secretion dysfunction of ciliary process. METHODS: This is a retrospective case-control study. All enrolled 20 patients were divided into two groups and followed for at least 6 months to observe the formation and transformation characteristics of ASI and long-term prognosis based on the degrees of ciliary function damage. RESULTS: The severity of ASI following HA injection could be subdivided into 4 grades according to the degrees of ciliary function damage, comprising ASI grades 0, 1, 2 and 3. In 20 patients, ophthalmoplegia at 1-month follow-up, ASI within 1 month, ASI at 1-month follow-up, hypotony within 6 months were all significantly more common in study group than in control group (60% vs. 0%, P = 0.011; 100% vs. 20%, P = 0.001; 100% vs. 0%, P < 0.001; 80% vs. 0%, P = 0.001, respectively). Sensitivity, specificity and the area under the receiver operating characteristic curve (AUC) for predicting subsequent PB at 2-year follow-up through the co-occurrence of ophthalmoplegia at 1-month follow-up and hypotony within 6 months was 100%, 100% and 1.00, respectively. CONCLUSIONS: The new grading system for ASI and novel predictive model for PB we proposed could predict the long-term prognosis and probability of subsequent PB due to ASI following HA injection through several dynamic assessments within 6 months. LEVEL OF EVIDENCE: Level IV, observational prognostic study.

A new injury severity scale for ocular complications following cosmetic filler injection.

BACKGROUND: Cosmetic filler injection can cause a variety of eye complications; however, there is currently no good way to evaluate injury severity and prognosis. By analyzing the injury manifestations of severe ocular complications following cosmetic filler injection and their prognosis, we propose a new injury severity scale. METHODS: Twenty-two eyes of 22 patients experiencing ocular complications following cosmetic filler injection were followed for 6 months to observe injury characteristics, manifestations and prognosis. Best corrected visual acuity (BCVA), intraocular pressure (IOP), split lamp microscopy, fundus photography, optical coherence tomography (OCT), and fundus fluorescein angiography were examined at the onset and follow-up visits. RESULTS: According to the immediate BCVA at the time of injury (with the presence or absence of brain infarction), a new injury severity scale was proposed, namely, Grades 1-4. Grade 1 (4 patients) and Grade 2 (2 patients) tended to have no atrophy of the globe. Grade 3 (12 patients) and Grade 4 (4 patients) were more likely to develop atrophy of the globe (4/12 patients and 2/4 patients, respectively) at the last follow-up. Grade 3 and Grade 4 were more likely to be complicated with ophthalmoplegia and ptosis (7/16 patients). CONCLUSIONS: The new injury severity scale we proposed can determine the prognosis of different ocular complications following cosmetic filler injection. Accordingly, we can inform injured patients regarding the possibility of phthisis bulbi and the extent of improvement of visual impairment, ophthalmoplegia, ptosis and stroke.