Increased incidence of acute primary angle closure during the COVID-19 outbreak in China: A retrospective analysis.

This study aimed to investigate the incidence and clinical characteristics of acute primary angle closure (APAC) during the Coronavirus Disease 2019 (COVID-19) pandemic in China. This was a retrospective study of patients diagnosed with APAC in a glaucoma clinic over a 5-year period. We compared the number of APAC cases during the COVID-19 outbreak (December 7, 2022 to January 7, 2023) with those during the same period in previous years and 2 months prior to the outbreak. We also collected data on the demographic and clinical features of APAC patients, such as age, sex, disease course, visual acuity, intraocular pressure (IOP), and lens opacity. We included 95 eyes of 88 patients with APAC were included. Of these, 65 were female and 23 were male. The mean age was 68.0 ±â€…8.1 years. The median disease course was 10.8 ±â€…9.5 days. There was a significant increase in the number of APAC cases during the COVID-19 outbreak compared with the same months over a 5-year period (44 vs 51, P < .001). A higher proportion of women developed APAC during the outbreak period than during the non-outbreak period (P < .001). Eyes with APAC in the outbreak period had a lower mean IOP than those in the preceding 6 months (40.5 ±â€…8.8 mm Hg vs 46.1 ±â€…10.1 mm Hg; P = .043). No significant differences were observed in disease duration, lens opacity, or bilateral or unilateral onset between the 2 groups. Our study suggests a potential correlation between APAC and COVID-19, marked by a significant surge in APAC cases concurrent with the COVID-19 outbreak. However, the underlying mechanisms and preventive strategies remain to be elucidated.

Correlations of Corneal Curvature with Corneal Spherical Aberration and Anterior Chamber Parameters in Eyes with Shallow Anterior Chambers.

INTRODUCTION: This study aimed to investigate the distribution of corneal spherical aberration (CSA) and the relationship between corneal curvature with CSA and anterior chamber parameters in age-related cataract patients with normal axial lengths and shallow anterior chambers. METHODS: Preoperative data of age-related cataract patients were collected in this retrospective comparative study. According to the average corneal curvature, the eyes were divided into groups of Km < 42 diopters (D), 42 D ≤ Km < 45 D, and Km ≥ 45 D. The axial length (AL) and corneal curvature were obtained using IOLMaster. CSA, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), and corneal diameter (CD) were acquired according to Pentacam. The above parameters were compared among the three groups. Correlation analysis was applied to these parameters. RESULTS: The average CSA value of 753 eyes was 0.41 ± 0.27 µm, with no significant difference among the three groups. Overall, CSA was significantly correlated with corneal curvature and ACD. The comparison of ACD among the three groups showed significant differences between the Km ≥ 45 D group, Km < 42 D group, and 42 D ≤ Km < 45 D group. Corneal curvature was positively correlated with ACD, and further analysis confirmed that the relationship was significant only in the Km ≥ 45 D group. There were statistically significant differences in CD between the three groups. A significant correlation was found in corneal curvature and CD in all eyes, which was also found in the 42 D ≤ Km < 45 D group and the Km ≥ 45 D group. Concerning ACV and ACA, no correlation with corneal curvature was found. In addition, the mean ACV and ACA of the three groups did not show any significant difference. CONCLUSIONS: CSA was higher in this population and had individual variance. Compared with ACD, ACV and ACA were more stable in different corneal curvatures and more objective in representing the anterior chamber space.

Analysis of macular structure in age-related cataract patients with different antibody levels of severe acute respiratory syndrome coronavirus-2 vaccine.

Objective: To analyze the macular structure of age-related cataract (ARC) patients with different antibody levels after COVID-19 vaccine injection, in order to obtain the effect of COVID-19 vaccine on the macular structure, and speculate whether the COVID-19 vaccine has adverse effects on the macular structure. Methods: This retrospective study is conducted to analysis on the status of COVID-19 vaccine and the thickness of different layers at different positions in the macular area of ARC patients. In the age, sex and eye axial length matched population, in the un-injection, no-antibody, IgM and IgG positive groups after vaccination, the choroid, ganglion cell complex, nerve fiber layer and retinal thickness at different positions of ETDRS zoning in the macular area were discussed. Results: A total of 164 patients (164 eyes) were included in the analysis. There were 63 males and 101 females. The average age was 65.99 ± 8.43 years. There was no significant difference in age and sex among the groups (p>0.05). The average axial length of 164 eyes was 23.56 ± 1.46mm, and no significant difference between the groups (p>0.05). Non parametric test and ANOVA test for the thickness of choroid, retina, ganglion cell complex and retinal nerve fiber layer in each division of ETDRS showed no significant difference in the four groups of un-injection, no-antibody, IgM and IgG (p>0.05). There was no correlation between the antibody concentration and the thickness of macular structure (p>0.05). Conclusion: There was no significant difference in the thickness of choroid, retina, ganglion cell complex and retinal fiber layer in different macular areas after COVID-19 vaccine injection. There was no linear correlation between the thickness of choroid, retina, ganglion cell complex and retinal fiber layer and the antibody concentration produced after COVID-19 vaccine injection. It suggests that the injection of COVID-19 vaccine might have no significant effect on the macular structure of eye.

Effect of cataract incision type on corneal spherical aberration.

Corneal spherical aberration (CSA) plays an important role in the ocular refractive system. However, ophthalmologists have not considered the effect of difference cataract incisions on it. The purpose of this study is to investigate the effect of transparent corneal incision (TCI) and scleral tunnel incision (STI) on CSA after the cataract phacoemulsification with foldable IOLs. One hundred ninety-three eyes (61 males and 79 females) for 1-month observation and 114 eyes (29 males and 51 females) for 3-month observation with age-related cataracts (ARC) were included in this study. CSA was measured with dilated pupil by Pentacam Scheimpflug system at 1 day preoperative and 1, 3-month postoperative. Preoperative CSA >1.00 µm was excluded. Both TCI and STI are 3 mm incisions with Infiniti system and Ozil handpiece. No significant difference of age or gender was found between TCI and STI groups in 1 or 3-month observation. In 1-month observation, preoperative CSA for TCI and STI are 0.31 ± 0.29 and 0.41 ± 0.19 µm, which of postoperative are 0.42 ± 0.17 and 0.44 ± 0.35 µm, respectively. The change of CSA is 0.11 ± 0.32 and 0.04 ± 0.33 µm (P = .233). For 3-month observation, preoperative CSA for TCI and STI are 0.32 ± 0.28 and 0.36 ± 0.23 µm, which of postoperative are 0.43 ± 0.16 and 0.39 ± 0.26 µm, respectively. The change of CSA is 0.10 ± 0.34 and 0.03 ± 0.21 µm (P = .312). For the phacoemulsification combined with foldable IOL implantation, STI has minimal effect on CSA, but TCI might increase postoperative CSA.

The different structure-function correlation as measured by OCT and octopus perimetry cluster analysis in intracranial tumor and glaucoma patients.

Background: To explore the correlation between visual field (VF) defect values and retinal nerve fiber layer (RNFL) thickness for intracranial tumor and glaucoma patients. Methods: Retrospective analysis is performed for the intracranial and glaucoma patients, whose VF defect values were measured with Octopus perimeter cluster analysis, RNFL thickness, ganglion cell layer (GCL) thickness, and optic disk parameters measured with swept-source OCT. The differences between VF and RNFL (including the data of optic disc) are calculated. The correlation between VF defect values and RNFL and GCL thickness are explored. Results: In total 43 eyes of 29 patients with intracranial tumor and 31 eyes of 19 patients with glaucoma were enrolled. The thickness of RNFL not only for the whole (360°), but also for the four quadrants was thinner in the glaucoma group than those of the intracranial tumor group (p<0.05), and similar to the thickness of GCL without significance (p>). There is no significant difference in VF for those two groups except glaucoma having lower sLV (p<0.05). A stronger correlation for mean deviations (MD)s of VF ten clusters and RNFL thickness of OCT twelve sectors is found in the glaucoma patients, but few in the intracranial tumor patients. Logistic regression also shows the loss of RNFL or increasing of vertical CDR and cup volume tending to the diagnosis of glaucoma and the irregular VF damage is inclined to the diagnosis of intracranial tumor. Conclusions: Intracranial tumor has a weak correlation between the RNFL thickness and Octopus VF MD, compared with that of glaucoma. OCT and Octopus VF might provide more helpful information for the differential diagnosis of intracranial tumor and glaucoma.

Comparison of Total Corneal Astigmatism between IOLMaster and Pentacam.

Purpose: To compare the total corneal astigmatism (TCA) measured by IOLMaster 700 and Pentacam and to investigate the consistency of corneal keratometry (CK) measured by IOLMaster and Pentacam. Methods: Cataract patients were retrospectively enrolled in March and April, 2021. Retrospective analysis was performed on those patients with binocular and monocular CK measured by IOLMaster and Pentacam. Results: A total of 102 patients (204 eyes) were included, 64 of whom were female (62.75%). The flat (K1) and steep (K2) CK of anterior corneal surface (ACS) and flat (TK1) and steep (TK2) of total cornea measured with IOLMaster 700 were 44.16 ± 1.60 D, 45.09 ± 1.68 D, 44.12 ± 1.62 D, and 45.14 ± 1.69 D, respectively. Those measured with Pentacam were 44.31 ± 1.57 D, 45.22 ± 1.65 D, 44.15 ± 1.67 D, and 45.19 ± 1.82 D, respectively. The astigmatism of ACS and TCA were -0.94 ± 0.63 D and -1.02 ± 0.69 D (p < 0.01) in the IOLMaster group and -0.90 ± 0.59 D and -1.05 ± 0.81 D in the Pentacam group, respectively (p < 0.01). TCA measurement results of IOLMaster and Pentacam were consistent (Pearson = 0.710, p < 0.01), and there was no significant difference (p = 0.591). Conclusions: Total corneal astigmatism measured by IOLMaster was consistent with that measured by Pentacam. The difference between the astigmatism of anterior corneal surface and total cornea was detected in the measurement of IOLMaster and Pentacam, respectively.

The mechanism for thermal-enhanced chaperone-like activity of α-crystallin against UV irradiation-induced aggregation of γD-crystallin.

Exposure to solar UV irradiation damages γ-crystallin, leading to cataract formation via aggregation. α-Crystallin, as a small heat shock protein, efficiently suppresses this irreversible aggregation by selectively binding the denatured γ-crystallin monomer. In this study, liquid chromatography tandem mass spectrometry was used to evaluate UV-325 nm irradiation-induced photodamage of human γD-crystallin in the presence of bovine α-crystallin, atomic force microscope (AFM) and dynamic light scattering (DLS) techniques were used to detect the quaternary structure changes of the α-crystallin oligomer, and Fourier transform infrared spectroscopy and temperature-jump nanosecond time-resolved IR absorbance difference spectroscopy were used to probe the secondary structure changes of bovine α-crystallin. We find that the thermal-induced subunit dissociation of the α-crystallin oligomer involves the breaking of hydrogen bonds at the dimeric interface, leading to three different spectral components at varied temperature regions as resolved from temperature-dependent IR spectra. Under UV-325 nm irradiation, unfolded γD-crystallin binds to the dissociated α-crystallin subunit to form an αγ-complex, then follows the reassociation of the αγ-complex to the partially dissociated α-crystallin oligomer. This prevents the aggregation of denatured γD-crystallin. The formation of the γD-bound α-crystallin oligomer is further confirmed by AFM and DLS analysis, which reveals an obvious size expansion in the reassociated αγ-oligomers. In addition, UV-325 nm irradiation causes a peptide bond cleavage of γD-crystallin at Ala158 in the presence of α-crystallin. Our results suggest a very effective protection mechanism for subunits dissociated from α-crystallin oligomers against UV irradiation-induced aggregation of γD-crystallin, at the expense of a loss of a short C-terminal peptide in γD-crystallin.

The Changes of Irisin and Inflammatory Cytokines in the Age-Related Macular Degeneration and Retinal Vein Occlusion.

Purpose: Age-related macular degeneration (AMD) and retinal vein occlusion (RVO) are irreversible chorioretinal diseases, which might induce severe damage in visual function. The metabolic factor and inflammatory factors might play important roles in the pathogenesis of AMD and RVO. The levels of irisin and 14 cytokines were analyzed in aqueous humor of AMD and RVO eyes to evaluate the roles of irisin and inflammatory factors. Methods: We collected aqueous humor samples from patients with AMD (n = 27), RVO (n = 30), and cataract (as control, n = 23) eyes. Samples were assayed using ELISA kit for irisin and a multiplex immunoassay kit for 14 cytokines. The macular thickness (MT) was measured with OCT in all included eyes. Results: MT in the RVO group is significantly higher than that in the AMD or control group. Irisin levels in the aqueous samples of AMD and RVO eyes were both significantly lower than that in the control. Furthermore, a positive correlation was found between irisin and MT in the RVO. Compared with the controls, AMD eyes had significantly higher levels of BDNF, VEGF-A, VEGF-R1, VEGF-R2, IL-10, TNF-α, VCAM-1, IP-10, and MCP-1. Similarly, RVO eyes had significantly higher levels of BDNF, VEGF-A, VEGF-R1, VEGF-R2, IL-6, IL-8, IL-10, TNF-α, ICAM-1, VCAM-1, IP-10, and MCP-1. However, there was no significant difference between the levels of PDGF-BB or TNF-ß in these three groups. A negative correlation was found between VEGF-A and MT in AMD, as well as in control. Furthermore, a positive correlation was found between IL-6 and MT in the 80 included eyes, as well as in RVO. A positive correlation was found between ICAM-1 and MT in the 80 included eyes, as well as in RVO. Conclusions: The metabolic factor, irisin levels in the aqueous humor are decreased in AMD and RVO eyes and show a positive correlation between irisin and MT in RVO eyes, prompting researchers to explore the relationship between irisin and macular edema. We also identified the higher expression of vascular growth factors (VEGF-A, VEGF-R1, and PDGF-BB), inflammatory cytokines (IL-6, IL-8, IL-10, and TNF-α), and chemokines (ICAM-1, VCAM-1, IP-10, and MCP-1) in AMD and RVO eyes.

Correlation of Sunlight Exposure and Different Morphological Types of Age-Related Cataract.

PURPOSE: The previous lab and clinical studies of the correlation between the ultraviolet B and age-related cataract (ARC) did not reach in the universal agreement, especially in different morphological types of ARC. It is important to systemically summarize those previous data of epidemiological studies, which might penetrate the relevance between three morphological types of ARC, cortical, nuclear, and posterior capsular (PSC), with sunlight exposure. METHODS: PubMed, Web of Science, CNKI, Embase, and Cochrane were searched online. Data were extracted and recalculated, and quality check was performed by hand. Review Manager was used to perform the fixed effects meta-analysis on ARC and its morphological types. The highest exposed dose group was defined as the exposed group, and the lowest dose group as the control group as possible. RESULTS: Finally, the number of analyzed studies was 31: 20 for ARC and twelve, eleven, and nine for the morphological types cortical, nuclear, and PSC, respectively. The pooled OR for ARC was 1.15 (range 1.00~43.78, 95% CI 1.09 to 1.21). The cortical cataract revealed a slightly higher risk, and pooled OR was 1.03 (range 0.67~2.91, 95% CI 1.02 to 1.03). But the pooled OR for nuclear and PSC were 1.00 (range 0.50~5.35, 95% CI 1.00 to 1.00) and 0.99 (range 0.57~1.87, 95% CI 0.95 to 1.01), respectively. CONCLUSIONS: The systemic analysis of epidemiological articles reported till now reveals a significantly increased risk of ARC for those exposed with more sunlight, especially the morphological type of cortical cataract.

High irisin and low BDNF levels in aqueous humor of high myopia.

BACKGROUND: The pathogenesis of myopia remains unclear. Both genetic and environmental factors play a role in the disease progression. Reasons including reduced physical activity (PA) and low-grade intraocular inflammation may be involved in the development of myopia. OBJECTIVES: To analyze the levels of irisin, brain-derived neurotrophic factor (BDNF) and other intraocular cytokines in aqueous humor of high myopia patients, and to evaluate the roles of PA and inflammation in developing myopia. MATERIAL AND METHODS: We collected aqueous humor samples from patients with axial length (AL) over 26 mm (n = 35) or shorter than 25 mm (n = 38) during cataract extraction surgery. Samples were assayed using the enzyme-linked immunosorbent assay (ELISA) kit for irisin and a multiplex immunoassay kit for BDNF, interleukin (IL)-6, IL-8 and IL-10, and tumor necrosis factor alpha (TNF-α). RESULTS: Irisin levels in the aqueous samples of the highly myopic eyes were significantly higher than in the control group (p = 0.027). The BDNF levels of the highly myopic group were significantly lower than in the control group (p = 0.043). Median level of leukemia inhibitory factor (LIF) for highly myopic group (2.035 pg/mL) was statistically significantly higher than in the control group (0.750 pg/mL) (U = 210.5, Z = -4.495, p < 0.001). Interleukin 1 receptor antagonist (IL-1ra) level in the aqueous samples of the highly myopic group was significantly lower than in the shorter AL group (p = 0.049). Interleukin 6, IL-8 and IL-10 levels were not significantly different between the 2 groups (p = 0.501, p = 0.059 and p = 0.192, respectively). Tumor necrosis factor α levels could only be detected in 30 samples and median levels in the 2 groups were not statistically significantly different (U = 99, Z = -0.482, p = 0.650). No correlation was found between IL-6, IL-8, IL-10 and TNF-α, and the AL (p > 0.05). Irisin was positively correlated with AL (p = 0.028, r = 0.287). The BDNF was negatively correlated with AL (p = 0.040, r = -0.246). Interleukin 1ra was negatively correlated with AL (p = 0.038, r = -0.276). There was also a correlation between LIF and AL (p < 0.001, r = 0.486). CONCLUSIONS: Higher irisin level in high myopia group opens a new direction to discover the relationship between PA and myopia. The decreased BDNF in high myopia group probably demonstrates the connection between myopia and neurodegenerative disease.

A comparative study of functioning and non-functioning pituitary adenomas.

ABSTRACT: Pituitary tumors commonly cause visual impairment and the degree of impairment can depend on the size, location, and type of the tumor. However, no studies have been made regarding the differences caused by functioning pituitary adenoma (FPA) and non-functioning pituitary adenoma (NFPA). We aimed to investigate the relationship between clinical characteristics and visual impairment in patients with FPA and NFPA.This case series study included 73 pituitary adenoma patients. All patients underwent ophthalmic evaluations, and we retrospectively reviewed their medical records. Tumor types were confirmed by histological analysis, and the tumor volume was calculated. Magnetic resonance imaging was used to determine the tumor diameter. The observation indices of the two groups were compared. The correlation between the visual field and tumor volume was analysed using scatter plots.We enrolled 30 patients in the FPA group and 43 in the NFPA group. The first symptoms presented in the eyes in 23% of FPA patients and 41.9% of NFPA patients. The best-corrected visual acuity of the FPA group was better than that of the NFPA group, and 34 (56.7%) and 73 (84.9%) eyes in these groups had visual field defects, respectively. The visual field defects of the FPA patients were lighter than those of the NFPA patients. Except for the anteroposterior diameter, there were no differences in the other parameters of tumor diameter between the groups. The tumor volume of the FPA group was smaller than that of the NFPA group. The tumor size was positively correlated with the mean deviation and negatively correlated with the mean sensitivity in both groups.There was a longer delay between the onset of signs and symptoms and treatment in the FPA group than in the NFPA group. Future studies should focus on visual field defects caused by FPA and NFPA.

Assessment of tear film optical quality in a young short tear break-up time dry eye: Case-control study.

BACKGROUND: The aim of the study was to evaluate the dynamic changes of tear film optical quality in a short tear break-up time (TBUT) dry eye by using a double-pass system. METHODS: Thirty-five short TBUT dry eye participants and 43 control subjects without dry eye were included in this study. One eye for each subject was analyzed. The Objective Scatter Index (OSI), modulation transfer function (MTF), and strehl ratio (SR) were recorded within a 20-second period with the participants asked to blink freely, and 10 successive seconds of nonblinking immediately after a blink was recorded to analyze the tear film OSI. The mean tear film OSI in 10 successive seconds, ΔOSI, and ΔOSI/time were evaluated. The correlation between tear film OSI and MTF, and the correlation between tear film OSI and MIT were also analysed. RESULTS: Short TBUT dry eye participants showed significant deterioration of MTF and SR compared to control subjects. The mean tear film OSI in 10 successive seconds was significantly higher in dry eye participants than in control subjects. The mean OSI of the tear film (0-5 seconds) and the mean OSI of the tear film (6-10 seconds) were significantly higher in dry eye participants than in control participants. Moreover, the ΔOSI was significantly higher in dry eye participants than in control participants. The tear film OSI was significantly correlated with the MTF and the SR. CONCLUSIONS: The tear film OSI of short TBUT dry eye participants is significantly increased in the early stage. Tear film instability in short TBUT dry eye participants has a significant effect on optical quality.

A CARE-compliant article: ipsilateral progressive idiopathic lipid keratopathy: A case report.

RATIONALE: Lipid deposition on the cornea without previous infection, inflammation, vascularization, or trauma is idiopathic lipid keratopathy. In vivo laser confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) are 2 noninvasive methods that can help identify the structures and morphological characteristics of the focus. PATIENT CONCERNS: A 63-year-old woman with ipsilateral corneal lipid deposits developing from a small white spot into a yellow-white superotemporal elliptic shape within a year. AS-OCT showed peripheral deep stromal deposits. IVCM showed hyper-reflective material with typical crystalline-like or needle-like structures in the superotemporal area. DIAGNOSIS: Idiopathic lipid degeneration. INTERVENTIONS: Topical steroids eye drops 3 times a day for a month and further consultation every 3 months. OUTCOMES: This patient of idiopathic lipid keratopathy was observed every 3 months and till now we have reviewed this patient twice. Topical steroids eye drops were only used during the first month. No further development was observed about the lesion and the patient's visual acuity remained good. CONCLUSION: IVCM and AS-OCT can help identify the characteristic crystalline-like or needle-like hyper-reflective material that could help diagnosis of idiopathic lipid degeneration.

αB crystalline upregulates the expression of matrix metalloproteinases in trabecular meshwork cells through TLR1/2.

PURPOSE: Our previous study identified the TLR1/2 complex as the receptor for αB crystalline (CRYAB). Here, we aimed to determine whether CRYAB could influence the expression of matrix metalloproteinases (MMPs) in trabecular meshwork (TM) cells through TLR1/2. METHODS: The expression of P65, P38, ERK and JNK, which are downstream of TLR1/2, was identified by western blot (WB) with the interference of a TLR1/2 inhibitor or siRNA-TLR1 (siRNA-TLR2). MMP2 and MMP9 were tested by WB analyses using the same interference conditions in TM cells. C57BL/6N mice were used to study the effects in vivo by anterior chamber injection of CRYAB. Finally, immunohistochemistry was performed to evaluate the alterations in MMP2 and MMP9 between the CRYAB injection group and the normal control group. RESULTS: For the NF-κB pathway, the expression of P65 was increased in TM cells with the addition of exogenous CRYAB (P<0.01), which was dramatically reduced with inhibition of TLR1/2 by its inhibitor (CU-CPT22) or knockdown of TLR1 (or TLR2) with siRNA-TLRs (P<0.01). For the MAPK pathway, P38, ERK and JNK showed no significant difference when CRYAB or CU-CPT22 was added. Subsequently, MMP2 and MMP9 were upregulated, which was consistent with the increased level of p65 (P<0.001). Finally, elevated expression of MMP2 and MMP9 in mice was demonstrated in trabecular meshwork tissue compared to that of the normal control. CONCLUSION: CRYAB triggers the activation of MMPs in TM cells in vitro and in vivo, possibly following the TLR1/2-mediated proinflammatory effect on TM cells.

Effect of Exogenous Alpha-B Crystallin on the Structures and Functions of Trabecular Meshwork Cells.

PURPOSE: Secondary open-angle glaucoma may develop as a postoperative complication of early childhood cataract surgery. Its mechanism is poorly understood. Surgical removal of cataracts is typically incomplete, and we estimate that this disease is associated with alpha-B crystallin (CRYAB) secreted from the retained lens material. This study, for the first time, focused on the role of CRYAB in undesired changes of the structures and functions in trabecular meshwork (TM) cells. METHODS: Cell proliferation and migration were assessed using a cell counting kit-8 (CCK8) and transwell assay analysis, respectively. Immunofluorescence (IF), quantitative real-time PCR (Rt-qPCR), and Western blot were performed to determine the effect of CRYAB on F-actin, tight junctions, and the expression of epithelial to mesenchymal transition- (EMT-) associated proteins in TM cells. RESULTS: CRYAB promoted proliferation (p < 0.0001), migration (p < 0.001), and F-actin reorganization in TM cells. There were statistically significant increases in the mRNA and protein levels of zo-1, cadherin-N, and vimentin (all p < 0.0001) and cadherin-E decreased (p < 0.0001) and the mRNA level of claudin-1 increased (p < 0.0001) compared to those of the control group. CONCLUSION: All of the changes in structures and functions first observed in the TM cells after exposure to CRYAB resembled alterations seen in primary open-angle glaucoma, suggesting that CRYAB might be related to the pathogenesis of secondary open-angle glaucoma after congenital cataract surgery.

The Correlation of Age and Postoperative Visual Acuity for Age-Related Cataract.

PURPOSE: Clinically, what is the best time for age-related cataract (ARC) patients to receive surgeries and get the most benefits is important. We explored the relationship between age and presenting postoperative visual acuity (POVA) in patients from rural China. METHODS: Three Lifeline Express Hospital Eye-Train missions of Peking University People's Hospital were chosen. At the first day after surgery, 3452 ARC eyes with the presenting POVA ≥ 6/60 were enrolled. The relationship between age and POVA was analyzed statistically. RESULTS: In these three missions, there were more female patients than males; the ratio of females to males was 1.71. The average age of females was older than males. Overall, the percentages of patients with good visual outcomes (≥6/18) were significantly decreased with aging. Different regions had variations, but the trends were the same. There was weak linear correlation between age and POVA. The correlations of females were stronger than males in Yuncheng and Sanmenxia and weaker than males in Zhoukou. CONCLUSION: The good visual outcomes of presenting POVA were significantly decreased with aging and there were weak linear correlations between age and POVA in rural China. The linear correlation might be influenced by the difference of gender and region.

The Ocular Biometry of Adult Cataract Patients on Lifeline Express Hospital Eye-Train in Rural China.

Aims. To describe and explore the distribution of ocular biometric parameters of adult cataract patients in rural China. Methods. Three Lifeline Express Hospital Eye-Train missions of Peking University People's Hospital in China were chosen. 3828 adult cataract patients aged 29 to 88 years with axial length (AL) less than 27.0 mm were enrolled. The ocular biometry including visual acuity (VA), intraocular pressure, AL, corneal power (K1 and K2), and corneal endothelial counting (CEC) were collected and analysis. Corneal radius (CR) was calculated from the corneal power. Results. The participants in Zhoukou of these three missions had the worse preoperative VA (p < 0.001), the lowest K1 (p < 0.001), K2 (p < 0.001), and K (p < 0.001) and the highest |K1 - K2| (p < 0.001), moreover AL/CR more closely to 3.0. The AL, |K1 - K2|, and AL/CR were normally distributed. But the K1, K2, K, and CEC were not normal distributions. Except K1, all parameters were positively skewed and peaked. Conclusion. Our study provides normative ocular biometry in a large, representative rural Chinese population. The AL is normally distributed with a positive skew and big kurtosis. The corneal powers are not normal distribution. The corneal astigmatism might have a significant effect on the visual acuity.

Efficacy of 1% carboxymethylcellulose sodium for treating dry eye after phacoemulsification: results from a multicenter, open-label, randomized, controlled study.

BACKGROUND: For patients who experience dry eye after phacoemulsification, vision and quality of life can significantly deteriorate. In this study, the efficacy and safety of carboxymethylcellulose sodium (CMC) 1% ophthalmic solution combined with conventional therapy in treating dry eye signs and symptoms after phacoemulsification were evaluated. METHODS: In this prospective, multicenter, open-label, controlled study, 180 patients with age-related cataract were randomized to treatment with conventional therapy plus CMC 1% (n = 90) or to conventional therapy only (control group, n = 90) after phacoemulsification and intraocular lens implantation. Tear breakup time (TBUT), the Schirmer test with anesthesia, and fluorescein and lissamine green staining were performed. The Ocular Surface Disease Index (OSDI) questionnaire and a patient subjective symptom evaluation were administered preoperatively (baseline) and postoperatively at 7 and 30 days. RESULTS: TBUT was significantly longer in the treatment group compared with the control group at day 7 (8.5 ± 5.5 versus 6.6 ± 3.8 s; P = 0.0475) and day 30 (9.0 ± 5.9 versus 6.7 ± 4.8 s; P = 0.0258) after surgery. Compared with baseline, TBUT significantly increased in patients in the treatment group (P < 0.001 at both day 7 and day 30) with a presurgical diagnosis of dry eye, but significantly decreased in patients in the control group (P < 0.02 at both day 7 and day 30) with no prior diagnosis of dry eye. Fluorescein and lissamine staining, OSDI questionnaire and subjective symptom scores all improved from baseline, with no significant differences between the two groups. No significant differences in tolerability and safety were observed between the group receiving CMC and conventional therapy, and those receiving conventional therapy only. CONCLUSION: Treatment with CMC 1% can provide significant improvement in tear film stability after phacoemulsification for age-related cataract. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT02028754 (Date of registration: Jan. 6, 2014).

[Analysis of refractive status after cataract surgery in age-related cataract patients with shallow anterior chamber].

OBJECTIVE: To evaluate the characteristics of postoperative refractive status in age-related cataract patients with shallow anterior chamber and the correlation between pre-operative anterior chamber depth and postoperative refractive status. METHODS: Prospective case-control study. Sixty-eight cases (90 eyes) with age-related cataract were recruited from October 2010 to January 2012 in People's Hospital Peking University including 28 cases (34 eyes) in control group and 40 cases (56 eyes) in shallow anterior chamber group according to anterior chamber depth (ACD) measured by Pentacam system. Axial length and keratometer were measured by IOL Master and intraocular lens power was calculated using SRK/T formula. Postoperative refraction, ACD and comprehensive eye examination were performed at 1 month and 3 months after cataract surgery. Using SPSS13.0 software to establish a database, the two groups were compared with independent samples t-test and correlation analysis were performed with binary logical regression. RESULTS: The postoperative refractive deviation at 1 month were (-0.39 ± 0.62) D in control group and (+0.73 ± 0.26) D in shallow anterior chamber group respectively which present statistical significance between the two groups (P = 0.00, t = 3.67); the postoperative refractive deviation in 3 month was (-0.37 ± 0.62) D in control group and (+0.79 ± 0.28) D in shallow anterior chamber group operatively which present statistical significance between the two groups (P = 0.00, t = 3.33). In shallow anterior chamber group, with the shallower of ACD, the greater of refractive deviation (P = 0.00, r1 month = -0.57, r3 months = -0.61). CONCLUSION: Hyperopic shift existed in age-related cataract patients with shallow anterior chamber and the shallower of ACD was, the greater of hyperopic shift happened.

[Analysis of the corneal spherical aberration in people with senile cataract].

OBJECTIVE: To investigate the distribution of the spherical aberration in people with senile cataract, in the interest of the customized selection of the intraocular lens in cataract surgeries and the future design of the intraocular lens. METHODS: Retrospective study. Analysis of 922 eyes from 504 patients over 60-years-old was made. Patients were subdivided into 3 age groups (153 patients of 60-<70 years-old in group 1, 251 patients of 70-<80 years-old in group 2, 100 patients of 80- ≤ 90 years-old in group 3). Pentacam anterior segment analyzer (OCULUS, Germany) was used to measure the average corneal and posterior surface K-readings. The Zernike coefficients of corneal spherical aberration was calculated. The difference of corneal parameters among each age group was compared. RESULTS: The average age of all patients was (73.5 ± 6.8) years-old. The average corneal K-reading was (44.50 ± 1.39)D and the average K-reading of corneal posterior surface was (-6.44 ± 0.25)D. There was no difference among 3 age groups (F = 0.738 and 0.373 retrospectively, P > 0.05). The corneal and posterior surface average K-readings had no correlation with the age. The average spherical aberration of anterior corneal surface was (0.361 ± 0.122)µm in group 1, (0.401 ± 0.139)µm in group 2 and (0.440 ± 0.145)µm in group 3 respectively. The spherical aberration of posterior corneal surface was (-0.122 ± 0.035)µm, (-0.105 ± 0.040)µm and (-0.090 ± 0.043)µm respectively. The total corneal spherical aberration was (0.360 ± 0.142)µm, (0.421 ± 0.158)µm and (0.476 ± 0.170)µm respectively. Significant differences were observed among 3 age groups (F = 10.561, 20.937 and 17.257 retrospectively, P < 0.01). The spherical aberrations of the corneal anterior, posterior surface and total cornea had positive correlation with the age (r = 0.203, 0.288 and 0.258 respectively, P < 0.01). The corneal spherical aberrations had no differences between right and left eyes, and had significant positive correlation between both sides. CONCLUSIONS: The people with senile cataract over 60-year-old had higher corneal spherical aberrations than other age. The corneal spherical aberrations increased with the age and had significant correlation inter-ocularly.