Pars plana vitrectomy for retinal detachment using perfluoro-n-octane as intraoperative tamponade: a multicenter, randomized, non-inferiority trial.

AIM: To evaluate the efficacy and safety of perfluoro-n-octane (PFO) for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy (PPV) in management of retinal detachment. METHODS: This multicenter, prospective, randomized, double-masked, parallel-controlled, non-inferiority trial was conducted in three ophthalmology clinical centers in China. Patients with retinal detachment, who were eligible for PPV were consecutively enrolled. Participants were assigned to PFO for ophthalmic surgery or F-Octane for intraocular tamponade in a 1:1 ratio. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, and dilated fundus examination were performed preoperatively and at 1, 7±1, 28±3d postoperatively. The primary outcome was complete retinal reattachment rate at postoperative day one. The non-inferiority margin was set at 9.8%. The secondary outcomes included intraoperative retinal reattachment rate, and mean changes in IOP and BCVA from baseline to 1, 7±1, 28±3d postoperatively, respectively. Safety analyses were presented for all randomly assigned participates in this study. RESULTS: Totally 124 eligible patients completed the study between Mar. 14, 2016 and Jun. 7, 2017. Sixty of them were randomly assigned to the PFO for ophthalmic surgery group, and 64 were assigned to the F-Octane group. Baseline characteristics were comparable between the two groups. Both groups achieved 100% retinal reattachment at postoperative day one (difference 0, 95%CI: -6.21% to 5.75%, P=1). The pre-defined noninferiority criterion was met. No significant difference was observed in intraoperative retinal reattachment rate (difference 1.77%, P=0.61), mean changes in IOP (difference 0.36, -0.09, 2.22 mm Hg at 1, 7±1, 28±3d postoperatively, with all P>0.05) and BCVA (difference 0.04, -0.02, 0.06 logMAR at 1, 7±1, 28±3d postoperatively, all P>0.05) between the two groups. No apparent adverse events related to the utilization of PFO were reported. CONCLUSION: In patients with retinal detachment undergoing PPV, PFO for ophthalmic surgery is non-inferior to F-Octane as an intraocular tamponade, and both are safe and well-tolerated.

Evaluation of new robust silk fibroin hydrogels for posterior scleral reinforcement in rabbits.

Background: Currently, there is no ideal material available for posterior scleral reinforcement (PSR) to prevent the progression of high myopia. In this study, we investigated robust regenerated silk fibroin (RSF) hydrogels as potential grafts for PSR in animal experiments to evaluate their safety and biological reactions. Methods: PSR surgery was performed on the right eye of twenty-eight adult New Zealand white rabbits, with the left eye serving as a self-control. Ten rabbits were observed for 3 months, while 18 rabbits were observed for 6 months. The rabbits were evaluated using intraocular pressure (IOP), anterior segment and fundus photography, A- and B-ultrasound, optical coherence tomography (OCT), histology, and biomechanical tests. Results: No complications such as significant IOP fluctuation, anterior chamber inflammation, vitreous opacity, retinal lesion, infection, or material exposure were observed. Furthermore, no evidence of pathological changes in the optic nerve and retina, or structural abnormalities on OCT, were found. The RSF grafts were appropriately located at the posterior sclera and enclosed in fibrous capsules. The scleral thickness and collagen fiber content of the treated eyes increased after surgery. The ultimate stress of the reinforced sclera increased by 30.7%, and the elastic modulus increased by 33.0% compared to those of the control eyes at 6 months after surgery. Conclusion: Robust RSF hydrogels exhibited good biocompatibility and promoted the formation of fibrous capsules at the posterior sclera in vivo. The biomechanical properties of the reinforced sclera were strengthened. These findings suggest that RSF hydrogel is a potential material for PSR.

Reactive Magnesium Nitride Additive: A Drop-in Solution for Lithium/Garnet Wetting in All-Solid-State Batteries.

Garnet oxides such as Li6.4 La3 Zr1.4 Ta0.6 O12 (LLZTO) are promising solid electrolyte materials for all-solid-state lithium-metal batteries because of high ionic conductivity, low electronic leakage, and wide electrochemical stability window. While LLZTO has been frequently discussed to be stable against lithium metal anode, it is challenging to achieve and maintain good solid-on-solid wetting at the metal/ceramic interface in both processing and extended electrochemical cycling. Here we address the challenge by a powder-form magnesium nitride additive, which reacts with the lithium metal anode to produce well-dispersed lithium nitride. The in situ formed lithium nitride promotes reactive wetting at the Li/LLZTO interface, which lowers interfacial resistance, increases critical current density (CCD), and improves cycling stability of the electrochemical cells. The additive recipe has been diversified to titanium nitride, zirconium nitride, tantalum nitride, and niobium nitride, thus supporting the general concept of reactive dispersion-plus-wetting. Such a design can be extended to other solid-state devices for better functioning and extended cycle life.

Effect of Adjunctive Intravitreal Conbercept Injection at the End of 25G Vitrectomy on Severe Proliferative Diabetic Retinopathy: 6-Month Outcomes of a Randomised Controlled Trial.

INTRODUCTION: This study aimed to evaluate the effect of pre-operative versus pre-operative plus post-operative intravitreal conbercept (IVC) injection on severe proliferative diabetic retinopathy (PDR). METHODS: This was a prospective, comparative and randomised study. A total of 84 patients who underwent vitrectomy for severe PDR were included in this study. Patients were randomly divided into control (41 eyes) and experiment (43 eyes) groups. Patients in the experiment group received adjunctive pre-operative and post-operative IVC injection, whereas patients in the control group only received pre-operative IVC injection. The incidence of post-operative vitreous haemorrhage (POVH), best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were determined. RESULTS: The incidence of early POVH was significantly different between the two groups, but no significant difference was observed between groups at 3 and 6 months. In the experiment group, the BCVA was significantly improved 1 month after surgery when compared with the control group (p 0.019). There was no marked difference in the mean post-operative BCVA at 3 and 6 months between groups (p 0.063 and 0.082). CRT was significantly lower in the experiment group than in the control group at 1 and 3 months after surgery (p 0.037 and 0.041), but there was no significant difference at 6 months (p 0.894). CONCLUSION: Additional IVC injected at the end of surgery improves the POVH and BCVA at the early stage after surgery in severe PDR, but this benefit is absent at 6 months. Further studies are needed to investigate the effect of IVC at the end of vitrectomy. TRIAL REGISTRATION: chictr.org.cn identifier: ChiCTR2200060735. Retrospectively registered, register date: 9 June 2022.

Reproducibility of macular perfusion parameters in non-proliferative diabetic retinopathy patients by two different OCTA sweep modes.

AIM: To assess the reproducibility of macular perfusion parameters in non-proliferative diabetic retinopathy (NPDR) patients measured by different examiners and two different sweep modes of optical coherence tomography angiography (OCTA). METHODS: Ninety-eight (98 eyes) patients with NPDR were included in this study. All participates were performed three times using Cirrus OCTA with Angiography 3×3 mm2 and 6×6 mm2 sweep mode by two examiners. The macular foveal avascular zone (FAZ) and vessel density (VD) in the superficial retinal layer (SRL) were measured. The reproducibility of the measurements was evaluated with intraclass correlation coefficients (ICC) and coefficient of variation (CoV). RESULTS: The intra-mode ICCs of Angiography 3×3 mm2 and 6×6 mm2 sweep mode were 0.957 to 0.959 and 0.964 to 0.977, respectively; and the inter-mode ICCs were 0.962 to 0.970. The intra-examiner ICCs of macular perfusion parameters were >0.950; and the inter-examiner ICCs were 0.928 to 0.969. All CoVs were <1.0%. CONCLUSION: Cirrus OCTA can measure macular perfusion parameters in NPDR patients with excellent reproducibility. The measurements of FAZ and VD in the SRL determined by Angiography 3×3 mm2 and 6×6 mm2 sweep mode are highly consistent and both sweep modes are suitable for macular perfusion parameters measurement.

A Randomized, Controlled Trial of Treat-and-Extend vs. Pro Re Nata Regimen for Neovascular Age-Related Macular Degeneration.

Purpose: To compare the efficacy and safety of conbercept using a treat-and-extend (T&E) regimen vs. a pro re nata (PRN) regimen in Chinese patients with neovascular age-related macular degeneration (nAMD). Methods: This was a randomized, multicenter, non-inferiority study. After an initial loading phase of three consecutive monthly intravitreal injections of 0.5 mg Conbercept, the patients were treated to PRN or T&E regimen. The prespecified retreatment criteria was defined as a more than 5-letter decrease in BCVA from the previous visit or any evidence of new retinal hemorrhages, or the presence of any IRF and any SRF of more than 200 µm in height at the sub-foveal center. The primary outcome was the mean change in best-corrected visual acuity (BCVA) from baseline to 24 months, with a prespecified non-inferiority limit of -5 letters. Results: From July 2016 through August 2018, 141 participants were allocated and treated (T&E, n = 69; PRN, n = 72). About one fifth of the overall participants were dropped out during the 12-month follow-up (28/141, 19.9%), and about one thirds of the overall participants were lost during the 24-month follow-up (51/141, 36%). At 2 years, mean BCVA letter improvement was + 4.0 in the T&E group vs. + 5.1 in the PRN group, and T&E regimen was not non-inferior to PRN regimen [difference, -1.169 letters; 95% confidence interval (CI): -6.864 ∼ 4.526]. Subgroup analyses also demonstrate the similar results in PCV patients, naive patients and no-naive patients. The mean decrease in central subfield thickness were 180 ± 165 µm in the T&E group and 247 ± 230 µm in the PRN group, respectively. The patients in the PRN group had required significantly fewer injections than those in the T&E group (12.4 vs. 14.6 injections, P = 0.041). The types and rates of adverse events were comparable in the two treatment groups. Conclusion: These findings suggest that the T&E regimen was not non-inferior to the PRN regimen in patients with nAMD in terms of BCVA outcomes through 24 months. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT02802657.

[Structural Design and Finite Element Analysis of New Type Posterior Integral Glaucoma Valve].

The treatment of refractory Glaucoma is a difficult problem in clinical ophthalmology. For refractory glaucoma patients with hyphema, shallow anterior chamber, anterior conglutination of peripheral chamber angle, corneal endothelium dystrophy or decompensated, at present, there is no effective treatment. In order to solve this problem, a new type posterior integral glaucoma valve with IOP control device was designed using medical titanium alloy, and the valve model was established by Abaqus software, and the stiffness and preload of the valve were analyzed by finite element method. The results showed that the opening and closing of the valve were controlled automatically by the pressure difference between the front and back of the valve, and the opening and flow rate of the valve increase dynamically with the increase of intraocular pressure, and finally reached the set ideal IOP value of steady state.

Excellent Li/Garnet Interface Wettability Achieved by Porous Hard Carbon Layer for Solid State Li Metal Battery.

Garnet-type Li6.4 La3 Zr1.4 Ta0.6 O12 (LLZTO) electrolyte is considered as a promising solid electrolyte because of its relatively high ionic conductivity and excellent electrochemical stability. The surface contamination layer and poor Li/LLZTO interface contact cause large interfacial resistance and quick Li dendrite growth. In this paper, a porous hard carbon layer is introduced by the carbonization of a mixed layer of phenolic resin and polyvinyl butyral on the LLZTO surface to improve Li/garnet interfacial wettability. The multi-level pore structure of the hard carbon interlayer provides capillary force and large specific surface area, which, together with the chemical activity of the carbon material with Li, promote the molten Li infiltration with garnet electrolyte. The Li/LLZTO interface delivers a low interfacial resistance of 4.7 Ω∙cm2 at 40 °C and a higher critical current density, which can achieve stable Li+ conduction for over 800 h under current densities of 0.1 and 0.2 mA∙cm-2 . The solid-state battery coupled with Li and LiFePO4 exhibits excellent rate and cycling performance, demonstrating the application feasibility of the hard carbon interlayer for a solid state Li metal battery.

Optical Coherence Tomography Classification Systems for Diabetic Macular Edema and Their Associations With Visual Outcome and Treatment Responses - An Updated Review.

ABSTRACT: Optical coherence tomography (OCT) is an invaluable imaging tool in detecting and assessing diabetic macular edema (DME). Over the past decade, there have been different proposed OCT-based classification systems for DME. In this review, we present an update of spectral-domain OCT (SDOCT)-based DME classifications over the past 5 years. In addition, we attempt to summarize the proposed OCT qualitative and quantitative parameters from different classification systems in relation to disease severity, risk of progression, and treatment outcome. Although some OCT-based measurements were found to have prognostic value on visual outcome, there has been a lack of consensus or guidelines on which parameters can be reliably used to predict treatment outcomes. We also summarize recent literatures on the prognostic value of these parameters including quantitative measures such as macular thickness or volume, central subfield thickness or foveal thickness, and qualitative features such as the morphology of the vitreoretinal interface, disorganization of retinal inner layers, ellipsoid zone disruption integrity, and hyperreflec-tive foci. In addition, we discuss that a framework to assess the validity of biomarkers for treatment outcome is essentially important in assessing the prognosis before deciding on treatment in DME. Finally, we echo with other experts on the demand for updating the current diabetic retinal disease classification.

Effects of Femtosecond Laser-Assisted Cataract Surgery on Macular and Choroidal Thickness in Diabetic Patients.

INTRODUCTION: This study aimed to compare the short-term changes in retinal and choroid thickness in diabetic patients after femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification (PE) surgery. METHODS: A total of 47 eyes in the PE group and 44 eyes in the FLACS group were included. All patients underwent measurement of central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) before and after surgery using optical coherence tomography (OCT). RESULTS: The effective phaco time (EPT) in the FLACS group was significantly reduced. The BCVA differed significantly between the two groups at 1 week and 1 month after surgery. The CMT in both groups increased at 1 week after the operation. It did not return to the preoperative level until month 12 in the PE group. In the FLACS group, the CMT began to decrease at month 3 and recovered to the preoperative level at month 12. The SFCT of the two groups increased at week 1; it began to decrease at month 6 in the PE group but did not recover to the preoperative level until month 12. The SFCT in the FLACS group recovered to preoperative levels at month 6. In the PE group, baseline CMT values predicted CMT change at week 1 and months 1, 3 and 12 after surgery. In the FLACS group, baseline CMT predicted CMT changes at week 1, month 1 and month 3. In the FLACS group, EPT predicted SFCT change at month 3. CONCLUSION: FLACS is safe and effective in patients with no fundus change or mild diabetic retinopathy. It has advantages in effectively reducing EPT, achieving good vision earlier and promoting faster recovery of the retinal and choroidal thickness. Preoperative CMT is a significant predictor of CMT changes in the early period after FLACS.

Tear proteomics of orbital decompression for disfiguring exophthalmos in inactive thyroid-associated ophthalmopathy.

The progress and achievements that have been made in tear proteomics in thyroid-associated ophthalmopathy (TAO) are critical for exploring the pathogenesis of TAO and investigating potential therapeutic targets. However, the tear proteomics of orbital decompression for disfiguring exophthalmos in inactive TAO have yet to be properly investigated. In the present study, orbital decompression was performed to repair disfiguring exophthalmos in patients with inactive TAO. Tears were collected before and after orbital decompression in patients with inactive TAO. Liquid chromatography with tandem mass spectrometry (LC-MS/MS) was performed to explore the changes in tear proteomics. Bioinformatics analyses were then employed to analyze the functions of the differentially expressed proteins (DEPs) identified by LC-MS/MS. The palpebral fissure height and exophthalmia area were significantly restored after 1 month of orbital decompression such that they approached the normal levels identified in healthy eyeballs. Among the 669 proteins identified by LC-MS/MS, 83 proteins were changed significantly between the preoperative and postoperative stages in inactive TAO patients and healthy control individuals. The DEPs were predicted to be involved in numerous signaling pathways. Bioinformatics analyses revealed that pathways associated with the immune system, metabolism, programmed cell death, vesicle-mediated transport, neuronal system and extracellular matrix organization may fulfill significant roles in orbital decompression in patients with inactive TAO. Taken together, these results provided a preliminary understanding of the mechanism of orbital decompression for disfiguring exophthalmos in inactive TAO patients.

Protein Kinase A Inhibitor H89 Attenuates Experimental Proliferative Vitreoretinopathy.

Purpose: This study aimed to explore the role of the protein kinase A (PKA) pathway in proliferative vitreoretinopathy (PVR) and the effect of the PKA inhibitor H89 on experimental PVR. Methods: Epiretinal membranes (ERMs) were acquired from PVR patients and analyzed by frozen-section immunofluorescence. An in vivo model was developed by intravitreal injecting rat eyes with ARPE-19 cells and platelet-rich plasma, and changes in eye structures and vision function were observed. An in vitro epithelial-mesenchymal transition (EMT) cell model was established by stimulating ARPE-19 cells with transforming growth factor (TGF)-ß. Alterations in EMT-related genes and cell function were detected. Mechanistically, PKA activation and activity were explored to assess the relationship between TGF-ß1 stimulation and the PKA pathway. The effect of H89 on the TGF-ß-Smad2/3 pathway was detected. RNA sequencing was used to analyze gene expression profile changes after H89 treatment. Results: PKA was activated in human PVR membranes. In vivo, H89 treatment protected against structural changes in the retina and prevented decreases in electroretinogram b-wave amplitudes. In vitro, H89 treatment inhibited EMT-related gene alterations and partially reversed the functions of the cells. TGF-ß-induced PKA activation was blocked by H89 pretreatment. H89 did not affect the phosphorylation or nuclear translocation of regulatory Smad2/3 but increased the expression of inhibitory Smad6. Conclusions: PKA pathway activation is involved in PVR pathogenesis, and the PKA inhibitor H89 can effectively inhibit PVR, both in vivo and in vitro. Furthermore, the protective effect of H89 is related to an increase in inhibitory Smad6.

High glucose causes apoptosis of rabbit corneal epithelial cells involving activation of PERK-eIF2α-CHOP-caspase-12 signaling pathway.

AIM: To investigate the effect of high concentration of glucose (HCG) on double stranded RNA-activated protein kinase-like ER kinase (PERK)-eukaryotic initiation factor-2α (eIF2α)-transcription factor C/EBP homologous protein (CHOP)-cysteine aspartate specific proteinase (caspase-12) signaling pathway activation and apoptosis in rabbit corneal epithelial cells (RCECs). METHODS: RCECs were treated by different concentrations of glucose for 0-48h. The expressions of PERK, p-PERK, eIF2α, p-eIF2α, 78 kDa glucose-regulated protein 78 (GRP78), CHOP, B-cell lymphoma 2 (Bcl-2), B-cell lymphoma-2-associated X protein (Bax) and caspase-12 were determined by Western blot. Apoptosis was detected by TUNEL assay. Meanwhile, the function of PERK-eIF2α-CHOP-caspase-12 signaling pathway activation in high glucose-induced apoptosis was evaluated using PERK inhibitor, GSK2606414. RESULTS: HCG significantly promoted the expression of p-PERK, p-eIF2α, GRP78, CHOP, Bax and cleaved caspase-12 in RCECs (P<0.05), while remarkably decreased the expression of Bcl-2 and caspase-12 (P<0.05), and the alterations caused by glucose were in concentration- and time-dependent manners. Meanwhile, PERK and eIF2α expressions were not affected in all groups (P>0.05). TUNEL assay showed that the apoptosis rate of RCECs in the HCG group increased significantly in contrast with that in the normal concentration of glucose or osmotic pressure control group (P<0.05), and the apoptosis rate increased with the increase of glucose concentration within limits (P<0.05). GSK2606414 down-regulated the expression of p-PERK and p-eIF2α in the HCG group (P<0.05), while still did not affect the expression of PERK and eIF2α among groups (P>0.05). Correspondingly, GSK2606414 also significantly reduced the apoptosis rate induced by high glucose (P<0.05). CONCLUSION: HCG activates PERK-eIF2α-CHOP-caspase-12 signaling pathway and promotes apoptosis of RCECs.

Comparison of 12-month therapeutic effect of conbercept and ranibizumab for diabetic macular edema: a real-life clinical practice study.

BACKGROUND: To compare the efficacy of intravitreal conbercept and ranibizumab in the treatment of diabetic macular edema (DME) in a real-life clinical practice. METHODS: This was a retrospective study. Among 62 Chinese patients with DME, 32 patients (36 eyes) received intravitreal conbercept (IVC) injections and 30 patients (32 eyes) received intravitreal ranibizumab (IVR) injections, once a month for 3 months followed by as needed therapy. All participants had at least 12 months of follow-up. We compared the changes in best-corrected visual acuity (BCVA) letter score and central retinal thickness (CRT) between groups, as well as the number of intravitreal injections delivered. Safety was assessed with the incidence of adverse events (AEs). RESULTS: At month 12, the mean BCVA letter score improved by 9.3 ± 5.2 with conbercept, and by 8.9 ± 4.4 with ranibizumab, the mean CRT reduction was 138.4 ± 97.7 µm and 145.2 ± 72.5 µm, respectively. There was no statistically significant difference of improvement in BCVA (P = 0.756) and decrease in CRT (P = 0.748) between the two groups. The number of intravitreal injections delivered was significantly higher (P = 0.027) in the IVR group (7.2 ± 1.0 per eye) than in the IVC group (6.6 ± 0.9 per eye). There were no severe ocular adverse reactions or systemic adverse events. CONCLUSIONS: Both conbercept and ranibizumab are effective in the treatment of DME, achieving the similar clinical efficacy. In comparison to ranibizumab, conbercept shows a longer treatment interval and fewer intravitreal conbercept injections are needed.

Minimally invasive percutaneous fixation with cannulated compression screw for young patients with femoral neck fracture / 中国组织工程研究

BACKGROUND: Screw fixation is mainly used in the treatment of femoral neck fractures in the youth; therefore, how to reduce surgical trauma, retain sufficient blood supply and reduce postoperative complications becomes so important. OBJECTIVE: To study the efficacy of minimal invasive percutaneous fixation with cannulated compression screws for young patients with femoral neck fracture and its impact on the length of bilateral lower limbs and hip joint function. METHODS: Thirty patients with femoral neck fracture admitted in the Shanghai Pudong Hospital Affiliated to Fudan University from January 2009 to December 2012, were selected as experimental group, followed by subjected to minimal invasive percutaneous traction bed-assisted closed reduction with cannulated compression screws. Meanwhile, 28 cases of femoral neck fracture admitted from January 2006 to December 2009, were given open reduction with square muscle grafting and cannulated screw fixation (control group). The efficacy, intraoperative blood loss, operation time, hospital stay, fracture healing time and incidence of complications were observed. Additionally, the length of bilateral lower limbs and Harris hip scores at 3 months and 1 year postoperatively were compared between two groups. RESULTS AND CONCLUSION: (1) All patients were followed up for 24-60 months. (2) The excellent and good rate in the experimental and control groups was 90% and 93%, respectively, which showed no significant difference between two groups (χ2=0.007, P > 0.05). (3) The intraoperative blood loss, operation time, and hospital stay in the experimental group were significantly less than those in the control group (P < 0.01); while, the fracture healing time, incidence of complications as well as length of bilateral lower limbs and Harris hip scores at 3 months and 1 year postoperatively did not differ significantly between two groups (P > 0.01). (4) These results suggest that the minimal invasive percutaneous fixation with cannulated compression screws applied in the treatment of young patients with femoral neck fracture exhibits satisfactory efficacy, good reduction, less trauma and rapid postoperative recovery, which is available for all types of young femoral neck fracture.

Intravitreal Conbercept Injection with and without Grid Laser Photocoagulation in the Treatment of Diffuse Diabetic Macular Edema in Real-Life Clinical Practice.

Purpose. To evaluate the efficacy of intravitreal conbercept (IVC) plus modified grid laser photocoagulation (MGP) versus IVC alone for treatment of diffuse diabetic macular edema (DDME). Methods. In this retrospective study, 51 DDME patients were treated with either IVC alone (IVC group) or IVC plus MGP (combined group) with 12 months of follow-up. The clinical records of those patients were reviewed. Results. 26 patients (31 eyes) received IVC alone and 25 patients (30 eyes) received combined therapy. At month 12, the mean best-corrected visual acuity (BCVA) letter score improvement was 9.1 ± 4.5 and 7.5 ± 4.2 in the IVC group and the combined group and the mean central retinal thickness (CRT) reduction was 145.1 ± 69.9 µm and 168.5 ± 53.6 µm, respectively. There was no statistically significant difference of improvement in BCVA (P = 0.164) and decrease in CRT (P = 0.149) between the two groups. The mean number of injections delivered was significantly higher (P < 0.001) in the IVC group (5.6 ± 0.8 per eye) than in the combined group (3.3 ± 1.2 per eye). Conclusions. IVC alone or combined with MGP appeared to be effective for treatment of DDME, achieving the similar clinical efficacy. Moreover, MGP helps to reduce the number of injections.

Expression of visfatin in the diabetic rat retina.

BACKGROUND: Visfatin has been found in adipose tissue, liver and kidney of healthy and diabetic people, with its expression being increased in the aforementioned tissues in diabetes. Based on the former researches, visfatin may exist in the retina and affect the development of diabetic retinopathy. The expression of visfatin in Sprague-Dawley rats' retina, which may carve a path to study the pathogenesis of diabetic retinopathy, was investigated by this study. METHODS: The mRNA and protein expression of visfatin in Sprague-Dawley rats' retina were detected by the reverse transcription-polymerase chain reaction (RT-PCR) and western blot. Immunohistochemical staining was applied to detect the expression location of visfatin in the rats' retinas. RESULTS: The mRNA and visfatin protein expressions in both normal and streptozocin-induced diabetic rats' retina increased significantly in 2 to 8 weeks of diabetes mellitus (DM). Compared with the normal control groups, the difference was statistically significant (P < 0.05). The histological examination showed that the retinal thickness decreased gradually over the course of DM and the decrease in the outer nuclear layer was the most obvious. At 4 and 8 weeks, the decrease in the retinal thickness was significant (P < 0.01). Visfatin was expressed in the retinal nerve fibre layer, inner plexiform layer and outer plexiform layer, and with the progression of DM, its expression was increased. CONCLUSIONS: Visfatin was expressed in the rats' retinas, mainly in the retinal nerve fibre layer, inner plexiform layer and outer plexiform layer. As the development of DM course, its expression was gradually increased.

Spontaneous resolution of idiopathic vitreomacular traction syndrome in a healthy young man.

PURPOSE: To report a case of spontaneous resolution of idiopathic vitreomacular traction syndrome developed in a healthy young man. METHOD: To exam the macular region using Optical coherence tomography (OCT). RESULT: OCT examination revealed an incomplete posterior vitreous detachment (PVD) which remains broad vitreous adhesion at the macular area. The foveal thickness increase to 573 µm. The maximal diameter of the adhesion suggested the broad Vitreomacular traction (VMT) type. The posterior vitreous cortex was revealed as a highly reflective band. After 6 weeks without surgery, the patient reported spontaneous improvement in visual symptoms. OCT revealed a complete PVD without macular traction. The foveal contour restored and the foveal thickness decreased markedly to 213 µm. CONCLUSION: A comprehensive OCT evaluation of the vitreoretinal interface, including VMT types, concurrent conditions like CME and ERM, should be taken into consideration before surgery.

Neovibsanin B increases extracellular matrix proteins in optic nerve head cells via activation of Smad signalling pathway.

The present study demonstrates the effect of neovibsanin B on the synthesis and deposition of ECM proteins and the signalling pathways used in optic nerve head (ONH) astrocytes and lamina cribrosa (LC) cells. For investigation of the signalling pathway used by neovibsanin B, ONH cells were treated with neovibsanin B. Western blot and immunostaining analyses were used to examine the phosphorylation of proteins involved in Smad and non-Smad signalling pathway. The results revealed that ONH cells on treatment with neovibsanin B showed enhanced synthesis of extracellular matrix (ECM) proteins. Neovibsanin B induced phosphorylation of canonical signalling proteins, Smad2/3. However phosphorylation of non-canonical signalling proteins, extracellular signal-regulated kinases, p38, and c-Jun N-terminal kinases (JNK) 1/2 remained unaffected. There was also increase in co-localization of pSmad2/3 with Co-Smad4 in the nucleus of ONH astrocytes and LC cells indicating activation of the canonical Smad signalling pathway. Treatment of ONH cells with SIS3, inhibitor of Smad3 phosphorylation reversed the neovibsanin B stimulated ECM expression as well as activation of canonical pathway signalling molecules. In addition, inhibition of Smad2 or Smad3 using small interfering RNA (siRNA) also suppressed neovibsanin B stimulated ECM protein synthesis in ONH astrocytes and LC cells. Thus neovibsanin B utilizes the canonical Smad signalling pathway to stimulate ECM synthesis in human ONH cells. The neovibsanin B induced ECM synthesis and activation of the canonical Smad signalling pathway may be due to its effect on transforming growth factor-ß2 (TGF-ß2). However, further studies are under process to understand the mechanism.

Analysis of peripapilary retinal nerve fiber layer thickness of healthy Chinese from northwestern Shanghai using Cirrus HD-OCT.

AIM: To investigate peripapillary retinal nerve fiber layer (RNFL) thickness of healthy Chinese individuals from northwestern Shanghai using Cirrus HD-OCT (Carl Zeiss Meditec, Inc. Dublin, CA, USA). METHODS: The peripapillary RNFL thickness of 720 eyes from 360 healthy Chinese participants were measured using the Optic Disc Cube 200×200 protocol. Each eye was scanned 3 times. Global and each quadrant's RNFL thickness around the optic nerve were compared between genders, and interocular differences were analyzed. The correlation between global RNFL thickness and age were also assessed in this study. RESULTS: The mean global, superior, nasal, inferior and temporal RNFL thickness of all the eyes were 96.04±7.40 µm, 118.36±13.52 µm, 67.63±8.60 µm, 125.17±13.48 µm, 72.49±10.70 µm, respectively. When analyzing between genders, the mean nasal RNFL thickness of male and female were 68.29±8.44 µm and 66.97±8.70 µm, with statistically significant difference (P=0.038), while the data of global, superior, inferior and temporal quadrant showed no significant difference (all P>0.05). When analyzing interocular differences, the mean RNFL thickness of all the right eyes and all the left eyes were 116.46±13.17 µm and 120.27±13.61 µm in superior quadrant (P<0.001); 68.74±8.80 µm and 66.52±8.25 µm in nasal quadrant (P<0.001); 73.16±10.95 and 71.83±10.41 in temporal quadrant (P<0.001), all having statistically significant differences. There were no statistically significant interocular differences of global and inferior RNFL thickness (both P>0.05). There was a significantly negative correlation (r=-0.618, P<0.001) between the mean global RNFL thickness and the age. CONCLUSION: In healthy Chinese from northwestern Shanghai, there were no significant differences detected interocular difference and between genders in the mean global RNFL thickness. Nevertheless, significant difference existed in the nasal quadrant between genders, and interocular differences existed in the superior, nasal and temporal quadrants. The RNFL thickness appeared to gradually decrease with age.