Analysis of risk factors for dry eye disease and effect of diquafosol sodium ophthalmic solution on the tear film after vitrectomy in patients with type 2 diabetes mellitus: a preliminary study.

PURPOSE: The purpose of this study was to investigate the risk factors of DM associated dry eye syndrome (DMDES) and to explore the effect of diquafosol sodium ophthalmic solution (DQS) on patients with DMDES after vitrectomy. METHODS: Totally 107 patients (107 eyes) received vitrectomy. The data of age, gender, left/right eye, duration of DM, duration of vitrectomy, fasting blood glucose and glycosylated hemoglobin were collected and analyzed for correlation between these factors and DMDES. Postoperatively, DQS was instilled in experimental group and sodium hyaluronate was instilled in control group. The noninvasive breakup time (NIBUT), tear meniscus height (TMH), Schirmer I test (SIT), corneal fluorescence staining score (CFSS) and ocular surface disease index (OSDI) were recorded before vitrectomy and 1, 2 and 3 months after vitrectomy. All data were used for statistical comparison. RESULTS: Gender, duration of DM and glycosylated hemoglobin were relevant factors of DMDES (P < 0.05). At 1, 2 and 3 months postoperatively, NIBUT and TMH of experimental group were significantly higher than control group (P < 0.05). Postoperatively, CFSS of experimental group was lower than that before vitrectomy, and CFSS at 2 and 3 months after vitrectomy was significantly different between the two groups (P < 0.05). At 1, 2 and 3 months postoperatively, SIT increased in both groups, but there was no significant difference between the two groups (P > 0.05). OSDI was significantly lower in experimental group at 1, 2 and 3 months postoperatively, compared with that of the control group (P < 0.05). CONCLUSION: These results suggest that gender, duration of DM and glycosylated hemoglobin are risk factors for DMDES. Postoperative instillation of DQS can improve the tear film quality in patients with DMDES after vitrectomy.

Vitreous amyloidosis caused by a Lys55Asn variant in transthyretin: A case report.

BACKGROUND: Amyloidosis is caused by misfolding of proteins and is characterized by formation of extracellular aggregates of insoluble fibrin. The primary effects in the eye include sharp deterioration of visual acuity as a result of vitreous opacity. According to the local and systemic distribution characteristics of amyloid deposits and their fibrin components, amyloidosis can be classified as primary, secondary or familial. Therefore, we report a typical case of vitreous amyloidosis in hereditary transthyretin amyloidosis (hATTR) to improve ophthalmologists' understanding of the disease and reduce misdiagnosis and recurrence. CASE SUMMARY: The patient was a 49-year-old man who complained of progressive visual decline in both eyes over a 2-mo period. No systemic diseases such as diabetes or hypertension were reported, and no obvious family history of disease was identified. The patient's visual acuity was HM/10 cm in the right eye and 0.06 in the left eye. He had a transparent cornea in both eyes, with a normal anterior depth, clear aqueous humor, no obvious iris abnormalities, round pupils of approximately 3 mm in diameter, normal direct and indirect light reflexes, and normal intraocular pressure. After various examinations, the patient was diagnosed with binocular vitreous amyloidosis secondary to hATTR associated with a Lys55Asn variant in TTR. The binocular visual acuity recovered to 1.0 after binocular vitrectomy. CONCLUSION: Vitreous amyloidosis is rare in the clinic and gene testing can assist the diagnosis accurately and effectively.

The Efficacy of Simultaneous Injection of Dexamethasone Implant and Ranibizumab Into Vitreous Cavity on Macular Edema Secondary to Central Retinal Vein Occlusion.

The purpose of this study was to determine the safety and effectiveness of simultaneous vitreous injection of dexamethasone implant and ranibizumab on macular edema secondary to central retinal vein occlusion (CRVO). We conducted a 6-month retrospective self-control study. Twenty-five patients diagnosed with macular edema secondary to CRVO were enrolled in this study. The patients received intravitreal injection of dexamethasone implant and ranibizumab. The changes in best corrected visual acuity (BCVA), central retinal thickness (CRT) and interocular pressure (IOP) before and at 2w, 1, 2, 3, 4, 5, 6 m after injection were recorded and compared. The adverse reactions in eyes and whole body were observed. The BCVA of all patients at 2 w (61.8 ± 5.42), 1 m (68.68 ± 5.23), 2 m (70.8 ± 5.8), 3 m (68.44 ± 5.61), 4 m (65.76 ± 5.76), 5 m (67.08 ± 5.57), and 6 m (70.12 ± 5.46) after surgery were significantly higher than that before surgery (52.2 ± 5.06,p < 0.01), and CRT of all patients at 2w (393.36 ± 52.66 um), 1 m (334.52 ± 32.95 um), 2 m (298.800 ± 29.97 um), 3 m (309.080 ± 28.78 um), 4 m (345.48 ± 39.81 um), 5 m (349.080 ± 29.88 um), and 6 m (309.76 ± 30.41 um) after surgery were significantly reduced than that before surgery (583.76 ± 121.09 um, p < 0.01). Macular edema recurred in an average of 4.44 ± 0.51 months after treatment, and those patients received combined treatment again. During follow-up, the most common adverse reactions were subconjunctival hemorrhage and increased intraocular pressure, with the incidence of 22% (11/50) and 18% (9/50) respectively. In all cases, the increased intraocular pressure could be controlled by a single intraocular pressure reducing drug. No patient needed to receive anti-glaucoma surgery. The overall incidence of lens opacity was 4% (2/50). After the first injection, no case showed lens opacity. After re-injection, 2 patients (2 eyes) (8%) developed lens opacity. None of the patients showed serious ocular adverse reactions or systemic complications such as vitreous hemorrhage, retinal detachment, endophthalmitis, uveitis or ocular toxicity. The simultaneous vitreous injection of dexamethasone implant and ranibizumab can significantly improve the visual acuity and anatomical prognosis in macular edema secondary to central retinal vein occlusion (CRVO-ME) patients, exhibiting good safety and effectiveness.

RETRACTED: Sustained delivery of epalrestat to the retina using PEGylated solid lipid nanoparticles laden contact lens.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief. Significant similarities were noticed post-publication between this article and an article submitted to the Journal of Drug Delivery Science and Technology on the same day, by an apparently unrelated research group: Tong Zhang, Tianhui Zhu, Fanyin Wang, Ling Peng and Mingying Lai 60 (2020) 101949 https://doi.org/10.1016/j.jddst.2020.101949 Moreover, the authors did not respond to the journal request to comment on these similarities and to provide the raw data, and the Editor-in-Chief decided to retract the article. One of the conditions of submission of a paper for publication is that authors declare explicitly that their work is original and genuine. As such this article represents a severe abuse of the scientific publishing system.

LncRNA MIR7-3HG executes a positive role in retinoblastoma progression via modulating miR-27a-3p/PEG10 axis.

Homo sapiens MIR7-3 host gene (MIR7-3HG), a long non-coding RNA, has been reported to be connected with the progression of several tumors and could be served as a prognostic marker. Our study intends to explore the biological function and potential molecular mechanism of MIR7-3HG in Retinoblastoma (Rb) progression. Two Rb cell lines Y79 and WERI-Rb-1 were applied to perform functional assays. Expression of MIR7-3HG in Rb tissues and cells were determined with the support of GEO database and qRT-PCR experiment. The effects of MIR7-3HG on cell activity and apoptosis were assessed through cell counting kit 8 and flow cytometry assays, respectively. Targeted connections between MIR7-3HG and miR-27a-3p, as well as miR-27a-3p and PEG10 were speculated by bioinformatics prediction software and verified by performing dual luciferase assays. Further interrelationships among MIR7-3HG, miR-27a-3p, and PEG10 were explored through rescue assays. MIR7-3HG overexpression was detected in Rb tissues and cell lines. Depletion of MIR7-3HG reduced the activity of Rb cells and increased the apoptosis of Rb cells, and vice versa. In addition, further exploration perceived that MIR7-3HG, miR-27a-3p, and PEG10 generated a competing endogenous RNA (ceRNA) mechanism to regulate Rb cells activity and apoptosis. Our results indicated that MIR7-3HG functioned as a ceRNA to up-regulate PEG10 expression via sponging miR-27a-3p to promote the proliferation of Rb cells and suppress the apoptosis of Rb cells, exhibiting a group of potential target molecules for Rb treatment in the future.

Clinical characteristics of acute zonal occult outer retinopathy in Chinese patients.

PURPOSE: To review the clinical features of acute zonal occult outer retinopathy (AZOOR) in Chinese patients. METHODS: All patients with AZOOR during 2002-2004 in our hospitals were reviewed retrospectively. RESULTS: Seven consecutive Chinese patients with AZOOR were recruited and followed up for 4-18 months. Their age ranged from 26 to 47 years and all were affected bilaterally. They were from the cities near the Pacific Ocean and were used to eating seafood. The common complaints were slightly reduced visual acuity and photopsia. At least one eye of each patient had a visual field defect or decreased local area sensitivity and one patient had bilateral blind spot enlargement. Ten in 14 eyes showed increased numbers of vitreous cells and 4 eyes had anterior chamber inflammatory cells and a keratic precipitate. In their initial examination, minimal or no fundus changes were found, only yellow-white dots or gray dots presented on the deep retina or outer retinal layer. Fundus fluorescent angiography showed large-area depigmentation and hyperfluorescein spots corresponding to fundus findings. Electroretinogram (ERG) or multifocal ERG was abnormal in all eyes with no changes in their follow-up examination. Not all of the initial diagnoses of these patients were consistent with the final ones. CONCLUSIONS: AZOOR is not a common disease in China, but easy to misdiagnose. Female predilection, photopsia, visual field defect, ERG abnormality and minimal ophthalmoscopic changes are the common characteristics of AZOOR in Chinese patients. Living habits may play a role in the development of AZOOR.

Proposed classification of lens capsule defects.

BACKGROUND: Capsule defects are common during or after intraocular surgery of various kinds. The purpose of this work is to establish a classification system of lens capsule defects to provide uniform description of these defects for ophthalmic research and IOL implantation. METHODS: A retrospective study of 128 patients (156 eyes) with lens capsule injury after ocular trauma and intraocular surgery was performed. The patients were divided into two groups. Capsule defects were defined and classified according to the location, size, shape and tension of the capsule and its effect on posterior chamber IOL implantation. RESULTS: Lens capsule defects were classified into four types: Type I - complete capsule; Type II - incomplete capsule, but has enough area and tension to support two IOL haptics; Type III - incomplete capsule, is able to support only one IOL haptic and the other haptic needs a suture; Type IV - no capsule, both IOL haptics need suture fixation. Type I and Type II were each divided into three subtypes. Type III was divided into two subtypes. The shape of the capsule defects included fissure-like, triangle, round, irregular and fan-like. All eyes with capsule defects can be sorted into one of these types, and it is easy to guide IOL implantation according to the classification. Type II was the most common among the two groups in this study. CONCLUSION: The classification of lens capsule defects is feasible and favorable for uniform clinical description, clinical research and IOL implantation.

[Diagnosis and differential diagnosis of acute zonal occult outer retinopathy].

OBJECTIVE: To study the clinical manifestations of acute zonal occult outer retinopathy (AZOOR) and to differentiate it from other retinal diseases. METHODS: Six patients diagnosed AZOOR had complete eye examinations including fundus photography, fundus fluorescein angiography (FFA), electroretinography (ERG), visual evoked potentials and visual field examination. Medical consultation and neurological consultation were performed in those patients. All patients were followed up and the data were collected for analysis, discussion, diagnosis and differential diagnosis. RESULTS: Six patients (five female and one male) aged 26 - 42 years (mean 35 years) with AZOOR were followed up for 4 - 18 months [mean (7.5 +/- 3.2) months]. All of them were affected bilaterally and their visual acuity were slightly reduced except one eye was CF/40 cm. Half of them had photopsia. At least one eye of each patient had visual field defect or decreased sensitivity in local area or blind-spot enlargement. Biomicroscopic examination revealed vitreous cells in 10/12 eyes and anterior chamber inflammatory cells and keratic precipitate in 4/12 eyes. Minimal (10/12 eyes) or no (2/12 eyes) fundus changes were found in their initial examination. Funduscopic examination revealed yellow-white dots (4/12 eyes) and gray dots (6/12 eyes) at the posterior pole of deep retina or retinal pigment epithelium-Bruch membrane-choroid capillary complex layer. FFA showed depigmentation (2/12 eyes) or hyperfluorescein spots (10/12 eyes) that identical to the retinal lesions. In the follow-up examination, the visual acuity was reduced in one eye and visual field defect enlarged in both eyes of one patient; the number of retinal dots increased in one eye, decreased in one eye and extinguished in one eye. ERG or mERG revealed abnormal in all of their eyes with no changes in their follow-up examination. All of the initial diagnoses of six patients were not consistent with final diagnosis. CONCLUSIONS: AZOOR is a rare eye disease, usually occurs in young females, with the characteristics of photopsia, visual field defects, abnormal ERG and slight changes in the fundus. The differential diagnosis of this disease is relatively complicate and is easily to be misdiagnosed.

Effect of high dosage of methylprednisolone on rat retinal ganglion cell apoptosis after optic nerve crush.

PURPOSE: To investigate the effect of high dose methylprednisolone (MP) on retinal ganglion cells (RGC) apoptosis. METHODS: One hundred and twenty six Wistar rats were divided into normal control, crush control and MP treatment groups. High dose MP and 0.9% sodium chloride were injected intravenously at 1 h after injury in the treatment group and crush control group, respectively. Apoptotic cells, Bcl-2 and Bax positive cells were located and calculated by terminal-deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling (TUNEL), immunohistochemical method and retinal whole-mount combined with section technique at day 4, 7, 14 after crush, respectively. RESULTS: The TUNEL-labeling cells, Bcl-2 and Bax positive cells were detected in the ganglion cell layer of retina. Few apoptotic cells, a few of Bcl-2 and Bax positive cells were observed in normal control groups. The numbers of positive cells increased gradually after crush. The number of apoptotic cells and Bax positive tells in treatment groups was less than that in crush group significantly (P < 0.05), while the number of Bcl-2 positive cells in treatment group was more than that in crush group at day 4, 7 and 14 after crush significantly (P < 0.05). CONCLUSIONS: These results suggest that high dose MP can inhibit the apoptosis of RGC after optic nerve crush probably through up-regulation of Bcl-2 expression and down-regulation of Bax expression.

[Combining diagnosis of IOFB and complications with multiple image-related methods].

OBJECTIVE: To evaluate the roles of diagnosing intraocular foreign body (IOFB) and their complications with CT, B-scan, X-ray film, MRI and UBM. METHODS: Retrospective study of 103 clinic inpatient cases. RESULTS: CT showing rate was 100% (103/103), CT scan could identify positions of high density IOFB, and define metal or non-metal. But for the size and shape of metal IOFB, the low density IOFB and complications of IOFB, the showing rate was lower. The total showing rate of B-scan for IOFB was 93.2%, but the discovering rates were only 68.7% and 66.7% for anterior segment and retrobulbar IOFB, but the showing rate was high to the vitreous opacity and retinal detachment caused by IOFB. X-ray film can clearly show the size and shape of the metal IOFB. MRI can show the low density IOFB and orbital FB. UBM has a good image for the low density and small IOFB at the anterior segment of globe. CONCLUSION: In the diagnosis and localization of IOFB, CT can well identify the IOFBs and show their relation with globe wall. B-scan can show even more clearly the relation between IOFB and globe wall, and complications of IOFB. X-ray film can distinctly reveal the size and shape of metal IOFB. MRI is good at showing low density, non-magnetic IOFB. UBM is only used in small or low density IOFB at the anterior segment of globe. The combination of multiple image-related methods can provide the required information on diagnosis and surgery design of IOFB.