The effect of the back optic zone diameter on the treatment zone area and axial elongation in orthokeratology.

PURPOSE: To investigate the influence of corneal parameters on the treatment zone area (TZA) after Corneal Refractive Therapy (CRT) with a 5.0-mm back optical zone diameter (BOZD) were worn and to compare changes in the axial length (AL) with traditional 6.0-mm BOZD lenses. METHODS: This retrospective study involved 146 subjects (7-12 years) who wore orthokeratology (ortho-K) lenses for one year: 86 subjects were treated with CRT 5.0-mm lenses, and 60 subjects were treated with CRT 6.0-mm lenses. The TZA was measured after one year of ortho-K treatment. Both TZA and AL elongation after wearing the two kinds of lenses was compared. The parameters were recorded in the CRT 5.0 group: flat K, steep K, corneal toricity, e value, and anterior corneal elevation values at the 3-, 4-, and 5-mm chords along the principal meridians of the superior, inferior, nasal, and temporal sides. The relationships between these data and the TZA were analyzed. RESULTS: The TZA was 12.90 ± 5.15 mm2 and 20.61 ± 4.54 mm2, and the AL elongation was 0.15 ± 0.18 mm and 0.26 ± 0.18 mm in the CRT 5.0 group and the CRT 6.0 group, respectively (all p < 0.001). The one-year AL elongation was significantly associated with initial age and the TZA (r =  - 0.394, 0.393; all p < 0.001) in the CRT 5.0 group. The following corneal parameters were found to have statistically significant correlations with the TZA: the e value, difference in corneal elevation (nasal-temporal at the 3-, 4-, and 5-mm chord), and the absolute value of elevation difference (nasal-temporal at the 3- and 4-mm chord and inferior-superior at the 3-, 4-, and 5-mm chord). The e value was the only relevant factor for the TZA by multiple regression analysis (unstandardized ß = 14.219, p = 0.008). In the CRT 6.0 group, the one-year AL elongation was statistically significantly associated only with initial age (r =  - 0.605, p = 0.005), but not with the TZA (p = 0.161). CONCLUSIONS: A smaller TZA induced by a smaller BOZD may be beneficial for retarding AL elongation in children undergoing ortho-K treatment. The morphology and eccentricity of the cornea may show effects on the TZA.

Different efficacy in myopia control: Comparison between orthokeratology and defocus-incorporated multiple segment lenses.

PURPOSE: To compare the efficiency of orthokeratology (OK) and defocus-incorporated multiple segment (DIMS) lenses in myopia control in children. METHODS: This prospective study involved 540 subjects (7-14 years) categorized into three groups: DIMS lenses (180 cases), OK lenses (180 cases), or single-vision spectacles (SVS) (180 cases). After a one-year follow-up, changes in axial length (AL) and differences among the groups were analyzed. The subjects were further divided into a low myopia degree subgroup (LM, -1.50 D ≤ SE ≤ -0.50 D), a moderate myopia degree subgroup (MM, -3.00 D ≤ SE ＜ -1.50 D), and a high myopia degree subgroup (HM, -5.00 D ≤ SE ＜ -3.00 D). A one-way ANOVA and multiple linear regression analysis were used to compare AL elongation and the factors influencing the different groups. RESULTS: A total of 496 (92 %) subjects completed the study. The mean AL change in the OK lenses, DIMS lenses, and SVS were 0.20±0.18 mm, 0.30±0.22 mm, and 0.38±0.19 mm, respectively (P < 0.001). In the LM subgroup, the OK and DIMS groups showed similar AL changes, but both exhibited slower changes than the SVS group (P = 0.001). In the MM and HM subgroups, the OK lens performed the shortest AL elongation compared with the DIMS lenses and SVS (P < 0.001). Multiple regression analysis showed that the AL change was associated with age (ß = -0.038 and P = 0.005), initial AL (ß = -0.010 and P = 0.011), initial SE (ß = 0.028 and P = 0.007), and interventions using OK lenses (ß = -0.172 and P = 0.020) and DIMS lenses (ß = -0.089 and P = 0.020). CONCLUSION: Over a one-year treatment period, OK and DIMS lenses can significantly retard AL elongation compared with SVS. In addition, the OK lenses were more effective than the DIMS lenses in controlling AL in patients with higher degrees of myopia.

The Influence of Accommodation on Retinal Peripheral Refraction Changes in Different Measurement Areas.

Background: The change in refraction caused by accommodation inevitably affects the peripheral defocus state and thus may influence the effect of retinal peripheral myopic defocus measures in myopia control. This study investigated accommodation changes in different peripheral retinas under cycloplegia to help improve myopia control. Methods: Fifty-six eyes of fifty-six myopic subjects were recruited for this prospective study. The center and peripheral retina refractions were measured using multispectral refractive topography. The subjects were divided into low-to-moderate myopia group (range: -1.25 D to -6.00 D) and high myopia group (range: -6.25 D to -9.75 D) according to spherical equivalent (SE). The compound tropicamide (0.5% tropicamide and 0.5% phenylephrine) was used to relax the accommodation. The difference between cycloplegia and non-cycloplegia peripheral retinal refraction was analyzed using the t-test. The correlation between eccentricity and changes in peripheral refraction was analyzed using Pearson's correlation analysis. Results: The manifest refraction of the retina significantly decreased with an increase in eccentricity after cycloplegia. The annular refraction difference value at 50°-53° (ARDV 50-53) showed the largest refraction decrease of 1.31 D compared with the central retinal refraction decrease of 0.84 D. The inferior quadrantal refraction difference value had the least change compared to the other quadrants. The relative peripheral refraction (RPR) changes in refraction difference value (RDV) at 15° (RDV-15), RDV-30, and RDV-45 were less than 0.15 D. When the range of annulus narrowed to 5°, the narrower annulus showed faster change with eccentricity increase in ARDV 30-35, ARDV 35-40, ARDV 40-45, ARDV 45-50, and ARDV 50-53. The RPR was highly correlated with eccentricity (R = 0.938 and P < 0.001). The high myopia group had a greater hyperopic shift in the periphery than the low-to-moderate group after cycloplegia. Conclusions: Peripheral refraction showed a significant hyperopic shift after cycloplegia with an increase in eccentricity. The RPR became more hyperopic than the central refraction. The high myopia group showed more hyperopic shifts in the peripheral region. Accommodation should be taken into consideration in peripheral defocus treatment.

Effects of Orthokeratology Lens Decentration Induced by Paracentral Corneal Asymmetry on Axial Length Elongation.

BACKGROUND: To determine the influence of the magnitude of treatment zone decentration on axial length (AL) elongation and to investigate the association between paracentral corneal asymmetry and orthokeratology (OK) lens decentration. METHODS: This retrospective study involved 268 subjects (7-14 years) who wore OK lenses for one year. The parameters that reflected the paracentral corneal asymmetry were recorded: corneal toricity; Q value; anterior corneal curvature; and elevation values at the 6-, 7-, and 8-mm chords along the horizontal meridian. The relationships between these data and the amount of treatment zone decentration were analyzed. The relationship of the decentration magnitude and AL elongation was also analyzed. RESULTS: AL elongation was significantly associated with initial age, baseline spherical equivalent, AL, and the decentration magnitude. The subjects with large decentration magnitude showed less AL elongation. The decentration was affected by corneal morphology at the 8-mm chord on the nasal side. In the low curvature group (≤41.0D), the decentration magnitude had a stronger correlation with AL elongation than in all subjects. In the high curvature group (>41.0D), the decentration magnitude was no longer correlated with the AL elongation. CONCLUSION: The decentration of the OK lens effectively slowed the elongation of the eyeball. When the nasal curvature was less than 41.0 D at the 8-mm chord, the magnitude of decentration was predetermined by the flatter curve.

Repeatability and correlation of corneal biomechanical measurements obtained by Corvis ST in orthokeratology patients.

PURPOSE: To evaluate the repeatability of the corneal biomechanical measurements obtained by Corvis ST in post-orthokeratology patients and analyze the correlation between the biomechanical and ocular parameters. METHODS: Fifty-one eyes of 51 myopic subjects were included in this study. The biomechanical parameters were assessed using Corvis ST. Repeatability was assessed using one-way ANOVA based on within-subject standard deviation (Sw), repeatability coefficient (RC), intraclass correlation coefficient (ICC) and correlation of variation (CoV). The correlation was evaluated using Pearson correlation analysis. RESULTS: All parameters measured by Corvis ST, except length of flattened cornea at the first and second applanations (A1L and A2L), showed a good intraobserver repeatability after a 3-month follow-up period. The ICC values for A1L and A2L were 0.444 and 0.654, whereas the other parameters were higher than 0.8. Similar trends were obtained for CoV, wherein the CoV values for A1L and A2L were greater than 13 %. The corneal biomechanical parameters were correlated with age, refraction, axial length (AL), steep and flat keratometry before and after orthokeratology, and central corneal thickness (CCT). Following orthokeratology treatment, post-keratometry demonstrated a higher correlation with stiffness parameter at first applanation (SP-A1), velocity of corneal apex at the first applanation (A1V), and radius than pre-keratometry, which showed a weak correlation with SP-A1. CONCLUSION: Corneal biomechanical parameters assessed using Corvis ST demonstrated a good repeatability, except A1L and A2L. The corneal biomechanical parameters were correlated with age, refraction, AL and pre- and post-keratometry. Thus, Corvis ST is a suitable device for investigating biomechanical parameter.

Spatial and Temporal Persistence of Fluorescent Lactiplantibacillus plantarum RS-09 in Intestinal Tract.

The beneficial effects of the probiotic strain Lactiplantibacillus plantarum (formerly Lactobacillus plantarum) are based on its adherence and colonization ability in the gut. However, little is known about the migration and long-term gut colonization of the strain. This study evaluated the gut colonization modes of Lactiplantibacillus plantarum RS-09 to identify the strain with long-term gut colonization potential. We established CFDA/SE-labeled RS-09 to study the temporal and spatial distribution of RS-09 in the intestine as well as to analyze its persistence in different parts of the intestine by flow cytometry. This study has shown that the RS-09 strain maintains strong adhesion abilities under acid (pH 2.5) and base (pH 8.5) conditions. In addition, CFDA/SE can be used as an indicator for the labeling of L. plantarum RS-09 in the intestinal tract in vivo. We established a growth kinetics model of RS-09 to elucidate its persistence in the intestine. In vivo persistence experiments showed that the persistence rate of RS-09 was the highest in the cecum (69.5%) and the lowest in the duodenum (12.8%) at 96 h. After 20 days, RS-09 was predominantly localized in the cecum and colon steadily. These studies provide new insights into the long-term persistence of L. plantarum in the gastrointestinal tract. The CFDA/SE label system may be used to study the in vivo colonization dynamics of other probiotic strains.

Lactobacillus plantarum RS-09 Induces M1-Type Macrophage Immunity Against Salmonella Typhimurium Challenge via the TLR2/NF-κB Signalling Pathway.

Lactobacillus plantarum can interact with macrophages against bacterial enteropathy due to its potential ability to modulate macrophage polarization. However, this mechanism is not completely understood. TLR2 can recognize microbial components and trigger macrophage cytokine responses to different gram-positive strains. The aim of this study was to investigate whether probiotic Lactobacillus plantarum RS-09 can induce macrophage polarization against Salmonella Typhimurium infection via TLR2 signalling. BALB/c mice were preadministered RS-09 continuously for 7 days and then infected with Salmonella Typhimurium ATCC14028. Mouse RAW264.7 mononuclear macrophages were stimulated with RS-09 and coincubated with ATCC14028 or PBS controls. The results of the in vivo study indicated that RS-09 could relieve S. Typhimurium-induced splenomegaly, body weight loss and death rate. RS-09 also limited the colonization and translocation of S. Typhimurium in the gastrointestinal tract and thereby protected against infection. We also observed that RS-09 upregulated the production of M1 macrophage characteristics (e.g., CD11c and IL-6) against S. Typhimurium. Furthermore, RS-09 induced the expression of TLR2 in macrophages. In an in vitro study, treatment of RAW264.7 cells with RS-09 either concurrently with or before S. Typhimurium challenge enhanced the secretion of Reactive oxygen species and Nitric oxide. This effect was related to TLR2 and NF-κB activation. Based on these findings, Lactobacillus plantarum RS-09 was shown to modulate M1 macrophage polarization and induce TLR2-linked NF-κB signalling activity in the innate immune response to S. Typhimurium infection.

Metagenome Sequencing Reveals the Midgut Microbiota Makeup of Culex pipiens quinquefasciatus and Its Possible Relationship With Insecticide Resistance.

Midgut microbiota can participate in the detoxification and metabolism processes in insects, but there are few reports on the relationship between midgut microbiota and insecticide resistance in mosquitoes. In this study, we performed metagenomic sequencing on a susceptible strain (SS), a field-collected Hainan strain (HN), and a deltamethrin-resistant strain (RR) of Culex pipiens quinquefasciatus to understand the diversity and functions of their midgut microbiota. The results revealed differences in midgut microbiota among the three strains of Cx. pipiens quinquefasciatus. At the phylum level, Proteobacteria was the most prominent, accounting for nearly 70% of their midgut microbes. At the genus level, Aeromonas made up the highest proportion. In addition, Aeromonas, Morganella, Elizabethkingia, Enterobacter, Cedecea, and Thorsellia showed significant differences between strains. At the species level, Bacillus cereus, Enterobacter cloacae complex sp. 4DZ3-17B2, Streptomyces sp. CNQ329, and some species of Pseudomonas and Wolbachia were more abundant in the two resistant strains. Principal component analysis (PCA) showed that the SS strain had significantly different metagenomic functions than the two deltamethrin-resistant strains (HN and RR strain). The HN and RR strains differed from the SS strain in more than 10 Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. The analysis of species abundance and functional diversity can provide directions for future studies.