Has-miR-199a-3p/RELA/SCD inhibits immune checkpoints in AMD and promotes macrophage-mediated inflammation and pathological angiogenesis through lipid metabolism pathway: A computational analysis.

More and more evidence shows that abnormal lipid metabolism leads to immune system dysfunction in AMD and promotes the occurrence of AMD by changing the homeostasis of ocular inflammation. However, the molecular mechanism underlying the effect of lipid metabolism on the phenotype and function of macrophages is still unclear, and the mechanism of association between AMD and cancer and COVID-19 has not been reported. The purpose of this study is to explore the interaction between lipid metabolism related genes, ferroptosis related genes and immunity in AMD, find out the key genes that affect the ferroptosis of AMD through lipid metabolism pathway and the molecular mechanism that mediates the action of macrophages, and find out the possible mechanism of lipid metabolism and potential co-therapeutic targets between AMD and cancer and COVID-19, so as to improve treatment decision-making and clinical results. For the first time, we have comprehensively analyzed the fatty acid molecule related genes, ferroptosis related genes and immune microenvironment of AMD patients, and determined that mast cells and M1 macrophages are the main causes of AMD inflammation, and found that SCD is the core gene in AMD that inhibits ferroptosis through lipid metabolism pathway, and verified the difference in the expression of SCD in AMD in a separate external data set. Based on the analysis of the mechanism of action of the SCD gene, we found for the first time that Has-miR-199a-3p/RELA/SCD is the core axis of action of lipid metabolism pathway to inhibit the ferroptosis of AMD. By inhibiting the immune checkpoint, we can enhance the immune cell activity of AMD and lead to the transformation of macrophages from M2 to M1, thereby promoting the inflammation and pathological angiogenesis of AMD. At the same time, we found that ACOX2 and PECR, as genes for fatty acid metabolism, may regulate the expression of SCD during the occurrence and development of COVID-19, thus affecting the occurrence and development of AMD. We found that FASD1 may be a key gene for the joint action of AMD and COVID-19, and SCD regulates the immune infiltration of macrophages in glioma and germ line tumors. In conclusion, our results can provide theoretical basis for the pathogenesis of AMD, help guide the treatment of AMD patients and their potentially related diseases and help to design effective drug targets.

Associations between brachial-ankle pulse wave velocity and hypertensive retinopathy in treated hypertensive adults: Results from the China Stroke Primary Prevention Trial (CSPPT).

Although the association between persistent hypertension and the compromise of both micro- and macro-circulatory functions is well recognized, a significant gap in quantitative investigations exploring the interplay between microvascular and macrovascular injuries still exists. In this study, the authors looked into the relationship between brachial-ankle pulse wave velocity (baPWV) and hypertensive retinopathy in treated hypertensive adults. The authors conducted a cross-sectional study of treated hypertensive patients with the last follow-up data from the China Stoke Primary Prevention Trial (CSPPT) in 2013. With the use of PWV/ABI instruments, baPWV was automatically measured. The Keith-Wagener-Barker classification was used to determine the diagnosis of hypertensive retinopathy. The odds ratio (OR) and 95% confidence interval (CI) for the connection between baPWV and hypertensive retinopathy were determined using multivariable logistic regression models. The OR curves were created using a multivariable-adjusted restricted cubic spline model to investigate any potential non-linear dose-response relationships between baPWV and hypertensive retinopathy. A total of 8514 (75.5%) of 11,279 participants were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy increased from the bottom quartile of baPWV to the top quartile: quartile 1: 70.7%, quartile 2: 76.1%, quartile 3: 76.7%, quartile 4: 78.4%. After adjusting for potential confounders, baPWV was positively associated with hypertensive retinopathy (OR = 1.05, 95% CI, 1.03-1.07, p < .001). Compared to those in the lowest baPWV quartile, those in the highest baPWV quartile had an odds ratio for hypertensive retinopathy of 1.61 (OR = 1.61, 95% CI: 1.37-1.89, p < .001). Two-piece-wise logistic regression model demonstrated a nonlinear relationship between baPWV and hypertensive retinopathy with an inflection point of 17.1 m/s above which the effect was saturated .

Predictive visual field outcomes after optic chiasm decompressive surgery by retinal vessels parameters using optical coherence tomography angiography.

AIM: To evaluate the predictive value of superficial retinal capillary plexus (SRCP) and radial peripapillary capillary (RPC) for visual field recovery after optic cross decompression and compare them with peripapillary nerve fiber layer (pRNFL) and ganglion cell complex (GCC). METHODS: This prospective longitudinal observational study included patients with chiasmal compression due to sellar region mass scheduled for decompressive surgery. Generalized estimating equations were used to compare retinal vessel density and retinal layer thickness pre- and post-operatively and with healthy controls. Logistic regression models were used to assess the relationship between preoperative GCC, pRNFL, SRCP, and RPC parameters and visual field recovery after surgery. RESULTS: The study included 43 eyes of 24 patients and 48 eyes of 24 healthy controls. Preoperative RPC and SRCP vessel density and pRNFL and GCC thickness were lower than healthy controls and higher than postoperative values. The best predictive GCC and pRNFL models were based on the superior GCC [area under the curve (AUC)=0.866] and the tempo-inferior pRNFL (AUC=0.824), and the best predictive SRCP and RPC models were based on the nasal SRCP (AUC=0.718) and tempo-inferior RPC (AUC=0.825). There was no statistical difference in the predictive value of the superior GCC, tempo-inferior pRNFL, and tempo-inferior RPC (all P>0.05). CONCLUSION: Compression of the optic chiasm by tumors in the saddle area can reduce retinal thickness and blood perfusion. This reduction persists despite the recovery of the visual field after decompression surgery. GCC, pRNFL, and RPC can be used as sensitive predictors of visual field recovery after decompression surgery.

The correlation of retinal neurodegeneration and brain degeneration in patients with Alzheimer's disease using optical coherence tomography angiography and MRI.

Introduction: Pathological changes in Alzheimer's disease can cause retina and optic nerve degeneration. The retinal changes are correlated with cognitive function. This study aimed to explore the relationship of retinal differences with neuroimaging in patients with Alzheimer's disease, analyze the association of cognitive function with retinal structure and vascular density, and identify potential additional biomarkers for early diagnosis of Alzheimer's disease. Method: We performed magnetic resonance imaging (MRI) scans and neuropsychological assessments in 28 patients with mild Alzheimer's disease and 28 healthy controls. Retinal structure and vascular density were evaluated by optical coherence tomography angiography (OCTA). Furthermore, we analyzed the correlation between neuroimaging and OCTA parameters in patients with mild Alzheimer's disease with adjustment for age, gender, years of education, and hypertension. Results: In patients with mild Alzheimer's disease, OCTA-detected retinal parameters were not significantly correlated with MRI-detected neuroimaging parameters after Bonferroni correction for multiple testing. Under multivariable analysis controlled for age, gender, years of education, and hypertension, the S-Hemi (0-3) sector of macular thickness was significantly associated with Mini-cog (ß = 0.583, P = 0.002) with Bonferroni-corrected threshold at P < 0.003. Conclusion: Our findings suggested decreased macular thickness might be associated with cognitive function in mild AD patients. However, the differences in retinal parameters didn't correspond to MRI-detected parameters in this study. Whether OCTA can be used as a new detection method mirroring MRI for evaluating the effect of neuronal degeneration in patients with mild Alzheimer's disease still needs to be investigated by more rigorous and larger studies in the future.

Positive correlation between hypertensive retinopathy and albuminuria in hypertensive adults.

PURPOSE: We investigated the association between albuminuria and hypertensive retinopathy (HR) in hypertensive adults. METHODS: This was a cross-sectional subgroup analysis of data from the China Stroke Primary Prevention Trial. We enrolled 2,964 hypertensive adults in this study. Keith-Wagener-Barker stages was used to assess HR. The urinary albumin to creatinine ratio (UACR) was calculated to evaluate albuminuria. RESULTS: HR was found in 76.6% (n = 2, 271) of the participants, albuminuria was found in 11.1% (n = 330). The UACR levels were significantly higher in subjects with HR than in those without HR (grade 1, ß = 1.42, 95% confidence intervals [CI]: -0.12, 2.95, p = 0.070; grade 2, ß = 2.62, 95% CI: 0.56, 4.67, p = 0.013; grade 3, ß = 5.17, 95% CI: 1.13, 9.20, p = 0.012). In the subgroup analyses, the association between HR and UACR was stronger in current smokers (p for interaction = 0.014). The correlation between HR grades 1 and 2 and UACR was stronger in subjects with higher triglyceride levels (≥ 1.7 mmol/L), but for grade 3 HR, this correlation was stronger in subjects with lower triglycerides levels (< 1.7 mmol/L, p for interaction = 0.023). The odds of albuminuria were significantly higher in subjects with HR than in those without HR (grade 1, odds ratio [OR] = 1.57, 95% CI: 1.08, 2.29, p = 0.019; grade 2, OR = 2.02, 95% CI: 1.28, 3.18, p = 0.002; grade 3, OR = 2.12, 95% CI: 0.99, 4.55, p = 0.053). In the subgroup analyses, the association between HR grades 1 and 2 and albuminuria was stronger in subjects with higher triglycerides levels (≥ 1.7 mmol/L), but for grade 3 HR, this correlation was stronger in subjects with lower triglyceride levels (< 1.7 mmol/L, p for interaction = 0.014). CONCLUSION: HR was positively correlated with albuminuria in hypertensive Chinese adults. This correlation was more remarkable when the population was stratified by triglycerides levels and smoking status. HR can be used as an indicator of early renal injury.

New Endothelial Corneal Dystrophy in a Chinese Family.

PURPOSE: The aim of this study was to characterize the clinical presentation of atypical endothelial corneal dystrophy (ECD) and to identify possible associated genetic variants in a Chinese family. METHODS: Six affected members, 4 unaffected first-degree relatives, and 3 spouses who were enrolled in this study underwent ophthalmic examinations. Genetic linkage analysis was performed for 4 affected and 2 unaffected members, and whole-exome sequencing (WES) was performed for 2 patients to identify disease-causing variants. Candidate causal variants were verified using Sanger sequencing in family members and 200 healthy controls. RESULTS: The mean age at disease onset was 16.5 years. The early phenotype of this atypical ECD was characterized by multiple small white translucent spots located in Descemet membrane of the peripheral cornea. These spots coalesced to form opacities with variable shapes, and eventually merged along the limbus. Subsequently, translucent spots appeared in central Descemet membrane and accumulated, causing diffuse polymorphous opacities over time. Finally, significant endothelial decompensation led to diffuse corneal edema. A heterozygous missense variant in the KIAA1522 gene (c.1331G>A; p.R444Q) was identified by WES, which was present in all 6 patients but was absent in the unaffected members and healthy controls. CONCLUSIONS: The clinical features of atypical ECD are unique compared with those of known corneal dystrophies. Moreover, genetic analysis identified the c.1331G>A variant in KIAA1522 , which may be responsible for the pathogenesis of this atypical ECD. Thus, we propose this is a new form of ECD based on our clinical findings.

Analysis of Ocular Surface Characteristics and Incidence of Dry Eye Disease in Systemic Lupus Erythematosus Patients Without Secondary Sjögren's Syndrome.

Objective: To investigate the differences in ocular surface characteristics, tear film quality, and the incidence of dry eye disease (DED) between Systemic Lupus Erythematosus (SLE) patients and healthy populations. Methods: This age and gender-matched cross-sectional study included 96 SLE patients without secondary Sjögren's syndrome (SS) and 72 healthy subjects. The Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), non-invasive tear film breakup time (NIKBUT), meibography, and tear film lipid layer grade were assessed. A receiver operative characteristic (ROC) curve was constructed to evaluate the predictive value of risk factors. Results: Compared with the control subjects, a significantly greater proportion of SLE patients met the TFOS DEWS II DED diagnostic criteria (34.3 vs. 18.1%, P = 0.019). SLE patients without SS had higher OSDI scores [10.0 (4.5,18.0) vs. 5.0 (2.5,11.9), P < 0.001], and shorter NIKBUT [9.6 (6.6,15.0) vs. 12.3 (8.4, 15.8), P = 0.035]. Furthermore, TMH, Tear film lipid layer grade, and Meibomian gland (MG) dropout in SLE patients were worse than those in control subjects (all P < 0.05). For ROC analysis, the area under curve (AUC), sensitivity and specificity of prediction were 0.915, 75.8 and 92.1% for the combination of SLE disease activity index (SLEDAI), age and NIKBUT. Conclusions: SLE patients without SS exhibited a higher risk for DED than healthy subjects, and the poorer Meibomian gland function in SLE patients may potentially contribute to the development of DED. The combined parameters of SLEDAI, age and NIKBUT showed a high efficiency for the diagnosis of DED in SLE patients, with practical clinical applications.

Self-Supporting Electrocatalyst Film Based on Self-Assembly of Heterogeneous Bottlebrush and Polyoxometalate for Efficient Hydrogen Evolution Reaction.

Developing efficient electrocatalysts to promote the hydrogen evolution reaction (HER) is essential for a green and sustainable future energy supply. For practical applications, it is a challenge to achieve the self-assembly of electrocatalyst from microscopic to macroscopic scales. Herein, a facile strategy is proposed to fabricate a self-supporting electrocatalyst film (CNT-g-PSSCo/PW12 ) for HER by electrostatic interaction-induced self-assembly of cobalt polystyrene sulfonate-grafted carbon nanotube heterogeneous bottlebrush (CNT-g-PSSCo) and polyoxometalate (PW12 ). Co2+ ions of CNT-g-PSSCo can function as junctions for interconnecting neighboring bottlebrushes to form the 3D nanonetwork structure and enable electrostatic capture of negatively charged PW12 nanodots. Moreover, CNT backbones can provide highly conductive pathways to CNT-g-PSSCo/PW12 . Such a self-assembled CNT-g-PSSCo/PW12 displays a low overpotential of 31 mV at a current density of 10 mA cm-2 and a small Tafel slope of 25 mV dec-1 , showing high efficiency toward HER. Furthermore, CNT-g-PSSCo/PW12 with a stable self-supporting film morphology exhibits long-term electrocatalytic stability over 1000 CV cycles without noticeable overpotential change in acidic media. The findings may provide a new avenue for constructing self-assembled functional nanonetwork materials with well-orchestrated structural hierarchy for many applications in energy, environment, catalysis, medicine, and others.

Evaluation of macular microvasculature and foveal avascular zone in patients with retinal vein occlusion using optical coherence tomography angiography.

PURPOSES: To quantitatively evaluate the vessel density of macular microvasculature, choriocapillary, and foveal avascular zone (FAZ) in both eyes of patients with unilateral retinal vein occlusion (RVO) using the optical coherence tomography angiography (OCTA) compared with the normal controls. METHODS: A retrospective review was conducted on 72 patients with unilateral RVO (72 eyes with RVO and 72 RVO fellow eyes) and 72 healthy individuals (72 normal control eyes). The 3 × 3 mm macular angiogram was acquired using the OCTA. The vessel densities of the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillary plexus (CCP) were measured, and FAZ was quantified. RESULTS: The RVO eyes compared to their fellow eyes, and the fellow eyes compared to the normal controls, showed a significantly lower vessel density in both the SCP and DCP in the whole image and parafovea (P < 0.05) and the CCP (P < 0.05), except for the foveal region (P > 0.05). No significant differences between the RVO eyes and the fellow eyes in the FAZ area and perimeter (P > 0.05) were observed, while the acircularity index in the RVO eyes was significantly higher than the fellow eyes (P < 0.05). Additionally, the FD-300 in the RVO eyes was significantly lower than their fellow eyes (P < 0.05). CONCLUSIONS: The OCTA reveals that the macular microvasculature of the RVO fellow eyes can be impaired in both the superficial and deep retinal layer as well as the choriocapillary, suggesting the influence of systemic factors in the development of RVO.

CoS2 Nanoparticles Embedded in Covalent Organic Polymers as Efficient Electrocatalyst for Oxygen Evolution Reaction with Ultralow Overpotential.

Cobalt disulfide (CoS2 ) has been explored as attractive electrocatalyst for oxygen evolution reaction (OER). However, bulk CoS2 sheets have limited catalytic activity due to low exposure of active sites. Herein, through an in-situ vulcanization approach, CoS2 nanoparticles are embedded into bipyridine-containing covalent organic polymer (BP-COP). The as-prepared nanocomposite CoS2 @BP-COP exhibits high catalytic activity toward OER with an ultra-low overpotential of 270 mV (vs. RHE) at a current density of 10 mA cm-2 , a small Tafel slope of 36 mV dec-1 , and an excellent durability for 24 h without decay. The surface of CoS2 is partially converted into CoOOH to form CoS2 /CoOOH as active sites under OER conditions. CoS2 @BP-COP displays superior OER catalytic activity to CoS2 nanosheets and commercially available RuO2 under the same conditions. The outstanding OER performance activity of CoS2 @BP-COP could be attributed to the uniform and small particle sizes of CoS2 /CoOOH distributed in BP-COP.

Changes of Peripapillary Region Perfusion in Patients with Chiasmal Compression Caused by Sellar Region Mass.

PURPOSE: To evaluate the peripapillary vessel density (pVD) and the peripapillary nerve fiber layer (pRNFL) thickness in patients with chiasmal compression caused by sellar region mass using optical coherence tomography angiography (OCTA). METHODS: This is an observational, cross-sectional study of 31 patients (31 eyes) with chiasmal compression caused by sellar region mass and 34 healthy controls (34 eyes). Automated perimetry and OCTA were performed. The pVD and pRNFL thickness were compared between the two groups. The impact of tumor diameter, duration of symptoms, and cavernous sinus (CS) invasion on visual dysfunction, pVD, and pRNFL thickness was also analyzed. Furthermore, we divided the patients into two subgroups according to whether there was an absolute defect in the central visual field and evaluated their pVD and pRNFL thickness, respectively. RESULTS: Compared to the healthy control group, there was a statistically significant decrease in pVD and pRNFL thickness in patients with chiasmal compression (p < 0.05), especially in patients with substantial absolute defects in the central visual field. Tumor diameter, duration of symptoms, and CS invasion did not appear to be associated with pVD and pRNFL thickness. There was a significant positive correlation between the pVD and pRNFL thickness in patients with chiasmal compression (p < 0.001). CONCLUSION: pVD and pRNFL thickness are significantly decreased in patients with chiasmal compression revealed by OCTA, especially in patients with more severe visual field defects. A significant correlation between pVD and pRNFL thickness was demonstrated, which provides a clue for the study of the mechanism of changes in retinal perfusion in compressive optic neuropathy. It requires considerable attention that OCTA may play an important role in disease monitoring of sellar region mass. Hence, further studies are needed to verify whether OCTA is helpful to predict the prognosis of visual function after decompression surgery.

Hypertensive Retinopathy and the Risk of Stroke Among Hypertensive Adults in China.

Purpose: This study aimed to investigate the association between hypertensive retinopathy and the risk of first stroke, examine possible effect modifiers in hypertensive patients, and test the appropriateness of the Keith-Wagener-Barker (KWB) classification for predicting stroke risk. Methods: In total, 9793 hypertensive participants (3727 males and 6066 females) without stroke history from the China Stroke Primary Prevention Trial were included in this study. The primary outcome was first stroke. Results: Over a median follow-up of 4.4 years, 592 participants experienced their first stroke (509 ischemic, 77 hemorrhagic, and six unclassifiable strokes). In total, 5590 participants were diagnosed with grade 1 retinopathy (57.08%), 1466 with grade 2 retinopathy (14.97%), 231 with grade 3 retinopathy (2.36%), and three with grade 4 retinopathy (0.03%). Grades 1 and 2 were merged and classified as mild retinopathy, and grades 3 and 4 were merged and classified as severe retinopathy. There was a significant positive association between hypertensive retinopathy and the risk of first stroke and first ischemic stroke, and no effect modifiers were found. The hazard ratios (HRs) for first stroke were as follows: mild versus no retinopathy, 1.26 (95% confidence interval [CI], 1.01-1.58, P = 0.040), and severe versus no retinopathy, 2.40 (95% CI, 1.49-3.84, P < 0.001). The HRs for ischemic stroke were as follows: severe versus no retinopathy, 2.35 (95% CI, 1.41-3.90, P = 0.001), and nonsignificantly increased HRs for mild versus no retinopathy, 1.26 (95% CI, 0.99-1.60, P = 0.057). Conclusions: There was a significant positive association between hypertensive retinopathy and the risk of first stroke in patients with hypertension, indicating that hypertensive retinopathy may be a predictor of the risk of stroke. A simplified two-grade classification system based on the KWB classification is recommended for predicting stroke risk.

The Retinal Vessel Density Can Reflect Cognitive Function in Patients with Alzheimer's Disease: Evidence from Optical Coherence Tomography Angiography.

BACKGROUND: There is increasing evidence that Alzheimer's disease (AD) patients may present decreased cerebral blood perfusion before pathological brain changes. Using the retina as a window to the brain, we can study disorders of the central nervous system through the eyes. OBJECTIVE: This study aimed to investigate differences in retinal structure and vessel density (VD) between patients with mild AD and healthy controls (HCs). Furthermore, we explored the relationship between retinal VD and cognitive function. METHODS: We enrolled 37 patients with AD and 29 age-matched HCs who underwent standard ophthalmic optical coherence tomography angiography (OCTA) for evaluation of the retinal layer thickness and VD parameters. Cognitive function was evaluated using a battery of neuropsychological assessments. Finally, the correlations among retinal layer thickness, VD parameters, and cognitive function were evaluated. RESULTS: The retinal fiber layer thickness and retinal VD of patients with AD were significantly reduced compared with HCs. The retinal VD was significantly correlated with overall cognition, memory, executive, and visual-spatial perception functions. However, there was no significant between-group difference in the macular thickness. CONCLUSION: Our findings indicate a positive correlation between retinal VD and some, but not all, cognitive function domains. Most importantly, we demonstrated the role of OCTA in detecting early capillary changes, which could be a noninvasive biomarker for early AD.

Analysis of Foveal Microvascular Abnormalities in Patients with Systemic Lupus Erythematosus Using Optical Coherence Tomography Angiography.

Purpose: To analyze the abnormalities of foveal microvasculature in patients with systemic lupus erythematosus (SLE).Methods: A cross-sectional study of 41 eyes of patients diagnosed with SLE and 40 eyes of healthy controls. Sections measuring 6 mm×6 mm centered on the fovea were obtained using optical coherence tomography angiography (OCTA).Results: The area and perimeter of foveal avascular zone (FAZ) in SLE patients were greater than those in controls (both p < .05). The parafoveal vessel densities in the deep capillary plexus (DCP) of SLE patients were significantly decreased than those in controls (p < .001). There was a negative correlation between SLE disease activity index and parafoveal vessel density in DCP (p < .05).Conclusion: Enlargement of the FAZ and decline of the parafoveal vessel density of DCP were revealed by OCTA in patients with SLE. Moreover, a negative correlation between parafoveal vessel density in DCP and disease activity index was detected in SLE patients.

Positive relationship of hypertensive retinopathy with carotid intima--media thickness in hypertensive patients.

OBJECTIVES: We aimed to explore the relationship of hypertensive retinopathy with carotid intima--media thickness (CIMT), and to examine the possible effect modifiers in Chinese adults with hypertension. METHODS: We conducted a cross-sectional study of 12 342 hypertensive patients with complete exit site visit data from the China Stroke Primary Prevention Trial. CIMT was measured by carotid ultrasonography. Hypertensive retinopathy was diagnosed according to the Keith--Wagener--Barker classification. RESULTS: The mean (SD) CIMT among study participants was 739.9 (111.4) µm. Compared with patients with grade 1 hypertensive retinopathy or without hypertensive retinopathy, a significantly higher CIMT level (ß, 7.63, 95% CI: 2.54--12.73) was observed in patients with grade 2-4 hypertensive retinopathy. Moreover, the association between hypertensive retinopathy (grade 2-4 versus grade 1 or normal) and CIMT was stronger in participants of younger age (<60 years; ß, 13.70, 95% CI: 5.65--21.75; versus ≥60 years; ß, 1.03, 95% CI: -5.58 to 7.63; P interaction = 0.006); or with lower total homocysteine levels [<12.1 µmol/l (median); ß, 12.70, 95% CI: 5.98--19.42; versus ≥12.1 µmol/l; ß, 2.07, 95% CI: -5.63 to 9.78; P interaction = 0.030). None of the other variables, including sex, BMI, study centers, treatment group, SBP, triglycerides, total cholesterol, fasting blood glucose, folate, serum creatinine, current smoking and alcohol drinking, significantly modified the relation of hypertensive retinopathy with CIMT levels. CONCLUSION: Hypertensive retinopathy (grade 2 and higher) was significantly associated with increased CIMT in hypertensive patients. The association was stronger in those of younger age or with lower total homocysteine levels.

Outcomes of 1.8-3.0 mm incision phacoemulsification combined with trabeculectomy for primary angle-closure glaucoma with cataract.

AIM: To compare efficacy of coaxial microincisions (1.8 mm, 2.2 mm) and small incisions (3.0 mm) on phacoemulsification combined with trabeculectomy for primary angle-closure glaucoma (PACG) with cataract. METHODS: Ninety-six patients (96 eyes) with PACG and cataract were recruited and randomly divided into three groups between January 2015 and June 2017. Group A (3.0 mm incision), B (2.2 mm incision), and C (1.8 mm incision) comprised 30, 34 and 32 eyes respectively. All cases were treated with clear corneal incision phacoemulsification combined with trabeculectomy. Data including best corrected visual acuity (BCVA), corneal astigmatism, corneal endothelial cell counts (CECC), intraocular pressure (IOP), and complications were collected before the operation, and at postoperative 1d, 1 and 3mo. RESULTS: All the patients were successfully treated with surgery. The BCVA of groups B and C were significantly improved as compared to group A at postoperative 1d, 1 and 3mo (all P<0.05), but there was no difference between groups B and C at each time interval (all P>0.05). The corneal astigmatism of group A was statistically higher than that of group B (P=0.026); corneal astigmatism of group B was statistically higher than that of group C at postoperative 1d (P=0.006). The corneal astigmatism of group A at postoperative 3mo was significantly higher than that before operation (P=0.003). At postoperative 1 and 3mo, corneal astigmatism of groups B and C were significantly lower than that of group A (all P<0.05). The CECC in group B was significantly higher than that of group A (P=0.020), and CECC in group C was significantly higher than that of group B (P=0.034) at postoperative 1d. At postoperative 1 and 3mo, CECC of groups B and C were significantly higher than that of group A (all P<0.05). In each group, postoperative mean IOP at each time interval was significantly lower than preoperative IOP (all P<0.05). CONCLUSION: Coaxial microincision phacoemulsification combined with trabeculectomy for PACG with cataract has better curative efficacy in reducing postoperative corneal astigmatism and corneal endothelial cell injury than traditional small incision combined surgery, and the 1.8 mm microincision has better curative efficacy than 2.2 mm microincision in the early postoperative period.

MiRNA-155-5p Reduces Corneal Epithelial Permeability by Remodeling Epithelial Tight Junctions during Corneal Wound Healing.

PURPOSE: Corneal epithelial cells play a vital role in the function of the cornea by forming a physical barrier to protect the eye from invasion by external pathogenic agents. A recent study showed that miR-155 promotes cutaneous wound healing. However, its function in corneal epithelial wound healing is unknown. The present study examined whether miR-155-5p reduces corneal epithelial permeability by remodeling epithelial tight junctions during corneal wound healing. MATERIALS AND METHODS: Rat corneal wounds were produced by removing the central corneal epithelium with a blunt scalpel blade under a dissecting microscope. One eye of each rat was treated with topical miR-155-5p, and the other eye was treated with topical agomir negative control for 3 days before and after corneal epithelial wounding. Corneal epithelial permeability was assessed by the macromolecular osmosis method. Expression of zona occludens 1 (ZO-1), occludin, and myosin light chain kinase (MLCK) and phosphorylation of myosin light chain (MLC) were detected by Western blot. Human corneal epithelial (HCE) cells were cultured in the upper chamber of Transwell filters, and transepithelial electrical resistance (TER) was measured using a voltohmmeter. The distribution of ZO-1 and occludin in HCE cells treated with miR-155-5p was determined by immunofluorescence. RESULTS: miR-155-5p significantly promoted the repair of corneal epithelial injury and reduced the permeability of the corneal epithelium. It significantly decreased expression of MLCK and phosphorylation of MLC and increased expression of the tight junction proteins ZO-1 and occludin in corneal epithelial cells during corneal wound healing. miR-155-5p significantly increased TER, decreased MLCK expression and MLC phosphorylation, increased ZO-1 and occludin expression, and promoted anchoring of tight junction proteins in the cell membrane and remodeling in HEC cells. CONCLUSIONS: Our results suggest that miR-155-5p reduced corneal permeability and accelerated the recovery of corneal epithelial wounds by decreasing the expression of MLCK and phosphorylation of MLC and by remodeling tight junctions.

Dry Eye Indexes Estimated by Keratograph 5M of Systemic Lupus Erythematosus Patients without Secondary Sjögren's Syndrome Correlate with Lupus Activity.

PURPOSE: To investigate the incidence, severity, and influencing factors of dry eye in systemic lupus erythematosus (SLE) patients without secondary Sjögren's syndrome (sSS). METHODS: A total of 78 patients who were diagnosed with systemic lupus erythematosus and met inclusion criteria were selected as the study subjects in this cross-sectional study. Tear meniscus height (TMH) and noninvasive Keratograph tear breakup time (NIKBUT) including NIKBUT-first and NIKBUT-average of the subjects were measured using a noninvasive ocular analyzer, the Keratograph 5M (Oculus, Wetzlar, Germany). Symptoms related to dry eye were assessed using the Ocular Surface Disease Index (OSDI). The severity of SLE was evaluated by Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). Results of the levels of 4 serum antibodies were collected from the patients' medical records. Correlations between SLEDAI and various ocular surface parameters were analyzed, and multiple-factor binary logistic regression analysis was conducted. RESULTS: In the study subjects, mean TMH was 0.22 mm, mean NIKBUT-first was 9.12 s, and mean OSDI was 13.14. The subjects (19 eyes) whose NIKBUT-average was < 10 s and OSDI was ≥ 13 accounted for 24.36% of all the included patients. SLEDAI showed a statistically significant correlation with TMH (r = -0.233, p=0.040), NIKBUT-first (r = -0.254, p=0.025), NIKBUT-average (r = -0.343, p=0.002), and OSDI (r = 0.256, p=0.024). According to multiple-factor binary logistic regression analysis, SLEDAI could be considered as a risk factor of the incidence of dry eye in SLE patients without sSS. CONCLUSIONS: One-fourth of the SLE patients without sSS suffered from dry eye, and the severity of dry eye correlated with the activity of SLE.