[Advances in research on the role of immune cells in optic nerve injury].

Optic nerve injury can result in the loss of retinal ganglion cells (RGCs) and their axons, representing a significant cause of irreversible vision impairment. Immune response is a common step following injury, and it often exhibits contrasting effects in optic nerve pathologies. Immune cells play a crucial role in this process, and understanding the differentiation of various immune cells post-injury, mitigating their neurotoxicity, and directing them towards a beneficial outcome for the protection of RGCs and axons are vital for optic nerve preservation. This paper provides a comprehensive review of the research progress on immune cells such as macrophages, microglia, T cells, and others in the field of optic nerve injury. Additionally, discussions include the identification of cell phenotypes and the exploration of the novel concept of innate immunity possibly possessing memory.

[An advanced imaging method for measuring and assessing meibomian glands based on deep learning].

Objective: To evaluate the application value of a deep-learning-based imaging method for rapid measurement and evaluation of meibomian glands. Methods: Diagnostic evaluation study. From January 2017 to December 2018, 2 304 meibomian gland images of 576 dry eye patients who were treated at the Eye Center of Wuhan University People's Hospital with an average age of (40.03±11.46) years were collected to build a meibomian gland image database. These images were labeled by 2 clinicians, and a deep learning algorithm was used to build a model and detect the accuracy of the model in identifying and labeling the meibomian glands and calculating the rate of meibomian gland loss. Mean average precision (mAP) and validation loss were used to assess the accuracy of the model in identifying feature areas. Sixty-four meibomian gland images apart from the database were randomly selected and evaluated by 7 clinicians independently. The results were analyzed with paired t-test. Results: This model marked the meibomian conjunctiva (mAP>0.976, validation loss<0.35) and the meibomian gland (mAP>0.922, validation loss<1.0), respectively, thereby achieving high accuracy to calculate the area and ratio of meibomian gland loss. The proportion of meibomian glands marked by the model was 53.24%±11.09%, and the artificial marking was 52.13%±13.38%. There was no statistically significant difference (t=1.935, P>0.05). In addition, the model took only 0.499 second to evaluate each image, while the average time for clinicians was more than 10 seconds. Conclusion: The deep-learning-based imaging model can improve the accuracy of the examination and save time and be used for clinical auxiliary diagnosis and screening of diseases related to meibomian gland dysfunction.(Chin J Ophthalmol, 2020, 56: 774-779).

Long non-coding RNA GAS5 contributed to the development of glaucoma via regulating the TGF-ß signaling pathway.

OBJECTIVE: We aimed at discussing the biological function of lncRNA GAS5 (Growth Arrest Specific 5) on the proliferative, apoptotic and differentiative abilities of retinal ganglion cells. MATERIALS AND METHODS: GAS5 expression was knocked down by transfection with siRNA targeting GAS5 (siGAS5) in retinal ganglion cells. After transfection, qRT-PCR was utilized to evaluate the mRNA level of GAS5 expression. The protein levels of smad2 and smad3 were detected by Western blot. Proliferative ability was accessed by Cell Counting Kit-8 (CCK-8) assay, and apoptosis and cell cycle changes were tested by flow cytometry. Also, the differentiative ability of RGC-5 cells was evaluated. TGF-ß was exogenously administered to test its function on regulation of GAS5. RESULTS: Knockdown of GAS5 promoted the cell proliferation and differentiation, but negatively regulated cell apoptosis, and had no effect on cell cycle. Exogenous administration of TGF-ß could decrease the expression level of GAS5 in a dose-dependent manner. Meanwhile, lowly expressed GAS5 could improve the phosphorylation of smad2 and smad3. CONCLUSIONS: In our study, we found that down-regulation of lncRNA GAS5 may maintain retinal ganglion cell survival in glaucoma through the activation of TGF-ß pathway to promote cell proliferation and differentiation.

[Expression of erythropoietin in neovascular glaucoma and its role in the angiogenesis in vitro].

Objective: To explore the expression of erythropoietin (EPO) in neovascular glaucoma (NVG) and its role in the angiogenesis in vitro. Methods: The levels of EPO in aqueous humor and vitreous body of NVG patients (10 cases) and non-NVG patients (10 cases) were detected by enzyme-linked immunosorbent assay (ELISA). Human umbilical vein endothelial cells (HUVECs) were used as the research object, and were divided into EPO 0.1, 1, 10 U/ml group according to EPO concentration, on the basis of treatment of HUVECs cells with 10 ng/ml vascular endothelial growth factor (VEGF). Effect of different concentrations of recombinant human EPO and VEGF on the proliferation, angiogenesis and the formation of capillary like structures of HUVECs in vitro was explored, meanwhile, protein and mRNA expression of hypoxia inducible factor-1α (HIF-1α) was detected by Western blot and RT-PCR. Results: In the study, no patients discontinued the trial. EPO level of aqueous humor in non-NVG patients was (29.4±0.6) ng/L, while EPO level in aqueous humor of NVG patients reached (307.5±7.6) ng/L, and the difference was statistically significant (t=2.186, P=0.039); vitreous EPO levels in non-NVG patients was (16.7±1.2) ng/L, while vitreous EPO levels in NVG patients reached (267.5±11.4) ng/L, with a statistically significant difference (t=2.517, P=0.019). Compared with control group, 0.1, 1, 10 U/ml EPO and 10 ng/ml VEGF promoted the proliferation of HUVECs, and formation of vascular lumen-like and capillary-like structure in vitro, and up-regulated the protein and mRNA expression of HIF-1α (all P<0.05). Conclusion: EPO was highly expressed in the NVG patients, and exogenous EPO could significantly promote the proliferation of HUVEC and formation of vascular lumen-like and capillary-like structure, which may be related to up-regulation of HIF-1 expression.

Correlation between serum melatonin and aMT6S level for age-related macular degeneration patients.

OBJECTIVE: To analyze the levels of serum melatonin (MLT) and assay of 6-sulfatoxymelatonin (aMT6S) of age-related macular degeneration (AMD) patients and study their correlation with AMD risk factors. PATIENTS AND METHODS: 58 AMD cases were selected and 58 healthy cases of the same time period were selected according to 1:1 closest matching method. ELISA method was used to test serum MLT and aMT6S level. RESULTS: Levels of MLT and aMT6S in AMD group were lower than those in the control group, and differences were statistically significant (p < 0.05). Based on analysis of AMD subgroup, differences on gender had no statistical significance compared with AMD type. For cases with smoking, cardiovascular disease and corrected visual acuity lower than 0.1, MLT and aMT6S levels were reduced at 0.05). Through the regression analysis, we concluded that smoking history, cardiovascular disease history, best corrected visual acuity, MLT and aMT6S level were independent risk factors, among which MLT [OR = 3.624 (odds ratio: OR)] and aMT6S (OR = 3.201). CONCLUSIONS: MLT and aMT6S may be related to the incidence of AMD.

Cardiac right-to-left shunt subtypes in Chinese patients with cryptogenic strokes: a multicenter case-control study.

BACKGROUND AND PURPOSE: Data on the possible association between cardiac right-to-left shunt (RLS) and cryptogenic stroke are lacking in Asians. RLS and its subtypes in Chinese cryptogenic stroke patients were investigated. METHODS: Patients (n = 153, mean age 42 ± 10 years, 81 male) with cryptogenic stroke from four medical centers in China and 135 healthy volunteers (mean age 34 ± 8 years, 54 male) were recruited. Contrast transcranial Doppler was used to assess the prevalence of RLS. A three-level RLS categorization was applied as follows: none, 0 microbubbles (MBs); small, 1-25 MBs; and large, >25 MBs. RLS was considered latent if it occurred only after the Valsalva maneuver or permanent when it occurred also during normal respiration. RESULTS: Overall, RLS (P = 0.02), large RLS (P < 0.001) and permanent RLS (P = 0.02) were more frequently detected in patients with cryptogenic stroke than in healthy volunteers. The prevalences of small RLS and latent RLS in the two groups were similar (22% vs. 21% and 11% vs. 10%, respectively). The proportion of large RLSs amongst the subjects with RLS was much higher in the patient group than in healthy volunteers (45% vs. 18%, P < 0.001), whilst the proportion of permanent RLS was similar (72% vs. 64%, P = 0.11). Most large RLSs in the patient group (22/27, 81%) were permanent RLSs. CONCLUSIONS: Cardiac RLS is associated with cryptogenic stroke in Chinese. However, the higher prevalence of overall RLS in the patient group was mainly due to the increased proportion of large RLSs. The results only support large RLSs as a pathological condition.

[Efficacy of argon and Nd:YAG laser combined in the treatment of primary chronic closed-angle glaucoma].

22 cases (29 eyes) of primary chronic closed-angle glaucoma were treated with Argon laser gonioplasty (ALG) and Nd:YAG laser iridectomy. Among 8 eyes in which the closed-angle was not opened by ALG, Nd:YAG laser gonioplasty was added, and 6 eyes became successful. For 9 eyes in which the IOP failed to drop inspite of the opened anterior chamber angle, Argon laser trabeculoplasty was added to bring remarkable curative effects to 7 eyes. During a follow-up of 5 to 14 months, 25 eyes (86%) obtained satisfactory results.