Male reproductive function before and after the adjustment of the COVID-19 prevention policy: a multicenter study in China.

At the end of 2022, the adjustment of the coronavirus disease 2019 (COVID-19) pandemic control policy in China resulted in a large-scale increase in public infection. To compare the fertility parameters of male patients before and after the adjustments of the COVID-19 pandemic control policy in China, we collected data on patients' medical histories and laboratory examinations on their first visits between June 2022 and March 2023 in five different hospitals. Data were divided into five groups according to the timeline of the policy adjustment. The data we collected from male patients included semen quality and serum reproductive hormone levels, and intergroup comparisons were made using the Mann-Whitney U and Chi-square tests. In total, 16 784 cases underwent regular semen analysis, 11 180 had sperm morphology assessments, and 7200 had reproductive hormone analyses. The data showed declining trends in semen volume, sperm motility, and the progressive sperm motility rate after the policy adjustment. Subgroup comparison revealed an initial decrease and gradual recovery in progressive motility rate. Sperm morphology analysis showed increased neck and tail abnormalities after the policy adjustment. No significant change in hormone levels was observed. Following the adjustment of the COVID-19 prevention policy in China, a decline in sperm motility and morphology was observed. This trend may gradually recover over 2 months. After the policy adjustment, reproductive hormone levels were relatively stable throughout, except for an increase in luteinizing hormone (LH). These changes in semen parameters suggest that the policy adjustment had a short- to medium-term impact on male reproductive function.

Association between Fundus Tessellation and Contrast Sensitivity in Myopic Eyes.

PURPOSE: To assess the association of fundus tessellation with contrast sensitivity, Quality of Vision questionnaire, and other factors at five years postcorneal refractive surgery. METHODS: This is a cross-sectional study. Both eyes of 98 subjects (196 eyes) who received femtosecond laser in situ keratomileusis (FS-LASIK) or small incision lenticular extraction (SMILE) five years prior were enrolled in this study. Fundus tessellation was imaged using wide-angle fundus photographs and graded into four categories with the assistance of the ETDRS grid. Photopic and mesopic contrast sensitivity were measured under the best correction. The Quality of Vision (QoV) questionnaire was used to assess visual symptoms. RESULTS: Fundus tessellation was classified as follows: 19 eyes were grade 0 (9.7%), 28 eyes were grade 1 (14.3%), 59 eyes were grade 2 (30.1%), and 90 eyes were grade 3 (45.9%). Higher degrees of fundus tessellation were associated with lower photopic contrast sensitivity, a significant difference was observed at spatial frequencies of 6cpd (p = 0.030, grade 1 >grade 3 p = 0.011). Higher degrees of fundus tessellation were also associated with lower mesopic contrast sensitivity, a significant difference was observed at spatial frequencies of 18cpd (p = 0.011, grade 0 >grade 3 p = 0.012). The preoperative degree of myopia was positively associated with fundus tessellation grade (p < 0.001). However, in linear mixed-effect model analysis, no significant influence of parameters (contrast sensitivity, preoperative myopia, and QoV scores) upon different tessellation grades was found (p > 0.05). CONCLUSIONS: Patients with moderate and high myopia were more likely to have higher grades of fundus tessellation. Higher degree of fundus tessellation associates with lower contrast sensitivity. Patients with moderate and high myopia should be concerned with retinal-choroidal changes. Contrast sensitivity could be a clinical sign for progression of tessellation and used to screen for early retinal-choroidal changes to prevent pathologic myopia.

Nitro-oleic acid ameliorates erectile dysfunction in a streptozotocin-induced rat model of diabetes by inhibiting oxidative stress and apoptosis and activating the NO/cGMP pathway.

The major vascular complications associated with diabetes make the management of diabetic mellitus erectile dysfunction (DMED) a challenging endeavor. Notable factors contributing to DMED include oxidative stress, nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway activation, and apoptosis, while nitro-oleic acid (NO2-OA) has been shown to be beneficial in treating these aspects of this condition. We, herein, investigated the effects and possible mechanisms of NO2-OA on erectile function as assessed in a streptozotocin-induced rat model of diabetes. Our results revealed that the erectile function of DMED rats was significantly impaired compared with that of the control group. However, in response to 4 weeks of NO2-OA treatment, there was an improvement in erectile function. The expression of oxidative stress-related indicators was significantly increased and the NO/cGMP pathway was impaired in the DMED group. The expression of proapoptotic factors was increased, while that of antiapoptotic factors was decreased in the DMED group. Moreover, the cell morphology in the cavernous tissue of the DMED group also changed adversely. NO2-OA treatment significantly reversed all these changes observed in the DMED group. In conclusion, NO2-OA treatment partially improved erectile function in DMED rats through mechanisms that included inhibition of oxidative stress, activation of the NO/cGMP pathway, and a reduction in apoptosis.

Multispectral imaging: Review of current applications.

Multispectral imaging (MSI) is a unique layer-by-layer imaging technique that allows the visualization of a wide array of retinal and choroidal pathologies including retinovascular disorders, retinal pigment epithelial changes, and choroidal lesions. Herein, we summarize the basic imaging principles and current applications of MSI together with recent technology advances in the field. MSI detects reflectance signal from both normal chorioretinal tissue and pathological lesions. Either hyperreflectance or hyporeflectance reveals the absorption activity of pigments such as hemoglobin and melanin and the reflection from interfaces such as the posterior hyaloid. Advances in MSI technique include creation of a retinal and choroidal oxy-deoxy map that could provide a better understanding of blood oxygen saturation within lesions as well as better interpretation of reflectance phenomenon of MSI images such as the different reflectance from the Sattler and Haller layers described in this review.

Retinal honeycomb appearance and its role in patients with X-linked retinoschisis.

BACKGROUND: To investigate the clinical characteristics of retinal honeycomb appearance in a large cohort of patients with X-linked retinoschisis (XLRS) and to determine whether it is associated with complications like retinal detachment (RD) and vitreous hemorrhage (VH). METHODS: A retrospective observational case series. A chart review of medical records, wide-field fundus imaging, and optical coherence tomography (OCT) was performed on 78 patients (153 eyes) diagnosed with XLRS at Beijing Tongren eye center between Dec 2017 and Feb 2022. The chi-square test or Fisher exact test was performed on the 2 × 2 cross-tabulations of honeycomb appearance and other peripheral retinal findings and complications. RESULTS: Thirty-eight patients (48.7%), and 60 eyes (39.2%) had a honeycomb appearance of different areas on the fundus. The supratemporal quadrant was the most commonly affected (45 eyes, 75.0%), followed by the infratemporal (23 eyes, 38.3%), the infranasal (10 eyes,16.7%), and supranasal (9 eyes,15.0%). The appearance was significantly associated with peripheral retinoschisis, inner retinal layer break, outer retinal layer break, RD, and rhegmatogenous retinal detachment (RRD) (p < 0.01, p = 0.032, p < 0.01, p = 0.008, p < 0.01, respectively). All the eyes complicated with RRD had the appearance. None of the eyes without the appearance had RRD. CONCLUSIONS: The data suggest that the honeycomb appearance is not uncommon in patients with XLRS and is more likely to be accompanied by an RRD, and inner and outer layer breaks, thus should be treated with caution and close observation.

Different Morphology of Branching Neovascular Network in Polypoidal Choroidal Vasculopathy: A Swept-Source Optical Coherence Tomography Angiography Study.

Purpose: To evaluate the classification system of branching neovascular network (BNN) morphology in polypoidal choroidal vasculopathy (PCV) patients based on swept-source optical coherence tomography (SS-OCT) and swept-source optical coherence tomography angiography (SS-OCTA), and analyze the morphological features in each group as potential prognostic features. Methods: A total of 32 PCV eyes were included in this retrospective study. SS-OCT and SS-OCTA images of 6 mm × 6 mm centered on the foveal of each eye were analyzed. PCV cases were classified into three types ("trunk", "glomeruli", and "stick" type) based on the morphological features of BNN. OCT and OCTA features were compared among the three groups. The correlation of OCT/OCTA features with visual acuity at 12 months after anti-VEGF treatment was also analyzed. Results: Type 1 group had the largest BNN area and the largest numbers of polypoidal lesions. Type 2 group has the largest pigment epithelial detachment (PED) area, PED volume, subretinal fluid (SRF) area, and SRF volume. Type 3 group had better baseline BCVA, the smallest BNN area, the smallest PED size, and the smallest SRF size. Type 1 was also featured by a clear break on Bruch's membrane which corresponded to the origin of neovascular tissue. BCVA at 12 months was not significantly different among groups. Baseline BCVA and baseline central macular thickness were correlated with the final BCVA. Conclusions: The current classification system based on BNN morphology on SS-OCTA was highly applicable and revealed distinct characteristics in each group. The BNN type was not correlated with BCVA at 12 months after treatment.

Does ICSI outcome in obstructive azoospermia differ according to the origin of retrieved spermatozoa or the cause of epididymal obstruction? A comparative study.

PURPOSE: To determine whether ICSI outcomes are affected by sperm source or genital tract inflammatory status. METHODS: A retrospective cohort study was conducted in all consecutive obstructive azoospermia patients who underwent testicular sperm aspiration (TESA) or percutaneous epididymal sperm aspiration (PESA) and ICSI between February 1, 2017, and December 31, 2020. Couples were excluded if they were diagnosed with monogenic disease, abnormal karyotype, or had female uterine malformation. The primary objective was to determine whether ICSI outcomes are affected by the use of testicular or epididymal spermatozoa, and the secondary objective was to explore the effect of granulocyte elastase on ICSI outcomes using epididymal spermatozoa. RESULTS: Compared with TESA, inflammatory and non-inflammatory PESA patients exhibited a better high-quality embryo rate, with significant differences among the three groups (49.43 vs. 55.39% and 56.03%; odds ratio, 6.345 and 6.631; 95% confidence interval, 0.340-12.350, and 1.712-11.550; P = 0.038 and P = 0.008, respectively). The fertilization rate, clinical pregnancy rate, live birth delivery rate, and congenital anomaly birth rate were similar in patients who underwent TESA or PESA (with or without inflammation). CONCLUSIONS: The high-quality embryo rate in PESA patients was higher than that in TESA patients. After successful pregnancy, ICSI outcomes did not differ between patients with obstructive azoospermia who experienced TESA or PESA and those with or without genital tract inflammation.

Validating automated eye disease screening AI algorithm in community and in-hospital scenarios.

Purpose: To assess the accuracy and robustness of the AI algorithm for detecting referable diabetic retinopathy (RDR), referable macular diseases (RMD), and glaucoma suspect (GCS) from fundus images in community and in-hospital screening scenarios. Methods: We collected two color fundus image datasets, namely, PUMCH (556 images, 166 subjects, and four camera models) and NSDE (534 images, 134 subjects, and two camera models). The AI algorithm generates the screening report after taking fundus images. The images were labeled as RDR, RMD, GCS, or none of the three by 3 licensed ophthalmologists. The resulting labels were treated as "ground truth" and then were used to compare against the AI screening reports to validate the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of the AI algorithm. Results: On the PUMCH dataset, regarding the prediction of RDR, the AI algorithm achieved overall results of 0.950 ± 0.058, 0.963 ± 0.024, and 0.954 ± 0.049 on sensitivity, specificity, and AUC, respectively. For RMD, the overall results are 0.919 ± 0.073, 0.929 ± 0.039, and 0.974 ± 0.009. For GCS, the overall results are 0.950 ± 0.059, 0.946 ± 0.016, and 0.976 ± 0.025. Conclusion: The AI algorithm can work robustly with various fundus camera models and achieve high accuracies for detecting RDR, RMD, and GCS.

An Artificial-Intelligence-Based Automated Grading and Lesions Segmentation System for Myopic Maculopathy Based on Color Fundus Photographs.

Purpose: To develop deep learning models based on color fundus photographs that can automatically grade myopic maculopathy, diagnose pathologic myopia, and identify and segment myopia-related lesions. Methods: Photographs were graded and annotated by four ophthalmologists and were then divided into a high-consistency subgroup or a low-consistency subgroup according to the consistency between the results of the graders. ResNet-50 network was used to develop the classification model, and DeepLabv3+ network was used to develop the segmentation model for lesion identification. The two models were then combined to develop the classification-and-segmentation-based co-decision model. Results: This study included 1395 color fundus photographs from 895 patients. The grading accuracy of the co-decision model was 0.9370, and the quadratic-weighted κ coefficient was 0.9651; the co-decision model achieved an area under the receiver operating characteristic curve of 0.9980 in diagnosing pathologic myopia. The photograph-level F1 values of the segmentation model identifying optic disc, peripapillary atrophy, diffuse atrophy, patchy atrophy, and macular atrophy were all >0.95; the pixel-level F1 values for segmenting optic disc and peripapillary atrophy were both >0.9; the pixel-level F1 values for segmenting diffuse atrophy, patchy atrophy, and macular atrophy were all >0.8; and the photograph-level recall/sensitivity for detecting lacquer cracks was 0.9230. Conclusions: The models could accurately and automatically grade myopic maculopathy, diagnose pathologic myopia, and identify and monitor progression of the lesions. Translational Relevance: The models can potentially help with the diagnosis, screening, and follow-up for pathologic myopic in clinical practice.

Multi-spectral imaging in adult-onset foveomacular vitelliform dystrophy: Report of two cases.

Purpose: To describe the characteristic findings of non-invasive multi-spectral imaging (MSI) for adult-onset foveomacular vitelliform dystrophy (AFVD). Observations: On examination of MSI, the characteristic performances of AFVD include the nodule-like high-reflecting lesions, the line-like low-reflecting lesions in the high-reflecting lesion, and the scattered high-reflecting and low-reflecting lesions around the nodule-like lesion. MSI has an advantage over color fundus photography (CFP) and fundus autofluorescence (FAF) in finding tiny lesions, which corresponded to drusenoid structures on optical coherence tomography (OCT). MSI showed different characteristics at different stages of AFVD, which may be instructive to the pathogenesis and progression of AFVD. Conclusions and Importance: MSI is a promising diagnostic and follow-up tool that will provide additional information in fundus imaging for AFVD, and the changes on MSI is partially instructive to the pathogenesis and progression of AFVD.

N-acetylcysteine improves diabetic associated erectile dysfunction in streptozotocin-induced diabetic mice by inhibiting oxidative stress.

Oxidative stress appears to play a role in the pathogenesis of diabetes mellitus erectile dysfunction (DMED). This study aimed to investigate the effect of N-acetylcysteine (NAC) on DMED in streptozotocin-induced diabetic mice and to explore potential mechanisms. In the present study, we show that an erectile dysfunction is present in the streptozotocin-induced mouse model of diabetes as indicated by decreases in intracavernous pressure responses to electro-stimulation as well as from results of the apomorphine test of erectile function. After treatment of NAC, the intracavernous pressure was increased. In these DMED mice, oxidative stress and inflammatory responses were significantly reduced within the cavernous microenvironment, while activity of antioxidant enzymes in this cavernous tissue was enhanced after NAC treatment. These changes protected mitochondrial stress damage and a significant decreased in apoptosis within the cavernous tissue of DMED mice. This appears to involve activation of the nuclear factor erythroid 2-like-2 (Nrf2) signalling pathway, as well as suppression of the mitogen-activated protein kinase (MAPK) p38/ NF-κB pathway within cavernous tissue. In conclusion, NAC can improve erectile function through inhibiting oxidative stress via activating Nrf2 pathways and reducing apoptosis in streptozotocin-induced diabetic mice. NAC might provide a promising therapeutic strategy for individuals with DMED.

Significance of hyperhomocysteinaemia as an effective marker for vasculogenic erectile dysfunction: a cross-sectional study.

Background: The primary objective of this cross-sectional study aimed at evaluating serum levels of homocysteinemia (Hcy) in a cohort of erectile dysfunction (ED) patients, and at assessing the correlation between Hcy and vasculogenic ED. Methods: A total of 119 Chinese patients presenting with ED [International Index of Erectile Function (IIEF)-5≤21] were enrolled in this study. The whole cohort was asked to complete the IIEF-5 questionnaire and blood analysis. A detailed medical history, physical examination, nocturnal penile tumescence (NPT) tests and penile color Doppler ultrasonography (pDUS) were performed by a urologist. Based on the pDUS result, they were further categorized into 2 main groups: non-vasculogenic ED (n=79) and vasculogenic ED (n=40). Results: Age and Hcy levels were significantly higher in the vasculogenic ED group compared to the non-vasculogenic ED group (38.45±8.51 vs. 32.29±7.57 and 22.91±5.85 vs. 16.31±5.23 µmol/L, respectively, P<0.01). Univariate and multivariable regression analyses showed that the incidence of vasculogenic ED raised significantly with the increase of Hcy level. After multivariable adjustment, ED patients with hyperhomocysteinaemia (HHcy) had 13.42 times the odds of vasculogenic ED compared with patients without HHcy (OR: 13.42, 95% CI: 3.78 to 47.64). Moreover, the risk of vasculogenic ED was 1.24 (95% CI: 1.04 to 1.48, P=0.01) per-unit increase in Hyc concentration for ED with HHcy. In addition, the smoothing curve revealed that Hcy levels were inversely correlated with peak-systolic velocity (PSV) (ß: -0.48, 95% CI: -0.91 to -0.05, P=0.04) in vasculogenic ED patients by multivariate regression analysis. Furthermore, in the analysis of receiver operating characteristic curve, the area under curve for Hcy to predict vasculogenic ED was 0.81 (95% CI: 0.73 to 89) in patients with ED. Conclusions: These findings suggest a dose-dependent association between Hcy and vasculogenic ED. HHcy was a risk factor for vasculogenic erectile dysfunction. Therefore, HHcy is likely to be a potential indicator to predict and diagnose vasculogenic ED when using pDUS.

ICSI outcomes for infertile men with severe or complete asthenozoospermia.

BACKGROUND: Severe or complete asthenozoospermia is a rare entity that can lead to male infertility. In this study, we explored whether different extents of severe or complete asthenozoospermia could affect intracytoplasmic sperm injection (ICSI) outcomes and compared the ICSI outcomes using testicular spermatozoa with those using ejaculated spermatozoa in couples with complete asthenozoospermia. RESULTS: Ninety-seven couples with severe or complete asthenozoospermia who underwent ICSI between January 2014 and December 2018 were included. According to the sperm category used in ICSI, patients were categorized into four groups: ejaculated progressive motile sperm group (Ep-group), ejaculated non-progressive motile sperm group (En-group), ejaculated immotile sperm group (Ei-group), and testicular sperm group (TESE-group). We compared the baseline characteristics, hormone profile, semen parameters, normal fertilization, good-quality embryos on day 3, transferred embryos, and ICSI outcomes in the four groups. The clinical pregnancy rate was significantly increased in the Ep-group (65.4%, P = 0.019) and TESE-group (63.6%, P = 0.035) compared with that in the Ei-group (23.1%). The ongoing pregnancy rate in the Ei-group was significantly lower than that in the Ep-group (23.1% vs. 61.5%, P = 0.041). Moreover, the biochemical pregnancy rate, ongoing pregnancy rate, and live birth rate were much lower in the Ei-group than in the TESE-group (30.8% vs. 63.6%, 23.1% vs. 40.4% and 23.1% vs. 40.4%, respectively). CONCLUSIONS: In couples with complete asthenozoospermia, testicular spermatozoa should be preferred to ejaculated spermatozoa for obtaining a better ICSI outcome. With the appropriate selection of testicular spermatozoa, the extent of severe or complete asthenozoospermia may not affect the ICSI outcomes. Future studies with a larger sample size are warranted to validate these findings.

RéSUMé: CONTEXTE: L'asthénozoospermiesévère ou complète est une entité rare qui peut conduire à l'infertilité masculine. Dans cette étude, nous avons exploré si les différentes étendues de l'asthénozoospermie sévère ou complète pouvaient affecter les résultats de l'injection intracytoplasmique de spermatozoïdes (ICSI), et nous avons comparé les résultats de l'ICSI obtenus avec des spermatozoïdes testiculaires à ceux obtenus avec des spermatozoïdes éjaculés chez les couples atteints d'asthénozoospermie complète. RéSULTATS: Quatre-vingt-dix-sept couples atteints d'asthénozoospermie sévère ou complète qui ont eu une ICSI entre janvier 2014 et décembre 2018 ont été inclus. Selon la catégorie de spermatozoïdes utilisée dans l'ICSI, les patients ont été classés en quatre groupes : groupe de spermatozoïdes mobiles progressifs éjaculés (groupe Ep), groupe de spermatozoïdes mobiles non progressifs éjaculés (groupe En), groupe de spermatozoïdes immobiles éjaculés (groupe Ei) et groupe de spermatozoïdestesticulaires (groupe TESE). Nous avons comparé les caractéristiques de base, le profil hormonal, les paramètres du sperme, la fécondation normale, les embryons de bonne qualité au jour 3, les embryons transférés, et les résultats de l'ICSI dans les quatre groupes. Le taux de grossesse clinique était significativement augmenté dans le groupe Ep (65,4%, P = 0,019) et le groupe TESE (63,6%, P = 0,035) par rapport à celui du groupe Ei (23,1%). Le taux de grossesse en cours dans le groupe Ei était significativement inférieur à celui du groupe Ep (23,1% contre 61,5%, P = 0,041). De plus, le taux de grossesse biochimique, le taux de grossesse en cours et le taux de naissances vivantes étaient beaucoup plus faibles dans le groupe Ei que dans le groupe TESE (30,8 % vs 63,6%,23,1 % vs 40,4 % et 23,1 % vs 40,4 %, respectivement). CONCLUSIONS: Chez les couples atteints d'asthénozoospermie complète, les spermatozoïdes testiculaires devraient être préférés aux spermatozoïdes éjaculés pour obtenir un meilleur résultat en ICSI. Avec une sélection appropriée des spermatozoïdes testiculaires, l'étendue de l'asthénozoospermie sévère ou complète pourrait ne pas affecter les résultats de l'ICSI. De futures études avec des échantillons de plus grande taille sont donc justifiées pour valider ces résultats. MOTS-CLéS: Asthénozoospermie; spermatozoïdes éjaculés ; injection intracytoplasmique de spermatozoïdes (ICSI) ; infertilité masculine ; spermatozoïdes testiculaires.

Three-Dimensional Analysis of Choroidal Vessels in the Eyes of Patients With Unilateral BRVO.

Purpose: To investigate the three-dimensional analysis of choroidal vascular changes in eyes with monocular branch retinal vein occlusion (BRVO) using swept-source optical coherence tomography (SS-OCT). Methods: Twenty two unilateral BRVO patients with superior-temporal branch retinal vein occlusion and 27 healthy eyes were analyzed retrospectively. OCT and OCT angiography (OCTA) images of 12 * 12 mm centered on the foveal of each eye were analyzed. Three-dimensional choroidal vascularity index (CVI), choroidal thickness, and choriocapillaris density were compared among BRVO eyes, fellow eyes, and healthy control eyes. En face CVI maps in BRVO eyes were generated to analyze the dilatation pattern of choroidal vessels. Results: CVI values in a few 1 * 1 mm grids in the non-affected hemi side were higher in BRVO eyes compared with the fellow eyes and control eyes (p < 0.05). Choriocapillaris density decreased in both BRVO eyes and fellow eyes compared with normal eyes while choriocapillaris density was higher in a few grids in the non-affected hemi side in BRVO eyes compared with fellow eyes (p < 0.05). Choroidal dilatation pattern was categorized into four types and inferior choroidal dilatation and posterior pole choroidal dilatation were the major types. Conclusion: Three-dimensional CVI tended to increase in non-affected hemi side and choroidal vessels tended to dilate in adjacent areas in BRVO eyes. Choriocapillaris density decreased in both eyes of monocular BRVO patients. The choroidal changes suggested that choroidal redistribution occurred in BRVO.

Macular Bruch's membrane defects and other myopic lesions in high myopia.

AIM: To compare the ocular fundus features of highly myopic eyes with and without macular Bruch's membrane (BM) defects and investigate the associations between macular BM defects and other myopic lesions. METHODS: This retrospective, observational case series included 262 eyes (139 patients) with high myopia (HM) refractive error ≥-6.0 diopters (D) or axial length ≥26.5 mm from March 2019 to December 2019. The patients underwent a comprehensive ophthalmic examination, including swept-source optical coherence tomography (SS-OCT). The features of macular BM defects and other ocular fundus lesions were examined in OCT images. RESULTS: Totally 51 eyes (19.5%) were detected with macular BM defects, which were characterized by a lack of BM, retinal pigment epithelium (RPE), and an almost complete loss of photoreceptors or choriocapillaris. Eyes with macular BM defects had worse best-corrected visual acuity (BCVA) than those without (P<0.001). Dome-shaped macula (DSM, P=0.042), retinal cysts (P=0.006), choroidal neovascularization (CNV, P<0.001), choroidal defects and abnormality (P=0.003), scleral defects (P=0.015), scleral deformation (P=0.005), posterior staphyloma (P=0.011), and perforating vessels (P<0.001) occurred more frequently in eyes with macular BM defects. In multivariate analysis, the presence of macular BM defects remained the significant association with presence of DSM (P=0.013), scleral defects (P=0.015), posterior staphyloma (P=0.001), perforating vessels (P<0.001) and CNV (P=0.004). CONCLUSION: Macular BM defects has a prevalence of approximately 20% in HM and it has tight association with other myopic fundus lesions. BM might be crucial in the pathogenesis of myopic fundus lesions due to its biomechanical function. A comprehensive understanding of BM's role is useful for further researches about myopic lesions.

Wide-field swept source optical coherence tomography evaluation of posterior segment changes in highly myopic eyes.

BACKGROUND: To investigate the features in the posterior pole of highly myopic (HM) eyes using a wide-field high-resolution swept source optical coherence tomography (SS OCT). METHODS: This observational cross-sectional study involved 262 eyes of 139 patients, who were diagnosed as HM and had consecutively been examined by SS OCT in the Ophthalmology Department of the Peking Union Medical College Hospital between March 2019 and December 2019. The characteristics of OCT images were documented and analyzed. RESULTS: In our study, SS OCT could demonstrate the entire layer of the choroid and detect the sclera in all eyes. The mean subfoveal retinal/choroidal/scleral thickness were 204.84 ± 119.86 µm, 92.80 ± 75.78 µm and 394.734 ± 123.09 µm, respectively. 138 eyes (52.67%) had posterior precortical vitreous pocket. Myopic foveoschisis was detected in 110 eyes (41.98%), and significantly associated with the presence of posterior staphyloma. 36 eyes (13.74%) had DSM in our study, of which 8 eyes (22.22%) showed a round dome, 16 (44.44%) were horizontal oval-shaped, 9 (25%) were vertical oval-shaped and 3 (8.34%) were oblique oval-shaped. Both SFCT and SFST were inversely and significantly associated with age and refractive errors. Macular neovascularization was significantly correlated with intrascleral vessels. Different deformation of the sclera and posterior staphyloma were vividly identified on SS OCT images. CONCLUSIONS: This study provided a relatively comprehensive picture of posterior pole in HM eyes. Such good visualization of ocular fundus provided by wide-field SS OCT could be useful for the therapy option, disease condition monitoring and pathogenesis investigation.

Development and evaluation of a deep learning model for the detection of multiple fundus diseases based on colour fundus photography.

AIM: To explore and evaluate an appropriate deep learning system (DLS) for the detection of 12 major fundus diseases using colour fundus photography. METHODS: Diagnostic performance of a DLS was tested on the detection of normal fundus and 12 major fundus diseases including referable diabetic retinopathy, pathologic myopic retinal degeneration, retinal vein occlusion, retinitis pigmentosa, retinal detachment, wet and dry age-related macular degeneration, epiretinal membrane, macula hole, possible glaucomatous optic neuropathy, papilledema and optic nerve atrophy. The DLS was developed with 56 738 images and tested with 8176 images from one internal test set and two external test sets. The comparison with human doctors was also conducted. RESULTS: The area under the receiver operating characteristic curves of the DLS on the internal test set and the two external test sets were 0.950 (95% CI 0.942 to 0.957) to 0.996 (95% CI 0.994 to 0.998), 0.931 (95% CI 0.923 to 0.939) to 1.000 (95% CI 0.999 to 1.000) and 0.934 (95% CI 0.929 to 0.938) to 1.000 (95% CI 0.999 to 1.000), with sensitivities of 80.4% (95% CI 79.1% to 81.6%) to 97.3% (95% CI 96.7% to 97.8%), 64.6% (95% CI 63.0% to 66.1%) to 100% (95% CI 100% to 100%) and 68.0% (95% CI 67.1% to 68.9%) to 100% (95% CI 100% to 100%), respectively, and specificities of 89.7% (95% CI 88.8% to 90.7%) to 98.1% (95%CI 97.7% to 98.6%), 78.7% (95% CI 77.4% to 80.0%) to 99.6% (95% CI 99.4% to 99.8%) and 88.1% (95% CI 87.4% to 88.7%) to 98.7% (95% CI 98.5% to 99.0%), respectively. When compared with human doctors, the DLS obtained a higher diagnostic sensitivity but lower specificity. CONCLUSION: The proposed DLS is effective in diagnosing normal fundus and 12 major fundus diseases, and thus has much potential for fundus diseases screening in the real world.

Generation of an iPSC line (HRMSDUi001-A) from an azoospermic patient with 45,XY,der(13;14)(q10;q10) karyotype.

Robertsonian translocation between chromosomes 13 and 14 is reported to be a cause of male infertility. Here, we established an iPSC line (HRMSDUi001-A) from an azoospermic patient with 45,XY,der(13;14)(q10;q10) karyotype. Peripheral blood mononuclear cells were reprogrammed to generate hiPSCs by non-integrating delivery of OCT4, SOX2, KFL4 and MYC. The iPSC line expressed pluripotency markers, could differentiate into cells of three germ layers in vitro, and carried 45,XY,der(13;14)(q10;q10) karyotype.

Identification of immune-related genes that predict prognosis and risk of bladder cancer: bioinformatics analysis of TCGA database.

BACKGROUND: Bladder cancer (BLCA) is the major tumor of the urinary system, and immune-related genes (IRGs) contribute significantly to its initiation and prognosis. RESULTS: A total of 51 prognostic IRGs significantly associated with overall survival were identified. Functional enrichment analysis revealed that these genes were actively involved in tumor-related functions and pathways. Using multivariate Cox regression analysis, we detected 11 optimal IRGs (ADIPOQ, PPY, NAMPT, TAP1, AHNAK, OLR1, PDGFRA, IL34, MMP9, RAC3, and SH3BP2). We validated the prognostic value of this signature in two validation cohorts: GSE13507 (n = 165) and GSE32894 (n = 224). Furthermore, we performed a western blot and found that the expression of these IRGs matched their mRNA expression in TCGA. Moreover, correlations between risk score and immune-cell infiltration indicated that the prognostic signature reflected infiltration by several types of immune cells. CONCLUSION: We identified and validated an 11-IRG-based risk signature that may be a reliable tool to evaluate the prognosis of BLCA patients and help to devise individualized immunotherapies. METHODS: Bioinformatics analysis was performed using TCGA and ImmPort databases. Cox regression was used to identify prognostic signatures. Two external GEO cohorts and western blotting of samples were performed to validate the IRG signature.