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The foveal avascular zone(FAZ)is the most sensitive region of the retina, which is interconnected by the macular capillary plexus. Its morphology can indirectly reflect the alterations of macular microcirculation. With strong repeatability and reliability, optical coherence tomography angiography(OCTA)can non-invasively visualize and quantify the FAZ. The great value of OCTA makes it an important supplemental examination tool in ophthalmology and other professions. The area and perimeter of FAZ have been demonstrated to be an effective clinical diagnostic indicator in high myopia, diabetic retinopathy, glaucoma and other ocular diseases. In recent years, the geometry of FAZ has also proven to have clinical value. The parameters describing the geometry of FAZ, such as circularity index, acircularity index and axial ratio, provide a new perspective for ocular disease research. The comprehensive investigation of the morphological characteristics of the FAZ is helpful to explore the pathological mechanism of the occurrence and development of ocular diseases, predict preclinical changes, make pathological stages of the disease precise, and provide a theoretical basis for monitoring the disease's progression and assessing patients' visual prognosis.
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Objective:To investigate the prevalence and risk factors of tessellation fundus (TF) among Tianjin Medical University students with different refractive statuses.Methods:A cross-sectional study. From September to December 2019, 346 students from Tianjin Medical University were randomly selected and underwent slit-lamp examination, non-cycloplegic auto-refraction, subjective refraction, best-corrected visual acuity, ocular biometric measurement, and non-dilation fundus photography. The differences in the prevalence of TF in basic characteristics and ocular biometric parameters were compared. Based on the equivalent spherical (SE), refractive status was divided into the non-myopia group (SE>-0.50 D) and the myopia group (SE≤-0.50 D). The myopia group was further divided into mild myopia group (-3.00 D<SE≤-0.50 D), moderate myopia group (-6.00 D<SE≤-3.00 D), and high myopia group (SE≤-6.00 D). According to the axis length (AL), the subjects were divided into AL<24 mm group, 24-26 mm group, and >26 mm group. The logistic regression was used to analyze the risk factors affecting TF. Trend tests were performed for each risk factor and TF.Results:Of the 346 subjects, 324 (93.6%, 324/346) were myopia, of whom 73 (21.1%, 73/346), 167 (48.3%, 167/346), and 84 (24.3%, 84/346) were mild myopia, moderate myopia, and high myopia, respectively; 22 (6.4%, 22/346) were non-myopia. There were 294 (85.0%, 294/346) students with TF in the macula, including 9 (40.91%, 9/22), 58 (79.45%, 58/73), 145 (86.83%, 145/167), and 82 (97.62%, 82/84) in non-myopia, low myopia, moderate myopia, and high myopia group, respectively; 52 (15.0%, 52/346) students were without TF in the macula. There were statistically significant gender differences ( χ2=4.47), SE ( t=6.29), AL ( t=-8.29), anterior chamber depth ( Z=-2.62), lens thickness ( Z=-2.23), and average corneal radius ( Z=-3.58) between students with and without TF in the macula ( P<0.05). Spherical equivalent and axial length were independent risk factors for TF and its severity ( P≤0.001). With an increasing degree of myopia, and increasing axial length, the risk of TF increased ( P for trend<0.001). Conclusions:The prevalence of TF is 85.0% among Tianjin Medical University students. TF is detected in the fundus of no myopia, mild myopia, moderate myopia and high myopia. The degree of myopia is higher, the AL is longer, the possibility of TF is higher.
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Posterior staphyloma (PS) refers to the local abnormal bulge of the posterior wall of the eyeball, which is one of the common pathological changes in high myopia.The appearance of PS is often accompanied by changes in fundus microstructure such as sclera, choroid and Bruch membrane.The abnormality of fundus microstructure leads to the decrease of its resistance to the expansion of ocular axis, or causes the remodeling of tissue structure in the corresponding area, resulting in the change of microvascular structure, and then giving rise to abnormal blood circulation in the posterior pole.The microcirculatory changes may be followed by changes in fundus microstructure, seriously affecting the visual acuity of the affected eyes.There is still no clear conclusion on the pathogenesis of PS in the world, and there are no good preventive measures or treatment methods.This article reviewed and summarized the interaction between PS, fundus structure and microcirculation in high myopia, so as to provide a theoretical basis for exploring the pathogenesis, prevention and treatment of PS and improving the visual function of high myopia.
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Objective:To evaluate the effect of short-term topical administration of atropine eye drops with various concentrations and frequencies on eye safety in children.Methods:A double-blind randomized controlled trial was conducted.Sevevty-two children with ametropia or pre-myopia (72 eyes) were enrolled in Tianjin Medical University Eye Hospital from December 2020 to January 2022.The subjects were randomly divided into 0.01% atropine group, 0.02% atropine group and 0.04% atropine group according to a random number table, with 24 cases (24 eyes) in each group.Automatic refraction with an automatic computer optometry device, subjective refraction with a phoropter, intraocular pressure with a non-contact tonometer, axial length by optical biometrics, the amplitude of accommodation (AMP) by the push-up method, pupil diameter with pupilometer, near visual acuity at 33 cm with a standard logarithmic visual acuity chart, tear evaluation with Keratograph 5M and Ocular Surface Disease Index (OSDI) questionnaire survey were performed among all subjects.One drop of 0.01%, 0.02%, and 0.04% atropine was administrated to the study eye according to grouping, and the pupil diameter was measured every 10 minutes until the pupil did not enlarge three times, then the data after a single treatment of the three groups were recorded.After one-week application of the corresponding concentration of atropine eye drops once at night, the data after one-week treatment were recorded.For the next week, the application frequency of 0.01% and 0.02% atropine groups changed to once daily in the morning and evening, and 0.04% atropine group maintained once at night, then the data after two-week treatment were recorded.Data of the right eyes were analyzed.The changes in pupil diameter, AMP and other eye parameters before and after atropine eye drops of the three groups were compared.This study adhered to the Declaration of Helsinki and the study protocol was approved by the Ethics Committee of Tianjin Medical University Eye Hospital (No.2020KY[L]-51). All subjects and their guardians were fully informed of the method and purpose of this study before entering the cohort.Written informed consent was obtained from guardians.Results:Pupil diameters of 0.01%, 0.02% and 0.04% atropine groups were (5.59±0.48), (5.35±0.76) and (5.65±0.43)mm before treatment respectively, (7.00±0.68), (7.17±0.58) and (8.40±1.71)mm after a single treatment, (6.67±0.62), (6.56±0.65) and (7.60±0.69)mm after one-week treatment, (6.96±0.49), (7.04±0.53) and (7.60±0.36)mm after two-week treatment.There were significant differences in pupil diameter at different time points after treatment among the three groups ( Fgroup=9.430, P<0.001; Ftime=156.620, P<0.001). The AMP of 0.01%, 0.02% and 0.04% atropine groups were (12.94±3.02), (13.25±2.81) and (13.42±2.60)D before treatment respectively, (11.62±2.61), (11.53±2.06) and (9.64±1.93)D after a single treatment, (11.14±2.61), (11.33±2.33) and (8.30±1.18)D after one-week treatment, (9.99±1.81), (8.72±1.25) and (8.76±2.12)D after two-week treatment.There was no significant difference in the AMP among the three groups ( Fgroup=2.800, P=0.063). In the three groups, the AMP at different time points after treatment were significantly lower than that before treatment ( Ftime=61.400, P<0.001). There was no difference in spherical equivalent refraction, intraocular pressure, near visual acuity, axial length, first none-invasive tear break-up time, average none-invasive tear break-up time, tear meniscus height and OSDI score among the three groups ( Fgroup=0.030, 0.630, 1.420, 0.580, 0.140, 0.120, 0.340, 0.142; all at P>0.05). There were significant differences in spherical equivalent refraction, intraocular pressure, first none-invasive tear break-up time, average none-invasive tear break-up time, tear meniscus height and OSDI score at different time points between before and after medication among the three groups ( Ftime=12.560, 4.730, 4.720, 5.220, 3.720; all at P<0.05). Conclusions:Varying pupil dilation and AMP reduction occur after the use of different concentrations of atropine and are more severe at higher concentrations.Increased administration frequency of atropine is associated with more pupil dilation and AMP reduction, but there is no intolerable adverse effect.
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Objective:To systematically evaluate the effect of repeated low-level red light (RLRL) therapy on controlling the progression of myopia in children.Methods:Medline, Embase, Cochrane Library, Web of Science, ClinicalTrial.gov and the CNKI, VIP, Wanfang database, and Chinese Clinical Trial Registry (www.chictr.org.cn) were searched from their establishment to September 2022 to obtain the randomized controlled trial (RCT) about RLRL controlling myopia progression in children.Grey literature was also searched.Inclusion and exclusion criteria were developed according to the PICOS principle.Two researchers screened the literature independently, extracted data, and assessed the risk of bias in the included studies using the Cochrane collaboration tool for assessing risk of bias.The data were imported into RevMan 5.4 software for meta-analysis.Mean and standard deviation of data were used to obtain mean differences and 95% confidence intervals of included studies.Changes in spherical equivalent (SE) and axial length (AL) were compared between before and after the intervention in RLRL and single-vision spectacle (experimental group) and single-vision spectacle (control group). The GRADE system was used to grade the quality of evidence for the outcome indicators.Results:A total of 157 studies were obtained.After the screening, 7 RCT studies including 1 038 study subjects met the inclusion criteria.Meta-analysis results showed that retarded SE progression was retarded and AL elongation was reduced significantly after different follow-up durations (1, 3, 6, 12 and 24 months) in experimental group compared with control group.As the follow-up duration extended from 1 month to 24 months, the retard of SE progression increased from 0.14 to 0.93 D, and the reduction of AL increased from 0.07 to 0.48 mm.Both 635 and 650 nm red light significantly retarded SE progression and reduced AL elongation.The two outcome indicators, SE change and AL change were moderate-strength evidence by GRADE.Conclusions:The current moderate-strength evidence shows that RLRL can better retard myopia progression in children than single-vision spectacle glasses.
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Objective:To observe the prevention and control effect of 1% atropine on the progression of form deprivation myopia (FDM) in guinea pigs and the potential biological mechanism.Methods:Sixty-nine 3-week-old tricolor guinea pigs with normal refraction were randomly divided into a normal control group ( n=19), a FDM group ( n=19), a FDM+ atropine group ( n=19), and an atropine group ( n=12). No intervention was given to guinea pigs in normal control group.The FDM model was established by covering the right eye of guinea pigs with a semitransparent latex facemask for 4 weeks in FDM and FDM+ atropine groups.For the FDM+ atropine group, 1% atropine gel was topically administered to the form-deprived right eyes once a day for 4 weeks.For the atropine group, the right eye was treated with 1% atropine gel once a day for 4 weeks.Refraction and axial length of guinea pigs were measured by retinoscopy and ophthalmic A-scan ultrasonography respectively at baseline, experiment week 2 and week 4.In experiment week 4, eyeballs were enucleated to make sections via the paraffin wax processing procedure, and the microstructural and ultrastructural changes of the sclera were observed under the light microscope and transmission electron microscope, respectively.The isobaric tags for relative and absolute quantitation labeling combined with liquid chromatography-tandem mass spectrometry were used to identify the differentially expressed proteins.Use and care of the animals complied with the Regulation for the Administration of Affairs Concerning Experiment Animals by State Science and Technology Commission.The study protocol was approved by the Institutional Animal Care and Use Committee of Tianjin Medical University (No.TJYY2020111028). Results:There were statistically significant differences in the diopter of guinea pigs at different time points among the four groups ( Fgroup=138.892, P<0.001; Ftime=167.270, P<0.001). Compared with normal control group, the diopter of guinea pigs in FDM group at experiment weeks 2 and 4, and FDM+ atropine group at experiment week 4 developed toward myopia, showing statistically significant differences (all at P<0.001). Compared with FDM group, the diopter of guinea pigs in FDM+ atropine group at experiment weeks 2 and 4 developed toward hyperopia, showing statistically significant differences (both at P<0.001). There were statistically significant differences in the axial length of guinea pigs at different time points among the four groups ( Fgroup=32.346, P<0.001; Ftime=353.797, P<0.001). The axial lengths of FDM group at experiment weeks 2 and 4 and FDM+ atropine group at experiment week 4 were longer than those of normal control group, and the axial lengths in FDM+ atropine group at experiment weeks 2 and 4 were shorter than those in FDM group, and the differences were statistically significant (all at P<0.001). The collagenous fibers of posterior sclera of guinea pigs were loose and disordered in FDM group, and were regular in FDM+ atropine group.The posterior scleral thickness of normal control group, FDM group, FDM+ atropine group and atropine group was (141.74±16.98), (101.46±9.15), (112.74±6.24) and (134.30±18.19) μm, respectively, with a statistically significant difference ( F=6.709, P=0.005). The posterior sclera was significantly thinner in FDM group than in normal control group and FDM+ atropine group (both at P<0.05). The diameter of posterior scleral collagen fiber gradually increased from inside to outside in normal control group, FDM+ atropine group and atropine group, and the diameters of the inner, middle and outer posterior scleral collagen fibers were smaller in FDM group than in normal control group.Proteomic analysis revealed 85 differentially expressed proteins (fold change>1.30) between FDM group and normal control group, FDM+ atropine group and FDM group, of which 38 were up-regulated and 47 were down-regulated after atropine treatment.Gene Ontology enrichment analysis showed that biological processes mainly involved were biological regulation, cell process, localization and metabolic process.Molecular function mainly involved were binding, catalytic activity, molecular function regulator, structural molecule activity and transporter activity.Cell components mainly involved were in cellular anatomical entity, intracellular and protein-containing complex. Conclusions:Atropine can increase the diameter of scleral collagen fibers in guinea pigs of FDM model, improve the arrangement of scleral collagen fiber, inhibit scleral thinning.The mechanism of atropine to control myopia progression is closely related to the tight junction between scleral cells, cytoskeleton and extracellular matrix remodeling.
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Objective:To investigate the effect of interleukin (IL)-23 receptor (IL-23R) overexpression on the balance of T helper 17 (Th17 cells)/regulatory T cells (Treg cells) in experimental autoimmune uveitis (EAU) mice.Methods:Twelve 8-week-old female C57BL/6J mice were randomly divided into LV-Ctrl group and LV-IL-23R group, with 6 mice in each group. Two groups of mice were injected with LV-Ctrl and LV-IL-23R lentiviruses through the tail vein, respectively; 7 days after injection, the EAU mouse model was established by active immunization with vitamin A-binding protein 1-20 between photoreceptors. Starting from 13 days after immunization, the fundus of the mice was observed by indirect ophthalmoscopy every 2 days and clinical scores were performed; 30 days after immunization, hematoxylin-eosin staining was used to observe the histopathological changes of mouse retina. The levels of IL-17 in serum of the two groups of mice were detected by enzyme-linked immunosorbent assay; the proportion of Th17 cells and Treg cells was detected by flow cytometry. The relative mRNA expression of IL-23R, IL-17, retinoic acid-related orphan receptor γt (RORγt), IL-10 and forkhead transcripyion factor p3 (Foxp3) were detected by real-time quantitative polymerase chain reaction. Comparisons between groups were performed using repeated measures analysis of variance, independent samples Mann-Whitney U test, and independent samples t test. Results:Compared with the LV-Ctrl group, the retinal inflammatory reaction of the LV-IL-23R group was more severe. At 13 days after immunization, there was no significant difference in fundus inflammation scores between LV-IL-23R group and LV-Ctrl group ( t=-2.001, P=0.058); 15-29 days after immunization. The fundus inflammation scores of LV-IL-23R group were higher than those of LV-Ctrl group, and the difference was statistically significant ( t=-4.429,-6.578, -7.768, -10.183, -6.325, -7.304, -4.841, -6.872; P<0.001). Histopathological examination showed that the infiltration of inflammatory cells in the fundus increased, the retinal structure was damaged more seriously, and the histopathological score was significantly increased, and the difference was statistically significant ( t=-4.339, P=0.001). Compared with the LV-Ctrl group, the relative expression of IL-23R mRNA in the spleen of the LV-IL-23R group was significantly increased, and the difference was statistically significant ( Z=2.087, P=0.037). The relative expression of IL-17 and RORγt mRNA increased, while the relative expression of IL-10 and Foxp3 mRNA decreased, and the differences were statistically significant ( t=-6.313,-5.922, 4.844, 7.572; P=0.003, 0.004, 0.008, 0.002). Compared with the LV-Ctrl group, the level of IL-17 in the serum of the mice in the LV-IL-23R group was significantly increased, and the difference was statistically significant ( t=-5.423, P=0.002); the proportion of Th17 cells in the spleen and lymph nodes was significantly increased, whereas, the proportion of Treg cells was significantly reduced, and the difference was statistically significant ( t=-4.290, 3.700; P=0.002, 0.006). Conclusion:IL-23R overexpression can promote Th17/Treg imbalance in EAU mice, and aggravate the clinical and pathological manifestations of EAU.
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Objective:To evaluate the effect of peripheral defocus soft contact lenses (PDSCLs), single-vision spectacles and single-vision contact lenses (SVCLs) on the progression of myopia in children and adolescents.Methods:A meta-analysis was conducted.To collect relevant studies on the myopia control effect of PDSCLs in children, English databases including PubMed, Medline, Embase and Cochrane library were searched with myopia, contact lens, children, adolescents, myopia progression, axial length, refractive error and relevant free English terms as key words.Chinese databases including CNKI, Wanfang and VIP were searched with corresponding Chinese phrases and relevant free Chinese terms as key words.Randomized controlled trials (RCTs) on the myopia control effect in children and adolescents, with PDSCLs wearer as experimental group and single-vision spectacles or SVCLs wearer as control group, were independently collected by two researchers.Quality of included studies was evaluated with the Cochrane tool to assess risk of bias for RCTs.Combined effects of change in refraction and axial length between experimental and control groups was calculated by weighted mean difference (WMD) and 95%confidence interval ( CI). The heterogeneity of included studies was evaluated by I2 statistic.The refraction and axial length of experimental and control groups were compared by Z test.Myopia control effect of different PDSCLs add powers was analyzed by subgroup analysis.The experimental data with add power ≤+ 2.00 D, low aberration and low depth of focus were assigned to low-medium add power subgroup, and the experimental data with add power >+ 2.00 D, high aberration and high depth of focus were assigned to high add power subgroup. Results:A total of 378 publications were retrieved.Finally, 10 high-quality RCTs and 14 groups of data were included in this meta-analysis.In these studies, 1 645 myopic children aged from 6 to 18 years were enrolled, including 808 cases in experimental group and 837 in control group.The follow-up ranged from 10 to 36 months.Among the 10 studies, there were two crossover trials without a washout period, so only the first intervention results were included.According to the meta-analysis, the change in refraction in experimental group was significantly less than that in control group (WMD=0.22 D, 95% CI: 0.15-0.30, Z=5.65; P<0.05). The change in axial elongation was significantly less in experimental group than control group (WMD=-0.10 mm, 95% CI: -0.12--0.09, Z=12.28; P<0.05). Subgroup analysis showed that the WMD of refraction change and axial elongation between experimental and control groups were 0.21 D (95% CI: 0.10-0.31) and-0.10 mm (95% CI: -0.13-0.08) in the low-medium add power subgroup, respectively, and were 0.26 D (95% CI: 0.13-0.38) and -0.13 mm (95% CI: -0.15--0.10) in the high add power subgroup, respectively. Conclusions:PDSCLs have better myopia control effect than single-vision spectacles and SVCLs in children and adolescents.When the add power is higher, PDSCLs can slow the progression of myopia more effectively.
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Objective:To investigate the immunoregulatory effects of lentivirus-mediated microRNA (miR)-31-5p overexpression on peripheral blood T helper cell 17 (Th17) in a rabbit model of autoimmune dry eye.Methods:The miR-31-5p recombinant lentiviral vector was constructed.Lentivirus overexpressing miR-31-5p and its control virus were packaged.The concentration measurement and lentiviral titer determination were carried out.A rabbit model of autoimmune dry eye was established and the peripheral blood mononuclear cells (PBMC) of the rabbits were isolated.PBMC infected with miR-31-5p and negative control lentivirus particles were assigned as the miR-31-5p overexpression group and control group, respectively.The miR-31-5p expression level was detected using quantitative real-time PCR (qRT-PCR). Then PBMC in the two groups were co-cultured with γ-ray irradiated lacrimal gland epithelial cells.The expressions of Th17 cell related transcription factor retinoic acid-receptor-related orphan receptor C (RORC) and interleukin-17 (IL-17) mRNA, IL-1β, IL-6 and IL-23 were determined by qRT-PCR.The IL-17 protein expression level was detected by Western blot.The use and care of animals complied with Regulation for the Administration of Affair Concerning Experiment Animals by State Science and Technology Commission.The study protocol was approved by the Ethics Committee of Tianjin Medical University Eye Hospital (No.TJYY20201221036).Results:The construction of the miR-31-5p recombinant lentiviral vector was verified by DNA sequencing.The lentiviral titer of lentivirus overexpressing miR-31-5p and control lentivirus particles was 3.82×10 7 TU/ml and 3.50×10 7 TU/ml, respectively.The miR-31-5p relative expression level of PBMC was significantly increased in miR-31-5p overexpression group in comparison with control group, showing a statistically significant difference ( t=-9.696, P<0.001). When PBMC were co-cultured with lacrimal gland epithelial cells in vitro, the relative expression levels of RORC and IL-17 mRNA in miR-31-5p overexpression group were 0.33±0.03 and 0.28±0.09, which were significantly decreased in comparison with 1.00±0.00 and 1.00±0.00 in control group, with statistically significant differences between them ( t=46.256, 13.810; both at P<0.05). The relative expression level of IL-17 protein in miR-31-5p overexpression group was significantly reduced than control group ( t=4.977, P=0.008). The relative expression levels of IL-1β, IL-6 and IL-23 mRNA were significantly lower in miR-31-5p overexpression group than control group ( t=220.076, 6.641, 13.271; all at P<0.05). Conclusions:The overexpression of miR-31-5p can inhibit the Th17-immune response via down-regulating the expression of IL-6, IL-1β and IL-23.
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Objective:To investigate the role of microRNA-338-3p (miR-338-3p) in regulating the generation and function of interphotoreceptor retinoid-binding protein (IRBP) 1-20-specific T helper 17 (Th17) cells in experimental autoimmune uveitis (EAU). Methods:Bone marrow cells were flushed from the femurs and tibiae of wild-type C57BL/6 mice and cultured in the presence of granulocyte macrophage-colony stimulating factor (GM-CSF) and interleukin-4 (IL-4)to differentiate into bone marrow-derived dendritic cells (BMDCs). On day 5 after induction, immature BMDCs were collected and divided into miR-338-3p mimics transfection group and mimics negative control transfection group, then transfected with miR-338-3p mimics or negative mimics according to grouping.Twenty-four hours after transfection, the BMDCs were stimulated with 100 ng/ml of lipopolysaccharide to mature.Relative expression levels of miR-338-3p, IL-6, IL-23 and IL-1β mRNA in BMDCs of the two groups were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The EAU model was established with IRBP 1-20, incomplete Freund adjuvant and mycobacterium tuberculosis (H37Ra) in mice.On day 13 after modeling, T cells were isolated from the mice spleen or draining lymph nodes and co-cultured with miR-338-3p mimics or negative control mimics-transfected BMDCs under Th17-polarizing conditions.Concentration of IL-17 in the supernatant was detected by ELISA.Relative expression levels of retinoic acid receptor-related orphan nuclear receptor γt (RORγt) and IL-17 mRNA were analyzed by qRT-PCR.The proportion of IL-17 + cells among T cells co-cultured with BMDCs was assessed by flow cytometry.To further verify the role of miR-338-3p in dendritic cells on Th17 cells, BMDCs transfected with miR-338-3p inhibitor or control inhibitor were co-cultured with T cells isolated from spleen or draining lymph nodes of EAU mice.Concentration of IL-17 in the supernatant was detected by ELISA.The use and care of the animals complied with Regulations for the Administration of Affairs Concerning Experiment Animals by State Science and Technology Commission.The study protocol was approved by the Institutional Animal Care and Use Committee of Tianjin Medical University (No.TJYY2019110117). Results:Relative expression level of miR-338-3p in BMDCs was significantly increased in the miR-338-3p mimics transfection group than the mimics negative control group ( t=6.861, P=0.002). In T cells co-cultured with miR-338-3p mimics-transfected BMDCs, the relative expression levels of RORγt and IL-17 mRNA were 1.34±0.16 and 1.33±0.16, which were significantly higher than 1.00±0.01 and 1.00±0.01 in the mimics negative control group ( t=3.632, P=0.022; t=3.681, P=0.021). ELISA showed that the concentration of IL-17 in the supernatant was (5 941.00±452.40)pg/ml in the miR-338-3p mimics transfection group, which was significantly higher than (4 299.00±348.30)pg/ml in the mimics negative control group ( t=4.979, P=0.008), and IL-17 concentration in the supernatant was (3 092.00±200.90)pg/ml in the miR-338-3p inhibitor transfection group, which was lower than (4 063.00±131.50)pg/ml in the inhibitor negative control group ( t=7.005, P=0.002). The proportion of IL-17 + cells among T cells was (8.03±1.35)% in the miR-338-3p mimics transfection group, which was significantly higher than (4.52±0.73)% in the mimics negative control group ( t=3.968, P=0.017). The relative expression levels of IL-6, IL-23, and IL-1β mRNA were 2.23±0.21, 2.21±0.56, 2.32±0.43, respectively in the miR-338-3p mimics transfection group, which were significantly higher than 1.00±0.06, 1.00±0.07, 1.01±0.15 in the mimics negative control group ( t=10.290, P=0.001; t=3.747, P=0.020; t=5.280, P=0.006). Conclusions:Overexpression of miR-338-3p in BMDCs can promote the IRBP 1-20-specific Th17 cell response by increasing the expression of Th17-polarizing cytokines including IL-6, IL-1β and IL-23.
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Objective:To compare the changes of corneal asphericity and higher-order aberrations after smart pulse technology-assisted transepithelial photorefractive keratectomy (Smart) for low and moderate myopia and to investigate the changes in the shape of the front corneal surface in patients with different diopters.Methods:A non-randomized controlled study design was used.Ninety-eight eyes of 54 patients with moderate or low myopia who underwent Smart surgery in Tianjin Medical University Eye Hospital from November 2018 to March 2019 were included.The 41 eyes of 23 patients with low myopia were set as the low-myopia group, and 57 eyes of 31 patients with moderate myopia were assigned as the moderate-myopia group.The Pentacam anterior segment analysis system was used to measure Q value, index of surface variance (ISV), corneal higher-order aberration (HOA), corneal vertical coma (Z 3-1), corneal horizontal coma (Z 31) and spherical aberration (Z 40) before surgery, 1 month and 3 months after surgery.The anterior surface morphology was compared between the low-myopia and moderate-myopia group.Pearson correlation analysis was used to analyze the correlations between measurement parameters.The study protocol was approved by an Ethics Committee of Tianjin Medical University Eye Hospital (No.2019KY-17). Written informed consent was obtained from each patient before surgery. Results:Corneal Q value, ISV, HOA and Z 40 were 0.445±0.191, 26.973±5.611, 0.671±0.142 and 0.384±0.188, respectively, in the low-myopia group at one month after surgery, which were significantly increased than corresponding preoperative values of -0.273±0.817, 13.784±2.376, 0.433±0.687 and 0.231±0.062 (all at P<0.05). Corneal Q value, ISV, HOA and Z 40 were 0.693±0.203, 34.038±5.773, 0.874±0.216 and 0.520±0.129, respectively, in the moderate-myopia group at one month after surgery, which were significantly increased than corresponding preoperative values of -0.309±0.104, 14.838±3.992, 0.409±0.081 and 0.228±0.089 (all at P<0.05). Corneal Q values, ISV, HOA and Z 40 in the moderate-myopia group were higher than those in the low-myopia group at different time points after surgery, showing significant differences between the two groups (all at P<0.05). There was no significant difference in postoperative 1-month and 3-month corneal Z 3-1 and Z 31 between the two groups (both at P>0.05). The results of correlation analysis showed that there were no significant differences in ΔQ value and ΔISV between the two groups, both of which were negatively correlated with spherical equivalent (ΔQ value: low-myopia group: r=-0.364, P=0.044; moderate-myopia group: r=-0.589, P<0.01; ΔISV: low-myopia group: r=-0.298, P=0.039; moderate-myopia group: r=-0.409, P=0.022). ΔQ value and ΔZ 40 were positively correlated in the moderate-myopia group ( r=0.348, P=0.009); there was no significant correlation between ΔQ value and ΔZ 40 in the low-myopia group ( r=0.180, P=0.266). Conclusions:The corneal high-order aberrations and ISV after Smart are increased in comparison with preoperative values in the low-myopia and moderate-myopia eyes, and the corneal Q values change from negative to positive.The effect of Smart on corneal asphericity is less in the low-myopia eyes.
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Objective:To evaluate the clinical features of interface fluid syndrome (IFS) after laser in situ keratomileusis (LASIK).Methods:We searched PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure Database, Wanfang Database, and Chinese Science and Technology Periodical Database for literature reports on IFS published from 1999 to 2021.Article selection, data extraction, quality rating, and data analysis were performed with reference to the PRISMA statement for priority reporting entities of systematic reviews and Meta-analysis.Results:A total of 30 publications were included, including 46 cases (62 eyes). Among them, 34 cases (47 eyes) were male and 12 cases (15 eyes) were female.Age ranged from 19 to 69 years with a mean of (36.57±13.40) years.There were 16 cases of bilateral eyes and 30 cases of monocular eyes.The 85.48% (53/62) of IFS was due to increased intraocular pressure (IOP) after LASIK.All 62 eyes included had decreased visual acuity.The 24.19% (15/62) of the affected eyes had ocular pain, redness, and photophobia.All 46 patients showed different degrees of corneal edema and interface fluid.Keratic precipitates and anterior chamber cells were visible in 9.68% (6/62) of the affected eyes, and 16.13% (10/62) showed visual field damage.IOP-lowering eye drops were given to 77.42% (48/62) of eyes.Of the 31 patients (40 eyes) with prognostic descriptions, and 75.00% (30/40) recovered their vision with treatment and 25.00% (10/40) did not.Conclusions:IFS is a rare complication after LASIK.It should be considered in patients with corneal edema after LASIK.Proper measurement of IOP and reasonable application of glucocorticoids and IOP-lowering drops can prevent irreversible vision loss.
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Objective:To explore the relationship between contact lens (CL) related dry eye and morphological changes of meibomian glands.Methods:A cross-sectional study was performed.A total of 157 consecutive subjects (314 eyes) to underwent refractive surgery from May 2014 to June 2015 in Tianjin Medical University Eye Hospital were included.The subjects wearing soft CL for a long time were divided into CL group (182 eyes of 91 subjects), while the subjects who never wore CL were divided into the control group (132 eyes of 66 subjects). The ocular surface disease index (OSDI) questionnaire, tear meniscus height (TMH), first non-invasive tear film breakup time (fNIBUT), average non-invasive tear film breakup time (avNIBUT) and corneal fluorescein staining (CFS) score of all subjects were collected and analyzed.Morphological evaluation of meibomian glands were performed.The meibomian glands dropout ratio of upper eyelid, lower eyelid and total meibomian gland area as well as meibomian glands distortion number of the two groups were compared.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Tianjin Medical University Eye Hospital (No.2014KY[L]-09). Written informed consent was obtained from each patients prior to any examination.Results:The OSDI score, CFS score, TMH, fNIBUT and avNIBUT were 16.67(10.00, 25.00), 13.88(7.50, 18.26), 0.20(0.17, 0.23) mm, 5.64(3.95, 7.92)s and 8.56(6.56, 12.12)s in CL group, respectively, while 13.88(7.50, 18.26), 1.00(0.00, 2.00), 0.22(0.17, 0.29) mm, 7.33(4.54, 13.21)s and 11.49(7.46, 17.83)s in the control group, respectively.Compared with the control group, the CL group had the higher OSDI score, higher CFS score, lower TMH, lower fNIBUT, lower avNIBUT, and the differences were significant (all at P<0.01). The MG dropout ratio and meibomian gland distortion number were (29.42±12.24)% and 4(3, 6) in CL group, respectively, while (20.37±10.83)% and 3(1, 4) in the control group, respectively.In comparison with the control group, the CL group had the higher MG dropout ratio and greater meibomian gland distortion number ( t=6.76, P<0.01; U=7 656.00, P<0.01). A positive correlation was found between the total meibomian gland area dropout ratio and duration of CL wearing ( rS=0.404, P<0.01), OSDI scores ( rS=0.275, P<0.01), CFS scores ( rS=0.319, P<0.01). Conclusions:Long-term wearing of CL can lead to severe ocular discomfort, dry eye syndrome and morphological alterations in meibomian gland, suggesting that morphological abnormality of meibomian gland is presumably associated with the occurrence of ocular discomfort and dry eye syndromes in CL wearers.
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Objective@#To investigate the effect of human umbilical cord mesenchymal stem cells derived exosomes (hUC-MSC-exo) on the phenotype of peripheral blood macrophages from rabbit autoimmune dry eye and the expression of related cytokines.@*Methods@#The hUC-MSCs were isolated and characterized.Exosomes derived from hUC-MSCs were extracted by ultracentrifugation and observed directly using electronic microscopy.Specific markers of exosomes were analyzed by Western blot.Six rabbits were randomly divided into the normal control group and the dry eye group by using the random number table method, 3 rabbits for each group.Rabbit model of autoimmune dry eye was established in the dry eye group, and the lacrimal glands were collected for quantitative real-time PCR (qRT-PCR) at the 8th week.In vitro, activated peripheral blood mononuclear cells (PBMCs) from rabbit autoimmune dry eye model were incubated with hUC-MSC-exo or phosphate buffered saline (PBS). After 48 hours, cells from the hUC-MSC-exo group and the PBS control group were collected.The mRNA expression levels of related cytokine genes and subpopulation-related marker genes in macrophages were quantified by qRT-PCR.The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.This study protocol was approved by Ethic Committee of Tianjin Medical University Eye Hospital (No.TJYY20181217001). Written informed consent was obtained from each family before obtaining umbilical cord.@*Results@#Exosomes derived from hUC-MSCs had typical morphology and specific markers.qRT-PCR results showed that, the relative expression quantity of M1 macrophages phenotypic molecular nitric oxide synthase 2 (NOS2) mRNA and inflammatory factor tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) mRNA in the lachrymal organization in the dry eye model group was significantly higher than those in the normal control group (3.06±1.00 vs. 1.00±0.03, 2.77±0.72 vs. 1.01±0.02 and 1.30±0.08 vs. 1.01±0.01, respectively), the relative expression quantity of M2 macrophages phenotypic molecular arginase 1 (Arg1), CD206 and IL-10 mRNA in the lachrymal organization in the dry eye model group was significantly lower than those in the normal control group (0.55±0.07 vs. 1.00±0.00, 0.60±0.13 vs.1.00±0.00, 0.65±0.14 vs. 1.01±0.01, respectively), with significant differences between them (all at P<0.05). In vitro, the relative expression quantity of M1 macrophages phenotypic molecular NOS2 mRNA and inflammatory factor TNF-α, IL-1β mRNA in PBMCs in the hUC-MSC-exo group was significantly lower than those in the PBS control group (0.59±0.08 vs.0.98±0.03, 0.56±0.07 vs. 1.03±0.11, 0.47±0.04 vs.1.00±0.08)(all at P<0.05); the relative expression quantity of M2 macrophages phenotypic molecular Arg1, CD206 mRNA and anti-inflammatory cytokine TGF-β, IL-10 and IL-4 mRNA in PBMCs in the hUC-MSC-exo group was significantly higher than those in the PBS control group (2.13±0.28 vs. 1.10±0.17, 1.32±0.03 vs. 1.01±0.06, 1.53±0.20 vs. 1.05±0.10, 1.47±0.08 vs.0.98±0.03, 1.51±0.16 vs. 1.01±0.03), with significant differences between them (all at P<0.05).@*Conclusions@#hUC-MSC-exo can polarize peripheral blood macrophages toward immune-suppressive M2-like phenotype, inhibit the production of pro-inflammatory cytokines TNF-α and IL-1β, and meanwhile increase the expression of anti-inflammatory factors IL-10 and TGF-β.
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Objective To explore the distribution ofchoroidal thickness and its influence factors in university students.Methods A cross-sectional study.A total of 896 eyes of 896 college students were included in the study.Among them,there were 350 males (350 eyes) and 546 females (546 eyes).All the eyes were right eyes.The average age was 19.18 ± 1.36 years old.According to the spherical equivalent refraction (SER),the eyes were divided into non-myopia group,low myopia group,moderate myopia group and high myopia group,which were 59,251,356 and 230 eyes,respectively.The subfoveal ChT (SFCT) was measured using a swept-frequency source optical coherence tomography scanner.According to the ETDRS,the choroid within 6 mm of the fovea was divided into three concentric circles centered on the fovea of the macula,which were the central area with a diameter of 1 mm,the inner ring area of 1-3 mm and the outer ring area of 3-6 mm.The outer ring area of 3-6 mm has a total of 9 zones.The inner ring and outer ring 4 regions were superior,inferior,nasal and temporal,respectively.The distribution characteristics of ChT in different regions,genders and diopter groups were observed.Bivariate correlation analysis were used to analyze the correlation of ChT and SER,axial length (AL).Results The average SFCT of 896 eyes was 221.28± 67.35 μm.The mean SFCT of males and females were 227.20 ± 69.38 and 217.50± 65.80 μm,respectively.The difference of SFCT between different genders was statistically significant (t=2.075,P=0.038).Compared with the central region ChT,there was no significant difference in ChT between the outer ring and the outer region (t=0.086,P=0.932).The difference of ChT in other regions was statistically significant (t=-21.973,-5.818,36.328,-3.065,-18.017,-10.595,57.007;P＜0.001,＜0.001,＜0.001,＜0.002,＜0.001,＜0.001,＜0.001).In the horizontal direction,ChT gradually thickens from nasal to temporal (F=2 251.558,P＜0.001);in the vertical direction,ChT gradually decreases from superior to the central,but have a little increased from central to inner inferior,then decreased to outer inferior again (F=45.425,P＜0.05).Correlation analysis showed that SFCT was negatively correlated with AL (r=0.478,P＜0.01) and a negative correlation with axial length (r=-0.395,P＜0.01),and positively correlated with SER (r=0.478,P＜0.01).SFCT decreased by 12.29 μm for every in myopic refractive error of 1 D,or by 20.14 μm for every increase in AL of 1 mm.Conclusions ChT is changed by different location.The horizontal direction is gradually thickened from nasal to temporal.The vertical direction is thicker than the center.The inferior inner ring area is thicker than the outer ring area.Gender,SER and AL are the influencing factors of SFCT.
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Objective To establish the model of autoimmune dry eye and analyze the level of cytokines and the pathological changes of autoimmune dry eye rabbits treated with human umbilical cord mesenchymal stem cells (MSCs).Methods Twentyfour female New Zealand rabbits were randomly divided into three groups:Normal control group,dry eye group and MSCs treatment group,8 cases in each group.After treated with MSCs for six weeks,the pathological changes were observed,and the expression of Th1 and Th17 cell differentiation related cytokines mRNA in lacrimal gland tissue was detected by real-time quantitative PCR.The percentage of regulatory T cells (CD4 +Foxp3 + cells) in the lacrimal gland and spleen tissues of the dry eye model group and MSCs treatment group was measured by flow cytometry.Results After treatment with MSCs for 6 weeks,HE staining from each rabbit lacrimal gland showed that,the normal control group showed no or only a few lymphocytes;The lacrimal gland cells were atrophied in the dry eye group,the distribution of lymphocyte scattered around the gland and small blood vessels;Compared with dry eye group,the lacrimal gland lymphocyte infiltration reduced in MSCs treatment group,and the cell morphology were better.Compared with dry eye group,lymphocyte infiltration and aggregation in the conjunctival conjunctiva in MSCs treatment group were significantly reduced,the epithelial structure was intact,and the degeneration and atrophy cells were rare.The expression of inflammatory factors including interferon-γ(IFN-γ),Interleukin-17 (IL-17) and transcription factor T-bet mRNA were decreased in MSCs treatment group,there were significant difference compared with dry eye group (all P ＜ 0.05);Thl7 cell associated cytokines IL-17 expression levels were decreased,but no significant difference was found between two groups (P ＞ 0.05);The expression of transcription factor RORrt mRNA in dry eye group was significantly decreased,the difference was statistically significant (P ＜ 0.05).The expression of inflammatory factors TNF-α in the lacrimal gland tissue of MSCs treatment group was significantly lower than that in the dry eye model group,while the expression of the anti-inflammatory factor TGF-β was significantly higher than that in the dry eye model group,and the differences were statistically significant (all P＜0.05).The regulatory T cells (CD4 + Foxp3 + cells) in the lacrimal gland of dry eye model group accounted for 10％ of lymphocytes was,while the treatment group accounted for 27.8％,MSCs group was significantly higher than dry eye group,the difference was statistically significant (P ＜ 0.05).Conclusion MSCs can reduce the histopathological changes of the immune dry eye,and they may have immunoregulatory effects on autoimmune dry eye.The mechanisms of immunomodulatory effects may be related to the balance of inflammatory cytokines and anti-inflammatory cytokines.
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Objectivc To observe the short-term changes of anterior corneal biometry after discontinuation of orthokeratology in patients with 2-year wearing.Methods Retrospective study.Sixty myopic patients aged from 8-14 years old during October 2012 and October 2014 were wearing orthokeratology for 2 years in Tianjin Medical University Eye Hospital.According to the degree of myopia,they are divided into three groups(SE≤-2.00 D for group A,-2.00 D ＜ SE ≤-4.00 D for group B and -4.00 D ＜ SE ≤-6.00 D for group C).The recovery of anterior corneal curvature,including flat K(FK),steep K(SK),average K (AVEK),changes of axial length and central corneal thickness (CCT) at 1 week,2 weeks,1 month after discontinuation of orthokeratology were observed.Results There was no statistical differences in FK,SK,AVEK before and 2 weeks after wearing orthokeratology in group A (all P ＞ 0.05).While in group B,there was no significant difference in FK,SK,AVEK before and 1 month after wearing orthokeratology;There were statistically differences in FK,SK,AVEK at 1 month after discontinuation in group C compared with the baseline (all P ＜0.05).As for CCT,there was no statistical differences among group A,B,C after discontinuation of orthokeratology for 2 weeks (all P ＞ 0.05).There were statistical differences in the axial length between 1 week and 2 weeks after discontinuation of orthokeratology in group B and C (all P ＜ 0.05);There were statistical differences in the axial length between 1 month and 2 weeks after discontinuation of orthokeratology in three groups (all P ＜ 0.05);Compared with the state before wearing orthokeratology,the increase of axial length in group A,B,C were (0.43 ± 0.36) mm,(0.35 ± 0.21)mm and (0.36 ± 0.29) ram,respectively.Conclusion The time course of returning to the original corneal parameter varies among different degree of myopia,and the axial length has no significant growth after short-term discontinuation.
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Objeetive To compare corneal densitometry measured by Pentacam in normal and keratoconic eyes,and assess the differences in densitometry values among the stages of keratoconus.Methods Densitometry values for 66 eyes (36 eyes from keratoconus group,30 eyes from control group) were obtained for the 0-2 mm,2-6 mm,and 6-10 mm zones of the anterior (up to 120 mm),posterior (posterior 60 mm),and central (between the anterior and posterior) cornea.The differences in densitometry values among the stages of keratoconus were compared.Pearson correlation analysis was used to access the relationship among Keratoconus optical density,cornea thickness and flat K values.1~l~ In total diameter,the corneal densitometry between keratoconus group (17.96 ± 3.23) and control group (17.39 ± 1.95) was not significant different(P =0.124),but there were significant differences between the groups for densitometry measurements in central 2.0 mm zones(anterior,central and total layers),annulus 2-6 mm(anterior layers) and anterior layers in total diameter (all P ＜0.05).Divided by different stage of keratoconus,the anterior layer in mild Keratoconus had no difference with control group(P ＞0.05),but therewere significant differences in moderate keratoconus group(all P ＜ 0.05).In severe Keratoconus group,a statistically significant difference was present at the 2 central annuli in total thickness and annulus 2-6 mm (anterior,central and total layers) with control group (P ＜ 0.05).The correlation between corneal densitometry and the other parameters,including cornea thickness and flat K values were significant (all P ＜ 0.05).Conelusion Compared with normal cornea,there is no change in mild keratoconus.The increase of corneal densitometry in moderate keratoconus group happens in the anterior layers of 0-2 mum zones.The anterior layers of 0-6 mm zones and central layers in 0-2 mm zones in severe keratoconus group are higher than those of control group.More advanced cases present a higher corneal densitometry.Corneal densitometry is an important characteristic of keratoconus,it can be used to detect the process and therapeutic effect of keratoconus.
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Mesenchymal stem cells (MSCs) have good immune regulatory function,can inhibit many immune cell proliferation,direct effects on activation and proliferation of T cell,play a role in immune regulation by Treg cells or by the secretion of soluble factors regulating Thl/Th2 secretion and reaction equilibrium,inhibit the inflammation through the anti-inflammatory,regulation of cytokines expression at the same time,so reduce the expression levels of matrix metalloproteinase-2 and-9,which may promote lacrimal gland tissue damage,and thus play a role in immune regulation.MSCs can reduce the autoimmune dry eye clinical index,recovery secretion function of part lacrimal gland.This article reviews the research advances in inmmmne regulation of MSCs on autoimmune dry eye.
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Objective To evaluate the repeatability and agreement of two optical biometers (Lenstar LS900 (R) and SW-9000) for ocular biometry in Chinese adolescents.Methods A prospective study was conducted which included 65 ametropic patients,with an average age of (11.45 ± 2.67) years (age ranging from 8 to 18 years).The ocular biometry for right eyeball was performed with Lenstar LS900 (R) and SW-9000 respectively,followed by evaluation of the repeatability of the two biometers using one-way analysis of variance,and the agreement of the two instruments using the Bland-Altman plot.Results The repeatability of parameters measured by Lenstar LS900 (R),including axial length (AL),K value in the flattest meridian (K1),K value in the steepest meridian (K2),central corneal thickness (CCT),anterior depth (AD),lens thickness (LT),pupil diameter (PD),was well,and all intraclass correlation coefficient (ICC) ＞ 0.9;the repeatability of white to white (WTW) was inferior to other parameters,but it was still ＞0.88.The repeatability of AL,K1,K2,CCT measured by SW-9000 was good,with their ICC ＞ 0.9,but the repeatability of other parameters was poor.The parameters with good repeatability including AL,K1,K2,CCT measured by SW-9000 and Lenstar LS900 (R) were compared respectively,and the results showed that AL and CCT examined by SW-9000 were slightly longer than those measured by Lenstar LS900 (R),and the difference was statistically significant (all P ＜ 0.05).However,there was no significant difference about K1,K2 (all P＞0.05).Moreover,the AL,K1,K2 and CCT measured by the two instruments had close linear correlation (all r ＞0.97,all P ＜0.01).The BlandAltman plot showed that 95％ LoA (limits of agreement) of AL was (-0.057 to 0.133) mm,K1 was (-0.456 to 0.369) D,K2 was (-0.388 to 0.549) D and CCT was (-3.483 to 8.016) μm.Conclusion Biometric parameters including AL,K1,K2,CCT measured by Lenstar LS900 (R) and SW-9000 have good repeatability in the adolescents aged 8-18 years and they are highly correlated;meanwhile,the agreement of AL,K1,K2,CCT measured by SW-9000 with Lenstar LS900 (R) is acceptable in clinical practices.