Repeatability of wavefront aberration measured by adaptive optics visual simulator and agreement of OPD-Scan Ⅲ / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To assess the repeatability and agreement of higher-order aberration obtained by adaptive optics visual simulator(VAO)compared with OPD-Scan Ⅲ.METHODS: A cross-sectional study was conducted from August to September 2023, including a total of 204 patients(204 eyes)with myopia whose right eyes were measured. The examinations were performed by the same skilled examiner using both devices separately. The VAO device was used to measure higher order aberrations of orders 3 to 6 at a pupil diameter of 4.5 mm, while both the VAO and OPD-Scan Ⅲ devices were utilized to measure total higher-order aberration(tHOA), spherical aberration(SA), coma aberration(Coma), and trefoil aberration(Trefoil)of the entire eye at pupil diameters ranging from 3 to 6 mm. Furthermore, the repeatability of whole eye aberration measurements obtained with the VAO device was evaluated and the agreement of the two devices was assessed.RESULTS: The whole-eye higher-order aberrations measured by VAO demonstrated excellent repeatability(0.767≤ICC≤0.941, Sw<0.01 μm, TRT<0.1 μm). There was no statistically significant difference in Coma measured by VAO or OPD-Scan Ⅲ for pupil diameters ranging from 4 to 6 mm(P>0.05), while a statistically significant difference was observed in whole-eye tHOA of other pupil diameters(all P<0.05). The agreement of aberration measurements for each order between VAO and OPD-Scan Ⅲ for 3 mm pupil diameters, SA at 4 and 5 mm pupil diameter and Coma at 4 mm pupil diameter showed a 95% limit of agreement(LoA)<0.1, indicating good agreement; however, poor agreement was found for the remaining aberration measurements at different pupil diameters, with a 95%LoA>0.1, and there were significant differences in higher-order aberrations measured by two devices under a pupil diameter of 3 mm(r=0.218-0.317, P<0.01), 4 mm(r=0.406-0.672, P<0.01), 5 mm(r=0.538-0.839, P<0.01 and r=0.030-0.109, P>0.01)and 6 mm(r=0.369-0.766, P<0.01).CONCLUSION: The VAO demonstrates favorable repeatability when assessing whole-eye higher order aberration under pupil diameters of 3-6 mm. However, there is inadequate agreement and interchangeability in whole-eye higher order aberration at 3-6 mm pupil diameter between VAO and OPD-Scan Ⅲ for clinical purposes.

Efficacy of capsular tension ring implantation on high myopia patients with cataract: a meta-analysis / 中华实验眼科杂志

Objective:To systematically evaluate the efficacy of phacoemulsification and intraocular lens (IOL) with and without capsular tension ring (CTR) in patients with high myopia and cataract.Methods:MEDLINE, EMBASE, Cochrane Library, and Chinese databases including CNKI, Wanfang Data, and VIP databases were searched from their establishment to October 2020 to obtain peer-reviewed clinical studies comparing the efficacy of cataract phacoemulsification and IOL implantation combined with CTR implantation (experimental group) and cataract phacoemulsification and IOL implantation (control group) in patients with high myopia and cataract.Literature screening, data extraction and methodological quality assessment were implemented based on inclusion and exclusion criteria.A meta-analysis of postoperative best corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution unit, posterior capsular opacification (PCO), capsular contraction syndrome (CCS), retinal detachment (RD) was performed using Revman 5.3 software with mean difference ( MD) and odds ratio ( OR) describing the effect sizes of measurement data and count data, respectively. Results:Eight studies with 2 085 eyes were included in this study, including 1 054 eyes in the experimental group and 1 031 eyes in the control group.Meta-analysis showed that there was no significant difference in BCVA between the two groups at 1 week, 1 month, and 3 months after surgery, but the improvement in BCVA at 6 months after surgery was significantly better in the experimental group than in the control group ( MD: -0.11; 95% CI: -0.15--0.07; P<0.01). The incidence rates of postoperative PCO ( OR: 0.24; 95% CI: 0.15-0.36; P<0.01) and CCS ( OR: 0.08; 95 % CI: 0.01-0.65; P=0.02) and RD ( OR: 0.21; 95% CI: 0.05-0.82; P=0.02) were lower in the experimental group than in the control group, and the differences were statistically significant. Conclusions:The combination of CTR in the treatment of patients with high myopia and cataract can improve the postoperative visual quality and reduce the incidence of postoperative PCO, CCS and RD.

Accuracy of different intraocular lens power calculation formulas in cataract patients with shallow anterior chamber: a meta-analysis / 中华实验眼科杂志

Objective:To systematically compare the accuracy of intraocular lens (IOL) power calculation formulas in cataract patients with shallow anterior chamber.Methods:A comprehensive literature search was conducted in MEDLINE, EMBASE, Cochrane Library, and the Chinese databases including CNKI, Wanfang, and VIP databases.The peer-reviewed literature on the accuracy of IOL power calculation formulas in cataract patients with shallow anterior chamber was searched from the establishment of the database until August 2020.Literature screening, data extraction and quality assessment were performed according to inclusion and exclusion criteria.The mean difference ( MD) of mean absolute error (MAE) among different formulas was analyzed.Meta-analysis was performed using Revman 5.3 software. Results:Seven studies involving 499 eyes were included.The accuracy of six formulas, Barrett Universal Ⅱ, Haigis, SRK/T, Hoffer Q, Holladay 1 and Holladay 2, was evaluated.The MAE of Barrett Universal Ⅱ was significantly lower than that of Hoffer Q ( MD=0.11 D; 95% CI: 0.05-0.17 D; P<0.001), Haigis ( MD=0.08 D; 95% CI: 0.03-0.13 D; P=0.002), and Holladay 2 ( MD=-0.06 D; 95% CI: -0.11--0.01 D; P=0.020). No significant difference was found in the remaining pairwise comparisons (all at P>0.05). Conclusions:The Barrett Universal Ⅱ formula is more accurate than Hoffer Q, Haigis, and Holladay 2 formulas in predicting IOL power in cataract patients with shallow anterior chamber.

Repeatability of CASIA2 for measuring the tilt and decentration of crystalline lens and intraocular lens under non-mydriatic and mydriatic conditions / 中华实验眼科杂志

Objective:To investigate the repeatability and correlation in tilt and decentration measurement of crystalline lens and intraocular lens (IOL) under non-mydriatic and mydriatic conditions using swept-source ocular coherence tomography CASIA2.Methods:A diagnostic test study was conducted.A total of 109 cataract patients (157 eyes) who received phacoemulsification with IOL implantation surgery in the Affiliated Hospital of North Sichuan Medical College from March to July 2020 were enrolled.The decentration and tilt of crystalline lens and IOL under non-mydriatic and mydriatic conditions were measured for three times by a single examiner using CASIA2 before and one week after surgery.The 0.5% compound tropicamide eye drops were used to dilate.Repeatability was evaluated by within-standard deviation, test-retest repeatability (TRT), coefficient of variation (CoV) and intraclass correlation coefficient (ICC). The correlation in decentration and tilt of crystalline lens and IOL between before and after mydriasis was assessed by Pearson correlation coefficient.This study adhered to the Declaration of Helsinki, and the study protocol was approved by an Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (No.2020ER030-1). Written informed consent was obtained from all subjects before any medical examination.Results:The decentration of crystalline lens under non-mydriatic and mydriatic conditions was (0.217±0.112)mm and (0.220±0.110)mm, respectively, and the tilt was (5.017±1.422)° and (5.310±1.645)°, respectively.The decentration of IOL under non-mydriatic and mydriatic conditions was (0.245±0.136)mm and (0.250±0.145)mm, respectively, and the tilt was (5.144±1.345)° and (5.437±1.646)°, respectively.No significant difference was found between non-mydriatic and mydriatic conditions (all at P>0.05). Under both non-mydriatic and mydriatic conditions, the crystalline lenses of both eyes decentered and tilted toward the inferotemporal direction, and the IOL of right eyes decentered toward the inferior and tilted toward the inferotemporal direction, and the IOL of left eyes decentered and tilted toward the inferotemporal direction.Except the crystalline lens decentration, the measurement repeatability of crystalline lens tilt, IOL decentration and tilt in cataract patients before and after mydriasis was good, with ICC range in 0.815-0.984, TRT<50% and CoV≤14.840%.The measurement repeatability of crystalline lens decentration was poor, and the measurement repeatability of decentration axis, tilt and tilt axis of crystalline lens, and the repeatability of decentration and tilt of IOL were good in both eyes, with ICC range in 0.757-0.998, TRT<50% and CoV≤17.763%.There were good correlations in decentration, decentration axis, tilt and tilt axis of crystalline lens and IOL between non-mydriatic and mydriatic conditions (all r≥0.679, all at P<0.01). Conclusions:The measurement repeatability of decentration axis, tilt and tilt axis of crystalline lens and IOL, as well as the decentration of IOL by CASIA2 before and after mydriasis is good.The correlations of the measured parameters before and after mydriasis are good.

Agreement evaluation between adaptive optics visual simulator and conventional refraction methods / 中华实验眼科杂志

Objective:To evaluate the difference and agreement of cycloplegic refraction between adaptive optics visual simulator (VAO) and conventional refraction methods.Methods:A diagnostic test study was conducted.Thirty-one eyes of 31 healthy subjects including 15 males and 16 females were enrolled in November, 2019 in Affiliated Hospital of North Sichuan Medical College.Mean age of the subjects was (20.1±1.0) years, and the right eye was taken for data analysis.Cycloplegic refraction was measured by VAO and conventional refraction methods, respectively.Spherical power, cylindrical power, Jackson cross-cylinder power at axis 90° and 180° (J 0) and Jackson cross-cylinder power at axis 45° and 135° (J 45) vector powers were recorded.Paired t-test was used to compare the refractive parameters between different refraction methods, and the intraclass correlation coefficient (ICC) and Bland-Altman plots were used to evaluate the agreement between VAO and conventional refraction methods.This study adhered to the Declaration of Helsinki, and the research protocal was approved by an Ethics Committee of Affiliated Hospital of North Sichuan Medical College (No.2020ER[A]018). Written informed consent was obtained from each subject prior to any medical examination. Results:For subjective refraction, the ICC for spherical power, cylindrical power, J 0 and J 45 between VAO and phoropter were 0.97, 0.75, 0.84 and 0.09, respectively.For objective refraction, the ICC for spherical power, cylindrical power, J 0 and J 45 between VAO and autorefractor were 0.98, 0.70, 0.74 and 0.61, respectively.The mean differences in spherical power, cylindrical power, J 0 and J 45 between VAO and phoropter were (0.05±0.32), (-0.23±0.28), (-0.10±0.14) and (-0.04±0.16)D, respectively, and the differences in cylindrical power and J 0 were statistically significant (both at P<0.01), whereas no significant differences in spherical power and J 45 were found ( P=0.41, 0.18). The mean differences in spherical power, cylindrical power, J 0 and J 45 measured by VAO and autorefractor were (-0.70±0.26), (-0.07±0.46), (-0.03±0.27) and (0.01±0.12)D, respectively, and the spherical power measurement by VAO was significantly more negative than the autorefractor ( t=15.09, P<0.01), while no significant differences in cylindrical power, J 0 and J 45 were found ( P=0.39, 0.59, 0.63). No significant difference values in spherical power, cylindrical power, J 0 and J 45 were found between the two objective refraction methods and phoropter subjective refraction (all at P>0.05). Conclusions:With cycloplegia, spherical power obtained by VAO objective refraction is more negative compared with autorefractor.There is a good agreement of spherical power and astigmatism vector values measured by VAO and phoropter subjective refraction, and the measurement differences are clinically acceptable.

Binocular vision problems associated with refractive surgery and the use of risk screening / 中华实验眼科杂志

Although binocular vision problems do not appear to be one of the common complications of refractive surgery,the available evidence suggests that these problems can occur after refractive surgery,and preoperative binocular vision status may predict the risk of postoperative binocular vision anomalies.Furthermore,because ophthalmologists usually do not clearly recognize binocular vision,or they do not pay enough attention to it,the existing literature may underestimate the actual prevalence of binocular vision problems after refractive surgery.This paper discusses the existing literature on refractive surgery-related binocular vision anomalies and recommends a screening protocol and risk stratification.It also discusses the expected results of binocular vision testing,the diagnostic criteria for common binocular vision problems,and strategies for treating these anomalies before and after refractive surgery.

Binocular vision problems associated with refractive surgery and the use of risk screening / 中华实验眼科杂志

Although binocular vision problems do not appear to be one of the common complications of refractive surgery, the available evidence suggests that these problems can occur after refractive surgery, and preoperative binocular vision status may predict the risk of postoperative binocular vision anomalies.Furthermore, because ophthalmologists usually do not clearly recognize binocular vision, or they do not pay enough attention to it, the existing literature may underestimate the actual prevalence of binocular vision problems after refractive surgery.This paper discusses the existing literature on refractive surgery-related binocular vision anomalies and recommends a screening protocol and risk stratification.It also discusses the expected results of binocular vision testing, the diagnostic criteria for common binocular vision problems, and strategies for treating these anomalies before and after refractive surgery.

miR-29a in Exosomes from Bone Marrow Mesenchymal Stem Cells Inhibit Fibrosis during Endometrial Repair of Intrauterine Adhesion

Background and Objectives@#Bone marrow mesenchymal stem cells (BMSCs) is an ideal source of stem cells in the treatment of intrauterine adhesion. Exosomes are a type of membrane vesicle and the diameter is 30∼100 nm. Exosomes can take their contents into the target cells, releasing and exerting their functions. In this study, we intend to study the role of human BMSC-derived exosomes (BMSC-Exo) in promoting endometrial damage repair in the treatment of IUA. @*Methods@#We used the magnetic bead affinity method to extract BMSC-Exo and analyzed its biological character. Then we co-cultured the BMSCs-Exo with endometrial cells to detect its effect. We injected BMSCs-Exo into the IUA mouse model. We over-expressed miR-29a in BMSCs-Exo by transient transfection, then used RT-PCR to analyze the expression of the related genes. @*Results@#BMSCs-Exo expressed exosome-specific proteins CD9, CD63, and CD81. BMSCs-Exo could bring the contents into the target cells. BMSCs-Exo can promote endometrial repair in vitro or in vivo. BMSCs-Exo overexpressing miR-29a can reduce αSMA, Collagen I, SMAD2, and SMAD3. @*Conclusions@#In this study, we successfully isolated BMSCs-Exo and proved its character and biological activity. BMSCs-Exo can promote cell proliferation and cell migration in vitro and can repair damaged endometrium in the IUA model. The presence of miR-29a in BMSCs-Exo may be an important factor in its resistance to fibrosis during endometrial repair of IUA. This study provides new ideas for the treatment of patients with IUA and has important clinical research significance.

Transcriptomic Features of Echinococcus granulosus Protoscolex during the Encystation Process

Cystic echinococcosis (CE) is a zoonotic infection caused by Echinococcus granulosus larvae. It seriously affects the development of animal husbandry and endangers human health. Due to a poor understanding of the cystic fluid formation pathway, there is currently a lack of innovative methods for the prevention and treatment of CE. In this study, the protoscoleces (PSCs) in the encystation process were analyzed by high-throughput RNA sequencing. A total of 32,401 transcripts and 14,903 cDNAs revealed numbers of new genes and transcripts, stage-specific genes, and differently expressed genes. Genes encoding proteins involved in signaling pathways, such as putative G-protein coupled receptor, tyrosine kinases, and serine/threonine protein kinase, were predominantly up-regulated during the encystation process. Antioxidant enzymes included cytochrome c oxidase, thioredoxin glutathione, and glutathione peroxidase were a high expression level. Intriguingly, KEGG enrichment suggested that differentially up-regulated genes involved in the vasopressin-regulated water reabsorption metabolic pathway may play important roles in the transport of proteins, carbohydrates, and other substances. These results provide valuable information on the mechanism of cystic fluid production during the encystation process, and provide a basis for further studies on the molecular mechanisms of growth and development of PSCs.

Repeatability and reproducibility of swept-source optical coherence tomography biometer for measuring the biological parameters of the eyeballs in healthy people / 中华实验眼科杂志

Objective@#To evaluate the repeatability and reproducibility of swept-source optical coherence tomography biometrics (Tomey OA-2000) for measuring the biological parameters of the eyeballs in healthy people.@*Methods@#A diagnostic test was carried out in this study.One hundred and three healthy volunteers who were recuited from July to September 2018 in Affiliated Hospital of North Sichuan Medical College were included, and the right eyes were examined.Two examiners used OA-2000 for 3 consecutive measurements, respectively.One week later, the first examiner used OA-2000 for 3 consecutive measurements.The ocular biological parameters including axial length (AL), anterior chamber depth (ACD), corneal curvature (K), lens thickness (LT), central corneal thickness (CCT), pupil diameter (PD), and white to white (WTW) were measured.The repeatability and reproducibility of each parameter based on within-subject standard deviation (SW), repeatability limit of standard deviation (2.77SW), coefficient of variation (CoV) and intra-class correlation coefficient (ICC) was evaluated.This study followed the Declaration of Helsinki.This study protocol was approved by Ethic Committee of the Affiliated Hospital of North Sichuan Medical College (No.2018ER[A]019).@*Results@#Of the ocular biological parameters measured by OA-2000, CoV was less than 2% while ICC was greater than 0.950, except PD and WTW.The repeatability and reproducibility of K, AL and ACD were all good.For K1(ø=2.5 mm and 3.0 mm), the SW was less than 0.120 D, the 2.77SW was less than 0.350 D, the CoV was less than 0.293%, and the ICC was greater than 0.990; For K2 (ø = 2.5 mm and 3.0 mm) , the SW were less than 0.175 D, the 2.77SW were less than 0.485 D, the CoV was less than 0.396%, the ICC was greater than 0.980; for Km (ø = 2.5 mm and 3.0 mm), the SW were less than 0.099 D, 2.77SW were less than 0.275 D, CoV was less than 0.227%, ICC was greater than 0.996; ACD SW was less than 0.024 mm, 2.77SW was less than 0.066 mm, CoV was less than 0.668%, ICC were greater than 0.993; the SW of AL was less than 0.014 mm, the 2.77SW was less than 0.038 mm, the CoV was less than 0.057%, and all of the ICCs were 1.000.@*Conclusions@#Except PD and WTW, the ocular biological parameters measured by OA-2000 have good repeatability and reproducibility, in which the accuracy of AL measurement is the highest.