Digital Gonioscopy Based on Three-dimensional Anterior-Segment OCT: An International Multicenter Study.

PURPOSE: To develop and evaluate the performance of a 3-dimensional (3D) deep-learning-based automated digital gonioscopy system (DGS) in detecting 2 major characteristics in eyes with suspected primary angle-closure glaucoma (PACG): (1) narrow iridocorneal angles (static gonioscopy, Task I) and (2) peripheral anterior synechiae (PAS) (dynamic gonioscopy, Task II) on OCT scans. DESIGN: International, cross-sectional, multicenter study. PARTICIPANTS: A total of 1.112 million images of 8694 volume scans (2294 patients) from 3 centers were included in this study (Task I, training/internal validation/external testing: 4515, 1101, and 2222 volume scans, respectively; Task II, training/internal validation/external testing: 378, 376, and 102 volume scans, respectively). METHODS: For Task I, a narrow angle was defined as an eye in which the posterior pigmented trabecular meshwork was not visible in more than 180° without indentation in the primary position captured in the dark room from the scans. For Task II, PAS was defined as the adhesion of the iris to the trabecular meshwork. The diagnostic performance of the 3D DGS was evaluated in both tasks with gonioscopic records as reference. MAIN OUTCOME MEASURES: The area under the curve (AUC), sensitivity, and specificity of the 3D DGS were calculated. RESULTS: In Task I, 29.4% of patients had a narrow angle. The AUC, sensitivity, and specificity of 3D DGS on the external testing datasets were 0.943 (0.933-0.953), 0.867 (0.838-0.895), and 0.878 (0.859-0.896), respectively. For Task II, 13.8% of patients had PAS. The AUC, sensitivity, and specificity of 3D DGS were 0.902 (0.818-0.985), 0.900 (0.714-1.000), and 0.890 (0.841-0.938), respectively, on the external testing set at quadrant level following normal clinical practice; and 0.885 (0.836-0.933), 0.912 (0.816-1.000), and 0.700 (0.660-0.741), respectively, on the external testing set at clock-hour level. CONCLUSIONS: The 3D DGS is effective in detecting eyes with suspected PACG. It has the potential to be used widely in the primary eye care community for screening of subjects at high risk of developing PACG.

Retinal Neurodegeneration in Diabetic Peripheral Neuropathy by Optical Coherence Tomography: A Systematic Review and Meta-analysis.

PURPOSE: The optical coherence tomography (OCT) has been used to evaluate the changes of retinal degeneration in patients with diabetic peripheral neuropathy (DPN) in recent years, but the results of previous studies were controversial. Therefore, systematic review and meta-analysis were performed to evaluate the degree of retinal neurodegeneration in DPN measured by OCT. METHODS: A comprehensive search of PubMed, Embase, Web of Science, Scopus, China Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI), VIP, and Wanfang databases were performed to identify studies that evaluate retinal neurodegeneration in DPN by using OCT. The included studies were critically reviewed and meta-analyses were performed to evaluate differences of the OCT-derived parameters between the DPN and non-DPN patients. RESULTS: Twelve studies were included in the final meta-analysis, involving a total of 1,807 eyes (573 in the DPN group and 1,229 in the non-DPN group). The mean peripapillary retinal nerve fiber layer (pRNFL) thickness was significantly lower in the DPN group than in the non-DPN group (weighted mean difference [WMD] = -8.37 µm; 95% CI: -11.00, -5.74). The reduction of pRNFL thickness was the most pronounced in the inferior quadrant, and the differences in the nasal and temporal quadrants were also statistically significant, with WMD (95% CI) being -4.63 µm (-7.51, -1.76) and -3.92 µm (-6.86, -0.98), respectively. Similar results were observed for macular parameters, with WMD and 95% CI being -1.0 µm (-1.5, -0.5) for macular retinal nerve fiber layer (mRNFL), -2.7 µm (-10.7, -5.3) for macular ganglion cell-inner plexiform layer (mGCIPL), and -2.2 µm (-4.4, -0.04) for macular ganglion cell complex (mGCC), respectively. CONCLUSIONS: Patients with DPN present with significant retinal neurodegeneration, with reduced pRNFL, mRNFL, mGCIPL, and mGCC thickness. Measurements of OCT parameters may serve as a biomarker for diagnosing and monitoring DPN.

Aerobic exercise reduces intraocular pressure and expands Schlemm's canal dimensions in healthy and primary open-angle glaucoma eyes.

Purpose: Aerobic exercise (AE) has been reported to decrease intraocular pressure (IOP) in healthy subjects and there are concomitant morphological changes in the anterior segment of the eye including the Schlemm's canal (SC). However, its effects on IOP and SC morphology in glaucoma patients had not been studied before. We aim to investigate the effect of AE on the IOP and SC dimension in both healthy and primary open-angle glaucoma (POAG) eyes. Methods: The area and diameter of SC and IOP were measured in 35 primary open-angle glaucoma (POAG) patients (59 eyes) and 36 healthy subjects (72 eyes) before and after performing moderate intensity of AE by running on a treadmill for 30 min. SC was imaged by swept-source optical coherence tomography (SS-OCT) for evaluation. Results: In comparison with baseline values, mean IOP decreased significantly following AE in both POAG and healthy eyes (both P < 0.001), in which POAG eyes showed a greater degree of reduction compared to healthy eyes (P = 0.002). In comparison with baseline values, in both POAG and healthy eyes, the average cross-sectional area (POAG: 80.48 +/- 59.54 vs. 99.20 +/- 54.87 pixels; healthy: 151.84 +/- 52.76 vs. 198.23 +/- 53.70 pixels; both P < 0.001) and diameter (POAG: 3.73 +/- 1.69 vs. 4.33 +/- 1.74 pixels; healthy: 5.61 +/- 1.02 vs. 6.47 +/- 1.20 pixels; both P < 0.001) of SC significantly increased after AE. In POAG, both treated and untreated with IOP-lowering medications, a significant reduction in mean IOP and increase in SC dimensions following AE were observed (all P < 0.05), and there were no significant differences of such measurements between the two subgroups (all P > 0.05). Conclusion: AE-induced reduction in IOP and an increase in SC dimensions in POAG eyes as in healthy eyes. Further studies to evaluate the long-term effect of AE on IOP control and SC morphology in POAG seem warranted.

WITH OR WITHOUT INTERNAL LIMITING MEMBRANE PEELING FOR IDIOPATHIC EPIRETINAL MEMBRANE: A Meta-Analysis of Randomized Controlled Trials.

PURPOSE: To clarify whether internal limiting membrane (ILM) peeling provides better outcomes for patients with idiopathic epiretinal membrane. METHODS: Randomized controlled trials comparing epiretinal membrane removal with and without ILM peeling were searched in Embase, PubMed, Web of Science, Cochrane Library, and CNKI before April 15, 2020. The pooled mean difference (MD) for best-corrected visual acuity, central macular thickness, and odds ratio for recurrence were calculated. RESULTS: Eight randomized controlled trials involving 422 eyes were included. No significant difference in best-corrected visual acuity (final follow-up: MD, 0.03 logarithm of the minimum angle of resolution [1.5 Early Treatment Diabetic Retinopathy Study letters]; 95% confidence interval [CI], -0.04 to 0.09 [-4.5 to 2 Early Treatment Diabetic Retinopathy Study letters]; P = 0.40) or recurrence rate (odds ratio, 0.21; 95% CI, 0.04-1.05; P = 0.06) between the groups was observed. However, patients with ILM peeling presented thicker central macular thickness at 3 months (MD, 16.36; 95% CI, 1.26-31.46; P = 0.03), 6 months (MD, 22.64; 95% CI, 10.29-34.98; P = 0.0003) and the final follow-up (MD, 25.87; 95% CI, 13.96-37.79; P < 0.0001). CONCLUSION: The study showed that ILM peeling did not significantly improve the postoperative visual outcome or decrease recurrence, but result in thicker central macular thickness, indicating that it is inessential for idiopathic epiretinal membrane.

Laser Trabeculoplasty for Open-Angle Glaucoma: A Systematic Review and Network Meta-Analysis.

PURPOSE: We sought to comprehensively evaluate the effectiveness of different types of laser trabeculoplasty (LT) in the treatment of open-angle glaucoma. DESIGN: Systematic review and network meta-analysis. METHODS: Eligible randomized controlled trials were identified by searching PubMed, EMBASE, Cochrane Library, SCOPUS, China National Knowledge Infrastructure, and the Chinese Biomedical Literature Service System for studies published between January 1, 2000 and April 20, 2020. Eight interventions were evaluated, including argon LT (ALT), medications, 180-degree selective LT (SLT), 270-degree SLT, 360-degree SLT, new LT, transscleral 360-degree SLT with SLT performed without gonioscopy, and low-energy 360-degree SLT. The primary outcome was reduction of medicated and unmedicated intraocular pressure (IOP) at 6 months. Secondary outcomes included reduction of IOP at 12 months, incidences of complications, and change in number of medications. Head-to-head meta-analysis and network meta-analysis were performed using Stata and R software. RESULTS: In total, 22 studies were included, involving 2859 eyes of 2704 patients. In terms of IOP reduction at 6 and 12 months, there were no statistically significant differences in both medicated and unmedicated IOP between any pairs of interventions considered herein, as determined based on both head-to-head and network meta-analyses (all P > .05). In terms of reduction of medications, the individuals treated with 180-degree SLT required fewer medications than those treated with ALT at 12 months (0.28 [95% confidence interval, 0.06-0.50]; P = .014). No severe adverse outcomes were reported for any of the interventions. CONCLUSIONS: All the available types of LT are equally effective for decreasing IOP compared with medication-based therapy. The 180-degree SLT was slightly more effective than ALT in terms of reducing the number of medications needed. Additional well-performed randomized controlled trials with larger sample sizes are needed.

Circular RNAs: Potential Star Molecules Involved in Diabetic Retinopathy.

Purpose: To summarize the research status on the function and mechanism of circRNAs in regulating the occurrence of diabetic retinopathy (DR). Methods: We systematically searched PubMed, Embase.com, and ARVO Abstracts website and reviewed relevant studies. Results: Thousands of circRNAs were found to be aberrantly expressed in DR patients, animal models, or cell models. A few circRNAs, such as cPWWP2A, circDNMT3B, circHIPK3, circ_0005015, et al were demonstrated to play an important role in DR by regulating the angiogenesis, proliferation, apoptosis, and inflammatory response of various cells in the retina. Conclusion: CircRNAs are involved in the development of DR. CircRNAs can not only serve as DR biomarkers, but also become therapeutic targets for DR. The role of plenty of circRNAs in DR is yet to be discovered.

Natural history of glaucomatous optic neuropathy in highly myopic Chinese: study protocol for a registry cohort study.

INTRODUCTION: Myopic maculopathy and glaucoma belong to the most common causes of irreversible blindness worldwide and, having an ocular axial elongation as one of their main risk factors, can occur together. The detection of glaucomatous optic neuropathy (GON) in highly myopic eyes is clinically and technically difficult, and there is no information available, neither about the natural course of GON or about the course of GON under intraocular pressure-lowering therapy. We therefore designed this study to explore the natural course of GON in highly myopic eyes. METHODS AND ANALYSIS: In this single-centred longitudinal registry cohort study, 813 highly myopic individuals will be recruited and undergo detailed ophthalmic examinations. High myopia is defined by a myopic refractive error of ≥-6 D or an axial length of ≥26.5 mm. GON is defined by a glaucomatous appearance of the optic nerve head or glaucomatous visual field (VF) defects. GON progression is defined by either change of the optic disc or VF. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the ethical committee of the Zhongshan Ophthalmic Center (ZOC), Sun Yat-sen University, China (ID: 2019KYPJ079). All the participants are required to provide informed consents. Results will be disseminated through scientific meetings and published in peer-reviewed journals. The data will be deposited at the clinical research centre in ZOC using electronic data capture system, and a copy of paper files will also be kept. Only members of the project team will have access to these data. TRIAL REGISTRATION NUMBER: NCT04302220.

Development and clinical deployment of a smartphone-based visual field deep learning system for glaucoma detection.

By 2040, ~100 million people will have glaucoma. To date, there are a lack of high-efficiency glaucoma diagnostic tools based on visual fields (VFs). Herein, we develop and evaluate the performance of 'iGlaucoma', a smartphone application-based deep learning system (DLS) in detecting glaucomatous VF changes. A total of 1,614,808 data points of 10,784 VFs (5542 patients) from seven centers in China were included in this study, divided over two phases. In Phase I, 1,581,060 data points from 10,135 VFs of 5105 patients were included to train (8424 VFs), validate (598 VFs) and test (3 independent test sets-200, 406, 507 samples) the diagnostic performance of the DLS. In Phase II, using the same DLS, iGlaucoma cloud-based application further tested on 33,748 data points from 649 VFs of 437 patients from three glaucoma clinics. With reference to three experienced expert glaucomatologists, the diagnostic performance (area under curve [AUC], sensitivity and specificity) of the DLS and six ophthalmologists were evaluated in detecting glaucoma. In Phase I, the DLS outperformed all six ophthalmologists in the three test sets (AUC of 0.834-0.877, with a sensitivity of 0.831-0.922 and a specificity of 0.676-0.709). In Phase II, iGlaucoma had 0.99 accuracy in recognizing different patterns in pattern deviation probability plots region, with corresponding AUC, sensitivity and specificity of 0.966 (0.953-0.979), 0.954 (0.930-0.977), and 0.873 (0.838-0.908), respectively. The 'iGlaucoma' is a clinically effective glaucoma diagnostic tool to detect glaucoma from humphrey VFs, although the target population will need to be carefully identified with glaucoma expertise input.

Smaller Anterior Chamber Volume Is Associated With Higher Risk of Intraocular Pressure Elevation After Laser Peripheral Iridotomy: A 1-Year Follow-Up Study.

PURPOSE: The aim of this study was to analyze the predictive value of swept-source optical coherence tomography (SS-OCT) derived anterior-segment volumetric parameters such as anterior chamber volume (ACV) in the long-term follow-up of primary angle closure disease (PACD). DESIGN: Longitudinal observational study. METHODS: In this single-center longitudinal observational study, PACD patients undergoing laser peripheral iridotomy (LPI) were recruited. Anterior segment images of the patients were captured using SS-OCT before LPI, and at 1 week, 1 month, 3 months, 6 months, and 1 year after LPI. Ninety eyes of 81 subjects were enrolled, and 72 eyes of 72 subjects finished the 1 year follow-up. Data of all the 81 subjects were included for analysis. Intraocular pressure (IOP) elevation was defined as IOP >21 mm Hg at any time point after LPI. The association between baseline trabecular-iris space area 750 µm from scleral spur (TISA750), ACV and iris volume (IV), and IOP elevation were analyzed using logistic regression. RESULTS: Eighty-one subjects were included, 59 were female, and 22 were male, with a mean age of 60.98±â€Š9.44 years. IOP elevation appeared in 14 eyes. Mean TISA750 was negatively associated with IOP elevation (OR = 0.94, P = 0.02). The correlation of TISA750 with IOP elevation varies across quadrants and there was only significant association in temporal TISA750 (OR = 0.98, P = 0.046), whereas in the other 3 quadrants, there was no significant association. Greater ACV was associated with lower risk of IOP elevation (OR = 0.80, P = 0.031), whereas IV was not associated with IOP elevation. CONCLUSIONS: ACV is a reliable and accurate predictor for the outcome of PACD. Due to its 3-dimensional nature, the robustness of ACV is greater than traditional angle width parameters such as TISA750.

Aerobic Exercise Increases Tear Secretion and Decreases Inflammatory Cytokines in Healthy Subjects.

PURPOSE: The aim of this study was to investigate the changes of tear secretion and inflammatory cytokines induced by aerobic exercise (AE) on healthy Chinese. DESIGN: A prospective, cross-sectional study. METHODS: A total of 73 eyes from 43 healthy participants were included in this study, which was composed of 2 parts. Thirty individuals were included to investigate the effect of AE on tear secretion. Tear samples from extra 13 healthy subjects were collected to explore the effect of AE on tear cytokines profiles. RESULTS: In the first section, both areas of lower tear meniscus and volume of lower tear meniscus showed significant increase at 10 minutes after AE (P < 0.01). In the second section, a total of 15 tear cytokines including interferon-γ, tumor necrosis factor-α, interleukin (IL)-1ß, IL-4, IL-5, IL-6, IL-10, IL-12P70, IL-13, IL-15, IL-17A, IL-21, and IL-27 were significantly lower at 20 minutes after AE than that of baseline (P < 0.01), whereas CCL/MIP-3α persisted to decrease at 60 minutes after exercise (P = 0.031). However, there was no significant difference of IL-2 concentration between baseline and any time point after exercise (P > 0.05). CONCLUSIONS: AE could promote tear secretion and decrease inflammatory cytokines in healthy subjects.

Performance of Topological Perception in the Myopic Population.

Purpose: Discriminating objects' topological property (TP) is a primitive function of visual representation, which is reported to be associated with magnocellular (M) visual pathway, temporal lobe (TL), and superior colliculus (SC)-pulvinar subcortical pathway. Previous studies have shown that M pathway and TL were affected in high myopia (HM) subjects. The study was accordingly designed to explore whether topological perception performance was abnormal in HM subjects. Methods: 30 mildly myopic, 25 moderately myopic, 35 highly myopic, and 20 emmetropic subjects were enrolled. All participants underwent a comprehensive ophthalmological assessment including automated refraction, intraocular pressure, Humphrey 10-2 standard automated perimetry, ocular fundus photography and swept-source optical coherence tomography. Defined by differences in hole, TP and non-TP discrimination with letters "E", "S", "P", "d" as stimuli in the central and peripheral regions was performed using the MATLAB 2017 software. d-primes extracted from the software were analyzed within each group. The correlation of peripheral TP/non-TP deficit with spherical equivalent (SE), axial length (AL) and average peripapillary retinal nerve fiber layer (RNFL) thickness was performed. Results: The patterns of topological perception performance were similar among the groups. TP discrimination peripherally was significantly better than that centrally in the mild myopia (P < .001), moderate myopia (P < .001), high myopia (P < .001) and emmetropia groups (P = .001). In the peripheral region, TP d-prime scores were significantly better than non-TP d-prime scores (all P < .001). The main and interaction effects of eccentricity and stimulus type were statistically significant(P < .05). There was no statistically significant correlation between peripheral TP/non-TP deficit and SE, AL or average RNFL thickness (P > .05). Conclusions: The current study first showed that patterns of topological perception among the myopic population were similar and not affected by the severity of myopia.

Clock position-based iris bow configuration after laser peripheral iridotomy in Chinese angle closure eyes: a swept source optical coherence tomography study.

BACKGROUND: To determine how many measurements should be evaluated to determine the iris bow and evaluate changes of iris bow at 12 clock positions after LPI in primary angle closure eyes. METHODS: A total of 93 primary angle closure eyes in 93 Chinese patients were enrolled. Anterior iris bowing was evaluated at 12 clock positions and 4 clock positions (3, 6, 9, and 12 o'clock) before, 1 week and 3 months after LPI using swept source optical coherence tomography. RESULTS: At baseline, almost all of the eyes exhibited an iris bow when measured using 12 clock positions, consistent with results obtained from measurements at 4 clock positions (Cronbach's alpha = 0.99). LPI caused a relative unified change in all of the clock positions (Cronbach's alpha = 0.91) except the LPI site. After LPI, there was no significant difference between 12 and 4 clock position measurements for the iris bow (both p > 0.05), with ~34.1% vs. 33% of the patients remained iris bow at 1 week and 34% vs. 31.9% of the patients remained iris bow at 3 months. However, the coexisting iris bow configuration was more common when measured using 4 clock positions (16.5% vs. 3.3% at 1 week and 25.5% vs. 10.6% at 3 months). CONCLUSIONS: There was excellent consistency when measuring the iris bow at 4 or 12 clock positions. LPI caused a relatively unified iris bow change at 12 clock positions, and a single LPI relieved only ~2/3 of the iris bow configurations.

Volumetric parameters-based differentiation of narrow angle from open angle and classification of angle configurations: an SS-OCT study.

BACKGROUND: To evaluate the diagnostic ability of volumetric parameters to differentiate narrow angle from open angle and distinguish different configurations of narrow angle. METHODS: The current study was composed of two parts. In the first part, with gonioscopy as reference standard, we tested power of each parameter to differentiate narrow angle from open angle. In the second part, we evaluated the efficacy of different parameters to distinguish angle configurations which were subclassified into type 1 (pupillary block) and type 2 (non-pupillary block and multiple mechanisms) based on ultrasound biomicroscopy (UBM) images. RESULTS: In part 1, the training set was composed of 117 narrow-angle eyes and 60 open-angle eyes, and the validation set included 38 narrow-angle eyes and 37 open-angle eyes. Anterior chamber volume (ACV) outperformed all the other parameters with an area under the curve (AUC) of 0.988. The sensitivity and specificity of the cut-off value 98.1 mm3 in the validation set were 90.0% and 97.1%, respectively. In part 2, training set was composed of 96 eyes of 88 patients with primary angle-closure disease, with 49 diagnosed as type 1 and 47 as type 2 configuration. 32 eyes were used for validation. A model comprised of iris volume (IV), iris thickness (IT) 2000 µm from the scleral spur and angle open distance (AOD) 750 µm from the scleral spur was found to have an AUC of 0.793 (95% CI, 0.695 to 0.870). Sensitivity and specificity of the model were 82.6% and 77.8% respectively in the validation set. CONCLUSIONS: With ACV, we can detect patients with narrow angle from open angle faster and more easily than AOD and anterior chamber depth. Then, for patients with narrow angle, the combination of IV, IT and AOD750 measured by swept-source optical coherence tomography could further classify configurations of angle closure compared with UBM.

Trabeculectomy and EX-PRESS Implantation in Open-Angle Glaucoma: An Updated Meta-Analysis of Randomized Controlled Trials.

PURPOSE: Accumulating studies comparing the efficacy and safety of trabeculectomy and EX-PRESS implantation in open-angle glaucoma (OAG) report inconsistent findings. Thus, we conducted the updated meta-analysis to clarify the issue. METHODS: Randomized controlled trials (RCTs) were selected through search of databases PubMed, Web of Science, Embase, and the Cochrane Library from their inception up until November 2018. The pooled mean difference (MD) for intraocular pressure reduction (IOPR) and antiglaucoma medication reduction, odds ratio (OR) for operative success, complication, and postoperative intervention was calculated using the random effects model. RESULTS: 8 RCTs were enrolled, including 223 eyes in the EX-PRESS group and 217 eyes in the trabeculectomy group. EX-PRESS device implantation had a better IOPR% at 12 months postoperatively (MD = 8.9, 95% confidence interval (CI) = 2.5-15.3, P=0.006). There was no statistically significant difference in the antiglaucoma medication reduction (MD = 6.01, 95% CI = -4.13-16.15, P=0.25) and qualified success (P > 0.05). Statistically higher complete success at 1 year postoperatively was found in the EX-PRESS group (OR = 3.26, 95% CI = 1.24-8.55, P=0.02). EX-PRESS was associated with a lower frequency of increased IOP (OR = 0.15, 95% CI = 0.03-0.93, P=0.04) and hyphema (OR = 0.20, 95% CI = 0.05-0.74, P=0.02). Less postoperative intervention was needed in the EX-PRESS group (OR = 0.43, 95% CI = 0.20-0.94, P=0.04). CONCLUSION: For OAG patients, EX-PRESS implantation provided better efficacy in IOP control and complete success at 1 year postoperatively, with fewer increased IOP and hyphema as well as postoperative interventions. EX-PRESS device and trabeculectomy were similar in the qualified success and antiglaucoma medication reduction.

Chronic ocular hypertension in rabbits induced by limbal buckling.

AIM: To establish a rabbit model of chronic ocular hypertension (OHT) by limbal buckling. METHODS: Eighteen New Zealand White rabbits were involved and divided into three groups. A latex encircling band of 20, 25 or 35 mm was implanted behind the limbus in the right eye of each animal. The intraocular pressure (IOP) was monitored for 8 weeks, after which optic nerve damage was evaluated by fundus photography, optical coherence tomography (OCT) retrograde labelling and histology. Meanwhile, the anterior chamber angle (ACA) was examined by OCT and gonioscopy. RESULTS: OHT was induced in all animals after surgery. The IOP peaked at 38.0±3.7, 32.0±3.9 and 24.1±6.5 mm Hg in groups 1, 2 and 3, respectively, and remained elevated for 22, 25 and 39 days on average, respectively. The elevated IOPs showed good consistency within 2 weeks, although the durations of high IOP varied moderately. The area ratio between the optic cup and disc (cup to disc area) was increased in 73% of the treated eyes, and the average changes were 0.10±0.13, 0.11±0.08 and 0.09±0.02 in groups 1, 2 and 3, respectively. The depth of the optic cup was also increased in the treated eyes, and the density of the retinal ganglion cells was reduced. Additionally, the ACA showed a dynamic change with IOP after the latter was reduced by paracentesis. CONCLUSION: Limbal buckling provides an effective method of producing chronic OHT and glaucomatous optic neuropathy in rabbits.

miR-155 Regulates Glioma Cells Invasion and Chemosensitivity by p38 Isforms In Vitro.

The critical role of microRNAs in cancer development has been extensively described. miRNAs are both specific markers and putative therapy targets. miR-155 has been identified to be an oncomiRNA and is highly expressed in several solid cancers, including glioblastoma. In this study, we found that miR-155 is a good potential therapy target. Knockdown of miR-155 sensitizes glioma cells to the chemotherapy of temozolomide (TMZ) by targeting the p38 isoforms mitogen-activated protein kinase 13 [MAPK13, also known as p38 MAPKδ or stress-activated protein kinase 4 (SAPK4)] and MAPK14 (also known as p38 MAPKα). As tumor suppressor genes, MAPK13 and MAPK14 play important roles in lowering the accumulation of reactive oxygen species (ROS), inducing cell apoptosis, and slowing the progression of cancer. Knockdown of miR-155 enhanced the anticancer effect of TMZ on glioma by targeting the MAPK13 and MAPK14-mediated oxidative stress and apoptosis, but did not affect the secretion of MMP2 and MMP9.