A H2O2 Oxidation Approach to Ti3C2/TiO2 for Efficient Photocatalytic Removal of Distinct Organic Pollutants in Water.

To develop versatile photocatalysts for efficient degradation of distinct organic pollutants in water is a continuous pursuit in environment remediation. Herein, we directly oxidize Ti3C2 MXene with hydrogen peroxide to produce C-doped anatase TiO2 nanowires with aggregates maintaining a layered architecture of the MXene. The Ti3C2 MXene provides a titanium source for TiO2, a carbon source for in situ C-doping, and templates for nanowire aggregates. Under UV light illumination, the optimized Ti3C2/TiO2 exhibits a reaction rate constant 1.5 times that of the benchmark P25 TiO2 nanoparticles, toward photocatalytic degradations of trace phenol in water. The mechanism study suggests that photogenerated holes play key roles on the phenol degradation, either directly oxidizing phenol molecules or in an indirect way through oxidizing first the surface hydroxyl groups. The unreacted Ti3C2 MXene, although with trace amounts, is supposed to facilitate electron transfer, which inhibits charge recombination. The unique nanostructure of layered aggregates of nanowires, abundant surface oxygen vacancies arising from the carbon doping, and probably the Ti3C2/TiO2 heterojunction guarantee the high photocatalytic efficiency toward removals of organic pollutants in water. The photocatalyst also exhibits an activity superior to, or at least comparable to, the benchmark P25 TiO2 toward photodegradations for typical persistent organic pollutants of phenol, dye molecule of rhodamine B, antibiotic of tetracycline, pharmaceutical wastewater of ofloxacin, and pesticide of N,N-dimethylformamide, when evaluated in total organic carbon removal.

The characteristics of acute macular neuroretinopathy following COVID-19 infection.

BACKGROUND: In this study, we report a case series of acute macular neuroretinopathy (AMN) associated with COVID-19 infection. METHODS: This retrospective observational study was conducted at Beijing Tongren Hospital. We reviewed patients who were diagnosed with AMN within one month of testing positive for COVID-19 using real-time reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: A total of 11 AMN patients (20 eyes) were included in the study. The mean age was 33.8 ± 12.6 years. The average interval between a positive COVID-19 PCR test and the onset of ocular symptoms was 2.8 ± 2.5 days. The mean follow-up period for the patients was 12.5 ± 3.8 weeks. Imaging characteristics of AMN patients following COVID-19 infection included areas of low reflectivity on near-infrared reflectance (NIR) imaging, hyperreflective lesions at the level of the outer plexiform layer (OPL) and outer nuclear layer (ONL) and disruption of the ellipsoid zone (EZ) on spectral domain optical coherence tomography (SD-OCT) B-scans. Visual field examinations revealed parafoveal scotomas that closely corresponded to the clinical lesions. Optical coherence tomography angiography (OCT-A) demonstrated impaired perfusion in the deep retinal vascular plexus. Fluorescein angiography (FA), indocyanine green angiography (ICGA), and spontaneous fundus autofluorescence showed no significant abnormalities. During follow-up, partial improvement in retinal lesions was observed in NIR imaging and SD-OCT in some patients, but a proportion of patients still exhibited persistent retinal damage and no improvement in visual field scotomas. CONCLUSION: COVID-19-related AMN share similar clinical and imaging features with AMN due to other causes, as evidenced by the persistent presence of visual field scotomas over a longer duration. TRAIL REGISTRATION: https://www.chictr.org.cn/ ; identifier: ChiCTR2100044365.

New onset or recurrence of uveitis following COVID-19 infection.

BACKGROUND: While the 2019 novel coronavirus disease (COVID-19) pandemic has resulted in millions of cases worldwide, there is increasing recognition of a wide range of ocular manifestations associated with the virus, including uveitis. Uveitis is an inflammatory condition of the uveal tract of the eye that can lead to permanent vision loss if not treated promptly. Here we report a retrospective observational study of patients who presented with new onset or recurrent uveitis following COVID-19 infection. METHODS: This is a retrospective observational study conducted at the Beijing Tongren Hospital. We identified patients who presented with symptoms of non-infectious active uveitis with positive real-time reverse transcription polymerase chain reaction (RT-PCR) of COVID-19 within 4 weeks. All patients received ophthalmic examinations, including anterior and posterior segment imaging, to assess the extent of ocular involvement. RESULTS: The 18 patients with a total of 33 eyes included in this study presented with symptoms of active uveitis within 4 weeks of their positive COVID-19 RT-PCR test. Among them, 9 patients presented with the development of uveitis following COVID-19 infection, and 9 patients had relapsed uveitis after COVID-19 infection. Treatment with corticosteroids resulted in improvement of symptoms and resolution of inflammation in all cases. In this study, all patients did not experience any adverse drug reactions during treatment. CONCLUSION: Our observational study highlights the potential for new onset or recurrence of uveitis following COVID-19 infection. TRIAL REGISTRATION: https://www.chictr.org.cn/ ; identifier: ChiCTR2100044365, date: 03/17/2023.

Mucosal associated Lymphoid Tissue Lymphoma of the uvea: an analysis of 3 cases.

BACKGROUND: Ocular mucosa-associated lymphoid tissue (MALT) lymphoma involving orbit and conjunctiva usually has an indolent clinical course with "salmon patch" mass as typical presentation. This study is to report a series of rare cases and investigate the clinical and pathological features of ocular MALT lymphoma that involved uveal tissue primarily and presented as posterior scleritis. METHODS: This retrospective, observational study was conducted at Beijing Tongren Hospital. From 2018 to 2020, 3 cases of 3 eyes (2 female patients and 1 male patient) with ocular MALT lymphoma that involved uveal tissue primarily and presented as posterior scleritis were included in the study. All patients had complaints of red eyes with blurred vision. The average age was 56.33 ± 2.08 years old and the average time from initial diagnosis to pathological diagnosis was 3.00 ± 1.73 months. Ophthalmic examinations including best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit lamp microscope examinations, fundus photography, B-scan ultrasonography, ultrasound biomicroscope (UBM), optical coherence tomography (OCT), fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were conducted. Systemic workups including orbital magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT) and blood autoimmune antibody tests were also conducted. Pathological tissue from patients were obtained through surgeries. Biopsy examinations were performed to accurately determine pathological diagnosis. All the information of clinical, imaging and pathological changes were collected and analyzed. RESULTS: At the initial diagnosis, the BCVA of involved eyes decreased seriously while the IOP were normal. All involved eyeball showed extensive hyperemia and local thickening in the wall of eyeballs. B-scan ultrasonography showed mass with abundant blood and irregular cysts inside the eyeball wall and in the retrobulbar orbit, surrounding the ocular wall and optic nerve. UBM showed solid lesions with low and medium echo under the conjunctiva and inside the ciliary body of 2 cases. OCT showed posterior polar wavy rise of RPE and local neuroepithelial detachment in all cases. FFA and ICGA showed vascular abnormalities (patch-like strong fluorescence and fluorescence leakage) and local thickening in retina and choroid (Rectangle-like weak fluorescence below the macula). The posterior wall of the eyeball was thickened and enhanced in MRI. PET-CT also showed thickening of posterior wall of eyeballs and increased metabolic activity but there was no sign of autoimmune disease. All patients were diagnosed as MALT lymphoma through pathologic examinations of biopsy tissue. CONCLUSIONS: The onset of primary ocular MALT lymphoma in uvea is hidden. The early clinical manifestations are lack of specificity and misleading. B-scan ultrasonography has characteristic manifestations and is valuable in diagnosis. However, pathological diagnosis through tissue biopsy is irreplaceable.

Ocular Adverse Events after Inactivated COVID-19 Vaccination.

Purpose: To report the clinical characteristics of ocular adverse events that have occurred, in China, after vaccination with inactivated COVID-19 vaccines. Methods: A retrospective cross-sectional observational study was conducted of ocular disorders that occurred within 15 days from any dose of an inactivated COVID-19 vaccine. Information on gender, age, the interval between the vaccination and ocular symptoms, laterality, duration of the ocular symptoms, primary visual acuity, and clinical diagnosis were retrospectively collected. Results: Twenty-four patients were involved in the study, including 15 females and 9 males, with a mean age of 41 ± 16 years (range of 8−71 years). The patients all denied a prior history of COVID-19 infection. Ocular adverse events occurred after the first dose of vaccine in 18 patients and, after the second or third doses, in six patients. The interval between vaccination with the inactivated COVID-19 vaccine and ocular symptoms was 6 ± 5 days; six patients were bilaterally involved and 18 patients were unilaterally involved. Regarding the diagnosis, 10 patients were diagnosed with white dot syndrome (WDS), 9 patients were diagnosed with uveitis, and 5 patients were diagnosed with retinal vascular disorders. The ages of patients with WDS were younger than those with uveitis or retinal vascular disorders (32 ± 10 vs. 48 ± 18, p < 0.05). For patients diagnosed with WDS, the best-corrected visual acuity (BCVA) was 0.74 ± 0.73 LogMAR. For patients diagnosed with retinal vascular disorders or uveitis, the BCVA was 1.44 ± 1.26 LogMAR. There was no significant difference (p > 0.05). Conclusions: A relationship cannot be established between inactivated COVID-19 vaccines and ocular disorders; therefore, further investigation of the clinical spectrum of ocular adverse events after vaccination with an inactivated COVID-19 vaccine is necessary.

Clinical Spectrum of Uveitis Induced by Herpes Simplex Virus with Posterior Pole Involvement at Initial Presentation: A Case Series and Literature Review.

PURPOSE: To report four cases of herpes simplex virus-induced uveitis with posterior pole involvement at initial presentation. CASE PRESENTATIONS: In case 1, the posterior pole initially showed dense vitreous hemorrhage from the optic disc, multiple subretinal lesions around the optic disc, and retinal arterial sheath prior to retinal necrosis. In case 2, the posterior pole presented with optic disc edema, retinal venous tortuosity, and arterial sheathing around the optic disc prior to the peripheral retinal necrosis. In case 3 diagnosed with posterior herpetic uveitis, the posterior pole showed retinal arterial sheath and macular structural abnormities. In case 4, the posterior pole demonstrated optic disc swelling, along with perivascular retinal hemorrhage 4 days prior to peripheral retinal necrosis. CONCLUSIONS: Posterior pole involvement might occur either solely or before the development of peripheral retinal necrosis in patients with herpes simplex virus-induced acute retinal necrosis with and without prior central nervous system herpetic virus infection.

Efficiency and Complication of 577-nm Laser Membranotomy for the Treatment of Retinal Sub-Inner Limiting Membrane Hemorrhage.

Objective: We investigated the clinical efficiency and complications of treatment of retinal sub-inner limiting membrane (sub-ILM) hemorrhage by 577-nm semiconductive laser membranotomy. Methods: The clinical features, ocular fundus photography, and SD-OCT image of patients who received 577-nm laser membranotomy for sub-ILM hemorrhage were assessed from January 2017 to April 2022 in this retrospective case-series study. Results: A total of 19 patients (19 eyes) were treated for sub-ILM hemorrhage of the macula, in which eight were women and 11 were men. The age was 15-83 years (with an average age of 49.05 ± 19.41 years old). The right eye was affected in 12 patients, the left eye in seven patients. The follow-up period after laser treatment was from 0.5 to 9 months (with an average follow-up time of 3.25 ± 2.45 months). Treatment was not successful in one patient, and 577-nm laser membranotomy was successful in 18 patients (equaling a success rate of 94.74%). The best corrected visual acuity (BCVA) before laser treatment was from figure count to 40/200, and the BCVA after laser treatment was from 20/2000 to 20/20. Complications after laser treatment comprised macular hole (one patient), macular epi-membrane (one patient), vitreous hemorrhage without absorption (two patients), and sub-ILM cavity (12 patients). Conclusions: The 577-nm laser is effective in treating sub-ILM hemorrhage and has a high success rate. Posttreatment complications should be monitored, and vitrectomy was needed with long-lasting vitreous hemorrhage and macular hole.

Six-Year Incidence and Risk Factors for Age-Related Macular Degeneration in a Rural Chinese Population: The Handan Eye Study.

Purpose: To describe the 6-year incidence of early and late age-related macular degeneration (AMD) and its associated factors in a representative large rural Chinese population. Methods: A population-based longitudinal study was conducted in rural China from 2006 to 2007. In total, 6830 persons aged 30 years or older participated in the study. The 6-year follow-up study was performed between 2012 and 2013. The modified Wisconsin Age-Related Maculopathy Grading System (WARMGS) protocol in the Blue Mountains Eye Study was used as the AMD grading standard. Results: Excluding 509 deceased subjects, 5394 (follow-up rate 85.3%) completed the follow-up. Among them, 5048 participants had gradable photographs of at least one eye at both examinations. The incidence of early and late AMD over 6 years was 4.2% (95% CI, 3.8%-4.7%) and 0.2% (95% CI, 0.2%-0.3%), respectively. In the multivariable analysis, per-year increase in age (P < 0.001; OR = 1.06; 95% CI, 1.04-1.07), male sex (P = 0.006; OR = 0.64; 95% CI, 0.47-0.88), and per-millimeter increase in axial length (P = 0.010; OR = 0.78; 95% CI, 0.63-0.94) at baseline were significantly associated with incident early AMD. Early AMD was not associated with systolic blood pressure, diastolic blood pressure, hypertension, diabetes, history of stroke, history of heart disease, body mass index, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglycerides, smoking status, refractive error, or corneal curvature radius. There were too few cases of late AMD for a valid statistical analysis of the risk factors. Conclusions: The incidence of early and late AMD over 6 years in a rural Chinese population was 4.2% (95% CI, 3.8%-4.7%) and 0.2% (95% CI, 0.2%-0.3%), respectively. Age, sex, and axial length are relevant risk factors for early AMD in rural China.

Genetic factors for idiopathic choroidal neovascularization.

Objective: The aim of this study was to investigate genetic factors associated with idiopathic choroidal neovascularization (ICNV). Methods: We conducted a case-control study including 69 cases with ICNV and 114 controls who underwent cataract surgery. Single nucleotide polymorphisms (SNPs) from genes reported to be related to AMD, CNV and uveitis were selected for this study. Results: In an univariate analysis, the rs669676 SNP located in the COL8A1 gene was associated with the proportion of people who has idiopathic CNV ( X2 = 9.3453, corrected p-value = 0.1). For the rs669676 SNP, minor allele homozygotes, in the dominant model of genotype analysis (GG versus AA-GA), it showed significant differences in the ICNV group vs controls (p = .01, OR = 1.219 (95%CI: 1.04-1.429)). Conclusions: The rs669676 SNP located in the COL8A1 gene may contribute to a genetic susceptibility for ICNV.

Micro RNA-19a suppresses interleukin-10 in peripheral B cells of patients with diabetic retinopathy.

A number of patients with diabetes suffer from retinopathy; the pathogenesis is to be further investigated. Recent reports indicate that micro RNA (miR) plays critical roles in the development of immune inflammation. This study test a hypothesis that miR-17-92 cluster is associated with the pathogenesis of diabetes retinopathy (DR). In this study, peripheral blood samples were collected from DR patients and healthy subjects. B cells were isolated from the blood samples to be analyzed the expression of interleukin (IL)-10. The results showed that lower levels of IL-10 were detected in peripheral B cells of DR patients as compared with healthy subjects. miR-19a was increased in B cells of DR patients, which was negatively correlated with the IL-10 expression. Exposure of naive B cells to IL-17 increased the expression of miR-19a and suppression of IL-10 expression in the B cells, in which histone deacetylase 11 (HDAC 11) played a critical role. In conclusion, the IL-17 suppresses IL-10 expression in peripheral B cells via enhancing miR-19a expression and HDAC activity in DR patients. The miR-19a and HDAC 11 may be novel therapeutic targets in the treatment of DR.

Optical Coherence Tomographic Features and Visual Prognosis after Treatment for Idiopathic Choroidal Neovascularization.

BACKGROUND: The aim of this study was to determine whether pretreatment spectral-domain optical coherence tomographic (SD-OCT) features are associated with visual prognosis after treatment for idiopathic subfoveal choroidal neovascularization (ISCNV) with intravitreal ranibizumab. METHODS: We retrospectively evaluated SD-OCT images of eyes with ISCNV undergoing treatment with intravitreal ranibizumab with a mean follow-up of 7 months. RESULTS: This study included 22 patients (22 eyes) with a mean age of 32.7 ± 8.1 years. In univariate analysis, better final visual acuity expressed in logMAR units was significantly associated with a lower amount of pretreatment ellipsoid zone defects (p = 0.03; standardized correlation coefficient ß = 0.46) and a lower amount of pretreatment external limiting membrane (ELM) damage (p = 0.007; ß = 0.56). All other SD-OCT parameters were not significantly associated with final visual acuity. A higher improvement in visual acuity was marginally significantly associated with larger pretreatment ellipsoid zone defects (p = 0.049; ß = -0.43). CONCLUSIONS: The integrity of the outer retinal layers at baseline, in particular of the ELM, is of importance in predicting the final visual outcome in patients undergoing intravitreal medical therapy for ISCNV.

Choroidal thickness in idiopathic subfoveal choroidal neovascularization.

PURPOSE: To evaluate choroidal thickness in patients with idiopathic choroidal neovascularization. METHODS: The observational case series study included patients who were consecutively diagnosed with idiopathic unilateral choroidal neovascularization as demonstrated by ophthalmoscopy, fluorescein angiography and enhanced depth imaging optical coherence tomography (EDI-OCT). Using EDI-OCT, choroidal thickness was measured at the fovea and at locations in a distance of 500, 1,000 and 1,500 µm temporal and nasal to the fovea. RESULTS: Mean subfoveal choroidal thickness was significantly (p = 0.002) thicker in the study group than in the control group (357 ± 99 vs. 316 ± 83 µm). In a parallel manner, the differences between the study group and the control group in choroidal thickness were significant for all other measurement points, except for the examination at 1,500 µm nasal to the fovea (p = 0.09). The results remained unchanged after adjusting for axial length and age. CONCLUSIONS: Idiopathic unilateral choroidal neovascularization is associated with a thickening of the choroid.

Subfoveal choroidal thickness change after intravitreal ranibizumab for idiopathic choroidal neovascularization.

PURPOSE: To investigate changes in subfoveal choroidal thickness (SFCT) after intravitreal injections of ranibizumab for idiopathic subfoveal choroidal neovascularization (ISCNV). METHODS: The prospective consecutive case series study included 16 patients with unilateral ISCNV. All eyes with ISCNV were treated with a single intravitreal injection of 0.5 mg ranibizumab followed by as-needed dosing. Subfoveal choroidal thickness was measured using enhanced depth imaging optical coherence tomography. RESULTS: The mean total follow-up time was 4.9 ± 1.5 months, and the follow-up after the last intravitreal ranibizumab injection was 4.4 ± 1.3 months. In the treated eyes, the SFCT decreased significantly from 354 ± 84 µm at baseline to 328 ± 79 µm at 1 month later (P < 0.001) and reincreased (P = 0.02) to 342 ± 75 µm at the final visit (P = 0.15 versus baseline value). Change in SFCT was marginally (P = 0.11) associated with the change in retinal foveal thickness. In the contralateral unaffected eyes, the SFCT did not change significantly during follow-up (P = 0.76). CONCLUSION: In patients with unilateral ISCNV, intravitreal ranibizumab therapy was associated with a thinning of an abnormally thick subfoveal choroid, marginally in association with a parallel decrease in retinal foveal thickness. It remained elusive whether the choroidal thinning was due to a direct pharmacological effect of ranibizumab or whether it was secondary due to the foveal retinal thinning. In view of the significant differences in SFCT between affected eyes and unaffected contralateral eyes at baseline and in view of the significant therapy-associated decrease in SFCT, the potential role of SFCT as an additional marker for the diagnosis and follow-up of ISCNV and other neovascular maculopathies may be examined in future studies.