Alteration of neurofilament heavy chain and its phosphoforms reveals early subcellular damage beyond the optic nerve head in glaucoma.

Background: Retinal ganglion cells (RGCs) axon loss at the site of optic nerve head (ONH) is long believed as the common pathology in glaucoma since different types of glaucoma possessing different characteristic of intraocular pressure, and this damage was only detected at the later stage. Methods: To address these disputes and detect early initiating events underlying RGCs, we firstly detected somatic or axonal change and compared their difference in acute and chronic phase of primary angle-closed glaucoma (PACG) patient using optical coherence tomography (OCT), then an axonal-enriched cytoskeletal protein neurofilament heavy chain and its phosphoforms (NF-H, pNF-H) were utilized to reveal spatio-temporal undetectable damage insulted by acute and chronic ocular hypertension (AOH, COH) in two well characterized glaucoma mice models. Results: In clinic, we detected nonhomogeneous changes such as ONH and soma of RGCs presenting edema in acute phase but atrophy in chronic one by OCT. In AOH animal models, an increase expression of NF-H especially its phosphorylation modification was observed as early as 4 h before RGCs loss, which presented as somatic accumulation in the peripheral retina and at the sites of ONH. In contrast, in microbeads induced COH model, NF-H and pNF-H reduced significantly, these changes firstly occurred as NF-H or pNF-H disconnection at ONH and optic nerve after 2 weeks when the intraocular pressure reaching the peak; Meanwhile, we detected aqueous humor pNF-H elevation after AOH and slight reduction in the COH. Conclusion: Together, our data supports that early alteration of NF-H and its phosphoforms would reveal undetectable subcellular damage consisting of peripheral somatic neurofilament compaction, impaired axonal transport and distal axonal disorganization of cytoskeleton beyond the ONH, and identifies two distinct axonal degeneration which were Wallerian combination with retrograde degeneration in acute PACG and retrograde degeneration in the chronic one.

The association between retinal microvasculature derived from optical coherence tomography angiography and systemic factors in type 2 diabetics.

Aims: To investigate the correlation between the retinal microvasculature using optical coherence tomography angiography (OCTA) and systemic factors in type 2 diabetes mellitus (T2DM) patients. Methods: This cross-sectional study obtained OCTA data from patients with T2DM administered at hospital and referred to ophthalmic services. Patient data about demographics, comorbid conditions, and blood biomarkers were extracted from electronic medical records. Data from OCTA scans obtained by CIRRUS HD-OCT Model 5,000 were obtained. Vessel density (VD) and perfusion density (PD) within the superficial capillary plexus, and foveal avascular zone (FAZ) area were automatically segmented. These parameters were tested for their correlations with systemic factors by univariate and multivariable linear regression analyses. Results: A total of 144 T2DM patients (236 eyes) were available for analysis, with mean age of 53.6 (SD = 10.34) and 56.9% were male. Chronic kidney disease, cardiovascular disease, increased serum creatinine (Scr), red blood cell count (RBC), platelets (PLT), apolipoprotein B (APOB), and decreased urine albumin to creatinine ratio (UACR) were significantly associated with lower VD and PD (all p < 0.013). UACR and triglyceride (TRIG) were significantly correlated with FAZ area (all p < 0.017). In multivariate analyses, PLT, eGFR, and APOB were independent risk factors for retinal rarefaction, and UACR was a significant predictor of FAZ area. Conclusion: We found several systemic risk factors, such as PLT, renal function and lipid profiles were associated with PD, VD, and FAZ area among Chinese T2DM patients.

Fruit and vegetable intake and the risk of cataract: insights from the UK Biobank study.

PURPOSE: A prospective cohort study to investigate the association between fruit and vegetable (F&V) intake and the risk of cataract. METHODS: We included 72,160 participants who were free of cataract at baseline from the UK Biobank. Frequency and type of F&V intake were assessed using a web-based 24 h dietary questionnaire from 2009 to 2012. Development of cataract during the follow-up was defined by self-report or hospital inpatient records up to 2021. Cox proportional regression models were used to estimate the association between F&V intake and incident cataract. RESULTS: During a mean follow-up of 9.1 years, 5753 participants developed cataract with a corresponding incidence of 8.0%. After adjusting for multiple demographic, medical and lifestyle covariates, higher intake of F&V were associated with a lower risk of cataract (≥6.5 vs. <2 servings/week: hazards ratio [HR]: 0.82, 95% CI: 0.76 to 0.89; P < 0.0001). Regarding specific types, significant reduced risk of cataract was found for higher intake of legumes (P = 0.0016), tomatoes (≥5.2 vs. <1.8 servings/week: HR: 0.94, 95% CI: 0.88 to 1.00), and apple and pear (>7 vs. <3.5 servings/week: 0.89, 95% CI: 0.83 to 0.94; P < 0.0001), but not for cruciferous vegetables, green leafy vegetables, berry, citrus fruit or melon. Smokers were found to benefit more from F&V intake than former and never smokers. Men also could benefit more from higher vegetable intake than women. CONCLUSIONS: More F&V intake, especially legumes, tomatoes, apple, and pear, was associated with a lower risk of cataract in this UK Biobank cohort.

Evaluation of Systemic Medications Associated With Surgically Treated Cataract Among US Adults.

PURPOSE: To comprehensively determine the associations between systemic medications and surgically treated cataract in the US population. DESIGNS: Retrospective cross-sectional study. METHODS: Participants aged ≥40 years from the 1999-2008 National Health and Nutrition Examination Survey (NHANES) were included. Surgically treated cataract was defined as cataract requiring a procedure. Data on prescription drug use over the past 30 days were collected via home interviews. Drug categories for ophthalmic indications and those prescribed in less than 0.5% of the participants were excluded from the analysis. Separate logistic regression models were used to explore associations between each drug category and surgically treated cataract. The Benjamin-Hochberg procedure was used to control the false discovery rate. RESULTS: A total of 14,931 were included in the present analysis. The weighted prevalence of surgically treated cataract was 9.6% (n=2010). We identified 20 drug categories that had significant associations with surgically treated cataract, of which 8 associations remained statistically significant after further adjustment for pertinent comorbidities. The 3 drug categories with the highest odds ratio (OR) values were tricyclic antidepressants (OR, 2.21; 95% CI, 1.38-3.51; P = .001), insulin (OR, 2.13; 95% CI, 1.48-3.07; P = 9.41×10-5) and group III antiarrhythmic agents (OR, 2.00; 95% CI, 1.25-3.19; P = .004). The use of sex hormone combinations among women reduced the risk of having surgically treated cataract (OR, 0.011; 95% CI, 0.001-0.089; P = 5.98×10-5). Dose-response relationships were observed for all 8 drug categories. CONCLUSIONS: Our comprehensive evaluation provides new knowledge on the complex relationships between systemic medications and surgically treated cataract.

The efficacy of fascial granuloma excision with conjunctival autografting after pterygium surgery.

BACKGROUND AND OBJECTIVE: Pterygium has a high recurrence rate after simple excision, and fascial granuloma is one of the common complications of pterygium excision. This study aimed to investigate the treatment for the fascial granuloma. METHODS: In this study, the 36 eyes of 36 cases with fascial granuloma after pterygium excision were collected and divided into two groups to receive granuloma excision and conjunctival autografting or simple granuloma excision. The patients in the treatment group containing 20 cases received granuloma excision and conjunctival autografting, while the patients in the control group containing 16 cases received simple granuloma excision. RESULTS: The pathology examination results showed that all the removed granulomas were inflammatory granulation tissues that without bacterial infection. After 12 months' follow-up, there was no recurrence of fascia granuloma and pterygium in the treatment group, in which the cure rate was up to 100%. In the control group, 6 cases experienced a recurrence of the granuloma fascia 2~3 weeks after operation; after further granuloma excision and conjunctival autografting, pterygium recurred in 8 cases. CONCLUSION: The fascial granuloma excision with conjunctival autografting is effective and safe in treating fascial granuloma after pterygium surgery, which contributes to reducing the recurrence of pterygium.