Discrepancy of eye injuries in mechanism, clinical features, and vision prognosis by different causative sports.

Objective: To investigate the epidemiological and clinical characteristics of sports-related eye injuries in China, as well as how they differ depending on the sport or other specific factor that caused them. Methods: Consecutive medical records from 2015 to 2019 of sports-related eye injuries from a standardized database in nine tertiary referral hospitals in China were retrospectively reviewed and analyzed. Results: A total of 377 eyes in 376 inpatients (mean age, 22.5 ± 7.3 years; men:women 15.4:1) were included. Soccer (46.8%), basketball (27.1%), and badminton (16.8%) were the top three sports that caused injury. Ball strikes (74.7%), physical collision (13.8%), and racket/equipment beating (9.0%) were the common specific causes of injury. Blunt force injuries (95.8%) and close globe injuries (95.1%) accounted for the majority of injuries. Open globe injuries occurred more in basketball (8.3%) than in other sports, mainly due to physical collision (12.8%) and racket/equipment beating (11.8%). Basketball (13.4%) or physical collision (21.3%) caused Zone I injuries more frequently than other sports. Soccer (60.5%) and basketball (54.6%) caused more injuries to the posterior segment of the eyeball than other sports, mainly due to ball strikes (96.6%). Badminton (69.8%) and racket beating (61.8%) caused more Zone II globe injuries than other sports. In badminton, the percentage of hyphema (85.7%), the most typical symptom of eye damage, and ultimate visual acuity (VA) ≥20/40 (88.9%) was the greatest. A final low vision score of (≤4/200) was observed in 10.6% of all participants, including three participants who had an eye removed due to rupturing. The final VA was positively correlated with the presenting VA (r = 0.421). Conclusion: Sports can lead to high proportions of ocular contusion injury and low vision. VA prognosis is closely related to initial VA following ocular sports trauma, which is directly determined by the causative sports and/or the specific causes. Effective eye protection is imperative to avoid or reduce visual impairments of sports participants.

Risk of anxiety and depression in patients with uveitis: a Meta-analysis.

AIM: To quantitatively evaluate the risk of anxiety and depression in patients with uveitis via performing a Meta-analysis. METHODS: Three electronic database (PubMed, Embase, and Cochrane Library databases) were searched for studies recording data about uveitis and anxiety as well as depression simultaneously up to January 2021. The incidence rate and standard mean difference (SMD) with a 95% confidence interval (95%CI) were calculated to analyse the association using random-effects models based on heterogeneity tests. RESULTS: In total, 12 observational studies containing 874 patients with uveitis were included. The results showed that there was a significant association between uveitis and anxiety (SMD=0.97, 95%CI: 0.39 to 1.54, P=0.0009) and depression (SMD=0.79, 95%CI: 0.51 to 1.07, P<0.00001). The overall morbidities of anxiety and depression in patients with uveitis were 39% and 17%, respectively. With subgroup analysis, the heterogeneity actually came from different kinds of uveitis. Specifically, the incidence rates of both anxiety and depression were relatively low in patients with anterior uveitis (33% and 15%), moderate in patients with infectious uveitis (46% and 22%), and high in patients with unspecified uveitis (59% and 35%). CONCLUSION: It is preliminarily indicated that patients with uveitis may have a high risk of anxiety and depression. Ophthalmologists and psychologists should pay more attention to the psychological state when dealing with patients with uveitis. Further high-quality studies with detailed direct data are needed to draw more precise conclusions.

Seawater immersion exacerbates the pathological changes caused by incisive corneal injury in rabbit eyes.

Background: Seawater immersion complicates injuries suffered during maritime conflicts and eye injury is one of most common injuries on the battlefield. This study aimed to delineate the pathophysiological changes in the cornea after corneal injury combined with seawater immersion. Methods: The left eye of New Zealand White rabbits was injured with firecracker and a 3-mm long whole-layer incision in the center of the cornea parallel to the corneal limbus, followed by seawater immersion. The right eye was used as a control. The histology of the cornea and the inflammatory cytokine/chemokine levels in the aqueous humor were examined on days 1 and 7 after injury. The protein levels of aquaporin 1, 3, and 5 were assessed by immunohistochemical staining 7 days after injury. The expression and activation of nuclear factor κB (NF-κB) were examined by Western blot analysis. Results: Seawater immersion exacerbated penetrating explosive injury caused progressive tissue damage of the cornea and ocular inflammation, with drastic increases in the expression of cytokines/chemokines in the aqueous humor, which was mediated by the upregulation and activation of NF-κB. Furthermore, corneal protein levels of aquaporin 1, 3, and 5 were significantly increased after incisive injury and seawater immersion. Conclusions: These data demonstrated that the combination of incisive injury and seawater immersion is a dangerous situation and effective care strategies should be developed for the management of such maritime injuries.

Optimization for ultrasonic-microwave synergetic extraction of total iridoid glycosides and screening of analgesic and anti-inflammatory active fractions from patrinia scabra Bunge (Valerianaceae).

BACKGROUND: Patrinia scabra Bunge is a well-known herbal medicine for its favorable treatment on inflammatory diseases owing to its effective ingredients, in which iridoid glycoside plays an extremely significant role. This article aimed to improve the content of total iridoid glycosides in crude extract through a series optimization of extraction procedure. Moreover, considering that both pain and inflammation are two correlated responses triggered in response to injury, irritants or pathogen, the article investigated the anti-inflammatory and analgesic activities of P. scabra to screen out the active fraction. METHOD: P. scabra was extracted by ultrasonic-microwave synergistic extraction (UMSE) to obtain total iridoid glycosides (PSI), during which a series of conditions were investigated based on single-factor experiments. The extraction process was further optimized by a reliable statistical method of response surface methodology (RSM). The elution fractions of P. scabra extract were prepared by macroporous resin column chromatography. Through the various animal experiment including acetic acid-induced writhing test, formalin induced licking and flinching, carrageenan-induced mice paw oedema test and xylene-induced ear edema in mice, the active fractions with favorable analgesic and anti-inflammatory effect were reasonably screen out. RESULTS: The content of PSI could reach up to 81.42 ± 0.31 mg/g under the optimum conditions as follows: ethanol concentration of 52%, material-to-liquid ratio of 1:18 g/mL, microwave power at 610 W and extraction time of 45 min. After gradient elution by the macroporous resin, the content of PSI increased significantly. Compared with other concentrations of elution liquid, the content of PSI in 30 and 50% ethanol eluate was increased to reach 497.65 and 506.90 mg/g, respectively. Owing to the pharmacology experiment, it was reasonably revealed that 30 and 50% ethanol elution fractions of P. scabra could relieve pain centrally and peripherally, exhibiting good analgesic and anti-inflammatory activities. CONCLUSION: Patrinia scabra possessed rich iridoids and exhibited significant analgesic and anti-inflammatory activities.

A Rapid and Highly Sensitive Chemiluminescent Method to Quantify HPV16E7 Antibody Based on Immunomagnetic Separation Methods.

BACKGROUND: In order to detect anti-HPV16E7 antibody in serum, a highly sensitive and rapid detection method based on chemiluminescence immunoassay and immunomagnetic separation was introduced. The technique that was developed is a novel, sensitive chemiluminescence (CL) immunoassay for HPV16E7 antibody detection. METHODS: Balb/C mice were immunized with HPV16E7 fusion protein to prepare monoclonal antibody against HPV16E7. The biotinylated antigen was prepared as immunomagnetic beads and its stability was tested (IMBs). The protocol used horseradish peroxidase (HRP) labeled HPV16E7 antigen and immunomagnetic beads (IMBs). The antibody induced the formation of IMBs-mAbs HPV16E7-HRP labeled antibody structures. IMBs were applied to capture CEA and immobilize CEA through the external magnetic field. Oxidized luminescence substrate can be catalyzed by HRP on antibody surface to generate optical signals which were detected by luminometer. RESULTS: HPV16E7 monoclonal antibody was prepared and validated. The HPV16E7 antigen can efficiently bind to the bead with a conjugation rate of 72%. The biological activity of IMBs did not decrease significantly when stored in the dark at 4℃ for 2 months. The sensitivity and stability of this proposed method were excellent and showed a good linear relationship (Y = 1.3203 X + 0.7, R2 = 0.9952). CONCLUSIONS: This proposed technique showed excellent performance in quantitative measurement of HPV6E7 and was expected to be used in clinical detection.

Changes of matrix metalloproteinases in the stroma after corneal cross-linking in rabbits.

AIM: To observe changes in the content of matrix metalloproteinases (MMPs) in the corneal stroma after corneal cross-linking (CXL) in rabbits, and further explore the corneal pathophysiological process after CXL. METHODS: Forty-two rabbits (42 eyes) were randomly divided into seven groups. One group served as the control group, while the other six groups were treated with CXL. The concentrations of MMPs in corneal stroma were evaluated through parallel reaction monitoring at baseline and 3, 7, 15, 30, 90, and 180d after treatment. RESULTS: The levels of MMP-2 in the corneal stroma of rabbits were 0.76±0.07, 2.78±1.39, 4.12±0.69, 2.00±0.29, 2.00±0.30, 1.22±0.18, and 1.35±0.18 (10-9 mol/g) at baseline and 3, 7, 15, 30, 90, and 180d after treatment, respectively. The contents of tissue inhibitor of metalloproteinase-1 (TIMP-1) were 1.83±0.26, 7.94±0.58, 6.95±2.64, 3.81±0.48, 3.07±0.92, 1.72±0.19, and 1.69±0.74 (10-9 mol/g), respectively. The ratios of MMP-2/TIMP-1 were 0.42±0.33, 0.36±0.20, 0.62±0.10, 0.54±0.15, 0.68±0.13, 0.71±0.10, and 0.68±0.09, respectively. After CXL, the expression of MMP-2 and TIMP-1 in the rabbit corneal stroma was initially increased and subsequently decreased. The levels of MMP-2 remained higher than those recorded at baseline 180d after treatment, but it was not statistically significant. The levels of TIMP-1 returned to baseline levels at 90d after treatment. The ratio of MMP-2/TIMP-1 started to rise from 7d after CXL. It was significantly higher than that calculated at baseline 30-180d after CXL. The results for MMP-1, -3, -7, -9, -13, and TIMP-2 were negative. CONCLUSION: CXL can lead to changes in the content of MMP-2 and TIMP-1 in the rabbit corneal stroma. The ratio of MMP-2/TIMP-1 remains higher versus baseline, indicating that MMP-2 is involved in the corneal pathophysiological process after CXL.

The Risk of Retinopathy of Prematurity in the Infants following Assisted Reproductive Technology: A Meta-Analysis.

Currently, the use of assisted reproductive technology (ART) is increasing. Because of the poor prognosis of retinopathy of prematurity (ROP), the association between ART and the ROP has been explored in several studies, but the result was still inconclusive. Conducting a meta-analysis, we evaluated the risk of ROP in relation to the ART. Subgroup analysis as well as groups with different embryo numbers and different ROP stages was further analyzed. The PubMed, Embase, and Cochrane Library databases were searched for studies recording data about both the use of ART and ROP occurrence simultaneously. Odds ratios (ORs) and 95% confidence interval (95%CI) were calculated to analyze the association by using random- or fixed-effect models based on heterogeneity test. In total 15 observational studies containing 10392 ART cases and 39474 spontaneous conception cases were included. Results showed that there was a significant association between the use of ART and ROP occurrence in the offspring (OR = 1.34, 95% CI: 1.05 to 1.73, P = 0.02). With subgroup analysis, we found that the influence actually came from a subgroup of ART, the in vitro fertilization (IVF). Moreover, there was a significant association between ART and ROP in singletons. Though insignificant, the ORs were larger than 1 in the analysis between ART and stage 1 and 2 ROP. But ART showed significant association with stage 3 ROP. Our study preliminarily indicated that the use of IVF was associated with higher risk of ROP occurrence. And ART is more likely to result in severe ROP and ROP in singletons. Further specific, high-quality studies with large sample size are still needed to draw more precise conclusion.

Efficacy of iontophoresis-assisted epithelium-on corneal cross-linking for keratoconus.

Corneal cross-linking (CXL) is a noninvasive therapeutic procedure for keratoconus that is aimed at improving corneal biomechanical properties by induction of covalent cross-links between stromal proteins. It is accomplished by ultraviolet A (UVA) radiation of the cornea, which is first saturated with photosensitizing riboflavin. It has been shown that standard epithelium-off CXL (S-CXL) is efficacious, and it has been recommended as the standard of care procedure for keratoconus. However, epithelial removal leads to pain, transient vision loss, and a higher risk of corneal infection. To avoid these disadvantages, transepithelial CXL was developed. Recently, iontophoresis has been adopted to increase riboflavin penetration through the epithelium. Several clinical observations have demonstrated the safety and efficacy of iontophoresis-assisted epithelium-on CXL (I-CXL) for keratoconus. This review aimed to provide a comprehensive summary of the published studies regarding I-CXL and a comparison between I-CXL and S-CXL. All articles used in this review were mainly retrieved from the PubMed database. Original articles and reviews were selected if they were related to the I-CXL technique or related to the comparison between I-CXL and S-CXL.

Iontophoresis-assisted corneal crosslinking using 0.1% riboflavin for progressive keratoconus.

AIM: To report the clinical results of iontophoresis-assisted epithelium-on corneal crosslinking (I-CXL) using 0.1% riboflavin in distilled water for progressive keratoconus. METHODS: In this prospective clinical study, we examined 94 eyes of 75 patients with progressive keratoconus who were treated with I-CXL using 0.1% riboflavin in distilled water. Best correct visual acuity (BCVA), Scheimpflug tomography, corneal topography, anterior segment optical coherence tomography, intraocular pressure, and endothelial cell density were evaluated at baseline and 1, 3, 6, 12, and 24mo after I-CXL. RESULTS: After 24mo I-CXL, compared to the level at baseline, BCVA significantly improved 0.14±0.07 (P=0.010); mean keratometry signifi-cantly decreased 0.72±1.97 (P=0.021); maximum keratometry significantly reduced 2.30±5.01 (P=0.014); central keratoconus index significantly reduced 0.04±0.08 (P=0.007). The demarcation line was visible in 83.1% of eyes at 1mo after treatment, with a depth of 298.95±51.97 µm, and gradually indistinguishable. One eye had repeat treatment. Intraocular pressure and endothelial cell density did not change significantly. CONCLUSION: I-CXL using 0.1% riboflavin halts keratoconus progression within 24mo, resulting in a significant improvement in visual and topographic parameters. Moreover, the depth of the demarcation line is similar to that previously reported in standard epithelium-off CXL procedures.

Comparison of central corneal thickness using ultrasound pachymetry during corneal collagen cross-linking.

PURPOSE: To study variation in central corneal thickness (CCT) during corneal collagen cross-linking(CXL) using ultrasound pachymetry. METHODS: Twenty patients (26 eyes) with progressing keratoconus undergoing riboflavin-UVA-induced CXL were involved in this study. Intraoperative CCT measurement using ultrasonic pachymetry was performed during the procedure. Measurements were obtained before operation, after epithelial removal, after riboflavin drop instillation, and after UVA irradiation. RESULTS: Mean CCT was 495 +/- 56 and 450 +/- 52 microm before and after epithelial removal, respectively. Mean CCT was 443 +/- 42 and 411 +/- 39 microm after riboflavin drop instillation and after UVA irradiation, respectively. Statistically significant decreases in CCT occurred between the preoperative period and after epithelial removal, after riboflavin drop instillation and after UVA irradiation. Twenty-six eyes from 20 patients undergoing CXL were divided into 2 groups (I with CCT > or = 400 microm after UVA irradiation and II with CCT < 400 microm after UVA irradiation). No statistically significant difference was noted between I and II in preoperative endothelial cell count, but a statistically greater postoperative endothelial cell count was noted in I compared to II. A statistically significant difference was evident between preoperative and postoperative endothelial cell counts in Group II (P < 0.05). CONCLUSION: Performing CXL with the use of riboflavin and UVA irradiation resulted in a statistically significant decrease in CCT, to a level where the corneal endothelium may be damaged.