The corneal biomechanical differences after wearing orthokeratology lenses and multifocal soft lenses in children: A self-control study.

BACKGROUND: To compare the changes in corneal biomechanics after orthokeratology (OK) lens and Defocus Incorporated Soft Contact (DISC) lens treatment. METHODS: Of 28 myopic children were recruited, with one eye wearing OK lens and the other eye wearing DISC lens for one year, and the data after discontinued for 4 weeks were also collected. Major outcomes were corneal biomechanics and axial length (AL) elongation. RESULTS: Throughout the follow-up period, the DISC group had longer the first applanation (A1) time, larger A1 deformation amplitude, A1 deflection length (A1 DLL), and A1 deflection amplitude than the OK group. AL elongation was less in the OK group at each visit (all P < 0.05) but faster in the OK group than in the DISC group after discontinuation (P = 0.006). Moreover, AL elongation was related to baseline A1 time, A1 velocity and whole eye movement max in the DISC group, and in the OK group, was related to the baseline the second applanation (A2) DLL, A2 delta arc length and stiffness parameter A1 (all P < 0.05). CONCLUSIONS: The cornea was more deformable after wearing DISC lens than OK lens, and corneal biomechanical parameters were associated with AL elongation. Eyes showed less AL elongation during OK lens treatment while faster AL elongation after discontinuation than DISC lens. The baseline corneal biomechanics may help to predict AL elongation in myopic control strategies.

Quantitative interocular suppression in children with intermittent exotropia.

Purpose: We have demonstrated that the depth of unbalanced interocular suppression can be quantified by balancing the interocular luminance differences required when both eyes are viewing simultaneously. In this study, we aimed to investigate the applicability of this method in children with intermittent exotropia (IXT), offering a quantitative assessment of interocular suppression in individuals with binocular imbalance. Additionally, we evaluated its association with the clinical characteristics of IXT. Methods: Interocular suppression in IXT was quantitatively measured using a polarizer and neutral-density (ND) filters. The density of the ND filter was adjusted incrementally from 0.3ND to 3ND, with a step size of 0.3ND (a total of 10 levels). Our prospective study involved 46 patients with IXT (mean age: 10.12 ± 4.89 years; mean ± SD) and 24 normal observers (mean age: 7.88 ± 1.83 years). Results: The suppression test exhibited good test-retest reliability, supported by statistical analysis. We observed more pronounced interocular suppression in individuals with IXT compared to controls. Notably, the magnitude of suppression during distant and near viewing significantly differed in IXT (1.55 ± 0.93 vs. 0.57 ± 0.64; Z = 4.764, p < 0.001). Furthermore, we identified a positive correlation between interocular suppression and data obtained from the Worth-4-Dot test. Additionally, interocular suppression showed a significant association with distance control scores. Conclusion: Our novel test offers a convenient and reliable means to quantify interocular suppression in patients with IXT. The quantitative assessment of interocular suppression provides a sensitive tool to evaluate the clinical characteristics of IXT.

Reading speed in school-age children with intermittent exotropia.

Reading speed in intermittent exotropia (IXT) children has been minimally examined. This study assessed reading speed in school-age children with IXT and determined clinical characteristics of IXT that impacted their reading ability. We compared the reading speed of 63 school-age (10-14 years) children with IXT to 44 age-matched normal counterparts. In addition, the correlation between reading speed and clinical characteristics of IXT were evaluated. The reading speed in children with IXT was 231 ± 51 CPM, while reading speed in normal counterparts was 257 ± 33 CPM. Age, gender were found to be factors associated with reading speed in children with IXT. After adjusting for the age and gender, we found a significant correlation between the LogTNO and reading speed in IXT group based on a generalized linear model (p = 0.014). These data show that reading speed was slower in school-age children with IXT assessed with the International Reading Speed Texts. When age and gender were adjusted, poor stereo function at near was found to be related with a slower reading speed.

Effects of orthoptic therapy in children with intermittent exotropia after surgery: study protocol for a randomized controlled trial.

BACKGROUND: Intermittent exotropia (IXT) is the most common type of exotropia in China. Surgery is usually required to align the eye deviation to maintain or obtain better binocular visual function. However, there is a high rate of exodrift or recurrence in surgically treated patients. Orthoptic therapy is sometimes recommended for IXT patients after surgery. However, there is a lack of high-quality randomized controlled trials to prove that orthoptic therapy could be an effective supplement to surgical treatment for IXT patients. The main purpose of this study is to test the clinical effectiveness of orthoptic therapy in long-term stabilization of postoperative IXT patient. This report describes the design and methodology of the Intermittent Exotropia Postoperative Treatment Clinical Trial, which is the first large-sample, blank-controlled, randomized clinical trial. METHODS: A total of 136 IXT patients (aged 7 to 17 years) will be enrolled and assigned to the orthoptic therapy group or blank control group according to a simple randomization scheme. Patients in the orthoptic therapy group will receive at least 2 months of orthoptic therapy, such as anti-suppression, vergence, and accommodation training. Patients in the blank control group will receive only refractive correction. All enrolled patients will need regular follow-up observation until 24 months after surgery. The primary outcome will be the proportion of participants meeting suboptimal surgical outcomes in this 24-month follow-up, which is defined as (1) exodeviation of 10 prism diopters (PD) at distance or near using the simultaneous prism and cover test (SPCT) or (2) loss of 2 or more octaves of stereoacuity from baseline, at any masked follow-up visit examination. The secondary outcomes will be the exodeviation at distance and near using the simultaneous prism and alternate cover test (PACT), magnitude of fusional convergence, stereoacuity, and accommodation. Measurements will be taken at baseline and at the 6-, 12-, 18-, and 24-month follow-ups. DISCUSSION: To the best of our knowledge, this will be the first prospective, randomized controlled study of orthoptic training in IXT patients after surgery. The aim of this work is to confirm the efficacy of orthoptic therapy in reducing the proportion of recurrence among IXT patients after surgery and improving binocular vision function. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900026891 . Registered on 25 October 2019.

Myopia progression and stabilization in school-aged children with single-vision lenses.

PURPOSE: To investigate the longitudinal changes in myopia from onset to stabilization in school-aged children with single-vison lenses (SVLs). METHODS: The medical records of patients wearing SVLs with long-term follow-up data between 2006 and 2016 were retrospectively reviewed. The patients who were 6-10 years old at the initial visit and 16 years old at the last assessment were included and analysed. The periods of progression and stabilization of myopia were evaluated by plotting fitted curves of the changes in spherical equivalent (SE). RESULTS: Seven hundred and seventy-three patients (median initial age 9 years) were accessed over an average of 7 years (IQR, 6-7 years). The initial mean SE was -1.92 ± 1.57 D and increased to -6.05 ± 2.14 D at 16 years old. The average age at myopia stabilization was 14.6 years, and girls slightly stabilized earlier than boys. 73.7% of the 6-year-olds and 85.7% of the 7-year-olds had high myopia at 16 years old, and the risk decreased each year from 7 to 10 years old. Children who had SE greater than -4 D up to 10 years had 89.0% risk of high myopia at 16 years old. Children with SE between -0.5 D and -2 D still had 34% risk of developing high myopia at 16 years old. CONCLUSION: This study provides a comprehensive picture of myopia progression from onset to stabilization in school-aged children with SVLs in China. All children who have myopia onset below 10 years of age were at risk for high myopia, and children who have myopia onset below 8 years of age require more attention.

Longitudinal Rehabilitation of Binocular Function in Adolescent Intermittent Exotropia After Successful Corrective Surgery.

PURPOSE: To study the longitudinal rehabilitation of binocular visual function in adolescent intermittent exotropia (IXT) after successful surgery and compare the results with those of a normal population. The role of binocular function in ocular alignment stability was also evaluated postoperatively. METHODS: In this prospective study, 30 adolescents with IXT successfully corrected after 1 month were followed for 12 months, and 30 children with normal vision were enrolled as controls. Stereopsis, the fusional vergence amplitude, sensory fusion, and accommodative flexibility were measured to assess binocular function at baseline and 6 and 12 months postoperatively. The controls were tested once when they were enrolled in the study. RESULTS: The deviation was -32.00 ± 8.60 prism diopters (PD) at distance fixation and -36.0 ± 9.10 PD at near fixation preoperatively with an average correction of 28.53 ± 3.79 PD and 30.67 ± 1.34 PD at 1 month postoperatively. Distance stereoacuity and near stereoacuity improved from 1 to 12 months postoperatively (p = 0.025 and p = 0.041, respectively). Compared with the controls, the fusional convergence reserve at distance (p = 0.025) and near (p = 0.033) fixations and fusion reserve ratio at distance (p = 0.000) and near (p = 0.000) fixations remained subnormal, whereas sensory fusion (p = 0.237), distance stereopsis (p = 0.120), and the fusional divergence amplitude at a distance (p = 0.168) were normal. However, no significant correlations were found between binocular functions at 1 month postoperatively and the postoperative drift. CONCLUSION: Binocular function significantly improved from before to after successful corrective surgery and continued to improve from 1 to 12 months postoperatively in adolescents with IXT. No significant correlations were found between binocular functions at 1 month postoperatively and ocular alignment stability.

Correlation Between Increase of Axial Length and Height Growth in Chinese School-Age Children.

PURPOSE: To identify the relationship between the increase in axial length (AL) and height in school-age children and explore the influence of refractive status on such a relationship. METHODS: In this 5-year cohort study, 414 Chinese children (237 boys) aged 6-9 years (mean 7.12) underwent measurements annually. AL was measured using the Lenstar; height with the children standing, without shoes; and refraction using subjective refraction without cycloplegia. Participants were divided according to the refractive status: persistent emmetropia, persistent myopia, and newly developed myopia. The measurement time points of the persistent emmetropia and persistent myopia groups were marked as T1, T2, T3, T4, and T5. The time of myopia onset in the newly developed myopia group was marked as t 0; the preceding time points were marked as t -1, t -2, and so on, and the succeeding as t 1, t 2, and so on. The association between increase in AL and height was analyzed using simple correlation analysis. RESULTS: The mean changes in AL, height, and refraction were 1.39 mm, 23.60 cm, and -1.69 D, respectively, over 5 years in all children. The increase in AL and height were positively correlated for T1~T2, T1~T3, T1~T4, and T1~T5 (r = 0.262, P < 0.001; r = 0.108, P = 0.034; r = 0.165, P = 0.001; r = 0.174, P = 0.001, respectively). The changes in AL and height in the newly developed myopia group were significantly correlated (r = 0.289, P = 0.009) after myopia onset (t 0~t 2). CONCLUSION: The increase in AL and height were positively correlated, especially in the newly developed myopia group after myopia onset. Thus, when children grow quickly, AL elongation should be monitored.

Impact of human papillomavirus infection in semen on sperm progressive motility in infertile men: a systematic review and meta-analysis.

BACKGROUND: Human papillomavirus (HPV) has been considered as one of the most common sexually transmitted viruses that may be linked to unexplained infertility in men. The possible mechanisms underlying correlation between HPV infection and infertility could be related to the altered sperm parameters. Current studies have investigated the effect of HPV seminal infection on sperm quality in infertile men, but have shown inconsistent results. METHODS: We systematically searched PubMed, Embase, Web of Science and CNKI for studies that examined the association between HPV seminal infection and sperm progressive motility. Data were pooled using a random-effects model. Outcomes were the sperm progressive motility rate. Results are expressed as standardised mean difference (SMD) with 95% confidence interval (CI). Heterogeneity was evaluated by the I-square (I2) statistic. RESULTS: Ten studies were identified, including 616 infertile patients with HPV seminal infection and 2029 infertile controls without HPV seminal infection. Our meta-analysis results indicated that sperm progressive motility was significantly reduced in HPV-infected semen samples compared with non-infected groups [SMD:-0.88, 95% CI:-1.17 ~ - 0.59]. There existed statistical heterogeneity (I2 value: 86%) and the subgroup analysis suggested that study region might be the causes of heterogeneity. CONCLUSIONS: HPV semen infection could significantly reduce sperm progressive motility in infertile individuals. There were some limitations in the study such as the differences in age, sample sizes and the number of HPV genotypes detected. Further evidences are needed to better elucidate the relationship between HPV seminal infection and sperm quality.

Retinal Microvasculature in Amblyopic Children and the Quantitative Relationship Between Retinal Perfusion and Thickness.

Purpose: To quantify retinal vascular density in amblyopic children and to investigate the relationship between superficial and deep retinal vessel density and retinal thickness. Method: In this prospective cross-sectional study, 85 amblyopic children (5-12 years) and 66 age-matched control subjects participated at a pediatric ophthalmology clinic. Macular vessel densities of the superficial and deep capillary plexuses (SCP, DCP, respectively) and retinal thickness were measured by clinical optical coherence tomographic angiography (OCTA). Vessel density and retinal thickness were compared between amblyopic groups and the control group, and correlations among these two variables were analyzed. Results: Of the 85 amblyopic children, 52 children had anisometropic amblyopia, 16 had strabismic amblyopia, and 17 had bilateral amblyopia. The foveal and parafoveal macular vessel density in the SCP was lower in amblyopic than control children (P ≤ 0.008). Compared to strabismic and bilateral amblyopias, anisometropic amblyopia SCP differed the most from controls (P ≤ 0.005). Macular vessel density in the DCP of amblyopic children was similar to controls. Multiple linear regression analyses showed SCP vessel density was positively correlated with inner retinal thickness in the fovea (P < 0.001) and in the temporal, nasal, and inferior quadrants of the parafovea (P ≤ 0.008). Conclusions: Macular vessel density is decreased in anisometropic amblyopia, and to a lesser extent, the other amblyopias. Retinal small vessel density was correlated with the thickness of the macular inner retina. The causality of retinal change (i.e., whether it is primary or secondary to the onset of amblyopia) has not yet been determined.

Proteomic profile of human spermatozoa in healthy and asthenozoospermic individuals.

Asthenozoospermia is considered as a common cause of male infertility and characterized by reduced sperm motility. However, the molecular mechanism that impairs sperm motility remains unknown in most cases. In the present review, we briefly reviewed the proteome of spermatozoa and seminal plasma in asthenozoospermia and considered post-translational modifications in spermatozoa of asthenozoospermia. The reduction of sperm motility in asthenozoospermic patients had been attributed to factors, for instance, energy metabolism dysfunction or structural defects in the sperm-tail protein components and the differential proteins potentially involved in sperm motility such as COX6B, ODF, TUBB2B were described. Comparative proteomic analysis open a window to discover the potential pathogenic mechanisms of asthenozoospermia and the biomarkers with clinical significance.

[Protective effect of Ligustri Lucidi Ait Polysaccharide against lipopolysaccharide-induced inflammatory injury of Sertoli cells in rats].

OBJECTIVE: To explore the effect of Ligustri Lucidi Ait Polysaccharide (LLP) on lipopolysaccharide (LPS)-induced inflammatory injury of Sertoli cells. METHODS: Rat Sertoli cells were isolated and cultured in vitro and then divided into five groups, blank control, LPS, LPS + low-dose LLP, LPS + medium-dose LLP, and LPS + high-dose LLP. After 48 hours of treatment, the proliferation of the cells was detected by CCK-8, their apoptosis determined by FMC, and the levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) activity and malondialdehyde (MDA) in the supernatant of the cell culture medium measured by ultraviolet spectrophotometry. The contents of IL-1α, IL-6 and TGF-ß in the culture medium were detected by ELISA before and after removal of LPS. RESULTS: The proliferation of the cells showed statistically significant differences among different groups (F = 153.93, P < 0.01), markedly reduced in the LPS group as compared with the blank control (P < 0.01), but remarkably increased in the high- and medium-dose LLP groups in comparison with the LPS group (both P < 0.01), and so did the apoptosis of the cells (F = 64.06, P < 0.01), significantly increased in the LPS group as compared with the blank control (P < 0.05), but markedly decreased in the high- and medium-dose LLP groups in comparison with the LPS group (both P < 0.01). Statistically significant differences were also observed among different groups in the levels of SOD (F = 56.07, P < 0.01), CAT (F = 41.57, P < 0.01), GSH-Px activity (F = 238.46, P < 0.01), and MDA (F = 285.31, P < 0.01), with decreased SOD, CAT and GSH-Px activity (P < 0.01) and increased MDA (P < 0.01) in the LPS group as compared with the control, but elevated SOD and CAT in the high- and medium-dose LLP groups and increased GSH-Px activity and decreased MDA concentration in all the three LLP groups in comparison with the LPS group (P < 0.01). Before the removal of LPS, the contents of IL-1α, IL-6 and TGF-ß in the culture medium were markedly higher in the LPS than in the control group (all P < 0.01), that of IL-1α was increased significantly in the high- and medium-dose LLP groups (P < 0.01 and P < 0.05) while those of IL-6 and TGF-ß showed no statistically significant differences in the three LPS groups as compared with the LLP group (P > 0.05). After the removal of LPS, the contents of IL-1α and IL-6 were remarkably reduced (t = 25.26 and 61.43, P < 0.01) and that of TGF-ß increased (t = －18.16, P < 0.01), even more significantly in the LLP+LPS groups (P < 0.01). CONCLUSIONS: Ligustri Lucidi Ait Polysaccharide plays a protective role in LPS-induced inflammatory injury of Sertoli cells by reducing cell apoptosis and regulating the contents of IL-1α, IL-6 and TGF-ß from Sertoli cells in inflammation.

The correlation of sperm morphology with unexplained recurrent spontaneous abortion: A systematic review and meta-analysis.

Sperm morphology displays a potential impact on sperm function and may ultimately impact reproductive function. Current studies have investigated the correlation between sperm morphology with unexplained recurrent spontaneous abortion (RSA) but have shown inconsistent results. Hence, we systematically searched MEDLINE, EMBASE, CNKI databases, as well as the Cochrane Library for studies that examined the association between sperm morphology and unexplained RSA. Fifteen studies were identified, including 883 cases and 530 controls. Our meta-analysis results indicated that the percentage of normal sperm morphology from men with RSA partners was significantly lower than those from normal controls(SMD [95% CI]: - 0.60 [-0.81, -0.40]; P<0.00001) and the percentage of sperm morphologic alterations was significantly higher in patients with RSA compared with the control group (SMD [95% CI]: 0.92 [0.42, 1.43]; P=0.0004). The present study suggested that the percentage of normal sperm morphology may indeed decrease in men from RSA group compared with controls. However, there were some limitations in the study such as the differences in stain techniques and classification criteria. Further evidences are needed to better elucidate the relationship between sperm morphology and unexplained RSA.

[Role of TGF-ß1 in Sertoli cells and tight junction].

OBJECTIVE: To explore the role of TGF-ß1 in the proliferation and apoptosis of Sertoli cells and its effect on the expressions of tight junction-related proteins and genes in rats. METHODS: Rat Sertoli cells were isolated in vitro, primarily cultured, and divided into groups A (blank control), B (TGF-ß1 receptor blocker), C (TGF-ß1), and D (TGF-ß1 + receptor blocker). The proliferation and apoptosis of the cells were detected by CCK-8 and flow cytometry, respectively. After establishment of the dual-chamber model for the primary culture of Sertoli cells, the trans-epithelia electrical resistance (TER) value was measured and the relative expressions of Occludin, ZO-1 and Claudin Ⅱ determined by RT-PCR and Western blot. RESULTS: The OD value of the proliferation of the Sertoli cells was markedly higher in group C than in groups A and D (0.79 ± 0.04 vs 0.66 ± 0.05 and 0.68 ± 0.02, P<0.05), with statistically significant differences among the four groups (F = 5.05, P <0.05). However, no remarkable difference with found among the four groups in the apoptosis rate of the cells (F = 1.13, P >0.05). The TER value was dramatically decreased in group C as compared with groups A and D (ï¼»176.37 ± 16.61ï¼½ vs ï¼»281.42 ± 9.83ï¼½ and ï¼»254.37 ± 13.55ï¼½ /cm2, P<0.01), with statistically significant differences among the four groups (F = 38.99, P<0.01). There were no remarkable differences among the four groups in the mRNA expressions of ZO-1 and Claudin Ⅱ (F = 0.49 and 0.93, P>0.05) or their protein expressions (F = 0.28 and 1.31, P>0.05). Both the mRNA and protein expressions of Occludin were markedly lower in group C than in A and D (P<0.01 and P<0.05), with statistically significant differences among the four groups (F = 6.86 and 6.87, P<0.01). CONCLUSIONS: TGF-ß1 can promote the proliferation of Sertoli cells in rats and act on the tight junction of the cells by regulating the expression of Occludin.

[Seminal plasma miR-122-3p and miR-141-5p stability and its diagnosis value for idiopathic asthenospermia].

OBJECTIVE: To explore the stability of seminal plasma miR-122-3p and miR-141-5p and their diagnostic value for idiopathic asthenospermia. METHODS: Seminal plasma miR-122-3p and miR-141-5p with various incubation time, freeze-thaw cycles and incubation time were analyzed. Real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to detect the content of miR-122-3p and miR-141-5p, with U6 snRNA as the reference. The idiopathic asthenospermia group was further divided into grade I and II based on the progressive motility percent, and the content of miR-122-3p and miR-141-5p in the two grades were compared. RESULTS: No difference was detected after incubation at room temperature and 4 degrees Celsius. But seminal plasma miR-122-3p and miR-141-5p have decreased along with the increase in freeze-thaw cycles increases. RT-PCR assayed showed that the miR-122-3p content in the idiopathic asthenospermia group was significantly lower than the control group, while miR-141-5p was significantly higher. The difference in both miR-122-3p and miR-141-5p content was statistically significant (P < 0.05). A significant difference in miR-122-3p and miR-141-5p content between a and b groups was also detected (P < 0.05). The AUC-ROC of miR-122-3p was 0.88. At the cutoff value of 1.02, the sensitivity and specificity was 83% and 84%, respectively. At the cutoff of 2.95, the AUC-ROC of miR-141-5p was 0.88. The sensitivity and specificity was 84% and 70%, respectively. CONCLUSION: MiR-122-3p and miR-141-5p in seminal plasma are stable and have certain value for the diagnosis of idiopathic asthenospermia.

Correlation between KLK6 expression and the clinicopathological features of glioma.

AIM OF THE STUDY: We measured the impact of changing KLK6 expression levels on the pathological grade of gliomas and on proliferation rate, cell cycle progression, and apoptosis in the U251 glioblastoma cell line. MATERIAL AND METHODS: The expression of KLK6 in 35 brain glioma tissues and adjacent noncancerous tissues was measured using real-time quantitative polymerase chain reaction (PCR) and the relationship between KLK6 expression and pathological grades was analysed. RESULTS: The KLK6 expression in U251 cells was silenced by a specific siRNA, and the effects on proliferation, the cell cycle, and apoptosis were compared to wild type cells. Expression of KLK6 was downregulated in gliomas relative to matched noncancerous tissue. There was no obvious relationship between patient sex, pathological grade, or tumour classification and the expression of KLK6. In the U251 cell line, cell proliferation was enhanced and the fractions of cells in the G2 and S phases were increased by siRNA-mediated KLK6 silencing. CONCLUSIONS: Expression of KLK6 inhibits tumour growth. Decreased KLK6 expression may be a possible risk factor for glioma.