Choroidal thickness, myopia, and myopia control interventions in children: a Meta-analysis and systemic review.

AIM: To investigate changes of choroidal thickness (ChT) in children with myopia and the effect of current myopia control interventions on ChT. METHODS: Major literature databases were searched for studies relevant to myopia in children. All studies used swept-source optical coherence tomography (SS-OCT) or enhanced depth imaging optical coherence tomography (EDI-OCT) to measure the ChT value. The weighted mean difference (WMD) and 95% confidence interval (CI) were pooled to evaluate ChT in myopia children. RESULTS: A total of 11 eligible articles, including 1693 myopic and 1132 non-myopic eyes, were included in the first Meta-analysis. The sub-foveal choroidal thickness (SFCT; WMD=-40.06, 95%CI, -59.36 to -20.75, P<0.001) and ChT at other sectors were significantly thinner in myopic eyes compared with the non-myopic eyes. The Meta-analysis revealed that the ChT decreased horizontally from the temporal sector toward the nasal sector in the pediatric myopia population. Another 11 studies reporting the effect of myopia control interventions were included in the second Meta-analysis for the relationship between myopia control treatments and ChT. SFCT significantly increased after orthokeratology (OK) treatment and OK combined with 0.01% atropine (OKA) treatment (WMD=19.47, 95%CI, 15.96 to 22.98, P<0.001; WMD=21.81, 95%CI, 12.92 to 29.70, P<0.001, respectively). The forest plots showed that SFCT changed little in myopic children receiving 0.01% atropine (P=0.30). Furthermore, the Meta-analysis showed that OK treatment had a stronger effect on the value of SFCT in myopic children as compared with 0.01% atropine (WMD=9.86; 95%CI, -0.21 to 19.93, P=0.05). There is no difference between the treatment with OK and OKA treatment in ChT in myopic children (P=0.37). CONCLUSION: The ChT in myopic eyes is thinner than that in non-myopic eyes in pediatric population. Myopia control interventions including OK and OKA lead to ChT thickening, but other treatments such as 0.01% atropine did not show an increase in ChT.

[Linkage analysis of a Chinese family with autosomal dominant congenital retinaochoroidal coloboma].

OBJECTIVE: To map the candidate gene by linkage analysis in a Chinese family with autosomal dominant congenital retinaochoroidal coloboma. METHODS: A detailed clinical examination was performed for all patients in the family. The genomic DNA of all family members was extracted from peripheral blood leukocytes. Linkage analysis and genome-wide linkage screening was conducted using fluorescent detection of 398 microsatellite markers representing all autosomes at an average resolution of approximately 10 cM. Polymerase chain reaction was carried out to amplify all 398 microsatellite markers. The allele sizes were determined on ABI 3130-Avant genetic analyzer according to an internal size standard, and the results were analyzed using Genescan 3.1 and Genotyper 2.0 software. RESULTS: Linkage analysis showed the markers D2S2382-D2S301-D2S2244-D2S163 co-segregated with the disease locus in all affected members. The maximum Lod score was 3.01(D2S2382). CONCLUSION: The candidate region of the disease gene in the family was located in 2q34-2q35.

[Analysis of mutation in KRT12 gene in a Chinese family with Meesmann's corneal dystrophy].

OBJECTIVE: To investigate the mutation of KRT12 gene in a large Chinese family with Meesmann's corneal dystrophy by molecular genetic study and linkage analysis. METHODS: Mode of inheritance was determined in a family with Meesmann's corneal dystrophy provided by Xingtai Eye Hospital. The blood samples were obtained from members of this family, including both affected and unaffected members. The genome-DNA was extracted from the samples. Linkage analysis was conducted in the selected markers (D17S800, D17S930, D12S390, D12S96) in the locus around KRT12 and KRT3 genes. The exons of linked genes were sequenced directly. All of the members in this family were examined with slit lamp biomicroscope and photographed. Blood samples were collected from 100 normal subjects and analyzed as the controls. RESULTS: The mode of inheritance of corneal dystrophy in this family was identified as autosomal dominant inheritance. The clinical diagnosis was Meesmann's corneal dystrophy. Linkage analysis revealed a lod score of 2.41 with theta = 0.00 at markers D17S800 and D17S930. Linkage was revealed between corneal dystrophy and KRT12 gene. Sequences of KRT12 gene in affected members showed the mutant in exon 1, T419A and L132H. All affected members in this family were heterozygotes of this mutation. No mutation of this type was identified in all unaffected member of this family and in the 100 normal controls. CONCLUSION: Mutation of KRT12 gene in exon 1, T419A and L132H is the molecular genetic change leading to the occurrence of Meesmann's corneal dystrophy in this Chinese family.

[The expression of TGF-beta1 and bFGF after LASEK and the effects of 20% ethanol exposure on corneal wound healing].

OBJECTIVE: To assess the effects of 20% ethanol used in LASEK on corneal wound healing. METHODS: Forty-eight eyes from 24 rabbits were deepithelialized by two techniques. The epithelium were detached with either 20% ethanol (applied for 30 seconds) or mechanical scraping, then ablated was performed. The number of superficial stromal keratocytes was counted and the morphologic changes were observed. Expression of TGF-beta1 and bFGF mRNAs was detected and analyzed by reverse transcription-polymerase chain reaction and immunocytochemical methods at 1, 7, 30 and 90 days after the surgery. RESULTS: One day after the surgery, the expression of TGF-beta1 and bFGF in the keratocytes in both treated groups was lower than that of the normal controls. Seven days after the surgery, the expression of TGF-beta1 and bFGF in both treated groups was greater than that of the normal controls (P < 0.01). The expression in the alcohol-treated group was greater than that of the surgical-treated group (P < 0.01). The expression of TGF-beta1 and bFGF reached the peak 30 days after the surgery, no significant difference was detected between the alcohol-treated and surgical-treated groups. There was no significant difference in expression level between the alcohol-treated and surgical-treated groups 3 months after the surgery; as well as between treated groups and normal group. The amount of TGF-beta1 and bFGF mRNA was positively correlated with the number of keratocytes. The correlation coefficient between TGF-beta1 and bFGF mRNA and the number of the keratocytes was 0.744 (P < 0.01) and 0.738 (P < 0.01) in the alcohol-treated group; and was 0.664 (P < 0.01) and 0.785 (P < 0.01) in the surgical-treated group, respectively. CONCLUSIONS: The expression of TGF-beta1 and bFGF mRNA undergo a dynamic process of "decrease-increase-normal". Although ethanol has a slight toxic effect on rabbit epithelial cells, but the effects do not persist over time, therefore, it is relatively safe to use the alcohol treatment in the LASEK.

[Treatment of dissociated vertical deviation by shifting fixating eye].

OBJECTIVE: To investigate the results of using shifting fixation eye to manage monocular or asymmetrical binocular dissociated vertical deviation (DVD). METHODS: Twenty-three DVD children whose corrected vision was better than 0.5 in the amblyopic eye were studied. The goal of the shifting fixation eye was gained by decreasing the vision of the primary fixation eye to 2 or 3 lines (Snellen Visual Acuity) lower than that of the fellow fixation eye by occlusion or optical methods. The vision, alignment and retinal correspondence were evaluated before and after the treatment. RESULTS: After the treatment, in 10 patients, the vision of the primary fixation eye did not decrease significantly and the vision of the fellow eye increased 2 lines. In 19 patients, a cosmetic result was achieved; the primary fixation eye was shifted in 4 patients that had similar hepertropia in two eyes (