Analysis of risk and protective factors associated with retinal nerve fiber layer defect in a Chinese adult population

AIM:To investigate the risk and protective factors associated with the retinal nerve fiber layer defect(RNFLD)in a Chinese adult population.METHODS:This study was a cross-sectional populationbased investigation including employees and retirees of a coal mining company in Kailuan City,Hebei Province.All the study participants underwent a comprehensive systemic and ophthalmic examination.RNFLD was diagnosed on fundus photographs.Binary logistic regression was used to investigate the risk and protective factors associated with the RNFLD.RESULTS:The community-based study included 14440 participants.There were 10473 participants in our study,including 7120 males(68.0%)and 3353 females(32.0%).The age range was 45-108y,averaging 59.56±8.66y.Totally 568 participants had RNFLD and the prevalence rate was 5.42%.A higher prevalence of RNFLD was associated with older age[P<0.001,odds ratio(OR):1.032;95%confidence interval(CI):1.018-1.046],longer axial length(P=0.010,OR:1.190;95%CI:1.042-1.359),hypertension(P=0.007,OR:0.639;95%CI:0.460-0.887),and diabetes mellitus(P=0.019,OR:0.684;95%CI:0.499-0.939).The protective factors of RNFLD were visual acuity(P=0.038,OR:0.617;95%CI:0.391-0.975),and central anterior chamber depth(P=0.046,OR:0.595;95%CI:0.358-0.990).CONCLUSION:In our cross-sectional community-based study,with an age range of 45-108y,RNFLD is associated with older age,longer axial length,hypertension,and diabetes mellitus.The protective factors of RNFLD are visual acuity and central anterior chamber depth.These can help to predict and evaluate RNFLD related diseases and identify high-risk populations early.

10-year fundus tessellation progression and retinal vein occlusion

AIM： To access the 10-year fundus tessellation progression in patients with retinal vein occlusion. METHODS： The Beijing Eye Study 2001/2011 is a populationbased longitudinal study. The study participants underwent a detailed physical and ophthalmic examination. Degree of fundus tessellation was graded by using fundus photographs of the macula and optic disc. Progression of fundus tessellation was calculated by fundus tessellation degree of 2011 minus degree of 2001. Fundus photographs were used for assessment of retinal vein occlusion. RESULTS： The Beijing Eye Study included 4403 subjects in 2001, 3468 subjects was repeated in 2011. Assessment of retinal vein obstruction and fundus tessellation progression were available for 2462 subjects（71.0%）, with 66 subjects fulfilled the diagnosis of retinal vein occlusion. Of the 66 participants, 59 participants with unilateral branch retinal vein occlusion, 5 participants with unilateral central retinal vein occlusion, 1 participant with bilateral branch retinal vein occlusion, and 1 participant with branch retinal vein occlusion in one eye and central retinal vein occlusion in the other eye. Mean degree of peripapillary fundus tessellation progression were significantly higher in the whole retinal vein occlusion group（0.33±0.39, P〈0.001）, central retinal vein occlusion group（0.71±0.8, P=0.025） and branch retinal vein occlusion group（0.29±0.34, P=0.006） than the control group（0.20±0.26）. After adjustment for age, prevalence of tilted disc, change of best corrected visual acuity, axial length, progression of peripapillary fundus tessellation was associated with the presence of retinal vein occlusion（P=0.004; regression coefficient B, 0.094; 95%CI, 0.029, 0.158; standardized coefficient B, 0.056）. As a corollary, after adjusting for smoking duration, systolic blood pressure, anterior corneal curvature, prevalence of RVO was associated with more peripapillary fundus tessellation progression（P〈0.001; regression coefficient B： 1.257; OR： 3.517; 95%CI： 1.777, 6.958）. CONCLUSION： Peripapillary fundus tessellation progresses faster in individuals with retinal vein occlusion. This may reflect the thinning and hypoperfusion of choroid in patients with retinal vein occlusion.

Influencing factors for peripheral and posterior lesions in mild non-proliferative diabetic retinopathy--the Kailuan Eye Study

AIM:To explore the influencing factors of diabetes type 2 patients with mild non-proliferative diabetic retinopathy(NPDR)in the Kailuan area of Tangshan,Hebei Province,China.METHODS:In this non-interventional,retrospective study,683 patients with type 2 diabetes were included in the Kailuan Diabetic Retinopathy Study involving participants with diabetes in the community-based longitudinal Kailuan Study.Based on the undilated ultrawide field(200°;UWF)images and partial dilated digital fundus images,the diabetic retinopathy(DR)of the surveyed population was graded.Interobserver agreement was estimated by using Cohen’s Kappa statistics.The main outcome indicators included gender,age,weight,height,body mass index,blood pressure,circumferences of neck,waist and hip,current smoking,levels of fasting plasma glucose(FPG),hypersensitive C-reactive protein,creatinine,and cholesterol,etc.According to different lesions’locations of patients with mild NPDR,logistic regression models were used to estimate the odds ratios(ORs)and their 95%Cls of each risk factor.RESULTS:The study group of 683 patients included 570 males and 113 females.The mean age of the patients was62.18±9.41 y.Compared with dilated fundus examinations,there was fair agreement with the level of DR identified on UWF images in 63.91%of eyes(k=0.369,95%CI,0.00-0.00).Detected by UWF images,there were 98 patients with mild NPDR having peripheral retinal lesions,35 patients with mild NPDR having posterior lesions,44 patients with mild NPDR whose lesions were detected both in and out the standard two fields area,and 336 patients with non obvious DR.Parameters that conferred a statistically significant increased risks for mild NPDR with having peripheral retinal lesions were neck circumstance(OR,1.124;95%CI,1.044-1.211),and with posterior lesions were FPG(OR,1.052;95%CI,1.007-1.099).CONCLUSION:UWF is an effectiveness means of DR screening.Moreover,it is necessary to evaluate peripheral diabetic retinal lesions which can help to estimate the severity of DR.The phenomenon that nonuniform and inhomogeneous distribution of DR lesions has been found.And the influencing factors in mild NPDR are differing by different lesions’locations.

Retinal nerve fiber layer thickness and retinal vascular caliber alterations in coal miners in northern China:a community-based observational study

AIM:To evaluate retinal nerve fiber layer thickness and retinal vascular caliber alterations in coal mine workers.METHODS:The community-based observational crosssectional study included 4004 participants of a subpopulation of the Kailuan Study.All the study participants underwent structured interviews with a standardized questionnaire,fundus photography and spectral-domain optical coherence tomography(OCT)examinations performed by trained doctors.RESULTS:The retinal nerve fiber layer thickness was significantly higher(P=0.006)and the central macular thickness was lower in coal miners(n=659,51.0±7.8 y)as compared to the control(working above the ground;n=477,51.8±7.5 y;P=0.032).Additionally,the downhole workers showed a significantly thicker retinal artery(P=0.012)and vein diameters(P<0.001).In multivariable regression,a thicker retinal nerve fiber layer was associated with a higher cumulative silica dust exposure(P=0.005)after adjusting for younger age and larger spherical equivalent.In a reverse pattern,a higher cumulative silica dust exposure(P=0.004)was significantly associated with a thicker retinal nerve fiber layer after adjusting for age,high-density lipoproteins and uric acid.Wider retinal vein diameters were associated with higher cumulative silica dust exposure(P=0.036)after adjusting for younger age and larger spherical equivalent.CONCLUSION:The retinal vessels diameters and retinal nerve fiber layer thickness are significantly thicker in long term of coal mining.The results of our study indicate that underground working environment may lead to retinal vessel dilation and inflammation.Thus,ocular examination might be needed within coal miners in order to monitor the occupational eye health as well as the incidence and progression of eye diseases.

MicroRNA-145 suppresses uveal melanoma angiogenesis and growth by targeting neuroblastoma RAS viral oncogene homolog and vascular endothelial growth factor

Background:Uveal melanoma(UM)is the most common primary intraocular malignancy in adults.It has been demonstrated that microRNA-145(miR-145)is correlated with the progression of various cancers by regulating the expression of multiple target genes,especially a number of genes that regulate angiogenesis and proliferation.However,the underlying mechanisms of miR-145 in tumor angiogenesis of UM are still not well illustrated.Thus,we aimed to explore the potential target genes or pathways regulated by miR-145 in UM and the effect of miR-145 on invasion and angiogenesis.Methods:Totally,24 choroid samples were collected in our study,including 12 UM samples and 12 normal uveal tissues.The expression of neuroblastoma RAS viral oncogene homolog(N-RAS),phosphorylated protein kinase B(p-AKT),and vascular endothelial growth factor(VEGF)in UM tissues and normal uveal tissues was analyzed using Western blotting analysis.Lentivirus expression system was used to construct MUM-2B and OCM-1 cell lines with stable overexpression of miR-145.Transwell and endothelial cell tube formation assay were used to measure the effects of miR-145 on the invasion and angiogenesis of UM in vitro.The downstream target genes of miR-145 were predicted by bioinformatics and confirmed using a luciferase assay.BALB/c nude mice models were established to investigate the mechanisms of miR-145 on tumor growth and angiogenesis in vivo.Group data comparisons were performed using analysis of Student’s t test.A two-tailed P<0.05 was considered as statistically significant.Results:The results of Western blotting analysis indicated that the expressions of N-RAS(1.10±0.35 vs.0.41±0.36,t=3.997,P=0.012),p-AKT(1.16±0.22 vs.0.57±0.03,t=7.05,P=0.001),and VEGF(0.97±0.32 vs.0.45±0.21,t=3.314,P=0.008)inUMtumor tissues were significantly higher than those in normal uveal tissue.Luciferase assay demonstrated N-RAS and VEGF as downstream targets of miR-145.Moreover,tube formation assay revealed that miR-145-transfected human microvascular endothelial cell line formed shorter tube length(36.10±1.51mm vs.42.91±0.94 mm,t=6.603,P=0.003)and less branch points(350.00±19.97 vs.406.67±17.62,t=3.685,P=0.021)as compared with controls.In addition,the numbers of invaded MUM-2B and OCM-1 cells with miR-145 overexpression were significantly lower than the controls(35.7±3.3 vs.279.1±4.9,t=273.75,P<0.001 and 69.5±4.4 vs.95.6±4.7,t=21.27,P<0.001,respectively).In vivo,xenografts expressing miR-145 had smaller sizes(miR-145 vs.miR-scr,717.41±502.62mm3 vs.1694.80±904.33mm3,t=2.314,P=0.045)and lower weights(miR-145 vs.miR-scr,0.74±0.46 g vs.1.65±0.85 g,t=2.295,P=0.045).Conclusion:Our results indicated that miR-145 is an important tumor suppressor and the inhibitory strategies against N-RAS/VEGF signaling pathway might be potential therapeutic applications for UM in the future.