Effects of posterior corneal astigmatism on the accuracy of AcrySof toric intraocular lens astigmatism correction

AIM：To evaluate the effects of posterior corneal surface measurements on the accuracy of total estimated corneal astigmatism.METHODS：Fifty-seven patients with toric intraocular lens（IOL） implantation and posterior corneal astigmatism exceeding 0.5 diopter were enrolled in this retrospective study.The keratometric astigmatism（KA） and total corneal astigmatism（TA） were measured using a Pentacam rotating Scheimpflug camera to assess the outcomes of AcrySof IOL implantation.Toric lOLs were evaluated in 26 eyes using KA measurements and in 31 eyes using TA measurements.Preoperative corneal astigmatism and postoperative refractive astigmatism were recorded for statistical analysis.The cylindrical power of toric lOLs was estimated in all eyes.RESULTS：In all cases,the difference of toric IOL astigmatism magnitude between KA and TA measurements for the estimation of preoperative corneal astigmatism was statistically significant.Of a total of 57 cases,the 50.88%decreased from Tn to Tn-1 and 10.53%decreased from Tn to Tn-2.In all cases,5.26%increased from Tn to Tn＋1.The mean postoperative astigmatism within the TA group was significantly lower than that in the KA group.CONCLUSION：The accuracy of total corneal astigmatism calculations and the efficacy of toric IOL correction can be enhanced by measuring both the anterior and posterior corneal surfaces using a Pentacam rotating Scheimpflug camera.

Novel application of multispectral refraction topography in the observation of myopic control effect by orthokeratology lens in adolescents

BACKGROUND Myopia,as one of the common ocular diseases,often occurs in adolescence.In addition to the harm from itself,it may also lead to serious complications.Thus,prevention and control of myopia are attracting more and more attention.Previous research revealed that single-focal glasses and orthokeratology lenses(OK lenses)played an important part in slowing down myopia and preventing high myopia.AIM To compare the clinical effects of OK lenses and frame glasses against the increase of diopter in adolescent myopia and further explore the mechanism of the OK lens.METHODS Changes in diopter and axial length were collected among 70 adolescent myopia patients(124 eyes)wearing OK lenses for 1 year(group A)and 59 adolescent myopia patients(113 eyes)wearing frame glasses(group B).Refractive states of their retina were inspected through multispectral refraction topography.The obtained hyperopic defocus was analyzed for the mechanism of OK lenses on slowing down the increase of myopic diopter by delaying the increase of ocular axis length and reducing the near hyperopia defocus.RESULTS Teenagers in groups A and B were divided into low myopia(0 D--3.00 D)and moderate myopia(-3.25 D--6.00 D),without statistical differences among gender and age.After 1-year treatment,the increase of diopter and axis length and changes of retinal hyperopic defocus amount of group A were significantly less than those of group B.According to the multiple linear analysis,the retinal defocus in the upper,lower,nasal,and temporal directions had almost the same effect on the total defocus.The amount of peripheral retinal defocus(15°-53°)in group A was significantly lower than that in group B.CONCLUSION Multispectral refraction topography is progressive and instructive in clinical prevention and control of myopia.

Optical performance of toric intraocular lenses in the presence of decentration

· AIM: To evaluate the optical performance of toric intraocular lenses(IOLs) after decentration and with different pupil diameters, but with the IOL astigmatic axis aligned.· METHODS: Optical performances of toric T5 and SN60 AT spherical IOLs after decentration were tested on a theoretical pseudophakic model eye based on the Hwey-Lan Liou schematic eye using the Zemax ray-tracing program. Changes in optical performance were analyzed in model eyes with 3-mm, 4-mm, and 5-mm pupil diameters and decentered from 0.25 mm to 0.75 mm with an interval of 5° at the meridian direction from0° to 90°. The ratio of the modulation transfer function(MTF) between a decentered and a centered IOL(MTFDecentration/MTFCentration) was calculated to analyze the decrease in optical performance.· RESULTS: Optical performance of the toric IOL remained unchanged when IOLs were decentered in any meridian direction. The MTFs of the two IOLs decreased,whereas optical performance remained equivalent after decentration. The MTFDecentration/MTFCentrationratios of the IOLs at a decentration from 0.25 mm to 0.75 mm were comparable in the toric and SN60 AT IOLs. After decentration, MTF decreased further, with the MTF of the toric IOL being slightly lower than that of the SN60 AT IOL. Imaging qualities of the two IOLs decreased when the pupil diameter and the degree of decentration increased, but the decrease was similar in the toric and spherical IOLs.· CONCLUSION: Toric IOLs were comparable to spherical IOLs in terms of tolerance to decentration at the correct axial position.

MP-3 microperimeter in early primary open angle glaucoma with a new pattern

AIM:To investigate macular microperimetry in patients with early primary open angle glaucoma(POAG)using a new custom-made pattern,and analyze the characteristics of macular sensitivity.METHODS:This case-control study included 38 patients with POAG,who were divided into pre-perimetric glaucoma(18 eyes of 18 patients),early-stage(20 eyes of 20 patients),and control(20 eyes of 20 patients)groups.All subjects underwent standard 24-2 humphrey visual field test.An MP-3 microperimeter with a new custom-made pattern(28 testing points distributed in four quadrants,covering the central 10°of the retina)was used to evaluate macular sensitivity.Ganglion cell complex(GCC)thicknesses were examined using an RS-3000 Advance OCT system.The features of structure and function were analysed per quadrant.RESULTS:The pre-perimetric glaucoma group had significantly lower inferior hemifield macular sensitivity compared to controls(P<0.05).The early-stage POAG group had significantly lower average,inferior hemifield,inferonasal,and inferotemporal mean sensitivities compared to the pre-perimetric glaucoma group(P<0.05),and lower macular sensitivity in all sectors compared to controls(P<0.05).Regarding GCC thickness,all sectors in the early-stage POAG group became thinner compared to those in controls(P<0.05);whereas all sectors in the early-stage POAG group,except the superonasal quadrant,became thinner compared to those in the pre-perimetric glaucoma group(P<0.05).Macular sensitivity and GCC thickness were significantly associated in each sector.The inferotemporal quadrant had the highest correlation coefficients(0.840).The structure-function relationship for the inferonasal and inferotemporal sectors was stronger compared to the corresponding superior sectors.CONCLUSION:Microperimetry reveals variations in macular sensitivity in patients with early glaucoma earlier than conventional perimetry,particularly in pre-perimetric glaucoma cases in which it might be undetectable by conventional methods.The new custom-made pattern may improve the accuracy of microperimetry by enhancing point arrangement and reducing fatigue effects.Macular sensitivity measured by MP-3 with this pattern shows statistically significant structural and functional associations with the thicknesses of the GCC.

Risk factors for diabetic retinopathy in northern Chinese patients with type 2 diabetes mellitus

AIM: To investigate the prevalence and risk factors of diabetic retinopathy (DR) in northern Chinese patients with type 2 diabetes mellitus (T2DM). METHODS: This retrospective cross-sectional study was performed between May 2011 and April 2012. A total of 1100 patients (male/female, 483/617) were included in this study. DR was defined following the Early Treatment Diabetic Retinopathy Study (ETDRS) severity scale. All included patients accepted a comprehensive ophthalmic examination including retinal photographs. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence interval (CI) after adjusting for age and gender. RESULTS: Retinopathy was present in 307 patients with a prevalence of 27.9%. In univariate logistic analysis, presence of DR was associated with longer duration of diabetes (OR, 5.70; 95% CI, 2.91-12.56), higher concentration of fasting blood glucose (OR, 12.94; 95% CI, 2.40-67.71), higher level of glycosylated hemoglobin HbA1c (OR, 5.50; 95% CI, 3.78-11.97) and insulin treatment (OR, 6.99; 95%Cl, 1.39-35.12). The lifestyle of patients with T2DM including smoking, alcohol consumption and regular exercise seemed not associated with the development of DR. CONCLUSION: Our study suggests that fasting serum glucose concentration, HbA1c level, duration of diabetes and insulin treatment are potential risk factors for DR in northern Chinese patients with T2DM, while the lifestyle of included patients seems not associated with DR.

Complement factor B knockdown by short hairpin RNA inhibits laser-induced choroidal neovascularization in rats

AIM:To evaluate whether recombinant complement factor B(CFB)short hairpin RNA(sh RNA)reduces laserinduced choroidal neovascularization(CNV)in rats.METHODS:Laser-induced rat CNV model was established,and then the animals underwent fundus fluorescence angiography(FFA)and hematoxylin and eosin(HE)staining.On day 3 and 7 after photocoagulation,the expression of CFB and membrane attack complex(MAC)was detected by immunhischemistry.A recombinant CFBsh RNA plasmid was constructed.CFB and scrambled sh RNA plasmids were intravenous injected into rats via the tail vein on the day of laser treatment,respectively.On day 7,the incidence of CNV was determined by FFA,and the expression of CFB and vascular endothelial growth factor(VEGF)in retinal pigment epithelium(RPE)/choroidal tissues was detected by immunhischemistry,Western blot and/or semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR)in CFB and scrambled sh RNA groups.The possible adverse effects of CFB-sh RNA injection were assessed by transmission electron microscopy and electroretinography.RESULTS:FFA and HE results indicated that a laserinduced rat CNV model was successfully established on day 7 after photocoagulation.The expression of CFB and MAC was extremely weak in normal retina and choroid,and increased on day 3 after photocoagulation.However,it started to reduce on day 7.CFB sh RNA plasmid was successfully constructed and induced CFB knockdown in the retinal and choroidal tissues.FFA showed CFB knockdown significantly inhibited incidence of CNV in rats.Moreover,CFB knockdown significantly inhibited the expression of VEGF in RPE/choroidal tissues.CFB sh RNA caused no obvious side effects in eyes.CONCLUSION:CFB knockdown significantly inhibits the formation and development of CNV in vivo through reducing the expression of VEGF,which is a potential therapy target.The alternative pathway of complement activation plays an important role in CNV formation.

Macular hole following phakic intraocular lens implantation:A case report

BACKGROUND Phakic intraocular lens(pIOL)implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia.However,it is associated with multiple complications.CASE SUMMARY This report describes a case of full-thickness macular hole(MH)in a patient with a history of bilateral pIOL implantation for the correction of myopia of–12.00 diopters in both eyes 7 mo ago.The MH closed after pars plana vitrectomy with internal limiting membrane removal and the best-corrected visual acuity improved to 20/40 in the left eye.CONCLUSION In rare cases,MH can occur following pIOL.In this present case report,we analyzed the formation process of MH following the surgery and emphasized that it is important to inform highly myopic patients about the risk of MH occurrence while being aware of the symptoms of this complication.

Tumor-associated macrophages in osteosarcoma

Osteosarcoma(OS)is the most common primary bone tumor in children and adolescents.It is an aggressive tumor with a tendency to spread to the lung,which is the most common site of metastasis.Patients with advanced OS with metastases have poor prognoses despite the application of chemotherapy,thus highlighting the need for novel therapeutic targets.The tumor microenvironment(TME)of OS is confirmed to be essential for and supportive of tumor growth and dissemination.The immune component of the OS microenvironment is mainly composed of tumor-associated macrophages(TAMs).In OS,TAMs promote tumor growth and angiogenesis and upregulate the cancer stem cell-like phenotype.However,TAMs inhibit the metastasis of OS.Therefore,much attention has been paid to investigating the mechanism of TAMs in OS development and the progression of immunotherapy for OS.In this article,we aim to summarize the roles of TAMs in OS and the major findings on the application of TAMs in OS treatment.