Ocular biometric characteristics of Han ethnicity in Tianjin and Uyghur ethnicity in Xinjiang undergoing cataract surgery

AIM:To analyze and compare the differences among ocular biometric parameters in Han and Uyghur populations undergoing cataract surgery.METHODS:In this hospital-based prospective study,410 patients undergoing cataract surgery(226 Han patients in Tianjin and 184 Uyghur patients in Xinjiang)were enrolled.The differences in axial length(AL),anterior chamber depth(ACD),keratometry[steep K(Ks)and flat K(Kf)],and corneal astigmatism(CA)measured using IOL Master 700 were compared between Han and Uyghur patients.RESULTS:The average age of Han patients was higher than that of Uyghur patients(70.22±8.54 vs 63.04±9.56y,P<0.001).After adjusting for age factors,Han patients had longer AL(23.51±1.05 vs 22.86±0.92 mm,P<0.001),deeper ACD(3.06±0.44 vs 2.97±0.37 mm,P=0.001),greater Kf(43.95±1.40 vs 43.42±1.69 D,P=0.001),steeper Ks(45.00±1.47 vs 44.26±1.71 D,P=0.001),and higher CA(1.04±0.68 vs 0.79±0.65,P=0.025)than Uyghur patients.Intra-ethnic male patients had longer AL,deeper ACD,and lower keratometry than female patients;however,CA between the sexes was almost similar.In the correlation analysis,we observed a positive correlation between AL and ACD in patients of both ethnicities(rHan=0.48,rUyghur=0.44,P<0.001),while AL was negatively correlated with Kf(rHan=-0.42,rUyghur=-0.64,P<0.001)and Ks(rHan=-0.38,rUyghur=-0.66,P<0.001).Additionally,Kf was positively correlated with Ks(rHan=0.89,rUyghur=0.93,P<0.001).CONCLUSION:There are differences in ocular biometric parameters between individuals of Han ethnicity in Tianjin and those of Uyghur ethnicity in Xinjiang undergoing cataract surgery.These ethnic variances can enhance our understanding of ocular diseases related to these parameters and provide guidance for surgical procedures.

Comparison of biological behavior of lacrimal gland adenoid cystic carcinoma with high-grade transformation cells

AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformation(non-HGT)primary cells cultured by non-highgrade transformation tissue in proliferation,metastasis,drug susceptibility,and genes.METHODS:LACC-HGT primary cells were established by tissue block culture,and the 4^(th)to 10^(th)generation primary cells were selected as research objects.The cells were preliminarily identified by immunofluorescent staining.The differences between non-HGT and LACC-HGT primary cells in terms of proliferation,metastasis,and drug susceptibility were compared by cell counting kit-8(CCK-8)assay,wound healing,and drug sensitivity experiments.Differentially expressed genes were screened using mRNA array.Gene expression was analyzed using real-time quantitative polymerase chain reaction(RT-qPCR).RESULTS:LACC-HGT primary cells were successfully cultured by tissue block culture.Immunofluorescence staining results showed that cytokeratin(CK)and CK7 expression levels were positive in LACC-HGT primary cells.CCK-8 results showed that the proliferation ability of LACCHGT cells was significantly higher than that of non-HGT cells.Wound healing experiment showed that the migration ability of LACC-HGT cells was significantly higher than that of non-HGT cells.LACC-HGT cells were also less sensitive to cisplatin and paclitaxel than non-HGT cells.Compared with non-HGT cells,9566 differentially expressed genes were found in LACC-HGT primary cells,of which 5162 were upregulated and 4404 were down-regulated.The expression of N-acetylneuraminate pyruvate lyase(NPL),MARVEL domain containing 3(MARVELD3),syntabulin(SYBU),and allograft inflammatory factor 1(AIF1)was higher in LACCHGT cells than in non-HGT cells,whereas that of periostin(POSTN)was lower.CONCLUSION:LACC-HGT primary cells have faster proliferation,stronger migration ability,and poorer sensitivity to chemotherapy drugs than non-HGT primary cells.The expression of mRNAs in non-HGT and LACC-HGT primary cells are significantly different.These features are speculated to be the reasons why high-grade transformation tissues exhibit higher malignant degree and poorer prognosis than their counterparts.

Prevalence and inconformity of refractive errors and ocular biometry of 3573 medical university freshman students for 4 consecutive years

AIM:To evaluate the prevalence of refractive errors and ocular biometry in 3573 freshman students at Tianjin Medical University for 4 consecutive years.METHODS:In this university-based, cross-sectional study, comprising 3573 students, visual acuity(VA), slitlamp examination, non-cycloplegic auto-refraction, and ocular biometry were recorded.RESULTS:The prevalence of myopia increased annually, from 2017 to 2020 were 93.5%, 94.5%, 95.9%, and 96.2%, respectively(P=0.03), and the prevalence of high myopia was 25.7%, 26.9%, 28.6%, and 28.6%, respectively. Males tended to have a higher percentage of total astigmatism than females, with astigmatism ≥0.75 and ≥1.0 D criteria. The percentage of with-the-rule astigmatism, against-therule astigmatism, and oblique astigmatism was 90.3%, 5.8%, and 3.9%, respectively, with astigmatism ≥1.00 D criteria. The mean spherical equivalent, axial length(AL), central corneal thickness(CCT), anterior chamber depth(ACD), lens thickness(LT), corneal radius(CR), and lens position(LP) were 4.37±2.52 D, 25.28±1.24 mm, 539.49±34.98 μm, 3.31±0.34 mm, 3.47±0.21 mm, 7.8±0.28 mm, and 5.04±0.32 mm, respectively. With diopter increase in myopia, the AL became longer, CR became steeper, ACD became deeper, LT became thinner, and LP became more posterior(all P<0.01). Females had a shorter AL, thinner CCT, smaller CR, shallower ACD, thicker lens, and more anterior LP than males(P<0.01). The 64% of high myopia had AL≥26 mm, meanwhile, 5.8% mild myopia and 21.1% moderate myopia had AL≥26 mm. With AL≥26 mm, mild and moderate myopia compared to high myopia, AL was shorter(26.51±0.46 vs 26.87±0.70 mm), CR was larger(8.10±0.3 vs 7.85±0.23 mm) and LT was thinner(3.39±0.19 vs 3.45±0.19 mm, P<0.001).CONCLUSION:The prevalence of myopia and high myopia is significantly high in freshman students. The majority of astigmatism is with-the-rule. Inconformity of refractive errors and ocular biometry existed in some students. Attention should be paid to the ocular biometry of myopia.

Role of glycolysis in retinal vascular endothelium, glia, pigment epithelium, and photoreceptor cells and as therapeutic targets for related retinal diseases

Glycolysis produces large amounts of adenosine triphosphate(ATP)in a short time.The retinal vascular endothelium feeds itself primarily through aerobic glycolysis with less ATP.But when it generates new vessels,aerobic glycolysis provides rapid and abundant ATP support for angiogenesis,and thus inhibition of glycolysis in endothelial cells can be a target for the treatment of neovascularization.Aerobic glycolysis has a protective effect on Müller cells,and it can provide with a target for visual protection and maintenance of the blood-retinal barrier.Under physiological conditions,the mitochondria of RPE can use lactic acid produced by photoreceptor cells as an energy source to provide ATP for survival.In pathological conditions,because RPE cells avoid their oxidative damage by increasing glycolysis,a large number of glycolysis products accumulate,which in turn has a toxic effect on photoreceptor cells.This shows that stabilizing the function of RPE mitochondria may become a target for the treatment of diseases such as retinal degeneration.The decrease of aerobic glycolysis leads to the decline of photoreceptor cell function and impaired vision;therefore,aerobic glycolysis of stable photoreceptor cells provides a reliable target for delaying vision loss.It is of great significance to study the role of glycolysis in various retinal cells for the targeted treatment of ocular fundus diseases.

Neuroprotective effects of acteoside in a glaucoma mouse model by targeting Serta domain-containing protein 4

AIM:To explore the therapeutic effect and main molecular mechanisms of acteoside in a glaucoma model in DBA/2J mice.METHODS:Proteomics was used to compare the differentially expressed proteins of C57 and DBA/2J mice.After acteoside administration in DBA/2J mice,anterior segment observation,intraocular pressure(IOP)monitoring,electrophysiology examination,and hematoxylin and eosin staining were used to analyze any potential effects.Immunohistochemistry(IHC)assays were used to verify the proteomics results.Furthermore,retinal ganglion cell 5(RGC5)cell proliferation was assessed with cell counting kit-8(CCK-8)assays.Serta domain-containing protein 4(Sertad4)mRNA and protein expression levels were measured by qRT-PCR and Western blot analysis,respectively.RESULTS:Proteomics analysis suggested that Sertad4 was the most significantly differentially expressed protein.Compared with the saline group,the acteoside treatment group showed decreased IOP,improved N1-P1 wave amplitudes,thicker retina,and larger numbers of cells in the ganglion cell layer(GCL).The IHC results showed that Sertad4 expression levels in DBA/2J mice treated with acteoside were significantly lower than in the saline group.Acteoside treatment could improve RGC5 cell survival and reduce the Sertad4 mRNA and protein expression levels after glutamate injury.CONCLUSION:Sertad4 is differentially expressed in DBA/2J mice.Acteoside can protect RGCs from damage,possibly through the downregulation of Sertad4,and has a potential use in glaucoma treatment.

Construction and validation of a neovascular glaucoma nomogram in patients with diabetic retinopathy after pars plana vitrectomy

BACKGROUND Neovascular glaucoma(NVG)is likely to occur after pars plana vitrectomy(PPV)for diabetic retinopathy(DR)in some patients,thus reducing the expected benefit.Understanding the risk factors for NVG occurrence and building effective risk prediction models are currently required for clinical research.AIM To develop a visual risk profile model to explore factors influencing DR after surgery.METHODS We retrospectively selected 151 patients with DR undergoing PPV.The patients were divided into the NVG(NVG occurrence)and No-NVG(No NVG occurrence)groups according to the occurrence of NVG within 6 months after surgery.Independent risk factors for postoperative NVG were screened by logistic regression.A nomogram prediction model was established using R software,and the model’s prediction accuracy was verified internally and externally,involving the receiver operator characteristic curve and correction curve.RESULTS After importing the data into a logistic regression model,we concluded that a posterior capsular defect,preoperative vascular endothelial growth factor≥302.90 pg/mL,glycosylated hemoglobin≥9.05%,aqueous fluid interleukin 6(IL-6)≥53.27 pg/mL,and aqueous fluid IL-10≥9.11 pg/mL were independent risk factors for postoperative NVG in patients with DR(P<0.05).A nomogram model was established based on the aforementioned independent risk factors,and a computer simulation repeated sampling method was used to internally and externally verify the nomogram model.The area under the curve(AUC),sensitivity,and specificity of the model were 0.962[95%confidence interval(95%CI):0.932-0.991],91.5%,and 82.3%,respectively.The AUC,sensitivity,and specificity of the external validation were 0.878(95%CI:0.746-0.982),66.7%,and 95.7%,respectively.CONCLUSION A nomogram constructed based on the risk factors for postoperative NVG in patients with DR has a high prediction accuracy.This study can help formulate relevant preventive and treatment measures.

Negative effects of enlarging internal limiting membrane peeling for idiopathic macular hole surgery

AIM: To observe the effects of the different extents of internal limiting membrane(ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole(IMH).METHODS: In this retrospective cohort study, 36 patients were reviewed and divided into two groups according to the extent of ILM peeling: group A(18 patients), with the peeling area within one-half of the optic disc macular distance as the radius;group B(18 patients), with the peeling area larger than that of group A but did not exceed the optic disc macular distance as the radius. The main outcomes included the best corrected visual acuity(BCVA), light-adaptive electroretinography, macular hole(MH) closure rate, central macular thickness(CMT), retinal nerve fiber layer(RNFL) and ganglion cell complex(GCC) thickness [nine regions based on the Early Treatment of Diabetic Retinopathy Study(ETDRS) ring] before and 1, 3, and 6mo after surgery.RESULTS: The closure rate was 94.4%(17/18) both in groups A and B. The BCVA in both groups improved significantly compared with the preoperative values, but there was no difference between the two groups. The b-wave amplitude of the electroretinogram analysis was significantly improved in both groups compared to that of the preoperative period, with a greater increase in group A than in group B at 6mo(P=0.017). The CMT in both groups gradually decreased after surgery, and there was no difference between the two groups. The RNFL thickness of the temporal outer ring region in group B was significantly lower than that in group A at 3 and 6mo after surgery(P=0.010, 0.032). The GCC thickness of the temporal outer ring region in group B was significantly lower than that in group A at 6mo after surgery(P=0.038).CONCLUSION: Enlarging the extent of ILM peeling doesn’t affect the IMH closure rate and visual acuity recovery, but the greater the extent of peeling, the greater the damage to the inner retinal structures.

Lag of accommodation predicts clinically significant change of spherical equivalents after cycloplegia

AIM: To evaluate related factors with the change of spherical equivalents(ΔSE) and determine the suitable predictor of clinically significant ΔSE(≥0.50 D) with cyclopentolate hydrochloride on Chinese children. METHODS: A total of 145 right eyes of 145 children aged 4 to 15 y were enrolled. Intraocular pressure, axial length and lag of accommodation(LOA) were assessed before cycloplegia induced by 3 drops of 1% cyclopentolate at 5-minute intervals. SE was measured before and 1 h after the first drop of cyclopentolate. ΔSE was compared between different gender groups and among refractive groups. Multivariate linear regression analysis was performed to find related factors with ΔSE. ROC analysis was used to figure out the suitable predictor of clinically significant ΔSE.RESULTS: For the total 145 eyes, the mean SE reached up to-0.70±1.86 D from-1.30±1.62 D, with the mean ΔSE of 0.60±0.55 D. The mean ΔSE were 0.63±0.55 D and 0.57±0.56 D respectively in the male and female group(P=0.40). The mean ΔSE was significantly different among different refractive groups(P<0.0001), with the ΔSE of hyperopia group(1.12±0.64 D) larger than that of the emmetropia(0.56±0.43 D, P=0.001) and myopia group(0.32±0.28 D, P<0.0001). The ΔSE was correlated with LOA(B=-0.54, P<0.0001), cycloplegic SE(B=0.10, P<0.0001) and age(B=-0.04, P=0.015). ROC curve indicated that LOA predicted clinically significant ΔSE by 82% [area under the curve(AUC)=0.82] alone, while the value was slightly improved to 85%(AUC=0.85) in combination with axial length and 86%(AUC=0.86) in association with axial length as well as age.CONCLUSION: After cycloplegia with cyclopentolate, the ΔSE decreases with larger LOA, longer axial length and older age. Specifically, LOA plays a more vital role in predicting clinically significant ΔSE.

Supporting suture combined scleral fixation of toric IOL implantation in traumatic aniridia,aphakia and corneal astigmatic eye:a case report

Dear Editor,Ocular trauma can cause severe visual functional impairment.The management is often challenging due to multistructures affected.Toric intraocular lens(IOL)implantation can be an effective method for the treatment of traumatic corneal astigmatism^([1]).Because of the optic design,the toric IOLs require more precise centration.Conventional toric IOL fixation methods require two-point fixation,which make the IOL tilting unpredictable,and have not been the first choice for patients without sufficient capsule and iris support.Now,we report a rare case of a woman with posttraumatic aniridia.

Comparative study of objective visual quality between FS-LASIK and SMART in myopia

AIM:To compare the changes in the objective visual quality of patients with low and moderate myopia postoperatively after transepithelial photorefractive keratectomy using the smart pulse technology(SMART)and femtosecond laser in situ keratomileusis(FS-LASIK).METHODS:Corneal higher-order aberrations(HOAs),horizontal coma,vertical coma and spherical aberration were measured using Pentacam,and cutoff for modulation transfer function(MTF cutoff),objective scatter index(OSI)and Strehl ratio(SR)was measured using an optical quality analysis system(OQAS-II),before and after operation at 1,3,and 6 mo,and data were analyzed by repeated measurement two-way analysis of variance.RESULTS:The difference in uncorrected distance visual acuity between SMART and FS-LASIK was statistically significant only 1 wk postoperatively.Approximately 86.36%and 80.69%of patients with spherical equivalent(SE)in±0.50 D were observed in the SMART and FS-LASIK groups,respectively.No significant difference was observed in SE between the two groups(P=0.509).The HOAs increased postoperatively compared with those before surgery in both groups(P<0.05).No significant difference in HOA,corneal horizontal coma,spherical aberration,ΔHOA,Δhorizontal coma,andΔspherical aberration were observed between the two group(P>0.05).Corneal vertical coma andΔcorneal vertical coma in the FS-LASIK group were higher than those in the SMART group(P<0.05).The OSI of both groups at 1 mo after surgery was higher than that before surgery(P<0.05).At 3 and 6 mo postoperatively,the OSI in the FS-LASIK group was slightly higher than that in the SMART group(P=0.040 and 0.047,respectively).At 6 mo after surgery,the MTF cutoff was statistically significant different between the two groups(P=0.026).No significant difference in SR between the FS-LASIK and SMART groups was observed at 1,3,and 6 mo postoperatively(P>0.05).CONCLUSION:The HOAs increase and visual quality is delayed in both groups postoperatively,and the long-term objective visual quality after SMART is slightly better than that after FS-LASIK.

Immunologic mechanism of fungal keratitis

Fungal keratitis(FK)is a refractory disease that poses a serious threat to vision,with common risk factors like eye trauma,contact lens wearing,topical corticosteroids and antibiotic abuse.Nowadays,topical and systemic anti-fungal drugs and ocular surgeries are still the main therapeutic modalities.However,the pathogenesis of FK,especially the immunologic mechanism within it,has not yet been deeply clarified.A better understanding of the pathogenesis of FK is imperative for more effective therapies and prognosis.Meanwhile,the immune protection strategies are also urgently required to manage FK.This review highlights recent advances in the immunologic mechanism in the pathogenesis of FK,in hope of providing valuable reference information for more effective anti-fungal treatment.

Disorganization of the retinal inner layers as a predictor of visual acuity in eyes with macular edema secondary to uveitis

AIM:To assess the correlation between disorganization of the retinal inner layers(DRIL)and best-corrected visual acuity(BCVA)in patients with uveitis and macular edema(UME)who underwent systemic treatment using optical coherence tomography(OCT).METHODS:A retrospective clinical study of 23 patients(30 eyes)with DRIL and 23 patients(31 eyes)without DRIL secondary to UME were included.All patients underwent comprehensive ophthalmic examinations at baseline,3,6,and 12 mo after local and systemic treatment.The OCTbased parameters included foveal center point thickness(FCPT),mean thickness(MT),and diameters of DRIL in horizontal and vertical directions.BCVA and OCT-based parameters were compared between the two groups.The relationship between each OCT parameter and BCVA was evaluated using linear correlation and regression analysis.RESULTS:At the initial visit,the mean baseline FCPT was 441.03±128.68μm in the eyes with DRIL and 337.26±99.31μm in the eyes without DRIL(P=0.001).No significant differences were observed in MT(P=0.357).The mean size of transverse and vertical diameters of DRIL was 684.07±267.51 and 267.07±104.61μm at baseline,respectively.There was significant improvement in BCVA and OCT-based parameters at 3,6,and 12 mo in all cases(P<0.001 for each timepoint).In addition,significant differences were detected in BCVA and OCT parameters between eyes with and without DRIL at each time point(P<0.01 for each timepoint).A greater DRIL range at baseline was associated with a worse baseline BCVA(transverse diameter of DRIL:r=0.875,P<0.001;vertical diameter of DRIL:r=0.622,P<0.001).The transverse diameter of baseline DRIL was found to be significantly correlated with the final BCVA(P=0.003).CONCLUSION:The improvement in BCVA is associated with DRIL in patients with UME.DRIL is an easy-todetermine and robust imaging biomarker that could help predict BCVA prognosis in eyes with UME.

A novel analysis of Scheimpflug total corneal refractive power following corneal cross-linking in mild to moderate keratoconus

AIM:To detect an earlier improvement in mild to moderate keratoconus following corneal cross-linking(CXL)with total corneal refractive power(TCRP)using ray tracing method.METHODS:A total of 40 eyes of 30 consecutive patients who underwent CXL for progressive keratoconus were retrospectively enrolled.The following keratometric parameters provided by Pentacam HR,including maximum keratometry(Kmax),steepest keratometry(Ksteep),3 mm zonal TCRP centered over corneal apex(TCRPapex,zone 3 mm),zonal mean keratometry and TCRP centered over corneal cone(Kmcone,zone and TCRPcone,zone 1,2,3 mm)were evaluated preoperatively and 1,3,6,and 12 mo postoperatively.Groups 1 and 2 were defined based on Kmax at postoperative 1 mo as improved(the initial improvement group)or worsen(the initial deterioration group)compared to the preoperative level.RESULTS:In the overall group,only keratometric parameters based on ray tracing method displayed significant improvement early at 3 mo postoperatively,in which TCRPcone,zone 1 mm and 2 mm exhibited the largest flattening(0.57 D and 0.53 D,respectively).In Group 1,only Kmax,Kmcone,zone 2 mm and TCRPcone,zone 2 mm showed significant improvement initially at 1 mo postoperatively,in which Kmax exhibited the largest improvement(1.05 D),followed by TCRPcone,zone 2 mm(0.82 D).In Group 2,only keratometric parameters based on ray tracing method and Kmcone,zone 3 mm showed slight but not significant improvement early at 3 mo,in which TCRPcone,zone 3 mm displayed the most improvement(0.19 D),followed by TCRPcone,zone 2 mm(0.15 D).CONCLUSION:The findings indicate that a 2 mm zonal TCRP centered over Kmax could earlier detect keratometric improvement by CXL compared to other commonly used parameters in mild to moderate keratoconic eyes.

Human umbilical cord-derived mesenchymal stem cells treatment for refractory uveitis: a case series

AIM:To evaluate therapeutic outcomes of human umbilical cord-derived mesenchymal stem cells(HUC-MSCs)treatment in patients with refractory uveitis.METHODS:A retrospective and noncomparative review was performed on four patients with refractory uveitis from December 2013 to December 2017.HUC-MSCs were administered intravenously at a dose of 1×106 cells/kg.Clinical response,relapse rate,change of visual acuity,and other metrics were evaluated.RESULTS:All four patients presented with responses to HUC-MSCs treatment,with three males and one female.The numbers of uveitis attacks per year after the HUCMSCs treatment(0,2,0,0 respectively)all decreased compared with the numbers before the treatment(3,6,4,4 respectively).The oral steroid and immunosuppressive agents were tapered in all patients without recrudescence of ocular inflammation,and three patients discontinued their oral medicine at the last visit.The best corrected visual acuity(BCVA)of 3 patients was improved to varying degrees,and the BCVA of 1 patient remained at 20/20(Snellen chart)from the first to the last consultation.CONCLUSION:The study provides an effective therapy of HUC-MSCs in maintaining remission in patients affected by uveitis refractory to previous immunosuppressant treatments.

Time trends in myopia and high myopia prevalence in young university adults in China

AIM:To investigate time trends in myopia and high myopia prevalence over 6y among young university adults in China.METHODS:This is a 6-year series cross-sectional study from 2016 to 2021.Totally 4910 freshmen were enrolled and completed a questionnaire concerning age,gender,and disease history.Students with eye diseases were excluded after a detailed eye examination.The refractive status was measured by non-cycloplegic objective refraction and ocular parameters were measured by Lenstar 900.The examination followed the same protocol each year.Trends over time in myopia and high myopia prevalence,as well as ocular biometry parameters,were analyzed.RESULTS:From 2016 to 2021,the axial length(AL)and corneal radius(CR)increased significantly(P=0.002 for AL;P=0.04 for CR).However,the spherical equivalent(SE)and the ratio of axial length to the corneal radius(AL/CR)did not change significantly(P=0.59 for SE;P=0.24 for AL/CR).The frequency of AL≥26.0 mm increased from 26.6%in 2016 to 29.3%in 2021(P=0.05 for trend).The prevalence of myopia and high myopia did not change significantly in our study(P≥0.18).Compared to a similar cross-sectional study conducted 10 years ago,the prevalence of myopia decreased significantly(94.9%vs 91.8%,P<0.001).Whereas the prevalence of high myopia increased largely(18.12%vs 27.6%,P<0.001).CONCLUSION:The prevalence of high myopia increases in young university adults during 10y period.Myopia control should begin earlier in childhood.However,these interventions are still needed for high myopia even in young adulthood.

The impact of posterior corneal astigmatism on the surgical planning of toric multifocal intraocular lens implantation

Purpose:To investigate the influence of posterior corneal astigmatism on the prediction accuracy of toric multi­focal intraocular lens(IOL)calculation.Methods:The keratometric astigmatism measured by Lenstar LS 900(KCA_(L)),keratometric astigmatism(KCAp)and total corneal astigmatism(TCA)measured by Scheimpflug camera(Pentacam HR)were documented and analyzed accordingly.Three deduction models using different parameters were compared.Model 1:KCA_(L)+keratometric comeal surgically induced astigmatism(KCSIA,0.30 D@50°);Model 2:KCA_(P)+KCSIA);Model 3:TCA 4-total CSIA(TCSIA,0.23 D@50°).The prediction errors of each model as the difference vector between the actual and the intended residual astigmatism were compared.Results:Seventy-six eyes implanted with toric multifocal IOLs were included in this study.The vector differences of the actual KCSIA and TCSIA were statistically significant in the total sample and against-the-rule(ATR)sub­group(both P<0.05).Model 1 deduced the smallest mean values of prediction error,while that of Model 3 were smaller than that of Model 2,both in the total sample and the ATR subgroups(all P<0.05).Meanwhile,in the total sample and ATR subgroups,the centroid vector magnitudes of Model 3 were smaller than that of Model 1(0.31±0.76 D and 0.39±0.76 D).Conclusions:The calculation of toric multifocal IOL should be individualized especially in the ATR eyes for the impact of PCA on the estimation of the preoperative comeal astigmatism and the CSIA.

Artificial intelligence can assist with diagnosing retinal vein occlusion

AIM:To assist with retinal vein occlusion(RVO)screening,artificial intelligence(AI)methods based on deep learning(DL)have been developed to alleviate the pressure experienced by ophthalmologists and discover and treat RVO as early as possible.METHODS:A total of 8600 color fundus photographs(CFPs)were included for training,validation,and testing of disease recognition models and lesion segmentation models.Four disease recognition and four lesion segmentation models were established and compared.Finally,one disease recognition model and one lesion segmentation model were selected as superior.Additionally,224 CFPs from 130 patients were included as an external test set to determine the abilities of the two selected models.RESULTS:Using the Inception-v3 model for disease identification,the mean sensitivity,specificity,and F1 for the three disease types and normal CFPs were 0.93,0.99,and 0.95,respectively,and the mean area under the curve(AUC)was 0.99.Using the DeepLab-v3 model for lesion segmentation,the mean sensitivity,specificity,and F1 for four lesion types(abnormally dilated and tortuous blood vessels,cotton-wool spots,flame-shaped hemorrhages,and hard exudates)were 0.74,0.97,and 0.83,respectively.CONCLUSION:DL models show good performance when recognizing RVO and identifying lesions using CFPs.Because of the increasing number of RVO patients and increasing demand for trained ophthalmologists,DL models will be helpful for diagnosing RVO early in life and reducing vision impairment.

Water-ultrastable perovskite CsPbBr_(3)nanocrystals for fluorescence-enhanced cellular imaging

Metal halide perovskites have attracted much attention in biomedicine because of their excellent fluorescence energy conversion properties;however,poor water-stability and cytotoxicity limit its applications as a biomedical tracer,especially in cellular imaging.Herein,water-ultrastable perovskites C sPbBr_(3):Cs_(4)PbBr_(6)nanocrystals(NCs)encapsulated in chitosan are fabricated successfully using a water-triggered method.The as-synthesized CsPbBr_(3):Cs_(4)PbBr_(6)@CS(chitosan,CS)nanoparticles in water display enhanced fluorescence emission for 35 days.Further,the viability of glioma cells(U87 cells)incubated with different concentrations of CsPbBr_(3):Cs_(4)PbBr_(6)@CS nanoparticles(0-20μg·ml^(-1))for24 h is found to be higher than 90%.In artificial body fluid,analyses using laser confocal microscopy,the standard Cell Counting Kit-8(CCK-8)method,and flow cytometry demonstrated the good water ultrastability and high biocompatibility performance of CsPbBr_(3):Cs_(4)PbBr_(6)@CS nanoparticles in cellular imaging.Overall,the water-ultrastable halide perovskites support promising perspectives in biological cell tracing and intelligent medical technology.

Changes in the peripapillary vasculature and macular thickness after cataract surgery using two phacoemulsification systems with optical coherence tomography angiography

AIM:To assess the changes in the peripapillary vasculature and macular thickness after cataract surgery using two phacoemulsification systems with optical coherence tomography angiography(OCTA).METHODS:Fifty-two eyes of 52 patients with agerelated cataract were randomized into two groups for phacoemulsification:Infiniti group(26 patients)using the Infiniti phacoemulsification system with gravity-fluidics and Centurion group(26 patients)using the Centurion phacoemulsification system with active-fluidics.The peripapillary vessel density(PVD)and macular thickness were examined using OCTA at baseline and at 1d,1 and 3mo after cataract surgery.RESULTS:In the Infiniti group,the PVD was significantly reduced at 1d after the cataract surgery(P<0.001).However,the retinal nerve fiber layer(RNFL)thickness showed no significant change during the follow-up.Change in PVD 1d postoperatively was significantly negatively correlated to the cumulative dissipated energy(CDE),estimated fluid usage(EFU),effective phacoemulsification time(EPT),intraocular pressure(IOP),and total operating time(TOT;P<0.05).The macular thickness was significantly increased in all regions after the cataract surgery(P<0.05).However,no significant changes were found in the macular vessel density(VD)during the follow-up(P>0.05).In the Centurion group,the VD and thickness in the optic papilla and macula did not significantly change in all regions during the follow-up(all P>0.05).The best-corrected visual acuity(BCVA)significantly improved in both groups postoperatively(P<0.001).CONCLUSION:Using the Infiniti phacoemulsification system,OCTA provides a promising analysis of retinal vascular alterations,demonstrating a reduction of the PVD and an increase in the macular thickness.The Centurion phacoemulsification system can provide better retinal vasculature preservation during cataract surgery.