AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(...AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(DME).METHODS:This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy.Comprehensive clinical evaluation was performed,including slit-lamp examination,intraocular pressure(IOP)measurement,fluorescein and indocyanine green angiography(ICGA),and laboratory tests.Inflammatory responses were treated with topical or systemic corticosteroids,and patients were monitored for visual acuity and inflammatory activity.RESULTS:The incidence of IOI was 0.8%per patient(Innsbruck)and 0.23%(Czechia),with inflammation typically occurring between the third and sixth injection(mean interval:10d post-injection).Inflammator y presentations ranged from anterior uveitis to posterior segment involvement.One notable case demonstrated novel choroidal hypofluorescent lesions on angiography,suggesting deeper ocular involvement.The mean patient age was 76y;five of six affected patients were female.All cases responded to local and systemic corticosteroids,with full recovery of initial visual acuity.CONCLUSION:Sterile IOI after faricimab appears to be a rare but relevant adverse event.Although the incidence falls within expected ranges for anti-vascular endothelial growth factor(anti-VEGF)agents,the observed choroidal involvement represents a potentially new safety signal.Prompt diagnosis and corticosteroid therapy are effective in all cases.Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.展开更多
Dear Editor,We introduce a novel surgical instrument designed to overcome the challenges in draining fluid from the suprachoroidal space in patients with choroidal detachment.In the evolving landscape of ophthalmic su...Dear Editor,We introduce a novel surgical instrument designed to overcome the challenges in draining fluid from the suprachoroidal space in patients with choroidal detachment.In the evolving landscape of ophthalmic surgeries,procedures that were once considered complex,such as those for choroidal detachment,are becoming increasingly common.Drainage of subchoroidal fluid was derived from 1985[1]with indirect visualization during scleral buckle surgery[2-4].展开更多
AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy...AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy(cCSC)eyes with macular neovascularization(MNV)using ultra-widefield swept-source optical coherence tomography angiography(UWF SS-OCTA).METHODS:This retrospective comparative study included 46 cCSC with MNV eyes(With MNV group),52 cCSC without MNV eyes(Without MNV group),and 40 age-matched healthy controls.UWF SS-OCTA imaging with a 20 mm×24 mm protocol was used to quantify CVI across 9 subfields(superotemporal,superior,superonasal,temporal,central,nasal,inferotemporal,inferior,and inferonasal).The CVI was compared among the groups.RESULTS:With MNV group demonstrated significantly older mean age than Without MNV group(56.2±6.1 vs 47.5±8.6y,P<0.001).The CVI was significantly lower in the With MNV group than in the Without MNV group,except in the superotemporal,superior,and temporal regions(all P<0.05).Notably,despite MNV-associated CVI reductions,the With MNV group maintained a higher CVI than the control group in all 5 subfields(superior,temporal,central,inferior,and inferonasal;all P<0.05).In the central region,CONCLUSION:CVI decreases,and choroidal structural changes extend beyond the subfoveal area in cCSC with MNV eyes,providing with an imaging evidence for the important role of choroidal ischemia in the pathogenesis of MNV in cCSC.展开更多
AIM:To quantify and compare longitudinal thickness changes of the ganglion cell complex(GCC)and the choroid in patients with different patterns of age-related macular degeneration(AMD)progression.METHODS:Retrospective...AIM:To quantify and compare longitudinal thickness changes of the ganglion cell complex(GCC)and the choroid in patients with different patterns of age-related macular degeneration(AMD)progression.METHODS:Retrospective cohort analysis of anonymized data from participants aged 50y or more and diagnosed with early/intermediate AMD in at least one eye(with no evidence of advanced AMD).A total of 64 participants were included from the Instituto de Retina de Lisboa(IRL)study(IPL/2022/MetAllAMD_ESTeSL)and divided into 4 groups according to the Rotterdam classification for AMD.Spectral domain optical coherence tomography(SD-OCT)was used to assess and quantify GCC and choroid thickness at two time points(first visit vs last visit)with a minimum interval of 3y.RESULTS:In the GCC inner ring,a thinner thickness(P=0.001)was observed in the atrophic AMD group(51.3±21.4μm)compared to the early AMD(84.3±11.5μm),intermediate AMD(77.6±16.1μm)and neovascular AMD(88.9±16.3μm)groups.Choroidal thickness quantification showed a generalized reduction in the central circle(P=0.002)and inner ring(P=0.001).Slight reductions in retinal thickness were more accentuated in the inner ring in the atrophic AMD(-13%;P<0.01).CONCLUSION:The variation of the analyzed structures could be an indicator of risk of progression with neurodegenerative(GCC)or vascular(choroid)pattern in the intermediate and atrophic AMD.The quantification of both structures can provide important information about the risk of disease progression in the early and intermediate stages but also for the evolution pattern into late stages(atrophic or neovascular).展开更多
AIM:To repor t the 24mo outcomes of vascular endothelial growth factor(VEGF)inhibitors for myopic choroidal neovascularization(mCNV)in routine clinical practice and simultaneously evaluated the real-world safety.METHO...AIM:To repor t the 24mo outcomes of vascular endothelial growth factor(VEGF)inhibitors for myopic choroidal neovascularization(mCNV)in routine clinical practice and simultaneously evaluated the real-world safety.METHODS:The patients who received intravitreal injections of VEGF inhibitors of either ranibizumab(0.5 mg)or conbercept(0.5 mg)for mCNV were analyzed from 1 January 2017 to 1 January 2022.The primary outcome variables were mean change in best-corrected visual acuity(BCVA)and central macular thickness(CMT)changes.The secondary outcome variables included IOP changes,the period of mCNV re-treatment,and ocular adverse events.RESULTS:Totally 83 patients aged 56.40±15.36y with axial length 29.67±2.09 mm were included.In visual acuity,the mean logMAR BCVA at baseline was 0.81±0.43.After the initial improvement at 1,3,and 6mo(P<0.05),from month 12 onwards,no statistical difference compared to baseline was found.The mean CMT from 1mo onwards had a statistically significant decrease compared with baseline CMT(P<0.05).The regression model showed better baseline BCVA and thicker baseline CMT,significantly associated with the final outcomes.In univariate analysis,choosing 3+pro re nata(PRN)as the initial injection treatment regimen was associated with better BCVA at 24mo[hazard ratio(HR)=-0.65,95%CI:-1.23,-0.07,P=0.048].However,the difference was not significant in multivariate analysis(HR=-0.59,95%CI:-1.21,0.03,P=0.089).Regarding mCNV recurrence,the mean period(P=0.725)and the proportion of mCNV reactivation(P=1.00)were similar between ranibizumab and conbercept.Kaplan-Meier plot also analyzed that the median time of re-injection was not significantly different among gender,drug,and initial injection treatment regimen.No systemic adverse events related to the therapy were observed.CONCLUSION:BCVA gains achieved by the end of our study maintain generally sustained at the 24-mo follow-up.The findings also indicate that ranibizumab and conbercept demonstrate comparable efficacy and safety profiles.Additionally,intravitreal anti-VEGF therapy using 1+PRN regimen,offers certain advantages in both efficacy and cost-effectiveness.展开更多
AIM:To investigate short-term changes in choroidal thickness in response to peripheral myopic defocus induced by two designs of multifocal corneal gas permeable contact lenses(MFGPCL)in young adults.METHODS:Seventeen ...AIM:To investigate short-term changes in choroidal thickness in response to peripheral myopic defocus induced by two designs of multifocal corneal gas permeable contact lenses(MFGPCL)in young adults.METHODS:Seventeen participants,with a mean age of 24.5±4y,underwent choroidal thickness and vascularity index measurements using enhanced depth imaging optical coherence tomography(EDI OCT)at baseline,one day,and one week following MFGPCL wear.Two center-distance MFGPCL designs with similar center zone diameters of 3.0 mm but different peripheral add powers(low add:+1.5 D and high add:+3.0 D)were tested.Each participant was randomly assigned to wear one of the two MFGPCL designs.Measurements of total,luminal,and stromal choroid thickness were obtained in five eccentric regions(6 mm towards the periphery)in all quadrants.RESULTS:Significant thickening in total choroidal thickness were observed after one week of wearing both high add(+10±6µm)and low add(+7±5µm)MFGPCLs,with no statistically significant difference between the two groups(P=0.42).Choroidal thickening was consistent across eccentric regions and quadrants,with no significant differences based on eccentricity or quadrant(all P>0.05).Both lens designs induced choroidal thickening,with no significant difference between them in total choroidal thickness(P=0.18 for quadrants,P=0.51 for eccentric regions).CONCLUSION:Peripheral myopic defocus induced by MFGPCLs lead to significant choroidal thickening,including total,luminal,and stromal components.This study highlights the need for future research to explore the dose-response relationship between peripheral myopic defocus and choroidal thickening,utilizing choroidal response as a potential biomarker.展开更多
Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected fro...Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected from March 2023 to February 2024 in the hospital.Their clinical characteristics and treatment effects were observed and their causes were analyzed.Results:After the operations,the eyes with choroidal detachment after glaucoma surgery had 2 cases of true microphthalmos,6 cases of advanced glaucoma,and 2 cases of glaucoma secondary to vitreoretinal surgery.The postoperative manifestations were persistent shallow anterior chamber,the formation of anterior chamber,and then suddenly became shallow or disappeared.Meanwhile,the intraocular pressure was lower than 6 mmHg.Ultrasound and funduscopic examination showed that the choroid and retina were partially elevated,and the choroidal detachment recovered after treatment.Conclusion:Choroidal detachment is one of the common postoperative complications in glaucoma,especially in some special types of refractory glaucoma.Adequate perioperative management before surgery,cautious and delicate operation during surgery,and close observation and treatment after surgery can obviously decrease the occurrence and damage.展开更多
AIM:To investigate the role of Forkhead box protein P3(FOXP3)in choroidal melanoma(CM)metastases and elucidate its underlying mechanisms.METHODS:FOXP3 protein expression was analyzed in CM clinical specimens and cell ...AIM:To investigate the role of Forkhead box protein P3(FOXP3)in choroidal melanoma(CM)metastases and elucidate its underlying mechanisms.METHODS:FOXP3 protein expression was analyzed in CM clinical specimens and cell lines.A stable FOXP3 knockout cell line and a transient FOXP3-overexpressing cell line were established,with transfection efficiencies confirmed by Western blotting(WB).Functional assays,including monoclonal formation,cell counting kit-8(CCK-8)proliferation,migration,invasion,and in vivo tumorigenesis assays in nude mice,were performed to assess the biological effects of FOXP3.Additionally,WB was employed to evaluate epithelial-mesenchymal transition(EMT)markers and the activation of the Wnt5a/CaMKII signaling pathway.RESULTS:FOXP3 expression was significantly elevated in both CM clinical specimens and cell lines.Functional analyses revealed that FOXP3 enhanced CM cell proliferation,migration,and invasion in vitro and promoted tumorigenesis in vivo.Mechanistically,FOXP3 upregulated EMT-related proteins and activated the Wnt5a/CaMKII signaling pathway.Rescue experiments further confirmed that the oncogenic effects of FOXP3 were mediated via modulation of the Wnt5a/CaMKII axis.CONCLUSION:This study identifies FOXP3 as an oncogenic driver in CM,promoting tumor progression through the Wnt5a/CaMKII signaling pathway.These findings provide new insights into the molecular mechanisms of CM pathogenesis and highlight FOXP3 as a potential therapeutic target.展开更多
Objective:The study aimed to report the distinctive fundus appearance of bilateral asymmetric choroidal melanocytosis and reviewed the clinical and multimodal imaging characteristics to differentiate choroidal melanoc...Objective:The study aimed to report the distinctive fundus appearance of bilateral asymmetric choroidal melanocytosis and reviewed the clinical and multimodal imaging characteristics to differentiate choroidal melanocytosis from malignant pigmented retinal lesions.Methods:An observational case report and literature review.Results:A 60-year-old patient underwent comprehensive ophthalmologic examinations.Underfunduscopic examination,bilateral choroidal melanocytosis with asymmetry choroidal pigmentation change was observed.In the right eye,there was diffuse darker coloration extending from posterior pole to the mid-peripheral retina.In the left eye,flat patches of choroidal hyperpigmentation were present,involving superior and inferior hemisphere region,while other regions were depigmented.Spectral-domain optical coherence tomography revealed that the layers of retina and choroid were basically normal,with no elevation of the retinal pigment epithelium.Near infrared reflectance images provided a clearer view of mottled focal hyperpigmentation area,which corresponded to the choroidal hyperpigmentation.Conclusions:This case highlights the effectiveness of multimodal imaging in distinguishing choroidal melanocytosis from malignant entities.It emphasizes the crucial role of multimodal imaging in guiding clinical management to prevent vision-threatening complications and monitor potential malignant transformation.展开更多
AIM:To compare the proportion of rhegmatogenous retinal detachment(RRD)associated with choroidal detachment(RRDCD)in the emergency surgery group with the routine inpatient surgery group and determine risk factors for ...AIM:To compare the proportion of rhegmatogenous retinal detachment(RRD)associated with choroidal detachment(RRDCD)in the emergency surgery group with the routine inpatient surgery group and determine risk factors for RRDCD.METHODS:A total of 694 patients(694 eyes)diagnosed with RRD in the emergency surgery(the median duration of RRD was 5d)group were included from the Department of Ophthalmic Emergency,and 692 patients(eyes)in the routine inpatient surgery group(the median duration was 15d)were selected randomly from the Ocular Fundus Department.Demographics,refractive status,macular status,lens status,extent of retinal detachment,number of retinal breaks,duration of symptoms before surgery,and the incidence of RRDCD were compared.A logistic regression analysis was used to determine potential risk factors for RRDCD.RESULTS:Compared to the routine inpatient surgery group,the emergency surgery group had a significant less median time to surgery(P<0.001)and a decreased proportion of RRDCD(2.88%vs 10.84%,P<0.001).Logistic regression analysis revealed that a prolonged duration of RRD[OR 3.51,95%confidence interval(CI)1.98-6.23],pseudophakia/aphakia status[OR 2.74,95%CI(1.50-4.98)],multiple retinal breaks[OR 1.67,95%CI(1.03-2.70)],and a substantial extent of RRD[OR 11.58,95%CI(7.12-18.84)]were independent risk factors for RRDCD.CONCLUSION:Emergency surgical pattern of RRD demonstrates a lower incidence of RRDCD.The adoption of an expedited surgical approach has the potential to reduce the duration of RRD,possibly correlating with a decreased risk of RRDCD development.展开更多
Purpose:To examine the changes in choroidal thickness(ChT)after 6-month topical treatment of 0.01%atropine eye drops in myopic children.Methods:A total of 46 low to moderate myopic children aged 8 to 12 years were rec...Purpose:To examine the changes in choroidal thickness(ChT)after 6-month topical treatment of 0.01%atropine eye drops in myopic children.Methods:A total of 46 low to moderate myopic children aged 8 to 12 years were recruited and received topical 0.01%atropine once a day for 6 months.Spherical equivalent(SE),axial length(AL),and ChT were measured at baseline,3 months,and 6 months.Results:During the first and second 3-month treatment,there is no significant decrease in progression of SE and AL.Within the range of 3 mm from the temporal side of the fovea to the nasal side,no significant changes in ChT have been observed at any measuring points in low and moderate myopic participants.Changes in ChT were not significantly associated with gender or AL progression.Conclusion:A 6-month topical treatment of 0.01%atropine could not cause significant changes in ChT in myopic children.展开更多
AIM:To classify polypoidal choroidal vasculopathy(PCV)into 2 subtypes based on the subfoveal choroidal thickness(SFCT)and to further evaluate their multimodal image features.METHODS:A retrospective observational case ...AIM:To classify polypoidal choroidal vasculopathy(PCV)into 2 subtypes based on the subfoveal choroidal thickness(SFCT)and to further evaluate their multimodal image features.METHODS:A retrospective observational case series study.Sixty-four eyes of 64 patients with PCV were enrolled and classified into 2 groups based on SFCT(thick-choroid group/thin-choroid group).Then further analyze the spectrum domain optical coherence tomography(SD-OCT)and indocyanine green angiography(ICGA)differences of the two subtypes.Imaging analysis included measurement of SFCT,maximum vascular diameter ratio(MVDR),choroidal vascularity index(CVI),central macular thickness(CMT),and the presence of pigment epithelial detachment(PED)on SD-OCT.Polypoidal lesions(polyps)number,branching vascular network(BVN)area,greatest linear dimension(GLD),and the choroidal vascular hyperpermeability(CVH)were analyzed by ICGA.RESULTS:The distribution of SFCT was bimodal with two peaks at 195 and 285μm,and a trough at 225μm.The 225μm was taken as the cutoff point for the following classification of thick/thin choroid groups.The PCV eyes in the thick-choroid group presented with greater MVDR,CVI within 3 and 6 mm of the fovea,but lower CMT,less PED,small PED diameters on SD-OCT scans,and fewer polyps,smaller BVN and GLD,but more frequency of CVH on ICGA.CONCLUSION:The SFCT at 225μm can be used as a readily available indicator for the classification of PCV subtypes.The thick-choroid group presents much apparent enlargement of the choroidal layer and vasculature expansion,which indicates different pathogenesis of the two subtypes.展开更多
AIM:To determine the effects of safranal on choroidal neovascularization(CNV)and oxidative stress damage of human choroidal microvascular endothelial cells(HCVECs)and its possible mechanisms.METHODS:Forty-five rats we...AIM:To determine the effects of safranal on choroidal neovascularization(CNV)and oxidative stress damage of human choroidal microvascular endothelial cells(HCVECs)and its possible mechanisms.METHODS:Forty-five rats were used as a laser-induced CNV model for testing the efficacy and safety of safranal(0.5 mg/kg·d,intraperitoneally)on CNV.CNV leakage on fluorescein angiography(FA)and CNV thickness on histology was compared.HCVECs were used for a H_(2)O_(2)-induced oxidative stress model to test the effect of safranal in vitro.MTT essay was carried to test the inhibition rate of safranal on cell viability at different concentrations.Tube formation was used to test protective effect of safranal on angiogenesis at different concentrations.mRNA transcriptome sequencing was performed to find the possible signal pathway.The expressions of different molecules and their phosphorylation level were validated by Western blotting.RESULTS:On FA,the average CNV leakage area was 0.73±0.49 and 0.31±0.11 mm^(2)(P=0.012)in the control and safranal-treated group respectively.The average CNV thickness was 127.4±18.75 and 100.6±17.34μm(P=0.001)in control and safranal-treated group.Under the condition of oxidative stress,cell proliferation was inhibited by safranal and inhibition rates were 7.4%-35.4%at the different concentrations.For tube formation study,the number of new branches was 364 in control group and 35,42,and 17 in 20,40,and 80μg/mL safranal groups respectively(P<0.01).From the KEGG pathway bubble graph,the PI3K-AKT signaling pathway showed a high gene ratio.The protein expression was elevated of insulin receptor substrate(IRS)and the phosphorylation level of PI3K,phosphoinositide-dependent protein kinase 1/2(PDK1/2),AKT and Bcl-2 associated death promoter(BAD)was also elevated under oxidative stress condition but inhibited by safranal.CONCLUSION:Safranal can inhibit CNV both in vivo and in vitro,and the IRS-PI3K-PDK1/2-AKT-BAD signaling pathway is involved in the pathogenesis of CNV.展开更多
AIM:To evaluate celastrol's effect on choroidal neovascularization(CNV).METHODS:In this study,neovascular formation in vitro(tube formation and aortic ring culture)and in vivo(laser induced neovascular in mice)was...AIM:To evaluate celastrol's effect on choroidal neovascularization(CNV).METHODS:In this study,neovascular formation in vitro(tube formation and aortic ring culture)and in vivo(laser induced neovascular in mice)was treated with celastrol to evaluate this natural compound's impact on CNV.Western blot was applied to explore the possible mechanism for it.For in vitro assay,triplicate for each group was repeated at least three times.For in vivo assay,each group contains 5 mice.RESULTS:Celastrol supressed tube formation and aortic ring sprout neovascularization.In vitro assay exhibited that celastrol inhibiting vascular endothelial growth factor(VEGF)-induced proliferation and migration of human umbilical vein endothelial cells and human choroidal endothelial cells,and by blocking VEGF signaling.Furthermore,intraperitoneal administration of celastrol significantly reduced the area of laser-induced CNV in an in vivo mouse model.By day 14,the area of CNV had decreased by 49.15%and 80.26%in the 0.1 mg/kg celastrol-treated group(n=5)and in the 0.5 mg/kg celastrol treated group(n=5),respectively,compared to the vehicle-treated group(n=5).CONCLUSION:Celastrol inhibits CNV by inhibiting VEGF-induced proliferation and migration of vascular endothelial cells,indicating that celastrol is a potent,natural therapeutic compound for the prevention of CNV.展开更多
AIM:To observe choroidal thickness changes in the choroidal hyperpermeability area(CHA)in patients with central serous chorioretinopathy(CSC)after photodynamic therapy(PDT)using indocyanine green angiography(ICGA)comb...AIM:To observe choroidal thickness changes in the choroidal hyperpermeability area(CHA)in patients with central serous chorioretinopathy(CSC)after photodynamic therapy(PDT)using indocyanine green angiography(ICGA)combined with optical coherence tomography(OCT).METHODS:This was a cohort study of 17 eyes(17 patients)with CSC.In all patients,the range of CHA was determined by ICGA.The patients were divided into two groups based on CHA covered the fovea(group A)or not(group B).All patients received half-dose verteporfin PDT over CHA in ICGA.Choroidal thickness was measured by OCT before,1,and 3 mo after treatment.The choroidal thickness values of the fovea and CHAs were obtained for each measurement.Secondary outcomes were changes in the best-corrected visual acuity(BCVA)and amount of subretinal fluid(SRF).RESULTS:The differences in center choroidal thickness at baseline and at 1 and 3 mo post-PDT were statistically significant in group A and all patients(both P<0.001).There was no significant difference in group B(P=0.059).The differences of thickness of CHA and BCVA at baseline and1 and 3 mo post-PDT were statistically significant in group A,group B,and all patients(all P<0.01).All patients showed complete SRF absorption at 3 mo post-PDT.CONCLUSION:Center choroidal thickness does not accurately reflect changes in CHA of patients whose CHA does not covered the fovea center.Using CHA as the observation target can make up for this limitation,expand the scope of application,and reduce bias.展开更多
AIM:To compare the three-dimensional choroidal vascularity index(CVI)and choroidal thickness between fellow eyes of acute primary angle-closure(F-APAC)and chronic primary angle-closure glaucoma(F-CPACG)and the eyes of...AIM:To compare the three-dimensional choroidal vascularity index(CVI)and choroidal thickness between fellow eyes of acute primary angle-closure(F-APAC)and chronic primary angle-closure glaucoma(F-CPACG)and the eyes of normal controls.METHODS:This study included 37 patients with unilateral APAC,37 with asymmetric CPACG without prior treatment,and 36 healthy participants.Using swept-source optical coherence tomography(SS-OCT),the macular and peripapillary choroidal thickness and three-dimensional CVI were measured and compared globally and sectorally.Pearson’s correlation analysis and multivariate regression models were used to evaluate choroidal thickness or CVI with related factors.RESULTS:The mean subfoveal CVIs were 0.35±0.10,0.33±0.09,and 0.29±0.04,and the mean subfoveal choroidal thickness were 315.62±52.92,306.22±59.29,and 262.69±45.55μm in the F-APAC,F-CPACG,and normal groups,respectively.All macular sectors showed significantly higher CVIs and choroidal thickness in the F-APAC and F-CPACG eyes than in the normal eyes(P<0.05),while there were no significant differences between the F-APAC and F-CPACG eyes.In the peripapillary region,the mean overall CVIs were 0.21±0.08,0.20±0.08,and 0.19±0.05,and the mean overall choroidal thickness were 180.45±54.18,174.82±50.67,and 176.18±37.94μm in the F-APAC,F-CPACG,and normal groups,respectively.There were no significant differences between any of the two groups in all peripapillary sectors.Younger age,shorter axial length,and the F-APAC or F-CPACG diagnosis were significantly associated with higher subfoveal CVI and thicker subfoveal choroidal thickness(P<0.05).CONCLUSION:The fellow eyes of unilateral APAC or asymmetric CPACG have higher macular CVI and choroidal thickness than those of the normal controls.Neither CVI nor choroidal thickness can distinguish between eyes predisposed to APAC or CPACG.A thicker choroid with a higher vascular volume may play a role in the pathogenesis of primary angle-closure glaucoma.展开更多
●AIM:To introduce a new method for suprachoroidal fluid drainage before 23-gauge pars plana vitrectomy.●METHODS:A 15o side-port blade was firstly used to create a sclerotomy into the suprachoroidal space for initial...●AIM:To introduce a new method for suprachoroidal fluid drainage before 23-gauge pars plana vitrectomy.●METHODS:A 15o side-port blade was firstly used to create a sclerotomy into the suprachoroidal space for initial drainage.A 30-guage needle was then applied to inject balanced saline solution through the existing sclerotomy for further drainage.After most of the suprachoroidal fluid was drained,standard 3-port 23-guage pars plana vitrectomy was performed.●RESULTS:We have succeeded in using this technique to treat five patients with retinal detachment and kissing choroidal detachment(KCD).The choroidal detachment was visibly recessed in all cases after drainage with no intraoperative complications.After removal of silicon oil at 3 mo follow-up,all patients obtained a reattached retina.No postoperative complications such as hypotony and endophthalmitis occurred.●CONCLUSION:The new technique is efficient and safe for suprachoroidal fluid drainage for patients with rhegmatogenous retinal detachment.In future,further larger series are needed to attest to its safety and efficacy.展开更多
BACKGROUND Pseudomonas aeruginosa(P.aeruginosa)is considered a common pathogenic bacterium.Choroidal metastatic mucinous abscess caused by P.aeruginosa is rarely reported.CASE SUMMARY We describe the diagnostic and tr...BACKGROUND Pseudomonas aeruginosa(P.aeruginosa)is considered a common pathogenic bacterium.Choroidal metastatic mucinous abscess caused by P.aeruginosa is rarely reported.CASE SUMMARY We describe the diagnostic and treatment processes of a case involving a complex choroidal space-occupying lesion.Our analyses of early clinical manifestations revealed a high possibility of choroidal melanoma,as indicated by the choroidal space-occupying lesion and uveitis.Further magnetic resonance imaging results revealed no positive evidence for the diagnosis of choroidal melanoma.The exact properties of the space-occupying lesion could not be ascertained prior to surgery.However,the lesion was subsequently confirmed as a metastatic abscess by diagnostic vitrectomy.The occupying lesion was found to occupy 75%of the vitreous cavity in the surgery.The entire white viscous tissue was completely removed,and the necrotic retina was cleaned up.After surgery,microbiological culture revealed mucoid P.aeruginosa,which was sensitive to a variety of antibiotics.The bacterial infection grew and disseminated towards the outside of the eye.After the fifth injection,the left eye was successfully retained.CONCLUSION This is a peculiar case because a huge,local,space-occupying lesion had formed due to the dissemination of low-toxic mucinous P.aeruginosa in the blood from the lungs to the choroid.After surgical removal,the bacteria were able to re-grow;thus,local infection re-spread following surgery.The patient lost vision,but we managed to retain the full structure of the eyeball and eliminated the focus of infection.展开更多
Choroidal capillary endothelia cell （CEC） plays a critical role in the development of choroidal neovascularization which is one of the major causes of blindness. An effective method for CEC cultivation was proposed....Choroidal capillary endothelia cell （CEC） plays a critical role in the development of choroidal neovascularization which is one of the major causes of blindness. An effective method for CEC cultivation was proposed. The isolation of human choroidal CECs using micro dissection followed by the use of superparamagnetic beads （Dynabeads） coated with the CD 31, which selectively binds to the endothelial cell surface. Cells bound to beads were isolated using a magnetic particle concentrator. The CECs were planted into type Ⅳ collagen coated 24 well plates. The results show that the primary cultured CEC is induced to tube formation in collagen Ⅳ coated environment, which can be presented as an in vitro model of choroidal neovascularization.展开更多
BACKGROUND Suprachoroidal hemorrhage(SCH) is a rare but potentially catastrophic ocular event. Surgery for SCH is often challenging because of the difficulty in resolving the retinal and choroidal detachment. Here, we...BACKGROUND Suprachoroidal hemorrhage(SCH) is a rare but potentially catastrophic ocular event. Surgery for SCH is often challenging because of the difficulty in resolving the retinal and choroidal detachment. Here, we describe a novel surgical technique in which urokinase is administered by sub-Tenon's injection to target an organized clot in SCH prior to drainage.CASE SUMMARY A consecutive case series of four eyes with serous and hemorrhagic choroidal detachments secondary to cataract surgery or trauma was documented to evaluate the feasibility of using a sub-Tenon's urokinase injection-assisted 23-gauge and 20-gauge incision to drain choroidal detachments. Urokinase(2000 IU) was given by sub-Tenon's injection one day before surgery for clot liquefaction. A 23-gauge infusion line was placed in the anterior chamber. A 20-gauge incision was created in the suprachoroidal space 3.5 mm from the limbus. After drainage, pars plana vitrectomy was performed because of concomitant pathology that demanded this additional procedure. Visual acuity, ocular findings, the timing of surgical interventions, surgical procedures, and outcomes were retrospectively reviewed in four patients. Postoperative follow-up of the patients ranged from 6 to 24 mo(mean, 13 mo). After the treatment, all patients achieved excellent anatomical recovery. CONCLUSION Sub-Tenon's urokinase injection-assisted vitrectomy makes clot liquefaction happen in the early treatment stage, resulting in marked stability during the procedure.展开更多
文摘AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(DME).METHODS:This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy.Comprehensive clinical evaluation was performed,including slit-lamp examination,intraocular pressure(IOP)measurement,fluorescein and indocyanine green angiography(ICGA),and laboratory tests.Inflammatory responses were treated with topical or systemic corticosteroids,and patients were monitored for visual acuity and inflammatory activity.RESULTS:The incidence of IOI was 0.8%per patient(Innsbruck)and 0.23%(Czechia),with inflammation typically occurring between the third and sixth injection(mean interval:10d post-injection).Inflammator y presentations ranged from anterior uveitis to posterior segment involvement.One notable case demonstrated novel choroidal hypofluorescent lesions on angiography,suggesting deeper ocular involvement.The mean patient age was 76y;five of six affected patients were female.All cases responded to local and systemic corticosteroids,with full recovery of initial visual acuity.CONCLUSION:Sterile IOI after faricimab appears to be a rare but relevant adverse event.Although the incidence falls within expected ranges for anti-vascular endothelial growth factor(anti-VEGF)agents,the observed choroidal involvement represents a potentially new safety signal.Prompt diagnosis and corticosteroid therapy are effective in all cases.Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.
基金Supported by Science and Technology Foundation of Tianjin Eye Hospital(No.YKPY2207)Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-016A).
文摘Dear Editor,We introduce a novel surgical instrument designed to overcome the challenges in draining fluid from the suprachoroidal space in patients with choroidal detachment.In the evolving landscape of ophthalmic surgeries,procedures that were once considered complex,such as those for choroidal detachment,are becoming increasingly common.Drainage of subchoroidal fluid was derived from 1985[1]with indirect visualization during scleral buckle surgery[2-4].
基金Supported by General Program of National Natural Science Foundation of China(No.82471110)National Key Research and Development Program of China(No.2022YFC2502805)Postdoctoral Foundation of General Hospital of Central Theater Command(No.20210517KY04).
文摘AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy(cCSC)eyes with macular neovascularization(MNV)using ultra-widefield swept-source optical coherence tomography angiography(UWF SS-OCTA).METHODS:This retrospective comparative study included 46 cCSC with MNV eyes(With MNV group),52 cCSC without MNV eyes(Without MNV group),and 40 age-matched healthy controls.UWF SS-OCTA imaging with a 20 mm×24 mm protocol was used to quantify CVI across 9 subfields(superotemporal,superior,superonasal,temporal,central,nasal,inferotemporal,inferior,and inferonasal).The CVI was compared among the groups.RESULTS:With MNV group demonstrated significantly older mean age than Without MNV group(56.2±6.1 vs 47.5±8.6y,P<0.001).The CVI was significantly lower in the With MNV group than in the Without MNV group,except in the superotemporal,superior,and temporal regions(all P<0.05).Notably,despite MNV-associated CVI reductions,the With MNV group maintained a higher CVI than the control group in all 5 subfields(superior,temporal,central,inferior,and inferonasal;all P<0.05).In the central region,CONCLUSION:CVI decreases,and choroidal structural changes extend beyond the subfoveal area in cCSC with MNV eyes,providing with an imaging evidence for the important role of choroidal ischemia in the pathogenesis of MNV in cCSC.
基金Supported by FCT/MCTES UIDB/05608/2020(https://doi.org/10.54499/UIDB/05608/2020)UIDP/05608/2020(https://doi.org/10.54499/UIDP/05608/2020)+1 种基金IDI&CA grant IPL/2022/MetAllAMD_ESTeSL by H&TRC-Health&Technology Research Center,ESTeSL-Escola Superior de Tecnologia da Saúde,Instituto Politécnico de Lisboaby Retina Institute of Lisbon(IRL).
文摘AIM:To quantify and compare longitudinal thickness changes of the ganglion cell complex(GCC)and the choroid in patients with different patterns of age-related macular degeneration(AMD)progression.METHODS:Retrospective cohort analysis of anonymized data from participants aged 50y or more and diagnosed with early/intermediate AMD in at least one eye(with no evidence of advanced AMD).A total of 64 participants were included from the Instituto de Retina de Lisboa(IRL)study(IPL/2022/MetAllAMD_ESTeSL)and divided into 4 groups according to the Rotterdam classification for AMD.Spectral domain optical coherence tomography(SD-OCT)was used to assess and quantify GCC and choroid thickness at two time points(first visit vs last visit)with a minimum interval of 3y.RESULTS:In the GCC inner ring,a thinner thickness(P=0.001)was observed in the atrophic AMD group(51.3±21.4μm)compared to the early AMD(84.3±11.5μm),intermediate AMD(77.6±16.1μm)and neovascular AMD(88.9±16.3μm)groups.Choroidal thickness quantification showed a generalized reduction in the central circle(P=0.002)and inner ring(P=0.001).Slight reductions in retinal thickness were more accentuated in the inner ring in the atrophic AMD(-13%;P<0.01).CONCLUSION:The variation of the analyzed structures could be an indicator of risk of progression with neurodegenerative(GCC)or vascular(choroid)pattern in the intermediate and atrophic AMD.The quantification of both structures can provide important information about the risk of disease progression in the early and intermediate stages but also for the evolution pattern into late stages(atrophic or neovascular).
基金Supported by Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-037A).
文摘AIM:To repor t the 24mo outcomes of vascular endothelial growth factor(VEGF)inhibitors for myopic choroidal neovascularization(mCNV)in routine clinical practice and simultaneously evaluated the real-world safety.METHODS:The patients who received intravitreal injections of VEGF inhibitors of either ranibizumab(0.5 mg)or conbercept(0.5 mg)for mCNV were analyzed from 1 January 2017 to 1 January 2022.The primary outcome variables were mean change in best-corrected visual acuity(BCVA)and central macular thickness(CMT)changes.The secondary outcome variables included IOP changes,the period of mCNV re-treatment,and ocular adverse events.RESULTS:Totally 83 patients aged 56.40±15.36y with axial length 29.67±2.09 mm were included.In visual acuity,the mean logMAR BCVA at baseline was 0.81±0.43.After the initial improvement at 1,3,and 6mo(P<0.05),from month 12 onwards,no statistical difference compared to baseline was found.The mean CMT from 1mo onwards had a statistically significant decrease compared with baseline CMT(P<0.05).The regression model showed better baseline BCVA and thicker baseline CMT,significantly associated with the final outcomes.In univariate analysis,choosing 3+pro re nata(PRN)as the initial injection treatment regimen was associated with better BCVA at 24mo[hazard ratio(HR)=-0.65,95%CI:-1.23,-0.07,P=0.048].However,the difference was not significant in multivariate analysis(HR=-0.59,95%CI:-1.21,0.03,P=0.089).Regarding mCNV recurrence,the mean period(P=0.725)and the proportion of mCNV reactivation(P=1.00)were similar between ranibizumab and conbercept.Kaplan-Meier plot also analyzed that the median time of re-injection was not significantly different among gender,drug,and initial injection treatment regimen.No systemic adverse events related to the therapy were observed.CONCLUSION:BCVA gains achieved by the end of our study maintain generally sustained at the 24-mo follow-up.The findings also indicate that ranibizumab and conbercept demonstrate comparable efficacy and safety profiles.Additionally,intravitreal anti-VEGF therapy using 1+PRN regimen,offers certain advantages in both efficacy and cost-effectiveness.
基金Supported by Ongoing Research Funding Program(No.ORF-2025-1160),King Saud University,Riyadh Saudi Arabia.
文摘AIM:To investigate short-term changes in choroidal thickness in response to peripheral myopic defocus induced by two designs of multifocal corneal gas permeable contact lenses(MFGPCL)in young adults.METHODS:Seventeen participants,with a mean age of 24.5±4y,underwent choroidal thickness and vascularity index measurements using enhanced depth imaging optical coherence tomography(EDI OCT)at baseline,one day,and one week following MFGPCL wear.Two center-distance MFGPCL designs with similar center zone diameters of 3.0 mm but different peripheral add powers(low add:+1.5 D and high add:+3.0 D)were tested.Each participant was randomly assigned to wear one of the two MFGPCL designs.Measurements of total,luminal,and stromal choroid thickness were obtained in five eccentric regions(6 mm towards the periphery)in all quadrants.RESULTS:Significant thickening in total choroidal thickness were observed after one week of wearing both high add(+10±6µm)and low add(+7±5µm)MFGPCLs,with no statistically significant difference between the two groups(P=0.42).Choroidal thickening was consistent across eccentric regions and quadrants,with no significant differences based on eccentricity or quadrant(all P>0.05).Both lens designs induced choroidal thickening,with no significant difference between them in total choroidal thickness(P=0.18 for quadrants,P=0.51 for eccentric regions).CONCLUSION:Peripheral myopic defocus induced by MFGPCLs lead to significant choroidal thickening,including total,luminal,and stromal components.This study highlights the need for future research to explore the dose-response relationship between peripheral myopic defocus and choroidal thickening,utilizing choroidal response as a potential biomarker.
基金Key Research and Development Program of Hubei Province(Project No.:2021BCA125)。
文摘Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected from March 2023 to February 2024 in the hospital.Their clinical characteristics and treatment effects were observed and their causes were analyzed.Results:After the operations,the eyes with choroidal detachment after glaucoma surgery had 2 cases of true microphthalmos,6 cases of advanced glaucoma,and 2 cases of glaucoma secondary to vitreoretinal surgery.The postoperative manifestations were persistent shallow anterior chamber,the formation of anterior chamber,and then suddenly became shallow or disappeared.Meanwhile,the intraocular pressure was lower than 6 mmHg.Ultrasound and funduscopic examination showed that the choroid and retina were partially elevated,and the choroidal detachment recovered after treatment.Conclusion:Choroidal detachment is one of the common postoperative complications in glaucoma,especially in some special types of refractory glaucoma.Adequate perioperative management before surgery,cautious and delicate operation during surgery,and close observation and treatment after surgery can obviously decrease the occurrence and damage.
基金Supported by the National Natural Science Foundation of China(No.81873345,No.82274585)Qingdao Key Health Discipline Development Fund.
文摘AIM:To investigate the role of Forkhead box protein P3(FOXP3)in choroidal melanoma(CM)metastases and elucidate its underlying mechanisms.METHODS:FOXP3 protein expression was analyzed in CM clinical specimens and cell lines.A stable FOXP3 knockout cell line and a transient FOXP3-overexpressing cell line were established,with transfection efficiencies confirmed by Western blotting(WB).Functional assays,including monoclonal formation,cell counting kit-8(CCK-8)proliferation,migration,invasion,and in vivo tumorigenesis assays in nude mice,were performed to assess the biological effects of FOXP3.Additionally,WB was employed to evaluate epithelial-mesenchymal transition(EMT)markers and the activation of the Wnt5a/CaMKII signaling pathway.RESULTS:FOXP3 expression was significantly elevated in both CM clinical specimens and cell lines.Functional analyses revealed that FOXP3 enhanced CM cell proliferation,migration,and invasion in vitro and promoted tumorigenesis in vivo.Mechanistically,FOXP3 upregulated EMT-related proteins and activated the Wnt5a/CaMKII signaling pathway.Rescue experiments further confirmed that the oncogenic effects of FOXP3 were mediated via modulation of the Wnt5a/CaMKII axis.CONCLUSION:This study identifies FOXP3 as an oncogenic driver in CM,promoting tumor progression through the Wnt5a/CaMKII signaling pathway.These findings provide new insights into the molecular mechanisms of CM pathogenesis and highlight FOXP3 as a potential therapeutic target.
基金found by the Key Research and Development Program of the Ministry of Science and Technology(2022YFF1202901)the National Natural Science Foundation of China(82171404)+3 种基金the Natural Science Foundation of Guangdong Province of China(2023A1515011529)the Science and Technology Planning Project of Guangzhou City(2023A03J0181,2024A04J6481)the Fundamental Research Funds for the Central Universities(22yklj04)the Research Start-up Founds of Sun Yat-sen University(Funded Talent[2020]18).
文摘Objective:The study aimed to report the distinctive fundus appearance of bilateral asymmetric choroidal melanocytosis and reviewed the clinical and multimodal imaging characteristics to differentiate choroidal melanocytosis from malignant pigmented retinal lesions.Methods:An observational case report and literature review.Results:A 60-year-old patient underwent comprehensive ophthalmologic examinations.Underfunduscopic examination,bilateral choroidal melanocytosis with asymmetry choroidal pigmentation change was observed.In the right eye,there was diffuse darker coloration extending from posterior pole to the mid-peripheral retina.In the left eye,flat patches of choroidal hyperpigmentation were present,involving superior and inferior hemisphere region,while other regions were depigmented.Spectral-domain optical coherence tomography revealed that the layers of retina and choroid were basically normal,with no elevation of the retinal pigment epithelium.Near infrared reflectance images provided a clearer view of mottled focal hyperpigmentation area,which corresponded to the choroidal hyperpigmentation.Conclusions:This case highlights the effectiveness of multimodal imaging in distinguishing choroidal melanocytosis from malignant entities.It emphasizes the crucial role of multimodal imaging in guiding clinical management to prevent vision-threatening complications and monitor potential malignant transformation.
基金Supported by the Medical Scientific Research Foundation of Guangdong Province,China(No.C2022060).
文摘AIM:To compare the proportion of rhegmatogenous retinal detachment(RRD)associated with choroidal detachment(RRDCD)in the emergency surgery group with the routine inpatient surgery group and determine risk factors for RRDCD.METHODS:A total of 694 patients(694 eyes)diagnosed with RRD in the emergency surgery(the median duration of RRD was 5d)group were included from the Department of Ophthalmic Emergency,and 692 patients(eyes)in the routine inpatient surgery group(the median duration was 15d)were selected randomly from the Ocular Fundus Department.Demographics,refractive status,macular status,lens status,extent of retinal detachment,number of retinal breaks,duration of symptoms before surgery,and the incidence of RRDCD were compared.A logistic regression analysis was used to determine potential risk factors for RRDCD.RESULTS:Compared to the routine inpatient surgery group,the emergency surgery group had a significant less median time to surgery(P<0.001)and a decreased proportion of RRDCD(2.88%vs 10.84%,P<0.001).Logistic regression analysis revealed that a prolonged duration of RRD[OR 3.51,95%confidence interval(CI)1.98-6.23],pseudophakia/aphakia status[OR 2.74,95%CI(1.50-4.98)],multiple retinal breaks[OR 1.67,95%CI(1.03-2.70)],and a substantial extent of RRD[OR 11.58,95%CI(7.12-18.84)]were independent risk factors for RRDCD.CONCLUSION:Emergency surgical pattern of RRD demonstrates a lower incidence of RRDCD.The adoption of an expedited surgical approach has the potential to reduce the duration of RRD,possibly correlating with a decreased risk of RRDCD development.
基金Education Department of Zhejiang Province(Project No.:201942041)the Health Commission of Zhejiang Province(Project No.:W20008)the Science and Technology program of Jinhua Science and Technology Bureau(Project No.:2020-4-106).
文摘Purpose:To examine the changes in choroidal thickness(ChT)after 6-month topical treatment of 0.01%atropine eye drops in myopic children.Methods:A total of 46 low to moderate myopic children aged 8 to 12 years were recruited and received topical 0.01%atropine once a day for 6 months.Spherical equivalent(SE),axial length(AL),and ChT were measured at baseline,3 months,and 6 months.Results:During the first and second 3-month treatment,there is no significant decrease in progression of SE and AL.Within the range of 3 mm from the temporal side of the fovea to the nasal side,no significant changes in ChT have been observed at any measuring points in low and moderate myopic participants.Changes in ChT were not significantly associated with gender or AL progression.Conclusion:A 6-month topical treatment of 0.01%atropine could not cause significant changes in ChT in myopic children.
基金Supported by the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2018PT32029)。
文摘AIM:To classify polypoidal choroidal vasculopathy(PCV)into 2 subtypes based on the subfoveal choroidal thickness(SFCT)and to further evaluate their multimodal image features.METHODS:A retrospective observational case series study.Sixty-four eyes of 64 patients with PCV were enrolled and classified into 2 groups based on SFCT(thick-choroid group/thin-choroid group).Then further analyze the spectrum domain optical coherence tomography(SD-OCT)and indocyanine green angiography(ICGA)differences of the two subtypes.Imaging analysis included measurement of SFCT,maximum vascular diameter ratio(MVDR),choroidal vascularity index(CVI),central macular thickness(CMT),and the presence of pigment epithelial detachment(PED)on SD-OCT.Polypoidal lesions(polyps)number,branching vascular network(BVN)area,greatest linear dimension(GLD),and the choroidal vascular hyperpermeability(CVH)were analyzed by ICGA.RESULTS:The distribution of SFCT was bimodal with two peaks at 195 and 285μm,and a trough at 225μm.The 225μm was taken as the cutoff point for the following classification of thick/thin choroid groups.The PCV eyes in the thick-choroid group presented with greater MVDR,CVI within 3 and 6 mm of the fovea,but lower CMT,less PED,small PED diameters on SD-OCT scans,and fewer polyps,smaller BVN and GLD,but more frequency of CVH on ICGA.CONCLUSION:The SFCT at 225μm can be used as a readily available indicator for the classification of PCV subtypes.The thick-choroid group presents much apparent enlargement of the choroidal layer and vasculature expansion,which indicates different pathogenesis of the two subtypes.
基金Supported by the National Natural Science Foundation of China(No.81760027,No.81860763)Youth Innovation Project of Affiliated Hospital of Inner Mongolia University for Nationalities(No.2018QNJJ01)Young and Middle-aged Ophthalmic Research Fund of Bethune-Lumitin(No.BJ-LM202005)。
文摘AIM:To determine the effects of safranal on choroidal neovascularization(CNV)and oxidative stress damage of human choroidal microvascular endothelial cells(HCVECs)and its possible mechanisms.METHODS:Forty-five rats were used as a laser-induced CNV model for testing the efficacy and safety of safranal(0.5 mg/kg·d,intraperitoneally)on CNV.CNV leakage on fluorescein angiography(FA)and CNV thickness on histology was compared.HCVECs were used for a H_(2)O_(2)-induced oxidative stress model to test the effect of safranal in vitro.MTT essay was carried to test the inhibition rate of safranal on cell viability at different concentrations.Tube formation was used to test protective effect of safranal on angiogenesis at different concentrations.mRNA transcriptome sequencing was performed to find the possible signal pathway.The expressions of different molecules and their phosphorylation level were validated by Western blotting.RESULTS:On FA,the average CNV leakage area was 0.73±0.49 and 0.31±0.11 mm^(2)(P=0.012)in the control and safranal-treated group respectively.The average CNV thickness was 127.4±18.75 and 100.6±17.34μm(P=0.001)in control and safranal-treated group.Under the condition of oxidative stress,cell proliferation was inhibited by safranal and inhibition rates were 7.4%-35.4%at the different concentrations.For tube formation study,the number of new branches was 364 in control group and 35,42,and 17 in 20,40,and 80μg/mL safranal groups respectively(P<0.01).From the KEGG pathway bubble graph,the PI3K-AKT signaling pathway showed a high gene ratio.The protein expression was elevated of insulin receptor substrate(IRS)and the phosphorylation level of PI3K,phosphoinositide-dependent protein kinase 1/2(PDK1/2),AKT and Bcl-2 associated death promoter(BAD)was also elevated under oxidative stress condition but inhibited by safranal.CONCLUSION:Safranal can inhibit CNV both in vivo and in vitro,and the IRS-PI3K-PDK1/2-AKT-BAD signaling pathway is involved in the pathogenesis of CNV.
基金Supported by National Natural Science Foundation of China(No.81570826)。
文摘AIM:To evaluate celastrol's effect on choroidal neovascularization(CNV).METHODS:In this study,neovascular formation in vitro(tube formation and aortic ring culture)and in vivo(laser induced neovascular in mice)was treated with celastrol to evaluate this natural compound's impact on CNV.Western blot was applied to explore the possible mechanism for it.For in vitro assay,triplicate for each group was repeated at least three times.For in vivo assay,each group contains 5 mice.RESULTS:Celastrol supressed tube formation and aortic ring sprout neovascularization.In vitro assay exhibited that celastrol inhibiting vascular endothelial growth factor(VEGF)-induced proliferation and migration of human umbilical vein endothelial cells and human choroidal endothelial cells,and by blocking VEGF signaling.Furthermore,intraperitoneal administration of celastrol significantly reduced the area of laser-induced CNV in an in vivo mouse model.By day 14,the area of CNV had decreased by 49.15%and 80.26%in the 0.1 mg/kg celastrol-treated group(n=5)and in the 0.5 mg/kg celastrol treated group(n=5),respectively,compared to the vehicle-treated group(n=5).CONCLUSION:Celastrol inhibits CNV by inhibiting VEGF-induced proliferation and migration of vascular endothelial cells,indicating that celastrol is a potent,natural therapeutic compound for the prevention of CNV.
基金Supported by the National Natural Science Foundation of China(No.81760174,No.31871261)the Zunyi Science and Technology Project(No.2018-166)the Research Initiation Fund for Masters in Affiliated Hospital of Zunyi Medical College(No.2016-43)。
文摘AIM:To observe choroidal thickness changes in the choroidal hyperpermeability area(CHA)in patients with central serous chorioretinopathy(CSC)after photodynamic therapy(PDT)using indocyanine green angiography(ICGA)combined with optical coherence tomography(OCT).METHODS:This was a cohort study of 17 eyes(17 patients)with CSC.In all patients,the range of CHA was determined by ICGA.The patients were divided into two groups based on CHA covered the fovea(group A)or not(group B).All patients received half-dose verteporfin PDT over CHA in ICGA.Choroidal thickness was measured by OCT before,1,and 3 mo after treatment.The choroidal thickness values of the fovea and CHAs were obtained for each measurement.Secondary outcomes were changes in the best-corrected visual acuity(BCVA)and amount of subretinal fluid(SRF).RESULTS:The differences in center choroidal thickness at baseline and at 1 and 3 mo post-PDT were statistically significant in group A and all patients(both P<0.001).There was no significant difference in group B(P=0.059).The differences of thickness of CHA and BCVA at baseline and1 and 3 mo post-PDT were statistically significant in group A,group B,and all patients(all P<0.01).All patients showed complete SRF absorption at 3 mo post-PDT.CONCLUSION:Center choroidal thickness does not accurately reflect changes in CHA of patients whose CHA does not covered the fovea center.Using CHA as the observation target can make up for this limitation,expand the scope of application,and reduce bias.
基金Supported by the National Natural Science Foundation of China(No.82101087)Shanghai Clinical Research Key Project(No.SHDC2020CR6029).
文摘AIM:To compare the three-dimensional choroidal vascularity index(CVI)and choroidal thickness between fellow eyes of acute primary angle-closure(F-APAC)and chronic primary angle-closure glaucoma(F-CPACG)and the eyes of normal controls.METHODS:This study included 37 patients with unilateral APAC,37 with asymmetric CPACG without prior treatment,and 36 healthy participants.Using swept-source optical coherence tomography(SS-OCT),the macular and peripapillary choroidal thickness and three-dimensional CVI were measured and compared globally and sectorally.Pearson’s correlation analysis and multivariate regression models were used to evaluate choroidal thickness or CVI with related factors.RESULTS:The mean subfoveal CVIs were 0.35±0.10,0.33±0.09,and 0.29±0.04,and the mean subfoveal choroidal thickness were 315.62±52.92,306.22±59.29,and 262.69±45.55μm in the F-APAC,F-CPACG,and normal groups,respectively.All macular sectors showed significantly higher CVIs and choroidal thickness in the F-APAC and F-CPACG eyes than in the normal eyes(P<0.05),while there were no significant differences between the F-APAC and F-CPACG eyes.In the peripapillary region,the mean overall CVIs were 0.21±0.08,0.20±0.08,and 0.19±0.05,and the mean overall choroidal thickness were 180.45±54.18,174.82±50.67,and 176.18±37.94μm in the F-APAC,F-CPACG,and normal groups,respectively.There were no significant differences between any of the two groups in all peripapillary sectors.Younger age,shorter axial length,and the F-APAC or F-CPACG diagnosis were significantly associated with higher subfoveal CVI and thicker subfoveal choroidal thickness(P<0.05).CONCLUSION:The fellow eyes of unilateral APAC or asymmetric CPACG have higher macular CVI and choroidal thickness than those of the normal controls.Neither CVI nor choroidal thickness can distinguish between eyes predisposed to APAC or CPACG.A thicker choroid with a higher vascular volume may play a role in the pathogenesis of primary angle-closure glaucoma.
基金Supported by the National Natural Science Foundation of China(No.81900875)Natural Science Foundation of Jiangsu Province(No.BK20191059)the National Key Project of Research and Development Plan(No.2017YFA0104101).
文摘●AIM:To introduce a new method for suprachoroidal fluid drainage before 23-gauge pars plana vitrectomy.●METHODS:A 15o side-port blade was firstly used to create a sclerotomy into the suprachoroidal space for initial drainage.A 30-guage needle was then applied to inject balanced saline solution through the existing sclerotomy for further drainage.After most of the suprachoroidal fluid was drained,standard 3-port 23-guage pars plana vitrectomy was performed.●RESULTS:We have succeeded in using this technique to treat five patients with retinal detachment and kissing choroidal detachment(KCD).The choroidal detachment was visibly recessed in all cases after drainage with no intraoperative complications.After removal of silicon oil at 3 mo follow-up,all patients obtained a reattached retina.No postoperative complications such as hypotony and endophthalmitis occurred.●CONCLUSION:The new technique is efficient and safe for suprachoroidal fluid drainage for patients with rhegmatogenous retinal detachment.In future,further larger series are needed to attest to its safety and efficacy.
文摘BACKGROUND Pseudomonas aeruginosa(P.aeruginosa)is considered a common pathogenic bacterium.Choroidal metastatic mucinous abscess caused by P.aeruginosa is rarely reported.CASE SUMMARY We describe the diagnostic and treatment processes of a case involving a complex choroidal space-occupying lesion.Our analyses of early clinical manifestations revealed a high possibility of choroidal melanoma,as indicated by the choroidal space-occupying lesion and uveitis.Further magnetic resonance imaging results revealed no positive evidence for the diagnosis of choroidal melanoma.The exact properties of the space-occupying lesion could not be ascertained prior to surgery.However,the lesion was subsequently confirmed as a metastatic abscess by diagnostic vitrectomy.The occupying lesion was found to occupy 75%of the vitreous cavity in the surgery.The entire white viscous tissue was completely removed,and the necrotic retina was cleaned up.After surgery,microbiological culture revealed mucoid P.aeruginosa,which was sensitive to a variety of antibiotics.The bacterial infection grew and disseminated towards the outside of the eye.After the fifth injection,the left eye was successfully retained.CONCLUSION This is a peculiar case because a huge,local,space-occupying lesion had formed due to the dissemination of low-toxic mucinous P.aeruginosa in the blood from the lungs to the choroid.After surgical removal,the bacteria were able to re-grow;thus,local infection re-spread following surgery.The patient lost vision,but we managed to retain the full structure of the eyeball and eliminated the focus of infection.
基金The Shanghai Science and Technology Com-mittee "Qi Ming Xin" Project ( No02QB14037 )The Youth Foundation ofShanghai Jiaotong University,School ofMedicine (No 040202)
文摘Choroidal capillary endothelia cell （CEC） plays a critical role in the development of choroidal neovascularization which is one of the major causes of blindness. An effective method for CEC cultivation was proposed. The isolation of human choroidal CECs using micro dissection followed by the use of superparamagnetic beads （Dynabeads） coated with the CD 31, which selectively binds to the endothelial cell surface. Cells bound to beads were isolated using a magnetic particle concentrator. The CECs were planted into type Ⅳ collagen coated 24 well plates. The results show that the primary cultured CEC is induced to tube formation in collagen Ⅳ coated environment, which can be presented as an in vitro model of choroidal neovascularization.
基金Supported by the Project of Science and Technology of Social Development Fund of Shaanxi Province,No.2016SF-100 and No.2016SF-133Xi’an No.4 Hospital Research Incubation Fund,No.2018LH-2
文摘BACKGROUND Suprachoroidal hemorrhage(SCH) is a rare but potentially catastrophic ocular event. Surgery for SCH is often challenging because of the difficulty in resolving the retinal and choroidal detachment. Here, we describe a novel surgical technique in which urokinase is administered by sub-Tenon's injection to target an organized clot in SCH prior to drainage.CASE SUMMARY A consecutive case series of four eyes with serous and hemorrhagic choroidal detachments secondary to cataract surgery or trauma was documented to evaluate the feasibility of using a sub-Tenon's urokinase injection-assisted 23-gauge and 20-gauge incision to drain choroidal detachments. Urokinase(2000 IU) was given by sub-Tenon's injection one day before surgery for clot liquefaction. A 23-gauge infusion line was placed in the anterior chamber. A 20-gauge incision was created in the suprachoroidal space 3.5 mm from the limbus. After drainage, pars plana vitrectomy was performed because of concomitant pathology that demanded this additional procedure. Visual acuity, ocular findings, the timing of surgical interventions, surgical procedures, and outcomes were retrospectively reviewed in four patients. Postoperative follow-up of the patients ranged from 6 to 24 mo(mean, 13 mo). After the treatment, all patients achieved excellent anatomical recovery. CONCLUSION Sub-Tenon's urokinase injection-assisted vitrectomy makes clot liquefaction happen in the early treatment stage, resulting in marked stability during the procedure.
