Dear Editor,Diabetic macular edema(DME)is a major cause of visual loss in diabetic patients,which is mainly caused by disruption of the blood-retinal barrier and loss of pericytes and endothelial cells,resulting in th...Dear Editor,Diabetic macular edema(DME)is a major cause of visual loss in diabetic patients,which is mainly caused by disruption of the blood-retinal barrier and loss of pericytes and endothelial cells,resulting in the leakage of plasma and lipids[1].Nowadays,laser photocoagulation,intravitreal injections of anti-vascular endothelial growth factor(anti-VEGF)drugs and dexamethasone implant.展开更多
Dear Editor,I diopathic macular telangiectasia(MacTel)type 1 is a retinal vascular disease characterized by abnormal dilation of macular capillaries,leading to metamorphopsia,progressive vision loss,and temporal scoto...Dear Editor,I diopathic macular telangiectasia(MacTel)type 1 is a retinal vascular disease characterized by abnormal dilation of macular capillaries,leading to metamorphopsia,progressive vision loss,and temporal scotoma enlargement.Currently,there is no standardized treatment protocol for MacTel type 1[1-2].Treatment outcomes can vary significantly among individuals,highlighting the ongoing need for further exploration of new and more effective treatment options.This paper presents a case of refractory macular edema associated with MacTel type 1,which showed a favorable response to pars plana vitrectomy(PPV)and internal limiting membrane(ILM)peeling.展开更多
Subretinal fibrosis is the end-stage sequelae of neovascular age-related macular degeneration.It causes local damage to photoreceptors,retinal pigment epithelium,and choroidal vessels,which leads to permanent central ...Subretinal fibrosis is the end-stage sequelae of neovascular age-related macular degeneration.It causes local damage to photoreceptors,retinal pigment epithelium,and choroidal vessels,which leads to permanent central vision loss of patients with neovascular age-related macular degeneration.The pathogenesis of subretinal fibrosis is complex,and the underlying mechanisms are largely unknown.Therefore,there are no effective treatment options.A thorough understanding of the pathogenesis of subretinal fibrosis and its related mechanisms is important to elucidate its complications and explore potential treatments.The current article reviews several aspects of subretinal fibrosis,including the current understanding on the relationship between neovascular age-related macular degeneration and subretinal fibrosis;multimodal imaging techniques for subretinal fibrosis;animal models for studying subretinal fibrosis;cellular and non-cellular constituents of subretinal fibrosis;pathophysiological mechanisms involved in subretinal fibrosis,such as aging,infiltration of macrophages,different sources of mesenchymal transition to myofibroblast,and activation of complement system and immune cells;and several key molecules and signaling pathways participating in the pathogenesis of subretinal fibrosis,such as vascular endothelial growth factor,connective tissue growth factor,fibroblast growth factor 2,platelet-derived growth factor and platelet-derived growth factor receptor-β,transforming growth factor-βsignaling pathway,Wnt signaling pathway,and the axis of heat shock protein 70-Toll-like receptors 2/4-interleukin-10.This review will improve the understanding of the pathogenesis of subretinal fibrosis,allow the discovery of molecular targets,and explore potential treatments for the management of subretinal fibrosis.展开更多
AIM:To quantitatively assess central macular thickness(CMT),macular neovascularization(MNV)area,vascular tortuosity(VT),and vascular dispersion(VDisp)in neovascular age-related macular degeneration(nAMD),type 1 and ty...AIM:To quantitatively assess central macular thickness(CMT),macular neovascularization(MNV)area,vascular tortuosity(VT),and vascular dispersion(VDisp)in neovascular age-related macular degeneration(nAMD),type 1 and type 2 MNV,by means of optical coherence tomography(OCT)and OCT angiography(OCTA)techniques.METHODS:In this retrospective and observational case series,patients were classified into type 1 or type 2 MNV groups.A comprehensive panel of OCT and OCTA metrics was evaluated,including CMT,MNV area,VT,and VDisp.All subjects underwent a standardized intravitreal conbercept(IVC)regimen[3+pro re nata(PRN)]with a 12-month follow-up.MNV area was obtained by manual measurements with OCTA software,and VT and VDisp were calculated by automated analysis with Image J software.RESULTS:A total of 101 participants were included,with 51 patients in the type 1 MNV group(mean age 67.32±9.12y)and 50 patients in the type 2 MNV group(mean age 64.74±5.21y).The mean number of IVC injections was 3.98±1.53 for type 1 MNV and 3.73±0.81 for type 2 MNV.Both subtypes exhibited significant improvements in visual acuity,accompanied by marked reductions in CMT and MNV area(P<0.05)at 12mo after treatment.In type 2 MNV,VT significantly decreased(P<0.05),whereas no significant change was observed in VT for type 1 MNV.VDisp did not significantly changed in either sybtypes.Moreover,in type 1 MNV,final best-corrected visual acuity(BCVA)using logMAR correlated positively with both pre-and post-treatment CMT,while in type 2 MNV,a significant positive correlation was found between the number of injections and final CMT.CONCLUSION:This study shows that conbercept treatment significantly improves visual acuity and macular structure in both type 1 and type 2 MNV with reductions in CMT and MNV area.The significant reduction in VT in type 2 MNV suggests its potential as a biomarker for disease activity.The findings imply the quantitative assessment useful for the stratification,prognostication,and personalized management of MNV in nAMD.展开更多
Proliferative diabetic retinopathy(PDR)affects approximately 6%of diabetic patients globally.The overall prevalence of diabetic retinopathy is around 22%.Wet age-related macular degeneration(ARMD),the sight-threatenin...Proliferative diabetic retinopathy(PDR)affects approximately 6%of diabetic patients globally.The overall prevalence of diabetic retinopathy is around 22%.Wet age-related macular degeneration(ARMD),the sight-threatening type of ARMD,affects approximately 1.2%-1.3%of the general population and represents 15%of total ARMD cases.While intravitreal anti-vascular endothelial growth factor injections are still the mainstay therapy,there are a few challenges,such as frequent administration,cost burden,and compliance barriers that prompt the need for exploration into systemic oral alternative drugs like fenofibrate,candesartan,and vorolanib.These oral therapies have the advantage of being noninvasive and systemically accessible with few logistical burdens.This review highlights current evidence supporting the use of oral therapies in PDR and wet ARMD management,along with practical limitations and future prospects.展开更多
AIM:To assess whether the implantation of a posterior chamber phakic intraocular lens produces changes in optical coherence tomography(OCT)measurements of macular thickness(MT)and two parameters that define the struct...AIM:To assess whether the implantation of a posterior chamber phakic intraocular lens produces changes in optical coherence tomography(OCT)measurements of macular thickness(MT)and two parameters that define the structure of the optic nerve,the peripapillary nerve fiber layer(RNFL)and the Bruch’s membrane opening-minimum rim width(BMO-MRW).METHODS:This nonrandomized prospective pre-post study included 86 eyes of 48 patients(age,20-47y;axial length:23.10-28.95 mm)scheduled for myopia or myopic astigmatism correction with implantation of the implantable collamer lens(ICL).Eyes with glaucoma or any other ocular disease that could alter OCT results were excluded.RNFL,BMO-MRW and MT were measured preoperatively,and at 1 and 6mo after surgery using spectral-domain OCT.Changes between preoperative and postoperative values were evaluated.RESULTS:There was a significant increase in BMOMRW at 1mo(mean change:3.48±15.07μm,P=0.041).No significant changes were found during the rest of followup(1-6mo postop.,P=0.623).There was also a significant increase in RNFL thickness at 1mo af ter surger y(1.45±2.18μm,P<0.001),but with a significant reduction from 1 to 6mo postoperatively(P=0.002).Regarding MT,it increased significantly at 1mo(2.46±3.76μm,P<0.001),with a significant decrease afterwards(P=0.048).Measurements of the three parameters at 6mo were slightly superior to preoperative values(P<0.01).CONCLUSION:Minimal changes are induced in BMOMRW,RNFL and MT after ICL implantation in healthy eyes,confirming the safety of the surgical procedure regarding the structure of the optic nerve head and the macula,and indicating that this phakic intraocular lens seems to have a slight impact on OCT measurements.展开更多
Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are...Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.展开更多
BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic im...BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic implications and longterm management strategies.Vascular and metabolic factors are being thought to play a role in such autoimmune neuro-inflammatory disorders,apart from the obvious immune mediated damage.With the advent of optical coherence tomography angiography(OCTA),it is easy to pick up on these subclinical macular microvascular and structural changes.AIM To study the macular microvascular and structural changes on OCTA in atypical optic neuritis.METHODS This observational cross-sectional study involved 8 NMOSD and 17 MOGAD patients,diagnosed serologically,as well as 10 healthy controls.Macular vascular density(MVD)and ganglion cell+inner plexiform layer thickness(GCIPL)were studied using OCTA.RESULTS There was a significant reduction in MVD in NMOSD and MOGAD affected as well as unaffected eyes when compared with healthy controls.NMOSD and MOGAD affected eyes had significant GCIPL thinning compared with healthy controls.NMOSD unaffected eyes did not show significant GCIPL thinning compared to healthy controls in contrast to MOGAD unaffected eyes.On comparing NMOSD with MOGAD,there was no significant difference in terms of MVD or GCIPL in the affected or unaffected eyes.CONCLUSION Although significant microvascular and structural changes are present on OCTA between atypical optic neuritis and normal patients,they could not help in differentiating between NMOSD and MOGAD cases.展开更多
AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This...AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This retrospective study involved 65 RVO patients(65 eyes)who received IVR and were followedup for more than 3mo.ME was categorized into cystoid macular edema(CME),diffuse retinal thickening(DRT),and serous retinal detachment(SRD)according to optical coherence tomography(OCT)images.The comparison of best corrected visual acuity(BCVA;logMAR)and central macular thickness(CMT)among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test.The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis.RESULTS:BCVA tended to improve in all groups,with marked improvement in CME and DRT groups.CMT showed the greatest reduction after 1wk,and remained stable over the following 3mo.DRT patients had the worst BCVA and the highest CMT at baseline,but the differences became smaller after IVR treatment.CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR.Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up.DRT patients were most likely to transform into the other morphological groups,while SRD patients showed minimal transitions.BCVA at baseline was identified as the most important prognostic indicator in all 3 groups.Additionally,DRT patients with a longer clinical course,higher CMT and central retinal vein occlusion(CRVO)tend to exhibit worse BCVA after treatment.In addition,CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion(BRVO)patients in CME group.SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment.CONCLUSION:The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups.Baseline parameters including clinical course,CMT,and RVO position are also useful in predicting the BCVA at different time points after treatment.展开更多
Background: Exudative, or “wet” age-related macular degeneration (wAMD), characterized by choroidal neovascularization and consequent accumulation of subretinal fluid, is the leading cause of visual loss in elderly ...Background: Exudative, or “wet” age-related macular degeneration (wAMD), characterized by choroidal neovascularization and consequent accumulation of subretinal fluid, is the leading cause of visual loss in elderly patients in Western countries. Objective: To compare the effectiveness of aflibercept vs. ranibizumab for treatment-naive wAMD patients in the real world. Methods: PubMed, Web of Science and Cochrane Library were searched to compare aflibercept with ranibizumab. 21 studies with a total of 13,004 eyes were selected and assessed in this meta-analysis. Results: Compared to ranibizumab, aflibercept was more effective in improving best-corrected visual acuity (BCVA) at 12 months (WMD: −0.04;95% CI: −0.07 to 0.00;p = 0.04). At 3 months, aflibercept was superior to ranibizumab in reducing central retinal thickness in patients with worse baseline BCVA (WMD: −36.19;95% CI: −71.47 to −0.92;p = 0.04), reducing subfoveal choroidal thickness in patients with better baseline BCVA (WMD: −12.67;95% CI: −21.33 to −4.02;p = 0.004), reducing height of subfoveal pigment epithelial detachment (WMD: −43.88;95% CI: −73.88 to −13.87;p = 0.004) and improving the incidence of “dry macula” occurrence (OR: 2.26;95% CI: 1.33 to 3.82;p = 0.003). Conclusions: Compared with ranibizumab, aflibercept showed better efficacy in improving morphological changes at 3 months and visual acuity at 12 months post treatment initiation in community clinical setting.展开更多
BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch a...BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch and central retinal arteries and veins,alongside anterior and posterior ischemic optic neuropathy.With the advent of optical coherence tomography angiography(OCTA),it is easy to identify these macular subclinical microvascular and structural changes.AIM To evaluate macular and peripapillary structural and microvasculature changes in patients with migraine with aura(MA),migraine without aura(MW),and healthy control(HC)participants using OCTA.METHODS In this observational cross-sectional study,we studied a total of 100 eyes:(1)32 eyes of 16 patients with MA;(2)36 eyes of 18 patients with MW,recruited based on the International Classification of Headache Disorders;and(3)32 eyes of 16 age and sex-matched healthy participants.Foveal flux,foveal avascular zone(FAZ),peripapillary flux obtained from OCTA,and foveal and peripapillary ganglion cell layer(GCL)thickness calculated via optical coherence tomography were compared among the groups.RESULTS The mean FAZ area measured in patients with MA and MW was significantly larger than that in the control participants(P=0.002).However,there was no significant difference between the FAZ of the MA and MW groups.Macular perfusion in the superficial capillary plexus in patients with MA was significantly lower compared to MW(P=0.0018)and HCs(P=0.002).There was also significant thinning of the GCL in patients with MA and MW(P=0.001)compared to HCs.However,there was no significant difference in temporal GCL thickness between the MA and MW groups.CONCLUSION Significant changes have been found in structural and microvascular parameters in patients with migraines compared with HCs.OCTA can serve as a valuable non-invasive imaging technique for identifying microcirculatory disturbances,aiding in better understanding the pathogenesis of different types of migraine and establishing their link with other ischemic retinal and systemic pathologies.展开更多
AIM:To conduct a comprehensive bibliometric analysis of age-related macular degeneration(AMD)research from 2002 to 2022,identifying key contributing countries,institutions,authors,journals,and research hotspots to inf...AIM:To conduct a comprehensive bibliometric analysis of age-related macular degeneration(AMD)research from 2002 to 2022,identifying key contributing countries,institutions,authors,journals,and research hotspots to inform future research directions.METHODS:Publications related to AMD were retrieved from the Web of Science Core Collection(WoSCC)database for the period January 1,2002,to December 31,2022.The search was limited to English-language articles and reviews.Bibliometric analysis was performed using Microsoft Excel 2021 for data management and annual publication analysis.Visualization and network analyses were conducted using VOSviewer,CiteSpace,and the Bibliometrix package in R.Collaboration networks among countries,institutions,authors,and journals were mapped.Keywords were analyzed for co-occurrence to identify research hotspots.Metrics such as H-index,total link strength(TLS),and citation counts were used to assess impact.RESULTS:A total of 16715 publications were analyzed,showing a consistent increase in AMD research output over the past 20y,peaking at 1445 publications in 2021.The United States was the leading contributor with 31.8%of total publications,followed by China and the United Kingdom.The University of Melbourne emerged as the most productive institution with the highest TLS,indicating strong international collaborations.Professor Frank G.Holz was identified as the most influential author based on H-index and publication count.Investigative Ophthalmology&Visual Science was the most prolific journal and had the highest citation impact.Keyword co-occurrence analysis revealed four main research clusters:pathogenesis,therapy,epidemiology,and diagnosis.Emerging research hotspots included anti-vascular endothelial growth factor(VEGF)therapies,optical coherence tomography angiography,and artificial intelligence(AI)applications in diagnosis.CONCLUSION:The bibliometric analysis highlights significant growth and collaborative efforts in AMD research globally.Key contributors have advanced understanding in pathogenesis,therapeutic strategies,epidemiology,and diagnostic technologies.Future research should focus on interdisciplinary collaborations,novel therapeutic targets,personalized medicine,and technological innovations such as AI to effectively address the challenges posed by AMD.展开更多
AIM:To elucidate causal pathways between oxidative biomarkers and age-related macular degeneration(AMD)phenotypes.METHODS:A bidirectional Mendelian randomization(MR)analytical protocol was implemented,which utilized g...AIM:To elucidate causal pathways between oxidative biomarkers and age-related macular degeneration(AMD)phenotypes.METHODS:A bidirectional Mendelian randomization(MR)analytical protocol was implemented,which utilized genome-wide association study(GWAS)summary statistics derived from the IEU OpenGWAS repositories.The investigation focused on 11 oxidative stress markers and AMD phenotypes,encompassing both wet and dry subtypes.The MR methodology incorporated inverse-variance weighted(IVW)calculations,MR-Egger statistical regression,weighted median approximation,and weighted mode assessments to estimate causative relationships.Sensitivity evaluations were conducted to verify result robustness and identify potential pleiotropy.RESULTS:Genetically predicted elevated catalase(CAT)concentrations demonstrated significant associations with heightened risks of overall AMD(IVW OR=1.084,95%CI:1.021-1.151,P=0.008)and wet AMD phenotype(IVW OR=1.113,95%CI:1.047-1.247,P=0.007).Higher genetically predicted albumin concentrations corresponded with reduced AMD risk(IVW OR=0.827,95%CI:0.715-0.957,P=0.013)but increased wet AMD risk(IVW OR=1.229,95%CI:1.036-1.458,P=0.018).Reverse MR analysis revealed that genetically predicted dry AMD exhibited significant association with reduced albumin levels(IVW OR=0.987,95%CI:0.979-0.996,P=0.004),while wet AMD corresponded with decreased total bilirubin(TBIL)and paraoxonase(PON)activity.CONCLUSION:The results offer strong support for a causal link between markers of oxidative stress and the development of AMD,indicating that oxidative processes play a role in driving the disease progression.展开更多
AIM:To describe the optical coherence tomography(OCT)features in the fellow eyes of individuals with full-thickness macular holes(FTMHs).METHODS:This multicenter retrospective study included observational and validati...AIM:To describe the optical coherence tomography(OCT)features in the fellow eyes of individuals with full-thickness macular holes(FTMHs).METHODS:This multicenter retrospective study included observational and validation groups,incorporating fellow eyes of patients diagnosed with idiopathic FTMH.OCT images were categorized according to International Vitreomacular Traction Study(IVTS)and Gass classification.Age-and sex-related cataract patients were served as control groups.Vertical and horizontal OCT images were chosen for further measurement.OCT parameters including foveal floor width(FFW),central foveal thickness(CFT)and FFW/CFT ratio were assessed and compared between observational and control groups and were validated by validation group.Receiver operating characteristic(ROC)curves were plotted for OCT parameters in identifying macular holes(MHs).RESULTS:A total of 73 patients were included in the observational group,comprising 51 females and 22 males,with an average age of 65.5±7.3y and an axial length of 23.9±0.8 mm.The validated group consisted of 47 patients,including 31 females and 16 males,with an average age of 65.0±7.4y and an average axial length of 23.6±0.8 mm.In the observational group,16.4%of the fellow eyes associated with FTMHs also exhibited MHs,while in the validated group,this prevalence was 12.7%.The 45.2%in the observational group and 44.6%in validated group of these fellow eyes displayed abnormalities including vitreomacular adhesion(VMA),vitreomacular traction(VMT),and MHs.Statistically significant differences were observed in FFW,CFT,and FFW/CFT ratio between control and observational group,as well as validated group(P<0.01),no matter in the vertical or horizontal layer.ROC curves revealed the area under the curve(AUC)for FFW and the FFW/CFT ratio was 0.85 and 0.90,respectively.CONCLUSION:In the case of unilateral idiopathic MHs,it was important to carefully monitor the condition of the fellow eye.The FFW and FFW/CFT ratio may be good metrics for predicting MHs.展开更多
AIM:To assess and rank the efficacy of various nonsteroidal anti-inflammatory drugs(NSAIDs)in preventing postoperative macular edema(PME)after cataract surgery.METHODS:A comprehensive search was conducted across PubMe...AIM:To assess and rank the efficacy of various nonsteroidal anti-inflammatory drugs(NSAIDs)in preventing postoperative macular edema(PME)after cataract surgery.METHODS:A comprehensive search was conducted across PubMed,Embase,Cochrane Library,and Web of Science databases.Randomized controlled trials(RCTs)comparing different NSAIDs and control treatments for the prevention of PME were included.Data from the studies were synthesized using the“gemtc”package in R.Risk of bias was assessed with the Cochrane RoB 2 tool,and heterogeneity was evaluated using the global I2 statistic.Surface under the cumulative ranking curve(SUCRA)values were calculated for each treatment.RESULTS:Of 132 identified records,9 RCTs met the inclusion criteria.The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME,followed by artificial tear substitute,ketorolac,diclofenac,and bromfenac.The league table comparisons and rankograms corroborated these findings,with nepafenac consistently ranking highest.Heterogeneity analysis yielded high I2 values,indicating substantial variability across studies.CONCLUSION:This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery.Given the substantial heterogeneity observed,further high-quality RCTs are required to confirm these findings and explore the sources of variability.Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients.展开更多
AIM:To investigate cuproptosis-related molecular and immune infiltration in age-related macular degeneration(AMD)development and establish a predictive model.METHODS:The expression profiles of cuproptosisrelated genes...AIM:To investigate cuproptosis-related molecular and immune infiltration in age-related macular degeneration(AMD)development and establish a predictive model.METHODS:The expression profiles of cuproptosisrelated genes and immune signature in AMD based on the microarray dataset GSE29801 were analyzed.A total of 142 AMD samples were used to identify the cuproptosisrelated differentially expressed genes(Cu-DEGs),together with the immune cell infiltration.To further refine the list of potential genes for AMD diagnosis,three machine learning techniques were used,and an external dataset were applied for confirming the accuracy of the predictive performance.Reverse transcription polymerase chain reaction(RT-PCR)were also performed to examine the level of mRNA of hub genes.The activated immune responses and Cu-DEGs were assessed between AMD and controls.RESULTS:Six genes,including ATP7A,DBT,VEGFA,UBE2D3,CP,SLC31A1,were screened as cuproptosissignature in AMD via three machine learning methods.Next,SLC31A1 and VEGFA was selected as hub genes by performance evaluation in an external dataset GSE160011,further analysis showed that SLC31A1 and VEGFA were associated with pathways related to immune signaling and immune function,which were then observed in relation to infiltrating immune cells.Finally,the mRNA expression levels of SLC31A1 and VEGFA were significantly higher in laser induced choroidal neovascularization(CNV)group than in control group detected by RT-PCR.CONCLUSION:In this study,the possible relationship between cuproptosis and AMD is expounded systematically.A predictive model is developed to assess the risk of cuproptosis-related genes and their clinical prognostic value in AMD patients.展开更多
AIM:To examine effects of switching intravitreal aflibercept to bevacizumab in neovascular age-related macular degeneration(nAMD).METHODS:Data from patients treated for nAMD with anti-vascular endothelial growth facto...AIM:To examine effects of switching intravitreal aflibercept to bevacizumab in neovascular age-related macular degeneration(nAMD).METHODS:Data from patients treated for nAMD with anti-vascular endothelial growth factor(VEGF)injections atÖrebro University Hospital between January 2014 and June 2020,were extracted from the Swedish macular register(SMR).A total of 230 eyes were included in the study:116 in the study/bevacizumab switch group and 114 in the control/aflibercept group.Central retinal thickness(CRT)was measured at baseline and after 2y.Primary outcome was mean change in best corrected visual acuity(BCVA)between baseline and 2y.Secondary outcome variables included proportion of patients with a clinically significant change in BCVA[increase or decrease of≥15 Early Treatment Diabetic Retinopathy Study(ETDRS)letters],mean change in CRT,number of anti-VEGF injections,number of visits assessing disease activity and number of visits with active disease.RESULTS:The mean difference in BCVA between baseline and 2y was 1.13±14.47 ETDRS letters in the bevacizumab switch group and 1.81±13.01 ETDRS letters in the aflibercept group.The lower bound of the 95%confidence interval of the difference in BCVA was-4.25,indicating non-inferiority within a 5 ETDRS letter limit.No significant differences in mean change of CRT between baseline and 2y were detected(study-185.9±167.0 versus control-149.4±193.1μm,P=0.127).The distribution of clinically significant improvement(P=0.598)or worsening(P=0.508)of BCVA during follow-up did not show statistically significant differences between groups.The number of anti-VEGF injections administered(study 12.76±2.20 versus control 13.10±4.20,P=0.442),the number of visits assessing disease activity(P=0.301),and the number of visits with active disease(P=0.065)did not show differences between subjects receiving bevacizumab and aflibercept treatment.No significant differences were detected in baseline characteristics between the study and control groups,including age,BCVA,CRT,neovascular membrane type or location,duration of symptoms or prior cataract surgery.CONCLUSION:Switching to off-label bevacizumab in patients responding to initial aflibercept treatment is noninferior to continued aflibercept treatment with respect to change in visual acuity at 2y.Switching anti-VEGF from aflibercept to bevacizumab may be a viable option in clinical settings with limited resources.展开更多
AIM:To evaluate whether fluid-air exchange is an effective treatment for unclosed macular hole(MH)after primary vitrectomy.METHODS:This retrospective study included patients with an unclosed MH within 1–2wk after vit...AIM:To evaluate whether fluid-air exchange is an effective treatment for unclosed macular hole(MH)after primary vitrectomy.METHODS:This retrospective study included patients with an unclosed MH within 1–2wk after vitrectomy.Patients were divided into the vitrectomy,fluid-air exchange,and observation groups according to the secondary treatment.The anatomical outcomes and postoperative visual acuity were recorded.RESULTS:The analysis included 25 eyes in 25 patients(16 females)aged 37–74y(vitrectomy group,n=10;fluid-air exchange group,n=9;observation group,n=6).Closure rate after secondary treatment was 100%in the vitrectomy group,88.9%in the fluid-air exchange group and 33.3%in the observation group.Optical coherence tomography images obtained at the last follow-up revealed that continuity of the external limiting membrane(ELM)was significantly more common(P=0.004)in the fluid-air group(8/9 eyes,88.9%)than in the vitrectomy group(2/10 eyes,20.0%)and that macular morphology was better in the fluid-air group than in the vitrectomy group.No serious complications were observed after secondary treatment.CONCLUSION:Fluid-air exchange is an alternative option to repeat vitrectomy for patients with an unclosed MH after initial vitrectomy with elevated macular edge.展开更多
Age-related macular degeneration(AMD)is a disease that affects the vision of elderly individuals worldwide.Although current therapeutics have shown effectiveness against AMD,some patients may remain unresponsive and c...Age-related macular degeneration(AMD)is a disease that affects the vision of elderly individuals worldwide.Although current therapeutics have shown effectiveness against AMD,some patients may remain unresponsive and continue to experience disease progression.Therefore,in-depth knowledge of the mechanism underlying AMD pathogenesis is urgently required to identify potential drug targets for AMD treatment.Recently,studies have suggested that dysfunction of mitochondria can lead to the aggregation of reactive oxygen species(ROS)and activation of the cyclic GMP-AMP synthase(cGAS)/stimulator of interferon genes(STING)innate immunity pathways,ultimately resulting in sterile inflammation and cell death in various cells,such as cardiomyocytes and macrophages.Therefore,combining strategies targeting mitochondrial dysfunction and inflammatory mediators may hold great potential in facilitating AMD management.Notably,emerging evidence indicates that natural products targeting mitochondrial quality control(MQC)and the cGAS/STING innate immunity pathways exhibit promise in treating AMD.Here,we summarize phytochemicals that could directly or indirectly influence the MQC and the cGAS/STING innate immunity pathways,as well as their interconnected mediators,which have the potential to mitigate oxidative stress and suppress excessive inflammatory responses,thereby hoping to offer new insights into therapeutic interventions for AMD treatment.展开更多
Macular pigment(MP)is a crucial pigment in the macular region.It plays an important role in filtering blue light,and exhibits anti-inflammatory and antioxidant properties.Macular pigment optical density(MPOD)is a key ...Macular pigment(MP)is a crucial pigment in the macular region.It plays an important role in filtering blue light,and exhibits anti-inflammatory and antioxidant properties.Macular pigment optical density(MPOD)is a key indicator for assessing the density of MP in the macular area and is closely associated with eye diseases,including age-related macular degeneration,diabetic retinopathy,and glaucoma.This review aims to explore the clinical significance of MPOD and its research value in ophthalmology and other medical fields.It summarizes the current MPOD measurement techniques,categorizing them into two main types(in vivo and in vitro),and discusses their respective advantages and limitations.Additionally,given the advancements in artificial intelligence(AI)and deep-learning technologies that offer new opportunities for improving MPOD assessment,this review analyzes the significant potential and future prospects of AI-based fundus image analysis in MPOD measurement.The goal of AI-based analysis is to provide faster and more accurate detection methods,thereby promoting further research and new clinical applications of MPOD in the field of ophthalmology.展开更多
基金Supported by National Natural Science Foundation of China(No.82171062No.82301222)Zhejiang Provincial Natural Science Foundation of China(No.LY20H120002).
文摘Dear Editor,Diabetic macular edema(DME)is a major cause of visual loss in diabetic patients,which is mainly caused by disruption of the blood-retinal barrier and loss of pericytes and endothelial cells,resulting in the leakage of plasma and lipids[1].Nowadays,laser photocoagulation,intravitreal injections of anti-vascular endothelial growth factor(anti-VEGF)drugs and dexamethasone implant.
基金Supported by Science and Technology Project of Sichuan Provincial Health Commission(No.24WXXT13)North Sichuan Medical College Doctor Start-up Fund Project(No.CBY24-QDA01).
文摘Dear Editor,I diopathic macular telangiectasia(MacTel)type 1 is a retinal vascular disease characterized by abnormal dilation of macular capillaries,leading to metamorphopsia,progressive vision loss,and temporal scotoma enlargement.Currently,there is no standardized treatment protocol for MacTel type 1[1-2].Treatment outcomes can vary significantly among individuals,highlighting the ongoing need for further exploration of new and more effective treatment options.This paper presents a case of refractory macular edema associated with MacTel type 1,which showed a favorable response to pars plana vitrectomy(PPV)and internal limiting membrane(ILM)peeling.
基金supported by grants from National Key R&D Program of China,No.2023YFC2506100(to JZ)the National Natural Science Foundation of China,No.82171062(to JZ).
文摘Subretinal fibrosis is the end-stage sequelae of neovascular age-related macular degeneration.It causes local damage to photoreceptors,retinal pigment epithelium,and choroidal vessels,which leads to permanent central vision loss of patients with neovascular age-related macular degeneration.The pathogenesis of subretinal fibrosis is complex,and the underlying mechanisms are largely unknown.Therefore,there are no effective treatment options.A thorough understanding of the pathogenesis of subretinal fibrosis and its related mechanisms is important to elucidate its complications and explore potential treatments.The current article reviews several aspects of subretinal fibrosis,including the current understanding on the relationship between neovascular age-related macular degeneration and subretinal fibrosis;multimodal imaging techniques for subretinal fibrosis;animal models for studying subretinal fibrosis;cellular and non-cellular constituents of subretinal fibrosis;pathophysiological mechanisms involved in subretinal fibrosis,such as aging,infiltration of macrophages,different sources of mesenchymal transition to myofibroblast,and activation of complement system and immune cells;and several key molecules and signaling pathways participating in the pathogenesis of subretinal fibrosis,such as vascular endothelial growth factor,connective tissue growth factor,fibroblast growth factor 2,platelet-derived growth factor and platelet-derived growth factor receptor-β,transforming growth factor-βsignaling pathway,Wnt signaling pathway,and the axis of heat shock protein 70-Toll-like receptors 2/4-interleukin-10.This review will improve the understanding of the pathogenesis of subretinal fibrosis,allow the discovery of molecular targets,and explore potential treatments for the management of subretinal fibrosis.
基金Supported by Natural Science Foundation of Shandong Province(No.ZR2023MH363)Bethune Langmu Young Scholars Research Fund Project(No.BJ-LM2021007J).
文摘AIM:To quantitatively assess central macular thickness(CMT),macular neovascularization(MNV)area,vascular tortuosity(VT),and vascular dispersion(VDisp)in neovascular age-related macular degeneration(nAMD),type 1 and type 2 MNV,by means of optical coherence tomography(OCT)and OCT angiography(OCTA)techniques.METHODS:In this retrospective and observational case series,patients were classified into type 1 or type 2 MNV groups.A comprehensive panel of OCT and OCTA metrics was evaluated,including CMT,MNV area,VT,and VDisp.All subjects underwent a standardized intravitreal conbercept(IVC)regimen[3+pro re nata(PRN)]with a 12-month follow-up.MNV area was obtained by manual measurements with OCTA software,and VT and VDisp were calculated by automated analysis with Image J software.RESULTS:A total of 101 participants were included,with 51 patients in the type 1 MNV group(mean age 67.32±9.12y)and 50 patients in the type 2 MNV group(mean age 64.74±5.21y).The mean number of IVC injections was 3.98±1.53 for type 1 MNV and 3.73±0.81 for type 2 MNV.Both subtypes exhibited significant improvements in visual acuity,accompanied by marked reductions in CMT and MNV area(P<0.05)at 12mo after treatment.In type 2 MNV,VT significantly decreased(P<0.05),whereas no significant change was observed in VT for type 1 MNV.VDisp did not significantly changed in either sybtypes.Moreover,in type 1 MNV,final best-corrected visual acuity(BCVA)using logMAR correlated positively with both pre-and post-treatment CMT,while in type 2 MNV,a significant positive correlation was found between the number of injections and final CMT.CONCLUSION:This study shows that conbercept treatment significantly improves visual acuity and macular structure in both type 1 and type 2 MNV with reductions in CMT and MNV area.The significant reduction in VT in type 2 MNV suggests its potential as a biomarker for disease activity.The findings imply the quantitative assessment useful for the stratification,prognostication,and personalized management of MNV in nAMD.
文摘Proliferative diabetic retinopathy(PDR)affects approximately 6%of diabetic patients globally.The overall prevalence of diabetic retinopathy is around 22%.Wet age-related macular degeneration(ARMD),the sight-threatening type of ARMD,affects approximately 1.2%-1.3%of the general population and represents 15%of total ARMD cases.While intravitreal anti-vascular endothelial growth factor injections are still the mainstay therapy,there are a few challenges,such as frequent administration,cost burden,and compliance barriers that prompt the need for exploration into systemic oral alternative drugs like fenofibrate,candesartan,and vorolanib.These oral therapies have the advantage of being noninvasive and systemically accessible with few logistical burdens.This review highlights current evidence supporting the use of oral therapies in PDR and wet ARMD management,along with practical limitations and future prospects.
文摘AIM:To assess whether the implantation of a posterior chamber phakic intraocular lens produces changes in optical coherence tomography(OCT)measurements of macular thickness(MT)and two parameters that define the structure of the optic nerve,the peripapillary nerve fiber layer(RNFL)and the Bruch’s membrane opening-minimum rim width(BMO-MRW).METHODS:This nonrandomized prospective pre-post study included 86 eyes of 48 patients(age,20-47y;axial length:23.10-28.95 mm)scheduled for myopia or myopic astigmatism correction with implantation of the implantable collamer lens(ICL).Eyes with glaucoma or any other ocular disease that could alter OCT results were excluded.RNFL,BMO-MRW and MT were measured preoperatively,and at 1 and 6mo after surgery using spectral-domain OCT.Changes between preoperative and postoperative values were evaluated.RESULTS:There was a significant increase in BMOMRW at 1mo(mean change:3.48±15.07μm,P=0.041).No significant changes were found during the rest of followup(1-6mo postop.,P=0.623).There was also a significant increase in RNFL thickness at 1mo af ter surger y(1.45±2.18μm,P<0.001),but with a significant reduction from 1 to 6mo postoperatively(P=0.002).Regarding MT,it increased significantly at 1mo(2.46±3.76μm,P<0.001),with a significant decrease afterwards(P=0.048).Measurements of the three parameters at 6mo were slightly superior to preoperative values(P<0.01).CONCLUSION:Minimal changes are induced in BMOMRW,RNFL and MT after ICL implantation in healthy eyes,confirming the safety of the surgical procedure regarding the structure of the optic nerve head and the macula,and indicating that this phakic intraocular lens seems to have a slight impact on OCT measurements.
基金supported by the National Natural Science Foundation of China,No.82171080Nanjing Medical Science and Technology Development Project,No.YKK23264Postgraduate Research&Practice Innovation Program of Jiangsu Province,Nos.JX10414151,JX10414152(all to KL)。
文摘Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.
文摘BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic implications and longterm management strategies.Vascular and metabolic factors are being thought to play a role in such autoimmune neuro-inflammatory disorders,apart from the obvious immune mediated damage.With the advent of optical coherence tomography angiography(OCTA),it is easy to pick up on these subclinical macular microvascular and structural changes.AIM To study the macular microvascular and structural changes on OCTA in atypical optic neuritis.METHODS This observational cross-sectional study involved 8 NMOSD and 17 MOGAD patients,diagnosed serologically,as well as 10 healthy controls.Macular vascular density(MVD)and ganglion cell+inner plexiform layer thickness(GCIPL)were studied using OCTA.RESULTS There was a significant reduction in MVD in NMOSD and MOGAD affected as well as unaffected eyes when compared with healthy controls.NMOSD and MOGAD affected eyes had significant GCIPL thinning compared with healthy controls.NMOSD unaffected eyes did not show significant GCIPL thinning compared to healthy controls in contrast to MOGAD unaffected eyes.On comparing NMOSD with MOGAD,there was no significant difference in terms of MVD or GCIPL in the affected or unaffected eyes.CONCLUSION Although significant microvascular and structural changes are present on OCTA between atypical optic neuritis and normal patients,they could not help in differentiating between NMOSD and MOGAD cases.
基金Supported by the Suzhou Medical Innovation Application Research Project(SZM2023027).
文摘AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This retrospective study involved 65 RVO patients(65 eyes)who received IVR and were followedup for more than 3mo.ME was categorized into cystoid macular edema(CME),diffuse retinal thickening(DRT),and serous retinal detachment(SRD)according to optical coherence tomography(OCT)images.The comparison of best corrected visual acuity(BCVA;logMAR)and central macular thickness(CMT)among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test.The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis.RESULTS:BCVA tended to improve in all groups,with marked improvement in CME and DRT groups.CMT showed the greatest reduction after 1wk,and remained stable over the following 3mo.DRT patients had the worst BCVA and the highest CMT at baseline,but the differences became smaller after IVR treatment.CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR.Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up.DRT patients were most likely to transform into the other morphological groups,while SRD patients showed minimal transitions.BCVA at baseline was identified as the most important prognostic indicator in all 3 groups.Additionally,DRT patients with a longer clinical course,higher CMT and central retinal vein occlusion(CRVO)tend to exhibit worse BCVA after treatment.In addition,CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion(BRVO)patients in CME group.SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment.CONCLUSION:The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups.Baseline parameters including clinical course,CMT,and RVO position are also useful in predicting the BCVA at different time points after treatment.
文摘Background: Exudative, or “wet” age-related macular degeneration (wAMD), characterized by choroidal neovascularization and consequent accumulation of subretinal fluid, is the leading cause of visual loss in elderly patients in Western countries. Objective: To compare the effectiveness of aflibercept vs. ranibizumab for treatment-naive wAMD patients in the real world. Methods: PubMed, Web of Science and Cochrane Library were searched to compare aflibercept with ranibizumab. 21 studies with a total of 13,004 eyes were selected and assessed in this meta-analysis. Results: Compared to ranibizumab, aflibercept was more effective in improving best-corrected visual acuity (BCVA) at 12 months (WMD: −0.04;95% CI: −0.07 to 0.00;p = 0.04). At 3 months, aflibercept was superior to ranibizumab in reducing central retinal thickness in patients with worse baseline BCVA (WMD: −36.19;95% CI: −71.47 to −0.92;p = 0.04), reducing subfoveal choroidal thickness in patients with better baseline BCVA (WMD: −12.67;95% CI: −21.33 to −4.02;p = 0.004), reducing height of subfoveal pigment epithelial detachment (WMD: −43.88;95% CI: −73.88 to −13.87;p = 0.004) and improving the incidence of “dry macula” occurrence (OR: 2.26;95% CI: 1.33 to 3.82;p = 0.003). Conclusions: Compared with ranibizumab, aflibercept showed better efficacy in improving morphological changes at 3 months and visual acuity at 12 months post treatment initiation in community clinical setting.
文摘BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch and central retinal arteries and veins,alongside anterior and posterior ischemic optic neuropathy.With the advent of optical coherence tomography angiography(OCTA),it is easy to identify these macular subclinical microvascular and structural changes.AIM To evaluate macular and peripapillary structural and microvasculature changes in patients with migraine with aura(MA),migraine without aura(MW),and healthy control(HC)participants using OCTA.METHODS In this observational cross-sectional study,we studied a total of 100 eyes:(1)32 eyes of 16 patients with MA;(2)36 eyes of 18 patients with MW,recruited based on the International Classification of Headache Disorders;and(3)32 eyes of 16 age and sex-matched healthy participants.Foveal flux,foveal avascular zone(FAZ),peripapillary flux obtained from OCTA,and foveal and peripapillary ganglion cell layer(GCL)thickness calculated via optical coherence tomography were compared among the groups.RESULTS The mean FAZ area measured in patients with MA and MW was significantly larger than that in the control participants(P=0.002).However,there was no significant difference between the FAZ of the MA and MW groups.Macular perfusion in the superficial capillary plexus in patients with MA was significantly lower compared to MW(P=0.0018)and HCs(P=0.002).There was also significant thinning of the GCL in patients with MA and MW(P=0.001)compared to HCs.However,there was no significant difference in temporal GCL thickness between the MA and MW groups.CONCLUSION Significant changes have been found in structural and microvascular parameters in patients with migraines compared with HCs.OCTA can serve as a valuable non-invasive imaging technique for identifying microcirculatory disturbances,aiding in better understanding the pathogenesis of different types of migraine and establishing their link with other ischemic retinal and systemic pathologies.
基金Supported by the National Natural Science Foundation of China(No.82371033)the Tianjin Natural Science Foundation(No.21JCZDJC01250)the Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-016A).
文摘AIM:To conduct a comprehensive bibliometric analysis of age-related macular degeneration(AMD)research from 2002 to 2022,identifying key contributing countries,institutions,authors,journals,and research hotspots to inform future research directions.METHODS:Publications related to AMD were retrieved from the Web of Science Core Collection(WoSCC)database for the period January 1,2002,to December 31,2022.The search was limited to English-language articles and reviews.Bibliometric analysis was performed using Microsoft Excel 2021 for data management and annual publication analysis.Visualization and network analyses were conducted using VOSviewer,CiteSpace,and the Bibliometrix package in R.Collaboration networks among countries,institutions,authors,and journals were mapped.Keywords were analyzed for co-occurrence to identify research hotspots.Metrics such as H-index,total link strength(TLS),and citation counts were used to assess impact.RESULTS:A total of 16715 publications were analyzed,showing a consistent increase in AMD research output over the past 20y,peaking at 1445 publications in 2021.The United States was the leading contributor with 31.8%of total publications,followed by China and the United Kingdom.The University of Melbourne emerged as the most productive institution with the highest TLS,indicating strong international collaborations.Professor Frank G.Holz was identified as the most influential author based on H-index and publication count.Investigative Ophthalmology&Visual Science was the most prolific journal and had the highest citation impact.Keyword co-occurrence analysis revealed four main research clusters:pathogenesis,therapy,epidemiology,and diagnosis.Emerging research hotspots included anti-vascular endothelial growth factor(VEGF)therapies,optical coherence tomography angiography,and artificial intelligence(AI)applications in diagnosis.CONCLUSION:The bibliometric analysis highlights significant growth and collaborative efforts in AMD research globally.Key contributors have advanced understanding in pathogenesis,therapeutic strategies,epidemiology,and diagnostic technologies.Future research should focus on interdisciplinary collaborations,novel therapeutic targets,personalized medicine,and technological innovations such as AI to effectively address the challenges posed by AMD.
基金Supported by National Natural Science Foundation of China(No.82371033)Tianjin Health Bureau Fund(No.ZC20030)+4 种基金Tianjin Eye Hospital Fund Project(No.YKYB1911)Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-016A)Nankai University Institute of Optometry Science Research Open Fund(No.YKPY2208)Tianjin Eye Hospital Science and Technology Fund(No.NKSGY202405)Xianyang Science and Technology Plan Project(No.L2022ZDYFSF038).
文摘AIM:To elucidate causal pathways between oxidative biomarkers and age-related macular degeneration(AMD)phenotypes.METHODS:A bidirectional Mendelian randomization(MR)analytical protocol was implemented,which utilized genome-wide association study(GWAS)summary statistics derived from the IEU OpenGWAS repositories.The investigation focused on 11 oxidative stress markers and AMD phenotypes,encompassing both wet and dry subtypes.The MR methodology incorporated inverse-variance weighted(IVW)calculations,MR-Egger statistical regression,weighted median approximation,and weighted mode assessments to estimate causative relationships.Sensitivity evaluations were conducted to verify result robustness and identify potential pleiotropy.RESULTS:Genetically predicted elevated catalase(CAT)concentrations demonstrated significant associations with heightened risks of overall AMD(IVW OR=1.084,95%CI:1.021-1.151,P=0.008)and wet AMD phenotype(IVW OR=1.113,95%CI:1.047-1.247,P=0.007).Higher genetically predicted albumin concentrations corresponded with reduced AMD risk(IVW OR=0.827,95%CI:0.715-0.957,P=0.013)but increased wet AMD risk(IVW OR=1.229,95%CI:1.036-1.458,P=0.018).Reverse MR analysis revealed that genetically predicted dry AMD exhibited significant association with reduced albumin levels(IVW OR=0.987,95%CI:0.979-0.996,P=0.004),while wet AMD corresponded with decreased total bilirubin(TBIL)and paraoxonase(PON)activity.CONCLUSION:The results offer strong support for a causal link between markers of oxidative stress and the development of AMD,indicating that oxidative processes play a role in driving the disease progression.
基金Supported by Jiangsu Provincial Medical Innovation Team(No.CXTDA2017039)the Soochow Scholar Project of Soochow University(No.R5122001).
文摘AIM:To describe the optical coherence tomography(OCT)features in the fellow eyes of individuals with full-thickness macular holes(FTMHs).METHODS:This multicenter retrospective study included observational and validation groups,incorporating fellow eyes of patients diagnosed with idiopathic FTMH.OCT images were categorized according to International Vitreomacular Traction Study(IVTS)and Gass classification.Age-and sex-related cataract patients were served as control groups.Vertical and horizontal OCT images were chosen for further measurement.OCT parameters including foveal floor width(FFW),central foveal thickness(CFT)and FFW/CFT ratio were assessed and compared between observational and control groups and were validated by validation group.Receiver operating characteristic(ROC)curves were plotted for OCT parameters in identifying macular holes(MHs).RESULTS:A total of 73 patients were included in the observational group,comprising 51 females and 22 males,with an average age of 65.5±7.3y and an axial length of 23.9±0.8 mm.The validated group consisted of 47 patients,including 31 females and 16 males,with an average age of 65.0±7.4y and an average axial length of 23.6±0.8 mm.In the observational group,16.4%of the fellow eyes associated with FTMHs also exhibited MHs,while in the validated group,this prevalence was 12.7%.The 45.2%in the observational group and 44.6%in validated group of these fellow eyes displayed abnormalities including vitreomacular adhesion(VMA),vitreomacular traction(VMT),and MHs.Statistically significant differences were observed in FFW,CFT,and FFW/CFT ratio between control and observational group,as well as validated group(P<0.01),no matter in the vertical or horizontal layer.ROC curves revealed the area under the curve(AUC)for FFW and the FFW/CFT ratio was 0.85 and 0.90,respectively.CONCLUSION:In the case of unilateral idiopathic MHs,it was important to carefully monitor the condition of the fellow eye.The FFW and FFW/CFT ratio may be good metrics for predicting MHs.
基金Supported by Natural Science Foundation of Chongqing(No.CSTB2024NSCQ-MSX0900No.CSTB2023NSCQ-MSX0593).
文摘AIM:To assess and rank the efficacy of various nonsteroidal anti-inflammatory drugs(NSAIDs)in preventing postoperative macular edema(PME)after cataract surgery.METHODS:A comprehensive search was conducted across PubMed,Embase,Cochrane Library,and Web of Science databases.Randomized controlled trials(RCTs)comparing different NSAIDs and control treatments for the prevention of PME were included.Data from the studies were synthesized using the“gemtc”package in R.Risk of bias was assessed with the Cochrane RoB 2 tool,and heterogeneity was evaluated using the global I2 statistic.Surface under the cumulative ranking curve(SUCRA)values were calculated for each treatment.RESULTS:Of 132 identified records,9 RCTs met the inclusion criteria.The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME,followed by artificial tear substitute,ketorolac,diclofenac,and bromfenac.The league table comparisons and rankograms corroborated these findings,with nepafenac consistently ranking highest.Heterogeneity analysis yielded high I2 values,indicating substantial variability across studies.CONCLUSION:This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery.Given the substantial heterogeneity observed,further high-quality RCTs are required to confirm these findings and explore the sources of variability.Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients.
文摘AIM:To investigate cuproptosis-related molecular and immune infiltration in age-related macular degeneration(AMD)development and establish a predictive model.METHODS:The expression profiles of cuproptosisrelated genes and immune signature in AMD based on the microarray dataset GSE29801 were analyzed.A total of 142 AMD samples were used to identify the cuproptosisrelated differentially expressed genes(Cu-DEGs),together with the immune cell infiltration.To further refine the list of potential genes for AMD diagnosis,three machine learning techniques were used,and an external dataset were applied for confirming the accuracy of the predictive performance.Reverse transcription polymerase chain reaction(RT-PCR)were also performed to examine the level of mRNA of hub genes.The activated immune responses and Cu-DEGs were assessed between AMD and controls.RESULTS:Six genes,including ATP7A,DBT,VEGFA,UBE2D3,CP,SLC31A1,were screened as cuproptosissignature in AMD via three machine learning methods.Next,SLC31A1 and VEGFA was selected as hub genes by performance evaluation in an external dataset GSE160011,further analysis showed that SLC31A1 and VEGFA were associated with pathways related to immune signaling and immune function,which were then observed in relation to infiltrating immune cells.Finally,the mRNA expression levels of SLC31A1 and VEGFA were significantly higher in laser induced choroidal neovascularization(CNV)group than in control group detected by RT-PCR.CONCLUSION:In this study,the possible relationship between cuproptosis and AMD is expounded systematically.A predictive model is developed to assess the risk of cuproptosis-related genes and their clinical prognostic value in AMD patients.
文摘AIM:To examine effects of switching intravitreal aflibercept to bevacizumab in neovascular age-related macular degeneration(nAMD).METHODS:Data from patients treated for nAMD with anti-vascular endothelial growth factor(VEGF)injections atÖrebro University Hospital between January 2014 and June 2020,were extracted from the Swedish macular register(SMR).A total of 230 eyes were included in the study:116 in the study/bevacizumab switch group and 114 in the control/aflibercept group.Central retinal thickness(CRT)was measured at baseline and after 2y.Primary outcome was mean change in best corrected visual acuity(BCVA)between baseline and 2y.Secondary outcome variables included proportion of patients with a clinically significant change in BCVA[increase or decrease of≥15 Early Treatment Diabetic Retinopathy Study(ETDRS)letters],mean change in CRT,number of anti-VEGF injections,number of visits assessing disease activity and number of visits with active disease.RESULTS:The mean difference in BCVA between baseline and 2y was 1.13±14.47 ETDRS letters in the bevacizumab switch group and 1.81±13.01 ETDRS letters in the aflibercept group.The lower bound of the 95%confidence interval of the difference in BCVA was-4.25,indicating non-inferiority within a 5 ETDRS letter limit.No significant differences in mean change of CRT between baseline and 2y were detected(study-185.9±167.0 versus control-149.4±193.1μm,P=0.127).The distribution of clinically significant improvement(P=0.598)or worsening(P=0.508)of BCVA during follow-up did not show statistically significant differences between groups.The number of anti-VEGF injections administered(study 12.76±2.20 versus control 13.10±4.20,P=0.442),the number of visits assessing disease activity(P=0.301),and the number of visits with active disease(P=0.065)did not show differences between subjects receiving bevacizumab and aflibercept treatment.No significant differences were detected in baseline characteristics between the study and control groups,including age,BCVA,CRT,neovascular membrane type or location,duration of symptoms or prior cataract surgery.CONCLUSION:Switching to off-label bevacizumab in patients responding to initial aflibercept treatment is noninferior to continued aflibercept treatment with respect to change in visual acuity at 2y.Switching anti-VEGF from aflibercept to bevacizumab may be a viable option in clinical settings with limited resources.
文摘AIM:To evaluate whether fluid-air exchange is an effective treatment for unclosed macular hole(MH)after primary vitrectomy.METHODS:This retrospective study included patients with an unclosed MH within 1–2wk after vitrectomy.Patients were divided into the vitrectomy,fluid-air exchange,and observation groups according to the secondary treatment.The anatomical outcomes and postoperative visual acuity were recorded.RESULTS:The analysis included 25 eyes in 25 patients(16 females)aged 37–74y(vitrectomy group,n=10;fluid-air exchange group,n=9;observation group,n=6).Closure rate after secondary treatment was 100%in the vitrectomy group,88.9%in the fluid-air exchange group and 33.3%in the observation group.Optical coherence tomography images obtained at the last follow-up revealed that continuity of the external limiting membrane(ELM)was significantly more common(P=0.004)in the fluid-air group(8/9 eyes,88.9%)than in the vitrectomy group(2/10 eyes,20.0%)and that macular morphology was better in the fluid-air group than in the vitrectomy group.No serious complications were observed after secondary treatment.CONCLUSION:Fluid-air exchange is an alternative option to repeat vitrectomy for patients with an unclosed MH after initial vitrectomy with elevated macular edge.
基金funded by Chinese NSFC(Grant Nos.:82373336,82303238,and U22A20311,Sichuan Science and Technology Department,China(GrantNos.:2024NSFSC1945,,and 2023NSFSC0667)the Third People's Hospital of Chengdu Clinical Research Program,China(Grant Nos.:CSY-YN-01-2023-013,CSYYN-01-2023-005,and CSY-YN-03-2024-003)+1 种基金Sichuan University“From O to 1”Innovative Research Project,China(Project No.:2023SCUH0024)Health Commission of Chengdu,China(Grant No.:2024291).
文摘Age-related macular degeneration(AMD)is a disease that affects the vision of elderly individuals worldwide.Although current therapeutics have shown effectiveness against AMD,some patients may remain unresponsive and continue to experience disease progression.Therefore,in-depth knowledge of the mechanism underlying AMD pathogenesis is urgently required to identify potential drug targets for AMD treatment.Recently,studies have suggested that dysfunction of mitochondria can lead to the aggregation of reactive oxygen species(ROS)and activation of the cyclic GMP-AMP synthase(cGAS)/stimulator of interferon genes(STING)innate immunity pathways,ultimately resulting in sterile inflammation and cell death in various cells,such as cardiomyocytes and macrophages.Therefore,combining strategies targeting mitochondrial dysfunction and inflammatory mediators may hold great potential in facilitating AMD management.Notably,emerging evidence indicates that natural products targeting mitochondrial quality control(MQC)and the cGAS/STING innate immunity pathways exhibit promise in treating AMD.Here,we summarize phytochemicals that could directly or indirectly influence the MQC and the cGAS/STING innate immunity pathways,as well as their interconnected mediators,which have the potential to mitigate oxidative stress and suppress excessive inflammatory responses,thereby hoping to offer new insights into therapeutic interventions for AMD treatment.
基金Supported by Ganzhou Science and Technology Bureau“Science and Technology+Healthcare”Leading Talent Project(No.GZ2024YLJ020)Jiangxi Provincial Department of Science and Technology Key Research and Development Plan Projects(No.20203BBGL73133)Jiangxi Province“ShuangQian Plan”Innovation Talents Project(No.S2021CQKJ2297).
文摘Macular pigment(MP)is a crucial pigment in the macular region.It plays an important role in filtering blue light,and exhibits anti-inflammatory and antioxidant properties.Macular pigment optical density(MPOD)is a key indicator for assessing the density of MP in the macular area and is closely associated with eye diseases,including age-related macular degeneration,diabetic retinopathy,and glaucoma.This review aims to explore the clinical significance of MPOD and its research value in ophthalmology and other medical fields.It summarizes the current MPOD measurement techniques,categorizing them into two main types(in vivo and in vitro),and discusses their respective advantages and limitations.Additionally,given the advancements in artificial intelligence(AI)and deep-learning technologies that offer new opportunities for improving MPOD assessment,this review analyzes the significant potential and future prospects of AI-based fundus image analysis in MPOD measurement.The goal of AI-based analysis is to provide faster and more accurate detection methods,thereby promoting further research and new clinical applications of MPOD in the field of ophthalmology.
