AIM:To compare the tear film quantity and stability parameters in keratoconus(KCN)and normal eyes using test breakup time(TBUT),noninvasive TBUT(NITBUT),and Schirmer test.METHODS:All participants(n=166),including pati...AIM:To compare the tear film quantity and stability parameters in keratoconus(KCN)and normal eyes using test breakup time(TBUT),noninvasive TBUT(NITBUT),and Schirmer test.METHODS:All participants(n=166),including patients with KCN and age-matched healthy individuals with normal corneas,were recruited from those referred to Farabi Eye Hospital,Iran,in 2023.To better account for genetic and environmental factors,the control group comprised healthy individuals who were relatives of KCN patients and had normal corneal topography.Tear quantity parameters were evaluated in the following order:NITBUT,TBUT,and Schirmer tests.RESULTS:The mean age of cases in KCN(61.7%males)and normal(63.5%males)participants was 27.54±5.44y(range 19 to 38)and 27.52±5.63y(range 20 to 38),respectively(P=0.976).NIBUT,TBUT,and Schirmer’s tests were significantly lower in KCN group compared to normal controls(all P<0.001).The mean difference for NIBUT was-7.81s(P<0.001),and for TBUT was-7.61s(P<0.001).Schirmer test values were also significantly lower in the KCN group,with a mean difference of-5.61 mm compared to normal people(P<0.001).CONCLUSION:Our findings demonstrate significant tear film impairment in KCN.The reductions in NIBUT,TBUT and Schirmer scores highlight an underlying tear film dysfunction in KCN that extends beyond the morphological changes of the cornea.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
AIM:To compare refractive error and angle of deviation in patients with basic esotropia and basic exotropia.METHODS:A retrospective review was conducted on the medical records of patients with basic-type strabismus.De...AIM:To compare refractive error and angle of deviation in patients with basic esotropia and basic exotropia.METHODS:A retrospective review was conducted on the medical records of patients with basic-type strabismus.Demographic data,refractive error,best-corrected distance visual acuity(BCVA),and the horizontal and vertical angle of deviation between basic esotropia and exotropia patients were compared.RESULTS:Among the 7129 patients(mean age 22.98±14.81y)evaluated,44.7%(3185 cases,54.9%male)exhibited basic-type esotropia,while 55.3%(3944 cases,53.9%male)presented with basic-type exotropia.Basic esotropia cases exhibited more hyperopic spherical equivalent measurements in both eyes(right:0.53±3.07 vs left:0.56±2.98 D)than those with basic exotropia(right eye:-0.33±2.84 vs left eye:-0.24±2.68 D,P<0.001 for both eyes).Patients with basic esotropia had significantly greater horizontal deviation angles(near:36.08±18.87 PD and far:35.56±18.75 PD)compared to those with basic exotropia(near:33.75±16.11 PD and far:33.26±15.90 PD,P<0.001).Conversely,patients with basic exotropia had slightly higher vertical deviation angles(near:1.67±5.80 PD and far:1.72±5.89 PD)compared to those with basic esotropia(near:1.12±4.57 PD and far:1.12±4.58 PD,P<0.001).Patients with basic esotropia underwent surgical intervention at younger ages compared to basic exotropia individuals(19.68±15.99 vs 25.66±13.20,P<0.001).CONCLUSION:Basic esotropia patients present more hyperopic refractive errors,better visual acuity,larger horizontal yet smaller vertical ocular misalignments,and tend to undergo strabismus surgery at younger ages relative to basic exotropia cases.展开更多
AIM:To compare objective dry retinoscopy and subjective refraction measurements in patients with mild keratoconus(KCN)and quantify any differences.METHODS:This cross-sectional study was done on 68 eyes of 68 patients ...AIM:To compare objective dry retinoscopy and subjective refraction measurements in patients with mild keratoconus(KCN)and quantify any differences.METHODS:This cross-sectional study was done on 68 eyes of 68 patients diagnosed with mild KCN.Objective dry retinoscopy using autorefractometer and subjective refraction measurements were performed.Sphere,cylinder,J0,J45,and spherical equivalent values were compared between the two techniques.RESULTS:The mean age of 68 patients with mild KCN was 21.32±5.03y(12–35y).There were 37(54.4%)males.Objective refraction yielded significantly more myopic sphere(-1.44 D vs-0.57 D),higher cylinder magnitude(-2.24 D vs-1.48 D),and more myopic spherical equivalent(-2.56 D vs-1.31 D)compared to subjective refraction(all P<0.05).The mean differences were-0.87 D for sphere,-0.76 D for cylinder,and-1.25 D for spherical equivalent.No significant differences were found for J0 and J45 values,indicating agreement in astigmatism axis(P>0.05).CONCLUSION:In patients with mild KCN,objective dry retinoscopy overestimates the degree of myopia and astigmatism compared to subjective refraction.The irregular cornea in KCN likely impacts objective measurements.Subjective refraction allows compensation for irregularity,providing a more accurate correction.When determining refractive targets,the tendency of objective methods to overcorrect should be considered.展开更多
AIM:To investigate the impact of multifocal gas permeable contact lens(MFGPCL)in various add power and distance/near area allocation on short-term changes of choroidal thickness(ChT),axial length(AL),and retinal defoc...AIM:To investigate the impact of multifocal gas permeable contact lens(MFGPCL)in various add power and distance/near area allocation on short-term changes of choroidal thickness(ChT),axial length(AL),and retinal defocus profile in young adults.METHODS:Seventeen young adults(2 males and 15 females;age 23.17±4.48y)were randomly assigned to wear two designs binocularly with a one-week washout period in between.Total of four MFGPCL designs were assessed.All designs were distance-center that varied in two add power(+1.50 and 3.00 D)and/or two distance zone(DZ)diameters(1.50 and 3.00 mm;design A:DZ 1.5/add 3.0,B:DZ 1.5/add 1.5,C:DZ 3.0/add 3.0,D:DZ 3.0/add 1.5).ChT,AL,and peripheral refraction data were collected on each subject at baseline,on days 1 and 7 of MFGPCL daily wear.ChT was assessed in four quadrants using a spectraldomain optical coherence tomography.RESULTS:AL was shortened by-26±44μm with lens C,-18±27μm with lens D,-13±29μm with lens A,and-8±30μm with lens B(all P<0.05).A significant overall increase in ChT was observed with all 4 designs(lens A:+6±6μm,B:+3±7μm,C:+8±7μm,and D:+8±7μm).Temporal and superior choroid exhibited more choroidal thickening associated with MFGPCL.All designs induced significant relative peripheral myopia(RPM)beyond the central 20o across the horizontal meridian in both nasal and temporal fields(P<0.05).CONCLUSION:MFGPCLs show a significant influence on ChT and AL,which are associated with significant increase in RPM after short-term wear.The reliability and feasibility of quantifying short-term changes in ChT support its use as a promising marker for the long-term efficacy of myopia-controlling treatments.展开更多
The neural retina is a part of the central nervous system.As it lacks regenerative capacity,in an event of injury or disease,neuronal loss leads to visual impairment and often to blindness.Moreover,Müller glia(MG...The neural retina is a part of the central nervous system.As it lacks regenerative capacity,in an event of injury or disease,neuronal loss leads to visual impairment and often to blindness.Moreover,Müller glia(MG),the predominant glia in the retina,undergo a variety of molecular and cellular changes and discontinue to carry out their important regular functions in the tissue(e.g.,maintaining tissue homeostasis and nurturing neurons).展开更多
AIM:To investigate the practice patterns of optometrists in Saudi Arabia regarding myopia management.METHODS:An internet-based survey was distributed to all practicing optometrists in Saudi Arabia(n=1886).The survey c...AIM:To investigate the practice patterns of optometrists in Saudi Arabia regarding myopia management.METHODS:An internet-based survey was distributed to all practicing optometrists in Saudi Arabia(n=1886).The survey contained questions related to 1)demographics,2)knowledge about myopia and its associated complications,3)current clinical care,4)type and frequency of myopia treatment prescribed,and 5)potential barriers limiting treatment adoption.RESULTS:The completed surveys were collected from 171 optometrists(9.06%response rate,60%male).Knowledge regarding myopia-associated complications was prevalent but somewhat inaccurate among the respondents.Cycloplegic refraction at initial visit was used by 59%of the respondents.The cover test was the most reported binocular vision test(83%),and 38%of optometrists did not perform any ocular biometrics.Twothirds prescribed single-vision spectacles for children with myopia.Increased time spent outdoors was selected by 80%of the practitioners who prescribed myopia control treatment as the primary approach.Insufficient support and lack of clinical experience in providing myopia treatment were reported as the most important factors limiting the adoption of myopia management strategies.CONCLUSION:The current optometric practices in Saudi Arabia require further investigation.Optometrists appear to be somewhat aware of myopia and the associated risks.However,most evidence-based myopia treatments are not being locally adopted,primarily because of lack of support,lack of experience,and limited availability.展开更多
AIM:To determine the choroidal thickness(CT)in young healthy Saudi adults using spectral-domain optical coherence tomography(SD-OCT)with an automated CT segmentation software.METHODS:Fifty-eight young adults(total of ...AIM:To determine the choroidal thickness(CT)in young healthy Saudi adults using spectral-domain optical coherence tomography(SD-OCT)with an automated CT segmentation software.METHODS:Fifty-eight young adults(total of 116 eyes),39 males and 19 females participated in this study between the ages of 18 and 38y(mean 22.65±3.9y).All participants underwent ophthalmic screening examination,including the SD-OCT for measurements of CT in each quadrant egmented into five eccentric regions starting from the foveal region up to 4.5 mm towards the periphery.RESULTS:The choroid was thickest in the foveal region(central 1 mm,300±60μm)and began to progressively thinner beyond the parafovea(1.5–2.5 mm,284±67μm)towards the peripheral region(3.5–4.5 mm from the fovea,254±83μm).The superior choroid showed the thickest profile(309±57μm),while the nasal choroid exhibited the thinnest(229±76μm).The rate of the thinning with increasing eccentricity was more predominant in the nasal choroid,which thinned from the foveal region(294±58μm)to the peripheral region(158±55μm).The superior and inferior choroid did not show a statistically significant thinning with eccentricity(all P>0.05).There was no statistically significant difference in the CT between gender,age,and laterality of the eyes(all P>0.05).A significant association of myopia with thinner subfoveal choroid was observed(Pearson’s,r=0.37),and regression analysis showed that a 10.3μm choroidal thinning for each diopter increase of myopia.CONCLUSION:CT profile depends on eccentric and the quadrant.The CT profile across the measured area in the young Saudi adult population is comparable to other previous reports.Refractive error is critical for CT evaluation.展开更多
Purpose:The use of colored filters is one recommended way for patients to reduce glare..This study assessed the effect of colored filters for reducing glare symptoms in post refractive surgery patients.Method:.Log MAR...Purpose:The use of colored filters is one recommended way for patients to reduce glare..This study assessed the effect of colored filters for reducing glare symptoms in post refractive surgery patients.Method:.Log MAR visual acuity was determined in 70 participants.(140 eyes).who had undergone PRK refractive surgery using three colored filters(Yellow,Green,and Red)in different light conditions.Results:.Measured visual acuity was significantly reduced with red and green filters in glare and nonglare conditions when compared to its measurement without a filter.An asymmetrical light condition also revealed a significant difference in the visual acuity of the right and left eye when compared to each other.However,no significant differences were observed for the yellow filter in either the measured visual acuity of each eye in both light conditions or of the right and left eyes compared to each other.Conclusion:Red and green filters are poor choices for reducing glare in post refractive surgery patients but a yellow filter could be used to decrease glare and improve acuity.展开更多
An approximate analytical solution in the form of a rapidly convergent series for tracing light rays through an inhomogeneous graded index medium is developed,using the multi-step differential transform method based o...An approximate analytical solution in the form of a rapidly convergent series for tracing light rays through an inhomogeneous graded index medium is developed,using the multi-step differential transform method based on the classical differential transformation method.Numerical results are compared to those obtained by the fourth-order Runge-Kutta method to illustrate the precision and effectiveness of the proposed method.Results are given in explicit and graphical forms.展开更多
Purpose:To establish whether the effect of improved glaucoma detection in the community suggested by an intervention study is maintained when intervention is extended to include all optometrists in the area.Methods:Op...Purpose:To establish whether the effect of improved glaucoma detection in the community suggested by an intervention study is maintained when intervention is extended to include all optometrists in the area.Methods:Optometrists’in the Ealing,Hammersmith,and Hounslow area were invited to ongoing training sessions following completion of an intervention study.The number of optometrist initiated referrals to Ealing Hospital Eye Clinic(EHEC)for suspect glaucoma was assessed over a 12-month period.The positive predictive value(PPV)of those referrals was calculated and a historical comparison made with the results of the original study.Results:A total of 376 new referrals for suspected glaucoma were assessed at EHEC during the 12-month period of data collection.This represents an increase in the number of referrals of 58% compared with an equivalent 12-month period during the initial intervention trial(376 vs 238).The PPV was maintained at 0.45(95% CI 0.41-0.51).Conclusion:The rising number of new referrals for glaucoma together with maintenance of the PPV suggests an impact on the number of new cases of glaucoma detected in the community.The increase in referral numbers was limited to glaucoma when compared with new referrals for cataract.This implies a targeted effect of the intervention in terms of glaucoma detection.We believe the next step is to perform the study in an alternative location to see if the effect is repeatable elsewhere.If proven to be the case,there is a coherent argument for widespread adoption of this strategy to improve glaucoma case finding.展开更多
AIM:To investigate the proliferation regulatory effect of cone-rod homeobox(CRX)in retinal pigment epithelium(RPE)and retinoblastoma(RB)cells to explore the potential application and side effect(oncogenic potential)of...AIM:To investigate the proliferation regulatory effect of cone-rod homeobox(CRX)in retinal pigment epithelium(RPE)and retinoblastoma(RB)cells to explore the potential application and side effect(oncogenic potential)of CRXbased gene therapy in RPE-based retinopathies.METHODS:Adult human retinal pigment epithelial(ARPE)-19 and human retinal pigment epithelial(RPE)-1 cells and Y79 RB cell were used in the study.Genetic manipulation was performed by lentivirus-based technology.The cell proliferation was determined by a CellTiter-Glo Reagent.The mRNA and protein levels were determined by quantitative real-time polymerase chain reaction(qPCR)and Western blot assay.The transcriptional activity of the promoter was determined by luciferase reporter gene assay.The bindings between CRX and transcription factor 7(TCF7)promoter as well as TCF7 and the promoters of TCF7 target genes were examined by chromatin immunoprecipitation(ChIP)assay.The transcription of the TCF7 was determined by a modified nuclear run-on assay.RESULTS:CRX overexpression and knockdown significantly increased(n=3,P<0.05 in all the cells)and decreased(n=3,P<0.01 in all the cells)the proliferation of RPE and RB cells.CRX overexpression and knockdown significantly increased and deceased the mRNA levels of Wnt signaling target genes[including MYC proto-oncogene(MYC),JUN,FOS like 1(FOSL1),CCND1,cyclin D2(CCND2),cyclin D3(CCND3),cellular communication network factor 4(CCN4),peroxisome proliferator activated receptor delta(PPARD),and matrix metallopeptidase 7(MMP7)]and the luciferase activity driven by the Wnt signaling transcription factor(TCF7).TCF7 overexpression and knockdown significantly increased and decreased the proliferation of RPE and RB cells and depletion of TCF7 significantly abolished the stimulatory effect of CRX on the proliferation of RPE and RB cells.CRX overexpression and knockdown significantly increased and decreased the mRNA level of TCF7 and the promoter of TCF7 was significantly immunoprecipitated by CRX antibody.CONCLUSION:CRX transcriptionally activates TCF7 to promote the proliferation of RPE and RB cells in vitro.CRX is a potential target for RPE-based regenerative medicine.The potential risk of this strategy,tumorigenic potential,should be considered.展开更多
Proliferative vitreoretinopathy(PVR)is a common cause of vision loss after retinal reattachment surgery and ocular trauma.The key pathogenic mechanisms of PVR development include the proliferation,migration and epithe...Proliferative vitreoretinopathy(PVR)is a common cause of vision loss after retinal reattachment surgery and ocular trauma.The key pathogenic mechanisms of PVR development include the proliferation,migration and epithelial-mesenchymal transition(EMT)of retinal pigment epithelial cells(RPEs)activated by the growth factors and cytokines after surgery.Although some drugs have been tried in PVR treatments as basic investigations,the limited efficacy remains an obstacle,which may be due to the single pharmacological action and lack of targeting.Herein,the anti-proliferative Daunorubicin and anti-inflammatory Dexamethasone were co-loaded in the RPEs-derived exosomes(Exos),obtaining an Exos-based dual drug-loaded nanocarrier(Exos@D-D),and used for multiple PVR therapy.Owing to the advantages of homologous Exos and the dual drug loading,Exos@D-D showed good RPEs targeting as well as improved uptake efficiency,and could inhibit the proliferation,migration,as well as EMT of RPEs effectively.The animal studies have also demonstrated that Exos@D-D effectively inhibits the production of proliferative membranes and prevents the further development of inflammation,shows significant therapeutic effects on PVR and good biocom-patibility.Such Exos-based dual drug-loaded nanocarrier investigation not only provides a promising approach for multifunctional exosome drug delivery systems construction,but also has great potential in PVR clinical therapy application.展开更多
Background:To identify biometric and implantable collamer lens(ICL)-related risk factors associated with suboptimal postoperative vault in eyes implanted with phakic ICL.Methods:This study reports a retrospective case...Background:To identify biometric and implantable collamer lens(ICL)-related risk factors associated with suboptimal postoperative vault in eyes implanted with phakic ICL.Methods:This study reports a retrospective case series of the first operated eye in 360 patients implanted with myopic spherical or toric ICL.Preoperatively,white-to-white(WTW),central keratometry(Kc)and central corneal thickness(CCT)were measured using the Pentacam.Anterior-segment optical coherence tomography(AS-OCT,Visante)was applied preoperatively for measuring the horizontal anterior-chamber angle-to-angle distance(ATA),internal anterior chamber depth(ACD),crystalline lens rise(CLR),anterior-chamber angle(ACA)and postoperatively the vault.Eyes were divided into three vault groups:low(LVG:≤250μm),optimal(OVG:>250 and<1000μm)and high(HVG:≥1000μm).Multinomial logistic regression(MLR)was used to find the sub-optimal vault predictors.Results:MLR showed that CLR,ICL size minus the ATA(ICL size-ATA),age,ICL spherical equivalent(ICLSE)and ICL size as contributing factors for sub-optimal vaults(pseudo-R2=0.40).Increased CLR(OR:1.01,CI:1.00-1.01)and less myopic ICLSE(OR:1.22,CI:1.07-1.40)were risk factors for low vaults.Larger ICL size-ATA(OR:41.29,CI:10.57-161.22)and the 13.7mm ICL(OR:7.08,CI:3.16-15.89)were risk factors for high vaults,whereas less myopic ICLSE(OR:0.85,CI:0.76-0.95)and older age(OR:0.92,CI:0.88-0.98)were protective factors.Conclusion:High CLR and low ICLSE were the major risk factors in eyes presenting low vaults.In the opposite direction,ICL size-ATA was the major contributor for high vaults.This relationship was more critical in higher myopic ICLSE,younger eyes and when 13.7mm ICL were used.The findings show that factors influencing the vault have differentiated weight of influence depending on the type of vault(low,optimal or high).展开更多
Background To identify biometric and implantable collamer lens(ICL)-related risk factors associated with sub-optimal postoperative vault in eyes implanted with phakic ICL.Methods This study reports a retrospective cas...Background To identify biometric and implantable collamer lens(ICL)-related risk factors associated with sub-optimal postoperative vault in eyes implanted with phakic ICL.Methods This study reports a retrospective case series of the first operated eye in 360 patients implanted with myopic spherical or toric ICL.Preoperatively,white-to-white(WTW),central keratometry(Kc)and central corneal thickness(CCT)were measured using the Pentacam.Anterior-segment optical coherence tomography(AS-OCT,Visante)was applied preoperatively for measuring the horizontal anterior-chamber angle-to-angle distance(ATA),internal anterior chamber depth(ACD),crystalline lens rise(CLR),anterior-chamber angle(ACA)and postoperatively the vault.Eyes were divided into three vault groups:low(LVG:≤250μm),optimal(OVG:>250 and<1000μm)and high(HVG:≥1000μm).Multinomial logistic regression(MLR)was used to find the sub-optimal vault predictors.Results MLR showed that CLR,ICL size minus the ATA(ICL size-ATA),age,ICL spherical equivalent(ICLSE)and ICL size as contributing factors for sub-optimal vaults(pseudo-R2=0.40).Increased CLR(OR:1.01,CI:1.00–1.01)and less myopic ICLSE(OR:1.22,CI:1.07–1.40)were risk factors for low vaults.Larger ICL size-ATA(OR:41.29,CI:10.57–161.22)and the 13.7 mm ICL(OR:7.08,CI:3.16–15.89)were risk factors for high vaults,whereas less myopic ICLSE(OR:0.85,CI:0.76–0.95)and older age(OR:0.92,CI:0.88–0.98)were protective factors.Conclusion High CLR and low ICLSE were the major risk factors in eyes presenting low vaults.In the opposite direction,ICL size-ATA was the major contributor for high vaults.This relationship was more critical in higher myopic ICLSE,younger eyes and when 13.7 mm ICL were used.The findings show that factors influencing the vault have differentiated weight of influence depending on the type of vault(low,optimal or high).展开更多
文摘AIM:To compare the tear film quantity and stability parameters in keratoconus(KCN)and normal eyes using test breakup time(TBUT),noninvasive TBUT(NITBUT),and Schirmer test.METHODS:All participants(n=166),including patients with KCN and age-matched healthy individuals with normal corneas,were recruited from those referred to Farabi Eye Hospital,Iran,in 2023.To better account for genetic and environmental factors,the control group comprised healthy individuals who were relatives of KCN patients and had normal corneal topography.Tear quantity parameters were evaluated in the following order:NITBUT,TBUT,and Schirmer tests.RESULTS:The mean age of cases in KCN(61.7%males)and normal(63.5%males)participants was 27.54±5.44y(range 19 to 38)and 27.52±5.63y(range 20 to 38),respectively(P=0.976).NIBUT,TBUT,and Schirmer’s tests were significantly lower in KCN group compared to normal controls(all P<0.001).The mean difference for NIBUT was-7.81s(P<0.001),and for TBUT was-7.61s(P<0.001).Schirmer test values were also significantly lower in the KCN group,with a mean difference of-5.61 mm compared to normal people(P<0.001).CONCLUSION:Our findings demonstrate significant tear film impairment in KCN.The reductions in NIBUT,TBUT and Schirmer scores highlight an underlying tear film dysfunction in KCN that extends beyond the morphological changes of the cornea.
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.
文摘AIM:To compare refractive error and angle of deviation in patients with basic esotropia and basic exotropia.METHODS:A retrospective review was conducted on the medical records of patients with basic-type strabismus.Demographic data,refractive error,best-corrected distance visual acuity(BCVA),and the horizontal and vertical angle of deviation between basic esotropia and exotropia patients were compared.RESULTS:Among the 7129 patients(mean age 22.98±14.81y)evaluated,44.7%(3185 cases,54.9%male)exhibited basic-type esotropia,while 55.3%(3944 cases,53.9%male)presented with basic-type exotropia.Basic esotropia cases exhibited more hyperopic spherical equivalent measurements in both eyes(right:0.53±3.07 vs left:0.56±2.98 D)than those with basic exotropia(right eye:-0.33±2.84 vs left eye:-0.24±2.68 D,P<0.001 for both eyes).Patients with basic esotropia had significantly greater horizontal deviation angles(near:36.08±18.87 PD and far:35.56±18.75 PD)compared to those with basic exotropia(near:33.75±16.11 PD and far:33.26±15.90 PD,P<0.001).Conversely,patients with basic exotropia had slightly higher vertical deviation angles(near:1.67±5.80 PD and far:1.72±5.89 PD)compared to those with basic esotropia(near:1.12±4.57 PD and far:1.12±4.58 PD,P<0.001).Patients with basic esotropia underwent surgical intervention at younger ages compared to basic exotropia individuals(19.68±15.99 vs 25.66±13.20,P<0.001).CONCLUSION:Basic esotropia patients present more hyperopic refractive errors,better visual acuity,larger horizontal yet smaller vertical ocular misalignments,and tend to undergo strabismus surgery at younger ages relative to basic exotropia cases.
文摘AIM:To compare objective dry retinoscopy and subjective refraction measurements in patients with mild keratoconus(KCN)and quantify any differences.METHODS:This cross-sectional study was done on 68 eyes of 68 patients diagnosed with mild KCN.Objective dry retinoscopy using autorefractometer and subjective refraction measurements were performed.Sphere,cylinder,J0,J45,and spherical equivalent values were compared between the two techniques.RESULTS:The mean age of 68 patients with mild KCN was 21.32±5.03y(12–35y).There were 37(54.4%)males.Objective refraction yielded significantly more myopic sphere(-1.44 D vs-0.57 D),higher cylinder magnitude(-2.24 D vs-1.48 D),and more myopic spherical equivalent(-2.56 D vs-1.31 D)compared to subjective refraction(all P<0.05).The mean differences were-0.87 D for sphere,-0.76 D for cylinder,and-1.25 D for spherical equivalent.No significant differences were found for J0 and J45 values,indicating agreement in astigmatism axis(P>0.05).CONCLUSION:In patients with mild KCN,objective dry retinoscopy overestimates the degree of myopia and astigmatism compared to subjective refraction.The irregular cornea in KCN likely impacts objective measurements.Subjective refraction allows compensation for irregularity,providing a more accurate correction.When determining refractive targets,the tendency of objective methods to overcorrect should be considered.
基金the Deputyship for Research and Innovation,Ministry of Education in Saudi Arabia for funding this research work through the project(No.IFKSUOR3-433-1)。
文摘AIM:To investigate the impact of multifocal gas permeable contact lens(MFGPCL)in various add power and distance/near area allocation on short-term changes of choroidal thickness(ChT),axial length(AL),and retinal defocus profile in young adults.METHODS:Seventeen young adults(2 males and 15 females;age 23.17±4.48y)were randomly assigned to wear two designs binocularly with a one-week washout period in between.Total of four MFGPCL designs were assessed.All designs were distance-center that varied in two add power(+1.50 and 3.00 D)and/or two distance zone(DZ)diameters(1.50 and 3.00 mm;design A:DZ 1.5/add 3.0,B:DZ 1.5/add 1.5,C:DZ 3.0/add 3.0,D:DZ 3.0/add 1.5).ChT,AL,and peripheral refraction data were collected on each subject at baseline,on days 1 and 7 of MFGPCL daily wear.ChT was assessed in four quadrants using a spectraldomain optical coherence tomography.RESULTS:AL was shortened by-26±44μm with lens C,-18±27μm with lens D,-13±29μm with lens A,and-8±30μm with lens B(all P<0.05).A significant overall increase in ChT was observed with all 4 designs(lens A:+6±6μm,B:+3±7μm,C:+8±7μm,and D:+8±7μm).Temporal and superior choroid exhibited more choroidal thickening associated with MFGPCL.All designs induced significant relative peripheral myopia(RPM)beyond the central 20o across the horizontal meridian in both nasal and temporal fields(P<0.05).CONCLUSION:MFGPCLs show a significant influence on ChT and AL,which are associated with significant increase in RPM after short-term wear.The reliability and feasibility of quantifying short-term changes in ChT support its use as a promising marker for the long-term efficacy of myopia-controlling treatments.
基金Financial support was received from SUNY Optometry Start-up FundsThe New York Empire Innovation Program Grant。
文摘The neural retina is a part of the central nervous system.As it lacks regenerative capacity,in an event of injury or disease,neuronal loss leads to visual impairment and often to blindness.Moreover,Müller glia(MG),the predominant glia in the retina,undergo a variety of molecular and cellular changes and discontinue to carry out their important regular functions in the tissue(e.g.,maintaining tissue homeostasis and nurturing neurons).
基金Deanship of Scientific Research,College of Applied Medical Sciences Research Center at King Saud University,for funding this work。
文摘AIM:To investigate the practice patterns of optometrists in Saudi Arabia regarding myopia management.METHODS:An internet-based survey was distributed to all practicing optometrists in Saudi Arabia(n=1886).The survey contained questions related to 1)demographics,2)knowledge about myopia and its associated complications,3)current clinical care,4)type and frequency of myopia treatment prescribed,and 5)potential barriers limiting treatment adoption.RESULTS:The completed surveys were collected from 171 optometrists(9.06%response rate,60%male).Knowledge regarding myopia-associated complications was prevalent but somewhat inaccurate among the respondents.Cycloplegic refraction at initial visit was used by 59%of the respondents.The cover test was the most reported binocular vision test(83%),and 38%of optometrists did not perform any ocular biometrics.Twothirds prescribed single-vision spectacles for children with myopia.Increased time spent outdoors was selected by 80%of the practitioners who prescribed myopia control treatment as the primary approach.Insufficient support and lack of clinical experience in providing myopia treatment were reported as the most important factors limiting the adoption of myopia management strategies.CONCLUSION:The current optometric practices in Saudi Arabia require further investigation.Optometrists appear to be somewhat aware of myopia and the associated risks.However,most evidence-based myopia treatments are not being locally adopted,primarily because of lack of support,lack of experience,and limited availability.
文摘AIM:To determine the choroidal thickness(CT)in young healthy Saudi adults using spectral-domain optical coherence tomography(SD-OCT)with an automated CT segmentation software.METHODS:Fifty-eight young adults(total of 116 eyes),39 males and 19 females participated in this study between the ages of 18 and 38y(mean 22.65±3.9y).All participants underwent ophthalmic screening examination,including the SD-OCT for measurements of CT in each quadrant egmented into five eccentric regions starting from the foveal region up to 4.5 mm towards the periphery.RESULTS:The choroid was thickest in the foveal region(central 1 mm,300±60μm)and began to progressively thinner beyond the parafovea(1.5–2.5 mm,284±67μm)towards the peripheral region(3.5–4.5 mm from the fovea,254±83μm).The superior choroid showed the thickest profile(309±57μm),while the nasal choroid exhibited the thinnest(229±76μm).The rate of the thinning with increasing eccentricity was more predominant in the nasal choroid,which thinned from the foveal region(294±58μm)to the peripheral region(158±55μm).The superior and inferior choroid did not show a statistically significant thinning with eccentricity(all P>0.05).There was no statistically significant difference in the CT between gender,age,and laterality of the eyes(all P>0.05).A significant association of myopia with thinner subfoveal choroid was observed(Pearson’s,r=0.37),and regression analysis showed that a 10.3μm choroidal thinning for each diopter increase of myopia.CONCLUSION:CT profile depends on eccentric and the quadrant.The CT profile across the measured area in the young Saudi adult population is comparable to other previous reports.Refractive error is critical for CT evaluation.
文摘Purpose:The use of colored filters is one recommended way for patients to reduce glare..This study assessed the effect of colored filters for reducing glare symptoms in post refractive surgery patients.Method:.Log MAR visual acuity was determined in 70 participants.(140 eyes).who had undergone PRK refractive surgery using three colored filters(Yellow,Green,and Red)in different light conditions.Results:.Measured visual acuity was significantly reduced with red and green filters in glare and nonglare conditions when compared to its measurement without a filter.An asymmetrical light condition also revealed a significant difference in the visual acuity of the right and left eye when compared to each other.However,no significant differences were observed for the yellow filter in either the measured visual acuity of each eye in both light conditions or of the right and left eyes compared to each other.Conclusion:Red and green filters are poor choices for reducing glare in post refractive surgery patients but a yellow filter could be used to decrease glare and improve acuity.
文摘An approximate analytical solution in the form of a rapidly convergent series for tracing light rays through an inhomogeneous graded index medium is developed,using the multi-step differential transform method based on the classical differential transformation method.Numerical results are compared to those obtained by the fourth-order Runge-Kutta method to illustrate the precision and effectiveness of the proposed method.Results are given in explicit and graphical forms.
文摘Purpose:To establish whether the effect of improved glaucoma detection in the community suggested by an intervention study is maintained when intervention is extended to include all optometrists in the area.Methods:Optometrists’in the Ealing,Hammersmith,and Hounslow area were invited to ongoing training sessions following completion of an intervention study.The number of optometrist initiated referrals to Ealing Hospital Eye Clinic(EHEC)for suspect glaucoma was assessed over a 12-month period.The positive predictive value(PPV)of those referrals was calculated and a historical comparison made with the results of the original study.Results:A total of 376 new referrals for suspected glaucoma were assessed at EHEC during the 12-month period of data collection.This represents an increase in the number of referrals of 58% compared with an equivalent 12-month period during the initial intervention trial(376 vs 238).The PPV was maintained at 0.45(95% CI 0.41-0.51).Conclusion:The rising number of new referrals for glaucoma together with maintenance of the PPV suggests an impact on the number of new cases of glaucoma detected in the community.The increase in referral numbers was limited to glaucoma when compared with new referrals for cataract.This implies a targeted effect of the intervention in terms of glaucoma detection.We believe the next step is to perform the study in an alternative location to see if the effect is repeatable elsewhere.If proven to be the case,there is a coherent argument for widespread adoption of this strategy to improve glaucoma case finding.
基金Supported by grants from the Zhejiang Medicine and Health Science and Technology Project(No.2018KY748)Ningbo Natural Science Foundation(No.2019A610352)+3 种基金Ningbo Major Scientific and Technological Research and“Unveiling and Commanding”Project(No.2021Z054)Chongqing Science&Technology Commission(No.CSTB2022NSCQ-MSX1413)Ningbo Clinical Research Center for Ophthalmology(No.2022L003)Ningbo Key Laboratory for Neuroretinopathy Medical Research,and the Project of NINGBO Leading Medical&Health Discipline(No.2016-S05).
文摘AIM:To investigate the proliferation regulatory effect of cone-rod homeobox(CRX)in retinal pigment epithelium(RPE)and retinoblastoma(RB)cells to explore the potential application and side effect(oncogenic potential)of CRXbased gene therapy in RPE-based retinopathies.METHODS:Adult human retinal pigment epithelial(ARPE)-19 and human retinal pigment epithelial(RPE)-1 cells and Y79 RB cell were used in the study.Genetic manipulation was performed by lentivirus-based technology.The cell proliferation was determined by a CellTiter-Glo Reagent.The mRNA and protein levels were determined by quantitative real-time polymerase chain reaction(qPCR)and Western blot assay.The transcriptional activity of the promoter was determined by luciferase reporter gene assay.The bindings between CRX and transcription factor 7(TCF7)promoter as well as TCF7 and the promoters of TCF7 target genes were examined by chromatin immunoprecipitation(ChIP)assay.The transcription of the TCF7 was determined by a modified nuclear run-on assay.RESULTS:CRX overexpression and knockdown significantly increased(n=3,P<0.05 in all the cells)and decreased(n=3,P<0.01 in all the cells)the proliferation of RPE and RB cells.CRX overexpression and knockdown significantly increased and deceased the mRNA levels of Wnt signaling target genes[including MYC proto-oncogene(MYC),JUN,FOS like 1(FOSL1),CCND1,cyclin D2(CCND2),cyclin D3(CCND3),cellular communication network factor 4(CCN4),peroxisome proliferator activated receptor delta(PPARD),and matrix metallopeptidase 7(MMP7)]and the luciferase activity driven by the Wnt signaling transcription factor(TCF7).TCF7 overexpression and knockdown significantly increased and decreased the proliferation of RPE and RB cells and depletion of TCF7 significantly abolished the stimulatory effect of CRX on the proliferation of RPE and RB cells.CRX overexpression and knockdown significantly increased and decreased the mRNA level of TCF7 and the promoter of TCF7 was significantly immunoprecipitated by CRX antibody.CONCLUSION:CRX transcriptionally activates TCF7 to promote the proliferation of RPE and RB cells in vitro.CRX is a potential target for RPE-based regenerative medicine.The potential risk of this strategy,tumorigenic potential,should be considered.
基金supported by the Zhejiang Provincial Natural Science Foundation[grant number LR23H180001]the Key Scientific and Technological Innovation Projects in Wenzhou[grant number ZY2021002].
文摘Proliferative vitreoretinopathy(PVR)is a common cause of vision loss after retinal reattachment surgery and ocular trauma.The key pathogenic mechanisms of PVR development include the proliferation,migration and epithelial-mesenchymal transition(EMT)of retinal pigment epithelial cells(RPEs)activated by the growth factors and cytokines after surgery.Although some drugs have been tried in PVR treatments as basic investigations,the limited efficacy remains an obstacle,which may be due to the single pharmacological action and lack of targeting.Herein,the anti-proliferative Daunorubicin and anti-inflammatory Dexamethasone were co-loaded in the RPEs-derived exosomes(Exos),obtaining an Exos-based dual drug-loaded nanocarrier(Exos@D-D),and used for multiple PVR therapy.Owing to the advantages of homologous Exos and the dual drug loading,Exos@D-D showed good RPEs targeting as well as improved uptake efficiency,and could inhibit the proliferation,migration,as well as EMT of RPEs effectively.The animal studies have also demonstrated that Exos@D-D effectively inhibits the production of proliferative membranes and prevents the further development of inflammation,shows significant therapeutic effects on PVR and good biocom-patibility.Such Exos-based dual drug-loaded nanocarrier investigation not only provides a promising approach for multifunctional exosome drug delivery systems construction,but also has great potential in PVR clinical therapy application.
文摘Background:To identify biometric and implantable collamer lens(ICL)-related risk factors associated with suboptimal postoperative vault in eyes implanted with phakic ICL.Methods:This study reports a retrospective case series of the first operated eye in 360 patients implanted with myopic spherical or toric ICL.Preoperatively,white-to-white(WTW),central keratometry(Kc)and central corneal thickness(CCT)were measured using the Pentacam.Anterior-segment optical coherence tomography(AS-OCT,Visante)was applied preoperatively for measuring the horizontal anterior-chamber angle-to-angle distance(ATA),internal anterior chamber depth(ACD),crystalline lens rise(CLR),anterior-chamber angle(ACA)and postoperatively the vault.Eyes were divided into three vault groups:low(LVG:≤250μm),optimal(OVG:>250 and<1000μm)and high(HVG:≥1000μm).Multinomial logistic regression(MLR)was used to find the sub-optimal vault predictors.Results:MLR showed that CLR,ICL size minus the ATA(ICL size-ATA),age,ICL spherical equivalent(ICLSE)and ICL size as contributing factors for sub-optimal vaults(pseudo-R2=0.40).Increased CLR(OR:1.01,CI:1.00-1.01)and less myopic ICLSE(OR:1.22,CI:1.07-1.40)were risk factors for low vaults.Larger ICL size-ATA(OR:41.29,CI:10.57-161.22)and the 13.7mm ICL(OR:7.08,CI:3.16-15.89)were risk factors for high vaults,whereas less myopic ICLSE(OR:0.85,CI:0.76-0.95)and older age(OR:0.92,CI:0.88-0.98)were protective factors.Conclusion:High CLR and low ICLSE were the major risk factors in eyes presenting low vaults.In the opposite direction,ICL size-ATA was the major contributor for high vaults.This relationship was more critical in higher myopic ICLSE,younger eyes and when 13.7mm ICL were used.The findings show that factors influencing the vault have differentiated weight of influence depending on the type of vault(low,optimal or high).
文摘Background To identify biometric and implantable collamer lens(ICL)-related risk factors associated with sub-optimal postoperative vault in eyes implanted with phakic ICL.Methods This study reports a retrospective case series of the first operated eye in 360 patients implanted with myopic spherical or toric ICL.Preoperatively,white-to-white(WTW),central keratometry(Kc)and central corneal thickness(CCT)were measured using the Pentacam.Anterior-segment optical coherence tomography(AS-OCT,Visante)was applied preoperatively for measuring the horizontal anterior-chamber angle-to-angle distance(ATA),internal anterior chamber depth(ACD),crystalline lens rise(CLR),anterior-chamber angle(ACA)and postoperatively the vault.Eyes were divided into three vault groups:low(LVG:≤250μm),optimal(OVG:>250 and<1000μm)and high(HVG:≥1000μm).Multinomial logistic regression(MLR)was used to find the sub-optimal vault predictors.Results MLR showed that CLR,ICL size minus the ATA(ICL size-ATA),age,ICL spherical equivalent(ICLSE)and ICL size as contributing factors for sub-optimal vaults(pseudo-R2=0.40).Increased CLR(OR:1.01,CI:1.00–1.01)and less myopic ICLSE(OR:1.22,CI:1.07–1.40)were risk factors for low vaults.Larger ICL size-ATA(OR:41.29,CI:10.57–161.22)and the 13.7 mm ICL(OR:7.08,CI:3.16–15.89)were risk factors for high vaults,whereas less myopic ICLSE(OR:0.85,CI:0.76–0.95)and older age(OR:0.92,CI:0.88–0.98)were protective factors.Conclusion High CLR and low ICLSE were the major risk factors in eyes presenting low vaults.In the opposite direction,ICL size-ATA was the major contributor for high vaults.This relationship was more critical in higher myopic ICLSE,younger eyes and when 13.7 mm ICL were used.The findings show that factors influencing the vault have differentiated weight of influence depending on the type of vault(low,optimal or high).
