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PURPOSE To evaluate iris volume before and after pupil dilation using swept-source anterior segment optical coherence tomography (SS-ASOCT) and investigate the associated factors of iris volume and iris volume change after pupil dilation in patients with type 2 diabetes mellitus (T2DM). METHODS A cross-sectional study was conducted in Zhongshan Ophthalmic Center among T2DM registered patients in the community of Guangzhou, China. Anterior chamber volume (ACV), iris volume, anterior chamber depth (ACD), angle opening distance at 500 μm (AOD 500) and pupil diameter were estimated using SS-ASOCT (CASIA; Tomey, Nagoya, Japan). Venous blood was taken for the measurement of glycosylated haemoglobin A1c (HbAlc). All biometric measurements were performed before and after pharmacologic pupil dilation. RESULTS A total of 117 subjects were included in the analysis. The mean age (±SD) was 64.96 ± 7.75 years, and 62.4% were females. After pupil dilation, iris volume decreased in all eyes. Shorter duration of diabetes (p = 0.035), longer axial length (p

Purpose To assess the efficacy and safety of different regimens, including monotherapy and double therapy, for primary open-angle glaucoma (POAG) or ocular hypertension. Methods We searched PubMed, EMBASE and clinicaltrials.gov for studies that fit our inclusion criteria in this network meta-analysis. Randomized controlled trials that report data on efficacy and safety of medications for POAG or ocular hypertension are included. Data on intra-ocular pressure (IOP) lowering effect and incidence of adverse events including hyperaemia and ocular discomfort were extracted and used in mixed-comparison analysis. Results This study includes 72 randomized trials. Data were available on 12 medical treatments of POAG or ocular hypertension. Of 66 possible comparisons of outcome efficacy, 15 treatments were compared directly. Compared to prostaglandin analogues (PGA), beta-blockers (BB) showed relatively weaker ability to lower IOP, followed by α2-adrenergic agonists (AA) and carbonic anhydrase inhibitors (CAI). For dual therapy, regimens composed of a combination of PGA with another treatment demonstrated more powerful IOP lowering efficacy, while the combination of two non-PGA drugs had lower efficacy in controlling IOP than PGA alone. There was no statistical significance in combinations that did not include PGA on efficacy of IOP control. In terms of tolerance, PGA alone leads to more severe hyperaemia than any other monotherapy regimen, while BBs have the lowest effect on the incidence of hyperaemia. Most dual therapy regimens containing PGA also lead to serious hyperaemia, with the exception of PGA + AA. Compared to regimens containing PGA, those with BB are less likely to cause hyperaemia. Conclusion Our network meta-analysis showed that PGAs provide best IOP lowering effect among all the monotherapy regimen. Combination of PGA and other category of drugs leads to better IOP decrease. Combination of BB and another non-PGA drug may have less ocular side-effects than PGA alone.

Purpose To analyse miRNA regulation in a rat model of acute ocular hypertension (AOH). Methods Acute ocular hypertension (AOH) was induced in the left eye of adult albino rats by inserting a cannula connected with a saline container into the anterior chamber. The contralateral eye served as a control. Seven days later, animals were killed. Retinas were used either for quantitative analysis of retinal ganglion cells (RGCs) and microglial cells or for miRNA array hybridization, qRT-PCR and Western blotting. Results Anatomically, AOH caused axonal degeneration, a significant loss of RGCs and a significant increase in microglial cells in the ganglion cell layer. The miRNAs microarray analysis revealed 31 differentially expressed miRNAs in the AOH versus control group, and the regulation of 12 selected microRNAs was further confirmed by qRT-PCR. Bioinformatic analysis indicates that several signalling pathways are putatively regulated by the validated miRNAs. Of particular interest was the inflammatory pathway signalled by mitogen-activated protein kinases (MAPKs). In agreement with the in silico analysis, p38 MAP kinase, tumour necrosis factor-alpha (TNF-α) and iNOS proteins were significantly upregulated in the AOH retinas. Conclusions Acute IOP elevation led to changes in the expression of miRNAs, whose target genes were associated with the regulation of microglia-mediated neuroinflammation or neural apoptosis. Addressing miRNAs in the process of retinal ischaemia and optic nerve damage in association with high IOP elevation may open new avenues in preventing retinal ganglion cell apoptosis and may serve as target for future therapeutic regimen in acute ocular hypertension and retinal ischaemic conditions.

This study aimed to evaluate the angiogenesis-related factors of the vascular endothelial growth factor (VEGF) family in the aqueous humour of patients with neovascular glaucoma (NVG).This study involved 22 eyes of 22 patients with advanced NVG requiring antiglaucomatous surgery and 20 control subjects with cataracts. The NVG eyes received an intravitreal injection of ranibizumab (IVR) treatment before antiglaucomatous surgery. Aqueous humour and blood were collected at the time of IVR and cataract surgery. Protein concentration of VEGF-A, VEGF-B and placenta growth factor (PlGF) in aqueous humour and plasma was determined by ELISA tests.The mean concentration (standard deviation) of VEGF-A and PlGF in the aqueous humour of patients with NVG were 3037 (2387) pg/ml and 1078 (712) pg/ml, respectively; both were significantly higher than the control group (both p0.001). However, levels of VEGF-A and PlGF in the serum of NVG and control subjects remained low. High concentrations of VEGF-A were closely correlated with high levels of PlGF in patients with NVG (r = 0.593, p = 0.004). Concentrations of VEGF-B in aqueous humour and serum remained unchanged (p0.05).There were high concentrations of angiogenesis factors of the VEGF family, with the exception of VEGF-B, in the aqueous humour of patients with NVG, and there was a positive correlation between VEGF-A and PlGF. High PlGF levels in patients with NVG may provide another potential target for treatment of NVG.

Purpose To compare the concentrations of chemokine (C-C motif) ligand 2 (CCL2) and chemokine (C-C motif) ligand 7 (CCL7) in aqueous humour of eyes with acute primary angle-closure (APAC), primary angle-closure glaucoma (PACG) or with age-related cataract. Methods The prospective investigation included a study group of 56 patients (24 patients with APAC; 32 patients with PACG) undergoing glaucoma surgery and a control group of 21 patients undergoing routine cataract surgery. The interval between glaucoma attack and trabeculectomy was 19.4 ± 9.8 days. Results The concentrations of CCL2 (3037 ± 501 versus 1127 ± 141 pg/ml; p = 0.003) and CCL7 (10.5 ± 2.4 versus 2.8 ± 0.4 pg/ml; p

Purpose Acute elevation of intraocular pressure (IOP) in acute primary angle closure (APAC) can cause huge damage to the variable cells in the eye; however, the mechanisms that connect the two processes still remain unclear. In this study, we aim to evaluate the levels of soluble CD44 (sCD44) and vascular endothelial growth factor (VEGF) in the aqueous humour of acute primary angle closure patients. Methods This study included 24 eyes of 24 APAC patients (11 eyes with current APAC and 13 eyes with previous APAC) and 15 eyes of 15 cataract subjects. Clinical data were acquired, and aqueous humour was collected. The levels of sCD44 and VEGF in the aqueous humour were determined by ELISA and magnetic bead immunoassay technique. Results The concentrations of the sCD44 and VEGF in the current APAC were 9.9 ± 8.8 ng/ml and 2440.2 ± 2107.1 ng/ml, respectively, which were significantly higher when compared to the previous APAC group (p = 0.001) and cataract (p

Purpose To investigate whether increased choroidal thickness is a risk factor for primary angle closure. Methods The study consisted of 162 patients with primary angle-closure (primary angle-closure suspect [PACS], 73 eyes; primary angle closure [PAC], 33 eyes; and primary angle-closure glaucoma [PACG], 56 eyes) and 87 healthy controls with no ophthalmic symptoms. EDI-OCT was used to measure and to compare the macular choroidal thickness between the primary angle-closure and normal eyes. The association between the choroidal thickness and the presence of primary angle closure was evaluated using logistic regression models to determine the odds ratio. Results The primary angle-closure eyes had a thicker choroid than the control eyes at all macular locations (all p

Purpose To compare the choroidal thickness (CT) in eyes with moderate and severe primary angle-closure glaucoma (PACG) with the eyes of healthy controls. Methods Fifty-nine patients (59 eyes) with PACG and 56 age-matched normal subjects underwent macular CT scanning using enhanced depth imaging–optical coherence tomography. The subjects with PACG were further classified as having moderate [−12 dB ≤ visual field mean deviation (VF-MD) ≤ −6 dB] or severe (VF-MD 0.05). Factors associated with a thinner choroid were ageing (p

Purpose To evaluate the effect of intravitreal triamcinolone acetonide (TA) on the activation of retinal microglia cells (RMGCs) and survival of retinal ganglion cells (RGCs) in an optic nerve crush (ONC) model. Methods Adult female Sprague–Dawley rats underwent a standardized ONC and either received an intravitreal injection of TA (TA group) or of phosphate-buffered saline (PBS, PBS group) in the right eyes. At 1, 3, 7, 14 and 28 days after the ONC, the animals were killed. The retinas were examined by immunohistochemistry, light microscopy, Western blot or retrograde labelling of RGCs by fluorogold injected into the superior colliculi. Results The TA group as compared to the PBS control group showed a significantly (p

Purpose To measure the levels of vascular endothelial growth factor (VEGF) in aqueous humor in patients with unilateral acute primary angle closure (APAC) and retinal oxygen saturation (SO2) after trabeculectomy. Methods Twelve patients, with unilateral trabeculectomy-required APAC, were recruited as the study group. Aqueous humor samples were collected prospectively for every subject. VEGF concentrations were analysed via enzyme-linked immunosorbent assay (ELISA), and retinal SO2 was measured using oximeter (Reykjavik, Iceland) at 1 month after trabeculectomy. Results In the APAC eyes, the mean aqueous humor concentration of VEGF was 388.4 ± 260.1 pg/ml and positively correlated with preoperative intraocular pressure (ρ = 0.658, p = 0.020). In the normal controls, the mean SO2 levels in the larger arterioles and venules were 93.0 ± 5.9% and 59.5 ± 5.4% and the arteriovenous [A-V] difference was 33.5 ± 6.3%. In the study group, the arteriolar SO2 at 1 month after surgery (97.6 ± 19.4%, p = 0.147) did not differ significantly from the values in the control group. However, the mean venular SO2 was significantly lower than the control eyes (50.0 ± 9.1% versus 59.5 ± 5.4%, p = 0.004), and a remarkable increased A-V difference (47.6 ± 22.7% versus 33.5 ± 6.3%) was found in the APAC eyes (p = 0.037). Conclusions Lower venular SO2 and increased A-V difference existed in the APAC eyes after surgery, and it is possible that the saturation was even lower during the attack. Together with the elevated VEGF concentrations in aqueous humor, these provided indirect evidence that ocular hypoxia was constantly present during APAC attack.