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Objective This study investigated the role of latent-transforming growth factor β-binding protein 2 (LTBP-2) in primary angle-closure glaucoma (PACG) by analysing its expression and the ultrastructure of the anterior lens capsule in PACG patients with age-related cataract (ARC).Methods Tissue samples of the anterior lens capsule were collected from patients undergoing cataract phacoemulsification surgery. Patients in the experimental group were diagnosed with primary angle-closure (PAC) combined with ARC (PAC+ARC) and PACG combined with ARC (PACG+ARC). The control group consisted of patients with only ARC. The techniques used included scanning electron microscopy, real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), western blotting and immunofluorescence.Results Ultrastructural analysis revealed disordered connections in PAC+ARC, loose connections in PACG+ARC and well-ordered connections in ARC. RT-qPCR and western blotting showed significantly lower LTBP-2 mRNA and protein expression in PAC+ARC and PACG+ARC than in ARC, with PAC+ARC having the lowest levels. Immunofluorescence confirmed these findings, showing varying LTBP-2 fluorescence intensities across groups.Conclusion The study identified ultrastructural changes in the anterior lens capsules in PACG accompanied by reduced LTBP-2 expression, especially in PAC+ARC patients. This suggests a potential role for LTBP-2 in PACG development, warranting further investigation.

BackgroundLarge-scale prospective cohort studies on diabetic foot ulcers risk factor screening in China are limited. Therefore, this prospective cohort study aimed to explore the predictive risk factors for diabetic foot ulcers to provide clinicians with concise and effective clinical indicators for identifying a high-risk diabetic foot and guiding the prevention of diabetic foot ulcers.MethodsPatients with diabetes who visited the Department of Endocrinology of Peking University First Hospital from October 2017 to December 2018 were selected as research participants by convenience sampling. A total of 968 patients were included. After enrollment, a dedicated person collected and recorded all baseline data. A dedicated telephone follow-up was conducted every 12–24 months to evaluate whether the endpoint event had occurred. All patients were followed up for an average of 61 (57–71) months, with 95% of them followed up for more than 60 months. According to the occurrence of endpoint events, they were divided into the DFU and non-DFU groups. The data between the two groups were analyzed using independent-sample t-test, Wilcoxon rank sum test, and chi square test. We used univariate and multivariate logistic regression analysis to analyze the factors that affected the occurrence of diabetic foot ulcers.Results and conclusionsAfter the 5-year follow-up, the incidence of diabetic foot was 25.83%. Multivariate logistic regression analysis revealed that body mass index (odds ratio: 1.046; 95% confidence interval: 1.001–1.093), abnormal pinprick sensation (odds ratio: 4.138; 95% confidence interval: 1.292–13.255), history of fungal foot infection (odds ratio: 2.287; 95% confidence interval: 1.517–3.448), abnormal 128-Hz tuning fork test (odds ratio: 2.628; 95% confidence interval: 1.098–6.294), and HbA1c≥ 8% (odds ratio: 1.522; 95% confidence interval: 1.014–2.284) were independent predictors of diabetic foot. Our study highlights clinically relevant indicators that may help to prevent the occurrence of diabetic foot and guide timely interventions.

Citrus spp. represent an economically important fruit tree crop worldwide. However, molecular mechanisms underlying the interaction between citrus and the Colletotrichum gloeosporioides remain largely unexplored. In this study, we analyzed the physiological and transcriptomic changes in Citrus sinensis at different stages of incubation with C. gloeosporioides. The results indicated that C. gloeosporioides infection rapidly triggered necrosis in the epicarp of C. sinensis fruits, decreased the total flavonoid contents, and suppressed the activity of catalase, peroxidase, and superoxide dismutase enzymes. Upon inoculation with C. gloeosporioides, there were 4600 differentially expressed genes (DEGs) with 1754 down-regulated and 2846 up-regulated after six hours, while there were only 580 DEGs with 185 down-regulated and 395 up-regulated between six and twelve-hours post-inoculation. Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes enrichment analysis indicated that the DEGs, which exhibited consistent up-regulation, were associated with metabolic processes and stress responses. Through Weighted Gene Co-Expression Network Analysis, 11 key genes have been identified that could potentially play a role in the transcriptional regulation of this process, including the transcription factor bHLH189. Furthermore, the infection of C. gloeosporioides had a notable effect on both the flavonoid metabolism and the metabolic pathways related to reactive oxygen species. Our findings help to understand the interaction between citrus and C. gloeosporioides and unveil how new insights into how C. gloeosporioides circumvents citrus defense mechanisms.

Dry age-related macular degeneration (AMD) is one of the main diseases that causes blindness in humans, and the number of cases is increasing yearly. However, effective treatments are unavailable, and arbutin (ARB) has been reported to have antioxidant, anti-inflammatory, and anti-aging effects in other age-related diseases. However, whether ARB can be used to treat dry AMD remains unknown. To explore the therapeutic potential and molecular mechanism of arbutin in the treatment of dry AMD. MTT assays, reactive oxygen species (ROS) production assays, flow cytometry assays, qPCR and western blotting were used to assess the impact of ARB on human RPECs induced by H2O2. A transcriptome sequencing assay was used to further explore how ARB acts on human RPECs treated with H2O2. Hematoxylin and eosin (H&E) staining and total antioxidant capacity (T-AOC) assays were used to observe the impact of ARB on mouse retina induced by sodium iodate. ARB counteracted the H2O2-induced reduction in human RPECs viability, ARB reversed H2O2-induced cellular ROS production by increasing the expression of antioxidant-related genes and proteins, ARB also reversed H2O2-induced cell apoptosis by altering the expression of apoptosis-related genes and proteins. Transcriptome sequencing and western blotting showed that ARB reduced ERK1/2 and P-38 phosphorylation to prevent H2O2-induced oxidation damage. The in vivo experiments demonstrated that ARB protected against retinal morphology injury in mice, increased serum T-AOC levels and increased antioxidant oxidase gene expression levels in the mouse retina induced by sodium iodate. We concluded that ARB reversed the H2O2-induced decrease in human RPECs viability through the inhibition of ROS production and apoptosis. The ERK1/2 and P38 MAPK signaling pathways may mediate this process. ARB maintained retinal morphology, increased serum T-AOC level and improved the expression of antioxidant oxidase genes in mice.

Abstract As of 2021, over 2.8 million small-incision lenticule extraction (SMILE) procedures have been performed in China. However, knowledge regarding the selection of intraocular lens (IOL) power calculation formula for post-SMILE cataract patients remains limited. This study included 52 eyes of 26 myopic patients from northern China who underwent SMILE at Tianjin Eye Hospital from September 2022 to February 2023 to investigate the suitability of multiple IOL calculation formulas in post-SMILE patients using a theoretical surgical model. We compared the postoperative results obtained from three artificial intelligence (AI)-based formulas and six conventional formulas provided by the American Society of Cataract and Refractive Surgery (ASCRS). These formulas were applied to calculate IOL power using both total keratometry (TK) and keratometry (K) values, and the results were compared to the preoperative results obtained from the Barrett Universal II (BUII) formula for the SMILE patients. Among the evaluated formulas, the results obtained from the Emmetropia Verifying Optical 2.0 Formula with TK (EVO-TK) (0.40 ± 0.29 D, range 0–1.23 D), Barrett True K with K formula (BTK-K, 0.41 ± 0.26 D, range 0.01–1.19 D), and Masket with K formula (Masket-K, 0.44 ± 0.33 D, range 0.02–1.39 D) demonstrated the closest proximity to BUII. Notably, the highest proportion of prediction errors within 0.5 D was observed with the BTK-K (71.15%), EVO-TK (69.23%), and Masket-K (67.31%), with the BTK-K showing a significantly higher proportion than the Masket-K (p

Abstract Background As the two most prevalent refractive surgeries in China, there is a substantial number of patients who have undergone Femtosecond Laser-assisted In Situ Keratomileusis (FS-LASIK) and Small Incision Lenticule Extraction (SMILE) procedures. However, there is still limited knowledge regarding the selection of intraocular lens (IOL) power calculation formulas for these patients with a history of FS-LASIK or SMILE. Methods A total of 100 eyes from 50 postoperative refractive surgery patients were included in this prospective cohort study, with 25 individuals (50 eyes) having undergone FS-LASIK and 25 individuals (50 eyes) having undergone SMILE. We utilized a theoretical surgical model to simulate the IOL implantation process in postoperative FS-LASIK and SMILE patients. Subsequently, we performed comprehensive biological measurements both before and after the surgeries, encompassing demographic information, corneal biometric parameters, and axial length. Various formulas, including the Barrett Universal II (BUII) formula, as a baseline, were employed to calculate IOL power for the patients. Results The Barrett True K (BTK) formula, demonstrated an mean absolute error (AE) within 0.5 D for both FS-LASIK and SMILE groups (0.28 ± 0.25 D and 0.36 ± 0.24 D, respectively). Notably, the FS-LASIK group showed 82% of results differing by less than 0.25 D compared to preoperative BUII results. The Barrett True K No History (BTKNH) formula, which also incorporates measured posterior corneal curvature, performed similarly to BTK in both groups. Additionally, the Masket formula, relying on refractive changes based on empirical experience, displayed promising potential for IOL calculations in SMILE patients compared with BTK (p = 0.411). Conclusion The study reveals the accuracy and stability of the BTK and BTKNH formulas for IOL power calculations in myopic FS-LASIK/SMILE patients. Moreover, the Masket formula shows encouraging results in SMILE patients. These findings contribute to enhancing the predictability and success of IOL power calculations in patients with a history of refractive surgery, providing valuable insights for clinical practice. Further research and larger sample sizes are warranted to validate and optimize the identified formulas for better patient outcomes.

Abstract Background Arginase-1 (ARG1) promotes collagen synthesis and cell proliferation. ARG1 is highly expressed in various tumour cells. The mechanisms of ARG1 in epithelial-to-mesenchymal transition (EMT)-associated cataracts were studied herein. Methods C57BL/6 mice, a human lens epithelial cell line (HLEC-SRA01/04), and human lens capsule samples were used in this study. The right lens anterior capsule of the mouse eye was punctured through the central cornea with a 26-gauge hypodermic needle. Human lens epithelial cells (HLECs) were transfected with ARG1-targeted (siARG1) or negative control siRNA (siNC). For gene overexpression, HLECs were transfected with a plasmid bearing the ARG1 coding sequence or an empty vector. Medium containing 0.2% serum with or without transforming growth factor beta-2 (TGF-β2) was added for 6 or 24 h to detect mRNA or protein, respectively. The expression of related genes was measured by quantitative real-time polymerase chain reaction (RT–qPCR), western blotting, and immunohistochemical staining. Transwell assays and wound healing assays were used to determine cell migration. Cell proliferation, superoxide levels, nitric oxide (NO) levels, and arginase activity were estimated using Cell Counting Kit-8 assays, a superoxide assay kit, an NO assay kit, and an arginase activity kit. Results ARG1, alpha-smooth muscle actin (α-SMA), fibronectin, and Ki67 expression increased after lens capsular injury, while zonula occludens-1 (ZO-1) expression decreased. Fibronectin and collagen type I alpha1 chain (collagen 1A1) expression increased, and cell migration increased significantly in ARG1-overexpressing HLECs compared with those transfected with an empty vector after TGF-β2 treatment. These effects were reversed by ARG1 knockdown. The arginase-related pathway plays an important role in EMT. mRNAs of enzymes of the arginase-related pathway were highly expressed after ARG1 overexpression. ARG1 knockdown suppressed these expression changes. Numidargistat (CB-1158) dihydrochloride (CB-1158), an ARG1 inhibitor, suppressed TGF-β2-induced anterior subcapsular cataract (ASC) by reducing the proliferation of lens epithelial cells (LECs) and decreasing fibronectin, α-SMA, collagen 1A1, and vimentin expression. Compared with that in nonanterior subcapsular cataract (non-ASC) patients, the expression of ARG1, collagen 1A1, vimentin, fibronectin, and Ki67 was markedly increased in ASC patients. Conclusions ARG1 can regulate EMT in EMT-associated cataracts. Based on the pathogenesis of ASC, these findings are expected to provide new therapeutic strategies for patients. Graphical abstract

Abstract Purpose To compare morphological changes in the anterior capsule of two intraocular lenses (IOLs) with different anterior edge designs 6 months after femtosecond laser-assisted capsulotomy surgery (FLACs). Methods This study included 168 eyes from168 patients undergoing FLACs. Group A included 74 eyes from 74 patients who had an Acrysof IQ Restor SN6AD3 IOL implantation with a flat anterior edge and Group B included 94 eyes of 94 patients with a TECNIS Multifocal ZMB00 IOL implantation and a "peak-like" anterior edge. All patients were followed up for 6 months. We assessed anterior capsule morphological changes including variation of anterior opening diameters and lens epithelial cell (LEC) proliferation in four directions, variation of anterior opening area, and the level of anterior capsule opacification (ACO). Results Variation of anterior opening diameters in 4 directions were significantly lower in Group B (P

Abstract Background Apoptosis signal-regulating kinase 1-interacting protein 1 (AIP1) participates in inflammatory neovascularization induction. NADPH oxidase 4 (NOX4) produces reactive oxygen species (ROS), leading to an imbalance in nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) and NLR family pyrin domain containing 6 (NLRP6) expression. The mechanisms of AIP1, NOX4, ROS and inflammasomes in corneal neovascularization were studied herein. Methods C57BL/6 and AIP1-knockout mice were used in this study. The alkali burn procedure was performed on the right eye. Adenovirus encoding AIP1 plus green fluorescence protein (GFP) (Ad-AIP1-GFP) or GFP alone was injected into the right anterior chamber, GLX351322 was applied as a NOX4 inhibitor, and then corneal neovascularization was scored. The expression of related genes was measured by quantitative real-time polymerase chain reaction, western blotting and immunofluorescence staining. 2′,7′-Dichlorofluorescin diacetate staining was used to determine the ROS levels. Results The expression of AIP1 was decreased, while that of cleaved interleukin-1β (clv-IL-1β) and vascular endothelial growth factor A (VEGFa) was increased after alkali burn injury. NOX4 expression was increased, the imbalance in NLRP3/NLRP6 was exacerbated, and corneal neovascularization was increased significantly in AIP1-knockout mice compared with those in C57BL/6 mice after alkali burns. These effects were reversed by AIP1 overexpression. NLRP3/NLRP6 expression was imbalanced after alkali burns. GLX351322 reversed the imbalance in NLRP3/NLRP6 by reducing the ROS levels. This treatment also reduced the expression of clv-IL-1β and VEGFa, suppressing neovascularization. Conclusions AIP1 and NOX4 can regulate corneal inflammation and neovascularization after alkali burn injury. Based on the pathogenesis of corneal neovascularization, these findings are expected to provide new therapeutic strategies for patients. Plain English summary Corneal alkali burn injury is a common type of ocular injury that is difficult to treat in the clinic. The cornea is a clear and avascular tissue. Corneal neovascularization after alkali burn injury is a serious complication; it not only seriously affects the patient’s vision but also is the main reason for failed corneal transplantation. Corneal neovascularization affects approximately 1.4 million patients a year. We show for the first time that AIP1 and NOX4 can regulate corneal inflammation and neovascularization after alkali burns. The expression of AIP1 was decreased, while that of clv-IL-1β and VEGFa was increased after alkali burns. We tried to elucidate the specific molecular mechanisms by which AIP1 regulates corneal neovascularization. NOX4 activation was due to decreased AIP1 expression in murine corneas with alkali burns. NOX4 expression was increased, the imbalance in NLRP3/NLRP6 was exacerbated, and corneal neovascularization was increased significantly in AIP1-knockout mice compared with those in C57BL/6 mice after alkali burns. These effects were reversed by AIP1 overexpression. Additionally, NLRP3/NLRP6 expression was unbalanced, with NLRP3 activation and NLRP6 suppression in the corneal alkali burn murine model. Eye drops containing GLX351322, a NOX4 inhibitor, reversed the imbalance in NLRP3/NLRP6 by reducing ROS expression. This treatment also reduced the expression of clv-IL-1β and VEGFa, reducing neovascularization. Therefore, we provide new gene therapeutic strategies for patients. With the development of neovascularization therapy, we believe that in addition to corneal transplantation, new drug or gene therapies can achieve better results. Video Abstract

Abstract Background To compare the accuracy of low-frequency ultrasound biomicroscopy (LFUBM) and 14-MHz ultrasonography with tissue harmonic imaging (14-MHz + THI) in the assessment of posterior capsule (PC) integrity in patients with traumatic cataracts (TCs). Methods From January 2019 to October 2020, 51 patients (51 eyes) with TCs who were scheduled for cataract extraction and for whom the PC of the lens could not be observed by the slit lamp visited Tianjin Eye Hospital, including 47 patients (47 eyes) with a penetrating injury of the eyeball and 4 patients (4 eyes) with a blunt injury of the eyeball. All eyes underwent LFUBM and 14-MHz + THI examinations before cataract extraction to determine the integrity of the PC. The integrity of the PC observed in surgery was the actual findings, and the consistency between the 2 methods was assessed in terms of the preoperative examination and intraoperative findings. Fisher’s exact test was used for consistency analysis, and P

Corticosteroids have for some time been used as first-line drugs for the topical treatment of noninfectious uveitis, but poor ocular bioavailability and the rapid clearance of eye drops necessitate frequent dosing, reducing patient compliance. In this study, we used an acid-sensitive stearoxyl-ketal-dexamethasone pro-drug microcrystals (SKD MCs), which is consistently safe and effective in the control of uveitis inflammation in rats. We used a rat model of experimental autoimmune uveitis (EAU) to evaluate the effects of SKD MCs in terms of clinical manifestations, molecular biology, pathological histology, and visual electrophysiology compared to dexamethasone sodium phosphate injection or phosphate-buffered saline. SKD MCs significantly reduced inflammation in EAU, improved the ability to suppress inflammatory cytokines and to protect retinal function, and significantly reduced retinal microglia activation, with no increase in intraocular pressure throughout the treatment. Our results indicate that the SKD MCs formulation holds promise as a new strategy for the treatment of noninfectious uveitis and potentially other ocular inflammatory diseases.

Despite advances in treatment of chronic arthritis, there is still a strong need for the development of long-acting formulations that can enable local and sustained drug release at the inflamed tissues. In this work, we fabricated microcrystals of an acid-sensitive stearoxyl-ketal-dexamethasone prodrug for treatment of arthritis. Microcrystals of the prodrug with two sizes were successfully engineered and showed pH-dependent hydrolysis kinetics in vitro. In a collagen-induced arthritis rat model, we evaluated the influence of particle size and injection dose on anti-inflammatory effect after intra-articular injection. Such prodrug demonstrated long-acting anti-arthritis effects with good safety. Our results indicate ketal-based prodrugs are promising for the development of long-acting injectables and may stimulate the development of new treatments for chronic diseases.

Diabetic peripheral neuropathy (DPN), peripheral artery disease (PAD), and foot deformity are the most common causes of diabetic foot, which can considerably worsen the patient’s quality of life. In this study, we aimed to investigate the prevalence and risk factors associated with DPN, PAD, and foot deformity among patients with diabetes living in Beijing, China. In total, 3,898 diabetes patients from 11 hospitals in Beijing were evaluated using questionnaires and physical examinations, and 3,758 patients were included in the analysis. We compared the demographic, clinical, biological characteristics, and comorbidities of patients with and without DPN, PAD, or foot deformity, and used binary logistic regression analysis to identify potential factors associated with these outcomes. Overall, 882 patients (23.5%) had DPN, 437 patients (11.6%) had PAD, and 1,117 patients (29.7%) had foot deformities, including callus. The risk factors for DPN included: age ≥40 years, a ≥10+year duration of diabetes, a body mass index of

Abstract Emerging clustered regularly interspaced short palindromic repeat/associated protein (CRISPR/Cas) genome editing technology shows great potential in gene therapy. However, proteins and nucleic acids suffer from enzymatic degradation in the physiological environment and low permeability into cells. Exploiting carriers to protect the CRISPR system from degradation, enhance its targeting of specific tissues and cells, and reduce its immunogenicity is essential to stimulate its clinical applications. Here, the authors review the state‐of‐the‐art CRISPR delivery systems and their applications, and describe strategies to improve the safety and efficacy of CRISPR mediated genome editing, categorized by three types of cargo formats, that is, Cas: single‐guide RNA ribonucleoprotein, Cas mRNA and single‐guide RNA, and Cas plasmid expressing CRISPR/Cas systems. The authors hope this review will help develop safe and efficient nanomaterial‐based carriers for CRISPR tools.

PurposeFungal keratitis is a sight-threatening corneal infection caused by fungal pathogens, and the pathogenic mechanisms have not been fully elucidated. The aim of this study was to determine whether NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome-mediated pyroptosis contributes to Candida albicans (C. albicans) keratitis and explore the underlying mechanism.MethodsAn in vivo mouse model of C. albicans keratitis and an in vitro culture model of human corneal epithelial cells (HCECs) challenged with heat-killed C. albicans (HKCA) were established in this study. The degree of corneal infection was evaluated by clinical scoring. Gene expression was assessed using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot analysis or immunofluorescence staining was performed to evaluate protein expression. TdT-mediated dUTP nick end labeling (TUNEL) staining was performed to examine the pyroptotic cell death. A lactate dehydrogenase (LDH) release assay was performed to assess cytotoxicity.ResultsCompared with the mock-infected group, we observed that the mRNA levels of NLRP3, caspase-1 (CASP1), interleukin (IL)−1β and gasdermin-D (GSDMD) in C. albicans-infected mice cornea was significantly increased. Our data also demonstrated that the protein expression of NLRP3 and the pyroptosis-related markers apoptosis-associated speck-like protein containing a CARD (ASC), cleaved CASP1, N-GSDMD, cleaved IL-1β and cleaved IL-18 as well as pyroptotic cell death were dramatically elevated in the mouse model of C. albicans keratitis. More importantly, NLRP3 knockdown markedly alleviated pyroptosis and consequently reduced corneal inflammatory reaction in C. albicans keratitis. In vitro, the presence of activated NLRP3 inflammasome and pyroptotic cell death were validated in HCECs exposed to HKCA. Furthermore, the potassium (K+) channel inhibitor glyburide decreased LDH release and suppressed NLRP3 inflammasome activation and pyroptosis in HCECs exposed to HKCA.ConclusionIn conclusion, the current study revealed for the first time that NLRP3 inflammasome activation and pyroptosis occur in C. albicans-infected mouse corneas and HCECs. Moreover, NLRP3 inflammasome-mediated pyroptosis signaling is involved in the disease severity of C. albicans keratitis. Therefore, This NLRP3 inflammasome-dependent pathway may be an attractive target for the treatment of fungal keratitis.

This study evaluated the safety of a modified method to implant an intraocular lens (IOL) into the capsular bag immediately after capsulorhexis with a whole or partial nucleus to protect the posterior capsule (PC) during phacoemulsification in a series of 12 Morgagnian cataracts. For 3 cases of hypermature cataracts with smaller and rigid nuclei, after a complete capsulorhexis, an IOL was directly inserted into the capsular bag, which protected the PC during the subsequent phacoemulsification process in the iris plate. For the other 9 cases with larger and softer nuclei, after the nucleus was partially emulsified, the IOL was inserted into the bag. Even with an obvious surge for some cases, the surgeries were uneventful in all 12 cases, with no PC rent or vitreous loss. IOL implantation into the capsular bag with a whole or partial nucleus can provide effective protection for the PC for hypermature cataract during phacoemulsification.

Abstract Background To compare the influence of posterior capsule opacification (PCO) morphology and severity on intraocular stray light and visual function with different levels of contrast. Methods Forty-five patients diagnosed with PCO were included in this prospective consecutive case series. The Optical Quality Analysis System II (OQAS II) was adopted to assess the objective visual function including objective scatter index (OSI) and optical quality analysis system values (OVs) with 100, 20, and 9% contrast. RTVue-100 OCT was used to evaluate the PCO morphology and severity. Comparisons among visual function, morphology, and severity between pear type and fibrosis PCO were performed. The correlations among the PCO morphology, severity, OSI, and OVs were also determined. Results There was a significant correlation between increased OSI and decreased visual acuity in PCO patients before laser capsulotomy. The changes of OSI were also correlated with the PCO area for the 3 mm IOL optic region (r = 0.43, p = 0.02). The OSI was significantly higher in pear type PCO when compared with fibrosis PCO (Z = − 4.06, p ≤ 0.001). In addition, the increased OSI in pear type PCO was significantly correlated with the 100% OVs and the 20% OVs but not with the 9% OVs. In fibrosis PCO, OSI was only correlated with the 100% OVs and the 20% OVs pre-YAG. Conclusions OSI and OVs could objectively indicate the visual function impairment in PCO patients. Effects of PCO on light scattering and on objective visual function might be explained by the variations of morphology and severity.

Background: Phenylephrine and atropine can cause serious adverse effects when applied in combination. We investigated the effect of phenylephrine eye drops combined with intravenous atropine on the cardiovascular system in patients under general anesthesia undergoing intraocular surgery.Methods: The effects of the drugs were observed through clinical study. Thirteen patients undergoing intraocular surgery under general anesthesia were observed in this study; all were injected intravenously with atropine due to the oculocardiac reflex during surgery. To study the combination of drugs, an in vivo study was performed on rats. Seventy-two standard deviation rats that received phenylephrine eye drops and intravenous atropine treatment under general anesthesia were assessed, of which 18 treated with these drugs simultaneously were administered normal saline, neostigmine or esmolol. Blood pressure and heart rate were recorded and analyzed.Findings: The age of the patients ranged from seven to 14 years old with an average age of 10.7 years old, and 11 patients were male. In patients, 5% phenylephrine eye drops combined with intravenous atropine led to a significant heart rate increase and the increase lasted 20 min. The significant increase in diastolic blood pressure and systolic blood pressure lasted for 15 and 25 min, respectively. From five to 25 min after intravenous atropine treatment, the systolic blood pressure and diastolic blood pressure were both more than 20% higher than that at baseline. In rats, the changes in blood pressure and heart rate were independent of the phenylephrine and atropine administration sequence but were related to the administration time interval. The neostigmine group showed a significant decrease in blood pressure after the increase from the administration of phenylephrine and atropine.Interpretation: Phenylephrine eye drops combined with intravenous atropine have obvious cardiovascular effects that can be reversed by neostigmine. This drug combination should be used carefully for ophthalmic surgery, especially in patients with cardio-cerebrovascular diseases.

Abstract Background To evaluate the results and complications of phacoemulsification with hydrodelineation and ophthalmic viscosurgical device (OVD)-assisted hydrodissection for posterior polar cataract (PPC). Methods Medical records of 24 eyes from 17 patients with clinical diagnosis of PPC, who underwent phacoemulsification with hydrodelineation and OVD-assisted hydrodissection, were retrospectively reviewed. Results The incidence of posterior capsule rupture (PCR) was 16.67% (4/24): 2 cases occurred during epinucleus removal, and 2 cases occurred during OVD removal after the implantation of the intraocular lens into the bag. No nucleus piece or lens materials dropped into the vitreous during cataract surgery, and no obvious postoperative complications were found during follow-up. All patients had improved best-corrected visual acuity (BCVA) 1 month postoperatively. Conclusion OVD-assisted hydrodissection could be an effective technique in phacoemulsification to reduce the incidence of PCR and achieve satisfactory postoperative outcomes.

Eye injuries due to corneal abrasions, chemical spills, penetrating wounds, and microbial infections cause corneal scarring and opacification that result in impaired vision or blindness. However, presently available eye drop formulations of anti-inflammatory and antibiotic drugs are not effective due to their rapid clearance from the ocular surface or due to drug-related side effects such as cataract formation or increased intraocular pressure. In this article, we presented the development of a dextran sulfate-based polymer wafer (DS-wafer) for the effective modulation of inflammation and fibrosis and demonstrated its efficacy in two corneal injury models: corneal abrasion mouse model and alkali induced ocular burn mouse model. The DS-wafers were fabricated by the electrospinning method. We assessed the efficacy of the DS-wafer by light microscopy, qPCR, confocal fluorescence imaging, and histopathological analysis. These studies demonstrated that the DS-wafer treatment is significantly effective in modulating corneal inflammation and fibrosis and inhibited corneal scarring and opacification compared to the unsulfated dextran-wafer treated and untreated corneas. Furthermore, these studies have demonstrated the efficacy of dextran sulfate as an anti-inflammatory and antifibrotic polymer therapeutic.

Purpose. To report the application of 14-MHz ultrasonography with tissue harmonic imaging (14 MHz + THI) to determine the integrity of the posterior capsule (PC) in traumatic cataract (TC). Methods. Patients with TC who were scheduled to undergo cataract extraction and whose PC could not be observed by slit lamp examination were included in the study. The status of the PC was determined by 14 MHz + THI before cataract extraction and confirmed during surgery. The results regarding PC integrity obtained from 14 MHz + THI and intraoperative direct observation were compared. Result. The study enrolled 52 eyes of 52 patients (49 men and 3 women), with a mean age of 42.15 years ± 11.23 (SD). The nature of the trauma was blunt (3 eyes) or sharp (49 eyes). The 14 MHz + THI method showed 21 PCs to be intact and 31 to have ruptured before cataract surgery. During surgery, 23 PCs were observed to be intact, while 29 PCs were ruptured. 27 PCs were ruptured and 19 were intact, as determined by the two methods. The 14 MHz + THI observations were consistent with the intraoperative observations of the PC (kappa = 0.764), with no significant difference between the two methods (P=0.687). The sensitivity, specificity, and accuracy of 14 MHz + THI for observation of the PC were 93.10%, 82.60%, and 88.46%, respectively. Conclusion. The 14 MHz + THI method can accurately reveal the integrity of the PC in TC. It has important clinical value in the selection of cataract surgery methods and the prediction of complications during TC surgery.

The Asian citrus psyllid (ACP), Diaphorina citri Kuwayama, is the only natural vector of bacteria responsible for Huanglongbing (HLB), a worldwide destructive disease of citrus. ACP reproduces and develops only on the young leaves of its rutaceous host plants. Olfactory stimuli emitted by young leaves may play an important role in ACP control and HLB detection. In this study, volatile organic compounds (VOCs) from healthy and HLB-infected young leaves of navel orange and pomelo were analyzed by headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS). A total of 36 compounds (including dimers or polymers) were identified and quantified from orange and 10 from pomelo leaves. Some compounds showed significant differences in signal intensity between healthy and HLB-infected leaves and may constitute possible indicators for HLB infection. Principal component analysis (PCA) clearly discriminated healthy and HLB-infected leaves in both orange and pomelo. HS-GC-IMS was an effective method to identify VOCs from leaves. This study may help develop new methods for detection of HLB or find new attractants or repellents of ACP for prevention of HLB.

Purpose. To report the application of 25 MHz B-scan ultrasonography (MHzB) to determine the integrity of the posterior capsule (PC) in posterior polar cataract (PPC). Methods. Patients with whom PPC was clinically diagnosed using slit lamp microscopy who underwent 25 MHzB before phacoemulsification were retrospectively reviewed. The status of the PC was determined by 25 MHzB before phacoemulsification and confirmed during cataract surgery. Results. In total, 21 eyes in 14 clinically diagnosed PPC patients were enrolled in this study. Out of 25 MHzB images, 19 PCs were found to be intact, while 2 showed dehiscence before cataract surgery. During phacoemulsification, 17 PCs were observed to be intact, while 4 PCs showed posterior capsule rupture (PCR). These 4 PCR cases included the above 2 eyes, in which preexisting dehiscence was detected by 25 MHzB. The other 2 PCR cases showed high reflectivity between high echoes in posterior opacities and the PC, indicating synechia between the PPC and PC. Conclusion. This is the first report to show that 25 MHzB can be used to clearly visualize the status of the PC in PPC. These results, in turn, could be used to select the appropriate treatment and to thereby avoid further complications during PPC surgery.

Objectives. To objectively evaluate posterior capsular opacification (PCO) with RTVue-100 spectral domain-OCT and assess the agreement with the Pentacam system. Methods. Sixty-seven eyes diagnosed with PCO were included. RTVue-100 SD-OCT was used to scan the IOL outline and PCO at horizontal and vertical meridians. PCO was also imaged with a Pentacam and slit-lamp photography system. With RTVue-100 SD-OCT, the PCO area, thickness, density, and objective scores were recorded and used to evaluate the severity of PCO at 3 mm and 5 mm diameter ranges of the IOL optic region. We assessed the correlation of visual acuity, PCO characteristics, and PCO scores. PCO scores acquired from RTVue-100 SD-OCT images were also compared with those from the Pentacam. Differences between pear-type and fibrosis-type PCOs were also compared using RTVue-100 SD-OCT cross-sectional images. Results. The cross-sectional images of PCO acquired with RTVue-100 SD-OCT corresponded well to Pentacam and slit-lamp retroillumination images. IOL-posterior capsular space, area, thickness, and density of the proliferated and accumulated LECs could be clearly visualized and quantified with RTVue-100 SD-OCT. PCO scores were correlated with decreased visual acuity, which was in line with the outcomes using the Pentacam. Differences between the pear-type and fibrosis-type PCO were statistically significant; pear-type PCOs showed a wider and thicker opacification region with lower density compared with fibrosis-type PCOs. Conclusion. RTVue-100 SD-OCT could be a powerful tool in PCO objective evaluation and classification. OCT could be used to visualize the morphology and outline of PCO. Thus, it could discriminate and quantify differences between different types of PCO. PCO scores seem to be a useful factor that could reliably reflect PCO severity.

A simple and efficient strategy for the synthesis of 1-ethynylcyclohex-2-enol derivatives was developed utilizing regioselective addition of acetylides to enediones based on steric effects. Further investigation of the substrate scope of enediones indicated that all the addition reactions ocurred in good yield.

Fungal infections of the cornea can be sight-threatening and have a worse prognosis than other types of microbial corneal infections. Peptidoglycan recognition proteins (PGLYRP), which are expressed on the ocular surface, play an important role in the immune response against bacterial corneal infections by activating toll-like receptors (TLRs) or increasing phagocytosis. However, the role of PGLYRPs in innate immune response to fungal pathogens has not been investigated. In this study, we observed a significant induction of three PGLYRPs 2-4 in primary human corneal epithelial cells (HCECs) exposed to live or heat-killed Candida albicans (HKCA). The C-type lectin receptor dectin-1 plays a critical role in controlling Candida albicans infections by promoting phagocytic activity and cytokine production in macrophages and dendritic cells. Here, we demonstrate that dectin-1 is expressed by normal human corneal tissue and primary HCECs. HKCA exposure increased expression of dectin-1 on HCECs at mRNA and protein levels. Interestingly, dectin-1 neutralizing antibody, IκB-α inhibitor BAY11-7082, and NF-κB activation inhibitor quinazoline blocked NF-κB p65 nuclear translocation, as well as the induction of the PGLYRPs by HKCA in HCECs. Furthermore, rhPGLYRP-2 was found to suppress colony-forming units of Candida albicans in vitro. In conclusion, these findings demonstrate that dectin-1 is expressed by human corneal epithelial cells, and dectin-1/NF-κB signaling pathway plays an important role in regulating Candida albicans/HKCA-induced PGLYRP secretion by HCECs.

Purpose. To analyze the prevalence and presentation patterns of corneal astigmatism in cataract surgery candidates in a teaching hospital in northern China. Methods. From May 1, 2012, to April 30, 2013, partial coherence interferometry (IOLMaster) measurements of all qualified cataract surgery candidates were retrospectively collected and analyzed. Results. The study evaluated 12,449 eyes from 6,908 patients with a mean age of 69.80±11.15 (SD) years. The corneal astigmatism was 0.5 diopters (D) or less in 20.76% of eyes, 1.0 D or more in 47.27% of eyes, 2.0 D or more in 13.16% of eyes, and 3.0 D or more in 3.75% of eyes. With-the-rule astigmatism was found in 30.36% of eyes, while against-the-rule was found in 52.41% of eyes. The percentage of against-the-rule astigmatism increased with age. Conclusion. Our study showed that almost one-half of preoperative eyes (47.27%) in northern China have a corneal astigmatism of 1.0 D or more, indicating that more surgical techniques or toric IOLs are needed to achieve better visual rehabilitation.

Background: The aim of this study was to explore the preventive and therapeutic potential of salvianolic acid B in inhibiting senile cataracts through network pharmacology and experimental validation. Methods; Disease-related genes were obtained from the DisGeNET and Gene Cards databases. Drug targets were identified from the Swiss Target Prediction and Pharm Mapper databases, shared genes were identified via the Venny website, links between genes were identified via a protein–protein interaction (PPI) network, and GO and KEGG analyses were subsequently performed via R software. The key genes were identified via Cytoscape software, and their binding with Sal-B was demonstrated by molecular docking. Then, the results were verified by cell experiments. A CCK-8 assay was used to assess the activity of human LECs with or without H2O2 or Sal-B treatment, and the cell apoptosis rate of each group was determined by flow cytometry. The gene expression levels of caspase 3, TNF-α and MMP-9 in human LECs treated with or without H2O2 or Sal-B were determined by qPCR. Results; A total of 705 and 152 cataract-related genes and salvianolic acid B-related genes, respectively, were identified, with 37 shared genes. The PPI results showed that MMP9, IL-2, JUN, TNF-α and caspase 3 were the core genes. GO data analysis revealed that the biological process, cell component and molecular function terms were most enriched in the categories “apoptosis progress”, “cytosol” and “protein binding”. Through KEGG enrichment analysis, we found that the core genes were related to the IL-17 and TNF signalling pathways. Cytoscape results showed that MMP9, TNF-α and caspase 3 were the key genes, and molecular docking showed that the drugs interacted well with the target molecules. The experimental results showed that salvianolic acid B inhibited H2O2-induced decreases in LEC activity and apoptosis and inhibited the gene expression of MMP9, TNF-α and caspase 3.Conclusion; Network pharmacology and molecular docking results showed that salvianolic acid B has the potential to prevent and treat senile cataracts. The experimental results verified the finding that salvianolic acid B can inhibit the decrease in LEC activity and apoptosis induced by H2O2 and verified the expression of the key molecules MMP9, TNF-α and caspase 3. [ABSTRACT FROM AUTHOR]

Huanglongbing (HLB) is a devastating citrus disease worldwide. A three-pronged approach to controlling HLB has been suggested, namely, removal of HLB-symptomatic trees, psyllid control, and replacement with HLB-free trees. However, such a strategy did not lead to successful HLB control in many citrus-producing regions, such as Florida. We hypothesize that this is because of the small-scale or incomprehensive implementation of the program; conversely, a comprehensive implementation of such a strategy at the regional level can successfully control HLB. To test our hypothesis, we investigated the effects of region-wide comprehensive implementation of this scheme to control HLB in Gannan region, China, with a total planted citrus acreage of over 110,000 ha from 2013 to 2019. With the region-wide implementation of comprehensive HLB management, the overall HLB incidence in Gannan decreased from 19.71% in 2014 to 3.86% in 2019. A partial implementation of such a program (without a comprehensive inoculum removal) at the regional level in Brazil resulted in HLB incidence increasing from 1.89% in 2010 to 19.02% in 2019. Using dynamic regression model analyses with data from both Brazil and China, we constructed a model to predict HLB incidence when all three components were applied at 100%. It was predicated that in a region-wide comprehensive implementation of such a program, HLB incidence would be controlled to a level of less than 1%. We conducted economic feasibility analyses and showed that average net profits were positive for groves that implemented the comprehensive strategy, but groves that did not implement it had negative net profits over a 10-year period. Overall, the key for the three-pronged program to successfully control HLB is the large scale (region-wide) and comprehensiveness in implementation. This study provides valuable information to control HLB and other economically important endemic diseases worldwide. [ABSTRACT FROM AUTHOR]

Objectives: To compare early subjective and objective vision quality of postoperative patients undergoing phacoemulsification cataract surgery combined with implantation of refractive segmental multifocal intraocular lens (MIOL) SBL-3 and apodized diffractive MIOL SN6AD1. Methods: As a prospective study, it enrolled 53 patients (53 eyes) to undergo phacoemulsification cataract surgery combined with MIOL implantation. According to differences in MIOL implanted, patients were divided into a SBL-3 group (25 eyes) and a SN6AD1 group (28 eyes). Ophthalmological evaluation included uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected intermediate (UIVA) and near (UNVA) visual acuities, distance-corrected intermediate (DCIVA) and near (DCNVA)visual acuities and corrected near(CNVA) visual acuity, contrast sensitivity, modulation transfer function (MTF) and high order aberration (4 mm pupil diameter) at three months postoperatively. Moreover, a questionnaire survey was carried out to assess near spectacle independence, patient satisfaction and symptoms of visual disturbance. Results: At three months after surgery, UIVA and UNVA in the SBL-3 group are statistically significantly superior to those of the SN6AD1 group (P<0.05). There was statistical difference in contrast sensitivity at four spatial frequencies (3, 6, 12, 18cycles/degree) under mesopic conditions and mesopic conditions with glare (P<0.05). The total ocular high order aberration, coma and trefoil were statistically significantly larger in the SBL-3 group than in the SN6AD1 group with 4.0 mm pupil diameters (P<0.05). Statistical differences were found in the MTF at spatial frequencies of 5, 10 and 15 cycles/degree between the groups. There were no significant differences in spectacle independence, patient satisfaction and visual disturbance between the groups (P>0.05). Conclusions: Both the two multifocal intraocular lens provided an excellent level of quality of vision three months postoperatively. However, the application effect of SBL-3 MIOL is superior to that of SN6AD1 MIOL as far as intermediate vision, near vision and contrast sensitivity are concerned. [ABSTRACT FROM AUTHOR]