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AIM:To evaluate the short-term efficacy and safety of intravitreal dexamethasone implant(IDI)for patients with retinal vein occlusion-related macular edema(RVO-ME)by using optical coherence tomography(OCTA).METHODS: Seventeen eyes in 17 patients with RVO-ME were treated with intravitreal injection of sustained-release IDI. The best corrected visual acuity(BCVA), central macular thickness(CMT)and superficial retinal vascular network were observed at baseline, 1d, 1mo, 2mo, 3mo, 4mo and 6mo.RESULTS: CMT was significantly reduced from baseline by 24h after injection and improved further during the 3mo follow-up, and the improvement of visual acuity was consistent with that of CMT. OCTA showed improvement from baseline in terms of decreased number and size of cysts and restoration of the retinal vascular network. A slight increase in intraocular pressure was observed in 2 eyes after injection. There were no systemic side effects associated with injection or medication during follow-up.CONCLUSION: CMT reduced as early as 24h after the injection of IDI, with further reduction during follow-up, and OCTA could visually observe the changes of retinal vascular network in macular area.

Background: To identify the ocular trauma pattern in the north Bund area of Shanghai.Methods: This is a retrospective, cross-sectional study. Patients between January 2016 and December 2018 with trauma in one eye and being hospitalized for at least one day in Shanghai General Hospital were selected in this study. All patients received first evaluation at the emergency room, followed by careful eye examination by one of attending ophthalmologists and reevaluation by one of the authors. Demographics and related patient’s clinical data at the time when trauma occurred were recorded, including age, gender, occupation, cause and type of trauma, location and size of injury, type of surgery, and hospitalization time. Results: 206 patients were reviewed. We found that gender and age are two mutually correlated risk factors for ocular trauma. We also identified occupation as a major risk factor, which is closely associated with penetrating/ intraocular foreign body injuries. Moreover, season change adds an additional layer of risk factor for ocular trauma, showing a significantly higher peak of ocular trauma percentage in hot summer months. Furthermore, retinal detachment and vitreous hemorrhage were identified as two prevailed types of complications. Importantly, we found that complications, along with location and/or size of injuries, determine the visual outcomes. Conclusions: We identified a clear ocular trauma pattern in the north Bund area of Shanghai. Importantly, complications, location and/or size of injuries determine the visual outcomes. Our findings pinpoint risk factors for ocular trauma, which predict visual outcomes and might be further applied in eye injury prevention.

Backgrounds To assess the changes in individual retinal layer thickness and visual function associated with gains in visual acuity after an intravitreal conbercept injection in the diabetic macular edema (DME) on spectral domain optical coherence tomography (SD-OCT) and microperimetry during 1-year follow-up. Methods Retrospective observational study. Twenty patients with clinically significant DME in the study eye were imaged by SD-OCT every 3 months and MP1 microperimeter in the third month while receiving anti-vascular endothelial growth factor (VEGF) (conbercept) treatment. In each patient, seven retinal layers were segmented in 98 scans covering a 6 mm × 6 mm area of the macula at baseline and during 1 year of treatment. An automatic, full-threshold microperimetry of the central field (10° × 10°, 40 stimulated points) with the MP1 microperimeter. Thickness and microperimetry changes were quantitatively measured and evaluated for their correlation with increases in visual acuity. Results Although thicknesses of the inner nuclear layer (INL) and the outer nuclear layer (ONL) were reduced the most after treatment (p

Purpose We determined vitreous and serum levels of high mobility group box‐1 (HMGB‐1) in patients with proliferative diabetic retinopathy (PDR) and elucidate their relationship with receptor for advanced glycation end products (RAGE), vascular endothelial growth factor (VEGF) and interleukin‐1β (IL‐1β). Methods In this cross‐sectional study, patients with PDR who underwent vitrectomy were enrolled, and the control group included non‐diabetic eyes. Vitreous and serum samples were analysed for HMGB‐1, RAGE, VEGF and IL‐1β by ELISA. We investigated the correlation between serum and vitreous levels of each cytokine, and we analysed the influence of intravitreal anti‐VEGF treatment prior to vitrectomy on the cytokine levels in PDR. Results Of 78 eyes of 78 patients enrolled consecutively, there were 32 PDR eyes and 46 control eyes. The serum levels were higher in diabetic than in non‐diabetic subjects for HMGB‐1, RAGE, VEGF and IL‐1β (all p

Backgrounds: To assess the changes in individual retinal layer thickness and visual function associated with gains in visual acuity after an intravitreal conbercept injection in the diabetic macular edema (DME) on spectral domain optical coherence tomography (SD-OCT) and microperimetry during 1-year follow-up. Methods: Retrospective observational study. Twenty patients with clinically significant DME in the study eye were imaged by SD-OCT every three months and MP1 microperimeter in the third month while receiving anti-vascular endothelial growth factor (VEGF) (conbercept) treatment. In each patient, seven retinal layers were segmented in 98 scans covering a 6mm×6mm area of the macula at baseline and during 1 year of treatment. An automatic, full-threshold microperimetry of the central field (10°×10°, 40 stimulated points) with the MP1 microperimeter. Thickness and microperimetry changes were quantitatively measured and evaluated for their correlation with increases in visual acuity. Results: Although thicknesses of the inner nuclear layer (INL) and the outer nuclear layer (ONL) were reduced the most after treatment (p< 0.05), decreases of the ganglion cell layer (GCL) (r = 0.591, p= 0.006) and inner plexiform layer (IPL) (r= 0.663, p= 0.001) in central subfield area was associated with best-corrected visual acuity (BCVA) gain, and had the best estimation of BCVA gain (adjust R2=0.544). Mean macular sensitivity in the central subfield was also well correlated with BCVA gain (r=0.531, p=0.016). Conclusions: Whereas the largest decrease of layer thickness occurred in the INL and ONL, the decreases in GCL and IPL were more associated with gains in vision and improved microperimetry. The decrease of the GCL and IPL might suggest that neural recovery occurred after the resolution of edema during conbercept treatment. Keywords: Diabetic macular edema, retinal layer thickness, layer segmentation, anti-VEGF, Conbercept.

Purpose To quantify and evaluate macular superficial capillaries and large vessels separately using an optical coherence tomographic angiography (OCTA)-based automatic segmentation algorithm. Methods In this cross-sectional study, all eyes were scanned using an OCTA device with 3 × 3 mm cube centered on the fovea. Retinal large vessels (arterioles/venules) were automatically segmented from superficial vasculature en-face images. All images were normalized, binarized, and skeletonized for quantification. Metrics of retinal capillaries were calculated by subtracting the measurements of large vessels from total vasculature. Perfusion density (PD), vessel length density (VLD), and vessel diameter index (VDI) within Early Treatment Diabetic Retinopathy Study (ETDRS) 3-mm ring were calculated for total superficial vasculature, large vessels (PDlarge, VLDlarge, and VDIlarge) and capillaries (PDcap, VLDcap, and VDIcap), respectively. Results Fifty-nine eyes from 59 healthy participants (mean age, 45 ± 14 years, 36 females) and 118 eyes from 67 patients with diabetes mellitus (mean age, 57 ± 10 years, 28 females) were included. The diabetic cohort included four subgroups (35 eyes without diabetic retinopathy, 30 eyes with mild to moderate nonproliferative diabetic retinopathy [NPDR], 27 eyes with severe NPDR, and 26 eyes with PDR). Linear regression showed that all above metrics were correlated with the disease stage (from healthy state to PDR), and the β value was -0.76, 0.24, -0.78, 0.80, 0.30, 0.77, -0.81, 0.16, and -0.82 for VD, VDlarge, VDcap, VDI, VDIlarge, VDIcap, VLD, VLDlarge, and VLDcap, respectively. Conclusions Retinal capillaries and large vessels responded differently in the context of diabetes. VLD of capillary is a potentially reliable metric in diabetic retinopathy staging.

Anti-vascular endothelial growth factor (VEGF) therapies are widely used for the treatment of neovascular fundus diseases such as diabetic retinopathy. However, these agents need to be injected intravitreally, because their strong hydrophilicity and high molecular weight prevent them from penetrating cell membranes and complex tissue barriers. Moreover, the repeated injections that are required can cause infection and tissue injury. In this study, we used in vivo-directed evolution phage display technology to identify a novel dodecapeptide, named CC12, with the ability to penetrate the ocular barrier in a noninvasive (via conjunctival sac instillation) or minimally invasive (via retrobulbar injection) manner. KV11, an antiangiogenesis peptide previously demonstrated to inhibit pathological neovascularization in the retina, was then used as a model antiangiogenesis cargo for CC12. We found that conjugation of KV11 peptide with CC12 peptide facilitated the delivery of KV11 to the retina, resulting in significant inhibition of retinal neovascularization development via topical application without tissue toxicity. Collectively, our data of multilevel evaluations demonstrate that CC12 may enable the noninvasive to minimally invasive intraocular delivery of antiangiogenic therapeutics.

Background: Choroidal neovascularization (CNV) is a serious eye disease that may cause visual loss, especially for older people. Many factors have been proven to induce this disease including age, gender, obesity, and so on. However, until now, we have had limited knowledge on CNV's pathogenic mechanism. Discovering the genes that underlie this disease and performing extensive studies on them can help us to understand how CNV occurs and design effective treatments. Methods: In this study, we designed a computational method to identify novel CNV-related genes in a large protein network constructed using the protein–protein interaction information in STRING. The candidate genes were first extracted from the shortest paths connecting any two known CNV-related genes and then filtered by a permutation test and using knowledge of their linkages to known CNV-related genes. Results A list of putative CNV-related candidate genes was accessed by our method. These genes are deemed to have strong relationships with CNV. Conclusions Extensive analyses of several of the putative genes such as ANK1, ITGA4, CD44 and others indicate that they are related to specific biological processes involved in CNV, implying they may be novel CNV-related genes. General significance: The newfound putative CNV-related genes may provide new insights into CNV and help design more effective treatments. This article is part of a Special Issue entitled “System Genetics” Guest Editor: Dr. Yudong Cai and Dr. Tao Huang.