Purpose:To evaluate the influence of corneal ablation patterns on the prediction error after cataract surgery in postmyopic-LASIK eyes.Methods:Eighty-three post-myopic-LASIK eyes of 83 patients that underwent uneventf...Purpose:To evaluate the influence of corneal ablation patterns on the prediction error after cataract surgery in postmyopic-LASIK eyes.Methods:Eighty-three post-myopic-LASIK eyes of 83 patients that underwent uneventful cataract surgery were retrospectively included.Predicted postoperative spherical equivalence(SE)was calculated for the implanted lens using the Haigis-L and Barrett True-K formula.Prediction error at one month postsurgery was calculated as actual SE minus predicted SE.For each eye,area and decentration of the ablation zone was measured using the tangential curvature map.The associations between prediction errors and corneal ablation patterns were investigated.Results:The mean prediction error was-0.83±1.00 D with the Haigis-L formula and-1.00±0.99 D with the Barrett True-K formula.Prediction error was positively correlated with keratometry(K)value and negatively correlated with ablation zone area using either formula,and negatively correlated with decentration of the ablation zone using the Barrett True-K formula(all P<0.05).In the K<37.08 D group,prediction error was negatively correlated with decentration of the ablation zone with both formulas(all P<0.05).Multivariate analysis showed that with the Haigis-L formula,prediction error was associated with axial length(AL),K value and decentration,and with the Barrett True-K formula,prediction error was associated with AL and decentration(all P<0.05).Conclusion:A flatter cornea,larger corneal ablation zone and greater decentration will lead to more myopic prediction error after cataract surgery in post-myopic-LASIK eyes.展开更多
Posterior capsule opacification(PCO)remains the predominant complication following cataract surgery,significantly impairing visual function restoration.In this study,we developed a PCO model that closely mimics the an...Posterior capsule opacification(PCO)remains the predominant complication following cataract surgery,significantly impairing visual function restoration.In this study,we developed a PCO model that closely mimics the anatomical structure of the crystalline lens capsule post-surgery.The model incorporated a threaded structure for accurate positioning and observation,allowing for opening and closing.Utilizing 3D printing technology,a stable external support system was created using resin material consisting of a rigid,hollow base and cover.To replicate the lens capsule structure,a thin hydrogel coating was applied to the resin scaffold.The biocompatibility and impact on cellular functionality of various hydrogel compositions were assessed through an array of staining techniques,including calcein-AM/PI staining,rhodamine staining,BODIPY-C11 staining and EdU staining in conjunction with transwell assays.Additionally,the PCO model was utilized to investigate the effects of eight drugs with anti-inflammatory and anti-proliferative properties,including 5-aminoimidazole-4-carboxamide ribonucleotide(AICAR),THZ1,sorbinil,4-octyl itaconate(4-OI),xanthohumol,zebularine,rapamycin and caffeic acid phenethyl ester,on human lens epithelial cells(HLECs).Confocal microscopy facilitated comprehensive imaging of the PCO model.The results demonstrated that the GelMA 605%þPLMA 2%composite hydrogel exhibited superior biocompatibility and minimal lipid peroxidation levels among the tested hydrogels.Moreover,compared to using hydrogel as the material for 3D printing the entire model,applying surface hydrogel spin coating with parameters of 2000 rpm�2 on the resin-based 3D printed base yielded a more uniform cell distribution and reduced apoptosis.Furthermore,rapamycin,4-OI and AICAR demonstrated potent antiproliferative effects in the drug intervention study.Confocal microscopy imaging revealed a uniform distribution of HLECs along the anatomical structure of the crystalline lens capsule within the PCO model,showcasing robust cell viability and regular morphology.In conclusion,the PCO model provides a valuable experimental platform for studying PCO pathogenesis and exploring potential therapeutic interventions.展开更多
Background:The accuracy of using total keratometry(TK)value in recent IOL power calculation formulas in highly myopic eyes remained unknown.Methods:Highly myopic patients who underwent uneventful cataract surgery were...Background:The accuracy of using total keratometry(TK)value in recent IOL power calculation formulas in highly myopic eyes remained unknown.Methods:Highly myopic patients who underwent uneventful cataract surgery were prospectively enrolled in this prospective comparative study.At one month postoperatively,standard deviation(SD)of the prediction errors(PEs),mean and median absolute error(MedAE)of 103 highly myopic eyes were back-calculated and compared among ten formulas,including XGboost,RBF 3.0,Kane,Barrett Universal II,Emmetropia Verifying Optical 2.0,Cooke K6,Haigis,SRK/T,and Wang-Koch modifications of Haigis and SRK/T formulas,using either TK or standard keratometry(K)value.Results:In highly myopic eyes,despite good agreement between TK and K(P>0.05),larger differences between the two were associated with smaller central corneal thickness(P<0.05).As to the refractive errors,TK method showed no differences compared to K method.The XGBoost,RBF 3.0 and Kane ranked top three when considering SDs of PEs.Using TK value,the XGboost calculator was comparable with the RBF 3.0 formula(P>0.05),which both presented smaller MedAEs than others(all P<0.05).As for the percentage of eyes within±0.50 D or±0.75 D of PE,the XGBoost TK showed comparable percentages with the RBF 3.0 TK formula(74.76%vs.66.99%,or 90.29%vs.87.38%,P>0.05),and statistically larger percentages than the other eight formulas(P<0.05).Conclusions:Highly myopic eyes with thinner corneas tend to have larger differences between TK and K.The XGboost enhancement calculator and RBF 3.0 formula using TK showed the most promising outcomes in highly myopic eyes.展开更多
High myopia has long been highly prevalent worldwide with a largely yet unexplained genetic contribution.To identify novel susceptibility genes for axial length(AL)in highly myopic eyes,a genome-wide association study...High myopia has long been highly prevalent worldwide with a largely yet unexplained genetic contribution.To identify novel susceptibility genes for axial length(AL)in highly myopic eyes,a genome-wide association study(GWAS)was performed using the genomic dataset of 350 deep whole-genome sequencing data from highly myopic patients.Top single nucleotide polymorphisms(SNPs)were functionally annotated.Immunofluorescence staining,quantitative polymerase chain reaction,and western blot were performed using neural retina of form-deprived myopic mice.Enrichment analyses were further performed.We identified the four top SNPs and found that ADAM Metallopeptidase With Thrombospondin Type 1 Motif 16(ADAMTS16)and Phosphatidylinositol Glycan Anchor Biosynthesis Class Z(PIGZ)had the potential of clinical signifi-cance.Animal experiments confirmed that PIGZ expression could be observed and showed higher expression level in form-deprived mice,especially in the ganglion cell layer.The messenger RNA(mRNA)levels of both ADAMTS16 and PIGZ were significantly higher in the neural retina of form-deprived eyes(p=0.005 and 0.007 respectively),and both proteins showed significantly upregulated expression in the neural retina of deprived eyes(p=0.004 and 0.042,respectively).Enrichment analysis revealed a significant role of cellular adhesion and signal transduction in AL,and also several AL-related pathways including circadian entrainment and inflammatory mediator regulation of transient receptor potential channels were proposed.In conclusion,the current study identified four novel SNPs associated with AL in highly myopic eyes and confirmed that the expression of ADAMTS16 and PIGZ was significantly upregulated in neural retina of deprived eyes.Enrichment analyses provided novel insight into the etiology of high myopia and opened avenues for future research interest.展开更多
Purpose:To investigate the anterior segment in nanophthalmic eyes and their association with intraocular pressure after cataract surgery.Methods:Thirty-two nanophthalmic eyes(axial length[AL]<18.5 mm)in 18 patients...Purpose:To investigate the anterior segment in nanophthalmic eyes and their association with intraocular pressure after cataract surgery.Methods:Thirty-two nanophthalmic eyes(axial length[AL]<18.5 mm)in 18 patients and 35 normal eyes(21.0≤AL≤24.5 mm)in 35 controls who had undergone uneventful cataract surgery were included.Swept-source optical coherence tomography was used to compare the anterior segment structures between the two groups.The associations between the anterior segment characteristics of nanophthalmic eyes and postoperative intraocular pressure(IOP)were also investigated.Results:The IOP-lowering effect of cataract surgery was remarkably insufficient in nanophthalmic eyes.Peripheral anterior synechiae(PAS)were observed in 56%(18/32)of nanophthalmic eyes,and a characteristic boomerangshaped iris was observed in 28%(9/32).The anterior surface of the iris seemed"smoother"in nanophthalmic eyes than in normal eyes.Schlemm's canal(SC)diameter,SC area,trabecular meshwork(TM)thickness,TM width,and TM area were generally smaller in the nanophthalmic eyes.Younger age,higher preoperative IOP,broader PAS,and smaller SC area were main contributors to higher postoperative IOP.AL and SC diameter may also be of great importance in IOP prediction in patients without glaucoma surgery and PAS.Conclusions:The morphological features of the anterior segment in nanophthalmic eyes are significantly different from those of normal eyes.Influencing factors such as age,AL,preoperative IOP,extent of PAS,SC and TM size could all be prognostic for IOP after cataract surgery in nanophthalmic eyes.Trial registration:ClinicalTrails.gov,Trial registration number:NCT02182921,Registered 8 July 2014.展开更多
In ophthalmology,the quality of fundus images is critical for accurate diagnosis,both in clinical practice and in artificial intelligence(AI)-assisted diagnostics.Despite the broad view provided by ultrawide-field(UWF...In ophthalmology,the quality of fundus images is critical for accurate diagnosis,both in clinical practice and in artificial intelligence(AI)-assisted diagnostics.Despite the broad view provided by ultrawide-field(UWF)imaging,pseudocolor images may conceal critical lesions necessary for precise diagnosis.To address this,we introduce UWF-Net,a sophisticated image enhancement algorithm that takes disease characteristics into consideration.Using the Fudan University ultra-wide-field image(FDUWI)dataset,which includes 11294 Optos pseudocolor and 2415 Zeiss true-color UWF images,each of which is rigorously annotated,UWF-Net combines global style modeling with feature-level lesion enhancement.Pathological consistency loss is also applied to maintain fundus feature integrity,significantly improving image quality.Quantitative and qualitative evaluations demonstrated that UWF-Net outperforms existing methods such as contrast limited adaptive histogram equalization(CLAHE)and structure and illumination constrained generative adversarial network(StillGAN),delivering superior retinal image quality,higher quality scores,and preserved feature details after enhancement.In disease classification tasks,images enhanced by UWF-Net showed notable improvements when processed with existing classification systems over those enhanced by StillGAN,demonstrating a 4.62%increase in sensitivity(SEN)and a 3.97%increase in accuracy(ACC).In a multicenter clinical setting,UWF-Net-enhanced images were preferred by ophthalmologic technicians and doctors,and yielded a significant reduction in diagnostic time((13.17±8.40)s for UWF-Net enhanced images vs(19.54±12.40)s for original images)and an increase in diagnostic accuracy(87.71%for UWF-Net enhanced images vs 80.40%for original images).Our research verifies that UWF-Net markedly improves the quality of UWF imaging,facilitating better clinical outcomes and more reliable AI-assisted disease classification.The clinical integration of UWF-Net holds great promise for enhancing diagnostic processes and patient care in ophthalmology.展开更多
Background:To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses(MfIOLs)in myopic eyes.Methods:Myopic(axial length[AXL]>24.5 mm)and non-myopic(21.0 mm<AXL≤24.5 mm)cataract eyes ...Background:To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses(MfIOLs)in myopic eyes.Methods:Myopic(axial length[AXL]>24.5 mm)and non-myopic(21.0 mm<AXL≤24.5 mm)cataract eyes were enrolled in this prospective study and randomly assigned to receive implantation of Zeiss AT LISA tri 839MP lenses(Group A)or Tecnis ZMB00 lenses(Group B).In total,122 eyes of 122 patients were available for analysis.Decentration and tilt of MfIOLs,high-order aberrations(HOAs),and modulation transfer functions(MTFs)were evaluated using the OPD-Scan III aberrometer 3 months postoperatively.Subjective symptoms were assessed with a Quality of Vision questionnaire.Results:Near and distance visual acuities,tilt and horizontal decentration did not differ between the two groups,postoperatively.However,myopic eyes of Group B showed greater vertical decentration than those of Group A(−0.17±0.14 mm vs.-0.03±0.09 mm,respectively),particularly when the MfIOLs were placed horizontally or obliquely.Overall decentration of myopic eyes was greater in Group B than in Group A(0.41±0.15 mm vs.0.16±0.10 mm,respectively).In Group B,AXL was negatively correlated with vertical decentration and positively correlated with overall decentration.No such correlations were found in Group A.Intraocular total HOAs,coma,trefoil and spherical aberrations were lower in Group A than in Group B for a 6.0 mm pupil among myopic eyes.Generally,Group A had better MTFs and fewer subjective symptoms than Group B among myopic eyes.Conclusions:Plate-haptic design of MfIOLs may be a suggested option for myopic cataract eyes due to the less inferior decentration and better visual quality postoperatively.展开更多
Background:To evaluate the distribution of lens thickness(LT)and its associations with other ocular biometric factors among cataract patients in Shanghai.Methods:Twenty-four thousand thirteen eyes from 24,013 cataract...Background:To evaluate the distribution of lens thickness(LT)and its associations with other ocular biometric factors among cataract patients in Shanghai.Methods:Twenty-four thousand thirteen eyes from 24,013 cataract patients were retrospectively included.Ocular biometric factors including LT,central corneal thickness(CCT),anterior chamber depth(ACD),white-to-white(WTW)distance,anterior corneal curvature,and axial length(AL)were obtained using the IOLMaster700.The associations between LT and general or ocular factors were assessed.Results:The mean age was 62.5±13.6 years and 56.1%were female.The mean LT was 4.51±0.46 mm.The LT was greater in older patients(P<0.001).LT was positively correlated with CCT,while negatively correlated with ACD,WTW,and anterior corneal curvature(P<0.001).Multivariate analysis revealed that increased LT was associated with older age,male gender,thicker CCT,shallower ACD,larger WTW,and flatter anterior corneal curvature(P<0.001).LT changed with a variable behavior according to AL.In short eyes LT increased as AL increased,then decreased with longer AL in normal eyes and moderate myopic eyes,but increased again as AL increased in highly myopic eyes.Thickest LT was found in the 20.01-22mm AL group.The correlation between LT and other biometric factors remained significant when stratified by ALs.Conclusions:In a large Chinese cataractous population,we found that the thicker lens may be associated with older age,male gender,thicker CCT,shallower ACD,larger WTW,and flatter anterior corneal curvature.As AL increased,the change of LT was nonlinear,with the thickest lens seen in the 20-22mm AL group.展开更多
Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(IOLMaster 700)to scan 131 e...Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(IOLMaster 700)to scan 131 emmetropic eyes(axial length<24.5 mm),25 mild/moderate myopic eyes(axial length 24.5–26 mm),and 123 high myopic eyes(52,29,and 42 eyes with axial lengths of 26–28,28–30,and>30 mm,respectively)as part of the routine preoperative examination before cataract surgery.SS-OCT involved B-scans along six meridians.The data were analyzed to assess the magnitude and orientation of the lens tilt and their correlation with other optical biometric parameters.Result:The mean tilt was 3.36±0.98°in emmetropic eyes,3.07±1.04°in mild/medium myopic eyes,and 2.35±1.01°in high myopic eyes.Tilt correlated significantly and inversely with axial length(Pearson’s r=−0.427,P<0.001).The crystalline lens tilt predominantly faced the upper outer quadrant relative to the visual axis,symmetrically in both eyes,with mean angles of 24.32°and 147.36°in the right and left eyes,respectively.The variability in the lens tilt direction increased with increasing axial length(χ^(2) test,P<0.001).Conclusion:The magnitude of crystalline lens tilt decreased with increasing axial length.The direction of tilt was predominantly towards the upper outer quadrant in both eyes.The variability in the tilt orientation increased with increasing axial length.Trial registration:NIH(clinicaltrial.gov),NCT03062085.Registered 23 February 2017.展开更多
Purpose:To investigate the anterior segment in nanophthalmic eyes and their association with intraocular pressure after cataract surgery.Methods:Thirty-two nanophthalmic eyes(axial length[AL]<18.5 mm)in 18 patients...Purpose:To investigate the anterior segment in nanophthalmic eyes and their association with intraocular pressure after cataract surgery.Methods:Thirty-two nanophthalmic eyes(axial length[AL]<18.5 mm)in 18 patients and 35 normal eyes(21≤AL≤24.5 mm)in 35 controls who had undergone uneventful cataract surgery were included.Swept-source optical coherence tomography was used to compare the anterior segment structures between the two groups.The associations between the anterior segment characteristics of nanophthalmic eyes and postoperative intraocular pressure(IOP)were also investigated.Results:The IOP-lowering effect of cataract surgery was remarkably insufficient in nanophthalmic eyes.Peripheral anterior synechiae(PAS)were observed in 56%(18/32)of nanophthalmic eyes,and a characteristic boomerangshaped iris was observed in 28%(9/32).The anterior surface of the iris seemed“smoother”in nanophthalmic eyes than in normal eyes.Schlemm’s canal(SC)diameter,SC area,trabecular meshwork(TM)thickness,TM width,and TM area were generally smaller in the nanophthalmic eyes.Younger age,higher preoperative IOP,broader PAS,and smaller SC area were main contributors to higher postoperative IOP.AL and SC diameter may also be of great importance in IOP prediction in patients without glaucoma surgery and PAS.Conclusions:The morphological features of the anterior segment in nanophthalmic eyes are significantly different from those of normal eyes.Influencing factors such as age,AL,preoperative IOP,extent of PAS,SC and TM size could all be prognostic for IOP after cataract surgery in nanophthalmic eyes.展开更多
Background:To evaluate the effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system.Methods:Nine elder cynomolgus monkeys were used,consisting of three monkeys without...Background:To evaluate the effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system.Methods:Nine elder cynomolgus monkeys were used,consisting of three monkeys without cataract as controls,three monkeys with naturally occurring cortical cataract,and three monkeys with nuclear cataract as intervention groups.Nanoparticulated thermogel with lanosterol and fluorescein was administered by subconjunctival injection in the monkeys with cataract.Fluorescence changes of injected thermogel and cataract progression were observed.Lanosterol concentration in aqueous humor,solubility changes in lens proteins,and oxidative stress levels were analyzed in the lenses of the control and intervention groups.Results:Injected thermogel showed decreased fluorescence during follow up.Lanosterol concentration in aqueous humor increased in the first 2 weeks and then gradually decreased,which was in accordance with the changes in cortical lens clarity.However,lenses with nuclear opacification showed little change.In the cortical region of lenses with cortical cataract,solubility ofα-crystallin was significantly increased after administration of lanosterol,as well as the reduction of oxidative stress.Conclusions:We demonstrated the effect of lanosterol on cataract progression based on in vivo models of primates.Lanosterol showed a short-term and reliable reversal effect on reducing cataract severity in cortical cataract in the early stages,possibly due to the increase in the solubility of lens proteins and changes in the oxidative stress status.Lanosterol administration using subconjunctival drug release system could be a promising nonsurgical approach for future clinical studies of cataract prevention and treatment.展开更多
Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(lOLMaster 700)to scan 131 e...Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(lOLMaster 700)to scan 131 emmetropic eyes(axial length<24.5 mm);25 mild/moderate myopic eyes(axial length 24.5-26 mm),and 123 high myopic eyes(52,29,and 42 eyes with axial lengths of 26-28,28-BO,and>30 mm,respectively)as part of the routine preoperative examination before cataract surgery.SS-OCT involved B-scans along six meridians.The data were analyzed to assess the magnitude and orientation of the lens tilt and their correlation with other optical biometric parameters.Result:The mean tilt was 3.36±0.98。in emmetropic eyes,3.07±1.04° in mild/medium myopic eyes,and 2.35±1.01° in high myopic eyes.Tilt correlated significantly and inversely with axial length(Pearson,sr=-0.427,P<0.001).The crystalline lens tilt predominantly faced the upper outer quadrant relative to the visual axis,symmetrically in both eyes,with mean angles of 24.32°and 147.36°in the right and left eyes,respectively.The variability in the lens tilt direction increased with increasing axial length(x2 test,P<0.001).Conclusion:The magnitude of crystalline lens tilt decreased with increasing axial length.The direction of tilt was predominantly towards the upper outer quadrant in both eyes.The variability in the tilt orientation increased with increasing axial length.Trial registration:NIH(clinicaltrial.gov),NCT03062085.Registered 23 February 2017.展开更多
Background:High myopia is one of the major causes of visual impairment and has an ever-increasing prevalence,especially in East Asia.It is characterized by excessive axial elongation,leading to various blinding compli...Background:High myopia is one of the major causes of visual impairment and has an ever-increasing prevalence,especially in East Asia.It is characterized by excessive axial elongation,leading to various blinding complications that extend beyond mere refractive errors and persist immovably after refractive surgery,presenting substantial public health challenge.Main text:High myopia-related complications include lens pathologies,atrophic and tractional maculopathy,choroidal neovascularization,peripheral retinal degenerations and retinal detachment,and glaucoma and heightened susceptibility to intraocular pressure(IOP)elevation.Pathological lens changes characteristic of high myopia include early cataractogenesis,overgrowth of lens,weakened zonules,and postoperative capsular contraction syndrome,possibly driven by inflammatory pathogenesis,etc.Dome-shaped macula and cilioretinal arteries are two newly identified protective factors for central vision of highly myopic patients.These patients also face risks of open-angle glaucoma and IOP spike following intraocular surgery.Morphologic alternations of optic nerve in high myopia can complicate early glaucoma detection,necessitating comprehensive examinations and close follow-up.Anatomically,thinner trabecular meshwork increases this risk;conversely lamina cribrosa defects may offer a fluid outlet,potentially mitigating the pressure.Notably,anxiety has emerged as the first recognized extra-ocular complication in high myopia,with an underlying inflammatory pathogenesis that connects visual stimulus,blood and brain.Conclusions:High myopia induces multiple ocular and potential mental health complications,underscoring the need to develop more effective strategies to improve both physical and emotional well-being of these patients,among which anti-inflammation might possibly represent a promising new target.展开更多
基金This work was supported by research grants from the National Natural Science Foundation of the People's Republic of China(Grant Nos.82122017,81870642,81970780 and 81670835)Shanghai High Myopia Study,Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission(Grant Nos.19441900700 and 21S31904900)+6 种基金National Key R&D Program of China(Grant No.2018YFC0116800)the Outstanding Youth Medical Talents Program of Shanghai Health and Family Planning Commission(Grant No.2017YQ011)the Shanghai Talent Development Fund(Grant No.201604)Clinical Research Plan of Shanghai Shenkang Hospital Development Center(Grant Nos.SHDC12019X08 and SHDC2020CR4078)Double-E Plan of Eye&ENT Hospital(SYA202006)the WIT120 Research Project of Shanghai(Grant No.2018ZHYL0220)the Shanghai Municipal Key Clinical Specialty Program(Grant No.shslczdzko1901).
文摘Purpose:To evaluate the influence of corneal ablation patterns on the prediction error after cataract surgery in postmyopic-LASIK eyes.Methods:Eighty-three post-myopic-LASIK eyes of 83 patients that underwent uneventful cataract surgery were retrospectively included.Predicted postoperative spherical equivalence(SE)was calculated for the implanted lens using the Haigis-L and Barrett True-K formula.Prediction error at one month postsurgery was calculated as actual SE minus predicted SE.For each eye,area and decentration of the ablation zone was measured using the tangential curvature map.The associations between prediction errors and corneal ablation patterns were investigated.Results:The mean prediction error was-0.83±1.00 D with the Haigis-L formula and-1.00±0.99 D with the Barrett True-K formula.Prediction error was positively correlated with keratometry(K)value and negatively correlated with ablation zone area using either formula,and negatively correlated with decentration of the ablation zone using the Barrett True-K formula(all P<0.05).In the K<37.08 D group,prediction error was negatively correlated with decentration of the ablation zone with both formulas(all P<0.05).Multivariate analysis showed that with the Haigis-L formula,prediction error was associated with axial length(AL),K value and decentration,and with the Barrett True-K formula,prediction error was associated with AL and decentration(all P<0.05).Conclusion:A flatter cornea,larger corneal ablation zone and greater decentration will lead to more myopic prediction error after cataract surgery in post-myopic-LASIK eyes.
基金supported by research grants from the National Natural Science Foundation of China(82122017,82271069 and 81900839)Shanghai Science and Technology Commission(22xtcx00103)Clinical Science and Technology Innovation Project of Shanghai Shenkang Hospital Development Center(SHDC12019X08,SHDC12020111 and SHDC2020CR4078).
文摘Posterior capsule opacification(PCO)remains the predominant complication following cataract surgery,significantly impairing visual function restoration.In this study,we developed a PCO model that closely mimics the anatomical structure of the crystalline lens capsule post-surgery.The model incorporated a threaded structure for accurate positioning and observation,allowing for opening and closing.Utilizing 3D printing technology,a stable external support system was created using resin material consisting of a rigid,hollow base and cover.To replicate the lens capsule structure,a thin hydrogel coating was applied to the resin scaffold.The biocompatibility and impact on cellular functionality of various hydrogel compositions were assessed through an array of staining techniques,including calcein-AM/PI staining,rhodamine staining,BODIPY-C11 staining and EdU staining in conjunction with transwell assays.Additionally,the PCO model was utilized to investigate the effects of eight drugs with anti-inflammatory and anti-proliferative properties,including 5-aminoimidazole-4-carboxamide ribonucleotide(AICAR),THZ1,sorbinil,4-octyl itaconate(4-OI),xanthohumol,zebularine,rapamycin and caffeic acid phenethyl ester,on human lens epithelial cells(HLECs).Confocal microscopy facilitated comprehensive imaging of the PCO model.The results demonstrated that the GelMA 605%þPLMA 2%composite hydrogel exhibited superior biocompatibility and minimal lipid peroxidation levels among the tested hydrogels.Moreover,compared to using hydrogel as the material for 3D printing the entire model,applying surface hydrogel spin coating with parameters of 2000 rpm�2 on the resin-based 3D printed base yielded a more uniform cell distribution and reduced apoptosis.Furthermore,rapamycin,4-OI and AICAR demonstrated potent antiproliferative effects in the drug intervention study.Confocal microscopy imaging revealed a uniform distribution of HLECs along the anatomical structure of the crystalline lens capsule within the PCO model,showcasing robust cell viability and regular morphology.In conclusion,the PCO model provides a valuable experimental platform for studying PCO pathogenesis and exploring potential therapeutic interventions.
基金supported by research grants from the National Natural Science Foundation of China(Grant Nos.82122017,81870642,81970780 and 81670835)Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission(Grant Nos.19441900700 and 21S31904900)+1 种基金Clinical Research Plan of Shanghai Shenkang Hospital Development Center(Grant Nos.SHDC2020CR4078 and SHDC12019X08)the Fudan University“Outstanding 2025”Program.
文摘Background:The accuracy of using total keratometry(TK)value in recent IOL power calculation formulas in highly myopic eyes remained unknown.Methods:Highly myopic patients who underwent uneventful cataract surgery were prospectively enrolled in this prospective comparative study.At one month postoperatively,standard deviation(SD)of the prediction errors(PEs),mean and median absolute error(MedAE)of 103 highly myopic eyes were back-calculated and compared among ten formulas,including XGboost,RBF 3.0,Kane,Barrett Universal II,Emmetropia Verifying Optical 2.0,Cooke K6,Haigis,SRK/T,and Wang-Koch modifications of Haigis and SRK/T formulas,using either TK or standard keratometry(K)value.Results:In highly myopic eyes,despite good agreement between TK and K(P>0.05),larger differences between the two were associated with smaller central corneal thickness(P<0.05).As to the refractive errors,TK method showed no differences compared to K method.The XGBoost,RBF 3.0 and Kane ranked top three when considering SDs of PEs.Using TK value,the XGboost calculator was comparable with the RBF 3.0 formula(P>0.05),which both presented smaller MedAEs than others(all P<0.05).As for the percentage of eyes within±0.50 D or±0.75 D of PE,the XGBoost TK showed comparable percentages with the RBF 3.0 TK formula(74.76%vs.66.99%,or 90.29%vs.87.38%,P>0.05),and statistically larger percentages than the other eight formulas(P<0.05).Conclusions:Highly myopic eyes with thinner corneas tend to have larger differences between TK and K.The XGboost enhancement calculator and RBF 3.0 formula using TK showed the most promising outcomes in highly myopic eyes.
基金Funding was provided by the National Natural Science Foundation of China,82122017:Xiangjia Zhu,81970780:Yi Lu,81870642:Xiangjia Zhu,81670835:Yi LuScience and Technology Innovation Plan of Shanghai Science and Technology Commission,19441900700:Xiangjia Zhu,21S31904900:Xiangjia Zhu+3 种基金Shanghai Hospital Development Center,SHDC12019X08:Xiangjia ZhuShanghai Shenkang Hospital Development Center,SHDC2020CR4078:Xiangjia ZhuDouble-E Plan of Eye&ENT Hospital,SYA202006:Xiangjia ZhuShanghai Municipal Key Clinical Specialty Program,shslczdzk01901:Xiangjia Zhu.
文摘High myopia has long been highly prevalent worldwide with a largely yet unexplained genetic contribution.To identify novel susceptibility genes for axial length(AL)in highly myopic eyes,a genome-wide association study(GWAS)was performed using the genomic dataset of 350 deep whole-genome sequencing data from highly myopic patients.Top single nucleotide polymorphisms(SNPs)were functionally annotated.Immunofluorescence staining,quantitative polymerase chain reaction,and western blot were performed using neural retina of form-deprived myopic mice.Enrichment analyses were further performed.We identified the four top SNPs and found that ADAM Metallopeptidase With Thrombospondin Type 1 Motif 16(ADAMTS16)and Phosphatidylinositol Glycan Anchor Biosynthesis Class Z(PIGZ)had the potential of clinical signifi-cance.Animal experiments confirmed that PIGZ expression could be observed and showed higher expression level in form-deprived mice,especially in the ganglion cell layer.The messenger RNA(mRNA)levels of both ADAMTS16 and PIGZ were significantly higher in the neural retina of form-deprived eyes(p=0.005 and 0.007 respectively),and both proteins showed significantly upregulated expression in the neural retina of deprived eyes(p=0.004 and 0.042,respectively).Enrichment analysis revealed a significant role of cellular adhesion and signal transduction in AL,and also several AL-related pathways including circadian entrainment and inflammatory mediator regulation of transient receptor potential channels were proposed.In conclusion,the current study identified four novel SNPs associated with AL in highly myopic eyes and confirmed that the expression of ADAMTS16 and PIGZ was significantly upregulated in neural retina of deprived eyes.Enrichment analyses provided novel insight into the etiology of high myopia and opened avenues for future research interest.
基金funded by research grants from the National Natural Science Foundation of China(Grant Nos.81870642,81970780,81470613,81100653,81670835,and 81270989)the National Key R&D Program of China(Grant No.2018YFC0116800)the Outstanding Youth Medical Talents Program of the Shanghai Health and Family Planning Commission(Grant No.2017YQ011).
文摘Purpose:To investigate the anterior segment in nanophthalmic eyes and their association with intraocular pressure after cataract surgery.Methods:Thirty-two nanophthalmic eyes(axial length[AL]<18.5 mm)in 18 patients and 35 normal eyes(21.0≤AL≤24.5 mm)in 35 controls who had undergone uneventful cataract surgery were included.Swept-source optical coherence tomography was used to compare the anterior segment structures between the two groups.The associations between the anterior segment characteristics of nanophthalmic eyes and postoperative intraocular pressure(IOP)were also investigated.Results:The IOP-lowering effect of cataract surgery was remarkably insufficient in nanophthalmic eyes.Peripheral anterior synechiae(PAS)were observed in 56%(18/32)of nanophthalmic eyes,and a characteristic boomerangshaped iris was observed in 28%(9/32).The anterior surface of the iris seemed"smoother"in nanophthalmic eyes than in normal eyes.Schlemm's canal(SC)diameter,SC area,trabecular meshwork(TM)thickness,TM width,and TM area were generally smaller in the nanophthalmic eyes.Younger age,higher preoperative IOP,broader PAS,and smaller SC area were main contributors to higher postoperative IOP.AL and SC diameter may also be of great importance in IOP prediction in patients without glaucoma surgery and PAS.Conclusions:The morphological features of the anterior segment in nanophthalmic eyes are significantly different from those of normal eyes.Influencing factors such as age,AL,preoperative IOP,extent of PAS,SC and TM size could all be prognostic for IOP after cataract surgery in nanophthalmic eyes.Trial registration:ClinicalTrails.gov,Trial registration number:NCT02182921,Registered 8 July 2014.
基金supported by the National Natural Science Foundation of China(82020108006 and 81730025 to Chen Zhao,U2001209 to Bo Yan)the Excellent Academic Leaders of Shanghai(18XD1401000 to Chen Zhao)the Natural Science Foundation of Shanghai,China(21ZR1406600 to Weimin Tan).
文摘In ophthalmology,the quality of fundus images is critical for accurate diagnosis,both in clinical practice and in artificial intelligence(AI)-assisted diagnostics.Despite the broad view provided by ultrawide-field(UWF)imaging,pseudocolor images may conceal critical lesions necessary for precise diagnosis.To address this,we introduce UWF-Net,a sophisticated image enhancement algorithm that takes disease characteristics into consideration.Using the Fudan University ultra-wide-field image(FDUWI)dataset,which includes 11294 Optos pseudocolor and 2415 Zeiss true-color UWF images,each of which is rigorously annotated,UWF-Net combines global style modeling with feature-level lesion enhancement.Pathological consistency loss is also applied to maintain fundus feature integrity,significantly improving image quality.Quantitative and qualitative evaluations demonstrated that UWF-Net outperforms existing methods such as contrast limited adaptive histogram equalization(CLAHE)and structure and illumination constrained generative adversarial network(StillGAN),delivering superior retinal image quality,higher quality scores,and preserved feature details after enhancement.In disease classification tasks,images enhanced by UWF-Net showed notable improvements when processed with existing classification systems over those enhanced by StillGAN,demonstrating a 4.62%increase in sensitivity(SEN)and a 3.97%increase in accuracy(ACC).In a multicenter clinical setting,UWF-Net-enhanced images were preferred by ophthalmologic technicians and doctors,and yielded a significant reduction in diagnostic time((13.17±8.40)s for UWF-Net enhanced images vs(19.54±12.40)s for original images)and an increase in diagnostic accuracy(87.71%for UWF-Net enhanced images vs 80.40%for original images).Our research verifies that UWF-Net markedly improves the quality of UWF imaging,facilitating better clinical outcomes and more reliable AI-assisted disease classification.The clinical integration of UWF-Net holds great promise for enhancing diagnostic processes and patient care in ophthalmology.
基金Publication of this article was supported by research grants from the National Natural Science Foundation of the People’s Republic of China(grant nos.81870642,81670835 and 81470613)the Shanghai High Myopia Study Group,the International Science and Technology Cooperation Foundation of Shanghai(grant no.14430721100)the Outstanding Youth Medical Talents Program of Shanghai Health and Family Planning Commission(grant no.2017YQ011).
文摘Background:To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses(MfIOLs)in myopic eyes.Methods:Myopic(axial length[AXL]>24.5 mm)and non-myopic(21.0 mm<AXL≤24.5 mm)cataract eyes were enrolled in this prospective study and randomly assigned to receive implantation of Zeiss AT LISA tri 839MP lenses(Group A)or Tecnis ZMB00 lenses(Group B).In total,122 eyes of 122 patients were available for analysis.Decentration and tilt of MfIOLs,high-order aberrations(HOAs),and modulation transfer functions(MTFs)were evaluated using the OPD-Scan III aberrometer 3 months postoperatively.Subjective symptoms were assessed with a Quality of Vision questionnaire.Results:Near and distance visual acuities,tilt and horizontal decentration did not differ between the two groups,postoperatively.However,myopic eyes of Group B showed greater vertical decentration than those of Group A(−0.17±0.14 mm vs.-0.03±0.09 mm,respectively),particularly when the MfIOLs were placed horizontally or obliquely.Overall decentration of myopic eyes was greater in Group B than in Group A(0.41±0.15 mm vs.0.16±0.10 mm,respectively).In Group B,AXL was negatively correlated with vertical decentration and positively correlated with overall decentration.No such correlations were found in Group A.Intraocular total HOAs,coma,trefoil and spherical aberrations were lower in Group A than in Group B for a 6.0 mm pupil among myopic eyes.Generally,Group A had better MTFs and fewer subjective symptoms than Group B among myopic eyes.Conclusions:Plate-haptic design of MfIOLs may be a suggested option for myopic cataract eyes due to the less inferior decentration and better visual quality postoperatively.
基金The Chinese National Natural Science Foundation(grant nos.81970780,81870642,81670835,Beijing,China)the Shanghai Talent Development Fund(grant no.201604,Shanghai,China)the Outstanding Youth Medical Talents Program of Shanghai Health and Family Planning Commission(grant no.2017YQ011,Shanghai,China).
文摘Background:To evaluate the distribution of lens thickness(LT)and its associations with other ocular biometric factors among cataract patients in Shanghai.Methods:Twenty-four thousand thirteen eyes from 24,013 cataract patients were retrospectively included.Ocular biometric factors including LT,central corneal thickness(CCT),anterior chamber depth(ACD),white-to-white(WTW)distance,anterior corneal curvature,and axial length(AL)were obtained using the IOLMaster700.The associations between LT and general or ocular factors were assessed.Results:The mean age was 62.5±13.6 years and 56.1%were female.The mean LT was 4.51±0.46 mm.The LT was greater in older patients(P<0.001).LT was positively correlated with CCT,while negatively correlated with ACD,WTW,and anterior corneal curvature(P<0.001).Multivariate analysis revealed that increased LT was associated with older age,male gender,thicker CCT,shallower ACD,larger WTW,and flatter anterior corneal curvature(P<0.001).LT changed with a variable behavior according to AL.In short eyes LT increased as AL increased,then decreased with longer AL in normal eyes and moderate myopic eyes,but increased again as AL increased in highly myopic eyes.Thickest LT was found in the 20.01-22mm AL group.The correlation between LT and other biometric factors remained significant when stratified by ALs.Conclusions:In a large Chinese cataractous population,we found that the thicker lens may be associated with older age,male gender,thicker CCT,shallower ACD,larger WTW,and flatter anterior corneal curvature.As AL increased,the change of LT was nonlinear,with the thickest lens seen in the 20-22mm AL group.
基金This research was funded by research grants from the National Natural Science Foundation of China(81870642,81970780,81470613,81100653,81670835,and 81270989)the National Key R&D Program of China(2018YFC0116800)+2 种基金the Shanghai Talent Development Fund(201604)the Shanghai Youth Doctor Support Program(2014118)the Outstanding Youth Medical Talents Program of the Shanghai Health and Family Planning Commission(2017YQ011).
文摘Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(IOLMaster 700)to scan 131 emmetropic eyes(axial length<24.5 mm),25 mild/moderate myopic eyes(axial length 24.5–26 mm),and 123 high myopic eyes(52,29,and 42 eyes with axial lengths of 26–28,28–30,and>30 mm,respectively)as part of the routine preoperative examination before cataract surgery.SS-OCT involved B-scans along six meridians.The data were analyzed to assess the magnitude and orientation of the lens tilt and their correlation with other optical biometric parameters.Result:The mean tilt was 3.36±0.98°in emmetropic eyes,3.07±1.04°in mild/medium myopic eyes,and 2.35±1.01°in high myopic eyes.Tilt correlated significantly and inversely with axial length(Pearson’s r=−0.427,P<0.001).The crystalline lens tilt predominantly faced the upper outer quadrant relative to the visual axis,symmetrically in both eyes,with mean angles of 24.32°and 147.36°in the right and left eyes,respectively.The variability in the lens tilt direction increased with increasing axial length(χ^(2) test,P<0.001).Conclusion:The magnitude of crystalline lens tilt decreased with increasing axial length.The direction of tilt was predominantly towards the upper outer quadrant in both eyes.The variability in the tilt orientation increased with increasing axial length.Trial registration:NIH(clinicaltrial.gov),NCT03062085.Registered 23 February 2017.
基金This research was funded by research grants from the National Natural Science Foundation of China(81870642,81970780,81470613,81100653,81670835,and 81270989)the National Key R&D Program of China(2018YFC0116800)the Outstanding Youth Medical Talents Program of the Shanghai Health and Family Planning Commission(2017YQ011).
文摘Purpose:To investigate the anterior segment in nanophthalmic eyes and their association with intraocular pressure after cataract surgery.Methods:Thirty-two nanophthalmic eyes(axial length[AL]<18.5 mm)in 18 patients and 35 normal eyes(21≤AL≤24.5 mm)in 35 controls who had undergone uneventful cataract surgery were included.Swept-source optical coherence tomography was used to compare the anterior segment structures between the two groups.The associations between the anterior segment characteristics of nanophthalmic eyes and postoperative intraocular pressure(IOP)were also investigated.Results:The IOP-lowering effect of cataract surgery was remarkably insufficient in nanophthalmic eyes.Peripheral anterior synechiae(PAS)were observed in 56%(18/32)of nanophthalmic eyes,and a characteristic boomerangshaped iris was observed in 28%(9/32).The anterior surface of the iris seemed“smoother”in nanophthalmic eyes than in normal eyes.Schlemm’s canal(SC)diameter,SC area,trabecular meshwork(TM)thickness,TM width,and TM area were generally smaller in the nanophthalmic eyes.Younger age,higher preoperative IOP,broader PAS,and smaller SC area were main contributors to higher postoperative IOP.AL and SC diameter may also be of great importance in IOP prediction in patients without glaucoma surgery and PAS.Conclusions:The morphological features of the anterior segment in nanophthalmic eyes are significantly different from those of normal eyes.Influencing factors such as age,AL,preoperative IOP,extent of PAS,SC and TM size could all be prognostic for IOP after cataract surgery in nanophthalmic eyes.
基金funded by research grants from the National Natural Science Foundation of China(Grants No.82122017,81870642,81970780,81670835,and 81700819)Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission(Grants No.19441900700 and 21S31904900)Clinical Science and Technology Innovation Project of Shanghai Shenkang Hospital Development Center(Grants No.SHDC12019X08 and SHDC2020CR4078)。
文摘Background:To evaluate the effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system.Methods:Nine elder cynomolgus monkeys were used,consisting of three monkeys without cataract as controls,three monkeys with naturally occurring cortical cataract,and three monkeys with nuclear cataract as intervention groups.Nanoparticulated thermogel with lanosterol and fluorescein was administered by subconjunctival injection in the monkeys with cataract.Fluorescence changes of injected thermogel and cataract progression were observed.Lanosterol concentration in aqueous humor,solubility changes in lens proteins,and oxidative stress levels were analyzed in the lenses of the control and intervention groups.Results:Injected thermogel showed decreased fluorescence during follow up.Lanosterol concentration in aqueous humor increased in the first 2 weeks and then gradually decreased,which was in accordance with the changes in cortical lens clarity.However,lenses with nuclear opacification showed little change.In the cortical region of lenses with cortical cataract,solubility ofα-crystallin was significantly increased after administration of lanosterol,as well as the reduction of oxidative stress.Conclusions:We demonstrated the effect of lanosterol on cataract progression based on in vivo models of primates.Lanosterol showed a short-term and reliable reversal effect on reducing cataract severity in cortical cataract in the early stages,possibly due to the increase in the solubility of lens proteins and changes in the oxidative stress status.Lanosterol administration using subconjunctival drug release system could be a promising nonsurgical approach for future clinical studies of cataract prevention and treatment.
基金This research was funded by research grants from the National Natural Science Foundation of China(81870642,81970780,81470613,81100653,81670835,and 81270989)the National Key R&D Program of China(2018YFC0116800)+2 种基金the Shanghai Talent Development Fund(201604)the Shanghai Youth Doaor Support Program(2014118)and the Outstanding Youth Medical Talents Program of the Shanghai Health and Family Planning Commission(2017YQ011).
文摘Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(lOLMaster 700)to scan 131 emmetropic eyes(axial length<24.5 mm);25 mild/moderate myopic eyes(axial length 24.5-26 mm),and 123 high myopic eyes(52,29,and 42 eyes with axial lengths of 26-28,28-BO,and>30 mm,respectively)as part of the routine preoperative examination before cataract surgery.SS-OCT involved B-scans along six meridians.The data were analyzed to assess the magnitude and orientation of the lens tilt and their correlation with other optical biometric parameters.Result:The mean tilt was 3.36±0.98。in emmetropic eyes,3.07±1.04° in mild/medium myopic eyes,and 2.35±1.01° in high myopic eyes.Tilt correlated significantly and inversely with axial length(Pearson,sr=-0.427,P<0.001).The crystalline lens tilt predominantly faced the upper outer quadrant relative to the visual axis,symmetrically in both eyes,with mean angles of 24.32°and 147.36°in the right and left eyes,respectively.The variability in the lens tilt direction increased with increasing axial length(x2 test,P<0.001).Conclusion:The magnitude of crystalline lens tilt decreased with increasing axial length.The direction of tilt was predominantly towards the upper outer quadrant in both eyes.The variability in the tilt orientation increased with increasing axial length.Trial registration:NIH(clinicaltrial.gov),NCT03062085.Registered 23 February 2017.
基金supported by research grants from the National Natural Science Foundation of China(82122017,82271069,81870642,82371040,81970780,82201161,81470613 and 81670835)Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission(23Y11909800 and 21S31904900)+1 种基金Outstanding Youth Medical Talents of Shanghai“Rising Stars of Medical Talents”Youth Development Program,Clinical Research Plan of Shanghai Shenkang Hospital Development Center(SHDC12020111)Shanghai Municipal Key Clinical Specialty Program(shslczdzk01901).
文摘Background:High myopia is one of the major causes of visual impairment and has an ever-increasing prevalence,especially in East Asia.It is characterized by excessive axial elongation,leading to various blinding complications that extend beyond mere refractive errors and persist immovably after refractive surgery,presenting substantial public health challenge.Main text:High myopia-related complications include lens pathologies,atrophic and tractional maculopathy,choroidal neovascularization,peripheral retinal degenerations and retinal detachment,and glaucoma and heightened susceptibility to intraocular pressure(IOP)elevation.Pathological lens changes characteristic of high myopia include early cataractogenesis,overgrowth of lens,weakened zonules,and postoperative capsular contraction syndrome,possibly driven by inflammatory pathogenesis,etc.Dome-shaped macula and cilioretinal arteries are two newly identified protective factors for central vision of highly myopic patients.These patients also face risks of open-angle glaucoma and IOP spike following intraocular surgery.Morphologic alternations of optic nerve in high myopia can complicate early glaucoma detection,necessitating comprehensive examinations and close follow-up.Anatomically,thinner trabecular meshwork increases this risk;conversely lamina cribrosa defects may offer a fluid outlet,potentially mitigating the pressure.Notably,anxiety has emerged as the first recognized extra-ocular complication in high myopia,with an underlying inflammatory pathogenesis that connects visual stimulus,blood and brain.Conclusions:High myopia induces multiple ocular and potential mental health complications,underscoring the need to develop more effective strategies to improve both physical and emotional well-being of these patients,among which anti-inflammation might possibly represent a promising new target.
