Uveal and conjunctival melanomas are relatively rare tumors;nonetheless,they pose a significant risk of mortality for a large number of affected individuals.The pathogenesis of melanoma at different sites is very simil...Uveal and conjunctival melanomas are relatively rare tumors;nonetheless,they pose a significant risk of mortality for a large number of affected individuals.The pathogenesis of melanoma at different sites is very similar,however,the prognosis for patients with ocular melanoma remains unfavourable,primarily due to its distinctive genetic profile and tumor microenvironment.Regardless of considerable advances in understanding the genetic characteristics and biological behaviour,the treatment of uveal and conjunctival melanoma remains a formidable challenge.To enhance the prospect of success,collaborative efforts involving medical professionals and researchers in thefields of ocular biology and oncology are essential.Current data show a lack of well-designed randomized clinical trials and limited benefits in current forms of treatment for these tumors.Despite advancements in the development of effective melanoma therapeutic strategies,all current treatments for uveal melanoma(UM)and conjunctival melanoma(CoM)remain unsatisfactory,resulting in a poor long-term prognosis.Ongoing trials offer hope for positive outcomes in advanced and metastatic tumors.A more comprehensive understanding of the genetic and molecular abnormalities involved in the development and progression of ocular melanomas opens the way for the development of personalized therapy,with various potential therapeutic targets currently under consideration.Increased comprehension of the molecular pathogenesis of UM and CoM and their specificities may aid in the development of new and more effective systemic therapeutic agents,with the hope of improving the prognosis for patients with metastatic disease.展开更多
Introduction: Eye health in children is a real public health problem in developing countries. The aim of this work was to determine the frequency of ocular pathologies in children aged 0 to 16 at the prefectural hospi...Introduction: Eye health in children is a real public health problem in developing countries. The aim of this work was to determine the frequency of ocular pathologies in children aged 0 to 16 at the prefectural hospital of Macenta in Guinea. Patients and Method: This was a descriptive prospective study. It covered a period of 6 months from October 1 to March 31, 2022 at the prefectural hospital of Macenta in Guinea. Children aged 0 to 16 received during the study period were included. Were excluded, those with an incomplete file and whose parents did not consent. Results: Out of 1816 consultations, 224 children aged 0 to 16 were collected 7.95%;mean age 7.35 years ± 4.6;sex ratio 1.38. The age group of 6 to 11 years was more represented. More than half of the patients were educated 50.4% and came from rural areas 52.7%. Pathologies of the orbit were dominated by orbital cellulitis 13% and those of the annexes by conjunctivitis 40.6%. Keratitis and cataracts were pathologies dominating the cornea and the lens, respectively 5.4% and 8.5%. Atrophy of the eyeball was the most frequent among those of the eyeball, at 3.6%. The most performed surgical procedure was phacophagy in 6.7%. The most common reason for consultation was eye pain, at 33.5%. Both eyes were affected at the same time in the majority 49.5%, and the most represented antecedent was malaria 22.3% of cases. Visual acuity without correction ≥ 3/10 was the most represented 37.5% in the right eye and 34.8% in the left eye. The therapeutic classes used were dominated by antibiotic-corticoid combinations 88.8%. Conclusion: Ocular pathologies in children from 0 to 16 years old constitute a real public health problem. They are dominated by pathologies of the conjunctiva and the lens. Popularization for early management of ophthalmological pathologies would be beneficial. .展开更多
AIM:To explore the effect of epidermal growth factor receptor(EGFR)inhibition by erlotinib and EGFR siRNA on epidermal growth factor(EGF)-induced activation of retinal pigment epithelium(RPE)cells.METHODS:Human RPE ce...AIM:To explore the effect of epidermal growth factor receptor(EGFR)inhibition by erlotinib and EGFR siRNA on epidermal growth factor(EGF)-induced activation of retinal pigment epithelium(RPE)cells.METHODS:Human RPE cell line(ARPE-19 cells)was activated by 100 ng/mL EGF.Erlotinib and EGFR siRNA were used to intervene EGF treatment.Cellular viability,proliferation,and migration were detected by methyl thiazolyl tetrazolium(MTT)assay,bromodeoxyuridine(BrdU)staining assay and wound healing assay,respectively.EGFR/protein kinase B(AKT)pathway proteins and N-cadherin,α-smooth muscle actin(α-SMA),and vimentin were tested by Western blot assay.EGFR was also determined by immunofluorescence staining.RESULTS:EGF treatment for 24h induced a significant increase of ARPE-19 cells’viability,proliferation and migration,phosphorylation of EGFR/AKT proteins,and decreased total EGFR expression.Erlotinib suppressed ARPE-19 cells’viability,proliferation and migration through down regulating total EGFR and AKT protein expressions.Erlotinib also inhibited EGF-induced an increase of proliferative and migrative ability in ARPE-19 cells and clearly suppressed EGF-induced EGFR/AKT proteins phosphorylation and decreased expression of N-cadherin,α-SMA,and vimentin proteins.Similarly,EGFR inhibition by EGFR siRNA significantly affected EGF-induced an increase of cell proliferation,viability,and migration,phosphorylation of EGFR/AKT proteins,and up-regulation of N-cadherin,α-SMA,and vimentin proteins.CONCLUSION:Erlotinib and EGFR-knockdown suppress EGF-induced cell viability,proliferation,and migration via EGFR/AKT pathway in RPE cells.EGFR inhibition may be a possible therapeutic approach for proliferative vitreoretinopathy(PVR).展开更多
AIM:To explore the effects of hepatocyte growth factor(HGF)on retinal pigment epithelium(RPE)cell behaviors.METHODS:The human adult retinal pigment epithelial cell line-19(ARPE-19)were treated by HGF or mesenchymalepi...AIM:To explore the effects of hepatocyte growth factor(HGF)on retinal pigment epithelium(RPE)cell behaviors.METHODS:The human adult retinal pigment epithelial cell line-19(ARPE-19)were treated by HGF or mesenchymalepithelial transition factor(MET)inhibitor SU11274 in vitro.Cell viability was detected by a Cell Counting Kit-8 assay.Cell proliferation and motility was detected by a bromodeoxyuridine incorporation assay and a wound healing assay,respectively.The expression levels of MET,phosphorylated MET,protein kinase B(AKT),and phosphorylated AKT proteins were determined by Western blot assay.The MET and phosphorylated MET proteins were also determined by immunofluorescence assay.RESULTS:HGF increased ARPE-19 cells’viability,proliferation and migration,and induced an increase of phosphorylated MET and phosphorylated AKT proteins.SU11274 significantly reduced cell viability,proliferation,and migration and decreased the expression of MET and AKT proteins.SU11274 suppressed HGF-induced increase of viability,proliferation,and migration in ARPE-19 cells.Additionally,SU11274 also blocked HGF-induced phosphorylation of MET and AKT proteins.CONCLUSION:HGF enhances cellular viability,proliferation,and migration in RPE cells through the MET/AKT signaling pathway,whereas this enhancement is suppressed by the MET inhibitor SU11274.HGF-induced MET/AKT signaling might be a vital contributor of RPE cells survival.展开更多
Anophthalmia is a condition of the absence of an eye and the presence of a small eye within the orbit.It is associated with many known syndromes.Clinical findings,as well as imaging modalities and genetic analysis,are...Anophthalmia is a condition of the absence of an eye and the presence of a small eye within the orbit.It is associated with many known syndromes.Clinical findings,as well as imaging modalities and genetic analysis,are important in making the diagnosis.Imaging modalities are crucial scanning methods.Cryptophthalmos,cyclopia,synophthalmia and congenital cystic eye should be considered in differential diagnoses.We report two clinical anophthalmic siblings,emphasizing the importance of neuroradiological and orbital imaging findings in distinguishing true congenital anophthalmia from clinical anophthalmia.展开更多
Context: Childhood eye health is a real public health problem in our context, the consequences of which go beyond vision, affecting education, social participation and future economic productivity. The aim was to stud...Context: Childhood eye health is a real public health problem in our context, the consequences of which go beyond vision, affecting education, social participation and future economic productivity. The aim was to study the frequency of ocular surgical pathologies in children aged 0 to 15 years. Patients and Methodius: This study covered a 4 years period from January 1, 2016 to December 31, 2020. It was a retrospective study of a descriptive and analytical nature. It concerned all children aged 0 to 15 who had undergone surgery for ocular pathology during the study period and who were included in the operating room register. Results: Out of 4974 patients of all ages operated for ocular surgical pathology, 124 were children aged 0 to 15 years or 2.49%. The 9 - 12 age group was the most represented with 29.03%;the mean age was 7.3 years ± 4.6 with extremes of 3 months and 15 years. A male predominance was observed at 62.90%. Pathologies of the lens, cataract and eyelids, traumatic edema represented the most frequent eye conditions in our patients with respectively 51 cases or 41.13% in the right eye (OD), 54 cases or 53.55% in the left eye (OG) and 14 cases or 11.29% in OD and OG followed by endemic limboconjunctivitis of the tropics (LCET), 10 cases or 3.23%, in OD and hemorrhage under conjunctival 13 cases or 10.48% in OG. Cataract surgery with the Technique Manuel Small Incision Cataract Surgery + Implantation in the posterior chamber (MSICS + ICP) was the most used in 74% of cases. General anesthesia was the most widely used anesthetic method in 100% of cases. The clinical course was favorable at 45.97%. Conclusion: We note a relatively low hospital frequency of ocular surgical pathologies in children, with a male predominance. The early consultation period and the improvement of the technical platform could improve their management.展开更多
Introduction: Hypertensive retinopathy is the set of retinal and papillary manifestations secondary to acute or chronic acute or chronic high blood pressure. Its frequency increases with age in women, its treatment re...Introduction: Hypertensive retinopathy is the set of retinal and papillary manifestations secondary to acute or chronic acute or chronic high blood pressure. Its frequency increases with age in women, its treatment requires the balance of blood pressure figures. Purpose: To study in women the epidemiological, clinical and therapeutic aspects of Hypertensive retinopathy at the application center of the Diploma of Specialized Studies in Ophthalmology (CADES/O). Patients and Methods: Prospective study conducted on 92 women who met the inclusion criteria over a period of six (6) months, from October 1, 2021 to March 31, 2022 in whom the diagnosis of Hypertensive Retinopathy was retained according to the Kirkendall classification. Results: We collected 92 patients with an average age of 57.88 years. The hypertensive Retinopathy was present at 61.75%. The age group of 60 - 69 years was the most represented at 40.22%. The socio-professional stratum most affected was housewives. The duration of the evolution of high blood pressure was from 2 - 5 years representing 57.61% of our study cases;the most common grade of high blood pressure was Grade II at 60.87%. Treatment of hypertension was irregularly followed in 73.91%. Stage II according to Kirkendall’s classification was 58.70% common;the recurrent sign was retinal hemorrhage at 30.43%. Blood pressure balance was the treatment recommended to our patients at 80.48%. Conclusion: Hypertensive retinopathy is common in women and its management remains the balance of blood pressure figures with periodic and multidisciplinary monitoring.展开更多
Introduction: Primary open-angle glaucoma, a chronic, potentially blinding disease, requires lifelong medical treatment that demands full patient compliance. The objective was to determine the rate of compliance and t...Introduction: Primary open-angle glaucoma, a chronic, potentially blinding disease, requires lifelong medical treatment that demands full patient compliance. The objective was to determine the rate of compliance and to study the determinants of compliance in glaucoma patients followed at CADES/O. Patients and Methods: This was an observational study, which included old and new glaucoma patients. Compliance was assessed on the availability of medication, regularity of dosing schedules, compliance with prescribed doses, and regularity at check-ups. Compliance was judged to be good when at least four (4) of these criteria were met, fair when only three (3) of these criteria were met and poor when only two (2) of these criteria were met. Results: Compliance was considered good in 38.4% of cases, fair in 48.2% of cases and poor in 13.4% of cases with an overall compliance rate of 86.6%. The correlation was not statistically significant for age, sex, origin, length of illness, route of administration, instiller, or therapeutic regime. On the other hand, profession, level of education, presence of systemic arterial hypertension, compliance with instillation schedules, prescribed dosage, regularity of treatment, compliance with control visits and the climate of trust between patient and treating physician were the determining factors with the greatest statistical influence on compliance with treatment. Conclusion: Compliance with glaucoma treatment is linked to the patient factor but especially to the doctor factor. Doctors should take their time to explain to patients their disease, its evolution with or without treatment and above all the necessity of a good therapeutic compliance.展开更多
Dear Editor,We would like to report visual disturbance due to choroidal metastasis as the first clinical sign of renal carcinoma.Metastatic tumours are one of the most common type of intraocular malignancy in adults w...Dear Editor,We would like to report visual disturbance due to choroidal metastasis as the first clinical sign of renal carcinoma.Metastatic tumours are one of the most common type of intraocular malignancy in adults with the most common origins of metastasis being the lungs in men and breasts in women[1-2].Ocular choroidal metastases from renal cell carcinoma(RCC)are rare with 3.5%of ocular metastases originating from the kidneys[3].RCC predominantly occurs in individuals in their seventh and eighth decades of life and has been reported nearly twice as often in men as in women[1,3].展开更多
Dear Editor,The advent of 23-gauge(G),25-G,and 27-G vitrectomy systems[1]since the beginning of the 21stcentury has allowed vitrectomy via a smaller incision compared to the 20-G system;hence the name"microincisi...Dear Editor,The advent of 23-gauge(G),25-G,and 27-G vitrectomy systems[1]since the beginning of the 21stcentury has allowed vitrectomy via a smaller incision compared to the 20-G system;hence the name"microincision vitrectomy surgery".Microincision vitrectomy surgery has gainedpopularity among vitreoretinal surgeons.展开更多
AIM：To investigate foveal avascular zone（FAZ）and parafoveal vessel densities（PRVD）by means of optical coherence tomography angiography（OCTA）in diabetic patients with or without diabetic retinopathy（DR）and to ...AIM：To investigate foveal avascular zone（FAZ）and parafoveal vessel densities（PRVD）by means of optical coherence tomography angiography（OCTA）in diabetic patients with or without diabetic retinopathy（DR）and to assess the reproducibility of FAZ and PRVD measurements.METHODS：Sixty diabetic patients（60 eyes）with different stage of DR（graded according to the International Clinical Severity Scale for DR）and 20 healthy subjects underwent FAZ area and PRVD measurements using OCTA by two experienced examiners.FAZ area in all patients was also assessed using fluorescein angiography（FA）.RESULTS：In subject with proliferative DR and with moderate-severe non proliferative DR,FAZ area was significantly increased compared to healthy controls（P=0.025 and P=0.050 respectively measured with OCTA and P=0.025 and P=0.048 respectively measured with FA）.OCTA showed significantly less inter-observer variability compared to FA.Concordance correlation coefficient（CCC）for FAZ area measurements was 0.829（95%CI：0.736-0.891）P〈0.001 with FA and 1.000（95%CI：0.999-1.000）P〈0.001with OCTA.CCC was 0.834（95%CI：0.746-0.893）P〈0.001and 0.890（95%CI：0.828-0.930）P〈0.001 for parafoveal superficial and deep vessel density measurements,respectively.CONCLUSION：OCTA shows progressive increase of FAZ area and reduction of PRVD in both superficial and deep plexus at increasing DR severity.FAZ area and PRVD measurements using OCTA are highly reproducible.展开更多
Hepatitis B virus (HBV) infection is a serious clinical problem worldwide. Conventional interferon (IFN)-α has been approved for the treatment of chronic hepatitis B (CHB). Short-term studies have demonstr...Hepatitis B virus (HBV) infection is a serious clinical problem worldwide. Conventional interferon (IFN)-α has been approved for the treatment of chronic hepatitis B (CHB). Short-term studies have demonstrated that IFN-based therapy is moderately effective in inducing the loss of hepatitis e antigen (HBeAg) or seroconversion (30%-40%) in HBeAg-positive patients and also produces sustained HBV DNA suppression (20%-30%) in HBeAg-negative patients. Many studies have reported a correlation between the HBV genotype and response to IFN treatment. The highest response rate to IFN treatment was found in patients infected with HBV genotype A, followed by HBV genotypes B, C, and D. The long-term effect of IFN-α on CHB has not yet been elucidated. The ability of IFN-α treatment to prevent new cirrhosis, complications associated with cirrhosis, and development of hepatocellular carcinoma (HCC) is controversial. The beneficial effect of IFN-α treatment in reducing the development of HCC has mainly been observed in treatment responders who already have cirrhosis. These inconsistent findings may be attributed to the inevitable limitations of comparisons across studies, including differences in the baseline characteristics of the study and the moderate suppression of HBV replication by IFN-α relative to nucleoside/nucleos(t)ide analogs.展开更多
Objective:To investigate the effects of puerarin on the activity of superoxide dismutase(SOD), and expressions of advanced glycation end-product(AGE) receptor(RAGE) and vascular endothelial growth factor(VEGF) in reti...Objective:To investigate the effects of puerarin on the activity of superoxide dismutase(SOD), and expressions of advanced glycation end-product(AGE) receptor(RAGE) and vascular endothelial growth factor(VEGF) in retinas of streptozotocin(STZ)-induced early diabetic rats. Methods:Diabetic rat models were established by inducing diabetes via intra-peritoneal injection of STZ.Rats were randomly divided into normal(control),diabetic(DM),and DM+ puerarin groups.After intra-gastric administration of puerarin(500 mg/kg/day for 4 weeks),levels of SOD and malondialdehyde(MDA) were determined in serum and retina.mRNA and protein expression levels of RAGE and VEGF in retinas were determined by real-lime polymerase chain reaction(RT-PCR)(mRNA) and Western blot analysis(protein levels).Results:There was significantly lower SOD activity and significantly higher MDA in serum and retinas of the DM group compared with the two other groups(P【0.05).After treatment with puerarin,SOD activity increased and MDA content decreased in this group(P【0.05).mRNA and protein expression levels of RACE and VECF in the DM group were significantly higher than those of the other groups (P【0.05),and decreased after puerarin treatment(P【0.05).Conclusions:Puerarin is able to enhance SOD activity,and inhibit RAGE and VEGF expressions in retinas of STZ-induced early diabetic ruts.展开更多
AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer(GCIPL) parameters between all the consecutive stages of glaucoma(from healthy to moderate-to-severe glaucoma), and to...AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer(GCIPL) parameters between all the consecutive stages of glaucoma(from healthy to moderate-to-severe glaucoma), and to compare it with the discriminating performances of the peripapillary retinal nerve fiber layer(RNFL) parameters and optic nerve head(ONH) parameters.METHODS: Totally 147 eyes(40 healthy, 40 glaucoma suspects, 40 early glaucoma, and 27 moderate-to-severe glaucoma) of 133 subjects were included. Optical coherence tomography(OCT) was obtained using Cirrus HD-OCT 5000. The diagnostic performances of GC-IPL, RNFL, and ONH parameters were evaluated by determining the area under the curve(AUC) of the receiver operating characteristics. RESULTS: All GC-IPL parameters discriminated glaucoma suspect patients from subjects with healthy eyes and moderate-to-severe glaucoma from early glaucoma patients(P<0.017, for all). Also, minimum, inferotemporal and inferonasal GC-IPL parameters discriminated early glaucoma patients from glaucoma suspects, whereas no RNFL or ONH parameter could discriminate between the two. The best parameters to discriminate glaucoma suspects from subjects with healthy eyes were superonasal GC-IPL, superior RNFL and average c/d ratio(AUC=0.746, 0.810 and 0.746, respectively). Discriminating performances of all the parameters for early glaucoma vs glaucoma suspect comparison were lower than that of the other consecutive group comparisons, with the bestGC-IPL parameters being minimum and inferotemporal(AUC=0.669 and 0.662, respectively). Moreover, minimum GC-IPL, average RNFL, and rim area(AUC=0.900, 0.858, 0.768, respectively) were the best parameters for discriminating moderate-to-severe glaucoma patients from early glaucoma patients.CONCLUSION: GC-IPL parameters can discriminate glaucoma suspect patients from subjects with healthy eyes, and also all the consecutive stages of glaucoma from each other(from glaucoma suspect to moderate-tosevere glaucoma). Further, the discriminating performance of GC-IPL thicknesses is comparable to that.展开更多
AIM: To compare the effectiveness of topical cyclosporine A emulsion with that of oral doxycycline for rosacea associated ocular changes and dry eye complaints.METHODS: One hundred and ten patients with rosacea were s...AIM: To compare the effectiveness of topical cyclosporine A emulsion with that of oral doxycycline for rosacea associated ocular changes and dry eye complaints.METHODS: One hundred and ten patients with rosacea were screened. Thirty-eight patients having rosacea associated eyelid and ocular surface changes and dry eye complaints were included in the study. Patients were randomly divided into two groups: nineteen patients were given topical cyclosporine twice daily and nineteen patients were given oral doxycycline 100 mg twice daily for the first month and once daily for the following two months. Symptom and sign scores, ocular surface disease index questionnarie and tear function tests were evaluated at baseline and monthly for 3mo. Three months after results were compared with that of baseline.RESULTS: Mean values of symptom, eyelid sign and corneal/conjunctival sign scores of each treatment group at baseline and 3mo after treatments were compared and both drugs were found to be effective on rosacea associated ocular changes(P 【0.001). Cyclosporine was more effective in symptomatic relief and in the treatment of eyelid signs(P =0.01). There was statistically significant increase in the mean Schirmer score with anesthesia and tear break up time scores in the cyclosporine treatment group compared to the doxycycline treatment group(P 【0.05).CONCLUSION: Cyclosporine as a topical drug can be used in the treatment of rosacea associated ocular complications because it is more effective than doxycycline. In addition ocular rosacea as a chronic disease requires long term treatment and doxycycline has various side effects limiting its long term usage.展开更多
AIM: To evaluate plasma and aqueous levels of adiponutrin and pannexin 1 in patients with and without diabetic retinopathy.METHODS: The study included three age and gendermatched groups of 20 cataract patients with no...AIM: To evaluate plasma and aqueous levels of adiponutrin and pannexin 1 in patients with and without diabetic retinopathy.METHODS: The study included three age and gendermatched groups of 20 cataract patients with no diabetes or additional disease(Group C), 20 cataract patients with diabetes and no retinopathy(Group DM+C), and 20 cataract patients with diabetic retinopathy(Group DR+C).All the patients were examined with respect to body mass index(BMI), fasting plasma glucose, hemoglobin A1c(HbA1c), and lipid profile.Phacoemulsification and intraocular lens(Phaco+IOL) implantation were performed to all patients in all the groups, and aqueous samples were taken during the operation.The plasma and aqueous adiponutrin and pannexin 1 levels were analyzed using enzyme-linked immunosorbent assays.RESULTS: A statistically significant difference was determined between the groups with respect to BMI, fasting plasma glucose, and HbA1c levels(P<0.05 for all parameters tested).The plasma adiponutrin levels of Group DR+C were statistically significantly lower than those of Group C and Group DM+C(P<0.001, P=0.004).No statistically significant difference was determined in the aqueous adiponutrin levels in three groups.The plasma pannexin 1 levels of Groups DM+C and DR+C were statistically significantly lower than those of Group C(both P=0.001).The aqueous pannexin 1 levels of Group DR+C were statistically significantly higher than those of Group C and Group DM+C(P=0.001, P<0.001).CONCLUSION: Adiponutrin and pannexin 1, which play an important role in the pathophysiology of diabetes and obesity, and have a regulatory role in hyperglycemia and insulin resistance.The measurement of adiponutrin and pannexin 1 levels may support clinicians in determining the risk of DR development.展开更多
Dear Editor,I am Dr. Lisa Toto, from Department of Medicine and Science of Ageing, University G. D’Annunzio ChietiPescara, Chieti, Italy. I write to present a case report of anterior capsule contraction syndrome(ACCS).
AIM: To evaluate the visual acuity and endothelial cell density according to the thickness in Descemet’s stripping automated endothelial keratoplasty(DSAEK)one year after surgery.METHODS: DSAEK patients’ data were r...AIM: To evaluate the visual acuity and endothelial cell density according to the thickness in Descemet’s stripping automated endothelial keratoplasty(DSAEK)one year after surgery.METHODS: DSAEK patients’ data were reviewed. Thirty seven eyes of 37 patients who underwent DSAEK for pseudophakic bullous keratopathy(PBK) were included in this study. Graft thickness was measured with optical coherence tomography(OCT) 12 mo after DSAEK. Eyes were divided into 3 groups based on the graft thickness:thick(】200 μm), medium-thick(150-200 μm) and thin(【150 μm). Best corrected visual acuity(BCVA),endothelial cells density(ECD) and complications were assessed and comparisons were done between groups.RESULTS: Median thickness of postoperative grafts was 188(range 73-317 μm). There was no significant difference in age, sex, preoperative BCVA, or follow-up period between DSAEK groups. At postoperative 12 mo,mean BCVA was 0.28±0.10 in thick graft group, 0.52±0.08 in medium-thick graft group, and 0.72 ±0.06 in thin graft group. Thin grafts showed better postoperative BCVA as compared with the medium-thick and thick grafts(P =0.001). Thick graft group had 1637.44 ±88.19-mm2,medium thick graft had 1764.50±34.28-mm2 and thin graft group had 1845.30 ±65.62-mm2. Thin graft group had better ECD at 12 mo after surgery(P =0.001).CONCLUSION: Thin grafts after DSAEK ensure better visual rehabilitation. Eyes with thin grafts had significantly lesser loss of ECD compared to eyes withmedium-thick and thick grafts one year after surgery.展开更多
AIM:To examine the mechanism of the development of pseudoexfoliation (PSX) syndrome via both cytokine formation and endothelial vasorelaxing and growth factors that will provide us new therapeutic insights for the tre...AIM:To examine the mechanism of the development of pseudoexfoliation (PSX) syndrome via both cytokine formation and endothelial vasorelaxing and growth factors that will provide us new therapeutic insights for the treatment. METHODS:This is a cross sectional study included two groups; Group 1:control patients with nuclear cataract(n =20, aged 51-80 years). Group 2:PSX patients with nuclear cataract (n=18, aged 50-90 years). Patients with other ophthalmic problems and systemic diseases were excluded. Vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) and interleukin-1β (IL-1β) and nitrotyrosine levels were determined through serum samples by Enzyme-linked immunosorbent assay (ELISA) method. Nitrite-nitrate levels were measured with photometric endpoint determination. RESULTS:There were no significant differences between the groups in terms of age, VEGF, IL-1β, nitrite-nitrate and nitrotyrosine. The significant results were the mean IL-6 levels that were higher in PSX group 2 (37.68± 29.52 pg/mL) compared to that in control group 1 (15.32± 10.08 pg/mL) (P 【0.001). CONCLUSION:Several interacting and extending biochemical pathways may lead to the promotion of VEGF and IL-6 expressions. IL-6 which is the only altered marker in our study may indirectly cause an increase of vascular permeability and neovascularization. We suggest inflammation as a factor that can be involved in etiopathogenesis of PSX.展开更多
●AIM:To study if one of the two molecules could lead to a lower number of follow up visits and intra-vitreous injection(IVI)with the same efficacy.●METHODS:ELU(or"elected"in French)study is a retrospective...●AIM:To study if one of the two molecules could lead to a lower number of follow up visits and intra-vitreous injection(IVI)with the same efficacy.●METHODS:ELU(or"elected"in French)study is a retrospective study conducted in real life in patients presenting suboptimal response after ranibizumab IVI(phase 1)and secondary switched to aflibercept(phase 2).The number of follow up visits and IVI were compared in both phases.Visual acuity(VA)evolution and"switching"reasons were secondary analyzed.●RESULTS:We retrospectively included data of 33 patients(38 eyes)with age-related macular degeneration(AMD;mean age:77±7.7 y).The number of monthly follow up visits[median(Q1;Q3)]:was significantly lower with aflibercept(phase 2),respectively 1.0(0.81;1.49)visits in phase 1,versus 0.79(0.67;0.86)visits in phase 2.The median number of monthly IVI also significantly decreased in phase 2,respectively 0.67(0.55;0.90)IVI in phase 1,versus 0.55(0.45;0.67)IVI in phase 2.The mean VA evolution(VA final-VA initial)was similar in both phases,(P>0.05).Whatever the reason for"switching"(loss of efficacy,tachyphylaxis,tolerance problems),there was no incidence on VA evolution over the time.●CONCLUSION:Our results show that switching from ranibizumab to aflibercept in"suboptimal"patients significantly reduce the number of follow up visits and IVI,with a comparable efficacy.This decrease in visit number could improve patients’quality of life and reduce surgical risk by reducing the number of injections.展开更多
文摘Uveal and conjunctival melanomas are relatively rare tumors;nonetheless,they pose a significant risk of mortality for a large number of affected individuals.The pathogenesis of melanoma at different sites is very similar,however,the prognosis for patients with ocular melanoma remains unfavourable,primarily due to its distinctive genetic profile and tumor microenvironment.Regardless of considerable advances in understanding the genetic characteristics and biological behaviour,the treatment of uveal and conjunctival melanoma remains a formidable challenge.To enhance the prospect of success,collaborative efforts involving medical professionals and researchers in thefields of ocular biology and oncology are essential.Current data show a lack of well-designed randomized clinical trials and limited benefits in current forms of treatment for these tumors.Despite advancements in the development of effective melanoma therapeutic strategies,all current treatments for uveal melanoma(UM)and conjunctival melanoma(CoM)remain unsatisfactory,resulting in a poor long-term prognosis.Ongoing trials offer hope for positive outcomes in advanced and metastatic tumors.A more comprehensive understanding of the genetic and molecular abnormalities involved in the development and progression of ocular melanomas opens the way for the development of personalized therapy,with various potential therapeutic targets currently under consideration.Increased comprehension of the molecular pathogenesis of UM and CoM and their specificities may aid in the development of new and more effective systemic therapeutic agents,with the hope of improving the prognosis for patients with metastatic disease.
文摘Introduction: Eye health in children is a real public health problem in developing countries. The aim of this work was to determine the frequency of ocular pathologies in children aged 0 to 16 at the prefectural hospital of Macenta in Guinea. Patients and Method: This was a descriptive prospective study. It covered a period of 6 months from October 1 to March 31, 2022 at the prefectural hospital of Macenta in Guinea. Children aged 0 to 16 received during the study period were included. Were excluded, those with an incomplete file and whose parents did not consent. Results: Out of 1816 consultations, 224 children aged 0 to 16 were collected 7.95%;mean age 7.35 years ± 4.6;sex ratio 1.38. The age group of 6 to 11 years was more represented. More than half of the patients were educated 50.4% and came from rural areas 52.7%. Pathologies of the orbit were dominated by orbital cellulitis 13% and those of the annexes by conjunctivitis 40.6%. Keratitis and cataracts were pathologies dominating the cornea and the lens, respectively 5.4% and 8.5%. Atrophy of the eyeball was the most frequent among those of the eyeball, at 3.6%. The most performed surgical procedure was phacophagy in 6.7%. The most common reason for consultation was eye pain, at 33.5%. Both eyes were affected at the same time in the majority 49.5%, and the most represented antecedent was malaria 22.3% of cases. Visual acuity without correction ≥ 3/10 was the most represented 37.5% in the right eye and 34.8% in the left eye. The therapeutic classes used were dominated by antibiotic-corticoid combinations 88.8%. Conclusion: Ocular pathologies in children from 0 to 16 years old constitute a real public health problem. They are dominated by pathologies of the conjunctiva and the lens. Popularization for early management of ophthalmological pathologies would be beneficial. .
基金Supported by the Natural Science Foundation of Shaanxi Province,China(No.2022JM-521).
文摘AIM:To explore the effect of epidermal growth factor receptor(EGFR)inhibition by erlotinib and EGFR siRNA on epidermal growth factor(EGF)-induced activation of retinal pigment epithelium(RPE)cells.METHODS:Human RPE cell line(ARPE-19 cells)was activated by 100 ng/mL EGF.Erlotinib and EGFR siRNA were used to intervene EGF treatment.Cellular viability,proliferation,and migration were detected by methyl thiazolyl tetrazolium(MTT)assay,bromodeoxyuridine(BrdU)staining assay and wound healing assay,respectively.EGFR/protein kinase B(AKT)pathway proteins and N-cadherin,α-smooth muscle actin(α-SMA),and vimentin were tested by Western blot assay.EGFR was also determined by immunofluorescence staining.RESULTS:EGF treatment for 24h induced a significant increase of ARPE-19 cells’viability,proliferation and migration,phosphorylation of EGFR/AKT proteins,and decreased total EGFR expression.Erlotinib suppressed ARPE-19 cells’viability,proliferation and migration through down regulating total EGFR and AKT protein expressions.Erlotinib also inhibited EGF-induced an increase of proliferative and migrative ability in ARPE-19 cells and clearly suppressed EGF-induced EGFR/AKT proteins phosphorylation and decreased expression of N-cadherin,α-SMA,and vimentin proteins.Similarly,EGFR inhibition by EGFR siRNA significantly affected EGF-induced an increase of cell proliferation,viability,and migration,phosphorylation of EGFR/AKT proteins,and up-regulation of N-cadherin,α-SMA,and vimentin proteins.CONCLUSION:Erlotinib and EGFR-knockdown suppress EGF-induced cell viability,proliferation,and migration via EGFR/AKT pathway in RPE cells.EGFR inhibition may be a possible therapeutic approach for proliferative vitreoretinopathy(PVR).
基金the Natural Science Foundation of Shaanxi Province(No.2022JM-521)the Science and Technology Plan Project of Xi’an(No.21YXYJ0031).
文摘AIM:To explore the effects of hepatocyte growth factor(HGF)on retinal pigment epithelium(RPE)cell behaviors.METHODS:The human adult retinal pigment epithelial cell line-19(ARPE-19)were treated by HGF or mesenchymalepithelial transition factor(MET)inhibitor SU11274 in vitro.Cell viability was detected by a Cell Counting Kit-8 assay.Cell proliferation and motility was detected by a bromodeoxyuridine incorporation assay and a wound healing assay,respectively.The expression levels of MET,phosphorylated MET,protein kinase B(AKT),and phosphorylated AKT proteins were determined by Western blot assay.The MET and phosphorylated MET proteins were also determined by immunofluorescence assay.RESULTS:HGF increased ARPE-19 cells’viability,proliferation and migration,and induced an increase of phosphorylated MET and phosphorylated AKT proteins.SU11274 significantly reduced cell viability,proliferation,and migration and decreased the expression of MET and AKT proteins.SU11274 suppressed HGF-induced increase of viability,proliferation,and migration in ARPE-19 cells.Additionally,SU11274 also blocked HGF-induced phosphorylation of MET and AKT proteins.CONCLUSION:HGF enhances cellular viability,proliferation,and migration in RPE cells through the MET/AKT signaling pathway,whereas this enhancement is suppressed by the MET inhibitor SU11274.HGF-induced MET/AKT signaling might be a vital contributor of RPE cells survival.
文摘Anophthalmia is a condition of the absence of an eye and the presence of a small eye within the orbit.It is associated with many known syndromes.Clinical findings,as well as imaging modalities and genetic analysis,are important in making the diagnosis.Imaging modalities are crucial scanning methods.Cryptophthalmos,cyclopia,synophthalmia and congenital cystic eye should be considered in differential diagnoses.We report two clinical anophthalmic siblings,emphasizing the importance of neuroradiological and orbital imaging findings in distinguishing true congenital anophthalmia from clinical anophthalmia.
文摘Context: Childhood eye health is a real public health problem in our context, the consequences of which go beyond vision, affecting education, social participation and future economic productivity. The aim was to study the frequency of ocular surgical pathologies in children aged 0 to 15 years. Patients and Methodius: This study covered a 4 years period from January 1, 2016 to December 31, 2020. It was a retrospective study of a descriptive and analytical nature. It concerned all children aged 0 to 15 who had undergone surgery for ocular pathology during the study period and who were included in the operating room register. Results: Out of 4974 patients of all ages operated for ocular surgical pathology, 124 were children aged 0 to 15 years or 2.49%. The 9 - 12 age group was the most represented with 29.03%;the mean age was 7.3 years ± 4.6 with extremes of 3 months and 15 years. A male predominance was observed at 62.90%. Pathologies of the lens, cataract and eyelids, traumatic edema represented the most frequent eye conditions in our patients with respectively 51 cases or 41.13% in the right eye (OD), 54 cases or 53.55% in the left eye (OG) and 14 cases or 11.29% in OD and OG followed by endemic limboconjunctivitis of the tropics (LCET), 10 cases or 3.23%, in OD and hemorrhage under conjunctival 13 cases or 10.48% in OG. Cataract surgery with the Technique Manuel Small Incision Cataract Surgery + Implantation in the posterior chamber (MSICS + ICP) was the most used in 74% of cases. General anesthesia was the most widely used anesthetic method in 100% of cases. The clinical course was favorable at 45.97%. Conclusion: We note a relatively low hospital frequency of ocular surgical pathologies in children, with a male predominance. The early consultation period and the improvement of the technical platform could improve their management.
文摘Introduction: Hypertensive retinopathy is the set of retinal and papillary manifestations secondary to acute or chronic acute or chronic high blood pressure. Its frequency increases with age in women, its treatment requires the balance of blood pressure figures. Purpose: To study in women the epidemiological, clinical and therapeutic aspects of Hypertensive retinopathy at the application center of the Diploma of Specialized Studies in Ophthalmology (CADES/O). Patients and Methods: Prospective study conducted on 92 women who met the inclusion criteria over a period of six (6) months, from October 1, 2021 to March 31, 2022 in whom the diagnosis of Hypertensive Retinopathy was retained according to the Kirkendall classification. Results: We collected 92 patients with an average age of 57.88 years. The hypertensive Retinopathy was present at 61.75%. The age group of 60 - 69 years was the most represented at 40.22%. The socio-professional stratum most affected was housewives. The duration of the evolution of high blood pressure was from 2 - 5 years representing 57.61% of our study cases;the most common grade of high blood pressure was Grade II at 60.87%. Treatment of hypertension was irregularly followed in 73.91%. Stage II according to Kirkendall’s classification was 58.70% common;the recurrent sign was retinal hemorrhage at 30.43%. Blood pressure balance was the treatment recommended to our patients at 80.48%. Conclusion: Hypertensive retinopathy is common in women and its management remains the balance of blood pressure figures with periodic and multidisciplinary monitoring.
文摘Introduction: Primary open-angle glaucoma, a chronic, potentially blinding disease, requires lifelong medical treatment that demands full patient compliance. The objective was to determine the rate of compliance and to study the determinants of compliance in glaucoma patients followed at CADES/O. Patients and Methods: This was an observational study, which included old and new glaucoma patients. Compliance was assessed on the availability of medication, regularity of dosing schedules, compliance with prescribed doses, and regularity at check-ups. Compliance was judged to be good when at least four (4) of these criteria were met, fair when only three (3) of these criteria were met and poor when only two (2) of these criteria were met. Results: Compliance was considered good in 38.4% of cases, fair in 48.2% of cases and poor in 13.4% of cases with an overall compliance rate of 86.6%. The correlation was not statistically significant for age, sex, origin, length of illness, route of administration, instiller, or therapeutic regime. On the other hand, profession, level of education, presence of systemic arterial hypertension, compliance with instillation schedules, prescribed dosage, regularity of treatment, compliance with control visits and the climate of trust between patient and treating physician were the determining factors with the greatest statistical influence on compliance with treatment. Conclusion: Compliance with glaucoma treatment is linked to the patient factor but especially to the doctor factor. Doctors should take their time to explain to patients their disease, its evolution with or without treatment and above all the necessity of a good therapeutic compliance.
文摘Dear Editor,We would like to report visual disturbance due to choroidal metastasis as the first clinical sign of renal carcinoma.Metastatic tumours are one of the most common type of intraocular malignancy in adults with the most common origins of metastasis being the lungs in men and breasts in women[1-2].Ocular choroidal metastases from renal cell carcinoma(RCC)are rare with 3.5%of ocular metastases originating from the kidneys[3].RCC predominantly occurs in individuals in their seventh and eighth decades of life and has been reported nearly twice as often in men as in women[1,3].
文摘Dear Editor,The advent of 23-gauge(G),25-G,and 27-G vitrectomy systems[1]since the beginning of the 21stcentury has allowed vitrectomy via a smaller incision compared to the 20-G system;hence the name"microincision vitrectomy surgery".Microincision vitrectomy surgery has gainedpopularity among vitreoretinal surgeons.
文摘AIM：To investigate foveal avascular zone（FAZ）and parafoveal vessel densities（PRVD）by means of optical coherence tomography angiography（OCTA）in diabetic patients with or without diabetic retinopathy（DR）and to assess the reproducibility of FAZ and PRVD measurements.METHODS：Sixty diabetic patients（60 eyes）with different stage of DR（graded according to the International Clinical Severity Scale for DR）and 20 healthy subjects underwent FAZ area and PRVD measurements using OCTA by two experienced examiners.FAZ area in all patients was also assessed using fluorescein angiography（FA）.RESULTS：In subject with proliferative DR and with moderate-severe non proliferative DR,FAZ area was significantly increased compared to healthy controls（P=0.025 and P=0.050 respectively measured with OCTA and P=0.025 and P=0.048 respectively measured with FA）.OCTA showed significantly less inter-observer variability compared to FA.Concordance correlation coefficient（CCC）for FAZ area measurements was 0.829（95%CI：0.736-0.891）P〈0.001 with FA and 1.000（95%CI：0.999-1.000）P〈0.001with OCTA.CCC was 0.834（95%CI：0.746-0.893）P〈0.001and 0.890（95%CI：0.828-0.930）P〈0.001 for parafoveal superficial and deep vessel density measurements,respectively.CONCLUSION：OCTA shows progressive increase of FAZ area and reduction of PRVD in both superficial and deep plexus at increasing DR severity.FAZ area and PRVD measurements using OCTA are highly reproducible.
文摘Hepatitis B virus (HBV) infection is a serious clinical problem worldwide. Conventional interferon (IFN)-α has been approved for the treatment of chronic hepatitis B (CHB). Short-term studies have demonstrated that IFN-based therapy is moderately effective in inducing the loss of hepatitis e antigen (HBeAg) or seroconversion (30%-40%) in HBeAg-positive patients and also produces sustained HBV DNA suppression (20%-30%) in HBeAg-negative patients. Many studies have reported a correlation between the HBV genotype and response to IFN treatment. The highest response rate to IFN treatment was found in patients infected with HBV genotype A, followed by HBV genotypes B, C, and D. The long-term effect of IFN-α on CHB has not yet been elucidated. The ability of IFN-α treatment to prevent new cirrhosis, complications associated with cirrhosis, and development of hepatocellular carcinoma (HCC) is controversial. The beneficial effect of IFN-α treatment in reducing the development of HCC has mainly been observed in treatment responders who already have cirrhosis. These inconsistent findings may be attributed to the inevitable limitations of comparisons across studies, including differences in the baseline characteristics of the study and the moderate suppression of HBV replication by IFN-α relative to nucleoside/nucleos(t)ide analogs.
文摘Objective:To investigate the effects of puerarin on the activity of superoxide dismutase(SOD), and expressions of advanced glycation end-product(AGE) receptor(RAGE) and vascular endothelial growth factor(VEGF) in retinas of streptozotocin(STZ)-induced early diabetic rats. Methods:Diabetic rat models were established by inducing diabetes via intra-peritoneal injection of STZ.Rats were randomly divided into normal(control),diabetic(DM),and DM+ puerarin groups.After intra-gastric administration of puerarin(500 mg/kg/day for 4 weeks),levels of SOD and malondialdehyde(MDA) were determined in serum and retina.mRNA and protein expression levels of RAGE and VEGF in retinas were determined by real-lime polymerase chain reaction(RT-PCR)(mRNA) and Western blot analysis(protein levels).Results:There was significantly lower SOD activity and significantly higher MDA in serum and retinas of the DM group compared with the two other groups(P【0.05).After treatment with puerarin,SOD activity increased and MDA content decreased in this group(P【0.05).mRNA and protein expression levels of RACE and VECF in the DM group were significantly higher than those of the other groups (P【0.05),and decreased after puerarin treatment(P【0.05).Conclusions:Puerarin is able to enhance SOD activity,and inhibit RAGE and VEGF expressions in retinas of STZ-induced early diabetic ruts.
文摘AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer(GCIPL) parameters between all the consecutive stages of glaucoma(from healthy to moderate-to-severe glaucoma), and to compare it with the discriminating performances of the peripapillary retinal nerve fiber layer(RNFL) parameters and optic nerve head(ONH) parameters.METHODS: Totally 147 eyes(40 healthy, 40 glaucoma suspects, 40 early glaucoma, and 27 moderate-to-severe glaucoma) of 133 subjects were included. Optical coherence tomography(OCT) was obtained using Cirrus HD-OCT 5000. The diagnostic performances of GC-IPL, RNFL, and ONH parameters were evaluated by determining the area under the curve(AUC) of the receiver operating characteristics. RESULTS: All GC-IPL parameters discriminated glaucoma suspect patients from subjects with healthy eyes and moderate-to-severe glaucoma from early glaucoma patients(P<0.017, for all). Also, minimum, inferotemporal and inferonasal GC-IPL parameters discriminated early glaucoma patients from glaucoma suspects, whereas no RNFL or ONH parameter could discriminate between the two. The best parameters to discriminate glaucoma suspects from subjects with healthy eyes were superonasal GC-IPL, superior RNFL and average c/d ratio(AUC=0.746, 0.810 and 0.746, respectively). Discriminating performances of all the parameters for early glaucoma vs glaucoma suspect comparison were lower than that of the other consecutive group comparisons, with the bestGC-IPL parameters being minimum and inferotemporal(AUC=0.669 and 0.662, respectively). Moreover, minimum GC-IPL, average RNFL, and rim area(AUC=0.900, 0.858, 0.768, respectively) were the best parameters for discriminating moderate-to-severe glaucoma patients from early glaucoma patients.CONCLUSION: GC-IPL parameters can discriminate glaucoma suspect patients from subjects with healthy eyes, and also all the consecutive stages of glaucoma from each other(from glaucoma suspect to moderate-tosevere glaucoma). Further, the discriminating performance of GC-IPL thicknesses is comparable to that.
文摘AIM: To compare the effectiveness of topical cyclosporine A emulsion with that of oral doxycycline for rosacea associated ocular changes and dry eye complaints.METHODS: One hundred and ten patients with rosacea were screened. Thirty-eight patients having rosacea associated eyelid and ocular surface changes and dry eye complaints were included in the study. Patients were randomly divided into two groups: nineteen patients were given topical cyclosporine twice daily and nineteen patients were given oral doxycycline 100 mg twice daily for the first month and once daily for the following two months. Symptom and sign scores, ocular surface disease index questionnarie and tear function tests were evaluated at baseline and monthly for 3mo. Three months after results were compared with that of baseline.RESULTS: Mean values of symptom, eyelid sign and corneal/conjunctival sign scores of each treatment group at baseline and 3mo after treatments were compared and both drugs were found to be effective on rosacea associated ocular changes(P 【0.001). Cyclosporine was more effective in symptomatic relief and in the treatment of eyelid signs(P =0.01). There was statistically significant increase in the mean Schirmer score with anesthesia and tear break up time scores in the cyclosporine treatment group compared to the doxycycline treatment group(P 【0.05).CONCLUSION: Cyclosporine as a topical drug can be used in the treatment of rosacea associated ocular complications because it is more effective than doxycycline. In addition ocular rosacea as a chronic disease requires long term treatment and doxycycline has various side effects limiting its long term usage.
文摘AIM: To evaluate plasma and aqueous levels of adiponutrin and pannexin 1 in patients with and without diabetic retinopathy.METHODS: The study included three age and gendermatched groups of 20 cataract patients with no diabetes or additional disease(Group C), 20 cataract patients with diabetes and no retinopathy(Group DM+C), and 20 cataract patients with diabetic retinopathy(Group DR+C).All the patients were examined with respect to body mass index(BMI), fasting plasma glucose, hemoglobin A1c(HbA1c), and lipid profile.Phacoemulsification and intraocular lens(Phaco+IOL) implantation were performed to all patients in all the groups, and aqueous samples were taken during the operation.The plasma and aqueous adiponutrin and pannexin 1 levels were analyzed using enzyme-linked immunosorbent assays.RESULTS: A statistically significant difference was determined between the groups with respect to BMI, fasting plasma glucose, and HbA1c levels(P<0.05 for all parameters tested).The plasma adiponutrin levels of Group DR+C were statistically significantly lower than those of Group C and Group DM+C(P<0.001, P=0.004).No statistically significant difference was determined in the aqueous adiponutrin levels in three groups.The plasma pannexin 1 levels of Groups DM+C and DR+C were statistically significantly lower than those of Group C(both P=0.001).The aqueous pannexin 1 levels of Group DR+C were statistically significantly higher than those of Group C and Group DM+C(P=0.001, P<0.001).CONCLUSION: Adiponutrin and pannexin 1, which play an important role in the pathophysiology of diabetes and obesity, and have a regulatory role in hyperglycemia and insulin resistance.The measurement of adiponutrin and pannexin 1 levels may support clinicians in determining the risk of DR development.
文摘Dear Editor,I am Dr. Lisa Toto, from Department of Medicine and Science of Ageing, University G. D’Annunzio ChietiPescara, Chieti, Italy. I write to present a case report of anterior capsule contraction syndrome(ACCS).
文摘AIM: To evaluate the visual acuity and endothelial cell density according to the thickness in Descemet’s stripping automated endothelial keratoplasty(DSAEK)one year after surgery.METHODS: DSAEK patients’ data were reviewed. Thirty seven eyes of 37 patients who underwent DSAEK for pseudophakic bullous keratopathy(PBK) were included in this study. Graft thickness was measured with optical coherence tomography(OCT) 12 mo after DSAEK. Eyes were divided into 3 groups based on the graft thickness:thick(】200 μm), medium-thick(150-200 μm) and thin(【150 μm). Best corrected visual acuity(BCVA),endothelial cells density(ECD) and complications were assessed and comparisons were done between groups.RESULTS: Median thickness of postoperative grafts was 188(range 73-317 μm). There was no significant difference in age, sex, preoperative BCVA, or follow-up period between DSAEK groups. At postoperative 12 mo,mean BCVA was 0.28±0.10 in thick graft group, 0.52±0.08 in medium-thick graft group, and 0.72 ±0.06 in thin graft group. Thin grafts showed better postoperative BCVA as compared with the medium-thick and thick grafts(P =0.001). Thick graft group had 1637.44 ±88.19-mm2,medium thick graft had 1764.50±34.28-mm2 and thin graft group had 1845.30 ±65.62-mm2. Thin graft group had better ECD at 12 mo after surgery(P =0.001).CONCLUSION: Thin grafts after DSAEK ensure better visual rehabilitation. Eyes with thin grafts had significantly lesser loss of ECD compared to eyes withmedium-thick and thick grafts one year after surgery.
文摘AIM:To examine the mechanism of the development of pseudoexfoliation (PSX) syndrome via both cytokine formation and endothelial vasorelaxing and growth factors that will provide us new therapeutic insights for the treatment. METHODS:This is a cross sectional study included two groups; Group 1:control patients with nuclear cataract(n =20, aged 51-80 years). Group 2:PSX patients with nuclear cataract (n=18, aged 50-90 years). Patients with other ophthalmic problems and systemic diseases were excluded. Vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) and interleukin-1β (IL-1β) and nitrotyrosine levels were determined through serum samples by Enzyme-linked immunosorbent assay (ELISA) method. Nitrite-nitrate levels were measured with photometric endpoint determination. RESULTS:There were no significant differences between the groups in terms of age, VEGF, IL-1β, nitrite-nitrate and nitrotyrosine. The significant results were the mean IL-6 levels that were higher in PSX group 2 (37.68± 29.52 pg/mL) compared to that in control group 1 (15.32± 10.08 pg/mL) (P 【0.001). CONCLUSION:Several interacting and extending biochemical pathways may lead to the promotion of VEGF and IL-6 expressions. IL-6 which is the only altered marker in our study may indirectly cause an increase of vascular permeability and neovascularization. We suggest inflammation as a factor that can be involved in etiopathogenesis of PSX.
文摘●AIM:To study if one of the two molecules could lead to a lower number of follow up visits and intra-vitreous injection(IVI)with the same efficacy.●METHODS:ELU(or"elected"in French)study is a retrospective study conducted in real life in patients presenting suboptimal response after ranibizumab IVI(phase 1)and secondary switched to aflibercept(phase 2).The number of follow up visits and IVI were compared in both phases.Visual acuity(VA)evolution and"switching"reasons were secondary analyzed.●RESULTS:We retrospectively included data of 33 patients(38 eyes)with age-related macular degeneration(AMD;mean age:77±7.7 y).The number of monthly follow up visits[median(Q1;Q3)]:was significantly lower with aflibercept(phase 2),respectively 1.0(0.81;1.49)visits in phase 1,versus 0.79(0.67;0.86)visits in phase 2.The median number of monthly IVI also significantly decreased in phase 2,respectively 0.67(0.55;0.90)IVI in phase 1,versus 0.55(0.45;0.67)IVI in phase 2.The mean VA evolution(VA final-VA initial)was similar in both phases,(P>0.05).Whatever the reason for"switching"(loss of efficacy,tachyphylaxis,tolerance problems),there was no incidence on VA evolution over the time.●CONCLUSION:Our results show that switching from ranibizumab to aflibercept in"suboptimal"patients significantly reduce the number of follow up visits and IVI,with a comparable efficacy.This decrease in visit number could improve patients’quality of life and reduce surgical risk by reducing the number of injections.
