Table of Content

22 October 2022, Volume 46 Issue 5

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Ocular abnormities after COVID-19 vaccination

Gao Min, Sun Xuguang , Xiao Yang

2022, 46(5):  385-390.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.001

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Vaccination remains one of the most effective interventions in human history against different viral infections. Definitly the benefits of the COVID-19 vaccine in preventing COVID-19 are well established. Reports of ocular adverse effects after COVID-19 vaccinations have emerged simultaneously. The ocular adverse effects may appear on the eyelid, cornea and sclera, retina, uvea, nerve and vessel. Clinical manifestations include keratitis, uveitis, retinitis, nerve palsy and vascular obstruction. The review summarizes ocular adverse effects possibly associated with COVID-19 vaccination，in order to raise our concern for the ocular manifestations after COVID-19 vaccination. (Int Rev Ophthalmol, 2022, 46: 385-390)

Application of transcriptomics on ophthalmological research

Li Yuting, Li Yan, Li Yadi, Huang Yue, Li Puyi, Hu Zhulin

2022, 46(5):  391-396.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.002

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Transcriptomics is a discipline that studies the disease process of a certain body tissue from the perspective of molecular mechanism. Transcriptomics sequencing technology has been widely used in research in various fields. In the transcriptomic study of ophthalmic diseases, cornea, aqueous humor, lens and retina are rich in a large amount of genetic information, which are ideal research objects of transcriptomics. Transcriptomics sequencing technology, through sequence hybridization or gene sequencing approach, applied in the laboratory and clinical researches on some ophthalmic diseases, such as microbial keratitis, congenital cataract, uveitis, diabetic retinopathy, age-related macular degeneration, retinitis pigmentosa, will provide a new direction for the pathogenesis, diagnosis and treatment of these diseases.(Int Rev Ophthalmol, 2022, 46: 391-396)

Effects of regulated metabolism by Hippo pathway on ocular development and diseases

Guo Yang, Zhu Manhui, Song E

2022, 46(5):  396-401.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.003

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The core of the Hippo pathway is composed of kinase cascades, transcriptional coactivators, and DNA-binding proteins that target a variety of biological processes, including the control of cell growth, differentiation, regeneration, and organ size. Recently, many studies have shown that Hippo pathway is involved in the metabolism of three substances, including glucose metabolism, lipid metabolism and glutamine metabolism. At the same time, Hippo pathway can regulate the growth and development of eyes, the incidence and development of retinal neovascularization, glaucoma, cataract and other eye diseases alone or in coordination with PI3K/Akt/mTOR, TGF-β, Wnt/β-cateninh and Notch signaling pathways.(Int Rev Ophthalmol, 2022, 46: 396-401)

Smoking and ocular diseases

He Hailong, Zhou Chunyuan, Liu Zhenyu, Jin Zibing

2022, 46(5):  402-409.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.004

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Smoking could be detrimental to multiple ocular diseases. The release of IL-1β and IL-6 together with activation of NF-κB was prompted by cigarette smoking may be associated with dry eye. Some studies found smoking was statistically significantly associated with increased risk of cataract and age-related macular degeneration (AMD). Cigarette smoking was related to a significant decline in the concentrations of serum thyroxine antibody in thyroid-associated ophthalmopathy (TAO) patients. Ischemia-related eye diseases, glaucoma, pterygium, refractive error, and other eye diseases that may be associated with systemic vascular endothelial dysfunction caused by smoking.(Int Rev Ophthalmol, 2022, 46: 402-409)

Basic fibroblast growth factor and its application on ophthalmological research

Jin Bihui, Li Guigang

2022, 46(5):  409-414.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.005

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Basic fibroblast growth factor (bFGF) is a multifunctional signal molecule widely existing in the eye, such as lens epithelial cells, trabecular meshwork cells, retinal pigment epithelial cells and so on. It mainly plays a role in protecting cells, promoting cell proliferation and maintaining the characteristics of stem cells in basic research. At present, it is commonly used in the treatment of keratitis, corneal epithelial defect, corneal ulcer, corneal surgery and dry eye. bFGF plays a role in the stem cell therapy of limbal stem cell deficiency because it can promote the proliferation of limbal niche cells. But the specific mechanism is not clear and needs further research.(Int Rev Ophthalmol, 2022, 46: 409-414)

Study status of idiopathic blepharospasm

Gong Zexin, Wei Ting, Kang Qianyan

2022, 46(5):  415-419.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.006

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Idiopathic blepharospasm is a form of focal dystonia. It is generally believed that the pathogenesis is related to the damage of the basal ganglia of the brain, hypoactive nigrostriatal gamma-aminobutyric acid neurons, hyperactive cholinergic neurons, or decreased inhibition of the cerebral cortex. The disease is more common in the middle-aged and elderly population, and is more common in female than male. The typical symptom contains forceful involuntary spasms of eye closure，which usually occurs in quiet or when gazing at people or objects. A clinical guideline for diagnosing blepharospasm can help physicians confirming or refuting suspected IBSP. The Shorr grade, a scale for rating the severity of IBSP availably, contains 5 levels depending on the degree of blepharospasm. It is a safe and effective method to inject appropriate dose of botulinum toxin into orbicularis oculi muscles for treating mild to moderate blepharospasm. (Int Rev Ophthalmol, 2022, 46: 415-419)

Research progress on eyelid malignant melanoma

Wang Jinjin, Li Jing, Ma Jianmin

2022, 46(5):  420-424.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.007

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Eyelid malignant melanoma is a rare tumor which incidence rate is higher in white race than in other races. Aged-people is susceptible. Excessive ultraviolet exposure relates to the malignant tumor. The lower eyelid is more likely to suffer from this disease than the upper eyelid. Eyelid malignant melanoma is often manifested as changes in the size, color and shape of the previous pigmented nevus of the eyelid, or a sudden new dark brown mass. With a high degree of malignancy, the tumor can metastasize to local lymph nodes or other organs in the late stage. Early diagnosis is very important, and the diagnosis requires histopathological examination. Extensive local excision is the main treatment method of this disease. Eyelid reconstruction should be considered if the resection range is large. At present, immunotherapy, as one of the new treatment methods for eyelid malignant melanoma, has attracted more and more attention. The application of immune checkpoint inhibitors on this disease may have a broad prospect.(Int Rev Ophthalmol, 2022, 46: 420-424)

Application of nanotechnology on diagnosis and treatment of diabetic retinopathy

Wang Feng, Shao Yi

2022, 46(5):  424-429.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.008

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Nanotechnology can use the special properties of nanoparticles to modify the surface of nanoparticles, which was used to produce sodium fluorescein modified with polyvinyl imine nanoparticles (PEI-NHAc-FS NP), can not only retain the optical properties of sodium fluorescein for the diagnosis of retinal and choroidal diseases, but also have a faster metabolic rate than free sodium fluorescein, so as to safely and effectively diagnose diabetes retinopathy (DR). The progress of DR can be monitored by detecting the metabolic characteristics of plasma by vanadium core-shell nanorods assisted laser desorption/ionization mass spectrometry. Encapsulated drugs in nanoparticles can form drug delivery carriers with targeted, controlled release and easy detection, which provides a new idea for the treatment of DR.(Int Rev Ophthalmol, 2022, 46: 424-429)

Treatment of corneal astigmatism of cataract patients

Zhang Fan, Li Shaowei,

2022, 46(5):  430-436.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.009

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Corneal astigmatism is an important factor affecting the efficacy of refractive cataract surgery. Astigmatism correction intraocular lens (Toric IOL) implantation is the main way to correct cataract astigmatism in clinic. Different materials and shapes of Toric IOL and long eye axis of high myopia will affect the stability of IOL in the capsule bag. Refractive excimer laser surgery can accurately correct residual astigmatism after cataract surgery, but it has not been widely used in clinic because of price and secondary surgery. Cataract surgical incisions on the steep axial of the cornea to correct astigmatism does not increase the additional risk, but the correction range is limited. Arcuate keratotomy is simple and easy, combined with femtosecond laser can further improve the accuracy of correction, which has a great prospect of clinical application.(Int Rev Ophthalmol, 2022, 46: 430-436)

Optimization measurements and formulas of keratometry before Toric intraocular lens implantation

陈紫亮 饶惠英,

2022, 46(5):  437-442.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.010

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Toric intraocular lens (IOL) implantation has become the preferred method for astigmatism correction due to its high safety and predictability. Corneal astigmatism includes anterior corneal astigmatism (ACA) and posterior corneal astigmatism (PCA). In the past, corneal astigmatism was evaluated solely base on ACA measurement, which will induce an overcorrection in the with-the-rule corneal astigmatism eyes and an undercorrection in the against-the-rule astigmatism eyes. Therefore the important contribution of the PCA to total corneal astigmatism (TCA) should not be neglected. IOL Master and Lenstar 900 show high predictive and repeatability for keralometry measurement. Some devices which can measure the total keratometry directly is theoretically more accurate than the simulated keratometry. It is suggested that the SimK measured by IOL Master or Lenstar, matched with Barrett Toric formula directly if SimK is consistent well with TCA. The choice in case of poor consistency between SimK and TCA remains controversial. When PCA≥0.8 D, the measured PCA is recommended. At present, ophthalmologists should make individual selection according to the measurement of diverse devices and patients' conditions to minimize the residual astigmatism.(Int Rev Ophthalmol, 2022, 46: 437-442)

Research progress on persistent pupillary membrane

Zhou Linglin, Wan Xiuhua

2022, 46(5):  443-448.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.011

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Existing studies believe that occurrence of persistent pupillary membrane may be caused by macrophage phagocytosis dysfunction and persistent synthetic activity of fibroblasts, but there are also case reports considering which related to maternal infectious factors during pregnancy. Its clinical morphology is quite different, and its impact on vision is also different. At present, its treatment is mainly based on the size of the residual membrane and whether it affects vision. The treatment methods mainly include drugs, lasers and surgery. (Int Rev Ophthalmol, 2022, 46: 443-448)

Pathogenesis of idiopathic epiretinal membrane

Yang Tingyu, Xie Laiqing, Xu Guoxu

2022, 46(5):  448-451.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.012

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Epiretinal membrane (ERM) can be divided into idiopathic epiretinal membrane (iERM) and secondary epiretinal membrane (sERM). The occurrence of iERM is not associated with any other ocular diseases. The complete pathogenesis of iERM is still unclear, but many theories have been proposed, including posterior vitreous detachment (PVD), fibrosis, neurodegeneration and epigenetic modification. Abnormal fibrosis leads to an unbalance of the extracellular matrix (ECM) synthesis, deposition and degradation. An important part of iERM is massive ECM deposition. The experimental models about iERM will develop the exploration of pathogenesis of iERM deeply and guide clinical treatment.(Int Rev Ophthalmol, 2022, 46: 448-453)

Pathogenesis of dry eye and neuropathic ocular pain after keratorefractive surgery

Zhao Lu, Zhou Yifan, Yang Tingting, Duan Hongyu, Qi Hong

2022, 46(5):  454-459.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.013

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With the prevalence of keratorefractive surgery, postoperative complications attract increasing attention from ophthalmologists. Among them, dry eye is the most common complication. What’s more, some patients suffer chronic ocular pain, which seriously affects the postoperative satisfaction of patients. Recent studies have found that tear functional units dysfunction plays a core role in the pathogenesis of dry eye after keratorefractive surgery. Meanwhile, researchers pay more and more attention to the relationship between neuropathic corneal pain and chronic ocular pain after corneal refractive surgery, trying to understand the pathological mechanism of ocular pain after corneal refractive surgery from this point of view.(Int Rev Ophthalmol, 2022, 46: 454-459)

Intraocular lens power calculation formulas in eyes of previous corneal refractive surgery

Yu Yangfan, Song Xudong

2022, 46(5):  460-464.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.014

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Nowadays patients who got laser corneal refractive surgery years ago began to develop cataracts. Because of the cornea changes caused by the surgery, the traditional intraocular lens (IOL) formula is not applicable for producing large postoperative refractive errors. The error sources include the measurement error of the cornea anterior surface curvature radius, corneal refractive power, the axial length, and the position of the effective intraocular lens. The formulas that do not require preoperative data before refractive surgery, such as Hoffer Q formula, Barrett True-K formula, Shammas-PL formula, etc., can be applied on the patients who had undergone the laser corneal refractive surgery. The accuracy and predictability of the new generation IOL formulas based on ray tracing principles or artificial intelligence, including Olsen formula, EVO formula, Hill-RBF formula, Kane formula, etc., have been confirmed in the calculation of intraocular lens power in patients undergoing conventional cataract surgery. However, the application value of those new generation IOL formulas in the patients after laser corneal refractive surgery still needs further research to confirm.(Int Rev Ophthalmol, 2022, 46: 460-464)

Research progress of macular fovea hypoplasia

Bai Dayong, Zheng Panpan, Li Li

2022, 46(5):  465-470.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.015

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The development of macular fovea can be divided into four stages: early embryonic stage, late embryonic stage, early stage after postnatal and mature stage. There are many factors which could affect the process of foveal development, such as foveal avascular zone, Müller cells and macular pigment. This process involves the bidirectional movement of inner and outer retinal neurons, involving ganglion cells, inner layer cells, photoreceptors and other cells. Foveal hypoplasia (FH) refers to the absence of both fovea pit and avascular zone. According to OCT images, the severity of FH is divided into 1~4 grades typical and atypical foveal hypoplasia, which is related to albinism, congenital aniridia, isolated central foveal hypoplasia and other diseases. Its pathogenesis is still unknown. (Int Rev Ophthalmol, 2022, 46: 465-470)

Correlation between type 2 diabetes mellitus and primary open angle glaucoma

Liu Jinlong, Hu Haijian, Zhang Xu

2022, 46(5):  471-477.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.016

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Glaucoma and diabetic eye disease are both serious vision-threatening diseases worldwide. Patients with type 2 diabetes mellitus (T2DM) may be accompanied by optic nerve degeneration and retinal ganglion cells（RGC) apoptosis, which are similar to the optic nerve damage of primary open-angle glaucoma (POAG). Risk factors such as high intraocular pressure, vasculopathy and retinal thinning in patients with T2DM may aggravate the progression of POAG, while pharmacological treatments for diabetes such as metforminmay have a protective effect on POAG. Further exploration of the relationship between T2DM and POAG may help reduce the risk of visual impairment in patients with T2DM and discover new treatment target for POAG.(Int Rev Ophthalmol, 2022, 46: 471-477)

Role of the complement system in the pathogenesis of diabetic retinopathy

Guo Xinyang, Jin Wei, Xing Yiqiao

2022, 46(5):  477-480,封Ⅲ.  doi:10.3760/ cma.j.issn.1673-5803.2022.05.017

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Diabetic retinopathy (DR) which is one of the common microvascular complications of diabetes mellitus is an important cause of vision impairment in diabetic patients. The pathogenesis of DR is not yet clear. As an important component of the immune system, complement system not only plays a key role in defending against exogenous microbial infestation, but also has a place in regulating the immune response and mediating inflammation. A large number of studies have demonstrated that the complement system are involved in the development of DR through classical pathway, the alternative pathway, the lectin pathway, and abnormal function of complement regulatory proteins, which will provide new ideas for studying the pathogenesis of DR as well as treatment options.(Int Rev Ophthalmol, 2022, 46: 477-480, cover III)