Table of Content

22 December 2024, Volume 48 Issue 6

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Research progress and clinical application of lens organoids

Xiong Yingyue, Chen Xiaona, Wei Jia, Gao Yali

2024, 48(6):  401-406.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.001

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The pathogenesis of cataract is relatively complex, lack of effective drug treatment, and postoperative visual quality cannot be restored to normal state. With the application of stem cell technology in ophthalmology, researchers have used stem cells from various sources to successfully induce the formation of humanoid lenses in vitro and reproduce the microscopic three-dimensional structure of some of their unique functions. These lens organoids are used to build disease models in vitro, study the mechanisms and inductions of related diseases, screen drugs and even regenerate alternative treatments. It provides more possibilities for preventing and treating cataracts. This paper reviews the research progress of lens organoids, introduces the breakthrough research methods, summarizes their clinical applications in mechanism research, drug screening and regenerative replacement therapy, and puts forward personal prospects in the direction of related research and cultivation and the construction of 3D lens or whole eye structure in cooperation with multi-bioengineering. (Int Rev Ophthalmol, 2024, 48:  401-406)


Factors affecting microbiological contamination of donor cornea in eye bank

Ma Yanran, Wang Qin, Yang Lihong, Ren Yi, Zhou Qizhi

2024, 48(6):  407-410.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.002

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Donor-related infections are a serious threat to patient safety after corneal transplantation. It is important that eye retrieval and eye bank practices are monitored to ensure the provision of high-quality and safe tissue to recipients. Contamination of the donor cornea can occur during its retrieval, storage and processing. This review is focused on the factors including donor, cornea harvest and storage that may affect the microbiological contamination of donor cornea aiming to reduce the contamination rate of donor tissue in eye bank.(Int Rev Ophthalmol, 2024, 48:  407-410)


Surface modification of intraocular lenses for the prevention and treatment of endophthalmitis

Zheng Xin, Wan Xiuhua

2024, 48(6):  411-415.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.003

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The surface modification of intraocular lens (IOL) can effectively reduce the risk of endophthalmitis and postoperative infection associated with cataract surgery. According to the effect materials modified by IOL, the surface modification of IOL can be divided into two categories, drug loading and non-drug loading modification. Drug-loaded IOL surface modification can be achieved by "coating", such as critical fluid impregnation, polymer/pharmaceutical chemical coating technology and "immersion". Antibiotics such as moxifloxacin are loaded on the surface of IOL to prevent endophthalmitis. Surface hydrophilic modification of hydrophobic IOL to inhibit the adhesion of lens epithelial cells can prevent the occurrence of after-cataract and endophthalmitis. (Int Rev Ophthalmol, 2024, 48:  411-415)


Relationship between ocular biological parameters and corneal higher-order aberrations in cataract patients#br#

Yong Zixuan, Huang Xionggao

2024, 48(6):  416-419.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.004

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The visual outcomes of cataract surgery are significantly influenced by preoperative ocular biometric parameters and corneal higher-order aberrations. As cataract surgery transitions from vision-restoring procedures to refractive surgeries, the demand for better postoperative visual quality has become increasingly stringent. This review explores the relationship between ocular biometric parameters (such as central corneal thickness, corneal refractive power, anterior chamber depth, anterior chamber angle, lens thickness, pupil size, and axial length) and corneal higher-order aberrations. The central corneal thickness is negatively correlated with total higher-order aberrations, spherical aberration, and coma, but positively correlated with trefoil aberration. Corneal refractive power affects higher-order aberrations, with myopic patients showing lower total higher-order aberrations, while hyperopic patients show higher values. The influence of anterior chamber depth on higher-order aberrations is controversial, with some studies indicating that a shallow anterior chamber increases corneal spherical aberration. An increase in pupil size is associated with an increase in higher-order aberrations. Additionally, axial length is negatively correlated with total corneal higher-order aberrations and spherical aberration. Accurate measurement of these parameters aids in predicting postoperative visual outcomes and optimizing individualized treatment for cataract surgery.(Int Rev Ophthalmol, 2024, 48:  416-419)


Affecting factors of refractive error after cataract surgery in patients with aqueous eye status

Su Wenhua , , Wang Xuelin , Lu Xiaohe , Chen Juanjuan , Huang Xinyu , Li Yingli

2024, 48(6):  420-425.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.005

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With the prevalence of myopia, there is a trend towards an increase in the number of people requiring vitrectomy to preserve the lens. The risk of cataract after vitrectomy (aqueous eye status) is about 22.5%~60%, and refractive drift after cataract of aqueous eye status surgery has received more attention. Although cataract surgery technology continues to advance and examination equipment is constantly updated, some preoperative, intraoperative, and postoperative factors cause postoperative refractive error to be more obvious than that of normal eye cataract. In addition to paying attention to the patient's ocular surface health, the accuracy and repeatability of optical biometry, and the selection of the appropriate IOL refractive power calculation formula, the change of the axial length and the actual position of the IOL should also be paid attention to. Choosing the appropriate IOL calculation formula can reduce the refractive error after surgery. The SRK/T formula, Kane formula, Haigis formula, and Barrett Universal II formula are used to calculate the refractive error of high myopia, but whether they can be used in patients with cataract of aqueous eye status is worth exploring.  (Int Rev Ophthalmol, 2024, 48:  420-425)


Mechanism of low-intensity red light therapy in regulating axial elongation

Wang Yumo, Sun Hongyan, Lin Hongzhan, Yang Mingming

2024, 48(6):  426-432. 

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Myopia has become an urgent problem in global public health. Low-intensity red light therapy has been shown to be effective in delaying axial elongation in a non-invasive manner, but its mechanism remains unclear. Low-intensity red light therapy is based on the principle that specific molecules absorb photons and respond to light signals, resulting in changes in the electronic excited state of molecules, temporarily changing their structure and function, and achieving highly specific and targeted biological regulation. The regulation of axial length involves a complex cascade of reactions that begins in the retina and affects the sclera. Light exposure is closely related to axial elongation. Previous studies have indicated that the visual stimulation elicited by low-intensity red light is received by retinal neurons and generates signals, which are transduced through the retinal pigment epithelium and choroid to the sclera, leading to the release of neurotransmitters, alterations in choroidal blood flow, and scleral remodeling. This review explores the relationship between low-intensity red light therapy and axial regulation, investigating the mechanisms by which low-intensity red light slows down axial growth. (Int Rev Ophthalmol, 2024, 48:  426-432)


The relationship between Wnt/β-catenin signaling pathway and the pathogenesis of myopia

Adilai·Aikebaier, Ding Lin

2024, 48(6):  433-437.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.007

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The etiology of myopia involves a complex regulatory process of the retina-choroid-sclera axis, wherein the Wnt/β-catenin pathway plays a pivotal role as a significant signaling pathway in myopia development. Studies indicate that activation of the Wnt/β-catenin pathway correlates positively with the severity of myopia, and inhibiting this pathway may potentially slow the progression of myopia. Moreover, individuals with myopia exhibit significantly reduced levels of DKK-1 (Dickkopf-1) in their blood, and supplementation of DKK-1 may mitigate axial elongation of the eye and progression of myopia. These findings pave the way for novel research directions in therapeutic strategies based on the Wnt/β-catenin pathway.(Int Rev Ophthalmol, 2024, 48:  433-437)


ICL implantation for moderate and low myopia

Li Guangyue, Wan Xiuhua

2024, 48(6):  438-442.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.008

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Currently, traditional corneal refractive surgery, such as excimer laser surgery, is the main treatment for myopia. However, corneal refractive surgery requires the removal of a portion of the cornea, which limits its application due to the corneal thickness and curvature constraints. In contrast, implantable collamer lens (ICL) does not require cornea resection, avoiding postoperative corneal ectasia and other complications. In the past, due to limitations in intraocular lens materials, design diversity, and therapeutic concepts, ICL implantation was mainly used for the treatment of high myopia. In recent years, with the development of novel intraocular lens materials and expanded therapeutic concepts, there has been increasing evidence that ICL implantation has a significant effect in the treatment of low to moderate myopia, comparable to conventional laser refractive surgery. Therefore, for individuals who cannot or do not wish to undergo corneal refractive surgery, ICL implantation has become a treatment option that can effectively correct myopia and provide visual experience.(Int Rev Ophthalmol, 2024, 48:  438-442)


Characteristics of the peripheral retinal refraction after orthokeratology

Wang Jiangnan, Wang Jiawei, Chai Song

2024, 48(6):  443-447.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.009

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Defocus theory is the mainstream theory of myopia prevention and control theory, from the initial animal researches and clinical trials to the current prevention and control methods (orthokeratology, defocus soft lens, defocus frame glasses, etc.) derived from this theory have all verified the importance of myopic defocus state of the peripheral retina in delaying the growth of the ocular axis. Among them, orthokeratology stands out with its predominant prevention and control effect, which is attributed to the more peripheral myopia defocus induced than other methods. Moreover, myopic defocus is mainly produced in the peripheral retina within the 10°~30° eccentric range ( it achieves the strongest prevention and control effect within 10°~20° eccentric range) and presents the asymmetric distribution of the temporal and nasal sides. Myopic defocus after orthokeratology is at its maximum on the first night and is stable after 1~12 months.(Int Rev Ophthalmol, 2024, 48:  443-447)



Progress on oxidative stress of trabecular meshwork cells in primary open-angle glaucoma

Gang Xiaorui, Xu Lijuan, Han Jialing, Zhou Tao, Liang Yuanbo

2024, 48(6):  448-453.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.010

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Primary open-angle glaucoma (POAG) is the most common type of glaucoma, while its pathogenesis remains elusive. In recent years, oxidative stress has been recognized as the critical role in POAG formation and progress. Specifically, excessive reactive oxygen species promote the pathogenesis of trabecular meshwork (TM), and lead to the dysfunction of aqueous humor outflow pathway, as well as intraocular pressure elevation. However, the relationship between oxidative stress and TM dysfunction is not fully understood yet. In this article, we aim to elucidate the mechanisms underlying oxidative stress-induced TM damage in POAG, including the oxidative stress sources, the responsive molecular mechanisms of TM cells exposure to oxidative stress, and the structural and functional changes of TM.(Int Rev Ophthalmol, 2024, 48:  448-453)



Research advances of retinal glial cells involved in glaucomatous optic neuropathy

Cheng Ying, Kang Qianyan

2024, 48(6):  454-459.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.011

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Retinal glial cells, considered as vital immunoregulatory cells, sparked widespread enthusiasm for studying on the mechanism of glaucomatous optic nerve damage via glial cell-driven neuroinflammatory response. In recent years, the important role and molecular mechanism of different types of retinal glial cells such as microglia, astrocytes and Müller cells in glaucoma progression have been gradually revealed. The activation of retinal glial cells is an early event of glaucomatous optic nerve damage, which occurs before the loss of retinal ganglion cells and is regarded as the "trigger" of retinal neuroinflammation. In this review, we make a preliminary sketch of the latest studies from the aspects of microglia, astrocytes, Müller cells and their crosstalk, thereby providing a reference for the molecular mechanism of retinal glial cells involved in glaucomatous optic nerve damage and the formulation of potential targeted treatment strategies. (Int Rev Ophthalmol, 2024, 48:  454-459)


Causes of choroidal detachment secondary to ophthalmic surgery

Xu He, Dong Rujiao, Li Dongyu

2024, 48(6):  460-463.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.012

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The occurrence of choroidal detachment is mainly related to decreased intraocular pressure, choroidal circulation disorders, and choroidal inflammation. The reasons for secondary choroidal detachment after glaucoma surgery include the use of preoperative antiglaucoma drugs, postoperative low intraocular pressure, the use of anti-metabolic drugs, systemic factors, etc. The reasons for secondary choroidal detachment after vitrectomy surgery include surgical operation issues, properties of intraoperative vitreous cavity filling, application of fundus laser, incision leakage, etc. The reasons for secondary choroidal detachment after scleral buckling surgery include high myopia, tight pressure during buckling, and posterior positioning. There have also been cases of secondary choroidal detachment during intravitreal injection. This review aims to enhance the understanding of choroidal detachment among ophthalmologists, thereby facilitating preventive measures to mitigate its occurrence.(Int Rev Ophthalmol, 2024, 48:  460-463)

Anti-VEGF drugs for fundus neovascular diseases

Hou Huimin, Chang Xueke, Jin Yujia, Song Zongming

2024, 48(6):  464-470.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.013

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Retinal neovascularization is a type of ophthalmic disease that involves abnormal proliferation of retinal and choroidal blood vessels. Vascular endothelial growth factor (VEGF) plays a key role in the pathogenesis of fundus neovascular diseases. Anti-VEGF drugs (such as pegatinib, bevacizumab, ranibizumab, busizumab, aflibercept, conbercept, fariximab, etc) can reduce vascular leakage, promote the absorption of effusion and accelerate the regression of neovascularization. Neovascular diseases in the fundus are related to multiple factors, and targeting multiple channels simultaneously may produce better prognosis. With the development of new drug delivery methods, sustained-release drugs, and novel drugs targeting more pathways, anti VEGF drugs provide a more efficient and safe option for the treatment of retinal neovascularization. Innovative drugs include gene therapy drugs ADVM-022 and RGX-314, local eye drops such as pazopanib, squalylamine, regorafenib, oral tyrosine kinase inhibitor CM082, and monoclonal antibody drug loaded implants , all of which have certain prospects.(Int Rev Ophthalmol, 2024, 48:  464-470)


The relationship between metal ion homeostasis and the formation of retinal degenerative disease

Du Yuzhi, Li Genlin

2024, 48(6):  471-475.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.014

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Homeostatic regulation of the internal environment is an important characteristic of natural ecosystems to maintain dynamic stability. Abnormal regulation of ion homeostasis in the body causes abnormal protein synthesis and folding in retinal cells, leading to the formation of various degenerative retinal diseases, including retinitis pigmentosa. Abnormalities in metal ion homeostasis include the “iron death” of elevated lipid peroxides and reactive oxygen species and reduced glutathione and glutathione peroxidase 4 levels due to iron overload; abnormal cytoplasmic and mitochondrial aggregation of calcium that precedes apoptosis; and the decrease of endogenous zinc ions in the retinal pigment epithelium with age, but the increase of extracellular aggregation all suggest a possible relationship between the abnormal homeostasis of metal ions and the formation of retinal degenerative disease. A number of novel interventions and technologies have shown promising therapeutic potential to address these mechanisms, including iron chelators such as “deferiprone”, zinc-desferrioxamine, and gene therapy for iron death, new calcium channel blockers such as D-cis-diltiazem and nivadipine, and the oral administration of zinc sulfate or zinc-monocysteine compound to restore zinc homeostasis. These strategies provide new ideas for intervening in retinal degenerative diseases, providing strong support for the important role of metal ion homeostatic regulation in disease treatment. (Int Rev Ophthalmol, 2024, 48:  471-475)


Current status of intra-arterial chemotherapy for retinoblastoma

Sun Fanqi, Guo Xiaoxuan, Gu Huali

2024, 48(6):  476-480.  doi:10.3760/ cma.j.issn.1673-5803.2024.06.015

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Retinoblastoma (RB), a common malignant tumor of the eye in children, has been continuously evolving in its treatment methods as medical technology advances and greater attention is paid to patients' quality of life. In recent years, intra-arterial chemotherapy (IAC) has become an important treatment modality for RB, achieving targeted local chemotherapy of the tumor through ophthalmic artery drug delivery, significantly improving treatment outcomes and reducing systemic adverse reactions. This article provides a comprehensive review of the technical operation, chemotherapeutic drugs (melphalan, carboplatin, topotecan), eye and systemic adverse reactions, prognosis, and limitations of IAC in the treatment of RB, aiming to provide reference value for the improvement and development of IAC in clinical practice. (Int Rev Ophthalmol, 2024, 48:  476-480)