AIM: To determine the relationship among the macular pigment optical density(MPOD), central macular thickness and body mass index(BMI).

METHODS: This is a comparative cross-sectional study performed in a single institution. Totally 210 volunteers who met the inclusion criteria were included in this study. The subject's MPOD was measured using Macula Pigment Screener II(MPS II, by Electron Technology). Central macular thickness was measured with Spectral Domain Cirrus Optical Coherence Tomography(OCT), Cirrus(Model 4000, Carl Zeiss Meditec). The information of both MPOD and OCT from both eyes were recorded. The data was analysed using Microsoft© Excel \〖Version 15.12.3(150724)℃2015 Microsoft\〗, SPSS(IBM© SPSS© Statistics Version 2.2), and R(version 3.2.1; R Core Team 2015).

RESULTS: There was significant positive correlation between MPOD and central macular thickness(r=0.42, P<0.01)and a significant negative correlation between MPOD and BMI(r=-0.23, P<0.01).

CONCLUSION: Our study showed a significant positive correlation between MPOD and central macular thickness. Further study is needed to look at the detailed structure of the fovea and its relationship with MPOD. Our study also found a significant negative correlation between MPOD and BMI, suggesting that a reduction in BMI may increase the density of macula pigment, which can be helpful in preventing age-retinal pigment epitheliitis(ARMD).

AIM: To analyze the clinical features and surgical outcomes of Duane retraction syndrome(DRS)patients.

METHODS: The clinical data of 94 DRS patients were evaluated. Complete ophthalmic data including age, sex, laterality, the type of DRS, angle of deviation, abnormal head posture(AHP), globe retraction, overshoots and the type of surgical approach were recorded.

RESULTS: The average age of patients was 15.4±9.18 years, and there were 78 males and 16 females. Unilateral and bilateral involvement were found in 87% and 13% of patients, respectively. In unilateral DRS patients, 65% left eyes predominance were observed. Of the 94 patients, 59.5% of the patients were type I, 29.7% of the patients were type II, 8.5% of the patients were type III and 2.1% of the patients were type IV. Most of the patients were 36(38%)esotropic and AHP over 10° was noted in 43(96%)patients, preoperatively. There were 40(43%)patients with overshoots which were more common in type II. Surgery was performed to 45(48%)patients.

CONCLUSION: An excellent surgical outcome was obtained in 32(78%)patients that underwent horizontal rectus surgery and AHP improved in 24(53%)patients. Y-splitting and posterior tenon fixation of lateral rectus both have satisfactory outcomes in the presence of significant overshoots. Foster augmentation with vertical rectus transposition achieved optimal results in abduction limitation.

AIM: To compare pain level and inflammation between preoperative topical Diclofenac 0.1% and Nepafenac 0.1% in patients undergoing cataract surgery.

METHODS: This research was designed as prospective randomized clinical trial and conducted in June to August 2017 at Dr. Yap Eye Hospital. There were 56 subjects underwent phacoemulsification operation(single operator)and diagnosed as senile cataract and no adverse events were found. Subjects were divided into 2 groups according to preoperative eye drop medication, namely Diclofenac group and Nepafenac group. Participants and phaco-surgeon were blind regarding to the treatment. Inflammation parameters(at 1, 7 and 14d follow up)such as pain, conjunctiva hyperemic, blepharospasm, flare and cell in anterior chamber level as the primary outcome, whereas density and morphology of corneal endothelial cells as the secondary outcome.

RESULTS: There were no statistically difference in conjunctiva hyperemic and blepharospasm level between 2 groups at 1d(P=0.284, effect size=0.29, 95% CI=-0.09 to 0.31; P=0.254, effect size=0.31, 95% CI=-0.13 to 0.49, respectively)and 7d(P=1.000 and P=0.556, effect size=0.18, 95% CI=-0.08 to 0.16, respectively)postoperatively. The pain scores(during surgery, 1d and 14d postoperative)in Nepafenac group was statistically lower than Diclofenac group(P=0.006, effect size=0.77, 95% CI=0.24 to 1.34; P=0.045, effect size=0.39, 95% CI=-0.10 to 0.62; and P=0.014, effect size=0.69, 95% CI=-0.06 to 0.50, respectively). The degree of flare and cell in Nepafenac group was lower at the 1d after phacoemulsification(P=0.029, effect size=0.59, 95% CI=0.02 to 0.36). Reduction of corneal endothelial density between 2 groups were not statistically significant, however the reduction of hexagonal cell percentage at 7d after phacoemulsification was lower than Nepafenac group(P=0.042, effect size=-0.55, 95% CI=-2.33 to -0.03).

CONCLUSION: The pain and flare-cell levels in Nepafenac group was lower when compared with Diclofenac group.

AIM: To investigate the effect of intestinal fungal dysbiosis induced by antifungal drug on corneal wound healing in mice.

METHODS: Male C57BL/6J mice(free of eye disease)were divided into two groups randomly: control(Ctrl)group and amphotericin B treated(Amph)group, The Ctrl group was given a normal diet, and the Amph group was supplemented with amphotericin B to induce intestinal fungal dysbiosis. After 4wk intervention, corneal epithelial trauma was implemented in both groups. Corneal fluorescein staining was used to evaluate the corneal wound area dynamically. Immunofluorescence staining was applied to observe the changes of corneal epithelial cells and inflammatory cells. HE staining was used to assess the change of corneal thickness.

RESULTS: Compared with Ctrl group, Amph group had delayed re-epithelialization rate and wound repair, less inflammatory cells and thinner corneal.

CONCLUSION: Intestinal fungal dysbiosis delays the corneal wound healing, leading to a weak inflammatory response.

AIM:To investigate the effect of microRNA-152-3p(miR-152-3p)targeting insulin-like growth factor 1(IGF1)gene on high glucose-induced retinal pigment epithelial ARPE-19 cell activity and apoptosis, and to explore its role mechanism.

METHODS: High glucose was induced into ARPE-19 cells and transfected with miR-152-3p mimics. MTT assay was used to detect cell proliferation activity. Flow cytometry was used to detect apoptosis. Fluorescence quantitative PCR(RT-PCR)was used to detect cells. The expression levels of IGF1 and VEGF in the cells were detected by Western blot and the binding relationship between IGF1 and miR-152-3p was detected by the dual luciferase reporter gene.

RESULTS:High glucose can decrease the activity of ARPE-19 cells, increase the apoptosis rate, inhibit the expression of miR-152-3p and increase the expression of IGF1 and VEGF. Over expression of miR-152-3p can up-regulate high glucose-induced cells. Increased activity and increased apoptosis inhibited the expression of IGF1 and VEGF. The dual luciferase reporter gene assay verified that IGF1 is the target gene of miR-152-3p.

CONCLUSION: miR-152-3p can inhibit the inhibition of high glucose-induced ARPE-19 cell activity and increase apoptosis by targeting IGF1 gene.

AIM: To explore a new method to induce the animal model of rabbit partial limbal stem cell deficiency(LSCD).

METHODS: LSCD was induced through corneal alkali burn, C57 mice and New Zealand rabbits were used to establish the animal models. Corneal alkali burn manipulation was accomplished in experimental animals under general anesthesia combined with surface anesthesia in the operated eye. Specifically, mice(n=30)were used to induce complete LSCD model. In brief, the filter paper(diameter of 3mm)that immersed in 1mol/L potassium hydroxide solution was placed on the central corneal surface of the left eye for 30s, followed by washing with saline. In addition, rabbits(n=19)were utilized to establish the partial LSCD model. Briefly, the nictitating membrane(third eyelid)was resected, and the filter paper(diameter of 5mm)that immersed in 1mol/L potassium hydroxide solution was placed on the superior temporal peripheral corneal surface of the left for 30s, followed by washing with saline. After surgery, the model eyes were treated with 0.5% Levofloxacin Hydrochloride Eye Drops four times a day. In addition, the slit-lamp microscope was adopted for observation and photo-taking before burn, as well as at 1, 2, 4wk and 2mo after burn; meanwhile, complications such as corneal ulcer and perforation were recorded. 2mo after surgery, the corneal goblet cell distribution was detected with impression cytology, and the severity of LSCD was classified according to slit-lamp microscopic findings and corneal impression cytology. The animals were sacrificed 2mo after surgery, cornea and conjunctiva sections were made to observe angiogenesis and goblet cell distribution in cornea. Animals died accidentally were not counted into the total number, and the successful induction rates of complete LSCD and partial LSCD models were compared.

RESULTS: Six out of the 30 mice died accidentally, while 2 developed corneal perforation after burn, and the remaining 22 had developed complete LSCD only, yielding the successful induction rate of 92%. 2mo after burn, extensive angiogenesis distribution in the superficial and deep corneal stromal layers could be observed, and pathological sections revealed corneal angiogenesis. Seven out of the 19 rabbits died accidentally, while the remaining 12 had various degrees of LSCD only(partial LSCD, average involving 1.17±0.39 quadrants). Additionally, no corneal perforation was observed, and the successful induction rate was 100%. The result of Fisher's exact test P value is 0.543, without statistical difference. No goblet cells were observed in the normal corneal region, while goblet cells were observed in the LSCD region, with the average density of 58.60±12.58 cell/HP.

CONCLUSION: Central corneal alkali burn can induce complete LSCD; however, some animals will experience failure in model induction due to corneal ulcer and perforation, LSCD is generally serious and may be combined with angiogenesis in deep cornea. Alkali burn in superior temporal cornea can induce partial LSCD, which may be combined with relatively minor corneal lesion, and the corneal angiogenesis is located in the superficial layer.

AIM: To investigate the effect of connective tissue growth factor(CTGF)on the proliferation and migration and transformation in Tenon's capsule fibroblasts(Tfb)of primary open angle glaucoma(POAG)patients.

METHODS: Tfb were cultured from Tenon's tissues in POAG patients in vitro. The free-serum DMEM-F12 containing 1.0, 10.0, 100.0ng/mL of CTGF was added into medium for 24h and 48h in different experimental group respectively, and only equal volume of free-serum DMEM-F12 was added in the negative control group. After 24h, the cell proliferation was analyzed through MTT assay, and migration was evaluated by crutch method. After 48h, Semi-quantitative RT-PCR was used to observed the mRNA expression of α-smooth muscl actin(α-SMA), and expression of α-SMA protein was examined by immunochemistry.

RESULTS: The proliferation values A of the cells in 1.0, 10.0, 100.0ng/mL of CTGF group respectively were 0.436±0.009, 0.643±0.009, 0.679±0.006, and 0.423 ±0.156 in the negative control group. The migrated cell number was 34.600±3.507, 70.400±2.074, 80.000±2.915 in different concentrations of CTGF group respectively, and 31.000±3.536 in the negative control group. And also in different experimental groups respectively, the absorbance ratio of α-SMA/β-actin was 0.873±0.161, 1.213±0.312, 1.352±0.376, and 0.851±0.158 in the negative control group, the expressing levels A of α-SMA protein in Tfb were 0.110±0.026, 0.141±0.017, 0.175±0.027, and 0.108±0.020 in the negative control group. The statistics of the above experimental data showed that, comparing with the negative control group, the 10.0 and 100.0ng/mL CTGF groups was statistically significant different(P<0.05), but there was no statistical different between the 1.0ng/mL CTGF group and the negative control group(P>0.05).

CONCLUSION: The proliferation, migration, and phenotypic transformation of Tfb can be promoted in CTGF group in POAG patients. These findings suggest that CTGF may play a role in the development of filtering bleb scarring.

AIM: To investigate the protective effects of berberine on Sprague-Dawley(SD)rat retinal Müller cells with high concentration glucose in vitro.

METHODS: The retinal Müller cells of SD rats were primary cultured by enzyme digestion. The second generation of Müller cells were randomly divided into 7 groups. They were normal glucose concentration(5mmol/L glucose)group, high glucose concentration(25mmol/L glucose)group, high glucose+ berberine group(5, 10, 25, 50 and 100μmol/L). After cultured for 24h, 48h and 72h, the cell proliferative viability was measured by CCK-8 method.

RESULTS: After cultured for 24h, 48h and 72h, compared to the normal glucose concentration group, the absorbance of cells in the high glucose concentration group reduced significantly(All P<0.01). Compared to the high glucose concentration group, the absorbance of cells in different concentration berberine(10, 25, 50 and 100μmol/L)groups increased significantly(All P<0.05). It showed a dose-dependent effect. There was no statistically significant difference on the cells absorbance between high glucose+5μmol/L berberine group and high glucose group(P>0.05).

CONCLUSION: Berberine could reduce the inhibitory effect of high glucose on the proliferative viability of Müller cells to some extent. The intensity of effect was positively correlated with the berberine concentration.

AIM: To explore the effect of phacoemulsification combined with goniosynechialysis or trabeculectomy on haemodynamics in patients with primary angle-closure glaucoma(PACG)and cataract.

METHODS: Totally 94 patients(94 eyes)with PACG and cataract who were admitted to Bazhong Central Hospital from January 2015 to June 2017 were divided into phacoemulsification and goniosynechialysis group(Observation group)and phacoemulsification with trabeculectomy group(Control group)by random number table method, 47 cases in each group. The indexes of curative effect were compared between the two groups.

RESULTS:The peak systolic velocity(PSV)and end diastolic velocity(EDV)of Observation group were larger than those of Control group at 1mo and 3mo after surgery. The resistance index(RI)of Observation group was significantly less than that of Control group at 3mo after surgery, while anterior chamber depth and open degree of angle were larger than those of group B(P<0.05).

CONCLUSION:Both goniosynechialysis or trabeculectomy combined with phacoemulsification can effectively reduce intraocular pressure, and promote visual recovery. But goniosynechialysis can better promote opening of angle, and improve hemodynamics.

AIM: To analyze the application effects of femtosecond laser assisted cataract surgery(FLACS)in patients with hard nuclear cataract.

METHODS: The clinical data of each 42 cases(eyes)in patients with hard nuclear cataract who underwent FLACS(observation group)and traditional phacoemulsification(control group)were retrospectively analyzed. The operation conditions and postoperative recovery were recorded in the two groups.

RESULTS: The mean ultrasound power, actual phacoemulsification time and effective phacoemulsification time and corneal edema degree at 3d after operation in observation group were lower than those in control group(P<0.05). The changes of postoperative corrected distance visual acuity(CDVA), uncorrected distance visual acuity(UCDVA)and corneal endothelial cell loss rate showed 3d after operation>1wk after operation>1mo after operation, and the changes in observation group were greater than those in control group(P<0.05). The corneal endothelial cell density in observation group at each time point after operation was higher than that in control group(P<0.05).

CONCLUSION: FLACS has significant effects on hard nuclear cataract.