AIM:To explore the possible effects of genetic variant S18Y of ubiquitin carboxyl-terminal esterase L1(UCHL1)gene on age-related cataract formation.

METHODS:We have investigated the frequency of this variant among the Han-Chinese population in a case-control study. A total of 242 cortical cataract patients and 144 controls were genotyped using polymerase chain reaction(PCR)and genomic sequencing.

RESULTS:There is no statistical difference between cataract patients and healthy controls for the frequency of alleles(P=0.746)and genotypes(P=0.813). Since there was in our sample a significant difference between the groups in mean age(P<0.001), OR and CI for UCHL1 allele A positivity were computed by a binary Logistic regression model, no association was obtained for a positive UCHL1 allele A carrier status(P=0.818).

CONCLUSION:We did not find any difference between the cases and the controls at allelic and genotypic level. Our results do not support a role for this variant in cataracts.

AIM: To evaluate the impact of active uveitis on refractive error changes.

METHODS: A prospective cohort study was conducted on 66 patients(88 eyes)with active uveitis. The subjects were classified based on the anatomical location of their disease activity as anterior, intermediate, posterior and pan-uveitis. Cycloplegic refraction was performed in both active and quiescent phases, and the results were compared.

RESULTS: Spherical changes in active anterior non-granulomatous uveitis resulted in an average of -0.25(0.77)D(95% CI: -0.5 to 0)shift toward myopia(P=0.039)and in active intermediate uveitis, an average of +0.39(0.8)D(95% CI: 0.09-0.69)shift toward hyperopia(P=0.003). Spherical equivalent changes in active intermediate uveitis resulted in hyperopic shift \〖+0.43(0.94)D, 95% CI: 0.08-0.79, P=0.005\〗. Cylinder had only significant changes in pan-uveitis \〖-0.3(0.39)D, 95% CI: -0.58 to -0.02, P=0.043\〗. In multivariate analysis, we noted that course of disease activity(acute versus recurrent)and anatomical location of disease activity had statistically significant effects on spherical equivalent changes(P=0.003 and P=0.004, respectively).

CONCLUSION: Active uveitis has a significant effect on the refractive status of the eye, the changes of which depend on the inflamed anatomical area.

Photorefractive keratectomy(PRK), laser-assisted in situ keratomileusis(LASIK)and small-incision lenticule extraction(SMILE)are the most clinically effective and safe techniques, for refractive surgery. All three kinds of laser vision correction, while varying in technique, have roughly a similar high achievement rate. Which method is best for you to rely upon various components like the refractive error, habits and profession, for example, sports and lifestyle. LASIK is as of now the predominant strategy in refractive surgery but SMILE also spreads rapidly between surgeons. This increments comfort amid the early postoperative period, takes into account quick visual recovery, and diminishes the wound healing response. And additionally that there would be less postoperative dry eye after SMILE contrasted with LASIK because the anterior stroma is exasperates just by the small incision, implying that the anterior corneal nerves ought to be less influenced. SMILE likewise lower induction of higher order aberrations(HOA)contrasted with LASIK and PRK. No contrasts between SMILE, LASIK and PRK medicines in postoperative corneal hysteresis(CH)corneal resistance factor(CRF)or corneal hysteresis values. PRK, but, remains a supreme option for moderate to mild modifications, especially for cases involving thin corneas, frequent erosions.

AIM: To discuss the protective effects of betaine-homocysteine methyl transferase(BHMT)on oxidative damaged human lens epithelial cells(HLEC)induced by homocysteine.

METHODS: HLEC were cultured in vitro and then randomly divided into 3 groups. Normal group:normal cultured HLEC; control group: normal cultured HLEC transfected with empty vector; BHMT gene overexpression group(OE): HLEC transfected with BHMT gene overexpression. All groups were cultured in 10% FCS DMEM +5mmol/L Hcy for 16h. After cultured, BHMT mRNA expression was measured by qRT-PCR and Western blot, the cell proliferation was detected by EdU Assay Kit,The level of ROS and GSH of HLEC were measured by Flow Cytometer and Visible Spectrophotometers. The expression level of of protein(GRP78, Nrf2, Caspase-12)was measured by western blotting.

RESULTS: After cultured 16h, cell proliferation ability in OE group was increased by 30.0% compared with NC group(P<0.05).The expression of ROS in normal group(89.2043±0.3511)% was obviously higher than OE group(49.5625±0.4502)%, P<0.05, GSH activity in OE group was obviously higher than control group and normal group,(P<0.05). The expression level of GRP78 in the normal group and the control group was significantly higher than overexpression group. The expression level of Nrf2 in the normal group and the control group was significantly lower than overexpression group. The expression level of Caspase-12 in the overexpression group was significantly lower than that in the control group.

CONCLUSION: BHMT in vitro can prevent the oxidative damage of HLEC by high homocysteine, clear the ROS and decrease the ER stress reaction. Apoptosis of lens epithelial cells was inhibited. BHMT plays an important protective role in oxidative damaged HLEC induced by Hcy.

AIM: To investigate the mechanism of Delphinidin(Dp)in protecting retinal against light induced oxidative damage.

METHODS: All 661W photosensitive cells were treated with 2 000Lx light(48h)and/or different concentrations of Dp(5, 10, 20μmol/L, 24h). Cell activity, intracellular LDH activity, TBARS content and antioxidant enzymes(SOD, GSH-Px, GST)activity were determined respectively. After the healthy SD rats were treated with 3 000 Lx light(24h)and/or Dp \〖100mg/(kg·d)for 4wk\〗, then changes in retinal tissue structure were observed and fluctuations in oxidative stress index(SOD, GSH-Px, GST)were determined.

RESULTS: The results of in vitro experiments showed that the cell activity was significantly decreased after irradiation, the LDH activity and TBARS content were increased, and the activity of antioxidant enzyme system were decreased. However, Dp treatment could increase cell viability, decrease LDH activity and TBARS content, and increase the activity of antioxidant enzyme system. In vivo experiments showed that Dp can protect the structural integrity of retina, reduce the content of TBARS in retinal tissue, and increase the activity of SOD, GSH-Px and GST.

CONCLUSION: Dp may protect retinal against Photochemical factors -induced oxidative damage by regulating the oxidation-antioxidant system.

AIM: To discuss the effect and mechanism of melatonin on diabetic retinopathy in rats and its mechanism.

METHODS:Totally 40 healthy male SD rats were choose and randomly divided into 4 groups, normal control group, diabetid group, low dose melatonin group and high dose melatonin group. The changes of retinal structure were observed by hematoxylin-eosin staining(HE staining), ultrastructure of retinal ganglion cells were observed by electron microscopy, superoxide dismutase(SOD)and malondialdehyde(MDA)level in the retina tissue were detected by xanthine oxidase method, and protein expression levels of B cell lymphoma/lewkmia-2(Bcl-2), Bcl-2 associated X protein(Bax)and P53 were detected by Western Blot.

RESULTS: HE staining results showed that the rat retina tissue structure of the normal control group was clear, the retinal tissue of diabetes group rats were not clear, the nerve fiber layer was edema, the retina cells of low dose melatonin group were probably distinct, the interlayer cells were arranged neatly, and the inner and outer nuclear layers were slightly disordered, rats retinal structure in high dose melatonin group were further improved than that in low dose melatonin group; Electron microscope results showed that compared with diabetes group, retinal ganglion cells form in melatonin group were improved in different extent; Xanthine oxidase method detected that SOD level in retinal tissue of melatonin group rats were higher than that in diabetic group, the MDA level were lower than that in diabetic group, compared with diabetes group the differences both have statistically significant(P<0.05); Western blot results showed that the protein expression of Bcl-2 in low dose and high dose melatonin group gradually decreased, Bax and P53 protein expressions increased significantly, compared with diabetic group the differences were statistically significant(P<0.05).

CONCLUSION: Melatonin could improve the morphological changes of retina in diabetic rats and inhibit diabetic retinopathy to some extent.

AIM: To analyze the association between refractive status and refractive factors, and to explore the effectiveness of mean ocular axial length(AL), mean corneal radius of curvature(CR)and their ratio in the assessment of amitropia in children and adolescents.

METHODS: Cross sectional study, 816 cases(1632 eyes)aged 3-16 years old suspected ametropia were selected in the Affiliated Eye Hospital of Nanjing Medical University from December 2017 to December 2018. Uncorrected visual acuity(UCVA), mean AL and mean CR were tested. Autorefraction was performed after cycloplegia, which was measured as the spherical equivalent(SE).

RESULTS: Among 816 cases of children and adolescents aged 3-16, 773 were ametropia, accounting for 94.7%, with the highest proportion aged 7-14. The difference(one eye)in the mean AL, and AL/CR ratio of different refractive groups were statistically significant(P<0.05). In different refractive states, the mean AL and AL/CR ratio showed a low correlation with SE in emmetropes and low hyperopes but higher correlation in moderately hyperopic and myopic children. The mean AL, AL/CR ratio were higher correlation with SE increased with age. Sensitivity was 0.880, specificity was 0.916, and accuracy was 89.2%. The area under ROC curve was 0.954.

CONCLUSION: The proportion of myopia among children and adolescents gradually increases and shows a large increase after 7 years old. The AL and AL/CR ratio showed higher correlation in moderate hyperopes, myopes and older ages. The AL/CR ratio is highly accurate in the diagnosis of myopia in adolescents and children.

AIM: To investigate the relationship among sleep apnea hypopnea syndrome(SAHS), nocturnal hypotension(NHP)and nonarteritic anterior ischmic optic neuropathy(NAION).

METHODS:The retrospective study participants included 31 patients with NAION and 31 age- and sex-matched controls. Twenty-four hour ambulatory blood pressure monitoring was used to evaluate the presence of NHP in NAION group and in control group. Berlin questionnaire was involved to evaluate the risk of SAHS. All participants underwent full-night respiratory polysomnography for monitoring apnea-hypopnea index(AHI), minimum oxygen saturation(MOS).

RESULTS: Totally 23 NAION patients(74%)presented with NHP, which was found in 14 control subjects(45%). The incidence of NHP was significantly higher among NAION patients compared to the controls(P=0.020). Of the 31 NAION patients, 22 patients(71%)had SAHS, compared to 13(42%)control subjects. Logistic regression analysis showed that NHP(OR=2.762, 95% CI: 1.275-3.746), AHI(OR=2.959, 95% CI: 1.478-6.432)and MOS(OR=3.058, 95% CI: 1.734-7.743)were risk factors for NAION.

CONCLUSION: SAHS and NHP were related with NAION. Taking precautions against SAHS and NHP may be crucial to the prevention and cure of NAION.

The fluctuation of anterior chamber depth(ACD)is one of the main causes of refractive shift after cataract surgery. Currently, there are numerous studies on the changes of ACD after cataract surgery worldwide. This article reviews the trend of the change of ACD after cataract surgery, and the influence factors and accompanying refractive shift.

Optic nerve sheath fenestration(ONSF), also known as optic nerve sheath decompression, was first proposed by Wecker. The procedure involves cutting incisions or windows in the retrabulbar optic nerve sheath to release the cerebral spinal fluid from the subarachnoid space of the optic nerve, reducing the pressure surrounding the optic nerve. With the development of surgical instruments and procedures, the safety of ONSF has been significantly improved with infrequent complications. Through the past three decades, more and more ophthalmologists realized that ONSF is an effective surgical treatment to stabilize or improve visual loss in idiopathic intracranial hypertension(IIH). Additionally, much progress in the use of ONSF has been made on secondary intracranial hypertension due to cerebral venous sinus occlusion, Cryptococcal meningitis, and intracranial mass or tumors. In this paper we review the application of ONSF in IIH, and secondary intracranial hypertension. From the review, it indicates ONSF is a good surgical alternative for ophthalmologists. It also indicates that ONSF can be used to prevent or halt progressive visual loss associated with intracranial hypertension, particularly when other treatment modalities fail to protect vision.