Cataract Progression Research Articles

Short-term Postoperative Visual Acuity Decrease and Recovery after Ahmed Tube Shunt Procedure for Glaucoma

To elucidate the vision loss and recovery course after the Ahmed tube shunt procedure 6 months postoperatively. To identify risk factors associated with significant vision loss. Retrospective chart review. One eye of all adult patients who underwent an Ahmed glaucoma valve procedure from January 2008 to December 2017 with a minimum 6-month follow-up. Patients' preoperative and postoperative corrected visual acuity (CVA) were documented for 1 week, 1 month, 3 months, and 6 months postoperatively. Preoperative and postoperative CVA at various time points were compared using repeated-measures analysis of variance. The proportions of patients with mild (<3 lines of Snellen CVA loss), moderate (3-5 lines, inclusive), and severe (>5 lines) vision loss were calculated and compared using a chi-square test. Logistic regression analysis was conducted to identify risk factors associated with a loss of 3 or more lines of CVA 6 months after surgery. A total of 375 patients were included, whose mean preoperative CVA was 0.76. At 1 week postoperatively, mean CVA worsened to 0.96 (P < 0.05), but recovered back to preoperative level by the third postoperative month (P > 0.05). In terms of any vision loss, 55.6% of patients had worse CVA than preoperation at 1 week postoperatively, including 23.5% who had 3 or more lines of vision loss; these proportions decreased to 39.2% (P < 0.001) and 9.3%, respectively, by 6 months postoperatively. The most common causes of significant vision loss were preexisting ocular conditions and cataract progression. Postoperative antimetabolite injection was associated with a lower risk of 3 or more lines of CVA loss 6 months postoperatively (odds ratio, 0.44; P= 0.023). After the Ahmed tube shunt procedure, the worst CVA occurred at 1 week postoperatively and mean CVA returned to the preoperative level by month 3 postoperatively. Approximately 40% of patients had any CVA loss compared with preoperation, and 9.3% of patients had 3 or more lines of CVA loss at month 6 postoperatively. Postoperative antimetabolite injection was associated with a lower risk of 3 or more lines of postoperative vision loss.

Effects of D-Limonene on aldose reductase and protein glycation in diabetic rats

Diabetes mellitus and hyperglycemia can lead to other health complications. The pathogenesis of diabetes mellitus can affect numerous tissues in the eye structure and cataracts are one of the major causes of visual impairment in diabetes mellitus patients. In this study, we aim to investigate the ability of D-limonene to inhibit aldose reductase hypoglycemic activity in lens organ culture and its anti-glycating properties in STZ-induced cataracts of rats with diabetes. D-limonene repressed aldose reductase in-vitro with IC50 ranges of ~13.9 ± 0.31 µg/mL in an uncompetitive manner. This compound also prevented hyperglycemic induced increases in aldose reductase activity, accumulation of sorbitol, altered crystalline proteins (α, β and γ), and opacification of the rat lens in ex-vivo lens organ culture. Supplementation of D-limonene in STZ-induced diabetic rats restored these changes and delayed the progression of cataracts. This study demonstrates that D-limonene is a pharmaceutically active component that inhibits rat-lens aldose reductase. Therefore, this study showed that D-limonene prevents advanced glycation end product formation contributing to the integrity of α-crystallin chaperone activity and delays cataract development. It has been concluded, D-limonene has a role in inhibiting aldose reductase activity and advanced glycation end products formation in vivo, and in delaying the development of diabetic cataracts. Further studies of D-limonene are needed to assess other complications in DM as they may provide additional evidence for establishing D-limonene as a potential pharmacological target therapy for diabetes mellitus complications.

Risk factors associated with development of senile cataract

Background: Cataract is the most common cause of reversible blindness worldwide, which has been associated with various causative risk factors. Hence, we aim to study the factors that might play a role in cataractogenesis. Material and methods: A total of 240 eyes of 240 subjects were included for the study, which consisted of 120 cases with age-related cataract and 120 age-matched controls, and in them various factors like blood pressure, body mass index (BMI), smoking, sun exposure, and serum cholesterol were studied. Results: A statistically significant difference between the two groups was found with respect to smoking profile (p = 0.007), sun exposure (p = 0.001), and serum cholesterol (p 0.05) was observed. Conclusion: Higher cholesterol levels, increased sun exposure, and smoking habit play a role in the development of senile cataract, and these are modifiable risk factors. Hence, control of these might help in delaying formation and progression of cataract.

Clinical and Morphologic Outcomes of Minimally Invasive Direct Corneal Neurotization.

To describe clinical outcomes of a minimally invasive technique for direct corneal neurotization to treat neurotrophic keratopathy. All cases of corneal neurotization for neurotrophic keratopathy performed by a single surgeon using minimally invasive direct corneal neurotization were reviewed. The supraorbital donor nerve was directly transferred to the cornea through an upper eyelid crease incision using either a combination of endoscopic and direct visualization or direct visualization alone. Detailed ocular and adnexal examinations as well as Cochet-Bonnet esthesiometry of the affected cornea were performed. Corneal histopathology and in vivo confocal microscopy after minimally invasive direct corneal neurotization were reviewed in one patient who underwent simultaneous penetrating keratoplasty. Five consecutive cases in 4 patients were included, with a mean follow up of 15.8 months (range: 11-23 months). Average denervation time was 17.8 months (range: 6-24 months). Baseline corneal conditions were Mackie stage 1 (20%), Mackie stage 2 (40%), and Mackie stage 3 (40%). All patients demonstrated improvements in corneal sensibility and appearance postoperatively. All patients demonstrated stable or improved visual acuity. No patients developed persistent epithelial defects postoperatively, and all achieved return of tactile skin sensation in the donor nerve sensory distribution. In vivo confocal microscopy after minimally invasive direct corneal neurotization and simultaneous penetrating keratoplasty demonstrated regeneration of corneal nerves. Complications included an asymptomatic small bony excrescence lateral to the supraorbital notch in one patient and cataract progression in the patient who underwent penetrating keratoplasty. Minimally invasive direct corneal neurotization is a safe and effective treatment of neurotrophic keratopathy.

Antioxidant Vitamins for Cataracts: 15-Year Follow-up of a Randomized Trial

Cataract remains the leading cause of blindness worldwide. 1 Flaxman S.R. Bourne R.R.A. Resnikoff S. et al. Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. Lancet Glob Health. 2017; 5: e1221-e1234 Abstract Full Text Full Text PDF PubMed Scopus (1312) Google Scholar Antioxidant vitamins have been proposed as a potential prophylactic therapy but results from randomized trials have not shown a protective effect thus far. 2 Mathew M.C. Ervin A.M. Tao J. Davis R.M. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract. Cochrane Database Syst Rev. 2012; (CD004567) Crossref Google Scholar Existing trials have largely been conducted in industrialized nations and have had relatively short follow-up. Longer-term studies in developing countries might provide a greater chance of finding an effect because such settings have high rates of both cataract and micronutrient deficiencies. We report 15-year results from such a trial: the Antioxidants for the Prevention of Cataracts (APC) study.

EFFECT OF NIRGUNDI (VITEX NEGUNDO LINN.) PATRA ARKA AS ASCHOTHANA (EYE DROPS) IN CATARACT-A CLINICAL STUDY

Purpose: Age-related cataract is one of the leading causes of blindness and avoidable visual impairment in the world. There is no time-tested, FDA-approved, or clinically proven medical treatment exists till date to delay, prevent, or reverse the progression of senile cataract. Nirgundi (Vitex negundo) is a Chakshushya single drug mentioned in Ayurvedic classics. Various animal experimental study and invitro studies in recent years using flavonoids extracted from leaves of Vitex negundo on selenite induced cataract models proved to be beneficial in arresting the progression of cataract. Hence a clinical study with Vitex negundo eye drops in the form of Arka was planned with primary objective to assess the effect of Nirgundi patra arka as Aschotana (eye drops) in pre senile cataract. Methods: The study design was interventional pre and post evaluation without control. Patients were advised to instill Nirgundi patra arka two drops thrice daily i.e. 6 am, 12 pm and 6pm for a period of 6months. Log mar visual acuity score and contrast sensitivity score were recorded before treatment, 3rd month of treatment, after treatment, 9th month (1st follow up) and 12th month (2nd follow up). Slit lamp photographs were recorded before treatment and 12th month. Study and follow up were done in 31 eyes. Result: The intervention is statistically significant while considering visual acuity and contrast sensitivity. All the 27 cases of nuclear cataract responded to the intervention, while only 83.3% of posterior sub capsular cataract and 60% of cortical cataract showed response. But the change was not significant statistically. Conclusion: The intervention was effective in improving visual acuity and contrast sensitivity in all types of pre senile cataract. Clinical assessment revealed the study was effective in preventing the progression of pathogenesis in early stage of nuclear cataract.

An Effective Nanoparticle-Biomaterial in Alleviating Diabetic Cataracts

To test an effective nanoparticle-biomaterial in alleviating diabetic cataracts (DC), CCTSOS. Composed mainly of CeCl3 and TiSiO4, nanoparticle-biomaterial was invented as an new compound nano-drug for DC treatment in these researches. To prove its anti-DC capacity, antioxidation and antiglycation in vitro and in vivo were tested and macroscopic and microscopic studies on cataract progression were carried out. hLECs and α-crystallin were used for extracorporeal test on antioxidation and antiglycation and STZ-induced mouse model was used for anti-DC test in vivo. The results showed that CCTSOS can inhibit oxidation by reducing superoxides and peroxides. While there was an increase of SOD and PRDX1 in hLECs, there was also a decrease of MDA and an increase of GSH in vivo. CCTSOS can alleviate glycation as shown in the decrease of CEL and the flourescence intensity of final glycated α-crystallin in vitro and in vivo. In terms of DC rescue, CCTSOS could slow down DC progress as shown in macroscopic image and grading score and presented in LECs smear and eye slice. In conclusion, CCTSOS has a significant effect of antioxidation and antiglycation and an anti-DC effect both in vitro and in mouse model, implying that CCTSOS can be a potentially compound nano-drug for DC treatment in the future.

Effect of astaxanthin on metabolic cataract in rats with type 1 diabetes mellitus

ObjectiveThe purpose of this study was to investigate the effect of astaxanthin on metabolic cataract in rats with type 1 diabetes and its antioxidant capacity to lens. MethodsRats were randomly divided into four groups (n = 8): control group, diabetes mellitus (DM) group, low-dose astaxanthin (DM + AL) and low-dose astaxanthin (DM + AH) group. A rat model of type I diabetes mellitus was established by intraperitoneal injection of 60 mg/kg streptozotocin (STZ). After successful modeling, rats in the administration group were given different doses of astaxanthin (AST) for 12 weeks. The lens opacity of rats was observed by slit-lamp camera system. The double antibody sandwich method was used to detect the levels of advanced glycation end product (AGE), lipid peroxide/malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD) and glutathione (GSH) in the lens. Hematoxylin-eosin (HE) staining was used to examine the morphologic changes in the lens. ResultsThe severity of cataract in the lens was obviously increased after induced by STZ, whereas it was significantly decreased after treatment with AST (p < .05, respectively). In addition, in the AST groups, the levels of AGE and MDA in the lens tissue were notably decreased when compared with those in the DM group (p < .05, respectively). However, the levels of GSH, SOD, and CAT were increased in the AST group in comparison with those in the DM group (p < .05, respectively). ConclusionsAstaxanthin may play an antioxidant role in the lens. Additionally, it exerts a protective function in the lens by delaying the development and progression of metabolic cataract and inhibiting the oxidative stress of lens in diabetic rats.

Prevention of in vitro glucose-induced cataract by Vasanjana prepared by Yashtimadhu Kalka (paste of Glycyrrhyza glabra Linn).

Background:Cataract is a major cause of blindness worldwide. Researchers received much attention from the traditional systems such as Ayurveda for the solutions of cataract through antioxidant activities apart from the surgical extraction.Aims:A To study, the anti-cataract activity of Vasanjana (VK) prepared with Yashtimadhu (Glycyrrhyza glabra Linn) Kalka (paste) in Vasa (fat) of the domestic fowl (Gallus gallus) on glucose-induced cataract in ovine (sheep) lenses.Materials and methods:Artificial aqueous humor with 55 mM glucose was used to induce cataract in sheep eye lenses. Treatment was given with cow ghee (CG), plain fat, Vasanjana, and Vitamin E to the same media and lenses were incubated at the room temperature for 72 h. Biochemical parameters studied in the lens were total proteins, malondialdehyde (MDA), Na+ K+ ATPase activity and electrolytes (Na+ and K+). Photographic evaluation was also done.Results:The complete opacification induced by the glucose in ovine lens was observed in 72 h. Cataractous lenses showed significant increase in Na+, MDA level and significant decrease in Na+ K+ ATPase activity and total protein content. Lenses treated with Vasanjana showed non-significant increase of total protein content and decreased MDA level and prevented formation and progress of cataract by glucose, as evidenced by photographic evaluation. Glucose-induced biochemical changes were found to be reversed in statistically significant manner in CG and Vitamin E treated lenses.Conclusion:The anti-cataract activity of Vasanjana and CG may be because of the antioxidant and free radical scavenging activity. Further in vitro and in vivo studies in various experimental models are required to validate their anti-cataract activity.

Effects of Laser Peripheral Iridotomy in Primary Angle Closure Suspect in asymptomatic patients (PACS) and complications of Laser Peripheral Iridotmy.

Objective: The Effect of laser peripheral iridotomy in&nbsp; Primary Angle Closure&nbsp; suspect in asymptomatic patients and complications of laser peripheral iridotomy. A single institutional study. This study’s aims to evaluate the&nbsp; effectiveness of Laser peripheral iridotomy(LPI)&nbsp; in&nbsp; eyes with&nbsp; asymptomatic&nbsp; primary angle closure suspect&nbsp; patients. We plan to conduct a retrospective chart review of patients who underwent an LPI , procedure by one glaucoma sub-specialist at Malabar Medical College and Hospital(MMC &amp;H) between January 2017 and December2018. Patients were treated with argon green laser and Nd: Yag&nbsp;&nbsp; laser applications over&nbsp; iris at 7 &amp; 4 clock&nbsp; in one session. Data obtained will include patients’ demographics, sub-type of glaucoma, baseline IOP, Visual Fields, OCT RFNL,&nbsp; number of anti-glaucoma medications, and post- laser IOP at 1 hour. LPI outcomes at 4, 12&nbsp; and 24weeks post laser will be evaluated by&nbsp; slit lamp examination and four mirror gonioscopy&nbsp; to know the patency of iridotomy. Statistical analyses will be performed comparing&nbsp; patency of iridotomy. Data on presence and degree of transient IOP rise 1-hour post procedure , complication of iridotomy will also be obtained. Design and setting: A retrospective study, A single institutional study. Materials and Methods: In this retrospective study, 67 adult cases of 134 eyes of&nbsp; Primary&nbsp; angle closure&nbsp;&nbsp; suspect(PACS) asypmtomatic patients&nbsp; were underwent 4-mirror zeiss gonioscopy&nbsp; before LPI procedure and slit lamp by Van Hericks ,OCT RFNL,HFA 24-2 Sita Standard ,stereioscopic&nbsp; fundus pictures enrolled into the study from out-patients Department of ophthalmology&nbsp; MMC &amp;H, Calicut for studies between January 2017 and&nbsp; December 2018. Inclusion criteria: All patients who underwent LPI treatment during above mentioned period were included. Exclusion criteria: Eyes&nbsp; with corneal scar, very shallow anterior chamber , neovascular glaucoma , Iridocorneal Endothelial syndrome(ICE) ,previous ALT/ SLT patients, unco-operative patients and&nbsp; Uveitis patients. Main outcome and Measure: To measure&nbsp; the patency of iridotomy at 4,&nbsp; 12 and 24weeks of post&nbsp; LPI treatment, to know the effects on&nbsp; angle of PACS patients. Statistical analyses will be performed comparing baseline&nbsp; gonioscopy&nbsp; with post-laser&nbsp; gonioscopy&nbsp; at4,12 and&nbsp; 24 weeks. Successful outcome will be defined as&nbsp; two&nbsp; or more&nbsp; ITC angles are open after LPI with no need for further&nbsp;&nbsp; medication or&nbsp;&nbsp; laser. Results: A total of 134 eyes in 67 patients participated in this study. All 134 glaucoma eyes were treated with LPI. The&nbsp; 134 eyes with Successful opening&nbsp; of angle more than 2 for at least 24 weeks. Follow-up ranged from 4 to 24 weeks. Gonioscopy was performed&nbsp; in each&nbsp; visit to confirm the angle status and patency of iridotomy.Success is defined as opening ofmore than&nbsp; 2 angles ITC for at least 24&nbsp; weeks, with no need for further&nbsp;&nbsp; medication&nbsp; or laser treatment. The percentage of open angle at 4 weeks was more 2 angles in 36eyes(26.9%), ITC&gt;3 angles in 28eyes, (20.9%) and&nbsp; ITC&gt;4 angles in 70eyes are&nbsp; (52.2%) ,at 12weeks&nbsp; more 2 angles24eyes (17.9%), ITC&gt; 3angles in ,30 eys(20.9%) ITC&gt;4 angles in&nbsp; 80 eyes(59.7%)&nbsp; and 24 weeks&nbsp; was more 2 angles14 eyes(10.4%), ITC&gt; 3,30eyes (22.4%) ITC&gt;4 angle in90 eyes (67.2%) .&nbsp; The success rate&nbsp; at 24 weeks&nbsp; ITC&nbsp; more than2 angle was 10.4%&nbsp; ,&nbsp; ITC&gt;3angles 22.4%&nbsp; and ITC&gt; 4angles in&nbsp; 67.2% respectively.In all cases, IOP was measured within 1 hour and IOP elevation of greater than 8 mm Hg was observed in&nbsp; eyes21 (15.7%) . Mild-to-moderate anterior chamber reaction is seen in 64eyes&nbsp; ,hyphema in 6 eyes, ghost images seen in 2 eyes,2 cases of macular edema, cataract&nbsp; progression&nbsp; seen in 16eyes,and closureof iridotomy in 26eyes&nbsp; were noted. Post laser procedure&nbsp;&nbsp; combination of steroid and antibiotic&nbsp; medication was prescribed for 5 days&nbsp; and IOP pressure more&nbsp; 8 mmHg seen in 21 eyes(15.7%) ,antiglaucoma medications&nbsp; started&nbsp; and oral T. Diamox 250mg 2 tablets wre prescribed followed up after 5 days to reasess the IOP. Conclusions:&nbsp; LPI &nbsp;is an effective treatment option for&nbsp; all patients with&nbsp;in&nbsp; Primary Angle Closure&nbsp; suspect to prevent the acute angle closure glaucoma.LPI&nbsp; is a effective, compliance-free, repeatable,most PACS eyes don’t receive further treatment and safe therapeutic modality having only minor, transient, self-limiting or easily controlled side effects with no sequelae. Progression to PACG is uncommon in PACS and PAC. Despite our methodology, the inherent limitations of studies should be considered, and conclusion drawn from our pooled results should be interpreted with caution. Future large-volume, well-designed with extensive follow-up are awaited to confirm and update the findings of this analysis

The level of stearoyl-CoA-desaturase in the lenses of rat eyes in cataract progression

The level of stearoyl-CoA-desaturase in the lenses of rat eyes in cataract progression

ОЦЕНКА СОДЕРЖАНИЯ МАКРОЭЛЕМЕНТОВ В КАТАРАКТАЛЬНЫХ И НЕКАТАРАКТАЛЬНЫХ ХРУСТАЛИКАХ ГЛАЗ

The elemental composition of cataract and non-cataract crystalline lenses was studied in this study. The study was carried out on Wistar rats (n = 30), two groups were formed: control and experimental. The animals of the experimental group were simulated age-related cataract using ultraviolet irradiation for 6 months. The sample collection of lenses was carried out after 2 (the early stages of cataract) and 6 months (the mature stages of cataract) of the experiment. The chemical composition of the samples was determined using by ICP-AES and ICP-MS. The generation of reactive oxygen species under the action of ultraviolet radiation leads to a change in the permeability of cell membranes and, as a consequence, to a disturbance of homeostasis of elements. There is an imbalance of macronutrients in the lenses with the progress of cataract accompanying by an increase in the level of calcium and sodium and decrease in potassium, magnesium and phosphorus.

Suprachoroidal Injection of Triamcinolone- Review of a Novel Treatment for Macular Edema Caused by Noninfectious Uveitis.

Macular edema is the most frequent cause of visual deterioration in noninfectious uveitis. The treatment of noninfectious uveitis with associated macular edema commonly includes systemic or locally administered corticosteroids, with long-term use limited by significant side effects. The need for a treatment with an improved safety profile has driven the development of a novel ophthalmic therapy: a proprietary triamcinolone acetonide suspension (CLS-TA) administered in the suprachoroidal space (XIPERE™; Clearside Biomedical, Alpharetta, GA, USA). Suprachoroidal delivery of corticosteroids allows higher steroid concentration in the posterior segment and decreases the risk of other adverse ocular events. Recent results from the PEACHTREE trial (ClinicalTrials.gov Identifier: NCT02595398), a phase III trial with two suprachoroidal injections of CLS-TA at 0 and 12 weeks with follow up lasting 24 weeks, showed the significant improvement in visual acuity and reduction in central subfield thickness, all without increasing the risk of elevated intraocular pressure or accelerated cataract progression.

Effects of dexamethasone treatment on serous retinal detachment in ranibizumab-resistant diabetic macular edema.

Purpose:To evaluate outcome of intravitreal dexamethasone implant (IDI) treatment on serous retinal detachment (SRD) in patients with ranibizumab-resistant diabetic macular edema (DME).Materials and methods:Forty-eight eyes of 48 patients with DME resistant to ranibizumab were enrolled in this retrospective and comparative study. Patients were divided into two groups according to presence of serous retinal detachment: (1) SRD or (2) non-SRD groups. All patients had at least three monthly ranibizumab injections, after which they were treated with IDI. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), use of antiglaucomatous drugs, and presence of cataract progression were noted at 1, 3, and 6 months post-IDI treatment.Results:There was not any statistically significant difference in terms of baseline characteristics of the patients. The mean CRT was declined in both groups at 1, 3, and 6 months (p < 0.001). After IDI treatment, the mean BCVA was improved in both groups at 1, 3, and 6 months (p < 0.001). When groups were compared, the change in CRT was higher in the SRD group (p = 0.018), while there was no statistically significant difference between groups in terms of BCVA changes (p = 0.448).Conclusion:The presence of SRD resulted in higher anatomical gain. SRD had no effects on visual changes after dexamethasone treatment in patients with ranibizumab-resistant DME.

Upregulation of miR-630 Induced by Oxidative Damage Resists Cell Migration Through Targeting ALCAM in Human Lens Epithelium Cells

ABSTRACTPurpose: To investigate the role of miRNAs in regulating oxidative damage during cataract formation.Methods: Microarray analysis and gene expression profiling assay were used to separately evaluate the miRNAs and mRNAs profiles in normal human lens epithelium cell line HLE-B3 treated by H2O2. The expression level of miR-630 was detected by RT-qPCR and the gene expression profiles were performed with gene ontology analysis using Bio Informatical database. The targets of miR-630 were predicted using miRecords and the results were used for screening targets of miR-630 combined with the GO analysis above. The mRNA levels of ALCAM, PCDH7, COL12A2, and EDIL3 in HLE-B3 cells after oxidative stimulation or miR-630 mimics transfection were measured by RT-qPCR, and the expression of ALCAM regulated by miR-630 was confirmed by Western blot and dual-luciferase reporter gene assay. The level of cell migration was measured by transwell assay and scratching test after transfection of miR-630 mimics and ALCAM siRNAs.Results: The microarray analysis demonstrated that miR-630 was significantly increased in HLE-B3 cells after oxidative stimulation. ALCAM, PCDH7, COL12A2, and EDIL3 were screened to be the possible targets of miR-630 by miRecords combined with GO analysis, but the results of RT-qPCR, Western blot and dual-luciferase reporter gene assay showed that only the expression of ALCAM was repressed by miR-630 transfection. Cell migration was inhibited through transfection of miR-630 mimics or ALCAM siRNAs and the upregulation of miR-630 partly reduced the cell migration increased by oxidative stimulation.Conclusion: miR-630 is one of the miRNAs increased by oxidative stimulation in human lens epithelium cells. Its upregulation may inhibit cell migration by targeting on ALCAM, which is important for HLECs to resist behavioral changes induced by oxidative damage and may delay the progression of cataract.

Pars plana vitrectomy combined with scleral buckle versus pars plana vitrectomy for giant retinal tear.

A giant retinal tear (GRT) is a full-thickness neurosensory retinal break extending for 90° or more in the presence of a posterior vitreous detachment. To evaluate the effectiveness and safety of pars plana vitrectomy combined with scleral buckle versus pars plana vitrectomy alone for eyes with giant retinal tear. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 8), which contains the Cochrane Eyes and Vision Trials Register; Ovid MEDLINE; Embase.com; PubMed; Latin American and Caribbean Literature on Health Sciences (LILACS); ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any date or language restrictions in our electronic search. We last searched the electronic databases on 16 August 2018. We included only randomized controlled trials (RCTs) comparing pars plana vitrectomy combined with scleral buckle versus pars plana vitrectomy alone for giant retinal tear regardless of age, gender, lens status (e.g. phakic or pseudophakic eyes) of the affected eye(s), or etiology of GRT among participants enrolled in these trials. Two review authors independently assessed titles and abstracts, then full-text articles, using Covidence. Any differences in classification between the two review authors were resolved through discussion. Two review authors independently abstracted data and assessed risk of bias of included trials. We found two RCTs in abstract format (105 participants randomized). Neither RCT was published in full. Based on the data presented in the abstracts, scleral buckling might be beneficial (relative risk of re-attachement ranged from 3.0 to 4.4), but the findings are inconclusive due to a lack of peer reviewed publication and insufficient information for assessing risk of bias. We found no conclusive evidence from RCTs on which to base clinical recommendations for scleral buckle combined with pars plana vitrectomy for giant retinal tear. RCTs are clearly needed to address this evidence gap. Such trials should be randomized, and patients should be classified by giant retinal tear characteristics (extension (90º, 90º to 180º, > 180º), location (oral, anterior, posterior to equator)), proliferative vitreoretinopathy stage, and endotamponade. Analysis should include both short-term (three months and six months) and long-term (one year to two years) outcomes for primary retinal reattachment, mean change in best corrected visual acuity, study eyes that required second surgery for retinal reattachment, and adverse events such as elevation of intraocular pressure above 21 mmHg, choroidal detachment, cystoid macular edema, macular pucker, proliferative vitreoretinopathy, and progression of cataract in initially phakic eyes.

Intraoperative Dexamethasone Intravitreal Implant (Ozurdex) in Vitrectomy Surgery for Epiretinal Membrane

ABSTRACTObjective: To study the effectiveness and safety of the intravitreal dexamethasone implant 0.7 mg (Ozurdex®) in vitrectomy surgery for epiretinal membrane.Methods: This is a prospective, multicenter, pilot study. Inclusion criteria included visually significant (<20/50) idiopathic epiretinal membrane. All patients underwent 23-gauge pars plana vitrectomy with membrane peeling and Ozurdex implant injection. The primary outcome measure was best corrected visual acuity (BCVA) change at 3 months. Secondary outcomes included BCVA at 6 months and changes in central retinal thickness (CRT). Intraocular (IOP) changes were monitored and cataract progression in phakic patients was documented.Results: 15 patients were enrolled in the study, 12 eyes of 12 patients were included in the analysis. Mean preoperative BCVA was 50.67 ETDRS letters and improved significantly to 63.67 (+12.91 letters, p = .008) at 3 months. Mean CRT improved from 548 to 409 microns (p = .002) at 3 months. The IOP showed mild elevation at months 1 and 2 and returned almost to baseline at month six. There were no complications related to the steroid implant injection procedure in an air-filled eye.Conclusions: Intra-operative injection of Ozurdex® at the conclusion of PPV can be done safely. The peak IOP and lowest CRT after 2 months strengthens the findings of prior studies demonstrating Ozurdex activity up to 3 months in vitrectomized eyes.

Protective Effect of β-Glucogallin on Damaged Cataract Against Methylglyoxal Induced Oxidative Stress in Cultured Lens Epithelial Cells.

Backgroundβ-glucogallin (GG) is one of the major plant polyphenolic antioxidants that have been associated with positive effects on human health and are crucial in the developing defense mechanism against the risk of diseases. However, reports on the protective mechanism of GG in lens epithelial cells are limited.Material/MethodsARPE-19 cells (a human retinal epithelial cell line) were exposed to methylglyoxal (MG) with or without GG to illuminate the protective role of GG in counteracting the cataract signaling.ResultsCells predisposed to MG demonstrated an increase in oxidative stress with augmented (P<0.01) inflammatory cytokines such as cyclooxygenase (COX)-2, chemokine receptor CXCR4, interleukin (IL)-6, IL-8, monocyte chemoattractant protein-1 (MCP-1), and intercellular adhesion molecule 1 (ICAM-1) genes. In addition, the expression of aldose reductase (AR) was increased to 2-fold with accumulated sorbitol in MG exposed cells compared to control. On the other hand, cells exposed to MG evidenced a 3-fold increase in RAGE (receptor for advanced glycation end products) and a 2-fold increase in NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) expression compared to control cells. Intriguingly, lens epithelial cells pre-treated with GG attenuated the reactive oxygen species levels with improved antioxidant enzymes. Simultaneously, the levels of AR and other inflammatory cytokines were observed in the levels closer to control cells in GG pre-treated cells.ConclusionsThus, the results of the present investigation show that GG may be a potential drug for the prevention of cataract development and progression.

Case report: persistent corneal epithelial defect after glaucoma device implantation for radiation glacoma

AbstractPurposeWe report a case with persistent epithelial defect after Barvert glaucoma implant for radiation glaucoma.Methods and Results62‐year‐old man had a total of 70 Gray radiation exposure for 2 months for left ethmoid sinus cancer In December 2015. In February 2016, the patient visited eye clinic for left eye pain. Only SPK was found and artificial tear drop was prescribed and followed‐up in the clinic. In January 2017, left intraocular pressure was elevated and angle neovascularization was found. Photocoagulation was started on diagnosis of radiation glaucoma. Although the treatment could not be completed due to progression of cataract, intraocular pressure had been within normal range under glaucoma drops treatment. He was referred to our hospital in August 2018 for the treatment of cataract surgery in his left eye. At the first visit, his left best corrected visual acuity was 0.01 and left Intraocular pressure was 20 mmHg. Mild Superficial punctate keratitis was found in his left eye but tear fluid meniscus was normal. We planned to add PC after cataract surgery at first. But in consideration of the possibility of deterioration of Neovasucular Glaucoma after surgery, we performed not only cataract surgery but also vitrectomy with Barvert glaucoma implantation and photocoagulation in September of the same year. Postoperative inflammation was transient, the intraocular pressure was good, and small corneal erosion was found immediately after the operation. However, after surgery, there was an extreme decrease in lacrimal secretion, and corneal erosions were enlarged, resulting in persistent epithelial defects. Treatment with a punctum plug, a therapeutic soft contact lens, eye drops etc. was poorly improved, and a corneal infiltration suspected of fungal keratitis was found during the course.ConclusionsImplantation or vitreous surgery for radiation retinopathy or radiation glaucoma may cause persistent corneal epithelial defects. It is necessary to carefully check the preoperative evaluation of tears and corneal condition and to carry out minimally invasive treatment.

LncRNA PLCD3-OT1 Functions as a CeRNA to Prevent Age-Related Cataract by Sponging miR-224-5p and Regulating PLCD3 Expression.

Long noncoding RNAs (lncRNAs) are important in disease progression and cellular functions. This study aimed to conduct global lncRNA profiling and characterize the role of lncRNA 1-phosphatidylinositol-4,5-bisphosphate phosphodiesterase delta 3-sence RNA 1 (PLCD3-OT1) in the progression of age-related cataract (ARC). We performed lncRNA expression profiling of lens capsule from ARC groups and age-matched groups using high-throughput RNA-sequencing. Real-time PCR was conducted to detect the expression pattern of lncRNA and mRNA in the clinical samples and cell model. Assays of cell-counting kit-8, 5'-ethynyl-2'-deoxyuridine, TUNEL, and propidium iodide staining were used to detect cell viability, proliferation, apoptosis, and cell cycle. We also performed fluorescence in situ hybridization assay to detect the location of lncRNA, and verified the endogenous competitive RNA mechanism between miRNAs, lncRNAs, and target genes via double-luciferase reporter analyses. The expression of lncRNA PLCD3-OT1 and PLCD3 were significantly decreased in ARC. PLCD3-OT1 overexpression promoted the expression of PLCD3, cell viability, proliferation, and inhibited cell apoptosis upon oxidative stress, while knockdown of PLCD3 showed the opposite results. Mechanistically, PLCD3-OT1functions through positively regulation the expression of PLCD3. In addition, PLCD3-OT1 may act as a ceRNA to regulate the expression of PLCD3 through competition for miR-224-5p. PLCD3-OT1 and PLCD3 may become potential therapeutic targets for the prognosis, diagnosis, and treatment of ARC.